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Home My WebLink About1031 WEST MAIN STREET �� 3 i �t1,�s�� 'h,��✓ S?,� �. ALTERNA WEATHERIZATION Date f Town of Barnstable Building Division 200 Main St. H annis MA 02601, The insulation/weat w herization ork has been completed and is reap r>i� p A# ;!dui ,•,4't; "d a. .r. Me �; -Timothy CabYF�; President 58 DICKINSON STREET I FALL RIVER,MA 02721 J (508) 567-4240 J ALTERNATIVEWEATHERIZATION@GMAIL.COM _ '2 ALTERNATIVE WEATHERIZATION C Date �. Town of Barnstable Building Division 200 Main St. Hyannis, MA 02601 The insulation work ath• � �' _ has been `a��'r _ _ - ,•';.,;,.-;�,:.,:� _. com leted in acco. "Y i O r.-ls.: h 't Ca President CSL I05454 U! 58 DICKINSON STREET I FALL RIVER,MA 02721 I (508)567-4240 I ALTERNA VEW'EATHERIZATION®GMAIL.COM 4 =I j Is{�f Town,of Barnstable �tHE, Regulatory Services qw gyp'' do Richard V. Scali, Director &AMS,AB Building Division BARNSTABI;E NT MASS. r` 1�4'RR510A5 LLS�JS1EA LLE &1iNTABIE 9q� 16,E ,0 Thomas Perry, CBO 163B4U3< �f01iA0rA Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 September 24, 2014 , Alternative Weatherization, Inc. Attn: Timothy Cabral 1440 Stafford Rd. Fall River, MA. 02721 RE: 1031 West Main St., Centerville, Map: 229 Parcel: 061 Dear Mr. Cabral, This letter is to inquire on the status of building permit application number 201400115. To date,this office has not been contacted by you in regards to an inspection. As you are aware, as the construction supervisor of record it is your responsibility to ensure all required inspections'are successfully completed. Please contact this office with an explanation and/or arrange for inspection Thank you for your anticipated cooperation in this matter. Respectfully, r L. L uzon ocal Inspector jeffrey.lauzon a,town.barnstable.maus (508) 862-4034 I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel CY4051 Application # c�61 q oo 1 1 S Health Division Date Issued dzihy Conservation Division Application Fee `J' �L Planning Dept. Permit Fee Ab Date Definitive Plan Approved by Planning Board OK Historic - OKH _ Preservation/ Hyannis Project Street Address plt /7 Village Owner /jq,rek, Address 40• 1174�4 J& Telephone -? Permit Request/`17/� `'-� CG /I;S. --��1 �'1�S i'c—� �� -FP(-/ �441T rellu se cv- / Y' Square feet: 1 st floor: existing proposed { 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 d Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (s, ry o Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new w Total Room Count (not including baths): existing new First Floor Roogn Countn 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 4 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name //'h Telephone Number ,Cho7—WIV6 Address �O " License# _ G �"� ! Home Improvement Contractor# %2JZf3 Worker's Compensation ALL CON TRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO F SIGNATUR DATE ". FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE `+ OWNER i DATE OF INSPECTION: FRAME INSULA -ION.i_ �'�.�k li t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING } DATE CLOSED OUT ,r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Pnnt Form Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 1:. www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Auolicant Information Please Print Legibly Name (Business/Organization/Individual): ALTERNATIVE WEATHERIZATION,INC. Address:1440 STAFFORD RD City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate bog: Type of project(required): 1.0 I am a employer with 8 4. 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 8. Demolition working for me in any capacity. employees and have workers' g 9. Building addition [No workers'comp.insurance comp.insurance.: required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.2] Other'NSULATION 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 insurance for my employees Below is the policy and job site information. Insurance Company Name:ACE AMERICAN INSURANCE CO. Policy#or Self-ins.Lic.#:6S62UB5B918901 Expiration Date:4/5/14 Job Site Address: � � ��T, City/State/Ziv(e- 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 certi uncle , ains qm416e�ah*fapedury that the information provided above is true and correct Signature: ,;- _ __ . _ __ Date ' Phone#:508-567-4240 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: _T xY; - a ACO d CERTIFICATE OF UABIUTY INSURANCE THl8 CERT�ICATE is tssw�AS A MTM Of:INFORl 9=ONLY AND CONFEN KO M�FR3 11 R THE COMM THIS CI:R11FiCATE OOES NOT AFFINAMMY OR NEGAMMY MBA Maur OR ALTER THE COYBtAGB AFF�tD�tiY THfi P011CIES F3ROVL THIS ATE OF INSURANfs DM NOT CONaTlT M A COITRWr BErWEEM TH6 FFtSUiNf.?WSURFiR(�,AUTFID REPREMMATWE OR PRODUCER AND THS CERZIPICATE HOUM.. Wnot contoXrrTtg-idataiaIIneWomewtl9de�ehooldgetm �.4 NatchPa �Y l � endors�tanl�sj. CWTACr VNSROS 94SAGE40Y M. ALL RNER MA 02T20 vauf0WARRMWM COVSPPM Nme IIi UMMA:ACmAad�CANaffiIRANC& aiSarwo YYSUA828t AVERNATNE WEATHERMki10N IND mac: 14a6 STAFFOPM RD R+g1A+ERo: FALL RNSR MA 0=1 at�rmsII: nto: 5.0ONTRACT CERTIFY THAT THE POLIt2ES OF WSURANCE LISTED BELOW HAVE BHEAI=JED TO THE"INSt�NAMED RTHEPOLCYpamoDHNDICATED. NOTWIfmANDING ANY Rmujts1 wr.TERM OR CONDtftoN OF ANY OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATH MAY 95 ISSUED OR MAZY PERTAIK TINS E AFFOEiDeD SY THE POLICIES DESCRIE183 HERON 16 SUBJECT TO ALL THE TERMS. E%CLUOMRSAND S OF SUCH POLECIGGL UMI TS SHOWN MAY HAVE SEEM REDUCED F3YPAID CLAM& trPeor wva so>sr vo,n.YOFF I i'oeteYan► IUlm �6gAtilAOLLtEY FAGIO :' S oae9u+.vAsnnr 7O s wane eAEDE7wpaer� s - usAovxnaor. ce► we a : Gi uwrAPPwPm S•eos+�onaao s IPQ=l I WTOMMMUMMT UDC I s ANYAITa Bt7011.7ufNRYF>'+'+od 9 �Csta?D AUMS8000.Y8'1AR?Pormoe�sJ B }�AtJiOS _ 9 . 111a111lAtAeJAB CCGfR EACHOCCLOPaCilB =MUAB I IcLiUMW01 AOFWM S aeo I spa s EMKO`A3e4LI BUTYAwpw x tORY4 gt cw in tror+� N RJA 6S62US 04.45,201E 044�l4 F1Epf,NALCtDElR 5t00.000 tm-%"'amq ' S8978901 ELDIAue-IR FOOD sy�+�'O1h°�0t Eton-vou�rurer 5100,000 FICATE o>s assemsneaw aeeia�►ttoltsJe,omt+oc�� o�ea+Aoorm�a.,maere�ma.�ms�a+aan�u�me.ta� SMOC ENERGY SERVICES SHOULD ANY OF THE ABOVE OEM= POLV ES BE MO HDWARD ST CANCELLED BEFORE THE EXP RATION DATE THEREOF �IN A0VM2 NOTICE: VVILL BE DEUtEERED IN ACCORDANCE tAglH IKE POLICY PRO1RSlON9. AtNtlol!® TATIUB IJ uPmodec ACORD 25 C10t01tt5? 'fie ACORD name Bad logo aw mWatmd otACORD i Office of Consumer Affairs and Business Regulation l 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 01 Home Improvement Contractor Registration Registration: 175683 Type: Corporation Expiration: 5/29/2015 Tr# 241009 ALTERNATIVE WEATHERIZATION, INC. TIMOTHY CABRAL 1440 STAFFORD RD. - FALL RIVER, MA 02721 Update Address and return card.Mark reason for change. Address Renewal J Employment scn� c, zann-osni ._ 1_ plo meat F-1 Lost Card C/ �G! I r�/IP 1GIIIIIII••NiI'oA/1 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 'SOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: �- Registration: 175683 Type: Ofl"rce of Consumer Affairs and Business Regulation Expiration: 5/29/2015 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 ALTERNATIVE WEATHERIZATION,INC. ,l TIMOTHY CABRAL 1440 STAFFORD RD. FALL RIVER,MA 02721 Undersecretary ; N tvali thout signature �Oa'd - im-itruction 5upt:r%j%,,,- _ CS-105454 TIM07HY CABRAL 's- 58 DICRERINSON ST Fall River MA 0'721 = - 05/08/2015 M " Town of Barnstable . oF�roil. . 0 -� Regulatory-Services mass.& Thomas F.Geiler,Director �' BuIding.Division Tom Perry;Building Commissioner 200 Main Street,Hyannis,1 A 02601 www.toWn.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usiri A Builder IG as Owner of the'subject property hereby,-authorize . /y!'1 to act on my.behalf,, . in all matters relative to woik authorized by this building pe=r it Vle (Address of Job). **Pool fences and alarms are the responsibility of the applicant. Pools- are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. w 5' tore_of Owner Signature of Applicant Psnt Name - ... , P t'Name Date sC Town of Barnstable Regulatory Services • searrsn SIX � Thomas F.Geiler,Director �Fo;A�►�0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner P �p wn r acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one P home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for aL such work performed under the building.permit (Section 109.1.1) The undersigned"homeownef'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements.and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. 'HOMEOWNER'S EXEMPTION The Code states that:''Any homeo—wner,performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1'1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware thai they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This tack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iast page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decoUikWppDataEocal\Microsoft\Windows\Temporary Internet Files\Contentoutlook\QRE6ZUBNIEXPRESS.doc Revised 053012 OWNER Au Ho " WIO FO�'ttNl 7 ,x (Owner`s Name) owner of the property located;at j f (Pro Address)' 11(Prop Ierty,Address) t CwG" hereby authorize Z (Subcontractor) an authorized subcontractor€or RISE E.4ineer rxg, to act on my behalf to obt:dima building, permit and to perform,work on my property., Owners signature Date u RISE.ENGINEERING' Pattern!il) 05 040i82S R1.Conttactnr Ra9ts!%atlon t�8186• . i�ivisign of ThieLsrti Engiseerit* MA Cortttaetcr Regl;tretiort No.124379 GT Cenact�sr negation No;6�f20:, 1341.:_Eliiiwood Avenue.Granstou,:Rl€f2910 �+T (401)784-3700 FAX(401.)784-371,0 )N-T RA Paige 1. PROGRAM TIilBCONTWACTf8ENS68ti0tTMiFt�tlSlc, ENGINE RING CLC-RCS of s�e u ci STOMM eu O."KAs .CWTOMER .. PNr DATE- CIIemS Christian;Boutiette (617.)620-0127 102'SL2013' 152019 SERVICE BTREET ..v,_.r.. BWNG-STREET: 1031 West,Main'Street 98:Brandeis Road SERVICE WY.STATE'LP - 8lt11kft CITY,8T7iTE.ZIP'.. Centervil;idi MA 02632 Newton,:MA 02459. AIDB DESCRiPT Provide!abet and inaircrals to seal aeeas:otpaur honwagainst ymiefnl:exems air feakage '[f>s wart:�v�H he pe formed in concert" with the.use of speciattoois and'diagnostktests to assure that your.home wi11 W left with a heahhf ii levetaf air exchange anti indoor air gtiahty.Mattatals to iie'used to seal}our home can inductc caulks,foams weaiherstri 'ing:and otherpTWu*. Primary ,. areas for sealing include atrliealage to ernes;basements;attacked .` and other unheated ar as{windows are not gages genetall}> addressed.}:,(1:6}Wrorl'ina:hours: At the compiled on of:the weatttesizatibn wort: and-at no additional o'the'homeowncr homed ,a final blower door andfgr egntibustlon safety ahl!ysis cvitl 'eonductedibv the"sub Contractor to enstire,16 safety afthe vfdoor,air;:quality 1.232.06 Provide laborand materials to iiistafl 0lon.wceilterstripptng o{!}t#oof(s as restrict air leakage: _ Provide labor and materials to.-instalt a f2"1 of R-38 unfacctl,fr , iris battx ta;(AU).syteare feet foi datum' aY� - ingpttrQases:; 5164 Provide tabor-and materials toinsteil a 12"laver oER=47 Ciass:;i Ceiiu)a5e.added to;(1344)squaw.feet 9fopen attic spare:. 'Prov[de:lahor:_and materials to.iristaU{I),cfstly ttlaved:insulatittg over for the attic accrss,'folding.stair A small:flat surface of plywood_will.:be'created.arotmd the OpenInA,witliin tiic,attic.-This will allow the covices.intcgrai weather=striQptag.to restrict*air. leakage: Provide laborand materials to inst�t!(1)'insiilated extiautt hose with-rooEmaunted flapper vent w.exhaust extatiri Bathroom farts):; Provide•labor and'maierials to install ventilattor►chutes i(72)rafter bays to maintain air flow.: : $25 1.28: Provide tabor and rnateriats to mate!!{10) °X its"rectangulaz aluminum soffit vents to incrcase.ventilation.ur,attic areas.$peetfy: .: color White :,g2g9.tQ' Provide labbrand•mtiteriais.to'instatl 70}linear fcet of R-l9 unfaced fib ass insulation tiisilie { periitreter of t3te'leiit cettutg atthc house,sill. $133.0U s RISE.ENGINEEKING Federst 0#01 , Rl CoWscUr fto No8186 A°4Wisiou of rhi0seh Engineering MA c6flbpi�91ift�N'420m. GT CoiTtraetor fiegisfraticr+#O'620120' 1341;E04991d Avenue;Cranston Rl 62.00` +� (461)784-3700 F4Ji(i011783 37:10 C N t RACT Page 2 R I S f PROGRAM TNIS:COtiTRACTis ENTET7ED iraroBEiIVEJ�i RtSE ENGINEERING �, Ttera?cFaR,rads ..CUSTOMER PPiONE ... OATS iGjmstµ: Christian Boutiette (6I;7)QN-4127` 1 t125 Qll 1,520,19 8ElWME STREET ;BILLING:-STREET 1031 West Main.Street 08 Brandeis Road SERVICE CM,STATH,W - .- 'aft RG Cm,STATE.Zip' ...- Centerville; MA.02b32 Newton,MA-02439 JORDESCRIPTION To*k $4�,"3.3.7 Program ltttierrtly� $ ;443,3.7 Customer Total::_ $fl,00 _ ,WE AGREE HEREBY,TOFURNMRSERVtm•COMPLETE IN ACCORDANG£:WITH ROVE SPECiFICATtOt4&-=FW.THE:SUW Oof Dollars. w . UPO?tFlNAL RdSPEl:TFO?1 AND ApPROYAL$Y R$E ERGINEERUtG:CUSTOlM1ER AGREES TO RE69T'AMOUNi OUE W fULLiNTE�-ST.OF LTi VALLBE.CMAROED>J.OHTRLY:OM AtdY UNPAID BAL tI AFTER l6 QAY&SEQ REVERSE FOR:tl16PORTANT INFOAS1ATiON:ON 6tMRASdTEEB,RK#ITS I pS.tOdV,SCNEntILINy'N4D;CONTRACTORYtEGDSTRA7I N, 99 NOT SIGN THIS CONTRACT I RE AttY 8 K PAGES AUTNOt=D$l,CNATUfRE-RSBE 8XPEERING CUSTOMER CE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY.US:IP.ROT.EXECUTED WITMN JE.�: DATE OF ACCEPTAtKE _ --. - ACCERT T-T#MASOVERRICES.SAEWICAUOWAND:COMMONS ARE. , SATIN, ANCE OF CONTRACT ACTORY TOU$AND ARE NET3PBYACCEPJED.YOti AREAUTNOR®TO 00:T1(E.VYORK UAYS.- - AS.SPECtF1ED.VAYVWT-U.BE,.MAOE AS OUT-W,ABOVE' . 5 T77, �' ,*I HE Ao Town of Barnstable *Permit# 2- Expires 6 months from issue date * snitxsrw8LE, t Regulatory Services Fee (HAM o0 9eb 1639. Thomas F.Geiler,Director A'EDN"rA Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 oe j40, Office: 508 862-4038 0 Fax: 508-790-6230 TO NO <000 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Feq Not Valid without Red X-Press Imprint R.S'TqN L Map/parcel Number Property Address Residential Value of Work Owner's Name&Addressr • S ,Contractor's Name 6Telephone Number Home Improvement Contractor License#(if applicable) PAW _ - Construction Supervisor's License#(if applicable) 4orkman's Compensation Insurahc,e Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name )JAUh ffih d Workman's Comp.Policy# Wl S Permit Request(check box)EA Re-roof(stripping old shingles) All construction debris will be taken to �'�U 1 Q Clll \1`E (A t ` �WIA ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *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. Home Improvement Contractors License is required. Signature Mark i`C.MI) Q:Forms:expmtrg Revise053003 Liberty Mutual Group PO Box 8094 .lCr Wausau,WI 54402-8094 =~ Telephone(800)-653-7893 Fax(715)843-2650 December 11,2002 TOWN OF BARNSTABLE BLDG DEPT 367 MAIN ST HYANNIS,MA 02601- RE: Certificate of Workers Compensation Insurance Insured: NICKERSON HOME IMPROVEMENT INC PO BOX 2476 ORLEANS,MA 02653 Policy Number: WCI-31S-318102-022 Effective: 1116/2002 Expiration: 11/6/2003 Coverage afforded under Workers Compensation Law of the following state(s): MA i Employers Liability: c Bodily injury By Accident: $ 1,000,000 Each Accident Bodily injury by Disease: $ 1,000,000 Each Person Bodily injury by Disease: $ 1,000,000 Policy Limits As of this date,the above-referenced policyholder is insured by Liberty Mutual Insurance Company under the policy listed above. The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not altered by any requirement,term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the policy listed above.- if this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. AUMORIZED REPRESENTATIVE LIBERTY MUTUAL INSURANCE GROUP ibis Certificate is e-tevAed by LIBERTY MUNAL INSURANCE GROUP as respects such nmrmx as is afforded by those con4mieS- cc..-Insured: - Producer of Record: NICKERSON HOME IMPROVEMENT INC PIKE INSURANCE AGENCY INC PO BOX 2476 PO BOX 1658 ORLEANS,MA 02653 ORLEANS,MA 02653 12ROV2002 L I� „E , r °F Town of Barnstable Regulatory Services BAMST"M r MASS.I E g` Thomas F. Geiler,Director 59. 16 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder • I, as Owner of the subject property hereby authorize K l CIA(Sb 0 b nv Q M�cp a mmf to act on my behalf, in all matters relative to work authorized by this building permit application for: main (Address of Job) Signature of Owner Date L a1'� T Print ame u Q:FORM&OWNERPERMISSION ��, fdWdP License or registration valid for individul use only Bo��c'�ot tso'i�c�°€ eguti a ¢expiration date. if found return to: S_ before the P s .� d Standard HOME IMPROVEMENT CONTRACTOR Board of•Building Regulations an - Reglstr One As hburton Pla ce Rm 1301 atfon: 13 1 _ Boston,Ma.02108 r , xpiratiori: '8/17/2005 nva aCorporation Type. NICKERSON HOME IMPROVEMENT MARK NICKERSON ��l-', 12 COMMERE DRIVE ��-" Not valid without signature ORLEANS,MA 02653 Administrator r a,.tsFt fa Y Y Mg k V. A? mg - $ cM $ : s<r Strip singles off entire roof Renail .ill loose sheathing Instal.l.;'8"r white aluminum drip edge on all lower edges Install ::ice & water shield on all lower edges Instal black underlayment felt paper on entire roof Install; new flanges around all vent pipes Install .ridge vent at roof peak over any living area for 0 per lineal foot additional to contract Install 25 year 3 tab shingles on entire roof using hurricane nailing All trash and debris will be removed and disrosed of properly All materials, labor and debris removal to above OPTIONS: To install 30 year Architect shingles add i to above To install 40 year Architect shingles add To install 50 year Architect shingles add above PLEASE INDICATE SHINGLE COLOR AND YES TO ANY OPTION ON RETURAD PROPOSAL To remove existing wooden gutters and replace 93 lineal feet of gutter and 6C lineal feet of downspouts with extruded aluminum WE<PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Cant R d dollars c$ C.:ont 'd Payment to be made as follows: deposit upon signing, progress payments upon reques-,, balance upon completion material is guaranteed to be as specified: All work to be completed in a professional All mate g Authorized r manner according to standard practices. Any alteration or deviationorder from above speafi an nature tons involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or Note:This proposal may be delays beyond our control. Owner to carry fire,tornado,and other necessary insurance.Our 0 days. workers are fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within ACCEPTANCE OF PROPOSAL—The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized signature to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: