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HomeMy WebLinkAbout0246 TURTLEBACK ROAD ,r.,,•a,�.�,,.,..,.,, -� ,,,...w......,.�r1�,...r..,..ML...; -.,.: .._�. - n..•r.w.•yn..�.,,.....�. "nr+h._r...-.«•...-.'v+�, trN"'°'�;"^ '�s-_—�.wrs.n,,.,....r....._,...n�. "`u.sM7.w.....t+L...; TOWN OF BARNSTARE R I S E Division of Thielsch Engineering,Inc. 2013 PgA F AM 11' 18 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 DIVISI®p4 May 1, 2013 Thomas Perry, CBO Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 ` Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 246 Turtleback Road has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 r .401-784.3700 •800-422-5365 •fax 401-784-3710 � 104784 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 0.100- L C5) Health Division `'Date Issued Conservation Division Application Fee n,p� Planning Dept. Permit Fee �/ > Date Definitive Plan'Approved by Planning Board Historic = OKH Preservation/ Hyannis Project Street Address 246 Turtleback Road Village Marstons Mills Owner Jill Quin Address PO Box 411 Marstons,Mills Telephone 508-420-2459 Permit Request air sealing, install 1178sq ft of R-19 to open attic 204sq ft of'-class I cellulose to sloped ceiling_ install 8 soffit vents install 68s'q ft of R-19 to the attic sloped areas Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1943 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 Proposed Use o o APPLICANT INFORMATION 1 (BUILDER OR HOMEOWNER) =� Name RISE Engineering Telephone Number 401-784-3700-- w Address 1341 Elmwood Ave Cranston, RI 02910 License # 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 3/31/10 Erik Nerstheimer for RISE Engineering FOR OFFICIAL USE ONLY r APPLICATION# - DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE -OWNER n DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL -PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL . FINAL BUILDING DATE CLOSED'OUT ASSOC IATION'PLAN NO. e i The Commonwealth of Massachusetis (Department of Industrial Accidents Office of Investigations 600 Washington Street Roston,AM 02111 >lwww.rnass.gov/dia Workelrs' cCOMPemsafion ffnsurance Affidavit: Bui➢dens/Contlractors/IE➢ectlrieians/P➢umbers Applicant Information Please Print g,_g%ld 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 1-800-422--5365 Are you an employeir?Check the appropriate box: Type of project(required): 1. I 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. ❑ VJe are a corporation and its required.] officers have exercised their I0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions .myself..[No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.� Other Insulation *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 affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy infonnation. 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 Policy#or Self-.ins.Lic. #: WC2-Z11-259874-019 Expiration Date: 04/01/ 10 _ Job Site Address:-7 P 1l�l,Y a,Qa� �� City/State/Zip: 1� � 1S 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do here�Z�#146r"` the 'ins an %penalties of perjury that the information provided above is true and correct. sya: 1�31/ v Si nature Date: Erik Nerstheimer for RISE Engineering Phone#: 401-784-3700 or 1-800-422-5365 Ext. 133 Official use only. Do not write in this area, to be cormpleted by city or town official .City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building(Department 3.City/Town Cleric 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: rage I OI 1 The Official Website of the Executive Office of Public Safety and Security (EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License 4 100459 Restriction WS,IC Name Erik Nerstheimer City, State, Zip North Scituate, RI, 02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Sack To Search ✓fie. Va��mw�uuea�� o�/�aoQac�zuce(�d '-' Board of T3uildine Regulations and Sta-ndarit �; License or registration vapid for individW use only i HOME IMPROVEMENT CONTRACTOR I. before the expiration date. If found return to: r Regist.—I— : 12097g Board of Building Regulations and Standards Ezpirtiati:o:ngj25/2010 One Ashburton Place Rm 1301 TYP;e" uP.P1emeni Card %T�! n,l-42. 02108 HIELSCH ENGINEEJIN � i. RIK NERSTHEIM,,ER=:;ram J.::r. 341 ELMWOOD.AVE = ' •;�` RANSTON,RI 02910 `✓ :ter _ Admin.isti:aicor !' - --- i Not valid .-without sign re hrtp:Hdb.state-ma.us/dps/llcdetalls-asp?txtSearchJ-N=CSL100459 o/,)/1/1)nnn I F ACORD- * CERTIFICATE OF LIABILITY INSURANCE OPID 27 DATE(MMIDDNYYY) PRODUCER THIEL-1 10 15 09 The Preston Agency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO 1350 Division Rd Suite 303 ONLY AND Ham.THCONFERS TEDOES NO�ND,EXTEND OR PO Box 810 East Greenwich RI 02818-0810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE INSURED NAIL# INSURER A: Hartford Underwriters Ins. Co Thielsch GroEngineering,pInInc Hartford t•s�t, insurance Co Thielsch Group Inc. INSURER e: Hl Tech Realty Inc. INSURERC: �� ry�l Ineuran.e �P Cranston Frances Avenue INSURER D: North American Cranston RI 02910 ai 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. TRW AM LTR NSR[ TYPE OF INSURANCE POLICY NUMBER pA7E GENERAL LIABILITY LJYITS EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY 02UUNTI)5678 04/01/09 04/01/10 PREMISES aooasenoe $300,000 CLAIMS MADE Fx�OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY X P C LOC PRODUCTS-COMP'OP AGG $2,000,000 AUTOMOBILE UAELTTI• Emp Hen• 11 000,000 B X ANY AUTO 02UENTD4850 COMBINED SINGLE LIMIT 04/01/09 04/01/10 (Ea accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Pet Person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LJABILIIY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $10,000 000 B X OCCUR CLAIMS MADE 02XHUUF6573 04/01/09 04/01/10 AGGREGATE $10,000,000 DEDUCTIBLE $ X RETENTION $10 000 $ WORKERS COYPENSATX)N AND E-- EMPLOYERS'UABILrTY X TORY UWITS ER C ANY PROPRIETORIPARTNERIEXECUiIVE WC2-Z11-259874-019 04/01/09 04/01/10 EL EACH ACCIDENT $500,000 OFFICERMIEMBER EXCLUDED? Des,describe under E.L.DISEASE-EA EMPLOYE $500,000 SPECIAL PROVISIONS below OTMER E.L.DISEASE-POLICY UMR $500,000 D Professional Liab DVL000025902 04/13/09 04/01/10 Prof Liab 2,000,000 A Leased/Rented Zqp 02UUNTD5678 04/01/09 94/01/10 E t 100 000 DESCRIPTION OF OPE NHS RATK I LOCATIONS I VEHICLES I EXCLUSIONS ED ADD BY E►DORSEMW I SPECIAL PRDVMMM *Except 10 days for non payment of premium. Holder is included as an additional insured when required by a written contract with respect to the General Liability coverage. CERTIFICATE HOLDER CANC t TIp TWNOAKB SHOULD ANY OF THE ABOVE DESCROM POLRXES BE CANCELLED BEFORE THE EXPIRATioN DATE THIEREOF,THE ISSUNHG 11116111RIERwILL ENDEAVOR To MAIL *30 oAYs WRITTEN M071 E TO THE COMFTCATE HOLDER HAMM 70 THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABUTY OF ANY KIND UPON THE 11111MMER,ITS AGENTS OR HtE3 EHTA71VES. AUTTION ACORD 25(2001/08) ©ACORD CORPORATION 1 r z y S a :r - J• E i" Also for RISE Engineering, a division of Thielsch Engineering, Inc. Gaskell Associates, a division of Thielsch Engineering, Inc. BAL Laboratory, a division of Thielsch Engineering, Inc. ESS Laboratory, a division of Thielsch.Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering, Inc. Water Management Services, a division of Thielsch Engineering, Inc. r RISE ENGINEERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of ThielscL Engineering MA Contractor.Registration No 120979 CT Contractor Registration No 620120 ' 1341 Elmwood Avenue,Cranston,RI 02910 ' 4. (401)784-3700 FAX(401)784-3710 CONTRACT Page 1 Al_ S .- _ THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client# Jill Quin (508)420-2459 02/17/2010 104784 SERVICE STREET BILLING STREET 246 Turtleback Road P O Box 411 SERVICE CITY,STATE,ZIP BILLING CITY,STATE,LP Marstons Mills,MA 02648 Marstons Mills,MA 02648 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 4 man hours.For setting up the rafter baffles in the attic slopes-This measure is not included in the$2000 incentive cap. $264.00 RISE Engineering will provide labor and materials to install a 6"layer of R-19 Class 1 Cellulose added to 1178 square feet of open. attic space. $1,060.20 RISE Engineering will provide labor and materials to install Class 1 Cellulose blown in to 204 square feet of sloped ceilings. $408.00 RISE Engineering will provide labor and materials to install 8/4" X 16"rectangular aluminum soffit vents to increase ventilation in attic areas. $136.00 RISE Engineering will provide labor and materials to install 68 square feet of R-19 faced fiberglass insulation to the attic sloped areas as soffit blockers for the enclosed insulation. $74.80 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently, for households where total income is less than or equal to 80%of median income, the Cape Light Compact offers 100%incentive toward eligible measures(not to exceed$2,000 total incentive.). -$1,943.00 D WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE PEC 46BO AR TBB 1111 O '*i00/Dollars $0.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGNEEItING,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 DECIMATION ON GUARANTMSS,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLAN PACES,' ` p ( A-' AUTHORQED SIGNATURE-RISE ENGINEERING CCKTO ACCEPTANCIF /� )) NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DA DANCE IJ'' ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHOR®TO DO THE WORK DAYS. AS SPECff®.PAYMENT WILL BE MADE AS OUTLINED ABOVE Town of Barnstable Permit: Regulatory Services Date: • /h li� �VW*Tqk Thomas F.Geiler,Director y a Building Division Fe4o 5 • BAPUNWABLE. Tom Perry, Building Commissioner 9 MASS. 039. �e� 200 Main Street, Hyannis,MA 02601 fny s www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL srOVE PERMIT Owner: Phone: _ b Install at: J- `l,e I Ur l�bCf'j I�D� _Village: t''� VK Map/Parcel: A _ Date: Stove A. N .: � � •i ew � Used �` p,4 Tort zw -t B. Type: Radiant/Circulating ts C. Manufacturer: e' k V1o. 3 D. Model No.: VFW CArST1,e Chimney A. New Existin (If existing,please note date of last cleaning) B. Flue Size C. Are other appliances attached to Flue? �Or� D. Pre-fab Type and Manufacturer- E. Masonry: Lined/Unlined Hearth / �� AXE A. Materials:_ - t 1 ( l`t 3 �N B. Sub Floor Construction: 3;_'AA I K �Ff' �� 4:n LE Installer Name: XIST��1 l� Address: Phone: Location of Installation: o H.I.0 Registration# Construction upervisor# p z OR check Homeowner Installing, o is n re uired v APPLICANTS SIGNATURE APPROVED BY: o t !1- io 6�0 N i< Please make checks a able to the T Ba:•nstable rn *This constitutes an official stove permit after inspection,photographed, and approved by the • Building Inspector Q:forms:stove Rev103107 i 1 � / i � f •y vt/6 / �- - - - 1 •fa ---- -. �. { I' N• gib'' �+S '4 h �•� .� a �+}'a \ � j � t4 w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street c Boston, MA 02111 �� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 7' City/State/Zip:VVt' �n 41 Phone #: 4 �� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I 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 g• ❑ Demolition workingfor me in an capacity. employees and have workers' Y9. ❑ Building addition Xam orkers' comp. insurance comp. insurance.# ed.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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#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. 1 am an employer that is providing workers'compensation insurance for my 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 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 d ai a 'olator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI r insuran a coverage verification. 1 do hereby c lily er th at. s a d p alties of perjury that the information provided ove i trite and correct. Signature: Date: v $• Phone#: Official se ly. 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#: Assessor's Office(1st floor) Map Parcel O Permit# Conservation Office(4th floor)(8:30-9:30/1:00-2:00)• Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fee 44ZI ot) Engineering Dept.,(3rd floor) House# 4� 7 442 7 Planning Dept. (1st floor/School Admin. Bldg.) , RNSTABLE. - *ProjecStreet pproved by Planning Board 19 ' I f0 N1At� TOWN OF�BARNSTABLE` Building Permit Application dress +' , Village S ' Owner Address , Telephone i Permit Request r .First Floor square feet Second Floor square feet 00 Estimated Project Cost' $ —�o Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name d Telephone Number r Address License# a'26 3 Z� Home Improvement Contractor# WA 2&63- Worker's Compensation# � NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CON , RUCTION DEBRIS UL ING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE' DATE /99 BUILDING PERMIT DENI FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY / i 1 - 1 i • PERMIT NO. v DATE ISSUED ' MAP/PARCEL NO. 1 ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: ` FOUNDATION , FRAME ` INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL ' FINAL BUILDING -. ! ✓ DATE CLOSED OUT ASSOCIATION PLAN NO. ► t °Erne r, •. The Town of Barnstable MASEL Department of Health Safety and Environmental Services ,659- P Building Division 367 Main Street,Hyannis MA 02601 I Ralph Crossen Office: 508-190-6227 Building Commissioner Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, addition to,any moderniexistza n, conversion, improvement, removal, demolition, or construction of owner occupied building COnta to' r to such ores residence or building be done by registered t least one but not more than four Icontractorsling units �with structures which are adjacent certain exceptions,along with other requirements. I Type of Work: Poo Est.Cost Q Address of Work: 1:0 Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _ 77J;ob under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: WITH OWNERS PULLING THEIR HO_ME MWROVEME DEALING OR WORK DLO NOT HAVE CONTRACTORS FOR APPLICABLE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply fMRs the a ent of the owner. 4 Date ntmctor Name Registration No. s • OR FF DEPP.,RTHEINIT OF -PUBLIC SAFETY ONE BOSTON, !,IA 02108-1618 OCI 7 1995 P T ASHBURTON LACE, P-1-1 13C)l RUC11_Gv N SUPERVISOR LICENSE Fr)). .,.I ­J) 1- V..,ipires: Birthdate: 11 - — 0:�632'5 1.0/20/1997 10/20/1959' 11170: 0Q) J C.A.ZEAU T Detach bottoin, fold sign on _«10 11AINIJ S)T back, and laminate license card. MA \V_ Keep top for receipt and chai of address notification. RVstricted To: 0*0 23407 -1. r r c, po E s s s a V 7 V 7 S 3 2 6 O ey e HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standardsi One Ashburton 'Place- Room 1,301 Boston , Mass-ac.h.usetts ,02108 HOME IMPROVEMENT CONTRACTOR 4-------------------- -------------- Registration 103714 Expiration _07/09_498_ e7k&...a Type — PARTNERSHIP HOME IMPROVEMENT CONTRACTOR Registration 1031714 PAUL J . CAZEAULT SONS,_..R.O0_F_1N.G_ ....... I ,Type - PARTNERSHIP Paul J . Cazeault I Expiration 07/09/98 22 Giddialt Rd . P .O . Box 278' 1- Orleans MA 02653 PAUL J. CAZEAULT & SONS ROOFI Paul J. Cazeault Giddialt Rd. P.O. Box 278 ADMINISTRATOR Orleans MA 02653 .. DATE(MMIDD/YY) ,acoRo. CERTIFICATE OF LIABILITY INSU:RANC�9P DR s ...:. 1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ,Drake, Swan & Crocker HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 114 Lot's Hollow Rd. ,PO Box 429 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orleans MA 02653-0429, COMPANIES AFFORDING COVERAGE Peter G Walther COMPANY PnoneNo. 508-255-3212 Fax No. A Assurance Co. of America (INSURED COMPANY B Credit General Insurance Co. Paul J. Cazeault etal DBA Paul COMPANY J. Cazeault & Sons Roofing C P O Box 2781 COMPANY Orleans MA 02653 D 'COVERAGES 1 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MMIDD/YY) i GENERAL LIABILITY , GENERAL AGGREGATE S 1,OOO,U OO. A X - ^AMERCIAL GENERAL LIABILITY CFP25552812 05/01/96 05/01/97 PRODUCTS-COMP/OPAGG IS 1,000,000. CLAIMS MADE X I OCCUR PERSONAL&ADV INJURY S 500,000. C MER'S 3 CONTRACTOR'S PROT I EACH OCCURRENCE S 500,000. FIRE DAMAGE(Anyone lire) $ 50,000. MED EXP(Any one person) $ 10,O 0 O. AUTOMOBILE LIABILITY A . AUTO COMBINED SINGLE LIMIT i S OWNED AUTOS BODILY INJURY S-HEDULED AUTOS (Per person) S aED AUTOS BODILY INJURY I S ': N-OWNED AUTOS I (Per accident) PROPERTY DAMAGE S t GARAGE LIABILITY ' AUTO ONLY-EA ACCIDENT $ A.+ :AU'f0 � OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY I EACH OCCURRENCE S U'IaRELLA FORM AGGREGATE S 0 HER THAN UMBRELLA FORM I S WORKERS COMPENSATION AND , WC STATU• OTH- EMPLC YERS'LIABILITY 1 TORY LIMIT'S ER _ __ ( EL EACH ACCIDENT S 100,000. _ g THEPF )PRIETORI INCL SWC17005900 08/09/96 08/09/97 EL DISEASE•POLICY LIMIT S 50O 000. PART!.:-RSIEXECUTIVE ----I I r _ OFFICE-IS ARE I EXCL EL DISEASE_EA EMPLOYEE $ 100,000. OTHEF DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS Roofing CERTIFICATE HOLDER `;.: CANCELLATION::. tT3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, I BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY J OF ANY KIND ON TIE COMPANY,ITS AGENTS OR PRESENTATIVES. AUTHORIZE EP ATIVE ACORD 25-S ©ACORD.CORPORATION 1988