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HomeMy WebLinkAbout0110 OAK HILL ROAD xu` / 7�a1, �7 _ t CAPECOD INSULATION IIBLR GlA55 SlA.1- SPR-AM SGSPI.- BARS GBR6RS INS BUIIIO" CSILINGS 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 P Date: �� 1//,3 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization 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 Villa e h�G`��Glf B /.o d Qa a-. lei o &l o l l A i S /V1 Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted , Ceilings Slopes (X) ( ) ( /�) oO ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls w GGw,GI�G��G� ►.-• cn � '-o cO Cl n Sincerely —' 0 hECasJr, Presidenton, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d-qQ) Parcel �' Application # 061_36&66 Health Division Date Issued f_J —/3 Conservation Division Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ,//® !44,41 Village AZ"AZ` -I Owner z:X P 4d V Alo"e & Address Telephone � '2 4N 6� Z r Permit Request ���'.�9��5.� "���'� ����,�f;40 Lie XY�p Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation J bej,3, 61V Construction Type _11vA, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Cr1Qo On Old King's Highway: ❑Yes -iTNo 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: o :. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ y Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION C) _ (BUILDER OR HOMEOWNER) Name Telephone Number Address T!: License#�>fJ U Home Improvement Contractor#/5�3,SJG Worker's Compensationj� f>DS�z,3��e ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# a 4 � DATE ISSUED k F MAP/PARCEL NO. ADDRESS VILLAGE t OWNER DATE OF INSPECTION: G e a FRAME FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH t' FINAL FINAL BUILDING,,- DATE CLOSED OUT ' ASSOCIATION PLAN NO. t 1 a �ln sua'buticfis - Ucll:u'tuacul of Public ' :afc1\ liuural arf Iaa�il'llin� I:c�ulatluns and �t:uld:u'tls q GonstruFtion Supervisor License Ltcen '.CS o 100988 HENRY CASSIDY 8 SHED ROWS WE3jF YARMOUTH, MA 02673 _r Expiration: 11/11/2013 l uuuissiuu�r Try: 7620 r.cr1(1/ 6?4/J 1 Office of Consumer Affairs and BuSlness 1legulati011 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/?t)14 Trk 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 ___._____.__.._...... .___.._....- Update Address and return craral. Mark reason for duinge. Address Cl Renewal �._I IFIriployuicnt I I host Card • ,jai,., i // le : . Uftiee of Consuluet-Affairs & Business Regulatio❑ License or,registration valid for individul use only 1,lOME IMPROVEMENT CONTRACTOR before the expiration date, If found return to; eyistration: 1535b7 Type: Office of Consumer Affairs and Business Regulation ' xpiratlow 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,NIA 02116 ..::nl'f;Ciil)INtiULATION,ZINC. 'u:rvl;1 c;As;;u1Y . I�i i�C:ARpc.)N CIKCLE - MA 02664 --------- --- ('tho otval w t hilt re CAPECOD-27 MYOUNG CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/8/2013 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 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 License#PC-514062 NAME: Margaret Young Rogers&Gray Insurance Agency,Inc. PHONE FAx 434 Rte 134 A/C o Ext: AIC No South Dennis,MA 02660 EADDREMAIL SS: Y 9 9 Y�m oun9@ ro ers ra com INSURERS AFFORDING COVERAGE NAIC 9 INSURERA:PEERLESS INSURANCE COMPANY INSURED _ INSURERB:COMMERCE INSURANCE COMPANY Cape Cod Insulation,Inc. -INSURER C:Evanston Insurance Company 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURERE: ° 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. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DDIYYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8263063 4/1/2013 4/1/2014 (Ea occurrence) $ 100,000 CLAIMS-MADE FX]OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PROJECI LOC $ AUTOMOBILE LIABILITY (Ea SINGLE LIMIT 1,000,000 Eaaccidenl $ B _ ANY AUTO 13MMBCKVMK 4/1/2013 4/1/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS X HIRED AUTOS X NON OWNED P ER ACCIDENERTY MAGE $ AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAR CLAIMS-MADE XONJ453512 4/1/2013 4/1/2014 AGGREGATE $ 1,000,000 DED X RETENTION 10,000 1 $ WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS'LIABILITY OR LIM TS R ❑ D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 6/30/2013 6/30/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Ryes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder, CERTIFICATE HOLDER CANCELLATION Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/]Electricians/Plumbers APplicant Information Please Print Legibly Name (Business/Organiza6on/Individual): Address: �i ae : �2GL ne Ci �'/Stt /Zi �'��`D�� Phone #: Are you an employer? Check the appropriate box: El I am a employer with. 4. [3I am a general contractor and I Type of project(required): l. employees(full andrior part-time).* have hired the sub-contractors 6. ❑ New construction i 2.[3 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp. insurances 9• ❑ Building addition required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12,E] Roof repairs insurance required.] t c. 152, §1(4), and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13171 Other%Sv1.4X.-O I general contractor(refer to#4) comp•insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workcrs'compcnsadolf' olicy 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. tConaucton that chock this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have cmployem. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ain an employer that is providing workers'compensation insurance for my employees: Below is the policy and job site information. , Insurance Company Name:_41-14 JZ72 Policy#or Self-ins. Lic.#: /A- ,-2 Zj A, 'j >, f ,, , Expiration Date: Job Site Address:_/YG p � � j�� ,4 tz L/Z City/State/Zip: 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 imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer fy der the pains and penalties of perjury that the information provided above is true and corrects Ph. Da i 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 Contact Person: Phone#: OWNER AUTHORIZATION FORM I, (Owner's Name) owner of the property located at 1�/,)/ (Property Address) (Property Address) hereby authorize �% �Gt +,'CA (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date Assessor's map and lot number ..... Sewage Permit number ..r ...:r..z`J ................................ °`T"E?°�y TOWN OF BARNSTABLE Z B9HB3 LBLE, i "b BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...c�nP...:`!a MIII ir....?-1- c+• •- - n ......................................................... TYPE OF CONSTRUCTION ....... + FramA................................................................................................... ?..7... ...................197b, TO THE INSPECTOR OF BUILDINGS: - "The undersigned•hereby applies for a permit according-to the following information: '`�"t ... T, nda T,anP T;�rarri7 c Location ........... ...... .................................. ....................................................... .......................................... ProposedUse .....R e.S i r1 end A it 1•........................................................................................................................................... .Zoning District Residential Hvanna s ................................... ................................... . Fire Distract ............,............................... Name of Owner Flovr3 .nd„ n al � i �Sr7 .....Address ..56..:T ixtc?,a 1:enp ,Kv"a:n:1?.q,...r�acc.:......... Name of Builder 97lovd ,and �tOnRld �i !�;Zr?a. Address Kh T,�n{�a T,�....P...�T.�ran,?i.�.; tula.cn ............. ..................... _...................t� . Name of Architect roY?E'.....................................Address Number of Rooms �' `.........Foundation .....P.()IaT.'eF d..I T. ............................................ ..,......:........................................... Exterior hA-nc'.�.f'...................................Roofing �h�xa�l ��. �s.�hal.t............... .. ....., ... ....................... Floors Dortble Vhi.gknes; .K/R" P1 vwCt ri.............Interior ...........T.............................. Heating ''7;P�1 xl;'�', ' Plumbing ....,,,, .,�,`,r. n 1, n �. ..............:............... Fireplace ....pn f , n...1.J tr7 rap .-rr ram ....... ...i........�..Approximate Cost „ h 1 l Definitive Plan Approved by Planning Board ._ 'x ___________19 _. Area ..t��!....., !. .•.� ... Diagram of Lot and Building with Dimensions / tJ Fee y SUBJECT TO APPROVAL OF BOARD OF HEAhTH � s j o q1 c� I� c;jd, 22- (�72— SOCOV19 F`o©n. . F t I hereby agree to conform to all the Rules and Regulations of the Town of Barn stableeregarding the above construction. ✓ Name.,.,. ...............................":7`,.................................... ' Silvia, Floyd & Ronald No 17157..... Permit for two. story, single„family dwellin> ' / ` Location - d�Lane:... .........................H1rannis...................................... e Owner Floyd & Ronald Silv ia ................. ......................... Type of Construction frame ................................................................................ Plot ............................ Lot .....A� ...................... Permit Granted ..........juns..19...............19 74 Date of Inspection ....................................19 Date Completed ......................................19 i. PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and' lot number L....l�. G � 7'7- w INSTALLED IN COAItKIANCt Sevvage.Permit number ....•.......a!'�°`.l......... J WITH ARTICLE II STATE SANITARY CODE. AND um yo�THETo,�=�� TOWN OF BARNTrm i IARISTOILE, " ` 1UI.LDI;NG INSPECTOR 1639• 9 .EIMPYa� `• �j APPLICATION;FOR PERMIT TO ...OTIe...family. .1 U St-ory-CaPe.......................................................... TYPE OF CONSTRUCTION ........Wl.o.ad..F.rame................................................................................................... .......June...1.7......................19.7.4-- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........Lot#..4-Linda...Lane...Hyannis........................................................................................................... Proposed Use .....Re,s.ideri:�;la'1........................................ Residential Z• H annis ZoningDistrict .......................................... . .........................Fire District ..........,y................................................................ Name of Owner .F1,Qyd..and...RQX.Ia.1.d..,9i1.Vi7........Address ..5.6..Linda..L=.e..Hyannis.l...]]Was•s........... Name of Builder IRk'.l0yd...aD.d...R0.r1a1C1...Sz.1 V.i.a.....Address ..56..Linda..Lane..Hy2nnis......Wa,S.S........... Nameof Architect ..................no.ne.....................................Address .................................................................................... Number of Rooms .............6........................................:.........Foundation ......Poured...i.Q'.:.............................................. Exterior .W.Qod...oe.dar...Sh.ingla:.................................Roofing .Shingles...asphalt........................................ Doubl T " Floors .............4'......11.7,C1CX1eS.S...S..$.....P.IyIN.O.Qd..........lnterior .................................................................................... Heating ..Elac uric..........................................................Plumbing .....capper...and plasti-c.............................. A Fireplace .....0.ne...1n...�..1.V.ix1g..S:O.OI71.............................. pproximate Cost .... .:...............................A; J Definitive Plan Approved by Planning Board _40—W _cam____-_______19 6____. Area ........ /E.... C..... Diagram of Lot and Building with Dimensions I�r Fee. ........................ SUBJECT TO APPROVAL OF BOARD OF HEA TH- to 3 k.o a T v 22r 9 9 r2- I hereby agree to conform to all the Rules and Regulations of the T w of rnstaVrt garcling the above construction. Name---7A ......... ........ .................................. Silvia, Floyd & Ronald , 17157 ` *--two story, ' No ................. Permit for ..................................... . , mloQle family dwelling ` ^ --------------------------' . Linda Lane - Location —.,�� ---- . — . ' � [' '' ' ' ----------- annis --------.---..�-------------.. Flo �� Ronald Silvia Owner ---...����-----------'..—.—. ^' frame Type of Construction -------------- / .� —~--.—^—.... ------------------ - �r � Plot ............................ Lot --- '-----' ` Permit Granted --.Jl��a..��. lg 74 | ' | Date of Inspection �' g ~ . � Dote Completed ...... lg � . - ' ' . ' � , PERMIT REFUSED ` - ---------------------.. lA . ^ ' —.---~-----------------.. ` -�.. -- —.. ----------- —. ...;,--.---.-----------~--.--... , ' . ^ —..''—.—.—.—.--.—.—....—..~—.----- . ^ . -- ----------- l� ,, - -- -�—' � ` -------.----------.--------. ^ ' . . , ------------------..'------- � .