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'Issue date
13LI)-4-1o3c177
EXPRESS BUILDING PERMIT APPLICATION •
TOWN OF YARMOUTH C PrVED
Yarmouth Building Department
1146 Route 28
South Yarmouth,MA 02664 1 DEC 0 6 2018 i
(508)398-2231 Ext. 1261 r
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CONSTRUCTION ADDRESS: /De rn leI S e r f
ASSESSOR'S INFORMATION:
Map: Parcel:
/0.-1,
Jtan I e MS 4%6'Mtette), SJ UGrirrry tIA n2 66 q 747- 77/-01'91NAME ENT ADDRESS TEL. # Email Address
CONTRACTOR:. n. oc f. e: .. on L -
NAME MAILING ADD• S ota•OI TII-# Email Addr•
esidential Commercial Est.Cost of Construction S /O 3(oP)
Home Improvement Contractor Llc.# /4602( Construction SupervisorLic.# O7z772-
Workman's Compensation Insurance: (check one)
I am the homeowner I am the sole proprietor ave Worker's Compensation Insurance
Insurance Company Name: Marl-ford (t re T'/15. r n. Worker's Comp.Policy# 2-1-- WEC L.7 Z 4 3 5
WORK TO BE PERFORMED •
ti
Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove
I 1
Siding: #of Squares Replacement windows:# /?i Replacement doors: # 1
Roofing: #of Squares ( )Remove existing*(max.2 layers) Insulation
Old Kings Highway/Hist/oric Dista ( )Replacing like for like •
*The debris w18bedisposed ofat tt/aCie !e//kt er "1 — , is re Is
Location of Facility
I declare underpenaldes of perjury at the s .4.._, - ,..rlifr. . .ed are true and correct to the best of my knowledge and belief. Iunderstand that any false answer(s)
will beeast cause for denial or re .Ai 1:1:010.1. �r :- M.O.L.Ch.268,Section 1.
Applicant's SigoeNre: �'f'Ii� 2. \ Date: 7 2 — 5 — /
Owners Signature or at _ e -c6 -.- lac i — Date: ,r�7 /' /�
Approved By' /i. . 1� /2 —Ci 7
"m-oral(. .es .ee) ,-
/"
Zoning District
Historical District Yes No Flood Plain Zone: Yes No
Water Resource Protection District Within 100 ft.of Wetlands:
Yes No Yes No
r Window World of Boston MA HIC Registration
,$ Offices & Showrooms
Number.
❑15A Cummings Park O 295 Old Oak Street 166025
Woburn,MA 01801 Pembroke,MA 02359 Federal ID#
s r rf�Z�I�iW (781)932-4805 (781) 826-6281 82-4898432
www.WindowWorldofBoston.com _
Customer, kink f4, ,(-99 Phone(h) -7,3/-71/—DSy,
Install Address: l0 R ?p44 Se 4-Net. Dr Phone(w) •
City: S014-44-.. %lala me.a in. State:MA Zp C &bye-mail
WINDOW WORLD GLASS OPTIONS •
_1000 Series Single-hung Alt-Weld $199 NSolarZone Elite-Dual Pane i $119 /5t/
2000 Series DH All-Weld $215 ____Triple Pane/Krypton $369
i 1 4000 Series DH All-Weld ' $240:01; Merles 6000 Only)
6000 Series DH Au-Weld
I 2 Lite Slider $37 WINDOW OPTIONS
3 Lte Slider er+.w,+r4 Of.4. $575 _Glass Breakage Warranty(4000/6000) $15INCWOW
_Picture/Fixed Ute (0-83ill) $365 _1/2Screens $g INCLUDED
i Picture/Fixed Ute (84-130 UI) $445 yam. Foam Insulation on Jambs and lead $11 INCLUDED
_Awning $310 Double Strength Glass(4000/6[00) $15 INCLUDED
Casement Plus$49(DR Sash Rail)$330 ___Double Locks(>267 $5 INCLUDED
2 Ute Casement $595 -if—Colonial
Screens $25
3 Ute Casement (tAilJ.+rn 014.1A1(4) $910 I{ Colonial Grids(Contoured/Flat) $65 7/5-
Basement Hopper $434 _Prairie Grids $75
_Bay Window-Soffit Mount/INS Seat $2660 __ Simulated Divided Ute $182
_Bow Window-Soffit Mount/INS Seat$2785 _Tempered 0H Sash(BSO)(TSO $75
Garden Window $2040 Obscure Glass(BSO) (TSO) $75
__
Bay,Bow,Garden Oversize (+109 UI) $975 _—Oriel Style(40/60 or 60/40) $75
Beige/Almond $40 f2 Foam Enhanced Frame
Wood Grain Interior(Series 40001 6000 only)$100 $35 Z/Z rn
(light OaAJDwk Oak!Chon-y/Fox Wood PRE 1978 BUILT HOMES(EPA LEA 'SAFE RENOVATION)
Rich Maple) _Lead Sate Practices Required I $30/teal
Brown Exterior(Arch.Bronze/American Terra)$100 MY HOME WAS BUILT IN THE YEAR iloy Initial/'
Designer Color Exterior $175 MISCELLANEOUS
Speciality Window
$ /3 Custom Exterior Aluminum Cladding(Two-Bend)
Window Color (�1,;-)te / (.v -f0 h, ❑Textured$90 CIG-8Smooth�$90 $ //7b
Inside Outside Facing Color
NON CUSTOM DOORS _Metal Window Removal $75
I Vinyl Rolling Patio Odor 5tt or en. $1095'ID T!1 S New Construction Vinyl Removal $175
Vinyl Rolling Patio Door 8R $1195 _Multi-Bend Cladding $20
' Add to base price for Custom Roping Patio Door$1250 _Mull to Form Multi Unit $30
_French Rail Sliding Patio Door St or OR $1395 2 Install Interior/Exterior Stops $50 /oo
_French Rail Sliding Patio Door St $1495 q Install Interior Casing Starts At $95 '39O
_French Rail Sliding Patio Door Oft $1595 _Insulate Weight Boxes $20
_Custom Exterior Cladding $300 _Roof for Bay/Bow Windows $500
2.. SolarZone Elite or ETC Glass $305 (..IO _Existing New Const.Ext Retro F $150
_Grids patio Door $210 Removal of Existing Bay/Bow 1 $250
Woodgrain Interiors $395 2. Repair Sill,Jamb or replace sill nosing $75 /Se
Exterior Designer Col.... $595
InteriorCasing 2r - $275 27 r _Full Sub-Sill(Single)replacement! $175
Handieset Options --••• $ —I—Mullion Removal $50 Jo
l} _Bay/Bow Conversion Ext.Retro $450
'! it 42) ii;j $� (New Siding Will Not Match)
i
Door Color • ® ROUND-UP FOR WINDOW WORLD CARES
Irisidq, outside
St.Jade Children's Research Hoipltal $ V
h
IDISCLAIMEN:Customer Is responsible for the following hi connection with this contract Painting,Staining,Alar System dlsconnecSreeonnect Bulking Permit fees In
excess of$25.00,Homeowner and or Condo Association Approval,Historic District Approval City of Boston parking&sidewalk Permit fetish connection with installation.
NO EXTRA WORK IF NOT IN WRITING! Customer agrees to the terms of payment as follows:
Extra Labor&Materials $
Site Set Up,Permit,Disposal&Delivery Fees$I $389.00
Total Amount $ I/03/10
Custom Order Deposit 33% $ 3q 1$ Ck# •
Project Start Payment 33% $ I3 q Is
Balance Due Day of Installation $ 3 72 q
Amount:41rd $ I (v?aCi°
Window World of Boston anticipates starting this work on s' • and being substantially completed ays.Security Interest Yes No�C
Any deposit required to advance of the start of the work S • 0 exceed 31/396 of the total contract price ora 4uat cost of any material or equipment of a
special order or custom made nature,which must be ordered In advance of the start of the work to assure that the project Wit proceed on schedule.No final payment
shalt be demanded until the contract is completed to the satisfaction of both parties.
Al home improvement contractors and subcontractors shalt be registered and that any inquires about a contract or subcontractor relating to a registration should be
directed to:Office of Consumer Allaire and Business Regidafroa,Teo Part Plaza,Salle 5170 Boston,MA 02116.Phone:(617)973-6700
No work shall heals prior to the signing of the contract and transmittal to the owner of a copy of such contract.
Window World of Boston under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-re ated permits,Window World of
Boston shall not be deemed responsible for delays in the work described In this agreement caused by regulatory,permit granting age les,authorities or individuals.
Notice:B the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals With unregistered contractors,
the PURCHASER(S)Is hereby advised that In the event of a dispute,judgement and nonpayment,the PURCHASERS)will not I e muffled to mate a claim or
A
collection from the guaranty fund established by chapter 142A,ML
You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.
Notice of cancellation must be in writing postmarked no later than midnight of the following third business day.
THIS ISA CUSTOM ORDER NOT FOR RESALE! I
IThis Window Worlds Franchise Is Independently owned and operated by L&P Boston Operating,Inc.under license from Window World,Inc. , I
Sign I /�•/i,.is
Do n sign If there many blank spaces. Date
/04 ea
Salesman:Do sign If there are any blank spaces. Date Owner.Do not sign if there are any blank spaces. Date
soea•oare White Co Original Yellow Copy Customer
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Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Construction Supervisor
CS-072772 Expires: 04/07120.2(
JEFF C STEEIE '
24 SHERWOOD AVE
DANVERS MA 01923 ' ' •
•Commissioner CAL
Office of Consumer Maks&Bastian Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:LLC
Rtglattate Ex.
166025 04/1/2020
WINDOW WORLD OF BOSTON.LLC.
JEFF C.STEELS 6k_CCQ"1----
15A CUMMINGS PARK
W OBURN,MA 01901 Undersecretary
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A RD6 CERTIFICATE OF LIABILITY INSURANCE DATE pnatiorrrro
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOOLLDDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, MEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTRUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: II the certificate holder is an ADDITIONAL INSUREp,the poticyiies)must have ADDITIONAL INSURED provisions or be endorsed
If SUBROGATION IS WAIVED,subject to the terms and etmditions-of.the policy,certain patties may require en endorsement A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsernerd(s),
PRODUCER CONTACT
Marsh&McLennan Agency LLC NA E cafi ,ac,MR,C61A
PHONE
5 N.Elm St. laic No ENT 336544.86511 PAX
Greensboro NC 27455 E-MAIL
IArc.Nol:292-BW-Fz,1F
AoartEss: CarEINtcher marstimma.com
INSUR[3HIS)AFFORDING COVERAGE 1 WIC 0 1
INSURED INSURBLa:Altme'icaFinancial Benefit . 1 31534
VlNDO&
L\SORER E;Hartford Fire Insurance Company i, 19882
Window World of Boston,LLC
118 Shaver Street • INSURER c:Eassechusets Bay Insurance Company i 22305 I
North Wilkesboro NC 28559 IPStrai D:
MEUREREr ' -
INs - F: 1
COVERAGES • CERTIFICATE NUMBER:1016015772 REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCEYISTFD'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIP,EnaENT,TERM OR CONDITION OF ANY CONTRACT Oft OrHER.D000MEN7 WITH RESPECT 70%MRCH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU.THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH PO&JCIES.LIMITS SHOWN MAY HAVE BEM REDUCED EY PAID CLANS. L
end i
TYPE OPFLYIIRANCE Irsd1ST= POLICYEPP PWArnxA r t
PISpINYL POIJCYNUe1BER IfNOYDDnryYT�irSFFJDIyyyYi� Latus 1
C ;'A :COMMERCIAL anzierLLLWen.rn 1
1 °uremia- • 412312, i 401201E fx
EACHOIF'.RETIC we F1. 000
1 • MAI:in-BADE E=cue I GAawbETC RENTED
I •PREMISES fEe=Mende` 1 2,ET.000 1
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ME:RCA(Any pro f+�an? •..5.000 j
i I
�ENLAGGnEGATE turf PP 1 I 1 _PERSONALSPDYINIUPY £'.0040'1...^ )
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r:._; 71 FRC` !--1
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GEN1R1LAGGR=GA?E I S2000.CX •
Foam .. LJ LOC 1 FROOUCTS-CONP,,,A AGO !TIME
=OTHER. { £
f AUTOMOBLELlAD)J l' i 3 AtWOTS7EIF
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i AIRED i AUTOS O,YED + I I I PROPERTY DAL1AuF
• J AUTOS MY J AUTOS OOZY 1
i t I I 1 Ipere:nwn0 £
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C , 'UMBRELLAn A a � OCCUR { I i ODE7=527 41t20.7 911201E 1 EACHoCCURRETCE £LDo[:=
CLAIMSaAiF; I i
1 1 1 +_AGGREGATE j;=dmotr
.TED f RE73.RICNF I pp li"
u 'WORKERS
IAND EMPLOYERS'i1AeIGH Yrb: , :p2l'4�ti-G®E ! 1/2720TF T:2Tle01V X RTl1iE i !EGA £ .
ANYP9OPRIE7ORPAnn1EI Lnua ' •
SE4^.RJC
IOFFICEPJMEMREREXCLUOCS �:f..AI � EL FJICIIAODIDEm
id yes.Mary in ender
n 1 i 1{I Li-DISEASE-D.EMPLO'IEE�£504000
I Pyac desed0e ulpm
?DES RPTIOF:OF OPENATONS Was 7 ! i :EL OISEA."E-POLICY LIAM I IF_TD00 I
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eSCR®YIDS OF OPERATIONS rLOCATIONS/VESPCUT.(ACCAM 9D1_AddRlmgl Remits 5ct15tlatcmq be/backed Einem spa%ere nfi!4)
•
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:ERTIMICATE HOLDER CANCELLATION •
' SHOULD ANY OF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE
•
THE tXPBIATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH.THE POLICY PROVISIONS. .
MTH OWLS REPTZMETTIMNF
•
( @ 1986-2015 ACORD CORPORATION. AI!rights reserved.
CORD 2E(2016133) The ACORD name and loge are registered marks of ACORD