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HomeMy WebLinkAbout0310 MITCHELL'S WAYV73o w ;q/ 30 3 -Pe SEPTIC SYSTEM i�IUVT �_S Assessor's map and lot number .....sc�... . ... ...�.........GQ qe p�� p� g �� 3\STALLED Am COMPL M F THE j WITH TITLE 5 Sewage Permit- numbertNV-..................��..~ '. .......... ' "ws� �+.� f;�: 6rr1 u =t ,, . '8ARNSTAILE, i Housenumber 3iO T WN � 9 r"�a....................................................................... !JllG r, 00 1639• \0� �0 MAY a' ., TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... L4 ........I.....P.�-�.^'�.......L.r>!.�SJG^ r !: .............................. J TYPE OF CONSTRUCTION ...... P.r9.G4... ...L » ....;. .a ...............................�................................................... ...... .... . .........19C.a " TO THE INSPECTOR OF BUILDINGS: The undersigned hereby a plies f o permit according to the following information: Location .. ....... ...... ....'! !Q.... .............. . ...C.4A.n.....)..................................... ProposedUse ..... ...............ef !-.....4 ........ .^ .................................................................................................... • �� Zoning District ............................................ .. .......................Fire Distri !��.5............... Nameof Owner/Wl ............................... :........Address ................................................ ems......... Name of Builder ........ � . ........Address .. ...... /........ .... ..... .a...•.•. ............••• C�.....�f.! .. ��.....Address .......... .. ^'. .:.. ............................................. Name of Architect ..��t��r.�./.....�ir� G/ Number of Rooms ......./J .................Foundation .�.0.�. .0........e-an G...................................... /j Exterior ......2...' 0... ..��.`'...............................................Roofing ........ ... . .. ......... V / kFloors �e� y� .Interior /AL /- 1 -� � �G................I......................................................... ............... I / .` Heating ....r GG�.Os`�.....................................................Plumbing .../. ' ...................................................... Fireplace '!l/1f '.........................................................Approximate Cost ....... ...... Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area ........ ............ Diagram of Lot and Building with Dimensions Fee 3. ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License ....o . . U3 . SMITH, WILHELMINA .4r, ,=+ Noj.A8 ... Permit for .One StorY................ .......Single Family Dwelling •....•..•••.••.• Location .......Lot At.. 310 Mitchell Way.., s : _Hyannis.......... _ - Owner .....Wi e.lmina. ...Smit . ........ ..........h.......................... Frame Type of Construction .......................................... .........................:...................................................... Plot ............................ Lot ................ ......... July -29, 85 ;I Permit Granted ...... . ...................:.. ...19 �J Date of Inspectior "' �- �..........`19 Date Completed ............................... ......19 .,_ Assessors ma and lot number. ...,. .. ... '.......,... p CFTHETO Sewage Permit. Py �y g �number � ��-''SS.'S �� Z BAUSTADLE, i Housenumber .................#.. <..4...................................:... ' Mae& 4Gr'G Gp i639' \0� �0 MIR a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................................................,...............:.. ,:............................... TYPE-,OF CONSTRUCTION ......e4/4 y.Gl..:./.!. TO THE INSPECTOR OF BUILDINGS: The undersigned. hereby/applies for'7a permit according to the following information: A'Location U .. ..... f.. t`''f�� .... ' ............� . >....?:�..... ................................... ProposedUse ..... .................... ... . F:. .........o.......................... ........................................................ ss ZoningDistrict ....../.. .. ....... ........................s:.;......................Fire Dist t^..........,,.................................................................. Name of`Ownerf�, °L.!y!yJa�/1..... .� • ........Address .. ..... ..... .. .................................. g ... �1..... r Name (of Builder� //�(� 1J,l .•., �".fi!` ........Address .. ''•' ....... nJ................... lr Name of Architect ,�" : .:! !!'.... :�`:�`....: Address !'.'. �.. ................................. ....... /. .. . Number of Rooms ......`'�...........................................::.........Foundation O L+ �C/a d.►(' 1E ....... Exterior ... .........................................................Roofing .. .... '..... �' '....:......:.:........1�........�...:. ...: ................... Floors ......................................................................................Interior ...................?.................,..,.............,............::........�a.... Heating ✓`''r ,, i _........................................Plumbing .......f✓./3� /.... ...........................,.............. Fireplace '� ..'.�''•. .........Approximate. Cost ........`.: rC�" ` <17 _,/ t ^ Definitive Plan Approved by Planning Board ________________________________19________. Area ......................�.....°_ . . ........... Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-regarding the above • construction. � �� '•.�/'` Name ...................................... .............. Construction Supervisor's License f- �� SMITH, WILHELMINA A=291-303 ONE Story No Permit for .......................... ......... Single Family Dwelling - .................................................................f.............. Location ......L.o.t..A.......3.I.0...Mi.t.c.he ......ay .......... Hyannis ............................................ ............. 0 Dwelling 1 M N t c S�-g h.-e .. ........ 0...r "g 5 .a W y .................. Owner .....Wilhelmina.. itb.. ...................... Type of Construction ...........Fra e..... ........................ ................................................................................ 0 Plot ............................ Lot ................................ July. 29, 85 Permit Granted ........................................1.9 Date of Inspection ....................................19 Date Completed ......................................19 I ' TOWN OF BARNSTABLE Permit No. ------2_8255------------- sauum { Building Inspector Cash ----------------__---- n. +ww — '"Y OCCUPANCY PERMIT' Bond • Issued to Wilhelmina Smith, Address Lot,'A� 310 Mi tche�Wnv. Hvnnni 5 r, Wiring Inspector J wo Inspection date /. r a Plumbing Inspector w ` Inspection date $� Gas Inspector 1-2 --Inspection date r ,Engineering,Department - Inspection date / f Board of Health .y .�~ Inspection date THIS PERMIT WILL/NOT BE VALID AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUIILLDDING CODE. . ' w ............f:. , ,..% Building Inspector 4 ..� •� TOWN OF BARNSTABLE i •�'� BUILDING DEPARTMENT i �sn6T HAS TOWN OFFICE BUILDING 1 1639 ,►��CIUK � HYANNIS, MASS. 02801 1 I MEMO.TO: Town Clerk FROM: Building Department An Occupancy Permit has been issued for the building authorized by BuildingPermit #........ &1. .� ..................................... ............................... . �..... ..�.. ..». issuedto ......................... ...... ......................... Please release the performance bond. s {J LoT , q r syoe x a a v _ .. °Y 39 x h' t a J N n„ An a Vl- I s sm /00—0-0 ° t r M / T c �/C' 4x sr, t of CERTIFIED PLOT PLAN ' , K '7 i,A icy L o.-r fl A/I 1 7- C C H np o ROBERT it Fk ELDREME y NO. 19367 o IN OVAL LA < ; .• SCALES ( "¢ 416 DATEtk. S � ` fl(�^(ST� tE hloCD/KGB I CERTIFY THAT THE Foyer T/oN „ Y CLIENT SHOWN ON THIS PLAN' 13 LOCATED #TERE RE41$TERED . ; }3 5as._8. I ph e „CIYiI, LAND 401 �• -- ON, THE. GROUND AS INDICATED NO 3 SURVEY OR DR !!Y� CONFORMS TO THE ZONING LAWS -ENGINE r OF DARNSTA® -E, MA8 7(2' M A I N $T R E.E•T:. Dli.oY� B 9D-iT—E— iHYANNIS, MASS. BNEET.LOf REG. LAND SURVEYOR k . P C t F x i pl fly L rha rf k >X (/'q A a S / � p 6 } J 33) N 0 41 M Ir/..� t`. � � o ! � 0 1 ✓ _ IN �c '+ R. T , �r x k Cy0 7"owN s of CERTIFIED PLOT PLAN /`l Al I T C 1- E{ ROBERTB. s YA z R ELDRSDGE No. 19367 a IN gECISTE���,�4" *;Uri lea b�l LA SCALE, I � �a ' DATES P FAN fIR/YS.T�► �� I CERTIFY THAT THE Gau�DA �I eAPe1Q7.� ---- '-- SNOWN_ ON TH_I�P_L.AN_I_3_LOCAT_ED_ Town of Ba;i-nstable *Permit �®a - ® I Expires 6 months from issue date $�PRESS, PE Regulatory Services Fee 25.00 FEB. 0 2 2010 Thomas F.Geiler,Director TOWN OF BARNSTABLE IBuilding Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION- - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 310 Mitchell's Way; Hyannis, MA 02601 X❑ Residential Value of Work $2,750.00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Ernestine G. Benson; 310 .Mitchell's Way; Hyannis, MA 02601 Contractor's Name RISE ENGINEERING: Telephone Number 401-784-3700 A Division of Thielsch Enggineering =Tome Improvement Contractor License# (if applicable) 120979 Exp. 3/25/10 construction Supervisor's License#(if applicable) 100459 Exp. 3/28/12 ]Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I_have-.Worker's-Compensation-Insurance— nsurance Company Name THE- PRESTON AGENCY Vorkman's.Comp. Policy# 02 WB NL0984 WC2-Zl l-259874-0.19 :opy of Insurance Compliance Certificate must be on file. ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side 0 Replacement W M. U-Value (maximum.44) PATIO DOOR *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pr pe wn must sign Property Owner Letter of Permission. (ATTACHED) o _mp.c eme . ontractors License is required. (COPY ATTACHED) IGNATURE: Forms:expmtrg ERIK NERSTHEIMER FOR RISE ENGINEERING vise071405 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers' Applicant I>tnformatioan Please Print Legibly Name (Business/Organization/Individual): RISE Engineering; A Division. of Thielsch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone #: 401-784-3700 or 1-800-422-5365 Are you an employer?Check the appropriate box: T 1.❑ I am a employer with 4. ❑ Type of project(required):I am a general contractor and I ❑New construction employees(full and/or part-time).* have hired the sub-contractors 6. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.© Other;REPLACEMENT_ PATIO DOOR 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: The Preston Agency Policy#or Self-ins. Lic. #: WC2—Zl l-259874-019 Expiration Date: 04/01/ 10 Job Site Address: 310 MITCHELL'S WAY City/State/Zip: HYANNIS, MA 02601 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 certif and th enalties of perjury that the information provided ab e ' true and correct. Signature: Date: C c7 Erik Nerstheimer for RISE Engineering Phone#: 401-784-3700 or 1-800-422-5365 Ext. 133 t 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#: t. THEr � Town of Barnstable 'JAN 2 8 2010 Regulatory Services RARNsrABLEMASS. '� Thomas F. Geiler,Director rF 639. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner lust . Complete and Sign This Section If Using A Builder r I, Ernestine G. Benson. , as Owner of the subject property hereby authorize RISE Engineering; A Div. of Thielsch to act on my behalf, _ Engineering in all matters relative to work authorized by this building permit application for: 310 Mitchell's Way; Hyannis MA 02601 (Address of Job) Signature of O ( r Date . Ernestine G. Benson Print Name _ If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. I V r �* �lassarhusctt•- Dcl►:u•tmrnt of Public Safct% _ Bn:ird of Buildiw, Rcg�ulatinns and 't:utdards Construction Supervisor Specialty License License: CS SL 1OD459 Restricted to: WS ERIK NERSTHEIMER 228 GLEANER CHAPEL ROAD NORTH SCfTUATE,RI 02W Expiration: 3125=12 (rrnuui:•irruer Tr.--: '100459 -- - - Bard of Buil ing Regula ons�ananda�rs One Ashburton Place - Room 1301 Boston. Massachusetts 02108 913�4bme Improvement Contractor Registration 64 Registration. 120979 Type: Supplement hard r Expiration: 3/25/2010 THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 --r. Update Address and return card.Mark reason for change. Address ❑ Renewal ❑ Employment Lost Card DPS-CA1 0 50M-07/07—PC8490 .- cr=1 0f. ell.noo� o��czc�ivaeCta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registratait:. 12og7g Board of Building Regulations and Standards Expiration 3/25/2010 One Ashburton Place Rm 1301 Boston,Ma. 02108 rt Type.__;Sup'plement Card THIELSCH ENGINEEk IN& ERIK NERSTHEIivIEk�`_; _` 1341 ELMWOOD AVE ! CRANSTON,RI 02910 Administrator Not valid without signature a r r,„ � ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 27 DATE(MMIDD/YYYY) THIEL-1 08/07/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURER A: Hartford Underwriters Ins. Cc INSURER B: Hartford Casualty Insurance Cc Thielsch Engineering, Inc INSURERC: Liberty Mutual Insurance Group 195 Frances Avenue INSURERD: North American Capacity Cranston RI 02910 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Imb POLICY LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,OOO A X COMMERCIAL GENERAL LIABILITY- 02UUNTD5678 04/01/09 O4/O1/1O PREMISES(Ea occurence $300,000 CLAIMS MADE 7 OCCUR MED EXP(Any one person) $10,000 " PERSONAL&ADV INJURY - $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 PRO OL JECT LOC ICY X Emp Ben. 1,000,000 AUTOMOBILE LIABILITY B X ANY AUTO 02UENTD4850 04/01/09 04/01/10 Ca accident) DSINGLELIMIT CO accident) $1 r OOO,OOO ALL OWNED AUTOS BODILY INJURY $ I SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ HOTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 B X OCCUR EICLAIMS MADE 02XHUUF6573 04/01/09 04/01/10 AGGREGATE $ 10,000,000 DEDUCTIBLE X RETENTION $10,000 $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS'LIABILITY WC2-Zll-259874-019 04/01/09 04/01/10 E.L.EACH ACCIDENT $50Q OOO ANY PROPRIETOR/PARTNER/EXECUTIVE r OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 H yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER D Professional Liab DVL000025902 04/13/09 04/01/10 Prof Liab 2,000,000 A Leased/Rented Eqp I 02LTUNTD5678 04/01/09 04/01/10 Equipment 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *Except 10 .days for non payment of premium. Certificate Holder is included as an additional insured as required by a written contract with,respect to the General Liability coverage. . CERTIFICATE HOLDER CANCELLATION TWNBARN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL, *30 DAYS WRITTEN Building Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Tom Perry IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED EPRES ACORD 25(2001108) ©ACORD CORPORATION 1988 x'=- x. �" e};SAY w,, tlf a. s x fi F .�top. ujne ��.D�a:?yM_�,'� sti r^,�fi�d< `�t a.b�.�r.y �..y.�Fs,•y+ td,-�5,i'�� :I 91y.`4�+ 1� �{E. u1�4.., s t's�t diY r tla 7. t <��i 4 xb.;'� °• rP. 1,� a:,�r;'�� 9�t'. :.§�t tly�.. y4: c,. a ajs-`-g�._ ti— tk-g.i&^' a+t: ers`t?tz�*,�-.ry°n �.� Z.s.t i tr�,A� 9J +._�a',�DATE.;r.08/07/r09�t Also for RISE Engineering, a division of Thielsch Engineering, Inc. Gaskell Associates, a division of Thielsch Engineering, Inc. BAL Laboratory, a division of Thielsch Engineering, Inc. ESS Laboratory, a division of Thielsch Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering, Inc. Water Management Services, a division of Thielsch Engineering, Inc. ` RISE ENGINEERING AGREEM ENT A division of Thielsch Engineering - ' i THIS CONTRACT IS ENTERED BETWEEN RISE AND THE CONTRACTOR FOR WORK AS DESCRIBED BELOW 1341 Elmwood Avenue,Cranston,RI 02910 RA S E (401)784-3700 FAX(401)784-3710 CASE 104961 Page 1 Baf,BiJ`8'BiiNc IT IS AGREED THAT: s CONTRACT DATE CONTRACTOR 0996 RISE window ` ( r �l 01/05/2010 ADDRESS uuu AUDITOR Doug Brown FOR THE CONSIDERATION NAMED HEREIN,SHALL PERFORM IN A FAITHFUL AND WORKMAN LIKE MANNER THE FOLLOWING WORK AT THE ADDRESS INDICATED BELOW: CLIENT NAME Ernestine G Benson CASE ADDRESS 310 Mitchells Way 104961 Hyannis,MA 02601 PROJECT NO HOME (508)790-7943 WORK Q X- RIS-81-10-7633 CELL FAX FURNISH AND INSTALL: 01/14/2010 9:52:06 AM Install a new,white,vinyl,2 Lite Harvey sliding patio door. With multipoint locking system and deadbolt. Federal Incentive Package glazing. Contractor is responsible for all material delivered and installed in connection with the above work. Any deviations from the above specifications must be authorized by RISE personnel. Contractor reaffirms the covenants set forth in its Application for Participation.Violation of any such covenant is breach of this Contract. Contractor Shall indemnify and hold harmless RISE,its employees and its agents from and against all claims,damages, losses and expenses,including but not limited to attorney's fees,arising out of or resulting from the performance of Contractor's work under this contract. r RISE Authorized Signature Contractor Authorized Signature DATE DATE 01/14/2010 9:52:07 AM RISE ENGMEERE Federal 5628 ((v�; v RI Contractor Registration No 6186 A division of Thielseh Engi r MA Contractor Registratio9n No 120979 CT Contractor Registratron No 62012d 1341 Elmwood Avenue,Cr 0291 r (401)784-3700 F ( 784!3ri' 1 1 2009 CONTRACT ��00 0PagPages1 •..� �U � _ R I S L THIS CONTRACT IS ENTERED INTO BETWEEN RISE'- ENGINEERING AND THE CUSTOMER FOR WORK AS 1 ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE glentil Ernestine G Benson (508)790-7943 10/26/2009 104961 SERVICE STREET BILLING STREET 310 Mitchells Way 310 Mitchells Way ' SERVICE CRY,STATE,ZIP BILLING CRY,STATE,ZIP r Hyannis,MA 02601 Hyannis,MA 02601 5- Srl- lo JOB DESCRIPTION RISE Engineering will provide labor and materials to install a new white,vinyl,Harvey's sliding patio door. Features include: Multi-point locking system and dead bolt Fusion welded sash corners Either bright brass or white handle(circle one) Steep slope sill design foi improved drainage Heavy extruded aluminum screen with advanced roller system ` With Double glass,Low E,Solar Ban 70,argon-filled,Federal Incentive Package Lifetime Limited Transferable Warranty on all vinyl members,20 years on insulating glass,and 10 years on screening and all hardware and mechanical components. Terms:50%with signed agreement,balance due upon completion.You may call us with your credit card information at 1-800-422-5365 x 120. Thank you $2,750.00 1 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF **'Two Thousand Seven Hundred Fifty&00/100 Dollars $2,750.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. - DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AUTHORIZED SIGNATURE-RISE ENGINEERING MER ACANC����� f � � ,� . NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE r P I / 33 oFT ram, Town of Barnstable Permit# �5 oErpires 6 months front issue date Regulatory Services Fee_ _ _ � y Y � / BARNSrABLE, v M^ Thomas F. Geiler,Director ArED K1A'�A Building ]Division Tom Perry, CBO, Building Commissioner 200 Main Street,.Hyannis,.MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red.V Press Imprint Map/parcel Number Y�� Property Address gKesidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address l� Contractor's Name Telephone Number— Home !/mot Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) [ >�kman's Compensation Insurance Pe*Iamone: �g a sole proprietor X��RESS 1—����` " ❑ I am the Homeowner NOV 2 ❑ I have Worker's Compensation Insurance 2009 Insurance Company Name 9--RAU4.0"/%OV,S TOWN OF BARNSTgg`E Workman's Comp.Policy# `L1 -7 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check.box) �e_roof(stripping old shingles) All construction debris will be taken to S ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows *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. of the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 090809 i The Commonwealth o Massachusetts Department of Industrial Accidents d' I Office oflnvestigations 600 Washin-ton Street b Boston NIA 02111 Z1ss� fvivw.mass.go v/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Address: Mtl City/State/Zip: ry �L Phone #: y Are�Yoan� employer? Check th ropriate box: Type of project(required): 1. I am a employer with . . 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me.in an capacity, employees and have workers' Y P Y• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its ]0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumb' g repairs or additions myself. [No workers' comp. right of exemption per MGL 12. of repairs in required.] t C. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#J 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy# or Self-ins. Lic.#: d'�A%J IM S- Expiration Date: Job Site Address: �� a y LSy1 _ ��.p!/ 5 ��{/ Cit /State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 for insurance coverage verification. I do hereby c tify un er t e pains and penalties of erjtrr that the information provided above i rue a correct. Signature: Date: el) , Phone#: vj 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#: 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 and including the legal representatives of a deceased employer, or the 'n engaged in a joint enterprise, g g p of the foregoing ) P 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 'n house of another who em to s. ersons to d`o maintenance, construction or repair work on such dwelling house dwells P Y P , g 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 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 pP roduced,acce t.able evidence of compliance with the insurance coverage required." i Additionally, MGL chapter 152, §25C(7) states Neither the commonwealth nor any of its political subdivisions shall ce of public work until acceptable evidence of compliance with the insurance act for the performance p enter into any contract p P t to`the contracting authority." een resen presented requirements of this chapter have b p o Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s) 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. 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. Self-insured companies should enter 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 permiUlicense 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 burn 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 call. The Department's address, telephone and fax number: i The Commonwealth of Massachusetts w Department of Industrial Accidents , Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.inass.gov%dia +py p�y� CSRAB - DATE IMMA)DIYYYY) I��lR_D„ CERTIFICATE OF LIABILI`TY.INSUTA14CE COREC50 09 09 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GOLDMAN s ASSOCIATES INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FINANCIAL SERVICES INC. HOLDER.IHIS CERTIFICATE DOES NOT AMEND,EXTEND OR 933 FALMOUTH RD. ALTER THE COVERAGE AFFORDED BY THE POLICIES-BELOW. HYANNIS MA 02601 Phone: 508-775-6010 Fax: 508-790-0249 INSURERS AFFORDING COVERAGE NAIC.# INSURED INSU REP A ST PAUL TRAVELERS INSURER B: CHARLES COREY DHA --— — -- COREY S COREY HOME IMPROVEMENT 1684 FALMOUTH ROAD #115 j INsuRERO: - CENTERVILLE MA 02632 -- ----- —..---._.__.— �-------------_—_-__-- UISURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW RAVE 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 ISSUE DOR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR 'ADDT. 1 EFFECTIVE POLICY EXPIRATION LTR 1NSRD i TYPE OF INSURANCE POLICY NUMBER DATE(MM1VDOIYY( DATE(MNlODIYYI LIMITS GENERAL LWBILffY EACH OCCURRENCE j E —.--_.__.___ I DAMAGETORENTED I , COMMERCIAL GENERAL LIABILITY j PREMISES(Ea accurmrs) E CLAIMS MADE _i OCCUR '. MED EXP(Arty PHaPP1— 3.—ti PERSONAL B ADV INJURY 1 GENERAL AGGREGATE 1 S ' GEN'L AGGREGATE LIMIT APPLIES PER: ' PRODUCTS-COMP/OP AGG E PRO- POLICY I17 JECT w LOC I AUTOMOBILE LIABILITY j COMBINED SINGLE LIMIT (Ea ac I—H E ANY AUTO 1 ALLOWNEDAUTOS I - _ I _ ' I BODILY INJURY -SCHEDULED AUTOS I I(PM PITS^) E ------—------- HIRED AUTOS _ BODILY INJURY E NON-OWNED AUTOS ' - - (PaP JtlmB j PROPERTY DAMAGE $ (Pa arritlml) j I i ; I 1 GARAGE UABILLTY' i I I AUTO ONLY•EA ACCIDENT E - j ' - E ANY AUTO OTHER THAN EA ACC AUTO ONLY. AGG 1 E 1 I I EXCESSAIMBRELLJA LIABILITY ; j EACHOCCURRENC[ OCCUR I — I.CLAIMS MADE i - I AGGREGATE DEDUCTIBLE I I I RETENTION E i E WC STATD- I OTH- i WORKERS COMPENSATION AND ' I ITORY UMITS ER- EMPLCYERS'UADIUTY A ! #0241'M37 09/14/09 09/14/10 E.L.EACH ACCIDENT s 100000 I ANY PROPRIETORMARTNER(EXECUTIVE - I OFFICERIMEMBER EXCLUDED? I • EL DISEASE-EA EMPLOYEE j E 100000 SPECIAL PROV1510ONS belwv EL DISEASE POLICY LIMITS SOOOOO I OTHER I I j I DESCRIPTION OF OPERAYMNS I LOCATIONS I VEHK:LES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION . FOREVID SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION . DATE THEREOF,THE ISSUING INSURER WELL ENDEAVOR TO MAIL DAYS WRITTEN - FOR EVIDENTIARY PURPO`S•ES.ONLY NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL .. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REM SENTATWES. r� AUTHORED REPRESENTATIVE IANN LOUISE E GER ACORD 25(2001108) j CORD CORPORATION 1988 11/13/09 FRI 16:01 FAX 508 775 9974 BUSINESS CENTER CAPE COD 2003 CHARLEN. � 0R--. -. EY " neR R_ 0~ The Cost of a Dumpster.and Removal of All Roofing Debris & Fulling the Necessary Building Permit is Included in this proposal. TOTAL HWESTMENT with New Ridge and Soffit venting--- S 4250.00 ]POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Fetal Flashing,Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Exira: Materials Plus Labor at the hate of$60.00 per Dour PAYMENT SCHEDULE: A Deposit of One Halt is due at the Signing ng of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE. All Roof Work is Normally Scheduled for Completion Within 30 Days of Acceptance and Receipt of Deposit providing the Materials are Available. Please Make Checks Payable to: CHARLES COREY CHARL S COMY Warranties the Shingles and Labor for 5 years. CERTAINTEED Warranties the shingles and labor 100% for the First 5 Yew and the Shingles your 30.Years if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a CATEGORY 11 HU CANE410 MPH WIND WARRANTY. CERTAINTEED Warrants the Shingles to be Algae Resistant for a dull 10'Years. This Pro sal May Be Withdrawn By Us If Not Accepted & De osited Received Within Thirty Days Or Before The Next price Increase In Materials. CHARLESCOREY carries Workmn's Compensation and Public.Liability Insurance on the above work DATE OF ACCEPTANCE:_-&—_ �1'" D�' ACCEPTED BY: '` SUBMI Y. HOMEOWNER ROOFING CO �T4R 09 FRI 15:59 FAX 508 775 9974 BUSINESS CENTER CAPE COD. 0 002 CORE: Y CHARLE: S 1# ne- es o fi o.' eflag, QRP.'O- Cod, sli: eo 197 16941FA►LMOUTH RD #1IS, CENTERVILLE, MA 02632 PHONE 1404 ,4715-M44 ATAI NTERD LANDMARKINOODSCAPE 30-AR AR- 0- HITECTURAL STYLE November 13,2009 E:a ' ' I ; , PROPOS.AL ERNES'TINE BENSGN 310 MITCHEL'S WAY HYANNIS,MA 02601 TO: 508-790-7943 CHARLES COREY hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old Asphalt.Rooting Shingles. Supply and Install CERTAMEEID LAANNDMARKIVVOODSCAPE 30 AR: 30 YEAR WARRANTY, 10 YEAR SURE START PROTECTION,CLASS A FIRE RATED,COPPER/ CERAMIC STONES for a FULL 10 YEAR WARRANTY AGAINST ALGAE CONTAMINENT,250 POUND,EXTRA HEARTY WEIGHT,110MPH WIND W.ARRANTY,CATEGQRY H HURRICANE.ST® lR-UR1.CANE NAILED (6 NAH.S PER SHINGLE/. MULTI-LAYERED,LAMINATED ARCH[TECTURAL STYLE,FIBERGLASS BASED ASPHALT SHINGLES. COLOR: BIRCHWOOD Supply and Install S"V 1UTE ALUMINUM DRIP EDGE SMART SOFFIT VENT SYSTEM on Both of the Eaves. Supply and Install HICKS VENTILATED DRIP EDGE on Both of the Eaves_ Supply and Install CERTAINTEEID WINTER-GUARD(lee&Water Shield),WATERPROOF UNIDERLAYMENT SYSTEM on hoof Eaves& 'lU'nder the Chimney Flashing. Supply and Install #15 BLACK SATURATED FELT ROOFING PAPER Supply and install AIR VENT SHINGLE VENT H RIDGE VENT on the Entice Main Ridge. Sul, "*K` Install ALUMINUM&NEOPRENE SOIL PIPE FLASHINGS Clean and Remove Debris from work area alter job is completed. i z' ✓fie i1din9 zcue a' Board ofill ►Idmg Reguons aqd Standards Construction Supervisor License . Licenser.CS 2881 T,# 18106 Ez�I�ation:2/44/2010 �sl 0= 1 .3 �Restrictior) p0(:l CHARLES E C0 �,1 � 1694-FALMOUTH CENTRERVILLE, MA 02632 Commissioner <2�\ �� 1Damrm�ureaf� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR !� `i Registra ion:,136066 t Exp ration 6I6/2010 7r1� 268785 -, ,I COREY&CORY �OIJIEIfaIPRO;JEMENTS CHARLES COREY N 1694 FALMOUTH RD 1�15Y1,f VILLE,MA 02632 Administrator 1i 1, CENTER -, stration valid for indiv►dul use only , j' License or regi date. If found return to: before the expiration Re ulations and Standards Board,of Building Place Rm 1301 One Ashbu Boston,Ma:02108 Not valid without signature r e