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Home My WebLink About0162 COTTONWOOD LANE 4 _ � r Assessor's map and lot number ..........................................�. TH E r0� Sewage Permit number-� ?�a.. ?,s� ,....., .........../.......... Z BAW STABLE. House number .... 64-47.1...�................................................ 9 Mae& �p 1639. \0� �0 MON a' TOWN OF BARNSTABLE -1 BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPEOF CONSTRUCTION ...........................................................................................`.`.......................................... ...........r � ,/�.......19Je TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the�following information: Location .. YJGrJc?Z'. .. ! /7r :......t /1G//r�e...../ ..... c ... Proposed Use ez ll ....................... ...J ...................... Zoning District ........................................................................ ..................................................................Fire District .............................................................................. Name of Owner ..... .0 .f.. .P..t ..........Address ....... J '--. tf z^- ,.:.................................. Nameof Builder' ! ...............................Address ....................: ............................................................. Nameof Architect ..................................................................Address -.... ...................... _ ......... ..f ! .................................... rc. Number of Rooms ..................................................................Foundation ...:......... '' , tt.``" .....✓'��' .................... Exterior T�TZ?� 1?�7i.�J.. �> .................:.............Roofing ....../ c�JC�'........... .......................................... r............ '......s �. y..�. ........... Floors C � �J� ...............Interior /�a r"O"P17.7� ..................................................... ......... ................... ...................I......................... Heating ...........................Plumbing &'6� ................................................................. ..................�...................... pis Fireplace ..................................Approximate Cost v.. �............. Definitive Plan Approved by Planning Board ________________________________19________. Area .:`.: . '.`........ ........... Diagram of Lot and Building with Dimensions s Fee ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r. � .........Name ............ ............ POPE, DOUGLAS W. A=252-26 No ..23950 permit for ,Addition ............ Single Family' Dwelling ............................................................................... 162 Cottonwood- Bane Location .............................................. Centerville ............................................................................... Owner ..Douglas W. Pope k ............................................ Type of Construction Frame ................................................................................ Plot ............................ Lot .:.............................. a April 12, 82 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 / ® �� .� add gzvn Z- y- „Assessor's map"anal lot number �. ........................................... SUBJECT TO APPROVAL OF oFtHEro -�- Sewage Permit number ...(�,lC... o..� �„Q 6-,f Jp 74_ARNSTABLE CONSERVATION COMMISSION Z BARNSTABLE, i ,3 House number ...... r raea• SEPTIC SXST TORN OF BARNSTA ® IN BUILDING 1HSPECTOR � ° 'APPLICATION FOR PERMIT TO ....4:; . :....1©X z V ......................................... TYPE OF CONSTRUCTION ........ ... ... ........ .....................................................................:............ ..................... c�.r .........19. � TO THE INSPECTOR OF BUILDINGS: t; The undersigned hereby applies for a permit according to the following information: Location ./Z-14 YJl�1J �"r'�C'.... f�.f2 - -......... !�r2.Y! ...... .................................... ProposedUse .......................................................... ........ .,. ..................... ...................... Zoning District ...... 1/.'/:..........................................Fire District .... ,rr�6.�`4t ......................... Name of OwnerrDO. !C n. ....PQV..1.e. ............Address .........4G. Name of Builder ..............45... ..................................Address ........ Name of Architect ..............72.-v ..............................Address Number of Rooms ..................................................................Foundation ...... .. P hYJ cT�-;�:;`-�..`...................... Exterior ..................................,. ........... ...............................Roofing ............... .........:.....✓.............................................. Floors ................ ..Interior Fieating .......................................................... .. ..Plumbing .................................... ...................................... Fireplace .......Approximate Cost Definitive Plan Approved by Planning Board ________________________________19________. Area ........ .......................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO ;APPROVAL OF BOARD OF HEALTH 2_q 1 I hereby agree to conform to all the Rules and eR ulations of the Town of Barnstable regardin the above construction. Name .. .-�......... ......... . .. ......... POPE, DOUGLAS W. »� w ! f 1 a wo .2.3.0.4.3... Permit for ....ADD DECK. �. ingle..Fa.Mily... e Dwll. i' 9 n ................. .. ... ....., .. ... . Location ...162 Cottonwood Land ..••..•. a = Centerville .......................................................................... ; Owner Douglas .'�•....Po'�e....' .......... .... Type of, Construction ......................... , ............ ................................................................ oP Plot .....................* . Lot ................................ `' Permit Granted Aril '24 � .................. ................19 81. Date of Inspection ....................................19 Date-Completed I PERMIT REFUSED ^.r ............................................... 19 .... r. .....................y�.g.t..................................... h `. ..... ............yam .......ya�...................................... • , •- �. • , .s •. U I ........ 'v g F. { .................................... a '� s � Iy' - a - .... ..........t1f y�q ^.' 'x..-. ............................... - b� bso.. d Approved .....:A:...:...................................... 19 .................... ' ............................................. �": ............................................... i , J a.� � !— Assessor'srmap send lot number ........... THE - i_ � PyoF toffy Sewage Permit number ... � .C...elh�.. 0 BAEBSTAXLE, i - House number ........,/OcrL-................................................. yO 16393 Oq�i6 • 6� 'F0 N a` TOWN OF BARNSTABLE v BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....1�% ..../D X 2 S/ IDX JD................................. ....... TYPE OF CONSTRUCTION .....��., . -...................................................................................................... .........19.r"P.` TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby appliesfor a permit according to the following information: Location .�1....�?. .�...�'.!.%!IJYJ.�flr ....4g.C..,er........... .................................... ' 4 ProposedUse ...................... ............................. . .................. ............................................. ................................................ Zoning District .... ! .. /...................... ................Fire District ....�alL -en.tie../.XoI.......................... . ........ Name of Owner4/`4� .!CX..?.....w......P Address ...........Z . ... !"3A.. Name of Builder 4.fl. . .. ................................Address C�5e.,� Name of Architect ............ .....................................................Address ........... . ....... ... ..... Number of Roams ....................................... Foundation ..... {?. 1.. �..v��er`�` Exterior ....................................................................................Roofing .................................................................................... Floors .....................:..........................................Interior .................................................................................... Heating :...•'::................:.............................Plumbing ..... .. .......... ......................................................... Fireplace ........................ ..................................................Approximate Cost .....�k 0... .......................................... ... Definitive Plan Approved by Planning Board --------------------------------19________. Area ..............��.................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ! r7 Y Zq�1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I �j Name .. ....... mar ....�!C............... ......... G POPE, DOUGLAS W. A 252-26 N0 23043 Permit for ..ADD DECl: Si.agle...Fami.ly �Dwe1_J-ing. . ............... ............... ....... .... Location 162 Cottonwood Lane yr ................................................... ......... Centerville Owner Dougla. ....s W......Pope. ......... . .. . ....... .. .................... Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ - April 24 , 81 Permit Granted .........................................19 Date of Inspection ....................................19 Date.Completed ........19 " ,-r PERMIT REFUSED _ ....................................... ..................... 19 , ................................ ........................................ ................................ ........................................... Me ...........�............a ..................... Approved ................................................ 19 ............................................................................... ............................................................................... Q_ SEPTIC SYSTEM MUS Sewage Permit number. ........... INSTALLED IN COMMOU TOWN, OF BARNSTABI Ej ONS SUBJECT TO APPROVAL 01 H Eft ILDING , INSPECTOR COMMISSION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin6 information: Location ... Proposed Use zo Name of Owne-�r ..(�. .I_P4 ..PCV ..........Address ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 -----------~'---- ...................... POPE, DOUGLAS W. 23950 ADDITION oNo ................. Permit for .................................... Single Family Dwelling ..........................................................:.................... 162 Cottonwood- Lane -Z Location ................................................................ Centerville ............................................................................... D6uglas W. Pope Owner .................................................................. 4 Frame Type of Construction .......................................... ................................................................................ Ail Plot ............................... Lot ................................ -3 Permit Granted ..........19 82 bate of lnspectioq�.4~.. - ......:', � � � Date Completed ............................f.....10 el 0 Ate' tt\ SUNSPACE-APIrlon!- Nei is mCT mTNT' �► ns-1-A iBLG 1='I nods . ,`` "--�. .. _ r1• ' P L 11V I W ►� , � 41,v 'LAN r�s.�Ess leiAP/R5E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel y Permit# 1� 005 3 Health Division �✓ Date Issued 1012,0)oq Conservation Division'. �6 �� ► PLAN 10/7/6y Application Fee,, 60 Tax Collector 04NI/� " Permit fee f-7,31L Treasurer r .. Planning Dept. ., EXISTING s PTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO #OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address Z ) ` Village ey- a jn�U1 Owner Ri ci)" is5wn kd,,n&n Address Telephone 7A -D695�3 Permit Request. .524 Square feet: 1 st floor: existing proposed proposed Total new 1 Zoning District Res,zin,,.c_'�X)� Flood Plain 'e Groundwater Overlay Project Valuation % (�� Construction Type-3 - fjr , Ga Lot Size ¢� ! _S, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family l TWO Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No. On Old King's Highway: ❑Yes DO Basement Type: 21 ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3-7 1 F, Number of Baths: Full: existing % new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count s�cC Heat Type and Fuel ❑Gas ❑Oil ❑Electric ❑Other f Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Y§s, ❑=No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑n6r size' ` / Attached garage:❑existing 2new •size/4X Shed:,U existing ❑new size Other: II = Zoning Board of Appeals Authorization LJ Appeal# Recorded O Commercial ❑Yes o If yes, site plan review:# rn Current Use / Proposed Use a r, BUILDER Y INFORMATION ( { ��`� // Name � �/� .0 5� Telephone Number}_ �/ 9-3 - 3, (' „ c F ¢ Address ®Vl 2` Li ense# Home Improvement Contractor# f `Z / �'T _� 1 �. �� Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO - ET SIGNATURE �L° DATE .� t FOR OFFICIAL USE ONLY - f PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. , 4 ADDRESS VILLAGE OWNER f - DATE OF INSPECTION: FOUNDATION WileV�Z 5 FRAME INSULATION (w l /Z. ' FIREPLACE A } ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH X Ma FINAL , GAS: ROUGH S Oj FINAL FINAL BUILDING ' n Ot h rr ? I >- DATE CLOSED OUT �. (ri Qp ASSOCIATION PLAN NO. Q N $o o u .o N • W W 1�1 � N Z O D x i rl J � _j UWa W j U I' j J LJ Q F U r N rF i 7_ I i 1 EXISTING HOUSE w U W PRGIS" &R6GM i; � II ; II ; IIII Qua -NEW GARAGE-. .. .. .. ..:. .. II , iI J� ooII , I I I � i I?"l I I III_j _.. :. ji --- FINISHED FLOOR �—FINISHED GRADE —_ - --�---=-�--. -I--s•t I r- II II rl- ---CD -------------------------------1----�� I Z L----J� ----'------------------------------- I -- I I ------------- ON SCALE_ �1�4 = o b b , N �O U W Q Q A A to A 3 � N Z Z (U O � X --- —TI J alu U > a- W L EXISTING HOUSE u r W g PROP. SUNROOM - - NEW GARAGE i .. :. .. -r -�. -�- ------- - .'— — --- --- -- --- -- LEVELED WITH EXISTING Q Z W u _ SOFFIT HT. IS ILI --- X d — o J. 1CILpp }y �/ �f I � A BASEWALL .. --- - ---� r_ e -" FINISHED FLOOR - M . .. - ---- - IN HE 0 -- ------------- --= - -- ------- F IS D GRADE - -- �- - - -. 31, •t —I ---- i }10" DIAM. SONOTUBE—:.L _——————— �I I I I Ira --------------_r ------------ —J F— E� ILJ 7r-5 LJ -5 �L--------------�L-------------------- � F ----------.---� "" --------.---J -- _ 14'-10 1�2" — - --- �1 zW z a , im q LELEVATIO SCAI._E: 1/4°= V-0' u a 1 0 3cli N n�w,uw 00 O X 8' z rs iov s eorta�. J q Lj W > a EXISTING HOUSE PITO TION p TOGA L --- FOUNDATION DETAIL o N \ E � > I. FULL 6' WALL /' d \\ \ EXISTING SLAB I \ \ I i \ W W I 4' CONCRETE SLAB /PUREDW A 4• O 69a 'NC, DIM W.W.M,C E \ u S AB - w l I 1 I \ WITH 4 MIL VAPOR BARRIER t L_ J\� \\ \ \\ \ r=4 o �z C �1— ------ —SL- —————— / 25 w ¢U \ \ 0, \ \ �' O \ \ GARAGE PROP. GARAGE \ � a n F OUNIJ(`-l"I�1N F F_AN SCALE 1/ 1,-0" \ F- NOTE: PROPOSED GARAGE IS PLACED DIRECTLY ON EXISTING PAVE DRIVEWAY. C °a PLEASE VERIFY IN FIELD. N �a --2r4 KD SPRUCE w 3 • � i ---._I/2'Wr SHEATHING O c w o _ __-T/2'SHEETROCN --SHINGLES TO MATCH EASING NOISE 3 ENT.I i ------R13 KRA"FACED O n cu --3/4-T FIR PLYWOOD SUB FLOOR Y -'--RI9 TIBERGLASS INSUL. A W .._EXISTING HOUSE / PLrn000 W j � .. ... ... .. .. .. .. -_...... .... .... -. ......-. .. !... .. ... !'�, __-_____-. CLEAT DPW— U Li M -----'----FIRE-RATED.DOOR �1J. BASEWALL DETAIL A w Y EXISTING SLAB V I I > w I J" Www Ilk _AkliX70 P.T. LEDGER BOARD rn - - _ L.Jo x� LAGGED TO DECK -7 -' I I �� \ 3-2X70 P.T. GIRDER ----- - - - 15'-8 1/2" PROP. GARAGE lF RAMING PLAN f1 •\ I NOTE: FRAMING FOR PROPOSED SUNROOM STARTS AT THE EDGE OF \, U OF EXISTING CONCRETE SLAB: \\ 90. . Q an _ = o EXISTING HOUSE 3'-6 w r 6 6 6 ¢ U K G Acli N -FIRE RATED DOOR - EXISTI G SLAB O Z x PROP. SUNRO❑ • Lo LJ Uwe \ > a ol \ � LD .. � CD - \ \ \ \ W o0 \ z\ ww <B) \ PROP.\GARAGE ,\ \ \ \ \ W w o sU w .13 1/4°= 1'-0" ` 9p :'y ; ��"' x SCALE / p � l� -� '\ JEXIST I ONCR..DRIIVEWAY �m i m • 00 $ o oa = � 3 � ti � N mZ X L.A. .W Q U > Q W f w Li _... p --EXISTING HOUSE NEW GARAGE O �..� PROP. SUNR OM _ > _ SOFFIT HT. IS LEVELED w L W - EXISTING \\ _ I\\ ----. 4—1111 p \\ I i t — -- W -- -_ -- _ 1 II --- ----- - � _ �ry-J III II - - — ---- BASEWAL - .,. FINISHED FLOOR --- EXISTING CONCRETE SLAB-- ----1-------- _-_- -- Y'POST ----- -- - _ FINISHED GRADE -- O - ---------------- -- ---- _ F----- - ,I I - 10" DIAM. SONOTUBE I I I I IL L----------1-}-------------------------'-- —Jyx -----L----------L ------------------------ L � I I �m z a ' SCALE: 1,14'= 1'--p„ The Commonwealth of Massachusetts - — Department of Industrial Accidents' • _ I�GB 8f��i'l9SL�d�' . _ 6Q0r Washington Street Boston,Mass. 02111'. workers': Con ensation,Insurance Affidavit-General Businesses y• �{y�� a� �( '*rstnat Y+'v—ta(. 'sy, se' j. .,.. +•Z'i,Lfi] • ME ]]'yJyv. ._ ♦' � Fv�'•i •I it• .. address: state; 2.1 hone#.tS 77� of work site looatio� full address : �S I am•a sole proprietor and have no one Business Type. Q Retail❑Restaurant/Bai-Bating Establishment working in any capacity. [] Office❑ Sales(mcluding•Real Estate,Antos etc.)' [] Other ,.• t . I am an emlo er with %/% %%%%///full& %%%y/%%////%//////%/%%%%% / orkers' compensation for my employees working on this job.. an,employer providingVA v�'. r; '• '':'' to •f:fit •A3�•,(+. 'r" J. COIn•aII y� c' r .. '�t,.j:r. ,�r:::�:. •',i ,y; .Y.t9I11C: •i'=A, •.fit, .t +� 'r':. :•i:' .'j' .t 'r .•(�•�i:;: rr�'.ji:•,. .. . �.; ;t. L addres + + t ..tr. r. ••J :l•1 t I Si Ctl 'p..• r,. r't t'•' r^�'. '{n'�!•r4• t; ;;n `.1.N•�'. "' .,••',. •t:'•'1•la':I.r• t O11C.'.# '/%s t.•.i 'n ii. I am a sole proprietor and have hired the independent contractors listed below who have We following workers' .compensation polices: .f' ' :.{: •.:(r''�• .l'-"il:'I�' •. .y' ,.t;•,r 1;�.4• •':•, •(S �`:•, .•�v�.`�:'•1 '.1..+Sy �„�.�`��31• J`.:.j'•'•L�`:� •+' coIIi aII II •:n- �.i�' {+ •f; ,:'. ''+:' ,tr;°, '� •,r:' ,ft:,i •jr,;,::�, �'Tr t' .l •,i '(' •,._ •��!.. :�• •'i�7.:.:• addre"s •�,•t•• ,�• r '��' ••i .l j• .J�r;� ;'r• :�: ,ii.n•r:":%.Yt)' .f i :S, ..'lY• , " '� ' i7°i�'•.h•:••r.�:"o( tr. .rt,:.::( ..t• �•::•:.' .tat;- (;J at - :;' .., r:i•. ,:t ... 5,:,;".y^.::+I.: a.;,,r� .::� Cl .„., t�e "::,:"'• 'i;r.r'��:'`(-"i:J:`(` ','1.i:': .r,tr•' �r; r•. "t .i 'r. �: �.,'''t• ;t ' • .1• t..t.r v`r;:; .•, , rt: it'• •�rr','Y:. � it'•;.•. ': 'ii ,'�':3; ' .'tS '.:wr.,r tr.,' .. ,z y.. .i''i`r,�'1•>,t�••' yi;, ,h. -r;:.r:. ,UZiC a'' .t.A .k'ti...':?`�.w• :r.,,•.�r.;,i;i� �{`•t,ti•;r; t', - •r J• •p-.• Ji(,:[•'i Tt:,•: i :':,b"' ';t•J r�..;, ,�: ,,�, 1 ' ::: :tl•, .?: �:?y:l ., •�:�:,' ;r''.5 t. Fr.•i:.$ 'C: ,{:"•.��(;:/"i�• 7•'{:.t ir",«'f.:(:r•'•: t' ''r7t:�'-t•. FIX Orn an. .f'r:« 1'�'elf:• .:�:.S tr•,,;�: •Y. i.. , _�-_ C ji9IIfE: �' a (• +' ir,s. '' J", • �.• , ,4.� .>i.. i,i'(.:+' sty' r �t; ttf t '. • �l ... "' ••• +" r• ;�;,,. .'r;'' ''�lOT1E.'sE'r:• t •'i'L. :t,: t;• .. • '.Sy •',i/ t:l� i••j,.ty.•��t.'3:r1, . 'A. I.S1 N.,' +'�• . . :'�1• 1, •rV•: ,i:.t.. ,�• �,•'1• Li' •_r•r '{(••� •r,r ,?:�;'..{�:.• •r�. ':1.�: :++.t i ' '!!. "sr' •OIiCVrlt',i• msuranCp-'ta� .......... aI:' / /::..: • '.'. �..� . d /... .r u•:' :r/:y r: // an ties of a ne to$1,500-00 Failure to secure Coveragag well as civil penalties n the foim o a STOP WORK OPME and a fine ofrequired wider Sectloii25A of MGL152 c��jeadio the imposition of �0 00e dlay againstt me.pI undersstandthat iL one years'imprisonmentp COPY of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereby c ify under the pains and penalties of perjury that the information provided above is true and c�ect Date Signzture 04r C. Phone# 7BI E5 pnntname �iii�u T a -rFyGc K s Jr official use o�y do not write in this area to be completed by city or town affidal I permit/llceme i' ❑Building Department city or town: ❑Licensing Board ediata res owe is required ❑selectmen's Office ❑checkitimri P ❑$ealtliDepartment , phoney"; ❑Other. ' r COnta Ct DeTgOn: - Inforn ation and Instructions. to ers to r'ovide Workers' comp ens atidh for*their.• �Zassachusetts General haws chapter 152 section 25•requires all;emQ y p , loyees: As quoted from the 4`Iaw", an employee is.defined as every person in the sernce of another under any contract � lied, oral or written. of hire; express or imp m to exe of r is defined as an individual,partnership, association, corporatioan or of a d ther eea ed ai �, or loan,two the receiver or An e p y Dint enf rise, and including the legal represent fiv ,� Y the foregoing engaged in a'] e'P 'However the owner of a trustee of an individual,partnership,, association or other legal entity, employing employees. dwelling house ha`nng'not'inore than three apartrnents and who resides therein, or the.occupant of the dwelling house of another who employs psbns to do,maintenance, construction or repair work on such dwelling house 6r on the grounds or building appurtenant thereto shall not because of such.employment.be deemed to be,an employer' MGL chapter 152 section 25 also•states fiat`every wi state'or local licensing-agency shall thhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.cbrnm,onwealth for any applicant who has not produced acceptable evidence 1 C0 subdivisions shall enter into any ontracgfor tce he performance of public work until Commonwealth nor.any-of its political a s acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting , authority. Applicants.. compensation affidavit completely,by Please fill,in .the workers'. checking ofu ace as all affidavits- be submitted supply company uanrie, address and phone numbers along with a certificate 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"Iaw"or if you axe orkers'•comP ensation policy,please call the Deparft*t at the number listed e1ow. required to obtain a w ^ City or Towns . Pleasebe sure that the affidavit is cbmplete andprinted legibly. The Department haas pe ai din te a space licaatat thd b Please f fne affidavit for you to fill oiit in the event the Office of Investigations has to contact y g g pp be sure to.fill in thep.e��cense number.which WM be used as a reference number. The.affidavits n�aybe.returzied to orFAX.unless othei'ariangemnmtshavebeenmade. theDepartmentb}•T ations would hike to thank y'ou in-advance for you cooperation should and The Office of Investig you have a questions, please do not hesitate to give us a-call.• is address,telephone and fax number: The Department . . The Commonwealth Of Massachusetts Department of Industrial Accidents - _ gt�ce of Ca>festi�afiens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone 9: (617) 7274900 ext.406 Hof dwa of Barnstable Regvilatory'.Servxces. $ a $ T4omas F.Geller,Dfrector b�l�a Ayk°� Building Division • Tom Perry,wilding Commissioner ' 200 Main Street, Hyannis,MA 02601 Office-, 508-862-4038 Fax: 508-790-6230 permit ao• D eta ' AFb�A'YZT . • HOME RORO'YEMNT CONTRACTOR LAW SUPPUMFNT TO PERMI'.0 A ULICATION meL 0.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, • •icaproYement,remtoval,demolition,or construction of an additioato nay pxe-existing owner-occupied btn'Iding aantainixig at least one but not more than four dwelling units or to structures which are adjacent to •• such rosideace ox building b a done by registered contractors,with certain exceptions,along with other requirements, ��+ r��-Gt•(;w►��,yr� Sct�Ialrryl . . • Type of Work:M e^C• &Ayt9 5 - ae& o timated Cost �'►S l afo. - Address of Wank: Owner's Name: •G�Y�v�� c�.Sct�i•1 . Data ofApplication: r • I hereby certify that: Registration is not required for the following reasons): ' • []Work excluded bylaw . []76b Vnder S l,000 []Building not o mer-oacupied []Owner pulling own permit Notice is hereby given that: OWnRS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED COP rp,kCTORS yojLA-'PLIC43 E SOME ZUROYEMENT WORKDO NOT EVE A•CCBSS TO THE ARBITRATION PROGRAM OR.GUARANTX P'm UNDER MGL c.142A, ' SIGNED UNDBRPENALTMS OF PLR7URY Ihereby apply for a' ermit as the agent of the owner: CS � G 9/9�r dies F• l 4eov ►bw Dat Canttacto=Name IteQiStrationl�to. OR Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 r Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot=1075or?, x.0041= 41 •d plus from below(if applicable) GARAGES(attached&detached) 3 square feet x$32/sci.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 " >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041 STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00. Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Town. of Barnstable p egdatory Services •» 'Thomas 's Geiler,'Airector, �, �6�9• }�� ujjftg DMslon 'OrFe � Tomperry, Building Commissioner 200 Main Street, gy ,MA 02601 . • . . • �w.tat�n.barnstable.ma,us -• Fam 508-790-6230 62-40 3 8 prop.er�r Owner-Must -Com fete and Sign This Section _.. • if us ing A Builder as Owner of the subject property on my be liereby authorizes utters relative to work authorized by this building perrrnt application f or. mature of Owner . _ print ame 4 CONSUMER IN FORMATION FORM—"SUNROOMS" Massachusetts State Building Code (780 CMR,Appendix J, Section J1.1.2.3.1) t The Massachusetts State Building Code (780 CMR) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom" of any size configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year-round conform considerations involved in selecting and utilizing a"sunroom" addition. The connection of"sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of "sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a "sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS" o Solar Orientation and Natural Shading o Type of Glazing o Insulating value o Solar heat gain o Frame materials o Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom o Adequate ventilation—Operable windows and fans o Applied Shading Systems o Insulation level in floors,walls and ceilings o Possible Sunroom isolation from the main house via a wall and/or door or slider o Heating and Cooling Methods: Efficiency, Zoning and Controls Homeowner Acknowledgement The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner (not the owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. r__ J_�__ +L +L: + +L 1 : . 1 1 .1... 1 «,... ICA .., +1i + l- /l. 1., a,A +1.0 . F..v .+' « lrl accoluaince w1111 1111J IUgU1rG111G111, 111e Unuersig'neu thereby ac1111VwheU es a at she/he hlas reau Ille inrvih11atior, in this document concerning sunroom comfort and energy conservation. ot)x,o A�� 2��"C _ Signature of Actual Building weer Date Print Name Address of Permitted Project Owner Address (if different than project location) Owner's telephone number May-21-04 09:U4am From-AIG JIJ—�jio vJL� � .SI• ';n.. "�;,h.o' .N' ..,I: ',..1i'.•I„�.,..+u.'Lid"i ,n,l,. :;r:;, i:li' ''�I,; ''5�:, '';I,::.•. 'd' f 1 � i IIF I G�A T:� INURA►�VE, 05/20104 7 "it•I�;, . 1, ... �' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAI Employers Ins Group Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 281 Main St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fitchburg, MA 01420 COMPANIES AFFORDING INSURANCE I-COMPANYA GRANITE STATE INSURANCE COMPANY INSURED Resource Management Inc 201 Main Street Suite 5 Fitchburg, MA 01420-0000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS 5HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c LTR TYPE OF INSURANCE POLICY NUMBER .POLICY EFFECTIVE DAME POLICY EXPIRATION DATE A HKERS COMPENSA ION ND EMPLOYERS'LIABILITY LIMITS HE PROPRIETOR/ PARTNERSIEXECUTIVE - - FFICERS ARE: ',TAYUTORY LIMITS NCL 0 EXCL❑ 4310649 3/02/2004 3/02/2005 THER ovcrape Applies to MAOperalionS Only. eACH ACCIDENT $ 100.000 ISEASE POLICY LIMIT $ 500,000 ISEASE-EACH EMPLOYEE $ 100,000, DESCRIPTION OF OPERATIONSNEHICLESlSPEC1AL ITEMS COVERS THE EMPLOYEES OF THE NAMED INSURED LEASED TO.SNE PRODUCTS INC DBA FOUR SEASONS SUNROOMS-600 PLAIN STREET, MARSHFIELO MA 02050. CERTIFICATE HOLDER CANCELLATION SNE PRODUCTS INC DBA FOUR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES'CE CANCELLED BEFORE THE SEASONS SUNROOMS EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 ATTN: PAUL TOWNSEND DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLOCR NAMED TO THE LEFT.BUT GOO PLAIN STREET FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF MARSHFI ELD, MA 02050 ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. 1 AUTHORIZED REPRESENTATIVE f �, BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 059196 Expires:.0412912006 Tr.no: 87485 Restricted:..1G JAMES E MACOMBER . 21 RIVER RUN w MASHPEE, MA 02649 Acting C mis over J(!:�7Iie &mwwmveq1& 0 rjBoard of Building Regula/ioLfd Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement-,gontractor Registration Reqistration: 126701 Type: Supplement Card 1 } Expiration: 7/8/2006 I SNE PRODUCTS/FOUR SEASON$ S �R0fW i JIM MACOMBER 600 PLAIN ST MARSHFIELD, MA 02050 -',•, _> Update Address and return card.Mark reason for chang )PS-CA1 Co 5OM-04/04-G101216 Address Renewal Employment Lost Card ✓!u iJam�,zaeuina� a�✓�aeaacla.,�aelta--- -- Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration; 126701 Board of Building Regulations and Standards gj*14llon /82006 One Ashburton Place Rm 1301 Tye S1 Boston,Ma.02108 element Card SNE PRODUCTS SS,,t7NS ,ill LT&TIMIBER 600 PLAIN ST ` MARSHFIELD,MA 02a'50' Administrator Not valid without signature I I 1 ' !4 9 it SHALLO Ff' POND f is, 1 j' LOT 1-16 DECK 1.ol' lop OCT — 7 2004 �� 4 10 If 5AJE '44� c�l ell �F .PC Thl.; \ U(Z'I'(� :\(; I , [\�'I'L(.,��fO� 1'1:�„ ,• Icir �: � 1 /'1,Oo/) zo: l:. Rink ITNe unit TO N: 1.1,�_ -- _ - 1%0;l:-�TRY OWNI-'I:: U._1.1'!I,'1_. �;.x .ill(l/ll._/,!," !ti_0';1:11 - -- - _ - k !)I:ED R[.l''. _t`f' `'�` LY-!1_L:[`1'1 U 1* - - - l):1'I'L: G' 0,v --;,00/ - - - - - - -- - PLAN NEI' l.[' :'�1��;�1� I'll. 1t �C' �Ll� (' _ v KI;:,I l HEREBY ('l'li'1'll'1' 'I't) 11%� �'_l_:1J►'�;l>----- -- -------- - YANI\E E U R\ L� 110.11E .1/��1�'1<,':Il.: l'11:1'P THE la111.UI.NG 1�OF a - - 1� '� �1iOIVN ON 'Vill< I L:1\ I.O(':\'I'E1) ON 'fIIL: (H(WND :,� +11 ('(}�.. L'L`l :\\'1 -IIOR\ AND 1111 IT:.: I'()Z1"1O N DOL. CONFORM PAUL •1013 (:i To 'ME '/,O\ING lAW �i•:'1'1;ACK RE'Ql�lltl•:\iF:.M'. c►I '1111.: a •IT( VA OF _ /+''I/;'.1:�'r::�/. 1\I) 'I'I{:1'I MERfTHEw INDU:�'I'RY ROAD IT Ix)! 1�J/' I., �'�l:,HIN TI,F:- - . 1►..-1'i 001) 11 ,'API) �:� saoee '{.• r 11:1h:'1'QX-z MILL:'. '.1:1 O::r> SHOWN r,N T::.. I 1 I). MAP DATED C.Wi,,,,i I ' I'.lr,!'� rr '�' �Ii�l1:; �a4 os v_- TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 252 026 GEOBASE ID 16349 ADDRESS ' 162 COTTONWOOD LANE PHONE CENTERVILLE ZIP - LOT 146 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 84601 DESCRIPTION ADDITION OF SUNROOM & GARAGE/#80053 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 111E .00 CONSTRUCTION COSTS $.00 � 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE 9*O' ' a _� * BARNSTABLE, MASS. 039. ♦� BUDtIl ISION BYE_ Of DATE ISSUED 06/03/2005 EXPIRATION DATE QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 07/12/05 PERMIT NUMBER 84601 PARCEL ID 252 026 162 COTTONWOOD LANE PERMIT TfPE BCOO CERTIFICATE OF OCCUPANCY DESCRIPTION ADDITION OF SUNROOM & GARAGE/#80053 CONTRACTOR PERMIT FEE 25 . 00 VARIANCE STATUS C COMPLETED CONSTRUCTION TYPE 756 GROUP TYPE 1 APPLICATION 06/03/2005 EXPIRATION VALUATION 0 . 00 DATE ISSUED 06/03/2005 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E)XIT TOWN OF BARNSTABLE �✓ Building Department - Foundation Permit Date /Oho%y Permit # 80053 Name 5t,)F7 PRo%J.CTS (fy1 AComt3EM6 Location CbA-4Mv%w*QA, C e.h�e.�u Insp. of Bldgs. PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 08/23/06 TIME: 11 :57 -----------------TOTALS-----------------. PERMIT $ PAID 25.00 AMT TENDERED: 25:00 AMT APPLIED: 25.00 CHANGE: .00 APPLICATION NUMBER: PAYMENT METH: CHECK PAYMENT REF: 5023 Town of Barnstable *Permit Expires 6 months from issue date ' Regulatory Services Fee j �b� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 X-PRESS www.town.barnstable.ma.us ��R�� Office: 508-862-4038 AUGE 15260?0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONL Not Valid without Red X-Press Imprint 1 OWN OF BARNSTABLE [ap/parcel Number A—o0�C9//�� /� roperty Address LP Q 4:� IVW O Q /,M 4e. esidential Value of Work �997. A.3 Minimum fee of$25.00 for work under$6000.00 wner's Name&Address /f ieharW •4alzbly ontractor's Name__T�ild Alp OLIO S- (-_JC— Telephone Number �'��p�l'p�p00;.O [ome Improvement Contractor License#(if applicable) 9 S40000 'ansfrac�ian Sugt=rvi sor's L�cEnse#(iappiieablej Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ Jen the Homeowner I have Worker's Compensation Insurance !k isurance Company Name lorkman's Comp.Policy#_W �, W-A q67 9, .opy of Insurance Compliance Certificate must be on file. emut Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement Contractors License is required. IGNATURE�. I:Fonm:expmtrg .evise061306 ContractY.' Pella Windows & Doors Westerly RI, Centerville MA, Wakefield RI Seekonk MA, Dartmouth MA, Plymouth MA Serving Massachusetts &Rhode Island Phone: Fax: +., anasr. ,1F�3.. �„.. ,. ,,,, ...,F .. .fie is u: : :! ,.., . @'�. .r14'..�, v ,_ g!• ...1.,3 a .4. m�11 � ,k_,_ �y�, ^�, .,�',,� h" +' ,4- y .d... .Aa, .� •I�, �u� I r,afi gyp, .M, t'. F °94 ,"} �'�I .il v�� .$,i. '..,.�. �, V,�+y„ ,'"5�...s � �.`-[r u, qU - 1 y� mi4. °:n�4k " ru rd�E €� �t ,N,' .*�� • w c:,�`'. .; x '� k01 �C� �E O '��+ .4 ��rd�1' `.a• �. -"7•> • _ � ro� ?�kk'a �R:'^.drf:�L,:• - .� � g.�z�.;sY'edi`¢;�9:�.m"'� a PFn:u.. x- .Y. LANDON Date 00/00/00 / No. / Need Date 00/00/00 Sales Rep. Name Prepared by Payment Terms Owner: RICHARD LANDON Architect Bus.Phone:( ) - Bus.Phone: Dist.Order No. Bus.Fax: ( - Home Phone:�v?- c(a,5= G ? Cellular: ( ) - Home Phone: ( ) - Comments: COMMON ATTRIBUTES: Unless otherwise noted under"Description"all units contain the following attributes.Fixed units to not contain screens or hardware. Product Brand: Prime Glass: Screen: Fins: Exterior Mat'l: DGP Color/Glass: Muntin: Brickmould: Color: j Shade: Hardware: •m M1. - `�.+.., ,. o"_ ?-us'+�C��: rc. .0 2 icg,.' -.'�a �� .. �'t�$t.: +`-„., " 'x'� w,.o.;`�`e .s'rm'�'t� -,'�+ Item# 10 Qty: 1 6081 Vent/Fixed XO Sliding French Door,Frame:59-1/4 X 80-1/8: 3,534.63 3,534.63 Location: Architect Series,Clad,Model 2,White, 5/8"InsulShld Temp IG Glazing, RO: 5'0" X 6'8-5/8" Sliding Screen 2/4 panel,Champ Int Hdwr w/Champ Footbolt,Fins(single unit o per design) Value Added Items:Install Entry/Sliding Doors/French-2 panel-Qty 1 Pre-finish Non-ILT door/sidelite panels-2-Qty 1 Prefmish Sliding Door Screen/Rolscreen-Qty 1 Disposal fee per wdo/door-Qty 2 Notes Item#15 Qty: 1 7281 Fixed/Vent OX Sliding Contemporary Door,Frame:71-1/4 X 80-1/8: 2,462.60 2,462.60 Location: ProLine,Clad,Model 1 ,White,3/4"InsulShld Temp IG w/Argon Glazing, R.O: 6 0" X 6 8-5/8" PreFinished White,Champ Int Hdwr w/Champ Footbolt,Match Cladding Color-Ext Hdwr,Fins(single unit per design) Value Added Items: Install Entry/Sliding Doors/French-2 panel-Qty 1 Disposal fee per wdo/door-Qty 2 Contract-Page 1 of 2 Contract for Customer Project: LANDON Order No: dm�„ � xn,?. •3-".'r>CT n a ,='A•"+r �Fi `� •� , r.�. ,•, �- :.,;�:' n,,.� � r s.. .✓1 �,, �'. .r 4 'Vrw..4,',"'•?u� YTA :q., .,'l,r;L' �. •.:., .+:.� .'e•..:,av .....R,. v-, ... x x�-,.•.. -.,..�, "��R rR..::. ii,,;uo �,,...1•.«t. ,. r .:.r.a, J. .a 1 t ra ? y „Ct^. i :.'7.. .+.,..T,.x�. „,... _ P l .�1',,,.t L. ^�i,,,:t•. �� s.. na�a"�.. ,;e:, -r ,•,, _-`� n, ,+n r.:e. �. n. s. .!.rti, ��. .se:_ •,�.,.,zr�k-.�: 4a•-. ..'�,: .7 a� :�� 2,.' ,�;M .t�z �'E.. "GxE r..,� a�x,a=sarssr� —_v, m .°�J, im,�:, ..�" .,� m•. �`�, _.C�2, ,t: :Th, � .�: .3,..,.� � '-Y^ �- e. -,4S%.a'L'. R,�. •-''�- 'rsti'�'a•`�n ,:i S �:2 M '�:z:r t. •m .-�s. :�k<.._.a�a. .a1�'... +� .ti ..r..v a., �,z.�J'x-�t �"�':�°:"��.. r.st.; pn- �eln,. _. ... . , .. ...�,- � �r Des. I tra,n � ... y, ,,; .M � ., -�.. ��. �• r ,. - _. �.. >, -•ai . . ...� 4�. ... .. .v. ,. �� Y:. . .. ,.-.... i_x„ ,ua.}. ....d ,. .. ,. <, t � ... r.. � ,a7. . Ili � �� ,.59,,. ,. a., � .�, :. F � • o . �.,.P, ,�� ` rc: �-. � .. ,� E � � ,r ,� . � . �_ ,.•, .� �' >�xtetl,ded ^� ;� `I : '� F '.€..t3t d� ��.�2r<t�»,...��.,iwu „• .,,a;9,r�.4x...�:dlay. r,�y;�.;.l......Sux:�,..:.�W�...�6,rui:.�.:s:�s.�� .r.u.� T L�� sR �.:r_=Y .�r�..•,f �... �; ��, & .�,,... R ;ip'} �..�:.,,...:, a.,. .�.�.:....: ,•:..aa.'� �u.x= . 4��w„r,L�&..r..� .�fi.��.��ur„:rri�:a4��`� i t o•`'Y` r.. r �3 s s l'� �: >,u,�:.:�,r.+�s�.�.�;"&:..�,...:�� r56. r&.t�:u. �s�-'�.��Y.��z-::�r�.`vzta"��..'�h��aL �-wa�: ::�.a��n'�' �°#.�;� Notes: ' yr v J. ., •ri., 4.,r ,,,fif .. ...,... ..A, ,.,s ? i,,i k .,,.. �€. y.minty'] Rr .5 34' ...r,'k9'" 5.... d�..✓,.�i¢.� i •:�""' :.e':"�ss;,;' .,.a.:;a am �.��. ��:, ,; �•�. . -: _• .. .,. � . : � � p � .u`r hasi Pella�Prd�f��cts� �,..� ,� ERR,4�:�r�.�t��:�*« .��'i��.�t� F.dtc.s .�rrr.��..-..tirM, :�.-..X,ss:��a�,,.,,d�€,�W,.�:..�r��; �rxa,.�«�: ��=�-�� ,.;7'§:��z•:e1t.?�.;kr�n_s•��,�i.�u. ACKNOWLEDGEMENT OF C.S.R. REVIEW WITH CUSTOMER(Customer initials)., Terms and conditions: This order is made especially for you, the customer. No cancellations are possible after 3 business days of the signing of this: order. This agreement becomes a binding contract only upon review and acceptance by authorized Pella Windows and Doors corporate representative in Fall River, MA. All promises of shipment are estimates only, and our best efforts are used in every case to ship within the time promised, but there is no guarantee to do so. Seller shall not be liable for any direct, indirect or consequential damage caused by delay in shipment. For non-installed orders the customer represents that the window/door sizes and specifications shown on this order are correct and may not be changed or cancelled. The Scheduling Dept will call you with your delivery date. We provide tailgate delivery only, please arrange to have assistance on site at time of _ delivery. For Installed ders, 50% deposit required at time of orde , and 50%upon completion. C timer Signature Pell ales Rq�iAgntafive Signature Taxable Subtotal $3,677.15 Non-Tax at 0.00% 0.00 None at 0.00% 0.00 None at 0.00% 0.00 Non-taxable Subtotal 2,320.08 -29 Total $5,997.23 19atZ Date Deposit Received $0.00 WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details, taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor branch will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening (egress) information does not take into consideration the addition of a Rolscreen [or any other accessory] to the product. You should consult your local building code to ensure your Pella products meet local egress requirements. O CEO / 02 Contract-Page 2 of 2 Commonwealth o -Massachusetts 07 Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston, MA 02111 w w.mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumabers Applicant InforM26on Please Print Legibly Name (Business/Organization/Individual): �4s Address:/3 14 r% � t4 City/State/Zip: l /�;ye✓ . /�� 0.2 Phone#: A,ree,y�an employer? Che the•appropriate bog: 1.I, R I am a employer with el` 4• ❑ I am a general contractor and I 6. of project construction fired): employees (fall 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# .❑ Remodeling ship and have no employees These sub-contractors have S: [] Demolition working for mein any capacity, workers' comp.insurance, g, ❑ Building addition [No workers' pomp,insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10•0 Electrical repairs or additions 3.❑ I am a homeowner doing.all work right of exemption per MGL 11.❑ Flumbing repairs or additions myself.[No workers' comp, c. 152, §1(4), and we have no 12-El Roof repairs mswance required.] t employees. [No workers' comp. insurance required.] 13,❑ Other *Amy applicant that checks box#1 must also fill out the section below showing their workers'=Mpemsation policyinforsnatiow - t Homeowners wbo subunit this affidavit indicating they are doing all work eadthen hire outside contactors must submit anew affidavit indicetizg such =Contractors that check this box must ettached an additional sheet showing the nmae ofthe sub-contractors and their workers'comp.policy information. ram 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.Lic. #: 1,06 810 a `'ice 7LZ Expiration Date: lr !1 Job Site Address:= &�*AIUVU ' #4 ' City/State/Zi • 1�/(J !j Z Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required undei 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. 1 do hereby c fy under the pains nd enalties of perjury that the information provided above is true and correct.. Sim Date: afore �,q Q� / PP Phone#: (e(r (P 0 c 210 Official use only. Do not Ysrite in this area,to be completed by city or town 0f1ciaL City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 3. Building Department. 3.City/•1•ovrc Clerk a.Electrical Inspector 5.p'lumbii?g Iusp.eer 6. Other ct Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. a r Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,.offal or written." An employer is defined as,"an individual,partnership,association, corporation or other legal entity, or any two or inote of the foregoing engaged in a joint enterprise, and inchrdmg the legal repres=tatives of a deceased employer, or the . receiver or trustee of an individual,partnershtp, 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 employs 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." E MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall"witbbold the issuance or , renewal of a license or.permit to operate a business or to construct buildings In the commonwealtb for any applicant who has not produced acceptable evidence of compliance with.the insurance coverage required." Addition ,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall cater into any contract for the performance of public work until acceptable evidence of compliance with the insurance reg1.±ements of this chapter have been presented to the contracting authority." t Applicants Please fill out the v+rorkers' compensation affidavit completely,by checldug the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),addresses) and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no enTloyees other than the members of 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 maybe 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•Depariment of . Industrial Accidents'. Should you have any questions regarding the law or if you are required to obtain a workers' compensationpolicy,please call the Department at the number listed below. Self-insured con3p'M i s'should der fheit 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 pievided 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/heense 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 poliey.informattion(if necessary)and.under`lob.Site Address"the applicant.should write"all locations in T(city or ` i6wn):"'•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. Anew 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 - R Department of Industrial Accidents Office of Iatvestigations 600 Washington Street Boston, MA 02111 T-1 617-727-4900 ext 406 or 1-877-M-ASSA.u'L• Fax 1 617-727-7749 Revised 5-26-05 www.mass.gov/dia ,per ✓lie -Pom�rw�uuea� o�,/�aaazcltrcae/�6 �\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration 1,49840 One Ashburton Place Run 1301 E JIB Z/1;3/2008 6 _ y Boston,Ma.02108 ,fypeWr Ltd,Liability Corporation PELLA WINDOWS ANQ B.'09#S'` Y f.::'� STEPHEN DICKINSR�M 1325 AIRPORT ROAfl'� = �� FALL RIVER,MA 02720 Administrator No valid without signature � Tfie !�omvru»uuel�i � RX .. win TTri, J'S JP'ER�/aaS'QR • Nnr l er CS 0,8'1�84'3 � -( � 7 � �0fi/,�an Tr.no. 17237 6MEP'Non, f D�°C� HIdS Comm_i§scone Fs d Pella Windows & Doors a 1325 AIRPORT ROAD t FALL RIVER,MA 02720 TEL.508-676-6820 FAX 508-676-6823 June 19, 2006 To: Whom It May Concern RE: Contractor and HIC License I hereby give permission for Steve Correia to use my Contractor Supervisor's License r #CS081843 and my HIC Registration#149840 to pull permits in the State of Massachusetts for all projects related to work performed for Pella Windows & Doors, Inc. Steve Dickinson Operations Manager Pella Windows & Doors, Inc Windows,Doors & Skylights ACORD CERTIFICATE OF LIABILITY INSURANCE LOP IDLA 2, DATE(MM/DD//0 PELA-1 07/11/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Greenwich RI 02818-0810 Phone:401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE NAIC# INSURED PFR Acuisition, LLC INSURER A: Peerless Insurance Company 24198 q dba: Pella Windows & Doors INSURER B: 1325 Airport Road Acquisition LLC INSURER C:' 1325 Airport Rd INSURER0: Fall River MA 02720 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.AGGREGATg.NMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR rNSR'1 TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE(MWDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8022572 05/01/06 05/01/07 PREMIsEs(Eaoccurence) $ 300,000 CLAIMS MADE OCCUR MED EXP(Any one person) $ 10,000 X EBL PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,0 0 0,0 0 0 POLICY JJECOT- LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A ANY AUTO BA8022972 05/01/06 05/01/07 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: .AGG $ _ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $10,000,000 A X OCCUR CLAIMSMADE CU8024072 05/01/06 05/01/07 AGGREGATE $10,000,000 RDEDUCTIBLE $ X RETENTION $10,000 $ . WORKERS COMPENSATION AND X TORY LIMITS I ER A EMPLOYERS'LIABILITY WC8023972 05/01/06 05/01/07 E.L.EACH ACCIDENT $1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under ' SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,0 00,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOMBAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ` DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Town Of Barns table - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Building Divi s ion IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street Hyannis.MA 02601 REPRESENTATIVES. AUTHO IZED REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J �j Parcel 2� Permit# f Health Division Date Issued _ Conservation Division Fee Tax Collector Application Fee �2 - _ Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address mo (�Cjaa , iCl Village Ce Owner 1„ JQ)C.` J Address Telephone �60 l F 9 Permit Request Square feW st floor: existing proposed 7,al 2nd floor: existing proposed Total new Valuation '1 �L Zoning District Flood Plain Groundwater Overlay - 9 Y Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting docukntatiofia t - Dwelling Type: Single Family 0?' Two Family Cl Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes �2110: On Old King's High d f: ❑Yes P;`No Basement Type: �ull ❑Crawl Cl Walkout ❑Otherl vJ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Cn m Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: VGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 34o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garaged existing ❑new size Shed:❑existing ❑new size Other: - Zoning Board of Appeals Authorization ❑ Appeal# Recorded O Commercial ❑Yes N4 If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name K)a m k Telephone Number Address License# � � 1-((0 Home Improvement Contractor# - Worker's Compensation# slif Ohs ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO � Pap DATE SIGNATURE ty 3 FOR OFFICIAL USE ONLY F • PERMIT NO. DATE ISSUED ' MAP/PARCEL NO. ADDRESS , VILLAGE OWNER ' DATE OF INSPECTION: r FOUNDATION 1 FRAME U INSULATION FIREPLACE F ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING b , t 1 I 1 DATE CLOSED OUT ASSOCIATION PLAN NO. r 7 `� �., Town of Barnstable Regulatory Services Thomas F.Geiler,Director - .�'��• Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. w ' Date r AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type-of Work: .� Y ' Estimated Cost Address of Work: qq Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law []Job Under$1,000 []Building not owner-occupied []owner pulling own permit r • Notice is hereby given that: - OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY ER MGL ' SIGNED UNDER PENALTIES OF Y I hereby apply for a permit as the agent of the owner. Date Contractor Name ll Registration No. OR Date Owner's Name QIorms1omeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE . New Buildings $100.0.0 Residential Addition $50.00 Altcrations/Renovations $50.00 Change of Contractor/Builder $25.G0 FEE VALUE WOEMBEET -NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq,foot 0 x,0041= plus frombelow(if applicable). QARAGES'(attached&detached) square feet x$32/sq.fL= x.0041= ACCESSORY STRUCTURE>120 sq.ft.. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 . >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0041— STAND ALONE PERMITS Open Porch x$30,00= (number) Deck x$30.00- (number) Fireplace/Chimney x$25.00- (number) Inground Swimming Pool 564.00 Above Ground Swkaming Pool $25.00 Relocatiou oving $150,00 M (plus above if applicable) Permit Fee C !`�:.qyR , i• rr.la sari Ul �1µ» u,R; 1= 'r,r°aaa iir'Au CColon pool :5tr a rs J cs ,• u - -09 101 r � p.. + w..�.'r.�..:�a?n - ."�„�..' -*•�`"'_, ,� .....� ��.: .,:_..... �, ,.....,,_-� "w.n.""{";.�:""` ";.in.,;n.nm`n.... w w�J.t ��w..i.�+sda�...�i�M"''", �`""i.M:.a�.'-.So�"a�rsn.,...m.',;.;r.oiq:;'�� Y�.... s�., .., ;G"..'.:.�'". ... ,dM..�,�.:�.'. y,u`,:.... 1.�w.�3�.:';�-..-.�'.� ,r,?np ..pe,.e,q:uvwawc�srvw�wser, _ -.;.-�ww-. -m. „w- -, .m,-...o:rea+a::•n>Wsre v=era._::aw�:�:.: .ar9e. ,_:.:,n say........ ex:r .„ a.:.. �, r.z,.:,>'^^ r_..-..:. .._.._........�-•.,a ,ws-:,na:`.=..r.. , asp -, '�-'y' :.f.. -• ...x-ti-.--:z.� .,.,,,w ..�,,:J...r:#.�za„ .W..�, -:...;,. m.-.4 .-.< «,,:,-w� v .�=:�.:_.�" "La � '..,J._..,.._�.'"�� :.:a .R...•_ :..%Y."_''� _ ::�:.. _� _ stir.? +u:..,. ^�: ti ..:�.'vn-..a..»..�s�r.!aet•^4I�Mt a ...,�. $ .r.o*A"�rwM:.4.mr�. '-„'rr .- ., _. :. _, - S# Y- ath+%,m- x'i1�^,�4eM-nuw+.�c�Mk"!^ta^' +.^n.P�..ru.�� rt�mwa.,n*r�*T�!k:mt wlnr.nr.+..a4,�5+n,.'eM+,.,.w..,.ew.rw,�h,yaw�-n°'•-y knriane .+5�*vnTrit+r a��,�ihnr ..P+t±E a 4mM •�n.M?..n:.,�".,!n+.....-. i� a, eS.� A AtLr� tJ\ Cep es c� c ec �� 1 � �( Xl oe ,r'�y�,,� �p/�I'� Ol tQ fI.4•".�`,'".9" ,,f i "? „yy,Ra.' ""� .aR11r I-, . ,:rFlsrl'.. —LO V 81l�d�+✓O tl) r=, J Fv Town of Barnstable do Regulatory Services i • IARNSfABLE, • s Mass. � Thomas F.Geiler,Director ajA 1639. �0 reo�„o�p Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, R�,--K—qk(A �n1'�C , as Owner of the subject property hereby authorize �V�Qf� �'ti1�Y� to act on my behalf, in all matters relative to work authorized by this building permit application for: a5TT()�&3 LA 068 (Address of Job) Signature of Owner Date Print Name Q:FORM&OWNERPERIMSION r cy�asr€tnR�P.a off ffa�:.rT+h JARD 4UILDING REGULATIONS Ler : COSRUCTfON SUPERVISOR Naar4seor: t:s 094632 1tDt2009 _ Tr.no: 94632 lP3d: Ice STEVE A SWk ' 108 RALPH Th O0. ;%.ST WEYMOUTH, 2190 �� c. Commissioner r AUG 29,2006 11:95A JOHN <• iP=.<S ( : 4 page 3 FuCsindie s(781)821-8552 federal Tax 10 N 14-188429T Mae,Home ImpnoverrbAt Cc-u 4 r.4 k4t p 13 t31;f Dew Custatnsr: GtratorntltlVsrno.gj #�,�.. �.,',�•�^t;a.iE�l.. Street Addrea t Tttia is a contrail DCAv68n the Contractor and url illto3:.1t4t\8d a;;;itr.lisr to sO and lr*W dte Owens Coming Basement Wa0 Finishing SyMern urd related Itemss apecified et f- s-W-4 reS IIi,N Ofemi a"t&W below: '1 inatsllatlon Prnmitas: t Street AdCIMU_ Scope of Work: A AM SkeKJft andlor epswfiCaWn sheep 4%- •�uivaMsrra�ainoomomdlabecdhrrebrdaapA spa �h+j�"�,�$*may y� '""'�, �''� r Description of Wofkl&peoUb"&q" t si i'or L z l Watt schodute" Apprwrimom�onuneiion+gnRDafx' Approt ttms CompiaUoo "Th0 propeeed work schedule is 6pptoxYnatl 10116�, ..tom dlatk r r , CantraOlPrim Toad OwWaut Prkm:Doom we WWI Cl dishilii rR �+38 ft"Ve Temu; I CQM 13 ftsnee ` f ICah flnrls Rre 14'A WpoNL 5t?!L on ar r pa Sortj SY�4�f r fr 't ��+ �:'.Can trAl tilllaitL .:,;�lY+ ii�,�,i;; w•,, s , OO NOT tRQN TNt6 CONTRACT UNM ALL t� �ito�: tac R m tll"RE COMPLETELY FILLED N!ANO u AND CHIS.STAND THE ENTIRE ANTRA t Afi tr 41 CIHNIM ATTACHED HERETO,AS W@t 1.A8 ANY ATTACHED ti3' dbu Nrti YOt!FlRST READ BKETCNEB.WIT8RtA4 Lt9T9 OR tHt;u API t 'tARt148 6YAl f OONi>jTIONS t1N Tt�BARK 6 i Tt1t8 CONTRACT DOACHENT, YDt!ARE PdwtTrtt HD TO A COa1Pi6Ta.i Y►l:, 31T&f- D t:O#arl ti;lh THIS C0e1TgART AT TH@ TIME OR>fitCONTRAC v*%w Our herx�s)end aae!(a)below on thta +� r dey a Contractor/AuetorlW RepraWIMIve; w.; cc NOT Sl"THIS CONTRACT w THERE Mm N d AUG 29,2006 11:38A page 7 SEP 12,2006 06:47A JOHN WORMS IO)STON page 2 i A yp'Q„ CERTIFICATEOF LIABILITY INSURANCE BAYSTD-i 04 r�0 0 THIS CBRTWiCATE I$MMUED AS A!MATTER OF INFORMATION Kaplsasky Yuauranae 8roo �nE�` - . MOLOWL TLY ANDHIS CFE�RTTFICATE bOM $NO MGbOOE3 NOT AMEND.UPON THE EXTE �. D OR 114 Harvard Straat ALTER TNS COVERAGE'AFFORDED BY THE POLICES BELOW. Brookline H& 02446 PQone:617-7E8-8400 Sax: :1: -`f$94214 INSURERS AFFORDINGCOVERAGE NAICI N mAERA: Norfolk Z DodAatn Group 13943 ROOM& naa� AAtate Bas'""' � L1`1'1 wsu c: 9i0�TuOwe i6 worn >a . Data ai Canton t�►1g021 Nam 01. COVERAGES ne SWLFCIEB CO bdiOAMM US O00.OW f## TO'ia H 4'Sr�X�NN D ABOVQ FOR TM£VOIiCY PEidOD NWAnD,NDNXWT*MV4 MN Re0uA8M0ff-W M CR l90lOI M OF CZ1, f#'M Ofl*A�DC:C.dWW WFM RBWU TO WMCN 1TR9(�R' O CATI MAN BE OR ►Ur PvnN •TSE ftMfiwcE AFFOIm Br N % rvzmw a Paw TO&L w 104.61fC1t18 m Me CWWONN Of'am FroLItba.AooReoATeuMnsa+ovwrMArNA rtrEosrcaAwa. TWB OF 14MA KB FOUt;"f iN RSER OA Trvwmm @ LN TS< taannr EACKOCCLRpim t 1000000 N�t�fitclAl.ae►$WALLWWTr s , L :lo0aoo w�Ma►eAas El. Mlmew-wwRmmm) a 5000 A X Business Owners &OA09626I 02/06/06 02/06/07 oBasoNALeAovrcAnr I000000 4EalAooREOAts a 2000000 O�YLAOOtiffpATHLpQTAF4KlEb FRW=8.00bS WAW i ftcluded Pq F0r L Auromom MOM ANYAUSO ls;liKIIBLBAIT i AItOWt6DAUi08 •••••�� "�.--- BOOLY 8C5lQOlAEQA1tf08 ` lF'Kpey011) Y f 19R5OALf1'O8 _ MON4tiN�EDAL7f08 - tpr+gy�ylr 1 OMAAEW190.AY AMOLY-FAALcfM i AMIAUfO SkACC I Y.' AN i CFfCuiJWABPAUUM6dlY -•u•� IsAC►i t OOCLY! ❑CLNMS ' ---- AOGAEG►TE i QMU0T= i IIBTffN[10N t '� t IT NfOrt�R!<GOlAA6ifaARONANO CAtPLOMBtC W16tSfY t ANY PIiOt+R 14 t�QIflVE _ El.EACH AMMO f 4— OFf v '�+nsaNseaw ' 8a..aFa�sE.�ewLores � - i s CERTIFICATE MOLDIER CANCELLATION • :...�� --. Ah+roRtheAeova{os�caleBl:POLlt�atsBcu+c�lsnaTaesxFaatars OATS TNfBiFOF,TF�fittANO tttlll@R WUi eNOBAVOR TO MAR 10 OAYO MAtRTMN NOTICE TOlti6 OBSttFICATT{NOLOBi NAMEp Td the LET,WN FAILURE TOO*to W&L No oBUt9ATSDFI ORifABN.IfY OF IWYSOep TpON� Rg A0ENt80R R6pmewrAwn. . TIM MORD CORPORATION 5888 SEP 12,2006 06:58A SUNTECH ;2,10 'ICIIi page 2 r< 91te Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement-:Contractor Registration Registration: 137943 Type: Supplement Card Expiration: 1/29/2007 OWENS CORNING BASEMENT FINISHING: STEVE SWEENEY 60 SHAW M UT PARK CANTON, MA 02021 Update Address and return card.Mark reason for change. 50M-05J06-PP BPS-CA1 is El Address Renewal ❑ Employment Lost Card ✓f2e e jC�B/490 /`/ ,q 7tOI2U/ ew O�`/l/GQ�6Q�L000P.�6 �\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 137943 Board of Building Regulations and Standards Expiration 1ji.29/2007 One Ashburton Place R 'Type: Supplement Card Boston,Ma.02108 OWENS CORNING`BASEMENT-A 60 SHAWMUT PARK C, ` CANTON,MA 02021 Administrator ot.va(id without signature �/ae V�omvnonusect/�! �ac�urae/6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number''C5 094632 'Expires"10/04/2009 Tr.no: 94632 Restricted:;f4G„ STEVE A SWEENEtY 108 RALPH TALB�OT ST WEYMOUTH, MA Commissioner 06/08/2006 15:05 F!1)t i 781 6 25 Andrew G Gordon Inc 10001 .. r AR WCIP -- Ubext.y ISSUING OFFICE 354 Mutual.. Workers Compensation and INFORMATION PAGE Employers Liability Policy ACCOUNT NO. SUB ACCT Liberty Mutual insurance Group/Boston 1-344359 0000 I Y83k TY MUTUALFIRE INSURANCE CO. POLICY NO. TD/CD „ S O I E CODE SALES CODE N/R 1ST WC2-31S-344359-016 XX X WEFT ; 102 REPRESENTATIVE 3000 2 YEAR ASSIGNED 2003 Item 1.Name of BAY STATE B . ENT3 I�LC .;. Insured DBA OWENS . ;KING�`�I�i,SHEll BASEMENT SYST' FEIN 14-I885527 .:{.. Address 960 TURNPIKE: ET I 1 ' RISK ID 000182837 CANTON,MA 0 2 Status 46 LIMITED LI�II; ,ITY C Other work Iaxs not s ` a e: ITEM 4bov 'E P hi!�t Mo. YBr j Mo.Day Year Item 2.Policy Period:From 05-2 ' to. 05-24-07. 12•tl staaidalrd time at the address of the insured as stated herein. Item 3.Coverage A Workers Coirtpensation t ance: aA One of the policy applies to the Workers Compensation Law of the states listed here: ; MA € " B. Employers Liability Ins;s:,' �e:,Part 7'wo of the policy applies to work in each state listed in item 3A.The limits of our liability wider Part ;' re: Bodily lnjq: %0 Acci&n 500,000 each accident Bodily Inj $oiseaye 500;000 policy limit Bodily Inj : DiseaL46 500,000 each employee . C. Other States Insurance: ' hree,cif°Ae policy applies to the states,if any,listed here: SEE END PVC 20 03 D. This policy includes these eorserm »ts and schedules: SEE EXTENSION OF INFORMATION PAGE Item 4. Premium - The premium 10 t golf be determined by our Manuals of Rules Classifications Rates and Rating Plans. All information rec lured be[ ' E14 verification and char b aadit. i Premium i Basis Ries LINE 110 Estimated Per siw Classifications Code ToW1 Annuai or RE- Fstimsted ---.-.-�---'w:.—._.;e �- Praniums munem Anne( lion !'mmiums SEE EXTENSION OF INFORMA tik WAGE;: Minimam Premium $ 500 ;; 1 Total Estimated Annual Premium $ 1,050 Interim adjustment of prenuum shall amide: : ANNUAL --—- , - This policy,including all endotsemen4 ed th r'with,is hereby countersigned by "-�"F Anthori—R resentative Date 05-22-06 RECEIVE i i r : Lac-cone I Term oPe*• ANDREti die ntitadi,�rss Pa G Home State Dividend RENEWAL QF: 05-22- NR MA WC2-31S-344359-01S r I - GF0 41M R1 Co t 198T IJ&tonal Council on Compensation Insurance wC 00 00 o1 A i BROKER COPY JUN 08,2006 01:31P 1 781 659 4725 4 page 1 N U CONTRACT= Customer Name N_,g, VA -f,Customer Signature ---�, a SKETCH Contract Date--t �06 o., Sales Representative Signature ATTACHMENT - -"Customer Phone-- ° Contract Price 3 a 5 6 7 8 9 t0 11 r 12 13 14� 15 16 17 is 18 20 21. 22 23 .24 25 28 27 28 28 30 31 - 32 33 34 35." 38 37 38 39 40. 41 42 43 44 46 46 47. 48 "49• 50'151 52 53 ..- I t I • f d , , Jr I 72 } 17f ) T171 a j ( .. .—r .u. 1 t k Wf I M yaw c 1. ' 1 pr x • Q E. � 1 h , , ES: s;°' - r `Each'box equals one foot unless otherwise noted.Tt,�t ropresontatlon.of.the work to be done, it is underst ry' a derived fram this sketch are appraxlmato.and that all ' r_ „ _ likturees plugs.incks and/or switchem nrA ant•linrtt to char._ f �6 / `5 Town of Barnstable *Per nnit#�� Expires ti months from issue date o,• :. Fee C' _ • - :;Regulatory Services �/7 snxxsrna ,Thornas:F.�Geiler,Director °'��__. ... . .—BuMbag Division" _. Buildin Commissioner PerrY� g � .. . .200 MainStreet,•Hyannis,MA 02601-.•... Office: 508-862-4038 .. :.:....:...... ..... . . Fax: 508-790-6230' `EXP tES :pERli�ilT. I�I.XXTION RESIDENTIAL ONLY. Not Valid without Red X--Press Imprint Map/parcel Number �t� Property Address d Minimum fee of$25.00 for work under$6000.00 [Residential Value of Work Owner's Name&Address Telephone Number 776 o �y Contractor's Name aC_T Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) rya Workman's Compensation Insurance ESS PERMIT Check one: �,� ❑ I am sole proprietor APR 11 2007 ❑ amthe Homeowner Ihave Worker's Compensation7Insurance TOWN OF BARNSTABLE Insurance Company Name Worio an's Comp.Policy# Copy of Insurance Compliance Certificate'must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles).All construction debris will be taken to ❑Re- oof(not stripping. Going over existing layers of roof) E n is Re-side ❑ Replacement Windows. U-Values_.(mum•44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improve ut Contractors License is required. Signature QTMTW:expmtrg The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston, M4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . IY � L � /v C Address: 3/ w`Q lii�t �/�c-l2 City/State/Zip: fi` K aye -Phone:#: Are an employer? Check the appropriate box: -Type of project(required):, 1.el am a employer with o 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 shipand have no employees These sub-contractors have 8, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp,insurance comp.insurance. t• 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing all work 11.❑Plumb' ng repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1.(4), and we have no employees. [No workers'.. 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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. lam an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 7�t Policy#or Self-ins.Lic.#: Expiration Date: lob Site.Address: 1 e ( , 7NLtd Z-7, City/State/Zip: L'EiYGrUt 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 er the pains and penalties of perjury that the information provided above is true and.correct.' Si ature: _ Date: _ 7 d 7 �/r G Phone#: )U D -7� rC �� 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#: Information and Instr°ucti®ns 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 itcP.i�ottruatee-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 employs 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 in-surance 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-conti-actor(s)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 bum 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 questionsplease do not hesitate to give us a call. The Department's address,telephone-and fax number: The.Comn omwealth ofMassaobus(-,tts Departmtrmt of Musttial Accidents Office of Invest gation$ 600 Washingtoli Streillt Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-977-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia hightp-ax Norcross Z/Z/ZVU*t 11:44 PAUL UU4/UU4 rax Server .. x: DATE ATE� F.1 Nk AM THIS CERTIFIr'ATt'I I SUED AS A MATTER OF INFOF[kkiiON PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1DWARD A GRAZU! INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR FO BOX 337 ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. COMPANIES AFFORDING COVERAGE MARST014S MILLS ig, 02648 COMPANY 28y2K A H.Z-RTF 0 R Q, UNDEEWRTTERS INSURANCE CC'hFAN- INSURED COM'ANY R L T CCNSTRUCTION INC B 31 Mk-NNI CIRCLE COMPANY C:NTERVILLE bLk 02632 C 30M nANY C01tERAGBS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION LT R TYPE OF INSURANCE POLICY NUMBER DATE(M ,DUNY) DATE(MM\00\YY) LIMITS P9 GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL G:NERAL LABLITY FRODLIC-S-COMPr-P AGG. $ C1UMS MADE F7OrCU FERSONAL&ADV NJURY $ OWNERS&CCNRA—,rOR'SPzl07 EACHOGOLRPIFNCE S FIRE DAMAGE(Any one*0 M ED.EXPENSE(Aq one parscr) $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY ALTO Llmi- I ALLOWNEDALITOS I BODILY lNjURY SCHEDULED ALTOS (Per Pewnl $ HI REC AJTC-S BODILY INJURY NON-OWNED AUTOG (Per A-.-idenll, PROPERTY DAMka6 CID IGARAGE LIABILITY AUTC ONLY.E64C!DEN7 AN"AUTO 07 HER THAN A "- NLY: EACk;OCIDENT � AG' GATE $ EXCESS LIABILITY EACH OCCURRENCE $.. UM3RELLA FORM AGGREGATE $CD .pq O-HER-HAV UMERELLA FORM WORKER'S COMPENSATION AND STATJT,---R-LAS A EMPLOYERS LIABILITY (UB-105IC04-3-06) 12-24—C6 12-24-07 EAC-f ACOID ENIT $ TILE PROPRIETOR! PA IECLITIVE INCL DISEASE-POLICY LMIT $ OF=CERS ARE EXCL DISEASE-EACH EMPLOYEE Is 1 CIO,0(1 OTHER DE'DCRIPTION OF OPE TIONS!LOCATI 0 NSVEHIC LESIR EST RIC71 ONSIS PECIA L ITEMS TFE POLICY CEE='_:NA71FD ABOVE :S CANCELED EFFECTIVE 02/14/07 THIS R3PLACE> ANY.PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. ........... D. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARNSIABLE 10 DAYS WFUTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ATTN! BUILDING DEPT LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR 2C0 MAIN STREET LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTSOR REPRESENTATIVES, HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE R��.V�r � -�f16' �YLI7't�l2L�UC�GLlG.6��/(��AAdQ,IYiLY4.C.uz1.6�"t Board of 13ui,dine Fegu[ati,ns and Standar HOME IM?ROVEF9EN7 OONTRACTO#s -Re istcato ,>afi I t Fyng Df3q j �Y 8 fT C6NS7 INCJEA ISt°AND SfUING&ROOFlN �! `RONNIE TAYLOR '. r f op hand of andRoofMg - - a division of RLTCowtruction,Inc. Richard Landon April 1, 2007 162 Cottonwood Ln. Centersdk Ma.02632 We are pleased to submit the following specifications and estimates for residing. Strip existing cedar shingles and flashings on gable end, and upper and lower areas of the back wall, stopping at the shower stall on the lower wall. Install new aluminum window and door flashing. Install Typar house wrap. Install Certainteed Mainstreet colonial white vinyl siding. Clean up and haul away all debris. We hereby propose to furnish material and labor- complete in accordance with the above specification, for the sum of FIVE THOUSAND NINE HUNDRED DOLLARS. $5900.00 -�-�`2'1rd1 v Payment in full is due upon completion of job, no down payment. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from:the above specifications 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. Owners to. carry fire,wind damage and other necessary insurance. RLT Construction,Inc. carries General Liability and:Workman's Compensation.insurance. Certificates of Insurance provided upon request.... ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature ., )W—u? C� Start Date: Si ature , &� 31 Manni Circle Centerville, Massacfcusetts 02632 d1_,-,f eflO 022 C7i➢a - (r-- Knp A9n 1 MMC -Ai" r � X 41? a-Is 0/6 ,uFTME'0 ,, Town of c Barnstable q (�*Permit# s Expires 6 months froae issue date i RAMSTAMr, RegulatoryServices Fee E 39. Thomas F.Geilr,Director Building Division Tom Perry, Building Commissioner Office: 508-8624038 200 Main Street, Hyannis,MA 02601 X-PR S IT Fax: 508-790-6230 A U G 1 7 2004 EXPRESS PERMIT APPLICATION - RESIDENT Not Valid without Red X--Press Imprint BARN�TgBLE lap/parcel Number~. D�6 roperty Address c�• ��-f-t— �t J .Residential Value of Work 6 01L> C3 owner's Name&Address � Minimum fee of$25.00 for work under$6000.00 � wt,.c ontractor's Name Telephone Number_ ome Improvement Contractor License#(if applicable)_ onstruction Supervisor's License#(if applicable) !�Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance nuance Company Name orkman's Comp.Policy# )py of Insurance Compliance Certificate must be on file. rmit Request(check box) 9) Re-roof(stripping old shingles) All construction debris will be taken to ��` �J ❑Re-roof(not stripping. Going over existing layers of rood a. ❑ Re-side El Replacement Windows. U-Value (maximum.44) `Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. om ov C rs icense is required nature mw:expmtrg I � r Fraser Construction Roofing & Siding Specialists Supply and Install - CERTAINTEED LANDMARK TL: Lifetime Warranty, 10 year sure start protection, CLASS AFIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. Color: Supply and Install- CERTAINTEED WINTER - GUARD: (ice &water shield) Waterproof Underlayment System -Entire Roof Deck Supply & Install - #15 Felt Premium Underlayment:Paper Supplp & Install-- Hick's Ventilated Drip Edge. Supply & Install-Aluminum &Neoprene Soil Pipe Flashing Supplp Sa Install- GAF Cobra Ridge Vent. Clean & Remove - Debris from work area daily. TOTAL INVESTMENT: LANDMARK AR 30 - $5,000.00 LANDMARK AR 40 - $59400.00,q,--- LANDMARK AR 50 - $59750.00 LANDMARK TL - $6,500.00 * Removal of Solar Panels to be done at a Time & materials Basis Payable immediately upon completion NO MONEY DOWN - NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA - AMERICAN EXPRESS Possible Extra -After the shingles are removed from the roof, we will life one sheet of plywood to make sure that the insulation be not up against the plywood sheathing so that ventilation cannot occur from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials.& Labor. There are 6 panels per sheet of plywood. ' Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$50.00 per hour, plus materials, plus A 20% overhead mark-up on total extras. Board of Building Re gulations and Standards f' HOME IIVEpROVEMENT Regigtr`a ton CONTRACTOR Licent i 12536 before 3r /2005 Board F One A RASER CONSTtF1CTlp�4co Y 'i Bostot D : N ERASER = 71 TARRAGON I COTUIT,AAA 02635 Administrator CENTER VILEoG�, l/W! ISLAND y SHALLOW . I SHALLOW � POND `��'g 0�` P POND K ' CUS G �� r �'0 o ASSESSORS WEQUAQUET o z LOT 252-43 LAKE oPgv w AREA=17556fS.F.' ,f�� LOCUS MAP fr 0 A :8� H S LOT 146 '�. �.�• �.� ,PLAN REF. 20239 C _ 1 DECK - - ' s _ ASSESSORS o e�; �Or zz s',,,, �.aE�` �sss� ASSESSORS MAP 252 2 LOT 252-26 `T ZONING »RD-1„ SETBACKS. , 20 —10 —10 4 b ,,,,,,,,,,,, • - PLOT P LAND OF - - AN L_ r 0 DECK o•,,,,,,,,, � Z_�o - -� LOCATED AT.• 162 COTTONWOOD LANE CENTER VILLE, MA: - „ .p. PREPARED FOR. ,y . .LA1VD0 RICHARD DECEMBER 09, .2004 t' LOT 145 - ASSESSORS ,, 0 REV- LOT 252-25 �0 O' REV REV . 0 LOT 158 YANKEE SURVEY CONSULTANTS GRAPHIC SCALE ASSESSORS UNIT 1, 40B INDUSTRY ROAD a o ,o Zo 40 80 P. O. BOX 265 z LOT 252-143 MARSTONS MILLS, MASS. `02648 / O TEL• 428-0055 FAX 420-5553 ( IN FEET ) SHEET 1 OF 1 JOB',¢ 53800 JF 1 inch = 20 ft.