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HomeMy WebLinkAbout0059 POND VIEW DRIVE tflcn: :,x argey..p. axe �, -4.1 4�'i, :r.� .,, . c y +vg f Lu ~, ,"_:�_I,._,,���,',T1,,"­,,��,�.--��;,,-,—i�,,",I�4,­..,':�I,,;,�I I_,,t�,',�,I,;,.,�-,I,�",,I,"�,,�'�",W,O,�,.I�I��,:I1 I�:��,�'%0,I,%i a,,'��"���I_DII,i 1�t�..,III��-',,t,�'.I��I'.,,,:I"r,.��1I.,'� !, ' ,. •c :'r - r. '� .c a' A• .S a xF '3 rh P '.. `r. a ,i � fY` } ,�I���.,�;,,���,C NII1��"',;g"�%�—"I I-;� .... Y -n .; t("! I .fw`t' 'l�.} �`.:�� i N -ri Si y 4, r. w n�f . y �4 i1 .t L .K' W,L ,� . . . ;, ' s' t i {t5 a j k ' _ ., } 2 l .,. , .. _ .. 1 C �" f' q .q Y r " i i n ,' ! •r i k. if :1 !Z t! 3 F O t f t , 'f.: 1 xn' ye h .r Y F „�' f t Y .l Y 1- s ,,;c ., r j1 f M .+Sy Y X'N t f -b t i !Y t i a ., • 1, rt -.f Ir S `, s s Y �. {,, Av^ 'a e s t t f f 1 roY k4f1'. A) tt !3 Y[ y. Ru''.. M a , .. - �, 4 _ i.y ` f i t y R Y i - ? f'y Mkt y , . . v .•,' n Q O. f. i .b , _ - ' -( lI __ �H, .'- • , ' Z-ZI16 rA GtCErd U�euj C,-(� 4(firuL cT (-J\\\ sle-ya, Ck cq� c-Gstmt,.,-zr , C�Asd . �7y�- Mi:W NE" SCHMIDT ELECTRICIAN FAX NO. :5084287747 May. 14 2015 06:10PM P1 Town of Barnstable T iMVII OF BARNSTkUE Regulatory Services,,-' Y;,,}. 15 AM e,: 0,5 Thomas F.Geiler,Director P .Building Division �ED " Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601�1 V I S Office- 508-862-4038 Fax: 508-790-6230 REQUEST FOR,ELECTRICAL INSPECTION ELECTRICAL PERMPT MUMMER 01-1-U 130761. Q' (Pet'mitiequir --� --- - Today's Date Requested Date of Itnspecdor. o� IMF hereby request an inspection tz (Electrician) Law chapter 143,section 3L and 2.37 CMR 4-02(3). The installation is complete and ready for inspection at � 4-q � - -Type of inspeetiola requested: � . (Property L ocation) ���` � • ❑ Tcmporary Service ❑ Service Ro-inspection ❑ Excavation ❑ Rough Re-inspection Service eetiou � ❑ Final Yte-inspection ❑ Rough Inspection for ❑. Final Inspection for ❑ Other Owner or tenagt, �l�y� WAYNE SCHMlDT to ELECTRICIAN Licensee's dame,address,and phone 222 C DRIVE MARSTONS M ILLS,IMA 02648 (508) 428.7747 f License number' R Licensee's Signature — This section to be completed by Barnstable Inspector of bras Inspection date—LY 1 ii d b DApproved ❑N'ot Approved s Tbis work was not approved or violation of'the following Articles and Sectious of the MA Electrical Code: , �i Q:WPFiles;BIdg:Elecrcquest OM :WAYNE PCHMIDT ELECTRICIAN FAX NO. :5084287747 Mar.- 18: 2015 05:24PM Pl r Town, of Barnstable ! : 'ST �� Regulatory Services LU terw Thomas F.Geller,Director } Building Division. Tom perry,$uilding Commissioner 206 Mai.Street,Hyannis,MA 02601 WISTON. Office: 508-862-4038 Fax: 509-790-6230 RE 1UEST FOR ELECTRICAL INSPECTION ELECTRICAL PERM T.NUMBER `-' 13070 (Permit required in order to process ' eetion Today's Date � Requested Date of Inspection r . hereby request an inspection tinder Massachusetts General (Electrician). Law chapter 143,section 3L and 237 CMR 4.02(3)_` q The Wstallation is complete and ready for inspection at l eLj j (Property Location) Type of inspection requested: ❑ Temporary Service „ ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection Service Inspection ❑ 1~ival Re-inspection Ej Rough Inspection for ❑ Final Inspection for D Other - - �.:� Owner or ten 1(1�. P��' �C1 WAYNE SCNMIDT - 76 I' ELECTRICIAN 5 Licensee's name,address,and one 222 WILLIMANTIC DRIVE p MARSTONS MILLS,MA�02648 (508)428.7747 License number CL Licensee's Signature This section to be completed by Barnstable Inspector of Wires Inspection date L I ❑A roved . Pp [JI40t Approved This work was not approved for violation of,the following Articles and Sections of the MA F-leetrical" Code: Q:W Kes:BIdg:EI", uest OM :WAYNE SCHMIDT ELECTRICIAN FAX NO. :5084287747 Feb. 14 2015 05:19PM P1 Town of Barnstable, _ . GA°MSTABL v Regulatory Services op > « 7 r AN T S 2 Thomas F.Geiler,Director � �6.PA &�� Building Division. Tom Perry,Building Commissioner DI 1 10f 20o Main Street,Hyannis,MA 02601 Office: 5.08-862-4038 Fax: 508-790-62 �10& MEQ ST FOR ELECT'RrCA T nvQP-vCTTON 30 ELECTRICAL PERMIT NLMER (Permit icquiredd^inn oQrder t process " ectioa Today's Date Requested Date of Inspection I 1' hereby request an " ection under (Elec ;clan) P sachuserrs General Law chapter 143,section 3L and 237 CMR 4.02(3). The installation is complete a.nd ready for inspection at ItL 1) A-N Type of inspection,requested: (Property Location) C--v�1� ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection Serviec In'spcction ❑ Final Re-inspection C4 on for ��kN_e pa"(A c ❑ Final Inspection forr ❑ Other 6V8 Owner or tans Lk C, WAYNE SCHMIDT ELECTRICIAN 222 DRIVE Licensee's name,address,and phoneme MARSTONS MILLS,IMA 02648 (508)428-7747 License number F— 4 33C g Licensee's Signature This section to be completed by Barnstable Inspector of)Imes Ynspection date []Approved ' []]�Iot Approved This work was not approved for violation ofthe followi>,g Articles and Sections of the MA Electti al Code: Q:WPFiles:0ldg:lrlacrequcst . v �V' —FAX NO. :5084287 FeS. 1-2 2015OB15AM P1 i. . t Town of Bairnstable , ' o Regulatory Services MINIM f BARNSTA ` y,� . Thomas F.Geiler,Director 3.P 4 019• ��� Building Division kES " r.0 �D MA'i Tom Perry,Building Co=dssioner 200 Main Street,Hyannis,MA 02601 . NON Office: 508-862-4.038 Fax: 508-79.0-6230 REQUEST FOR ELECTRICAL INSPECTION EI,ECMCAL 12ERMTf NUMBER (Permit required in order to process ' ectio'ii Today's Date Requested Date of Jnspection 1 / I, ��'1'-7�" "` � jhereby request an inspection tmdez Massacbusetts General' (Electncta'n) Law chaptcr 14.3,section 3L and 2.37 Qv1R 4.02(3). The installation is complete and ready for inspection at (Property Location) 1 Type of inspection requested: ❑. Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ hough Re-inspectiop Service Inspection ❑ Final Re-inspection on for [] Final Inspection for' ry ' D other Owner or tena � W S �� WAYNE SCHMIDT 1 Z� ELECTRICIAN 222 WILLIMANTIC DRIVE Licensee's name,address,and phone MARSTONS MILLS, MA 02648 (508)428-7747 License number' .E ,�3Cq-7 n Licensee's Signature This section to be completed by Barnstable Inspector ojWires FEB 1 7 'b iy Inspection date ❑Approved ❑Not Approved This work was not approved for violation of*the following Articles and Sections of the MA Electrical Code_ Q:WPF=-.f3idg:Elecrequest l ROM :Q9YNE SCHMIDT ELECTRICIAN FAX NO. :5084287747 Oct. 28 2013 06:54PN P1 Town' of Barnstable TOWN OF ARMS- S'r Regulatory Services 100""' OCT 29 AM 7: 52 z s�xsrwe Thomas F.Geiler,Director ^ �j ®( l �,,,�b,�. • Building Divisio>uI _ . Tone ferry,Building Commissioner ,` 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 REQUEST FOR. ELECTRICAL INSPECTION ELECTRICAL PER11UT NUMBER I V�- b3 (Permit iequired in order. o process ' pcction) Today's Date Requested Date of Insp ection `� AS V —D hereby request an inspection under Massachusetts General (Electrician) Law chapter 143,section 3L and 2.37 CMR 4.02(3). a The installation is complete and ready for inspection at_59�lfw (Prope Location) Type of inspection xegUested; ❑ Tempora Y'Service ❑ inspection ❑ Excavation ❑ Rough Re-inspection -ii- Service Inspection . ��� ❑ Final Re-inspection ❑ Rough Inspection for ❑ Final Inspection for ❑ Other t. Owner r tens WAYNE SCHMID � ~ , ..� T ELECTRICIAN 222 WILLIMANT C DRIVE Licensee's tiame,address;and phone_,. MARSTONS MILLS, MA 02648 (508)428-7747 1 License number p( Ra Licensee's Signature This section to be completed by Barnstable Inspector of Wires _ Inspection date ❑Approved ❑r4ot Approved This work was not aPWAVe40T1 v 816on ofthe following Articles and Code: Sections of the MA Electrical Q:WPFiles!BIdg.V,1CC equtst' U ck� t�ommonweak, of///a3dachu6etb Official Use Onl/yEOQN� c�� n Permit NO-6( c2,rart`med ofc7 ire Serviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR E ALL INFORMA .rZN) Date: 1 City or Town of: To the Inspector of Wtres:. By this application the undersigned rues notice qf, his or her intentig 4 to perform the elec cal work descri e below. Location(Street&Number) 91 OKAle- j OR . Owner' r Tenant Telephone No _ .ate- Owner's Address C VA11e Is this permit in conj ti n w'th a ilding permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. -F _llc. rti T .,�...,d AT - f T. tor- XLSt1IlbS erlti � rUn d❑ vo.o ., S New Service Amps / Volts Overhead Undgrd ❑ - No.of Meters Number of Feeders and Ampacity Loca 'on and Nature of Proposed Electrical Work: f Il� �--- Completion of the following able may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In ❑ o.o Emergency Lighting . rnd. rnd. Batte Units No.of Receptacle Outlets No:of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of etechon and Initiatin Devices No.of Ranges No.of Air Cond. Tonsl No.of eel4ing Devi6e3 q No.of Waste Disposers Heat Pump umber Tons W.••....._ No,of Self ontainech p Totals: " Detectio'!tt/Alertin Devices _ No.of Dishwashers Space/Area Heating KW Local❑1'Muniectio �❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* :1a No.of. evices or-Equivalent No.of Water KW No.of No.of Data Wiring: °- Heaters Signs Ballasts No.of)Devices or, uiv*nt Telecomrhunication§'Wiring No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or`l; uivaaent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Elle trical Work: (When required by municipal policy.) Work to Start: lb t Inspections to be requested in accordance with MEC Rule 10,and upon completion, INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ' undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ,BOND 0 OTHER ❑ (Specify:) I certify, of - J'iat the information onthis application is true and complete. ? �' FIRM NAi WAY EC RICIAN T LIC.NO.: ELECTRICIAN Licensee: 222 WILLIMANTIC DRIVE Signature LIC.NO.: MARSTONS MILLS, MA 02648 ��� (Ifapplicabh (508)428-7747 Bus.Tel.No.: Address: Alt.Tel.No.: *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No, _ OWNER'S INSURANCE WAIVER:. I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one). owner ❑owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ l OFI E tgy, Town of Barnstable P� Inspectional Services + BARNSTABLE, MASS. 16,39. 10� Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 February 28,2020 Sharon Carlisle 44 Pond View Dr Centerville,MA 02632 Finding of Unfitness for Human Habitation and Determination of Immediate Danger In accordance with M.G.L. c.l 11,sec. 127A and 127B, 105 CMR 400.000: State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter II: Minimum Standards of Fitness for Humans. Jim Parziale, R.S., Health Inspector for the Town of Barnstable on February 28, 2020 conducted an investigation of a dwelling unit located at 44 Pond View Drive, Hyannis, MA. The owner's name of this dwelling unit is Sharon Carlisle. Based on the results of that investigation, the Barnstable Health Department finds that the dwelling is unfit for human habitation. Pursuant to M.G.L. c. 127B and 105 CMR 410.831.(D), (E) the Health Department further finds that the conditions within the dwelling are such that the danger to the life or health of the occupants of the subject dwelling is so immediate that no delay may be permitted in making this finding. Conditions found within the dwelling, which give rise to the emergency finding of unfitness and determination of immediate danger, include: 410. 750: Conditions Deemed to Endanger or Impair Health or Safety 410.750 (G)—The egress throughout dwelling is severely obstructed by belongings.Numerous_exterior egress doors are blocked. Based upon these findings any and all occupants are hereby ordered to vacate within (24) twenty-four hours and the landlord/owner is ordered to secure the subject dwelling within 48 hours of receipt of this order. If any person refuses to leave a dwelling or portion thereof, which was ordered vacated they may be forcibly removed by the local Board of Health(Massachusetts General Laws C. 127B), or by local police authorities at request of the Board of Health. - oK- 3lZs��3 U Cape Save Inc. TOVV1 r OF WN T ' 7-D Huntington Avenue South Yarmouth MA 02664k= x a y , _ .: Tel: 508-398-0398 Fax: 508-398-0399 s 3/17/13 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 59.Pond View Drive,Centerville has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-19 fiberglass blanket in open frame slopes All work performed meets or.exceeds Federal and State Requirements. Sincerely, William McCluskey TABLE BUILDING PER TOWN OF BARNS _MIT APPLICATION � A pi Parcel pl Health Division ° Date Issued C21 Conservation Division Application Fee Planning Dept. : Permit Fee I-! ' Date Definitive Plan Approved by Planning Board _ V ! IZ Historic OKH _ Preservation / Hyannis Project Street Address 5 9 Pon 4 View N,.y P.. Village Owner D&bbrk. Gros ma r� Address Telephone 401 " 141 — 9 4 2.$ Permit Request _ i t 6e�\a t:-_ s- E WO TS� �btc^y)cLSSiv► �,n�� �� D�GS ���'►a �, _�!'nr_� wa��. Square feet: 1 st floor: existing proposed 2nd.floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Farnily Two Family ❑ Multi-Family (# units)" `` Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes L4 No ,.., Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) CD Number of Baths: Full: existing new Half: existing new v Number of Bedrooms: _ existing _new Total Room Count (not including baths): existing new First Floor Room Count Z Heat Type and Fuel: ❑ Gas )a 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 Id No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION `— (BUILDER OR HOMEOWNER) Name i(l 1 /c." G _ Telephone Number 393 - U 1� Address �G 1 f144VA Pwe License # G 10 a. 7-7_6 SOUwq�.�h Yfgf M pu Home Improvement Contractor# _ b�l 4 3 Worker's Compensation # I C 301� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yam mo V.-4-!.► SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP/PARCEL NO. � } - - c � µ _ ADDRESS VILLAGES' OWNER . DATE OF INSPECTION: y :!;FOUNDATION ', y FRAME ' ` INSULATION' ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ROUGH FINAL f 'FI.NAL BUILDING " F: -DATE CLOSED OUT - ASSOCIATION PLAN NO. `" Y f !w 1'he Commonwealth of Massachusetts Department o Industrial Accidents P .� - sa. Office of Invesag"ons "600 Washington Street s Boston,MA 02111 www.massgov/dia orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AmUcadt Information Please Print Legibly Name(Business/organization&dividual):- MIC„14 A A r.jam'A S I[ea-r,*l jtA &A U Address: '� -C_ A u a'nl"s: n tJ . City/State/Zip: YARMouT[ Ma one#: 3 ~ Are you an employer?Check the appropriate box: Type of project.(required}. 1.(K I am a employer with I 4• 0 1 am a general contractor and I employees(full and/or part-time). have hired the sub-contractors ,6 .0 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 8. 0 Demolition working for me in any capacity. employees and have workers' q 0 Building addition [No workers'conip. insurance comp.insurance.* required.] 5.0`Wc arc a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 ant a homeowner doing all work officers have exercised their 11:[]Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs' � insurance required.].} c. 152,§1(4),and we have no � '•` employees. [No workers' 13.®Otltcr�llt a-hal comp.insurance required.] ' *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Conbactors 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. Ian an employer that is providing workers'compensatiow insurance for my employees Below is the policy and job site information- Insurance Company Name:._ �_to A n o 1 o ra V S UV'mceL� o cn D OI./1 Y Policy#or Self-ins.Lie.#: `T"W C % 9 Expiration Date:- 1 0 e%1 a.0 kk Job Site Address: 5 9 F o n C •y l'c W b r`►v e City/Stele/Zip: C6n fY i Ile 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 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains d nakies erjury that the information provided above is true and c:otreeL sign r Date: w F5 � Official use only. Do not rtirite 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 --------------- N Contact Person: Phone#: 4 AER ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/20/2011 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(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.p A statement on this certificate does not confer rights Y P Y qI tS to the 9 certificate holder in lieu of such endorsement(s). PRODUCER CNAONMeA T Shannon Sperrazza Risk Strategies Company PHONE (7B1)986-4400 FAX C .(781)963-4420 15 Paaella Park Drive EMAIL .ssperrazza@risk-strategies.com ADDRESS Slate 240 INSURERS AFFORDING COVERAGE NAIC#. Randolph MA 02368 INSURERA:SeleCtive Insurance INSURED INSURERB:Safety Insurance Company 3618 Michael McCluskey, DBA:, Cape Save INSURER C:Technolo , Insurance Company 7 C Huntington Ave INSURER D: + INSURER E: ' South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL11102041451 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE •POLICY NUMBER MM/DD /DDIYYW LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ° PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE F OCCUR `PPS1994480 _ +0/16/2011 0/16/2012 MED EXP(Any one arson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY 7 JFCT PRO- LOC $ AUTOMOBILE LIABILITY CO aBl dentSINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY Per accident) $ AUTOS AUTOS ( _ X HIRED AUTOS X NON OWNED,,'„ PROPERTY DAMAGE , AUTOS _+- - Per accldant $ X Underinsured motorist BI split $100000 300000 R UMBRELLA LIA8 X OCCUR. CPPS1994480 0/16/2021 0/16/2012 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE • AGGREGATE $ 1,000,000 DED RETENTION$ $ C WORKERS COMPENSATION Executive excluded X WC STATU- OTH-. AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN rom'coverage OFFICERIMEMBER EXCLUDED? N I A E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) 3297972. 0/21/2011 0/21/2012 E.L.DISEASE-EA EMPLOYEE $ 500,000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If 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 t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Housing Assistance Corp 484 Main Street Hyannis, MA ,02601-3698 AUTHORIZED REPRESENTATIVE , Michael Christian/SM3 ACORD 26(2010/06) 01988-2010 ACORD CORPORATION. All rights reserved. IN$025r9n1nnFilrM , - The Annan nama and Innn_ara reniafamrl m2►6e of A(tAQn — , Office of Consumer Affairs and usiness Regulation _ 10 Park Plaza - Suite 5170. Boston, Massachusetts 02116 ~ - Home Improvement.Contractor Registration ' - Registration: 164432 Type: DBA _. Expiration: . 10/6/2013 Tr# 217656 CAPE SAVE MICHAEL MCCLUSKEY ` 7C HUNTING AVE. ". f S. YARMOUTH, MA 02664 _.. . _. .Address return .... reason_ _ - change. F Update Addr and turn card Mark for -OPS-CA1 40 50M- Address ( � Renewal (J Employment ( j Lost Card 04/04G101216 � 1—� A' - . U16LPIL�YEfY/el/ O� 66 Office of Consumer Affairs&.B mess Regulation License or registration valid for.individul use only, { HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: " 'f � Registration: 164432 Type: Office of Consumer Affairs and Business Regulation f ` rPExpiration: 10/6/2013 DBA 10 Park Plaza- _ Suite 5170 ` Boston,MA 02116 ' CAFE SAVE MICHAEL MCCLUSKEY l p - 8201 S.HOURD CT CHAPEL HILL, NC 27516 _ .O _ Undersecretary of valid without Signature~ ti. 111assachusetts- Depatrtment of Public Safety Board of Building Regulations and Standards Ccsnstructi©n Saspervisor Specialty License License: CS SL 102776 : Restricted to: IC WILLIAM MC CLUSKY 37 NAUSET ROADy *, WEST YARMOUTH, MA 02673 Expiration: 6128/2013 C mmi..i.�ncr Tr# .102776 08l25:2010 09:_3 9113K12955 PAGE 01/01 COE 6AVE Weatherization 508-398-039 August 22, 2010 To Whom It May Concern: William J. McCluskey is an employee of Cape Save. He is authorized to negotiate contracts and building-permits for our.company. Michael McCluskey Cape Save—owner 919-593-5939 cell X Huntington venue., South Yarmouth,MA 02664 s / 14 ; ^ Free' Weath riza-Ai v n Your tenant has requested and is eligible for weatherization.of,your . . . rental home through government funding This will.be provided at no cost to you. Program regulations permit us to spend around $4,'000- $10,000 in materials and labor, pvr &welling unit* Program regulations require us to weather-strip and caulk doors and windows; insulate attics, sidewalls and floors. All work is professionally done by established private contractors. We will.conduct a final inspection to make sure that all work is completed to'specifications. If you request, you will be informed of the estimated measures before they are done and provided with a list of the actual measures and costs following the completion of the work_ • , We also need proof that you own the property. A copy of a CURRENt TAX BILL OR DEED listing you as the owner will satisfy this - �. requirement. Please fill in all blank areas of the enclosed agreement and return with `. the proof of ownership as soon as possible. If we do not receive the enclosed form within two weeks, we will do a basic energy audit of the home, but no weatherization work. can be recommended or done. If you have any questions please call Cathy`Finn at'508-771-5400,- ext. 105. LANDLORD TENANT j'was. � f f J k j & t�3. PHONE !LO -�12 PPHONE :��� � f- ��7a-- TENANT/PROPERTY OWNERIAGENCY WEATHERIZATION AGREEMENT 1. The Parties to this Agreement are the following: 76-0,,4-f E: 4 t C r4 (hereafter known as Tenant), (print your tenant's name) re (0,1 1_(hereafter known as Property Owner) " J4 U L�� (Print your name) and Housing Assistance Corporation(hereafter known as Agency), i In consideration of the mutual promises hereafter stated,the Parties agree as follows: 2. The date of Agency's signature will be the effective date of this Agreement. 3. Property Owner and Tenant consent and agree that the Agency may do the following with respect to the property located at(street, town) J rl �o�,�, ��� ��. ���cr �uc[ • , unit# and currently leased or rented to the Tenant: a) Enter the premises for the purpose of performing a Weatherization inspection. b) Enter the premises to perform Weatherization work which the Agency determines in its discretion is necessary and appropriate as a result of the Agency's inspection of the property and in accordance with the appropriate priority list for the type of dwelling. The Agency and the Agency's contractors may also enter the appropriate common areas of the building for the purpose of accomplishing the Weatherization work. The Agency and representatives of the Commonwealth of Massachusetts, Department of Housing&Community Development(DHCD) may further enter the property to inspect any and all work hereunder. The Agency will provide reasonable notice of the timing of the Weatherization work and inspections. The Weatherization work will be performed in'accordance with the Property-Owner's consent as further specified below, INITIAL.ONLY DATE OF THE FOLLOWING�* I consent to performance by the Agency and its contractors of any ` Weatherization work determined necessary and appropriate-by the Agency as a` result of its inspection of the property. I understand that the Agency will provide' a detailed statement of the actual work performed and the associated value at. the completion of work. I will provide a separate consent to performance by the Agency and its contractors of Weatherization work following my receipt of the Agency's inspection report and a statement of the estimated work and associated value. This additional consent will be sent under separate cover as Attachment A- I understand that the Agency will provide a detailed statement of the actual work s performed and the associated value at the completion of the work. 4. The Property Owner understands and agrees that any and all work, including related repairs for which the Property may also be eligible,will be performed at the Agency's discretion. The Agency estimated completion of the Weatherization work by the end of 2011.. 5-• If the Property Owner is required to make repairs to the property prior to the commencement of Weatherization work by the Agency, the Property Owner will be notified by the Agency and will be required to make the repairs as soon as possible. Except where the Property Owner receives a written extension from the Agency, time is of the essence in the performance of repairs by the'Property Owner. B. The Property Owner and Tenant authorize the Agency to receive a statement from the fuel suppliedutility supplier as to the quantity of fuel/utilities used at the above address in each of the past three years and the future three years. The information is to be used only to determine the cost effectiveness of the Weatherization improvements. 7. The Property Owner agrees that the rent for the dwelling unit will not be raised because of any increase in the value thereof due solely to the Weatherization work performed. 8. In consideration of the Weatherization work hereunder, the Property owner further agrees that upon the effective date of this Agreement and during a period extending through 2011/12, approximately one year from the time the work is completed, a) The presenti"rent$i "'� per month will not be raised for any reason. (The rent amount must be filled in). However,this Paragraph (8a)will be waived by the Agency in writing if,and only if,the premises are leased under a state or federal rent subsidy program, in which case the actual rent charged by the Owner shall conform to the standards of the rent subsidy program Please state which Housing Subsidy program your tenant is on and through which Agency: b) The Property Owner will not institute any summary process action for possession, except in the case of non-payment of rent or other good cause related to the Tenant(or any successor Tenant). c) , -In the event the Property Owner decides to sell the premises, Property Owner shall comply with one of the two requirements below,- -The Property Owner shall not sell the.premises unless the buyer agrees(with a copy forwarded to the Agency)in writing prior to sale to assume all obligations of the.Property Owner set out in this Agreement, or t -The Property Owner shall pay the Agency an amount equal to the cost, as certified by the Agency, of the Weatherization materials installed and labor performed in the premises as of the date of sale. Said amount shall be paid to the Agency immediately upon sale. . 9. (Applicable only if Tenant's heat Is included in rental payment and blanks are filled In) At the end of the period set forth in Paragraph 8 above, the rent shall not be raised. more than _ %per for an additional period of one year,and the provisions of 8b and 8c above shall continue in effect for such period. However, the rent provisions of this Paragraph'9 may be waived by the Agency in writing if,and only if,the premises are leased under a state or federal rent subsidy program, in which case the actual rent charged by the Owner shall conform to.the standards of the rent subsidy program. 10. The Pardes'agree.that the terms of this Agreement are incorporated into any other lease or agreement between the Property Owner and the Tenant, and between the Property Owner_ and any successor Tenant and if there is any conflict between the provisions of this Agreement and the provisions of such other lease or agreement, the provisions'of this Agreement shall govern. However, if such other lease or agreement, including without limitation a lease or agreement under state or federal rent subsidy program, contains stronger protections for the Tenant, such stronger protections shall apply. 11• for breach of this Agreement by the Property Owner, the Property Owner shall reimburse the Agency in an amount equal to the cost, as certified by the Agency, of the Weatherization materials installed and labor performed on the premises, as well as attorneys fee and court costs. The Property Owner may also be liable for damages to the Tenant in accordance with applicable law; in such instance, the Property Owner shall reimburse the Tenant for attorney's fees and court costs. Without limiting the foregoing,the Agency may at its option terminate this Agreement, by providing written notice to the Property Owner and Tenant, in the event of breach by the Property Owner or Tenant 12. Performance of the Weatherization work hereunder by the Agency is contingent upon the availability of funds to the Agency from the commonwealth of Massachusetts and the federal government,as well as the eligibility of the Tenant under WAP program requirements. The Agency may terminate this Agreement, by providing written notice to the Property Owner and Tenant, if the Agency determines that the unavailability of funds or ineligibility of the Tenant warrants termination. 13. The Parties acknowledge that this Agreement is under seal. It is intended by the Parties that the Tenant or any successor Tenant is the intended beneficiary of the Agreement and shall have a right of enforcement P(ppe ;Ownv er�'r Signa�sre: __��' ✓✓✓ Date: Phone: .,u, )g, - Address: '1-\ Tenant St re ` Date 1 Agency.Signature Date