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HomeMy WebLinkAbout2414 MAIN STREET - A li ,, , .,a ,... .,..- , . .. , „, . ,..... ,,,„,-, ..., .., : .•: ,, , ,. ,_, ., . .. . , ,„ , . . , ., .. , ., , . , nrL�..m19'ra�ww.Ylll c . .i • n • • • ^r • • • LI • • • • • • • • • • • • • • I. • o 0 • s • c c let4El c, ,��� � edV2w�-+, ' Application number - 19*- 36R- .�.ss .� r Fee S �.,, ! 3 o 6 2''' • M,I tv �N�I : 0t iis I �bjII LL ADLC ate Issued '// J(rL.( Map/Parcel c23 7 — Oa TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 211I li M j N 5T ( Kr t A ) uki• (w ►Q VU5T/l Y L C-, M d NUMBER Ab4A/C. STREET VILLAGE Owner's Name: 64 fk fZ 14 IN) _=T= �_=-=== Phone Number 5 D' — Z 3 7-y o 9 I Email Address: Qa.Crct,on jp p rvt 1 I • core Cell Phone Number Project cost$ S,0 0 0 Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK El Siding D Windows(no header change)# n Insulation/Weatherization E Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to ya I(ow ui-A, H /4- CONTRACTOR'S INFORMATION Contractor's name f}, M Ej&) S lot FA rt.Yt l 1 Home Improvement Contractors Registration(if applicable)# I ' 3 20 Z- (attach copy) Construction Supervisor's License# ( 0 t ( Ott (attach copy) Email of Contractor CO 0 0I)w y ( o o t'i� ma l •oinPhone number s o -7.� 6— 2 q u D ALL PROPERTIES THAT HAVE STRUCTURE OVER t5 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. c OR & C OR " The Roofers " ADDITIONAL RECOMMENDED WORK: Supply and Install ALL NEW 3/8 CDX PLYWOOD ON THE FRONT MAIN ROOF SECTION CHEEKS AND SKIRT,OVER THE EXISTING ROOF BOARDS------$1,000.00 Supply and Install WHITE CEDAR CLEAR SHINGLES at Average of 5"Exposure with Galvanized Staples and/or Stainless Steel Ring Shank Nails ON THE ENTIRE FRONT SHED DORMER WALLS AND CHEEKS WITH NEW ALUM1NUM/LEAD FLASHINGS ON THE WALLS-------------_--_--_--_-_-------_------_------$1,500.00 POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing, Missing Metal Flashing, Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Materials Plus Labor at the Rate of$60.00 per Hour(For Each Laborer Involved). PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Scheduled for Completion Within 90 Days of Acceptance and Deposits Received are Non-Refundable After a Three Day Cooling Off Period from the Date of signing. Please Make Checks Payable to: COREY & COREY COREY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warranties the Shingles up to a CATEGORY III HURRICANE-130 MPH WIND WARRANTY. CERTAINTEED Warranties the Shingles to be Algae Resistant for a Full 10 Years. COREY & COREY carries Workman's Compensation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: 01.18.19 ACCEPT D BY: SUBMITTED BY: N CY RRAN ARMEN SAFARYAN NER COREY & COREY HIC # 183202 CSSL# 106102 The Commonwealth of Massachusetts 1 G Department of Industrial Accidents • 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information I. Please Print Legibly Name(Business/Organization/Individual): Pt- .L S 6--ff F'y A/ Address: E 7 S 1 p j City/State/Zip: th y l iv U'i� n�} G 2 1 Phone#: f; - 2.'' o Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).' 7. D New construction 2.01 am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8. Remodeling 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.0I am a homeowner and will be hiring contractors to conduct all work on my p roPnY e I will 10 El Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.EIROOf repairs 6.1:1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp)insurance required.] 'Any applicant that checks box if 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u r the a a lie o jury that the information provided above is true and correct 0' Signature: Date: Phone#: o':- 7 ' I,-- 1oU 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): I? 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I AccrR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4lao...----- 09/13/2018 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 endorsement(s). PRODUCER CONTACT Ashley Paiva NAME: Eastern Insurance Group PHONE (508)997-6061 FAX (508)990-2731 IA/C.No.Eut): (A/C,No): 439 State Rd. ADDDREEAIL SS: apaiva@easteminsurance.com P.O.Box 79398 INSURER(S)AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURERA: Arbella Protection Insurance 41360 INSURED INSURER B Armen Safaryan INSURER C: DBA:Corey and Corey INSURER D: 67 Sea Street UnitA4 INSURER E: Hyannis MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER: 2018-2019 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP UMITS LTR INSD WVD (MMIDD/YYYY) (MNUDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 - A 9520046441 04 09/18/2018 09/18/2019 PERSONAL&ADV INJURY $ 1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY !I'm n LOCI PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE UABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED -SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _� AUTOS ONLY (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LWB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER X(OTH- AND EMPLOYERS'LIABILITY Y/N 'STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 952004644104 09/18/2018 09/18/2019 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS/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 DATE THEREOF,NOTICE WILL BE DELIVERED IN Display Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i trZ,• Office of Consumer Affairs and Business Regulation t One AstibUrton Place - Suite 1301 Boston, Massachusetts 02108 Home ImproVe4ent.COntractor Registration '::::----:. -:::--.7--,-71--7-'•,:::-.1: Type: Individual .,. . :: - - - -, Registration: 183202 ARMEN SAFARYAN : .:: :,7---- = ' "::::::::: i - Expiration: 09/13/2019 • 67 SEA ST APT A4 HYANNIS, MA 02601 . I • ,. — _ ' 1 -.. _.• Update Address and return card. i 1 0 20M-05117 ) --— - - - -------------- ---------- - .-.Z go'hogzonzewaiel:i....letz3.3.7e-Ze-ierref; i Office of Consumer Affairs&Business Regulation ,HOME IMPROVEMENT CONTRACTOR imistration valid for individual use only TYPE:Individual fore the expiration date. If found return to: Office of Consumer Affairs and Rusin Regulation Regime-4i- on_ _ jmfari 10 Park Plaza-Suite 5179) C 7'.0#10724;'ff;'..--,' 09/13/2019 - BOston,MA 02116 ARMEN SAF**A-N _'._ _.,-:-;':-:-;-5-:•-.._ • . D/B/A CORE14ANTICQR-EY ..., ! c -3: ARMEN SAFAlirk*-- f*.- .-:- : 4 HYANNIS,MA 02601:i.: Undersecretary ! ''' Not valid without gn re , 1 , . c jmassachusi.._ . . partment of Public.Safety ' Board of Building Regulations and Standards P i -Licente:CSSL-106102 Construction SupelWisor Specialty I ARMEN sp.-7ARY,miv 67 SEA STROET1'147 44 , -,-._.,, • HYANNIS MA 02001 I i i • - , . - • ; 4 I..i."ft:Ae:- ..- JA,---,,a......_ Expiration: comniissibiier 10/02/2020 1 ' 3 w : 4 ' I - k 40 , 4 i i • i i 1 i 1 :. - APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , X , X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm.Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES * Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's 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 ;1"' ' ICANT'S SI . NATURE Signature r Date - 17 All permit applications are su ije to a building i ' ial's approval prior to issuance. x ) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a.3 3- Parcel °4-4 , Application # (=>?O/ SO 6 S S 1( Health Division Date Issued /9''3"(C ee Conservation Division Application Fee V Planning Dept. Permit Fee ic..3-.5 •0 0 Date Definitive e e Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 9 1 LI ,0 v t ‘' P- Village R c.rnJ+Q(, l l e, Owner 'v 'u^c l Gat'MY) Address OaMC Telephone So B $ 6 345 I 'I Permit Request Ad c� R - t,� I e t,A,-`U,SE.. -}-0 -4ke__ ci11 c. �; SeQJ +Le " cv- -ic lane, kg01 \ & cv , 1- i -111 ela a ty 4. 04-ra Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4 a,ad 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ :I Commercial ❑Yes j to If yes, site plan review# -- 1 ---1 Current Use Proposed Use r, I APPLICANT INFORMATION Ni �' (BUILDER OR HOMEOWNER) .. WL m I �Name 0 ` 'G C lv(`e Spe, -1—n c• Telephone Number 5 0 8 3 98 o 3 9 8 Address -'D ihn/�{-I��}�,n r8 License # / OAR- 4- b S. Yak , /�0,A1 P g a b 6 y Home Improvement Contractor# / 7—I3) Email Worker's Compensation # Cn cAcc 3 136 a-7—y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO farAlfmcf I) SIGNATURE DATE [ Oil ii 5 t� FOR OFFICIAL USE ONLY -- APPLICATION# DATE ISSUED . MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 4 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. rj Building Permit Authorization I, Nancy Garran , as owner hereby give my permission.to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth,MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 2414 Route 6A Barnstable, MA 02668 Signed Date ��,�4f rs Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 ,4 - cD 1/25/16 011 Thomas Perry CBO . Town of Barnstable Building Division co 200 Main St. Hyannis,MA 02601 0 � RE: Insulation Permit 201506554 Il�' Dear Mr. Perry This affidavit is to certify that all work completed for 2414 Route 6A,W. Barnstable has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, \\\\Iv William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION R S (� Map 2 r� Parcel 002 6 Application #A qiiii012._. Health Division Date Issued /—/te -PI P Conservation Division Application Fee Planning Dept. Permit Fee r-3 5-- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street c _4 ddress / ?' /alAie 64 Village ' f--- L ' &c f e . __,?' Owner G C JV'a.� ' s'� .�.: A .5 qiM e acS Q&C V �1 p � Address Telephone SUU F' a 3 1 J "1U p / ( Permit Request /P/` 'e a/ WI/ex,c dici%'1 4. . ��c1 '&/ r e'Jose //4Sfri.{Q! fk`Oi 1LQ ')i c . 4-& red �',- 1� �v IChei tv4/ls A KI) ( 7,-6 i`tis („ tc I i'c11 -o KGB ee k/a Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation4111-11l70d-^ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family II/ Two Family ❑ Multi-Family (# units) , p o --t r-- Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'�s. Highwa$0 YR ❑ No Basement Type: ❑ Full ❑ Crawl U Walkout ❑ Other c? f: Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) CO , .30 Number of Baths: Full: existing new Half: existing I rrew tn Numtier of Bedrooms: existing _new 1 •LaJ - LO m Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil 0 Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION , (BUILDER' OR HOMEOWNER) - C -, Name W,v /"/`cC 5 byey (Ul� e u � Telephone Number(-5-08),.3> �O `16� 7 L.) Address ( I 14- fi e License# /Oc ')/) J£ \to.i/m Acioz 66y Home Improvement Contractor# / /$gO Worker's Compensation ate C,i.3 (� 76 8, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO VIC/‘41-0(-4-4-1/ SIGNATURE DATE L /7` k FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4 - i ADDRESS VILLAGE { OWNER i . DATE OF INSPECTION: r.:fFOUN.DATJON'__r_ - FRAME FRAME _ -_ -.__ INSU,LATIONrr` -, L , - _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 ` GAS: ROUGH FINAL FINAL BUILDING • DATE CLOSED OUT ASSOCIATION PLAN NO. . • -i• :k55 t f. f - - Building Permit Authorization I, _ Nancy Garran � , as owner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office: 508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 2414 Route 6A West Barnstable, MA 02668 Signed Date s-7-2.011 n ^ / Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 11/10/2014 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 2414 Main St./Rte 6A(#201400072) has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements Sincerely, ‘'\\\\\\\V William McCluskey NOISIAIO 318VISNM dO N :Ul ' F Nrru, - ow t.W44-fl. X-PRESS PERMIT ME Town of Barnstable *Permit lic0/ Z_ODD?5-- ' Expires 6 months from issue date 1 2012 Regulatory Services Fee # Thomas F.Geller,Director rEo mo BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 2 Not Valid without Red X-Press Imprint ' a Map/parcel Number rJ i U 2LQ Property.Address a - Li I / /t /t J ` ( ams.-u_t- 1 d Residential Value of Work /f On!) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Na/N•e 0 ad'1.--�� yiy /1/leafii ' s F s46 Contractor's Name 7d-c> N /" £ W/Afigett-4 Telephone Number 901 617/ ij g...57.) Home Improvement Contractor License#(if applicable) / 7 3 ` Construction Supervisor's License#(if applicable) / / a . . ElfWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ,I have Worker's Compensation Insurance Insurance Company Name 4-f-j ONa.,L2 5 c 0 - Workman's Comp.Policy# S.C qt ! 6 '?O 5 5- 3 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors dReplacement Windows/doors/sliders.U-Value © a 3 0 (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note. Property Owner must sign Property Owner Letter of Permission.. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNA N. Renewal I o RI Res#t2Z59/30g39 t t, i7�/�r� pry .4,►.°r'� RENEWAL BY ANDERSEN' CI[i1C.o563725 by 1!tderse L. �� MA tii It 119535 WINDOW REPLACEMENT'an•Aede„nC.a,ap:n, 1137 Park East Drive•Woonsocket,RI 02895 Lead Hazard Cuniro,firm . Phone 401.671.6401•Fax 401.671.6262 License#LHCF-0059 Federal Tax OH 46-0556630 Southern New England Windows,LLC d/b/a Renewal by Andersen of Southern New England CUSTOM WINDOW AND DOOR REMODELING AGREEMENT . Buyer(s))N One ofAgreemenc • NOVI a� A,r1r- I/ prf z.�/z Buyers)Street Add s,Cit5 State,and Zip Code Zyly . MainAi nS Wp l , 0244 . _ E-Mail Address Home Telephene Number WorkTekphone Number 56g7— 0'6.- 1Y5/ Sdf 237 5'09/ 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 on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this'Agreement"). Total job Amount: 7Si 9 Estimated Starting Date: Method of Payment: 0 Check 0 Cash 0 Fnanced Deposit Received(33%): 2 60 y /" �/' Credit Cards are accepted for deposit only-maximum 113 of the Balance at Start of job(33%): Z d 0 Y project cost.(Please see Credit Card Payment Form-)By signing this Estimatell Completion Date: Agreement,you adinowledge that the Balance at Start of Job and the Balance on Substantial V e a Zo/'L Balance on Substantial Completion of Job cannot be made by credit Completion of job(33%): 'Z IPV c/ I! card and must be made by personal check,bank check.or cash. Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are`no verbal understandings changing any of the terms of this Agreement.Buyer(s) 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.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales Only)Notice to Buyer:(1)Do not sign this Agreement if any of the spaces intended for the agreed terms • to the extent of then available information are-left blank.(2)You are entitled to a.copy of this Agreement at the time you sign it.(3)You may-at any time pay off the fullunpaid balance due under this Agreement,and in so doingyon may be entitled to receive a partial rebate of the finance and insurance charges.(4)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement.(5)You may cancel this Agreement if it has not been signed at the main office or a branch office of the.seller,provided you notify the seller at his or her main office or branch office sbownin the Agreement by registered or certified mail,which shall be posted not later than midnight of the third calendar day after the day on which the buyer signs the Agreement,excluding Sunday heel any holiday on which regular mail deliveries are not made.See the accompanying notice of cancellation form for an explanation of buyer's rights. Buyer(s)received the co s• r er education materials provided by the Rhode Island Contractors Registration Board. (Buyer's Initials) Renewal by An�/outhern New England Buy s) Buyer(s) By.. 21 .AI • la� P l`ductManager S' nature Signature. -. , Print ante of Product Manager .. Print Name Print Name YOU THE'BUYER(S);•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 FORMS FOR AN EXPLANATION OF THIS RIGHT. NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction // Oct Z4/7—.You may cancel I Date of Transaction .You may cancel this transaction,without any penalty or obligation,within this transaction,without any penalty or obligation,within three business days'froth the'above date.If you cancel,any-I three business days from the above date.If you cancel,any property traded in,any payments made by you under the I property-traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed I Contract or Sale,and any negotiable instrument executed by you will be,returned within ten business days following i by you will be returned within ten'business'days'following receipt by the Seller of your cancellation notice,and any I receipt by the Seller of your cancellation notice,and any security interest arising out of the transaction will be security interest arising out of the transaction will be canceled.If you cancel,you must make available to the Seller I. canceled.If you cancel,.you must make available to the Seller at your residence,in substantially as,good condition as when I at your residence,in substantially as good condition as when received,any,goods delivered to you under this Contract or I received,any goods delivered to you under this Contract or Sale;or you may,if you'wish;comply with'the instructions of i Sale;or you may,if you wish,comply with the instructions of the Seller regarding dse return shipment of the goods at the the Seller regarding the return shipment of the goods at the 1 Seller's expense and risk.`Ifyou do-make the goods available X Seller's-expense and risk.If you do make.the goods available to the Seller and-the Seller-does:not,pick them up within , to, he Seller and the Seller does not pick them_up within twenty.days-of.the,date of cancellation,you may retain or I twenty days of the date of cancellation,you may retain or dispose of the goods without any-further.obligation.If you I dispose ofjtne goods without;any,fu'rther obligation.If you fail to make the goods available to the Seller,or if you agree. I fail tomake the goods available to the Seller;or if`you agree to return`the'goods to`'th-Seller'and fail to do'so,then I to'return"the'goods"to the'Seller and'fail to dose,then you remain liable for performance of all obligations under you remain liable for performance of all obligations under the Contract.To cancel this transaction, mail or deliver the Contract.To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Renewal by I other written-notice,or send'a telegram to. Renewal by Andersen of Southern New England-at 1137 Park East Dr., I Andersen of Southern New England at 1137 Park East Dr., Woonsocket,RI 02895,NOT LATERTHAN MIDNIGHT OF I Woonsocket,Rl 02895,NOT LATERTHAN MIDNIGHT OF /5 pref'7Ai7-.(Date) .(Date) I HEREBY CANCELTHISTRANSACTION. i I HEREBY CANCEL THIS TRANSACTION. i X • Buyer's Signature Print Name Date Buyer's Signature Print Name Date RbA Copy:White Buyer Copy:Yellow Buyer Copy:Pink ' . . g/i?A''. e/ Town of Barnstable "Pertnit N 7 7 S� -.i 1)tt g..-t " -'4' /? Ittplru Sn�oxthr om Lrtus datr =111 Regulatory services %�`J� �� 4 YAANRAP_tl, D pf / •i ie o. '�� Thomas F.Gaeiler,Director X REtt ;; 1/SS"''1.a. K — • ° Building Division MAY 1.. 2004 • Tom Perry, Building Commissioner : TOWN OF BAi;i-e 200 Main Street, Hyannis,MA 02601 ; �„gLE Office; 508-862-4038 - Fax: 508-790-6230 . EXPRESS PERMIT APPLICATION - R]ESY1)ENTILAL ONLY Not-Valtd without Red X Pren Imprint • . . . Mapiparcol,Number aB (e)2.0 Property Address 2 L1 1 -` 1 i 1Pc�IV ��' TJ (OJT SA f4-6 L , `►► Residential Value of Work 1\ ) (Y)CY Owncr'e•Narne at Address NPt AJ-c 1)• ('Sv-p1,�t rA / Ph 2).s.3\S )�ARt\) LP 'M.ir 024030 Contractor's Name_ C )\ J • 0GZ-Ca.LD + Sons 0 Tcicpbonoilumbcr LL OZ1 1^.\G0 --.—1 -7 Home Improvement Contractor License#(if applicable) t0 3-7 i`7 • Construction Supervisor's License#(if applicable) (C(D 3 j ;'Workman's Compensation Insurance . Chock ono: ❑ I am a Sole proprietor 0 I am the Homeowner ( I have Worker's Compensation Insura-ncce^ m Insurance Company Nae 11r v 0.e.� J--f d.2cr,\-l•\t y ..��O. O S 4,t Y 1.S Workman's Comp.Policy# .7 PJ U B—q a-a X Ci? 5 3 -- 602- Permit Request(chock box) • Re-roof(stripping old Shingles) All construction debris will be taken to (X rm;j,) L.00Aalt . ❑Re-roof(not stripping. Going over existing layers of roof) • ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) • •Where requited: Issuance of this permit dots not exempt compliance with other town department regutat one,I.e.Historic,Conservation.etc. i Signature ‘,4) • . Q:For eu:expm ! Revise4121901 J • PROPERTY OWNER MUST COMPLETE AND SIGN THIS SECTION IF USING A BUILDER / ROOFER (Please return this form to Cazeault Roofers with your signed proposal/contract) I, A/,Wv/ 4/ as Ow ner of the subject property Hereby authorize _ Paul J. Cazeault & Sons Roofing To act on my behalf, in all matters relative to work authorized by this building Permit application For (address of Job) -VIII lb gait/ 5ft 5/147/7514/§ /0 62630 Si gnat ofnel ?2V /Mia/ 4/647(yeliti Print Name.