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0282 ELLIOTT ROAD
11iO4. y . ,. Town of Barnstable Building v �nnxsrn '6'sf This Card So That it is Visible From the Street-Approved'Plans Must be Retained on Job and this Card Must be Kept MAS& Posted Until:Final Inspection Has Been Made..Mxe Where'a Certificate of Occupancy is Required,such Building shall Notbe Occupied until a Final Inspection has been made. er 1t Permit NO. B-19-1577 Applicant Name: FABIO PRETTI Approvals Date Issued: 05/21/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 11/21/2019 Foundation: Residential _Map/Lot 227-089 Zoning District: RC Sheathing: a, Location: 282 ELLIOTT ROAD,CENTERVILLE i Contractor Name FABIO PRETTI Framing: 1 Owner on Record: PALADINO, ROBERT& LYNN Contractor License: CS-108659 2 Address: 282 ELLIOTT ROAD Est. Project Cost: $24,500.00 Chimney: CENTERVILLE, MA 02632 Permit Fee: $ 174.94 Description: RENOVATE 2 BATHROOMS Fee Paid:' $ 174.94 Insulation: . 7 , Final: Project Review Req: NO STRUCTURAL WORK OR RECONFIGURATION Date: 5/21/2019 Plumbing/Gas y Rough Plumbing: ",Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. J ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building'and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for AIL Construction Work: Service: 1.Foundation or Footing ' Rough: 2.Sheathing Inspection _ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:. 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT P Application Number...... (.5D. .... �7 * BANAM RNWABLE, � MAY`i} 9 2OJ9 Permit Fee.............).J.�.�, .Other Fee........................ a6;q. p TOWN OF BARNSTABLE Total Fee Paid. ................................................................. ...... TOWN OF BARNSTABLE Permit Approval by...... . ......................On.. �2!...f..`l..... BUILDING PERNIIT Map............. . .......Parcel........................................... APPLICATION Section 1 — Owner's Information and Project Location Project Address2A2 Of k 0 Village ��<ALL— Owners Name__ /(� azwap Owners Legal Address City State Zip Owners Cell # E-mail �JA/,95M Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 —Type of Permit �' ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure . ❑ Change of use J ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty- ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar Renovation ❑ Pool ❑ Insulation Other Specify Section �4 -- Work Description V '/ l f Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics i i ❑ Wiring ❑ Oil Tank Storage Smoke Detectors ❑ Plumbing ❑ Gas Fire Suppression i ❑ Heating System ❑ •Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private si Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility:,Iy'clm I am using a crane ❑ Yes ® No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland coastal bank. Yes ElNo ❑ Section 8—Zoning Information J i Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed r�. Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No 1 T air—fiot-1- 11/i i/)nt 2 Fa bio-I n CO CSL 108659 HIC 182418 Proposal Date: 04/15/19 o: Lynn Paladins 282 Elliot Rd Centerville, MA r Work to be performed at: same address above Scope of work: ' 1. Kitchen floor tiles replacement; (2,500.00) o remove existing floor tiles; install new ceramic tiles leaving a 1116",gap for grouting; o owner will provide tiles and grout; 2. Downstairs bathroom remodeling; ( 9,500:00) o demo existing tiles on floor and walls; o install new greenboard on half wall all around; ' o install new wood molding around 48" on.walls; o remove existing bathtub; o install new bathtub and shower valve; install hardieback on shower walls; apply redguard on shower walls; install new tiles on bathtub walls; build custom wall niche on bathtub wall; install new tiles on,floor; grout tiles; install new baseboards; paint celing and:walls o install new exhaust fan; f o owner will provide: tiles,"grout, bathroom fixtures; 3. Upstairs bathroom remodeling; (12,500.00) demo existing tiles on floor and walls; x install new greenboard on half wall all around; t - install new wood molding around 48" on walls; o remove,existing bathtub; build custom shower curb; 38 Wendward Way-W. Yarmouth -MA 02673 608-360-3412 .M" e . Fablo-Inc-0 CSLIOM59 HIC 182418 install hardieback on shower walls; o build custom niche on shower wall; apply redguard on shower walls and floor; o install new shower valve; install new tiles on shower walls; l �^ lv it�talt tt 'LiIC's-onr bor.; o grout tiles; install new baseboards; install new exhaust fan; o paint ceiling and walls; L, o_ owner will provide: tiles, grout, bathroom fixtures; F , All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted and completed in a substantial workmanlike_ manner for the sum of; ($ 24,500.00 ) with payments to be made as follows: deposit $ 10,000 _ n $ 14,500 at work completion General Provisions: Any alteration or deviation from the above specifications,including but not limited to,any such alteration or deviation involving additional material and/or labor costs,will be performed only upon a written order for same,signed by Owner and Contractor and,if there is any charge for such alteration or deviation,the additional charge will be added to the Contract Price of this Contract. . Unforeseen Condition: Unanticipated or unexpected circumstance or situation that atTects the final price and/or completion time of this contract or project,will became an extra cost,and will be charged a rate of 70.00h/worker. ,'acceptance of contract Name: , .L4. N 0, Title:. a /�-/_n2 • _ Signatur - —38 Wendward Way W. Yarmouth—MA 02673 _ 508-360-3412 = Commonwealth of Massachusetts ' Division of Professional Licen:,u e Board of Building Regulations and Standards Constrq'016n Supervisor r/ CS-108659 r� E�pires:.04/19/2021 FABIO PRETTI i 38 WENDWARD WAY i f I WEST YARM6uTH MA 02111 ijt�t,x� LJ���4 CIL i Commissioner '— Office of Consumer Affairs&Business Regulation c (z HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only iy TYPE:Individual before the expiration date. If found return to: Registration Expiration' Office of Consumer Affairs and Bu 'ness Regulation , Y' '182418 06/18/2019 10 Park Plaza-Suite 5170 FABIO PRETTI Boston,MA 02116 D/B/A FABIO HOME IMPROVEMENT FABIO PRETTI e,[w - .38WENDWARDWA-Y_.:,-s,;, YARMOUTH,MA 026M. N a 1 thout signature Undersecretary R ACORV CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD/YYYY) `� 1 02/15/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAME: PAUL SCHLEGEL Schlegel&Schlegel Ins Broker (A No.Ext: 508-771-8381 FAX No); 508-771-0663 34 Main Street E-MAIL West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING'COVERAGE' NAIC# INSURERA: NGM INSURANCE COMPANY 14788 INSURED INSURER B: ATLANTIC CHARTER FABIO INC INSURER C: 38 WENWARD WAY WEST YARMOUTH,MA 02673 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 REDUCED BY PAID CLAIMS. INSR OUL SUM POLICY LTR ITYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD EFF MMlDD P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE o OCCUR PREMISES Ea occurrence $ 500,000 MED EXP An one person $ 10,000 A MPS6863R, 11/19/18 11/19/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2iOOO,000 POLICY❑JEa LOC PRODUCTS-COMPlOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE CUT6863R 0910811E 09/08/19 AGGREGATE $ 3,000,000 DED RETENTION$ ' $ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY y I N /� STATUTE ERH ANY B O FICERIMEM PROPRIETOER�EXCLUDED ECUTIVE� NIA WCV00936903 09/09/18 09/09M9 E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) FABIO PRETTI HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE- THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. ATT BUILDING DEPARMENT 200 MAIN ST.HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE DAIANE BENRCA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachuseiffs. Department of IndtistrWAccUents Office of Investigations 600 Washington Street Boston,MA 02111 wwM.massgov/dia Workers' Compensation Insurance Affidavit:Bulders/Contractors/Electricians/Pinmbers Applicant Information / -/ r Please Print Lealbly, Name(Business ownizwonnndividual). ✓ 1. ; Address L , City/State/Zip: hone#• Are you an employer?Check the appropriate bor. Type of project(required): 1.0_-1 am a employer with. 4. I am a general contractor and 1. 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. P3.Remodeling ship and have no employees These sub-contractors have 8. O Demolition working for mein any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance# 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ Ir aammra homeowner doing all work officers have exercised their 11.[]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance revue]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 0 out the section below showing their workers'compensation policy information t Homeowners who submit this afduit 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 sbeet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepoUcy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: (((/G TW- 3 Expiration Date: V Job Site Address: I � � V 1 /State/Zip: Attach a copy of the worker's'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 vioWor. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ksur6ce verage verification. , I do hereby certify un P and p of perjury that the information provided above is true ald correct. Si Date: 0 Phone#: 0ift al use only. Do not write in this area,to be completed by city or town of trial 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 Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the or burl thereto shall not because of such employment be deemed to be an employer."- grounds � �P� MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not regrind 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 lime. City or Town Ofcials Please be sure that the affidavit is complete and panted 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 drat must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike 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. Tile Commonwealth of Massachusetts Department of IndustrW Accidents Office of Investigatim 600 Washington Street Bostca,MA 02111 - Tel.#617 727-4900 ext 406 or 1-877 MASSAFE Fax#617-727-7749 Revised 42407 WWW.MRW.gov/dia Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address 1U2LJQL&!Z 96ty CV1,,9WdnVWState Zip Cd T License NumberLS License Type ' �'. 'r Expiration Date Contractors Email rtq,610 PAL- E-1 LLI A14-W. CtXj Cell #&(98)360,— I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Build' g Code. I understand the construction inspection procedures,specific inspections and documentation required by 78 and the Town of Barnstable.Attach a copy of your license. Signature Date 9 Section 10—Home Improvement Contractor Name ( Telephone Number ) &2- 7 X Address ( 9� � �}y City V"AdrH-- State gj l A - Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Buildingmo-dde. I understand the construction inspection,procedures,specific inspections and documentation required by 780,C '' d the Town of Barnstable.Attach a copy of your H.I.C... Signature Date 0 Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date y APPLICANT SIGNATURE Signature Date / Print Name Telephone Number 4a� 912 E-mail permit to: Q Section 12—Department Sign-Offs Health'Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit.application for: (Address of job) Signature of Owner date Print Name of ti Town of Barnstable # eF-/ 3S-� ^� O Etpires 6 monlGs from issue drtte Regulatory Services Fee e amwirABLF- 9c�y L` 10�°` Richard V.Scali,Director A n Buildin-w Division N Tom Perry,CBO,Building CommissionerMAY 0 2 2018 240 Main Street Hyannis,�tA � 11 v, Stre-towet Hyatable_ma�60l��� BA Office: 508-862-40385 790-b230 EXPRESS PER&VUT APPLICATION - RESIDENTIAL ONLY Not Valid tvidrout Red X-Press Imprint i4tap/parcel Number o2-o27_Je!j Property Address Residential Value of Work$�(o S$ 'Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /_yn/it �L 6/4-0 4 ill C-P,4,of y We ( /A a2u,-�,2-- Contractor's Name ) E 'n1r;a '1�ra_/I � rJp� Telephone Number[L{D( 2- Hatne Improvement Contractor License f(if applicabie) / 7�Z s Email: Construction Supervisor's License#(if applicable) Q -7 :Z (Korkman's Compensation Insurance Check one: ❑ I am a sole proprietor Q jm he Homeowner I have Worker's Compensation Insurance Insurance Company Name F;P ame- BLS Insurac\a e . Workman's Comp_Policy# W C A 3 1 S 7 2 9 s L) Copy of Insurance Compliance Certificate must accompany each permit. F Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping oldshingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing lavers of rooO . ❑ side Q Replacement Windows/doors/sliders.U-Value ,�i(maximum.32)#of windows 0 #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 arith other town department regulations,i.e.Historic.Conservation,etc. ***Note: Property caner must sign Property Owner Letter of Permission. .--- - - A copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\LacaNMicrosoft\)hindows\Temporary Internet Files\Content.0utlook\2P10I DHMEXPRESS.doc Revised 040215 Renewal Agreement Document and Payment Terms byAndersen. dha:Renewal By Andersen of Southern New England Robert Paladino mtgtroz Legal Name:Southern New England Windows,LLC 282 Elliott Rd. RI#36079, MA#173245,CT#0634555,Lead Firm#1237 Centerville,MA o2532 10 Reservoir Rd I Smithfield,RI 02917 H:(508)254-5583- Phone:866-563-2235 1 Fax:401-633-6602 I sales®renewalsne.com C:(508)450-3149 Buyer(s)Name: Robert Paladino. Contract Date: 04/20/18 Buyer(s)Street Address: 282 Elliott Rd.,Centerville,.MA 02632 Primary Telephone Number: (508)254=5583: Secondary Telephone Number: (508)450-3149 Primary Email: robertpal28@gmail.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 b the parties and incorporated herein b reference(collectively,this"Agreement"). Buyers)hereby agrees to sign a completion certificate after Contractor as completed al work under this Agreement. Total Job Amount: $24,658 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: $12,329 Balance Due: $12,329 Estimated Start: Estimated Completion: Amount Financed: 8 to 10 weeks 8 to 10 weeks $24,658 Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate..We will-communicate an official date and time at a later date.Rain and extreme weather are the most common causes for. delay, Notes: Taxes paid in Barnstable. Ma. Buyer(s)agrees and understands that this,Agreement constitutes the entire understandings between the parties and that.there are no verbal. understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both:the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has:read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement: NOTICE TO BUYER:Do not sign this contract if blank.You are entitled to a copy of the:contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/24/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER:SEETHE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renewal Andersen of Southern New England Buyer(s) � ' Signature of Sales Person Signature Signature . Gino Montesi Robert Paladino Print Name of Sales Person. Print Name. Print Name., UPDATED: 04/20/18 Page.2 / 14 .. Massachusetts Department of Pubific :atari 3card of Building Regulations and Sanba- S License: S-095707 BRIAN D DENNISON 7 LAMBS POND CIRCLE _ CHARLTON MA 01507-- Commissionera9/!)8i.2a18 �- �T_ _a LSLrr Z_ , =ram f$ D ]L t.LJI 1C'1J `.igi - Re4istration: 173245 Type: Supplement Card — c::pirati0n: 9ii9/olB SOUTHERN NENN tN3L4ND 1l1liiND0VJS LL `—_— BRIAN DENNISON -7 _...- 26 ALBI ON R --- -------- — LINCOLN, RI 02885 _. ----------- --... . .�udute.lddr-ss:Ind rettim,zrrL Ylad:uun for�'un a Address _ $zLmnval _ Employment _ �cr.Card or C.—mer Affairs-Y 3asincs ialid for indnnduai ise ani,'nefore he , -_ :nnir3Liw:late- it round return _=+HOME IMPROVEMENT-CM.TgACTCP. �iLc a2�att5nmc.�Tas:.and 31 iness.?e^ Cue 9e5istion:.17,3245 TY tra Fe: ?0?art?Ian-Suite 5170 -- E--pirationc.9i14/2D13 Supplement Cari 3,htun.NL-\33_lb .SOUTHERN MEN ENGLAND WINDOWS I-_C. REi`EVIAL 3Y.ANDERSON 3RIAN DENNISON LJ�COLN.RI 02865 'yodersecrcu>~ Nut r3 Y The Commonwealth of Massachusetts. �! Department of Industrial Accidents 1 Conbo•ess Street,Suite 100 7 Boston,4L-4 02114-2017 www.mass-gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERty1ITI•II\•G AUTHOPJTY. Applicant Information Please Print Lev_ibiv Name (Business/Organizai1on,1ndividual): e L '\ Ows Address: 2 ,d,(s1 City/State/Zip: P Phone#: ,D� Are you an employer?Check the appropriate boa: Type of project(required): 1 K1 am a employer with ZO femnloyees(null and/or pa -time).* 7_ New construcuor. I 2.7 I am a sole proprietor or partnership and have no employees\vor}ang for rime in $. �Remodeling I any capacity,rNo workers'comp.insurance required.l : 1 3.Lj I am a homeowner doing all wor}:myself.Mfo workers`comp.insurance reaui-ed.l 7 9. ❑Demolition i 10 D Building addition j 4. m I a a homeowner and will be hiring contractons to conduct all work or,my property. 1 v%ill I ensure thai all contractors either have workers'compensation insurance or a7e sole 11_❑Electrical repairs or additions l j Droprietors with no employees. 12. Plumbing repairs or additions `.71 1 am a general contactor and I have hired the sub-contractors listed on the attached sheet 1 These sub-contactors have employees and have worker'comp.insurance.= l _�Roorrepairs �/�6. title are a coma attar:arid it:officers have exercised their right as exemptior,Der Iv1GL c� 1? them/n D t)r 152_§1(4),and we have no employees.[No workers'comp.insurance required.] r P/J/G re, V 'Anv applicant that checks box i�I must also fill out the section'below shown,theta workers'Cpmpensa ion policy informaior 'Homeowners who submit this affidavit indicating they are doirie all work and then hire outside contactors must submit a new affidavit indicating such. Contractors that check this box musi attached an additional sheet showing the name of the sub-contractor and state whether or not those entices;-nave employees. Ti the sub-contractors have employees,they must provide their workers'coop.polio•number. I am an employer that is providing workers'compensation insurance for my employees. Below is the poke,and job site information. o Insurance Company Name: [d'e Mled' S ¢ Policy-or Sell'-ins.Lic. : W U -3 y 2,q — �- Expiration Date: ! 1 Job Site Address: ,Z F Z Ell i o—4 Rs. Ciiy,'State!Zip: Attach a copy of the workers'compensation policy declaration page(showing the police number and eg iration date)'. Failure to secure coverage as reouired under MGL c. 152,§25A is a criminal violation punishable by a fine up to SI,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to S250.00 z day against the violator_A coPy ofthis statement may be forwarded to the Office oflnvestigations of the DLA for insurance coverage verification. 1 do hereby certify under th dpenalties ofperjun,that the information provided above is true and correct 5ienature: Date: Z — Phone#: CIO 1- 2Z 19—'—T zy Official use only. Do not write in this area,to be completed by city,or lawn official Cite or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. S.Plumbing Inspector 1 S.Other Contact Person: Phone r: CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY1Y) 12/29/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE.OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the'certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: CoBiz Insurance, Inc.-CO PHONE FAX 1401 Lawrence St,Ste. 1200 N a 303-988-0446 (AIC No:303-988-0804 Denver CO 80202 ADDRESS: COMa'il@cobizinsurance.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Firemen Insurance Company of WA,D-C. I 21784 Southern New Enaland Windows, LLC. dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY FRCP LIMBS LTR i TYPE OF INSURANCE POLICY NUMBER Mtd/DDIYYYY I MM/DDmw I A X I COMMERCIAL GENERAL LUIBILITY CPA3158728. 1112016 I 1112012 EACH OCCURRENCE S 1.000.000 DAMAGE TO RENTED CLAIMS-MADE I_:OCCUR I i I PREMISES occurrence S 300.000 MED EXP(Any one person) S 10,000 i I PERSONAL 8 ADV INJURY S 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: ! I I GENERAL AGGREGATE S 2,000,000 JECT I PRO- LOC � POLICY I I I PRODUCTS-COMP/OP AGG 5 2.000,000 i � _ I I !OTHER: I 5 A I AUTOMOBILE LIABILITY i I N CPA3158728 I V12016 1/12019 MBINED SINGLE LIMIT S. , Ea adent CO cci Doe 000 X ANY AUTO I I BODILY INJURY(Per person) S I ALL OWNED SCHEDULED I BOMY INJURY(Per accident) S PROPERTY DAMAGE AUTOS AUTOS i i X . X NON-OWNED S HIRED AUTOS I AUTOS I(Per accident) ! is A I x UMBRELLA LW6 x OCCUR I_ CPA315872B I 1112011, 11112111LI EACH OCCURRENCE S 10A00.000 EXCESS LL46 II--l CLAIMS-MADEI AGGREGATE S 10.000.000 DED I X I RETENTIONS I _ is g WORKERS COMPENSATION 'VVCF.3158729-20 1112018 -.1/12019 X STATUTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ EL EACH ACCIDENT I S 1,000,000 OFFICERIMEMBER EXCLUDED? NIA I (Mandatory in NH) E.L DISEASE-EA EMPLOYEE{51.000.000 Ii yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S 1.o00.o0D C IPollution Liability I I 7930073340000 1/12015 1/12019 Each Occunnce S1.000.000 Claims Made Policy I Aggregate S1.005.000 iRetroactive Date 06202013 I I Deductible 510,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ExPIRATION r DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE f� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD T TOWN OF BARNSTABLE Permit No. _ _27D95------_,_-_- 1 Building Inspector cash OCCUPANCY PERMIT Bona Li rid-i A. McKnight and Rosalie, L. Giannini Issued to Address q T,-,±- Wiring Inspector Inspection date .- •�. i. ;.-fez._ Plumbing Inspector - i /,� ;._ ` Inspection date Gas Inspector I�j�� ^` �.' , Inspection date Engineering Department \ �` -. f F /¢�*��f j i Inspection date Board of Health Inspection date _ . Y THIS PERMIT WILL NOT BE VALID, AND TH E BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ......................... ....... ........ � _, ........ Building Inspector .. ........... -- �.. ' °•wa' TOWN OF BARNSTABLE t BUILDING DEPARTMENT z, �`ilsaaaT TOWN OFFICE BUILDING 2639•' HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: � { An Occupancy Permit has been issued for the building authorized by Building Permit #... �! � ? l ». issued to / '? _ ., ...�..�fi/%1. Please release, the performance bond. Assessor's map and lot number ..... Ot #18 pTIC �� � cf roe T E Sewage Permit number tf ,�"� ° STALLED �Pll 41i T!�'LE 5 � Bsala AELa. • cc � i House number ....... f�.... ...... ............. CQ t���� 9�0 39• omMIENTAL TOWN OF B.ARNS�TABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... ;& R, Associates Residential Home TYPEOF CONSTRUCTION ..................................................................................................................................... " 8-28-84 ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Lot #18 Elliot Road, Centerville, Mass Location ....................................................................................................................................................................................... Residential Home ProposedUse .................................. .................. ............................................................................................................. Zoning District R.C. L. .........................:.g...................:...........Fire District .............................................. .......................... i......nda A. McKnz ht 243 Parker Road, Osterville, Mass Name of Ownerft$.alie.. +....'x.JL1T7�riall ......................Address 4.2...Sul.liVan-RA:ad.,...W....YarmOut,h.r...Mass M.G. Construction 42 Sullivan Rd, W.Yarmouth, Mass Nameof Builder ....................................................................Address .................................................................................... Maurice Bilodeau Sagamore Nameof Architect ...................................................................Address .................................................................................... Number of Rooms ................................................................Foundation COriCrete........................................................... White Cedar Clapboards p Exierior ...Roofing Asphalt Floors Hardwood Plastered ..........................................Interior .................................................................................... .....Hct_ water.....Qas V 2 Baths Heating ...............---.—}-................ ... ..........:'.............Plumbing ..........................:....................................................... Fireplace ..............2....................................................1.............Approximate. Cost ......$90,000.00 - ..................................... Definitive Plan Approved by Planning Board _______________________________19________. Area ....k ! ........: Diagram of Lot and Building with Dimensions attached Fee ......ACC.. . ........... 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 construction. Mario Giannini, M.G. Construction Name ..................................................... ......................... 001939 .....Construction Supervisor's License ............................... -!!ADA A. /ROSAL E R(�,AfIE I L. GIANNINI 27005 13-, Story No .............. Permit for .................................... Single Family Dwelling ...........I................................................................... Lot 18, 282 Elliot Road Location ...................................I............................ Centerville ..............:......................................................... C, Linda A. McKnight Rosalie L.'-Giamin-i Owner .................................................................. Type.of Construction ..Frarre........................................ . ...........;..................................................................... Plot .......................... Lot ............................. Permit�Grantecl ......;�P-P.t,.Wber..25.....--.19 84 -Date of Inspection ..................................c.Iq Date Completed ..... ......... i gis . k Assessor's'map and lot number o #1 ""`� ...........r.. .. . .....r --�' y �. � v - Z, Ba oFt ETo� r � , SeVva e Permit number ......... BARNSTAXE, i House number ...........:. ............................... ........................... 1 :�O MM6 � p 039. `00 ' A�,O YPY Ilr• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........L..j&...R Associates ............... . ............ r Residential Home TYPEOF CONSTRUCTION ......................:............................................................................................................;:, +8-28-84 ...... ° ......................................19........ TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies for a permit according to the following information: Lot #18 Elliot Road, Centerville, Mass `=y Location ...............r...................................................... ....................................................... ........... ............ ....................... Residential Home ProposedUse ..................................................... Zoning District L.......R.C.l................. Fire District ...r' r:`.. ...'. ....'.... ^" inda A. McKnight' 2°43 I?arke6 ,,Road-, Os ,ville, Mass Name of Owner ASgi X�'•, +e..C,1c'xI JIC. .....................Address ... dx ..?...t�R' ��.. .0a.d......'�.�...7.?;t?► )akkt ss M.G. Construction 42 Sullivan Rd, W.Yarmouth, Mass ' Nameof Builder ....................................................................Address .................................................................................... Maurice Bilodeau Sagamore Nameof Architect ..................................................................Address .................................................................................... 7 Concrete Numberof Rooms ..................................................................Foundation ....................................................:......................... White Cedar, Clapboards Asphalt Exterior ....................................................................................Roofing .................................................................................... Hardwood Plastered Floors ......................................................................................Interior .................................................................................... Hot -water gas _ - 2.,Baths_.. Heating ,.............................:.......:............Plumbing ...............................................................................,;.. Fireplace .... ......... ................................................... 2 . ::.............Approximate. Cost ......$90,000.00.....................�............ . .. Al Definitive Plan Approved by Planning Board ________________________________19________ . Area .... .......................... Diagram of Lot and Building with Dimensions attached Fee ...... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 41 y rr 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. Mario Giannini, M.G. Construction Name .................................................................................. " � a x 00193-9 Construction Supervisor's License .................................... c. tt ,L- i KNIGHT, LINDA A. /ROSALIE L. GIANNILNI % No ...2.70 1 Q5!.. Permit for ....2.....St......o '........... Single Family Dwelling ... location Lot 18, 282 Elliot Centerville Owner Linda A. McKnight & Rosalie L. Giannini Type of Construction .......Fr ....................... Pot .....:...................... Lot ................................ Permit Granted ......Sept.,ember..25......19 84 Date of Inspection ....................................19 Date Completed ......................................19 a Town of Barnstable *Permit# �/)off o i Expires 6 months from iss date X,-F, RE= S PERMIT Regulatory Services Fee aS° aU Thomas F.Geiler,Director I MAR 3 0 2007 Building Division y!3/o� TOWN OF BARNSTABLE 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 Not Valid without Red X-Press Imprint Map/parcel Number ;2sidential Address 1 lvral' e Value of Wor y ,�, Od Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address r d Qd CU&iy 'd e WIC e a,�3 �. Contractor's Name �� � aj 1 hhuis C— Telephone Number Home Improvement.Contractor License#(if applicable) y9 0 7 Q Construction Supervisor's License#(if applicable)__ C S ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ 14m the Homeowner have Worker's Compensation Insurance Insurance Company Name Awe-IeS.5 S _ Go Workman's Comp.Policy# fidC 84a't J Q 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-roof(not stripping. Going over existing layers of roof) 0 Re-side eplacement Windows/doors/sliders. U-Value . 3 (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 Lgktvrpf Permission. co y of th Ho e Improvement Contractors License is req k1j , SIGNATURE: Q:Forms:expmtrg Revise061306 s f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers.' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print LeLyffily el of Name(Businessiorganizationgndividual): , �! Address: City/State/Zip: JQ Phone.#: Jed�'6 7(O'�o g Are y an employer?Check the appropriate bog: Type of project(required):. 1, a employer with 4• I am a general contractor and I 6. ❑New construction.. employees (full and/oipait-time).* have hired the sub-contractors 2.El am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.insurance comp.insurance.t 5. We are a corporation and its 10.❑Electrical repairs or additions required.] 3.El am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.]t c. 152, §1(4),and we have no ] employees. [No workers' ME1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: 4"le-SS _ /a SC�o Policy#or Self-ins:Lic.#: �� �� GJ Expiration Date: 5,1 D 7 Job Site Address: o790.1% E:C.G./d/� City/State/Zip: MA eAa 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r t e pains nd enalties ofperjury that the information provided above is true and correct. Si afore: 1/ Date: d Phone# 0 e- 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. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the reaei_vrr_oLtrustee 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`(either the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until-acceptable evidence of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(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 lin6. 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. r->�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 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 fo 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 questions.,,- please do not hesitate to give us a call. The Department's address,telephone-and fax number; The Commonwealth of Massaehw0a Degart=nt ofIndustdal Aeel€lents O fee of Investigations 600 W'ashingtan Street Bostan,MA 02111 TO.#617-727-4900 ext 406 ar 1-877-MASSAFE Fax 617`-727-7749 Revised 11-22-06 WAWMass.gavtdla °FTHE Tpy, Town of Barnstable. Regulatory Services 9saxiv MAN. Thomas F.Geiler,Director �p 1639- TfDMA'IA 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) �nl Gjo��'niac� Signature of Owner Date Print Name QTORMS:OWNERPERMISSION - ACORDs ---CERT-IFICAT-E�-0F LIABILITY INSURANCE oP�o�2� °ATE`MMI°°'Yr"' PELLA! ' 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 INSURERS: 1325 Airport Road Acquisition LLC INsuRERc: 1325 Airport Rd INSURER D: Fall River MA 02720 I 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.AGGREGATI}NMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRN TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MWDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8022572. 05/01/06 05/01/07 PREMISES(Eeoccurence) $300,000 CLAIMS WADE. FX—]OCCUR MED EXP(Any one person) $10,0 0 0 X EBL PERSONAL&ADV.INJURY $1,0 0 0,0 0 0 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT.APPLIES PER: PRODUCTS-COMP/OP AGG $2,0 0 0,0 0 0 POLICY j LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 A ANY AUTO BAB022972 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 FICLAIMSMADE CU8024072 05/01/06 05/01/07 AGGREGATE $10,000,000 DEDUCTIBLE $ X RETENTION $10,0Q01 $ WORKERS COMPENSATION AND X I TORY LIMITS ER A ANY PROPRIETORJIETOR/EMPLOYERILRYPARTNER/F_XECUTIVE WC8023972 05/01/06 05/01/07 E.L.EACH ACCIDENT $1, �000 000 OFFICER/MEMBEREXCLUDED7 E.L.DISEASE-tAEMPLOYEE $1,000,000 If yes,describe under .-. SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,.000,000 OTHER - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWNBAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ' 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 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 > M- �'!ze >°anvnonureal!/ a�✓�,aaaac/ttcaeda . Board of Building Regulations and Standards License or registration valid for inJividul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration ,_ 4g840 Board of Building Regulations and Standards WRn ;µ /A3/2008 One Ashburton Place km 1301 n 'Type Lid Liability Corporation Boston,Ma.02108 PELLA WINDOWS)AND'D,O.R-SP STEPHEN. DICKI S( 1 1325 AIRPORT ROA-?'�`;-_='-'°' __� FALL RIVER,MA 02720 ZZ Administrator No valid without signature _ �/ze Uammw�ruuea�C`c � � gAR�? 1F � l�IRF1]A�If�I�fS 3 f. f .L�cense t;©NSRIi�TION S'tJ'P h2+V�15OR �. NurrabaQ5 0:817843 �. �• 161�J6:6 B .. kv Tr.noc 17237 . _ if r 12 BUR+Rl,�5F©E LA� rs C. I MEf�R41vIAC, MA Q�8 ,.5- : E Cgmm!_ssloner Office Order Copy Pella Windows & Doors Westerly RI, Centerville MA, Wakefield RI - Seekonk MA, Dartmouth MA, Plymouth MA Serving Massachusetts & Rhode Island Phone: Fax: a 't` FrQ ... ....... T ...........z-cie�r.................................................................................................................................................................... .. .. .:.:....:.:.:.:.:..:.:.:.:.:.:.:.:.:.:: J.................... P.. ......................................:........ Woods,Alfred Woods,Alfred Order No. 73822IX82 Order Date 01/10/2007 282 Elliott Rd. 282 Elliott Rd. Customer No. WOOALF Need Date 05/21/2007 Tax Code MA Sales Rep.Code 22 CENTERVILLE,MA 02632 CENTERVILLE,MA 02632 Taxable no Sales Rep.Name Conchinha,Kevin BARNSTABLE BARNST Tax Exempt No. Window Store 000001 Terms Code Wells Fargo Financing Territory Lic.No.: P.O.No.: Customer Type H Ship To County BARNST MDR Code SP Prepared By Lucy Alfred Owner: Mr.Alfred Woods Overall Discnt. 13.021 % Architect Name Bus.Phone: ( ) - Bus.Phone: (508)775-7673 Comm.Split 22: 100.% Dist.Order No. Bus.Fax: ( ) - Home Phone: Cellular: ( ) - Home Phone: (239)598-4560 Delivery Instructions: Comments: t [ :' 1 :il I :::lr �::::=::: XCIi '. (3u.sxd .Y u ....I. m........:....:.:.:.:.:.:.:.:.:.:.:( h'...:.:.:.:.:.:.:.:.:...:e . t.a.......:.......................................................................................................:.:.:.:.:..................:n t.P. c ..:..:.....................ded,.. t..:.7......... ... � l -Hun Frame:27-1/4 X 524/2: Pella Im ervia Alternative : 6 2 Item#�10 Qty: �Vent Double-Hung,a g, p e 898.70 6,290.90 Location: Material,Model 1 ,Half Vent/match Half Vent,White, 11/16"InsulShld IG (107.84) (754.88) R.O: 2'3-3/4" X 4'5" Glazing,Full Screen,White Hardware, 3/4" Custom Colonial GBG(muntin 790.86 5,536.02 WallCond: 1 11/16"(Fin to Roomside) pattern:4Wx3H/4Wx3H), White, 1 11/16"(Fin to Roomside),Precision Fit 12.000% Frame-3 1/4" Value Added Items:Install Precision-Fit(3 - 10 units)-Qty 1 Disposal fee per wdo/door-Qty 1 Notes Item# 15 Qty: 1 Behind the bed....replace sillnose w/cedar 100.00 100.00 Location: Value Added Items: Repair Rotted Sill-Qty 1 (100.00) (100.00) 0.00 0.00 100.000% Notes: Office Order Copy-Page 1 of 3 Office Order Copy for Customer Woods,Alfred Project: Woods,Alfred Order No: 738221X82 Sir, ....... 0 ........ ... ....... . ......... ::::------ ... ......... ............................ ......... . ..... . ................. ........ ..... ........................ . .......... Item#20 Qty: I Vent Double-Hung,Frame:27-1/4 X 36-1/2: Pella Impervia,Alternative 751.48 751.48 Location: bath Material,Model 1 ,Half Vent/match Half Vent, White, 11/16" InsulShld IG (75.15) (75.15) R.O: 2'3-3/4" X 3' 1" Glazing,Full Screen, White Hardware,3/4"Custom Colonial GBG(muntin 676.33 676.33 WallCond: 1 11/16" (Fin to Roomside) pattern:4Wx21-I/4Wx2H), White, 1 11/16"(Fin to Roomside),Precision Fit 10.000% Frame-3 1/4" Value Added Items: Install Precision-Fit(3 - 10 units)-Qty I Disposal fee per wdo/door-Qty I Notes: Item#25 Qty: I Trim Provided by Pella 0.00 0.00 Location: 0.00 0.00 0.00 0.00 0.000% Notes: ....................... ................................. d" tS ::::::::-.................................. 00.1 0.0 .... ........ .......... .......................... . Subtotal at List Price $7,142.38 Discount at 13.02% 930.03 Discounted Price $6,212.35 Customer Signature Pella Sales Representative Signature Payment Discount 0.00% 0.00 Taxable Subtotal $4,659.15 MA at 5.00% 232.96 None at 0.00% 0.00 None at 0.00% 0.00 Non-taxable Subtotal 1,553.20 Date Date Total $6,445.31 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 Office Order Copy-Page 2 of 3 Contract for Customer: Woods,Alfred Project: Woods,Alfred Order No: 73.822IX82 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. Per the manufacturer's limited warranty, stainable exterior, wood windows and doors must be finished upon receipt and prior to installation. Stainable exterior, wood windows and doors must be refinished annually, thereafter. Variations in wood grain, color, texture or natural characteristics are not covered under the limited warranty. Office Order Copy-Page 3 of 3 tract for Customer Project: Woods,Alfred Order No: .: .. #.�. '. .AI' v _�... ,. ,-, •.. � ..T t t: ,u. ..-:..,�rL'.::. '.R^'4a*..,, 1p '�"k""KY+x. .udae,.::' °n'.. .y ^"p':Y! ,!Wwa::'+.w,m,�. ,..:x.r 'r ":aR 2�rpeao: ;a9T„s...... .'�u -n ..�,,. L-..,t , n: � 1,? .:.:. °3 lr "` '�- •,, �. , °.s,. E. `� �S r .:,t ,. _ .., r,= n: -:d xte de u T � .. r...� ,;. 91stSx,L�tii�J:,. .:�723w:�twW�,��,�"''.a3�',�..e.z�w�-_:u..:.e�+.a4f�....w.A�r in.,r:�sa�i�.rre� �'w}. �?:a' u� uuum .,e '�•,J'.'��:� ��.iF�:�.,�fl�:,�u.�,.._ ..u.,....,,_15.,..,....a.9,�u�ue��� Y'�.a:c ',�N�.>' �:,L�'ssan Ye�iuislr:a�,➢:'a,�.,1..,9,5'.a,'�:,udd�,x,...::9�,�.+:µ Item#20 Qty: I Vent Double-Hung,Frame:27-1/4 X 36-3/4: Pella Impervia,Alternative 676.33 676.33 Location: bath Material,Model 1 ,Half Vent/match Half Vent, White, 11/16" InsulShld IG R.O: 2'3-3/4" X 3' 1-1/4" Glazing,Full Screen,White Hardware,3/4" Custom Colonial GBG(muntin WallCond: 1 11/16"(Fin to Roomside) pattern: 4Wx2H/4Wx2H),White,Precision Fit Frame-3 1/4" Value Added Items: Install Precision-Fit(3 - 10 units)-Qty 1 t; lotes .. .. .� ..: .. m.e .,.. •.. .... .k,.. ...�. :. , ,.::,. ++� nk _ .:: , .,. .: C. .. ;� �7 s"">ki�""�"T^'n:I :!�+ .37q +� A �9 £.. e.,.�, arb ,• ...� �, ..r• .''�'. ,M1l- �,-,:F... ,... ... a.v. .. -, . _ .. _ ry:...t., _ .. t.__.:. .:�`, ..,.:'� ..... :.. ., 5'1.,".,.S_ �f��"�Il.:t�^ kw�' :::�,a,.,,4r.,.�,rah.�,.�t:,w.1,s41,s,L,,:w.�, d„�.da �" auu.::,�.,�,.<d�,�:..x�,aJ,1,ws,�a:a'�,�asr,.�aaa�Twk:._..........,....M,:L.d��;..m.�.n..:..�Ar.�.sv.;.�..v:..:�a...........�,,.�,:-+:�e....i.�.`J.:''�.,a....i�o:„«:,au�.my.,z.,.,.�.�....,m.....,—.:�:�St-�..cif.;mk:;rita.�.rw.e.sraa.;:�'�ard — ,r..�d: `�" .b�;,M..,,.s�as.:i'n•-- �` "c�� _ "ACKNOWLEDGEMENT OF C.S.R. REVIEW WITH CUSTOMER(Customer initials): W 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 iri 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. 1'he 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 orders, 50% deposit required at time of order, and 50%upon completion. f Taxable Subtotal $4,659.15 Customer Signature Pella Sales Representative Signature €r MA at 5.00% 232.96 None at 0.00% 0.00 None at 0.00% 0.00 Non-taxable Subtotal 1,553.20 0 7 I o(o Total $6,445.31 Date 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 irito 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. Per the manufacturer's limited warranty, unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually, thereafter. Variations in wood grain, color,texture or natural characteristics are not covered under the limited warranty. Contract-Page 2 of 2 REVISIONS: TEST PIT DA TA DATE a` TESTING G - z4=� � PERC. TEST DATA : SEPTIC TANK DETAIL : sIzE-- �-�� o GAL. DIST. BOX DETAIL LEACHING FACILITY DETA /L� *TLC ^^ovE� A0' `=L =E �° �LL '°� TEST BY � 4 r�• >>�,,, ..� c.,„� s®.,,� _ R Z , sF:p'T1'` -r A+sK sz�.t_ac;,ATtr.� T. P. / 3 ` � Z DATE OF TEST/NG <o - 4" t�F TANK TO CONFORM TO TITLE 5 REOU/REMENTS. TO CONFORM TO TITLE 5 REOU/REMENTS 4�� 23�E3� w�� WITNESSED BYE ..ro,�,�: .T�c c�:; % � � TEST BY: �. w,� sQN:-- ----- — NO. OF OUTLEU, _ s - , , d . 14 1,. - - d. rll. EMOVEABL E I).F Q7¢'f� I 5 y - - --- - WIT BY sn.�.,.. _ram c _ �- T- - --r rt - 3� ...�.. {,� '', a,. R COVER Z T I�+J T .,:..L>o`'tbl►JC► -- -- - — — /\/ �// w7i .'/ain' /i /�// /!lam// / / Y�/c t�\G t\%\\���\3 T � l2 MA NHOL BROUGHT TO • L .off - _ — - -- -- -- -- , .. ; .i `• _ r FINISH GRADE. e o 2 PEAS �rLC14M 9 F1LL /2"M/N. _— 3 CL EAR • 3 CLEAR - T pl _ •• OU LET PIPES r, DEPTH OF TEST, 3. U -- -- --- 6"M/N�- 2"MIN 6„M/N. — I �I . ' o 1 �1 AS REOUI RED I - - - --- - zse. .Su3 a, — --- 7G•�T y;• 2/ � RArE: -- � �Z��v _..�.c'y ---- - -- INLET I 3 - - /O•MIN. I� (��� B X /Z I / ?y /�C L• -- - — INLET TEE -- ,` OUTLET TEE b II \ / I A GAL. INLET AND OUTLET 4'-0" MINIMUM OUTLET TEE DEPTH• � � SEPTi+CTAAWY � TEES TO BE CAST L IOU/D DEPTH /4 AT L/OUID DEPTH OF 42 6 / I PRECAST OR BLOCK `y7 Vj /9" „ „ „ 5' / CONCRETE � � � SEEPAGE PIT ----- - -- ---- --- - — -- IRON, SCHED. 40 `, �. CONSTRUCTION • I DEPTH OF TEST __ - -- P VC. OR CAST IN 24 ;: 6 b o /O , PLACE CONCRETE 29, MIN. 4 RATE: CONCRETE b_ 34 " B BOTTOM ON LEVEL STABLE BASE j CONSTRUCTION ti I. + TER T/GHrI ' T / FOUNDATION INLET TEE PROVIDED WHERE SLOPE , . .� ,.,_.. _e ._ , . .' ,r;. •• ... . OF INLET PIPE EXCEEDS 0.08 % OR I• /- --------- - l i -- •BOTrOM-OF TANK ON LEVEL STABLE BASE ` TANK TO BEAGLE TO W/THSTAND IN A PUMPED SYSTEM. 20'M/N \ WASHED STON / I H-/0 LOADING UNLESS UNDER - - -- - - -- - PAVEMENT OR IN DRIVE. H-20 � / E I � L OA D/NG UNDER PAVEMENT OR OR/VE. H — NOTES : INVERT EL E I�A TIONS. PLAN I//EW /. THIS PLAN/S FOR THE DESIGN AND CONSTRUCT/ON OF rHE SEWAGE DISPOSAL FAC/L/T Y ONL Y. z 8. 34 . SCALE / zn " ; .�t. k G INV. AT BUILDING _ 2. AL L CONSTRUCT/ON METHODS AND MATERIALS SHALL CONFORM TO F=K,"-)/v T` 20 / --INV AT SEPTIC TANK(IN) MASS. D.E.Q.E. TITLE 5 AND THEcs•�.. :,�. ;.�._ � BOARD OF r /NVAT.S�PT/CTANK(GYJT� z'7-OP/ HEALTH REGULATIONS. — --- ( .: ICJ Y✓iV ���TE/.! t,` ✓:•"� ._ ?r ,'_-: 7� 7 f'/i . U T• T fs• 9 O r/►— �/¢ / O N l•%y D., I s k ' + i 3 CctIuN r-.•.r, ��: z�.�s -- - -- .�? e� .►4 r7 �' —--INV. AT D/ST BOXON) _ _z y �. ,� �a X �8 2� _ — — NV. AT DIST. BOX(Ol/r> z . 4 4 Qd AT LEACHING FACILITY: 07. c(D r '-•— ---___.___ _ � � BOSTON, MASS. WORCESTER, MASS. AT BOTTOM OFP/T: ; HALIFAX, MASS. NORWELL, MASS. J BEDFORD, MASS. LEXINGTON, MASS. / HYANNIS, MASS. MANSFIELD, MASS. • / �_ ` i CRANSTON, R.I. DERRY, N.H. AP .i - F}----t�f. 1 /4, 4 - 4U x S o BCLA All DESIGN DA TA f ! DESIGN FLOW ' 3 82 f <' '` ,� ...••i `_ � - NC _G,A�rZ��ks�'" Cin.se�'nrQ�'"�- - - \ / r _'' \ REQUIRED SEPTIC TANK �}• --.,.._.. v N -,:_ _, ,'� .f � - 4 9 5 GAL. SEPTIC TANK PROVIDED = �doo GAL. CAPE COD SURVEY CONSULTANTS REQUIRED SIZE LEACHING FACILITY: 76 ENTERPRISE ROAD HYANNIS, MASS. 02601 • 75 7155 775-7815 DIVISION OF • x E Z 1 BOSTON SURVEY CONSULTANTS INC. M SIZE OF LEACHING FACILITY PROVIDED: ENGINEERING SURVEYING PLANNING TYPE OF SYSTEM: TITLE: 4 3 I ` '.,� 1I_#a �-� C L' .5�'_"__4'�-LPG SEWAGE DISPOSAL \ \ _ r �,,F , E OS L �.� DESIGN I CEFT1f 'r THAT _T_HE � � `�► --- - - -- - - - - ,r ;A� /1 Y \ / •r i ..'•C H -r t_G O I V 1-I••1� G,F:s.'•U 4\1 l::> , / \ \\ � ` \ } � 7 /� �r3Za e \ \t y L OCUS, PLAN FO R• SCALE 'Y METERS AS SHOWN ! / �a \ �' �,•�� (. ' /e` \ / FEET 0 sl '�, .> �-R f / // • - _ COMP./DESIGN: CHECK: �. �, o/, A, DA TUM' DRAWN: ,Z3 c.,/� is ,,,�,� ,•� ,� s�::�;;. : � •�•'% d Q FIELD: E44V. s i G Z!ro ^4 CT. �/• !>. FILE NO: DWG. NO: 7/9' JOB NO: 0 3-1400 SHEET: I OF: I