Loading...
HomeMy WebLinkAbout0298 CAP'N LIJAH'S ROAD ��. ,, � .: � ,•- .. k :: ,. ., gr .. .. � � - ,. .. ® .. � .. - a � - I Town- of Barnstable permit# r ` �, 4P Regulatory Services Fee 6monthafronrissuedate y 14S 13 9 Richard V.Scali,Interim Director 'O",'N O AMSTABL , Building Division m Perry,CBO,Building Commissioner� 200 Main Street,Hyannis,MA 02601 ® allllpll� www.town.barnstable.ma.us Office: 508-862-4038p -1 2508- R1 6230 EXPRESS PERMIT APPLICATION - RESIDENT .1A BLE Map/parcel Number /9 3 - /( / Not Valid without Red X-Press Imprint �����m Property Address ir Residential Value of Work Minimum fee of S35.00 for work under$6000.00 Owner's Name&Address Zcl 2C0. few✓. I I~`. M,/� Contractor's Name er TelephoneNumber QD/-2,z? ?go Home Improvement Contractor License#(if applicable) Email: _Construction Supervisor's License#(if applicable) O QS707 kvorkma'n's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name_dZ1' .1A.) Ti4t_ F�,,v ��S Workman's Comp.Policy# C 3 l 3 1p 6 Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris w111 be taken to ❑Re-roof(hurricane nailed)(not stripping Going. over ❑ e-side g s existing layers of roof) { [�Replacement Windows/doors/sliders.U-Value • (maximum.35)#of windows - #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Wheie 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. 4 A copy of the Home Improvement Contractors License&Construction Supervisors License is requir d. SIGNATTJRE: ,b Q:1WPFlLEST0RMS\building permit fOrmslWRESSA00 Revised 061313 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England y g Sarah Xander Legal Name:Southern jah5 Road R1 #36079, MA#173245, CT#0634555, Lead Firm #1237 Centerville,LI MA 02632 WINDOW RE IACEMENT 26 Albion Rd I Lincoln,RI 02865 H:(508)289-3048 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com C:50877762534 Buyer(s)Name: Sarah Xander Contract Date: 04/01/17 Buyer(s) Street Address: 298 Cap'n Lijahs Road, Centerville, MA 02632 Primary Telephone Number: (508)289-3048 Secondary Telephone Number: 50877762534 Primary Email: sarahxander@yahoo.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $9,C92 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $4,846 Balance Due: $4,846 Estimated Start: Estimated Completion: Amount Financed: $9,692 6-7 wks 6-7 wks Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 6.99% 7 yr 1/2 dwn, 1/2 due at completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first.written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/05/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renewal By Andersen of Southern New England Buyer(s) FV --- Signature of Sales Person Signature Signature Ryan Ahern Sarah Xander Print Name of Sales Person Print Name Print Name UPDATED: 04/01/17 Page 2 / 10 S R Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-095707 aT-r� Construction Supervisor BRIAN D DENNISON 7 LAMBS POND CIRCLE';: ..: CHARLTON MA 01507 Expiration: at io. r Commissioner 09/0812018 - � n�/z.e `t�anr-�ri=n�rrclerrl�f c�`• '�'�.�z��crc/u�Je�• and Business ReQulatlon �• `� Office of Consumer Affairs ;ham 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement:Contractor Registration Registration: 173245 Type: Supplement Card Expiration: 9/19/2018 SOUTHERN NEW ENGLAND WINDOWS LL ' BRIAN DENNISON = 26 ALBION RD =- LINCOLN,RI 02865 : Update Address aid return card.Mnrkreason for change. sca 1 1,ma-0sn: ❑Address ❑Renewal ❑Employment ❑lost Card '�iJ,.•Y.r:nar.<nrnro(/i r�����i:.nr�rr�efh -- ne of CoawmerARa-irs&Business Begalation Registration valid for individual use only before the expiration date If found.elm to: t��91OME IMPROVEMENT CONTRACTOR - Office of Consumer ASairs and Basin e4 Regulation ?5"ems�':='Registration:.y73295:, Type; lO park Plara-Suite 5170 "Y='" Expiratidn2.9/19f20te,: SupoementCiud Bostoo.NIA 02116 SOUTHERN NEW ENGL'AND WINDOWS LLC. _ RENEWAL BY AND FASON-,i'i; BRIAN DENNISON - - 26 ALBION RD t LINCOLN.RI 02865 lAh Not valid without signature T The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/din NVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED wrm THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly in Name (Busess/OrganizaiorAndividual): 30"Aa-rn W e �►'1C,�Gn r!1 �t'J4 Address: c26 All-i2n - City/State/Zip: L:it 1) . Phone#: 40) Z 2g_ 9 8 DO Are you an employer?Check the appropriate bor. Type of project(required): 1-Cil am a employer with !0 employees(full and/or part-time)-* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition IM I am a homeowner doing all work myself[No workers'comp.insurance required]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees- 12. Plumbing repairs or additions 5-0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs These sub-conuactors have employees and have workers'comp-insurance t r 14.�theTi �q"��u d t70'r 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.(No workers'comp.insurance required.] /'P�(q[t/►+el;:� 'Any applicant that checks box#1 must also fill out the section below showing their workers compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providin;workers'compensation insurance for my employees. Below is the policy and job site information. ,, //• _ Insurance Company Name: 2�7�R Weis ! In S Co — Policy#or Self-ins.Lic.#: W C-A 113 b0 k I Expiration Date: Job Site Address: q ►��✓� L( ►ct �l S �d! City/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 MGL c.152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thep andpenalties ofperjury that the information provided above is true and correct Si ature: r Date: /2 - Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Healtb 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 4 SOUTNEW-01 CZOLLINGER CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYM 612912016 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 ADDIMONALINSURED,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 Gerlificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: CoBiz Insurance,Inc.-CO PHONE FAX 821 17th St (AIC,No,Est 003)988.0446 AI No):(303)9BM804 Denver,CO 80202 �.CoB7mlnsurance@_!:obWnsurance.com L INSURER( AFFORDING COVERAGE NAICK INSURER A:Continental Westem Insurance Company 110804 INSURED INSURER B: I Southern New England Windows LLC INSURER c- 1 D/B1A Renewal by Andersen s 26 Albion Road INSURER D. I Lincoln,RI 02865 INSURERE: INSURERF: 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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W(TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY.THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.'LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR I TYPE OF RMRANGE )PIS vvvD POLICY NuxmER POLICY EFF 1 P E>� ; 5 A II )f COMMERCIALGENERALUABILTfY I :EACH OCCURRENCE I S 1,000,000 I CLAIMS-MADE n D�� ! ICPA3936080 07IOi12016107/01/2017 1 Py � ) i s '100,000. i —J E HIED ExP(Any on°n�) 15 10,000' i PERSONALSADVINJURY 1 S 1,000,000 2,000,000 �EWL AGGREGATE UMIT APPLIES PER: 1 GENERALAGGREGATE. Is 2,DOO,000 �1 PRO LOC 1 i PRODUCTS-COMPIOP AGG i S i ! 1 Poucr�I JOT EMPLOYEE BENEFI 2,000,000 1 ? i i5 .OTHER ; I AUTOMOBILE LUU3111TYCOMBINED SINGLE UM1T I S 1,000,000 1 ea acadeMl i Y INJURY eroPlSon I S A I n ! ICPA3136080 10710112096 07/01/2017.HODIt .__(P.:. _)..,. . 1-�ANY AUTO = I ALL OWNED SCHEDULED I I BODILY INJURY(Per acddenl)j S AUTOS —'AUTOS NON-OWNED i ' ?ROP — DAMAGE 5 —= HIRED AUTOS I j AUTOS I ; I 1[Per2a'dent i is I X f UMBRELW We i X I OCCUR i I i 1 i EACH OCCURRENCE �S 5,00%00 A '! " II EXCESS LIAB CL/UMS MADEI I ICPA3136080 10710112016 07/01/2017 I ALGA;E j s DED RETENTION S 0, I 1 ggregate i s 5;000,000 OT I WORKERS COMPENSATION j I f I { I STATUTE ! +ER' I AND EMPLOYERS'LIABILrry Y I N I I 1,000 000 A ANY PROPRIErORIPARTNER/EXECUTIVE *CA31360Bi 071011201610710112017 c L EACH ACCIDENT I S , OFRCERIMEMBER EXCWDED? ❑1 NIA! 1000000 {A9endetor}In NH) I i I i I E.L.DISEASE-EA EMPLOYEd S I,yes,d7be under I E.L.DISEASE-POLICY LIMIT I S 1,000,000 .DESCRIPTION OF OPERATIONS below I i I , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES{ACORD 101,Addlftntl Remaim Schedule,may be avachW ITS more space is mquhad) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE wn.L BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS- AUTHOR®REPRESENTATIVE . -- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD r •' �. I Z4��6 o6 -16 - 3 �6 Town of Barnstable *Permit# Regulatory Services iees b F.zxire on:issue dare `0$ Richard V.Scali Director Building Division Tom Perry,CBO,BuSding Commissioner zoo Mai.street,Hyannis,MA 02601 FEB 2 31016 w w+own bamstable.ma_ns TO U�' , Office: sas-862-4438 %a ,1�. ,,q�, STAB.LE r( pxsS PERwr APPucA oN - RESIDENTIAL ONLY t-I Not Vandwi2 ordI dX-PressZm Map/parcelNivaber 1lr7iarr Property Address ❑Residential Value of Work$—�� d d 11'fmimam fee of$35.00 for work under$6000.00 Owner's Name&Address . / G,v✓t 2 S �01 t4 CcaftwtoesName kl,72_56pe, �fi,�� .r. �;s 0—C Telephone Number '5C>S' - 1Y-2IR- — Z_ Home Improvement Contractor License (1 applicable) 9 ?_C3 Emad: f: 1;' /�C�,�/��2s 9 r..;rf-�:n.�G%��t irrt Construction Supervisofs License#(if applicable) 6 s5 a QWorlcman's Compensationlnstnaace Check one: ❑ I an a sole proprietor ❑ I an the Homeowner have Worker's Compensation Insurance Tusurance Company Name Worlflnan's Comp.Policy# ,ry f 1 G 47 2" t Copy ofbasura;ee Compliance Certificate must accompany each permit Permit Recpu-cst(check box) jT Re-roof(hurricane nailed)(strlpping old shingles) All contraction debris wM be taken to ❑Re roof(hurricane nailed)(not stdppkD Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U Valne (ma)Cmum 32)4 of windows #of doors: ❑ Smoke(Carbo7n Mono)ide.rletectors 4 floor pleas marked with red S and inspections required. Separate Electrical&Hire Permits required. *Where sequin=Issnance ofthis pemi±does noto=pt compliance with other tnm depamaent reZdatieas,i.e.Mstcuiq Consaoadon,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required.. 5IGNA.T'URE: • Q\WPF ESTORMS -1dmg nas Revised 0402,45 i The Com momma of-Ms adrusetb Office Of L"esu.-ad=S r�attrrerxt a,�' rrs�iat.Acciderrts ' 660�as�ui�aFt,S'�et Gaston, .02111 ' _..y i•DiY1�G:Fi1ASS�fIY�l�I(I Wor ereCompensaff-Giaicer"idavit13.ugdea-JContract=--,Uectxicians/Plx=bers AmUcant Iufarmation /f [ 1 f /Please Pri&��v Name nciiiPccil7it•LaniTtE7tSnlft�rTivE_2 is �� �Y L ���t�fi�r/ter/76'1 Ll Address: isc<� . CityiStat&Zip-- L0 6,L+i^ MA 0 2-6 3 (— Phone;2 e &eyou an eruplo-,wer?Checlrtheappropriatebo= T . of project r �-�e : - �y I am.a general co�ctor and I Yip FBI f e9: �- 1_f� Lama employzs�i#Ii.__� ❑ (� ❑I*ietvcansfsncfiaa empioyew(541an&=pmt-time).* havebiredfhe=b--c=tmrt as 2.❑ I am a sole praprietor orpartuer- Nsted•oa the attached sheet 7- ❑Remodeling ship and have no emplayees. . Drese eels-cau2rac#ars have []Demnllfioa •zar1� far SIIe in any capacity employees and.baVe Wa30ers' 4 tYS3=COmP.rrnvtrrnr cOml7_*r cnrany g- �UiIC aridifiort r�1 5. [] �,de are a cospotafifln aad ifs MEI Elect deal repairs or ad&tiom 3.❑ Iamahz=--D7ner doing allwork officersbavee=msedfheir ILO Flumbingrepairsaraddidms myselt[No Trcxkm,comp_ tight of exen*d--on per MGL LZ❑Roofregaim itsu*ancereriuired-]i c.1,52,§1(4) and we haven:a employees.[No Viers' 13-❑Other Cpmp_+nsa anm Mquired.] ;Any sgo�t�rcEedsl�as`.1�else�IIovtttt�s�tioa8etnwsb�i5r¢aro3cess'mmpeasatia�paTacgim�siiaz KameuwxcSSRbos¢bmEtcFiisa�dacnia�'ratm�thegaa•anin�a2f+�c�aif�lmeea5iaers�sabmitaneara��zeitmdia�a�� tCaa�cm�3�tcaecYils�bcasaast�es�aasddisin�sixeetshoua�gthenam�oftt�es¢b-ca�xsc#urs�eist�eWhetha�amthase�sbxc� . ®3Qyees.Ifthas¢a-c=txctmmk rre v=playrts=$tey=Lstpmside this war m:e crosp.poRry a=bw- I era ari aifipar of afisPrafarizirg taarars=caarperrs�rctt i�isrirancenr m* npIaj*ees 3etasir is Yhe�paTicy Uzi jo7a s fit•formariort, IUSUCa*ce,CompamyNtrame: -7ar/j m ! 117;' Urnr7" �Q - •FoRcp 9 or-Sem-ias.Yic. G l?/ 1 { E�risaCi�stl?aiL: V2(�/�i✓ Job Site Address: CiVStafet Ad2ch a.copy ofthe workers'compensationpoRzy duration page•�shatving the policy=tuber and e3pira-don iffaI4 Falkm to secure coverage as re l.nuder SwEba 25A.cf MGL a 157-can lead to the imposKoa of crimimai peaalfies of a iin°up $ 4(Y ilk aarllar aae Tearinzprisonme as aretl as civs�peuabEies in the farm.of ar SAP WORK ORDERand a fne of usr tFs tLfrfiI a dap a fifie trialatar. Be adtdsed'fad a cape of fhis sofa ent=gy.be fosmaraied fxs lhe D ce of laves€igati ons offhe DYA far insm=m coverage s ce- .Fai'D F emby cBChffly der dw " w zmdp8 iaNks gfpm:usy-ffiat tsia i�arma#im.pvt•-&d arlymvyi%btu and casrect SiMMSt,,,,s- ar Pliane a t ZZ`$ Z t3,69ci d is art}. Do jwt wry in fib mFea,&be.cmnpTeted by cfiy urtmu afrcias ChyorTawm P ,icense;9 �a.3.a.•�rmrFty(��flne�: I.Saardo 22.DuffTng3lpa tnmt S.'CityZownQerii 4 EiecfticalL=peror• S.PhEmbing,IisperEmr &Other Comtaet P'ersoa: Pltoaae�_ 6 GRANITE STATE INSURANCE COMPANY 0103090-00 WC 009-93-0601 13102 013-82-0915-5o r PENN YLVAN FRASER CONggTRUCTION, LLC IAIGI P.O. BOX 1845 COTUIT, MA 02635-2443 An AIG company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 175 Water Street New York, NY 10038 I.D# 0001 0646 MA UI#: PROCUCERS KEATING GROUP INC THE WORKERS COMPENSATION AND EMPLOYERS 144 TURNPIKE ROAD LIABILITY POLICY INFORMATION PAGE SUITE 150 S UTHBOR UGH MA 2-0000 IS EL�YN0INSURED MITED LIABILITY COMPANY RENWAL 099 0601 OTHER WORKPLACES NOT SHOWN ABOVE SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 ITEM 2 POLICY PERIOD 1221 A.M.standard time at the insureds mailing address FROM 09/26/15 To 09/26/16 ITEM 3 A. Workers Compensation insurance: Part One of the policy applies to the Workers Compensation law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease S 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID 61 IN KS KY LA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI WV D. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE- WC990612 ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Estimated Classifications Code Number Total Remuneration 51000FRe- Premium OAnnualQ3Year muncration QAnnual ❑3Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE- WC7754 TAXES/ASSESSMENTS/SURCHARGES EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) MINIMUM PREMIUM $500 MA TOTAL ESTIMATED ANNUAL PREMIUM If indicated below,interim adjustments of premium shall be made: Semi-Annually Quartedy Monthly DEPOSITPREMIUM ,����flaGtlr�dnrMt �r r 08/25115 PARSIPPANY 82 Issue Date Issuing Office Authorized Representative WC 00 00 01A 39967{ReVd 04108) I �lc� � �1 Office ofConsum5rAffa s- B si d ess Re datiaa 14 $jaZa.--S-che 5170 ?Ostm,mmtsachpse`s 0211;5 Home lmpror7emer�CbmtradorRela��Qm 'Type 7BA F ASER€;ONS t RjCTIONI 00. DEAN ;RASER P.O.BOX 484 CO T UIT,MA 02635 L'p d3te address sad:ear�rrd.laic rsasan Yar:.rages IJ Address Q 3Z.mave=� Q Tmaioyr,.�s Q�Cara �l',£cm�.�em�o�U��laex�a23 _ OSzcedPCo+�+ s sSbLs�ssF sit oa Ya'c s�orre oar�iaror3taraiazIuse:only O&�WROVSMU, COUrRACTOR btfnmtaetzaa ioa 7911m=filctm Tr. ��zS� �K 117536 Tyres OeeoPZaasm^rlsits�sdesuT�F�r �� S=Pua�=- C7 DBA lIIPerkPiza-SaaoSl1@ Sostcn.D3A021{6- FPAs'�t C0USTRTJ=0N CO_ J MEAN SSE?, 2 FALMCOM MA 026W 4� �(aCwfidwzthot s use f . 7�s �P.assaen:.s�::s-7�a�^r:anec�=.:hiie ar;:?r and Si2anca;t9 Comtraciion Snpen•icor _lcznsa:CS-097668 ' DEAN C nWER= I04 Twm Vmv LANE:.:'s _ EAST FALMOUM MA,:O'2n6 ✓�.�-f1>f� 06107/20 1 7 P .: Fraser Construction, LLC 31 Bowdoin Rd. Mashpee, MA 02649 Email: info(a fraserconstructioncapecod.com A www.fraserconstructioncapecod.com \' FAX 1-508-428-0123/ PHONE 1-508-428-2292 HICL#112536 CS#97668 RE-RO 3FING PR PGSAL Date *- 12, 30 15 --- Name � °`` �. James Email Jamiemack9@yahoo.com oo.com Phone 617-671-8432 p Job Address = 2," 298 Ca 'n,Li'ahs Rd . '�.. FRASE]k,CONSTRUCTION.here'Y proposes to�perform the following services in a neat, professional manner in accordance with the;manufacturer's specifications,and local building code. f Ce-rtaznTeed Shin le O tions Good 1 Better Best r' Shin. less Landmark Landmark Pro Landmark TL Algae Resistant 10 ',ears '1 15 ears 15 ears- Wind Warrant 130,MPH 130 MPH 130'MPH Weight/squire 240.1bs 260-270lbs 30:5,1bs Shingle desi ri`-,,` Two-Piece . Two-Piece -Three-Piece Color Palate Standard Max Definition Max Definition Valleys R Closed cut Closed cut r Open copper Investment '1,$11,700 1 $20,800 Shingle Selection: �0 VA Color Initial: r' Ironclad, Lowest Investment Guarantee Any contractor can price your roof for less by cutting corners and utilizing cheap materials and unskilled labor. It's important to know what is and isn't included in the roof you choose for your home. You don't want to be left with an inferior roof built by an untrained labor force. That's why Fraser Construction offers the Ironclad, Lowest Investment Guarantee. Not only do you receive a state-of-the-art roof built by highly skilled craftsmen, you also receive peace of mind knowing you obtained your roof for the lowest investment possible. If you later discover a comparable roof for less money than the one we constructed for your home, we will pay you the difference plus a $50 bonus. All we ask is the comparison be "apples-to-apples." "We have no quarrels with the man with lower prices,for he knows what his product is worth." PATENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. 1/3 initial payment, remainddr,to be paid upon completion Payments accepted are: CASH - CHECK-,,MASTERCARD -VISA' ',AMERICAN EXPRESS *Any payments not immediatelXpaid-upon job,completion,will'>be charged 0:005%for every day after the given 5(day grace period'upon day of job=completion. FRASER CONSTRTCTIONmguarantees the labor for'LIFETIMEFof roof. FRASER CONSTRUCTION.guarantees the shingles against Blow-Offs,for 15,vears. Please note that all pricing is contingent upon current market pricing. If contract is not accepted within thirty-days of date of proposal;_elange<in price may occur 4due to deviation in material price Any:deviation or alteration from above specification will be executed upon written orders and will become an extra charge over'and,.above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry necessary insurancelupon the above'fwork. We, if not accepted within thirty, days may withdraw this proposal. f l Work Permit- I r lumfaz' cat. (Sign Name) give.Fraser Construction ll a,permit for the work being done at the permission toT� ,ell -R� (Address) FRASER CONSTRUCTION;LLC: Carries Workman''s Compensation and Public Liability Insurance on the above work, certificate.available upon request. DATE OF ACCEPTANCE: x� c" Homeowner Fraser Construction, LLC aRW 1 Roof ng,Pro'duct & Installation Details ti Supply & Installs- (Soffit Venting)`Hick's Ventilated.,Drip Edge or, 8 Aluminum Drip Edge with existin soffi't�vents. Y � g .. Smart vents over white drip edge. e. ` Protection,against damage to the roofing'materials and structure. The most,effective system is a balance of air intake and'exhaust that creates a uniform flow`of bix'through the attic. This system creates a condition in which the roof temperature is equalized from top to bottom, supplying a,uniform air flow along the entire underside of the roof deck.'' ' Supply.&-Install- Ice &Matershield a Waterproof Underlayment System (3ft. on evesland` g valleys, 18" on rakes, walls, and skylights) , Ice and Water Shield is a self-adhering roofing underlayment used on critical roof areas such as eaves, rakes„-ridges, valleys, dormers and skylights to pprotect roofing structures and interior spaces from water - penetration caused by wind-driven�raixi and ice dams. Supply & Install - Surroun&Underlayment (A'Typar`Brand) A smart alternative to.felt; it.is water's toughest opponent, creating a seeondary water barrier that reduces the incidence of leaks,caused by storm damage, wind-driven rain, ice dams and worn roofing materials. It is a waterproof, synthetic polymer'material that will protect your home against moisture intrusion. Supply & Install- CertainTeed. Swift Start With self- adhering asphalt starter course on all eves, and rake edges. CertainTeed requires this product for Integrity Roof Systems and upgraded wind warranties. W � Supply & Install-Aluminum & Neoprene Soil Pipe Flashing Supply & Install- CertainTeed Ridge dent High performance ridge vent with external baffle. Supply & Install- Pre-Cut CertainTeed Hip & Ridge shingles Shingle Ridge meets the hip and ridge accessory requirements for the CertainTeed'Integrity Roof System which is comprised of underlayment;,,shingles„accessory products and ventilation all working together.. The.Integrity Roof System is designed to provide optimum.performance--no matter how bad the weather conditions are. (As recommended by CertainTeed) Clean &Remove -Debris from work area daily. A 1, cf e"'a • 41 b "ram f u 4 a l8, 197 S.r. e 23 O S A', © N of C7PPelPit . ^/L goo TW(4c1 ;7Z:-}eL�' T M N L% THOMAS E.KELLEY CO. y 'ENGINEERS—SURVEYORS O 346 LONG POND DRIVE FG/STERN � SOUTH)[ARIA01) H.MA �qNo SuRVEyo oz664 CERTIFIED PLOT PLAN LOCATION : .� SCALE . �.r�- 4 0/ DATE DEC 22, 1?7 PLAN REFERENCE . �•- / r (.Q/�.. . � !"t�1.�'L.L.� �� ,.� ..t�f�/J�•.i�f . Cf-11�te 4,c-s Al, .S'��G�7, i,�c Sunvgp!z, AAu�,y k Z-77 AG �8 I CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE 5.T�AI�E SETBACK REQUIREMENTS OF THE TOWN OF J E3A f?.iv s-rf A. ( ..I,, . . . . WHEN C STRUCTED. /jOLL/AJr f,/T C/./ ,�nIl U DATE Z.. � .22- 7.IT . , PETITIONER: (—GI C� REGISTERED LAND URVEYOR p1j, Assessor's map and lot,number .. .............:............... ... ...... Oj��C � 1,2 -2 T 7 7 v L SEPTIC SYSTEM MUST BE> c -,n 77 x �,k• INSTALLED -IN.COMPLIANCE Se -wade'Permit number ...............� .. ( . WITH.ARTICLE-SAN'I II STATE THE TO� TOWN 11 1 `I OF Lr11.=1' OTI:1, Catt,r W� Z HAHHSTADLE, i r, 0 "Aa UUILDING , INSPECTOR �p 1639• +r. 0 MPy ,'T APPLICATION FOR PERMIT TO .'......: :.................. ' .............................fir..!...........��/G�>............ r .._1 �iGG'G �/1 C//r'^�s . TYPEOF CONSTRUCTION .................................... ...... ............................:........................................................... ' {.. ................................................ TO THE INSPECTOR OF BUILDINGS: ermit a o g to for according the followinginformation: The undersigned hereby applies p !�' Location..... + .... ..°Z ProposedUse ...... Il/�" .................................................................:................................................:.................:.......... / 1 — Zoning District Fire District_ ..... Name of Owner ... Q ` `.. ....................:.............Address ../.............. .. !. .z ..... ...... ti Nameof Builder .:...........................................:......................Address ................................................................................... Nameof Architect ....... .....................................Address ................................ ................................................... Numberof Rooms ............ .................................................Foundation ...IQ........4�................................................... Exterior . ....1/�G�C!Z...............:4�`'�` ............................Roofing .............. .......................................... Floors 1.j_ �e ....Interior .�L °.'........ .............p............................ .................../............ Heating �G2C.'.................... .....Plumbing ........................:......................................................... Fireplace � ...A Approximate Cost ®" .... .. .. . .. . ---- Definitive Plan Approved by Planning Board _________________________ 19________. Areab. t�.... ..................... Diagram of Lot and Building with Dimensions Fee L SUBJECT TO APPROVAL OF BOARD OF HEALTH --------------- Cm��99 e� r III 13 of 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name /Z" G ............................. C. F. Stanley No .42�....,Pe-rm--it--for ... ............................................................................... Locaticrri Lot 25 298 .Ca Li ah's ........................... ...............�j...............R 4 .......................... ........................ Owner ........... Type of Construction ......... ........... ; .......... -4 .. ..................!............................................... Plot .... .................... Lot ........2.5....... ........... Permit 'Granted ......Decembe; 27. .....19 77 .. ....... . p 19 Date of Inspection .... jr...... Date Completed .. ...........................19 PERMIT REFUSED ............ ..... 19 ........... ................................................................... ....... ................. ...................I.................... ...................................................................... .................................................... Approved ................... .............................. ig A:�r ............................................................................... .................................. ............................................ 2 y� Assessor's map and lot number ................................. . .� �f���///l_ 1� -Z T 77 Azil 7T Sewadi'Permit number ..............Z.d.�................................ y�F714Et��y �} TOWN OF BARNSTABLE Z BARNS AXE. i " 9 BUILDING INSPECTOR A" APPLICATION FOR! PERMIT TO ..... te...Q'... .: t r. v . ................. ........................ TYPEOF CONSTRUCTION ............LJ(fCF�.. ....: ..................................................................... ... ....... ..................................19....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................................................... � ` L....... ..:......: ��.. .y. ` ` ............................... ;Proposed Use / .... Zoning District .......... ................................................Fire District .....: '. ... . t,,.�..... r'........:....................................... f Name of Owner :. �fl", � .............Address /. t iL c; ..................!..:.... .................... .7-................... �,. ................... ' . Nameof Builder .....................................................................Address .......................................................................:............ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms �.. ........................................Foundation art 'pT-e Exterior .......�Gr i'� c .. ; ram..............................Roofing Floors ......................./....�.............................. ............... Interior ...... � ..9..�...... .. ........I....�..�.........:.�....:........ Plumbing '. mot Heating ...................... W Fireplace ..................................I...........................Approximate Cost ................r ................................................. Definitive Plan Approved by Planning Board ________________________________19--------. Area ...f. a ... ................ Diagram of Lot and Building with Dimensions Fee ... �?.................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH t • tit I • � I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .............................. °..C1 ``�............................ _ 4 C. F. Stanley No .... Permit �or .....Pli�4�iPf.............. ............................................................................... Location ....Lq.t...Z5....29O..Q.%). 1 tj.gh'.q...Rd. ...................... ................................. Owner .......................... Type of Construction .......W.9.Q.d..F.r.AM.9.*........... Plot ....................... Lo... t ..... ....2�... .. .... Permit Granted ...........be-:ember ...27...19 77 ................... .... Date of Inspection ....................................19 Date Completed ..............................19 PERMIT REFUSED ............................ ....................... ... 19 .......... ... .... ............. .................. .............. .. .................... ........ ... ...... . ..... ...... ..... . . ................. .. .... pprove ............ . .......... ......../ . ...... 19 ....................... ............ ..... .............. ........... t v �oFZHe ro�ti Town of Barnstable / Permit# Ezpires 6 monthsfrom issue date sasz OLE, Regulatory Services Fee ax 3 �d 9�A MASS..a`� Thomas F.Geiler,Director Xp�� rED Mai Building Division �$ P Tom Perry, Building Commissioner left 200 Main Street, Hyannis,MA 02601 S EP 2 7 200 Office: 508-862-4038 TOW 2 Fax: 508-790-6230 N OF BgRNS7 / L EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Work Owner's Name&Address Contractor's Name Je2y 779zoy a/ Telephone Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance .Insurance Company Name Workman's Comp.Policy# Permit 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 ,(� Replacement Windows. U-Value / 3 / (maximum.44) ❑ Other(specify) h *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg 1?evised121901