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HomeMy WebLinkAbout0078 PITCHER'S WAY August 24, 2019 Town of Barnstable Mr. Ells,Town Manager 367 Main Street,Town Hall Barnstable,MA 02601 cc:Town Councilors, Health Department Director, Public Works Dept., Police Dept. Dear Mr. Ells, Manager,Town of Barnstable, My.neighbors and I are writing for your awareness and assistance in the following,and have cc:d other parties that should also have awareness, oversight authority and/or responsibilities pertaining to below. State and condition shared below has been ongoing for at least 6 months but in nearly all instances for years at these properties. It is a growing trend negatively impacting family, residential properties below in our neighborhood, and perhaps more importantly,neighboring residential properties and the neighborhood as a whole. • Residential properties being used as a central point for business, including business/commercial vehicles/equipment on the property as well as advertising signage of the business • Residential properties that appear vacated,abandoned,or otherwise are not maintained;overgrown brush/vegetation overtaking the property and structures in some cases;Same obstructing abutting sidewalk/walkway in some cases • Residential properties being rented short-term and frequently, in part(e.g.a room)or whole; sometimes as many as 5-7 vehicles parked in driveway, roads or in yards;Concern of exceeding occupancy limits Properties below have been observed to have at least one/of above conditions: -230 Scudder Ave 245 Scudder Ave 5 Sylvan Dr 16 Sylvan Dr (78'Pitchers Ways 20 Arbor Way . _, .._-•_ gip_ 52 Pitchers Way 53 Arbor Way 65 Sylvan Dr 73 Sylvan Drive 7 Briarwood Ave 142 Pitchers Way 93 Arbor Way It is my understanding that Town regulation/code touches on one or more of these conditions, nuisance,violations at these addresses,though is not limited by just these: Chapter 170, Rental properties 160, Problem properties,chronic 192, Signs 224,Vacant&foreclosing properties 54, Building Premises Maintenance 240,Zoning Several neighbors and I have discussed selling our properties and moving to another village or town presumably where these conditions are not the sustained/growing issue they are here before things continue to worsen the neighborhood and property resale values. If one cannot afford to own a single-family, residential property/home: without a turnstile of renting rooms;or because they cannot afford the most minimal/basic upkeep and maintenance of that property;or without operating and advertising business services from that residential property,than perhaps one solution they should consider is renting themselves and leaving home ownership to those who can,and who are interested in all the responsibilities that go along with property ownership-rather than cutting comers and skirting laws/code,and ultimately adversely impacting the neighbors and slowly dragging down our (once)quiet residential community, never mind the property values from resale perspective. I s xl' Additionally,I wanted to call your attention to the increasing and persistent traffic issue in our neighborhood.I am told that neighbors have submitted complaints,and have visited the Barnstable Police Department in the past to request relief in some form. Vehicle traffic on Pitchers Way and Scudder Ave regularly experiences dangerous speeds,and far exceeding that for the population density that exists in our neighborhood,and for the pedestrian traffic that area children, bikers and dog walkers use it for. From Scudder and Marston Avenues intersection to the West End rotary& Pitchers Way and West Main Street intersection to Scudder Ave,traffic more often than not reaches and exceeds 45-50mphl While it may be significantly worse during peak season months, it exists all year long. I think it's reasonable to understand that these are primary roads that see a lot of traffic, but the consistent traffic speeds we experience is both absurd and dangerous for our neighborhood and the people who live and visit here. May we make a suggestion of 1)increased police, speed trap monitoring presence 2)speed bumps/tables(either permanent or temporary)and/or 3)the traffic study resources needed(if any)to install solar powered signage with speed limit with real-time speed alerts of traffic to drive proactive behavior changes by drivers-like in Hyannisport,Osterville and South St in Hyannis Any other solutions or suggestions are needed and welcome toward the goal of improvement and safety. I welcome your review of the matters,and know you will find status as described. I hope that the Town can assist with addressing and responding to the matter such that conditions above are curbed and prevention of reoccurrence such that this community can be safely maintained. Sincerely yours, Voting neighborhood residents r iK � •� r Application number . .�...L........................ Fee .�. ....... Qti , ............. i....................... T J /oy/� Building Inspectors Initials.........a.. .. �......... Date Issued.....d......�a.....l...l..... . : Map/Parcel...... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/'WEATHERIZATION PROPERTY INFORMATION Address of Project: 26 e it S: tOA y NUMBER'\ STREET VILLAGE Owner's Name: ..J F) k-f= 1.,1 E y Phone Number OZ Email Address: /��{qS�i �eP�il�� cQ Cell Phone Number Project cost$ Check one Residential // Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780'CMR Owner Signature: Date: TYPE OF WORK Q Siding UU Windows (no header change)# 0 Insulation/Weatherization. 0 Doors (no header change)# Commercial Doors require an inspector's review Q Roof(not applying more than 1 layer of shingles) Construction Debris will be going to Ce- CONTRACTOR'S INFORMATION Contractor's name All 14•-/ �\` L.,' Home Improvement Contractors Registration if applicable) S- ?O E"', (attach copy) Construction Supervisor's License# 5 �T & 2. I (attach copy) Email of Contractor /%i r ��O� LU�(� J�. 6,,Phone number �- r 2��— G/ ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER.........................................i�................ r� , *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X. X 9 X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet ofeach tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No___, if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is.required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date LIC NATURE Signature A61 Date Alt permit applications are subject to a building official's approval prior to issuance. ' � r a 9 . Commonwealth of Massachusetts 1 lug Division of Professional Licensure . Board of Building Regulations and Standards Constructio�!,,�S1Y�fei � 1 & 2 Family •1p CSFA-106219 -> —'' ires: 06/28/2019 ��2a. MICHAEL SIL--V]Av O 82 WALTON HYANNIS MA 42601- ':;UOI��OAS ¢O Commissioner ' �ZCb n 10L� ` \%n9 �0 — �o 1,oo a Boa Ssas oa ol a�n\ .:- s fyy sluff a�10%ash 003 r,0 on a' dPas `e3 o��\p a5 5¢Waql)o J nu s11as 'os,Naani,, , ajoosiapun _ l09Zo dW`SfNNNd1:H 'NO -LI dM ZB y, �(. lIS'4-13`dHOIW n'llS'13`dH0lIN 6.l.ozlsol190 �o—�e��s�.� -' uo!;-3 jr;npwpul.3dl.1 c OHdW131NOH E liOlO dB1NOO 1N3 Wan o ao! ±>' L,, Lj6jElnBad ssaaupnng S�1e11V�awnsuo�; !dU - - Q �P P 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/EIectricians/Plumbers Applicant Information / Please Print Lezibly Name(Business/Organization/Individual): G Address: City/State/Zip: Phone#: Are you as employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I e ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. 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' 9. ❑Building addition [No workers'comp.insurance comp.insurance$ 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 11.❑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.[:1 Other 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 submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those 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 M employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 certify un t pen ofpeijury that the 'formad provided a t above is true and correct. Signature: Date: �1 1,4� eu 2017 Phone2— 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced'acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to-your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerfifcate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(UP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city-or townthat the-application for the permit or license is being requested,not the Department of �_____......_,7 +l.v 1.,..r vr:F<r.,,,.ira rgmTlrp.A to nl-fain q wfwla S' Industrial Accrcients. Jhoula you have K y qucSLL0ns raga d—g " -�+• �• -- --- compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a reference number. In addition, an applicant that must submit multiple permitflicense,applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or ' town)."A copy of the affidavit.that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for firit>re permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or'pennit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massaahusefts Department of Tndustdai A=dents ` officc of TAvesti.gatima€s 600 Wasbi-4an meet Boston,MA 02111 Tel :ff 617-727-4900 ext 406 or 1-977-MASSAFF, Fax##617-727-7749 Revised 4-24-07 wvw.mass,gov/dla MICHAEL SILVA 82 WALTON AVE. HYANNIS Mass. 02601 H.I.C . 175708 C. S . 106219 - Jake Dewey Nov 12018 78 Pitchers Way Hyannis Mass Job description Remove old casement window and replace with new harvey casement . Remove old double hung mulls and replace with Harvey double hung mull . Replace double hung windows with new Harvey . Remove and replace bow window with with picture window . Replace casing on inside of windows with 2 1/2 colonial casing . out side of windows replace trim on all new windows with P.V.0 board and new sill nose Remove all debris and clean no painting or staining included in cost'of job Total cost $6,200.00 1/2 to order windows rest when ' is done Michael Silva AJae Dewey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel \' Application # 6 06S3 Health Division Date Issued z 2 3 45 Conservation Division Application Fee Planning Dept. Permit Fee ta',S Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Stree Address Village M Owner 1v� ,c� rG5 Address Telephone p Permit Request 0 VU G �'W 6N g �j 6 �' ZS ( �DRik- V__ U Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 ( q ft) Number of Baths: Full: existing new Half: existing `new `- Number of Bedrooms: existing _new y Total Room Count (not including baths): existing new First Floor R ,om Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other �r+ 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) Name Telephone Number Address vd t"" License # G 4V Home Improvement Contractor# f�✓�S� Email Worker's Compensation # C � �S ALL CONSTRUCTION DEBRIS RESULTING FROV THIS PROJ CT WILL BE TAKEN TO SIGNATURE DATE C t FOR OFFICIAL USE ONLY APPLICATION# DATE.ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE 4 OWNER p DATE OF INSPECTION FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL,BUILDING z DATE CLOSED OUT ASSOCIATION PLAN NO. ' " ` i *..:board Massac:husetts - Department.of Public Safety of Building Regulations and Standar ds Construction Superviscir License: CS-100988.. HENRY E CASSPIZ 8 SHED ROW }� WEST YARMOUfiH 4 `✓, �1 '� " � Expiration Commissioner 11/11/2015 x .b Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY --- 18 REARDON CIRCLE ---- SO, YARMOUTH, MA 02664 Update Address and return card, Mark reason for change. ;CA1 4) 20M•0er11 Address Renewal Employment ❑ Lost Card �e ai�N�zaracueu�C�c�'C�/P/l�cwoac/uaett Office of Consumer Affairs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date, If found return to: egistratlon: 1.53567 Type: Office of Consumer Affairs and Business Regulation xpiratlon;:;,;.1.21:1.;?/20.1.6 Private Corporation 10 Park Plaza-Suite 5170 :- ':':::. y. Boston,MA 02116 CAPE COD INSULATI;ON;;1NC;.`-.: 1ENRY CASSIDY 18 REARDON 30.YARMOUTH, MA 026641. Undersecretary VYv t sign •e The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations a d I Congress Street, Suite 100 ry Boston, MA 0211 A-2017 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Or 'zation/Individual); Address; 60V City/State/Zip; t, Phone #; Are you an employer? Check he appropriate box; Type of project (required); 1.�I am a employer with 4, ❑ I am a general contractor and I employees (full and/or part-time),* have hired the sub-contractors 6• ❑ New construction 2,❑ I am a sole proprietor or partner- listed on the attached sheet, 7. ❑ Remodeling shipand have no employees These sub-contractors have 8, ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp, instrrance,t 9. ❑ Building addition required,] 5. ❑ We are a corporation and its 10,❑ Electrical mpau•s or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑ Plumbing repau•s 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,] // ' "Any applicant that checks box NI must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this fffffdavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those 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 lire policy and job site ,,Information.Insurance Company Name: l,.�(, Q.V,,.I�6v Policy#or Self-ins, Li�c/, f� �� ! 0 Expiration Dater i f Job Site Address; C City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy numb r and expiration date). Failure to secure coverage as required under Section 5A of MGL c. 152 can lead to the imposition f 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$250,00 a day against the violator. Be advised that-a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance""overage verification, I do hereby certrfy n r pains and penalties of perjury that the Information provided r bove Is�yue anrd correct, Si nature: �, IP7 Date; Phone#: Official use only, Do not write In this area, to be completed by city or town offlclal, City or Town: Permit/License # Issuing Authority(circle one): 1, Board of Health 2, Building Department 3, City/Town Clerk 4, Electrical Inspectol• 5, Plumbing Inspector 6, Other Contact Person: Phone#: V. r ` I CAPECOD-27 KLIGETT �.� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.ITHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement($). PRODUCER CONTACT Rogers&Gray Insurance Agency, Inc. NAME; Barbara DeLawrence 434 Rte134 PHONE FAX ;. South Dennis,MA 02660 a/c A/C No: (877) 816-2156 ADOREss: bdelawrence@rogersgray.com INSURERS AFFORDING COVERAGE _ NAIC d INSURE INSURER A:PeerleSS Insurance Company INSURER e;COMMERCE INSURANCE COMPANY Cape Cod insulation Inc INSURER c:Evanston Insurance Company 18 Reardon Circle South Yarmouth,MA 02664 INSURERD;ATLAN I IC CHARTER INSURANCE GROUP INSURER E 0-0 ERAGES NSURER F: ------ — CERTIFICATE NUMBER: T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NIAMOED ABOnVEBEOR THE POLICY PERIOD IN ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH FHIS 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. SR n o TR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP ----_ a X COMMERCIAL GENERAL LIABILITY MM/DD/Yl YY MM/DD/ay LIMITS i CLAIMS-MADE J OCCUR CBP8263063 EACH OCCURRENCE $ 1,QQQ�QQO 04/01/2014 04I01/2015 PREMISES Ea occurrence $ _ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL $ 11000,000 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY❑PRO. ❑ GENERAL AGGREGATE $ 2,000 QQQ JECT LOC _ OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000 rA.UTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT I ANY AUTO 14MMBCKVMK (Eaaccidenl $ 1,000,000 ALL OWNED X SCHEDULED O4/O1/ZO14 04/01/2015 BODILY INJURY(Per person) $ AUTOS AUTOS HIRED AUTOS X NON-OWNED BODILY INJURY(Per accident) $ AUTOS PROPERTY DAMAGE (Para cident $ X UMBRELLA LIAS X OCCUR $ EXCESS EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE y XONJ453514 04/01/2014 04/01/2015 --- - -- X RETENTION 10,000 AGGREGATE $ ORKERS COMPENSATION Aggregate $ 1,000,000 LOYERS'LIABILITY OTH-RIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 STATUTE ER EMBER EXCLUDED? N/A 06/30/2014 06/30/2015 E.L.EACH ACCIDENT In NH) $ 1,000,000ribe untlerE.L.DISEASE-EA EMPLOYEE $ 1,000,000as, OF OPERATIONS below —_ _ E.L.DISEASE-POLICY LIMIT $ 1,000,000 SCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Irkers Compensation Includes Officers or Proprietors. — ditional Insured status is provided under the General.Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. ?R IFICATE HOLDER CANCFI I GTIr)M - OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at I / (Property Address) (Property Addre s) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. i O wn s Signature Date .Val' Town of Barnstable *Permit# Expires 6 months f rs ue date O;. Regulatory Services Fee Thomas F.Geiler,Director 16 ArfD��. Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.rna.us -Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number a We/ Q(Q Property Address 7� Qr fC,hS1 l'� �/ dylm tl tS /!1 ebi t'00 Residential Value of Work gdoo Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address b be,Jey r 7li, Ptl-ej•er`S c,Jck� 601(00( Contractor's Name S ors A IC I.,Q- [IOMe_ Tvi orev�at e.r T Telephone Number5OV- -7 7.5-t 118 Home Improvement Contractor License#(if applicable) 1 O 7 5 7 Construction Supervisor's License#(if applicable) (1' S (.p(-c y.� Vorkman's Compensation Insurance `" R SPPERMIT Check one: ❑ I am a sole proprietor ISEP 1 0 2010 ❑ I am the Homeowner ❑ fhave Worker's Compensation Insurance I OWN OF BARNSTABI P Insurance Company Name QUO C�cjC�— Zr1&t kF -,r- Workman's Comp.Policy# I.JC 7 W`{9 4 3 U(2,00`j Copy of Insurance Compliance Certificate must accompany each permit. r : Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders. U-Value ,� (maximum .44)#of windowsrj _, 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of th ome Improvement Contractors License&Construction Supervisors License is SIGNATURE: Q MPFILESTORMbuilding permit fotms\EXPRES .doc Revised 090809 Town of Barnstable Regulatory Services . r Thomas F.Geller,Director suss. $ Building Division Tom Perry,Building Comrnissioner r 200 Main Street,Hyannis,MA 0260E www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 Property OwnerMust Complete and Sign This Section If Using ABuilder L O—K:2 y ,as Owner of the subject property hereby authorize r �C,I Q_ to act on my behalf, in all matters relative to work authorized by this building permit application for. .(Address of Job) Tl� S' tore of Owner I?ate Print Name , If Property Owner is applying for permit please complete the Homeowners License Exemption Dorm on the reverse side. f1•Fl1RMC•f1WtJFRPF.RMi.CCInN :. The Commonwealth of Massachusetts Department of Industrial Accidents f, Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APPUcant Information t Please Print Leeibly Name(Business/Organization/Individual):S 1)r',n Y_t4L } We..- Zv i n fbVILMC.Af Address: L99 ; a.rn5 W RwA City/State/Zip: 4 A Oa(00) Phone#: 50T 7 7.5 1-77 g Are you an employer?Check the appropriate box: Type of project(required): 20,010 4. I am a general contractor and I 1. am a employer with � 6. ❑New construction employees(full and/or part-time).* r have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractars have g, Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.insurance comp. insurance.= required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised I I. Plumbing 3.❑ I am a homeowner doing all work d their g 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. k)i 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 coritrectots must submit a new affidavit indicating such. tContractors 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 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 information. 1 Insurance Company Name: }-�S$OC.i�1.ir� -r kL St f-ke S Policy#or Self-ins..Lic.#:AEG ZOo L4 9 q 301 kb l0 Expiration Dater 0( . Job Site Addresv` it's-_- _ City/State/Zip y S. rn (ou( Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to sequie coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$I,300.00 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 Investip,ations of the D vera a verification. I do hereby certi rrde a ain enalties of perjury that the information provided above is true and correct Signature: Date ' �Z--` 16 _ Phone#: Official use only. Do not write in this area,to be completed by city or town ofjiciaL 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#: O}rcef`Co,�umer 'iairs 8c iisiness ego a`% ense or registration valid:for individul use only ' Lie HOME 1MPR0VEMtNT CONTRACTOR before the expiration date. If found return to: Registration: 03757 Type Office of Consumer Affairs and Business Regulation Expiration: �Q12 Private Corporate! 10.Park Plaza-Suite 5170 - Boston,MA 02116 tTSU E HOC�IY NC. I 199 Barhstatt�li3 Rd� - ��jQ� ��_- �. Hyannis,WIk;i326�1 :� ;e;` Under§ectetirry Not valid without sign,tore Mh�sac.husetts- Department of Puhlic $afet� i Restricted to: 00 Board of Building Regulations and S6ndards I 00- Unrestricted Construction Supervisor License ! 1G-1 2 Family Homes License: CS 6643 Restricted to: 00 BRAD.K SPRINKLE `:. i Failure to possess a current edition of the 190 LQTHROPS LANE*`' ' Massachusetts State Building Code W BARN3BL E, MA 02668 , is cause for revocation of this license. Y Refer to: WWW.Mass.Gov/DPS Expiration: 10/8/2011 I ' Commissioner Tr#:-5478 • ��® OP ID Ds DATE CERTIFICATE OF LIABILITY INSURANCE SPRIN-1 01/05 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax:508-790--1414__ IINSURERS AFFORDING COVERAGE NAIC# INSURED II RER A_Associated Industries of MA" — INSURER B. Spprinkle Home Improvement Inc. INS_URER C — 199 Barnstable Rd INSURER D — Hyannis MA 02601 ----_- --- — INSURER E: " COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR�NSRE TYPE OF INSURANCE POLICY NUMBER DMA ECMMIEDDtYYYY I DATE MMWD DrIYYY LIMITS GENERAL LIABILITY _ - -EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY - - � j PREMISES(Ea occurence) $ CLAIMS MADE OCCUR I MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: j" PRODUCTS-COMPIOP AGG $ POLICY PRO• LOC - _ I •. - .. JECT AUTOMOBILE LIABILITY. j COMBINED SINGLE LIMIT ANY AUTO ALL OWNED AUTOS i BODILY INJURY SCHEDULED AUTOS " - I (Per person) HIRED AUTOS L BODILY INJURY $ NON-OWNED AUTOS I (Per accident) PROPERTY DAMAGE -- - _ - -I $ (Per accident) GARAGE LIABILITY i AUTO ONLY-EA ACCIDENT $ i ANY AUTO" OTHER THAN EA ACC $ j I AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY _ EACH OCCURRENCE $ OCCUR F—ICLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION TORY LIMITS ER AND EMPLOYERS'LIABILITY YIN , A ANY PROPRIETOR/PARTNERIEXECUTIVq--j AWC7004.943012010.. . 01/01/1.0 01/01/11 EL.EACH ACCIDENT s500000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) i I E.L.DISEASE-EA EMPLOYEE S 500000 If yes•describe under SPECIAL PROVISIONS below I E.L.DISEASE-POLICY LIMIT $500000 OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 4 CERTIFICATE HOLDER _ CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SPRNKHO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL Sprinkle Home Improvement, Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR . Fax #508-775-1350 REPRESENTATIVES. Margo Mack AUTHORIZED REPRESENTATIVE 199 Barnstable Rd. Kelley A.Sullivan annis MA 02601 ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD