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HomeMy WebLinkAbout2100 MAIN STREET (M.MILLS) c7� `` 'j r r 1 } f i i t � , f w t 4 t 1 e _ — - X-PRESS PERMIT MAY 16 2013 olNN of BARNSTawn of Barnstable *Permit# WE T ,O Expires 6 m nths fr issue Regulatory Services Fee a � BARNMBL& • �AntAss. � 'Thomas F. Geiler,Director R2 _ � 4no rEp MA't `0� K 6 ) Building Division ) Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma:ua Office: 508-862-4038 Fax: 508-790-623 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY /�� Not Valid without Red X-Press Imprint Map/parcel Number02 0 Property.Address r"tw [Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address&gje f C 611 5 Contractor's Name 7)e 0 Ge S Telephone Number Home Improvement Contractor License#(if applicable)f��-l a �9 � /�5?,,IL Construction Supervisor's License#(if applicable) l (0 8 3 DKorkman's Compensation Insurance Check one: ❑ I am a sole proprietor WI am the Homeowner have Worker's Compensation'Insurance Insurance Company Name /v,W Split ra 1/;e, TV S ` Workman's Comp.Policy# D7i- 05- 3 IV Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ERe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to N" l A ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side . #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and.inspections required. Separate Electrical&Fire Permits required. - *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 the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: 0:\WPELESTORMS\building permit forms\EJPRESS.doC The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): � Address: c C.e�5 City/State/Zip: k0oxv`tom- ah- 303-3 Phone #: 9Z�D 6 ? " 5_1 90- Are you an employer?Check the appropriate Yox: Type of project(required): 1.❑ I am a employer with 4. M I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El 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 g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 11. Plumbing 3.❑ I am a homeowner doing all work g repairs p •rs or additions myself. [No workers' comp. right of exemption per MGL 12.[VRoof repairs insurance required.] t c. 152, §1(4), and we have no 13.[ ther employees. [No workers' 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. Ua40 Insurance Company Name: � 2 's `I Policy#or Self-ins.Lic.#: W 1, 0 3 J S_7. 3 j / Expiration Date: 3` 1 111 Job Site Address: M City/State/Zip: w_�r� l 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 cert'y unde the alit and penaltie f perjury that the information provided above is true and correct. Sijznature p (f Date: Phone# 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#: L 211/ A CERTIFICATE OF LIABILITY INSURANCE D/11/201IDDIY3 3 THIS CERTIFICATE IS ISSUED iAS 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 bF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODU q ER,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 endorsemen s). PRODUCER I e:CT Katie Randolph Christensen Group Ins>rance PHONE (952)653-1000 1 Ul..Ne:(952)653-1101 11100 Bren Road West IL .krandolphOchristensengroup.com INSURERS AFFORDING COVERAGE NAIC 0 Minnetonka Mq 55343 INSURERA:Gemini Insurance Company INSURED i INSURER B:OWn erS 32700 AMERICAN BUILDING CONTRACTORS, INC. INSURER CAlterra E&S 2960 Judicial Road 1 INSURER D:Auto-Owners 18988 Ste 100 I INSURERE! Burnsville MN 55337 INSURERF: COVERAGES 1 CERTIFICATE NUMBER:12/13 Liab-MN Full Limits 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 0$ 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 ADDLSUSR POLICY EFF POLICY EXP TR TYPE OF INSURANCE wum POLICY NUMBER (MMMDfYYYYI IMM93DNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERALLIA61LI I PREMISE (Fa o en_ $ 50,000 A CLAIMS-MADE QX VIGPOI3952 /11/2012 5/20/2013 MEDEXP oneperson) $ 5,000 i PERSONAL&ACV INJURY S 11000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER:. PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY X PRO-JER LOC $ AUTOMOBILE LIABILITY =ED SINGLE LIMITnti 1 000 000 B X ANY AUTO BODILY INJURY(Per person) S ALLOOWNED SCHEDULED 4917006400 /28/2012 /28/2013 130DILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY D GE $ X HIRED AUTOS X AUTOS aeddeM � $ UMBRELLA LIAR [I OCCUR EACH OCCURRENCE S 5,000,000 C X EXCESS CLAIMS-MADE AGGREGATE t 5,000,000 DEO RETENTION KXYARCSO000157 /11/2012 /28/2013 $ D WORKERS COMPENSATION X WC STATU E& AND EMPLOYERS'UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEa NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ' (Mandatory In NH) oe093916 5/28/2012 5/26/2013 E.L.DISEASE-EA EMPLOYE $ 1 000 000 if yes describe under DESCRIPTION OF OPERATIONS below E.L.OISEASE-POLICY LIMIT S 11000,000 I i DESCRIPTION OF OPERATIONS 1 LOCATION$1 VEHICLES(Attach ACORD 101,Additional Remarks Schodute,If more space is required) . I I i f CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR INFORMATIONAL PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Bill Finley/MM ACORD 25(2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. INS025(20100e).01 The ACORD name and logo are registered marks of ACORD May 11, 2013 Barnstable Building Dept. The following is a list of our approved sub-contractors for The Home Depot: Ericsson Torres — CSSL # 100546 HIC # 163528 Michael Viola — CSSL # 099403 HIC # 140993 Vincent Smith - CS # 106837 HIC # 165927 Timothy Thomas — CS # 51899 HIC # 152121 Ronaldo Solano — CSSL # 101027. HIC # 152206 Joseph Duarte - CS # 70077 HIC # 132349 Douglas Szynal — CSSL# 103950 HIC # 146142 Brian Laroche — CSSL # 100478 HIC # 152612 Joseph McKeon — CSSL# 98863 HIC # 132614 If you have any questions please contact Mike Bedard our permit coordinator at 508-962-6942 or myself at 617-438-9017. S' erel uss one Bra Installation Manager THD At-Home Services, Inc. 908 Boston Turnpike• Unit 1 •Shrewsbury, MA 01545 Phone:774-275-2139 9 Fax:508-845-6076•Toll Free:800-657-5182 1 I P.pr�01,,13 11:08p Chris Read 1-508-681-8800 P.1 JVIU, ,'111111J111U U11V 11131U111:U Uy- Branch Name: Boston Date: e,�f�/�3 THD At-Home Services,Inc. d/b1a The Home Depot At-Home Services 908 Boston Turnpike,Unit 1,Shrewsbury,MA 01545 Toli Free(800) 657-5182; Fax(508)845-6017 Branch Number: 31 Federal ID;1 75-2698460:ME Lic#C 02439; RI Cont. Licft 16427 yJ CT Lic 5 HIC.0565522;MA Flome Improvement Contractor Reg,# 126893 installation Address: /f/!�✓�it� `a _ iQS���� 1.l L� 4v Ctry talc Zip Purchaser(s): Work Phone: Home Phone: Cell Phone: � -3y9 Home Address: _-es .4— S Z9 F110-0�(If different from Installation Address) City states Zip -mail Address(to receive project communications and Home Depot updates): PgJ.nO NOT wish to receive any marketing emails from The Home Depot Project Information: Undersigned("Customer"), the owners of the property located at the above installation address,agrees to bury, and THD At-l-lome Services, inc. ("The Home Depot")agrees to furnish, deliver and arrange for the installation ("Installatiun") of all materials described on the below and on the relen:nced Spec Shect(s), all of which are incorporated into this Contract by this reference, along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders (collectively; "Contract"): Job#: (lnlern 1 wr« Products: Spec Sheet(s)#: Project Amount _ Roofing ❑Siding ❑Windows ❑ Insulation ❑Gutters I Covers ❑Entry Doors ❑ ❑Roofing ❑Siding ❑Windows ❑ Insulation �— ❑Guuers/Covers ❑Entry Doors ❑ ❑Roofing ❑Siding ❑Windows ❑ Insulation ❑Gutters/Covers ❑Entry Doors❑ _ $ —`— ❑Roofing ❑Siding ❑Windows [:] Insulation ❑Gutters/Covers ❑Entry Doors ❑ Minimum 25°1,Deposit of Contract Amount due upon execution of this contract Total Contract Amount Maine Purchasers may not deposit more than onc4hird of the Contract Amount. ' Customer agrees that, immediately upon completion of the work for each Product, Customer Will execute )iCompletion Cert.ificare (one for each Product as defined by an individual Spec Sheet) and pay any balance due. As applicable, e ch Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Products) included herein,at its discretion, if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home, enviromneatal hazards such as mold, asbestos or lead paint, other safety concerns, pi-icing.-rors or because wont required to complete the job was not included in the Contract. Payment Summary: Thu Payment Summary #__7_2�92 3_j_2, included as part of this Contract, sets lorth the total Contract amount and payments required for the deposits and final payments by Product(as applicahlc). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion'Certificate for each listed Product as defiged by individual Spec Sheets) before work on that Product is complete. In the event of termination of this Contract, Customer agrees to pay The Home Depot the costs of materials, labor, expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination, plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DE POT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either Drat or written, relating to said Products and Installation.This Agreement cannot. be assigned or amended except by a writing signed by Customer and The Home Depot. Customer acknowledges and agrees that Customer has read, understands_ voluntarily accepts the terms ql has received a copy of this Agreement. lcepte V. Submitted b it X usto ncr's Signaturetc Sales C nsultanl's Signature Dale t r - ��CiG�aa�zc>li,►���. ; Office TofMosume�rrAA fairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Wsachusetts 02116 K Home Improve iWontractor Registration Registration: 165927 " Type: Supplement CardAu ° AMERICAN BUILDING CONTRAG," - Expiration: 4/9/2014 VINCENT SMITH 2960 JUDICIAL RD. SUITE 100 BURNSVILLE, MN 55337 !� VOW •,r a0 Update Address and return card.Mark reason for change- scn 1 4 wu-osr" _ ❑ Address R ❑ enewal ❑ Em Pto ymeat: ❑ Lost Card Mee of Consumer Affairs&Business Regotation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the ezpiratioq date. If found return to: Regsstratlon:�E165927P Type: Of me of Consumer Affairs and Business Regulation Explr 10 Park Plan-Suite 5170• a"iion� ' �f�v. _ Supplement Lard Boston,MA 02116 AMERICAN BUILDING;pl G7ORS INC. VINCENT-SMITH 2960 JUDICIAL RD.S 000 r_ , BURNSVILLE,MN 55337 Undersecretary Not valid without signature i Massachusetts -Department of'Publio Safety Board of Building Regulations and.Standards Construction Supumisor " License: CS-106837 ' VINCENT SMIT[t= - y 2960 JUDICIAL.RAADMm 00 P. Burns,,Ue MN-5kik ��,.. _lY_ew_ " Expiration Commissioner 07/20/2016 I G `'Unrestricted-Buildings of any use group which : . contain less than 3000 cubic feet(99Im3)of enclosed space: { Failure to possess a curreni•edition of the Massachusetts i State Building Code is cause for revocation of this license. for DPs licensing information visit: www.Mass.Gov/DPS . r i1 t4,4 > Omw � 1 r i a ffice of consumer 1 ffai grid Business.Regulation ) = j ' 10 Park Plaza - Suite 51,74 4 c7" Boston, Massachusetts 02.116 Y Home Improver'en ontiactor.Registration Registration: 126893 PPlement Card Tvpe: Su ~= Expiration: 8/3/2014 `At-H ,._ �F;1. ; t le Nome Depot ome Services:= M ICNAEL BEDARD �� ,2690 CUMBERLAND PARKWAY1S`tJ,IT;E ATLANTA, GA 30339 Update Address and return card..Mark reason for change: Address Renewal Employment Lost Card 'sFQ7$-(:J:i -„r uUFd-U�iJ•I•C'.1fi121G /�� �s--. / y • :.J9Le •�u�,vnwvuueoll/s O�✓I�taUJCLfdL[I4PG[O } License or registration valid for individul use only 06-1cc of Consumer Affairs&Business Regulation before the expiration date. -If found.return to: 11jf w i�' i MomE WROVEMENT CONTRACTOR i77^�40 �.{(•��� ":. Office of Consumer Affairs and Business Regulation g Registration :126893 Type: 10 Park Plaza:-Suite 5170 Supplement Card Boston,MA 02116 -rhe Home Depot:At-Home'Setyices hhICHAEL 19E0AP.D-:`; 26 c RLAIVD PA R KWAY S � '� GA 30339` Undersecretary Not`va d with tiuf signature „ 1 1t K' fl ` \T P0 30 Town of Barnstable *Permit# TF1Eo Fxpires 6 months from issue date Regulatory Services Fee -- -•--snxtvsx,'si.�-•- . MASS• Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commfssioner X-PRESS PERMIT 200 Main Street,Hyannis,MA 02601 �(W www.town.barnstable.ma.us APR _��f V Office: 508-862-4038 ax: 0 - -6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Presslmprint TOWN OF BARNSTABLE Map/parcel Number �7� �� w . Property.Address I 'A S Residential Value of Work / 3 3 Minimum fee of$35.00 for work under$6000.06 Owner's Name&Address C, a �d ® Plats -rods /V11 BLS I QG � hone Number Telephone Contractor's Name ���'� I )U ` Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) G / 0 r ❑Worlcman's Compensation Insurance Check one: (�I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side �> c�`� #of doors Replacement indows oors/sliders.U-Value v" (maximum.35)#of window ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. '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 the Home Improvement Contractors License&Construction Supervisors License is required. r SIGNATURE: QAWPFILES\FORMS\building ernit forms RESS.doc Revised 053012. Ma u�r E 4?^ K�Rfi gft" �j �* . ;'.?� TF�^a� }`i atc'k.•, r• �+ IrLsA t iice .� - .., 4 n d y ...7' Z may. '4•a �s�K�" »� 4�n ry 'r�^GSY•. � {�'w R.^ .Y / ~�! c f `»� y ra ''. �� uT a^�Yl• � k•�'.. U1/l �• u i "Y'K J/�i•.. _ t IJ1I � ;1 r 5A t +� a 'ri5r ;�: r�:, �.� ��� ,,s �` yi'�,• mi '• f,3� r'».<1. x.:��,� x� e ���F j tom' _ �`y a -� /�rrF'' �"�• i,.'�.y ;. kli row, ig• o Kt�'E1rd Y <' w= r •� '. .. Leh,, F `. '. `c.+.,� y�� � - t .. .d. •ry '. � +�"�} '<" ��Fy Y >t^+'';- �°"�d. . ..'�,y.. r;_� � -'c'" �. 'y>�.i.Fii-C•,y �`^:yy.,'��: 15.���� •� .i ''•4 ..�?r'. ,*:,� _� i.�✓r,%r,� - 'rr'� .y }� .� ��- S `.4-.t' _'�3 �yr.��+` ; ��r -`�ye`:� ,;:w �4x"'• ten, � 'r`,� �.- Q �RrY Sf����*ya, t f.'•' r.•• =r=µ.C'1�,�'�, '^^' .. 'h + �`�,�'..i� � ��v.t -� - �... � ''`+1• � it 'SPr' n �' _' ..- � �,�����y�.r. r✓ �'' �-5i rg •.�r hpS+',i r _ dY� 1 '�4p, "•. '4:' _ � � 1^ t ' '" f-. l: '. -� -.X�' y �_.ip r � �r:• ,A '^•� r-i.,� ,..: # - ..Ai,.'. }, i:, t r��'.: 3u l S� ,3� - -,�' ��� Y, 'i r•4k�'` F 3+t .s sc `x � � -t` � - + - .l�sx v � +�,y.:� Oince of Consumer Amin a 777, AL*AMA* c ME IMPROVEW egis -- 10-10 nI * trat 32349 ,,r P iiation: ItIl=-- IS . ' i & i Remodefing uarte 571 ra License or registration valid for individul use 0-My before theexpiration date. if found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Mai 02116 ./ �- Not Vol�a W,thoUt ��gnatu xe I a. A _. .s + V 1Z6 `YM7L77d(YILU/GC((.V(��J�'(.cctw2GLL[Of.Ko .: �zfegisti-ati ce of Consumer Affairs&Business Regulation License or registration valid for indiretur use only before the expiration date. If found return to: ME IMPROV NT CONTRACTOR pace of Consumer-Affairs and Business Regulation Type. r.% 10 Park Plaza-Suite 5170 tapir tl Supplement :ard "'Boston,MA 02116 The Home Depot t , MARK NIADNA " 2690 CUMBERIAND. S )k�►M,GA 3.0339 Undersecretary of valid with ut signature r �� y+ V. August 17, 2012 Barnstable Building Dept. The following is a list of our approved sub-contractors for The Horne Depot: Ericsson Torres—CSSL# 100546 HIC# 163528 Michael Viola —CSSL# 099403 HIC# 140993 Robert Reposa - CS # 60526 HIC#1147080 Timothy Thomas-CS# 51899 HIC# 152121 Joseph Duarte - CS # 70077 HIC# 132349 Douglas Szynal - CSSL# 103950 HIC# 146142 Brian Laroche - CSSL# 100478 HIC# 152612 Joseph Mckeon - CSSL# 98863 HIC# 132614 If you have any questions please contact Mike Bedard our permit coordinator at 508-962-6942 or myself at 617-438-9017. S' cer y, ussel Jo t e Branc bstallation Manager THD At-Home Services,Inc. 908 Boston Turnpike• Unit 1 -Shrewsbury, MA 01545 Phone:774-275-2139 9 Fax:508-845-6076-Toll Free:800-657-5182 063—A—'379 43-43 Di{ Siinal I .Vinilo iVFRC E1j]G Frtduct Doi li—:dun j I V>ntana de doble guillotina Argon/?ro'3ola= I olrg6n!?ro2olaz National Fenestration 3;32" Glass I 2.39 mix+ VLdrio Ratlng0ounc4 No Laminatad Class I Sin vidrio laminado No Grids I Sin rajillas ENERGY PERFORMANCE RATINGS EVALUACION DE RENDIMIENTO ENERGETICO . U-Factor Solar Heat Gain Coefficient Factor-U Coefidente:Gananda de Energia Solar 0 . 32 1 . R •n . 2g (USA-P) Wetrrco/Sa ADDITIONAL PERFORMANCE RATINGS EVALUACION SUPLEMENTARIA DE RENDIMIMM Visible Transmittance Transmision de LuzVlsible —` 0 . 52 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC. ratings are determined for a fixed set of environmental conditions and a specific product site.NFRC does not recommend any product and does not warrant the subbgity of any product for any specific use.Consult manuhcturer's literature for other product performance Information.www.nhc.org Este fabricarde esdpula quo esfos valores cumplen con los procedimlentos aplicables de NFRC para deterninar el rendimlento total del producto.Los valores usados par NFRC son deterninados par un con)unto fiJo de conditions ambientales y un tamano de producto especifico.NFRC no recomierMa ntngun producto y no garantlta que el produeto sea adeasdo para un use espectflco.Consur a con el . folleto del fabricarAD para el uso,aproplado de este producto.www.nh.org unit qualifies for ENERGY STAR . rQgion(s) : Northern, North Central, South Central, Southern. 6NERV STAR L3 unldad CaLi11Ca pars LAW y ,kzt ragl0n(a2) ENERGY STAR: Norte, Norte Central, Sur Central, Sur. IND: Rein Ott/Class 3/32"/K—R43 Tasted Size: 36" x 63" IND: Rafuerzo 00/Vidrio 2.38 mm/K-R43 DP : +45/—4 5 Taxano probado: 91.4 cm x 160 cm GtvQ�ngG f n 40773 KS Koffatan 295112G Keep this label for possible ENERGY STAR®rebates.-To learn more visit www.energystor.gov Guarde esto e6queto para posibles reembolsos ENERGY STAR®Paro conocer mds acerco de esto,visite www.energygor.gov. lWorkers' The Coninionwealth of�Iasscicliusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.niass.gov/dia Compensation Insurance Affidavit; Builders/Contractors/El / lease Print L lumbers Applicant Information -t S `R� nn�d�1 n� Name(Business/Organizatiordlndividual): , 6 Address: UU City/State/Zip: IV) borb �1� Phone#: you an.employer?Check the appropriate box: Type of project(required): [Arne . 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 Remodeling 2 ] I am a sole proprietor or partner- listed on the attached sheet. ❑ These sub-contractors have g. ❑Demolition ship and have no employees employees and have workers' working forme in;any capacity. 9. ❑Building addition comp.insurance% [No workers'comp. insurance 10.❑Electrical repairs or additions required.] 5• ❑ We area corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I I.[]Plumbing repairs or additions right of exemption per MGL 12;❑Roof repairs myself.[No workers' comp. c. 152,§1(4),and.we have no � insurance required.]t 13.@(,Other �►0�^ ►�'' employees.[No workers comp.insurance required.] �'0 '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. tContractors 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'.compensg(igh nnsliTncSe for My employenes. Below is the policy and job site information. Insurance Company Name: V Expiration Date: Policy#or Self-ins.Lic.#: Job Site Address: CitylState/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. 1 do hereby certify nder the pains and enalties of pc that the info1mation.provided above is trueand correct. — Date: Si nature: Phone#: Official use only. Do not write in this area, to be completed by city or town offi==a City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Depart 3. City/Town Clerk 4.Electric 6. Other Phone#: Contact Person: i HOME IMPROVEMENT CONTRACT ' PLEASE READ THIS J Sold,Fu mished and Installed by: t' Branch Name: Boston Date: 3-3 THD At-Home Services,Inc. "/_/ d/b/a The Iiome Depot At-Home Services. . 908 Boston Tumpike,Unit 1,Shrewsbury,MA.0154. Toll Free(800)657.5182;Fax(509)845-6017 Branch Number:Al Federu)M#75-2698460;MF Lie#C 02439;RT Conti.Lic#16427 CT Lie#14(Ct0561522;MA Home Improverneni Contractor Reg:#'126893 Installation Address: _ M�,�, _ Q 02, City Stateip.: Y.ttrchaser(s): Work Phone: Home Phone:. CullYhone: Rome Address: _ _ _ (IEdifferent from installation Add ss) City Sucre Zip E-otail Address(to receive pmjec communications and Home Depot updates): ❑1 DO MY17 apish to receive any narketing emails from The Uome Depot -Project Information:-Undersign ("Customer"),the owners ofthe property located-at the above installation address,agrees to buy, and THD At-Home Services,Inc. "The Home Depot")agrees to furnish,deliver and arrange for the instaliatioia("Installation")of, all materials described on the beli w and on the referenced Spec Sheet(s), all of which are incorporated into this Contract by this, reference,along with any applicat a State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job!/: (t .—I Rd—) Products: Spec Sheet(s)#: Pro ect Amount Routing C ISidjar JKWindows Ej insulation p 6 ( ❑clutters/C vers ❑Entry Doors ❑ Roofing ]Siding Windows Inwiation ❑Gutters/C vers ❑F,otry Doors ❑ $ ❑Roofing E Siding ❑Windows Insulation ❑Gutters/C vers ❑retry Doors❑ $ Roofing E Siding ❑Windows 0 insulation ❑Gutters/C vets ❑Entry boors ❑ Mi6imum25%pepositofContract onntdue.uponexecutionofthiscontract' Total Contract Amount $ Maine Purchasers may not deposit m re than one-third oft he contract Amount. 3 Customer agrees that, immediatel3 upon completion of the work for each Product, Customer will'execute a'Completiott C:eriificaw (one for each Product as defined an individual Spec Shcet)and pay any balanco due. As applicable,each Customer uildar this Contract agrees`to be jointly and se erally obligated and liable hereunder. 'fie Homc Depot reserves the right to issue a Change Order or terminate.this Contract or any individual Product(s)included lierein,at its discretion,if The Home Depot its authorized service provider determines that it cannot perform its.obligation.S due to 11'structural problem with the home,envirunmic tal hazards such as mold,asbestos or lead paint,other safety coitcerlls,pricing cm>rs or hccause work required to complete the job v as not included in the Contract. -Payment Summary: The Paym t Surtunary# ��. 5 4 , included as part of this Contract, sets forth.the total. Contract amount and payments req ircd.for the deposits and fnal.payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to'a completely led-in copy of the Contract at the time you sign. Do-not sign a Completion C:criiticatc.(dote: there is one Completion Certific- a for each listed Product as defined by individual Spec Sheen)before work on that Product is complete. In the event of termination of th Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The ICI me Depot or Authorized Service Provider through the date of termination,plus any other amounts Set forth in this Agrecm tnt or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DF.,P T FROM THE DEPOSIT PAYMENT OR OTHER PAYMI:N7:S MADE, 'WITHOUT LIMITING;THE HOME DEPOI S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authnrizatipn: Luslornur agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard It the Products and Installation services and Supersedes all prior discussions and agrccmente;either oral or written,relating to said Proi nett and Installation.This Agreement cannot he assigned or amended except by a writing signed . by Customer and The Home Depot Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terns of and bas received a copy of his Agreement. cc t by Sub itted by: Customer's Signature ate Sslc onsultant's Signature Date X Telephone No._9t Lf Y u y Customer's Signature bate Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THiS (na applicabtc) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. • THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE 1S SPECiFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE:ADDITIONAL TERMS AND CONDrt-IONS ARE STATED ON THE.REVERSE SIDE AND ARF PART.OF THIS CONTRACT. 05.10-12 White-Branch File Yellow-Customer . Tel Wd2U:5. 600? LT 'daS T2_7 Z9£80S: 'ON XHd p26tuef: WOad 1� The C'oninionwealth of-Vassacl?usetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 WW1N.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El ers lease PriaLm bibs Applicant Inforulation . Naive (Business/organization/Individual): I Address: @ / 5 City/State/Zip: O� ),%nib Go, 20VI Phone#: F22. e you an.employer?Check the appropriate box: F[]Newconstruction ject(required): 4. ❑ I.am a general contractor and I �am a employer with * have hired the sub-contractorsemployees(full and/or part-time). deling listed on the attached sheet. ❑ lam a sole proprietor or partner- These sub-contractors have g, ❑Demolition ship and have no employees employees and have workers' working forme in:any capacity. 9. ❑Building addition comp.insurance.t [No workers' comp.insurance 10.❑Electrical repairs or additions required.] 5• ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions right of exemption per MGL 12;❑Roof repairs myself.[No workers' comp. c. 152,§1(4),and.we have no insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant that cheeks 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. 1Contractors that check this box must attached an additional sheet all 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 workelrs,'.compensation insurance for my employees..Below is the policy and job site information. Nb VU I '�/�q Insurance Company Name: Lf d _ r Policy#or Self-ins.Lic.#: W C O 3 S 7 � ' / Expiration Date: v ` Job Site Address: b b- M n S City/State/Zip: 0_5�oOS )A tion policy declaration page(showing the policy number and expiration date). Attach a copy of the workers' compensa 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 overage verification. I do hereby certify under the pains and penalties of perjury that the infp►mation provided above is true and correct. Signature: 1 � Date: 0� to # / `� t Official use only. Do not write in.this area, to be completed by city or town off cial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Departir►ent 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Parcel Detail Page 1 of 3 �r THE Logged In As: Parcel Detail Tuesday, Decemb. Parcel Lookup Parcellnfo I Parcel ID 078-066 DeveloperLot Location 2100 MAIN STREET (M.MILLS) , Pri Frontage 257 Sec Road I Sec Frontage village MARSTONS MILLS Fire District C-O-MM Sewer Acct Road Index 2163 Interactive Map Owner Info owner ELLIS, PAMELA A Co-owner Streetl 2100 MAIN ST Street2 City MARSTONS MILLS I State MA zip 02648 Country US Land Info Acres 1.63 use Single Fam MDL-01 I zoning RF Nghbd 0105 Topography Level I Road ,Paved utilities Public Water,Gas,Septic Location Construction Info Building 1 of 1 Year Roof Ext Built 1900 - Struct Gable/Hip Wall Wood Shingle Effect 1534 Roof Asph/F GIs/Cmp AC None Area Cover Type Style Conventional I Int Wall Brd/Wood 1 Bed 2 Bedrooms 1 Wall Rooms Model Residential I Int Bath 2 Full I - - Floor --- — --- Rooms Grade Average Type Hot Air I Total 7 Rooms - --- - - - -- ..__ Rooms — http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=4768 12/18/2007 Parcel Detail Page 2 of 3 D►34 5 1, 14 dH Heat 11 Found ��stories 1 1/2 Stories Fuel Gas 1 ation Typical AS 3 QS '3 " 6 1 4 EP 32 31 Permit History Issue Date Purpose Permit# Amount Insp Date Comments Visit History Date Who Purpose 12/7/2005 12:00:00 AM Paul Talbot Meas/Est 1/12/1999 12:00:00 AM Frederick Stepanis Meas/Listed - Sales History Line Sale Date Owner Book/Page Sale P 1 8/15/1995 ELLIS, PAMELA A 9822/156 2 6/15/1991 ELLIS, JAMES M & MEG M 7586/036 3 1/15/1991 MOSSEY, DOROTHY E 7586/034 4 MOSSEY, EARLE R& DOROTHY E 1104/344 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2007 $155,800 $0 $8,500 $195,900 2 2006 $123,400 $0 $6,000 $212,300 3 2005 $109,000 $0 $6,200 $193,000 4 2004 $90,800 $0 $6,400 $164,100 5 2003 $81,600 $0 $6,600 $63,700 6 2002 $81,600 $0 $6,600 $63,700 7 2001 $81,600 $0 $6,600 $63,700 8 2000 $57,900 $0 $6,600 $40,700 9 1999 $51,400 $0 $5,300 $40,700 10 1998 $52,600 $2,000 $5,300 $40,700 11 1997 $48,300 $0 $0 $34,900 12 1996 $48,300 $0 $0 $34,900 13 1995 $48,300 $0 $0 $34,900 14 1994 $52,100 $0 $0 $47,100 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=4768 12/18/2007 Parcel Detail Page 3 of 3 15 1993 $52,100 $0 $0 $47,900 16 1992 $59,300 $0 $0 $52,400 17 1991 $70,800 $0 $0 $64,000 18 1990 $70;800 $0 $0 $64,000 19 1989 $70,800 $0 $0 $64,000 20 1988 $55,900 $0 $0 $22,000 21 1987 $55,900 $0 $0 $22,000 22 1986 $55,900 $0 $0 $22,000 Photos a i http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=4768 12/18/2007 Map Page 1 of 1 Town of Barnstable Geographic Information System Parcel Viewer Custom MapIF Abutters Map Size ® ■ ■ Zoom Out{J' J J J J In "" R.a gym, ® ]PG Map: 078 078072 J Location: N 20 0 078039 88 Owner: 0780690D3 0780690DI 078069008 0780681 t130 q 2D k 115 p 95 r 078069007 �078069002 N29 Location In N 214 Map & Parce 078077 ~~ ! N 81 Location D78073 078D69006, Acreage V176 N39 r'r�11 Current 01& )078074'J Mailing Addi N 164 078116 N 59 078066 E 078064 N 2100 N2134 pi78066-1Appraised 1 ` N212D! Extra Featur 078067001 Out Building N 20 78 43, Land Buildings 4 Total Apprai M41 N 2064 001 k���Fp Assessed V (078D59 078068 077026 Extra Featur )78f�1 N2`351 II 141 F fe # 7 N2096 078057 Out Building q21 N 2 ' 077D34 Land � N 2069 Buildings Total Assess Set Scale 1° oo - A r - P Copyright 2005-2007 Town of Barnstable,MA All rights reserved.Send questions or comm( BarnstableMA v0.2.91 [Production] http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=078066 12/18/2007 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO OASFITTING PQ wl, (Print or Type) TOWN OF BARNSTABLE Date 17— 1r 19� Hyannis, Massachusetts permit 1 Building Owner's / AT: Location ��00 A ql K S Name f'11 114,/1 Type of Occupancy:-. 041 New [3 Renovation Replacement GPlans Submitted Yes [] No M M a ac a e 0 a = s W W W F O W ~ � s a O p c M O 0 0 = !- W W a j = Z R ! W t- W F = a Q a H Z R H < 'y r O a Z e s O O fl a a I< o a .<i u a: > o H 0 SUB—aaMT. BASEMENT IST FLOOR 2N0 FLOOR SRO FLOOR ITN FLOOR $TN FLOOR GTN FLOOR ?TO FLOOR aTN FLOOR (Print or Type) S a`� Check One: Certificate Installing Company Name Corp. Address 33 reve [3 partnership T ❑Firm/Company Business Telephone,4 Z� U �O Name of Licensed Plumber r Gasfitter 1 busby certify dat d!of the detaW and Inforrnetion i have submitted(or entertd)In above spplieesion an but and accurate to the kat of sup knowledge and that all plumbing work and Installations performed under hermit broad too this sppUatbn wW be is s%rmpYana NW N Frdwao: provisions of she Meaachnotts Stab Gas Clode and Chapter 142 of the C."Wal laws. 1 have Informed the owner or his agent that 1 .do not have liability Insurance Including completed operations coverage. Signature of Owner/Agent 1 have a current liability Insurance policy to Include completed operations coverage. By c ��c� `oit`�� (�rr��— TYPE LICENSE: P um er Title Ct..*A•S '^� }} r Gasfitter Signs re of Licensed City/Town:, jpt'T1s"f O t; Master Plumb r or Gasfitter Journeyman APPROVED (OFFICE USE oMLr) L�� s^ Number l BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION 1c �_ 9 FEE / I NO. 1 y9ci b ,rLL� V'e.h� ham, APPLICATION FOR PERMIT TO DO GAS FITTING NAME A TYPE OF BUILDING i LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED ' DATE 19 4 4 GASINSPECTOR