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HomeMy WebLinkAbout0088 ELIJAH CHILDS LANE � . � - � . .. o0 � � � � � P o �. -y ;. A . � o e - u ., u ' � R-- -' L - � c .. ❑. .. � p � .. r. � � _ .. p �. E ,. .. o - - i - .- - � o � _ ,. o _ �: � � e �. � .. � ,. � ,. .. A � _ �. � _ � r .. o p A LT'E.R N AT I V E Nor* WEATHERIZAT:I O N6-4 M Date: aa: Town of Barnstable 200 Main St a,; Hyannis,MA 02601u. i Re-Permit# x:.':i Yii''s'arl'"'' .�,,,a',:�'<li;:�:; ,.;�;., - ,rah•. Ir ..'1a-•`,�•�j'i•`,''r. � cf}`�'1F° ;;r .��'! •,•a. ,ri�_ ;yry . in ula / {Er',; :;� ,... w� let ce tl ' . com .. - en (, rS'Y -ri`.�:%}'.;A +�.f;y.!i:. ','i+C 1I;r. �; �' ��y:µi• :y'�!'•ti•! '�;j�:•.^.-•• 1'• - „�• ":��r�fr:="i��.:.�.��<4.-. •:;-/'/Y i „V�+ ., r.[)%::,N.'a5, •'C.'`...: ".!:�. Y C,F. j,�:.�i;.';.1;;? :.i�':3;��?.. ,Yi.:h�� r.:i�r;;y.•.;4r ti��,'��'u°,,' ,.:,.y";..=¢:.'�:..;,�V:�c.:;'>� ,lai:(i ;'•✓;f+t: �'v%-:?.C...,`.fit. � :1:�;..".��•�"A::• - ;•1:".rri ,.•>ny,...!�.fr:"ye-"-':,.=: . l� �D t3�.�r.`,;7;�i. .:•T,:N ::1 7 ;yF' �.:+:_•J., _ ,�'C'•,. :.My.:i��.. egar��; . ^•}!r,:' `��,;:;3': .>t:.;r:','r ��'� .)FEE.:'•h"'+~ :,,'j,\%y^,io •+u'•: w.£!'yr��/.�� ?��x.t,�jt"%"'ti' t..1':3'r';1:�; .:,.�.��:• ij�'"��y'9-_;�:,,;�:.,;"�. Timothy Cabral, President CSL-105454 58 DICKINSON STREET I FALL RIYER,:MA,02721 ' ,� (508).567.42�40 ,� AL RNATIVEWEi�HERIZ,a11ON@GMAIL:COM.. . ppii anon numb Date Issued,. .�. ... ` .... Building inspectors initials ..C ,-. ......... lwt� �;�.� v t, sap�Parcel ..... � . TOWN OF BA�RN TABLEr rY , EXPEDITED PERII�IIT APP ,ICATION. ROOF/SIDING/WINDO-WS/DOORS/TENTSdSTOVES/WEATHERIZATION PROPERTY I'NFORMATON ' , t k y .- .. • . t i 4. 'v..s. 4 • .t f Address"of Project. NUMBER e` . ',` a.k ST1tEET A GE " Owner's Name: n,_ �' Phone Numbe� /� 4�3J rVk Email Address: Cell Phone Number :w Projject cost$ a7 fV'-7 Check one:. Residential 4- Commercial Y: S AUTHORIZATION ` iyg, As owner of the,above property I hereby.authorize Q'•L; p7v to make apphcatton for a buildtng permit in accordance with 78 MR Owner Si gnature: Date. / ._. TYPE OF WORK pk Siding waowsT(no header change)#sx R Insulatton/Weathenzahon _t 0 Doors(no header change)# Commercial Doors require ari inspector's Tevaew Roof.(not applying more than l layer of shingles) Construction Debris will be going to - CONTRACTOR'S INFORMATION Contractor's name µ _IIL- .Home Improvement Contractors Registration(if applicable) attach# l,J�La.�� ( .,co PY) Construction Supervisor's License# (attaeh copy)' r , Email of Contractor eryl�fil GU); : Zl J71`rl,:.>Phone number. ALL PROPERTIES'THAT HAVE STRULTURES,OVER 75 YEARS OLD OR.IF THE SUBJECT PROPERTY/S 1N: A HISTORIC:DISTR/CT, YOU MUST OBTAIN HISTORIC APPROVAL BEFOREA.PERMIT CAM BE ISSUED. APPLICATION NUMBER............................................................. *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacture r# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APP ICOT9S SIGNATURE Signature Date / .3 All permit applications are subject to a building official's approval prior to issuance. DocuSign Envelope ID 85306234-AC4C-46A3-87AB-71 D49F44192D u} *on tMISS save Farm. 15 Site (Q .3572493 Customer;;Lynne Ingraham Lynne Ingraham tiwner-f the sraperty located at; _ (ear's��rrie.;pftrrtedl'; 88 Elijah Childs Lane Centerville, MA 02632 (Prbp�riy Stre�t;Addressj (�`�tyrj hereby-authori- theMasSSave"l omeEnergy$E!rbiCE'SPfograrn""-SlgtteE ParttcipatinR�Con#ractdr-listed belrs to act"on h*'beh"alf and i l3tain a buiidin—"perm t to"perfarm insulatidn'and/or weatheriiiatiibh work�n"my;property,, • . DocuSigned by: Uwnioesvgnaure:, l�jlnl�t, Iw�val a� 12/17/2018 1 9:04 PM EST `4 f,0 9 0 D/r,o,0 //// p 0 a r 0 0,0,0/%y pw qw,to,0 Ow 40 a 1,0/0 0 v w'iirr, FOKOFFICE USE ONLY` We"stave assigned the following /lass Save 1=1r me,"Energy Si rvices ,ar.titipaUng.Contractor to the aboue,referenced prpject: l Lcd cufryt Tn c_ . ,z .zd partiepattng.Contractor Date Name: RISE Engineering Phone: 401-784-3700 Email: I Page 1 of 1 For WKL�- se-1on,Y RevAbkis k The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 16 employees(full and/or 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 3. _�I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 4.❑I 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 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ]3.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 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. 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: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#: XWO(19)58867158 Expiration Date:6/8/19 Job Site Address: City/State/Zip: Attach a copy of the workers' c pensation policy declaration page(showing the policy number and expiration-dale). 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: I do hereby certify u d ain a p lti s f perjury that the information provided above is true and correct Signature: Date: l Phone#:508-567-4240 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 r Contact Person: Phone#: f o ' ® DATE(MM/DDIYYYY) ACC)Ro CERTIFICATE OF LIABILITY INSURANCE 06/11/18 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 have ADDITIONAL INSURED provisions or 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). GONIAGI PRODUCER NAME: Anthony F.Cordeiro Insurance Agency aCPHONN Ell: 508-677-0407 FAX No): 508-677-0409 171 Pleasant Street aoDREsS: HSouza@Cordeirolnsurance.com Fall River,MA 02721 INSURERS)AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual INSURED -INSURER B: Ohio Security Alternative Weatherization INSURER C: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MM 0rYYYEXP LIMITS X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE9___ CLAIMS-MADE FRI OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JECT PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) S B OWNED X SCHEDULED Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY X AUTOS ONLY Per accident S X UMBRELLA LIAB IOCCUR EACH OCCURRENCE S 1,000,000 X A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE S 1,000,000 DED RETENTION$ S WORKERS COMPENSATION PER Oi YIN AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? n N/A XWO58867158 06/08/18 06/08/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liabilitv is a following form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT ©19q-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD zr y : r a Pst C?///e, (657omwwInwe�4 s k � , Office of Consumer Affairs and Business Regulation " W 10 park Plaza- Suite 5170 Boston, Ma$6khusetts 02116 Horne lmproveme.WCtractor Registration x Type: Corporation a Registration: 175683 ALTERNATIVE 1NEATHERIZATION,INC Expiration: 0512812019 2 LARK ST FALL RIVER,MA 02721 ° '` Update Address and retain card. Mark reason for change, ____„._...ff:w...,,....,._..._._._.,...,_...... .JJ..... .......................w..._.__._.._...._.........,....._.............0-ji t a—n j3+"i3�,'n Fl"niny3f3�!]3 ,.:,. '�/�, �'{ 'irrYtr;.)f+lf*,flf��f.�C� ;r��,L✓.SlXf�tlL:f'�� Office of Consumer stairs&Susiness Rogulation y> HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Corporation before the expiration date. If found return to: Office of Consurner Affairs and 8asirtess Regulation 05/2812019 10 Park Plaza-Suite 5170 ALTERNATIVE 1N)Eft' iEi iiA ION' ,INC. n,MA f?2118 7 TIMOTHY CA$RAL 2 LARK ST U ~ FALL RIVER,MA 0272t UtitISrSBGretary ti V fl'.. 3 8tililZ I 2'}7iJiJ TOWN OF BARNSTABLE, permit Building Inspector Cash ------------------ _ .-X --- ,, '•'"'� OCCUPANCY PERMIT Bond __---- __- _-- Ala ..��_ . n S Address Issued to � f lot #59 88 Elijah Childs Road,, Centerville f. Wiring Inspector � v� Inspection date Plumbing inspec �/'r Inspection date tor 1 A _ I Gas Inspector Inspection date ` Engineering Departments f :✓ !�f Inspection date , . v Board of Health i�Gd�� ,� __ t Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ` (1''. Y. Building".Inspector Assessor's map and lot'-number �fTHEr�� Sewage -Permit number' .................. f :... �.... . %� ,a_ d�'� °,► F ouse number ... ! ... ',,.���9S'�;��.LED�IN, C��, "�,� �'� 'Ba8a9TODL t �.�. rasa 1639 WITH TIT' � � CYPYa' h TORN OF ­.B �A k , AfRN "'T�ABLEQ �� � 411 UIL01 Un INSPECT0R APPLICATION- FOR: PERMIT TO .. ........................... . ... .... .!•..:. ✓. �.. ........................................... TYPE OF CONSTRUCTION .... ..... ......... .. ........ ...... ........... ......... ......:..... ......... .19 TO THE INSPECTOR OF BUILDINGS: '* _- The undersigned he eby applies for :a pe"rmit-according to the followin information: z&,5,, s'Z�Location ..... `�// ---- ......... l 4:.................. ... ...,. ...:..... CProposed Use ....... ....... ... ... .......... ..............k.................. ........................ ,. :..:..... ......... ...... Zoning District ............. ...(2.e....... ......... ......:..Fire District ... ` Nameof Owner .. . . , ..... ........................................Address .... .... ........ ......... ......... ......... ... ................ Nameof Builder. .............................................. ...................Address ................. ................................................................. Name of Architect ......... ................................ ,.Address ...........:........ ::..:... Number of Rooms ......................................................................Foundation J .... ......... ..... .... Exterior .. .... ....................... Roofing ........ Floors .........0 �'�`� Interior ... .. j " ............. ..a 7 l .�-, Heating ............... �.. .........................G ..................Plumbing ........................................... ................. ... Fireplace .......... ............ Approximate Cast ?.v�(. . Definitive.Plan Approved.by-Planning Board _____________—______._____,_19 _______. Area �... ..11:.�..: -Diagram.,of Lot and Building with Dimensions g Fee .! SUBJECT TO APPROVAL OF BOARD OF HEALTH ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS • I hereby agree to conform to all the Rules and Regulations,of the Town of Barnstable,r ording the above construction. Nam ... .. .......... .............................................. �S S'�'7 SMALL, ALAN 2 4 9 010. One Story 'No 4 , Permit for .................................... ;Single Family Dwelling .................................................................. Location Lot 59, 88 Elijah Childs Road ......;......................................................... Centerville ........................................................................... Owner Alan Small .................. ................................................ . Type of Construction ....................Frame...................... ................................................................................ Plot ...................... Lot ........ .... ..................... ' e A March , 31, 83 Permit Granted ...............i................19 Date of Inspection ......................................19 Date ;Completed ........19 ,7 4 V 4p%, Assessor's map and lot number ........ ... ./,! r •• .. fit.. u .� r ....... Py�S THE rO� I 1 Sewage Permit number ...................................`:...1��...:...... 7 �y�� BASd9TAX i Housenumber ...........X,....?�•..�..�...................::.......................... � MAO 039. Aj�.O YAY a, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....:..:�......`�'... ...........:.::.:�............. .. ............................................. TYPEOF CONSTRUCTION ........ .....................�. ................................................................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following, information: Location ................................................-.:f. i .f: ......:. ....: fCE:, ....:....: :........................................................................... Proposed Use ......!......:.{:`..!"$: .......................................... ............................................................................................. . ` .............Fire District .........�:: ...... .... . Zoning District .............../..:�.....:....`. ,. ........................ Name of_Owner ........r ::....... . :...........................Address ......... .� .....x .. c r........ ..................................... Nameof Builder. ................r...................................................Address .................................................:.................................. Nameof Architect ..................................................................Address ............:....................................................................... F l Number of Rooms ....... .....................................................Foundation ......ram.......`::`: .' ............................................... Exierior ......... :: �. :... ..............................................Roofing .. ;yg {� f .. ................................................ C- Floors ................:..:......`............................................................Interior ..... :..::J..................................... r • ? `` Heating f:.............................. .... .................Plumbing ........�:..... . ..`.......... .............................................. Fireplace .....::: c z. �z✓ ............I.........................Approximate Cost ........... . Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .......�.. ............................ Diagram of Lot and Building with Dimensions Fee 5" 00 ....!...........?. ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH �� 1 t t 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS _ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f Name ...f ....... :: ,C:................................ A=171-251 + SMALL, ALAN o� No 4 9 ....`Permit for ,,, One Story �w Single Family Dwelling Location „Lot 59, 88 Elijah Childs Rd. ........................................... Centerville ............................................................................... .....Owner Alan. . . .............Small... .. . .. .. ..................................... Type of Construction ..,,Frame ........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .........March 31, 19 83 Date of Inspection ....................................19 Date Completed ..................... n -7-)v vy`7 IV 1 y J-r4`d>1-1ddb i" Q`►ncrty S►13s;ldv �1'11-'� J�7n?,n5, L.t`9Swn?�J-5�n) •Ss�yY • 3"1'11A•zs�.�:so NV pto a-35v1B ION -,;I NVId 5;Iti.L I'j i �o�►�l��!�s a h�a9��33.t 193'ZS '7INI x.3XN a-A%3.L%vg za-zl•11 N I'V d a oo�� �.N I�11N:1.I M• a 31d�o-1 �rin�c 15 aHi Ns.1M S�•�awo7 Ncav�H _ NJ++l0t1s �'Io1lvGrn4� �ML .L.'dHl ��Ihi37 � �7tv3Zf9d9?� rdnd - TlAll� �1`dQ '►� �-1d7s zalv7S ON � �'lIdQ21d •GpaS rr d�d w•1 d C�71 I.LZ! 7 aaYy • 9N�u.9 cslisWA 'Ism U42 'r?fa LOIS 111 i M ^Mt nNt J.Id I,Gws 117v3.1 715 ••+v9 rrv�. 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