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Home My WebLink About0008 FERNBROOK LANE , r-r �Ir�b Jc h..a.n e �` F - ._ , �. , .., e .n, - ,. .. ' - � i .. ., -. � -� ... .. �� .. _ .. �d. Cam• �•� Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 8/23/16 Thomas Perry CBO AUG 2 Town of Barnstable C-tj Building Division TOVVN OF B 200 Main St. Ah•.., Hyannis,MA 02601 RE: Insulation Permit 16-1969 Dear Mr. Perry This affidavit is to certify that all work completed for 8 Fernbrook Lane, Centerville 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 a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map n.,yo Parcel Application # Health Division Date Issued- 7 G Conservation Division Application Fee Planning Dept.t. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis �r+ry Pry S �.✓ Project Street Address F�c G�ro o�L Lq,n Village C Owner �ol„r^� p Lrl J0 r Address S G m ei Telephone Permit Request S Ce 1IJ1k c� �"�9 G A , r 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3&0 o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su�porting Mcurn-�entation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway'. ❑l ❑ No r- 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 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 KN 0 If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 C. Telephone Number 568 3 9 3 03 D Address 4604 '�44 e/ License # - -G l 0 a�� • �a«f�dTc h _ a 6 b Home Improvement Contractor# ` 3 Email Worker's Compensation # ��, U FI� !0�00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE U l y FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE ti OWNER DATE OF INSPECTION: r = FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 'Regu latory.Services xwrtN Richard V.Scaly,Director maAssSS �Fo � l30 Iellog�aVasxisiu TOM Perrj,Buildin&;C:nqurnSSJQuer 206 Ma a treet, 02601 iv wAowa.barnstab1e.ma.us 4ffiea: 508-962A038 Pax. 509 '+90.-623(} Property m1 .wt C;oxn plete,a'n 1. Sign '_Ilis Section I as C? �r�er�f Elie s er hor h� aucbcime. . _ tip rct.ou n1 j behalf, in all mattob- rrbidv,t tc 7o�kauthoi ze8 by-`ibis b."t�any p ruut"a; Fhc cn for.: (Addi ss o[f ob) Pool fences and.alarms are the respomIlhty of the applicant. Pools are not to:be filled tar°sit ed lie c re fenc:c is mta&d. and 4 fii l iospecuons are performed and accepted. S gnamre o. C? ner S. -z� titre of,:AFpl , O/J U�0 Z'z nt Mame Priat Narz e 6 Z6 f Q:FORA4S;��ta�..�pr;�traysiCr�Pc�c�.5 The Commonwealth of Mdssachusetts' Department of Industrial Accidents 1 Congress Street,:Suite:100 k ', Boston,MA 02114-2017- `' + www massgov/dia NN'orkers'Compensation Insurance Affidavit:Builders/Contractors/Eleetricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. r Applicant Information Please Print Legibly Name(Business/Organization/Individual):Cape Save Ind Address:7-D Huntington Avenue - City/State/Zip:South Yarmouth, MA 02664 phone:.#:.508-398-0398 Are you an employer?Check the appropriate bog%, Type of project(req >, r uired s L[D I am a employer with 15 employees(full.andlor.part-time).* , . . • 7. Q New.construction 2. I am a sole proprietor or partnership and have no employees working forme in ' T ❑ y g r ,, ...8. Q Rembdel'ing: any capacity.[No workers'comp.insurance required] '. IM l am a homeowner doingall work myself 9• Demolition y [No workers comp:.msurancerequired.]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to.conduct all work on my property. I will ensure that all contractors either have workers'compensation.insurance,or are sole 11.❑Electrical-repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I.have hired the sub-contractors listed on the attached sheet. Thesesub contractors have employees and have workers'comp.insum ce.1 13: Roof repairs 6.❑We are a corporation and:its officers have exercised.theirri t of exemption 14.�✓ Other Insulation IP right p• perMGL.c, 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:submita new affidavit indicating such. +Contractors that check this box ntast attached an additional sheet showing the name of the sub-contractors and state whether or notthose,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:_ Star Insurance Co. Policy#or Self-ins.L,ic.#: WC085540700 Expiration.Date: 4/9/2017` Job Site Address: 8 Fernbrook Lane' rvity/State/ZiP Centerville Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiratiop date). Failure to secure coverage as required under M- 01,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 01A.for insurance coverage verification. -.••� ... ... I do hereby certify under th pains and Penalties ofperjury that the information provided above.is true and correct Si ature: Date: 11/16 Phone#:508-398 0398 ` Official use only. Do^not write in this area,to be completed by city or town officiak , City or Town; - Perinit/License# k Issuing Authority(circle'one)' ' 4 1.Board of Health 2-Building Department 3.City/Town Clerk 4.Eleetrical.Inspector 5 Plumbing Inspector 6.Other Contact Person: - _ - - _ ' Phone#: ACORID� DATE(MMroomvY),, CERTIFICATE OF LIABILITY INSURANCE 4/12/2016 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 pollcypes)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 endorsements.. PRODUCER ..__._ + _ CONTACT Risk Strategies. Company Risk Strategies Company HC� 8 )986- 400 (781)963-4420q E ( Ao: 15 Pacella Park Drive � SsAIL :randolphcld@risk-strategies.00m Suite 240 INSURER(S.AFFORDING COVERAGE NAICg Randolph NA 02368 INSURERA:Selective Ins. of America INSURED INSURERBAllmerica Financial Alliance Ins Co 10212 Cape Save, Inc INSURERC:Star Insurance Co 7 D Huntington Ave +- INSURER D: INSURER E: South Yarmouth P?F: 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 WIrH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THEINSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE.TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIESAIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR DDIL SUBR POLICYEXP LIMITS LTR_ TYPE OF:INSURANCE .'.POLICY.NUMBER. MMIDD M 1 _ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GE ToRENTED A CLAIMS4VIADE �OCCUR PREMISES Ea occurrence $ 100,000 X 01004480 10G36/201S 10/16/2616 MEDEXP(my oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY�PIERCOT LOC PRODUCTS-COMP/OP.AGG $ 2000,000. OTHERc $. AUTOMOBILE LIABILITY BINEEeaccideM r , IMI $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED -71 SCHEDULED -- — AUTOS X AUTOS AH8A46796600 11J6/2015 11/6/2016 BODILYMAJRY(PeraccidentI $ X HIREDAUTOS X AUTOS PeraCocidentDAMAGE $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,600,000 A EXCESS LIAB CLAIMS-MADE I " AGGREGATE $ 1,000,000 DEC) I X I RETENTION.$ NIL 81994480 10116/2015 10/.16/2016- $ WORKERS COMPENSATION. M oPP3cera Included Por AND EMPLOYERS'LIABILITY YIN X STATUTE ERA ANY PROPRIETORIPARTNERIEXECUTIVE NIA coverage. E.L.EACH ACCIDENT $ 500,000 C OFRCERIMEMBER EXCLUDED? N❑ - (MandatorylnNH) VCOSS540700 4/9/2016 4/9/2017 E.L DISEASE-EA EMPLOYEE $ 500,000 Ityes,describe under j - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 10i,Additional Remarks Schedule,maybe attached If more apace Is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and N$tar Electric are all included as .Additional Insureds with respects to the General Liability coverage of named .insured as required 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 Ccnipact ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable County 460 West Min Street AUTHORIZEDRa+REsFlrranvE Hyannis, MA 02601 Michael Christian/CLG .01988-2014 ACORD CORPORATION. All rights ressrved. ACORD 25(2014/01) The ACORD name and logo are,registered marks of ACORD INS025(20 ao ) �1 Office PC Consumer Affairs and Bus ess Regulat>on:. � J 10 Park Plaza Sulte 5.170 Boston<lUlassachuse,ts 021 L6 Horne Improyement.Corltractor Reglstratlor Registration 171380:; Expiration 3/14/201t3 Tr# 419291 CAPE SAVE INC. Y WILLIAM. McCLUSKEY (I , 7=D WUNTINGTON N ` "AVE UE � SOUTW WYARMO'UTW MA 02664. Update Address and returwcairt.mark reason for change. . �__ Address [!.Renewal �,Employment L Lost Card SCA 1 C 2OM-05/11 - �e�annnancueal!/a�Q/�licuacl cued. "Office of Consumer Affairs:&Business Regulation License or registratron valid for jndividul use only r HOME IMPROVEMENT CONTRACTOR before the egp�ration date If found;return o: h� Office of Consumer Affairs and Business R: ulation �Registrat�on �i71380 Type: � r Expiration 3[14/2018 Corporation 10 Park Plaza Suite 517¢ Boston,MA 021 16 CAPE SAVE INC. WILLIAM MCCLUSKEY W 7-D HUNTINGTON AVENt1E , ;•' � _ t ,, SOUTHYARMOUTH,MA-k664 Undersecretary 'Not valid> i signature . Massachusetts -Department.of Public Safety Board of Buiiaing Regulations and Standards ^--` r._--_ n_. •" 1.i111111111i11'111 JLLIIC IY ivlll JIICl1A/Lv'- License: CSSL 102776 WILLIAM J MC au 37 NAUSET ROAfl West Yarmouth MA Expiration Commissioner 06iM2017" T f " TOWN OF`�B A - � 9 r ARNSTABLE Permit No 273Q0 s Building, Inspector 1 .,..,.... . - - — . . � Cash_ o...•. OCCUPANCY PERMIT, , _ •Bond - - - • - Tssuea 10. Bayside, Building Co. ;'Address' ` t f• lot 1-1 R Fernhrnok T.aTiP. CpntPrvil•1a, % •1 z Wiring Inspector ,- a Inspection date• • _ Plumbing Inspector//�� . ��vTd; {f vInsPeotion date: �. . Gas Inspector.._ Ok�� G 4.M r � D r1 - EasPection date - Engineering Department v Inspection date,• �. r.. .,/'ii.141' Div%./ / E,.P Board of Health .Cc.' &( �1 , Inspection date' THIS PERMIT WIL_L-NOT BE• VALID, AND',THE.BUILDING SHALL NOT BEr,OCCUPIED UNTIL SIGNED BY THE BUILDING_INSPECTOR--UPON,'SATISFACTORY--COMPLIANCE WITH TOWN;' REQUIREMENT$ AND'IN ACCORDANCE WITH SECTION 118.0'OF.THE MASSACHUSETTS STATE ' BUILDING•.CODE. r �- Building .Inspector .JOSEPH D. DALU2 '!TELEPHONE, 775-1120 Building PJ EXT. 107 4 _ TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been. issued for the building authorized by Building Permit 4t1! issued to Please release the performance bond. - 4 �i III 7 -1 4.9 3 ' 4AYa �V 4-1 a ; •� 5 ,r ,.� DAX-111R .r.;aa Al GOC,4T/OTC/ CC�J T�V/LLB :. �•" / CE'2 r/may THAT THE Fv�✓DA 7-7 o Aj O.4TE f',�,/of�✓�yE,2EGLl/CO�IOG YS h�/rh' SCA - �.�CO — 7'.4/E s•/GE.0 ,2E4v/•�EMEN1s' Ooc' T.A/E Tow.✓OF / 8/a/LitJSTA 6 L� ANO /.S 407- L a cA TE'G W/THY/�t/ TyE FLoanPG4/�! lQ 9 72 .. F OA re. 4-da 1.=-�; - BASEO Do/A./ .eE'G/STE•eE. 0 LAAIO SU•e✓6yt�.� //VST,e!/ME�t/T S'!/•eY6y I` 77f/4-- GZSTE.21i/.C.L�o MASS• O��SETS Syol�✓�Y S.�v�� M07- U.sEO T!� OETE��/r�/E SOT�/iv�S. �' r�}t� ...�, F v } :. y�� r _� � 1 '� Vim„'^_"'-`� r i ,tom_ /�<7�j,7/'��/y-��.-�••--.=. .-. 7'Assessor's map 'and lot number*,. . � � ... �� QQ --° ; 4 o rY..} �� yp �OFTHEtO� Sewage Permit.,number `cr .....':��....�':� 1 4L � �• � � rtT H�HB9Ta LE, �- r House number . �'..' .... i 1-AlI H TITL 9 ` .....u.... t• i ,�, �p �6 9• :� 1 �t'f �a taz,Y w = " TOrWN O kNSTABLE .E . .. ... b F3. F BAR BUILDING INNS-,P,ECTOR (n nn�� -APPLICATION .FOR PERMIT.TO....(-19"Y1. l.!V. ., .��+!IStI,<.. . ......�:?�..... TYPE•,OF CONSTRUCTION p . . . . ....... .............................................................. • - ..................."4............... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according ;to' the'following-information: Location ... .. 1J.. lQ� f4.....I�/f/��. C... �!' ��<��°... ...!. �r2.......................... r Proposed Use ....IfS.� r �.. .... ....... ... ..:.. s.`Zoning District ....��..:C. .................. ........:.................. .Fire'District ..L.'.� . ..� ...........:............................ Name of Owner... . ! �' l... ..... G!l./u./..�r�j ........Address ? `C':..................:................................ ` Name of Builder ........:.S �!' ......................................Address .. � ................................................. r /! ..s4 � � ....................:Address l� iP& Name of,Architect r..... . Foundation c•'c-� Number, of Rooms ..... ...................:............................. .... ....... ,.......... ... ........ ...................... ' Exterior ....1..1.L(�Q. . //......� .....Roofing. ... 7`:...... ........ ........ ............ (/ /f Floors :..;....Q l[.. ...�/ ! .......� ....... /1 nterior ......( .........V..�.�".1.... .�. . .... r:...... `.. :. .. Heating ....:..:..................... :.: .Plumbing .. ..4.::.... 4.: �✓': C... Fireplace ......A?./. C.`:..... ......W..!.Q.t..................................Approximate. Cost ........... ..� Definitive Plan Approved by Planning $oard _____________ _-----19 ___. • Area ....... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH � � 't• , 3 ' OCCUPANCY.PERMITS REQUIRED FOR NEW DWELLINGS , I hereby agree to conform 'to aH"the Rules and.Regulations of the Town,of Barnstable regarding the above .construction. w Name .... s ...... ........... Construction. Supervisor's License ....Q ..... 1. ...:. :... y. E BAYSIDE BUILDING CO. (' 27,300 Flo .... _ ....:. Permit gar ..Gie Story.............. JS "'` _` _'••_ '- ,, r '' y �-+ . _. , L P; �. •4--•+s '•ram . t" Single Family Dwelling �� j r _ • . • ,� fl �t• .... �. .. . ..�........... . �� r L _ s' `'' "• r Location Lot 11�....8..Fernbrook Lane , 1 i• ;^ , Centerville { % . r _ ' '" ? Owner .... e uilding a :Type.;of; Construction` ....Frame...... _ ... tz ... .................... .. Plot ............................ Lot,: ........................... ` December 4, - . ' 84. Permit Granted .......................... J Date of Inspection ......... .......... 1 ..:T9 Date Completed l. ............... 9 - s . r , Assessor's map and lot number ..,........Q.:.. :....................... - o�TNETo Sewage Permit number . Z 11AWSTABLE. i House number ..`.... Y� a l..,.�...................... 9�0 39• 0 ` f�._..,.r. TOWN ' OF BARN-STABLE BUILDING : INSPECTOR APPLICATION FOR PERMIT TO ...��;?!!,.... .✓.�.... ........................ ...... ...................... ... :. TYPEOF CONSTRUCTION ..... ...................................................................................... .............. DvZ y...19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .// ............... rid, Gz.0:/1r /s l ProposedUse ....J.l..`P 5•/ z°//!1 .. ....................................................................................................................................... ZoningDistrict ..... ?,. ..(................................. ....................Fire District ... .....{.... ......................................... * `... 1.. j'.....!�!%/.//G/•�•`'!4 ..... .Address ..!...�° �. ... Name of Owner ... ;f�� .�r. � ...... ........................................................... Nameof Builder ............... f......................................Address ............:.a. ....................................................... Name of Architect ...Ii4:(......, u ...2 .....................Address ........,��!.Je Igvj.!`�ff............................................. tzNumber of Rooms .........6........................ .......Foundation !/"07�fJz. `'` 2i= ...�.�!/!>.,�/�yfh�.f S!!/i>1� ./Y.....�1.�. .......Roofing .......... .� .`l.�l/..1.. ...... Exterior 0, ............. ......................................... Floors . TA. /_�� . .....!...hh...; :�!..�...//.../ nterior ......(4.7. 5J l �.. :�':/7.. � ��.5.. ..: :Plumbing U��.`. .�............ / . ....... ........................................ Heating .....:. ..... ....:....: ( ;, T. Fireplace ��./. 1.......... IJ G ............................Approximate Cost i. .S• • •„ _ Definitive Plan Approved by Planning Board _______________________________19________. Area ...... ..................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH C�lti1� AG 3 4 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. 1 _ Name .. .. ?'1....��.................................... '�. . Construction Supervisor's License ....r� ...�.5.......... BA SIDE BUILDING CO. A=20 —85-8 No ..27300.... Permit for One..Story ..... ..... ,r �.� Single` Fan y Dwelling ....... Lot 1'L 8 Fernbrook e Location ........... Centerville . .. ..... .................................................... ........ Owner ....Bayside Building Co......., r Type of Construction' Frams .......................................... Plot ......... '............................ Lot ....................... _ Permit Granted ' December 4,.....:.....1.9 84 Date of Inspection 19 Date Completed ......................................1,9 s I�