The URL can be used to link to this page

Home My WebLink About0519 WILLOW STREET 9 e 0 o UPC 12543 Now HA8T1N08. UN al�e�.�_- '--•-- �aMun....ri.1+:Ar:�siM�.l..._�:.�. J., - _� `W'- Y L X-PRESS PERMIT Town of Barnstable *Permit# 8•� � 9 � AUG. 2 3 2005 Expires months from issue date Regulatory Services TOWN OF BARNSTABLE Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number < 30 3 Property Address __-- �°"'— �� 9 l/�' L�p GvS4- [Residential Value of Work foe. • Minimum fee of$25.00 for wdflt`dntler 0 0 rr ,&)wner's Name&Address .,Whi10 Contractor's Name �2 twit/ 4-// Telephone Number 2- Home Improvement Contractor License#(if applicable) Z J— 1- Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance C ne: am a sole proprietor ❑ Yam the Homeowner have Worker's Compensation Insurance Insurance Company Name ��'�<o�y,2( Workman's Comp.Policy# li✓ G �3 l 2 4 o Copy of Insurance Compliance Certificate must be on file. 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 �� U MA- F-1 Replacement Windows. U-Value (maximum.44) 1 "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner ust sign Property Owner Letter of Permission. Home Im r t Contr icense is required. SIGNATURE: Q:Forms:expmtrg Revise071405 I Application:to: Old King s Highway Regional',Hisporic District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves o1 Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY DATE �' Z 31d ADD'RESSOF PROPOSED WORK '57 io�/Zz, -sue ASSESSORS MAP NO. ?O OWNER - Lf V�ti / � ASSESSORS LOT NO. HOME ADDRESS '5 � TEL. NO. AGENT OR CONTRACTOR �� f/�✓ � ADDRESS TEL. NO. -6 This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition is involved,show. ing location of existing building. / 5'IWI/ 4 , r7� SSE i I I SIGNED Space below line for Committee use. . Owner-Contractor-Agent Received by H.D.C. The Certificate is hereby Date /All Time By Date Approved The categories of work entitled to exemption are listed on Disapproved the back of this form. J Ceic BOARDrOF7 ....erase B(la'•76- � "Al CONS3TR Cps �RE", t; 1N Gu, 061499 j A 81Zy,,Y ReS7 qN rri�t �s 1 '��f e '0•_ � Tr no- 1r25g0 .r • �I'. W BgRNST��Rgii�•� � f 01 : artl Uf rl:zi!iln �""`ul�L dl 7224��2""`�O� Regulations an MElrfp Oy �Stch;:alds FMEN7 CONT ' { Registt3��.' RAC i'�,,, 2535 2 2907 BRIAN S• tl vidual' HIBBA, . _ 8RIAN HIBggRp< d 185 CAPESrt. i � FRAIL •;k . .,.MA 02668 r J ofTM� Town of Barnstable Regulatory Services Thomas F.Geiler,Director MM Building Division Tom Perry, Building Commissioner ` 200 Main street, gymmis,MA 02601 wwmiown.barustable.•ma.us Office: 508-862-4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using ,ABuilder as Owner of the subject property ' q�/ j.. to-act on mybehA :hereby authorize j in all matters relative to work authorized bytU building pernit application for: K Address of Job) • �/13 Joy Signature of Owner Date • �lit,�/ Lil7?�r/� Print Name pF1NE 1p� Town of Barnstable *Permit Expires 6 months ro u date BAMSPABLE, Regulatory Services Fee "�' i639. Thomas F.Geiler,Director 9� ,0� �FDtA`�p Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 X-PRESS PERMIT EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint J UN 14 2005 I Map/parcel Number— t 30 0 3 y TOWN OF STABLE Property Address 7 I1 / ,11,DG/ ST/LGG� � • ��4,oys;7�� P Residential Value of Work (3,P00.ov Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 7,0 AAJ 5/'!l*/ ` s/9�'''1►L Add�w s Contractor's Name Telephone Number 39 Z — 414 1 Home Improvement Contractor License#(if applicable) / 3 Z 'r3 1 ' Construction Supervisor's License#(if applicable) CT 04 I ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner M/I have Worker's Compensation Insurance / Insurance Company Name �ziY� N/�� -1 ��q-iyy�Z (i4)S. Workman's Comp.Policy# C1.5 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) E5"Re-roof(stripping old shingles) All construction debris will be taken to � 17.s1•oIr ��ti trC>!�"� ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) '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. Ho a Improvement Contractors License is required. Signature Q:Fonns:expmtrg Revise063004 Application'to: 0P � Old King s Highway Regional His'tiric District Committee in the Town of Barnstable for a i CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. J TYPE OR PRINT LEGIBLY DATE �'� % o S� ADDRESS OF PROPOSED WORK W 11IM-1 S71Yc7 ��/� S7 Jt-ASSESSORS MAP NO. 003 I _ OWNER `f a�, sy -l� ASSESSORS LOT NO, 3 HOME ADDRESS S 2``' TEL. NO. 36 Z- —4-7 AGENT OR CONTRACTOR A, , ADDRESS �� S W '� � TEL, N0, -261 411 I This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. [� (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition Is involved, show. ing location of existing building. A l/d 1 Sri�f Go/Aa 3 -7i173 C, a,lo,�c SIGNED Space below line for Committee use. Owner-Contractor-Agent Received by H.D.C. The Certificate is hereby i Date Time By-AyDate Approved The categories of work entitled to exemption are listed on Disapproved the back of this form. i t ` -_ The Commonwealth of Massachusetts Department of Industrial Accidents - Office of investigations 600 Washington Street, 7`4 Floor Boston,Mass. 02111 Workers'Com ensation Insurance.Affidavit:Building./Plumbing/El!ctrical Contractors- name: ^ /4✓ f7/�35/f7lI address: /P� - city ��+ s�'�✓�- state:' ./I zin: O26/.� phone# work site location(full addressl: ❑ I.am a homeowner performing all work myself. Project Type: ❑New Construction[Remodel Fall'I amr�c+a sole �aproprietorR�and have t�ngo�y one tw�forkin man ca�}gcit�yg. ❑Building Addition I ,°Rn-IT.`mua.� i d +n lZrj�F�ft31!S fir•i.[i'oi° �-Ta w°+ � +�';• :.tt•v :�•i� La 5L «�r'��Tq rYi�t•4':f• ° 4it '.� f� 13.�a t}:�`n��i�i f'Y<�i469 0] I am•an employer providing workers' compensation for my employees working on this job. company name: city. phone#• insurance co. policy •R�3," 'S6'�,a +ari��, .3i' .. �Ica - "^�<"•f � ':>b�:�ki§'`�'�:;%:.�.'�'wiffi ??i+�w�",�'rF;��itYJ::./�'�`vr$,ices:�:ii4:zL�h-.i,x'=';� +�.s;l'�f•,i:�"`�,�m'�» earn a sole prop'ieto eneral contracto r homeowner(circle one)and'have hired the contractors listed below who have the following workers'compensation polices: company name: l[,r!Z-f address city phone#: ✓�/�S/ insurance co. olic # Q I L W Sq 2 ,q�y ;' r�..¢� `,'�: a x. �:�Pi,.�:3}r0'y Y�:.•`.,t*nA.'.�72.•ai.iF•w.: �6.•rarUi''�ta:a.•.'�°P•.11.'Yi1''.¢.r5� P_l{`.)°yfi•: .hi�Y,'�.'} 'S`�'�:�ti'•'+�' `...a;'•h�'d ::C. .t'�•v, .vS?p�i�'•.c� .. sN44�t'', 'i?'�!'�t� :�; , ,'• .�..., �.. X 8"P C 5, �•.., Y;;, °7h -'�-.l . 'company name: address: city: phone#•. insurance co. policy# A. dil4A ` Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition-of criminal penalties of a fine up to$1;500.00 and/or one years'Imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a- copy of this statement maybe forwarded to the Office of investigations of the DIA for coverage verification. ' I do hereby certify under the pain and penalties of perjury that the information provided above is true and correct. Signature e'G � Date Print name Phone# 36L `f b (,Cl fficial use only do not write in this area to be completed by city or town official ty or town: permit/license# ❑Building Department check filmmediate response is required ❑Licensing Board ❑Selectmen's Office ❑Health Department ontact person: phone#; ❑Other. miscd SepL 2003) it . 1 Information and Instructions Massachusetts General Laws-chapter 152 section 25 requires all-employers to provide'workers' compensation for their '. employees. As quoted from the"law", 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 section 25 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, 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 t.bis chapter have been presented to the contracting authority. d �+' }r "r .•:9► •N, 5• .r di ..7•: :ihi:? �3�F'' .'a '4'�'' i?'.�.JA.'teitf^u QYy - Applicants Please fill in 'the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be 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 town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed,below. a?6� .e .��w:oC«.� - - ,•.. r•�t.7��'G6�r ' .tir�d�,. �.�f_. uc:Z'1�J:��.�'.s.a' �'''i• .o. 3 I' City or Towns 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 permit/license number which will be used as a reference.number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for.you cooperation and should you have any questions, please do not hesitate to give us a call. , s °a D ; v a NO MINN, � r�:c'.�_ .n^, — .The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,?h Floor Boston,Ma. 02111 fax#:(617)727-7749 phone#: (617)727-4900 ext.406 . f of Town of Barnstable Regulatory Services I Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Jiyannis,MA 02601 www.town.barnstable;maxs office: 508-862-4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize- �/� to act on my behalf; in all matters relative to work authorized by this building permit application for. xgz (Address of Job) Signature of Owner Date TkA) an*G Print Fume ' ` Fes...::.. .... ...._..... Ldard of"building Regulations and Standards HOME IMPROVEMENT CONTRACTOR: Reg is.frEz Ciori:`_ 132535 TExRir�a ion:m2/23/2007 _Type: Individual BRIAN.S. HIBBARD= `=-` � 185 CAPES TRAIL CR, �STABLE, MA 02668 Administrator � _ BOA�I�pOF gU1LD`IN '' RUCTIONSIiJPEf21%lSOR � .f Nt�m`beir 1 i p �u 5. 18CAFEmWjl:` A 1,07 1�/B�,RGS `ABE y� rr r:r r � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 O .3 Parcel Permit# Health Division Date Issued Conservation Division Feet Tax Collector Application Fee 'l� Treasurer Checked in By Planning Dept. Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address S Village Owner l(L2 14 Z4; Address Telephone -7-7 nn r Permit Requestw-le Square feet: 1s/t floor: existing proposed 2nd floor: existing proposed Total new Valuation T l/ 4 Zoning District Flood Plain Groundwater Overlay 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 Cl 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 Cl 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 BUILDER INFORMATION Name 1 e— d1444 C Q 1�, Telephone Number -�z '7 -Tn Address s S 4, � S� � �_ License# 44://4. Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNA flE DATE � FOR OFFICIAL USE ONLY Y ' PERMIT NO. DATE ISSUED R, ago MAP/PARCEL NO. e r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION' FRAME INSULATION 6 FIREPLACE ELECTRICAL: ROUGH FINAL- PLUMBING: ROUGH FINALS GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED�OUT-' Y ASSOCIATION PLAN NO. F' J >= The Commonwealth o Massachusetts =_ Department of Industrial Accidents Office of Investigations 600 Washington Street, 7`h Floor Boston,Mass. 02111 �, Workers'Com ensation Insurance Affidavit:Buildin�Q7/Plumbing/Electrical Contractors :lAz �.h'Ca}lf��n�Ur at � ..:• t _`..s�'c" R::_ � 1� 8 r�t� fir•! <�%ori'ir__M1u°'; '.�.'�F+�'3;i-��E.q name: I / ,• r ti., address: '�� 7' 4�E ( ( M, S �l city 4- k.44 state: .4--4-_ 2ip:c�—�-•C Q( phone# work site location(full address): ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel ❑ I am a sole proprietor and have no one working in any capacity. }�Jl @p Buildin Addition twat':SjC1•i5. ,:e^ c�r`7l^"4r :>'§£;•`N z?p;f vg. w ..� .�7fd%:C�' •�.:r.;r: 1'+;re: $,-C•..^_""..:. er. Y�7"s'Y.•. .:.:.. �31.�_ .f .� �.�•+, t�' .ayiY.E3'�;'�.;i;•�j+.P.r ltc2l; .��_��yy:: , ,.`.'d.:�`��•Y.: �','.'."..4:,.,"i'�,..;5'iri:�'K_tf•S�?�6's:fr�:?r:CS:7'J:��'�C% �,�r r a*;l!: am an employer providing workers' compensation for my employees working on this job. +� company name: /! l��c address: r G U [ice o g44-2,.. �� city: /�/� e r phone#: 7:2 insurance co. policy# 2 ia."r1�c_t'k�Li:4!F':i.^.:3�i'•(Cr12��Yib•�.`S'pr`,uw�;�:•.:-4�::V�'ir�.4ldffia?•q'••4,i;''eVji4:.t"F`....A.i'�E? :.,i.:..:�.: 'n'hr.V1, .�,u'4• ' ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address. city: phone#• insurance co. policy# . .-.... ..,.. >+is ¢�.:; +;fs;F.�:r'::+...4.'d._>'...:...�.�54 .r.�'.-�.'....r.'F(�?.c,. .`',t•Yv i{�':7F:�.`Ik.'a. .+.?5...2., :.�',(:G a 5i ''i;0?'T''y:f'.: 'company name: address- city: phone#•. insurance co. olic # .. 4 l a._> ��•fir..' :•�y;Df ''•K" � Ir'l� a:...,�,. „M1S;....,.3?:" b"-::b r��: •r ktxFR ai�di�d�iaf s.e,.t.it►ec?,ssaX� ; +b' ss '� {�' ¢. !' y �•$��y ��;..�.•...,,. t ,f 3^r<. �Qr xlfirk7;.+A 1 �M?E+T};d 1'�aL'''...�r 69.44 Failure to secure coverage as required r Section 25A of MGL 152 can lead to the imposition or criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as"ells c it penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of this statement ma fo rded to the Office of investigations of the DIA for coverage verification. I do hereby certi un r the ains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permittlicense# []Building Department ❑check if immediate response is required ❑Licensing Board ❑Selectmen's Office ❑Health Department contact person: phone# ❑Other (reviscd Sept.2003) J. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers io provide workers' compensation for their employees. As quoted from the"law", 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 br 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. j MGL chapter 152 section 25 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, 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. s� r-_ ,�Cz; •,: tip. � �^mt�,a�as++�'�y��'�. ?�;+�;�,'_�: 3 j"P•'£�F�."6- V. l ��"C' �,. .s�'�•, pTe.' ._... f :. i .N:' 1f *kr:.'r..�. .°,�y..^-�: Gp��e..'� .'.' �3 i.� 'ii .v •�r�: c�&'}�:�".� Sa''.�,r:'+�:;:h:'t:.f:�srii�fi`d'• a�:::�8?'�r:r...ateii.: J.:i<"'�'��.`�' Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be 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 town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. r�. �'�'9'�t i�S; ,.k�r,�p\ h.';;�T,T?t�'ag r .m..�_ §. _ -.,gt�.•,•- r'4ti a `�?:.`i•no;..�:,. �.�:•,.tip;':".� e 1' s',.� 1 '�1 }{ 'r• :.� i •�� '-�i�r a."`i?:.>;:�, �. ;�� ': .r;. ;:.b•r.�. :+�it;��•','..ti.i,r�'�(i>:,,.�.,y., ,�yr: r t�Ad '4r,�$. i� 1.y�i--•H� � �? �14, qL '+x r 7''� ..� s.'rtl '+t'��.��3 �s Y�K+=ti!s j re' f r al v tk'N XsS��x� rib �'v.1/�".n'`1{r��.t>la/9 4n-� A• 33�+�'txt�vl.F:�.1.�n�t��1��'�fa. City or Towns 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 permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for.you cooperation and should you have any questions, please do not hesitate to give us a call. •.y uaa<•k;' :.i:• :ir.� .,-..�,. - .re;- _S; i•Ri'^`*'a eY�Y •5�' .:G�"ii' ::�,r�;;,Y•r..t'e: P :Y�vi':'d:'�.,'j!L•.;,.'f,�.,.�,:, �..:�..,kn.mSt •�I�an� a 'ME.Y' e�Ki••.(2. f.,..A.44�?iTr.'.�I•.{�8T' Ytl ,9UR. ��•.R � �t_.''3 �' ��"F}v.. 6:�t; m';"rv�V^ �f �` ).�'-" f. ��cR.'.; fi fir t' i�'S.^,K•� }. ''C r �� "�,' ��.� ��.��,�' �� i+ ° +E3r. 4Y'�°STx'�'fxt'i;P-se'r�"'cr.•S�r sJ��S«.. .�S:�.w r�xsis"�so"�"iaii.•o..�. Y a n �r •�F'4.w 6 xR• Xyea .rr` 7ai�a n�' G r' The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7a'Floor Boston,Ma. 02111 fax#: (617)•727-7749 phone#: (617) 727-4900 ext.406 • — I 55 LISA LANE 'WEST BARNSTABLE MA 02668. (508)775-7763 (508)362-6654 FAX HOME IMPROVEMENT LICENSE HITCHCOCK CONSTRUCTION GILLIE WOOD TEL#(508)7710202 519 WILLOW STREET HYANNIS,MA 02601 FURNISH AND INSTALL MATERIAL AND LABOR TO RE-ROOF HOME AS FOLLOWS: • REMOVE AND DISPOSE OF EXISTING ROOF. • CHECK ALL BOARDING AND NAIL WHERE NECESSARY. • REMOVE EXISTING DRIP EDGE AND SOIL PIPE FLASHING. • INSTALL NEW ALUMINUM DRIP EDGE. - • INSTALL NEW ALUMINUM AND NEOPRENE SOIL PIPE FLASHING. • INSTALL ICE AND WATER BARRIER IN VALLEYS. • INSTALL 25 YEAR THREE TAB SHINGLES-(CERTAINTEED). • REMOVE ALL DEBRIS FROM JOB SITE. • NOTE: ALL DUMP FEES FOR REMOVAL ARE INCLUDED IN THIS QUOTE. HITCHCOCK CONSTRUCTION GUARANTEES LABOR FOR 10 YEARS. PAYMENT TERMS:$11,500.00. 1/3 DUE ON ACCEPTANCE;REMAINING 2/3 DUE UPON COMPLETION OF JOB. ACCEPTANCE OF PROPOSAL: THE ABOV Y,PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREB C PTED. PAYMENT WILL BE MADE AS OUTLINED ABOVE. SIGNATURE OF CONTRACTOR DATE: a SIGNATURE OF CUSTOMER:. DATE: