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HomeMy WebLinkAbout0015 OAK DRIVE T) Assessor's map and lot number ..... ...9.. �.. THE �Q�pf tp�O Sewage Permit number lrr. : 1.1 "o—We, Z B9BBSTADLE, i Housenumber .......................................................................... 9� NAM p� p 1639• \00 MPY a' TOWN OF BARNSTABLE n s DU-ILDING INSPECTOR APPLICATION FOR PERMIT TO ....0.........:b�.- .... ....................................................................................... r� TYPE OF CONSTRUCTION ............ ,14no, ..... ,;.....~' ........... .........191y L. . .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following 4information: Location ........ � f„ .! .:. .... '^� . ......... ...... !,a, <.;,ra'61 ..:... . Proposed Use t l 1 .., r�`C^:.. a.,.4 P .... ... ..... ....... .. ....... ............... ............... Zoning District .........Fire District ..... ... ......................... ......................... Name of Owner - ^ �. Address ' n ++s�...( .. � '. fr?f 1" !'3 `- R- Pam✓f`-�' r Name of Builder e.,w................ .. .,Address ......:..... Tom.. a.1.`........... �f �. 1 Nameof Architect ................��? .....................................Address .................................................................................... Number of Rooms ................... .....................................Foundation t . ... „!-t_. Exterior „ f .�f'..... +.:: ...Roofing .3 ....... :... - ..................... ....... ..C Floors .......................... ..........................................................Interior . ?.:,/� !�� 1;�... "" ft .t� ................... Heating ... .................................................Plumbing .. :, ., l ' c4 .► Fireplace ..:..........� • . !!-* ..:: ................................Approximate Cost ........... �'... � ... .. L... Definitive Plan Approved by Planning Board ------------------------------19--------• Area - =' .... ... !�.: Diagram of Lot and Building with Dimensions Fee .....�' ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Ba�table regarding the above construction. / / Name... ..................... _ ~^ l.^~^~l__ L. 2.6-9 , � No ...........2l774-'~itfor ..... dWPlU1.19 ' � � --------------------------' ' . � f� ` Location -- =���.. � . . ............................ .----- C^wner --'L?.. ............................. Type of Construction ...........f Plot � � Permit Granted. � Date of Inspection/" -_- -_,_ te/' ......................................19 ^ � ,==M�" R="=°== / )........ 19 ^ —' —' -- -----'' ' ' ' -- ' ----'''' ----' � Approved lQ -----�—'-----.-------------. � --------------------~—^—''—^' r TOWN OF BA.RNSTABLE Board of Appeals Petitioner Appeal No. - _ 19 PAOTS and DEOISION Petitioner ____ filed etition on 19 -r ,,-_. p --�,�---,��---�- �Err�,3"�,."a. .�.....z. .. .�.-X'raa�: q•-�,� �. requesting a variance-permit for :prenuses at _ 'Street, in the village..: o.fl* 7 �� , adjoining premises Of � .'u� , •:S2twm;9+.+t 'rY. . Y4 '� '. ' for the purpose offt sum , _ Locus is presently.zoned in Notice of this. hearing was.:given by mail, postage ,prepaid,'to all' persons deemed affected_and: by publishing in Cape Cod Standard Times, a daily. .newspaper published in. Town of Barnstable .a copy of which is, attached to the record of these proceedings filed with Town Clerk: . A public hearing by the Board of Appeals of :the: Town of Barnstable; was held at, the Town; Office Building, Hyannis, Mass.;at 11 ; P.M.upon said petition .ender zoning by=laws: Present at the hearing were the:following nienibera: nrao At the conclusion of. the hearing;:the Board took said petition under advisement. A view:of the .locus"was had by the Board;;, On 19- the Board of Appeals found, Antorry 011v.n.delloa 3'•''f qq, .,: r epo'o'se3iifed.. s1:1e tat J:c.i'ia '•e 'j•€: 7,: V?'}c37C1Q3:�Lk� 1 ;7 nn i.,^^ nrp�2`. ,��, jj,,ae A..}. C,�.f y P°,.+:.V 9 '• c L, �.± toed n U .31'e att,onnpi.yy str.bteG ,, Halt 'L7,3�3 .., *f le.�: ..4�+C84:t,.. J'.r�,...1 S.7. �W:. VC..� ,i'.�m 1 fa. Oai -.rge Gxittix garage s;l. exi d. not :o 111urval3F + 14-[1taC3I'L'at.Ion ' 'ha ;ne t t icineI' hu,r, ,no ne anci livedLzf? C�. ('Jo.kg `•4�'Q �£s� r'.yr,' '5..;' .�ki`St...v�:'✓OI'.+: * .tabl.?ll '`1 �;3twQ.i'w'�.� .Y�,10 , j"S:�i.7..'LS j. is: ir. a ::' a r C'i divmpair :.sic, so,-mu v,,rrk MAMI.- be e rT• iia tr.�L . re n� 1 d: in col,-- ile ��p a zII t o anlarg e> It wnc ELKO It 11107M ;5OVVIC :zM111), 0 'f,'b.r t.116 'ion ell Lix, hi',-'Iself• and i1� '!:tilI'E9 :SriC'.f 1]t� s20 oliz--bi e 3 ° i..,':�I;`Yer... faG' .i ti: € M' tz �:_tt'.y.�:nt ti .=...�..". 4 _ � "as,Y4".}, r 40 tO µ } rt ...�L�/n �t�� s en� -Of t-.Yie :,s;x '�'€e: f'C. °tget,€.' 'i11 a.e? x;oti r3:;�L �3't;Gk�' l i ;qoi dd- not bo- dee ?• M.n :, y, 4-IL-0i„, "f r 7in -'' '� f.. 4 'LlC'�r`�`,Lr :-a' :aS ' •T=O. ... tr r.�. iris r.�. t2 6 - Q a �.a»�.. a, t f^ t.#'.r A r^:'.n r u.'. Vias £?I. :i. a i.y "Vvi ¢.o. Vhe �..t.'t. -11� '. t.''P- v"llitt-V(a. rI�Q �' M t31(3u 1', 3 �' Fi63 t.l'3 f. Llf31a t11L31"5 1iCF,r . �.i J.L,}.�._ _ �c `rc, '� �n t L u t 1�+ CMA—ti� z,$t n ,'ect a Qz� Lz V'r,6 �.c=w in-wY �f'T}:^. .•/�In wF;- y .'1i/,.`1 :L�r 2:i .1.t)` .ytWy! {;�'♦�H- ''831 ¢./ 1;dP1sL:�t�Lf� €Tltrq©t :ast2 �y y—Da- �4�3 �Sh ii Vr,IV -v-411 ,tJ i ftlpd . i'lai j"r 6.G to SS 3.L0 at�Y i.nrw and, ,,p 1.a ,:. �., � t '. „ 3 's�.13€L ! aS. t 41t. 1If y '3? '' 'al U3 ':' =4: CC} ,k 'tt,a :.&. YB ;.>`l�. �..'k i". 7a�.a, nl; =.d `�.u� 0se a it0- silr=::X 14, t:ly = G13ti14z T at.r' `s£1f� '` Co ..s`'L°': 1Fa'x'�fi �a�'C3;r: Restrictions'.,imposod: I Distribution.— Board of Appeals Town Clerk Town.of Barnstable Applicant Persons interested Building Inspector r" Public Information By i Board of Appeals ;iZx Chairman aa0o � no . 203� ono ° LY �� � � a th tz IL • r 4b etl , g � o \ Ell 02 Y Q� � Q t TOWN: OF BARNSTABLE oo BOARD OF APPEALS =uasr S • ■,�` NOTICE OF PUBLIC HEARING e39. UNDER ZONING BY-LAWS Appeal No. lchr_.H T'....^"'r?. -t�3 _ 196 5 nn. Ure, IJohn . . .d es4n Y limit!. l � . i.�.. ...iS = ✓ . ';�1... 4- UAJI-X Being all persons deemed. interested or affectad by the Board .,of Appeals, under Sec,. 15', of Chap. 40A of (General Laws of the Commonwealth of Massachusetts and all amendments thereto,, you are hereby notified that has appealed to the Board of Appeals from,_a decision,of the Building Inspector and petitions for: t i .s-F: .z.r'. 4, v,*f.�N t`'ie Lon i_.r� V�+, ` :.:.1J'i ,Gin S_1 0d. a 01-,' c' eY.11 1,J`tl,: f r �. ^?� r.'iG JO`Li.1Llf?, Y'C�CIis� 1�1'C .11;938 b@.'i'nf1 'on . A public hearing will be given on this:petition, in on T r at You are invited to be.present. By order of the Board.of'Appeals,. ?O ?6 s T i;:T, :.4 , ,1"; Chairman. ds .� ;. 00 PA,. F slonoomd `1VW3.LVW ONla'11ne 3 " i COO- +.. 7 os�+ �M $10naMid -ldlMg-L V4 ONIalin8 mom„ sasasT ; q MA66 RAYa� TOWN OF BARNSTABLE PETITION FOR VARIANCE SPECIAL PERMIT UNDER THE ZONING BY-LAW To the Board of Appeals, Hyannis,Mass. Date' .;19 The undersigned petitions the Board of Appeals to vary, in the,manner and for the reasons hereinafter,set forth, the application of the provisions of tho zonin�Qg bye,-law to;the following described premises: ��- Applicant. - FlillName)�/�C�-2 YWinterAddress) 2 Owner: _ (Full Name) (Winter Address) ' Tenant (if any)': _ (Fall Name) 0 to ddress) 1. Location of PremiseskL (Name of treet) What se n of Towne / SO J9cc. 2. Dimensions of lot D 7 _- _ Area • (Frontage) (DeDth) (Square Feet) 3. Zoning district in which premises are located...._ 4. How long has owner had title to the'above premises 4 5. How many buildings are.now on the lot?.. . 6. Give size of existing:buildings ' ✓`X Via` - .� `�y Proposed buildings 7. State present use of premises S. State proposed use of premises •� 9. Give atent of proposed eo stru 'pm oralterations 10. Number of living units for which building is'to be.arranged il. Have you submitted plans:for above to,the Building Inspector _ �h 12. Has he refused permit? A. 13. What section of zoningby-law do.you ask:to be varied.? 11 State reasons for'variance or.special permit:.-.- (Signature, Petition.:received'by. - (Address) Hearing date.set for _.... .19 :._. ° FSling fee of$15.A0 required with this petition.. • This form may also be-used.for Appeals: (Over) d The following are the names and mailing addresses of,the'.abutting,owners°of,property and the name and address of the owner- across the street, according to the reeords.in:the Assessor's Office at the date of this application: NNJpt`2�y'rl� . drifted;b r's�Office':: Assessor. .. There must be submitted'with the vi ithin application at the time of filing l'a plan of the land,.in ... duplicate, (or two prints)'showing: 1. The:dimensions of the leniL. 2. The location of existing bniidings on the land: 3. The exact:location of `the improvements sought,to be,placed'on the land: Applications filed without such plans"will,bo returned without action by the Board of Appeals,. i Town of Barnsta bile �- \n`` r:p mvnfktj orr!i's:re,�ste rr Regulatory-Services Fee. ''\,y �r,C;?- ,�bA• <PviTi_., F. G c i 1 r, Direitor Building Division (� Toni Perry, CBo, Buda}r;€cmmissioner- :? \Ia:n JCree YYu?nFS, iVr. 2F�ti fvti��v/J,,0vm.ba nsta fe-ma.us 862-401)8 Fax: St�o-79�-523 EXPRESS PERMIT A PLICA 1'14� - -RLSI.DF..'�fjA- i��;'L�' ro:';!slid:�•;"ficcrr'Red.:i',-eSs lr,+:arrnf A.d d resi_ �S�Lk. , _ _ :c 'v/orK _ _11}}!n1um fee ofS35.✓Zi F61- Yoric- der S6000.00 0'., t 's \wine a -, cr 2 s s L I/t/0 _, W't r oni ra:mr''s Namcl& cCS'e 5e��✓l�e �r� a� ��l'1'eS Telephone N . er Sy - - 312 d ieph i t 9b !tom--I1nproVe: ent Coii-F-ict•Sr LicenS,: F(il` ii:pi:CaC! /6292 J ,YD Cg -� Co : MCF10r, SuperVisor'.- LiC-­(,_,.=ir-ar iicabic! �OV �j c_n C< orc:, AUG 2 1012 i.i , �fii tr:e L�IoPco�.yr�e- I h&vim WOrker's .is f:ce. C Co }per-satien nStirai-,c,, � � OW F SAMgSTA6LE om.pany'ame /Ve kLe i& < tvC,i. as ::;orr?p. .'oiicyY_._ O�/ J Cony cjf Insurance Compliance Certificate must accromp:Zf?v er ch per(nit. ReauC�Zt (Check Con') J tiC-rooT i?!':ft�i{f;e nailed) iSir, in., OiG S`iirlgies) I;CO?SiCJCtfQn debris will OC taken Re-Toot (hurric3nc iirl.'Ied)fnot strippfn Go:n ov T, exisling fa`%ers of room J J R -side CQp'i3Ce,:+eli ::i^CO:YS<`dOCCS!'St:'d`(S. - J aiF e ©y 30 jniaXim 4m, .15)r oFw?;:dQ:�S ''N;_i • u: 355ii31:.of-iiNS•1tf:i;...SSS ibi moo=—• i_C(•+'eie02,VC, . . ,Te: `i S "gn I'roperty'vl%'r!er L2i:er Ji PerP.IESSion. 4 copy of he Home Imprc, ;:men C?;7iraCi+Jrs License a Construction Supervisors License is -c—Bred. tt i n-E i-a A ni T e T -L f �tj! u 1", 15 SUIE DATE . . . . . ........ ... .... .............................. . . . ...... C ........... .......... THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY ORNEGATIVELY 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 poliefies)must 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 NAME: BRYDEN&SULLIVAN INS AG PHONE FAX 88 FALMOUTH ROAD (Ar,No,Elt): (NC No): E-MAIL HYANNIS,MA 02601 ADDRESS: PRODUCER CUSTOMER IDO: INSURED INS )AFFORDING COVERAGE NAIC# TORRES,ERICSSON DBA INSURER A TRAVELERS PROPERTY CASUALTY ERICSSON HOME IMPROVEMENT COMPANY OF AMERICA 16 HOOVER ROAD INSURER B WEST YARMOUTH,MA 02673 INSURER C INSURER D INSURER E INSURER COVERAGES CERTIFICATE NUMBER REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IS SUED TO THE INSURED NAM ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIRELUNT,TERM OR CONDITION OF ANY CONTRACT OR OTHM DOCMMAT 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.L2GT S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS VAM LTR INSR (WNDDfYYYY) M&DD/YYYY) EhCH0cCV&VMME $ GENERAL LIABILITY 11KNAGE 10 RVIED $ 0 COMxw1AL0MiaALUPM11y PRwff2(F"h oGammme) .EXPERSE(Awoze $ 0 eLkniSNAM 0 C)CCUL pozon I PELMAL&ADV. $ IMULY GMIELKLAGGIMP62E $ GMrL JZGIMAIRLIMI i0aSPEL- P1=UcC=PJCP $ Opaxy Opumt our PZG--- CCNM SINGLE AUTOMOBILE LIABILITY LUUI= $ D3MY $ a AITYAUTO w1nY $ a PilowmKialot tl-'= $ 0 WHEDULZI3 P61alos Poxucido a HIBFDAIISOS $ a NM-OvMA1I1109 0 $ a uximmi-kLLU 0 OCCUL AGGREGATE $ CE E=199LW a cumi-xkm $ E=IERE $ almlimus wc WOR1(ERS'COMPENSkTI0N NABSIKIVIOLY AND EMPLOYERS LIABILITY Lnurs YIN A1Ty:PSJOnzTCwA11Kw Y 11109/12EXCLIIDEDT 1L.=xAzcIDM11 $100,000 NIA 7PJUB-4433P248 11109111 3EL.=MK9E-EACH (MAMATOPLY Iff IM EHPU= $500,000 Ifyos,aaoaxb=&xIXC31PTM1TCF $10Q'000 EUCR=OH OF OPELATIOMILOCATIOMMMCIn(hiWhPXOLD 101.Aadifvw13AM&*Webb.ifMon opwo i nimima) IRE VORMS C=WLMEN P=YDOESVOI PROVIDE C0VnWEMLnXSMK'CR'RSMKDZ1XffwnWUMDVEM:bTT llm11ysumsmAvc&XMCCKMgKIMUPCLMYAIMIISIMUZIEDOIM!LslAIESUTOLUMEMMCZMMMIKUIEMT SI]MPPLMMICFBDMISMLCLAMINMZBYI]Elggnm EVIDMinT SIAIESOIMELIRKUMK.NOAIUIBORIZKIMNIg GIVEN topAYCLUMSMLBmmqtg]N"y SLATE oIMEL IMAM xkUrIBEDTfUREDMEtCLEksm=mm=sauzs= TMSRU71ACI1AN!pRIol Ci:&7MCATE38UEDTO THE CIRTMCATEROLMA"ECTING WORXM COUP COVERAGE X, ....... ............ .......... . THD-AT-HOME SERVICES INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ATTN:INSTALLERRFLATIONS DEPT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 2690 CUMBERLAND PKW SUITE 300 IN ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 F ATMR2=141MMWITAMIN 8rCawMaaLww t aesEn ctod'to ► . K .-l)cparimctu of Public$afrt} i IA— Masonry'oa0y' °lasrachu ctt RF. Roof CoWdrig• 9 8a:ird of Buitditt;; Rer:+lations tool Standards VS.Windo%4s nail Siding Construction supervisor Specialty License SIr. Solid el Burning-Mevices License: CS•SL 100546* DM-Demolition only Restricted W: WS Failure to possess a current edition of the n .ERICSSQN:•TORRES • Massachusetts StateBuildl g Code 16<HOOVEI�ROAD is Cause fOr revocation Of'this license- is Refer to: •W,EST`11ARMOUTH,MA 02673 yyyi►11V•lYlass.Cov/DPS,, �.� -fir •� Expiration: 6H912012 Y�,ntni+ h•nvr T(x: 10050 I License or registration valid for individul use only � _ • 4 - �f 1' O. o[QcegC awe Aff ea Be.. before the expiration date. If found return t Office of Consumer Affairs and Business Regulation }t UE MppaNEHI� � Type. )O Park Plaza-Suite 517tl RegleNattew..-VIsSM29' . - bpi .Ni�Q13 [� • Boston,MA 02116 0310; _ —�,'"" ERICSSON tift00111:RTORfi .Y�` -. .�` WEST YARMOUTN '• Iladetnaereta'7 w Not valid without signature l i i. `tai7rf� r Rf 600 Washington S-Veet Boston,AM 02h i 1VWW.tpe03s govldiU Workers' Compensation Insurance Affidavit: Bnilslet°s/�ontrn�4orsf le�triclan���l bees A ant Informitlon - Please Frint ICI& Name (Business/Organization/IZdividual): N I 0 o 2-CQo_4�:: Address: �� L�5 �t"t' ZQA­t� City/State/Zip: til�1 �o . 3 e3✓' Phone#: 91�D Are you an employer?Check the Appropriate bo . Type of pry (required): e ` 4. am a general contractor and I 1.� I am a employer with_'�� 6. ❑N 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. modeling ship and have no employees These sub-contractors have g• ®Demolition workingfor mein any'.ca aci employees and have workers' capacity. 9. ®Building addition [No workers'comp. insurance' comp. insuranceJ required.] 5. ❑ We are a corporation and its 10.[]Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I LE]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' 13.[] Other comp.insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homedwners 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: �!ew �Policy#or Self-ins.Lic.#: W l 36 � Expiration Date: Job Site Address: City/State/Zip: /i//✓r D A. ' e _i" date). ` Attach a copy of the workers compensation policy declaration page(showing the policy number and xp ration d ) Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under tlee andpen�lties ofperjury that the information provided above is true and correct: y si :atur ���' Dater y Phone#• F 0fflcclaal use only. Do not write in this area,to be completed by city$or town o,ftial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other } , r1, Contact Person; ___-- _-- Phone#;�� 9.4e Office of Consumer Affairs and Business Regulation p ' 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improve rnebl t Qontractor Registration 2 S -"- f , Registration: 126893 _ TYpe: Supplement Card - Expiration: 8/3/2014 The Home Depot At-Home Services,-- - DARREN DEMERS 2690 CUMBERLAND PARKWAY 5 ATLANTA, GA 3,0339 � �` tr 4v Update Address and return card.Mark reason for change. DPS-CAt Co 50M-04/04-G701216 Address ❑ Renewal Employment ❑ Lost Card ✓�ze 7oo�avn2oo�!eiea�t o�✓�acftu6e�`6 Office of Consumer Affairs&Business Regulation g License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration +126893 Type: ration._.:'g/3[2.0.14- Supplement Card 10 Park Plaza-Suite 5170 Expi PP Boston,MA 02116 The Home Depot At Home Services DARREN DEMERSc 2690 CUMBERLAND PARKWAY S A' t3 , GA 30339`"''- Undersecretary Not valid without signature HOME IMPROVE NJ*M()OFT TAUT 4) PLEASE READ THIS Sold,Furnished and Installed by. Tl#17 At-Home Scrvict;s;Inc. Branch Name: Boston Dam: d Wa The Home Depot At-Home Setviccs 908 Boston Turnpike.Unit 1,Shrewsbury,MA 01545 Toll Free(800)657-5182;Fax(508)845-6017 Federal iD#75-2698460:ME Uc#C 02439:RI Cunt,l.ic#16423 Branch Number:3i C-T r1c#tIIC.6S65522;MA Home Improvement Cimtractar_ Reg.#136593 To Installation Address: hriU c I City gvaa&nXdState Zip Purchaser(&): Work Phone: Home Phone: Ceti Phw.c: L, Oda L-6 Home Address: A �-- (If different from Installation .ddre_ss) City State Lip E-mail Address(to receive proja t communications and Home Depot.updates)' ❑1 DO NOT wish to receive any marketing emails from The Home Depot Proiet:t Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to huy, and THD At-Hottte Services,Inc.("The Home Depot")agrees to furnish.deliver and arrange for the installation("Insfallation")of all materials described on the below and on the referenced Spcx:Shccl(s),.all of which are incorporated into.This Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: pmcr rot Rd--) p uct5: Spec.Sheet(s)#: Pro' ct Amount _ � coo Roofing Sidinc Vl,ndaw% Insulation q (//((JJ []cutter~/Covers []retry Docxy [] 20! ❑Roofing-[]Siding Windows []Insulation $ 040utters/Covers (]Entry Dom Roofing Siding wiinaows Insulation $ QCGutter /Cover. []Entry Doors[] Roofing Siding Windows insulation $ []'Gutters/Covers ❑Entry Doors ❑ i nimurn 25%Deposit of C011"'aa Amount am upon e=11timOfthiscan4act- Total Contract AMunt $ Mainc Purchasers may not defiW t more thtm one third of the Con ractAmnunt. Customer.agrees.that immecliafcly:upon completionof the work for each Product Customer wilt execute a.Completion.Certific=7te (one,for each Product as definedby an individual Spec Sheet)and pay any balance due. As applicable, each Customer under this . Contract agrees to be jointly and severally obiioaated and liable hereunder. The-Horne Depot reserves the right to issue a Change Ordet or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural - problem with the home,environmental hazards such as mold.asbestos or lead paint,other safety concerns,pnctng cTrurs or because work to to complete the job was not included in the Contract. 'payment Summary: The Payment Summary# .,... included as part of this.Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You.are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certif sate(note: there is one Completion Certificate for each fisted Product as defined by individual Spec Sheets)before work on that Product is complete,. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs or nurteriaLs,labor,expenses . and services provided by The Home Depot or Authorized Service Provider through the date of termination,plat any outer amounts set forth in this Agreement or allowed under applicable taw. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LiMTTTNG THE HOME DE.POT'S OTHER RE&tEDI)ES FOR RECOVERY OF SUCH AMOUNTS. tr uce and ndAuthorization.: Customer agrees and understands that this Agreement is the entire agreement between Customer he Iio111e Depot wit regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.This Agreement cannot be assigned err amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the tenns of and has received a copy of this Agrccmeni r i tCuAtomWer's ted by: �. *. n y: r r' e D c tant's Signamre Date Telephone No Signature Date Sales Consultant License No. _ CANCELLATION: CUSTOMER MAY CANCEL THIS ias,ppliwblc) AGREEMENT WITHOUT PENALTY OR OBi,IGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE 'THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE ` STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USI!: IF ONE IS SPEC.TFICALLY PRESCRIBED BY LAW IN _ CUSTOMER'S SPATE. NOTICE:ADDITIONAL•PERMS AND CONDITIONS ARE 3TATRn ON TtiE RF.VERJE grnE ArvDARE PART OFTtuS CONTRACT 03-.Z-12 C-SC White Branch File Yellow-Customer Td Wdt7£:£ 6007- 7Z uef tLZZZ9£809: 'ON X1J4 pe6we[: WOJd