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00620064 FRESH HOLES RD
4C7 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Pre-application for Business Certificate pp s C hficate Date — Map Parcel Applicant Information Applicants Name • C CS 5• J 9 U er o G u Applicants Address Y g S 401 le-S Email Address I Cvt F'I n Sy[i23 CJ.rA4 L • C o l Telephone Number �-} —3�g` �-p � _ Listed ❑ Unlisted ❑ 5-3 Business Information New Business? ------------------------------- --------- 'j'es No Business is a registered corporation? _____ _-_____. Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes o, Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business �)C)fy t Yt" C (tIli L,\ C_.t, Business Address I„ A I&es L_�)\ e,5 VA�C,ry7,�,5 (` ,4 (2-�_6 o l Type of Business_ ` gr\,Dt \G S t r U 1 C -e c4-,, BuRd' Commissionek Office Use Only Conditions Y'�`� Building Commissioner ^— C4 fi ` Date �! 7 Clerk Office Use Only Town of Barnstable Building Department °k o Brian Florence,CBO Building Commissioner * BARNSTABLE, 200 Main Street,Hyannis;MA 02601> y MASS. �+ �b i639 www.town.barnstable.ma.us ATFp�.�A , Office: 508-862-4038 Fax: .508-790-6230 . Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: I�- \4 Name: 1�'� C� C^( . 012� k Z Phone#:— 3 b g a-01—($� Address: b uV �'�,� C Village: Name of Business: Do Cn i V 1 I C a V� �' k Ect IQ 1 h Spy U t C Type of Business: C_ e ar)i Yl! . S E V V IC-C Map/Lot: / INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling' there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located C� within that dwelling unit. O r C . Such use occupies no more than 400 square feet of space. M • There are no external alterations to the dwelling which are not customary in residential buildings, and there y.0 is no outside evidence of such use, No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke,dust or other particular �p rrl matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. CThere is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess C -=4 of normal household quantities. —I _ • Any need for parking generated by such use shall be met on the,same lot containing the Customary Home Z Z =O Occupation,and not within the required front yard. U) 7, • There is no exterior storage or display of materials or equipment. mT m • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one 1n D O pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to C n exceed 4 tires,parked on the same lot containing the Customary Home Occupation. m No sign shall be displayed indicating the Customary Home Occupation. .--1Di If the Customary Home Occupation is listed or advertised as a business,the street address shall not be O included. Z • No person shall be employed in the Customary Home Occupation who is not a permanent resident o f the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: � C.,�_ LC/L— Date: Homeoc.doc Rev. 10/17 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION • ; r :7 BA R sLE A 0/S Map � Parcel O� pplicatio ��3 Health Division Date Issued /2 T 7 Conservation Division Application Fee Planning Dept. ,., �F. • _ Permit Fee m. ;S `� r p tj Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Iddress Q /)7r7 'T2 Village VA 3 "Hal , Owner II�n Address Telephone �� 'v� Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District tFlood Plain Groundwater Overlay Project Valuation �® U Construction Type�r 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 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 ❑0 If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ( !' c Telephone Number �� Address t t License # f�I/ V 41 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT�_D W� ILL BE TAKEN TO z-`7 /0 f6 SIGNATURE DATE t �`� r •. FOR OFFICIAL USE ONLY c' APPLICATION# f , 'DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING y DATE CLOSED OUT ASSOCIATION PLAN NO. aM�ala mass save CO R _ ��� fir•► PERMIT AUTHORIZATION FORM I, RAFFAEL RODRIQUEZ ,owner of the property located at: (owner's Name,printed) 64 Fresh Holes Rd HYANNIS (Property Street Address) (City) • 5 hereby authorize the Mass Save Horne Energy Services Program assigned Participating Contractor lisied below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Xqz"2,t,—-swap-- .40 Owner's Signature --� 0.—t 6 Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy'Services Participating Contractor to the above referenced project: Participating Contractor Date } . • OffO For Office Use Only Rev.12132011 — _ ! { 4 r .r: Massachusetts Department of Public Safety Board of Building Regulations and Standards «. ` , License: CS-100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROW WEST YARMOUTH MA 02673 CA— f. ^^� Expiration: Commissioner 11/11/2017 ` Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170. `tr Boston, Massachusetts 02116 F Home.Improvement Cohlractor Registration i Registration: 153567 `"K« r. .Type: Private Corpor llon R^ I Expiration: 12/15/2016 zTr#;a259188x CAPE COD INSULATION, INC HENRY CASSIDY i 18 REARDON CIRCLE - V.. SO, YARMOUTH, MA 02664 ' Update Address and return card, Mark sra for�11 Address Renewal Employ �` �� ios $CA i :S 2OM•06111 License or registration V/ie cpanu��caouue�r�C�a�C�/l/`�wd�ro�ctdeG�J _ 'J �\ Of(lce or Consumer Affalis& Business Regulation g 'atlon valid for Indfvldul use only UqOME IMPROVEMENT CONTRACTOR before the explration date, If found return to, eglstratlon: A.53567 Type; Office of Consumer Affairs and Business Regulation xplratlon: • 2l1.•15b20:16 Private Corporation 10 Park Plaza-Suite 5170 i Boston,MA.02116 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE`: �Q �B,,,p_ SO. YARMOUTH, MA 02664 Undersecretary N valid wi ut sign e ' • i .. 1 r , R t. The Commonwealth of Massachusetts Department of Industrial Accidents j Office of Investigations =- 600 Washington Street Boston, MA 02111 wfvw,mass,gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers A pplicant Information Please Print Legibly Name (Business/organization)qndividual); !'✓f�t� Address: oo,'la���� J City/State/Zip:_ 4VIM 94 11 a iv Phone 9: Are you an employer? Check th appropriate box: e7 4, [] I am a general contractor and I Type of project (required): 1.Y -1 am a employer with � employees(full and/or part-time), have hired the sub contractors 6, [—],,.New[—],,.New const ttction n 2,❑ 1 am a sole proprietor 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' comp. insurance,t 9. ❑ Building addition [No workers comp, insurance p� 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 l,❑ Plumbing repairs or additions right of exemption per MGL myself, [No workers' comp, g p p 12,❑ Roof repairs insurance required,) c. 152, §1(4), and we have no employees, [No workers' 13Y Other ' comp, insurance required,] 'Any applicant that checks box N 1 must also fill out the section below showing their workers' compensation policy information. r Homeowners who submit this aMZJavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attaghe,d an additional sheet showing the name of the sub-contractors and-state whether or not those entities have employees, If the subcontractors 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 ,xnfo;rmation, { Insurance Company Name: r ` � , Policy # or Self-ins. Lic. 4: t -c�0G Expiration Dater VO�v 1 Job Site Address; � City/State/Zip; Attach a copy of the workers' compensation p licy declaration page (showing the policy numbe and expiration date), .Failure to secure coverage as required under Section 25A of MGL t, 152 can lead to the imposition of criminal penalties of a Fine up to $1,500,00 and/or one-year Knprisonment, 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 insurarv,% coverage verification, I do hereby certify d the pal an penalties ofperjury that the information proVabis t ue correct, LSi nature; Date: t! L Phone#: 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 I 6. Other (-'nnfart Pcrcnn Dlw. �-1 CAPECOO.27 BDELAWRENCE Acoizo's CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 6130 12015 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(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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc, PHONE ac No):(877 816-2156 434 Rte 134 E-MAIL South Dennis,MA 02660 ADDRESS; INSURERS AFFORDING COVERAGE NAIC H INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER B,ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER C 18 Reardon Circle INSURER D South Yarmouth,MA 02664 INSURER E INSURER F: r 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR TYPE OF INSURANCE ADDL POLICY NUMBER MM/DDY� MM/DDT P LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE MOCCUR CBP8263063 04/0112015 0410112016 PREMISES Ee occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 O.pqPOLICY❑PEC POLICY PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $, Ea accident ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED AUTOS AUTOS e001LY INJURY(Per accident j $ NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Peracc,denl S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPER OTH- AND EMPLOYERS'LIABILITY TATUTE ER _ B ANY PROPRIETORIPARTNER/EXECUTIVE Ya NIA WCE00431901 06/3012015 06130/2016 E,L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES j CORD 101,Additional Remarks Schedule,may be attached I(more apace Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD :1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2qZ Parcel V 1 Y?1fN OF BARNSTABLE Application # � L) 6��" Health Division - Date Issued Ali, `-i "1 i141- c Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village i Owner �7 , N4ld ess Telephone r (a - 3124 P�r (6 Permi equ�e/st t ��/��, �v Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation OV> Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Familw❑ 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 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 �61\lo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name JawC��rD J h o` ��J Telephone Number lI 7i Address -YJ License # Nq (I �LV Home Improvement Contractor# . Email Worker's Compensation # 0 ( C ALL CONSTRUCTION DEBRIS RESULTING F O THIS PRO CT ILL BE TAKEN TO SIGNATURE DATE GJ1> i FOR OFFICIAL USE ONLY z APPLICATION# 6ATE ISSUED MAP/PARCEL NO. `r ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Massachusetts Department of Public Safety - �' Board of Building Regulations and Standards License: CS-100988w r Construction Supervisor HENRY E CASSIDY. �. 8 SHED ROW WEST YARMOUTH MA. 02673- A, �^^,K Expiration: Commissioner 11/11/2017 • � r 3 Office of Consumer Affairs and Business Regulation j . ,l0 Park Plaza - Suite 5170 Boston, Massachusetts 02116 E Home Improvement Cbr>:tractor Registration f Registration; 153567 Type; Private Corpo t n^ 'Expiration: 12I15/2016 C2591 8 CAPE COD INSULATION, INC ' I ' HENRY CASSIDY 18 REARDON CIRCLE '" I SO, YARMOUTH, MA 02664 . l` i, y•Rt 's Update Address and return card, Mark sots i forh.t` Address Renewal Employ $CA I t5 2OM•05/11 V/ee (0007YA7tO0 LGUG'CFG��I/Q�/KOJ0 CF OX4ej a'�cl C—\ Office or Consumer Affairs& Business Regulation. License or registration valid for Individui use only U�j , QME IMPROVEMENT CONTRACTOR before the expiration date, If found return to; eglstratlon; -:153567 Type; Office of Consumer Affairs and Business,Reguiation ` xplratlon 1211`5/2016 Private Corporation 10 Park Plaza••Suite 5170 ' Boston,MA 02116 I; CAPE COD INSULATIQN INC HENRY CASSIDY 18 REARDON CIRCLE.'., S0. YARMOUTH,MA 02564 Undersecretary N valid wi ut sign e The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations -- 600 Washington Street Boston MA 02111 mass.gov/dia Workers' Compensation Insurance Affldavit; Builders/Contractors/Electricians/Plumbers A pplicant Information Please Print Legibly J Name (Business/Organization/Individual); IrfJl ;�, /� ] 1 � M11 J r�I/ J — 1�/U ✓ Address: (ii, r City/State/Zip. l ' �� / �,t Phone Are you an employer? Check th-e"appropriate box; l Y-employees am a employer with4, [] I am a general contractor and 1 TYPe of project (required); have hired the sub-contractors6. ❑ New construction (full and/or 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. T [] Remodeling ship and have no employees These sub-contractors have g, [] Demolition working for me in any capacity, employees and have workers' comp, insurance,t 9, ❑ Building. ddition [No workers comp, insurance p� required,] 5. 7 We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I,❑ Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12,❑ Roof repairs insurance required,] t c, 152, §1(4), and we have no employees, [No workers' 13,� Other comp; insurance required,] -jmuia "Any app!icant that checks box 41 must also fill out the section below showing their workers' compensation policy information. _ r 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 attaF.hed an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp, policy number. 1 am an employer that is providing workers' compensation insurance for my employees, Below is the policy and job site xnfo.rmation, Insurance Company Name; , hy/, e; Policy # or Self-ins, Lic. #; t �it�!'✓ ' Expiration Date; Job Site Address; � City/State/Zip;, Attach a copy of the workers' compensation policy declaration page (showing the policy nu r and expiration date), Failure to secwe 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 Knprisonment, 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 insura coverage verification, 1 do hereby certify ad the pai an penalties ofperjury that the information provided above s true and correct, L/ Signature: Date: 1 . Phone#: 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 (-'nntart Porenn D u. � -? CAPECOD-27 BDELAWRENCE .acoizo" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 6/30/2015 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 INSURERi.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 Ileu of such endorsement(s), PRODUCER CONTACT NAME; ROgRte 134 ers&Gray Insurance Agency,Inc. PHONE E AIC 434 Not:(877)816-2156 South Dennis,MA 02660 E-MAIL INSURERS AFFORDING COVERAGE NAIC p INSURERA:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER B:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER c 18 Reardon Circle INSURER D South Yarmouth,MA 02664 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, XP INSR TYPE OF INSURANCE POLICY NUMBER MMIDDY MFMID EFF D/YY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR CBP8263063 0410112015 04/0112016 PREMISES Eaoccurrence $ 100,000 ME EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO, LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY a COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Par' Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE. $ _ DED RETENTION$ $ WORKERS COMPENSATION PER OTH. AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETORIPARTNER/EXECUTIVE YIN NIA WCE00431901, 06/30/2016 0613012016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ( CORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors, Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD r PAWICIPAnNc mass savecou"UWWR PERMIT AUTHORIZATION FORM I, DARYL BOSWELL ,owner of the property located at: (Owner's Name,printed) 62 Fresh Holes Rd HYANNIS (Property Street Address) (City) { hereby authorize the Mass Save.Home Energy Services Program assigned Participating Contractor listed_ below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X Owner's Signature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date 0�`L7 - 01 For Office use Only - Rev.12132011 oFtHE rq,,, Town of Barnstable Regulatory Services Y Y * B"NSTABU, MASS. g Thomas F. Geiler,Director 1639o. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 March 8, 2011 Dear Property Owner, This letter is to inform you that Regulatory Services canvassed the general area of Hiramar and Fresh Hole Roads on Friday afternoon, March 4, 2011 in an attempt to assess the current conditions of the properties located in this area. This department recommends that all landlords personally inspect their property in order to obtain an accurate assessment of their individual rentals. For your convenience I am identifying the findings in a generic list below: • Broken window panes and storm doors, • Failed glass • Missing storm doors. • Torn or missing screens • Broken glass strewn along the perimeter of dwellings • Broken glass surrounding dumpsters and in parking areas • Peeling paint • Uncontained outside storage of household trash • Abandoned appliances outside • Missing or clogged•gutters • Failure to post contrasting house numbers • Rotting window sills and support posts • Missing or broken outside lighting fixtures • Blocked egress including a rear exit nailed shut. In addition, landlords should confirm that all units have the adequate number of operable smoke detectors properly placed as required and units relying on fossil fuels are also required to have carbon monoxide detectors. Please feel free to contact me directly at 508-862-4027 in the event that you require additional information concerning this letter. i erely, . Robin C. Anderson F.. Zoning Enforcement Officer CC:Chief Paul MacDonald,BPD,Debra Dagwan,Town Council Town of Barnstable f a stable r Regulatory Services �4SHE7p� _ `wlP� '►% Thomas F.Geiler,Director sniwsi°Astir, +' Bi111diIIg Division 39.• Tom Perry,Building Commissioner ArED Mp1l 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 548,-.79&-6230 Approved: Fee: r Permit#: Ana 70 00 Y1 HOME OCCUPATION REGISTRATION Date: Name: e/l.e 9 (I-et're—; Phone#: Address: f�'L��!S f1149�eS Village; 90, Name of Business: Type of Business: ►� Map/Lot: c� l 7c INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise.or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • &uch use occupies no more-than 400-square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by.such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, v re d agree with e above restrictions for my home occupation I am registering. Applican Date: Homeoc.doc Rev.5/30/03 YOU WISH .TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30 you must do by M.G.L.-it do .00 for 4.years). A business certificate ONLY REGISTERS YOUR NAME in town es not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1°` FL.(367h Main Street, Hyannis, MA.02601 (Town Hall) yicu rorca uxna nxu��R`d -- o.o.TE: Fill in please: -.Y..tfiilSl ...L. p 1 f� . APPLICANT'S YOUR NAME: �//�/)I`G!�L' Ile- YOUR HOME ADDRESS: FrS 7 t� TELEPNONE # Hoh4e Telephone Number U G©r EADDREESS EW BUSINE55' pi ;n ;.�. OME OCCUPATION? yE. NO TYPE'OF BUSINESS ; ✓� en given ap.proVal from the building div lion? YES NO 1 F BUSINESS plea / 4veqo`gip :MAP/PARCEL NUMBER When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations o Y Barnstable. This form is intended to assist you in obtaining the information you 9 f the Town of Rd. & Main Street) to make sure you have the appropriate permits and licenses.required to legally opera0te yOourNbusiness ain in this town.armouth 1. BUILDING COMMISSIONER'S OFFICE This individual has b informed• f ny permit requirements that pertain to,this type of business. uthorized Signatur FOLLOW HOME COMMENTS: OCCUPATION RULES �4 2. BOARD OF HEALTH This individual been i&Siiwn,atu;p** e pe requirements that pertain to this type of business. AuthorizCOMMENTS: . Is Q 3. CONSUMER AFFAIRS LICENSING AUTHOR Y) This individual h s e'n inf ed of the nsi r ents that pertain to this type of business. Authorized Signature.* COMMENTS: -K L 40 q [ ] [R292 172 . . ] LOC] 0062 FRESH HOLES ROAD CTY] 07 TDS] 400 H KEY] 203648 ----MAILING ADDRESS------- PCA11041 PCS100 YR100 PARENT] 0 LYON, JEFFREY & JENNIFER MAP] AREA163AD JV1379334 MTG12012 P 0 BOX 611 SP1] SP21 SP31 UT11 UT21 . 18 SQ FT] 1440 HYANNISPORT MA 02647 AYB11945 EYB11980 OBS] CONST] 0000 LAND 17700 IMP 37000 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 54700 REA CLASSIFIED #LAND 1 17, 700 ASD LND 17700 ASD IMP 37000 ASD OTH #BLDG (S) -CARD-1 1 37, 000 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 62 FRESH HOLES RD HY TAX EXEMPT #DL LOT 18 RESIDENT'L 54700 54700 54700 #RR 0576 0110 0723 0040 OPEN SPACE #SR HIRAMAR ROAD COMMERCIAL #UP FY98 INDUSTRIAL EXEMPTIONS SALE] 01/96 PRICE] 65000 ORB] C139494 AFD] I TE LAST ACTIVITY] 05/24/96 PCR] Y I 1, R292 172 . ep P R A I S A L D A T A! KEY 203648 LYON, JEFFREY & JENNIFER LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 17, 700 37, 000 1 A-COST 54, 700 B-MKT BY 00/ BY ME 9/87 C-INCOME PCA=1041 PCS=00 SIZE= 1440 JUST-VAL 54, 700 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 63AD -- TREND EXCEEDS STANDARD NEIGHBORHOOD 63AD HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 177001 LAND-MEAN +00 547001 54197 IMPROVED-MEAN -320 250-o ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 10001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADDS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] i 1 R292 172 . P E R M I T [PMT] ACTI*1 CARD [000] KEY 203648 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT I RESIDENTIAL PROPERTY MAP NO. LOT NO. STREET Fresh Holes Rd. Hyannis FIRE DISTRICT SUMMARY H 73 LAND 113 c 6_ ,. . 292 / BLDGS. Sv 172 OWNER N.•I t/.��Z�.�r ce �.-�tZ ��c°.._ _ TOTAL c a Now ' RECORD. OF TRANSFER DATE ak PG I.R.s. REMARKS: �G /� LAND L' BLDGS. r-- r- TOTAL • LAND 01 BLDGS. { Q TOTAL V LAND =Jone,. 1 i zabeth C. ,. Trustee (LGL Trust) 12-19-78 Ctf• 50213 BLDGS. o� TOTAL LAND c ,�J {^ � BLDGS. / - U R O S 1 O N GZ- Oa 10 TOTAL LAND .Z - 9.0 BLDGS. TOTAL LAND Ot BLDGS. TOTAL LAND INTERIOR INSPECTED: BLDGS. TOTAL DATE: _ fj'- 7 ' LAND ACREAGE COMPUTATIONS 01 BLDGS. D TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HouSE `/3Ln ro n W3 0 3 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND AC r BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND I MC FUUIVLJAIIVIV U.Jn �. �'h(Il..�"" LAND COST ' nc.Wells Fin. Bsmt.Area Bath Roomy Base ne.Blk.Walls Bsmt. Rec. Room St. Shower Bath BLDG. COST Bsmt. _ PORCH. DATE no,Slab Bsmt.Garage St. Shower Ext. Wells PORCH. PRICE. + ick Walls Attic F. &Stairs Ila Toilet Room Roof RENT bne Walls Fin.Attic Two Fixt. Bath Floors 6rs INTERIOR FINISH Lavatory Extra Gnt. F AL 1 2 3 Sink 1/21/4 IVV Plaster Water Cie.Extra Attic 1 ' -XTERIOR WALLS Knotty Pine Water Only uble Sidin Bsmt. Fin. g PI - ywood No Plumbing igle Siding Plasterboard Int. Fin. uq,Uhingles TILING CC/L 6a u. Blk. G F P Bath Fl. Heat ce Brk.On int.Layout Bath .&Wains. Auto Ht.Unit Veneer int.Cond. BAth Fl.&Walls Fireplace ' m. Brk.On HEATING Toilet Rm. Fl. Plumbing j> lid Com.Brk.. Hot Air Toilet Rm.Fl.&Wains. Tiling O[� ` Steam Toilet Rm. Fl.&Walls ®nket Ins. i Hot Water,4 St. Shower of Ins. Air Cond. Tub Area Total l� Floor Furn. ROOFING -2- one 9 COMPUTATIONS ph.Shingle Pipeless Furn. O S.F. !J (o O iod Shingle No Heat S. F. -- • � o Ce bs. Shingle Oil Burner S.F. de Coal Stoker S. F. a Gas S.F. OUTBUILDINGS ROOF TYPE Electric ble Flat S.F. 1 2 3 4 5 6 7 8 9 10 1 1 2 3 4 5 6 7 8 9 10 MEASURED 3 Mansard FIREPLACES S.F. Pier Found. Floor mbrel Fireplace Stack Ala Wall Found. 0. H. Door LISTED FLOORS Fireplace Sgle.Sdg. Roll Roofing nc, D61e. _ _ LIGHTING Sdg. Shingle Roof --�'' _ rth No Elect. DATE Shingle Walls Plumbing — ie fy rdwood ROOMS Cement Blk. Electric O ph.Tile Bsmt. 1stgd3 TOTAL Gq Ll ly Brick Int.Finish P DV ngle 2nd 3rd FACTOR REPLACEMENT 3 90 3 OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. NLG. G It c yL. �/I 1 — oZ 3 70 i 9 SG 7 SU _ 1 2 3 -- 4 - 5', - 6 7 6 9 _. l O TOTAL i PROPERTY ADDRESS I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD KEY NO. 0062 FRESH HOLES ROAD 07 IRS 400 07HY 01/04 96 1041 0 6 292 7 4 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS y UNIT ADJ'D.UNIT L:,nn BvtDaiu se omen.,pn p ACRES/UNITS VALUE Deseriptlon M C C A L L, - R I C H A R D H & CAROL A MA P— LOC./vR.snEc,CLnSs ADJ. COND. PRICE PRICE #LAND 1 17,T00 eD FFDcIhtAces ' E CARDS IN ACCOUNT -- L 10 18LDG.SIT 1 X .18 =10c 328 29999.9S 98399.9 .18 17700 #BLDG(S)—CARD-1 1 37,000 01 OF 01 A I #PL 62 FRESH HOLES RD HY N BATHS 2.0 U X C= 100 7000.00 7000.00 1.00 7000 B #DL LOT 18 MARKE T D — NO BSMT S X C= 100 5.95 5.95 1440 8600—d #RR 0576 0110 0723 0040 INCOME A #SR HIRAM R A ROAD USE APPRAISED PPRA ISED VALUE D J A 54,700 A PARCEL SUMMARY T U LAND 17700 A S T BLDGS 37000 ' M 0—IMPS TOTAL 54700 F E N CNST E DEED REFERENCE DATE PRIOR YEAR VALUE T Inste Selea Pre A T Book Page MO, Vr.D LAND 17700 T C108854 I,11/86 135000 BLDGS 37000 U C103688 ; :10/85 N 2400000 TOTAL 54700 R C60213 :00/00 E - BUILDING PERMIT *N O ATTIC....... SNumber Date Tv- Amount ................ LAND LAND—ADJ INC ME SE SP—BEDS FEATURES 9LD—ADJS UNITS i 17700 1600 Con sl. TOIaI Year Bulll Norm. Obsv. Class U, I Units Base Rale AOI-Rale A�� 11l'1 Age Oepr. Contl. CND. Loc. °ro R.G. Repl.Cost New Atlj.Repl.Value $Tories Height Rooms etl Rms.Baths A Fi s. PeriyweIf F. 02C— 000 100 100 55.25 55.25 45 80 14 87 60 47 78656 37000 1.0 8 4 2.0 8.0 Deso��pl�On Rate Square Feel Repl.Cost MKT.INDEX: 1 -00 IMP.BY/DATE: ME 9/87 SCALE: 1/00.7 5 ELEMENTS CODE CONSTRUCTION DETAIL S BAS 100 55.25 1440 79560 GROSS AREA 44 TWO .FAMILY DWELLING CNST GP:00 T FOP 35 19.34 36 696 *----------------=----60-------------------- * STYLE 17DUPLEX 0. - -------------- --- R ! DESIGN ADJ MT 00 -------------- -- 0.- D ! �XTC WALLS _ _1OCLPBDTSHINGLE 0_ HEAT/AL TYPE 11GAS—WARM AIR E 0. T I INTR.FINISH 04DRYNAl 0. _ T U 24 BASE 24 INTER.LAYOUT 12AVER.-fNORMAL 0. - _ AS--.-------------- ! INTER.ti UALTT _�72SAMEME E_XTER._ .__0._ R ! ! FLOOR STRUGT OGCONCRET_E__SL_A_B_____0._ L D W• ! EFLOOR_ tOVER 04CARPET 0. A,eas Aqa _ 36 Base= 1440 BUILDING DIMENSIONS .*----------- • RO Of TYPE OI GABLE—AS PH SH 0. ______ ___ ___________________ _ 4----*--9---*--------26--------X ELECTRICAL 01AVERAGE 0. --------------- 'B�S W26 FOP SO4 W09 N04 E09 .. 4 FOP 4 FOUNDATION 03CONC MET E SLAB BAS W34 N24 E60 S24 ______________ . _-- ----------------------- 99. L NEIGHBORHOOD 63AD HYANN:IS LAND TOTAL MARKET PARCEL 17700 WOO AREA 3871 VARIANCE +0 +1313 STANDARD 25 TOVM OF DABNSTA 3LZ = REPOBT S MENTABY/CONZ ATO REPORT x G , NAME (LAST, nRST, MIDDLE) DIVISION X" 2 NOTE DETAILS i ERVATIONS-ITEMIZE EVIDENCE, SERIAL IS ETC• 28 ! O - .. PAGE / Town of Barnstable Approved Regulatory Services Fee A Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Home Occupation Registration Date: l I q I Z Name: L�K\e-Ca-e ` Phone#: 4$• Address: l— 6 q F (Z�S Village: �5/ / O Name of Business: f YU Cla 4714 Type of Business: K-; f, Map/Lot: ' 2- INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home.occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided treat the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the (� following conditions: 4 • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors, electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering, Applicant: Date: 9-5-� 2-- Homeoc.doc