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0067 SUFFOLK AVENUE
r/7 SuG��K �� _ -_._ Imo- � _- Complaint Call Report Nrinted On:7/9/2020 67 SUFFOLK AVENUE, HYANNIS Case# C-20-196 Case#: C-20-196 Address: 67 SUFFOLK AVENUE, Date: 6/5/2020 HYANNIS Owner Info: Property Info: DOWNING, JON. MBL:` 67 SUFFOLK AVENUE 291-125 HYANNIS MA 02601 Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Fences, Medium Priority Phone Complaint Summary: Fence extends all the way to the street through an easement creating sight hazard for abutting driveway Action History: Action Taken Date . Description Fee Inspector, Close Case 7/9/2020 No violation present $0.00 bowerse Inspector Assigned to Complaint: bowerse Filed by: scaliam Comments: Comment Date Commenter Comment J Date: 7/9/2020 town of Barnstable 4 A Town of Barnstable 'p Building Pe • . `� That it,is,§Vasikile'-From�the St"reet A �roved�Flans Must beRetamed on Job and this Card Musi�beKe t IN enr asBeen IVlade .�. g h F, .16 PostedyUntil Final Inspectton H , r y� i ,� Where a Certificate o#Accupancy is Required,such Bu�ldmg shall Not be Qccupied until a Final Inspection has been made ; Permit No. B-18-3497 Applicant Name: Jon Downing Approvals Date Issued: 11/01/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 05/01/2019 Foundation: Location: 67 SUFFOLK AVENUE,.HYANNIS Map/Lot 291-125 Zoning District: RB Sheathing: . g ContractoryName Framing: ` y2 Owner on Record: DOWNING,JON �- � �� � � , � /rl Address: 67 SUFFOLK AVENUE Contractor License'. 2 Est Pro ect Cost: . HYANNIS,'MA 02601 � �, : Ct $60000 Chimney: Description: replace garage door with wall Permit Fee: $85.00 ' Y Insulation: Fee Paid 4 $85.00 Project Review Req: NOTE:additional permits will be required to finish this space . br Date 11/1/2018 Final: L� fir. Plumbing/Gas y Rough Plumbing: ici Building Off' .al Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six,,._ rip s after issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl cation and theapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structuresshall a in compliance with the local zoning by Ias aid codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical I IN The Certificate of Occupancy will not be issued until all applicable signatures by the Building and'Fire O,fficciials are:provided n this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing Rough: 2.Sheathing Inspection r" _•m � "_� 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed final: 4.Wiring&Plumbing Inspections to be completed prior to 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: "Pers racting with unregistered contractors do not have access to the guaranty fund" (as set forth in MG c.142A). .Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT X m m m X 0 0 rL) X F9 13SO-13 ro td 0 :K m ......................-.........................- ..........................- .................... ........................................................ ............ ...................... ............ 7X8 GARAGE DOOR TO BE REMOVED ........... z TI z < 7K Ej 0 Fri X Fri z z LINE OF SLOPED CEILING CLC....t 9-8- ................................... ............ .......................... N 0 1 S flul "10VISNPO'JO NhQj� BEDROOM #2 BEDROOM #3 LIVING ROOM r BATHROOM KITCHEN co7 MASTER BEDROOM -E DINING ROOM i7 m rn 1/2 BAT f T CLOSET DOWN f RAILING. Z i 3 J bi o ui m E Z o �( Y x yI NOTE A: NEW 2X6@16' O.C. STUD WALL UNC❑NDITIONED o� W/R-21 FIBERGLASS INSULATION j 3 STORAGE ^� NOTE B: EXIST. 2X4@16' O.C. STUD WALL 4 W/R-15 FIBERGLASS INSULATION a . ELECTRIC PANEL i EXIST. WINDOW PROPOSED FLOOR PLAN 1-17.<r ivvlS � l8 3 �9 T owe, 3� o0 50� Zr�D bH'�`I `� � `1 � 15 �1ME r TOWN OF BARNSTABLE Building 201501791 • BARNSTABLE, Issue Date: 04/08/15 Per m.i t 9 MASS. �ArEG 3�A�� Applicant: MCCARTHY,MICHAEL J Permit Number: B 20150703 Proposed Use: SINGLE FAMILY HOME Expiration Date: 10/06/15 Location 67 SUFFOLK AVENUE Zoning District RB Permit Type: RESIDENTIAL INSULATION Map Parcel 291125 Permit Fee$ 35.00 Contractor MCCARTHY,MICHAEL J Village HYANNIS App Fee$ 50.00 License Num 58633 Est Construction Cost$ 1,400 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DOWNING,JON j BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 67 SUFFOLK AVENUE ,r�HYANNIS,MA 02601 INSPECTION HAS BEEN MADE. V Application Entered by: PF Building Permit Issued By: THIS PERMIT CONVEYS NO.RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART;THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS'ON PU IC PROPERTY,NO SPECIFICALLY.PERMFITED UNDER THE BUI L;DING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET:OWALLEY-.GRADES`AS"WELL AS DEPTH AND.LOCATION O1PIMIdC SEWERS MAY BE OBTAINED FROM THE.DEPARTMENT OF PUBLIC.WORKS. THE ISSUANCE OF.THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALLFIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PWOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a^�n�F;3 F RJR �, D/ ,,, r Efr ;°;� F STABLE Application # S �? Map 2� I Parcel, �J Health Division / l'ts sip Date Issued � Conservation Division Application Fee S Planning Dept. --. _ Permit Fee �5 0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 7 �)G vt Village i. r-- Owner Address -S=hC Telephone Permit Request `J Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation'-) Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family I" 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 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 Mike McCarthy Construction Telephone Number PO Sox 52 Address West Dennis, MA 02670 License # Cell (508) 280-6964 C-SL-58633 HIC-169393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO an SIGNATURE DATE �►� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4)lr I 3 , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i� FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f ` I�11 f IENGI EERIge OWNER AUTHORIZATION FORM 50 e (Owner's'Name) owner of the property located at: ��vC! (Property Address) (Property.Address) I hereb authorize YCI� - j G (Sub ontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. Owner's 'gnat re. Date . I RISE Engineering 5 Dupont Avenue South Yarmouth, MA 02664 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058633 MICHAEL J MCgAR y PO BOX 52 'Y W DENNIS MA 4 64 9 J °✓~..�,.w �J.6lc. )I lit Expiration Commissioner 04/10/2016 I%J. 'Office of Consumer Affairs and Business Regulation r` 10 Park Plaza - Suite 5170 Boston, Massachusetts`02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY ---- ----__ - -- P.O. BOX 52 ----- —--- — WEST DENNIS MA 02670 ------ ----- ----_ f —�^ Update Address and return card.Mark reason for change. Address ❑ Renewal "Employment ❑ Lost Card SCA 1 Ei 20M-05/11 [a The Commonwealth of Massachusetts Department oflndusirkdAccidents Office of Investigations 600 Washington Street . Boston,MA 02111 kulop mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ' I { ><ke cCarthy Construction Name(Business/OrganlzatianPubdividual):- PO Box 52 Address: West Dennis, NIA 02670 City/State/Zip: CS1pht§§P HIC-169393 Are y u an employer?Check the appropriate box: Type of project(required): 1.ERl am a employer with 1 4. ❑ I rim a general contractor and I employees(full and/or part-time). * � have hlCed the sub-contractors 6. ❑New construction 2.❑ I am a sole propridtor 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. (Q Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its l0.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL. 11.❑Plumbing repairs or additions myself.[No workers'comp. a 152,§1(A),'and we have no 12.[]Roof repairs insurance required.]t employees.[No workers' - comp.insurance required] 13. ther *Any applicant that checks box d1 must also fill out the section below showing their workers'compmation policy Information. t Homcu%vners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a now affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy Infwaation. lam an employer brat is providing workers'compensation insurance for ruy employees Below is the policy and job site ~ Information, Insurance Company Name: Policy 9 or Self ins.Lic.9, V W C A Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showfug the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition ofcriminal 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 3 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 I Investigations of the DIA for insurance coverage verification. I I do hereby caWy thepa a enaltles ofperjury that lire Information provided ove is true and ear=4 Si Lure: Date: 1'1 Phone Pf f Offlcial use only. Do not write In this area,to be completed by cify or town ofjklal. } City or Town: Permit/Lleense# 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 i#: PAUR �® CERTIFICATE OF LIABILITY INSURANCE °ATE`MM/°°"YYY' 07/1012014 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(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 NAME CT Bryden&Sullivan Ins Agcy of Dennis Inc AIC.No.Et): (508)398-6060 ,No.: (508)394-2267 PO Box 1497 �"Sss: So Dennis,MA 02660 INSURER AFFORDING COVERAGE _NAIC ft INSURERA: A.I.M.Mutual Insurance Company 26158 INSURED INSURER B: Michael McCarthy Construction Inc IN U P 0 Box 52 - -INSURER D: West Dennis,MA 02670 INSURER E: I COVERAGES CERTIFICATE NUMBER:- 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. N07WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONITRACT OR OTHER DOCUMENT WITH RESPECT TO IATIICH 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ivy TYPE OF INSURANCE yp� POLICY NUMBER raw RM LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PR MI E o nce �_, CLAIMS-MADE OCCUR MED EXP(Any one person) Is PERSONAL&ADV INJURY $ Ed___ GENERALAGGREGATE $ GLLEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ --�POLICY I URO ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED _J AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED 3 PROPERTY DAMAGE $ AUTOS -(Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ X AM,MIT"s ° _ ANYICROMR JJWP&TNSFg�ECUTNE Y/N E.L.EACH ACCIDENT $ 500,000.00 A OFF ER/ME ILUU a N/A VWC-100-6017656-2014A 7/17/2014 7N7/2015 — (Mandatory Ine�NH) ef E.L.DISEASE-EA EMPLOYEE $ 500,000.00 D�SsCRIF ON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required). Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION - Thielsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �&ea ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 7r T Town ®f Barnstable *Permit 420 Fxpires 6 months from issue date Regulatory Scrdccs Pee �� sAJ?rMABLE, " Rom. Thomas F.Geiler,Director i639• `DPED RAPT 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 syy Not Valid without Red X Press Imprint Map/parcel Number �C'{ Property_Address NI Residential Value of Work �� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address cN d1,� y� Contractor's Name Telephone�urber � e Ila Home applicable #(if a Li Improvement Contractor License pp ) P Construction Supervisor's License#(if applicable) liJ� r031 q0 (�Worloatan's Compensation Insurance N Check one: OF ❑ I am a sole proprietor eq9 ❑ I am the Homeowner [� I have Worker's Compensation Insurance srgeCli� Insurance Company Name N04 4 ,.4�.� Workman's Comp.Policy# I�IC C4S°l z7� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors (Replacement Windows/doors/sliders.U-Value a (maximum.35)#of windows 2- ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required SIGNATURE: QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 053012 °&U9 r * &UWgrABLE. ' Regulatory Servic.es Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-740-6230 Property Owner lust Complete and. Sign This Section If Using A Builder CAS iC ; as Owner of the subject property hereby authorize 19Q5—fcsm to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 7174 S gnature ,f caner Date J r Print N me If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on;the reverse side. Q:IWPFILESIFORMSIbuilding permit formsTXPRESS.doc Revised 070110. - 1 The Commonwealth of Massadzuseffs Department ofindush iat Accidents Office o, Investigafions 600 Washington Street Boston, 02111 wal.".Mass.gowld!ia Workers' Compensation Insurance-Affidavit- B.vildex-s/Coimtractoi-s/Electiici2ns/Phunbers Applicant Information Mease Frkt I.ec bI� Name(Business,10r�tiontindkidual): 065myv\ Ad&ess: A- 5W146 4W dt - City/Sta&Zip: 1TU6a " aL-,�—)d I Phone 4k 566 Are you an employer?Check the appropriate box: 'Type of project{required}: 1.Lid 1 am a employer with - ❑ I am a red ralthe contra nh and i 6- ❑New construction employees{full ar>;d/or pat-time). have#ric�ed the sub-�antractofs 2_❑ I am a sole proprietof or partner- fisted on the attached sheet. 7. ❑Remodeling ship.arid Lmre no employees These sob eortbractors have 9. ❑Demolition. working, for me in any capacity. employees and have workers' 9.- ❑Building addition [No workers' comp.„asura+ce comp.insneance.l .] 5. ❑.We are a corporation.and its 10.El Electrical repairs or additions required 3_❑ I am a homeowner doing.all workofficershaveexercised their 11 ❑Plumbing repairs or additions myself [No workers'camp- c. 15 of exemption per Ie n 1 ❑Roof repairs insurance required.]r c. I52,�l{�},and we have too e ] employees-[No workers' 13. other tC " comp.insurance required.}. f �M17�►5 Any applicant that checks boat Al must also fill out thesection below showing their wo$sere compensation policy inforrmation t Ronteoaaners who submit thus of idsvit in&cat>ng they are doing all woat and dm hire outside contractors most submit a new affidavit indicating such_ lContrac:tnrs that check this box must attached an additional sheet shouting the name of the soh-contractors and stare whether or not those entities hate eampbnyees. If the sab-contmaou have employees,,they urnst.pxcvide their v,oO&ets'comp.policy number. F um all employee that is providing workem'congMw boar insuraaarce for my employ Below is the po icy and,job site informadon. Insurance Company Name: &n/d CO, — Policy g or.Sel€ins.Lic.#: WC— �30 UO 127� Expiration Date: CT7 0 B l� Job Site Address �� ��.� m� City"atate(zip: 15,W Bch 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 impiisOnmerC as well as civil penalties in tie form of a STOP WORK ORDER and a tine 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 IMrestigations of the DJA for;rrc,mme coverage verifirstiom I db h bye eora i p aralpeataticas ofpediuy that the informalian prooided above is b�aa�s and cart ect z S Zo�3 Si ire' Phone M ojgkial am party: Da not write it,this arm,to be cOMPleted by ci#y ar tM 10 C City or Town: PermitfUcense 0 Bsui g Authority(circle one): 1.Board.of Health 3.Building Ikeepartment 3.CitylTm�Clerk �.Electrical Inspector §.1'i Plumbing Irrspectoe 6.other Contact Person: Phone 9: 6 Ai DATE(MMBmNYYY) CERTIFICATE OF LIABILITY INSURANCE 07/30/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TIME 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,subgect 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 endorseanent s. PRODUCER CONTACT Aon Risk Services,(no of Florida NAME: Aon Risk Services,Inc of Florida 1001 Brickell Bay Drive,Suite#1100 P ON FAX Miami,FL 33131-4937 A/C,No,Ext:800-743-8130 (A/C,No):800-522-7514 MAIL ADDRESS: ADP.COI.CenteL@Aon.com INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: New Hampshire Ins Cc 23841 ADP TotalSource FL XVI,Inc. INSURER B: 10200 Sunset Drive INSURER C Miami,FL 33173 ALTERNATE EMPLOYER INSURER D: Rescom Exteriors Inc. 714A Southbridge St INSURER E: Auburn,MA 01501 INSURER F: COVERAGES CERTIFICATE NUMBER:5o2877 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN AREAS REQUESTED_INSR ADDL SUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS MMID MMID GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS MADE OCCUR MED EXP L/Lny oneperson) $ PERSONAL&ADV INJURY $ . GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED IN E LIMIT ANY AUTO Ea accident $ ALL OWNED SCHEDULED BODILY INJURY Per on $ AUTOS AUTOS. BODILY INJURY Per accident $ HIREDAUTOS AIOJTO QED PROPER DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC I I RETENTION$ WORKERS COMPENSATION WC STATU- OTH- A AND EMPLOYERS,LIABILITY YIN WC 038089278 MA 07/01/12 07/01/13 X TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ NIA X E.L.EACH ACCIDENT $ 2,000,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES lAttach ACORD 101,Additional Remarks Schedule,if more space Is required) IF- All worksite employees working for the above named client company,paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy. The above named client is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION Rescom Exteriors Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 714A Southbridge St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Auburn,MA 01501 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD MA R-e-r#120598 „' -" 4yJ - Federal ID -3311838 RI Reg. #20747 CT.Reg. #573209Exalia" Corporate Headquarters 714A Southtridge St Au um.MA 01501(508)M--5202 1-800-287.9076 s , ,f THIS CONTRACT MADE THE.............................°...g..... in.day of• ..... e':16P1....:............... 201..G,�.:.between c 0. ...... .... 11.... ........D� i< .....:...:..... ...... So.���.5 -..�0_........ l (Hone owners) / (Name Phone) (Bus.Piton) Of.......�....1........:�U.. - �...' �'{..:............ :.: .!,� .��:.".[.. ., ,,, -...... .:...-.oa (Address).. (State) (Zip Code) the"Owner'and Rescom Exteriors Inc.,"Rescom".. Rescom hereby agrees that it will for the consideration hereinafter mentioned,.furnish all labor and material necessary to install the following described work. TOTAL Wondows Purchased Additional Work Style Oty TOTAL CASH Window Color Specify .I P Sliding Glass Door / PRICE Capping Color Specify Steel Security Door / DEPOSIT Double Hung /� Insulated Storm Door i Picture Window r Specialty Windows / NTH ORDER Stationary Casement l I Leaded Glass BALANCE Dill:AT «' .Casement-Model# / Obscure Glass lafilL Bottom 1. 2 Lite/3 Lite Slider /- Screens Full INSTALLATION Bay/Bow Frame / Rescom does not do any painting or staining: CASH Garden r Balanpaid to Beacom Is not responsible for conditions or Awning i installer at insta�t;on a Other: - clrcumatanlres beyond tie control including condensation resulting from or due to pre- IVCE axlatlng conditions. Bank COrnp mGrids:Colonial sgned at instaiso DESCRIBE WORK: 1( f COd4 t� der L �5 04- L&_ o y fA;h t ✓ Ya�R�� ti141 kif>! t v t y st.Start Date: t Est.Completion Date: ?It shall be the otillgatio n of RESCOM to obtain any and an psmnns rncessay under this agreement.as the Owners Agent. The Owner who secure their own permits,or dog with unregistered conbados will be enduded from the guaranty fund proMsion of MGLC;142A All hone irnprovextent =itractos and subco>trados shall be registered by the Director and any inquiries abort a contractor or suboonbracW relating to a registratio)should be directed to: Director,Flan Improvement Contractor Rogistriallon,One Ashburton Place,Roan 1301,Boston,MA 02108,(eM 7V-&W. If the Owner is Wining financing by way of a RBI Instdmwd Safes Agrees sM such Agrserrrent shell include a tans schedule of pwflnoft to be mob , under said cont►ad and the a r cunt of each payment stated in dollars,indicting an finance dsages.The Retail Insta9hrvht Salsa Agisornent sloli be innxupmated herein by romance.If the Owner is obtaining a tewlving credit line to pay,in whole or in part,for the contract amount Ihadn,the terms d the risviAkig line or credit including interest rate and payment ton, ,shell be dearly set out on the credit application.The portion of the credit application m5snincing a tuna schedule of payrnsK to be made ureter this contract,and the amount of each payrcent stated in dohs,including OR fanace charges.Shan be ink herein by ram. Rescom represents that it corrlss NUolonnens Corponselioh and Public Liability Inxuranoe. If the Owner refuse;to permit Rescom to prod with the wok herein,or in the mart of wry breach of this Owner of this agreanat,for any mom whatsomw shed coarse fheowner to pay Rest om a sum of mosey equal tothin4y three and oes•third permit of the price agreed to be polo ea fond,nqudaesd and ,and not as a panty,without further prod of toss err damage. Resoon shoal not behold liable in dam for delays in the parPomanos of this contract due to coxes bsyohd its ressonabte control. Owner warraris that he is the owrm of the property on which the work is to be perfonrned or that hole dhawise a ffi ariaad on behalf of the owners to enter into this agre> t. Thin contito nopreasrts that entire agreement bairn the Owner ad Rescon and wrist be chard eraoept by a writing signed by bath the Owner and Resoon. You ere Now to a copy of the Cotrad at the time you sign.Keep it to prated your legal righls.We,the aforesaid owners,certify that immediately Star the signing of the aforesaid agreement,a copy was furnished to us.' DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. , The has seen"sarh�a wsvrartiea that win be pravidsd by Beacon upon irxPallatiorh." , i So""ma ties prlsv4dsd to owner. �� IN WITNESS WHEREOF,the parties have hereunto signed their names this 29—day of 201'� Signed Signed Sales Represents vve Owner P Sigma Accepted:Rescom Exteriors Inc.. Owner BY p Authorized Signature, Title �• �p You ffey canW this agreement tit has bm signed by a party thereto 9 a pkae other than an address of the serer,which may be his main dfice,orbranch , theist,proufsd you n"saillor in wilting at his own dfioe or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the ftd bhainess daffy foflownsg the signing of the agmamant.(Son%*is a legal business day). i . YOU 0AY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS '.FROM THE DATE BELOW.' �. ' TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR. AM OTHER MITTEN NOTICE,OR SEND A TELEGRAM TO: Raiseom,7144A Southbridge St',Auburn"MA 01509 <' NOTICE OF CANCELLATION I HEREBY CANCEL THIS TRANSACTION. DATE . DATE BUYER'S SIGNATURE C�ffi e o onsumer .�aurs i usmess . egu a on 10 Park Plaza - Suite 5170 Boston, tilassachusetts 02116 Home Improvement_Contractor Registration _ Registration: 120598 - --- Type: Supplement Card Expiration: 2/512014 RESCOM EXTERIORS, INC -- SCOTT HEBERT 714A SOUTHBRIDGE STREET - AUBURN, MA 01501 -_ Update Address and return card.Mark reason for change. spay 0 zapn-awry Address Renewal 0 Employment Q Lost Card o"!:a mar�ranruealf�o!' llua;ac�rrdelfu OMet of Consumer Affalra&Badness Regulation License or registration valid for individul use only M€IMPROVEMENT CONTRACTOR be-f9 a*-he expiration state. If found return to: Office of Coirsurner Affairs and Business Regulation eglstr�tion=... �0598- Type: 10 Park Plaza-Suite 5170 Expl ratio rt:: 215 2E1f4 Supplement Card, Boston,M,-%02116 RESCOM EXCERIO ANC. SCOTT HEBERT ' 714A SOUFHBRIDGE STREET � — �-- AUBUI2iV,P/lA 01501 Undersecretary Not valid without signature gas gach use tta -?eoartment of Public Sa;ety Bo-area o'f G§lc€s 3g Reg la.tjoils and StPnrdlarils NI 3 13 Weaathrop St u West BOY15ton 7[ g g s, p Crs rnissia;eP 10105/2014 , 12T Thompson Rd _.._ Mary.L. Chabot p Webster MA 01570 i a: 508 826 5757 RRPEPA.coin Certificate of Attendance and Completion: A00vator Halteal per 4o CIFR part 745.22 Seott.:Hebert w. uX K `j 2 Hacker Court 5 t Worcester MA 01603 Y ' Course&Exam Date 2/27/10 r r Expiration late:2/27/15 Certificate#Yt I-18867-10-00153 xtz (-- `J---Date: i 1 � I -- ®f�flee"oVonswumer �f airs 4Ausin=ss eg �aftL 10 Park plaza o Suite 5170 Boston9 Massachusetts 02116 Home 1mprovenit ®ntract®r lZegistrati®n Registration: 120598 a'r Type: Supplement Card r { der° Expiration: 2/5/2014 RESCOM EXTERIORS, INC JAMES PEZZANO 714A SOUTHBRIDGE STREET S 't AUBURN, MA 01501 ' Update address and return card.Dark reason for change. address Renewal � ]Employment � ]Lost Card SCA 1 sa 20M-05/11 C=J�B �(,077t/7LCTJ.CC/CCLII�G/ri!•(CLddU.C�CGdGIL Q-�_ ffice of Consumer Affairs&Business Regulation ]License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer affairs and Business Regulation egistration,. 12059.8 Type: 10 Park Plaza-Suite 5170 ,. Expiration+'2%512014 Supplement i:ard ]Boston,MA 02116 RESCOM EXTERIORS INC r - � -. JAMES PEZZANO ..' 714A SOUTHBRIDGE-STREET}'j AUBURN,MA 01501 Undersecretary R4Fure ! t Y • • �• -• it ®Qualified WINCHESTER INDUSTRIES HDR-BRISTOL 755 DOUBLE HUNG Vinyl frame, Triple glazed, NaationalFenesbab0m Low E coating(e=0.035,S2&4), RatingCount9l® Argon/Krypton/air filled e WCI-K-0-0000"0001 ENERGY PERFORMANCE RATINGS U-Factor(U.SJI-P) Solar Heat Gain Coefficient 0n21 0n22 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 041 Manufacturer stipulates that these ratings conform to applicable NFHC procedures for determining whole product performance. NFRC ratings are determined for a fixed set of environmental conditions and a specific product size.NFBC does not recommend any product and does not warrant the suitability of any Product for any specific use.Consult manufacturer's literature for other product performance Information. www.nfrc.org • d �2 Town of Barney -C� stable Permit Expires 6 months from issue Regulatory Services Fee ` snaxsUBtE, 9 1639. ,�� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner . 200 Main Street,Hyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ii Not Valid without Red X-Pre_ss Imprint Map/parcel Number Property Address b7 5dcj 2 -, &4�-- duo/ Residential Value of WorlA� 19? Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ��^� v- dC ��; IblUN I/VS :1 ►�-�e,�c,4� /5 ` odd a Contractor's Name &1cr�l � , Telephone Number S Home Improvement Contractor License#(if applicable) 124 Construction Supervisor's License#(if applicable) /Q'. -PR . a<Workman's Compensation Insurance JUN 1. 2Q12 Check-one: ❑ I in a sole.proprietor I am the Homeowner P .rOWN OF BARNSTABLE I have Worker's Compensation Insurance Insurance Company Name "Nr✓1U.% rvZyi�l/i �111 C� d Workman's Comp.Policy#' Ord I� Copy of Insurance Compliance Certificate must accompany each permit. - . .Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane.nailed)(not stripping. .Going`over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value -1 p maximum( .35)#of wmdows .. *Where required: Issuance of this permit does not exempt compliance with other town deparhnent regulations,i.e.Historic,Conservation,etc.. ***Note: Property Owner must sign Property Owner Letter of Permission: - A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:IWPFILESTORM&' per.init LS.doc Revised 051811 t The Common"walth of Massach usseth Depaphnent of 1'rrdustrial Accidents Office of irn5tigadons 600 Washington Street Boston,A4 02111 wrvk��nass /din Workers'Compensation Insurance Affidavit BmlderslContractors(Electricians/Plumbers Applicant Information Please Print 1,mbly Name Musmess0zganizzfim ndividna): R_Z C5 L 5 Address: 7t q A Sou It bestz; City/state/zip: i 2- Are you an employer?Check the appropriate box: Type of project(retprir�ed}: �a emp with4. ❑ I am:a general contractor and I employees(full and/or Part-time)- have hired the sub-contractors 6. ❑New construction 2-❑ I am a sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolition wcA ng for me in any capacity- employees and have workers' [No workers'comp.insurance comp.iosurancae,1 9- ❑Budding addition required] 5. ❑ We area corporation and its ME]Electrical repairs or additions 3.❑ I am homeowner doing all.work officers'have exercised their 11_❑Plumbing repairs or additions of on per MGL myself[No wvrinsurance &]Tcomp. c. 2,§1(exemption e have no 12.❑Roof repairs employees.[No workers' 13.ElOther comp. insurance required.] 'stay applicant Poet cheeps bo$C mast also fill out the section below showing their workers°ca atiau policy intmatiom �Homeowners rho mb.,this affilsvitinfficatmil they are doing all work and then hue outside canuacwrs= sabanit a new amdawt indicating such tCsnttacturs that check this bast must attached an additional sheet shoeing the nmne of the sdp-cwr:acbots=and on whether ortiot dose entities have euphryees. Ifthe:sub-c�ors Lase euployees,they must provide their warkery comp.policy number I am an emp145,w that isptovidfng workers'compensation.insurance for my emptnyem Below is the p ury and f ob site. informadan. Insurance Company Name: /yew e-5" + zj�5 .C� Policy#or Self ins.Lic.#: WC f ZC1_-V i2 Expiration Date: _7 O/ Z— Job Site Address: ' 7 SoRbi //(AVM.5, ? CityfStat&24): 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 MCL 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 ofup to$250.00 a day against the violator. Be.advised that a copy of this state ten t may be forwarded to the Office of Investigations of the DIA for irtsir=Ce coverage vedfrcatiem: I do hereby cardAwyAWI thepains andponalties refpedw y that the information—provided above is true and correct Si tore: J Bate_ Phone#_ GiRMal use only Do not wMe in this area,to be completed by city'ar town offlciat City or Town: 1. Permit/License Issuing Authority(circle one): 1.Board of Health 2.Bung Department 3.Cityirown Clerk 4..Electrical Inspector 5.Plumbing Inspector 6.Other: Contact Permnr Phone tt• 6 A6O& DATE(MWDD/YY) CERTIFICATE OF LIABILITY INSURANCE 06/10/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS (,ERTIFICATE 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 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 CONTACT' Aon Risk Services,Inc of Florida Aon Risk Services,Inc of Florida NAME: 1001 Brickell Bay Drive,Suite#1100 A/O NE.Ext: 800-743-8130 FAX A/C,No: 800-522-751 Miami,FL 33131-4937 E-MAIL ADDRESS: ADP.COLCenter@Aon.com PRODUCER 10762287 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED -' INSURER A:New Hampshire Ins Co 23841 ADP TotalSource FL XVI,Inc. INSURER B: 10200 Sunset Drive Miami,FL 33173 INSURER C: r ALTERNATE EMPLOYER INSURER D: Rescom Exteriors Inc. 714A Southbridge St, INSURER E: Auburn,MA 01501 INSURER F: COVERAGES CERTIFICATE NUMBER: 326832 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADOL SUBR W� POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR VD DATE(MMIOD/YYYY) DATE(MM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE_ $ s ❑COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ❑CLAIMS MADE ❑OCCUR - PREMISES(Ea occurrence) $ s MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $ ❑POLICY ❑PROJECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ANY AUTO (Ea accident) $ ❑ALL OWNED AUTOS - BODILY INJURY $ ❑SCHEDULED AUTOS (Per person) ❑HIRED AUTOS BODILY INJURY $ (Per accident) ❑NON OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) ❑ UMBRELLA LIAB OCCUR - - EACH OCCURRENCE $ ❑ EXCESS LIAB CLAIMS-MADE AGGREGATE $ ❑ DEDUCTIBLE $ ❑ RETENTION $ - $ A WORKERS'COMPENSATION AND WC 012438412 MA 07/01/11 07/01/12 x WC STATU- OTHER EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 2,000,000 (Mandatory in NH) E.L.DISEASE—EA EMPLOYEE If yes,describe under $ 2'D00'�00 DESCRIPTION OF OPERATIONS below E.L.DISEASE—POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) All worksite employees working for the above named client company,paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy. The above named client is an alternate employer under this policy. " CERTIFICATE ttOLDER wF` � fi s � ,CAPICELLATIQN - 1 R@$Corn Exteriors Inc. u, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 714A Southbridge St THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Auburn,MA 01501 '< .,, AUTHORIZED REPRESENTATIVE (c6e$Vt es, gdBQ 0 f(f4dt`ron ,sLCORD"25(2009709) � '`��1i� �R � ;����� ��� ,� * �,;;: _'�} a'����#� ©1988&2Q09 ACORD CORPORATION�Atl rights served The ACORD name and logo are registered marks of ACORD . y Office of Consumer Affairs and usiness Regulation 0. 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116- Home Improvement Contractor Registration Registration: 120598 " Type: Private Corporation Expiration: 2/5/2014 Tr# 221379 RESCOM EXTERIORS, INC SCOTT MERRILL -- 714A SOUTHBRIDGE STREET ' — -- — AUBURN, MA 01501 — —=- Update address and return card.Mark reason for change. ❑ address Ej Renewal 0 )Employment Lost Card DPS-CAI 0 50M-04/04-GIO1216pp ✓die C�oulseG 0�✓ a�a2uQ��b g.ICCI1Se Or Office of Consumer Affairs d&Business IItegalatioo registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 120598 Type: Office of Consumer affairs and Business Regulation Expiration: 215120.14 Private Corporation 10 Park Piaza-Suite 5170 - Boston,MA 02116 R OM EXTERIORS [M f SCOTT MERRILL 714A SOUTHBRIDGE STREET:' T. ys AUBURN,MA 01501 (Undersecretary --— Ni&t vali athouf si nat° e r • - 4 71. C�om�mwoasaed C� . Office of Consumer Affairs.&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration: 161166 ' Type ; Expiration: 9�29/2012 Individual SCOTT HEBERT SCOTT HEBERT * _, i 2 HACKER COURT, 4 WORCESTER,MA 01603 ,c: ' Undersecretary - - - Y zlassacllusetts- Departwilt of Puhlic`S.lfetl Beard of Buildin<i, € e-tdations and Stan(la ' Construction-Su pervisot License " . License: CS 103140' u - ResEncted to 00: SCOTt HEBERT ,. . . 2 HACKERSCT " W.ORCESTER MA 0160 1- Expiration: 10/5/2012 ( Ynnnisi'°ci' TO: 103140 � r x MA ter?,,#120598 Federal ID 00"311838 RI Reg. #20'i47 v � o CT Reg. #573209 Kamm Caryorete Headquarters 714A SouthtnEge St.AuDum.MA 01501(508)832-5202 1.890-287-t1f176 THIS CONTRACT MADE THE.....................Z�..................day of...... !............... ��.................. ...........between 201 t1D 111 (Horne Own*Sf (Home Phone) (Bus.Phone 'I (( (Address) (State) (Tap Code)the"Owner"and Rescom Exteriors Inc.,"Rescom". Rescom hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following described work. TOTAL Windows Purchased Additional orli Style Qty TOTAL CASH Window Color Specify �;fe, Sliding Glass Door /-;;' PRICE ''� 0,� Capping Color Specify ;•r Steel Security Door G Double Hung Insulated Storm Door DEPOSIT Picture Window � Specialty Windows NTH ORDER� ; Stationary Casement =3 Leaded Glass I3ALARICE DUE AT Casement-Model# %� Obscure Glass Top Bottom 2 Lite 13 Lite Slider �� Screens Half Full INSTALLATION Bay/Bow Frame ' Rescom doss not do any painting or staining. CASH Garden cal Balance pail to Awning Bascom Is not resporhslthle for condition or installer at lnstaladon � cImumsances beyond Its control Including (� Other: U condensate resulting from or due to pre- FINANCE completion form V Bank X Grids:Colonial ( conditions. signed at installation \j � h ESCRIBE!ftoRa: � _ .; ; c?114 .. c.• a' � tZ "" Y .JCS' '> - � •�d ,% �,�,� ��;r i�f rid ��_r,� l� �,�• > ti t.start Date: l at 06irnpletion Date' It shell be the obligation of RESCOM to obtain any and all permits necessary uncW the agrearrowit,as the(ems V y i permits,or�with unregistered contractors will be�u*w from • The Dasher D a . im their t eat it om ens and subcwrtraolm shall be registered by that Director and guaranty fund subcontractor of toGLC,ng to Aar hots sr�rovald be Mon" any inquiries about a n 130hxor or sr or reatirg to ahnhhgistr arh ehcrW batdirect to: DlnnsC�t,Horroe Improvefmnf Registreion,One Asltburtan Place.Ramn,30,,Bash,MA(Y110n,(B,7,rl7.lt5ge. If the Owner is obtaining financing by way d a Real Instalbrient Sales A, ,such Agrestent shell include a time sdradrte of to be m� under said cOntild end that amount of each paymant statad in dollars.Including all finance do .The Retell Instiffirrent Sala Agramnant Shall be incorporated herein by rem.If the Owner is obtaining a reuolvirrg credit One to pay,in whole or in part,for the contract amount hareb.tha tsrrna of the t—�\ rswhdng line or craft t Including Irhtai raft and payment farrrhs,shall be clearly se out on the cede Wokmoot.The portlon d the oaedt �, ` r^ In r r&erencirg a time schedule of paiymant,to be made urn this contract,and the amount of each payrnat stated in dinars,hxk dlrg all finance charges,shag be mcmpareed herein by reference. �•1 Reawn repr saiwft that it carin WwWrie's CcriVensdiar awl Public Liability Insurance. If the Quasi tall sea to perrrd Raw=to p►ootad with the work herein,or in the wait d any breach d the Owner of this agrean ant,for am reason r7 whOzosmahall cause Pere oaer to pay Rssoom a sum of money equal to thirt t and d or"Ird pecan!of the price agreed to be paid,as fb®d,Equidellad arn / d scmIdnsd damage an s, d not as a penalty,without further prod of loss or damage. o�' Reason shdl not be held liable in d for delays in the p rformasoe of this attract due to senses bsyoid Its reasmiable control. r� Ownsr warrants that he is the owrna of the propsity on which the wok is to be parfomad or that he Is otearwise authorized an bahaff of the owners to eider into this agrhsamart Thisoo0trectrapresentsthelafte agreement between the Owner and Rescom aid cannot be chaiged swept by a writing signed by both the Owner and r l' You am entitled to a copy of the Contract at the time you sign.Keep it to protect your legal rights.We,the aforesaid owners,sentry that imrredmtety meter the signing of the aforesaid agreement,a copy was furnished to us. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. rar The Ow has seen*svW warranties that will be pro by Rssomn upon installdimh. [ 1 S warantss to Owtahar. IN WITNESS ,.ER the pa haven o signed their names this /� day of Signer � 1 / igned Sales Owner �/ J /rf Accepted:Rescom Exteriors Inc., Y x Owner f By Authorized Signature Title YOU may ca vO this agrear,oil it itho ban signed by a party thereto at a place othx that an address d the sder,which may be his main office,or branch amnia,prowftd you no*adar,in wrtirtg at his main office or branch by ordinary mso'1 pasted,by telagra. sent or by daliway,not later than midnight of the third bsainsas day fdIca g the signing of this agreartait(Saturday Is a legal business day). YOU MAY CANCEL THOS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FOB 499E DATE BELOW. TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO: Res om,714A Southbridge St.,Auburn,MA 01501 NOTICE OF CANCELLATION I HEREBY CANCEL THIS TRANSACTION. DATE DATE BUYER'S SIGNATURE r C4 t wt Pate: 5 . : c� Z)r e Qm+ r Na�n�' lC? l � l✓e� 1� dx SS C? f'Af i poi Phone:, Word Phi}e . 1 . G.The ypar The House Was Build:. BEST TIME POR PRE.(NST.A:l 4loAT(ON, N P..ECTI :N::A M/P M,. N LOCATION STYLE W SIZE ti UI GRIDS SCRt;ENS R'OUGH.QP CO4WIEN7` CUCS Mx7` G o '� �"Wkk. u � - c - WINDOW COLOR _W BROWN BEIGE WHITEIWOODGRAIN LXWWH�T�Ti BROWN BEIGE OTHER SPECIAL INSTRUCTIONS O COMMENTS: DETAILED DIRECTIONS: ® Original Order:(X) WINCHESTER ORDER#: ® ® ® a ® ' ® ® ® Remake Order:(X) DISTRIBUTOR#: ® Process with Window Order:(X) VES NO SALES REP#: ��� ,�� ��vr r Date Entered: ORDER DATE: (If Different than Sold to:) SOLD TO: Ship To: �n , ,AA ADDRESS: s0 �' j r Address: PHONE#: GS le— glJ�f Phone#: PO or Job Name: Original Order Number: (,ATV Model Sufli Code Color Width Height Options(X Choice(s)) �- Aluminum Ke Alike �✓ J% ��� 7 7 Screen(X) (X) Right to left 57 Model Number will designate glass and size.Use sub-code of 57 or 58 to designate slide. slide from inside SPECIAL INSTRUCTIONS: 58 3110 Left to right slide from inside e Double Clear SL100 SL200 SL300 SL400 SL500 5'0"x 6'8" 59"x 79 1/2" Glass Double with Low- E SL110 SL210 SL310 SL410 SL5 00 6'0"x 6'8" 71"x 79-1/2" Triple Clear Glass SL120 SL226 N/A SL420 N/A 8'0"x 6'8" 95"x 79-1/2" Triple wlL.ow-E 8 Gas SL130 SL230 N/A SL430 N/A 9'0"x 6 107-1/4"x 79-1/2" Triple/Double Low-E&Gas SL160 SL260 N/A SL460 N/A L-01,x 6'8" 143-1/4"x 79-1/2" m 02 Outside Key Lock COLONIAL GRID rown 03 White Brown DIAMOND GRID Beige 06 B-Brass CONTOUR GRID (Gold-N/A) Woodgrain InteriorMhite Ext. 12 B-Brass with Key Grid Color(CHECK ONE): Woodgrain Interior/Beige Ext. 64 Solid Brass White Beige Woodgrain Interior/Brown Ext. 34 Solid Brass with Key Brown Gold Satin Nickel Woodgrain Interior/White Exterior Satin Nickel with Key Woodgrain Interior/Beige Exterior Woodgrain Interior/Brown Exterior. Dealer Signature: IBEVELED GLASS Page Of -All merchandise is custom manufactured on a per order basis and cannot be cancelled after order is entered. Form 70-0056 07/08