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Home My WebLink About0035 HOLLY HILL ROAD r kip•4,0 t. , y. w « l L k S TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel V (0 Application Health Division Date Issued 31 Z Conservation Division Application Fe � Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Q c► ) $�31JI 2.. v Historic - OKH _ Preservation / Hyannis Project Street Address Village G've j, J 2 Owner Address Telephone_ 2271 Permit Request 1;?tZ —Jy TIf� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation c f�,4 o- 4 Construction Type /4�1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U-' Two Family ❑ Multi-Family (# units) a ; Age of Existing Structure Historic House: ❑Yes ❑ I-o- On Old Kin g g o d g s Highway: ❑Yes .0-Rdo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ._ •ram. Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) x == 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 ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) I Name �� ,��y�� l Telephone Number Address License#_/D e�9 % P ZF Home Improvement Contractor# /c5 Worker's Compensation # 41Z,4/J;j ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ®ATE �9�� j FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED } r MAP/PARCEL NO. 1 r 1 ADDRESS VILLAGE ; 't OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL # PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ 1C -- f i - = 10 Park Plaza - Suite 5170 Boston, Massachusetts'02116 Home Improvement Contractor 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. L-I Address I_ Renewal L I Employment L I Lost Card s-c�i t5 5i;m o4/o4-u 1 o r2 i e Office) or Aumer Affairs taus n,e"it, I-Ition license or registration valid for i-ndivide! use r:!; HOM P bV `f`l` �T71�1 AAw" before the.expiration date. If tbund return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 OD INSULATION INC HENRY CASSIDY 455 YARMOUTH RD, HYANNIS,MA 02601 Undersecretary " t alid "ith t si tore { ' Va„arhusctts-'lepartn►ent of Public sill eh Board of Buildin! Rolulations antl standar(Is' . Q.onstruction Supervisor License License: CS 100988 " HENRY CASSIDY 8 SHED ROW WES;;T'�ARMOUTH, MA 02673 Expiration: 11/11/2013 ('uuinii..i,urr Tr#: 7620 4. LVIZ � : iirivi No, 1605 P. Client#:4597 CCINSUL ACORD,,, CERTIFICATE OF UABILITY INSURANCE OATE(MMIDDIYYYY) 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,TH1S2 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 AbDITIONAL INSURED.the policy(ies)must be endorsed.If SUBROGATION 13 WAIVED,subject to the terms and conditions of the policy,certaln pollCles may require an andorEament.A statement on this certificate does not confer ri9lTt3 to the certificate holder in lieu of such endorsemenl(s). PRODUCER Rogers&Gray Ins. -So. Dennis NAME: Mar aret Youn PHONE 508-760-4602 AIc No Ew: F 8/7-816.2'1S6 434 Route 134 E-MAIL Arc Na ,^ South Dennis, MA 02660-1601 508 398-7980 _IN9URER(9)AFFORDING COVERAGE _NAIC N INSURER A!Peerless Insurance 18333 INSURED ---- Cape Cod Insulation(no INSURER8,Evanston Insurance Company 455 Yarmouth Road INSURERC:Atlantic Charter Insurance Hyannis,MA 02601 INJURER D:Commerce Insurance Company _34754 INSURER E INbUfteRF: COVERAGES CERTIFICATE NUMBER, 135VISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE- 1-15TfED IJCLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER16D INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY C014TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVrz BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF I149URANCE ADDL SUER - POLICY EFF POLICY E1r rOLICYNkINBEn MMIDDIYYYY YY MMIDDAY LIMITS A GENERALLIA6ILITY CBP8263063 0410112012 04/01/201 EACHOCCURRENCE $1 OOUOUO X COMMERCIAL GENERAL LIABILITY FNTEO —I CLAIMS-MADE Fx�OCCUR PftEMIS s aoccurrence $�UU UUU 1_ MED EXP 1AIly one Pawn) _$5 000 PERSONAL&AOV INJURY x 1 000 000 GENERALAOQRQOATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIE8PER; PRODUCTS-GOMPIOPAGG $2000000 POLICY PRO LOC p AUTOMge1LELIA9ILITY 12MMBCKVMK 4/01/2012 04101/201 �OMBIINEDSINGLELI MIT 1000000 ANY AUTO OODILY INJURY(P..person) $ JA LL OWNED X SCHEDULED UTOS AUTOS BODILY INJURY(Per accident) S IRED AUTOS X NON-OWNEDPROPERTYOAUTOSB MBRELLA LIAO OCCUR XONJ453512 4/01/2012 04/01/201 EACH OCCURRENCE $1 000 000 XCE56 LIAa CLAIMS-MADEAGGREGATE $1�000000 Eo X RETENTION 10000 WORKER> COMPENSATION $ C AND EMPLOYE7R3p'�LIgApBILITY WCA00525902 6130l2012 06f30/201 X WCSTATU. OTI4. efft— (Flakd'yioNMRPExCdq �RCUTIV&YEN E,L,EAC14ACCIDFZNT 1000000 NIA IMendelory in NH) If yen,deseribe under E.L.DISEASE-E.A EMPLOYEE $1 00O 000 DESCRIPTION OF OPERATIONS neluw _ E.L.DISEASE.POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VE141CLES(AUaah ACORD 101,Addlilonal Rdnmrks SChRdula,It Plora apRCe le reQuIod) "Workers Comp Information" Included Officers or Proprietors Certificate Holder is included as an additional insured undor General Liability whan required by Written contract or agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod lnsulation,lnc SHOULD ANY OF THE ABOVE DES CRIB ISO POLICIES RE CANCELLER BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01B8 -2010 ACORD CORPORATION,All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are roglstarad marks of ACORD #S83849/M83848 MAY The CorriMon i iv,ll th of Massachusetts Department ulf Industrial Accidents _ w Office (v Investigations 600 Wu,) liflgton Street 'ILA 02111 <� -- lioslr�r-. wIv .mt iss.gov/dig Worket''s cunlipeiisation Insurance At'tia,,,,it: Builders/Contractors/Electricians/.Pitinibers 1llplicaut Information Please I'rit>It Legibly N:mic jjflsitie s/Ot-gani:Zatioli/lndividu�ll): ( t _ .1rc ytiu all etupluyer? Ct►ecic the appropriate box: �.-- Type u1'project('required): I. l ant a employer with-.. - _ q ❑ I am a nri,il contractor and I have 6. ❑ New construction cullaluyccs(Full and/or part-tinie).* . hired tile..sill,-,ontractors listed on �� n the attach,:):.heat. 7. ❑ Remodeling I—I I tu a sine proprietor or partnership These Sala-�-ilractors have 8. ❑ Demolition and have; no ctrtployees working for employee.;;mJ have workers'comp. 9. ❑ Building addition, me in any capacity. [No workers' insuraue"'.1: Willi) insurance required.] 5. We are:t 1:01I)uration and its 10. Electrical repairs of-addiliuns (( Plumbing repairs or additions�� officers liav, exercised their right of 11. ❑ LJ t Jilt a hunteitwner doing all work exemptiot-i pet MGL c. .152§(4),and 12. Roof repairs myself. Iivn workers' comp. we have.n()c-utployees.[No workers' / utsurancC rec aired.. r 13. Ochol I I comp. iu�ur:ut«required.] lC C. Anv applicant that checks box #I must also fill out the section below shop ,w,chair workers'compensation policy information. f I luutcu:vncls who sutnnit this affidavit indicating they arc doing all work:aid dwn hire outside couu'actors must submit a now affidavit indicating such. t't'(MU rlchns that check this box must attach an additional sheet showing th,wmil of the sub-contractors and state whether or not those entities have employees.If u sub-:uunactors Itavc employees,they must provide their wolkC00w C01111!.hblii y number. l ant an employer that is providing workers'compensation insurance j'or my.employees.Below is t1 q policy and job site intorouttron. IusuranceC'onipany MUTle: -- F Policy#or SeIF-iris. Lic. a0: C' t .• i u =- ' Expiration Date: tub 0itC Address: _ __-.— City/State/Zip: Attach a copy of the worli.ers' cotnpensution policy declaration puge((bowing the policy number and expiration date). I ALUC to securC k:ovoraga as required under Section 25A of MGL c. l 5'-in Icad to the imposition of criminal liertaltics of a fine up to$1,500.00 and/or unr-year inyinsuutnant,as well as civil penalties in the form of a STOP W()kK ORDER and a fine of up to$250.00 a day against the violator.Be advised than a copy of this statement ilia e l'orwtirded to the Office of Investig;m,-iis of the DIA for insurance coverage verification. I do here c if under the ins and penalties oj'per,jury that the information provided above is true and correct. tilC,tlilLUhC: ° Date: E7- fly t„ply. nt,riot write it,this area, to be completed Lt rip ortpwn official Citywu: _ t'ertnitlLicense k thority (circle one): Health 2. B.tidding Department 3.City/min Clerk 4,Electrical Inspector S.1'lnntbiltb Inspector sun: __ Phone#; E i _ ' k �O e OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 3 5 Na l (Property Address) Ile /t-) p Z L5Z , (Property ddress) A hereby authorize e (Subcon ` tor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. a i f Own is Signature ' Date ![j------------------ f Town of Barnstable BAWABt, ,,, ,� 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: B-17-2823 Date Recieved: 8/17/2017 Job Location: 35 HOLLY HILL ROAD,CENTERVILLE Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: STEPHEN J DEVLIN State Lic. No: CS-047993 Address: COTUIT, MA 02635 Applicant Phone: (508)420-1340 (Home)Owner's Name: RASHTI,DANA A TR Phone: (617)448-9341 (Home)Owner's.Address: 16 WARREN SQUARE, JAMAICA PLAIN,MA 02130-2576 ) . Work Description: Re-roof, re-side and replace 4 windows(no header changes)on dwelling. F Total Value Of Work To Be Performed:. $12,000.00 . Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of.this application or the authorized agent of the property owner and have, been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. ,Requests for inspections must be made at least 24 hours in advance. Signed: Steve(or Lorri)Devlin 8/17/2017 (508)420-1340 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $12,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $61.20 8n7/2017 $61.20 XXXX-JXDC-XXXX- Credit Card x 1823 ...........................................................................................................:........................................................................................................................................... ......................... Total Permit Fee Paid: $61.20 01, CA COD INSULATION El®® NBER 01A55 SLAMUS`+ SPRATTOAM SUSPEND" BATT$ GiliiERS INSULATION C51UN05 1-800... 96-6611 'Town 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 & completed the insulation and weatherizatioo work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal& State Requirements. Property Owner Property Address Village , 11 � .`, y Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors ( } ( ) ( ) ( ) ( ) Walls ( ) (�) ( �� ) (K ( ) L.� �d�r� ��Cjp T � i�- Sincerely - ; 3J He y E Ca sidy r, President Ca e Cod sulation, Inc. -�