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HomeMy WebLinkAbout0024 DOGWOOD LANE Z/17 . a� ct/1q)13 CAPECOD INSULAT1014 IINGR DLASS SEAMLESS .SPNAT EDAM 9YSVENDED ` NATTS OYTTfiNE INSULATION GfILIN05 ' 1-800-696-6611 p Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 0260 Y' Date: V, Dear Building Inspector T Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape C6d 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 Insulation Installed: Fiberglass 'Cellulose R-Value, Restricted Unrestricted Ceilings Slopes . ....E � Floors ( ) ( ) ( ) Walls QiVli Sincerely He y E Cas y Jr, President C e Cod I ulation, Inc, a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 010 Parcel Health Division Date Issued a Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address a, 'e'a Village Owner ,�12 e d o'd -Address .� Telephone �d.7 -?;Z 2 l0 Z Z Permit Request �� > �' ��'/✓u�®ram j � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation@� t�Construction Type �,Y' /9 <�-� --j O Lot Size Grandfathered: ❑Yes ❑ No If yes, attach ' porting4ocurentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) a w Age of Existing Structure Historic House: ❑Yes XNo On Old King's ighway: L3 Yet ONo 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 ❑ No If yes, site plan review# Current Use Proposed Use - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) M Name O' 1 Z' elJ Telephone Number - / fi Address 7z1 '�- � - License# , i Home Improvement Contractor# Worker's Compensation # .�EJd' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECTWILL BE TAKEN TO / SIGNATURE DATE F c FOR OFFICIAL USE ONLY `APPLICATION# DATE ISSUED t` MAP/PARCEL NO. 4 T ' 1' f ADDRESS VILLAGE :s OWNER i t. 4 DATE OF INSPECTION: 'FRAME :;.. INSULATION=.{ f ,_,.• � .. . FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' Y DATE CLOSED OUT ASSOCIATION PLAN NO. 1. • t ,, �lxssuchusrtts - !)clru'Uurnl of Pulllii lafci� livar'tl of I alililin� l2e"�ulaliolo anti 'l)larld;u-dN m Gonstru•Ftioa Supervisor License a r , .- Licen� - ���� HENRY CASSIDY tsi �. Tlt' 1 £i SHED ROW �. �� ,; • WESIjT YARMOUTH, MA 02673 ^ Expiration: 11/1112013 _.._........... l uuuui,si uicr Tr'F';: 7620 <�E.'C7i/�`! Cz. �f%'CCr,11CZL° 2ll�C' 1.. Office of Consumer Affairs and Business Regulation . .9 10 Part. Plaza- Suite 5170 Boston, Massachusetts 02116 Iome Improvement Contractor'Registratioll ` Registration: I53567 , Type: Private Corporation ,. Expiration: 12/15/:?bl 4 Trk 233831 CAPE COD INSULATION, INC h-IENRY CASSIDY —_ 18 REARDON CIRCLE ........ _ SO. YARMOUTH, MA 02664 _ _.._ __.... Update Address tutu return card. 111lark reason I'm change. 1_.1 Address L) Renewal _) 1?1111loynlcnt L I,oS(t,llrll in fi'I rr.iier,rrrr crrrl/l t��:'ll rr,1eCC ulli,c ui,('ousumer AfPu,r s S Business Ittbul;l[ilin ., License or registration valid for Illdiv:itlul use only bfore the expiration date. It found retrll•11 to: e IIitOME IMPROVEMENT CONTRACTOR. N t:yistratioly 1535bi Type: Office of Consumer Affairs and Business lteglrlatiou ,Expiration: 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 :At l:C011 W.',ULATION, INC. r,t:rvitr t;asSiflY is!,'I Al'\l.,(.)N CIRCLE. Y ARN1OlJ J i i, MA 02664 )11 cI ersex re to r y of val witho t ❑at re - CAPECOD-27 MYOUNG CERTIFICATE OF LIABILITY INSURANCE DAT 7/812 DIYYYY) _ 7/8/2013 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 License#PC-514062 - CONTACT _ NAME: Margaret Young Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 AIc o t: AIC No South Dennis,MA 02660 ADDRESS:myoung rogersgray.com INSURERS AFFORDING COVERAGE NAIC N wsURERA:PEERLESS INSURANCE COMPANY INSURED INSURERB:COMMERCE INSURANCE COMPANY Cape Cod Insulation,Inc. INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 wsuRERE: rr 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 CONTRACTOR 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. IL R TYPE OF INSURANCE AD POLICY EFF POLICY EXP - LIMITS POLICY NUMBER MMIDD/YYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8263063 4/1/2013 4/1/2014DAMAG F� 100,000 PREMISES Ea occurrence $ CLAIMS-MADE ® OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY' $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOC $ - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .1 000 000. • (Ea acadenl _$ , � , B' ANY AUTO 13MMBCKVMK 4/1/2013 4/1/2014 BODILY INJURY(Per person) $ ALL OWNED rk SCHEDULED BODILYINJURY(Peraccident) $ AUTOS AUTOSNON•OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS ER ACCIDEN X UMBRELLA LIAR X OCCUR EACH OCCURRENCE' $ 1,000,000 C EXCESS LIAB CLAIMS-MADE XONJ453512°' 4/1/2013 4/1/2014 AGGREGATE $ 1,000,000 DED I X I RETENTION$. M000 $ WORKERS COMPENSATION - - - WC STATU- OTH- , AND EMPLOYERS'LIABILITY - - _ TO L MITS Y/N D ANY PROPRIETOR/PARTNER/EXECUTIVE WCA00526904 6/30/2013 6/30/2014 E.L. ACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/ E.L. — (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 f yas,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contractor agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc ', p.. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p * ACCORDANCE WITH THE POLICY PROVISIONS. ` AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. . ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/lElectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): l'i�f �d %.ev Address: / / City/State/Zi i2 WA g hone #: 14VF7, � .Are you an employer? Check the appropriate box: 4. ❑ I am a general contractor and I Type of.project{required). 1.❑ I am a employer with_ ' employees (full and/or part-time):* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- Misted on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition, i. working for me in any capacity, employees and have workers' [No workers' comp. insurance comp..insurance.t 9• ❑ Building addition required:] 5. We are a corporation and its 10,❑ Electricafrepairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 1 ❑ Plumbing repairs or;additions myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 3a.❑ I am a homeowner acting as a employees. [PIo workers' • 13.❑ Otherj��h���dD� general contractor(refer to#4) ` camp. insurance required,] Lj I- Any applicant that checks box#1 must also fill out the section below showing their workers'compensation jtolicy information. t Homeowners who submit this affidavit indicating they are doing all worst and then hire outside contractors must submit a new affidavit indicating such. tConnactom 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. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site, information, Insurance Company Name: Policy#or Self-ins. Lic.#: ,�L /> i, j � ; Expiration Date:• Job Site Addrem,-, q La ;�� . City/State/Zip; 4 Z',?,3 Attach a copy of the workers' compensation lie declaration page(showing the policy number and expiration date . s P policy P g ( g P Y p. ) Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year'irnprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 insurance coverage verification. I do hereby certify under the pacers and penalties of perjury that the information provided above is true and correct t Da -113 Phoh PAW use only.' Do not,write in Phis area, to be completed by city or town officiaL City or Town v Permit/License# Issuing Authority(circle one): , !+ a 1.Board of Ilealth 2, Building Department 3:,City/Towtr Clerk 4.Electrical Inspector S. Plumbing Inspector., 6.Other Contact Person: Phone#: ,r1lalAnaYoF�� Von PERMIT AW'H®RBZAT ION FOB M . i i owner;of the roe located at: property�Y (Owner's Name,printed) LL r .24 �61CWOD.b l hA1 Tur7� ~� (Property Street Address) (City/Town) hereby authorize the Mass Save Home Energy Services Program assigned Participating I Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Signature Dale.—�—�---_- FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: _ _. ---_ - - Participating Contractor Date • i i Rev.12132011 i t TOWN OF BARNSTABLE Permit No. 25421 --------------------------------- Building InspectorNAUSTAU cash • ------------------A � �oY�+►` OCCUPANCY PERMIT Bond f _ -��________________ Issued to Cedar Acres Realty Trust Address lot #13 24 Do wod Lane, Cotu7t Wiring Inspector 4 Inspection date Plumbing Inspector Inspection date Gas Inspector ? A �-Eaha�G Inspection date ac ,-Engineering Department Inspection date += LBoard of Health � � -— '` - Inspection date/,-.�/l THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. '/ vao, l �` /� � 19......_.. ........................................................................................................._...... �✓` �' Building Inspector FROM . TOWN OF BARNSTABLE OWLDING DEPARTMENT Mr, Francis Lahteine - 367 MAIN STREET HYANNIS, MA;: ­026M. Town Clerk - x Rhine': 775-1120" , SUBJECT: FOLD HERE" DATE 7 Jan 10, 1984 1W9SSAGE 10 Work 'has been completed.,ug4er ,Peg;I#t .dar� Acres .Realty,., t; Trust). : ,Please releas "BQnc . _ - SHED ( �f `�+�...",ay • . DATE •REPLY N87.RMI Y I RECIPIENT, RETAIM WHITE COPY,RETURN PINK COPY - PRINTED IN U.S.A. SENDER:SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. 4�r�u. .. Y; a 7r�C ;y '0' ,,,.��,,1h.fi a:r.• �r • - � V 4 Aj OfML ia�s �� '! -e 5j. �� :y wj.x n� ,�f , •�f .w�� i tt�Y a�}dY54.��`14, t �+ t'y 4� .�kr 'V� •'R "K ',��"4 �":�•� ri vj.,�j�`;"+ �i n' ',y' �t C� tom'",;'� � 27�`�'S�'r PN �-��••1� e'' ., ,.+r•'k3, rX` aS.... 14*�;!` s c1.f ,�i• � d�.n-•��,:�x�•�` ". Nil ID ` a�1tr,� ft';�.p +$•�W'.j� Kr •, : �,, ; `tr _ y. ♦ �.•. e� �+�:�� � r` ,- `�* ���" �', t� ii .. � �♦ .p " y "*s c �... i � ✓ _ A 48�`-4 ., �.K 1•.�ir;t -F� • S! gyp.. tY F • ,k ° Ep•.�. 4t ".z' � °`y+ yic -c�> a'f� r� "'•' y a -t . SSyl �! rL Alt - 2 PLAN bHUWlN`Ei FOUNDATION LOCATION COTUIT MASSACHUSETTS - ro OWNED BY: cE'Di9�Z i9C.�Es ,�E�9L r Tim , SCALE l ��=.�O DATE : y = )VORMAN GROSSMAN-------REGISTERED LAND SURVEYOR � I MERJ'� CERTIFY THAT TNIS FOUNDATION /S LOCATED ON Mf �Ol-AS SHOWN AND CONFORMS TO THE TOWN OF.84RI ABLE ZONING REGULATIONS REGARDING S€fBACK"S FROM STREET LINES AND LOT LINES . MO�tIGA?Y GROSSNAN R.L.S. DATE •" i 'Assessor p s ma and lot number ........ �.. ...... - , Sewage Permit number �FTNEtO i i7 o f 33ARN TADLE, : House number ..........................................'�'..Z.. c............. INSTALLED i �C�I��I�I,�i�+C. 'V, rb 9 \e�C ' � � •, - ��MAY a' WITH TITLE �. TOWN OF BARNS�A �TOMM L 'y `:; BUILDING INSPECTOR x... Construct APPLICATION FOR PERMIT TO ...............:.................................................................. 1.... TYPE OF CONSTRUCTION .......................Wood Frame ..................................... ........................................ 19%.. :.. .................... I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....:. ......................................................................................................... ProposedUse .............RegicieI7.t.1ai......................................................................................................................................... Zoning District ..........A/.C. ...............................................Fire District CAtUjtr--Ma,,................. Name of Owner CedraC..Aares..Realty...Trust.................Address ....2g..Gree t.P-•ond.. r wr••S•..•••Va uthp.-Ida• Nameof Builder .......SaMF_1...................................:................Address .................................................................................... Nameof. Architect ..................................................................Address ........................:....................... Number of Rooms 5 poured concrete ..................................................................Foundation .............................................................................. -gh ing.cedar shingle ior ........................:..........................Exle .................................Roofing ................. .......................' .................................... plywood ...Interior Sheet rock Floors ........................................................................ ....................................................................... . Heating ...F_F.....gas..........................:...............................Plumbing ....... . ..k3at��; Fireplace ...one........................................................................Approximate Cost ........25 r 000.................:......................:... .. Definitive Plan Approved by Planning Board Sept.__211____________19'_71_. Area l .2_6... 9. .:.`. Diagram of Lot and Building with Dimensions Fee .................... . .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. N ............ ................... . ............................ 016681 Construction Supervisor's license .................................... CI CEDAR ACRES REALTY TRUST 25021 One TRUST v No ................. Permit for ...................9U......... ......single Family Dwelliag............... .................................................... Location ..Lot. .1.3 .... .. .. . ... 24 Do wood ....... Cotuit . ............................................................................... t Cedar Acres Realty...Wr Owner ..............................:................ Type of Constructi6n 9r4Me............................. • ................................................................................... Plot ............................ Lot ................................. April 29, Permit Granted ........................................19 83 Date of Inspection ....................................19 Date Completed ........ ......... .........1,9 Assessor's map and lot number ...... . ..... - - w. �F IN TO — •+�;. Sewage Permit number � d � Z BAMSTADLE, i Housenumber ...................................................`?'.................... rasa 1639- \00� �aN TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct TYPE OF CONSTRUCTION dd Fra¢�e ...................................................................................... .P.......................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locajt on„'' ..13.e..� vqc T we c..G(aa�Ll�, a... <............................ Prox'osed Use ` dbt ...... p r ...... Zoning"District ..........d'C.......................................................Fire District ......Cattii..�,..1!+i�.� ........ ....................... Name of Owner =.AQ ..FPAlt L.�a1,IS-t.................Address ...2.4.Great..Pcmd..br:i.im,..5; YaXT t- ,..Ma. Nameof Builder .......INMe..................................:..................Address .......................:...........................................:................ Name of Architect ....N Address .................................................................................... Number of Rooms .....5......................................:.....................Foundation ...:.p4lmd concrete..:..................................... asw ajj; � n Exterior .....oeda sU g�e r . gle................................................Roofing ..............:"' -.+� . •- I:................ Floors ........pl �..............................................................Interior ............sheet rock.................................................. HeatingFHV3 — gas 3. Plumbing ,.,:....,.11�2.. ,................... ................ ..................... .... - ...... ... . Fireplace' ..............................Approximate Cost ........25,ON Definitive Plan Approved. by Planning Board Sept __21., ?_3___. Area f.. ...... -..�. S.....'. Diagram of Lot and Building with Dimensions Fee n / ' �•. ............... ...... _........... SUBJECT TO APPROVAL OF BOARD OF HEALTH (i I a �'" `.. 1 1� ` i fr 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. ....... .-......-.�' ... ......................... 016681 Construction Supervisor's License CRDrfi ACRES R A Y TRUST A=40-81 250221 One Story No ............j:.... Permit for .................................... Single Family Dwelling ............................................................................... Location ...Lot...1.3......2.4....Dogwood Lane .. . ............................... ................................ ..................Co........tui.t............. ............................... .... .. Owner .....Cedar...Acre Realty...Trust .... .. .... ..... ..... ..... .. . .. .. .. .... .. Type of Construction ...............FrAme............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ....Z P K.1i .1...2.9..9.............19 83 Date of Inspection .......1............................19 Date Completed .......................................19 iT