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HomeMy WebLinkAbout1178 SANTUIT-NEWTOWN ROAD 11 �� �c�n�ul� -yU�ccl�a�h MCP, �, Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 June 17,2016 Thomas Perry CBO '21 a Town of Barnstable �� Building Division �; c> 200 Main St. ® � �� NJ Hyannis,MA 02601 w RE: Insulation Permit#B-16-1250 r Dear Mr. Perry This affidavit is to certify that all work completed for 1178 Santuit-Newtown Road, Cotuit has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey o _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,q Map09A Parcel Application# s Health Division Date Issued s 3'►1/ AA Conservation Division Application Fee Planning Dept. Permit Fee _ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis EIMAX 1, Project Street Address ` �'g ��-�A,+ &w�OWn Village C+Wil Owner To R.n n t W a-M A Address S;!CA p Telephone 6$ = a8 35 9D Permit Request 35 cg 11,11,10<e an � a ri��� �nSA a4 i on A*G 11 12.•I q .IberS r Yam, a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full 0 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 0 new size _Shed: ❑ existing ❑ new size _ Other: c-2, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If yes, site plan review# Current Use Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V" 111AN CIML F, . Telephone Number f0 8 Address ��� 41-1 '�►A 6r!'/ License # �, L Ott Sr Home Improvement Contractor# �T o Email Worker's Compensation # WC o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ra Mnd,nr-� SIGNATURE DATE n FOR OFFICIAL USE ONLY APPLICATION # 4i DATE ISSUED S MAP/ PARCEL NO. `t ADDRESS VILLAGE OWNER DATE OF INSPECTION: ,' FOUNDATION FRAME s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. u : t-, {7a!'(Zt �•ltfD: - i;AJC: -79 �4�7.17; CIO UL • '•.^"� �"'.'w°!"! . w+'`�'i:.ii �r:w jam. ?,•.;f��( �,;a. - : s .0tiow" a :: -'.v Ohm GN .I-i`L.17 ACOR� CERTIFICATE OF LIABILITY INSURANCE Dart idMioDIYWYf 4/12/2016 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY rAMEND, 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 0bI1cyQes)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an:endorsement. A•statement wthis certificate does not confer fights to the certificate holder 1n lieu of such endorsements. r PRODUCER . - CONTACT.Risk Strate ies .0 NAME: g. �y Risk Strategies Company k y WCC N E : (781)986-4400 FAC Nc:(781)M-4420 E4AAIL 15 Pacella Park Drive ADOREssirandolphcld®risk-strategies.com Suite 240 _ _ INSURER(S)AFFO RIDING COVE RAGE NAIC Randolph MA 02368 IneuReRA:Seiective Ins. oE America _ _. INSURED .,. , 4 INSURER Allmerica Financial Alliance Ins Cc 10212 Cape Save, Inc )NsURERC:Star Insurance Cc 7 D Huntington Ave INSURER D: INSURER E: _ South Yarmouth NIA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1641211375" 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, EXCLUSIONSAND CONDITIONS OF SUCH.POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IR TYPE OF.INSURANCE .POLICY.NUMBER. ....MMCY EFF IO M�CY EX DD LTR - LIMITS.. LT X COMMERCIAL GENERAL.LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE OCCUR PREMISE$Ea occurrence) $ 100,000 X S1994480 .i0/i6%2015 -10'J16/2016. MED Ev'(Any one:person). $ 10,00.0 PERSONAL&ADVIN:URY. $ 1,000,000 GENt.AGGREGATE:LMIFAPPLIE5PER; GENERAL AGGREGATE $ 2,000„_000 PRO- POLICY�.,.ECT LOG - � y s PRODUCTS-COMP/OP AGG $ 2,000,000. OTHER`. AUTOMOBILE,LIABILrTY +' EeaccdeD, NGL LIM $ 1.,0:00,000 ANY AUTO BODILY INJURY(Per person) $ B. ALL OWNED SCHEDULED ' X ANNA46796600 11/6/2015 11/6/2016 BODILY IN:AJRY(Per accident). $ AUTOS aOOuroW NED .. r PRO� RDAMAGE �dX HIREDAUTOS AUTOS Were, _$ _ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1 000 060 A EXCESSLIAS CLAImS ADE y. /-, +q T ) AGGREGATE _. $ 1;000 000 _ DED X RETENTION.$ Ir1L 81994480 16/16/2015 10/16/2016- $ WORKERS COMPENSATION - officers Included for ,. } �'„�- 1 X P�ITUTE `�� AND EMPLOYERS'LJABILITY .. - . ANY PROPRIETOR/PARTNER/EXECUTIVE YIN Coverage. EACH ACCIDENT $ 500�j000 OFFICER/MEMBER EXCLUDED? ®NIA _. C (Mandatory In NH) t F E.L.IRC085540700 r4/9/2016 4/9./2017» E.L.DISEASE!EA EMPLOYE $ 500,000 it yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $•. -500,000 DESCRIPTION&OPERATIONS I LOCATIONS I VEHICLES{ACORD 107„Additional Remarks,Schedule,may be attached if more space is required) _ National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are- all included as•Additional Insureds with respects to the'6eneral Liabilit-coverage'of. named insured as re quired by written contract, - •' ' 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 Cape Light Compact= ACCORDANCE WITH THE,POLICY PROVISIONS. -.Barnstable County 460 Neat Maia Street- - AUTHO,RIZEDREPRESEWAT1VE .•S - - Hyannis, MA 02601 Michael Christian/CLG 00 1989-2014 ACORD CORPORATION. All rights rsserved. ACORD 25(2014101)--`= The ACORD name and logo are-registered'marks of ACORD INS00(201401) G .The Commonwealth of Massachusetts Department of Industrial Accidents d 1 Congress Street;Suite 100 Boston,MA 02114-2017 www.massgovldia NN'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electrieians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Cape Save Inc Name (Business/Organization/Individual, P Address:7-D Huntington Avenue City/State/Zip:South Yarmouth,MA 02664 Phone#:508 398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 15 employees full andlor art-time ❑ ., � part-time),* 7. ❑New construction 2. I am a sole proprietor or partnership and have no employees working for me in ❑ 8. ❑Remodeling any capacity.[No workers'comp.insurance required:] 9, El Demolition 3F1 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 4.❑l am a homeowner and will be hiring contractors to:conduct all work on my property. I will 10❑Building addition ' ensure that all contractors either have workers'compensation insurance or are sole I L.M Electrical repairs or additions proprietors with no employees. 12.2.❑Plumbing repairs or additions . 5,❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1 These submcontractors have employees and have workers'comp.insurance.' [].Roof repairs r 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[✓]'Other Insulation. 152,§1(4),and we have no 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. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors mustsubmit 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 tharis providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Star Insurance Co. Policy#or Self:ins.Lic.# WC085540700 Expiration_Date: 4/9/2017 Job Site Address: 1178 Santuit-Newtown Road City/State./Zip: Cotuit Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a.criminal violation punishable by 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$250.00 a day against the violator_A Copy of this statement may be.forwarded:to the Office.of Investigations.of the DIA for insurance coverage verification. 1 do hereby certify under th pains and penalties of perjury that the information provided above is true and correct Signature: \\' Date: 5/10/16 Phone#:508-398 0398 Official use only. Do not write.in this area,to be completed by city or town official City or Torun; PermiflLicense# Issuing Authority(circle one): I.Board of Health 2:Building Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 0.Other Contact Person: Phone#: ex l Office om uatlorAd n } 10 Park Plaza Suite 5170 BAoston Massachusetts 02116 Horne Improvement'Contractor:Reg> tratlon �s Registraton 171380 . {„ Type Corporat P gn Ex i�.io 3114/2D18 Tr# 419291 CAPE SAVE INC.. �r � m WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE SOUTH=YARMOUTR MA.&664 a'F a Update Address and reiur..n card Mark reason for change. {` Address l enewal Em to meat Ci Lost Card: C;. ❑ p y u SCA 1 :5 20M-05/11 C�'0'llb7Jt417GUCU•G��0���/��CCa6CtCf!/L,i$ Office of`.Consumer Affairs&Business Regulat* License or<registration valid for mdividul use only' ^N HOME;IMPR0 EMENT CONTRACTOR before the expiration date If found return:ao rye Registration -t71380 'Type, Office of Consumer Affairs.and Business Regnlatiort ✓ 10 Park Piaza-Suite 5170 7 Expiration 3/14/2018 Corporation Boston,.1VIA 021i6 CAPE SAVE INC WILLIAM MCCLUSKEY 7-0 HUNTINGTONrAVENUE= SOUTH YARMOUTH,MAA2664 Undersecretary Not valid: i signature [� Massachusetts-bepartmentbf Public Safety Board of Building Reguia#ions and Standards V11./11LIU1.L1411..JIj.11C1i{lll%'JIICIla/LY' 3R'�.�2'6�YRa�. I License. CSSL 102776 WILLIAM J MCIU G 37 NAUSET ROAD West Yarmouth IRA `.%•�.•: l .J� �zr;�` Expiration Commissioner ffii 201T £. � 044 3.5 .r L O7 4' ` ,- 00 . 7 . 2a 0 7-. gig PL O7 A71 A I L 0 C A T/ON 1v8 &15-/1IL45 01-AAI /26F,eeerA1CL-: t3i!�/A/6 L.07- ' 2 7 A5 5,hrO AI IJ ©n/ OIC Pecos: ;. r m6k?E$y cevmrY TA-/AT /MtE jfX45r t wt:.F`1?E'C F. / /6 AOVAI&A7-10,V 4QC-17'IO,V 45QaZAeZ TAYLO .45 `t, �:� ;�� k� 7's�e�' �3Ut�13/�✓�'•SE?'6.4C.�&'�QUiQE.M��t/7 y J { J� �"4A"-, . : 8 ft/.rGy Olt/S7: yA2M4 ciTs/NO.L�r M,4. A sessor's ma and lot number .................. 0 g p SIEP'T!C SYSTr:, WSW T BE ' MSTALLED IN CC "'If. A�t:CE �. Sewage Permit number yy V'iTH A£TIC,E 11 STATE A .l.................. y �A1`31TA Y COS� Ai M TOWN o�tHETo _ TOWN OF BARNS "A LE = :h BAHBSTAMLE;.i 0 C: ' "6 w :. BVIIDIHG - INSPECTOR. 'ED.NAY A to i c APPLICATIONFORcPERMIT TO. r� CA TYPE OF 'CONSTRUCTION ..:.'.... ��� �' .r. ... f., ..... ........... / ...................................... �.. .......................................�P .........19 W� .._ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....��? ......................�........................................................................................................ .....`h..... ProposedUse ....�?. e.��.... ................................................................................................. �� G i f Fire District .........� Zoning District ...............�......................,.......... .............,.................................................... . ,cam. C Name of Owner ........................................................rn..........Address ................ t:...l........�................. ...... ................... Name of Builder ....... / p „/...�1../`P .......:`.............................Address ................... ..................................... Nameof Architect .......... ...�'�.. .............................Address .......................:............................................................ � ....... ................... Exterior . G!/ ,��......................Roofing .............C��3.. ............. ��tStS �..................... ............................................... . c Floors ................ 1` ........................................................Interior ....... .................. Heating �•..�i...... ........... ..5.........................Plumbing ..../....... . ..... . . / / mow Fireplace ...................:................................................:.............Approximate Cost Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area jqv.#.... R �-D 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 abo construction. Name ............... .................................. .... i Cobb, William E. No .... Permit for ........1. l./.2..s.t.o.ry.,.. single family dwelling ......................... ................................ 1.76cation//7F Newtown Road a.d............................ fA ............................................................................... Owner ...........Wi 1 l.i.a.m..E.....Cobb............................... . . .. .. . ...... . . "o �' / r � ' Type of Construction ................fr ................... Plot ............................ Lot ...........-#27 ..................... 75 OPermit Granted ......... 19 Date of Inspection ......... 19.. Date CompIet-e-d­&2/iLW?6..... PERMIT REFUSED ........................................................ 11g,(7 19 Nj ................................................................................. 49 I..........................;........................................... . ............................:.................................................. /7 Approved ................................................ 19 ............................................................................... .................... .............. ........................................ Assessor's map'and lot 'number ........... .. ...... ... ... VCV- Sewage Permit number ............................ ............................. y�FTHETO�yTOWN OF BARNSTABLE ARNSTABLE, M6,3 AM 9. M BUI.LDING ' INSPECTOR APPLICATION FOR PERMIT TO ....... ...... .......................................................................... TYPE OF *CONSTRUCTION ................ .............................. ,2......................................... .............. ................................... .9........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: (-5�7 7 Location ..... ................................................................................................................................................... Proposed Use ..................?..< Zoning District ........ District ......... ................................................................Fire Distri ............................................................. ............................... Name of Owner ...................... .................................:'`...........Address Nameof Builder ..........................z........................................Address ...................................................................................... Nameof Architect ................ ....................................................Address .................. ................................................................. Numberof Rooms ............... .............................................Foundation ........................................!,,z.................. ...... Z,2 fing ..... ....... ................... Exterior ..... ........... ..... ......................Roofing..... ....... Floors .........4�,,'7r!�7........................................................Interior .......... .................. ................. ..................... ........... Heating ... .......:.............Plumbing .... .......................................................... !......f�.......��.,'� �.............. Fireplace ........ ......................................................................Approximate Cost ...................................................................... Definitive Plan Approved by Planning Board --------------------------------19--------- Area ........ Diagram of Lot and Building with d mensions ee ........... .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Lj I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ Cobb, William E. A=26-22 r 7 9 A 1 1/2 story, No ................. Permit for .................................... single family dwelling ......................................................... Newtown..�?AV............ Location ...................... .................... .................... ..... ......... Owner William . Cobb ............................ ............... ..................... Type of Construction ...,,,,.frame........................ .................... ............ ............................................... Plot ............................ Lot ........ #27 ........................ e I\V Permit Granted . ........Octobr 75 ..... ....... ...............19 Date of Inspection ................ ...............19 Date Completed .................. ...................19 jPERMIT EFUSED ................................... ............................ 19 ................................. ............................................. .............................. ................................................ .'E R..M.T E F.0.... ................ ........................... ................................................... .............. r� Approved ................................................. 19 ............................................................................... . ................ .............................................................