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Home My WebLink About3420 MAIN ST./RTE 6A(BARN.) (4) �h ;�- g �. _ ,� e - - -�.— ._ . v , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION W , Map Parcel �p�ricaon # Health.Division Date Issued 3 Conservation Division Application Fee � 3 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �'e 7-1 3 Historic - OKH _Preservation/ Hyannis Project Street Address � '�{ 20 Ai �-r�z, �r Village IAA aW 57ti E5 LE HA 02-6�3 0 Owner 1261 S GI LLA 57"121 EM 1A Address 0 , 06A 115 1 1?4at J5-r P � Telephone 5O8 '" �J2 - :-�)O\\1 S Permit Request uL-A-r10f 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 I o C � Basement Finished Area (sq.ft.) 'k Basement Unfinished Area O sq Number of Baths: Full: existing new Half: existing nbw o Number of Bedrooms: existing _new ^? Total Room Count (not including bath.:): existing new . First Floor Ro� m Court? n Heat Type and Fuel: XGas ❑ Oil ;Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name t'(rNf�i2 D V Telephone Number !�2-nB --7 7 _0 1 V -1 Address �P"k Tr,, License # C " C) qarC�[)'f1�,) C�2(�7 Home Improvement Contractor# C Zl q Worker's Compensation # V= 50055 9'50 t 2O 1`Z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE A117-4o I b FOR OFFICIAL USE ONLY APPLICATION# F , DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: Y y _FOUNDATIQN, . ti FRAME }i Y 1 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL y. PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 302 OWNER AUTHORIZATION FORM (Owner's N me) owner of the property located at (Property Address) (Property Address) hereby authorize d� (Subcontractor an authorizedsubcontractor for RISE Engineering, to act on my behalf to obtain a building permit.and to,perform work on my property: Owner's Signature ,Y . Dafe � •1.--] i t i UlL JIMCi PERFUMUMUE INSTITUTji,iHti 4 MASS a Ghu ettS-Department of Pudic Safety 107 H Road,Suiia 110 .Board of Building Regulations and Standard Mafta>NY 12D20 C onstru tion Superri r (877)274127a Lai nse CS-069068 www,bpi.com RICHARD S.TUPF'ER 3 79 B MID-TECH DR � ¢u WEST VARMO H A<42 fdchwd Tuppw # r ESP#3Lw' � '• CERTIFIED PROFESSIONA-L Expiration tSEE R€VERSE SIDE FAR DE3dk1i0R:i AtiA E? Aitfl#AAtESi t Commissioner 1213112614 fYiee of Consumer:Allain M1110 a{uea ite ali►ttc l HC?M6{ NT Cow MCTO x ion 61i8 14 Individual RIC Ct UPPFi 29 Rob a Or eeg W YAR UTH, 2613 tlatdersecrc#aryW._ yak , A66Dec. 19. 2012 4:37�M No, 8524 F. 1/2 HU1, @I DATE. MIDDNYYYy CERTIFICATE OF LIABILITY INSURANCE 12/19/2012 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 poticy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 endorsoment(s). PRODUCER COWACT NAME, Lora Lowe Southeastern Insurance. Agency, Inc. AtC No.Ex1; (508)997-6061 ArC N, (508)990-273.1 439 State Rd. .Mw1 ADDRESS: P.O. Box 79398 PRODUCER CUSTOM ID0: N. Dartmouth, MA 02747 COVERAGE INSURER{S)AFFORDING COVERAGE NAIL INSURED INSURERA: Arbella Protection Insurance Tupper Construction Co LLC INSURERB: AEIC INSURER : CNA Surety 27 Roberta Drive ......................................................:...:....:..............................................__._______ INSURER D West Yarmouth, MA 02673 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 12/13-2 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 CONTRACTOR 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 INSR yyVO POLICYNUMBER i MIVDiD IMMIDONYM LIMITS GENERAL LIABILITY - - - - 85000087431.1110112012 1V01/201.3;EACHI CURRENCE. $ 1,000,00 X COMMERCIAL GENERAL LIASIUTY E hdAC T cN _. _....... P�tEMi$a=S{_Ea nrcur erxe( $ 100,000 CAIMS MADE IF OCCUR MEG EXf>(Any one pare ) $ 5,000 A PERSONAL a ADV'NJURY $ � 1,000,000 GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPlOP AGG $ 2,000,000 IPOLICY JET LOC AuroMoaltELIABMY 566624000021210112012 12/01/2013 h $ i COMBINED SINGLE LIMIT e aoctla::i 1,000,000 BOD LY NJURY(Per person) $ ALL OWNED AUTOS BO LY NJURY(Pe accident) $ AX SCHEDULED Aji-Os I PROP E RTY-DAMAGE ._.:.....,.._..__$. _.�,..�_.......,..... X H:RED AUTOS !.,Per accitle:e)- INC. X=IdCN-.OWNE0:4ti1tt,S '$ UMBRELLA LIAB OCCUR i EACIIOCCURRENCE $ EXCESS LIAR Clr?RJSMI+.DE i i AGC>>REGFTE $ --�- DFCU $ _._.......... t=T19LE ! I GETE^tt;ON $ i WORKERS COMPENSATION WCCSOOS59301200 10/D312D12 10/D312013 X "C`'A } X I I I AND EMPLOYERS LIABIL TY Y I td T RY MIT, . ER ANY 'NrA` RICHARD TUPPER I E1 EACH ACCIDENT 500.,00 B -FI EF31E18_R ExcLuoEr INCLUDED FOR WC COVERAGE E.L DISEASE-EA EMPLOYE-E$ 560,00 (Mandatory in NH) If es cf scams urtler _ Dt LR.f?I'IN Of OPERATIONS t below _ E DISEASE•POLICY L.I?,41 $ 500,000, Pond or t e t ot money Por 71068913 0212812012 02/28/2013 Limit of S10,.000 C property. iiSCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES(Wch ACORD 101,AddMonal Remarks Schedule,N more space is requlmd) ll.ju i.o@csgrp:.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE'DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Conservation Services Group AUTHORIZED REPRESENTATIVE Attns Bill: 3uiio 50 Washington Street We..tborough, PIA OIS81 Lora Lowe .. ..... .............. 019882000 ACORD CORPORATION. All rights reserved: ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massaehitsetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelzibly Male(B sineSsiprganizatit}nlIndividttal): Tupper Construction to. , LLC Address: 79B Mid Tech Drive City/State/Zip: West Yarmouth, MA 02673 Phone#: 508.-778-0111 Are you an employer?Check the appropriate box: Type of project(required): 1.21 1 am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).'" 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-contractors have 8. ❑Demolition working for me in any capacity. workers'comp. insurance. 9. ❑Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its .required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL. 11.❑Plumbing repairs or additions myself.[No workers'camp. c. 152,§1(4),and we have no I2.0 Roof repairs. insurance required;]r employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks boy:#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 shcet'showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that:is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A81C Policy#or Self-ins. Lic.#: WCC 5 0µ0 5 5 9 3 012 012 Expiration Date:. 10/0 3/2 013 Job Site Address: ZA20 {Mai to City/State/Zip: n5} e. MA 0ZV30 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 tine 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. 1 do hereby certify.und t e pa ns andpenalties ofperjury that the information provided above is true and correct. Signature: Date. tO Phone#• ,1-7 S -d N 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 b.Other . Contact.Person: Phone M 04/28/2011 15:23 5087785010 TUPPERCO PAGE 01/01. U'PPER CONSTRUCTION CO.LLc 788 MID-TECH DRIVE,WEST YARMOUTH,MA 02673 PHONE: 508-778.0111 FAX: 508-778.5010 WVWV.TUPPERGO.COM Date: '- 1 Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application # 2.0 H A I►j 5r A l2-1J 5-ra I,-3LE- Issued on / Z Z i has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sin el , Richa d Tupper Licens -69058 130291 Check #: (A6%13 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f .. Map 299 Parcel 070/00H Application Health Division Date Issued Z— Conservation Division Application Fee $50.00 Planning Dept. Permit Fee $35.00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation /Hyannis Project Street Address 3420 MAIN STREET #8; Village BARNSTABLE Owner PRISCILLA SAPIENZA Address P.O. BOX 151• BARNSTABLE, MA 02630 Telephone 508-525-3015 Permit Request WEATHERIZATION WORK: PERFORM AIR SEALING MEASURES; SEAL HEATING/COOLING DUCTS; INSULATE DUCTS; INSTALL R-10 FSK SEMI-RIGID FIBERGLASS BOARD INSULATION TO ATTIC SKYLIGHT AREA; INSTALL CELLULOSE INSULATION TO OPEN ATTIC; INSTALL NEW ATTIC ACCESS HATCH; INSTALL VENTIALTION CHUTES, INSULATE BASEMENT DOOR - SEE COPY OF CONTRACT AND CHANC�E ORDER. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed IOtal new Zoning District Flood Plain Groundwater Overlay Project Valuation $2827.05 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 ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other- Zoning _ Board of Appeals Authorization ❑ Appeal # Recorded ❑Commercial ❑Yes ❑ No If yes, site plan review # _ Current Use RESIDENTIAL Proposed Use RESIDENTIAL APPLICANT INFORMATION -c (BUILDER OR HOMEOWNER) RISE ENGINEERING; A DIVISION OF Name THIELSCH ENGINEERING Telephone Number 401-784-3700 EXT. 6133 1341 ELMWOOD AVENUE Address CRANSTON, RI 02910 License # CSSL-IC 100459 EXP. 3/28/14 Home Improvement Contractor# 120979 EXP. 3/25/14 THE PRESTON AGENCY, INC. Worker's Compensation # 3730961-01 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YARMOUTH TRANSFER STATION• 50 WOWHOP AD• SOUT YARMOUTH _ MA 02664 SIGNATURE DATE ERIK NERSTHEIMER FOR RISE ENGINEERING FOR OFFICIAL USE ONLY APPLICATION# BATE ISSUED ' :`r-',' ;,7 ry MAP/PARCEL NO. i . ADDRESS VILLAGE OWNER DATE OF INSPECTION: . 'FOUNDATION FRAME INSULATION i r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 GAS: :_zM ROUGH,, FINAL :FINAL BUILDING}_ ;ai •t,, DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office Investigations f.� of '! 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/Organization/Individual): RISE ENGINEERING; A DIVISION OF THIELSCH ENGINEERING Address: 1341 ELMWOOD AVENUE City/State/Zip: CRANSTON, RI 02910 Phone #: 401-784-3700 OR 800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1. X� 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 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. insurance. # 9. ❑ Building addition required.] 5. ❑ We are a corporation and its ME] 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.❑X Other INSULATION 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 my employees. Below is the policy and job site information. Insurance Company Name: THE PRESTON AGENCY, INC. Policy#or Self-ins.Lic.#: 3730961-01 Expiration Date: 01/O1/13 Job Site Address: 3420 Main Street #8 City/State/Zip: Barnstable, MA 02630 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 certif der a ns a penalties of perjury that the information provided ab ve is tru and correct. Signature: Date: ERIK NERSTHEIMER FOR RISE ENGINEERING Phone#: 401-784-3700; EXT. 6133 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#: x i Division of Thielsch Engineering; Inc. 1341 Elmwood Avenue Cranston,Rhode Island 02910 RISE ENGINEERING DEBRIS AFFIDAVIT Debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter 111, Section 150A. If the debris will not be disposed of as indicated below, the holder of the permit shall Notify the Building Official in writing as to the location where the debris will be disposed. 780 CMR Section 111.5 The debris will be disposed of in: Yarmouth Transfer Station; 50 Workshop Rd; S. Yarmouth, MA 02664 Location of Facility 3420 Main Street #8; Barnstable, MA 02630 Name of Property Owner/Location of Proposed Work RISE Engineering; A Division of Thielsch Engineering Name of Contractor/Agent 1341 Elmwood Avenue; Cranston, RI 02910 Address of Contractor/Agent Signature Erik Nerstheimer for RISE Engineering Date Disposal,Affidavit 2006 RISE U ENGINEERING 1341 Elmwood Avenue,Cranston,RI 02910 9 TO CHANGE ORDER NO. ADDRESS S� DATE / 6 PHONE 0 5,DR -5zs-3®lS JOB NAME AND LOCATION I / JOB NUMBER Z) DATE OF EXI TING CO RACT 3 u.#--3 PoF d-Ac cf s o, (j--V a;6 ;n4A va 1 n lei _. rE 7 "; f a C1; j Note:This revision becomes part of, and in conformance with, the existing contract. WE AGREE hereby to make changes as specified above, at this price $ PREVIOUS Date / CONTRACT $ 2 AMOUNT I cc7 UTH IZED SIGNATURE) REVISED ( h CONTRACT d TOTAL 71 ACCEPTED:The above prices and specifications of this Change Order are satisfactory and are hereby accepted. All work to be performed under same terms and conditions as specified in original contract unless otherwise stipulated. DATE, ^!� l �— SIGNATURE/'/`ram , 4 RISE ENGINEERING rederal ID#05-0405629 . RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R102910 (401)784-3700 FAX(401)784-3710 CONTRACT Page 2 I S PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE MF-CLC ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client# Priscilla Sapienza (508)525-3015 03/18/2012 130291 SERVICE STREET BILLING STREET 3420 Main Street 8 P.O.Box 151 SERVICE CITY,STATE,ZIP - BILLING CRY,STATE,ZIP - Barnstable,MA 02630 Barnstable,MA 02630 (( ,!T JOB DESCRIPTION w - -$936.04 !' MAR 2 2 2012 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Three Hundred Twelve&01/100 Dollars $312.01 .UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS,SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. - DO NOT SIGN THIS CONTRACT IF THERE ARC A LANK SPACES AUTHORIZED SIGNATURE•RISE ENGINEERING - CUSTOMER ACCEPTANCE - - NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE _ - ` - ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE ' - - SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK ' DAYS. - AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE THIEL-1 OP ID:.27 CERTIFICATE OF LIABILITY INSURANCE DATE °"""' 01t13/12 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 - 401-886-8000 CONTACT The Preston Agency,Inc. NAME: 1350 Division Rd Suite 303 401-885-1700 PH E,rt: Arc, rc No): PO BOX 810 EMAIL East Greenwich,RI 02818-0.816 ADDRESS: Judith A.Wright CPCU AAI ARM INSURER(S)AFFORDING COVERAGE NAIC a INSURER A:Zurich-American - INSURED Thielsch Engineering,Inc.Thielsch Group Inc. INsuRERe:American Guarantee 8 Liability Hi Tech Realty Inc. INSURER C:Twin City Fire-Hartford Attn:Trent Theroux INSURER D:North American Capacity - 195 Frances Avenue Cranston,RI 02910 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. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 3730962-01 01/01/12 01/01/13 PREMISES(Ea occunence $ 300,00 CLAIMS-MADE �X OCCUR MED EXP(An y y one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,00 POLICY X jECTPRO LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 2,000$ ,00 A X ANY AUTO 3730963-01 01/01/12 01/01/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE AUC-4857188-01 01/01/12 01/01/13 AGGREGATE $ 10,000,000 DED RETENTION$, $ WORKERS COMPENSATION WC STATU- OTH- 'AND EMPLOYERS'LIABILITY Y/N X T DRY L MIT ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01/12 01/01/13 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDE( ElN/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS betow E-L.DISEASE-POLICY LIMIT $ 1,000,00 C Property Section 02UUNHE6930 01/01/12 01/01/13 Property see belo D Professional Liab DVL000026802 01/01/12 01/01/13 Prof Liab 2,000,00 y DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) When required by a written contract. CERTIFICATE HOLDER- CANCELLATION TWNHARW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 ��44 ©1988-2010 ACORD CORPORATION. All rights reserved: ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD r Ue[dIIS r-dye 1 UI I Licensee Details Demographic Information Full Name: ERIK S. NERSTHEIMER Gender: M Owner Name: License Address Information Address: 228 Gleaner Chapel Rd. Address 2: City: North Scituate State: RI ipcode: 02857 Country: United States License Information License No: CSSL-100459 License Type: CSSL-IC - Insulation Contractor Profession: Building Licenses Date of Last Renewal: 4/24/2012 Issue Date: 5/6/2009 Expiration Date: 3/28/2014 License Status: Active Today's Date: 4/25/2012 Secondary License: Doing Business As: Status Change: 18 Prerequisite Information =LR'eclan NERSTHEIMER, ERIK S. Attribute Of CSSL-100459 Discipline No Discipline Information Documentum t a R http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1 Mcense_id... 4/25/2012 �'In4 Office of Consumer Affairs d Business Regulation — — 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 i °'Home Improvement Contractor Registration JUN 2 0 2C12 Registration: 120979 Type: Supplement Card THIELSCH ENGINE +RING Expiration: 3/25�2014 1341 ELMWOOD AVE. CRANSTON, RI 02910 Update Address and return card.Mark reason for change. sCA 1 0 20M-05/11 Address Renewal Employment Lost Card n�1r.e �c.�nanao�rraealt�o�'G�/�lt�s;ac�u.telf nMce of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration:.<:::�20979._. Type: 10 Park Plaza-Suite 5170 Expiration::3/25/2014..:.. Supplement card Boston,MA 02116 THIELSCH ENGINEERING J ERIK NERSTHEIMER .. 1341 ELMWOOD AVE CRANSTON,RI 02910 Undersecretary Not valid without signature d Control No: 34244 THE COMMONWEALTH OF MASSACHUSETTS " DEPARTMENT OF LABOR 0 DIVISION OF OCCUPATIONAL SAFETY 19 STANIFORD STREET, BOSTON,MASSACHUSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielseh Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 WAIVER: LW000672 EXPIRES: April 15, 2015 IN ACCORDANCE WITH M.G.L. C. 111, § 197(B)(b)AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b)AND 454 CMR 22.04 WHEN PERFORMING LEAD-SAFE RENOVATION WORK. -?_'y0'W HEATHER E. ROWE,ACTING COMMISSIONER r Printed on Recycled paper - - - L r o R I S E Division of Thielsch Engineering,Inc. ; --- -- -- 1341 Elmwood Avenue -ENGINEERING Cranston,Rhode Island02910 Tuesday, July 17, 2012r - - -- --Town of Barnstable -- --- - --Thomas Perry, CBO 200 Main Street ____ .^Hyannis, MA 02601 - ___ RE: 3420 Main Street#8; Barnstable, MA 02630 - = Barnstable Building Permit#: 201203984 — - - Dear Mr.-.Perry, This affidavit is to certify that all work completed at 3420 Mdm; treet#8; Barnstable,MA -- .-- :_ - 02630, has been inspected by a certified Building Performance'Institute (BPI) inspector. The following weatherization/energy saving measures were completed -- 1. Perform 14 man-hours of air sealing to include all app priate blower door tests, combustion safety tests and procedures. -2. Seal heating and/or cooling ducts within,&signated unheated areas. Start at the largest -- ducts near the air handler. Highest priorities,are disconnected ducts and large holes. Seal -- ; carefully all wall and floor caviities;use as returns. Apply mastic to all take-offs and - -- _ duct size transitions. Seal all boots`to_ceilings and floors. 5 Man Hours. - - 3. Install 2.25" R-10 FSK faced semi-rigid fiberglass board insulation to 60 square feet of - ATTIC SKYLIGHT area Tapewall seams and edges with FSK tape. 4 -Install a 13" layer o„f-R-45 lass 1 Cellulose added to 589 square feet of open attic space. 5 Install one, new,.fimslied plywood, attic space access hatch. The hatch will be held closed by eye hooks. 6. Install ventilation,chutes in(15)rafter bays to maintain air flow. 7. : Insulate the,back,of the basement door leading to the EXTERIOR with 2" rigid foam -- board that meetts-the sections R-316.5.4 and 316.6 requirements of building code. 8. Install,R-8,faced fiberglass insulation to the exposed heating and/or cooling ducts in the - GATT C pa e. Total to be installed is 153 square feet. All work performed meets or exceeds Federal and State Requirements. _.- Sincerely, _ Erik J RISEEngineering Residential In stallations Department — - RISE Engineering; A Division of Thielsch Engineering CSL 100459/HIC 120979 ., - 401-784-3700 . 800-422-5365 . Fax 401-784-3710