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',�' 90 MR RIERM ZOE V� F k:�,..-�:.,<.. �. ,._- ��Q �.�, ' » � � ■CNj� �a #eedrrtts 15 '..: ., Y.� ��r �'�` `�.�``,- Fr� ` r+, x., ✓��,,>r�"Ss�r��s FuIlBaths 2 ��;F^ �m .��'e�.� � �,-'"' '- 'r}- `' `�sZ- �' 1930ACTUAL 4' may—'" UALO i 4�I YI4 S Ft�Z2.2.2.70.51 N Z r ? _ s_-Y�'`��a•�a� .. � `�� 3.2 Air 67 LONG BEACH TR 7061/153 S � ���-`= — #1369/5 NO Subdiv BohOwner PUBLIC 6-2 Mi'Beach BEACHFR7 641800 Taxes 9642 2000 PUBLIC otalAssmt 8 1999 HeaUCool NAT GAS W WaV/Sewr/Util PRV SWR Int 5a T" IT .0 Fe Intat I E BAR" Eq Y ET BAR" Equip/ADP DISHWSHR _ IR d Y. �` •_ HWSHR.MICR ?_ Dock � xr 5 ' Y Lead U Uffi N Gar DETACHED 4 ' zwr�c`Y laem OCape Cod residence set on one of the highest points on Re �, q custom home Long Beach Rd.,"behind-a sea grass covered dune.Spectacular Poa �� a� - ' ilchen/family tiews of Nantucket Sound.Apartment over garage for extra I-Kt floors ShW-APPT REO` s Owner MCCULLAGH �„ �� tr` APPT REO.CA lislOff COTTON REAL ESTATE INC Ph (508)428.9115 v ` (508)420-1130 t-JOHN GOTTON.JR —'"Ph `508 428.6700 �� g 508 999-9999 Dir Crai u lle Beach Rd.to Long Beach Rd t dge.1st L.2nd �-a^�.. .'�` _. # k-•:��- z �^` `�` v - ---. -c '�. -mac.. _ k � a Assessor's office(1st Floor): � � �� Assessor's map and lot number lu moo`THE To` Conservation Board of Health(3rd floor): • Sewage Permit number t sAU3TAntt � rua Engineering Department(3rd floor): �o 16j9. House number �o arr Definitive Plan Approved by Planning Board 1g 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 'E TYPE OF CONSTRUCTION — 19 / 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a--``perm''ii-t according to the following information: Location 9 �t'''7 I.��C- -✓L�lf�� �'� r 3 L u i II Pyoposed Use Zooing District Fire District Name of Owner Ci 1 I /Ay Ll��r^-V Address N.ame of Builder �` t S Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Z�D_ Area Diagram of Lot and Building with Dimensions Fee �y i 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 �e,,,a3�Q 111�i Construction Supervisor's License McCAULLUGH, CHARLIE No,-3,5 3 r Permit For RE-ROOF -Single Family Dwelling Location-4-?' Long Beach Road Centerville Owner Charlie McCaullugh Type of Construction Frame J. Plot Lot Permit Granted May 3 , -19 93 Date of Inspection -19� c Date Completed 19r 1t _ ! I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map .Ow Parcel O 1'1 Application �1�4 W 7 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee --Y •00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project niwmt eet Address gVilla e r Owner L,e 0_11aeld Address Telephone o -7 Permit Request kny6 a l ir l t n �JV I cvr! l Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction TypeT �4 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 (s ) 414 Number of Baths: Full: existing new Half: existing Number of Bedrooms: existing —new Q FC Total Room Count (not including baths): existing new First Flood oun 6 �Vla Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other s� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Ye� eo 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 Telephone Number Address UGfI� License # Home Improvement Contractor# 7 Email Worker's Compensation # � // ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WI L BE TAKEN TO r� SIGNATURE DATE 2 ti� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER t F DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. s Town,of Barnstable. Regulatory-Semees .►�; : Rict,sra'Vsc�li;.Dirrclor' 6 �x►10 Baild�iiag'DYvisiva Tom Perry,building-;Commissioner 200 Main Street,Hyannis;M&02601 www towi:barnstable uia.as Office: 50.8462-4038 Fax: 508 790-6230 P.ropigty Qmmer,Must Complete!�and Sign Tlu.* 'Section If Us-in, ,,.A Builder Q i V n _ ,as flamer of,-the subjecrp gpeny herebrautho ize a 1: �. L��'t�10, ac'an rnp bebalf, in au matters,relative to wo authorized by-this build], permit application for: t2(� � .;�I-�lis�l 1(�: 11 �Zt��-2 "Pool fences and-ala=- .are tie-res onsl'b" of the a licant Poa1s P pp. bfmfene� instaHed and allfinalare not-to be`fed or uriliz s inspections?areperformed.md accepter of Owner. Signature ofFApplicanr. JU Print Naiie Print.Name _ - ate Q;F0RMS:0\VNF.ttPk"JtMMSl0NP00Lti Massachusetts Department of Public Safety . Board of Building Regulations and Standards License: CS=100988' . ;{ Construction Supeivi sor• + HENRY E CASSIDY tt 1 8 SHED ROW WEST YARMOUTH MA 02673 )I I'11 124— 1` Expiration; f Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza 'Suite 5170 Boston, Massachusetts 02116 w ; Home Improvement Cor�,tractor Registration r �' Reglstratlon; '153567 Type: 'Private Corpor�ti'on I• Expiration; 12/15/2016 T# 259188 CAPE COD INSULATION, INC HENRY CASSIDY a 18 REARDON CIRCLE } a': SO, YARMOUTH,,MA02664 Update Address and return card, Mark on for ehi scA i zoM•os�t [] Address Renewal EMployrn ; �� Los V/ie (Q0�17G17L0�/uueC!•G��0����CGJd CIO�ccJG'�1 a `. . - ,t. � ' �\ -.Omce of Consumer Affairs & liustneMs RegUiRtloo License or registfatlon valid for Indlvidul use only t before the ex iration date, If found return to; i{ OME IMPROVEMENT CONTRACTOR P eglstratlon; 1.53567 Type; Office of Consumer Affairs and'Business Regulation ' # % xplration; 1'2l15F2016 Private Corporation 10 Park•Piaza-Suite 5170 1' Boston,MA 02116 3 CAPE COD INSULATIbN, INC r HENRY"CASSIDY x 18 REARDON CIRCLE" SO.YARMOUTH, MA02664' Undersecretary. N valid wi utslgn�_ The Commonwealth of Massachusetts " �- Department of Industrirl Accidents Office of Investigations == 600 Washington Street Boston, MA 02111 r.: ww}v,mass,gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual); I V Address; 1) JGf ZI _ ilo. C 1,ylG City/State/Zip; 11, M 'tea i'V' Phone r iul Are you an employer? Check th appropriate box; Type of project (required). 1.` ,1 am a employer with . 4, [� 1 am a general contractor and 1 l employees(full and/or part-time),'% have hired the sub-contractors 6, New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7, [] Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' comp. insurance,t 9, ❑ Building-addition [No workers comp, insurance p� required,) 5. We are a corporation and its 10.0 Electrical repairs or additions 3,❑ I am a homeowner doing all work officers have exercised their 1 LEI repairs or additions myself, o workers' comp right of exemption per MOL insurance required,) t a 152, §1(4), and we have no 12,❑ Roof repairs employees, [No workers' 13,� Other ' comp, insurance required,] "Any applicant that checks box#1 must also fill out the section.beIow 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 attaghed an additional sheet showing the name or the subcontractors and state whether or not those entities have employees. If the subcontractors 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 the policy and job site ,xnfo.rmation, Y Insurance Company Name, rc � t � 0' t � i //,�, Policy # or Self ins, Lic. #; �i i Expiration.Date; t? I 936 Ito Job Site Address: 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 MOL c, 152 can lead to the imposition of criminal penalties of a fine up to $1,500,00 and/or one-year il:inprisonment, as well as civil penalties in the form of.a STOP WORK ORDER and a fin( 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 insurartd coverage, verification, 1 do hereby certyy ad the pai an penaltles of perjury that the information provided ovIe is true and correct, Signature: a Date:2v ff l 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 5, Plumbing Inspector 6. Other C nnfnrf Parcnn• - DL...,..,.. .J. - CAPECOD-27 BDELAWRENCE ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/30/2016 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 pollcy(les)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 Ili lieu of such endorsement(s)• PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc, PHONE Ex FAX A/C No): (877)$16.2156 434 Rte 134 E-MAIL South Dennis,MA 02660 ADDRESS, INSURER(S)AFFORDING COVERAGE NAIC p INSURERA:Peerless Insurance Company•see LIBERTY MUTUAL INSURED INSURER B:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc, INSURER C 18 Reardon Circle. INSURER D: South Yarmouth,MA 02664 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. ILT R TYPE OF INSURANCE POLICY NUMBER ADDLSUBR MM/DDYIYEYri MMIDDNYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS-MADE a OCCUR CBP8263063 0410112016 04/01/2016 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER4' GENERAL AGGREGATE $ 2,000,000 X POLICY❑P'D LOC' PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY o COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS (Per accident) $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ OED F7 RETENTION$ $ WORKERS COMPENSATIONPER STATUTE �RH AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNERIEXECUTIVE Y� NIA WCE00431901 06130I2015 06/30/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E,L.DISEASE-EA EMPLOYEE $ 1,000,000 II yes,describe under DESCRIPTION OF OPERATIONS below, E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation Includes Officers or Proprietors, Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved, ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD y yIu1�6 CAPE COD INSULATION V15IR O%A55 51AMII53 SPRAY FOAM SU$P5N010 PATTI OUTTiCS INSULATION CIRIN05 1-800-,696-6611 1'own of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 r Date: 5 40 Dear Building Inspector 0 --: Please accept this Affidavit as documentation that Cape Cod Insulation, nc. perfoyme 5 completed the insulation and weatherization work at the property listed below. C-ape C 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 �oyc�e. 61�ver� (61 l.ars��3eLh Zd. Insulation Installed: .Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings (�O ( ) ( -71 ( ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( } Walls �N r (,or k PWr ro rje re,a/ Sincerely q 2Hr E ssi r, President Te InsInc,