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HomeMy WebLinkAbout0025 WEQUAQUET AVENUE Ave,LteT f " m W lid . Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 1/16/12 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 fo(Wequ�aquet Avenue as been inspected by a certified Building Performance Institute(BPI)I Open Ceiling: R-30 cellulose C, O z, Enclosed Slopes and decked over ceilings:R-11 cellulose Knee walls: R-11 fiberglass All work performed meets or exceeds Federal and State Requirements. w Sincerely, William McCluskey r' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .fib Map Parcel Application # Health Division Date Issued _ '7 t Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan'Approved by Planning Board — co2� z/7h?- Historic - OKH Preservation / Hyannis Project Street Address _ A l) L 1' AV Village (fCN7L7?-V 1 LL Owner �1 © F�L L , x +f: . {' J0,/.{AJA1&_ Address 7 �✓YCZ 1 FFC: X 0, � W,q �C.r � Telephone 7 Permit Request Mai _SZRtr --r fe'L4-La-o U llu_rul,AT-70t-f C rd U O J i.oP[�' , /dU��G FF�2� TJ'l� V L'NT1&9Tf 4-,) l C pPe tj i-r1+ r,4,6 r, Rco F 01M _sar��T Square feet: 1 st floor: existing proposed _2nd floor: existing proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 35 0 Construction Type Lot Size _ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family �al Two Family ❑ Multi-Family # units) A of Existing Structure Historic House: ❑Yes �No On Old Kin 's Highway: ❑Yes ❑ No 9e g 9 Basement Type: J 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: Ct'Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes CdrJo Fireplaces: Existing New Existing wood/coal stove: ❑Yes O(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 ❑ � �< S. Commercial ❑Yes C�"No If yes, site plan review# =y "' ZE .„D Current Use . _ _ Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) CXJ of rn Name �JI1114M Me (Ul_rl j ZM.'rSlWe Telephone Number Address 7`e— UVVjV(; A) .VC i 1 '-) License # I(, Home Improvement Contractor# 16 gq3l— Worker's Compensation # ?-W �29777)_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE )Z. FOR OFFICIAL USE ONLY 5 +. APPLICATION# rtDATE ISSUED �. MAP/PARCEL NO., ADDRESS VILLAGE 'r OWNER E J e y DATE OF INSPECTION: FOUNDATION► ' ' FRAME s INSULATIONS FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL iGAS,: s- s ROUGH FINAL ''FINAL BUILDIN&3,-` i DATE CLOSED OUT. l r ASSOCIATION PLAN NO. s r r r f _ The Cominwnwealth of Massachusetts Department of Industrial Actdents Offce of Investigations 600 Washington Sired Boston,M14 021I1 www`massgov/dia. Workers' Compensation Insurance Affidavit: Builders/Contractors/E.lectricians/Plumbers_ Applicant Information Please Print Legibly- Name(Business/Organizatiowbdividual) /�I C' itiCE�t. �t���t�_����� ��j�' S)A0 Address: .� ' t u►ay el ntfb'[ls / , City/State/Zip: ' a72 �ou-n�. tl. Zbone#: 3 � Are you an employer?Check.the:appropriate box: Type of._projecf(required): 1. 1 am a employer with. I"1 . 4i I apt a,general contractor and I. employees(full and/or part-tinjej:. $. aiavc;hired.thc sub-contractors 6. ❑New construction:; listed on die attached sheet 7. O;Remodeling 2.❑ I ant a sole.proprietor or partner : ship and have no employees These.sub-contractors have 8:..,[],Demoliton working :for mein an capacity. employees and have workers'' Y P ty 9:. `]Building addition. (No workers.'cotitp. insurance_ comp.insurance;+. re uired. 5: We area coiporation.and.its 10.[]Electrical;repairs or additions: officemhave exercised their 11. Pluitibin re airs or additions: .3.❑ 1 ant a homcowner doing alf work ❑ g P myself No workers'comp. nght.of exemption per MGL Y t- P ..12❑Roof repairs. . ,. insurance required.]' c. 152„j l(4);andwe have.no employees. [No.workers' KE]Od1&S nGd1"M comp.Insurance required.): .*-Any applicant that checks box A 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 of tside contractors must:submit a.new affidav►t.endieating such. tContracton that check this box must attached an additional sbeet showing,the name of the sub-contractors and state.whether or not those entities have employees_ if the sub cantisetprs.have:emp�oyees;tHey must provide-their workers'comp.policy number_ I am an errrplgyer that tis providing`workers'compensation:insurance for my:enWloyees. Belo_to is theppl cy and job site informadon.Insurance Company Name:: I 1 -L T nS &n COMPOOX Policy;;#orSelf-ins.Lit..#: TWc_ 3a. 9 l T Expiration Date:.. 1 0I C 1 kOIa. Job Site Address:. e lk,ek, 2 e. City/State/zip._Eon_ r= e -77 Attach.a copy of the workers'compensation policy declaration page-(showing the.policy nuniber and expiration date). Failure to secure coverage as required under Section 25-A of MGL c 152_can lead:to the im°. position of criminal'pen elites:of a fine up:to$1,5.00.00 and/or one-year imprisonment,as weU,as civil penalties m-the form of a STOP WORK ORDER and:a fine°: of up to$25.0.00:a day against the:violator: Be,advised that a copy of this statement;may be forwarded.to the Office of Investiaations of the DIA for insurance coverage.verification. I do hereby certrfy under thepains' d venafties' erjury that the informatloa provided above is true and correct Signature. C . ' . . Date: Phone# 3q F5jq _. Officrol'use on1p Do not li ire M#!ns area;t be completed by city or town official. City:or.Town::.. Permit/License# _ Issuing Authority(circleene): 1'.Boardof'Health 2:.Building Department 3.City/Town Clerk 4.Eleetricaf .Inspector 5.Plumbing,Inspector 6.Other Contact Person Phone#: . .. . CERTIFICATE OF LIABILITY INSURANCE 102o 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(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 _ NAMNT EACT Shannon Sperrazza Risk Strategies Company PHONE (781)986-4400 FAYIAIC.No:(781)963-4420 15 Pacella Park Drive, A-MAILgs:ssp®rrazza@risk-strategies.com Suite 24!) DDREINSURE S AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:Selective Insurance INSURED INSURERB:Safety Insurance Company 3618 Michael McCluskey, DBA: Cape Save INSURER :Technology Insurance Company 7 C Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02644 INSURERE 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 TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY XP LTR POLICY NUMBER MM/DD MM/DONYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ � � DAMAGE TO RENTED PREMISES jEa,occunence $ 100,000 A CLAIMS-MADE OCCUR PP31994480 A 0/16/2011 0/16/2012 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000, GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident) S 11000,000 B ANY AUTO BODILY INJURY(Per person) $ ALTO SCHEDULED 6208200 AUTOSS AUTOS 1/6/2011 1/6/2012 •BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident) XI Underinsured motorist BIsplit $100000 300000 X UMBRELLA UAB X OCCUR CPPS1994480 0/16/2011 0/16/2012 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ - $ C WORKERS COMPENSATION ecutive excluded X WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN from coverage OFFICER/MEMBEREXCLUDED? ® NIA E.L.EACH ACCIDENT $ 500 OQO (Mandatory In NH) 3297972 0/21/2011 0/21/2.012 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required?? Issued as evidence of insurance. National Grid Corporate Services LLC d%/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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. 484 Main Street Hyannis, MA 02601-3698 AUTHORIZED REPRESENTATIVE a Michael Christian/SMS ���` = ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025t2ntnrsini Tho eRrinn n2ma anri Innn.2m mnictarori m7rire of At1nRn - _ Office of Consumer Affairs and usiness Regulation. . ' 10 Park Plaza - Suite 5170 ' � ­S Boston, - - Massachusetts 02116 I Home Improvement Contractor Registration =` •� ° Registration: 164432 . - Type: .DBA CAPE SAVE Expiration: 10/6/2013 Tr# 217656 ' MICHAEL McCLUSKEY - - °. .. '.... ., _ - • - v 7C HUNTING AVE. . S. YARMOUTH, MA 02664 . r Update'Address and return card.Mark reason for change ^ Address f Renewal •.y Employment ` DPS-CA1 0 50M-oa/oa-G10121s t_I �_.� f.-� ( 1.Lost Card .l�LPfL»NJ021lJp-CLGGdL O+U i'dLQ'AIIL! f y, ° - ' Office of Consumer Affairs&B mess Regulation License or registration valid for rodividul use only . HOME IMPROVEMENT CONTRACTOR - _ before the expiration date. If found return to: ' Registration: 164432 Type: Office of Consumer Affairs and Business Regulation _ rExpiration: 1002013 DBA 10 Park Plaza-Suite 5170 ,MA 02116 CA�SAVE Boston MICHAEL MCCLUSKEYZ�a - L 8201 S.HOURD CT CHAPEL HILL, NC 27516 Undersecretary of valid without signature • �. . elas-achuKtts''a. Department or Public Safch Board of Building Regulations and Standar(ls Construction Supervisor Specialty License License: CS SL 102776 Restricted to: IC r x r, WILLIAM MC CLUSKY " ' t 37 NAUSET ROAD WEST YARMOUTH, MA 02673 ,.:Expiration: 6/28=13" ► (=n tits E,01ia.ner Tr# 102776 . K ' R 08f25/201a 09:23 9193212955 PAGE 01i01 k CAPEOW 1 ,'SAVE weatherization 508-398-0398 August 22, 2010 To Whom It May Concern: William J. McCloskey is an employee of Cape Save. He is authorized to negotiate contracts and building permits for our.company. f )� rCL Michael McCluskey Cape Save—Owner 929-593-5939 cell X Huntington Avenup, South Yarmouth, NIA 026" y�THEA Town of Barnstable Regulatory Services RAYXSTs &WRIABi-E Thomas F. Geiler,Director 1 6 �a`� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab le.ma.us Office: 508-862-4038 Fax: 508-790-62: Property Owner Must Complete and Sign This Section If Us ing A B uilde_r 0)/L ER , as Owner of the subject property herebyauthorize �L� ��J to act on my behalf, in all matters relative to work authorized by this building permit application for. 'q✓fit (Address of job) 1a/.1 Signature of Owner j]a� A& Piilit Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. .Q:FO RMS:O WNE RPERMISSION i ./ y r � Assessor's map and lot numb r ....J... . ..................... .... , J THE Sewage Permit number .. . • ; S BAWSTADLE, i House number .. 9 rasa F TOW1V� �O A R.N TAB+LE ,ar h . B.UILDI G• INSPECTOR , r APPLICATION FOR•PERMIT TO .. ... .. ...... ......... .... .. . TYPE OF CONSTRUCTION ... �..... .; .... F .19, . TO THE INSPECTOR OF BUILDINGS: The undersigned'hereby a s fo a it according'to the following information: Location _d s... .!!.. ... ...�......�........+:........ ....... { ...... ..... ..................... Proposed Use ........................ ...... . . . :....... ...: . '. ..: ............... ...... ...... .. ..... .... . / t Zoning District ....... ..!......................................................Fire District ... ......... ........ ......... Name of Owner ..........{`�k• xcl...�.. Ji;�.Nk,_04,*\ ���.Address .. {<iAt� tr2� : ? ,r.... Nameof Builder �.............. .......... .......................Address ....................................r` .............................................. Name of Architect Address ............... Number of Rooms .. Foundation .:..... . K Exlerior ......... ..... . ..............� .... . ...., ... ......:...........:.:......Roofing ....... � ..: .... ,..~ .. ........................... � Floors !/........ ....................... ...........................Interior ... _.. ........................................I Heating �..:.......... ...`�`'l` . . .... . . . .. Plumbing .1 .: .... elx /1�,:.. ...L�>.� �iti � IQX� • dd I Fireplace Approximate ............... ........................................................................:...:.... A roximate: Cost .....:..... Definitive Plan Approved by Planning Boar_`d _____:_ ____:_ ___,__19________. . Area .r./.,� . .��. :.` b...... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD' OF .HEALTH. OCCUPANCY PERMITS REQUIRED FOR, NEW DWELLINGS- ' _ s I hereby agree to conform to all the Rules and Regulations of the Town:of Barnstable regarding the above construction. Name //�r �^. = ....... Construction Supervisor's License `...... . .. ....... CHURC-rIW=, JANICE & DAVID { ,� � � ''• �: "-°ems - + _ No 29873 ' Permit for Build Dormer - . ............................... E Single. Family Dwelling :.............................................................................. 25 Wequaquet Avenue Location Centerville ........... ~ .....•.,•.,•,,,, ............................................................................... Owner ... . ... . Janice & David..Churchwell........ .. .......... ...... ........ ...................... - F Frame Type of Construction .......................................... i wZ ................................................................ - = •. Plot .....................:.....: Lot. ..........................:..... a Permit Granted August 22, 19 84 " _ • r Date of Inspection,/4 . 19 Date Completed :....:...............:. .....19 ` r ; r "Y - y C� T -• s f '�y'" • y..:5 r.* L ,q �• • Y`4 p • f y f • t ' - f � . 4� 'tea�• _�:''"� - � _� §,, ,. • Assessor's map and lot c number �r .... THE ( ro • S age Permit. number �b.:::..:<:`.'ut.e. . .. ....... STABLE, House number ....................... ........................ . .� nea ft TOWN OOF BARNSTABLE " .BUILDIN,G INSPECTOR APPLICATION FOR PERMIT TO `��� !� `.�''�-" .................. .............................. a t CSC. ram'. 4V 4 TYPE OF CONSTRUCTION .:. .....:�'� .......: .......:. p 19.... TO THE INSPECTOR OF BUILDINGS:'- The undersigned hereby applies foraZ it according to' the following information: �j� Location ...�.t5.:y.!!�t Q{. .. / R. ?.... ............................................................................................................................. y ProposedUse ......................... r.6./1,W..kot...:............................................................................................. ZoningDistrict ........W.1...........................................:.........Fire District .............................................................................. Name of Owner ..... .1.,. 4`rGs1U�P�,�..Add'ress ..c?S KR611,Q ..!..........:i4:f.................................. Name of Builder - 11 .:...................................................................Address ..........:................,....................................................... Nameof Architect .... ............................:.....................Address ...................:...................................: Number of Rooms)............................:......................................Foundation ......:._..........0................... Exterior L .. ( ...,.. -a. ...................Roofing 1, f•A ..... ......................... Floors .............. ...........................................Interior ,!.� �. J�-+ ......�............................... Heating � !��: flll a!+. ... .Plumbing `.�1± /1 . ..... ;!1�n.X?Ge�e ...� �- .... F�J Fireplace .................Approximate. Cost ..........., h ......... .I.......................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ..,....:...._....... ............ OU Diagram of Lot and Building with Dimensions Fee SU�JECT TO APPROVAL OF. BOARD OF HEALTH 7 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS h . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................. .......... � . ...,....-,�.,... ......... .... Construction Supervisor's License `"'.. . / JLy:C/........... CHURCHWELLf JAN C�E DAVID A=251-124 2% 40C) 2 3 rmit fo r No ermit forBuild Dorm ............................ Single Family .Dwelling ............................................................................... Location ......2.5..Wequaquet Avenue................. . .. .................... ............. Centerville ......................W........................................................ Owner ...Ja.rLice...&...David..Churchwell .... ...... . . ........... ...................... Type of Construction .....Frame........................... ........... ............................................................................... Plot ............................ Lot ................................. gus Permit Granted ......A.....0 t...........2..... 2,.............19 84 Date of Inspection .............................. .....19 Date Completed .....................................19