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0037 CRYSTAL RIDGE ROAD
39 ��i����� �dyrlr/ . �Tr Town of-Barnstable *Permit# Regulatory Services li ee 6mo�dhsfroiss date i + yMASS..A33�'� Richard V..Scali,Director Building Division Paul Roma,Building Commissioner mAY ®3 2011 200 Main Street,Hyannis,MA 02601 www.town bamstable.ma.us Office: 508-862-4038 � �'�i a "50 - 0 6230 EXPRESS PERMTr APPLICATION - RESIDENTIAL ONLY Not Vand without Red X-Press Imprint Map/parcel Number D5�:O b Property Address* �� S t7- � Residential Value of Work$ Ll Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 1 Contractor's Name IM Telephone Number 50 �1 Home Improvement Contractor License#(if applicable) Email:Z-O ZOL• C Construction Supervisor's License#(if applicable) z ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner joq have Worker's Compensation I=ance- Insurance Company Name Workman's Comp.Policy# P w C.. W Z��j Z� / - Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof). 4OKe-side ❑ Replacement Windows/doors/sliders.U-Value {maximum.32)#of windows #of doors: *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-NWP=S\FORMSIbuildmg permit formsTEXPRESS.doc Ol/25/17 HM CGWAMrweal&qfmassa&ayetls ��asl��t cr� r�strraf l�ccid�rtr . fl�rce afters• . 600 FfTashfilgt=Sheep Bastin,M4#21H iPFPiv mmxgov1dfa Workers' Con3pensaffan Iusurance Affidavit:lgmlders OantractarslEle+-hicianslplmmbers Applicza#lufarmafign Please Print Env Tame Phow Are you an employer?.Checkthe appropriate bc= Type of project(regna ea): L❑ I am a employes wit& 4 ❑I am a geuw9 rust and I 6. ❑New cc=kuaEoa emplloyew(fall.a=for pnt_ime).* 1mve lziredffm sub-cosftacfam Z.❑ I am a sole pmpdotor orparbaer- Yis cl 01"lle attached sheet: ?- ❑Re— deHng, 4 and have no eoxplafiees. , These seb-ca*ad=have $ ❑Demolition wading forme in any capa6idy. �a�aad have warms' 9..El B•nildiag additiaa INN wadon&Camp-iasuraace Camp."=.'. 1 • re;e&l 5.❑ We are a imipomfi=aad ifs 14.0 Ewhical repairs ar add Eoas 3.❑ I am.a homrovmer&kff aII vet officers have �*r*�ed fim=sr ' ILQ Flambmgrepai=or additiams o wc�xb=' of a meinr6o per M-GL �- a y - c:M§I(4�=dwe have no I?El lioofrepais employees-[NO WD tars' aEl other comma insutxmm mquire&] •Any.gpffcwt9scd3aclx cxflmastalso porkyin5-119— # vino submit dos�idu` siey s¢etlaio;agwa�t�ddzen�aumd�c�crosamst snhmit:near affidaait'tadia MCTL ICa�aif�tebedcihts bea nmst�che3�taaddisi�al slxeei sbaxiIIgt�tn�of the sub-cavlsth��d st�etdzether ormtfhnse e�shsee . Meyers.Ifthesn�tts3 ace empr cbey�sspmu�ae rs Roma•gyp.ge&�»vmbez I am act saiplaysr fiiaf isgrauidirrg yvcrkers'cat�rtsafiatt arszirartca far ac;�etrtpFaJ�ees BeTvrP is tlts pricy ruzd jc8 spa infornudiaa, . IasUMUce Company ibalme: 'PcFficy 4-Cr Self-irrLJUc A aI}ate: Job Sit�Address_ Cityl5tafetp: AtEach a-mpy of fm worlmrs'compensatiQapoIicy declaration page(showing the policy number and ezplrafron da4 Fw-l=e fn secmm coveeage as requiredua&r Setting 25A of MO-m lr-c2ta lad to Sic imposifie=Gf cumistal penalt%es of a fine np to$L,5ODOa asdl'or one-yeisimpds=ment,as w&as-ciO p—m'Kes sa fire form of a STOP W01M f?BDEltand a fine of up#s. DU a clay ab�amst fbe vinlz�or. Be advised'fbaf a copy of fhis.statrmea t saaybe fi�wazd'ed fa the Mie of luvestirpatians of le I?-TA fcc hm mee coverage+ .aa.. 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Paul Roma,Building Commissioner 200 Main-Street,Hyannis,MA 02601 www.town.barnstable.mans Office: 508-862-4038 Fax: 508490-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf in all matters relative to work authorized by-this building permit application for: (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. Signature-of Owner Signature of Applicant Print Name Print Name Date QYORNMOWNERPHRMISSIONP00IS Town of Barnstable Regulatory Services ptr tbr._ Richard V.Scali,Director Building Division swmver.�s. = Paul Roma,Building Commissioner 039. & 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 MALC.ING 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 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- f unily dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one 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 all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"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 homeowner 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 that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack 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 last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFHXS\FORMS\building pemut fomu\MTRESS.doc 06/20/16 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR �_a, ' .; e: Registration. 4,15971 Type: Expirati 9WOR&8 DBA R.J.HAMEL CO. ROBERT HAMEL � `'"-''�� V 1y.:! PO BOX 543/74 DEP10'ef, CATAUMET,MA 02534 UndersecretarY License or registration valid for individual use before the expiration date. Of Re of Co If found return to: only 10 Park nsumer Affairs and Business Plaza-Suite 5170 Regulation noston.MA 02116 r - Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-098778 Construction Supervisor Specialty ROBERT J HAMEL 74 DEPOT ROAD BOX 543 r4} CATAUMET MA 02534' a Expiration: Construction Supervisor Specialty Commissioner Restricted to. 05/06/2019 CSSL-RF-Roofing CSSL-WS_Windows and Siding Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: Wyyyy MASS.GOV/DPS i' 1 SloING PROPOSAL, Hamel Roofing R.J. Hamel PO Box 543 Cataumet, MA 02534 (508) 563-6092 CS SL 98778 HIC 115971 Jc.r�2� ✓-�Ul lr.�Q'�I�- Sophie & IwaAc-PdNTRUV ch _" 10/22/14 37 Crystal Ridge Rd Cotuit MA 02635 We hereby submit specifications and estimates for: Garage ' Strip approximately 500 square feet of siding. Apply Typar House Wrap and new splines,if needed. Re-sidewall using Waska Extra white cedar shingles to match existing exposure. All face nails to be stainless steel. $3,500 First Floor Deck Right Side above window - Strip approximately 75 square feet of siding. Apply Typar House Wrap and new splines if needed. Re- sidewall using Waska Extra white cedar shingles to match existing exposure. All face nails.to be stainless steel. $525 Second floor above deck Strip approximately 350 square feet of siding. Apply Typar House Wrap and new splines if needed. Re-sidewall using Waska Extra white cedar shingles to match existing exposure: All face nails to be stainless steel. f $2,450 We Propose hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: - Six Thousand Four Hundred Seventy Five Dollars, ($6,475) ' Payment to be made as follows: $3,000 in advance,and $3,475 upon completion All material is guaranteed to be as specified.All cork to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications r= 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 delays beyond our control.Omer to carry necessary insurance.Our workers are fully covered by Workman's Compensation Insurance. Authorized--- - - ' Signature Acceptance of Proposal —The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the Note:Thi(days. lay a :?wn by us if not accept within work as specified.Payment will be made as outlined above. Date of Acceptance: ^ ' Signature Signature ACQ® DATE(MWDDNYYY) /A L7 w �� CERTIFICATE OF LIABILITY INSURANCE 05/06/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER' CONTACT Cynthia Holland EASTERN INSURANCE GROUP LLC a/co"N E, : (508)620-3342 a/c No: ADD E-MAIL choliand@easterninsurance.com 233 WEST CENTRAL ST. INSURERS AFFORDING COVERAGE NAIC# NATICK MA 01760 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURERB:, - ROBERT HAMEL INSURERC: HAMEL ROOFING INSURER0: P O BOX 543 74 DEPOT ROAD INSURER E ° CATAUMET MA 02534 INSURER F COVERAGES CERTIFICATE NUMBER: 50873 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 013 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. _ INSR TYPE OF INSURANCE ADD_WVQSUBR POLICY NUMBER MMIDDIPOLIC EFF MMIDD POLICY EXP LTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 'MED EXP(Any one person) $ N/A PERSONAL BADVINJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JECTPRO ❑LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) , $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ - HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N s X STATUTE ER H ANYPROPRIETOR/PARTNERIEXECUTIVE '` - :E:L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? NIA NIA N/A AWC40070259242016A 05/13/2016. 05/13/2017 - - -- (Mandatory in NH) E.L.DISEASE'EA EMPLOYEE $ 100,000 Ives,6escribe under - - SCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for,benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationfiinvestigations/. Sole proprietor has not elected coverage. z CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN• Town Of Barnstable - BUllding Department ACCORDANCE WITH THE POLICY PROVISIONS.. ; 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02061 Daniel M.Crcyey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved.. ACORD?5(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Print Form Department of Industrial Accidents` , Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individua): 46kv Q �h ; Address: -No )L,, S`,t J O LS�7 � I City/State/Zip: pT Phone#: 5 v� 5" 1 .Are you an employer?Check thg appropriate box: Type of project(required): v 4. I am a general contractor and I I am a employer with _ _ , ❑ 6. ❑New.construction-. employees(full and/or p -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 hate workers 9 Building addition [No workers'comp.insurance comp.insurance.+ required.] 5•❑ We are a corporation and its 10:❑Electrical repairs or additions officers have exercised their - 11.❑Ping repairs airs or additions - 1.❑ I am a homeowner doing all work � myself. [No workers' comp. ` right of exemption per MGL epairs 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have _ employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. , Insurance Company Name: Policy##or Self-ins.Lie.#: AwC S_ LA -2-0 1 A- kk Expiration Date: j y S �/ t nSD- Co TV% Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration e). 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to'the Office of Investigations of the DIA for insurance coverage verification I do herebv certift.,under the pairs and penaIdes of per' ry that the in formation provided above is true and correct. Date:_.._ - ------ --- n Phone#• - Z 2A4� Official use only. Do not rite in this area,to be completed by city or to►vn official City'or To«-n: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i c 1 �s s90 9'j0 r� O �o O� �6 �x _ LOT 11 45, 162 +/- SF (1.04 +/- AC.) 2A V0 86- 59-C-11 CERTIFIED PLOT PLAN LOCATION : CRYSTAL RIDGE RD. COTUIT SCALE . I " = 50 ' DATE : 06114189 REFERENCE : LOT 11 LCP 23747-8 PREPARED FOR: I HEREBY CERTIFY THAT THE STRUCTURE BAYSIDE BUILDING CO. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. IH Of JOHN �yG� down cape engineering inc. I ULWEE CIVIL ENGINEERS LAND SURVEYORS �JU�tlE 14 1IV9 RTE 6A - YARMOUTH, MASS. DATE R psi A t'OR "•,^'t -•.%rt.`��,y�tig, d �,.t1..3�• "e.SF} ';.... , a �1. 3.-kr'coy�B UI�_ DIN � P`;'':.- - Noll N'OF BARNSTABLE, MASS ACHUS.ETTS � ER1M111 c>.--•O U"'..�V Z1 � 19 �L� .I 'k$ .12477 '�x - DATE ,ILll.lr: 1� PERMIT NO. APPLICANT;01dIZG Y' ADDRESS Ij l ri'_C'tr� �� •�low (�W��, INO.), (STREET) ICONTR•S LICENSEI PERMIT TO dUild U1rJ:.`iliri i (�_) STORY"]11)( lt3 F'ami lv I)wE::I 1 in,r NUMBER OF DWELLING UNITS,- . (TYPE OF IMPROVEMENT) NO. (PROPOSE USE) AT (LOCATION) LQ �;1 1 _ 37 Cry 71-•a 1 I?i r'lr ZONING ; • ��� CCltLilt DISTRICT — (STREET?' (STREETh 7 .. BETWEEN ' AND _ y (CROSS STREET.); -;.(CROSS"STREET) SUBDIVISION LOT, , LOT,' BLOCK SIZE' I BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT,.^IN'HEIGHT AND SHALL CONFORM IN CONSTRUCTII TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION ' .. (TYPE) REMARKS: �fr�l+/iiCJC #89 2�2.. Bond AREA OR x VOLUME- 19cQ 3(I f,t. ESTIMATED COST 250 I QUO• QU PERMIT . 173 UO' } (CUBIC/SQUARE FEET) FEE OWNER 8" /L",ido oi(ILI Co t { BUILDING DEPT.95 celt,a-vil , i f�ADDRESS B THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY c PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED-UNDER THE 'BUILDING CODE, MUST BE A {` PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY OBTAINS -FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE. OF ANYr,APPLICABLE SUBDIVISION RESTRICTIONS. CONDITIOI Y MINIMUM. OF THREE CALL INSPECTITI APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE' SEPARATE' NSPEONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN FOR ELECTRIERMITS ARE REQUIRED P . ALL CONSTRUCTION WORN: ERMITSJ AR PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANrCAL INSTALLATIONS.;. 2: PRIOR TO-COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINALMEMB INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. • - 3. FINAL INSPECTION BEFORE " ..` OCCUPANCY. „• �..,.;.., . PO T THIS CARD SO IT IS VISIBLE FROM STREET BUIL JG INSPE I N APPROV PLUMBING INSPECTION APPROVALS �rf ELECTRICAL INSPECTION APPROVALS 4 1 � � 70 c 3 HEATING INgPECTION APPROVALS ENGI'EERING DEPA TMENT a I ,i OTHER 2 ' BOARD OF HEALTH `. WORK SHALL NOT PROCEED UNTIL THE INSPEC• PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIDUUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION, ARRANGED FOR BY TELEPHON PERMIT IS ISSUED AS NOTED ABOVE, L3 OR WRIT'I NOTIFICATION. I j TOWN OF BARNSTABLE Permit,No. ......3.2977 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash Y i6jq v ��our HYANNIS,MASS.02601 Bond A CERTIFICATE OF USE AND OCCUPANCY Issued to BAYSIDE BUILDING COMPANY Address lot #11 37 Crystal Ridge Road, .Cotuit USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 25 89 ............................. 19................. ; ........... Building Inspector 17 ��P�o ` '°•.w TOWN OF BARNSTABLE BUILDING DEPARTMENT = IAIlSTAU : - - TOWN OFFICE BUILDING - - rua i639' � HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has. been issued for the building authorized by Building Permit $ : �. ........ ... ................ ............. ... ..... .... .... issued .to .............. ..........:................. .................. ............::. .......................... _ .. ...... ._._.� �. Please release the performance bond. I e? 1 . t i 00, 7BA`(SME PSUILOING Co1Nc .. CENTE2VILt_.E //SASS• Iia•a P.cr zs Au se �o •�` � ��i AP¢96 ¢ems 4uf-eb. Ff20NT ELEVATION UNIN MF 1 EB _=j r=.. Al - - - -- 1111 I I - -.- 1 7 BAYBIDE BUIL.71NG Co 1"co . CE NTUP-%J1LLE. ..._ /AA95.. Ile 6 AuC. A V R. U.beB REAR- ELGVA'T.IQN_ 9 B--I -1 cp-1 —I - - -- I I I I t I ]IF JLACI c ��ILI IF7;E: BAYSICIE BUILDING-Ca'ING. , I I ( I 1 CENT,ER�/II..LG /hA95. I ( I I I SIDE ELEVATIONS. • H` I ']•JOoq p6GK �•R/.I�.• s 1 9`.o`• I-o- I B`-O. ' e'-to'�Y d,_ioT�„' Ella• �`.��••. . :. Y 91.1 uN1T a•o9 a ai5 l� 3}A6S I/IJYA. � '4 ild r�•d/ai o I 1i 4 ,T N 4 d4. �V�w i iAwG a tso..00 oil -=- _. I S�t11 D -�I ..^.•_ I�_ I- .. aY(RQ.MA,do wpO.lt iSecLlor.�_. +t P. OAS O' DINCTTG I w I ® ® ® ® s 41 I rvs r' P,nAK -PICO man, oAK FLa7URCyC�NT IJ A" Su y IIN3O�p I yttf7K•��iI 'S/FOL JF�.�ii r�S<`3C•�'¢11_-.:41VI'G-Tv'G 1T4 R•'Yo IaG.'Kf�. TM.•4 I(I L- 1�4. '' y �1I 1��•"'��I 4'�f� �` `I'IIIII,,�•�, -_aO '✓�_^�i_•'�4 - b_- TC4R RCocNa rueoCaAsR�Plti C- TSTca. . WS-Ie IL i IN1 U A"REIWF tGNc. 4t.A.4 LwW4 AooM :Pmcw -L- TD DOOR-j. cAR7&-T " -.2 I� CN.AAIL WAIND AAH u 9"M fn-bIN4 Lt7L ,- - T•V :I jai .. f J! cif oi/er '•tea/8• .o e • I :• •o -- 1't M1 I 2Y♦<�. aVft I I I ' rOv R I � ' I 1 Z7 rT ►a •q O 104 r'Gy I ' I V- PA Al?SII7E FbuILnING c. Illc CEIJTE-RVILL-E /^A3fa. • I +e ld 11 auose. • R®6 2ev 4 dab 88 - F-IGzs�• FLooFz- �L_�a.N• 88-1 . . _ 1's'•o• 1S'.o• IA'•o• I �— �-. . I C 9S p 41� TPO 4 ` T►b 4 9.1,/i 5�1'B� - - _.._.. - — J�4•o./ti... T_���s14.o`/L 4'•Yy,f+ 41•oh��� f-e v p 1 I r � �o+l � Cw.� J. O++ a O t��l.w0 �t•d�4Tv5 ®1 f�'I --- ,.�wst.. 1i V S 14'4'• �,•p" � r:<<4 0 �:TRb 41 '•+ ,ITPs d i 'P wry : ® �, �•cJ•�ro2oow+ 2 --iL;0. 496 4-11 L' CAq/LT qq TV.. Q' I• m ® ,I VIP M " /A alsT G2 SUITE-- NO 711 1 .. . ......_._�_.. . I ® - I Vdooa -- �' fnTwepa�c-• ir CD ... ro II 0Li CAM -aTUOY_Gua:�. g _ C Aypd-r .I CT 45 'i914r.� � a4�1 6r►4 .,.• - I-- I I cASLN 0 b7 S1 as . I Q St • I __ �.� tb�2.l Yt ZI AWtN`T-1 � -r .sr cZ 4.rVi I ; -,t'.B• B'. �'-s'. 4'-60 ; ��.On 1,-`y., {UP to,!) 8 a.- cl I :.:BAYSIgE BU{LOING C:oIwG•` _ CENTERNILLE /AASS. _ � �/4•c :� 2�l Au4 HB P fL 8 r[£vdq (a SECO140 Ft.00R- PL&I 1 II t3. i m.. ZS.,o- 1f3•m• 60. j Ir tIo.. I 12 wq.L-�t. I Pw. a oeo I w P I I wn pocuppeT w aHD 9'/a't_w�w uj,n -j I I „RauNO.ACC .Y 19� OOTI Nbf v im- - �- 9 �t(o•Y 10':COA7G.'FOCI-r t.Nl�•s -a+ I r-- a 241.0" 'bQ•-o•• -__ 1B-cr 80•o., �SAYSIGL ewit-OtNCs 1•m WG. CEN-TEIZVILL6 /NA95. APR ge, BASE//�CNT- FGUN�A.Tt01-l' Ae.-I w aA s office (1st floor): yy� Assessor's map and lot number . �i.l. p..-J~6 .. A Ole Y �piTHET�`♦ UST EE Q Board of Health (3rd floor): Q g . � ���' IN �� a Sewage Permit number .............. .............:...� .:..a......... *�' � r LIANC 2 13AMTADLE, Engineering Department (3rd floor): � � EwBR •,,�.e Jr 'oo "6,9• \0�° House number .......................................... .7. ..:. .. r a ` p CNMEHTALCODE,q�yD �oMa Definitive Plan Approved by Planning Board.----,-��_� 1 --_-_--- `1goff._® REGULATIONS APPLICATIONS PROCESSED `8:30-MO 'A.M, and 1:00-2:00 P.M. only TOWN., OF . BARN-STABLE RUILDING-.1. I'N•SPECTOR APPLICATION 'FOR' PERMIT TO D� C� TYPE OF CONSTRUCTION' .......:...4.W 40.1O.... rRl9ln e . .1..:..-..�9. � TO'THE INSPECTOR OF BUILDINGS: The undersigned-.hereby applies for a permit according to•the following information: Location ....;... ..D.7........��. C(R Y57114- X l D .6 E AD — G07v!7_................................ Proposed Use•...... /l/..G� ......................................... ..... ...... . .......... .................. F �o7v�7 Zoning District ........ .........................:..... .................... .......Fi.re District /3�} 5/vt; >3LD CD D Name of Owner .................. ................................:P....... .....Address ...A. � ..... ��x. ��. .C,,.5..�..y.9 �/ufL Name of Builder ..: .... ......... .1....:...:.......:........ ...Address jl....................:. D Name of Architect . '.....X 14A/Sv � Address ...... �.47l1 I r Number of Rooms ....... � 9�b�.1 ....Foundation .' lJ/2,E/�... cs .!i/C% F� ... Exle6or. CI-19P�.� R �: 1 �� .�......... .......Roofin 51' s9� 7'' 9 qL n. .. Floors QJ9�`. `lL �/}/�� 7.. `.I �L ......Interior ...PIN .... ....( YP6U/Y/ . . .......... .... /► ...........: ....... Heating CO.r95......I�U-T.....U/'1'� �2...:.............:..........Plumbing (/C 1` C'O!°P�/�'.......... a2 a /jft7�tfS Fireplace CD!vC/e %T •:.• COG•! •••g- ..P�.ie /G/ ••;,••Approzimate.Cost .....o?S®� // ...... .... Area l" .. Diagram 'of Lot and Building rwith Dimensions Fee .� .......... OCCUPANCY PERMITS REQUIRED FOR''NEW DWELLINGS .I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the-above CO • construction. f ..�......�.y�...........Name ... ....(�..-.....E.�...li.z. . ............................ Construction,Supervisor's License .... / J. BAYSIDE BUILDING CO":,` 32 •....... •.Permit for ...Two• StorY......••. Sin le FamilyDwellin • ......J............................................g....... Location ..Lot #1.1.........37 Crystal Ridge- Road' k " Cotuit ............................................................ ' Owner ....Bayside...Buildin.g...Co........... _ I Type of-•Construction .Frame i ..... .. ........ ........•................................... ,- - - `fir " - .. ♦ .. - f** Plot .....,,..................... Lot ................................ Permit Grdn`ed� .,.June...X-At..............19 89 Date of Inspection ....... — " Date 19 Completed .... r� , .ft... .. Z- . . 4100 • ,.g.��+'.'v»��+:F:;sr.524(w7�i�f�.tit-;�'iwia�Y`k.--+,..t�'�2�' s"�'':;.�'�T, nr9i+'�k *FCrl'v'�d++s7 '�� ��w^JI'$$5C4'L1:�¢'BETy"p„e`-i�:�c•'i�;'�SiS��.il�.i±�{° e�+d%'a-;�' S-.i.F Assessors office (1st floor) r ���� T = " s e OFTNETo Assessor's map and lot number ... ........... ?.ram'...:............. a� a ,' T �j `` S Q� Board of Health (3rd floor): ;vg '.� o Sewage Permit number .................................� ................. Z EARISTADLE,a Engineering Department (3rd floor): 4k MA°a 3 -7 i Op t639- 0� Housenumber ......................................... ............./....... /.... Definitive Plan Approved by Planning Board ------- __�_ ----------- 191----- APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....'�....::5.111-lCa/-F- IC r9 f/0 Z- y ��.S /b e A1C e .......................................................................................................... TYPE OF CONSTRUCTION � 0 `1q. I ............................................. ....................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location � D 7 // Ce Y5 T' - l', / D 6 C �1a . CG)-TU 1.�....................................... .................................................................................. ..................................... Proposed Use ..... .......5 /vj��C— ............................................................................................................................................................ Zoning District '� Fire District ..... r...7U' T ................................... ................................................................. Name of Owner •� t/`� /. i3G-C�� �!� GJ �0 �� Lam.' V ,gX lJ'I LLJF Address ................................... .................�............ Nameof Builder ! t fr....................................................................Address ...�-.................................................. . ............................. ' Name of Architect ..�.......�n.'.`:..�... .........................Address ....... r Number of Rooms ............................. .......................... ..'....Foundation ..................Roofing ... ............................................................................ Floors � G/,'✓`IL / /:. F. ... :..!'.�L ......Interior ...!�� � 4` �Y1 IJ�A// .........E.....................�.... ............................... 45....... `�..! �,r/f17 � P/C CO P Pi:,� a a 819 rr�s Heating ...... .......................................................Plumbing .................................................................................. Fireplace o / TC..../�.L.O�. ...? .... . .� ......Approximate Cost ...... `>C�, (fVV Area .......................................... Diagram of Lot and Building with Dimensions Fee. ............................................. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ..l.... ... ... Construction Supervisor's License r'C..S .. .. ��....... BAYSIDE BUILDING CO. No ............ Permit for ....TWO...S.tary......... .......S. ngl.(�...F�LMjjy...D.W.el.ling......... Location .....LQ.t;...#ii.........a.7...Crystal...Ridge Rd. ....................C.Q.tuit........................................... Owner ....Aayai.de..Building..Co............ Type of Construction ......Frame...................... ..............................................................I................ Plot ............................ Lot ................................ Permit Granted ........ ..............ig 89 Date of Inspection ....................................19 -Date Completed ......................................19 of I. Town of Barnstable *Permit# Expires 6 iyondisftom issue date , Regulatory Services Fee -: LA BARNSPABLE, i .. 9 639; � Thomas F. Geiler,Director . �prfD MPS A . Building Division Tom Perry, CBO, Building Commissioner YV 200 Main Street, Hyannis, MA 02601 www.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not.Valid without Red X-Press Imprint_ Map/parcel Number7� .Property Address Residential Value of Work E 'Minimum fee of$35.00 for work under$6000.00 Owner's Narne & Address j Z„ o V 7-r Contractor's Name i `7:s Telephone Number —~p-? L�� Home Improvement Contractor License#(if applicable) � ) Construction Supervisor's License#(if applicable) _ 9 3 7� X h .. pry i, s Re T ❑Workman's Compensation Insurance Check one: Fr -- 8 01, ❑ I am a sole proprietor ❑ I14n the Homeowner4l�( 7 gf��l` %�1L have Worker's Compensation Insurance Insurance Company Name A< _r- Workman's Comp. Policy# .Z� 5 �- 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 O �✓'01 e ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side Z / #of doors Replacement:Windows/doors/sliders._U-Value (maximum .44)#of windows *Where required: Issuance ofthis permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. . ***Note: Property Owner must sign Property Qtvner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: tWPHLESTORMS%uilding permit formsTXPRESS.doc Y.:..,.,J 07n t In The Commonwealth of Massachusetts c >^i Repartment of Industrizrl Accidents ;, Office of Investigations 1ju600 Washington Street Boston, M4 02111 t`}� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): {M.-CI Address: City/State/Zip: CA.--r ,,m g r- m y . o zs,.f hone #: S t3� 5��� 17-4 Are ou an employer?Check the appropriate box: Type of project(required): 1. I am a employer with t' _ 4. ❑ I am a general contractor and I ❑ 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its. required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4),and we•have no 12.MpRoof repairs insurance required.] t employees. [No.workers'- 13.0 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C 6 S Ts:-R /� Policy#or Self-ins. Lie.4: C_ _ -L 77 Expiration Date: S I3 Job Site Address: l !tl S 7t/ 71K I-P -o City/State/Zip: C.Ty i M 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 under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: V 2 2 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#: s Information and Instructions Massachusetts,General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and'who resides therein, or the occupant of the dwelling house of another who employ's persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or.to construct buildings in'the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall , enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out .the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact.you regarding the applicant. Please be sure to fill in the permit/license number which will be.used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department,of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia ® DATE(MMIDDNYYY) A�o CERTIFICATE OF LIABILITY- INSURANCE 10 '7 2010 PRODUCER Phone: 508-651-7700 Fax: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC. - Main ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Natick MA 01760 INSURERS AFFORDING COVERAGE NAIC# INSURED - - INSURERA:Geminl Insurance Company Robert Hamel Dba Hamel Roofing INSURERB:ACE USA Po Box 543 INSURER Cataumet MA 02534 - - - INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE.FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR TYPE OF INSURANCEA GENERAL LIABILITY VIGPO12116 5/13/2010 5/13/2011 EACH OCCURRENCE $1000000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100000 _ CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 0 0 0 0 0 0 7 . X POLICY PRO- Ll LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO - (Ea accident) $ ALL OWNED AUTOS - - - BODILY INJURY _ SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE- $ OCCUR CLAIMS MADE -. - AGGREGATE $ DEDUCTIBLE - $ RETENTION $ - $ B WORKERS COMPENSATION C46294579 5/13/2010 5/13/2011 X OCYLIAT OER AND EMPLOYERS'LIABILITY. - - ANY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT - $100000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) i. E.L.DISEASE•EA EMPLOYE $100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $5 0 0 0 O 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONSWIWI - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE Gordon Waring CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO 57 Old Forge Rd SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON 57 OS Hole MA 02543 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE. 7�l/�vU.'is�aJ ACORD 2&(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1rRT0T0 'rfTi 'Tn • Hamel Roofing R.J. Hamel ` PO Box 543 . Cataumet, MA 02534 (508)563-6092 CS SL 98778 HIC 115971 Sophie Markovich 508-419-1551 10/21/10. 37 Crystal Ride 585-309-2711 Cotuit, MA We hereby submit specifications and estimates for J Strip approximately 3,332 square feet of roofing 8rr white drip edge along rake boards. Apply ice &water barrier to first three feet of bare roof deck. Apply synthetic roofing underlayment to rest of bare roof deck. Remove and replace all vent flanges. Strip approximately 200 square feet ofcpslar siding at garage/main house transition to allow for new flashing. Residewall, using Waska Extra white cedar shingles. Remove and replace torn'chimney flashing. Roof, using GAF/Elk Prestique lifetime warranty, algae resistant roof shingles. Install ridge vent. Remove all debris from_job site. Roofing $13,328 Chimney lead $300 Siding $1,300 $14,928 We Propose hereby to furnish material and labor—complete in accordance.with above specifications,for the sum of Fourteen Thousand Nine Hundred Twenty ($14,928) Payment to be made as follows $7,000 in advance, and $7,928 upon completion AD material is guaranteed to be as speMred All work to be completed in a workmanlike involver extra og to standard practices Any n written deviation orders, and ill l above specifications nextra ` involving extra costa will be executed only upon wmlen ordare,end twit became an exlre charge over and above the estimate AN agreements contingent upon stnkes,acodants or delays beyond our control Owner to carry necessary insurance Our workers are u( .... _ covered by Workman's Compensation Insurance - Authorized Signature Acceptance of Proposal--The above prices,specdicstlons, and cowsbons am satisfactory and am hereby accepted.You are authorizes to do the Note:This proposal may be withdrawn by us If not accepted within _ work as apsaeed.Payment will be maids as outlined alsave Date ofAcceptance: V days, Signature Signature e � �1ie -�o•nvn�.a�.zurea/,C/ o�,/�aaaacfzuaella � _. ':� License or registration valid for mdividul use only r Office of Consumer Affairs&Business Regulation } g `s before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration 115971 10 Park Plaza-Suite 5170 g Expiration 5/4/2012 Tr# 294524 Z Boston,MA 02116 Yp a� R.J. HAMEL CO ROBERT HAMEL �.- 1 } PO BOX 543/74 DEPOT RD CATAUMET, MA 02534' Undersecretary � � of vali ignature +-- Massachusetts- Department of Public SufetN Bound of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 98778 Restricted to: RF,WS ROBERT HAMEL 4 DEPOT ROAD BOX 7 543 < CATAU MET, MA 02534 Expiration: .5/6/2011 Tr#: 98778 ' ('nnmissiuncr t r� .. StD� 1 r, �►!��It-1rcE1? G, 1 auk ts�ri i 4P6 7-4 11bg q N> MUN �q \ 1, D4TU t t t4s I'-ZLY-S 1 r-P_oM t s&,,i nn-ru tT©LtAt7 , \ j I Z_. MU"lG►POL Wn.Ti✓2 �S b.VO.I11�3,>✓ , ? 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