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HomeMy WebLinkAbout0274 ARROWHEAD DRIVE „y �nros Town of BarnstableBuilding... : Po This s Ca So That it is Visible From the Street Approved;Plans Must be Retained on Job and this Card Must be Kept « eaivasrnei.e 4 MMIM Posted Until Final Inspection Has Been Mader " � �� tf �� <- a �� �� cMa�° Where a,Certificate_of Occupanc ,is Re'uired such Buildin shall hot be Occu ied until a Final Inspection has been made. a Permit No. B-19-3431 Applicant Name: Steve J Spengler Approvals Date Issued: 10/30/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 04/30/2020 Foundation: Location: 274 ARROWHEAD DRIVE, HYANNIS Map/Lot: 270-092 Zoning District: RB Sheathing: Owner on Record: DUMONT, MARCIANO B Contractor Name: �.STEPHEN J SPENGLER Framing: 1 Address: 274 ARROWHEAD DRIVE Contractor License CS-071546 2 HYANNIS, MA 02601 n - f Est. Project Cost: $ 17,600.00 Chimney: Description: Installation of roof mounted photovoltaic solar systems,25 panels 8 `k Permit Fee: $ 139.76 kW Insulation: j Fee Paid:f $ 139.76 ii7 Final: Project Review Req: # Date: fr' 10/30/2019 Plumbing/Gas Rough Plumbing: :: �. r ui rn icia This permit shall be deemed abandoned and invalid unless the work authorized by thispermit is commenced'within six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which.this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or.road and shall be maintained open for public mspectioA for the entire duration of the work until the completion of the same. t Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building.and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection ., 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed _. x �' Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Pers ns contra with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: C� Tow ofarnstabe _ _. r+ i�; u •e: ,a ,� ',-' P:".. r.. �r.:. ?'sr°`. _ � : ...•u' ,.; ■„„■■■ 5.. ... ,.. �.. • .. /,:: /n .. ,: .. ,... ,o ... n r .. � a ;f t' ,; r. Pot his.C r 5a T at t.;S V+sr SFr r -A coved Pla Il �,• ,,. h_. .°� 0►n` .ex� t ns Must.,be�'Ret aned::on J .bin MAIM 'Al ;.. x d�t a 1C -x... ... � :., , Posted. tr, lnahins: ectlon.H s B. ,. a n: ade ..., . <. � � .�r ..- < ,, , <, e._ a aM . _ ,... a s r. ,3 < . . }•, �, `� . _•„ .._. ._... >.4 ,..:.... ,. o..,... ...". < ,.,. .. R 5 c fa ,..,Si:,. ..e. ..n , �::, 5Z ;.;y. E.:.. .7' .,.:Si., ..< .v, ,G „>," t., •. 5. ,,. .,., ... ,. s � -�" ,, � ,A ,s. . . ,...,. :.�� :._Er .:�� ��, �,,.., ..;. � �.. heLe-a,•Ce Ificate of 0"ccu anc ,rs Re urged s0ch J3uild�nshalL,Notrbe Occu ed.untrl,a Frnalans e r Pr q t ct orahas Been made ..,..92.1-�Y�-,z. �."'w.wm�.: Permit_N0 B-17 3`102 - Applicant Name Mike McMahon APProvals Date issued 09/19/2017 .,:Current Use=" Structure Permit-Type :Building'="Inssulation-Residential .,Expiration Date 03/1.9/20.18 : ation Found Location: 274 ARROWHEAD DRIVE,HYANNIS , •.. Map/Lot 270 092 Zoning District: RB Sheathing: s Owner on Record: DUMONT, MARCIANO B Contractor Name: MICHAEL T MCMAHON Framing: 1 Address:' 274 ARROWHEAD DRIVE : � � Contractor L,gcense CS-068111 2 EstPojectHYA NNIS, i Cost: $3,100.00 Chimney. Description: Weatherization,air sealing,weather strippin ,and'blown cellulose fr" g Permit,F $85.00 - Insulation: Project Review Req: Weatherization,air sealing,weather strppmg:and blown F;ee Paid' $.85.00 cellulose rT � 017 Final: Date 9/19/2 Fi Plumbing/Gas Rough Plumbing: : . Building , �,, . Official Final Plumbing: - Z zft , This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six�vaaftmonths erissuance. Rough Gas: All work authorized by this permit shall conform to the approved ion . applicat ha iheVapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws�and codes.WE Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpubhc mspection for the entire duration of the work until the completion of the same. Iq n Electrical The Certificate of Occupancy w.il.l not be issued until all.applicable signatures by the Butld�ng and�Fire Officials a�reprovided on this permit. ,,. Service: Minimum of Five Call Inspections Required for AII Construction Work 1.Foundation or Footing t ` Rough: 2.Sheathing Inspection �-� • <'�-<� � �� A"�� - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed priorto Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various.stages of construction _ - . :.... ., ... ... . ._„'.. Final. Persons contractin :w I r ,_. g...lth unr,,eg st.e ed-contractors.do-not::h .ve'access to,the uaran .fiund : as•sefi€orth-ln MGL.c.•142A . ' g tY r rt V ,'Fire,Depa me•t Building plans-are"to"beavailable on -'- . . � Final -t ;AIL Permit Cards are the ro e, p p rty of the APPLICANT-ISSUED RECIPIENT•' Last defendant in slaying sentenced CapeCodOnline.com Page 1 of 2 Last defendant in slaying sentenced By STEVE DOANE sdoane@capecodonline.com November 20,2012 2:00 AM HYANNIS—It's been nearly four years since 16-year-old Jordan Mendes'charred body was pulled from a pit in Hyannis. He was riddled with knife wounds and wrapped in a comforter before being doused with gasoline and set on fire—a grisly end to a short life. What started that day in December 2008 with smoke and blood ended earlier this month with a plea and a five- month jail sentence. On Nov. 9, Kevin Ribeiro, 17, became the last of three defendants to be sentenced when he pleaded guilty to a reduced charge of assault and battery in Barnstable Juvenile Court.The misdemeanor will keep Ribeiro in the custody of the Department of Youth Services until March,when he turns 18 and must be released from the juvenile court system, said his attorney,William Gens. He has been in custody since being charged in the slaying. Family members found Jordan Mendes'body smoldering in a pit on the edge of woods off Jennifer Lane in Hyannis on Dec. 16, 2008. He had been stabbed 27 times and shot during a robbery in the basement of 2741 Arrowhead Drive.The three defendants stole a large amount of oxycodone and about$13,000 in drug money from Mendes that they later used to buy a BMW, according to prosecutors. Days later, Robert Vacher,23;the victim's half brother, Mykel Mendes; and Ribeiro were charged with the killing. Earlier this year, Mykel Mendes, 13 at the time of the crime, pleaded guilty to being an accessory after the fact and illegal possession of a firearm and was sentenced to jail until he turns 18 in March. Both juveniles received the maximum sentence for their crimes,a period limited by the fact that they were younger than 14 at the time of the killing. "The idea of returning these two people to the community in a matter of months when they reach 18 as the functional equivalent of convicted murderers was something I didn't want to do given that status among their criminal community,"Cape and Islands District Attorney Michael O'Keefe said about the pleas. - The only adult defendant,Vacher,was convicted of first-degree murder at a trial in November 2011 and was sentenced to life in prison without parole. His case is on appeal to the Massachusetts Appeals Court, according to court documents. The disparity in the sentences was not lost on the victim's mother."It just looks to the community that they (defendants)didn't do anything to Jordan,"said Paula Carberry. "It's horrifying to my family that they'll get out of jail." State law mandates that anyone 14 or older charged with first-degree murder be tried as an adult. But there is no provision that allows perpetrators under 14 to face any kind of adult punishment. About a month after the Mendes murder, O'Keefe endorsed a bill that would allow for a person convicted of murder in the first degree,committed before the age of 14,to receive a maximum 20-year sentence. Murder in the second degree for those under 14 would be punishable by up to 15 years.The bill is still pending in the Legislature, O'Keefe said. "It's the poster child for the difficulty that exists in trying to punish these people,"he said of this case. In 2009,the state Supreme Judicial Court struck down a provision that allowed the Department of Youth Services to petition to keep an offender in jail until age 21 if he or she was determined to be a physical danger to the public.The court ruled that it violated the offenders'civil rights. http://www.capecodonline.com/apps/pbcs.dll/article?AID=/2012112O NEWS/211200333... 11/20/2012 Lst defendant in slaying sentenced I CapeCodOnline.com Page 2 of 2 All of this made little difference to Carberry,who said she's been living in constant pain since that December day. She does little things every day to remember her slain son. She keeps clothing and shoes around. She places his photos where she'll see them every day. It's about keeping his memory alive. "It's still as sharp as ever and now that the trial is over,everyone has moved on and forgotten,"she said. "I still miss him a lot." Copyright©Cape Cod Media Group,a division of Ottaway Newspapers,Inc.All Rights Reserved. t I http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20 1 2 1 1 20/NEWS/211200333... 11/20/2012 Engineering Dept. (3rd floor) Map Parcel Peimit# �(J House# ' Date Issued _. Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) < Fee - �,S Conservation Office(4th floor)(8:30-9:30/1:00 z.2:00) Planning De t.(1st floor/School Admin. Bldg.) ram, ►p D nitiv P n Approved by Planning Board 19 BARE.MAqFL 6 9 TOWN. OF-BARNSTABLE f ' Building Permit Application Project Street Address 1 �j'tga*yi ew t) �D a Village Owner U/��`)1 V? Nu 1 014 A Address -Zjq J WOW 14 t ( ! `Telephone < rR p � Permit Request, IZP.f6o �ou � u N( ay 3~1 l 1:�� as��,�l�' s1�r�•g�Qs �if 1� sk ��les c�y�er 1 e)((S4)K4 04trs are e `a to 1(0 nIt. lu First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No u I 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 No.of Bedrooms: Existing New 2 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use A, Builder Information Name S E�t?2l-`�1 �y` i U Telephone Number '7c�1 '2g 3- l(13 Address f 1(o cw"o yI `g License# 6S2,(o J"Z pew byrJ vq 1 (}17 S Home Improvement Contractor# 11�rr1(o Worker's Compensation# Ai/,A NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRI ESUL r NG FROM THIS PROJECT WILL BE TAKEN TO / n SIGNATURE DATE BUILDING PERM EN D FOR TH OLLOWING REASON(S) FOR OFFICIAL USE ONLY _ ' . _ - PERMIT NO. DATE ISSUED MAP/PARCEL NO: - R ADDRESS VILLAGE' `t OWNER ' y DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL ' GAS:;; ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT f. , ASSOCIATION PLAN NO. The Commonwealth of Massachusetts „H - Department of Industrial Accidents Office 011MestfgaMONS - � 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name• t r- location• (., c CM4, tl mod\ - - city 1 A" Y e V-M phone ❑ am a homeowner performing all work myself. II am a sole proprietor and have no one workin in amp capacity ❑ I am an employer providing workers' compensation for my employees working on this job. _ .. . comaanv name• ..:::::::::...:.... ... - ::. address- city. phone#: ;...... . insurance co. � •• obey# .. ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the;contractors listed below who i have : .. . the following workers compensation polices: company name: address: :.:...... .:..... city phone ininranee co ._:.:.;:.;,:.::.::. ':::.. no LT. / /0%/ vname ::: :::,,:.,;::::>;:':;::.:.;;>:.;::..::::.«':;::.;;;,..::«.:.:.: ...::::.::,::..::,.:: : :.<.;. address: ......:............. insurance"CO; Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a line up to S1.s0o.0o and/or one years'imprisonment as well as civil penalties in a form of a STOP WORK ORDER and a line of$100.00 a day against me. I understand that a copy of this statement may be forwarded to O e of Investigations of the DIA for coverage verincation I do hereby certify r the pe ies of perjury that the information provided above is true and coned Signature Print name �Y i°t; 1-"4U' Phone# •'1 1 '2°i`�� I i 5 official use only do not write in this area to be completed by city or town official city or town: perndt/license# ❑Building Department ❑Licensing Board ❑checicif immediate response is required ❑Selectmen's Otdee ❑Health Department contact person: phone#; ❑Other_ oeraed 9/9S PJA) The Town of Barnstable KAM• L►siverw�. • �0 Department of Health Safety and Environmental Services Eo ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:. 1 k) (y Estimated Cost .2 C1.(3C) Address of Work: 7i `f' AyzwwWid Lim) p i2 ��'/ ANM�S Owner's Name: V Q L V2 �=L i►"1 Date of Application: 9 . I hereby certify that: Registration is not required for the following reason(s): Work excluded by law E]Job Under S1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME E"ROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED ER ENALTIES OF PERJURY I hereby apply for a permit as a agent o er. Date Contractor Name Registration No. OR Date Owner's Name q:fortns:Affidav �' - = l .• , `✓fLC UI G�Y7/I'IEO�ItCC/C2GUL d`�a_��(.C7.JJClC�CI�P.�� y R OEPARTH,ENT OF PUBLIC SAFETY F. CONSTRUCTION,SUPERYISOR LICENSE } Nut bsr' zpires: 8irth0ate CS O52652 07/11/1999 07/11/1954 Restrrctd To j _ -1G JEFFRE'Y` 716VER; JVVSW6 CLARAONT;"RO PENBROKE, NA 02359 0 E�IMPROVEMENT CONTRACTOR 4 Y y Reg��str tloh H7618 �{'� � BA � P Yp w . . _ zpirat on 1`0/26/ii x" Ej Y '4 z JS 70JUILUIN6E OL IN6Ilk ,�x fFFREYD LARENON� x ' . . � nrasrRasoa -AMOKE MA �2359 Engineering Dept. (3rd floor) Map a'70 Parcel Permit# 3 .2 0---1 House# 4 -x?B Date Issue Board of Health(3rd"floor)(8:15 9:30/4:00- ~a3� � � Fee a -Conservation Office(4th floor)(8:30-9:30/1:00:2:00) Se Planning Dept.(19t floor/School Admin. Bldg.) "MALLCD ST BE De f' ive P Approved by Planning Board 19 Wi • 1ANCE TOWN OF BARNSTABLE ,�J Building Permit pplication , L*)treet Address d PT���/2°�Q �,�'�• C j L Village A"/AII'�' 1 Owner Q f/l l /�' Address Telephone Old 0 ' Permit Request , e� !o �1 S? ;First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes To On Old King's Highway ❑Yes 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 No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name ( � ` ��1/ Telephone Number Address �'(� /�i�s'7 �/1�) License# Home Improvement Contractor# � y Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT.. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE I)iN 'la, DATE y W. BU LDING PER T D IM FFOL G REASON(S) ML �- FOR OFFICIAL USE ONLY PERMIT NO. 4 DATE ISSUED MAP/PARCEL NO. 4-7 - ADDRESS t VILLAGE: _ 1 t ,,4a OWNER DATE OF INSPECTION: FOUNDATION FRAME t INSULATION FIREPLACE r d • ' ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL + FINAL'BUILDIIV. t7 c " DATE CLOSED O �3 ASSOCIATION PLA 1-NO. ; • A The Town of Barnstable - � L►stvsrest� t 9 N Department of Health Safety and Environmental Services 9- Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission: 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, repair, modernization. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,alon/g�wwith other requirements. Type of Work: ' ' 10 � �lQl' "� Est.Cost wUG' ` Address of Work: d 7 ` �� L� Owner's Name V ,Q S '/,r,�j/''���` a�/"� Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agen 4he ner. 4 Awl Date '&ontractor'Naife Registration No. OR Date Owners Name The Commonwealth of Massachusetts �-- - Department of Industrial Accidents .. — .-' Office 911alv950atfons l� — 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: _P &[� ' location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole ro r,etor an %/ d have no one workin in/%any ca ac. % / %%%///%%////%//%%//%/%/%%//////// O/%%///%/%/%///////%%/////%%///%//%//%//%%///%////%///%////%///%%////////%%%%%%%%%/%%%/%/%%/%%%%%/%%// ❑ I am an employer providing workers' compensation for my employees working on this job. coniaanv name - address - city _ :.... phone#. insurance co. Rolicv# ❑ I am a sole proprietor,ge a contractor, or h meowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comaanvname address. . { hone#. insurance co. oltcv# / - _ cam anv name. :. ... address: city ... c phone . insurance co. olicv # . FaIIure to secure coverage s,required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 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 may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify r he p and pe /�oj/pe/rjury at the information provided above is true a'nnd Phone# correct,, Signature J C l` Date 7 Print name official use only do not write in this area to be completed by city or town official city or town: perudt/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required - ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (wAsed 9/95 PIA) 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 this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, 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. 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 io 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 F.I.D.No. 11 320449 `1/C/�/�+/�\ ME Lic.No.DD00001093 {� Job# I LVfL �/7�y NH Lic.No. MA Lic.No.120456 HomeCentFa New York Department of 3: SALES: FOR ALL Consumer.No.Affairs Lic.H270415 0 0686 New York: SERVICE/REPAIRS The Service Side of Sears'" SuffoNassau Lic:No. 964HI 50000 800-942-6111 PLEASE CALL Yonkers Lic.No.2964HI Yonkers 654 Boston: 800-942-6111 SIDING Westchester WC 613H87 ' 800 SEARS 31 New Jersey Lic.No.097578 CONTRACT Connecticut Department of Springfield/Hartford: Consumer Affairs Lic.No.532774 o. 800-SEARS-56 Ri Lic. o. �/ h m RI Lic.No. SOLD TO I/4 1iV///2 t//�!�/�J m DATE r ADDRESS�f ��, ` ll/� PHONE(Home,)21,E�cSO CITY /—v_j&,41l�S STAT ZIP PHONE(Work) ] JOB SITE ADDRESS(if different) APPLIED VINYL & ALUMINUM SIDING Sold,Furnished&Installed by Bil-Ray Aluminum Siding Corp.of Queens,Inc. Q� 18 Lymar.St.,Suite M1 A Sears Authorized Contractor Westborough,MA 01581 40 Elmont Rd. Elmont,NY 11003 General-Description of ork at Above Address: Approx.Start Date: Type of House: rame ❑Masonry Approx.Completion Date: SPECIFICATIONS Sears approv d materials will be furnished and installed to these specifications: YES �1 PLEASE READ CAREFULLY:ONLY THE ITEMS CHECKED"YES"ARE INCLUDED IN YOUR ORDER. p SOLIDVINYLSIDING-coveron fiatwallarea g�t lorsiding,excepithoseareasdes' natedbelow.Size Color _ a tern Package f/ Custom corner posts color CIO IA..�SIDING will be applied to the following areas only: ront/Elelya lion �� Elevation ❑Entire Details: �earllevation eft Elevation ❑Partial(SEE DETAILS) // Other ❑(SEE DETAILS) 2. INSULATION-cover only Ilatwall areas designated for siding with inch insulation. 3. Us ears approved GALVANIZED STEEL STARTER STRIP where contra r dee s necessary.(Not available with Nailite.) 4. ❑ .Siding to be applied over existing foundation. 5. p,:�i.Use Sears approved PERMA TABS AND FINISH STRIP where contractor deems necessary in same color as siding.(Not available with Nailite.) 6.1a- ❑ WINDO OPENINGS stom wrap with Sears approved vinyl clad aluminum# Color ❑Jump over castings with siding and"J'channel# Color ❑Channel existing window only leg.Andersen type or previously wrapped)# _Color Details 1 7.6� `J .CAULK-all sills with rubberized color co-ordinated caulking t 8. DOOyS-custom wrap with SEARS approved VINYL CLAD ALUMINUM.#of Doors .Color O� 9. CI 1 1 j,4ARAGEDOORFRAMES-customwrap'withSEARSapprovedVINYLCLADALUMINUM.Color ❑Single ❑Double With Mull ❑Double No Mull 10, LF 0 FASCIA-custom wrap with SEARS approved VINYL CLAD ALUMINUM.Color �Z 11. �OFFIT-(eaves/overhangs)cover with SEARS approved SOLID VINYL SOFFIT SYSTEM.Except area noted below.'h Vented.Color 12. ❑ p/ffoTTEN WOOD-Will only be repaired or replaced where specified online item#27listed below.Any additional areas needing a repair will be estimated upon theor-dissccovery and priced accordingly.(Does not include wood studs,or exterior sheathing). 13. ❑ D-4emove existing material on exterior of house. Vinyl ❑Aluminum ❑Wood Shingle ❑Wood Siding ❑Other Doe include any asbestos removal. 14.❑ RCHCEILINGS-cover with SEARS approved SOLID VINYL CEILING MATERIAL in the following areas 15. ❑ TAMS/COLUMNS-wrap with SEARS approved VINYL CLAD ALUMINUM(No circular or round columns).Color 16. ❑ 7,-513 RS/LEADERS-remove existing and replace withnew custom seamless gutters and leaders.White Brown 17.❑ @y'SHUTTERS-provide and install pair SEARS approved polystyrene shutters.Color 18. U,-'IYII(ASTER MOUNTS-provide and install for exterior light fixtures nly.Col 19. ❑ GABLE VENTS-provide and install vents.Color G No circular or triangle vents. 20, fU-^ CLEAN UP property at completion of work. 21. g�'IyINSURANCE-all required WORKMANS COMP.and LIABILITY to be maintained. J�RAll Discounts Have Been Applied. 22. � WARRANTY-mail to customer after completion and full payment is received. 23. L7 L�J PAYMENTS-oli NON-FINANCED orders installer is authorized to collect progressive payments. Deferred Payment,Interest Will Accrue. 24. /lt} ld ALL DISCOUNTS APPLIED. 25. ❑ ADDITIONAL WORK-not specified above. Job Total$ Less deposit 25% Balance OCl Start Y2 rl F[NA9'CED$ does not include' t Completion 1/2 If financed,balance payable i L In installments of approximately$ per month,payable by'Owner"to contractor but if financed by Owner then Owner llrpay said amount to the lending institution plus such in erest and credit service charge of said lending institution payable directly to the lending Instil 9-loaning such monies to'Owner"and will execute a Retail Installment obligation and any documents required by such lending institution in connection wd ch loan. 26. ❑ LV WORK NOT tobedone. 27. ❑ Repair or replace the following woods NOTICE:If financed,any holder of this Consumer Credit Contract is subject to all claims and SALESMAN HAS NO AUTHORITY TO CHANGE ANY TERMS defenses which the debtor could assert against the seller of goods or services obtained OR MAKE ANY REPRESENTATIONS OTHER THAN CON- pursuant hereto or with the proceeds hereof. Recovery by the debtor shall not exceed TAINED IN THIS AGREEMENT AND"OWNER"REPRESENTS amounts paid by the debtor hereunder. THAT NONE HAVE BEEN MADE TO OR RELIED UPON BY "OWNER REPRESENTS TO HAVE READ AND "OWNER".YOU ARE ENTITLED TO A COMPLETELY FILLED RECEIVED A DUPLICATE ORIGINAL OF THIS IN DUPLICATE ORIGINAL OF THIS AGREEMENT. AGREEMENT AND TO BE THE AUTHORIZED "YOU,THE BUYER,MAY CANCEL THIS.TRANSACTION AT AGENT OF ALL "OWNERS" OF THIS PROPERTY ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS UPON WHICH THE WORK OR THE MATERIALS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ARE TO BE SUPPLIED. ATTACHED NOTICE OF CANCELLATION FORM FOR AN OF THIS RIGHT.ON ALL ORDERS CANCEL- NOTICE TO THE HOME OWNER(S),GUARANTOR(S), LED AFTEROTHE RECISION PER OD CUSTOMERS WILL BE LESSEE(S),CO-SIGNER(S). RESPONSIBLE FOR A 20% ADMINISTRATIVE AND RE- STOCKING FEE. Contractor, at the•expense`of owner, shali-procure ail,permits THE COMPANY WILL DEPOSIT ALL MONIES RECEIVED required by law as follows: 1. owners who secure their own permits will be excluded from the FROM guaranty fund provisions of MSL Chapter 142A. IN AN ESCROW ACCOUNT AT CHASE MANHATTAN BANK 2. Any person who shall have co-signed,guaranteed or signed #105-1-062089, WIT IN FIV BUSINESS DAYS OF ITS. -. any credit application or note relating to this agreement hereby RECEIPT. 16 accepts to be bound by this agreement. Date 3. Owner(s)represents that the contents on the back of this agree- ment is a true part hereof and has been read and accepted by DO not S greement before you read it or if Owner. it conta any b Ink space or if it does not contain 4. ALL INSTALLATION LABOR LABOR GUARANTEED I (ONE)YEAR. eve agre d upon. Print \✓�/Y�. �/""/ FN�/� Salcsr.:ansName J Ignalure _ 1 ustomer Sign Here) Salesman's License No. Signature EE REVERSE SI FOR DITIONAL Ti AND CONDITIONS ' r -^: Et j. a HOME- - E I2�PROy�MN CONTRACTORS REC_S i RAQ J �{ Boas o7 Eu_ e'-n5 ReSu�aticns and Sta;tGc0 s �- 0 ne AshLu;tc n P iaca Rccm 2301 - _ . - - .. Ecston, Massachusetts 02108 - ------ - = -- - - HOME IMPRCVE`1EN I CON►RAC ^R ReC11S"'at�via 120A / - �o Expiration 0z 0 /99 = type - PPIV _ - B-7L-RAY ALUM . S7D=NG CORD JOHN Q 'NE=L - 123-10 AILAN- C AV= - RICHMOND H NY I- I 1 " ACOR-Q. CERTIFICATE OF LIABILITY INSURANCE DATEVXWDD/YY) 08/05/98 PRODUCER - T�iIS CERTIFICJLTE IS ISSUED AS A MATTER OF INFORMATION COUNTRY INN INSURANCE AGENCY, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA'iF. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 217 MERRICK ROAD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SUITE 212 E;ISURERS AFFORDING COVERAGE AMITYVILLE, NY 11701 s . INlxritee BIL—RAY ALUMINUM SIDIN(. CORP. INSURERA;THE I1ST)RANCE CORPORATION OF NY` 134-10 ATLANTIC AVENUE INsuRERs_CIGNA INSURANCE COMPANY RICHMOND HILL, NEW YOZK 11419 INSuRERcREALM INSURANCE COMPANY INsum vGUARD IAN INSURANCE COMPANY INSURER E: • ---•.—�_��.._.....__._�. j COVERAGES 1 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE;=AR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RL,.PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE:INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;flfCLMO"AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF DNflDitANCE POLICY NUMBl3i POUCY HFECTr1/C POUC Y EXPFAT10N LTR LIMITS GENEM LIAIZusr EACH OCCURRENCE s l 0 0 0 0 0 0 X COMMERCIAL GENERAL LIABILITY RRE DAMAGE Wry one tire) $ 50,000 CLAIMS MADE �OCCUR MEO EXP IAny one parfan► 0 51 000 A IGLOO6886 05/14/98 05/14/99 PERSONAL&AOVpvJUAY sl 000, 600 GENERAL AGGREGATE a 2 0 0 O 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1 000 0000 { PoucY El�OJECT Loc 1E AUTOM011LE IJAM TY t COMBINED SINGLE LIMIT 9 ANY AUTO (Ea accident ALL OWNED AUTOS � 80DLLY1NJURY f SCHEDULED AUTOS (Par parson) HIRED AUTOS - BODILY INJURY 6 NON•OWNEO AUTOS • (Par accidart) PROPERTY DAMAGE f CPcr accident) I ! sARAGE LINTY AUTO ONLY•EA ACCIDENT C ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCeas LIAMUTY EACH OCCURRENCE s3,000,000 OCCUR ❑X CLAIMS MADE AGGREGATE s3 ,000,000 B BINDER # 05/14/98 05:114/99 s omucTISLE CI I 514 9 7 s REtENTION $ a I WORICERS COMPENSATION AND X WC STATU- EN OTH C DY»uAryerTY BINDER y # 05/14/98 0 5/14/9 9 LL EACH ACC �PL IDENT $5 0 0 0 0 0 C I 1514 9 8 E.L.DISEASE-EA EMPLOYEE s 5 0 0 0 0 0 E.L.DISEAse-PoucwuMrT s500,000 OTHIM 1 D DISABILITY BINDER # 06/01/98 UNTIL i CII51499 CA:4CELED 013CF11MION OF OPERATIONEJL.00ATIONSNEHlCl ESlI=W&IQI"AOWO by H'IDOIRS OffISPECIAL PROVISIONs • . i. I K . F CERTIFICATE HOLDER AVOTIONAL INSURM;INSURER LETTER_ CANCELLATION SHOULD ANY OF THE WOVE DESCRIBED POLICIES BE CANCE11m 61 IRME THE EXPIRATION DATE TM=r-.THE ISSUING INSIIRSL WILL ENOEAVOR TO MAIL 30 DAYS WRITTHI NOTICE TO THE COM aCATE HOLDER NAMED TO THE UX-T,SurT FAILURE TO 00 60$HALL IMPOSE NO OBUGATN'IN OR UANUTY OF ANY IGND UPON THE INSOR@L TTd ACAYia OR REPRssavra -� 1 AUTHORO3ED RF I+ 1 /