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HomeMy WebLinkAbout0011 OLD KINGS ROAD _../ � - ' s f t t i Parcel Lookup Page 1 of 2 •gym t'w"`"`et'3 v W.6 µYry a�X s �� t ✓ 9 ". ,ri a Logged Tn As: Parcel Lookup Tuesday,October 31 2017 Road_ Lookup Condo Lookup Multi le Address Lookup Reports Search Options Search By Street Street# Street Name old kings ... ....... . . ........ Village All Villages v Searches <Prev Next> Page 1 of 1 Rows/Page: FOo V I Parcel Location Owner Village Index Map 022- 11 OLD KINGS PISCH, JOHN J & PATRICIA COTUIT 1154 022040 040 ROAD 022- 12 OLD KINGS MALOY,JOHN L JR TR COTUIT 1154 022106 106 ROAD 022- 29 OLD KINGS HERDER, MARK T & LORAIN M COTUIT 1154 022068 068 ROAD 022- 40 OLD KINGS GERGYES, JOSEPH.M & THOMAS, COTUIT 1154 022105 105 ROAD RICHARD E TR - 022- 45 OLD KINGS 067 ROAD HOLLYWOOD, DONNA & JOHN COTUIT 1154' 022067 022- 64 OLD KINGS 09$ ROAD GOSHDIGIAN; JOHN COTUIT 1154 022098 022- 67 OLD KINGS PONTE, JOHN F JR &HURLEY, COTUIT 1154 022001 001 ROAD CATHERINE 022- 80 OLD KINGS CINCOTTA, JAMES J & JULIE C TRS COTUIT 1154 022097 097 ROAD 022- 81 OLD KINGS LOWE, ALISON A COTUIT 1154 022002 002 ROAD 022- 92 OLD KINGS MULLIN, RICHARD F & ELEANOR G COTUIT 1154 022096 096 ROAD 022- 95 OLD KINGS WIGHTMAN,:MARILYN COTUIT 1154 022003 003 ROAD 022- 104 OLD KINGS GERGYES, JOSEPH M & THOMAS, COTUIT 1154 022095 095 ROAD RICHARD E TR 022- 111 OLD KINGS DONHEISER, ALAN D & BEVERLY J TRS COTUIT 1154 022004 004 ROAD JOHNSON, COREY A & KATHRYN M COTUIT 1154 022094 http://issgl2/intranet/propdata/lookup.aspx 10/31/2017 Parcel Lookup Page 2 of 2 -02�- 116 OLD KINGS 094 ROAD 022- 130 OLD KINGS PERRY, ARTHUR•J & PATRICIA & COTUIT 1154 022093 093 ROAD BRESETTE, M 022- 131 OLD KINGS ROAD 005 ROAD ANKERWIN, N & KAITLYN M COTUIT 1154 022005 022- 140 OLD KINGS MAJOR, DAVID B & KATHARINE C COTUIT 1154 022092 092 ROAD r 022- 145 OLD KINGS ROAD 006 ROAD RICE, DAVID D & RICE, DEWEY E COTUIT 1154 022006 022- 154 OLD KINGS BUCKLEY, LEO E JR COTUIT 1154 022091 091 ROAD 022- 170 OLD KINGS BUFFINGTON, RICHARD B & DONA COTUIT 1154 022090 090 ROAD 00 OLD KINGS 001 LAAKSO, CANDACE E COTUIT 1154 008001 ]ROAD http://issgl2/intranet/propdata/lookup.aspx 10/31/2017 Town of Barnstable OFTHE r Regulatory Services °w o Richard V. Scali,Director lARNSTABLE ,; Building Division BARNSTABLE 9 MA9S. OAPNSiA9lECENfE0.V[LF•CONR•HYAHfiiS 11639. Thomas Perry, CBO MESONS"'S 1639-201 SMiNi40F 1639-201i' ATED1'°'�A Building Commissioner � 200 Main Street, Hyannis, MA 02601 = www.town.barnstable.ma.us . Office: 508-862-4038 o Fax: 508-790-6230 October 17, 2014 h Victor Cimino 267 N Quincy St. Abington,MA. 02351 RE: Insulation-Permit Applications Dear Mr. Cimino, This letter'is to follow up on permit application numbers'201403977 and 201403981 submitted to.work at the.above referenced address. As you may recall, a letter dated July 17, 2014 was sent by this office detailing that the construction documents did.not demonstrate compliance with 780 CMR. To date,this office has.not received resolution to these issues. Be advised that the applications shall be considered withdrawn effective" November 1,2014 unless sufficient cause is provided to keep the:status as active. Thank you for your attention in this matter and please do not hesitate to contact this office with any questions. `. Respectfully, e L. Lauzon ocal Inspector jeffrey:lauzon ,town:barnstable.ma.us (508) 862-4034 'PERMIT PAYMENT•RECEIPT, `-'. TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, .MA 'J02601 DATE: 06/17%14 TIME: 09:46 -----------------TOTALS----------------- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 CHANGEPLIED: 50.00 APPLICATION NUMBER: 20143977 PAYMENT METH: CHECK PAYMENT REF 29600 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map TI Parcel 'ip)p I i c a t il,0 Health Division Date Issued Conservation Division Application Fee ` Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address G!� kl45 't Village CO t-61 Owner I17 rICf417 �f1Ch Address 04) C�f'v/If ✓�S Telephone 50- Permit Request 1'-1 (k-21)&Yr ce/1 ZD I - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed*-;� TOtQ never Zoning District Flood Plain Groundwater Overlay --- Project Valuation gC Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documetation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) � c� 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 Jar 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) Name Vfr_tv!- C141IAO Telephone Number Address 2-67 AP QvJ?eZ J/- License # 06f*?g6 � Home Improvement Contractor# l ctS`�3 Email I/C� � �F�J�I—��o %�'C< <G� Worker's Compensation # MQ66Zo Y-.35 2-1�f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� - eCc,1/al CLih SIGNAT 1 DATE GC l(1_1l y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i� MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 9 , FINAL BUILDING. } DATECLOSED OUT A,!O IATION PLAN NO. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel _ v ;`f�pplication # Health Division r Date Issued f Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive-,Plan Approved by Planning Board f Historic - OKH _ Preservation/ Hyannis Project Street Address Villages fiv;f Owner t��r�iC/�) �i1cf'� Address / O/) A'1142 Telephone 561" y20—C'lrYV01111 a. Permit Request ,, JH-I /� �G�"zi� ��.�r �fi/ o�,� 4—V14h i � h��ll�/ � 01_7_11___1I/ ff�/f 6 ,111/ 061, f o-mow/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total,new-: _J Zoning District Flood Plain Groundwater Overlay Project Valuation c/GQ Construction Type -a Lot Size . Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) � a a 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 Euel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑'Y'es ❑ No_ Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ me` " size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Vlc t-r Ci,kirnO Telephone Number Address 2&7 /y 'Qv 4 c y f License //1 S Home Improvement Contractor# /6/,5/23 Email Worker's Compensation # X4&'13&oZ( 5SL/y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNAT 4 DATE Gl /(e�/ y 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. A- RISE-ENGINEERING Federal ro#os 04os¢zs RI CorrtractonR tstrati60 No 8186 AAA.Corltractor Registration No 120979 A,dlvision.ofThielsch Engineering CT Contractor Registration No 626120 1341.Elmwood Avenue,Ceansfon,R102910 (401)7t34-3700 FXX(401)7*94-37:10 CONTRACT Page 1 n+ PROGRAM . .. V. 1�e THfS CONTRACT-19 ENTEREDJNTO 9ETKIEEN RISE . ENGINEERING:ANDTHE CUSTOMER FOR WORK:AS: .CI+C-RCS. ENGINEERING DESCRIBED BELOW h'^ :PHONE :DATE` - Client It PatriciaA Pisch (508)420-9888 I1/0k(i3 1.51984 :SERVICE-STREET ._.... .- .. BILLING STREET.11 O;ld Kings':Road I l:Old Kings:Road SERVICE.CnY;STATE;LP WNG.CnY;.STATE;ZIP CoWit,MA 0263:5 Cotuit,MA 02,655 JOB DESCRIPTTON. Provide laborand materials to install(720)'square feet of R 21:_alosed cell§prayficiariv insulation to:the crawlspace penmeterwall, sill and band joists Then instill.a spray applied Ignition barrier liver eaposed foam..Any'crawlspace.arcess within the perimeter wall will be wcathcrstri. ed and.insulated to;,R-20. Any present:crawlspacg vents will be permanently sealed. Pp $3;960 00: RISE:Engineering will apply all applicable,eligible inccnUvesao thu contract.You will be billed only the Nct amount. Fora!liinited time;the,Gapetight Compact is:ofTering.100%in.eniivetowards.egibfe insulation measures;notto cviceed.$A;000 per calendar' yeeand an incentive of 100n/o.for:the Air:sealing.measures; DEC, - 9 2013 ' i I VYE AGREE HEREBY TO FURNISH SERVICES-COMPLETE tH ACCORDANCE WIN ABOVErSPECIFICATIONS.FOR THESUM OF I ""RThree Thousand S1 &401100 DoNts $3,060.00 UPON_FINAL MpECTION AND APPROV BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT-AMOUNT DUE IN FUL - EST,0F.N%WILL SE.CHARGEO M ON ANY , UNPAN)BAIAN AFTER.300AYS.3 REVERSEFOR IMPORTANT INFORMATION ON.GUARANTEES,RIGNT80F ISION S ULIG,AND CCINTRA.3M R TRA N. Ei6NpT SIt3N`THIS CONTRACT'IF' RE A ANY K SPACE ? AUTN R SIG,ATU, ,:.BEENGINEERING T^OMER- CCE�ANC NOTE:THIS CONTRACT.MAYBEWITNDRNWNBYU9IFNOTE?(ECUTED WITHIN ATEOFACCEP&(- ACCEPTAN6S O&F CONTRACT-TH .ABOVE RICO.SPECIFICATIONS AND COMMONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK. DAYS: AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE 4 I OWNER AUTHORIZATION FORM (Owner's Name). owner of the property located at . :�f '. ((Property Address). (Prope .y Address): hereby authorize F)ro (Subcontractor) an authorized.subcontractor for RISE Engineering, to act on my behalf'to obtain a building permit and to perform work on rnypjDker,Ity. Owner's Signature, zv3. Date' I he Commonweauh of Massachusetts Department of Industrial Accidents ,. Office of Investigations - 1 Congress Street, Suite 100 v ;l Boston, MA 02114-2017 "%W mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): yu c, Address: City/State/Zip: 4�2 1 , S 0)-W Phone#: 7,4l' l�7/-d^2S2 Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with `f 4. ❑ I am a general contractor and I 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 8. ❑ Demolition working for me in any capacity employees and have workers' 9. ❑ Building addition [No«orkers' comp. insurance comp.insurance.+ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.ElI am a homeowner doing all work officers.have exercised their l l.❑ Plumbing repairs or addition myself. o workers' com . right of exemption per MGL - � p 12.❑Roof repairs insurance required.]t c. 152, §l(4),and we have no 13.0 Other/"h144Y /off employees. [No workers' 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. TContractors 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. 1 am an employer that is providing workers'compensation insurance for MW mrloyeex Below is thepo&y and job site information. Insurance Company Name: I r"ye l CIJ r c t �O Policy#or Self-ins.Lic. #: X AV/3 �(q Z (o Y 3 52 1 Y Expiration Date: Job Site Address:_ City/State/Ziprr, v f t ? 02 6 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 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 insurance coverage verification. I do hereby ce! fig under the airs and enalties o er'un,that the in ormation provided above is true and correct Si ature: l� t' F ate: Phone#: W- 0//— 6VJ2— Official use only. Do not write in this area, to be completed bh cih'or town official Cit< 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#: I A6 ® CERTIFICATE DATE(MM,DDYY""' OF LIABILITY INSURANCE 5i6/2014 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 NANMEACT Denise Butcher Strategic Insurance Solutions, Inc. PHONE (617)558-7100 ]L122 FAX(AIC-No AfC o:(781)459-8282 2000 Commonwealth AvenueE-MAIL .db@strategicinsure.com INSURERS AFFORDING COVERAGE NAIC N Newton MA 02466 INSURERA:Scottsdale Insurance Company INSURED INSURER B:Commerce Insurance Company 4754 Insul—Pro Insulation Co. , Inc. INSURERC:Torus National Insurance Co 267 N. Quincy St INSURERD:Travelers Casualty & Surety Co INSURER E: Abington MA 02351 INSURER F: COVERAGES CERTIFICATE NUMBER:CL145602872 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 LTR TYPE OF INSURANCE POLICY NUMBER MM/DDY EFF MMIDDI EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENT CLAIMS-MADE /13/2014 /13/2015 PREMISES Ea en $ 50,000 A Fx_ MED EXP(Any one person) $ 10 000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE 1 $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY Ea accident)SINGLE LIMIT(Ea11000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X71 SCHEDULED HLS563 /5/2014 /5/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAB X JOCCUR EACH OCCURRENCE $ 5,000,000 C X EXCESS LIAB I CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$. C 79425F141ALI /5/2014 /5/2015 F $ D WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? El N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) UB6626Y35214 /6/2014 /6/2015 If yes,d E.L.DISEASE-EA EMPLOYE $ 1,000,000 scribe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD_101,Add1donal Remarks Schedule.If more anare.11 reauired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Denise Butcher/DMB ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r?ninnsi nt Thn Annon n2mu onel Innn o►n ranic4arort marlrc of Ar`npn Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers License: CS-M969 VICTOR CIMINO;- 267 N.QUINCY Sf x . ABINGTON MA:023 PJ- )rw Expiration Commissioner 05/11/2016 Office of Consumer Affairs&Business ME IMPROVEMENT CONTRACTOR License or registration valid for individui use only egistration. 149123 RACTOR before the eg iration date. If found return to: Piration 11/28/2015 Type' Office of Consumer Affairs and Business Re Y INSUL-PRO,INC. Private Corporaffor; 10 Park Plaza_Suite 5170 Regulation ,- Boston,AAA 02116 VICTOR CIMINO h 267 N.QUINCY ABINGTON,MA 02351 Undersecreta-arry� Not valid without signature I 2/z7 h i Insulate save Weatherization & Insulation 410 Grove SL Fall River,Ma o2723 ' Insulateasave.aet t4 _vo J 3, February 26, 2014 v� TOWn Of Barnstable Thomas Pe rry, CBO 200 Mair1 Street Hyannis,MA 02601 RE: 11 Old Kings Rd w�v Dear Mr.Ferry, This Affidavit is to certify that all work completed at 11 Old Kings Rd has been inspected by a ccrtif e Inspector. R35 Cellulose was added to open attic space,All Work Performed Meets or exceeds Federal nd I State Requirements_ Sincerely Roland Langevin Insulate 2 Save, Inc President CSC, 103861 HIC 166311 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 022 Parcel O`4 0 Application #o(6130 q ql Health Division Date Issued a-1 Conservation Division Application Fee Planning Dept. Permit Fee S� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis I ZlL7 �t? Project Street Address 1 CC\6 1hi 12C �d Village -4-- Owner Cs a Pi SCh Address 11 U MS V-d Telephone`-Q` - L-Or) - Q�F5 elk Permit Request I r1 +(A 1I Wk4�c i m �la4ic�n '� h�bk on 0T 11l JL oso) ' Square feet: 1 st floor: existing ro osed 2nd floor: existing proposed Total n w q 9-proposed e 9 p p Zoning District Flood Plain Groundwater Overlay Project Valuations Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family id/ Two Family ❑ Multi-Family(# units) Ca Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's2�l Iighway: `d Yeses❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)I 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 i :eat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other !3entral Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No f, Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name b - 1'1(J LCAjOCA 1,)i t� Telephone Number '08 f�`l�C2`ZC CQ Add-�ress � c- `u dn i p SA- License # �'J a C r �A 1\ ex 0 M'_A Home Improvement Contractor# I LD LP 3�l Worker's Compensation C2 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO I Q C2'r J\Q S4 0\1 bjPf: YYA SIGNATURE DATE 13431193 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. i t. f. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: i FOUNDATION m FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT t `ASSOCIATION PLAN NO.� `'' " c 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/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizatiorOndividual): i I'1 )w a-4-e a S Cs.\i e 1 n e . Address: Q 10 6-trUv P 5-1 City/State/Zip: "FQ i I giV k r WVA Phone #: 50`6' -�5Q)—7 -Ca-7o Co Are you an employer?Check the appropriate box: Type of project(required): 4. am a genera contractor an I 1.Tam a employer with�_ ❑ I l d 6. New construction employees(full and/or part-time).* have hired the sub-contractors 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 working for me in any capacity. employees and have workers' insurance. 9. ❑ Building addition comp.[No workers' comp. insurance p. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13.0Other 1Y�SulCztc b� 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 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:(77t_Lav, Policy#or Self-ins. Lic.#:X N\jU( _')S1, 1 LA?>1 Expiration Date: i a,10 11� Job Site Address: 11 01CA V)Jf- ee t & City/State/Zip: -�-- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of 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 insurance coverage verification. I do hereby certify and tfpat a d penalt Es.of perjury that the information provided above is true and correct. Signature:_ Date: D E C 13 2013 Phone#: C>L.P Official use only. Do not write in this area,to be completed by city or town offrcial.- 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#: A 12.% CERTIFICATE OF LIABILITY INSURANCE °�'�`"MIDDI "'"' �,...,..i 12 11/13 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(Pes) must:be endorsed. If SUBROGA'IIOWIS WAIVED;tutiOct1b 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 endorsemen4s). PRODUCER CONTACT - - NAME: Anthony F. Cordeiro Insurance PHONE FAX 508). 677-0407 wl :No: (508) 677-0409� 171 Pleasant Street EMa Fall River, MA 02721 ADDR6S: lbrizido@::cordeiroinsurance.com - INSURER (S)AFFORDING COVERAGE NAICq _ m INSURER A:Atlantic Casualty Ins. Co INSURED INSURER B:Torus Specialtv Ins. Co. Insulate 2 Save, Inc. iNsuRER c:Great.American Ins. Fall Grove St. _ INSURER D:Guard Insurance Group Fall River, MA 02720 )NSURER: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. NSR - ADDS I SUER......._....-_.. _.. .....__. . ..._._.._.... .............POLICY EFF POU'CY EXP ......,..... LTR TYPEOFINSURANCE POLICY NUMBER MIDD/YYYY WIDIXYYYY LIMITS A GENERAL LIABILITY Y Y M081000174-1 6/12/13 6/12/14 EACH OCCURRENCE_ $ 1,,.0,00J0 0 Q X COMMERCIAL GENERAL LIABILITY REM$ZGE 70(es RENTED r $ 10O O00 ..P.E31~M1S S.IEa oraalrsea,9) __-- � CLAIMS-MADE n OCCUR MED EXP(Anyone person) $ 5,000 PERSONAL&ADVINJURY _ $-. _1,.000.t_QOO -- GENERAL AGGREGATE .�_ $ 2,,_0.0�0,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 X I POLICY _ PRO .(-7.LOC AUTOMOBILE LIABILITY COMB SINIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PRQPERTY DAMAGE $ -_-- HIRED AUTOS _AUTOS <anacadaiit B UMBRELLA LIAB X OCCUR 78264D131ALI 6/12/13 6/12/14 EACH OCCURRENCE $ 2 0OO__r 000 �- EXCESS LIAR CLAIMS-MADE AGGREGATE Is 2,000,000 DEC) X . RETENTION$ 10.000 $ WORKERS COMPENSATION WC STATU- OTH- D ANDEMPLOYERS'LIABILITY YIN INWC311431 12/10/13 12/10/14 X L..^Et,Y_LIIT.1UTi_ ER__ ANY PROPRIETOR/PARTNER/EXECUTIVE _E.L.EACH ACCIDENT $ 500,000 OFFICERMIEMBEREXCLUDED? N/A — (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI$ 500,000 If yyes describe under DESlR(PTIONOFOPERATIONSbelow E.L:DISEASE-POLICY LIMIT $ 500 000 C Equipment Floater IMP 375-99-76-01 6/12/13 6/12/14 Shop Storaqe 75,350 Veh `Storage 76,250 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is regdred) Proof of Insurance, Residential•Insulation Contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St Hyannis, Ma 02601 AUTHORIZED REPRESENTATIVE I ©1988-2010 ACOM CORPORATION. All rights reserved. ACORD 25(2010I05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: i - . -�e -C mwwwweald Office of Consumer Affairs and Business Regulation lOPa Suite 5170 Park - - Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 166311 s Type: DBA Expiration: 5/11/2014 Tr# 222532 INSULATE 2 SAVE ROLAND LANGEViN -------------._..----------- 536 EASTERN AVE. FALLRIVER, MA 02723 Update Address and return card.Mark reason for change. Address Renewal —� Employment Lost Card DPS-GA1 is 5OM-04/04-G101216 Omer Affairs& ` n License or registration valid for individul use only Office of Consumer Affairs&Business Regulation g Y -HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1 Registration: -166311 Type: Office of Consumer Affairs and Business Regulation Expiration: 5%_1'1J2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 IN LATE 2 SAVE:;:;-. ROLAND LANGEVIN 536 EASTERN AVE.., FALLRIVER,MA 02723..• °.: ---...._.._....- ----_------------------ - Undersecretary Not valid without signature Massachusetts.-Department of Public Safety Board of Building Reguiations and Standards Construction Super%-isor License: CS-103861 ROLAND LANGEVIN ; 536 EASTERN ACE Fall River MA 0237231 J� ��` =xpiratiOr` 08/2412015 commissioner i RISE ENGINEERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of'I'hielsch Enl ineerim- MA Contractor Registration No 120979 CT Contractor Registration No 620120 t 1341 Clunwood Avenue:(.'ranston.111 02910 (401)784-3700 UAX(4411)784-371(1 CONTRACT Page 9 RI S E ?Y'RO(J)RA\'l THIS CONTRACT IS ENTERED INTO BETWEEN RISE t.,0 1'._I;��S ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE client o Patricia A }Fisch (508)420-9888 1 1(05 2013 151984 SERVICE STREET BILLING STREET I I Old Kin s Road 1 1 Old Kings Road SERVICE Cl rY,STATE,ZIP BILLING CITY,STATE,ZIP Coiuit,MA 02635 Cotuit, MA 0263,5 JOB DES�;1C��:E'1'�0l�T Provide labor and materials to seal areas of your home against,.vasteful.excess air leakaite. This work will be pert(rmcd in concert with the use ol'spccial tools and diagnostic tests to assure that your home will he iefl«ith it healthful level of air excharuc and indoor air quality.Materials ter be used to seal your home can include caulks,f lanTs,tycathcrstrippin and other products. )'runalrN areas for sealing include air icakai,c to attics,hasements,attached garages and other unheated areas(windows are not generally addressed.) (19)working hours. At the completion of the weatherization,cork.and at no additional Cost to the homeowner,u final Mower door and,or coluhustion safety analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. S1,386.00 Provide labor and materials to install a 10"laver of R-35 Class I Cellulose added fo(928)square fact ofopcn attic;space. 11 #:5� Provide labor and materials 10 insulate the hack of(1)anic hatch wiih 2"ri,_id"(hennas board.Weatherstrip the perimeter. S35.12) Provide labor and materials to make(2) temporary access to an attic area through the roof. The opening,will he close(]with materials similar to those existin,.Roofin,,will be sealed property when insulation work is complete. +184.54 Provide labor and materials to install ventilation chutes in(105)rafter bays to maintain air flow. Provide labor and materials to install 2"C-SK faced semi-rigid fiber class board insulation to(120)square feet ofcommun wall area. 397.20 RISE Engineering will apply all applicable.eligible incentives to this contract.You will be billed only the Net amount. Fora limited time;the Cape Light(:'ornpact is oll'ering l00'%>incentive towards Okzible insulation measure.-,not to exceed k-1,000 per Calendar year and an incentive of 100`?'o fur the Air Sealing measures. 5556.%8 r RISE ENGINEERING Federal ID#05.0405629 RI Contractor Registration No 8186 A division DI'Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood:wcour.Cranston.RI 02910 pp�,��"�' w "g' (401)784-3700 FAX(401)784-3 710 CON 1 RAC I R I LL Page 2 6J; PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS E NGIN E E RING DESCRIBED BELOW CUSTOMER PHONE DATE Client F Patricia ,4 PisCII ( 08)420-9888 y y} ; 13 151984 SERVICE STREET BILI.INC,STNE I I Old KinTus Road I I Old 1< nt s 1,oatY 'L^ SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Cotuit.MA 0263-5 CoWit. �4A 0263 . ,JOB DESCRIPTION Total: $3,056.35 Utility Incentive: $3,056.35 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***001 Dollars $0,00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN F .L..INTER. OF 1%WILL BE CHARGE ONTHLY N ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF CISION.SCHE LING.AND CONTRACTOR ON. li DO NOT SIGN THIS CONTRACT IF THE ARE Y NK SPACES AUTHOR DSIGNATURF RISE ENGINEERING t Cu.,IOMERACCEPTANCE� NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN - DATE OF ACCEPTANCfi ACCEPTANCE.OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE L" SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK ... DAYS. AS SPECIFIED.PAYMENT WILL BE MADE.AS OUTLINED ABOVE - i OWNER AUTHORIZATION FORM - 1 (Owner's Name) Li copy. owner of the property located at jj(Property Address) (.Property Address) f hereby authorizeJY? (Subcontractor)an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my r erty: Owner's Signature A Date TOWN OF BARNSTABLE'BUILDING PERMIT APPLICATION Map OaDN ,5 Parcel lJ =r ` Permit# ' Health Division Date.Issued Conservation Division Fee, Tax Collector n - Treasurer Planning Dept. t Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis { -Project Street Address i n S 12 cQ Village,' U+�Al Owner a h n, e f Sc.v, Address Telephone w :Permit Request ko Sf Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost goo Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family = Two Family 0 Multi-Family(#units) 'Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: 0 Yes 0 No Basement Type: ❑Full ❑Crawl O 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 O Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:0 existing 0 new size Pool:0 existing ❑new size Barn:O existing Cl new size 'Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: S Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial O Yes ❑No If yes,site plan review.# Current Use - Proposed Use BUILDER INFORMATION Name FRAS R UGINSIR C I ION Telephone Number Address 71 TARAGON CIR< 'License# COTUI ' I1tiA 02635 Home Improvement Contractor# r) 429-2292 Worker's Compensation# NW 19 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE (�>o O00 F FOR OFFICIAL USE ONLY PERMIT NO. ' s DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGEcn • j ` 4' 1 OWNER •:L DATE OF INSPECTION: FOUNDATION FRAME , . . - INSULATION FIREPLACE ^- ; ELECTRICAL: ROUGH FINAL' k i PLUMBING: ROUGH S FINAL; "' a � FINAL• 7 a r r y � +i • GAS: ROUGH - FINAL BUILDING t '+ DATE CLOSED OUT i ,3 ASSOCIATION PLAN NO. 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' :' . : ISh W. . ?:: } .nk.Y;...Y.•',:.•::.?v.r : ;,:hk k:+:..rt:..i:,•.,xc. .$ }} nv•::}$:.<}xL:;:; Fallure io secure coverage as ngi&W raider Section 2U of MW,1.4 Alm lend to the impedtion of akftd pem mes of a Alas up to 51,500.00 andlor one years'impikesoneat aswall aV44 ge*I7tles in the h m of a STM WORK ORDER and a Ate of 5100.00 a day ageitst me. I tmduviand that e copy of this statemaot may be fmwaeded taft-amcs oflnveadgadons of tiro DIA for coverage verlAloadom I do hereby Car: and. 009riary that du injornradon provided above is fro and greet Signatnre Date Print name MONSOON official use only do not write in this ores to be completed by city or town oMdal city or town: Batiding Department Qg Board ❑check irimmWinte response isregnired -. ❑Sdectmst'sOfIIce _ QHuM Department contact person: Phan (mued 9195 PJA) 1 _ . t HOME IMPROVEMENT CONTRACTORS REGISTIRATION and of Building Regulations and Standards One Ashburton Place - Roos 1301 Boston, Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR --- ---------------------- -_-•_-. Registration 112536 Expiration 04/06/01 Type - DBA .. UK UPROVOUT �T 41 +wl a atir rpxr 5+pr dt A°Le..y'{•,IYY+4 +w. _ ftistrati 1125% u �,I.S r - .; wel h.x A•+{.ib.y'Ar'...{.- .• r{n'R 1'1"AN'.?NAYnfl"1 • •9' - FRASER CONSTRUCTION co q + Type - — DEAN C. FRASER _---- -= -------- - o — - 1 TARRAGON CIR COTUIT MA 02635 , fRRSER CONSTRNTIOR co, . KO C. FRASM Ledo-7f CIR TUIT VA 02M - t SHE The Town of Barnstable 9 9 MAM ���' Department of Health Safety and Environmental Services 1659. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date %/86A000 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: P, Estimated Cost Address of Work: Owner's Name: �� Date of Application. �OUC7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED_ CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 90 boo � rRvg-,S� , ate Contractor Name Registration No. 3 OR Date Owner's Name q:forms:Affidav