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119 HIGHLAND AVE - BPA-07-275 ROOF What is the current use of the Building? Material of Building? if dwelling.how many unit? Asbestos? Will the Building Conform to Law? Archited's Name Address and Phone ( ) g Mechanic's Name c'�( —2 Address and Phone 02 C'Oc bra P c ' Construaw Supervisors License S HIC Registration 0 Estimated Coat' vi ? 6 Permit Fee Cak:uladon Permit Fee S Estimated Cost X S71311000 Residential -- -- - -- - - Esymated Cost X S41/S1oo0 Comnwda4— ----- - An Additional$5.00 Is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays In processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of per!ury x to N t y� F •� i s CL O NY: Ue,I.OWC-11339-RX Gmq NY * Cl 4211imcomerR000 , uuyff`-12205 .,��.�..d„o °i"`0i1 " - ca { ■,Y 0 1415Mt fles=BoulewN florhesrer,NY N606 fk �591i•���7.%). l I�,�� ['.. 'ccr rJ ❑6443 RidingsRwd•Suite 112-Symmse NY•13206 1 uLn ^�{(� 7y „,vCC D rises Mafn5onn maiam5rac NY.14221 ❑1133Route SSafLe WN,Po,kN Bldg Suit F America's Finest in takoRgenlle,NY•13540 Home Improvement CT: LL III "•s L p 100(orponreFluor-RockyHeL(7.06067 Sys A V NRPoMTFOPFIfF: MA: Linens¢1132093 e�nmlun mcm 1000arporate Place ❑94Ntfm5ho-S(e.307•W IAr4MAros85 .1 Rocky Hill,C(W067 RI: !home a 20283 e-VPx 131970 1-W5-543-0505 ON: O NOD(edar8oa= 5fe.101 5.Eurli40HN118 °�°°'^* www.1)INasociatounan B11111:11 Jill:2.101TJ livils s B L111FAI[elk,MCI fiFiffil The Buyers)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on the front and the reverse of this Agreement,and Buyer(s)have requested that such goods or services be installed or provided at Buyers address listed above. FJB Associates LLC("Contractor),hereby agrees to install or cause to be installed the products or services listed in this Agreement. Buyer(s) agree to sign a completion certificate upon completion of the installation of the goods.The Buyer(s)agree to pay the purchase price as described below. Descriptions for siding and roofing orders are contained in the accompanying addendum to this Agreement.The Buyers)may request Contractor to try and obtain financing for the Buyer's purchase. Any financing agreements for the purchase will be contained in separate financing documents.THIS IS A NOW NEGOTIABLE CONSUMER NOTE. THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE,AND IN CONNECTICUT THIS SALE Is 5UBIECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT.THIS INSTRUMENT IS NOT NEGOTIABLE. 1 11 • All windowswill be Triple Glass,Double Low-Ewith:(thecka9e rypton Gas ❑Argon Gas Other(SeeAddendum) WINDOWMODEL TOTAL SCREENS WINDOW N0. MULLS. NEW TOTAL INSIDE OUTSIDE DECORATIVE TYPE OF NUMBER UNIT ¢�rta MOALL COLOR CASES COLOR REM STOOL DOOR MODEL DOOR FINISH FINISH MOLDING LOCK SET oxD wortUNITS err HTOTALWINDMPAINTING STAINING OR DECORATING IS NOT A PAiTZNE'Str TOTALDOOROFbURcdNmAcr,gk + s.;Tv JrA'•�E '.z"<.'„ 11 •;,f^ uNus M 1 $TIh1T D.' SG r• ' t �q �s � � r.�Tt4�ART,)NfpAT ,r fie;1t/Q� DOWNpAYMENT•`. 50 � Rya STIMATEo 6 #AC MPLEYION OATE HELR OHEI ., ru+ws.�u�.sas�uur k n 4�M SyBAIJANCE.DUE ONE �i;414' x It is agreed and understood by and between the parties that this Agreement,front and back constitutes the entire understanding between the parties,and there are no verbal understandings,changing or modifying any of the terms of this Agreement. This contract may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and the Contractor. Buyer(s)hereby acknowledged that Buyers)has read the front and the reverse of this Agreement and has received a completed,signed and dated copy of this Agreement,including the two attached Notice of Cancellation forms,on the date first written above. Buyer(s)also acknowledged that they were orally informed of their right to cancel this transaction. Notice to Owner of Deposit:If we receive payment under this contract from you prior to the substantial completion of work as required by lien law section 71-A(4),we will deposit such payment in an escrow account within five business days,and we will use the deposits for the purposes of this contract and for other purposes permitted bylaw.You are hereby advised that the name of the depository where the funds will be placed is Bank of America. 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 full unpaid balance due under this agreement,and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges.(4)The seller has no right to enter unlawfully 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 main office or branch office shown in the agreement by registered or certified mail,which shall be posted not 1attL.J;kNeNNqRidmght of the third calendar day after the day an which the buyer signs the agreement,excluding Sunday and any holiday on which regular elive'e are not made.See the attached notice of cancellation form for an explanation of buyers rights. FJB Associates LLC License No. 5SQc>�C) BUYER(SIGNATU): 3 (J-p S GNATURE Date: !+t CSIQ SIGNATURE U Date: 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 form for an explanation of this right. _______ _______________________________________________________________________________________ NOTIC OF CANCELLATION NOTICE OF CANCELLATION Date of Transaction ���, .)_7 Date of Transaction u a$�'G 7 You may cancer this transaction, without any penalty or You may cancel this transaction, without any penalty or obligation,within three business days,from the above date.if you obligation,within three business days,from the above date.if you cancel,any property traded in,any payments made by you under cancel,any property traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed by the Contract or Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt by the Seller you will be returned within 10 days following receipt by the Seller of your cancellation notice,and any security interest arising out of of your cancellation notice,and any security interest arisinq out of ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE NM DKMYq FJBAS-1 08/16A06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sinclair Insurance Group, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 4 Tower Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wallingford CT 06492 Phone: 203-265-0996 Fax:203-265-5863 INSURERS AFFORDING COVERAGE NAIL INSURED INSURER A'. Peerless Insurance Company 24198 FJB Associates LLC 6 INSURERB'. Clearwater Gutter Protection msuRERc. Attn: Bette Kielb 100 Corporate Place INSURER O'. Rocky Hill CT 06067 INSURER E COVERAGES 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 T IS 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDKY) DATE IMMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8055678 08/15/06 08/15/07 PREMISES IEe occurenca) $ 300,000 CLAIMS MADE X�OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&MV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00Q GENT AGGRFGATF VMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY r JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY Auto BA8056178 08/15/06 08/15/07 (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY if SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Par accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY'. AGO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 A X OCCUR F7 CLAIMS MADE CU8057179 08/15/06 08/15/07 AGGREGATE $ 1010001000 $ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS'LIABILITY WC8056578 08/15/06 08/15/07 E.L.EACH ACCIDENT $ 1000000 PNY PROPRIETORYPARTNER,EXECUTIVE OFFICERMEMBER EXCLUDED? e� E.L.DISEASE-EA EMPLOYEE $ 1000000 It as deunbe under SPECIAL PROVISIONS deli E.L.DISEASE-POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION EVIDENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Evidence of Insurance IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REP EI�ATNE �I ACORD 25(2001108) �.((1y �A ©ACORD CORPORATION 1988 Board of Building Regul Lions and Standards f One Ashburton PNte - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 132093 Type: Ltd Liability Corporation Expiration: 11/16/2008 Tr# 125286 F J B ASSOCIATES LLC. FRANK BOCIAN 100 CORPORATE HILL ROCKY HILL, CT 06067 Update Address and return card.Mark reason for change. CA, 0 50M 04/05-PC869e Address ❑ Renewal ❑ Employment Lost Card J 1��W Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 132093 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 11/16/2008 Tr# 125286 Boston,Ma.02108 Type: Ltd Liability Corporation F J B ASSOCIATES LLC. FRANK BOCIAN 100 CORPORATE PLACE ROCKY HILL,CT 06067 Administrator Not valid without signature ra Crrrms AL&i -- PUBLIC PROPERTY ' DEPARTNI&NT Kl.%QwJLsr DISC %IAVM 130wwwtt+anv+SrtF�r ' fury.�latt�an;st�is 01970 Tm 97e.74 5. 9"s•FNe M74&"" PA APPLICATION FOR THE REIR. RENOVATION CONSTRUCTION DEMOLITION, OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING STRUCTURE OR BUILDIN . 1.0 SITE INFORMATION Location Name: c Building; --- Property Is located In a;Conservation Area Y/N Historic District YIN 2.0 OWNERSHIP INFORMATION 2A Owner of Land Name: Address: Telephone: 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Storlee Renovated Change in Use New Demolition Existing Approximate year of Area per floor(so Renovated construction or renovation of existing building New Brief Description of Proposed Work: �c woo u-e e krrS� U� �,� j . Gj \� �`S �G��a u V' ` L -- Mail Permit to: - - --