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• � Town, of Barnstable *Permit#
a
Expires 6 months from issue date
yY '^ Regulatory Services Fee
BARNMBt.E, r
MAC' '
1639. Thomas F.Geiler,Director �1
RFD MA't a '
Building Division ��
Tom Perry,CBO, Building Co Commissioner �
200 Main Street,Hyannis,MA 0260`11,EP 1
www.town.barnstable.ma.us 152016
Office: 508-862-4038QN �/ �,��- ��Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIALkO �' -
Not Valid without Red Y Press Imprint
Map/parcel Number
Property Address O` 6 " /l/� ?
Residential Value of Work�'yt Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Sc/"ehIl k
P1 Ile
Contractor's Name JON11 ®. 145ISI Telephone Number �6-7 o7�Y 7J`"yo
Home Improvement Contractor License#(if applicable) 14 f
Construction Supervisor's License#(if applicable)
[�Workman's Compensation Insurance
Check one:
0 I am a sole proprietor
IIam the Homeowner
have Worker's Compensation Insurance
Insurance Company Name -)! !V r ( O•
Workman's Comp. Policy# WCG<S-S/gA/9
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
E!�Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to.;MY e0f1hel"Y/6�/L
G�/�l1,01yAt, ��0 7
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof]
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
re ' ed.
SIGNATURE:
C:\Users\decollik\AppData\Loca\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
CONTRACT#. 001218717
f`A � ryY
MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT
t
LOWE'S AUTHORIZED REPRESENTATIVE NUMBER CUSTOMER
STREET AD DR
STORE N0. .-' - r:
STREET AD ESS / /�' ..
f >✓''.CG /�//` 0
CITY ST TE j ZIP
ZIP
kflt� I!Y r �._. l
i—/. � / %y��y TELEPHONE a }
DATE IOWE'S HOME CENTERS,LLC S MA HIC NO.:748668 `." Cases 9ANK _ Lcc
1� FEIN:56-07483 REG
56 i. CARD f.: CHARGE _�yi
\J (p
This is only a quote for.the merchandise and services printed below This�be nes an agreement upon payment Upon payment the enbre agreement,mdudmg;the specificalty�corn leted pages of this
documeM thelems and.Condmons indudeE will th'a document antl any other addenda and attachments hereto,shail be referred to herein as this Conbact :-
PLEASE READALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING -
INSTALLATION STREET ADDRESSCjTY 4t ~STATE ZIP
U •,
NOTICE TO CUSTOMER=PRICE CALCULATIONS:In order to properly perform the installation of certain Goods,the Contract Price may include more i
Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price #'
stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual
square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste).
By signing this Contract below,Customer acknowledges)receipt of this notice and agrees and understands that the Price includes these costs which may
not be refunded once the Installation Services are performed. t
Contract Total D� _6
Are permits required for this installation?:[XYes [ ]No "applicable tax included / 1
NOTICE TO CUSTOMER:Federal law requires Lowe's to provide you with the pamplet Renovate Right.By signing this Contract,Customer
acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure
from renovation activity to be performed in Customer's dwelling unit.
NOTE:If rotted wood is discovered during installation additional charges will apply.You will be given a quote and a change order
must be completed and signed by the customer for any additional charges. Customer must initial.
'Any work or material not specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor.
PHOTO RELEASE:Customer 'rants to Lowe's and Lowe's g o s employees and independent contractors the right to take photographs
Pp g phs of the Premises where
Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and
interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright,use and publish the
photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,,�+�Ptctuding,but not limited to,marketing,
advertising,publicity,illustration,training and Web content.By initialing here,Customer agrees to the foregoing. ICA .[Customer to initial to the left].
Work is to commen a upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be
�— ���� [fill in date].Estimated completion date is 2- -21- /t__ [fill in date].
Said estimated substantial completion date is not of the essence.A statement of any contingencies that would materially change said estimated substantial
completion date is as follows: _2 J
(if applicable insert a statement of such continge:.,ies) ..
applicable', .__.._............... ,...,, .,,yam,.., ��.
IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
613ustomer to Pay in Full; OR [ ]Customer to use the following payment schedule:
(1)Deposit $ to be paid upon signing contract.Deposit should be 1/3 the total contract price;and I
(2)Payment of$ to be paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's
to do one of the following(check appropriate box below):
[ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; [
or - {
[ j Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and
(3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. ]
NOTICE REGARDING ARBITRATION—AGREEMENT FOR CLAIMS COVERED By M L c f42A
LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT
LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT-
IVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION t
AS PROVI
By: Date: V
Low ' ome Eggnnteys,LLC
By Owners'gnatLffe
lf�,{D, C +; Date: v- �7 7
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED
' BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE t
SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES. d
{
DO NOT SIGN-THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND
CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.
BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE
TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS
CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE.
WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS 3 DAY OF V
Lowe' H nm ,
L i
thorize Owner
—owner I
or Witness
Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof.You,the buyer,may
cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation
form for an explanation of this right.
I` 55102 REV. 12/13 _ FILE COPY -®2004 by Lowe's.0 Lowe's and the gable design -
.. ... are registered trademarks of LF Corporation.
oFtaE., Town of Barnstable Permit
Expires�6 moi t n is e
Regulatory Services Fee
BARNSTABL& )
J' 9 s Thomas F.Geiler,Director
✓ lip�ED
1 � Building Division
O,� 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 A.P.PLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address ;L/ /fie 7&. t91. Oen 1' eill//2 Hu.
2-Mesidential Value of Work fso/b Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address ��/�[ �� !j �� f� 1"' -Y�N� C�f'I�✓�f L
Contractor's Name lacyes 14<1 S/Af/S 'Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
[Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
[al have Worker's Compensation Insurance
Insurance Company Name A1Q1 1T W1 . hte ,
Worknran's Comp.Policy#_
Co of Insurance Compliance Certificate must accompany each permit.
PY P P Y
Permit Request(check box)
ER/Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Jatt5 - ;4Zl C ,4keely
('{pjt'. �l/�ctt�kcra►� tsc: C7��'6 1,-.
❑Re-roof(hurricane nailed)(not stripping. Going aver existing layers of roof]
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
*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.
s nAcopy of the Home Improvement Contractors License&Construction Supervisors License is .'
SIGNATURE:
C:\Users\decollik\AppDat<1\Local Internet Files`.Content.Outlook\DDV87AAZ\EXPRESS.doe
Revised 072110
ss
A.
CONTRACT# (J
IVIASSACIit9SETTS,SERVICES SOLUTIONS INSTALLED SALES CONTRACT
LOWE'S AUTHORIZED REPRESENTATIVE NUMBER
�,,.. BE a [STREET
USTOMER
.. C.-IG.J',�1 i :%`'�i✓�/1 �'l:-.C f .� �:
�• STORE N0. STREET ADDRESS ti_ AD ESS
CITVJ t STATTEy� ZIP e CITY _ .J. �. S/TA�iEj ....ZIP
1 ,+s,z .C elji tG.tV" /e- f�P/y� /�" Z --i4
' TELEPHO ICE ', TELEPHONE
. 1
�7- 12 /
DATE LOWE'S HOME CENTERS,LLC S MA HIC NO:748688 GASH BANK REG
Y '2 /� FEIN:56-0748358G /,R/`' CHARGE r.,
This is only a quote for.the march
ardise and seances p64 below This becomes an agreement upon payment Upon payment the entire agreement mGudmg the spe salty completed pages of this
doament,the Terns:and-Conditions included wRh this document and any other addentla and.attachments hereto;shall be refertad to herein as this Contract -_
PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE-SIGNING t
INSTALLATION STREET ADDRESS �CjTY STATE ZIP -
dh
n
J� i /7, .\ cl�% ,SG y�..'flldl `i // r... r r� f / .
J t 1 Sri'r/'>-' .lr> ,.T r•'1'J' r�i. �4 l
r� ✓X l42
TE`K:s.s-'.
X/ 14 rr_ > t . t 'r may.,� .� / L -.,_�. /1; �r 3 �f �=t<-• G t'f�, a j y
NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order to properly perform the installation of certain Goods,the Contract Price may include more .
Goods than actually will be installed based.on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price
stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual
square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste).
By signing this Contract below,Customer acknowledges)receipt of this notice and agrees and understands that the Price includes these costs which may
not be refunded once the Installation Services are performed.
Contract Total /w,
Are permits required for this installation?:[ Yes [ ]No *applicable tax included }
NOTICE TO CUSTOMER: Federal law requiresf Lo(we's to provide you with the pamplet Renovate Right.By signing this Contract,Customer
acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure
from renovation activity to be performed in Customer's dwelling unit.
NOTE: If rotted wood is discovered during installation additional charges will apply.You will be given a quote and a change order
must be completed and signed by the customer for any additional charges. Customer must initial..
`Any work or material not specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor. -
PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photographs of the Premises where
Installation Services will be performed and.all.work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and
interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright,use and publish the
photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpos!&,{cluding,but not limited to,marketing,
advertising,publicity,illustration,training and Web content.By initialing here,Customer agrees.to the foregoing. t fi [Customer to initial to the left].
Work is to commence upon reasonable availability of Contractor and/or any special order or customer mate Good(s)which is anticipated to be
7 /-/,6 [fill in date].Estimated completion date is `7- �Z/' /l [fill in date].
Said estimated substantial completion date is not of the essence.A statement of any contingencies that would materially change said estimated substantial
completion date is as follows: Z �7
(if applicable insert a statement of such contingencies):
,�'-ter..---._,insert..................................�.,„y�,,,,,��,.
IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full.
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
k_fCustomer to Pay in Full; OR ( ]Customer to use the following payment schedule:'
(1)Deposit $ to be paid upon signing Contract.Deposit should be 1/3 the total contract price;and
(2)Payment of$ I to be paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's
to do one of the following(check appropriate box below):
[ ]Charge my/our credit Card for the amount of the payment indicated above anytime after the date this Contract is signed;
or
[ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and '
(3)Final payment of$100.00 to be paid upon completion of.the installation and both parties'satisfaction.
NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c 142A
LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT
LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT-
IVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION
AS PROVI
By: w Date:
Lowe ome COtekx r LLC f
i� dri
Date:
L l
Owner Signatdie
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED
BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE
SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES:
DO NOT SIGN THIS.CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND
CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.
BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE
TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS.
CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE.
WITNESS OUR.HAND(S)AND SEAL(S)BELOW THIS 3 DAY OF
Lowe's,Home C nters LLC t' ^
r r �ILI,
Lowe's_-Authorize -Representative Owner i kPJ1 Co-owner or Witness
Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof.You,the buyer,may,
cancel this transaction atany time prior to midnight of the third business day after th
e he date of this transact
ion.tton.See the attached
ached notice of cancellation
form for an explanation of this right. �,.
55102 REV. 12/13 FILE:COPY ®2004 by Lowe's.0 Lowe s and me gable design
are registered trademarks of LP Comoration.
OF 7ME rp�
* BARNSrABLE, `
MAC i639• Town of Barnstable
��
QED MA'S A
Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
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, Y�r 5�hv as Owner of the subject property
(� � l p p h
hereby authorize e) to act on my behalf,
in all matters relative to work authorized by this building permit application for:
�6 At,
(Address of Job)
6P
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Piles\Content.0utlook\2PI0I D}IR\EXPRESS.doc
Revised 040215
�l2 c
,111 to
r
_ o�VNE Pca Town of Barnstable rmit#
Regulatory
'euAat®r Services
Elq Tres 6 months from issue date
� sAFtN9l'ABL& � � e
MA83. r
i6gq Thomas F.Geiler,Director
Building Division
Tom Perry,CBO,'Building Commissioner
200 Main Street,Hyannis,MA 02601 JUN 14 2016
www.town.barnstable.ma.us T
Office: 508-862-4038 OF BARNSTABC ...
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL, ,i Y Y`
Not Yalirl►vithout Red X-Press Imprint
JJ v (�
Map/parcel Number�S4 PER"#
�' / Z
Property Address .1;'/ pil l e %�' - JUN'
15 2016
21kesidential Value of Work 3� ',Minimum fee of$35.00 for work under 6 , 0.00 V�
- /�----- AFL
Owner's Name&Address Z CI Gt .5G h
inn VD/
Contractor's Name
Telephone Num.
Horne Improvement Contractor License#(if applicable) /y
Construction Supervisor's License#(if applicable)
E orkman's Compensation Insurance j
Chock one:
C I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy
Co of Insuran
ce nee Compliance Certificate must accompany each permit.
i
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be takej t°I "es-' LfLl 1y
i
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) i I � IA�Cc/��'l�uy'�e1ac�'d3v 71
Re-side
#of do
❑ Replacement Windows/doors/sliders.U-Value (maxtum.35)#of w' d ; s
Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.I.is oi'c,Conservation,etc. y
***NAte: Property Owner must sign Property Owner Letter of Permission. '
A copy of the 11ome Improvement Contractors License&Constructio u jervisors License is
J quire '
SIGNATURE:!
C',Usets',decolak\AppData\Local',Microsoft\WindowsI ciiiporary Inteinct Files`,Content.outlook\DDV87AAZ\EXPRESS.doe
Revised 012110 I
f �j
• saRNsiABLE,
9��MASS,
,�� Town of Barnstable
s
'Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 509-790-6230 y
Property Owner Must
Complete and Sign This Section
If Using A Builder
l �� � �G` `� � ,as Owncr of the subject
1 property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
/V,A(C 772-CC- /2
(Address of Job)
Signature of()wner Date
A+I�r
SG 61 k
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\tlscrs\Dccollik\AppData\Local\Microsoft\Windows\Temporary Intemel FilesWontent.0utlook\2P10I DIIR\EXPRESS.doc
Revised 040215
f
S
T# 001 218
` [CoNT RAC
t:.
rXr.
MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT_
LOWE'S AUTHORIZED REPRESENTATIVE NUMBER CUSTOMER
T
STORE NO. STREET ADDRESS STREET ADDRESS -
3 26
CITY STATE zip 7 CITY , ,t ST97E ZIP
7/ C� �� �.� r`1/rf�f'
TELEPHONE�—J � - TELEPHONE
LJ DATE LOWE'S HOME CENTERS,LLC'S MA HIC NO.:148688 CASH CAARRxD /YC REG .-
FEIN:5"748358 CHARGE
This is only a quote for the merchandise and services printed below.This becomes an agreement upon'payment upon payment,:the entire agreement,inducing the specifically mmpleted pages of this.
document,the Ten and Conditions included with this document and any other addenda and attachments hereto,:shall 8e referred to herein as this"ConVac.�t."
PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OE THIS PAGE AND'FOLLOWING PAGES BEFORE SIGNING.:
INSTALLATION STREET ADDRESS (\'\'� CITY STATE ZIP
NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order to properly perform the installation of certain Goods,the Contract Price may include more
Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price
stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual
square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste).
By signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may
not be refunded once the Installation Services are performed.
Contract Total
Are permits required for this installation?: Yes [ ]NO *applicable tax included f f �z "T
NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right. By signing this Contract,Customer
acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure
from renovation activity to be performed in Customer's dwelling unit.
NOTE:If rotted wood is discovered during installation additional charges will apply.You will be given a quote and a change order
must be completed and signed by the customer for any additional charges. Customer must initial.
'Any work or material not specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor.
PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photographs of the Premises where
Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and
interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright,use and publish the
photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,.chiding,but not limited to,marketing,
advertising,publicity,illustration,training and Web content.By initialing here,Customer agrees to the foregoing. 7' , [Customer to initial to the left].
Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be
7_ -< ---,e' 0 [fill in date].Estimated completion date is -7-_7 G-,/('-, [fill in date].
Said estimated substantial completion date is not of the essence.A statement of any contingencies that would materially change said estimated substantial
completion date is as follows:
i 4Z (if applicable,insert a statement of such contingencies).
IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full.
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
['Customer to Pay in Full; OR [ ]Customer to use the following payment schedule:
(1)Deposit $ to be paid upon signing contract.Deposit should be 1/3 the total contract price;and
(2)Payment of$ to be paid anytime after this Contract is signed and before commencement of installation,I tWe authorize Lowe's
to do one of the following(check appropriate box below):
[ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed;
or
[ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and
(3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction.
NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c 142A
LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT
LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT-
IVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION
AS PROVIDED IN M.G.L,�.142A--
By: !���' ' s Date: `-} 3'-Z/ .
Lowe's Home•�enfers�L�LC;t ``,, ,f j1 j
By: "'� i ir✓n(4.rr, N .,sXa!/t/� Date; �, i,�l J ��i
Owner Signature
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED
BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE
SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND
CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.
BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE-
TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS
CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE.
WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS DAY-OF fin't ( ✓Gr l ,
Lowe's-Home Ce_n_ters,LLC Ii)
4_$'ran -.'�'•�'`� /7. -
Lowe's.Aufffonzed Representative ) Owner a �� Co-owner or Witness
Custil acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof.You,the buyer,may
cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation
form for an explanation of this right.
FILE COPY 02004 by Lowe's.0 Lowe's and the gable design
55102 REV. 12/13 are reglslered trademarks of LF Corporation.
I
Addendum
Contract No : ..r :. j Date { y
6
4
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PSE • Customer:'
Cfaig Stout
Project Specialist—Exteriors
�t ►a,, Town of Barnstable *Permit#
X-P �h1 I� E%Pires 6 nuts tlu rnm i use
M Regulatory Services Fee
BARNSCABLE,
y MASS 2 Thomas F.Geiler, Director
Building Division IL #Z/
Tom Perry,CBO, Building;Commissioner
TOWN OF BARNSTABLE
200 Main Street, Hyannis, MA 02601
www.lowil.biii-nstal)lc.inii.tis
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Hof Valid without Red:X-I'rexs Imprint
Map/parcel Num f/ber- / /
4
PropWy Acl(lrL-,s
[Residential Value of Work / �°],� ®-- Minimum fee of$35.00 for'work under$6000.00
Owner's Name&Address
Contractor's Name 4Q/1)cA =-4222&e-1/?Mse/7-k-� Telephone Number 19 677-(g 0m
Home improveiiKnit Contractor License#(if applicable)'
Constriction Snpca-visor's License(1 (if applicable) 75/Tj.�
❑Worknrui's Conip(115a11oii insurance
Check onc: ,
❑ lain it sole proprietor
❑�-,�ani the Homcxiwnc,r
l have Workci-'s Ccinipcnls ilion'insiu'ance
Insurance Compiuiy Name-
V1 orkman's Conip. Policy I/ GU e, U - 36 j 63
Copy of insurance Compliance Certificate must accompany each permit.
r
Pennit Request (clicck box)
❑ Rc-cool'(-hurricane nailed)(stfiphiiig old shingles) All constnictioii debris will be taken to
❑ Rc-rool'(hurricane nailed)(not stripping. Going ovcm existing layers of rooO
❑ Rc-side
#of doors /
[�.Replaccinet Windows/doors/sliders. U-Valti' 0-99 Tl l (inaxii -ni.35)#of window_
*lkliere required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner inust sign Property, Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is :
required.
SIGNATURE: ,
C:�l'ui:cldcxollik\:\p}fl)ala\I��calltiiicrosofl\k#ind�iws\lcmpoi�iy inlcmcl Pilcs\Content.Outlook\lll)VS71A1.,\I.\CRP.SS.doc
Revised 072110
* BARN"ABLE,
Q MASS.
i679• Town of Barnstable
Vp ♦0 -
rED MA'1 A
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hy,mnis,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 PAP Sr ..i i V,
�� � , as Owner of the subject property
hereby authorize y t on my behalf,
in all matters relative to work authorized by this building permit application for:
v� 9),A P (?i✓. U/f It V� P -t. i/I/1,(�-t-�
(Address of Job)
Pon-
1
i�.
Signature of Owner Date
Print N;.ime
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\IJsers\decollik\APPData\Local\Microsoft\N\%indows\Temporary Intentet Files\Content.Outlook\DDV87AAZ\EYPRESS.doc
Revised 072110
N I
DURABLE POWER OF ATTORNEY
KNOW ALL MEN BY, TVESE 'PRESENTS: .
,
That I , JEAN W. SCHABLIK, of Centerville,. Barnstable
County, Massachusetts 02632,ydo hereby make, constitute and
appoint my son, PETER SCHABLIK my true and lawful attorney for
me and in my name ' place ;And .stead ';:.
(1 ) To 'receive, take receipts for and hold in possession,
manage and, control all- property both real and personal which I
now or hereafter own, hold, possess or be or become entitled to
with full power to sell, mortgage or pledge, assign, transfer,
invest and reinvest the same or any part thereof in forms of
investment, including bonds, notes and other obligations of the
United States , deemed prudent by my said attorney in her
discretion with full power to retain the same without liability
,for loss or depreciation thereof..
( 2) To demand, sue for, collect, recover and receive all debts,
moneys, interest and demands whatsoever now due or that may
hereafter be or 'become due to me, including the right to
institute any legal proceedings therefor, and including the
right to make deposits or withdrawals on any accounts in any
j bank or financial institution on my behalf and the right to make
- - - -direct deposits of m social---securit,�,,- y---checks--sn a-ny accounts in
banks or' her financial institutions of my behahf
i
(3) To make, execute, deliver and endorse notes, drafts,
checks certificates of deposit and order for -the payment of
money or other property from or to me in order of my name.
(4) To,make, execute and deliver deeds, releases , conveyances
and contracts of every nature in relation to both real and
personal property, including stocks, bonds, contracts of
indemnity and insurance; and with respect to insurance, to have
full authority to deal mith any policies of insurance on my
life, including but not limited to the right to make irrevocable
assignments thereof , to surrender, borrow against or convert any
such policies and to change beneficiaries thereof.
(5) To have access to my safe deposit boxes, if any, to act as
my proxy with power of substitution, to vote all stocks or
securities in my name in relation to any individual or corporate
action, to deposit any stocks or securities in connection with
ar=y plans of protective or -reorganization committees, to accept
same.
.(6) To receive and receipt for all rents and income to which I
am or may become entitled, pay therefrom all necessary expenses
for the maintenance, upkeep, care and protection of my property,
deduct therefrom his own reasonable compensation and pay the net
income from time to time to me in such mariner as I . shall direct,
or in the absence of such payment to me or such direction, to
invest the same in his judgment in the manner above. directed.
(7) In the event of my . illness`, incapacity or other emergency,
to incur and .pay and satisfy such. expenses and obligations for
my comfort, benefit and care and obligations of a nature
customarily incurred by me, as in his judgment he may consider
necessary or 'desirable or consistent with my wishes.
fk
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'. ..�, a-tri�".o_+i�r+•...:.:..tea.-ti-c!?:� 4^' .. '1.. "�Y�•�'e'�"�Y`- _ _ _ ,__
.A
(8) To prepare, execute and file federal or state income or
other tax returns and other real .and personal property tax lists
and to pay all such taxes or collect any refunds due.
(9). To make outright gifts of my property to or for the
benefit of. such ,persons who, in the opinion of my said attorney,
would be the donees I may choose.
( 10 ) To do and perform -all acts necessary or incidental to the
carrying out of powers conferred, and at my 'decease to pay,
transfer and deliver over to my legal representatives,. all
principal and income then in his possession and control.
�_._ .__..._. . r preby__further—g a—nt—tcmy__-�;�-d-attorney .ful l_Power
in and concerning the above premises 'and to do any "and all acts
as set forth above as fully as I could do if I were personally
present, and I do ratify and confirm whatever my said attorney
shall lawfully do under these presents.
Any party dealing with my said attorney hereunder may
rely- absolutely on the authority granted herein. and need not
look to the application of any proceeds. nor the authority of my
said attorney as to any action taken hereunder.
In the event a petition is filed in any court for the
appointment of a 'guardian or a conservator to care for me or my
estate, then-:1 nominafe my: son, PETS S L f as
appointee. Nothing in this ,part shall be- construed as a
direction that such a petition ,be filed or such an appointment
be made, and -it is my express wish .that such action be taken
only when and if absolutely necessary.
A photostatic copy of this power, as executed, may be
treated as an original. power by any third party dealing with my
attorneys in fact.
This Power of Attorney in the said PETER SCHABLIK,
shall not be affected by my subsequent disability or incapacity.
IN WITNESS WHEREOF, I have hereunto set my hand and i
seal this 20th da.y of December, 1990: .
AN lq.: B:CHABLIK
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SAGAVE
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