Loading...
HomeMy WebLinkAboutBld-20-004207 _ . . ... .. ... ...,.....,. . • ,., . ... ....,„• ...,.„., .. ., . . ... . • '. ' " •''' ' • • • '•••••`''':''''''''''''''''',.:'"•'';'''-••••• .'' -...',"."-,';';.7'-'-':-'7.Y.,,,' -:*,i. 41,112--'''''..7-7'7,•-'7,'''-'1',-P7---'",*•:=A.-t:',47571.-"li-s.f:7"-:, •.,','----11;'..i".4-5,'•:".".,•'0•:,-.47:4,_. ;-7:',,-.•:';:'•-,.. . '•..- ...• - -...'-::::',-, ' • . • '''..,„7----..71 . •. ,..•cr'W,',::...-;V!'P.!'f':'.0'"1•. ..' -1--7-1.-','..'4'7',1;i4-*-, Yt'".,,.''7-1'71'7 '" ;: :.7ie.4;.:44''i..'47;:silt;-..v.t.i-i-•.71-7--.-;-!-„....-::::,:,...17.-7.t.,,,i,.. .•:1-';;Figi..,'''i•-,'-''-,..."':..,c'•-..'.'4''7; :". '':•l'••-'..;N-7-.7,. - ' •.''" • .';'....,0- - ' -• ' • •••--F.',4,-":-.)$%44:,'V-• - ''' -:...'7.4-.'t.Y1,17 4 7:-':'-'4,`74'5'f'.i.:::34rellin4i'.,,,•i;,,ige -1.2.:;:hitit.:',1,:T,.',-';',L,••••,,N'4,1";:*ki.4:Z:ii.`",ts • ..: ',',..-.t..,.;,4,';',•i;tt,,,...-,.'?-vi,,r•..=-,:; -,•-,,.*-1.-.T.m -:•.:.,', -,. . .-. :.... ,,' ,•. - ...••4-A,....,.--....,.t.-Afs:F.N.....v.,..... .•„ ....-,,;.,-.....,..,.5•_. t, ;::=,',..,,,,.,$!.,,,,,,,,.,,,,,..4.,.x..,,,i.,,,,,,e:p...;. ,.vt c.,..r.,.,.....,,.v. .;',:f.,,...,:-5.k.t,t,,...,s A.4,,...., -. ::,:4t,,I.,,,k,t..,-,:,,,,-,:,,,/,-,y,„--J,,,... .,Q,15.4::,*1 ,...... , ;,„:-: - ..;''''''.,'''.F1'..::::.:';-::.,':',:','-:.:,',. ',:';'.*".';,1.'4-.M.,t,:M:I.T.',:-.•-::.',-::'' •:':::-,:'''it.:1•4,r, :',1 :1:'? ',.1::::',:‘!j,`:,':''•,."):'•:.-:::''''''?:41.. 1.'! ''',%''''','-';:'::::i.,:.: :::. •,:-.t:::;;•:.iii;.",:','''.'':',..k.4:-$;,';;;:,'' r',',';7,71'..,,itiffirj;ki.,:'-'4.?, f1:1t-'"1,'''-''••'':::'',', :''''-.' '-'':'' : '-7,:r'4"ti''..?1',.$"iii;14,,''. '-,',,'',','"::',:-.i.4',';4114 4:,.4,,,:il-V,,,,.:;!,,,,,,.,..,1S, :. \ .. , . ,...: : ,. , .: . . ., .,,,,,,,,,..,., ,.,,, ,,,.„,,,..,,..,:•,.,,„,,,, , , • -':"*.-;.:',..:::: '''.::'"' . :-: ,,,,:,,,,,!4..„1.;,,...,.::,,,,,.., .,....., :.,..;: , ',-.,:„1,..;,,,;:4::,..:-.,..: ft!,.‘04,,:,,:,.;. .,.;,';:- :,,,,-:.:.„....".....4-.Cr„. 7. 4 6.:,,,....4 tic,,,,4i,,-1, -..'i-,•:A.r-dc...-,-.,41,-':c.....i.74.4 C, .-- ' • '' '4,1:.' '' ''•• '-•' -••'''''''.•I'. :`.1tti?jf.Z.13:0'... '.',.'..7.-.7:'::---7,;,,,fTI.L14'.0i$ : 4,-.Pc,;yz,.,4,:4,77i7,- . • '' ' ' '7'.-''.'-'7,7'- ';* A...,.r%'..""q'7' ".-'4":1--1$ril....';'.).i7,',Ii.'''''I',4"4.:P.L.;;.4,,r.,•:A.1.,4 '',.".1..': '..-7.•7- - - '.*• 'k- :':-: •'.''''1:'?-:4;•;M:..1717'I.:- ......,...:'.'-''-.'''-q1-.:r4V74',.”.-- .7 -A,.3,71f,"T‘iti.,.'',i•A.:.:,-ri ,,...;,-..,,,,p.,7.4..,-94-14 "-;•7i;:;:f.'''........-:,. -1.':3.1P,%12.1:11.-.*RNd:4:7 igg'''',i,'., ,4-.;;;...,: -.:- :'''',:1,/,?!,,T."--:-:,....,,:.;:;;).:13.11 .--"-"''': '-' 0 hi ''''4'4. ‘..,•' 0 '' '.-f:;.'"----''';';';''.'. .7', '''i."":7''-''i::'''' '.'. •7'',.'>•••l't:7;:':":3:tir,.;;:,,!-I:r4k''21:''''':',',.''.''.i..7',•.JI'i:iit!,;4,;;-.7',1-471,4't.:4•q': ,";','2,7'..•:.:';'''-•'''..;''•;7!'":7‘''''..f:',.77''''.:.',...!,.;. •:: ',T,IT: -f,,,,•,,',/',, ,;-,4:1 „i'•' 7.**.4;d-,.„,,,-„-r.'„;,: ;; -•:'. •; ', • ::' cote‘•;.4(31 . ,;•• ,•",•''••;,';,„;-;. "-„•,••:':',--•.,:,:„•'; •.• : •,-,;•••'••(,.'„';:;;,;"'7;‘..:4;,;";;;;;510,41. „-':";,...6;.,•1„,,,,',,,'.,',,,,I;p4iik:,,ki.`.4Ji,X .•';':;-,• ;"•'• ''.;',3',,,';',•'• ",., ,t','";g-V",!?";•;::, .1,.'''',•-"":•;',";;'..- ••••"c• '•,';:r'''.7'•'-; !' '•- • ", • •; 0 '1%,..4 t r. -: :•';':,' ','.,''.'";E',•:"',''!,1.V,r,'-',;-'''' • '.'''',:,'":":''..:., 71::,:',':±1,,'-!:',4;F:'Y....,;':.4::'''''':::,..:-.."-.1.'V:',•,'*';':::'f',.-'74, '.7.L'IH''''.'. . :: r:;',"l''''".:'•'::'.'..-';;;;:':::::.:::...-Z: ,,,,,,,':•''f.., ,,'-'..,:',''„:.:.'Z:-.".•-.; -•:::-..:.2 ',-';':,;:"..,:;.':;:k -•.Te ''''''l' ' -`''':'' ''''''''': • . . , ', .. .,,,. . :..•;:•':',..,'..'.,",:;;:::::::•;?;"..t.-, .:'''',-::':'.:•:: •:::''•":•'',".'.:: ':::'''_'i.7"..,••:.:",,•:::.;: . . .-"..:"H.','',.:::.--:.:•''':;•. 4101:480444t9/1V • ' • '''- r.''!''''.:*'. • :' -:".'''',.,"; .f,:'''.,':':•'.,;:;::',::',1-:''''•' ' '.''''f::;:r':•,',1:417:ii•i';?';', ,''''',':i'i •ii`:2-'''',,::':','•:- : -.4:e.'•,. ::,,;-, 4::';'•:. -.;..;:, ..'•, .''' .,,, ,,..., ',,:!.i,-H .' . ...:,,,;-.;: .,-..,.;..,.,;,,. .,":z.:.,,:::: ::: .....-„,,1::.;,:y.,...;;???/,‘,4',„.'!r.tA',!..;,;;3:,.';',...,:.'..:-;.,'..: •-!,•4".2.k.,:44•:;.,„;414,„*.:);'?i•%". i,'...' '- • ..:•4".,'..- ..,,`,.„1.i..Z,..".... ::., !..,..%.•••• '. : '.• .= ' .,:. ' ". ,, .: .. • • ,',6"•;,';',,,".'.:-,i-;';,,;"',,'.t.4.'.. " ' ,'''.'',-.'.1'.'','Vr.,'W-..t071'7,,,i,V,,t=;';-...',.',,..,e4...,-;:0;..47.-,k,7',';,v4.,.v1.3'e..'4...7•.;-.. -,?..::''''44:7.:,1',Ii,•:-•7:4-,• •'•':4 .4-,C.,.-E,:i..11.-E.,t) •• -- - ": • _:'...,.•••i!.. -:,-,-;.,:•,•,i'.,'[,-,44,f,,..2},4-.ir-,.,••••,.:.,....,,,:...,,:i.?4.;:g.f!:0K.r.,:‘,. ,..),,,,!,:isthy;?:,,-..,,,,,,,,,•,:‘,..:4,:2,,,,T.,4t.--t.,• „4„.41:-.--,..--..„..,:.,..,:-.;t-••••ptiv,•.,,,..,."#••?,-,•., -,..!,' ..,4.r,.:`,::::::,:',.".•,....:::.!-•.T•:•,,..•....:::',,,-.t.:-: : .''''''.'• :'• ' ''''r'''''S/OnS$11;$•'''''''f''•0-4''e'. OPE litirPlaeli-V ',I Itt i*ilf.),•Pp.::.-ii'••;;,•-';I•,• :':';',.,".... -..'„'/;;;•iT;;:7,,',"•';.':'',:'::::••J; '•'` • ':::.":".. i;.'",l.:.:,• ; , •-• :,•••'i;,`i-:','-.• ';;; ,, 1 •• ,;„,;-,,, •••,,r, •,0k,,,%. ',.,,,,,',0.4., t.„ ,,....`-;„j„,„;: ,-,,,i-.4,4',•'•-,-,.f''''',:•':'N',•.;'4,/..!.,'..,4,, .' ,,t,,:..-:4,:..4-iti.i..,,.:3-•-...--„,„_.3.,,,:-..i.-..,:;•:(i.,-,,,..,........•,, •... -.,. • •..,,. ...,, • .' .... : . ••,... ..!,•::::•:::'..„1.,..g.i.iii4.,•:•.:H,''.': i','..14':'.'4i.:'4410:4 24". kt 44)Ft'-iY,' •'1.C.,..;',..„,....:,,,i ill."-#:, ,,it',.....-IV. ". .7:-•-•-•,',.11424:1Z ,i,g'?,,•,-S."',, '..-- "' ''.. •' ' •.':,•,:',.-'"--7;•-:,';;"f.,•,;,,.;!--4-",,-7•'''".-•'.'.•:•77.-:',?,:ff...'!"..1.f!f-..74,`,.. ,, g,--4,,,.',..,,,,....-7,i7.e.:1- .'77,j.,77.3,', ....,.''6...',"•,:',.'.'1'-'..:'44lr'!'t 1'',:iiir. 777.'i'Y-'•'.74,-.• ',,•-. .7.1,"7-'-.,.';':'' .-'''' , ' -••-':',.:':'.1.7.71-.4i-,'...-',ttts•:` ''' ' ' ••' ,'''.:';-:!'A. •:',.. ''-f-;.;',,i' i''Bad , 'tit,:'..::•....:..•...,w,..,:-,,::,<,x,,,P•:::''iv...`.x.-•••,..,.-:..,,,,f,?.;,:.,.'z.....:•-4--1,.1.--5-. ',','..,,,....,,y.:i.,,,--, -.:.-,- .,: . • •,,,..'..4,;.,-,,,,.....,,,,i.:,,,,,,•,,,,.-.-•• .-.' .-,-••.-,..:,_:',,,,•... r.::::.• ,-,..„,..,.1.;-„„•„..,..•-,,,,...... ..f.A7,?-•,,,- ':,',1'•‹'.'t.ir-':-,•',.•-•.•'•:•,-H••'-',;,"-!,;:„k,!,'' '''••P k,%•4,ti,,,•,rm- -.-'''F-i.... ,,,.., '-', -,...•,••,.•.,,,,q,c,,,ci'..i, '•• : ." .,- '••',,t••.•:,,.•''l:!!1,,',',,r.,:::- '••.''',,,''',-•;",-`.,,,1;,•,'?l',.=•,!--.:-ra:;,.'.. ,1A-L4t.•^R-bit.i;',4g4-‘'4',:t4-',;11:'..,-;,';' '''',••,.'",.'.,:.'..-_-.7:7,•-'''...':'•,'''t•';''!i20,4,0.C4OFIT-0,0'''4.1•EPANTM514t' '"'. •' - -. ''-'''--f-••,•'•,,-'''',,•!.."t":::-.::- . - •''•,'•H,- :..::.•,. -.•''"-,' r-,:.:•••.:',••',:.,.:.,,'.•1".!:"'•,,:,u‘•,'.-',2ko,',`-',•!'tr.t,;,•'y a'''',r, t•*,t ur:,•;':'-Caooc‘,,"•.: •'_. ••''' :-.-' :*.•''.',' •',T.,,,,,,.-,',, A„..•-•••'' ••.,:„..,.. '•• - '': .-....-.,•[.. ..:• .•• •".:..--,.-:••,•,..ii,'...,-...-...•••- , .•-.r iii, 7----.7-7.---,--- ., . •.• ••. . ,• .....• • , •• . .7... i-71•- .•'.• ' ,. .•..'..; .• • . •.-;••.:„-..-,•:,,...,-4,$.08.y.5.-.-90.-223:•:1:,g442.6t,..,. .'•- • • r , .•••......:.•,.-.. „..,..., ., - : :,,. , --7?- 1.t,o- . .• . .:, ,..,-,, ....--„,:,:„.,:. •.-•.•;,=,..,.. •. ;.•,,•:.::,..„-:,...i,y,•....,- -.,,,-,- •..,•,;•,.. ,,,f,••.... .••:•.,.,_,•,.,:i,..,,,.....'•4:;',.,:,.(-4-..fi.,:.•,,,,•:',-,,,fi,-...--•:,.. ••••,....,..,..,..,',,,L,,,.:,-,..,•: -.,-„,...;,-.;,•-..-• " '••- .-. • . .' .-.,•• • - • CONSTRUCTiON •pRE140. „... . .. . .. . . , „... . An -:-fr-." ••. 1 ''--,-„-;(.1k -." • . '' '-'-' -' ''''''' . '.:,)14,' . •ed14,:-`f'0' '•' ''"Alt.`:- ' '- '''. • ''- '.:' ' . ,' . ,;'' .1.:":. ':'''.'.'. .„:,, :.-",,,.:Ii;,,-;,?..,..":1,:i:'".;;;ii;,••1,•:.•,',,...','..:,,:-.:Ft:";:i.:','iii'er'•:::,,, . .. ...,: -4.ifj,,klir,M74,14:, , ,:',•:,'"..''.'.:.';'::: fe;:c‘.,;.!)`1:::',"i`''', y 11`.:441],- ..:.;;;:.'4.i',:,i';:T" :;',...1.4„;:i-,t•15'71:',*:'..',..1:".''J .• • : •"'• b -,-1:20,,,,,i.4.3:4:-.'.., ....,,,,..- ,k.,:,,,A, '.?,''',-"R It.-...>".V.-''..,:.'".'''',..:•;'...7" ...,.':V.:iii'47:44;7.:g.....it'.1,-.:,4,i. ., ..,,,..-,.••..,-...-..,.,-7:-•.i.';',74:.•,c,7:ht.. :.77. .fity.ii.'.',',',1-•',-.If 7.:•;-1.-..:.t.'74.:';';',.7•7• .-...' •-.'• • .;„.....!:..7E.7_l..8.:*.'S.:P.'1;P':'..S,IfIsW' 111+447I : ':i2,3,1C."‘*•:: ..'''"Vi •:::f.f.TC;'•'''.1..ki.;471' '''f•il.'1,..,;1.;.,.;5.*'....;•,1,3'...,:' ."::.:".."r-Kitiiitifititi' ''I'f,1,,,ii•L':.,..•P'41.•':14.634 -':''',:2.::':.1.....:1.1;'..:,.1"'''''•$f,:;:fiill;;*,Aikt' ,....• .'4'.4.••Vti'•H4'''''''''f''''If''':;":.:'":':;.z'.'::.:';''''•''i;.-'i.'::'-''':''''':!::.;2:.i'..:_.':'';?•'*T.:-.%'ll'::;':'.;;::f''!Y;i':':'::j;1'''I::"'••--'''':::. : ' .: :• - ' • :•. ' ':;,'-'7'':-.•:'41•'• ';',','''';'U'•V' '•'-': '•'F'.`•''''Ir':•'•4:lil''.•4 '•0%.'.1 ....'7,'-';..',,..i'...(f.•:,4.-',.t410:59•::,..,,-.;'..!)-...'.,.,‘,'',''''-.':. '''''','...:',*---.'-',.1-74,,4'01•7,i;T:„,,' ; .,..r4,••4..,:•...,•:.•••:„....J.,'::.:;•.',.,-,•,:.'.qr,.,•,.,,,,,,:',:..;.:-..,i, \ .. „ ., ,,..,",_.,. _..,.:;.',,,,.:-„,,:••r:..,...ils .•.....-,„..., -,'•,..4„,,,,L.:•,-,,,,t,,z3,. .„,,,,i,1: .,.,,,;,4„,.6k-4,,,i,,,,...-..-.,1,0,4.•:-.,..-, di›..:_i6pT-...,,,,e i.,.. .. 3.,...•_,,,,,,.,.,. ,.--- ..... - • .. ,..., ,•04..2.,....11, .5'... _. , ., •4•:-•'•,,-."•',- bcl-f-T.3'2,0L4-•,••••u?J,ii--F+A.~7.,,:,•..,144.7v./ , ..,••••••vii:t444.1.:()At‘. y.. .--, .,.4. /.,..,•-.1.•,.--,,:::,:-•,-,.-•,..,' • •,,c,,',:•.,.• •-"•.•-••-•,‘,• ' ,. '--'', ,'' ,• . ' CONTRACTOR ..191, - N,:,...',-...„':'.•.;:...,.7‘.,':,.-.'N•:.. . ._ . ..-•-.•,-:-,..,,i'.'.;,,•,,,,,A5.0'.1 i,,,,,,,,,:-....„.••,i,•.•i,•.,:,c ..,..,r,; l -„--,s-. q +.: .'..,..•,':„i Af-,•I NAME — mAil40 ADDReSt - i-I:y.-,•„.-20 3z-Cf'a-/(0 qt x•7•D , .. •. 4 •. ;•;'•, " . . -,,,'" ., ' iTOte‘4140,11TAII: " "..,,',',„",,,,-.4,,,l,tr,A,,, „ ,..,.:. ,..„,„ ,,,,7,-*11 -'.,p ,.:'• ,„),i'',1..„,-‘,,,,;,,,, ''••''V,• : ' '.,ti r ,41,','.'V'''k.',''',i,4:, '''',;••• ' . , : ,.. .•.','-,.;.•::: :''. 1 , , ,,-','A•.'",•,.,•',,,V 4 1,;0.'• ,,,X-,••.,•'',,,,.',,,'',':'If" . . 51,',r.,,74,."'" ‘',,.:1,11,r, ..;•.(,..n.j,•V, -''',,,',,,,ce,.." :•'.•'..•.,;,",..T.44,,=",,;;;;,:!cid,„\••,14•• _ii.Z.;•' •• 6'•-••••'-''-'•-• ' • - . •„_... .,,,,,,,.:.„.‘,. ...,, . , ..,, •-....,...:).• -8,,:,...--• ,,,-•:.ii.•,.,•,•., ..;-, Orfisist."""I''' Ifomi Improyement Colig;ft*Pktr-7::' = ..-. '''.4.t-i,4, '•• ;:1,:•::.;.,.,:-,,,,,,,Vi. ::„,..r<:.7:i• ';;". ,,,i'l'••••.,..,i.1:•''',.!,'''''f'Ns'I'tr. .4f rttk • .10:'•',.','''I.•'•,,f'..,:••• :•,•-"r"••••.,''':7•,''''''' ','.1i'•.... •',,,,• " ' 414 .'t;.,-, ,, ,••,...- . ..' -."-'.1•1•:s:I,) ,`: ;Y"'','..T•i!,'-'','; '',•',, •::.V.?..‘:‘,1i..i440141.i1:0414.4..,,,,,..4kit.. ,.4c4t...t .iiti4:*r....'',..:'..•...,4".. .-fr ..,. .ir.itX 1'14: 1.;404::•.f.."37:;..j.-Y':-.'',.. ,..4,1.,L. . •- ' '• - '- Workman 's C•o•mp,ans•8'40.'...4‘1 4-....'.'4.,i'. ,'.i:..n,!P„,,9•!;"A-v C I inthmiiMtliha'al'::vi-•,:.:...n,..X..,O4. ,,4, #.?, t.. I.'4,'.•4'-''r•.n.-•'.. ,V*,'.';'.', *4'A,.')t,,,,.:'U.'t;li„•!i,',,'0',4.::•Y?,,4t,;,,0#:,7:.,'.:„'',..,-•:s',,VC.'':,.__-, 1:•4:•'._.•:';,,'-,1..°--'.-'"'-,.'('::'t'.7•' f',,"::c,L',•.,:.:.'„17"•, '-.' 0 . . ' i: 2'0A..ti,.7.1'.,,i.,:.,::,',•':k 1,.,1:i•,-t11',6',,kl'-y•H;,:1,2..,/L•,,'".':t.:,'".'•..:.i.'N'!-4,4'''-.::',:g:::•':,•.'''!'',',.r..?'.;''.,•'•'„;,,'",.,•:''-,.:...,'j';."-1...' • Insurance Company Name • *iiOa. t.:.:-.''''-"P,.,•:,.',_.::':;-t',.;:,:..'•.::.:-:''i,•'g,:..:.:..,y..'.''.',,,:-,'';;'2:i,S';'7',.'''. ,.'•,;•,.-.',„' . ':•. . ;, ,, .,,,....„,..:„. ,, . „,... ,,,,,•,,,, , , . •._ .., .., ..:14F14ED,,..,. ,.,,,.,..,,,,,,,,:.i:,.,..,;A:•:,-:,:,..1.,..:rc.,;,:i...."':.-",.--- ',•..,, - .. .•.::. •.•:. - -' '',' .. . ' :•.',...': ••••,.',I..'„.. •,. ".-. :•.-,,,:90::;:,,r'it.4.. :::.,-,"; ;;;'',-;.-;.r' .-. ........:,, ,...'44,1A'.". .:,...,f,lt f..'.::.,',.-;'2...i...411t.:4,4.fili,•:. ,',. .-.,frt.'", ...5:,''.....•••:,c/.`.'."'..)`.2-•V,I''. .T,•;'..'1'..v,•1".V.,1•JI.V.-:.•-,';':,--'",,'... . : ',".•-,.•-•;.., '...;•-k,•,..r..• .' .,,`.'-'7w' .:',..;:i,•.,,I''.,'.1',';-•'.1•A'.......:4i14-,,:-47.77?'.1-...,77.,,,:4:1,,,,,7„7-.7..;-, .=..L-.::‘,7,7•!....4. ...,,-;,.ii,--,-..-„, v.;,,......,.......,,..,,,,„.. ,,, ,,,,,...s.„ L.r:,,r„,1..,:,,,,•;.,....,,,. , . ,,, -.:,--.: ',- ,'. ':, • '4,';',,-': •-".7',.'.244.i;.r_._c“),7-41.'. -,,:..'-'Tent 1htlt ,•„f,,,,m,„„...• ,,,,,... ..... r,..,&„.-:;.;1,.„.:„4,•,-,i.4,,-;i.•-.7,....::;.,_,. ,..,. • • • ..,..": Ailie7,:'ii"-.,,":-,.....i..,-,-.41--.7..f...'.:•'..,:'..`-...-fi.):,,7 ;. , • ' ••.:Siding: *o .Square* ,.- N. •-.. ::,-, ...i.,..--.,'t ,.4•, ‘''.'," 1. #1'..•,.'-.'i-,.,if..L,••`,,;'1,.",4,-.,.:,,,,,.,";,,-P,:i,,•A-..,'4'.'..•:,-.'.'',.,•1,-!,4,4,,,'t..'.,.'..,.t.%,.:','•1,,'.',;,-'',,..')i,'"/..•''e.'b'•,','k''''''r-. kil,li:.• "".ittV:.ts!•w`''','-Li.',''6-'.',''''',.'''''•''•I,f't•..,',',''••,•''.'•r:',,i-'',''''....4.,,',''/",'";••••'••.• '.: gi,":'',.-,7..t,..,.ist',....7,'P'..7.4....'7:•:'•;•77'.'"'4;',•,".'•',,',*i,;•'•,..,,-,\'‘•';', • ' ' . • '"'• •••••' ''' ' '• ;"' •• '''-'•':';•-`'•," •.‘1'•.1,•",'-'-•''•, • ;•'.•••:,;.:,'• ';',..,•a:4i'- t',,,•,,,....:„,45,1„;,-,1•,•* 'Roofing #of Squar•,et•••••••.. ....,•,,,,,, ( •..•,.:.,)-.•;7;:.--x..•,...4i,:vo,1.4; ,;.,g.:-,••. 1•,.4:t,,,,,,,,„...i4-..,.,-,,.,-,,-;,.•,.,.;i,,w,.. :„,•-„,f,•,,,.,,,,,:,•,.i,.,..7I;.,.,,,,;,:„.-..,„:,..:..,,,,,,,,,..,,•,.•...,!.....,-1::,;,:,•..,,,,.,.4,;.•.,,„.,4.ii..,,,;,,,,,,11-„;,,,,:,.,,,,,„r.,4,, frr,,,,.,,,,:-:-„,;,;.—,,,-.,.,,„,,,,.:,,.,,-,,..,.,-...,.1•.-,..,f,,',,:,;•.,;•.: ..... „...: ,.•,...,:,..,:::......,,,:,.„,,•,„....:....,... ., . .„.... .. . , , . . .. ., . . . . . .„. . .„. .. feu .: • .• Old Kings.1.41134,0y/instoric.Disti..,.. (--).-goplachis like fr .,.e . . POOl .• _. . .- .-.--:.:•.••'.--z.,'•' ';.. .. ;•,••....-....:•...:-••........-:,:;?:' ,.1,.,i.....,..:..:,• • •....--.;f:,:f-,•',•..-.:,•,2•:.-1 --.,.". ' '•:,--;!:•,":::.f.;::•••,•,:-';',:•„ Ln.t.'..;.';',,...',‘.'.:•;•,,-:, ••, . • „ . .., .. -.:.:::.;:,;-,',..:',...:.f:'•••.',•;.• ' •6;;)(y.y..-,(•. •;4414k:6.•" 4...-64-4, ,. • ... .,0..,.A.,..,;. ,,,,,,,..„,,.„.d.,,,,,i,,,,,,?...,,,,„.:,„. .....:...:.....,..,.... „.. ...:.„,.. , „ Th' debrig. wilt befd bud'''.•-614?`'''''''.1•} '''' - ''''''..0.1'''''','" t- • i.:;tr'''' *:'' ... ' ' :: "''' t 14/12•-„-•-.4',ci.-Ni-ti-.', .-.4-,--.0,;:1',•-r .,.i.„, .,..,,-... ....,., .„.•,., .,. „,..7. ,,„ .„ - ' '•,.',,.--P„,— : ., ,-isPP,,.. •;;;,-;'•••,'•'4`:'., •- ‘„. 1' •.,A, '•,•'.,g;wlir-.E.,,,-).-.'..iii. - .,s141.:•:,110,-0;11:1;,0,-•;.;,•;•„:',,,,...),4,-..,;•••,k,y, '1,•.4:1, --.. :4N4,,,i).r';;,"•it.',-•;',;;;;,;•,'„, ",,•,' •; •-•-;-.'' • ;;"'„,'!".4,".; .' , ,- • ,. ,. '.- .•, , • ••• •.„,.. ,,i,•-,,,Z,•„'"f•!,1,,;•-Ik'',„-„',:•:.....-,•••• ;i',.;4,.:'-•.'-;1'1•'•-,41,1t.i',- .911404 ox•FA..,...01,145,..fq 1:4,11,,,...,...i.."....,...,..",':,".•,,:,.."..i';:i4: 41ir;,,Af, t";e:,i'lei'i,'•'. ,' •••".;:„, •„••.. '''.„'-',;,'„,:•,.'; ', ; . ,-:•,•;,,'.,.:": -• •',.•••.i. ‘,'.i';,';1••-7til--•'• '• ::,,,'.••::'., ...'i••?•-•.',1.'‘.'•;•-•4t(1,4„ `,4;';';,,;‘,1'-',;Q:',:•-•,'"••,•;•.!,:i.:•‘:,-•,'','"-.,'.7-„,•''''''"r:1--.4,?-';',..-.;:,4:•„-,; :'-.4-41-',.'''`,•;, •,'41,:‘•1',;444-?--'-,,,„`•,-,"i"'•,!;;.-7,'',;,;;.5,--: • •:•••'•-. •,-_,:;',,;••';,„,:f,'-'•• ,,• - - ; i. . ., , . , .:.„,.„,,,,„„,„ „•,F,,,,x•,.., , ., ,. .1.,,;,./,,„; ,,, .,;,„!,•3,, •-••-•-,„,,; , A loosivjAke ant. , thittelY413erfASITult, ,,,,h1 •'' 46(arO run.c14-.1)ootilties ' -,'!'• ',S4,001#4;t"lit.„-. „„-,,' 1:4#FP ,ft'aq •••. ; •T , • . .,:.,--.,,-,,,-...,.-•. .,- . •,.tt ..("-..:,..:•,.:•.•:,,,,, ,-.1...:.,.., 4,..;',: :'.:Y.::.." fi..,1;‘...:1;;,p. .411.,,); , '.,?. .....!:•'..;'-''','•,'''',1-",".'•i';:.-"((.T,4'!".,:t.Z..1';''',,''•' ' , will be lust cause for 4ealakOr#:- OViger°04{K . ';10ftiT;%.,.: '--.,...,t4. •' '.f<!".',-..-:,...c. '' ''i-qt:.4'•:,?;i,4`..!*: '.'.- . ''.:"..•2,4fq:;-:,', ,,,'•,-,,.:.•.:',';,.i.'.4,-...,.„• -• .. 7 •Appti • • • '' ' .. ! ..-;';'::•-• ' '• '''''''''''...?':-•..i•;.1ligiatl•_;',t•T,:•„!;!,-.1-'.-.`.,•:,- Te..;, ,•:, .:V•ti4445ii(Of•••.I" 1.Y.V..ii•Pr.•,'-•••:, , -,-• ,--. -,..••..-- --.-- '..:.:.•,, • • ,,r,,,,..„,...,,,,,:. ••,...„....- ...,.:,..,-,..•„,i•?-•'..•-•..,:2,,,,.-,,-,..-...,.•-•-..„ . ., ,Owners Sg i.o. tore(or ot toth'.•.',..i•,-,iot.),•• . ,, :,.4 '•. '• D4t0: -••.,•',','',,,,;".5',,"..:4•-.1.'...;...'.,.',•„,,••..•"•;•,••••••;'•,• ;•••• •• ; -, •-,-• .•-'-'• -••• • ' .... •'''. 52' ' ' ••- ''•D$tC• ••• I'''''V•'-'• Ok••••''- '• • '' • '- , • ., , . , ,.• ;.'',, ,,, ' ; 7'-'-'-',...',;i7.4•".-...-,,: '''.,i;,•:''.;?'•', '.i''' ' A •;',4,,14:i.4,.;,:•7;•.; l ..i. i.-„,.,:4...„3-:,--,;',.....77-- -;..is.im. .f',4,,,, , • ,..,174/• ; "" ,.;.; . •••,,,,,,,f,---..: .. . ' ' 'l',1....:.i.,,,.!•.:.:;;," ,:,, - '-.,.,,'.';,,;',•,-L.'2•1,21.',.::.:4,":..,...,i.lt.';;;,,, ::,-:,,1-rii'k :' ', ,,, ct4'.'`'i.q'Zi•,..o. i . .,1 A.J'.....,..,I•i"i7.,,,P.TU,,...1,4ipii k...-•4'. 's 41,1.,,'‘,4,\,'"::7.'.';,...., -',..,,.',.,:.:-.,,,.'•, . .,,,.,: ", • . ,.!,y.,-,,,,,4,',,,-,...:_;,..- '..;' •,,,"*....,..,:i!t,ir.t.4t,tri'Kt'4.•'••!.•.:*' "•''...1'Jitjiki),t. - •'-'":a'10..q.". .1 t.4' '' ',.',,,t".;'"';':,.....:....•,...-.,cyj... .,..!. , Vs • • .7117,4...;‘,...,..;.••,,,,'-',..';...."':..•7.."-7.".",;.-‘, . •'',. '-' • , ,. " ..'..i'''',',..`;W:44:: .1.. •'l' ,''r- ''.1..40 ".,,.'•„ • •.:'.'.: ' ';....:,,,., , •:" ', ,...",;,"il:,,j",,`,,!A:,i4.:,'i,y. .10100 14,_ '', .. ,, .i.:4X6,..i.i'4. • ,..•'., , ' .;-;:Vsa 114,4 , s : i"!":i-Al...:4,•:;,4,,,IT.': ...••....:`,...,,,,,,-.71,.,.,,, ._. , v.*,:,,..i,,,,..,,','.1.:,.1.-:'-;;A,.,,,i'....,i4 i. h...''. •,„•!:tt14 .,....'ifL,:i ' .'•'•i''.r?':,!'N''',•-':f-'." ' '• . . • -- -'''';!..."' '''---..'.,.'••.:' ': -','.',7;,;-:;...j;Z.4.5'..'.;•.,••.'A•,.'-•:..r...'''. '':'l',.-.::::,....' l'--•.•-"--%.•, $4,/,:.!-',..'.i,`:.•,'••'..f.•,, ; - lzii. .', 11.11..t.-'.-:-.'2.;•'.'...,':.. •-•z.'•".e.i-4:;.,•1:,:f ii/Ir , ... —-.44: Ptiv.:','::: •:t-,'::' '''''''',"'";i'''t' 'fi) '4'i'";""`'''' '''l'''';'‘:''',7'.';'`i. '' '" -: - '14M'. •'' 17',1-2:::•.--;L.77.4-,1..,-,,,..s.i:.,-:k -,.;•,.., ..,,.,:.....--, ,-,r.......;....,:.-.- .,i:.... . -. . .. ....,-,....-•-,.:7,,,:'-Afitter iteSQUIt' ,..101..1;',-..,.'7. -'-:-..--77-471047 'i'• • "• ./W'ri• ....'6-,,,--,. .;•••-,-••••••=j,•••:,-,•...i.,..1•.:.-,..,.....••:••,"f• -•,•:•'.•• '',".`,--":'' .i .''':•'''''- :'''',..' .' •'''.''-' ' -":,571'-'":',i''',:'!'':.-44t\. :''':',.'':.El•.'41.4''•••''' ...1v. -k..•••`••'••: f••••••;•••'5'.:4•,`,•;,•'',1;•.;;;•-,..4.,-.1.1./;11-1:0.--: ,, •,.t;'`:',•"':''..'"':*!••;?,..,'-'1.;,',...";./.'..•••'.-. . ' .'...r,.''.:,;.;".:".•• :1*.t;-.., ••• , .:Lc.. ,',-i: '1?''.7,:•.,,,14-.';;•-.; .;: ,,.'-1.-',,:,..:,;,'•y%.f,i.3. z..:.),ii...,:::: • ,,: ..,,,,•-L',':' . ' ''';-••" ,•;,: :. :.:.'' ,' , '''. • . .'. . '`-::; ,. . . . . • . ,. . , . . , . . . . . . •.„. ,... . . : , .•...„,, ..,. ... .. - . ..- ... 0..;..'.•:I. '.: . " -'••t•-'-!,..'''''''11'..'":1..''.'il r';''•••.‘ '''''''•--',',1..',:i.v...,•;yi,..,,,,,.. ;4.,,,,,,,,.„•..,.•' . .l',-,'•..;:,,,,,' '.'' •' • • • - • ..,.•-•-:,-......•.,-....„-.•....,,...,,,,„.,,,..„, • . , •.:‘.,._.',-F-..,',',",;•Ii.1'.fi'm'',t.,.,,V•e-4".1;•k•,i•!.,',..,...,;,:,,':',:',.:!;,,"-47,.-f, „ q4,,:,:,;,-a":1•,t:$ ,..,,::....4.,..,.,.•.,,,..- N.- .,, • 4 •, ,,;,.,;,ix4.,,,4,,.,,.A,•.4i..,;,;:!....,4,.,",,-,.••,•,,,,,•;.....•.-,••,,.,,..,,...;.. ....,.,,,,.-.-.,:•,...• , .. .. t 7•',?..,:p....4.,....4,,,Ali4,4.... ,.,'',,-,,,-.-...,....,',-;.,,,,:7.,.-..:.-••-''' '•--' '.: : ' .• • --- -*"...-,::,,, ,,,k,c',,y.g,y,', •:',, ..::: :::-:.:::;.‘.;:.•:."!!!),,,,: ,‘,17:2,.:-... '... ' :,,,.'1,,,#.;.:4:-..,"„.....1 i`p,M3e.l•tt,4,-,:,•••. '.'•.•^..,....•'•.• . . , ,. • ,_ ,, . • . ••,,•.. ¢ ir. ',, iall n¢ fin.rU ', " # . ti :,r 34,4, t The C d 1 M mh�.'of Alin :t4(+� . , !x�{i1 t 1A -, ,S,;,S i -:: �tr ', �{ L ' ad .p e,� . • "1j $ E f - ' r ? { _ (� �„,,`` {' t F , >1 �yfa ! - 1 ig, is �:=�101 �.' 1.}{��-" , ae5""i'. . _ 3. s• K__-_ .q4 4 ., '•ir � M,,,r ,A,�tr , ^,,{ et= y. r �) x r ]� !., .T ': i p,�y �s.�+r r r.....,., : , { �^. 'J, a : tC h:^,:i {.Y.� `�" h i1��'. j4 M ;: 1 :r „r rkT { ., ', >,. �...,.... 1. t .:;�' s6�t'-;}!, w ta , A r �,i';_,: jj1s:}v�,p. u�r r ,}� _ ..�fdx 5�".-Wf } a d.:- i�5 Workers'Com�petiaanon Insutance Afmm�davitr Buifder5/Contractors/Electrici.ans/Piumbers. ' TO BE FILED wri" I TIE PERMITTING AUTHORITY. pnnlicant 1n�o�ma � • � .0��p���y'y�, : � �� ,° f Ploase Prlrat La�Ibly . . i,Narnt.` : .K {'lVid04):. • L_4+f .'i.�j #.` -.Lb ' .. - . . a { 1 �'G r i -±� }} .' t�.'q�Tk1� r.:�t#'b`��j�y c}{ ,_ , {H" a lrfiv,yea�' r 1 �,{ c ��.}� Yl�{fit .i'f^�.4}4 } ,...,,,,,.: .. : :,:,:,...::,,.,,.,::,::�Addrei73K°. TG l�'i x .l , ,� !'a; 4 ^.3r , 'i .. � a , ! �:r< , ,fi her, ,,,:.:. ,... ....:,,.. -_,,..: :. -.-,, : : ;: . --, a a �' �.; ek y 1 �iy� ,1� � ,/ 1 eta �� �i riak �w�1t� City/State/Zip R r i � . � hont ;..�r, r 3 i• ,. Are you an employer?Cleck ttttt`a appraprtate box: Type et pro jest(required): 1;70I am a employer with 3 employees(full and/or;pan-time).* ?, []New construction 2 I am a Bole prppdetoror�tnershi and have no employees working forme to r} i • r`;$. Remodelin >my fty,two w i* obrtip taurance req 8 tl�d t { r ,� 3. I am a htlmeownet d ."r- 9. Detnolttion . , Clefill**,16*1f(No:wark t` a�'�nauran°"i4uirad11:; 14Hh ; I am a hGlaeoWhtlr yt�l b�tltradtoit - �::: o ?G ;1t " T �'tJ Btt..dtQE addltlon . �snort that ell 'oom b su.►be:i r ara sol ° `;11.0 1�C.`„at c rs or eddrtions '; < proprietor.wft no aaptoy & >. l> ='k .- :I2.CD P1i unbind repairs or additions 5,0 l am a geateral corttfactof an `I lows lifrridthe sub eotttritntorslisted on'theattachedfeet Theca tub-contractoa hays;employeee and have workers'comp. nswance.t 13.Q RblS repairs• 7 6.0 We are a corporation and its Qftloera-have exercised their right of exemption per MGL c 14.E Other 152,§,I(4),and we tt;vrti no smployeeL lNo workers`camp ittauranoe required] Zs t 1; xif is r+ i," l) ? ,` *Any applicant that checks box ttt oiust ilab;tlil out the section}below r Wingtt elr wb�rkers'-aotttpez ton policy lnfdrmation« `. t.Homeowner.who submit thlU!$dayitiedlcetlng they are•doinii{ale.work and-hen hit'e outgidac agt¢p must submit a t(ew g.;1 1 tuft in - such. i . ' ;Contractors that check this Bale iela atOie ed an additions)slues " � ►B �g the Berne bf the ttilrr�+�il6dtgrt and state whethel:o�n'3if ttnoie eritititd have employees. If the sub a:,"`s iztt.l' eos;.tl'tay must. . " .tHeir,wofiters'comp..;,,, :a ptibar . I am an employer deaf is pra n g tivor.kegs'coriise o1lon•firsurance for m sly pfo ees: Below Istlie p6l oy"and Job site information., . ( ,, Insurance.Company Name:" .�..X' .SvV !e rY .7'T `QUt, Policy#or•Self-gins Lzo #^ C 1( .j Expiration Date' /"3 ' -/ ar 1. 'F0 ;r,r .:: .. r. trt S F1 ..' Job Site Address `�� i. j. .� t�U. l,�rm l City/StAte/Zip:r o •� Attach a copy of th;a wolhltena compensation declarattion page(*l**ing the policy number itnd.expiration date), .!.. Failure to secure coverage:as`retluir ad.under MOL;c.1S2•, 25A is a•crii al,Io1ation punishable l y.a fine up to$I,5Ub.00 and/or one-year itnprisontnent,as well as civil penalties in the form of a STOP-WORK ORDER.and a;fine of up to$250.00 a day against the violator,A copy of this statement may be forwarded to the Office.of Investigations of the DIA for insurance coverage verification. I do hereby certfjjr un r�;LOW,' and penultips:of perJury tit-Olt, infortiaatlon provided above is true.and correct Signature:. •• D • 3FZ phone#: 1 t t,t ` Official'use only. Do not;write fn this area,to be.completed by city ortowf.ofciat. City or Town: Permit/License#"•. Issuing Authority;(eircle•one 1.Board of Health Zi$uilding_Department 3:City/Town Clerk 4*.llsotrfcal Inspector.,$.Pluttthing Inspector b.Other 4 Contact Persona-` Phone#a :._ .,. -• .. _ ., . . • . . . - _ ,..- , . ,• . . .7.4 Wommanipea.4icy",AoMait4J.9.0, i Consum : i i 'i • _. ViOtola IMPROVIMINT C t . , office of er Affairs ,Individual 0 A..... 81 BuOsitanesf:Ageer01° " 1 ' . .s... -.,--... — 03115i2021 ... PHILIP BOIRET,),Z-J,Ilia I:\ , 1 I . . . 1.7.. —'&.:.... - ... ..„- 1 . . 21 OCEAN AVE '4,-J.I. .-ov Undersecreta .i -.. HAMA/ICI-WORT,MA . • . . ___.---_- . .. . -.---,---_—_------_------, _ ---- — .---------- ' - . ,.. . .- Common4lealth of Massachusetts .. - • • , . , Division of Profession-al Licensure' • Board of Building Fr ulations and Standards -•:. Cons ' isor CS-092745 iz ' ire*:05118/2021 PHILIP BOI 21 OCEAN A ' HARWICH. 0 r , ' Oissga0* . , • , a. 4• 0°' .Commissioner 4. _ ( • \ . .,, • • , t ,L ,. ; • , ,. ,..,ib . • . . • ., . f 41 . • .. ri• •', , • !' ' 1' . S ..•.... •, • A ,...t.• . • . ?''• . , • ',1'• .•., • • ' . ,.• •',t,' : ,0 . ... A Worker's Compensation and Employer's Liability Policy �V{ Bar .hire Hathaway NorGUARD Insurance Company - A Stock Co. �tGJ A �D O Policy Nu of STWC1394590074 Insurance �= Renewal of STWC009749 Companies NCCI No. [25844] Policy Information Page [1]Named Insured and Mailing Address Agency Straight and Level Inc WEST'S INSURANCE AGENCY DBA/TA Mr. Handyman Capecod and Islands 1225 Tri-State Pkwy. 21 Ocean Ave Suite 500 Harwich Port, MA 02646-2130 Gurnee, IL 60031 Agency Code: ILIROQ17 Federal Employer's ID 82-3025675 Insured is Corporation Additional Names of Insured (N2) Mr. Handyman Capecod and Islands [2] Policy Period { From January 3, 2020 to January 3, 2021, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance- Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $500,000 Bodily Injury by Disease -each employee $500,000 • Bodily Injury by Disease -policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. a D. This policy includes these endorsements and schedules: a $ See Extension of Information Page -Schedule of Forms 40 [4] Premium The Premium Basis and, therefore, the premium will be determined by our Ma Classifications, Rates, and Rating Plans. All re • audit. (Continu I t I