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0037 ELIJAH CHILDS LANE
T I - A All < b c i aF 6 u, a x v a , - " v n e • 4 0 t . v � n C , ° d v • a � , e o .. i h ' " ° , , r t, , Y v y,.t 2 a ^ c . loh CAPE Coo' �� � N'S U L A T I O-N 2012 JIURI l ' 31 w FIB GLASS SEAMLESS SPRAT FOAM ,SUSPENDED. 1 ,BARS GUTTERS INSULATION"' CEILINGS • rs.'�•.Ca mot` •—+-" --'ray y,. . 1-800-696-6611 , a� Town of Regulatory Services ` Building Division Address - _ Address 2 - Date: �/�/ '' , r , Dear Building Inspector Please accept this'Affidavit•as•documentation that Cape Cod Insulation, Inc.'performed& fi- completed the insulation and weatherization work at the property listed below. Cape Cod ; Insulation did this in accordance to the specifications listed on the building permit , application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner ,.. Property AFddress: Village T m� uso� 61enm ��► �a: 31 Ali' h CC� / n Insulation Installed: Fiberglass Cellulose, R-Value ' Restricted,- Unrestricted ` Ceilings ( )• ( >{) ( 2�> (' ), w ''('X) E Floors Walls c u a � r Sincerely t -r `' v r w ,' .HY Cassidy E Cassid Jr, President A - L , • Cape Cod-'Insulation, Inc: Y � • µ'me n a A� 1 �• y kyM• 11. *k !- x ., • . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Application # � Health Division Date Issued " Conservation.Division Application Fee Planning Dept. ~' Permit Fee 2i Date Definitive Plan Approved by Planning Board �� ,5�2�-��I Historic.- OKH _ Preservation/ Hyannis Project Street Address 3:2 r��s Z a _ Village z r`A' ;rz'e_ ,,� OwnerT/ ,�s�_ ! Q/ Address Telephone 7 7 cS�o2/ 3 Permit Request 'P AtL e j&o� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new - Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type 7-1- ell Lot Size Grandfathered: ❑Yes ❑ No If yes, attach b�porting`c ocurr tation. Dwelling Type: Single Family Two Family ❑ , Multi-Family (# units) _ µ Age of Existing Structure - Historic House: ❑Yes do On Old King s! lighway:c Yes -No w:...,. .! `PC Basement Type: ❑ Full , ❑ Crawl ❑Walkout ❑ Other_ Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) I q? 4.1..E •°g'7 Number of Baths: Full: existing _ new Half: existing _ new-0 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: LJ 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 Telephone Number Address � License #_ Home Improvement Contractor# ,lee 9 Worker's Compensation #4z<4 A h --f-2 si:el ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Qv 7,20 SIGNATURE DATEJT/7� FOR OFFICIAL USE ONLY APPLICATION# ,,,PATE ISSkJfD, •�.: n, r j,MAP/PARCEL N0—.: 4 ADDRESS VILLAGE OWNER J " DATE OF INSPECTION: LFOUNDATIONI..- 'a FRAME INSULATION j w FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:•:,ot ROUGH o FINAL FINAL BUILDING•4.+ .... P _ DATE CLOSED OUT 1 ` ASSOCIATION PLAN NO. OWNER AUTHORIZATION FORM "00;00v (Owners.Name) ' , ' 11 • • • 1 owner of the property located at a 3 7 (Property Address) Ile (Property Address) ; hereby authorize k (Subcontra ) ., an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. C� Own s .Signature,/ a r ` 1,2—//"oolz-- Date r lLIAR 5 �012 i , ly i - 1 C iSnk�►r, ��d�A� 10 Park Plaza- Suite 5170 Boston, Massachusetts. 02116 Home Improvement Contractor Registration Registration: - 153567 Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INCH HENRY CASSIDY I a 455 YARMOUTH RD. HYANNIS, MA 02601 -- S , /..C1lpdate Address and return card.Mark reason for change. Address Renewal D Employment Lost Card DPS-CAI 0 50M-04/04-G101216 Office go mer Affairs us ne,,,,,,!!!!`R,,�,e��gal tion License or registration valid for iedividt:!use en!y HOM rfsffl&M&l� f1��''C°�'� before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 OD INSULATION, INC,,:. HENRY CASSIDY P 455 YARMOUTH RD= HYANNIS,MA 026gl, ;'z Y' Undersecretary t alid ith t si tune �., y ' ;llAs itchusetts-Department of Public Safet% Board of Btiittling Regulations and Standards',- - e. Qonstruction Supervisor License License: CS 100988 HENRY CASSIDY r 8 SHED ROW , WEST YARMOLITH,(MA 02673 o-- Expiration: 11/11/2013 (unuuissi"i�i' Tr#: 7620 ,i �'1- )rrllYlO?'ihl�clC11111 L?1�1�IL25Sid �'11(S�l(J r _ I IQr1L,S'£r1cT!r1C1l1t'7'r.I.J' of'fl ' rr L-1 vesu.aan ons 600 )1" h rngrort Sl'I or MA 02111 wr, w.rnaSs.goVAYis C;or_riI ens atron I its u ran c.e. :�ttittavu: J3ullderalC.onfracCursl� lt'�ctt`tct:ans(l'lt.unl_,t:rs tr1_1 lrtl:ol 11t iC:iort l'lL��3.S f1i11C l,C-lrilily iltiut:'. (li,i inc;:sl )rl,ani .atIort/tndividual): vs - --- 1�11� - — ---- - — �.— ._ .. one # tru , Iltl]luj �r Cltcctc I:11 41-)Pr-opriatV. bu.ti ,y 'L'yhr_ of toroje,t, (rr.d,ullod). n, I ,Ili ,: t tuirlo) ., trtth I am ,,:neral contractor and 1 --- b {m j Nctv-r.6osiruc:tmil "u >lv}rc ' ((uU utcLror trio.-ttnlcl. Iiavc itIcd lh(;s Ib-.C, rdC[tus. hi ,J ac, •o., the attached sheet. . Ruttoiar•ln; a;A .t ;,,.rlt, i:>t o(,rintor or. pa,t tn�.r- 7 t --1 r.l ,ulil ltuvr. [I(:) c1ilplo'yc;Cs -lhrs� t.irconoacrors' have: ti. ❑ LJ�'riu:,li[iun uthutt, Cot trio' it, gray capacity. unployecs and have workers' a I � corrrp �usurance.l 9. -[� Builduls 1dCliliOfI j L1•,U V/llihCl's Courip. insula.tico S. We arc-a corporation and its 10.[] 1-, -cincal rt l.,dl,s ur tlddi ions i tt tauirr.d.) ❑ rp 1.1tnn�t7 vnlcr (,to lrlg all-woik olficrrs hayc curctscd t)'lcir t 1.�..J Z'lwhtb illg I cpalis or add1tit,ns right of rxcmppon pct 1,IGL l n; ,r.tl. II�t1 workers cotrll). l n�:L] Roofi,epalrs i „,',tllaur'r. re.yunc(J.) I. e. l�' , gl(9), and svc have lio' . etxlploy.ces. [No workers' 1 3 [] 0113e,r -� _1. 3t_.Lok MIT, wsurauce ret uutd. ay ;1)1110rJnl that ch,':cks' box t11 tluls[also fill out the.section below shouting ante worKc15',compe1Iea60f1 policy infornu,lion, i;>Irro.cu,:rs witu submit this ahtld'ayit indicating(icy arc doing all wail;o.nd Lhcn hire OulSlde rontractors must submil a nc:w affitlavll indu:uting sur.h. kmhdc..lurs that chock this box must attached L additional shoe(showing the name of the sub-eoirti'actofs and sfatc whcthcr or not dli,m.,cnti(ics have: a.:,i,!u•;cos, if'U,c.sub-Cootractors buvc employees,they must provldC thtlr woiUrs'Come poliQ)'"umber. un : Mpi Oyrer (ha( (s pr-ov(ding rvorlcers' cotiyerisa(iu)t insurance f)r_lily employees. Below is rhal,o4cy1 I1rrd jub slit: Ir rrlt tiv,l- t.ii,iitozi.ny f\ /l df or \elf tns. I_ir. il: ( � �Zs -�" Lkpuatrou Tate :ut, `,Ito', r1t.1t1tcaS - ''s '- Cll-y/Jt�l[4/�,lp - ,.t I.it a cup), of th(t policy ('leclaration pale (shon'inl; the policy nutuber• irld.ez 1.)rr a ti i,n (la tk.). a.l,:rc to scourc covr_ragc- a.s rt:quired uodcr Seaton of MOO c. 152 can lead to the irr(positunl of cr irninal hrrttthit. of III, tIj 9;1,':.)00.00 and/or onto-year-unprisoamezlt, as w.11 as civil penalties in Lbe, form of a S7'01' WORK 0Pv_D ',k ,uul :t tint to $"50.00 a day against the violator. Be, advised that a copy of this statement may be forwtvdc•,d to thc.'0ff C:r.nl c;tlgr,.tiGrts ut Cltr. .DIA for insurallcc coverage veriflcariorl. -- errhy cr't(r/ r ut�e— j�cc lurid pen�lliesofpe)•1'y'that the information provided above 6- trees!. curd corset. Date: F i� Of It r.11,ICJe. wily. 0o rlol write in this area, ro bt cnmtllefed by City or iowr, of ii6aL ;I r ll t•,�I ur ;kUthority (t tr'Cle Otte) I. Ku trtt of Healtll 1. Bulldirtg Department _) Ciry;`iny" Clerlc 4 Cl(—CAr'ical inspector S. 'C'lurribiii; tllaperror ,. Phone Client#: 4597 CCINSUL AORD ,M CERTIFICATE OF LI� BILITY INSURANCE UATE,MM,°DIYYYY, 2102/201 z INS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE•DdES 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. e ce I Ica e Mier Is an the policy les must be endorsed. ,subject o 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 .. .. ., - - - ` NAME: MargareRoutng Rogers&Gray Ins. -So. Dennis , PHONE FAX, 434 Route 134 F (AIC No Ext:5081760-4602 r__ _ (Alc, Ne): 877-816-2156 EMAIL P.O.Box 1601 ADDRESS: 9tingma.& gersgray.com PRODUCER (South Dennis,MA 02660-1601 a CUSTOMER ID a: , r. INSURER(S)AFFORDING COVERAGE. NAIC q ;INSURED ' x+ INSURER A:PeefleSS Insurance, 18333 Cape Cod Insulation Inc T ' _ , 455 Yarmouth Road ;' INSURER B:Ohio Casualty Insurance Company Hyannis, MA 02601 "c x INSURER C:Atlantic Charter Insurance • �` INSURER D:Commerce Insurance Company . 34754 * ,INSURER E2 INSURER F: S - 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 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. r NSR ADDL SUBR POLICY EFF POLICY EXP A GENERAL LIABILITY CBP8263063 ,O4/01/2011 04/01/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY r t DAMAGE TO RENTED ' { PREMI,$ES(Ea om"Tence) 000,000 ' CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 ' ¢ vs } PERSONAL&ADV INJURY $1,000,000,, GENERAL AGGREGATE' $2,000,000 GEN'L.AGGREGATE LIMIT APPLIES PER •' + PRO ) PRODUCTS-COMPIOP AGG $2,000,000' $ D AUTOMOBILE LIABILITY - 11MMBCKVMK. . ; A4,101/2011,04/01/2012 COMBINEDSINGLE LIMIT ,* ANY AUTO (Ea accident) 1,000,000 a ALL OWNED AUTOS k ' BODILY INJURY (Per,,person) $. > - ..! .. - + x� - .. •, • ,. " r. -X SCHEDULED AUTOS BODILY.INJURY(Per accident) $ , ' PROPERTY DAMAGE X HIRf_D AU IDS - ,- •_ $ (Per accident) X NON-OWNED AD VOS $ < ... B UMBRELLA LIAR .X �OCCUR• - - _ �0001254514645 04/01/2011.04/01/2012EACH OCCURRENCE $1,000,000 • EXCESS LIAB « :CLAIMS-MADE y..,t ,.`;�,. ..ra. a ..•', R,:' { AGGREGATE �.;.. $1,000,000 �. ...X RETENTION $ 10000 G WORKERS COMPENSATION _ WCA00525902 .06/3O/2011 WC STATU- OTH-' ' AND EMPLOYERS'LIABILITY - YIN 06/30/2012 X TORY LIMITS• ER ANY PROPRIETOR/PARTNER/EXECUTIVE ". , E:L.EAT ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH)It yas,describe under ! E.L,DISEASE:EA EMPLOYEE$500,000 Err .. - .. UES�RiPTQN OF OPERATIONS h-low t ,�:..' T, )ESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach`ACORD 101,Additional Remarks Schedule,if more space is+required), Norkers Comp Information Included Officers or Proprietors 4• ` ' :ERTIFICATE HOLDER. ' { CANCELLATION r SHOULD ANY OF,THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN '`k 5 ACCORDANCE WITH THE POLICY PROVISIONS. - a e AUTHORIZED REPRESENTATIVE a f 01988-2009 ACORD CORPORATION.All rights reserved. .CORD 25(2009109). , 1 of 1' The ACORD name and logo 'are registered marks of ACORD <. #tS77368/M68179 MEY OF THE rq� Town of Barnstable *Permit# Expires nt o e date Regulatory Services Fee' * BARNSTABLE. Thomas F.Geiler,Director glis yC Building Division Tom Perry,CBO, Building Commissioner RNST 'L , 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not,E Valid without.Red X-Press linprint Map/parcel Number ( �� j Pro rty Address � EL /3 di kA Residential Value of Work L "` Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address (/�ati SUM Contractor's Name TAO04kneS�f�r�CeS i/rC �^ P [ n ` �JOS /% QIJ�h' elephone Number .�O Home Improvement Contractor License#(if applicable) " _/ 3 a 3�4 / 7�0 Constru ion Supervisor's License#(if applicable) 7 )o 7 orkman's Compensation Insurance Check one: Va sole proprietor the Homeowner e Worker's Compensation Insurance"j` Insurance Company Name aw Workman's Comp. Policy# �9 �1Z Copy of Insurance Compliance Certificate must accompany each permit. 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- de #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. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPPESS.doc Revised 070110 �t The Commonwealth of Massachusetts w Department of Industrial Accidents Office of Investigations 600 Washington Street y,y Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): cr-M Address: a q5 jr„�e City/State/Zip: (" -3v331 Phone #: Are you an employer? Check the appropriate b Type of project(required): 1 ? I am a employer with_s 4. I am a general contractor and I 6 0 N 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 g, Demolition _ working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance r,. comp.insurance.$ 10. Electrical ie airs or additions required.] 5• ❑ We are a corporation and its ❑ p 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other 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 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 providing workers'compensation insurance for my employees. Below is the policy and job site information. w cc) Insurance Company Name: /], � Policy#or Self-ins. Lic.#: 0 t ` 3 Expiration Date: f � � Job Site Address: City/State/Zip. Attach a copy of the workers'compensation policy declaration page(showing the policy number and a iration 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 certify under the s and penalties o jury that the information provided above is true and correct Si Date:Sip-nature: p f •� Phone Official use only. Do not write in this area, to be completed by city or town gffk iaL 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#• I The Commonwealth of Massachiisetts Department of Industrial Accidents Office of Investigations tt 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information T Please Print Le 'bI Name (Business/Organization/Individual): •J C °O 7 t�.� Address: V ^I S aAl WA, City/State/Zip:A y e ` Phone#: Are you a employer?Check the propriate box: Type of project(required): 1.❑ I afn a employer with 4. ❑ I am a general contractor and 1 6 ❑ construction loyees(foil and/or part-time).* have hired the sub-contractors 2.;- k1amp a sole proprietor or partner- listed on the attached sheet. 7. emodeling R These sub-contractors have g, ❑ Demolition ship and have no employees working for me in any capacity. employees and have workers'comp. ❑Building addition [No workers' comp. insurance comp.insurance. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 1 LM Plumbing repairs or additions myself. [No workers' comp. ;" right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' 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 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 providing workers'compensation insur nce for my employees. Below is the policy and Job site information. — Insurance Company Name: 0 A t-G Policy#or Self-ins.Lic.#: 1t� Expiration Date: / C Ci /State/Zi Job Site Address:_ ty p_�e C� �e IJ3 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify ''ie information provided abo a is true and correct Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: x 7�a. hoar.-.zV:csr0�et��Y$ cry,_. �a Off,•ee of Consumer affairs&Business Regulation HOME IMPROVEMENT CONTR,11CTOR `S Registration'_;;126893 Tyre: ,ti y Expiration 813/2012 . Supplement C The Home Depof.At.Home.Seniices DARREN DEMERS 2690 CUMBERLAND PARKWAY S �-���— ' GA 30339 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 ;ard Boston,MA 01116 Not valid without signature i lily office of Consumer Affairs and usiness Regulation 10 Far..PIazu Suite 5170 Boston, h2assa54psetts 02116 Home Improvement ���9xactor Registration Rwistration: 132349 Type- Partnership Expiration: 1111/2013 Fr# 207392 J 8t J Remode{ing Joseph Duarte 15 Fa{{ St. Wareham, ma 02571 Update Address and return card.Mark reason for chsage Address Renewal � Ratployment f,o#Card )P$.GA1 0 BOW04104-011001�2166�_ / Office ofiCoaa"'m� a rs�Bnos egu ab° License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Type: Office of Consumer Affairs and Business Regulation Registration: .. 132349 10 parts Plaza-Suite 5170 Expiration: 1./t1/2013 Partnership. Boston,MA02116 kvismodeling.: Joseph Duarte 15 Fall St. Wareham,ma 02571 Undersecretary of v�dwiiitboujsignature Ola�±a�huatt•' Dclrtruncnt�11'PuhliC"xfe" 1 Board(of Buildimi Re�1,ul:ttiun;upd titattd:trd• Construction Supervisor License License: rs 70077 j0SEPH C DUARTE 15 FALL ST WAREHAM.MA 02571 Expiration: 12j30r2D12 Trii: 7048 (onuui.vantcr . , TO 39dd Z9L696Z ES:TZ TTHZ/Z6/T0 SOAK I.tufpROVEMENT CONTRACT PLEASE READ THIS f Sold,Furnisher!and Installed by: I 1 Branch Name: Bosuwn Date: 7, a- 1 L THD At-lionie Services,Inc. fir/ d/b/s The:Home 0cpot At-Hone Services J 345A Cm cnwoud Surct,Unit 2,Worcester,MA 01007 Toll Free(900)657-5182;Fax(508)7i6-8323 Branch Nurnhcr:31 1•cdcral Lll#'S-2dyS46b:tv1T;Lic#C U'L439;h1 Qont.Lich,ltit27, ,_.,,,.f,,. fCr Lic 4 HIC.05655'7;, Drug jrnpprtrvpmtnt contruuor Rcg-1126m. Installation Address: ! °' pa City State Zip Ptwehaser(s): Work Phone_ Home Pboue: Celt Phone: Home Address! (If different from Installation.Address) City State Zip E-mail Address(to receive project communications and Honte,Depot updates): ❑I DO NOT wish to receive any marketing emai is front The Horne Depot Project Information: Undersigned("Customer"),the owucts of the property low-tiecl at the above inrallation address,agrees to buy. and TUD At-Home Scrviccs,Inc.('"Tbe home Depot")ao ecs to furnish.deliver and arrutge for the instAPRtion("In.Gilation")of all irnterials described on the below and on the referenced Spec Sheet(s),all of which are incorporatrd into,this Contract by this- reference,along wick any applicable Stag Supplemerit and Payment Summary attached bowto nod any Change Orders(coitcetivety, "Contract"): Job#: I!Imduds• ;S,Lrre$hecUAl#: 1'ra ect Amount RouSu,g Siding indows Tnsulatjtm / $ _ .i (-J �j ,3 g 3}�„ []Guticc.![^.u��cr,• [Entry Doors ❑ Rootiag ❑Siding [ Wind-Z ❑Insulation I]Ggners/CAYCrS ❑fcnuy Doors Q - _ -:. Rootiu Siding Window77 s nag aeon $ (]Gutters/Covcrs L]Erirry Doors❑ _ ❑Rcx)fing ❑Siding ❑WinuOWS ❑rnWlalOn $ l . 0 OP15 ❑(iutler�l Covers ❑Entry Donn: ❑ MiumurnLIMDepositofCurutrntAnxxmtdueupuntx0uG[xiordricenntract TotalCualractAmount $ rt( ,!lain Pu cb est:rs tkv not depoeit more auto one third of ttte ContractAmDUaL pL Customer agrees that,immediately upon completion of the work Car each Product,Customer will execute a Completion Ceruf'rcate (one for each Product as defined by an individual Spec Sheet)and pay any balance due_ As applicable,tech C.ncrcnncr under this Contract a0reesto be jointly and severally obligated and liable hereunder. The Home Depot reserves the right.to issue a Change Chdcr or terminate this Contract or any individual Producl(s)iiiOuded herein,at its discretion,if The Home Depot or its authorized service providct dclemiiaes that it cannot perf0i0I AS Ohli�ations clue LO a snuctuu':ul problem with the home,cnvironmeaud hazards such as mold,asbestos or lead paint,other safety concerts,priein errors or bemuse work=19ired to complete the jub was not included in the Contract. plYtttcat gummarr Tbc Payulznt Sutn.mary;tom -.1—C�"=•included as part of this C:entract,,eta Furth the u?a1 Contract.,mount and aaymants required for the deposits and final payments by prodect(as applicable). NOTICE.TO CUSTOMER You are entitled to n completely fdled4n copy of the Contract at the time you sign. Do net sign a Completion Certificate(note. there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Produci k complete. - In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,tabor,expen es and services provided by"I'he Home Depot or Authorized Service Provider through the date of terrnilistion,plus any other amounts set forth in this Ag*eernent or allowed under applicable law. THE IiOI�tE DEPOT AIRY W1'fl3tfOi"D AMOUNTS ONY'ED TO THE HOME. DEPOT FROM THE. DEPOSIT PAy.vMNT OR OTHER PAYNF.NTS �lADI, WITH0(JT LIMITING THE FfOM> DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS, Acceptance and Authori;•.ution: Customer ao cs and understands that tru',Ae.ceenient is the enti-agreement hctwcen C'.ustomcr nt1 The—Home Depot with regard to the Products and Installation servic ,and Supersedes elf prior discussions and agrEcmcnts,einc�r prat or written,relatin-to Said Products and TasWiation.Thic Agr�ement Cannot he.assifrned or amended except by fl writing signed. by Custutncr and The Plume f put Cuslonter acknowlLu_and tgrces that Customer has read,understuud5,volu-aLarly accepts the terms of and has received a copy of this Agreement Sutra s (`l X Saks "LI, tant's St; lure Date C st er'S Si awre Date X Telcph neNu. Gustomc is Signature Date Sales C multdnt Licensc No. tag appiicnl;�e) C4N _EL^ L4Ti_UN: CUSTOMTR MAY CANCEL THIS y AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRI1'TEN NOTICE TO THE HOMF, DEPOT BY MIDNIGHT ON 'CITE THIRD BUSIIr'ESS DAY AFTER SIGMs G THIS AGREEMENT. TIIE STATE SUPPLEMENT ATTACIUM HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED IIY LAW IN CUSTOMER'S STATE, NOTICE:ADD.tTIONAL TERn/S AND CONDITIONS ARE STATF-"i)-'J"F AL iRSE S1Ut AND ARE nafiT OM"rIIIS cONTR.aCT wma-Sranch Ffls `GJJ0W-CuSWmef 12-27-10 GSC Td WUPT:S 900E 2E 'rPil TLZZE92909: 'ON XtiJ Pe6wei am, Assessor's map and lot number ' wwY��I� �� T Q�06 Sewage Permit number ............:......8.3....9 6J� dr..... 6 .. �,9�� Q� WITH' TITLE M5 io6��N�K, �8VAS�LE. s House number ....................................,. ...... . .................... ,` .iR ��� °o �e t v�3u ��vt s� }.1�i � 'EOtlAYA,- TOWN OIL DADNS"'"ADEE D � dD � 1D � �pDD�OLM f .APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ............. . ........ .............. � TCi THE'I'NSP EC' T0R OF BUILDINGS: The undersigned hereby applies for aa'ppeermit /according to the following information: 44 Location ......... ... ..�.........!- l.l�k�1...... ...............:........................................................................ ProposedUse ...... ...................... .................................................................................... Zoning District ....................Fire District ........ .......................................................... .... .................................................... ...... Nameof Owner ................Address.. ......... . .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ......... ........................................................Foundation ...........................,.................................................. Exierior .....*Roofin Floors ...........'C1' .................................:...................Interior ..... .............. ... ................................. 1�. � Heating .....................H........................................................Plumbing ...................... Fireplace ...................................... ... ......................................Approximate Cost ........ ...:. ... Definitive Plan Approved by Planning Board --------------------------------19________ . Area ..z.Py,6................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �Q I hereby agree to conform to all the Rules and Regulations of the Town of Bar t ble regarding the above construction. Name .................................................................................. F4-1 o is� 17 / 5 ✓ " SMALL, ALAN E. N. Permit for 25705 One Story .................................... P ..... ....... Single Family Dwelling ............................................................................... Location ....Lot...50 , 3.7...Elijah....Childs Rd'. Centerville ............................................................................... Alan E. Small Owner ... ................................................... ............ Type of Construction ...Frame............. ................................. .. .. ................................................................................ Plot ............................ Lot ................................ Permit Granted ......Oc.t.ob.er. 2 7 .......19 83 .... .. .... ............... Date of Inspection ....................................19 Date Completed ...........................19 q PERMIT REFUSED .................................................................. 19 ............................... ............................................... ..................................................7............................ ............................................................................... ............................................................................... Approved .......*........................................... 19 ................................................................................ ....... ..... . ..................... .................. OK "d, Assessor's map and lot number ........................................... • ypF THE Sewage Permit number Z.:`. ............. /� ��JJ y��� Z BARNSTABLE. i House number .....................................�..2..�?.-:;�...................., 9 ,"6 L 0�D CD�Q MOR a�9 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO r '............:................................................................................................................ TYPEOF CONSTRUCTION `..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a/ permit according to the following information: _+ .,� b ^ �n /' A Location ...... �..'.'t.....: ..C"�.........r. ,/ � .............'.:'{"--. ProposedUse .. + C. ., .................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner . .... ......!.................!....`......' ........................Address ...............:........................ ...................................... Nameof Builder .....................................................................Address .................................................................................... Nameof Architect ......................Address............................................ .................................................................................... Number of Rooms .........:.........................................................Foundation ............................a - r `-�' .. .................................................. Exterior ..................... .....A;.. t .............Roofing Floors '.................'...........`::......................................................Interior ....�::....�'::�::�... .......................................................... Heating ............. .................................0................................Plumbing ............ .......`..... .................................................... + y i_ s , i ) le—.01 E- ' c 0 Fireplace ................�.......................I.......................................Approximate Cost .................. .....::'.......................................... Definitive Plan Approved by Planning Board --------------------------------19--------. Area .1 Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. ti SMALL, ALAN E. A=171-275 No ..2 5 7 0 5 permit for .,One Story Single Family Dwelling ....................................... Location Lot 50 , 37 Elijah Childs Road Centerville ............................................................................... Owner ....Alan...E. S...m.a1.1............................ .. .. Type of Construction .......Frame ................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...Oct.ober. . ... . .2 7,........19 83 .... .. .. .. . Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ................................................................................ ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... .y o�TM TOWN OF BARNSTABLE 257_15 o Permit No. ----------___------------- • Building Inspector swn Cash --------------—------------= f �a■nr� Izolq OCCUPANCY PERMIT Bond ---_--------------------- Issued to Alan E. Small Address Lot 50, 37, Elij hChilds- Road, Centerville Wiring Inspector �"" Inspection date Plumbing Inspector ), �'r Inspection date Gas Inspector Inspection date Engineering Department /S r�^�,,��T Inspection date,,"' - Board of Health iK Inspection date / THIS PERMIT WILL ,NOT1BE 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 BUILDING CODE. (� n lz"fIL ........ p..........1 19 4l .�;......./.. .�A'.f.�� /,f f/ Building Inspector �..3, FROM:..- - TOWN OF BARNSTABLE" Mr. . Francis Lahte YneBUILDING DEPARTMENT "M STREET HYANNIS, MA aM Town Clerk Phone:" 775-1120 SUBJECT: FOLD HERE DATE - - Jan. 20, 1984 � � � .� . �tP4ESSAGE " Work teased . P. yF? (,fan _E.,.Small).; . - Please ee�,���"�S'�Ag44•�!r>r�s'w�e3y:e,���'��•e!��°.ism.....ir•��*, ' .. • SIG NE P i/r�S T`s'C dJ t �f PK 'fs'f DATE Cj1 R'EP1Y m - SIGNED N87-RMI < - :RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY PRINTED,I.N U.S.A.. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. pEs►c.► A I]ATA. ;1`SI0 LC- FAMtL"( - :5 Bnop_ooM fi�• I:1:Q GARBAGE (j¢a►.1D�rz360 I I - ; I. v�aL P1.0W .- .IIUx 3 - ?,3o6.Pp �5� { II 5EPT1G TA►JK = 330x15o'/. = �49iG,P. R �� /' •,Irl � ,; rI) _ U5E loo0 6AL . rf r __T , l So D%5Po5AL A944 5 DCv+�ALL AR.GA r4;c BOTToM IiQEA- !� 5 r o - : _ N r ; -,� 1. 0 5 N - TN S 4 .I� -To PESIG - .425 �OI.Lt/Di01'/O/�1 I r { 7oTA.L D,a►►-Y F�o�( 33oG.Pc? ti. »r I Ili PERGOLA-rIDIJ aAYE I'�IN ZMIN ot~LE55 i� • a7 1 l•'1� � r, � RiCHARD 2� �cs A. ALAN ° W. rn i I z I , fi v JONES % . A p No. 25100 0 F I 4 Qt8Tif i8TE - TOP FNo .3 laov - L'�'g a- D►ST. INd. CAL, 41 I { ` '� Y j, I000� I►Jd eUx �•L TANK . , e.,� 1 `• 41 1 LAY PLT - ---INV. _INV - ¢ I � _ VL r IJ�I 'WA LNG D ' Ct`RTIFICD PLOT PLAN P R U F I L4-T ► I r ,., NO .f>CA.LE 14 'DATE s o wAT�. EzeN CIE- f -.'I CERTIFY.; ,TNAT• 'TµE FOv�A4T/Ot) SNoWN j NERt~oW COMPL` 6 WITP -THE- S 1 PV-UW ;-aaT A Q P 56T CK (l_6 Ul2EMEN'1-� ' '(o art/N O F:5ArU 7I AfiSLa I LO'G f+.T E D W I T F►I IJ TN E F 1.O o D P L 1!mil DATE ��$ `(E I N C. I REGI gT6Q6-D'1.AWo'5uevRN6-- ' 15 P L 61 N1 15 Kj CYIT t3 N 5 r P 0►d A Ki O ST E 2-V I L L A -IuSTR�MENT ;v 'VE`( � "TNE n1-FSETS Suou� oZ- �. 1NE� APPL iCp,r-1T � �.