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HomeMy WebLinkAbout0019 GENERAL PATTON DRIVE � 9 6�Cner41 a`�- .l1oA Cape Save Inc. T `3 ` 7-D Huntington Avenue 2013 South Yarmouth, MA 02664 '' 22 4N, I/; 5C Tel: 508-398-0398 Fax: 508-398-0399 3/17/12 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 19 General Patton Drive,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. . Ceiling: R-38 cellulose Walls: R-13 dense pack cellulose All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey I ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TOWN OF Ril�,mS TABLE Map '� Parcel Application C) � f Health Division 4 Date Issued Conservation Division Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation /Hyannis Project Street Address 9 G ene C&I P a`t1-o n Drive Village I-I m n r", Owner R u S Ru�S S Address same Telephone 508 " 7—+J " b 1 1 9 n n Permit Request ce.IILIOS� laq Ever 1AmJrj ro%M. Nc - 3 0 c ell vlase �ensc Qae I,� Walls w►t� ' 13 cell y,1 ose—T R 4 c-o-P Square fJ 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuationAt 00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family . Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ill Oil ❑ Electric ❑ Other Central Air: ❑Yes KNo 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) Name _ Telephone Number 0 - •�4 `3 gam_ Address n A�irp_, License # C 10 - In1 armaa_4 h1 Home Improvement Contractor# 1 ` I4 4 3 c� Worker's Compensation # :1W C 3 919 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO rend j&� SIGNATURE DATE _ `�` FOR OFFICIAL USE ONLY i APPLICATION# µ; DATE ISSUED F 21 MAP/PARCEL N0. ' ADDRESS VILLAGE OWNER :t DATE OF INSPECTION: -- FOUNDATION] FRAME ' 1 INSULATION FIREPLACE r r ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL y GASr-t n ROUGH :: FINAL ,,FINAL BUILDING Y:• 4 ' `z DATE CLOSED_OUT ASSOCIATION PLAN NO. 4 Idtr/L,:Lt7:.b U%J::L� U1101 1CAPtVwP"7.V. SAVE Weatherization 508-3 - 39 August 22, 2010 To Whom It May Concern: William J. McCluskey is an employee.of Cape,Save. He is authorized to negotiate contracts and.building-permits for our-company. Michael McCluskey Cape Save—owner 919-593-5939 cell 7C Huntington.Avenup.,South Yarmouth, DNA 02664 P 4G0 Vest Blain Sheet Housing -- i Tamjis,Mrs 02607-3698 g of t��.., T ,(508)77I-sa.W F(508)7i5-7 - 3'I'�an-alines Cd p o raft o s b bnca�iecod ora HOME OWNER WEATHERI ATiON WORK PERMIT&FUEL RELEASE: PLEASE A SE FIX.I,OUT AND SIGN T WS XORMIF YOU.ARE THE APPLICANT HOME OWNED hereby consent to and agree that sveatherization work map be done by the Weatherization Program,of Housing Assistance Corporation ( herein after referred as 'Agency") on the property located at The weatherization work done will be based on,programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-st ippiug&c�Lnllcing of windows and doors,insulation of attics;"sidcwajls &basements,attic and other ventilation measures and.possiblp replacement of badly deteriorated windows.In consideration of the weatherization work to be done az my home I agree to the following: 1_ I give permission to the "Agency"its-agents and employees to travel onto or across said property with such equipment and materials as may,be necessary to perform weathecization work on said property. 2_ The Housing Assistance Corporation reserves the tight to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (S)years after the weathezization work is completed_ I have read the provisions of this agreement as listed and freely give my consent- Home Owner:'(Signature) Date .. I Agent: (signa=re) Date: �." 7D HAC Weatherization Company CAI- Caliber approved P • . . Building&Remodeling Cape Cod Insulation Save Creswell Consfxmctzo3 Frontier Energy Soludom Lohr&Sons Peter Smith ResoMon l�aezgy— Rock Solid Cowtuction" All Cade Irisu7ation The Commonwealth of Massachusetts ry' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mtass.gov/dia. Workers' Compensation Insurance-Affidavit: Builders/Contractors/Electricians/Plumbers Anolicant Information t Please Print Legibly Nance(BusineworganizationlIndividual): imi'1 �44E C' Z�c��� T A &ALjG Address: City/State/Zip:_S YAalmagnL 1"'Q 6Zk- hone#:. - - Are you an employer?Check the-appropriate box: Type of project(required.): I.[K lam a employer with 1. 5 4. 0.1 am a general contractor and I employees(full and/or part=time). a liavc hired the sub-contractors 6. Q New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0.Remodeling ship and have no.employees These sub-contractors-have. g, 0:Demolition. working for me in any capacity. employees and have workers' 9 Building addition (No workers'comp. insurance comp.insurances 5: We are a corporation and its 1.0.0 Electrical repairs or additions required.] ❑ rP 3.❑ I am a homeowner doing all work. officers have exercised their 11.0 Plumbing repairs or additions myself No workers'comp. right of exemption per MGL_ Y P 12.0 Roof repairs �. insurance required.]+ c: 1.52,.y 1(4),and we have no -` employees.(No workers' 13.®OtlicrTtk l kr�M comp. insurance required.]; *Any applicant that checks box#I-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.affidavitindicating such. =Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if the sub-contractors have employees,they must,provide their workers'comp.policy number. I awe an employer that is providing workers'compensation insurance for my.employees. Below is the policy and job site information. Insurance.Company Name: I P.GI)f1 a Q&)L nS(kir(k6Cf C om g�Y Policy#'or.Self-ins.Lic.,#: TW 3 a. 9 / T Expiration Date: 104 i / a o l k Job Site Address:_ ' J G&Ae rot 1 �k4u o rl f P City/State/zip:. -1 4.n..n.11 s Attach a copy of the workers'compensation policy declaration page(showing.the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can.lead.to the.impositiom of criminal penalties of a fine up to$1,500.00 and/or one-year irtiprisontnent,as well as civil penalties in the form of a STOP WORK ORDER and,a fine of up to$250.00 a day against the.violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ida hereby cerdfy under the pains d enakies erjury that the M ormation provided above is true and correct Si ature: r Date: d-- Phone#: 3:9 I&- 0 Official use.onlp. Do not itirire in this area,to be completed by city or town offciaL City or.Town: Permit/License# Issuing Authority(circle one): 1..Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing_Inspector � 6.Other Contact Person:.- _ _ __Phone#: ... /4 ® DATE(MM/DONYYY) CERTIFICATE OF LIABILITY INSURANCE 10/20/2011 TI-Ift 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 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 endorsemengs). PRODUCER NANMTACT Shannon Sperrazza Risk Strategies Company PHONE (787)986-4400 FAQ (781)963-4620 15 Pacella Park Drive ADDRES :ssperrazza@risk-strategies.com Spite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:Selective Insurance . INSURED INSURERB:Safety Insurance Company 33618 Michael McCloskey, DBA: Cape Save INSURER C-TechnologyInsurance Company 7 C Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL11102041451 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. INSR AD TYPE OF INSURANCE POLICY NUMBER rPMOIUD POLICY MLI DYNYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO REN X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAWS-MADE a OCCUR PPS1994480 0/16/2012 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ' PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ A JFCT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY accident $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident X Underinsured motorist BI split $100000 300000 X UMBRELLA LIAR X OCCUR CPPS1994480 0/16/2011 0/16/2012 EACH OCCURRENCE $ 1,000,000 4EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ C WORKERS COMPENSATION Executive excluded X WC STATU- CT"- _ AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N from coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBEREXCLUDED? y NIA C3297972. 0/21/2011 0/21/2012 (Mandatory in NH) E.L.DISEASE-EA EMPLOYER$ 500,000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National Grid, d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc., and Housing Assistance Corporation are listed as additional insureds as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. F THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN. ACCORDANCE WITH THE POLICY PROVISIONS. Housing Assistance Corp 484 Main Street Hyannis, MA 02601-3698 AUTHORIZED REPRESENTATIVE ' •. Michael Christian/SMS ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025rmmnn5im Tha Ar oRn nnma nnel Innn era ranicfcrarl m2rlrc of AriflRn 91te O ice of ronsumer 4Aairal�d Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement_-:Contractor Registration _ Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/6/2013 WILLIAM McCLUSKEY " 8201 S. HOURD CT = CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. Address Renewal 0 Employment ❑ Lost Card DPS•CAt as 50M-04/04-G101216 fie.ZJaaav�na�zure� o�✓l� �u6e/� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only. OHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: flF_ i_K4_jy_' Office of Consumer Affairs and Business Regulation Registration:: 164432 Type: 10 Park Plaza-Suite 5170 Ex iratio ,_.,.j. ��.. p 10/6/2013 Supplement Card Boston,MA 02116 CAPE SAVE = '` WILLIAM MCCLUS l 7C HUNTING AVE � --- S.YARMOUTH,MA 02664' `-' Undersecretary Not valid without ' nature Massachusetts- Department of Public Safet, Board of Building Regmiations and Standard. Construction.Supervisor Specialty License License: CS SL 102776 Restricted.to: IC WILLIAM MC CLUSKY 37 NAUSET.ROADAVI WEST YARMOUTH,I MA 02673 £ Expiration: 6/28/2013 ('+nnmissi"g1 r Tr#• 102776