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0028 GREENWOOD AVENUE
O?f �iZel7ullulct � ��II . 'r � � 1 ;� f .i Owner-- 15 �toA t,, CAPE COD OF INSULATION Bq��sT IIIIA OCA II IIAMCIIS IPA AY FOAM JY:1IN010 IAII1 OW11A7 INSMATION CItIN01 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc, performed & completed the insulation and weatherization work at the property listed below, Cape Cod Insulation did this in accordance to the specifications listed on the building permit application, All work has been inspected by a certified Building Performance Institute '(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements, Property Owner Property Address Village Insulation Installed: .Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) X) Slopes ( ) ( ) ( ) ( ) ( ) ' I Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) C ) ( ) ( ) ( ) GtJO r k Sincerely 2Hry E ssi r, President Ins ation, Inc, TOWN OF BARNSTABLE BUILDING PERMIT APPLIC.,XTION R BUILDING DEP Map Parcel T. Application # Health Division OCT 04 2016 Date Issued Conservation Division TOyyN O s�� STq Application-Fee Planning Dept. $�` Permit.Fee ' 6v Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address JP �J��4C, Village �si Z , � Owner f /C ,W. Address Telephone �!!�W 34 � Z.Zz ,.g Permit Request t�� '/I �� „ ,� �Li��c�� � 612�� 5✓ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family fii(- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ;4No On Old King's Highway: ❑Yes No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ` Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size_ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - -- —- - - (BUILDER OR HOMEOWNER) Name /f.&,u f�A 7/,�,eg Telephone Number J-0(J� Z �4- Address. "Af Ci 0 License# /v Home Improvement Contractor# 1.S�3 6 2 � Email�2iiD ���� ro�Z&Sy11 'b!1'I`dlorker's Compensation #44)L' e'L�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE JD ztzl FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED -f MAP/ PARCEL NO. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' +°' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t! r DATE CLOSED OUT f ASSOCIATION PLAN NO. I Oar astable : eulaoiry Se rvice �; SicUard'V ScaL,Directok. �u Rdib'DiYisxon TomFeriq,Bngdf oner 200:MiiA Spopet;:Hxamma.MA42fAi w►4w tw�uaiaras�blesnav Office: 500624039. Fax .-508=790-6230 Prop mer Must . : cOI ?I f arlld '.tmsse-c-txall I .Tsm Ahuiildeir: I, Set V1d y1 ri1 W LI h i s as.owm::f* subjecr:pxoCa ty hetbp authoiEizen�U ��T r'ao;acc vn r�ybefia�£,, in all:mattem,zehtiv+e to wo k:authorized by tiis bAdh3g pem-I t-app'kation:for. 1-3 i rt "To ol Peaces and afams ae=tle respoi of tbie:applicant:Paos are.nott:ta be::filled OT utilized before fens is:nstalled and 0-fnal' inspections ampezformed:aud:accepted.. 42 'L� Signature o .Ovmer S*aaia m-,ot:APPli (sad r ,�s TrintgoAe Ptiat Name Date Q:MRMS,,OWNMMMMSierrMIS: I . . Wd The Corrtmo�tiverchlc of Massrcehuset�s Deprcrlm.enl of Inrlccstrtrcl Aeetctents 1 Congress Street, Sutle 100 Bo$(OH, MA 02114.2017 1'Vu1'kcrs' Compcnsatioa IasurapcclA d�arritrBuIldclrs/Cont raotoTO BE FILED WITH THE PERMITTING AUTHoR�Yctrlcinns/PJumbers, cant Informs I n Name(Business/OrgenizalioNlndividual)'. !'' -,,n i Please Print Le Ib(y Address. Clry/State/Zip: p F -' —lo hone #; A�ri you an employer?' eck the a r pp opriate boxy am a em to ° w' �'• ..r p y r rth..�._.,employeos(IvII and/erparl,(lmo)•, TYpe of proJcct (reyulred) 1 am a$olo proprtolor or partnorship and havo no omployoes working for mg in anycapa°tty.(No workers'comp, insuronoo required.) 7' 0 New ConstiuClion )•�I am homeownor doing all work m self. $•.,� Remodeling Y (No workers'comp, insurance required.)r 9. a I am a homeowner and will be hiring contractors to conduct all work on m `�^+ Demolition onsuro that all contractors crther have workers'compensation insurance or are rsolo ry l will I O Building addition proprietors with no omployees. S.Q I ama general eonlraolor and I havo hired the sub corilraclors listed on the ells I l 1✓IOCtriC81 repairs or additt00% These sub conlrao�.l9rs hava employoos and have workers'comp. Insuranco,r cited sheet. I Z' plumbing repairs or acidili�;r 6 wo are a corporation and its 13. om Roof M.§10),and wo havo no omployeosa(No workersiod,their rightof exempgon Per MGL o, Q repairs Any applicant that chock box N l must also till out p swanco required.) I Q'�,Cther1//�,,J% ���, Homeowners who submiPlhis aPildnvll Indicating they aro doing all work and Than hire oulsldo coniraolor I to section below showing their work ors'Ornponsallon pollcy Information. iContractors 11181 check this box must nnached nil additional shoal showing the name of the sub contrao �^� T M omployees. If Uto sub.coniractor$havc employoos,they must provide Ihoir workers'oomp,policy numbers must submit a now affidavit in entities such. /err►an employer l/rrr!is prot1lr tiff workers'corn err tors and state whether or not those emitics havc f�rforn►ntlon, p srrtton lrrsnrance for trry 81Ytployees, Below Insurance Company Namo.; i and ubs r JZ• � Policy b or Self-ins, ,r o .h Job Site-Address:c�?k e< hxpiration Date; Attach a copy of the Workers'' compensation p icy d°cl ration page t bowln Failure to secure coverage as required under MpL c. 152 ng thStatel Zip; d g the policy aumb� 'rat( 1ct. and/or ona•year imprisonment, t�'s'Well as civil penalties in the form of i STOP day agatrisl the violator. A co}�y d'f,tl�is slateme §25A is a criminal violation punishable b nt May WORK p}ZpE Y a fine up to$I,SOG GU coverage verification, Y be forwarded to the Office of investigat ens of the DIA fand a fine of or In u5anctF ---- ---ve_.... /rlo/lereby cerl�y rnrrler lice pr:lrrs nnrl percnitles ofper,/ury that!re pE/orc . i na a e. ,�' � �'on provlrled above !s true rcrcrl correct �"�' ton a, 0)97ctal arse only, Dq."I'l.,ot w4te lr, ticls area, co be cornpleled by city or lo►vr City or Town; c of✓tclrrW Issuing Authority (circle one)t Permll/License 1. Board o-f Healtb .2. Building lee artmcat g, Cl i� ty/Towa Clerk 4, Electrical Inspector S, Plumblag Inspector 'Contact Person.; Pborae 9: �� �. Massachusetts Department of Public Safety I t; ?jr• Board of Building Regulations and Standards License: 08-100966 Construction Supervisor HENRY E CASSIDY 8 SHED ROW WEST YARMOUTH Expiration: Commissioner 11/11/2017 - ��GZ7^/12Gt%LPi� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co:n:tra'ctor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259185 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE 30. YARMOUTH, MA 02604 Upda,te,Address and return card, Mark reason for change. $CA 1 !+ 20M-0s111 [� Address Renewal Employment (] (Jost Card . .. . . ........................ ................. .......... dis anm�aaracve�r•�G/o�C�/��rwaa.c�udeCtd \ •Ofnce of Consumer Affairs& Business Rquintion License or registration valid for Indlvldul use only OME IMPROVEMENT'CONTRACTOR before the expiration date, If found return to: egistratlon: -1,53567 Type: Ofke of Consumer Affairs and Business Regulation ;j xpirallon: 5k20:p.6 Private Corporation 10 Park Plaza •Suite$170 Boston,MA 02116 CAPE COD INSULATa'QN:;:;INC HENRY CASSIDY 18 REARDON CIRCLE $0. YARMOUTH,MA 020$4 Undersecretar Y N• valid wl tit sign e CAPECOD-27 CLEDDUFCE ACORO' DATE(MMIDDlYYYY) CERTIFICATE OF LIABILITY INSURANCE 7/1/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder In lieu of such endorsement(s), PRODUCER CONTANAME: Barbara DeLawrence Rogers&Gray Insurance Agency,Inc. PHC t N FA AIc No 434 Rte 134 E MAIL South Dennis,MA 02660 ADDRESS:bdelawronce@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company INSURED INSURERS:Safety Insurance Company 39464 Cape Cod Insulation,Inc... INSURER C:Endurance American Specialty Insurance Company 41718 18 Reardori.:Clrele INSURERD;Atlantic Charter Insurance Company44326 South Yarmouth,MA:02664 INSURER E; INSURER F; COVERAGES CEi*TIFIC ,l �Nl1MBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLIOMS OF'1NSURANCE-,LI$TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AM!•'REQUIREMENT, -9-A iA b'R,CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY.:0,9}TAIN, THE,:(NS`UW,CE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUC.H;POLICIES.LIMI7S'SHOWNWAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR TYPE OF INSURANCE (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,001 CLAIMS-MADE OCCUR C9128281,063 04/01/2016 04/0112017 PREMISES(Ea occurrence) $ 100,001 MED EXP(Any one person) $ 5,001 PERSONAL&AOV INJURY $ 1,000,00, N'LAGGREGATELIMIT.AF%,I 'P.ER: GENERAL AGGREGATE $ 2,000,001 POLICY PRpp•' �•.,Ippr LOC PRODUCTS-COMP/OP AGG $ 2.000,001 OTHER: $ AUTOMOBILE LIA9ILITY d„ a ED LE LIMIT $ 1,000,001 B Me acci enl ANY AUTO 6232707 COM 01'•' :' ,':•" 0.4'(01!(2016 `04'/,0:112017 BODILY INJURY(Per person) $ ALL OWNED''; X SCHEDULED AUTOS '.AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS XWN. AUTOSED . MAGE ;;•:..: Per a Ident $ X UMBRELLALIAB X OCCUR•: HACHO.000RRENCE $ 2,000,001 C• EXCESS LIAR CLAIM.S,MADE EXC1.0006636001 04/0112Q16 04/01/201'# AGGRt GArE $ DEO X RETENTION$ 101000 Aggregdtt3••. $ 2,000,001 WORKERS COMPENSATION w. AND EMPLOYERS'LIABILITY D N ' ` TRTY! ; UT ER ANY PROPRIETOR/PARTNER/EXECUTIVE WCEOQ431802 06130120% •06130/2017j8(; ' OFFICERIMEMBEREXCLUDED? N!A Nc;; $ , , 1 (Mandatory In NH) If Yes,describe under ;::, E.L.DISEASE•Eq:@.MpLQYE $ 1,000,001 DESCRIPTIONOFOPERATIONSbelow E.L.DISEA,Ei,:p•, L'ICYLIMI,T::;$: 1,000,00I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICL0 (ACORD 101,Additional Remarks Schedule,.may,be;attedKed;IFmore space Is required) ' Workers Compensation Includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Ll "1'i11tywuhe6 required by written contract or agradment with'the Certificate Holder. a CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ( }IfQO{D U� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 94A Co erce Park Sou.h ACCORDANCE WITH THE POLICY PROVISIONS. Souhatham,MA 02665N-,, AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION, All rights reserved, ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map PP P cel ' I�ication C n Health Division P vAr Date Issued Conservation Division I�/�,/,c? ��® �(��N6-E �� � Application Fee �'0&rM1 W Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project StreetAddress/?�F �Kf(f 4"10001 0yfif -. VillageA�Urlc Owner 7rG� Gdl�'_ GLci Address � n` aJ Telephone ,S"OS Z,,26) 7 Permit Request 1� CA 64 GL2el r- . G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Val uati S9510Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No . On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full " 0 Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft ' `�' zF �. ca Number of Baths: Full: existing new Half: existing new _ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other r r 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 - ->_r_ ---,_ __ Proposed.Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Namek Telephone Number_S�� �6 �� Address / �r9� /t�� License # AV 4 0 aC- �� Home Improvement Contractor# m a Worker's Compensation #�Zz • ■ orb■■ i D ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE R OWNER DATE OF INSPECTION: 4 FRAME YINSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f CA% The Commonwealth of-Massachusetts Department ofhuhuhial Accidents O`Kwe of Investigations 600 Washington Street Boston,MA 02111E wnw.mass_go Idia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeziMy -Name Ge,� @ r, AA&ess: G-7 Gyv��� City/Stat&Zip: A45 Pho=3� Are you an employer?Chec the appropriate bow: Type I am a contractor d Ior and of pr.oIect(required): I. am a employei with 4 _ ❑ 6_ New construction employees(full and/or part time.).* have Dined the sub-contractors. ❑ . 2_❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ ❑Remodeling ship and have no employees These sob-contractors have g_ ❑Demolition wodang for me in any capacity. employees and have wodcers' g ❑Building addition [No workers' comp.insurance camp_insurance.$ required-] 5_ ❑ We area corporation and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all work f officers have exercised their I1_❑Plumbing repairs or additions myself[No workers'camp. j rigght of exT-mption per MGL 12-.❑Roof repairs insurance required.]j c.152,§1(4),and we from no employees-[No workers' 13-❑Other comp_insurance required.] *Any appticaat that checks boat#1 must also fill out the section helots slowing their wodeie compensadou policy iufrurmation_ Homeowners who submit this affidavit mdicatmg they au a doing all mm k and than hue outside contractors nmst submit a new afidwUh indicating m clt_ ICcnitoctots that checlk this book must attached sa additional sheet showing the mmne of the sub-camactors ad slate whether or not those entities have empkayees. Ifthe sub-cout:actats have employees,they must provide their workers'comp.policy number. I am an employer that is prm idYng workers'compenswdon invirance for my employees Below is the policy and job site information. Insurance Company Name:2-J rJ h Poluq#or Self-fins-Lic.#: U 2 2[j g�L 3 Expiration Date: Job Site Address: �0 �re m lfad� CityfState/Zip: t 6i r 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 bead to the imposition oferiminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the frnm of a STOP WORK:ORDERand a fine of up to S250.00 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 verificatitin_ I do hereby cerhfy' cinder the pains nd r Iff�jjury that the information provided above is true and correctcorrect Si tut Date: .-C/ Phone#: OUkial use only. Do not write in this area,to be completed by city or talon officiaL City or Town: PermitUcense if Issuing Authority(circle one): .. _.. , 1.Board of Health 2.Building Department 3.CitylFown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r * i - r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant•to this statute,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, §25C(6)also states that"every state or Iocal 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,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Z1ie 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. Self-insured companies should eater their self-insurance license number on the appropriate line. City or Town Officials 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a tail. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Deparbuent of Industrial Accidents Office of I.uvestiptions 600 Washington Street Boston,MA 02111 ToI.#617-727-4900 w 406 or 1-977-MASWE Revised 4-24-07 Fax#617-727-7749 www.massgovfdia Aco 0 /201R"s CERTIFICATE OF LIABILITY INSURANCE DATE (712013 YW) 10/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER.THIS CERTIFICATE DOES. NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 508-540-6161 Fax: 508-457a660 O°NTArfT Bob Allietta " NAME: ALMEIDA&CARLSON INSURANCE AGENCY INC. PHONE FAX P.O.BOX 654 ac o E,a)_(508)888-0207 -�Nc No): (508)888-0550 E rallietta@almeidacarlson.com FALMOUTH MA 02541 ADDRDDR ESS: _ INSURER(S)AFFORDING COVERAGE NAM 9 INSURED INSURER :Travelers Indemnity Company of Connecticut 25682 � — DENARDO HOME IMPROVEMENT OF CAPE COD INC. INSURER :Zurich American Insurance Group 17 WILANN ROAD INSURER MASHPEE MA 02649 INSURER D: INSURER E INSURER F " COVERAGES CERTIFICATE NUMBER: 25610 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN A HAVE BEEN REDUCED BY PAID CLAIMS INSR' ADD'L.�SUER POLICY EFF POLICY EXP I LTR I TYPE OF INSURANCE `.II�R D POLICY NUMBER , MDD I�yuDpryyYY) LIMITS I - --O - _._..-.."..._.."_.-.— q '1 GENERAL LIABILITY j 680883OA369 09/10/13 091,10/14 EACH OCCURRENCE . Is 600,000 X COMMERCIAL GENERAL LIABILITY 1 DAMAGE Eowre l � � I PREMISESS(Ea ocarence) I $ 300,000 t CLAIMS-MADE i XI OCCUR « I ! MED.EXP(Any one person) i$ 6,000 X I BLANKET ADDT PERSONAL&ADV INJURY 1 $ 500,000 I GENERAL AGGREGATE is 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 1 PRODUCTS_COMP/OP AGG is 1,000,000 POLICY OT LOC is AUTOMOBILE LIABILITY t COMBINED SINGLE LIMIT (Ea acdderd) i$ I ANY AUTO )ALL OWNED4NUTOSON-OVVNED SCHEDULED BODILY INJURY(Per person) $ i — "",AUTOS UTOS 1I #BODILY INJURY(Per accident) $ f iHIREDAUTOS i 1 PROPERTY � $ —- ---- Wr I — UMBRELLA LAB j OCCUR f ' i EACH OCCURRENCE I $ i I EXCESS tJAB j CLAIMS-MADE 1 1 AGGREGATE Ills$ i DIED I RETENTION$ WORKERS COMPENSATIONC I { 6ZZUB9859L330-12 1 12120/12 12/20/13 1 1�uMrrs j "ER" $ AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER(EXECUTWE YIN OFFICERIMEMBER EXCLUDED? E.L.EACH ACCIDENT ! $ 100,000 11 1 (Mandatory in NH) IN/ A ( I E.L DISEASE-EA EMPLOYEE $ 100,000 iIf yes,describe under j I DESCRIPTION OF OPERATIONS below - _—i I i E.L.DISEASE-POLICY LIMIT ;$ 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES{Attach ACORD 101,Additions(Remarks Schedule,if more space is required) BUILDER 4 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SANDWICH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRESENTATIVE - Attention: GREG . Bob Allietta ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,, .Y :.4` _ i i � .� moo F ^. s� \ eE ca �;�.*`:.,.-Z::--,,-,....4.--,---;,�-F,G.,i.;_-"1_�.9,.—..:.-".tm.'�-,��.z�-.,�,-,:!o-,,.�-�-.��.-;�,�.'-��"—-.�-,,�-!,�.:.�---.-��!-t,:�,..,�-:,,.�:.:-,-.-f-.-,�,—.,..,.,4:,.,-:-�.i.,-.":,,.*.�L�.-,.-`-�::�"-�,,-;,�--..��,.—,...,,..�.W,":.�,1;;;.-,..-W.�.�.*..,,,�:j.-:",�j,�,.�1.I,t�--:..,o I;-�,--::�.7�:-,-.��H---z,..;-'.,1,;.....,.-��:-.:,,,-�-t�-�,,-.,".-.i a+o �. • .; !pw-1:�"-,.',i,7.�dz � ° 3s4'3� ioo . t �, fi n r .-RO.;.�..�......�,_,.���.'.-,,.,..-;,���_---�!�,�-�--,:....�-.-,-..-,'`.*:.���,�--:�---:.--�1-,.,--, b` 7's i c ,x��± _ �� Ali x t i S S: t }h' t o S .E 1 �� 1 .- 3.. ... C k r yj f. t , e 't o C { t +:I` 4 y. / �'� 1i a„v-,, r - a ,. y y2 -_.�W.,..t;�-L,.�:"",,��.��:,*1.,P—,,1�-�:,..�..;�1i -;_: Y u <r1 �° r . -. k- '' , x 4 Z 3 J "i✓ l 1. ,, 4 �� r Y ; �✓ L�T: 5 .4 EC ,- - Y 8 \:. CIF n�E1�S C8,4;� �rar� � o) 3 �' '�C O� - F f r o` p F �►K; - -., ' C� 'r �FY ,�� Tom : F . .--! { {G `�' .5 T 2 U C 7`U ,? �, n—:�� r-f r f ter., Ito9?�b9 c<i _: �u : �� BBB/ . 0 EG 4. n t/ i �'U YS/I� SU,�' Y COk'�' CC ssvar�Lovt�sry � � r .� tJ sk �~ - 4 - IL:;j{, { �' ,t.,. ° , + rFo3i2'r.n�.c L�+' C,e� w E--tr3 Tqf ,�. '�:�,�-�,L--=i �-(, ,.:� - s. �,r, 7 7 ?: P 41 ! - Massa hose r +D ��`o BNf1 g Re ar#mentof Public Safety Cunstr 'taQnsor �a = �.arcls's i License: C " S-072276 t � MARC gbEDO Commissioner It1i k �5lration 014 f � p " Y.11, pM1 "Q]► .$ hPok NA , 'MA$Hot` Ca i `- M /`loj2 �P�v4t/�YJ Z C� GC CC k ex Sfi .� s cr /t�G %�/crS7►'rr!7 crib �7 L'r[o� 16'f �efi.e e75 � Tube tv r��r- l DeNardo AWIN HAR vev r Liability Insurance HbME! ALCOA ov t ✓ Workman's Compensation Imprement Master Contractor Windows 4-Year Labor Guarantee of Cape Cod. Inc. 0 t5os1 477-5574 Vinyl Siding MA HIC Reg. #102603 Aluminum Trim MA Cont. Lic. #072276 Established 1984 " 17 Wilann Road, Mashpee,MA 02649 Vinyl Replacement Windows 1-800-920-4882 PROPOSAL rPRQeOSAL SUBMITTE PHONE DATE �/ - STREFft 109NAME .71 (� CIT ATE,ZIP CODE JOB LOCATION ARC 1 ATE OF PLANS JOB PHONE 1/7 W hereby propose to furnish the aterials and perform the la r necessary for the completion ofz ' job V� re�� 5 /�c o 3 czttS I psi .�' � �/�' f�Z e -� /yt . fir.• G r < � t3 cdvr , , Is G - 711 ze 7 'Y1-= c � - ✓Li d All material is guaranteed to be as specified,and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantialZ�_, rkmanlike manner for the sum of --� f C Dollars ($ 01V ) w, ayments to a made as foil w Any alteration or de via' n fro Dove specifications involving Respectfully submitted -- extra costs will b e ► onl upon written order,and will be- come extra chi td er and a ove the estimate.All agreements Per co t' ent jj�on s kes,accidents,or delays beyond our control Note—This proposal may be withdrawn O r t c�rfy fire,tornado and other necessary insurance. t by us if not accepted within ays. ACCEPTANCE OF PROPOSAL The above prices,specifi ations and conditions rare satisfactory and are hereby, ccepted.You are authorized to do the work as specified.Payme s wi be made as outlined above. Signature-- Date / Signatu „o�TM�'• TOWN OF BARNSTABLE ' Permit No. ' '” ' Building Inspector Cash — .... - 00 °"pY~ OCCUPANCY PERMIT Bona "No building nor structure shall be'ereeted, and no land, building or structure shall be - used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." "W"= �r. ii! t Issued to Ernes-4- Farind Address lot 471 28 Gee -IcQd Avenue, Hymrds Wiring Inspector 1' �y f-�,`'.t"r �,�+,,,. Inspection date Plumbing inspector L' Inspection date Gas Inspector "'k lu/ ;-r�_ h r.`�,y` 7 ,�%�e1' Inspection date ?.7_ f Engineering Department Inspection date THIS PERMIT WILL NOT BEVALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. r Building Inspector Assessor's ma and lot number p G�....... (./ %TN E Sewage Permit number S�:Y Ic Syv �,w K ♦�F '-• ,zw. O S N L, INSTALLED IN2 38ASBSTODLE, House nv'ir er o r WITH TIT ` E � CAENTATOWN O F B A RAN S T A 1REGUI.ATIONS," ','s -JECT TO BUILDING� INSPECTOR 'SC®LMMISSIO � �WPLICATION FOR PERMIT TO .......... ......... ,,. ..... ........................ TYPE OF CONSTRUCTION .............4 .�....e.. .- . . .... ........................................-..v.............................................. TO THE INSPECTOR OF BUILDINGS: �€; The undersigned hereby applies for a permit accordini to the following information: Location .... -'�........./....... ...... :......7. a . . .... ProposedUse ........ . ....... .......................................................................................................... Zoning District .....................................................,.. .........Fire District ......................................... ... ..................................... Name of Owner ... .: ..............:.... .. ......... ..........Address ..J��...d.�:.....,,1`...�.:3........ ...���..1.G..e�rf. '� Nameof Builder ............. Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .,. ......:�,r........ ... .............. . ..............Foundation .. . .......................... Exierior ..... .......................................................Roofing ..... rr ................................... Floors ................. .............................................Interior ...........: c. �................................. Heating .......... ............................................Plumbing ............ ............. ... . ........ Fireplace ............../....................................I..........................Approximate Cost ...... .�.(�� +� ........... Definitive Plan Approved by Planning Board ________________________________19________ . Area ..... ?�..4......................... Diagram of Lot and Building with Dimensions Fee ........ V,� ...... .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 S� o � I hereby agree to. conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ............ fT MARINO, DRNDST ��No .2. Z� . Permit for One. Story '....Sing1 F. i.ly..Z?Taellig............. Location ... o ... 1.....2s...Gr�se.nwaod--,Ave. annis ......... ...... ................................. .................. � L ` Owner . Ernest .l`Iarind :. r ��..... .. .. ......� .. .. = Type of,Construction .Frame c...:............:............................... .. plot ..........�•.................... Lot ................................ Permit Granted ..,. December 115, 19 81 r Date of Inspection.`: 1-- . ............�... Date Completed '/ 1 r................... .... ,19 PERMIT REFUSED , f .............................................................................. ........................... , r ...................f ................. 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',r eq -1'. • - ). s :, a j. .. :� r` • 'M y i a{: �'f t. lµ n Sr y r t Y J� k.. 4 i t p. 4 a . i , y - , , G 1 Assessors map and lot number ... .�r...,.5....... . YNe _ ypi Tp� Sewage Permit number ...Rol ................................. N.177 t 9 BAHB9TADLE, i 'e�...a..�........ 17 MABa House number ................ ....... .......... v a p 1639- � •F�MAY a�9 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............. .......... t ...:....- •- :........................ TYPE OF CONSTRUCTION .............// .......................... ............................. .........%�./..� .......� 19 � d o TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fore a permit according/to the following information: Location Location ...�y'>? ' ......... .......--- ! .Qr�< ?./— ^ '.:.....� .............1;.GIiC ... :r:l ProposedUse ........ ...... .................................. .................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner*..(/U - .. / ' ...........Address .. .....;`7�, ....... .. ���1,/� .... ........... OO. Nameof Builder ...,... / ..................................Address .........................................................,.......................... Nameof Architect .... ..................................................Address ............................................................./ 4......4............... Number of Rooms I ..................................................Foundation ,./�........ N�- a �:-'t .•�:........................... Exierior ........ .... ...................................................Roofing ..... .r ............................... ... y Floors ......... .. . ............... �. .....................................Interior .............,/ +.�y��................................. .. 414 Heating ......... ... .............................................Plumbing ...... � ��.�............ '.. � ....... Fireplace ............ ....... . ..:..........0.............................. .,.. .Approximate Cost ...... ..................... Definitive Plan Approved by Planning Board ________________________________19________. Area ...................... Diagram of Lot and Building with Dimensions Fee ��............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. + Name ... ��....... ...0.2.. .h.............. MARINO, ERNEST 67 A=--�8 9 1�12 No .23697................ Permit for .One Story ................................ Single q Family Dwelling .......... . ..................... ...................................... # Location ...... got! ..................................................1 28 Greenwood Ave. Hv*annis ..................-14............................................................ Owner ...Ernest...Marino.................................. .. . .. .. Type of Construction ...Frame.............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted .,December....15.........19 31 .. ............ Date of Inspection ....................................19 Date Completed ....................................... 19 PERMIT REFUSED ............................. .................................. 19 .......................................... .................................... ................... ............. ................................. ............................................. ................................ -'Appro ved ................................................ 19 ............................................................................... ................. ............................................................. Town of Barnstable •�•�►�r �a �73 �� s�lre,1 w..u,�►,w Lnr,veer {' Reguisst®ry Services at« 6 Tf�snaaa err. ,Dlrasaor W Se"at Division Tom hwy, altsaWWC Con risewsw Cffioe: 509•862-4038 200 Me*$nsa, dywn�:.mAowj X.P ESS PEK_A.k. F"; 50e-790-6230 T 2 g 2003 Not YeAr wrMaor Rat JX P"m l rwe MAY..patcel Number %16�_ /��, � TOWN OF BARNSTAKE Pmpaty Address atissdratisl Val"of Wank C DO•-d0 0%,nw's?lame d,Address s Coasrscwr's�.a�. d�`IY OQr�� [/<E _.___faioppoas Nwaber nQ Horne Irropcovement Coaricwr Uceore Caastrveoao Suparvrgor s Uccase r,(iF spplieabis)�, ,________ _�._�.. �.. _.. �:�Wcririaen's Cus+peosatkm Iasur.tace• Luck as& ass a sole proprietor I am tM Hormawaar - Wit Worker's Compsnsatio!:Insuraace laowboo;e Company Na ao diddu&L Workman's Comp.Policy•� Perssit 3taq.►ast(c_bsek bob (� Rc•road(aMdppiet old shales) []Re•roof(ON m*pio8. ( QW4 over vast ax layers of ruoh ❑ Re-,we (1Rrplecwvut windows. V•Vabe 0a 3(Maxwrum.44) C Otbar(spay) o _ •+'�haet�„waM. i„r.else OP Crr yenrn�soiq wot eKsenp�carNylist+or arrd ocher:pwc+geperarsn:r.pataow,s• s.Mis,ork:,Cp�Hc•�,ax." ol'1�iatlirC r„ 4..,� Clow C4PVMa Board of Build' Re t gulations and stAndards -4 HOMEIMR;OV. EAWIVT CONTRACTOR . Re�Stta�ro 2689• 4{ E�"a�$ai� 3 1, ,,N004 i qt �= P"MOM Card Home Depot fn� I CON JOHN kt°rras , 3200 B COB ALL ALTANTA G 30339 Kt y#26 i Adrtuoistra-tor l i r w * � The Commonwealth of Massachusetts Department of Inditstrial Accidents Office offnyesUgalfons 600 Washington Street ;r Boston Mass. 02111 Workers Compensation Insurance Affidavit .m-vx. i}`..: :'!:",�.,r 'i Ti3z) ?.4SiSc .. ._;..:�•r. Cs:'�. n tnfar: a i WE easezPR1N11k}le A�`" lick name: /�Ar y /f'i9dLL location:.6 grr&Z2,f41,M City ❑ I am a homeowner performing all work myself. ❑ l am a sole proprietor and have no one working in any capacity !�3 .�`:� t. s?�u :3��.i.'�.s'e.:� '� :r}, �zx;,Y±:��,;�:.�; ���s�'ik:u`��!fk�"�f;'�"��.• ❑ I am an employer providing workers' compensation for my employees working on this job. company name: /l m/# e� o ji /!!C= oli /47 /J'1 ty&—n e`'ffs address: t/2 ra7 O �iQ�/�. city: /i � phone#: �KJ t��+ / ✓1 s insurance co. trR L --JC??.S D• olic # CAl �f ::i1:f39i �EfT J•�`3 gg °yrj'.`.V,.,.N.�;, ,,,ahi.T4amwl � 1"•„�^. "(tStHi�❑ I am a sole proprietor, general contractor,or homeowner(circle o'ne) and have hired the contractors listed below who have the following workers' compensation polices: company name address city: ` phone#• insurance co. policy# 4 `. 4�. tY' lx�S�" .110 .{.'i. Se..X:kO..? WYI.AA. '1.'XiSA..�eE3� 7tf N company name: address city: phone#: insurance co. Policy# AtfiyGlllsldt Ir's � y siytS'„��^ �;r �:•? ,L,g• , }` r,ttifaftA.f�., t Failure to secure coverage as required under Section 25A of jNl(:L 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. 1 understand that a copy of this statement may be forwarded to the OI'lice of Investigations of the DIA for coverage verification. do hereby cert' y under the pains and pe its of perjury that the information provided above is true and correct. Signature L Date Print name �n`/� �' ✓(//f 'f0�j Phone# t5'Z99' Qlp*1r-- 1; �'yeZRc >lk - offi:1ey do not write in this area to be completed by city or town official citypermit/license# (—(Building Department❑Licensing Boardmediate response is required ❑Selectmen's Office '❑Health Department ,con phone#; ("!Other ' { • at 063-A-047 '40-45 DH ' NFRC 6100 Renovations Double Hunq - Vinyl Argon/Lour E SC Ndit Fens*dm S.S !aft Cm d. 1 . • For woa Mor �Mi1c rib dbiewrweAI u 0 . 3 worn 0 . 2 0 . 4 -------75:U -------- ------- I ffw,Ktm yet tm mmpr wIb,. �a��ro�rw�ce.r�n�anaeosrm�,ea�rnm�ea retdaMiorona�I oon:mm NW soft PrOA K Order .i:336.7129010001 40199 gg Soot or wMM mW eta � Nome MOW) VIOWT ca r*ATM f. W: 1 AlSIM Vww "M cow Home Dpot A1448M SWWM CONRAD JOHNSON 3M Cosa oALLEYwA PKWV On ALTANTA.GA 303U A HOME IMPROVEMENT INSTALLATION CONTRACT Branch Name: B0141 Date: (J (J�J3 a- • Sold,Furnished&Installed by The Home Depot Installed Sales Branch Number: 1- Job#: U ,Z 345A Greenwood Street,Worcester,MA 01607 Toll Free(800)657-5182; (508)756-6686; Fax:508-756-2859 Federal ID#75-2698460 ME Lic#C 02439 RI Cont.Lic#16427 Cr Lic#565522 l' MA Home Improve nt Contractor Reg.#126893 Installation Address: _Q �`P� OC/ D� v City State Zip rchaser(s): Work Phone: Home Phone: Home Address: U e (if different from Installation Address) City State Zip Pro iect Information I/We("Purchaser"),the owners of the property located at the above installation address,offer to contract with The Home Depot Home Depot")to furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet# i i�n I ,incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home or because work required to complete the job was not included in the contract. DEPOSIT PAYMENT OPTIONS (Subject to fund verification and/or credit approval.) 1 ` 1. Check,Cashiers Check or US Postal Service Money Order CONTRACT AMOUNT $ { J 4� (made payable to The Home Depot). 2. Credit Card'an tier payment options-Circle One Belop *LESS DEPOSIT Visa Mastercard iscover American Express BALANCE DUE Home Improvement Loan 11ome Depot Credit Card ON COMPLETION $ J //Ir A'r�_. c Credit:�..__. =/___(H1L&HDCC ONLY •25%of Contract Amount due upon execution of this '� _1 contract.One-third(1/3rd)of Contract Amount is required Acct#: _ tom_F`:F. .te:� for MASSACHUSETTS RESIDENTS ONLY. j/j Name as it appears on card: 1 Indicate Payment Method For *By my/our signature below,I/We agr to allow The Home Depot to charge the BALANCE DUE ON COMPLETION abov eferenced credit card for the de sit indicated. ardholdem natttre at If this is a finance transaction,the agreement for financing is contained in a separate document,which iS i c ated herein by Reference,and made a part hereof. At-Home Services Credit/Loan Application Ref.# Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any balance due(unless the job is financed,in which case,upon submission of the executed Completion Certificate,Home Depot will be paid in full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder. For Mass.Residents Only: Contractor,at owners expense,shall procure all permits required by law as follows: Owners who secure their own permits will be excluded from the guaranty fund provisions of MSL Chapter 142A. Unless otherwise noted within this document,this contract shall not imply that any lien of other security interest has been placed on the residence. Entire Agreement: This agreement and its attachments,including any financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25% of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,I/WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, I/WE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I/WE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES,INC.,A HOME DEPOT AUTHORIZED CONTRACTOR, TO-VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. ' SUBMITTED BY: �Wr� Date: / Sates Consultant - ACCEPTED D ' Date: U Date: t Homeowner NOTICE:ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT r white—amnch File Yellow—Customer Pink-Sales Consultant - 9.18-02 C•Sc , GeE-ENluo4►P (i=oQ se*S2LS� LorkZC'S L.w+.'/1s� !qt/EF. GBr.,.o OQF��_' . , „t�.�3,-u�a1Z:.g 2.9 v•�,r.,- �--•r-x.:r-� ',v•. 2/�/S'- '. - r;�- �-L �`3 _z zz.8.o 27x �PSO Lek Z4i 6006.al.rw{� t 23r3 y 2 E32�k/ 19K a /9r r. I AI 11 }�7f_ r /9 a 1 . ~. s :'/y9• «/�k5'_ m;. %3Yo "'lrN�'"'' +..V r7':f.�Gs7 ',Icf".►A/ �:Ii!�IS",/�,1i � My'Uf��✓�I d n/ �w"fi -- .JArt-+e.^5 E�aS c.9e� fob+ - - '• � - a ��� _ Spa 3o%c. /7 3 " - k .J.�OAt'a-t -L7y.Si;T.+41VC:�..' a' • .11��C,.'/M /QDL�'.�.."�� 1�/s9J3lN.3'T. _ - f a"` .�� `r sw z �. ✓� X/S(J - G .'M./ ! / L 2 of j - .» MA�/f-ILA.=.E:`�` �'�l%��L TD €�E'7��.✓�1D .TO �/N/-S'� G.C�L1ZDE O✓f� °,.: T'�F' JF Gt`�:Jn/I�G1 Tlt�/t/ )//7t-1/�V1 J11E F.��T Off"-F/n//Sfr 6..Gr41� L A:GN A 1 MiN_' 2%d o pA/ l� �2�{ D/A•�r •SOX S70 'y/N �4 %�r��rcH ' ^.3 n-tnv 4 DiA:P I$T2 L E✓Ei_ G 24DE /n/�/�>2ATinsG' i4CAST/�O�i--. ___ _ ^ � � DiA ,OScH'QOPI/G A.FLOW n- L/n/E n i' IPVG '/I r 0�, voco T � G✓ 03/.¢� I%2 Dlq. GA L L lC! 4'-Mint. i �� } CA F'AC t 7-r Z -�¢1 3.S ' oA20 Un li i 1 �iNA rETiG f 1T} gin/v r I _GA e.eaGE G /A1DE E'_ v� 16-3 197 SEPTi�" S Y5 T`M-�_Jti•ST,2tJC T!pfJ . ' !h. _ - , ' `• VF0,2M, 7-O' T-IE ^1A S.S. t v, 1Q/T" T��d. t ✓ice Nr::1EA-177fi•I L C6L:) T/7L Y El_ V �9.3 wA7*a ,... SE�T/C TAn; SH Of D / Af r(. G>.v�/ 3 3..c . GA LyI.1),4 Y. !-Jivice--7E M/Al:. o cRAiCs �G L� NI/UC7 ,e.4 T6 - RAYMOND 'S#i4R* '=i -,% d•. No, 7483 CA P,. 3 - GAL.�D.4 Y 1r� �'1S1[@ni D/(Ef vvA y �ln7;TO 8E /`. CA —;:c D- loft, r ALLPl>a� SITE- P,LA. N -, CAST ' ,kk OF ►' C, s` r �F � �/�/�' .�o y f AS..Sor.�a:d o..✓ -^* r•-r FRANK c. r WHITING Cal Nb. 29869 H t AAA tiQ• eY G�ZS��/ 89rV/LLOW ST. Y.4�ti�CDUTJ-�P0�2T,. �`fA�S. , 7"AY'i-O,e' GORPOQ,�I T'/O N./�