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HomeMy WebLinkAbout0089 CHILDS STREET Lr a � a 10 �-d Lie _ _ ` A-� CL z . v y t n SEPTIC SYSTEM MUST SS Assessor's office(1 st Floor): /�q r MED ���P C-E Assessor's map and lot number 6 ` — �� g o*'TNE T0�.yw Board of Health(3rd floor): Sewage Permit number �/% �p '� EmnRoM n p (�{ _ TOWNR 'E'�1ULAS'O■ S = BAXISTADLL i Engineering Department(3rd floor): rasa House number '639 \®� Definitive Plan Approved by Planning Board 19 . �£0 Mph�` APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF BARNSTABLE BUILDING - INSPECTOR APPLICATION FOR PERMIT TO �D� ✓er r Ly/�r��e K� Liv)u!!� TYPE OF CONSTRUCTION Uj CUC� /Y 19 9Y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ` ( tl c/t 1 �� Proposed Use Zoning District Fire District c, Name of Owner Aft Address S�'►nrl -z_ Name of Builder Y1 Address _�5,00 Name of Architect Address Number of Rooms— ,?' ooms �'-- Foundation is77 A'�r i Exterior f � Roofing ���iLy Floors/9,4ei Interior Heating 1- L_' Plumbing Fireplace Approximate Cost Z — 3 ZFO U Area d Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ��-r Construction Supervisor's License ©�we- HUSE, MARK & MARCIA No 33449 Permit For Convert Garage to Living Space Single Family Dwelling A Location 89 Child Street Centerville %,. Owner Mark & Marcia HtSsP Type of Construction Frame Plot Lot Permit Granted January 11 19 90 ` Date of Inspection 19 Date pleted 19 F 4 AsSessor'stoffice(1st Floor): Assessor's map and lot number :'• / OF THE>O Board of Health(3rd floor): Sewage Permit number Z SAUSTADLL i Engineering Department(3rd floor): rnsa` House numberi679•111 Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN ' OF BARNSTABLE HILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 7 r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: t Location Ly ` 1 ` Proposed Use ` '-- 1 ' �' Zoning District , Fire District sy Name of Owner r - �'� " � Address '=`1 E. Name of Builder k Address Name of Architect Address Number of Rooms =J t' Foundation Exterior f- e CE r4 r Roofing Floors - ! �' Interior Heating - r Plumbing - '� -1 ' Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee . 3 Y� 6 r ' Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS e o r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License HUSE, MARK & MARCIA A=249-003 J �yR oo3 No 33449 Permit For Convert Garage, to Living Space Single Family Dwelling Location 89 Child Street Centerville Owner Mark & Marcia Huse Type of Construction -Frame Plot Lot Permit Granted January 1-1, 19 90, Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1l1/ l/ i . 8aPosEb ,4atRA iOAJ6 ' �U871.607_61STv s�T 6)J PLASTIC fall/L.b/06 AWPEV Ail 4'�i/P/y e(�• Sdeln•ta _ -_ 4 S41rt - '� M lJ`11� 'Yv E 2 )44IJ lAlsuc.47/sfe , p 11 aTlQt f�PtAl� t -h �irr�/Q�fLt1J4L�. C 'tG1/J a /kb 7-e) 4-`xts7/pj 7'e.s 6ix� 7a Sk 6US7441-4p :AETwCEA/ tsar@ tsr EL��rrerc.At ooTLeTs -7 �� /jvST/gLL[-�b �,�F'hC.�r� I�CcDr�Dl�v.�, 76 GJ��Iovr/ if��7" 70 8� �r7�uDc O o lt'lkl,e-d AA . '. µ t EX/STIUG COLA AA__7IESi�-C.EP;_ro1Jc,= i� SovT�l 9"1E��T/DAl 73goPp ' igpyr ��E I�AT70M 330 L " To yalG/ R6F- Uv A/�u)3 SIblA/6 7-a mi47c:,*1 exts17A;s. Te RE IFIA RS ARt4C, 2 x L fa rE-b AT 7-aw t XIsT/A!d CeR V C-R ar '.so u-f,4 s/aEcRs.P��,u� C$ 3ot/J)F4.P be 7' oxq GlosEr Ta e r co msrR dtreo A-T AExR w4Ll. of ?,*rg44v!-ARt4 �3 GOAL _�out'N 9tg- -A7TLo�sLa/6) �1 i LUJ BtDRM 3 K�rCHEH RtP .00 y ; GAFi►�Ga ,�,1 � � EU IN . � _ rk�R�►s� F 0 i • �SPNr<!kT `�hr(NG41i �ODF _ r r r r r----r• r t L. r eAVAR WwctE '316 e t ! r' a j j 7 .E . vt ds= �q C-611. -5 sr. CAPE COD INSOLATION ��IF]NR nQEQ OLAaa SPRAY fOAM 9YSVENUEG QAiiS .. . iNSuIATON CIILIN05 1"8010"0-36-6611 F own of Barnstable Regulatory Services ' Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed b completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the �ptcifications listed on the building permit application. All work has been inspected 1)y a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner` Pro ert k0dress Village Insulation Installed:_,Fiberglass Cellulo,c R-Value " Restricted Una ricted ' Ceilings Slopes ( ) ( ( ) ( ) ( } Floors Walls Sincerely He y E Cps , President Ca e Codn, Inc. - I oFtHe ram, Town of,Barnstable �y' o Regulatory Services Richard V. Scali,Director Regulatory Service BMWSI'ABLE, 9� 16 9. � Building Division ArFD'"°rA Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 ---Getober 16,2014 - -- - Nina Knights Richard P Sullivan 89 Childs Street Centerville, MA 02632 RE: Inquiry—Boat Storage ZONING: RD-1 Single-family LOCUS: R249-003 89 Childs St, Centerville, MA Dear Ms Knights & Mr. Sullivan, I am writing to you as a follow up to your recent inquiry concerning boat storage (owned by others) on your property. During our conversation I explained the zoning restrictions. I identified that your property is located in a residential zone that limits the use to a single family home. I made you aware that our local ordinance restricts commercial ventures to appropriately zoned locations as well During our discussion with both of you(over speaker phone),I repeatedly stressed that you would not be able to store boats in your yard for the convenience of others. While I clearly understand that you object or may otherwise disagree with the regulation, I am required to formally submit notice to you regarding this restriction. I am also required to advise you of any penalty that may be incurred as the result of non-compliance. If you are found.to be storing boats at your residential property,you will be subject to non-criminal citations of$100.00 per day per violation. Please know that I certainly do not anticipate a violation and I remain confident that you will, continue to respect the.ordinance. If you find that you require additional clarification, I am available directly at 508=862-4027. erely, r . r Robin C. Anderson' Zoning Enforcement Officer JAIllegal Apartments\89 childs st nina knights richard p sullican 10162014.doc Parcel Detail Page 1 of 3 r� ,71 G4 THE ,�D..�:�..,..�.- ."s-"-•-•-^ '�, .. I.x BARINSTMILE, �A�FD �Rq_�l .. � .i1%(//dle./� i�;,i'=. .' r 4 '. r.�,,,�s•a�v�% d s,. _ . . - Logged In As: a Pa rCe I Detail I I ` Wednesday,October 15 2014 Parcel Lookup - ----- - -- --- Parcellnfo ( : ._. .. Parcel ID 249-003 Developer I Lot F:&T. 8 Location f89 CHILDS STREET I Pri Frontage Sec Road Sec Frontage Village CENTERVILLE I Fire District C-O-MM Town sewer exists at this address sN�__o .._.� .�v.�_._�.�.I Road Index 10298 Interactive Map Owner Info Owner FNIGHTS, NINA&SULLIVAN, RICHARD P I Co-owner C/0 UNITED BANK Streetl 195 ELM STREET > I Street2 j mm - City IWEST SPRINGFIELD I State MA zip 101089-270 Country Land Info Acres 10.48 .� use ISingle Fam MDL-01 I zoning jRD-1_. <,.., Nghbd 6 Topography[Level I Road Waved Utilities 1Public Water,Gas,Septic I Location I Construction Info Building 1 of 1 Year 1965I Roof Gable/HipI . Ext Wood Shin le Built Struct Wall° g Living Roof AC Area 1440 Cover Asph/F GIs/Cmp Type one s g h 1A style Ranch I wall Drywall I Rooms 22 Bedrooms I i I" _ _ _ b Bath Model jResidenfiai I Floor..Carpet � I R corns I1 FUII Grade Average° I Heat Hot Water I .Total 4 Rooms�I Type Rooms Stories Story ) Fuel 1Heat Oil I Fund-1'"oured Conc. I ` ' ation Gross Area I i Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17889 10/15/2014 Parcel Detail Page 2 of 3 Issue Date Purpose Permit# Amount Insp Date Comments 1/28/2011 Insulation 201100319 $4,000 AIR SEAL,I NSULATE,WEATHERSTRIP 3/15/1991 1/1/1990 Addition B33449 $3,000 12:00:00 CE ALTER. AM Visit History Date Who Purpose 2/14/201212:00:00 AM Denise Radley Change of Address 2/16/2011 12:00:00 AM Robin Benjamin In Office Review 10/17/2008 12:00:00 AM Nancy Finch In Office Review, 10/26/2001 12:00:00 AM Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 4/25/2002 KNIGHTS, NINA&SULLIVAN, RICHARD P 15084/145 $100 2 12/23/1993 KNIGHTS, NINA 8967/232. $119,900 3 5/18/1978 HUSE, MARK J 2709/37 $0 Assessment History ; Save# Year Building Value XF Value . OB Value Land Value Total Parcel Value 1 2014 $102,000 $34,100 $2,300 $137,100 $275,500 2 2013 $102,000 $34,100 $2,400 $142,500 $281,00.0 3 2012 $102,000 $33,300 $1,800 $137,100 $274,200 4 2011 $127,700 $7,900 $500 $137,100 $273,200 5 2010 $127,600 $7,900 $500 $139,200 $275,200 6 2009 $124,800 $7,300 $300 $176,000 $308,400 7 2008 $145,400 $7,300 $100 $192,600 $345,400 9 2007 $144,700 $7,300 $100 F $192,600 $344,700 10 2006 $127,400 $7,300 $100 $201,800 $336,600 11 2005 $118,500 $7,200 $100 $180,100 $305,900 12 2004 $96,100 $7,200 $100 $180,100 $283,500 13 2003 $92,100 $7,200 $200 $66,800 $166,300 14 2002 $92,100 $7,200 $200 $66,800 $166,300 15 2001 $92,100 $7,200 $200 $66,800 $166,300 16 2000 $70,300 $6,800 $100 ; $37,000 $114,200 17 1999 $70,300 $6,800 $100 $37,000 $114,200 18 1998 $70,300 $6,800 $100 $37,000 $114,200 19 1997 $83,000 $0 $0 ,. $29,600 $112,600 20 1996 $83,000 $0 $0 $29,600 $112,600 21 1995 $83,000 $0 $0 $29,600 $112,600 22 1994 $69,400 $0 $0 $33,300 $102,700 23 1993 $69,400 $0 $0 a•' $33,300 $102,700 24 1992 $78,900 $0 $0 }. $37,000 $115,900 25 1991 $80,000 $0 $0 $66,500 $146,500 26 1990 $80,000 $0 $0 $66,500 $146,500 27 1989 $80,000 $0 $0 $66,500 $146,500 28 1988 $59,900 $0 $0 $34,600 $94,500 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17889 10/15/2014 Parcel Detail Page 3 of 3 29 1987 $59,900 $0 $0 $34,600 $94,500 30 1986 $59,900 $0 $0 $34,600 $94,500 Photos ---- - --- - — ---------- I . i e r a { http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=17889 10/15/2014 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel :Application # k,00 3 1" Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board If! Historic - OKH Preservation / Hyannis Project Street Address Village�1�� s t, ��Y A , Q'I 3 2 Owner Avr(�— SA Q A-t-� Address Telephone Sdr�-- 7:7 1 — S-S^ Permit Request ►41�,c /Wt Sir m 1bU-_S- rat r Syt.A &- 6 C `N wjW- on Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00 0 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 ❑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 w f Total Room Count (not including baths): existing new First Floor Room Counf 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) - N _ t: Name C �� Telephone Number 0�= 1 c� Address y S S License # t 00 q q7_ �4ypw rvt S 0"o Home Improvement Contractor# /S3 S`-7 Worker's Compensation # WCA 00S o S R 01 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO y�rrn oyYl. � a) n SIGNATURE DATE l U—� I ' 1 FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED L+ 7 }= MAP/PARCEL NO. J f ADDRESS VILLAGE OWNER DATE OF INSPECTION: C,FOUNDATION - FRAME INSULATION . 2" FIREPLACE I' ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL ,r _GAS: .�r; s ROUGH ;0— '_ FINAL i }FINALBUI_LDING 4 !Tu ., • DATE CLOSED OUT . ��� ASSOCIATION PLAN NO. 'i The Commonwealth of Massachusetts r= Department of Industrial AccideWs 1 _ Office of Investigations 600 Washington Street t F Boston, MA 02111 y Www.rnass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plunlbel•s Applicant Information Please Print Legibly Name (Business/Organization/Individual):_CA ,�iV ,Su (A f urm - Su c Address: ✓� City/State/Zip: a Phone #: S�B 7 7 I f Are you an employer?Check th• appropriate box: Type of project(required): I. I am a employer with ?Q 4, ❑ 1 am a general contractor and.1 6, E]New construction employees(full and/or part-time).* have hired the sub-contractors.. . 2.❑ I am a sole proprietor.or partner- Misted on the attached sheet. 7. ❑ Remodeltng ship and have no employees These sub-contractors have g, E] Demolition working for mein any capacity. employees and have workers' .9 Building addition [No workers' comp. insurance comp. insurance. required.] 5. F] We are a corporation and its 10.0 Electrical repairs or additions - 3.❑ I am a bomeowner,doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other(,�P�.� > > At t comp. insurance required.] 'Any applicant that checks box 41 must also fill outthe 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 namc'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. fain an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site inforinatioiL Insurance Company Name: '��� G�c el Policy# or Self-ins. Lic. #: ( )CA WrZ5790 Expiration Date: Job Site Address: City/State/Zip:CPrtr�es'vt��t� MKl • Attach a cop),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. Ldo hereby certify it e pa' and penalties of perjury that the information provided above is trice aand correct. Si nature: Date; Phone#: S 1S '' 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#: Kagers 6 Gray Irlr:• Palle; 002 C l i e ntt#: 4597 CCINSUL � 9 ti �CERTIFI ATE"OF LIABILITY, INSURANCE OATE(INIVIIUDIYYY'Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE IiOLDE12/1 NOjO 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 tha ition ieal.e Holder is an ADDITIONAL INSURED,the poliey(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to till'tellns dllCl COIIdItIO11S OP t'he pol'cy, certain policies may require an endorsement.A statement on this certificate does not canter rights to tile tiiiratt holder in lieu of such endorsernent(s). PRUUUCER Rogers&Gray Ins. -So. Dennis coNTACT yAlNe Margaret Young PHOtJE 434 Route 134 (A/c.No_,Exg 508-760-4602 E-MAIL '--—- - ac, U. Box 1001 _. ADDRESS: South Dennis, MA 02660-1601 —_....._._._....__.-_,.--- cusrolNL IIJ.I-URELI - INSURER(S)AFFORDING COVERAGE NAIC is Cape Cod Insulation Inc wsURERA PearleSS Insurance - — 455 Yarmouth Road wsulieR a Ohio Casualty Insurance Con �n'1 - P< y Ely�lnnis, MA 02601 wsuRERc:Atlantic Charter Insurance �--- • INSURER 0, COII1n)6rCe Insurance Company 34754 ISURER E COVERAGES NSUR�R F: -- CERTIFICATE NUMBER: D CEft I Ir i 'LHAT 1 HE_I OLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE REVISION NUMBER:I' POLICY PERIOD IP1UIr A1I[) NCII i l l H�;'I ANDINP ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WLIICH 1'FIIS CER I JHCAI E MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, GX1':LUtiIC)NS AND CONDITION`";OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED Bl'PAID CLAIMS, Tk f'rPE OF INSURANCE NSR nvn POLICY NUIVIHER OLICY IS POLICY EXP A GENERAL LIA81Lr1'Y MIN/00JYYYY IV1MlDO/YYYY LIMITS CBP8263063 410112010 0410112011 EACH OCCURRENCE 000000 X 'i'tdMt hi iiU.IILNL:HAL.LIAkSIL.rI`r DANIAGk TO R-NT u/vrls NvrLmI occLlR PRrwl rs Eunr ann: $100,000 - - _—._--------- MED EXP(Any one Uortnn) T5,000 PERSONAL&ADV INJ(JRY $1,000,QQO— ..-.-.. _.._.._. I GENERAL ACCRCGATE $2 000,000�— llIV �i(Ii;l 117i 1 P t I(vll I Ht I'I-II.�:,I 1 K I I rc1 - PRODUCTS COMP/OPAC;G s2,000,000 r' L.CIC — D AUMNIUHILE LIASILITY - 10MMBGKVMK 0410112010 04101/2011 COMBwtiUSINGLELIkIl1 nA;-r,+UIV (Ea aruaanl) �1,000000 An i!VVI'VI'n F1UIr,l:i BODILY INJURY(1''tlr pr:rSUn) $ i I lui v I)AkjI t1 UODILY INJURY War amilanl) $ X I iinllU r((I l r l`i PROPCRTY DAMAGE X (Per a(clnam) $ NUNavaNILl,;ulUS B U r1URLLLA LIAL1 - $ , X UccuR MEYAPP397725 06117/2010 W0112011 EACH OCCURRENCE $1 000,000 LXCESS LIAtl CLAIMS-NWIJI: ULUTA..I ILil I- - AUGREc;AIr r1 000000 X KrlrrJluvv 10000 -----------__.._ -_._..__..._.._.-- L WORhL•RS COMPENSATION $ AND ENIPLOYERS LJAall-AY WCA00525901 -- 6/30/2010 06/30/2011 X WCSTAru- C11-I-I (fr I Ki)I'n L.I(�h I AR I IVI Wr XECaII IVE YIN 1DI3y I IMI ()it u I:K�D:II P Il.ii h I:;{CI 111JL'U7 N NIA E.L.EACH ACCIULN' $50Q,U00 (Mtrnijla 7 ul Ni ILo ausenbu cedar RA bc;luw I,L DISEASE-FA LMPI mo: $50�,000 II.KIPII(IIV UI-(11'F - -- -..----.---...-- .. ........... F L DI Sin.ASF_Poi-ICY uMrr $500.000 OESCRIP'rIUN Ui OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addilional Romurks Sgnedulu,if morn space is roquuou)Workers Cotnp Intormation Included Officers Or Propriators (See Attached Descriptions) "ERTIFICATE HOLDER CANCELLATION '10 Days for Non-Pa ment .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE r THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CORD 25(2009/09) 1 of 2 Tire ACORD name and logo are registered marks ofACORDB 2009 ACORD CORPORATION,All rights reserved. 4S548141M53353 MEY aa 1C � TOPark Plaza - Surte 5170 ' Boston, Massachusetts 0211.6 Home Improvement CQatractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. -- -- -------- - ._..__.._---_-__-- HYANNIS, MA 02601 - - - .;Update Address and return card.Mark reason for change. D Address ❑ Renewal Employment L Lost Card CA1 0 50M-04/04-G101216 0 I'll ce o`�'mer Affairs us ne, Regui tion License or registration valid for irdividul use en!y HOM�I7� Gf�"' � � before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation =- _ = Expiration; 1,2/15l2012 Private Corporation 10 Park Plaza-Suite 5170 _ Boston,MA 02116 OD INSULATI-ON;:[NC..,.... 1ENRY CASSIDY: _, 155 YARMOUTH RD;,,: ± iYANNIS, MA 02601• 1, Undersecretary t(slid ithtore `ia-ssachusett. - Department 1)1,Public Jafch Board orBuildin� Re„„ulutinnx ,rrltl titan(l:u•d'r Constrttction Supervisor License License:'-CS 100988 L Restricted to: 00 �� HENRY CASSIDY 8-SFiED ROW WEST YARMOUTH, MA 02673 Expiration: Ii/11/2011 (umiui.�i„ner Tr#: 100988 - _, _ 460 t--st Ma' Street -- �, d- E TE ti �'Y ? I O E I P _R ��..f MTV `�� y T (508) 7�7r.-5400 E (508)790-2425 P �_ 1 ��T:._.� ~'�_i' on all. 1.1ricsEMS UJ:��dJ.l��G7,•(C3??t so�7 e fi�.U1`�,f HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I 1:qh hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency") on the property located at: wn4 The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping& caulking of windows and doors,insulation of attics, sidewalls &basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows.In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of thiss agreement as listed and freely give my consent. Home Owner: (Signature) Date: Agent: (signature) It Date: HAC approved Weatherization Company : C A9Z c� Caliber Building&Remodeling Cape Cod Insulation Cape Save Creswell Construction Frontier Energy Solutions Lohr& Sons Peter Smith Resolution Energy Rock Solid Construction All Cape Insulation J m C p E Co o 10V11 1-1111UNIST BLE INSULATION f _ Pill 1 : 38 ' cu., KO KEI FIBER GLASS SEAMLESS SPRATiOAM SUSPENDED - BATi5 GURERS INSULATION CEILINGS - 1-800-696-6611 f UIMSM6 c • . Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601. f Date: Dear Building Inspector E 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 1 application. All work has been inspected by a certified Building Performance Institute I (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner ProDertv Address Village I Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( } ) ( ) ( ) ( ) o Floors Walls Sincerely He C si Jr, Pr ident z l Ca e Cod ns ation, Inc. . . C F ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Parcel l� A lication`40) :t D� aJ 0V Mappp q, Health Division Date Issued I ly Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board = Historic - OKH _ Preservation / Hyannis Project Street Address F"'p Village , Owner 4401_Llje� Address ,Telephoned tPermit Request 2 ZZ -z z6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation *4J�,Po, d �2 Construction Type ,is�Tv��3'�o,�D 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 .81�No On Old King's Highway: ❑Yes Flo Basement Type: `,❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (s t) Number of Baths: Full: existing new Half: existing Z_) neW C Number of Bedrooms: existing _new '' Total Room Count (not including baths): existing new First Floor Ro@m 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 U.Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C/.gA. 9 �� ?� / . .� Telephone Number cy0,�_ Address Ze rVa/� �� License# �/ 1Wl��fJ/ j Home Improvement Contractor# 5��✓ � Worker's Compensation #/,dG1�4D�Z L 5 �l�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATES/I �' FOR OFFICIAL USE ONLY rf APPLICATION# e DATE ISSUED MAP/PARCEL NO. f`r ADDRESS VILLAGE OWNER DATE OF INSPECTION: I . YFOUNDA`TIO.NaLjt ��ll �; �xAu, t FRAME j, a),INSULATION.,'i y �? FIREPLACE 'r ELECTRICAL: ROUGH FINAL it PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING" , is DATE CLOSED OUT ASSOCIATION PLAN NO. 411 1 he Commonwealth of Massach usetts • Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers An.� PUeant Information Please Print Legibly Name (Business/Organizadon/Individual): �• �0� CGS /G,' �� l ,� Address; ; .. city/state/zip: /. o ,Rhone•#: Are you an employer? Check the appropriate box: 1. I am a employer with j, 4. ❑ I am a general contractor and I Type of project(required): employees (full and/or part-time),* have hired the sub-contractors'. 6• ❑New construction 2.❑ I am a sole prbprietor 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' [No workers' comp, insurance comp, insu.rance•t 9, ❑ Building addition 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 . 11.17Plumbing repairs or additions myself. [No.workers' comp. � right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.❑ Roof repairs 3a.❑ I am a homeowner acting as a employees. [No workers' 13.E� Other/,�/'1,,/ �/- general contractor(refer to#4) comp,insurance required•]• "Any applicant that checks box#1 must also fill out the section below showing their workers'compensatiot#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-contrsntors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide then workers'comp."policy number. y i dam an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information i Insurance Company Name: Policy#or Self-ins. Lic.#: /�C,9oi>y, �1��/ J Expiration Dater Job Site Address: Rf /7lJ4 _�,r City/State/Zip:2 , G?G Z Attach a copy of the workers' compensatioa policy declaration page (showing the policy number and expiration I 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. d do hereby certify u ,nqW the pains and penalties of perjury that the information provided above is true and correct Si a Date: Phone Qfflcial use only. Do not write in this area, to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: I Y �y CAPECOO.27 KLIGETT CERTIFICATE'E' Of LIABILIT I -INSURAN6E .. DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON 1312014 LY AND CONFERS Np RIGHTS UPON THE CERTIFICATE HOLDER, I 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(les)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 Iieu of such endorsement s PRODUCER �0gers&Gray Insurance Agency, Inc, rcI°arneAOT Barbara D@Lawrence 134 Rte 134 PHONE fi __��•__ _ iouth Dennis, MA 02660 iAlc.No eXl -- Ic No; 877 816.2166 E-MAIL •bdelawrence re ers ra .comb --� — INSURER 3 AFFORDING COVERAGE -"' INSURER Insurance COmpany NAICN LERAGES — INSURER e:COMMERCE INSURANCAOMPANY Cod Insulation Inc INSURERC;Evanston Insurance Company ardon Circle INSURERo;ATLANTIC AHC RTER INSURANCE GROUP �^ Yarmouth, MA 02664 __—"'-'�-- INSURER E; - INSURERF; _ CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED aELQW HAVE BEEN ISSUED TO THE POLICY PERIOD INSUR D NA REVISION D ABOVE FOR THE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON C R;TIFICATE MAY BE ISSUED OR MAY PERTAIN R OTHER DOCUMENT WITH RESPECT TO WHICH THIS , THE INSURANCE A TRACT OFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,, E C USIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLIO F POLI E P X COMMERCIAL GENERAL LIABILITY POLICY NUMBER MIDDIY M I Y _ LIMITS ;• _. 1 CLAIMS-MADE l X] OCCUR CBP0263063 �, y EACH OCCURRENCE $ 1,000,000 04/01/2014 04101/2015 E"p117� -- - __. PREMISEs(Ea occurrence) - MED EXP(Any onejerson $�^ 6,000 L- O GREGATE LIMITAPPLIES PER: PER90NAL 8 AOV INJURY $ 1,000OOp LICY J 0 LOC GENERAL AGGREGATE $ 2,00.0,000 lIER PRODUCTS.COMPIOP A .$ 2,000,000 AUTOMOBILC LIABILITY r co aeoi�E len S NG E LIMIT $ 11000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2016 BODILY INJURY(Par person) $ � ALL OWNED ..X SCHEDULED -- AUTOS AUTOS HIRED AUTOS X NON-OWNED. 6001LY INJURY AUTOS (Per accident) $ - PROPERTY DAMAGE Per accicl nl $ X UMBRELLA LIAR X OCCUR $ EXCESS LIAR CLAIMS-MADE XONJ463514 EACH OCCURRENCE $ 11000,000 DEO X RETENTION 10,000 04/01/2014 04/n112016 AGGREGATE $ _ _ WORI(ERSCOMPENSATION A cUregate $ �00 AND EMPLOYERS'LIABILITY ORH ANY PROPRIETORIPARTNERIEXECVTIVE YIN WCA00625904 - sTA TE _ OFFICER/MENIBER EXCLUDED? N/A 06/30/2014 06/30/2016 E.L.EACH ACCIDENT (Mondalory In NH) $ __ 1,000,000 ll yos,d°Scribe under ' OkSCRIPTION OF OPERATIONS below E.L.DISEASE•EA EMPLOYEE_$ 1,000,00 OISEASE•POLICY LIMIT $ 1,000,000 Ll �RIP7ION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is requirod) tloqal I suped sttatus Includes rovldedlcere or underths Proprietors, Liability and Auto Liability when required• Y by written contract or agreement with the Certificate Holder, i • ITIFICATE HOLDER -" CANCFI I ATinN r eMassachusetts -Depat`tnitmt of Pp is Safety lipA�rcl of Building Regula;funs p•nd Standards Cunstmction Supervisor License; CS-100988 ., 1-.1]3.NRY.R CASS11)'! 8 SILED.ROW - WEST YAR1Y1OLM-I 9�11 i itl 1 % ,I 1,,"• ' Expiration Commissioner 11/11/2015 H. ^!�, Office of C..onsum' er Affairs and Buslness F�egulatioii. . 10 Park Plaza - Suite 5170 Boston, Massachl:lsetts 02116 p�J Home Improvement Cq.!ra- tor Registration Registration; 153507 Type, PrivEit'e Corporation • tf : :. i:.:'..... , Expiration; I2/15/2014 Ti'(t 233831 1 CAPE COD INSULATION, INC :•- HENRY CASSIDY 18 REARDON CIRCLE _._..._._....._........................... 80. YARMOUTH, MA 02664 ...--. . ,':.i,; ;? . •� Update Addross and returncnrd,.Mrrrlc mason I'm,ch,wgo, Renewal Address Re Employment 1.ustDrd ' L7 [::.1 `60-1/1arwo?'(0:(rAM e��C %'lreddeac�ea�a!!� - Office ul'Consumer Affairs& Business ltebulatiun License or registration valid for individul use Only F�1OME IMPROVEMENT CONTRACTOR before the expiration date. If found return tu; 1Ropistration: 153�67 Type; office of Consumer Arfairs and Business Ttobulatimi �. EEExpiration: 1MM014 Private Corporation 10 Park Plaza-Suite S170 -` ,. ,...:.. : Boston,NIA 02116 y (OD INSULA'I•I.QN,i,iIMq. .... ., Y CASSIDY 4 'DON CIRCLE ^� \ MOUI'I I, MA 02664 llndersecrclarfy^ ^�of vat' Fvithu t not 10� - Housing Assistance Corporation Cape Cad e HOME ®MINER WEATHERIZATI®N WORK PERMIT& FUEL RELEASE: PLE SE FILL OUT AND SIGN THIS FORM IF YOU ARE' THE APPLICANT HOME OWNER. , I l � J hereby consent to and agree that weatherization wor may be done by the Weatherization Program of Housing Assistance Corporation ( herein t r referred as 'Agency" ) on the property located at': . Cj ,� The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures, 'and ' possibly replacement of badly deteriorated windows. In consideration of. the weatherization work to be done at' my home I agree to the following: ' 1. .I give permission to the "Agency"- its agents and employees to travel onto or across said property with such-equipment and , materials as may be necessary to perform weatherization work ,on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions ofjjthis ag eement s listed and, freely give my consent. # ) r r , —� A l' Home Owner: (Signature) Date: F s Agent: (signature) Date: A � t TOWN OF BARNSTABL.E BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB:.LOCATION Ind S 5 � um er treet a ress ection o town "HOMEOWNER" 70 T 7 7 ame n ome Phone Wor pone . PRESENT MAILING ADDRESS C ity town .y- .. a Le o e The, current exemption, for ."homeowners" was extended to i dwellings. Of six:.uni-ts..or ess an o allow such homeowners,uto enner-occupied; ivi ua for hire. who. does not possess a license, provided that the9owner.. acts as supervisor. (State Building Code Section ?D.EFIN,ITION OF HOMEOWNER: (Per.Son(s-) who owns a parcel of land on which he/she resides or intends re- :side, on which there is, or is intended to be, a one .to six family dwellin , (attached on-detached structures accessory to such use and g' A person who constructs more than one home' in a two-year period rshall uhotrbe ;considered a homeowner. Such "homeowner" shall submit to the Buildin ,Offic' `on a. form- acceptable to the Building Official, that he/she shall be responsible ,for all such work performed under the bui'iding permi e ec ion . The undersigned "homeowner" assumes responsibility ..Building Code and other applicable codes, by-laws, rules, andiregulations. ance with the State :The undersigned "homeowner" certifies that he/she understands the Barnstable Building Department. fiinimum inspection procedures and requirementsnof !and ,that he/she will comply with said procedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet,'`or larger, will be required .to .comply with State Building Code Section 127.0, Construction Control. . 1 g 5 1 HOME OWNER'S .EXEMPTION The Code state that Permit is re tired "Any Home Owner performing work for which a building 4 shall be exempt from the (Section 109.1 ,1 — Licensing of Construction Supervisorrs)slons of this section 'Home Owner engages a porson(s) for hire to do such work, that-prosuchdHometOwf a shall act as supervisor. -, ' . - Many Home Owners who use this exempt,lon are unaware he responslbilities of a supervisor that they are assuming. for. Llcepsln (see Appendix Q, Rules and Regulations g Construction Supervisors, Section 2.15) . This lack of awareness soften results in serious problems, Particularly when the Home Owner hires Unlicensed persons. Unlicensed In this case our Board cannot Person as it would with licensed Supervisor.. TherHomedOwnnernacting ervlsor Is ultimately responsible. To ensure that the Home Owner Is fully aware of his communities require /her .responsl,bllities, many certify that he/she understands t application, last that theies .'Home Owner page of this Issue Is a form curr a supervisor . On th care to amend and adopt such a form/ceetlficationbforeuseal towns, e You may n your community. ,