Loading...
HomeMy WebLinkAbout0081 LITTLE RIVER ROADor S4 b AWE� Town of Barnstable *Permit# � /?- ►3 � � � Expires 6 months jronr issue dare ° Regulatory Services Fee 7®f 2 iasrtsrnate. r$ tan i69- Richard V.Scali,Director m Building Division Tom Perry,CBO,Building Commissioner MAY 0 3 2017 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us TOWN O� 8WRNS ABLE Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address _ /e Residential Value of Work$ 13. `J 7 ?j — Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 90%a �; �� CpC K Contractor's Name n ALE ( /t:5o/( Telephone Number NO/ q.0O 0 Home Improvement Contractor License#(if applicable) �73 Z q S Email: Construction Supervisor's License#(if applicable) 1%4 7 O 7 Calworkman's Compensation Insurance Check one: ' ❑ I am a sole proprietor ❑ Lgffi the Homeowner I have Worker's Compensation Insurance . Insurance Company NameL�' Workman's Comp.Policy# W6 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 E ' ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ['Replacement Windows/doors/sliders.U-Value • 3 O (maximum.32)#of windows_7 #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property _Owner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require � o SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet FileslContent.0utlook\2PI01 DHR\EXPRESS.doc Revised 040215 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England i Rosa &Bill Babcock r . Legal Name:Southern New England Windows,LLC 81 Little River Rd. RI#36079, MA#173245,CT#0634555, Lead Firm #1237 Cotuit,MA 02635 WINDOW NE IACEMEN. 26 Albion Rd I Lincoln,RI 02865 H:(508)428-5852 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com Buyer(s)Name: Rosa & Bill Babcock Contract Date: 04/17/17 Buyer(s) Street Address: 81 Little River Rd., Cotuit, MA 02635 Primary Telephone Number: (508)428-5852 Secondary Telephone Number: Primary Email: cotuit8lgaol.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $13,773 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $4,590 Balance Due: $9,183 Estimated Start: Estimated Completion: Amount Financed: $0 6-8 WEEKS 6-8 WEEKS Method of Payment: Credit Card We schedule installations based on the date of the signed contract and secondarily on Cash/Check the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 4590.00 DEPOSIT-MC; 9183.00 BALANCE DUE UPON COMPLETION-CHECK Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/20/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renewal By Andersen of Southern New England Buyer(s) Signature of Sales Person Signature Signature Chris Hutson Rosa Babcock Bill Babcock I Print Name of Sales Person Print Name Print Name UPDATED: 04/17/17 Page 2 / 12 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-095707 Construction Supervisor BRIAN D DENNISON 7 LAMBS POND CIRCLE}%I „ slu CHARLTON MA 01507 0 k CA, Expiration: Commissioner 09/08/2018 -J a � V 92e �77'G9�2�9?�Clp.LYi 2 LL- .1J 2LG1�/J• Office of Consumer Affairs d Business Regulation 40—T 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home lmprovemen�Contractor Registration _ Registration: 173245 Type: Supplement Card Expiration: 9l19I2018 SOUTHERN NEW ENGLAND WINDOWS LLB BRIAN DENNISON - 26 ALBION RD LINCOLN,'RI 02665 f Update Addressand.return card.Marl,reason"for.chaage —. ❑Address I]Renewal IJ Employment o Lost:Card SCA i C 20M-05M r��e�:urini>rnra�/��C✓��rLor.�rr�c/Y.' . - (fire of Consumer Affairs 8 Business Regulatioa Registration valid,for individual use only before the OME.IMPROVEMENT CONTRACTOR expiration date.If found return to- Office of Consumer Affairs and Business Regulation F'Reyispation 1732g5: Type: lo.RarkpL,=•Suite 5170 =� Expiratlon:=g/.19720_19 Supplement Card Boston..MA 02116 SOUTHERN NEW ENGLANf)WINDOWS LLC. RENEWAL BYANDERSON BRIAN'DENNISON" x'gnWF� 26ALBION RDZ�..C� ' LINCOLN,RI.02865 Not valid without,sigoature r • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wwiv.rnass.gov/dia Workers' Compensation Insurance Affidavit: �uilderslContractors/Elec Se Pr it Le bs Please Applicant Information L f s Name (Business/Organization/Individual): ,rJ l3'� , i(! Address: Dq l t9� AL City/State/Zip: L-l�� / Are you an employer?Check the appropriate box: Type of project(required): 4. � I am a general contractor,and I G �New construction 1.[� I am a employer with 0-* have hired the sub-contractors employees(full and/or,part-time). 7. Remodeling listed on the attached sheet. ❑ 2.❑ 1 am a sole proprietor or partner- These sub-contractors have 8. ❑Demolition ship and have no employees employees and have workers' 9 Building addition working for me in any capacity. comp.insurance$ [No workers'comp.insurance 5 We are a corporation and its 10•❑Electrical repairs or additions required.] officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1�,0 Roof repairs myself.[No workers' comp. c. 152,§1(4),and we have no 13 [�Other 4J�/1 c�o insurance required.]t employees.[No workers' comp.insurance required.] �e�lArP��f S *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 stavit indicating an additional one doing allshowingork the name of the sub contractors and state wh and th ether or not those en hire outside contractors must submit a new affidavit'entiti entities have tContractors that check tlra b employes. 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: c 31 p Expiration Date: l j Policy#or Self-ins.Lic.#: Job Site Address: = 1 �,Ve �o a c1 City/State/Zip: Attairation date). ch a copy of the workers' compensation policy declaration page.(showing the policy num. er and osition of criminal penalties of a Failure to secure coverage as require under Section 25A of MGL c. 152 can lead to the imp fine up to$1,500.00 and/or one year imprisonment,as well a coas py penalties of thisstatement ay be forwarded tto the officeof d a fine of up to$250.00 a.day against the olator. Be advised that Investigations of the DIA for ins ce coverage verification. I do hereby certi der the pa• a d pepalties of perjury that the information provided above is true and correct Date: Si ature: Offrcial use only. Do not write in this area,to be completed by city or town official t1 Permit/License# City or Town: Issuing Authority(circle one)'. 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ' Phone#: Contact Person i SOUTNEW-01 CZOWNGER DAM 0 CERTIFICATE OF LIABILITY INSURANCE s/ao>±2912zo16 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(Jes)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endo_rsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endomement(s). CON ACT PRODUCER NAME: CoSiz Insurance,Inc.-CO PHONE No. (303)988-Q446 No ( )988-0804 821 17th SFAX t. Denver,CO 80202 CoB¢Insuran obainsurance.com INSURER( AFFORDING COVERAGE NAICS iNsuRERA.Continental Western Insurance Company 110804 INSURED INSURER B I Southern New England Windows LLC INSURERC• DINIA Renewal by Andersen LNsuRERD 26 Albion Road 1 Lincoln,R102866 INSURERE: INSURHtF COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED_BELOW-HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEFOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR.CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE THE.POLICIES DESCRIBED HERON IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PbUCIES"UMFTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. [INSR TYPE OF INSURANCE PO EFF JJ POLICY ExP Ln1fIf5INSO WVD POLICYNUMBER I I X 1 COMMERCIAL GENERAL LIABILITY I I EACH OCCURRENCE S 1,000,00 CLAIMS-MADE ,X OCCUR 1 CPA3136080 1GE TO REN 07/0112016 I O7/0112017 PREMISES(E,.=manta. I s 100,00 i ' I MED ExP(Any one Pew) S 10,00 k + I 1,000,000 PERSONAL 8 ADV INJURY 5 It AGE 2,000 lN'L AGGREGATE LIMIT APPLIES PER: 1 1 GENERALAGGREGATE i 5 2,000,00 000 � � PRODUCTS-COMPIOP AGG i S ix POLICY CII JECT I_J L� j I ! I E7=I 1 S 2,OOD,0o0 OTHER: I 1 j EMPLOYEE BEN II COMBINEDSINGLEL.IST s 1,000,000 1 AUTOMOBILE UABUTY I ! ? i ' I(Ea secdardl A . X ANY aUro CPA3136080 '07/0112016 107101/2017�,BODILY INJURY(Perperson) !.s, ' ALL OWNED Laos i E i BODILY INJURY(Per acaden[)is AUTOS NLaos NED ! PROPERTY DAMAGE i 5 i t + P�aeadent HIREDAUTOS AUTOS Is I � I i 5,ODD,000 X UMBRELLA IJAB .X 'OCCUR i j I EACH OCCURRENCE S A EXCESSLIiB �CLAIMS-MADE i CPA3136080 07/0112016'07/01/2017 AGGREGATE ;s DID X RETENTION S 0 ggregate IS 5;0D0,D WORKERSCOMPENSATION 1 ! I srAME ERA AND EMPLOYERS'LIABILITY YIN i �WCA3136081 1071011201610710112017 EL EACH ACCIDENT S i3OD0,00 A ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ N I A� I ` 1,000,00( OFFICER/MEMBER EXCLUDED? i E.L S DISEASE-EA EMPLOYEi (Mandatory In NH) 1,000,00 It yes.describe under i i E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below I i DESCRIPTION OF OPERATIONS I LOCATIONS'VEHICLES(KCORD t07,Atld91o,m1 Ramarfm sehedulo,may ue aaaenea H nrore apa`a eagwl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N0710E WILL BE DMJVERED IN ACCORDANCE-WITH THE POLICY PROVISIONS- . AUTHORIgD REPREsENTATNE - ©1988-2014ACORD CORPORATION. All rights reserved- . ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i a �ll6 pmMor 0 Town of Barnstable *Permit MI V 1 � 6nroxtlis ,� t, Regulatory Services Fee OWN � ELE Richard V.Seali,Interim Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 _ - www.town.barnstable.ma.as Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Mafparcel Number 0'-3 off/5 Not Valid without Red X-Press Impnitt Property Address O 1 'RI 064-L KLResideattal Value of Work$ 90 3 Y Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address -I MA 606 3.s Contractor's Name SoAfrP 1j_F—. W( tf)S NN/ O Telephone Number Home Improvement Contractor License#(if applicable) 173�`f.� Email: Construction Supervisor's License#(if applicable) D t67LO 7 XWoflmiim's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name A) IPS Workman's Comp.Policy# W& 7 a--7 Copy of Insurance Compliance Certificate must accompany each permit. i Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �? ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side KReplacement Windows/doors/sliders.U-Value L�6 (maxim=.35)#ofwindoJ� #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *where required: Lc mum of ibis permit does not exempt compliance with other town dgwftnm regulaWw,i.e.Historic.Cowavabon,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. t � SIGNATURE:Xj;2..�se TAUVIN D\Buildiag Changes\EXI'RFSS PERMIIIEXPRESS.doe Revised 061313 M1 Renewal Rt.Liaax k36079 byAndemen. RENEW `BY ANDERSEN r ium M.4535 LY Liun•e k,163S555 wuoow uruetrrn m w,.mr�., 26 Albion R oad • Lincoln,R102865 lead rirm kn r L (ILI Phone 866.5 3.2233•Fax 401.693.6602 ¢s� 1'eder�traxrok�rossra;so Soutbern New E mgtand Windows,U C d/b/a 1 Renewal by Andei semi of SouthernNew England �f> CUSTOM WINDOW AND DOOR REMODELING AGE J� •- a saran[srreei� c cur saor.loin rn coat r vu t>ox- L) ,I e 1�1 U e r D ei ct c _ %, 26.3s p o, rs l,x Vg 3 .sssZ I E•H�YAdGest Home. �Aber� -..wor9iT¢,feplwne Number;. Buyers)herebyjointty and severally agrees to pufuhmie die OrWt u and/or services of Southern New.England Windows;LL.C.d/b%a Renewal by Andersen or Southern New England("Contractor'),in accor lance with the ternrs-and conditions described con the frxmf and file reverse cr' this agreement and on the a ttarhed'specificadon sheet(s)(eollectit l'this"Agreement'.')., p Histork p Condo O HOA? TotalJob Amount Esamaced eting t)ate Method of Payment O Check. J(Ciih U Rni wced Deposit Received(33%) w1C Cr4t Cards are accepted for n on ,=i6w m.113 of the, �J _ Aepos lf' Balance at SraR of.Jcb(334Gp 7 I I '� pr opa cost(fkme see Cm&tart"rent Fdimi By signing this. Esttrnaied Co pt .Dina: °" you adatowledge d+at the Balance at Sort of Job and the Balance on Subsiantnl / 6 W)( Balance on SulsantnlComptetion of Job cannot be made by credtr Compledar of Job(33X,) J I card anA must. made bi Personal check'bank dledc or cash. Biiyer(s).agrees_and understands that trite Ag;eemeat oisdisites the entire.unders+tanding between the, es;and that these are no verbal understandings chaogiag any of tterms-of this Agreement..Bayer(s)aclmowledg a that B%rer(s)- (1)has neat this Agreement,ttnderstaada the terms of this Agreement;and has-' c_ -a,completed km`i' ,;and dated. copy,of this Agreement, nclndiugtbe tav'at6c'hed Nods es of Cancellation,qa the date first written above aad'(2)was orally> informed of Buyer's right to cancel this Agreement;DO OT SIGN THIS CONTRACT IF THERE AREANY BLANK SPACES. (Rhode[eland Salsa On yf Notate t6 Buyer(1)Do not s tfiis Agree_meat ti any of the spaces iuteaded for the ageeed teems:. to the,eztent of ib`en available tnfoatinatiori are left b (Y)You are entitled to a copy of'this Agreement---atthe time you sige ii:(3)You may at any time pay ti8'ihe fall tmpaid balaw e due under this Agreement,.and in so doing you may be entitled to receive a partial rebate of.the finance and insurance ch urges.(4)The seller has not right to unlawfaRk eater' - prea"ii or commit nay breach of the peace'--"--repossess goods adder this Ageeemtnt:(S)Yoa may cancel this Agreement' if it has not been ssgned at the main office or a branch flee of the seller,provided you notify.the:seller athis or bet main office or braaeh office shown in the eat re ' t red or certified Agreean by gis assail,whsch shall be posted not later than midnight of the third calendar day after the flay on which the hay r signs the Agreement;excInd& Snaday lad aayi hohday an winch ii.gular mast&**ryes are nocrosule See the acoumpan notice of cancelladonfornti foe ioi.R1auaiU n of bnyes's Agbts:> Buyers)receiuxd the consumer education'materials praided.by a Rhode[eland Contractors'Reg stration Board:: ' (Bgn!r lniti j Renewal by Andersen of Southern New England? B r `y Bnyek(s) Signatu of Product tUamager Signatu Signature , AIM gAAD iGc/A" c. -C� . Print Name >i Prodtic Manager< Print lVaiiie. l?ritt Name YOU,THE BUYERS) MAY CAN68I.THIS TRANSACTION'AT.ANY fl1& PRIOR TO MIDNIGHT.OF THE THIRD BUSINESS DAY AFTER THE DATE OF THI$TRANSAC OIV.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS'RIGQT- OF f— — NOTICE C 1 NOTICE CF CANCELLATION' Oate of Transaction :You may .eel,l Date.of Transaction. You may cancel this transaction,vinthout : or oblisit6iA.wt iii this transaction;without any penalty or obligation,within three 6ruiness:days from;the above"date.If.you cancel, i three business days.from th above date;if yotr earteel,.any, Propert*.traded in,any payments made•by.you under a property traded in;any payments made by you under.the Contract or Sale,and any negotiable instiument"exec 1 Contract or.Sale,and any negotiable iinerument executed by you will be returned'w thin term business days folio rig 1 by you will be'retu red within ten btisi+ess'days following receipt,by due Seller,of your cancellation'notice;arid. i receipt by cite Seller of your cancellatiot► notice,and.athy security interest arising out of the trarsaction will be security interest arising out;.of'the transaction will be caiceled.lf you e:aricel,you must make available to the S ter i canceled.If you cancel;you must make avalable-to:the Seller at your`residence;in sy stanttally as good con dnLon-ass w „n 1 at your residence,in'substariNWIras good c-onditicn as when received,any goods delivered to"you uncle ibis Con ; or i received,any goods delivered to you under this Contract or Sale,or,you may,if you wish,comply with the initructio of 1 Sale;or you may,if you wish,comply with the instructions of the Seller;regarding tie return shipment of the goods at tfie.Seller regarding the return shipment of the cods at the Seller's expense and risk.if you do male kif a goods avai It Seller's ens t and risks If you do mAke:eheg 'available to the Seller and the Seller does.not picft them.up vrn to the Seller and the'Seller does not pick them up within twenty;days of t►e datr of cancellation;you may.retar o ! twentlr days,of dte date of cancellations you majr retain or dispose o.dye goods without any:further obligator:If ou I dispose of the"goods,without any further obligation.If you fat[to make the goods available to dye Seller,or if you j fai7 to make tfe goods avaitable to the Seller,or if.' agree to return dta goods to tie Seller aired fail bo tfo so;,then ou ) to retturn the gods to'the Seller and fail to do so;then you remain liable for periorriiance of.alI obligations under a remain liable for performance of all obligations under tie ContraciTo to<rtcel this transactor,moil or,deliver.a INed l Conttxct To cancel this transacticn mail or deliver a si � and "dated copy,,of dais cancellation notice; or arty o i and dated copy- opy of this cancellation notice .a o'rrny`other written rnotzix�or send a telegram to Renewal rse of. 1 written notice ro send a te'le to ltehir"byAndersen of Souhern'_New.En i 26 Albion,Roat1, n 2 bS- j Southern New England at 26 Albion Road,tmeoln;R1028tSS . NOT,LATER THdN MIDNIGHT OF NOT.LATER THAN MIDNIGHT OF' ' (Dane) ,_. (Date), A HEREBY CANCELTHISTRANSACTIOW 1 HEREBY CANCELTHISTRANSACTION - MeE Name Oita,r<- F"Cepy White yer Copy.Yellow B ryer'Copy Nit- Southern New England Windows d.b,a Re SIME I. fn.asszChw ett's partt'ilr.'_8? CD` F_oasd o id ding t acul s=ons and Ctind3 cis { CS-095707 xT' BRIAN D DENN7SON t I 7 LAMBS:POND 6 RC 3t, v� Chafiton KA'OMIF s ✓.�..�11 ae aY1 I 0910,812016 t { ( k,t �- Office of Consumer Affairs d Business Regulation 10 Park Plaza - Suite 5170 Boston; Massachusetts 02116 Larne hnpravemer t Contractor T~;egrstrati+�n Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2016 DENNISON BRIAN 26'ALBI.ON.RD -- LINCOLN:,:RI 02865 Update Address and return card.IN-lark reason for change. sea, 2a;r.os?ii17,, Address Ej Renewal F—, Employments Lost Card 1� ifice of Consumer Affairs&Business Regulation License or registration valid_for individul use only. bfOME IMPROVEMENT CONTRACTOR before the expiration date.if found return to-- .. yC fi 7 Office of Consumer Affairsd:m Business Regulation aRegiWation: 173245 Type 10ParkPlaza'-Suite5170 "}J Expiration: 9/19/2016 Supplement-,'aid Boston,MA 02116 SOUTHERN NEW ENGLAND WINDOWS'LLC. RENEWAL BY ANDERSON DENNISON BRIAN 26 ALBION Rl) � = UNCOLN RI't32863 Undersecretary "Not vatt&41thoutSignatuce - _ r T'he Commonwealth ofmassachusetts Departnent of Pndw*jd lccldents Off we of Investiigations 600 Washington Street Boston,M-4 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aonlacant Information , PIease Print Legibly Name(Busmess/organization&dividual)' J 1 • Address: o�k Az� i -70 �> I � City/State/Zip: [�/",C o 1,1J Phone#: �'1' Are you an employer?Check the appropriate boa: Type of (]act ro r p e4aired): 1. I am a employer with 4. ®I am a general Jd ctor and I 6. New construction employees(full and/or part-time)-* have hired the ntractors ❑ 2.❑ I am a sole proprietor or partner- listed on the att sheet 7. ❑Remodeling ship and have no employees - These sub-conts have g. ❑Demolition working for mein any capacity. employees and orkers' [No workers'comp.insurance ce comp.insurance9• ❑��g addition required.] 5• ❑ We are a corporand its 10.®Electrical repairs or additions 3.® 1 am a homeowner doing all work officers have exd their I L[I Phnnbing repairs or additions myself[No workers'camp. right of exempti MGLinsurancereq�ed-]t c. 152, §1(4),anhave no 12 ®Roofrepairemployees. [No rs' 13.Other WII'V LA) comp.insuurance red) `Any applicant that checks box#1 must also fill out the section below showing their worlous'compensation policy' on. t homeowners who submit this affidavit indicating they are doing all wok 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-contactors and state whether or not those entities have employees. If the sub-contactors have employees,they must provide their wows'comp.policy number. I am an employer that is providing workers'compensation insurance for tray employee& Below as the policy and job site information. Insurance Company Name:AQ,O 4S Vf-4,tvc._ Mvv ZY Policy#or Self-ins.Lic.# ' I jj j ` 7 Expiration Date: j Job Site Address: �l City/State/Zip, Attach a copy of the workers'compensation policy declaration page(showing the policy number and ez lration 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DL4 for insurance coverage verification. I do hereby7�ZeTpains and penalties of perjury that the information provided above S&&e and correct c s• signafore: Date: 3' / Phone#: 7 / Of}icial use only. Igo not write in this area,to be completed by cafy or town ogwial City or Towns PermitYUcense# Issuing Authority(circle one):I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Zther �►� CERTIFICATE OF LIABILITY INSURANCE 00/2'1/3014 TM$CENTSCATE IS i89M AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIMS UPON THE CER MCATE HO'LOM THE CERTIFICATE DES NOT.AR R A71VELY OR NEGA 1VELY AMEND,EXTEND Oft ALTER THE COVERAGE AFFORDED DY UM PoLoM 13ELOW THIS CERTMATE OF MIRANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISM DfSUPAP44 J►tRHW€MD ATIVE OR Cam,AND THE T9.I MnM ,t)a mustI a�dwnd.tf ----Y -ubjvd Jo OWUNceft ft~IS Hou oisuti big PROD Finis of Now ray, rue. e%25 Century S1vd P.O. Sm¢305292 Nsabvi22®, = 372305192 0S8 Me How vZola d windimm t..,M1' ompa!Minn Zen-7 v/8/A Asneu01 by esdar"A tA�ilRER C ISM26 A1Mon Rood Linda, III 02865 00 0: DwRot B t 0MRStf. COVEMGES CERTIFICATE NwBER.-029290 RHO` Ai�jiRO@@S. TM dS TO CERTIMM15i POLICIES�t3F 04SURAMEE USiED BELOW HAVE BEEN MAM TO ldECOMRCA Tg WAY BE SUM OR MAY.PMrAM?»)NSWCE Aff0t=B+1- f H A)D.C=TlONBS OF SUCH FOtIOM.Mn$Ft9M BRAY NAVE BEEN RHXM BY PAID CAM. SAMTVFB 0i8U1tANCEBum SLIM 6 om X CCOMMKIALGORRALLMMM EPMOOMMENCE S 2.040,000 �Ebt7CP me S 1tl.000 S 2025"9 08/10/2024 08130/aol5 Pr ttl /0 f 2.QQ0.00$ AG MAW APPMPM GEMER&AGGREGATE 8 31080,000 POIII;Y �. SDC. j'F ' 310001000 O fgft 1 5 AUTOMOSIEUMMM SIN tJkOT 5 1,00.000 X AWA M POmLYmm(ftPomf) 5 & ALL M* 8 aaasas9 08/10/2024 O9/10/2025 80®B.YtTim(PstO 5 3t�ffi15t]Tdy3 W.Ay � 3 6 MS 41 .- S,Og0,Ob0 t:o=m CW1iSMIPDE 8 2029459 08/10/2014 08/10/2015 AGGAEGME j 5,000,000 o® RE7I3YrtON g $ vtra X OFRCOMMNM atA ®tltlotl6ctlts oB/2afztll4 tla121/2013 EL fEucitaxoar 5 s.00e.aoo loL -6z S 2,000.990 0 s� C � u v5�s$20m�g23fa5cP2�us.'5..� `. �3v66�i ' tstatory Limits we .L. vises"Boliay 2nt - $1r000,000 L Disssn lOtt. �@ltryes - 51,OOtl,000 i�t� RA7t01WllOCATtQtIS t lfBFtCI1S t81.Atl�ttaW Rnnuhs80.s0�be ett�lm0lf lmsa�&/eq�id) CE TTMCATE"OLDER CANCELLATION SttfJllL.9 ArBY AF 71iEr A�VE �t�S�CAN��SSB! TtiE E]CI�11?t6p tDATE 'l11t�OF. tltYl� lYtlt, BE 0 tl! . AUTNORM FMPRESWMTM it1i640 1i 26 AU31"Bond M 02969-0000 0IM-20U ACC CORPORAUK AN fht5 fmrd*t ACC 25(209409) The AFORD name and fto we vegttmd tt oft of ACORD SS;Ds5B19s25 SAS:BsiceA 6s 9%27 312 -))Y o d �Q Town of Barnstable *Permit Regulatory Services 6 Tr MLMR Richard V.Scab,Interim Director t�A Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number 0 s 3 6 � 5� Not va!ut witliowt Recrx-Pnsss r„�,var Property Ades 9'l Lr Tl"L�-=- Residential Value of Work S (p 33 Minimum fee of SM.00 for work under$6000.00 Owner's Name&Address !Gt— �C el vim- -P-&4 • 70u T I 6 1�6 3 5-- Contracxor's Name a�d�t���J Il���G/V61,4W 4 A46DI S Telephone Number Home Improvement Contractor License#(if applicable) 7 3;—"IV I— Fanail: Construction Supervisor's License#(if applicable) of S7a 7 Workman's Compensation Insurance Check one: - ❑ I am a sole proprietor MAR 2 8 2014 I am the Homeowner I have Worker's Co lion Insurance Insurance Company Name �A-�-� aus c-,o . TOWN OF BARNSTABLE Workman's Comp.Policy# � Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side kReplawnent Windows/doordsliders.U-Value 3y (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of Kris permit does not exempt compliance with other town department regulaticros,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 uired. r SIGNATURE: T:IKEVIN BNBuilding Changes SS PERMT\EXPRESS.doc Revised 061313 Renewal ��� v Andersen. RENEWAL BY ri1�DERSEN AM`""v`"""'a' Ct'LWa 017ag3 3 wrNoow Naouetrsnr et�c vym 26 Ibion Road • Lincoln.RI O'18fi5 t.#t Finn#t2i7 Phone 866563.2235•Fax 401.633.6602. reaer a Tax It)9146o366CW n Southern New England Windows,LLC d/b/a r � Renewal by Andersen of Southern New England � CUSTOM WINDOW AND DOOR REMODELING AGREEMENT f)SveetAdGnu.GkrSat4md Tip Code/P.O:.Bma g) L if I,.2(tK e- Ro } .464u,t ,Ma _I n M _ EM.9AdAress Clod l O���4.C�1- ltomeTekpMnoute � ����L Wo+kTdepko1rotiwaber Buyers)hereby jointh•and severally agrees to purchase the products and/or services of Southern.New England Windows,LLC d/b/a Renewal by Andersen of Southern Net.England("Contractor'),in accordance with the terms and condition described on the front and the reverse of this agreentent and on the.attached specification shect(s)(collectively;this"Agreement).. O.Historic O Condo D HOA? Toul)obAmoune y 5�' b �S +NS�+� Method of Payment: O Check Cash U Rn..d Deposit Received(3 r Credit Cards am accepted for deposit only—riwctmum 1/3 of 33 job the- Balance at Start of 2'e I ( projest.(Plegdesee t ro&Card h"eru Fan.)By signing this ). ( Esrirtuced Completion Date: co you acknowledge that.the Balance at Start of Job and the Balance on suw- W1C. Balance on Subsantlal Corrtpledon of Job cannotbe made 4 credit Completion of Job(33#1 and and must be made by personal check bard[check,or ceh Buyer(s)agrees and understands that this constitutes the entire understanding between the parties,and that there are no verbal understandiss changing any of the terms of-this'Agreement.Buyers)acknowledges that Buyers). (1)has read ibis Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above amid(2)was orally informed of Buyer's right to cancel this Agreement:DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales On(p)Notice to Buyer:(1)Do not sign this Agreement if any of the.spaceai intended for the agreed terms to the extent of then avas0able information are left blanit.(2)You are entitled to a copy of this Agreement at the time you sign it.(3)You may at any drire pay off the fall unpaid balance due under this Agreement,and is so doing you may be entitled to receive a partial rebate of the finance and insurance charges.(4)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement.(5)You may cancel this Agreement if it has not been,signed-at the:main office or a branch office of the sellerr provided you notify the seller at his or her main office or branch office shown in the Agreement by registered or certified mail,which shall be Posted not later than midnight of the third.calendar day after the day on which the buyer signs the Agreement,excluding Sunday.and any holiday on which regular mail deliveries are not made.See the accompanying notice of cancellation form for an explanation of buyer's rights. Buy&(s)rccciwd the consumer education m iterials pray ded by the Rhode Island Contractors Registration Board. (IIsrtr• Inifisls) Renewal by And /of Southern New-England Buyer(s n Buyer(s) Bv: `2 L AA­ SignatureiWirroduct Manager Signature Signature 'JlAlfl t'bLA wb Print.Narnc of.Product\tanager Print Name Print.Name YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIM PRIOR TO MIDNIGHT OF THE,THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. :1C- - - --- - - - - - - - - -NOT � - - - - - - - - - = -�- - - - - - - - - - - = - 1 E O ELLATI- NOTICE OF CANCELLATION Date of Transaction of"' .You may cancel Date of Transaction You may cancel this-transaction,without; y en ty or obligation,within l this transaction,without any penalty or obligation;within three business days from the above date.If you cancel,any I three business days from the above date.If you cancel,any property traded in,any payments made by you under the l property traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed I Contract or Sale,and any negotiable instrument executed by you will be returned within ten business days following l by you will bei'returned within ten'business days following receipt by the Seller of your cancellation notice,and any, t receipt by the Seller of your cancellation notice,and any security interest arising out of the transaction will be security Interest arising out of the transaction will be canceled.Ifyou cancel you must make.available tothe Seller I canceled.if you cancel you must make available to the Seller at your residence,in substantially as good condition as when I at your residence,in substantially as good condition as when roceived,any goods delivered'to you under this Contrail or I received,any goods delivered to you under this Contract or Site;or you may,if you wish,comply with the instructions of I Sale;or you may,if you,wish,comply with the Instructions of the Stiller regarding the ireturn shipment of the goods at the the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods available Seller's expense and risk.It you do make the goods available to the Seller and the Seller does not pick them up within to the Seller and the Seller does not pick them up within twenty days of the date,of cancellation,jou may retain or t twenty days of the date of cancellation,you may retain or ` dispose of the goods without any further obligation.If you 1 dispose,of the goods.withoui'any further obligation.If you fail to make the goods available to the Seller,or if you agree I fall to make the goods available to the Seller,or if you agree to return the goods to the Seller and fail to do so,then you I to return the goods to the Seller and fall to do so,then you remain liable for performance of all obligations under the remain liable for perromunce of all obligations under the Contract.To cancel this transaction,mail or deliver a signed I Contract.To cancel this transaction.mail or deliver a signed and dated copy of this cancellation notice or any other I and dated copy of this cancellation notice or any other written nodce,or send a telegram to Renewal hyAn4emn of I written notice,or send a telegram to,Renewal byAndersen of Southern New England at 26 Albion Road Lt. Southern New England at 26 Albion Road,Lincoln,11102865, NOT LATER THAN MIDNIGHT OF S I NOT LATER THAN MIDNIGHT'OF (Date) 7 (Date) I HEREBY CANCELTHISTRANSACTION. I HERBY CANCELTHISTRANSACTION. Buyer's signature Pont Nance Oats X Buyrr'f Strum" Print Name - Date RhA Copy:White Buyer Copy:Yellow Buyer Copy:Pink 4i Southern New England Windows d.b.a Renewal by Andersen of SINE r Massachusetts Department of Pubhc-.Safety Boaid,'of Building RegWatons and Standards,;, Consiructto. Socn-isor` ce,nse CS-085107 8410 D DENMSON,, 7 LAMBS,POND EIRC `+�' rChariton MA.-0150'Z ~ `_` J.�e.,.,.1J .. Expiration. 'Commtssioiier` ;09108/2014 cJfieoonimcmcaeaC_�L Office of Consumer A airs d Busmess�eation 10 Pa*-P1==Sohe 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration igg Re0slrandn. .inns Type; Supplement Ca(i1 SOUTHERN NEW ENGLAND WINDOW$LL E>aliranon: fln9rzota DENNISON BRIAN } i, 1137 PARK EAST DRIVE , I WOONSOC.KET;RI 02895 ,t« _ y'Update Address and nt=card.Mark .ad.for change. SCA 1 C Mhl o 1 p Address ❑Renewal ❑Employm-t ❑Lost curd 11ke of Coos—, A'Ma A B Regeledea Luse or registration valid for Iadividol an only E IMPROVEMENT CONTRACTOR beforethe expiration date.If found return to Office of Consumer Affairs and BusiRm Regulation IatPBon 173245 Type: 10 Park Plara Suite 5170 E?Wln fV18/2014 SupPldnenli:ard Boston,MA.02116 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWAL BY ANDERSON 1DEN p 1137 PARK BRIAN - _ 11J7 PARK EAST DRNE WOONSOCI(ET,RI 02895 Uadrraecretary Not valid without signature _ CrWO:30124 SOUTNEW DATE(mWooffy" ACORD. CERTIFICATE OF LIABILITY INSURANCE &MM013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD..THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATMELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy((es)must be endorsed.If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not corder rights to the certificate holder In lieu of such endorsement(s). PRODUCER ;Nae"S; Anita Little Willis of New Jersey,Inc. °Na 856 9144660 Na; 856-914-1881 1015 Briggs Road,PO Box SODS I e�xA� , anita.11ttie@willis.com PO Box 5005 I R+s AFFORoatG COVERAGE NA1C S Mount Laurel,NJ 08054 INSURER Selective Insurance Co of the S 39926 MURED INsuRERstArgonaut Insurance Co. 19801 Southern New England Windows LLC INSUmc;Beacon Mutual ins.Co. 24017 D1B1A Renewal by Andersen INSURER 26 Albion Road INSURERE Lincoln,RI 02865 -INSURER F 1 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT 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 grREDUCED BY PAID CLAIMS, LTR TYPE OF INSURANCE UMV POLICY NUMBER tNIDDY ! LIMIM A GENERAL LIABILITY 'S202945900 98horan ishoi2iii EACH OCCURRENCE $i 000000 X COMMERCIAL.GENERAL LIABILITY 1 �°PREMSt�fca 31t1D 000 CLAIMS-MADE OCCUR i � I MED,EXP(Any one Person) $1 O 000 { I PERSONAL L&ADV INJURY $1 000 000 GENERAL AGGREGATE $3 DDD,000 GEN'L AGGREGATE LIMIT"PLIES PER: i t` ) PRo°uCTs.comProPAGG s3,000,000 1 POLICY PROZCT LOC $ A ALrrolaOelLELtaBILIn 5202945900 8f{10/2013 08/10/201 ET11'1�NdEeDmsiNGLE LIMIT 1,000 00Q X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I BODILY INJURY(Per accident) $ AUTOS AUTOS X PORED AUTOS X AUTOS P°PERTY°AR ' $ A X UMBRELLA LIAR OCCUR S202945900 SN012013 081101201 EACH OCCURRENCE $ 00Q 000 _ EXCESS UAB LCLAIMS-MADE: AGGREGATE 410001000 DED i RETENTION I $ OTH- C WORKERS COMPENSATION 10000068028-RI 8I2112013 08121/20ij X We sraTU ER AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNEIVEXECUTIVE�YVN i AIC927$16352394 81;112013 10171/201AE.L.EACH ACCIDENT $1 000 QQO OFFICERIMEMSER EXCLUDED? Lam' NIA' (►Ayyaeenssda"In NH) f I E.L,DISEASE-EA EMPLOYEE $1 DD0 00Q do DESCRIPTIONOFOPE RAT IONS below I E.L.DISEASE.POLICY LIMIT $1 00D 000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addl@anal Remarks Schedule,M hors apace is required) i CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE POLICY PROVISIONS. Lincoln,RI 02865 AUTHORIZED REPRESENTATIVE 1 i I • zL 61988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and lop are registered marks of ACORD 0S2151091M215088 AXL •- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investibaadons 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers A licant Information Please Print Legibly Name(Business/Organizationghdividual): AnJ LtG Address: City/State/Zip:_L//t>'CD�N , W6' Phone#: DZ ,? - ?YDO Are you an employer?Check the appropriate box: Type of project(required): 1.1 I am a employer with A 0 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ^❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity, employees and have workers' [No workers'comp.insurance comp.insurance.$ g Building addition required.] S. ❑ We are a corporation and its 1D.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their l l. Plumb'❑ mg 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.] Q xT., *Airy applicant that checks box#1 must also fill out the section below showing their workers'compaction policy informatioa t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors mustsubmit a new affidavit indicating such. $Coictras tors 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site Information, . Insurance Company Name: Policy#or Self ins.Lie.#:R' g� f?3 _ .37 15( Expiration Date: Job Site Address: C /State/Zi __CZ=/r• try p. /n!4 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 ofa STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of [nvestieations of the DIA for insurance coverage verification r do Hereby certi under thepains andpenaMes of perjury that the information provided ah ve is true and correct --nature: /� Dom• Z7 r 'hone# Lzo�' oZ o2 9 — / RM 0ffic1a use only. Do not write in this area,to be completed by ctty 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."Piumbing Inspector ' 6.Other Contact Person: Phone#: �oFr roy Town of Barnstable �6IC�G6�3 y *Permit# • Regulatory Services E.rpires6montlrsfrom issue(late BAAjRvffrA 3LE. Fee y t -v ynss. Thomas F. Geiler, Director A RE SS E RNJ Q - Building Division Tom Perry, CBO, Building Commissioner ��v 200 Main Street,.Hyannis, MA 02601 I� TMajh,OF BAD NSTABLEW-ww.iown.barnstable:ma.us Office: 508-862-403�8` EXPRESS PERMIT APPLICATION RESIDENTIAL .ONLY Fax: 508-790-6230 C Not Valid)Pillrou!Red X-Press rtnprinl Map/parcel Nurnber J d S Prop 6 Address p! y ��: i, � ` , �/ _ � U c Residential Value.of Work "� `� ` Minimum fee of$35.00•for work under$6000.00 Owner'.s Name & Address11 KIL11�° VhCo� Contractor's Narne /�-11'1 �e S � Telephone Number `f��`��1 � 00 Home Improvement Contractor License #(if applicable) 7r1l/cl'ion Supervisor's License#(if applicable)kman Is Compensation Insurance Check one: ❑ I am a sole proprietor the Homeowner I have Worker's Compensation In C C Insurance Company Name ' Workman's Comp. Policy# q 59 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ' ❑ Re-roof(hurricanenailed) (stripping old shingles). All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ R ide #of doors Replacement Windows/doors/sliders, U-Value (maximum .35)#of window *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: ..�'/.• o'er----_ , QAWPFILESIFCRMSIbuilding permit forms\EXPRESS.doc Revised 072110 . 77,t Com oinveallh of.Mazssachusetts - — Depart'inertt afIndusfrial Accidenis 0191ce of-["Vestib a ions k.. 60 F1'�rslral7gtoti Street Bostolr;.1fL4 02111,' turf nt.rnnss gov1rfia "Warlce -s' Compensation Insurance Affidavit: Builders/+C'ors:tractorsJElectrici:ins/pIumbers hcant hforanation PI-ease Print Legibly Narue (Businewjor ® n fridividual)- INOOA' SO �Ikc Address: /� f� �} City1' ie/Zlp: 40 Are y u an employer?�Che�r s the appropriate.box.: L1100ther project r. wire 0 4. I am a general contractor and Ip J { eq : 1. I asu a erirployer with Zeodeltng construction - enVIoyees(full and/or part-time).* have hired.the sub-contractors 2.,❑ I am a sole proprietor orparkl-er--. Fisted on the attached sheet. sihi and hmre no l fees These sub-contractors have p; P tnolitsan �varking :for me in'any capacity.. employees and have miters' coin iusurzlnce..7 ittiing addition [No workers' comp.insurance p .required.] . ❑ �ir'e are.a corporation and its ctrical repairs or additions �aff.cess have exercised their. .❑ :I.avi a homeowner doing all work mbing repairs or additions myself [No workers';comp, right of exemption per NfG frePurs ins-:urance required.]t' c. 152, 1( ,and.eve have go ems .Ioyees.;jNoworkers' er ownp,insurance required.] +Any appticmr that checks box t#I.mast also 5Il olat the seciioa belon,showing theirworkers'compensation policy information- t Homeowners who submit this dEdavit indicating they are doing sat w ml aad then hire outside-contractors must submit'.a anew aflydartit indicating sacl1 aCantracl ars than check this.box must sttachod an additional s7teet shawing the nsnte of the sub-contract rs sod unite vrhether or not,those entities hwe employees. If the sub-contmctors:have employees,.they.must provide their wurkers'comp.policy number. Iam all-e"IPIoyer that isproviding workem compenrsadoll ilisitrarice for r:ty enzpkye" BflQtt-is thepo,&U,and job site informlatioui Insurance Company Name: e (% Il Pol *,or Self-iris.Lac.#: �' a �5' E.xpiratian I}ate: Job Site.Address: at ,� �-V�' tatldStateaip: 1 g Attach a ropy of,thae workers' ompensa tion P.Olicy declaration, page(showing the policy numb,er an expiration date). Failure to secure coverage;as required under Section 25A of NfCL,c. 152 can lead to the imposition of.criminal peLilties of a fine up to$1,St10.00 andr'or one-year imprisoment,its well as ciiil penalties in the forte of a STOP WOILP ORDER and a fine of up to$250M a day against the violator. Be advised that a copy of this statement may:be farwarded to the Office of Lnt :stigations of the D.IA for insurance cm erage verification: . .I do hereky certtfy intder the punts andponaNgs rtfpe dry that the inform wtian prm id: .v.bat�is ct.e aarrl eo,r�rt Date: Phone#: O ffcinl lase only. Do not write in fins area,to tia completed Sy ci6 or toi.lyn ofciaL G`it} or To-"M: Permitfl.,icense# IssuingAuthority(circle one): 1.Board of Hearth 2.Building Department 3. ItpT,ov n,Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person. Phone.# _ 6 +� 14001,TA-1 C®� CEF�TIFICAI'E OF LIABILITY INSURANCE oPla SRFDATEIMWDDNM) PROD cER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND;EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville RI. 02838-0001 Phone:401-769-9500 Fax:401-769-9502 INSURERS AFFORDING COVERAGE NAIC# INSURED Moon Associates Inc. INSURER A: Naiional Grange. Tnsurance co 14788 DBA Gutter Helmet DBA Renewal by Andersen of RI INSURER B: Beacon Mutual DBA Gutter Helmet Roofing DBA Moon Works INSURER C: 1137 Park East Drive INSURERD: Woonsocket RI 02895 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 MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH. PQLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER DATE(MMIDDNYYY) DATE(MM/DDNYYY)LTR SIRE TYPE OF INSURANCE LIMITS' GENERAL UABIUTY EACH OCCURRENCE $ 10 0 0 0 0 0 A X COMMERCIAL GENERAL LIABILITY 14PS26619 09/16/10 09/16/11 PREMISES(Eaoccurence) $500000 CLAIMS MADE X❑OCCUR MED EXP(Any one.person) $10000 PERSONAL&ADV INJURY $ 10 0 0 0 0 0 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2 0 0 0 0 0 0 POLICY JEa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A X ANY AUTO BIS26619 0.9116110 09/16/11 (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 $10 0 0 0 0 0 A X I OCCUR CLAIMS MADE CUS 2 6 619 09116110 09116111 AGGREGATE $ I RDEDUCTIBLE $ X RETENTION $10 0 0 0 $ WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LIABILITY YIN B ANY PROPRIETORlPARTNER/EXECUTIVE ❑ 28586 10/01/10 10/01/11 E.L.EACH ACCIDENT $500000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $5 0 0 0 0 0 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $5O O O O O OTHER DESCRIPTION OF OPERATIONS%LOCATIONS T VEHICLES)-EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MOONAS s DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR' REPRESENTATIVES._ AUTHORIZED REPRESENTATIVES y^ _/0-!. ACORD 25(2009/01). ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - - xIt 1� - o Ttff r Bm - _ on MOON _ " � � ��-- - .;_'-.,. ram' ..• � - WDONSUP 4-8 PAINE ROAD umsEP,4N . Rl 02864 MOV-06-20I0 SAT 10:44 AN Dan u Griffin. core FAX NO. 508 362 1437 P. 05 1371411faitPrNt iU.pt.0;MZ jMXOAemA4WOM14he.) �t YtmmaadmL trrurdrpMs aa87S Nam tcrr►tucpat�rlc p4aanrtmdktastmf {0oo)91s-5aee ram.fi r 1�ssp,�.A4oa�aa+a3 I 1 Ntvtre i s��t G�. S sib.. tw o-- Mo tAddroc 'ZDt15ok 2.7 Gc'' r-r- k--62,1 '�: Iioapa trlaane; Sow+-�a�-s 9�eala� �,e-�,m: Yar Meeva g�,O pdgatr. Tams 7at4 a Tegtp ear �'i ta.� A..F l.P,� Uwe.the above pwdtaser(s11'mrnmarisl7 and dw otnods)of the praptvty wmw at ft daova in�sdd"A hertiDylda�f a+ad�erallyatrrt to contract with Moon Assotiatas.fnc.Oftftaforkel to(MMUN&DM.and Img1 of all adtkfth as deWbW In iblS"Writ('Agrowwet"J,the anmhed Spot WetM and dteparrt(1)wrhidr art Oobpw*M herein bynbrem and made apart hired.A Genf Certllleate vita be teamed for all jons atdro and of dta inn+dladon_ 0 r rjlber _ OrderNomW ft1w Type 3e&2�-2;51 Pn j=Typlr PMJM Tool Agreement A fmmt S N jar7 AWWOM Are M S�,_._� Agmeml AffwjM S L*sDepos" 5.-AA40 tesspolmtt f aaast7tepvdtt $ tabnw Due Q+eemple*A $ �_ Palma Cue On Comootlon S aa4 fa cus(IncBmPletlen 6 ^- tkl�uA$KMA�raanev.MapiKda4eaeaMKnas RF4�dguaa3taoltlleaeeMAaoWedrAWrkaa�m�e0. �IIN+t�a77tidApaaf�ntARawiR�llWKul4Mq� /✓ II tirrggatf�p�,aptteamodiartidarrce M�raPayrrteettteatbegt�ttpleaea tnssagaterrrearttgeNlbadAa6ae►sn ` OaertTlrtla dlrtstaWrdon: Dw atT�e atdtstel�flma pee at iMm�Il�tlaabn: Fes.Start to; pkttM Data: Es;.Start Data EOt.Camptedon Dom Est Start flaeer 6+t conlpletjmt Daps! 1 � � QE r/PAVMWOM""Vwtpfwd=xta,0veamomo�tsMpvveq f.dxdy CasR6ea Check or INtsey Crier Ck# 3. Imade proble to Moab) A=$ Approval Cade L Cradk Card•W xM %IW okc"W Ace 91mw ape re r�aetmaeia enatp�w gbr+aa4 anal kue mr dude�er7t kax�r Aaf 7aaA6 SeartNCo4i tnrwua tom apeetlamd Anetlmtalgputerreadatq.a it Is speed be and betaken the pasdw ant alit A6►emnntt ewwiWces the firsts sptdeMUM t{tregraen rho parties,ad drere we no vertaa( uodunermOMcbariftor—Opktanrir.r0MIsrpsof"Apaem ut.Pttrdtese"Mtabyadr-doi4m 04hcdtlmeds)1)beg rmddmfrmttaed mom of ddt Agisemeet and has rw6W a aornpfue4,aptaeA end dMd a*F of dda apt ind 41re the wo maompanyliw Mgdw of cmcd mn forma,on rho dame i1ra Woof,above and a)was espy informed M I K4w right to aaael Otis uwmdlm.DO NOT SPIN THIS comrk=w tMrlrF AAtY84ANJi t P+ MOAfrYprlt7 d $mature Prhn Nairn Mint Nana Prfet NaMe YOU.TNR BUYS,MAY CANO LIM TRANSACTQ N AT ANY TIME aN OR TO MDlP T OF THR TlNllls UMM DAY AMR THE DATE OF TNISTOM"CTIM SETHI NOTICE OF COCEWTION FORMGROW RM AN MIPIAMATMM OFTHO fM W. a — 1- ----- - I t.��... MPlTfL cANCE"MR oats of f1'stfsm"on ►b Dario of TtarbaWar You Inay canto ibb ttaltsact fh mild-1 t am pv:raft or owlsoft I You M" goat Otis ttafoolksty wlehwa any pmahy ar obillgadon, "Mall&aa dim 4*hm lair abraa dat&if you o rw*my. within Wee habeas data arum dw above df.If Yoa aae®L airy Araperty traded 1%a"Awammb pWde W yap ter the Cwdratt w pa'ope4f traced La say ptp vo spade bf You under taro Cariblw or Sala,and an neap:Wble bonito taaon Md by you W be returned sae,wall any nlp*Me kmumm saawbod 4"m wX be rewroad wkhfs t.o dio MOWN aeaelpt by the Soper of Your t9 imsopoa wfahba W OF f low(w faeew by d*Sadie►of)arse samema p notles,and aoY som"ItnN , -ad ft out of the trankWop wIN to fWl m and arty tu>wft kftwd wbft wd of the It!atls cW wilt br if Ym Md."M mess ntte&Mb*to tare Seller at yaw emeekd.tf you tntroab yqa mwt nadm ttralhble to He Sngur at your mssdeaao.In slaAmantaily as and OOMdnlon as when tat Kv4 M4 mddow% In*&Ow ddev as geed men a>s vfim novel" r my deeds d Inmd to yes wider this 6enmra.'t or uk or you my,If you Meads doaiaed to you under#W Ctsnhatt m Sala;or Ya stray,it yoy vw0 wmpfy Ift doe bmwucdont of slur Seller mpwlrrg the return wl%%comply wfeh ibe hu netlats of doe Saw+amercing Me rot wo dripm4m of Ore pain at firs faems and Mk.If you do make OWnead of the Fords at the loom atmeirse and fig#,K yteo do make Ala pods swWA to ft Seger and the MR&des ant pick shim alp the pads a mdUde to the 5elter and i m Seger deer not pith than up adddn 30"of the data of yaw Nods of commobsbme ytta may wMn 30 days of the date of vow Native of CafroiboM Ymr may retain or d 4vso of the pads wWkwt MW ftudw obNpdan.If ytw tooht w dlspoee tit the look WMps any f num obSp$".if yea to to Mike die gnab avalbbkr to the Seller,or N yw Wee to return fnfi to emit the widlabb to tke S&VW:or if M spree to return the goods to fat0 Wer OW fop w do so,theta you rm urn!able for the goads w two saw Bird fall to do son then you roman 4"far pwformante elf ag at (ors tutelar flak Contract 7C CMPW this pe 6nmorteo of US abNgatlons rmdu the CMIft Ta capal ft tla octlbn, mail or ddWw a slpted and dated cwv of $m traxNe elm% ad or doh" a dorad and darW an of ft camo ilmt rmdee w"other written iwdm,or Deli a telapen to cartrc kom nodes or my other trifles Mike,or send a telegram to MOOMOfMtit 1337 " P.att GMMe, W IMwas UbM taaaaurwktfi UR Parer Mt Mw. Wt e6 Rhodr island 42895,OK7 f LASER 7TiAN NppN16liY OR r, tdwsl• 02M NOT{AM TITAN MMMG iT OF—tPfta I NUM C UiMMTRUAAC11`101• I HkTi8 CANC THUTRANSACWK comum ess aanrre Pala Carolonef'sSlgnamra OadR A elfff= REP WEER � MOMS r 10' • • + J. ;�'«•-. y�y�..'/t�tl��JJ ,s. ',l YAK g' - L•e• 4�,--- # f.r..-,n rra .+ t , �• .l '-� ,�'. {� ��-...a _. .. ..Y l.•..�E R'Y•_�.�� ..C��.����+ �A .d, # --,�.•�•-'rd:s� * -+i<S, 'iwP mod= s r - r 7t+^^f y• v ,�� '.f � r�' t•.«w�'r7�.S�L��jMaTJ}- �mRiV�g0drvi yt i ; a _ c ' '.... A't 4ib CO _' s. �L��]'•1Kk�-�� S:�t1tlslCi s��. �f G►:G 1�" � €t �x � i' .4< � g . �._•i �,...-_X� .v' R d �. of �jY['QD1-���A���i.[�- -t�, • ��1�t�h, -�t11.1�.���.]'��,�2� `� '� � �..�. �r. '.� ,`� :.�`_�.:t�� -�„w�"-.::.�,-x,. , i ST BE Assessor's map and lot number :...J........�.:jg.........:.�, SEPTIC SYSTEM M g ........ . ............................... !i INSTALLED IN COMPLIANCE y F TH E r0� Sewage Permit number a (DS� WITtl TITLE 5 ii ONMENTAL CODE : BaEaSTsnLE, House number ....., .1... ...................................................:. ENVITOWN REGULATIONS 9,0,0�M639 e�9 QED YPY TOWN OF- .BARNSTABLE BUILDING .1 SPECTOR ... ...e1i`!1. ............................................................ APPLICATION FOR PERMIT TO .......A TYPE OF CONSTRUCTION .........ZO.O.Oa....................... .........',46.. ..... . ........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....�..,..... .1.�a e.....R� .....lg.a............... —,5��9,1.1 ..................................... ... .. .. ... Proposed Use ............ :4tP. ..... .. ............................................ .. . ......................... —............. ... ......... ZoningDistrict ........................................................................Fire District ..........®.L\ ................................................ Name of Owner ... . �. `�+�c� p e (� W � •Address �t...�� � �?.�:...... .. �.. Name of Builder ... . . .... . 4X,.�-,'. .....Address ... i ... �Q.....4.1,.5 G1 .���' ................... Nameof Architect ..................................................................Address ......../........................................................................... Number of Rooms ........OA....................................................Foundation .. .C+ . >.C..,......................................................... Exterior ........&JQ0-cl........................................................Roofing ......A>C..f`ra. .• ................................................... Floors ......iL". O.......... .................................................Interiorrior ................................................. Heating ...... ..w...............................Plumbing ......... .:.. ............................................. Fireplace ....... � Approximate. Cost ...-�..�.......................I....... ............................................ Definitive Plan Approved by Planning Board ________________________________19________. Area ....�9.c�...a..................... Diagram of Lot and Building with Dimensions Fee ...................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH o erg- 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. Nam . ....... ....................................................... Construction Supervisor's License , / ............... — Permit for —�\d�i�i��----' ' Single. .Dwelling_______ Location ......8l..Lit�le.. ..Doud____.. . -----.��.�.C�tI�i�------.-------- J. i` Will .S Babcock ; Owner ---------.�-----_'-----' | > , r � ! � . . � . � Type ofCon�ruchon --������--.------ ' . --.------------.-----------. . ` . Plot Lot � --------- ----.--..---. ^ - - November 27� ' 85 . + ` Permit Granted lP � -------------' ~ ! Doha �� Inspection —'lP ( Dote Completed -----.. --]V - - ~-~~ ' ' \ � . . . ' | � � �. K-?; f 3 p J- .�"..15............ 11.• Assessors ma and lot number oFtHe to Sewage Permit number ........:��.�............... ...� i Z BA"STADLE. House number ..... !. : rAea GD 2 639. ,FD YPY 6` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT LTO ....... � .... .:. " .......................................................... TYPE OF CONSTRUCTION ........./0% ........... ......................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit�according to the following information: Location .....:?..I...... ....! .............. � U... ..... ProposedUse .... `.. ,- .kGr. . ..... .................................. ................................................ , ....... ZoningDistrict ........................................................................Fire District .......... ..!.!r!:��................................................ Name of Owner ... .t:�.E.l�,ba�.. ......! C1z .Address R1... ....... Name .of Builder ...Ro..M— T4- . `. � k. l -�G......Address . ��?.......?.1<......4�r �!.d�. .................... Nameof Architect ..................................................................Address ......................................................................:............. Number of Rooms ....... ....................................................Foundation .. h, ..t....................... Exterior ........ .a..........................................................Roofing ..... � ................................................... Floors ....... a.............................................................Interior � l Heating . '... ...............................Plumbing ........ ......a-? -A. ............................................. Fireplace .......NO.................................................................Approximate. Cost ...�®� ........................................... Definitive Plan Approved by Planning Board ----_------_-------------------19________. Area ....450........................... m Diagram of Lot and Building with Dimensions Fee 1............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH o e r . 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. Nam(;::A ................................................... �i Construction Supervisor's License .17. ............... C BABCOCK, WILLIAM S. A=53-15 f No ...28714... Permit for .....Addition ............... Single Family Dwelling ............................................................................... Location 81 Little River Road • ............................................................... Cotuit ............................................................................... Owner Wi.11iam. . ..S.....Babcock. . ................... ...... . .. .. . ........ . .... Type of Construction .......Frame Plot ............................ Lot ................................ Permit Granted ......November...27...........19 85' Date of Inspection ....................................19 ` Date Completed 19 (�C1 tK d Gy``f� a��--� A 4 i r �. l CN�w s3- �� FEE co 03 TOWN OF BARNSTABLE, MASS. 19 O wpm 0d)•� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO c r�r s _....................................................................._.._......................................................................_......................... .............................................................................................._.....__.. O .0 (PROPERTY OWNER) (ADDRESS) cl cd b _. c.a TO ............................................................_..............................__....................... ...._._.___.......................................................................................................................oO FI^ URy (BUILD) (ALTER) (REPAIR) d N cs p,R u' ......._........................_....................................................................................................._......_.._._............................... .................................................................................._...__...__._. C � C (TYPE OF BUILDING) (APPROXIMATE SIZE) w w o LOCATION .............................................................................. .............. V (STREET AND NUMBER) (VILLAGE) tic yE NAME OF BUILDER OR CONTR TOR _._....._ ._..._.._..................................................................................._............................................._............__....._.... \� A qd �� APPROXIMATE COST .._...._...._....__...._.._._.........................................._...._.........................._....................._._._........... ___...._._._._____. +� � y w eow 1 HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN OF BARNSTABJ,.E, REGARDING THE ABOVE CONSTRUCTION. m / oP40a _._..__... ........_...___............................................................. _...__............._.......... W a) N (OWNER) (CONTRACTOR) � 03 0 . U r..: M U � a BUILDING INSPECTOR Subject to Approval of Board of Health. Qf /. 6 . �I !S£'e,,ct g._ 7 .. A ax-': K, a •~3 '�* f. �`:+' Ta1F irUt .x .t2fJs i1.•, a4,YA .f.d "Yf .i>r; .V9 ".�' a j• :.l t Ir f R • ~ � �f` �. fir. I' a . a ' R Assessor's map and lot number ... ............. .................. INSTALLED IN COMPLIANCE Sewage Permit number ......3.�.3....................................... WITH ARTICLE 11 STATE SANITARY CODE AND TOWN �QyofTHE.r TOWN OF BARNSrT- MIE 2 i ISUNSTSDL i ;9. BUILDING INSPECTOR APPLICATION FOR PERMIT TC�' ............ TYPEOF CONSTRUCTION ....14 .. ............................................................................................................... ......1./....�..%..........................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for �appermit according ,tto the following information: Location .... rt.,J.t�G......1�:!...........I.O.�.�s.++�P C.AA*j.................................................................................................... Proposed Use ...... .,cs1 ( ZoningDistrict ........................................................................Fire District .............................. ................. .............. Name of Owner .... .. Ad r oc. .... .ry�..s;.. .a'.Z.z..,s.................. J Name of Builde ...........................Address ......�li�l�.../.4e,=e...................................... Name of Architect .. . . t.t .....�� �......Address ..... Af .............................................. Number of Rooms ."S..O1P.0't"!�1-.... .,... .. . . ...........Foundation A,�......1� .. .ram ............... Exierior ..Ffl1=11.. .............Roofing .... ................................................. Floors .r.SN.Q7..T -................................Interior ......... t �........................................ Fieating '.. ................................................................Plumbing ... .. .. .................................................................. I Fireplace ... Approximate Cost ........ !t!r.�. d....... .......... ca�o*.c-scr 7 70 Definitive Plan Approved by Planning Board ---------------_---------------19________. Area ...... .:......... ...S Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH y f 36 "Sl 20 Z I hereby agree to conform to p�I hie les an egu a ion o e own of Barnstable regarding the above construction. Na � .. < ill........................... Babcock, William S. No ... 7.4§... Permit for ..... 1 1/2 storq, ................... single family dwelling Location ......Little River Road ............................................... .........................Cotu..t........................................ Owner ............William S. Babcock �- Type of Construction ..........frAmOR.................... ................................................................................ Plot ............................ Lot ................................ �'' ► Permit Granted ..........Jnl3►//..17....,,.��.rr.��........1474J- Date of Inspection Date Completed ....... ... �19` PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ./ v 0 y ............................................................................... .................... ......................................................... . Assessor's map and lot number �.................. .................. Sewage. Permit number ..... 3................................ y�FTHE tO�♦ TOWN OF BARNSTABLE Z BAHISTADLE, i "6 9 A`' BUILDING INSPECTOR 'FI MPY lo APPLICATION FOR PERMIT TOrfdf ..�c` ter 1 .. ..r ..... s'�.,�.....�: �/ ............ - TYPE OF CONSTRUCTION .. .:�....................................... ...... .................... 7 / .....19.,7'/ TO THE INSPECTOR OF BUILDINGS: F The undersigned hereby applies for a permit according to the following information: Location s r cscd �.................................................. .................................................. .. ......... ......... ............. ProposedUse ..�.�?1 d,.f.. ,� r fd./,�r >~s ........................................................................... ZoningDistrict' .......................................... ........ ..................Fire District ...........:... ............................................................. 40- u � r Name of Owner ... .. ........ ` ` r c Address 7 i Name of Builder' AL , r:�1fv' ���+' ....lF� � fr�`r . +............................ ... ..... ... .. ..... .. Name of Architect `/rri �! �, r� 3 - Address ..... ..... ....... ........ }................................................ _ "Y�+7 f s' , Number of Rooms �. ....... ... s f ........Foundation ..rf.d....... ........................................... Exi_erlor '..............Roofing ......:.. , ..z.... ... ...... �. r / Floors Interior ... .............. �N E s k Heating ................. ...... .......... ..Plumbing . .......'................... . ... Fireplace ...... t ,- t ................Approximate Cost 4t�') o f d �.:..* ..................................`........ r. Definitive Plan Approved by Planning,Board ____________________19 __:___ . Area .. .... . fro ... Diagram of Lot and Buildingwith Dimensions Fee;...... ...................... ........ ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH y 41, y}ti . , S 4f. i t ��_j�►f r Y .rI r• j�_ hereby agree to conform to all ,the Rules and"Regulation's of"the Town of Barnstable regarding the above construction. , ` E-�R U,, , . `.�.i............................. Babcock, William S. `J • Y 17218 1 1 2 story No ................. Permit for ................................... single family dwelling ............................................................................... Little -River Road Location .................................................................. 8otuit ............................................................................... Owner William S. Babcock .................................................................. Type of Construction frame .......................................... ............................................................................... Plot ............................ Lot ................................. Permit Granted ..........J.ul.y....17...............19 74 Date cif Inspection .............19 ....................... Date completed ......................................19 PERMIT REFUSED a ................................................................ 19 ....................................................K......................... ................................................................................ ............................................................................... Approved ................................................ 19 0 .................... ......................................................... 11 . )'. �{�A s 1. . . ,1 ..._ +' : ' .. .:,n ...��ti .. .,' •P .�. .•.. ..' .. :,. S 1 .. .. .r -, i....F .. I _y {. ; S .-M. . V r r f "i 2' :. � . �+ �. s.- - . 2. 4 r -�• ;:t ,. ; , , �{ .,v. - _ -, •. ,✓ - k '�.• Z{T.J ) i. ... , .. - _ „ •' }} T . .. _.- . }; � . ,. rr w tv : . d: .- . } jtfy ;L r :: ; N} .,.... .... .. �' "I 7 ,'.. ..e. , , .. ... .. .... '1, y _ _ _ -. Ita r .. -:. ,I .. : :. :� - ,R < 1: j::. ...' . .. .-. . .-. .. I. 8 :4 I. h D `• is .:. r� ) _ _ .. : 6 .; . ""._I. _... ,Y ., t. t1 } ��.- , .- •� r• �-F . �• . Siiy� t� I + :• V t r. ,.v .: .. - - �' •E k:;-: .: ,- 1. ,• . 'F'''.. 1 i. t.. - - , .,.. } 7. . .. .,. .. fI.1. ,. .-..a. �+ w l,•>. .. :. .. -. .. .. h .. 1. ..t.r.: ..., ,.... a . ..'. s ♦ v. to Y- 1 �` f 1 I' _1 .. .. ..((��.,.�� ... r -f • - n. ,. .f. F ,. G :� u. {}l} .. •t Lj�p.. l: S f. ._._ :r• .., -.. a _ ,roast' ,, t ,. r:. :.._.. .. - .,. .ft• . r. ... 1. . - ,i ,< -v >:. - ..- �� •if'R _ . +/ r . k _ .. ... ... .i.:., f y,;4 ..,..... ..J .. 5. Y•.c •s.a 1 •, _tr ?( .•t'?' r. 11 ._ .. .. .. : ....r.. .-. ..» . v, x .: _ .: y ._ > . .. r1.I. w. ..; ... .... 1.. .. , d r. ..... .! , . . .. .. .. ,.;..,. mac. ..:. ..:. ..r. > -.... nr , -. 'r:..:,>'.. AU tar p 'a• v -..c. ..i: ...,;T, : - .: ... :....5 +1 .. .. .. :✓ .1 w�i .:..�w4 Vf / :�'R w. >, ra , . , � :: a. r .a t s I. -yt - c r ::.iE. i z s , .. . .>.:. .. too l ,. r . ._ . ,► a.. ..,R .. : 4. K r w .., : . . .... . r . x x. s..:... .. .•. t .. fi r, i .. _. :, '4 4, t r t. "� 7. ..x: - ".� .-. .. : ,.-.. .,' 1 .yam df - -� r r 14 a. 414" _ �. '..... .-'_: :.. -... -,. -..i .i.i, ., .:. �: •. '-: �.�,:.i fir. i 'ir .c -.:y ..,,r t. , - • .. ::: --.. n. ::J ,r .c,. .ri '. t.. -'h..I. i,.< .rC-,;C'. .... :..... .,.,... , r li�- fof- t ... :' ..• < .. .,_: ....r,- Y -f .'- 6 :tie' ).. . r s: P4 c `�1 Y �: 3 - ! r 3:" , a ` [ v� A .. t .i... .. . .... ,. .> •.:--. ..s.. - al t ! -- f'L-, Yz - `f {: t: :.' 0... , tiI'll s. -. . - -. J ✓: . . . '�i .. 4 X ., - .. X .4 1.: _ . ! * . . - ;� _ : ra. j ,.. 1 �-r ; ;.- i , . ,. ,. . . ti >,, f t 4 :f'.� "; ... .. . ... - :. ,. - A. r )7. J( ' rr r... _ .. n NA ..i :- z \. J, 0 is.an 1 .., -., .....- : .. - �, fr .I'. t Y Z Y � i 5 'T k: t ,A Ir , .. .. '.'. .a.. .n :i f Y u ,♦ 1 3 r. 1 3 a +:' x r . 1... . '. � - , , .,! 7 Ya G'4 ..t. �.• J �L :t�. S }+ .:r % 1. v'i'.. :Vat .,1,. t , '• t .•... ,.. , : s.. , a. t : TRAB,. ^.. .. r .. ... • ... ,_4... 4 .,. , ,:.-..mac, ..-•:' •2 .P: l ',,s, l.. .. -.. .,.,. .... ..,. .. ,rl. .. . �- .5, l s" ..,, . r. _ ... . - _ .. :..... .. ...:..... .. T'i.. ..: . r } P , Id .. .. .., . r S. ,,..:� ... a -1.... i f ,. 5 r u. : `.., i.'•. >• Y a \ C t t l r t 'ti 5 "aY my Ii .: : _ .. .. e .. - O. �} ^ 1. T rz ri \,{' % . .. y' ,. ., .. .. .. .. ... ...... e t . 'Jjj .r :-.�..:. - .w i r y t' < r i:... ':�: .. !»r•. .. ..y. 1. I,i . ... tA.a4 .,. tR ..r. .. .., - .. , -,. .S.tk , , ., ..: r.... 't. 1. r- . c r ,t t. t.. F r ... ,r . t... �. h•'.' .. r F i Y.• A a �, y 1. ti r:. ..R. 4, v� w Ar: N m tooF- µ'Y r iAm" :f F,.;�r .,f ,.-. '� :. , t ,. i.+ y-.�►w 1 i tC' N. r v: t +>K a v r^ t, r X y:. tY ts+w ,.. RTI ( . ;:l.. n 3 r: ... <. l• 1. t a, i :4 ,,. ,. ..:-.... ., r - ..... . v, .. If _.J!1,4, F : yf� i' a 4gnat .f. i ::Rf•,.. y:;:,R•ff,` / , +:v.l- �...... .-. r...:t. ,, . 17R1 .t . .: - : : ,. .. '!'rites ..-f a t. ,. 1 . t ..".... a as ya . ,., : . r r Y. r. Y-'AS r' S. 4 .) �,'tt '� ii r -. . '?4. •.rt. a. r. ,w rr.' �•. '} ', { 'f'�' L.. i - « +. . �, , ,��,,�1 I. •'1 F t .u�'. yy 3. 1 4' ( J ♦ a ,!� t, i -saa ,.p.•, i. ,#"a.'s7 _:tl ''tIng i , a.,•'/. 4 * ' ..'. E. 1rr. A : .�• .n.t i':^ *s C • , .�F`C x v a. F n - t. t 7 +'. ....,, t. .. ... •x A� S w a rs t .., n: f - .. e.R 3., t... t. 7," a Z ::4 A +` 1.1; .: , a. ...,. .� ,f��ar7•.4,•',. q ... .k :..•1 xs?: t a4 7 k e•-;-..,'- .f ` , S.S. f :•..'r•'fi...' '.-< '.�� -fie a-' i 'r -i S ..r t:.•. ,L 4l- d. �y x -.s ^c Ys, ,rp '. 'r: e- a { r t"• r c ,- "r �r ylf ..• r.s 1 _. 1+.. .a U .- M.. a , .t .. .... . ,.n .. ..•. ?. ..'9Ec ,': `• S. y .t.. .;t: :J-..` .w f Lt 'rJ- 4: ..t'. . ... a. .., .. ... '.§. .a ..,,. ..' .Y:e -..f.rt• ,l,-z .ti.. .)t.. .rl.r ,.!�, •.! t,+l` ... ._. fr nr..L+... ls_. .. ._ .a v- > ,_.q,. .. . .. :1• t7 Z', �♦ .�: t ,1.-:J; �e +...�. .,jj. .s. T .r'.i ♦. 1. T:+ •:.. W .f 9 !a. �' i 5i. .4 t. ;..� t�!,of { .: T. ., ...,h......, ,. , ... ,.;. Y '1`y ,y '4, .:< .. .,. .,f., .. a. .r .. _ :. ... .7 .. .r .. a .. .... .. J. ,.....a .__ r ...x. v,v; .1 r.::. im.: ,P 3,. , -. r. .a l.. .S{,... Yt c..... �::.�-:d. t: :'. -1 'Y' t'1 } Y.yy��,, .a,,.f,y l ♦ 'f.. • •'.....-•.. t. �,:... .. w ,r fit.. .,.. { .t t�� 'C qY C:I ,r,t� A Ya ..L. a .i..a -a , r. 4 "tt ) s .. e • '•. >n .,e,•., .i r .,.t a.4t a a .+».. ♦ !. .! ".c '.•\`' 1 -V ��F: L. , .,..4. ,. a+ , `. a t. L is •6 a .�.. VAN '.t ,�.° n. .r t.ri Esc •�• :6, �� z ._. .a'_�„1t..,._. .. .....�.yq.Gt;�{ a.4Y,... �..4. u-.i ... .n •- ,i.4 S.. ,-"S•. :i- .. ... '.- .. .. w0!� . 6.f•(�L _ _ �r. .. .•.t � ^12�� � ... - J r 1:� �.d _ J{�.: R ,