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HomeMy WebLinkAbout1033 SANTUIT-NEWTOWN ROAD �033 Sv-r�uA"t - W� .� 49 Herring Pond Road I Buzzards Bay,MA 02532 P.508-888-174o F.508-833-3377 Resolution E N E R G Y March 25, 2013 Thomas Perry, CBO Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 --+ ` 'IX : Re: Insulation permitsJ,,�' ,� Dear Mr/Perry: j f This affidavit its o certify that all work completed for �nsula ion w4i* at 1033 Santuit-Newtown, Cotuit has been inspected"by a certif ied � 1 Building Performance Institute (BPI) Inspector. All work performed meets or-exceeds Federal and State requirement. Sincerely, Lisa M.`Haglof; -- -'� Executive Office Coordinator TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #2 I �- Q 33 / Health Division Date Issued - Conservation Division Application FeeVt d' Planning Dept. Permit Fee .$5- 1Si a Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 1033 .SG n U►�- {�1 C uJ �'u�i(1 Q l` G� Village CU�-I) Owner -1 Lt 6 n-c I ( Address Telephone Permit Request i �-a-�^�"� °,.Q_ u.rC a- � z 0.-!� u-� CAA--, S`l_ L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation *-L�r-d0 Construction Type L a^c-1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ rs Two Family ❑ Multi-Family ,(#/units) � Age of Existing Structure 51I f95-33Historic House: ❑Yes ❑'IVo On Old King's Highway: ❑Yes ITN�o 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: ,3 existing _new Total Room Count (not including;ba>hs :_g�xisting new First Floor Room Count H t T n F I: ❑ G iI ❑ Electric ❑ Other Heat Type and Fuel: as Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 0}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 �t I t IT-0nv l (BUILDER OR HOMEOWNER) ei?Name c S o lu L.ch 1 c mac,�„ I r c. , Telephone Number �5� ? -n 9 O Address !qq lac r ri r!� p yAcA n-G( License # C S 3 O v i-Lurds 6CW CY1(� (��3'-- Home Improvement Contractor# t 99 Worker's Compensation # WC-5 3 15 310 S a:5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (:ve%_cl (Ut Q)v 1L L-tAd S GCS, !Ja-r S SIGNATURE DATE l l I 1 d- FOR OFFICIAL USE ONLY t � ' APPLICATION# DATE ISSUED M � MAP/PARCEL NO. ADDRESS VILLAGE' - OWNER _ DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL I , f' PLUMBING: ROUGH FINAL t t GAS: ROUGH FINAL- FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i = The Commonwealth of Massachusetts .. fW Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): O(V J _e oG j I✓lC Address: 4q (-c r r'i n,n\ wr { CLC( City/State/Zip:'BV ,1r.I rd_ &l,I MR Phone#:(sa Are an employer?Check the appropriate box: Type of project(required): 1. I am an employer with (Q 4.❑ I am a general contractor and I 6. 0 New construction employees(full and/or part time).* have hired the.sub-contractors 7. ❑Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet, 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 workers' comp. insurance comp.insurance.T required] 5.0 We are a corporation and its 10. ❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. 0 Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12. ❑ Roof repairs employees. [no workers' comp.insurance required.] 13. Other UJU-1 I� L tZ U"` Cn *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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 thepolicy and job site information. Insurance Company Name: C L o. )a, 5- L o Policy#or Self-ins.Lic.#: SII 3 S O S Expiration Date: 3—/�-—al o<3 Job Site Address: d 3 3 SCt`1 pu Y N CU-) City/State/Zip: .CU Iv i I- M"or 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature-?�yo._ ` 1 `� `' 2-6-�-i Date: `D— Print Name: /S c,�_ 0-) Phone#:(Soe 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 Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: 4y '� ® DATE(MMIDDIYYYY) AcoR" CERTIFICATE OF LIABILITY INSURANCE 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 SMALL BUSINESS INS AGCY INC CONTACT NAME: 542 MAIN STREET PHONE A/C No Ext)_(508)795-0635 FAX(A/c No): 508 798-5008 WORCESTER, MA 016150022 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual Insurance INSURED INSURER B: RESOLUTION ENERGY INCORPORATED 49 HERRING POND ROAD INSURERC: BUZZARDS BAY MA 02532 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:14094595 _ — __-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. INSPOLICY EFF POLICY EXP R LTR TYPE OF INSURANCE ADDL S BR POLICY NUMBER MMIDD/YYYY MMIDDfYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ _ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE E OCCUR ; MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOD - $ AUTOMOBILE LIABILITY Eaa acccident SINGLE LIMIT S ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS — NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS - Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIA6 CLAIMS-MADE - AGGREGATE $ DED RETENTION$ $ $ A WORKERS COMPENSATION WC5-31 S-370523-052 3/12/2012 3/12/2013 wC ST m - oE7 l- AND EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PAP.TNE,2EXECUTIVE YIN - - - - E:L EACH ACCIDENT .$- _ 500000, -- OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) - E.L.DISEASE-EA EMPLOYEE $ _500000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) - Workers compensation insurance coverage applies only to the workers compensation laws of the state MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HOUSING ASSISTANCE CORPORATION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 WEST MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE Jeff Eldrid e ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 14094595 CLIENT CODE: 1558558 Anne Chandler 9/14/2012 7:06:57 AM Page 1 of 1 This cercifi.cacc cancels and supersedes ALL previously issued cerLifi.cates. - x �ias.�nchusctt� [ cpartnient nl Public `,il'ct.N Bn.ird of Buildin- Re;;ulations and Standards Construction'Supervisor License License: CS 53202 JEFFREY R TONELLO ° i PO BOX 1516 SAGAMORE BEACH M A 02562 Expiration: 7/14/2013 ( .nnui .inoi' TrR': 21481 leo"11TL11111ICLN1 4 �('U.w�CLC>/2CC4(iLGl1 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .:=171991 Type: Office of Consumer Affairs and Business Regulation _ Expiration:iration: 5/g/2014 Corporation 10 Park Plaza-Suite 5170 Boston, MA 02116 RESOLUTION ENERGY:`INC JEFFREY TONELLO 43 FIELDWOOD DRIVE'= SAGAMORE BEACH, MA,02562 Undersecretary t lid NY' out signature 460 West Main Stteet Hyannis,MA 02601-3648 T (508) 771-5400 F (508)775-7434) N101 ,, TTY on all lines 1-1O S n ;far:. www.haconcapecodoq Assistance Corporation Cape Cod Fre%e Your tenant has. requested and is eligible for weatherization of your rental home through government funding. This will be provided of no cost to you. Program regulations permit us to spend around $4,000- $10,000 in materials and labor per dwelling unit. Program regulations require us to weather-strip and caulk doors and windows; insulate attics, sidewails and floors. All work is professionally done by established private contractors. We will conduct a final J inspection to make sure that all work is completed to specifications If you request, you will be informed of the estimated measures before = they are done and provided with a list of the actual measures arid; costs following the completion of the work. w f We also need proof that you own the property. A copy of a CURRENT TAX BILL OR DEED listing you as the owner will satisfy this f requirement. Please fill in all blank areas of the enclosed agreement and return with the proof of ownership as soon as possible. If we do not receive the enclosed form within two weeks, we will do a basic energy audit of the home, but no weathorization work can be recommended or done. if you have any questions please call Cathy Finn at 508-771-5400, ext. 105. � LAND ORD ?Z'a J' TENANT L AV I i t PHONE PHONE