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HomeMy WebLinkAbout0076 HOPEWELL LANE '\ ,� rr CAPE CO® INSULATION MIA OlA11 11AMC111 MAI 11AM 1111VINDID YA711 OUTTIY$ INSULATION CIRIN01 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector r Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod 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 ( ) ( ) ( ) ( ) ( ) Floors ( ) ) ( ) ) ( ) Walls. tierg/ CUOr k Fer)rorol �i w v�Ce-u0 Sincerely 2Hr E ssi r, President Ins ation, Inc. y n * TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ONO Parcel NO 3 Application # Health Division 4 I s.,, Date Issued Z 2 Conservation Division Application Fee Planning Dept. E Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Stre"ddress Village ► "W Owner Address Telephone �J v~ I Permi Request V Via/z7 aw 4-6 I d W G I obv Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation tUlb`O Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 1 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 "ill No If yes,'site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I � Z Telephone Number � 1 Addr ss Q,�i�G C� License # �d j U 'o Z'V �l Home Improvement Contractor# I �6 -7 A +�Email I Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT ILL B TAKEN TO SIGNATURE DATE l 2 Ito r FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. (evrrrrr . � o PAnCIPATING mass save C; `..>wNAi fhnxtUh M.vv f114.ronp: - PERMIT.AUTHORIZATION FORM kNE_ Rdc-)fIAa& ; owner of the property located at: (Owner's Name, printed) (Property Street Address)- (CitylTown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/orweatherization work on my property. i Owner's Signature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home.Energy Services Participating Contractor to the above referenced project: �l 1 Z t I �0 k Participa ing Contractor Date Rev.12182011 1 i i i. Massachusetts Department of Public Safety I Y; Board of Building Regulations and Standards License: CS-100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROW (. WEST YARMOUTH I IA t� CA— Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Buslness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card.Mark.reason for change. - SCA i t) 20M-05/11 Address Renewal Employment Lost Card _._. ... �e cpanr»zoazcueccCC�11aK1ddcccXcweCt 1 •Office of Consumer Affairs&Business Regulation License or registration valid for individul use only U OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: - 53567 Type: Office of Consumer Affairs and Business Regulation xpI rat!on: -, =1;2h1:5/20:16 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION.,.,INC: HENRY CASSIDY 18 REARDON CIRCLE` SO, YARMOUTH, MA 02664 '` Undersecretary N valid wi ut sign e The Commonwealth of Massachusetts � = De artment of Industrial Accidents r _ Office of•Investigations 600 Washington Street ;. . Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip:"} ' � L` a Phone #: Are you an employer? Check th appropriate box: Type of project (required): •''1.�,l am a employer with 4, am a_ I , eneral contractor and I❑ g employees(full and/or part-time).* have hired the sub-contractors 6, ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor mein an capacity. , employees and have workers' Y P Y com insurance.$ 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 11.❑ Plumbing repairs or additions myself, o workers' comp, right of exemption per MGL � P 12.Y Roof repairs c. 152, 1 4 and we have no P insurance required,] � #, employees. [No workers 13. Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below 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 attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors 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: 7 P,li�"" ilf Policy 4 or Self-ins. Lic. Expiration Date: b Ito Job Site Address: �C �C/V� City/State/Zip; ( Y� Attach a copy of the workers' conipensation policy declaration page (showing the policy number and expiration date), 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 imprisonment, 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 insura coverage verification. I do hereby certify d the pai an penalties of perjury that the information provided a ove is t ue and correct.' Si nature: a Date: / 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: CAPECOD-27 BDELAWRENCE ACORO DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/30/2015 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 pblicy(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 CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/C No E t: A/C No): (877)816'2156 South Dennis,MA 02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: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. INSR EXP LTR TYPE OF INSURANCE D BR POLICPOLICY NUMBER MMI DYE MM/L DYIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH-0CCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 04/01I2015 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 PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 a a OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) ccident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB Ll CLAIMS-MADE, AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER _ B ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A WCE00431901 - 06/30/2015 06/30/2016 E.L.EACH ACCIDENT. $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If,yes,describe under - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ()%CORD 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 contractor 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(2014/01) The ACORD name and logo are registered marks of ACORD /1/ 12 11_ ' ksor"O-map and lot number ..... .................... ........ SEPTIC SYSTEM MUST Ot TH E Cj - 6 S 3 INSTALLED IN COMPLIAN Sewage Permit numbe ......................................... ...... WITH TITLE 5 33A"STAXE, 'ENVIRONMENTAL CODE A ' • House number ........Z".1.............................................I............. TOWN REG' ULATIONS '6 3 9'* YPY TOWN OF BARNS TABLE BUILDING INSPECTOR Ott' 014,5< 4 7� lo APPLICATION FOR PERMIT TO.............. ........................................ ............................... ... ............................... TYPE OF CONSTRUCTION ..W.Q.q;9 ....... ............................................................- ............. ................... ...... . ..................................19J� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. 0..1.........I.....................;.............................................. ...... ..... ................................................................ ProposedUse .... .s.?..VCAJC-e.............. . ...................................................................................................... . ............ ZoningDistrict ...................14...................;j-X...... Fire District ............................................................................... Name of Owne .......................... ... ........... ........Address .............. . ........ .. ............ 777-,? Sol, Name of Builder . . . .........Address ........ ............. .. .......... . ... ............... ... .......... Name of Architect .........S�r_"..'C-:5Acldress ................................................................................. tle ............. Number of Rooms .... ........ Foundation ........................................ Exterior W.4�. . . ..... ..... ......s4..., ..................................Rooiing ...a.5 2 . . .. ...... LP. . .......... ?_0 C Floors A&....... ... .....f ........................................interior .�94..................k....................................................... Heating .90,9...... ........................................................Plumbing ...........I...... ................................................................ Fireplace �.=.........................................................................Approximate Cost ................................................................. -:F%Definitive Plan Approved by Planning Board ------------------------------19--------- Area ....7U;V:2- .1 .......... Diagram of Lot and Building with Dimensions Fee ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town-of Barnstable regarding the above construction. Name x. ................... NURNEY, THOMAS 16 2 2 6 8 0.... Permit for ...Q9.P...-5.tQ.:KY..... ... Singl Jajj.y tQ.:Ky .... .. ............... ... ..... ...... Location Lo.t...#.2.9....7.6 ...7.6....Ho.P.ew .1.1..... ..�enue .. . .... .. ..... ....... Cotuit ......... ...................................................... .... ............ Owner ....Thomas. . . Nurney .. .... .. .. Type of Construction ................Frame.......................... ................................................................................ Plot ............................ Lot ................................ 19 Permit Granted .. November 14 , r--' 80 ... ...................... ......... Date of Inspection ....................................19 00, 19 Date Completed ....... PERMIT REFUSED ........ .......................... ................ 19 .............................................. ..................... • ..................... ........................................................ ............. ......................................................... ............................................................................... Apprbved,,...'...'� ......................................... 19 ............................................................................... ............................................................................... Assessor's map and lot number ........................ ........ .......... Q�oF YNe To�� Sewage Permit number R- a ' G 5 3.... 6� o� ............................................. Z BAHHSTADLL i House number .............. C�M639 L 00 \0'p NAY fr• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... :.[, l d i�7uu�c a7 /U f 217 (n 41 , 70 C�ort-r�rcjv S ....................................................................................................................... ` TYPE OF CONSTRUCTION .�,tM0 0...E"l 4 t.............. ................................................................................... `f.. . .........................19. v TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /11. - r7 u' ' ` r ��.....��.. o,.l`j.............. f���'�r�c'fy-S %fit'././� ................................... ...................... ........... ProposedUse ....!� .'!'.VCiu,C�......................................... ................................................................. ..I......................... ZoningDistrict .................................................�.,..........................Fire District .............................................................................. Name of Owner .� (:+ ..�.. ..... ........t/..�. ` ..........Address ......................................................v ��-� ��q�1....1;7,............. ? Y ' Name of Builder /1 r� "'�` �j �Cf' /! .' � .......................:....................r...�.................Address ........,...:....................................................................... Name of Architect .�......... .....................................?E °:'.'.: Address Number of Rooms ..........Foundation ' X � � �. . .. Exierior !:.'"� �� �e q1G r ��� , t/r S Roofing ...rla"JL7�r..................... ;C ...................................... .............................. y ........................ ::j.: 1/v r ii7lc.tc�v��............................Interior ..� �`� T'� Floors ............................................I.... Heating c.c� �' Plumbing :....................................................... v. ............................................ ......................... Fireplace ............................................Approximate Cost ........... .....�.�.>................................................ Definitive Plan Approved by Planning Board ________________________________19_______. Area ....7?t� .'../3. Diagram of Lot and Building with Dimensions Fee . j SUBJECT TO APPROVAL OF BOARD OF HEALTH .-7 <� y , a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name !!,......... .......... ......... ......................... i NURNEY, THOM,?s No IR 6 8.Q... Permit for ....one...S:�Orx........ ........Sing-.e...F'.ami.lx..Dwelling............. Location ...Lot 2 9 7 6 Hopwell Ave. ...............Cpt:qit................................................ Owner ... ... Thomas Nu.rney. ............................................ ..... ....... .. Type of Construction ...„Frame ............................. ................................................................................. Plot ......................... . Lot .............................. Permit Granted Nol .ber 141 19 80 Date of Inspection ...................... 19 Date Completed 19 PERMIT REFUSED i ................................................................ 19 g. ..... ............... ............. a............ ......� ............................ : : . .................... . . ..... .......................... ....................... ... :..... ../.. l l � Approved ................................................ 19 ............................................................................... ............................................................................... 22 °- 37'-4.0.,E 36 Z 7 7 a: n O =� o N N o �9 N EMSTo-0 ;:7,0 u to D RT"l 0 0i 14' 0' S �2°_g7'gp"E 130 ,00 0y- 1 E:P-9, `f 4-A D \ I CERTIFY THAT THE FOUNDATION VIOLATE ANY SHOWN DOES NOT V _Tov�N OF EXISTING ZONING REGULATION OF � Cp-r-i t T THE TOWN OF F-7pV ►j Df,:Ti otj Cz-2T t lcA1"IYJ n1-hA2G_� O W v.c r OF 1J .'TER � C `Jo?L 1445 -. >QZ�P-U5 F. OL2 'N�r2 3 20 7 ov ScA L-t ► 40 ' t� �3 , �g �o