HomeMy WebLinkAbout0198 TOWER HILL ROAD 9'f �wa�. 1'17i/ 41-
MIT Co
�oFrruro� Town of Barnstable 'Wit#
Regulatory Services �dD r a,r rjrorrrimie.dnre
y drtss. �q
a RNSTA �� Thomas P. Geiter, Director
G� Ok '7h9l2
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
Not Yaiid tvithout RedX-Press Imprint
Map/parcel Number
;/Res'iydential
AddressA.
Value of Work '
S d�� IYiiuimum fee of,�35.00 for work under,�6000.00
Owner's Name & Address
Contractor's Narne -/Rm-e S /000/✓ Telephone Number
Home Improvement Contractor License#(if applicable) &/,r.?
Constr ction Supervisor's License#(if applicable) �0
orkman's Compensation Insurance
Check one:
❑ I a sole proprietor
❑ am the Homeowner
I have Worker's Compensation Insurance !
Insurance Company Name— - k,
�,' C ✓/ � v�C _�
I Workman's Comp.Policy# [,[
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 root)
VReplacement
side
#of doors
Windows/doors/sliders. U-Value 0, 30 (maximum .35)#of windows_
Where required: Issuance of this permit does not exempt compliance with other town department regulations,i-e. Historic,consen ttion,etc.
**Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License & Construction Supervisors License is
required.
,NATIJRE: GAY
'P;=ILESIfo?H'Slb!,ildingpe:nitins,� Xpri�rSS_doc
Renewal _
• e
bYAndersen. teao Marard ConuW Film Rt Reg 1225g73 A33 37 Pan asr y,r
4cense ml HCF-0059 CTH(C.6'362775 tVtrnsir.yer R.".wf
WINDOW REPLACEMENT dn.{n.krwnl•.uqunv a41 HId119535 .3CY14?5-:222 _. p."cir
PxCnasenslName Pox i-rwPUL.L fzn) and
VnsD,IIaINN1 AdCtess. 1 � TJ lr htk /-�/C_G (l L2 City �.�a St LIp
r a y�c.—�._— IV3
Melling Audiress city SI. zip
Home Phone p<}- _ S� Work Phone laer/Aa,l Cell Phone, lA4'1 rrsi
Email Address: Taxes Pad In
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:I'�d✓rtmr.i'CGraracicV'f tp lSTren,der'yar end ns:er as mdi<ftals as dCYl2elnmrs.f�'Mr'H:'N I•A�n!Cn•a+n{'1,:'•.t a:��3�'.•Nr�htt'Ii S1 ar0$]'45$tfnim3r'�t�a^yy}ra�;tiNm SIMNJr nfC;.0..uL'M
tM,Crn Oy r,•CreKP,y1y0 mane A nhtn he MC'?CMTG4"v'4r::CnfeWte tilt Oe•;rnu.�n kN al:�q'S al o,e l•A70'LvC+lStd!I dIR'r.
Agreement Amount: T Check Cashiers Check.or Money Order - CHECK# _-
Les Deposit rna,33%j. 0 v 2 Credit Caro ccncle) VISA MASTER CARD DISCOVER
Balance Due upon Completion:
3 J 3 Account Minibei
Esl$'a Date S Est Frmsh Date 4,I'T Exp Date ( i Security Code: ( j
hate oaynoert tmino;to,gar xe FINANCING' Bank- D
t Approval Kiiatber
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-Rh!2i t "vaicn Y riot"iI,oxc aa'.e
Customer hos reviewed Product ejilfra gs end het been made of g/ats loss her occers with the inAollotbn of reprdcemm, id,_
✓: ThliApgimCntW4lU0kS N 3 ; 11CUSTOMERpPfpotulhTAlor
/r Drsposa'v"I air di::un,!i and dean uD of aD jGD-related CripnS •u!•„a,!;:;rig aid w s41'f❑yg o!Mnticea.Am or walls
n:>Iainrs e•il cave s,rkipWS[lea,of smut es a'a h sprints 'l. tpi p
'x]e � r^::`�abl;.'!'dr+r'.".Cis dr:aY aa:o nvL10N5 (KrO installation
An)Duilong Demiis iewred by tD,vn fry wttldew anu doot tnslanau0n t. 'tY.•tangval of feansiallaton bt any existing alarm systen-e Customer to Call alarm x
�Ar•'y Lead-sate wort practices it applicadle as teoulfed my RI State Law ,! 1he removal and temstailation of any wj dow AC units unless crocked Delow
„� Q.ni1!�•esttive d!#rerr,4em wrtrP.r ACunmis,
Customer aAays Renewal by Arniersen Io use pnotogfafNts ill t+mtea:Di nt:,re —,+ �e:e+nd.ar A:W remsWlabon of tit dew trea•Jnems S oractets umess cned.eo DCIOw
malYe'bd materials �.) �SAtP•anwre and mnsaa wrndaw rrea'.•�3,vs3dnr:t:s
I s rgroeu ay Iv,rerw Iv, me panes[net inis Apeer'eruof 5f.,wte,dog AVn we P•u ell JYt'i'ivi,,V t,2.a'+•.�rn1R?r57dryryT,'li.-ASP@n u'le(F::ras a'10IrgrC ere NU Y�AfiA1 d^aen:;crtnys
ule!wng dr rnoddy ng;ne tenru of rhs Agreement A,rrJbsens7 nereDyec:rw,r!edgeJ!ha; ftourchase,ts)ras read rhe:navendmversa olat¢agreement and pas reces'eda mmak:e sgnecane dated Cry
r'+a Agreer vwArcn mNWes Me Ndre or CanoeNarron�saucrsNrA bebw.ontheoah)FAwrdree Pbmt mid 2)wes oraeyin'u iofourtmr1s)o9m;ocancefdus PansawrA Pu.•A&ier(s)and RMesA!cy
•trdwrsai myrde il:f!;n'a AgfCCmen1 pncrndJ,g Pe Pfgmcr soeu5Ca w Sleet And a,a.^c'cnen'dnis)S in,ine!er,relwi^Cr 01a ayreerru,t eM rs the re'MNek arc dr:.me slarement rif Our!elms erN cor adlys of
.•nl,igre<•,ie;13^d Supe,ceoes ee agr,mr xin s L^.]C'.1N•;�nrg`M OC t:,iSars,wPeme,Ol..V,wf1(eP f"`N:n^r;twraln(•;'ner:<fi,;t:.-r.•„r^93er,2mert Tn,r agreernM!r.,ay rtN:+?nKKkRBC nr alrtendaC el<e:r<+
erAtig ilgnap ey'?J4ntlse'IS!ape Al•I+i•WAr l:J l.^derSa'1
•Sicyte any•Zva la,:bFlG,ic�t-V'u�I LeN_ez lM:arw:'rerca i.MAtv,M:es:a:Ll',fr.::,,sAN'-ily aMi;ua,ar""'ir+✓S of NAat tCt'AM8 d'p, lb,6$Ue:5:ect,f'W
DO NOT SIGN THI5 AGREEMENT IF THERE ARE ANY BLANK SPACES.SEE REVERSE SIDE FOR TERMS AND CONDITIONS OF THIS SALE.
PURCHASER r PURCHASER..n.. CONTRACTOR SPECIALIST <
ynafur_ 547naWle
-nabne
1_�-0-4r,4 u. �w fL tis SS,--,ri
Print Nam, Pint Nate pill!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 NOTICE OF CANCELLATION FORM BELOW FOR AN EXPLANATION OF THIS CONSUMER RIGHT.
There will be a service charge of 1011e of the Agreement amount it the lob is cancelled by Purchasers)AFTER the third business day.but BEFORE materials
were ordered.There will be a service charge of 33%of Agreement amount if job is cancelled bu Purchasers)AFTER materials are ordered.
•---•'..-....--•............................._.......-.•-•-------_..-_..-....._..--•---......--__------------.--_ ------------------• ....
Notice of Cancellation Notice of Cancellation
DATE OF TRANSACTION: -J-.,_ `/ L- DATE OF TRANSACTION:` Ej.-.,;L3-J.Z
YOU,THE BUYERISI,MAY CANCEL THIS TRANSACTION,WITHOUT ANY YOU,THE BUYER(S(,MAY CANCEL THIS TRANSACTION,WITHOUT ANY
PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE
ABOVE DATE.IF YOU CANCEL,ANY PROPERTY TRADED IN..ANY PAYMENTS ABOVE DATE.IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS
MADE BY YOU UNDER THE AGREEMENT OF SERVICES,AND ANY MADE BY YOU UNDER THE AGREEMENT OF SERVICES,AND ANY
iNEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN NEGATIOBLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN
10 DAYS FOLLOWING RECEIPT OF THE SELLER OF YOUR CANCELLATION 10 DAYS FOLLOWING RECEIPT OF THE SELLER OF YOUR CANCELLATION
NOTICE.AND ANY SECURITY INTERST ARISING OUT OF THE TRANSACTION NOTICE,AND ANY SECURITY INTERST ARISING OUT OF THE TRANSACTION
I WILL BE CANCELED IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE WILL BE CANCELED.IF YOU CANCEL.YOU MUST MAKE AVAILABLE TO THE
SELLER,AT YOUR RESIDENCE,ANY GOODS DELIVERED TO YOU UNDER SELLER,AT YOUR RESIDENCE,ANY GOODS DELIVERED TO YOU UNDER
THE AGREEMENT OF SERVICES;OR YOU MAY,IF YOU WISH,COMPLY WrTH THE AGREEMENT OF SERVICES:OR YOU MAY,IF YOU WISH,COMPLY WITH
THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT
OF THE GOODS AT THE SELLER'S EXPENSE AND RISK.IF YOU DO MAKE OF THE GOODS AT THE SELLER'S EXPENSE AND RISK.IF YOU DO MAKE
THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT THE GOODS AVAILABLE TO THE SEVER AND THE SELLER DOES NOT
RETRIEVE THEM WITHIN 20 DAYS OF THE DATE OF YOUR CANCELLATION. RETRIEVE THEM WITFUN 20 DAYS OF THE DATE OF YOUR CANCELLATION,
YOU MAY RETAIN AR DISPOSE OF THE GOODS WITHOUT ANY FURTHER YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER
OBLIGATION.IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE OBLIGATION,IF YOU FAIL TO MAKE THE GOODS AVAILABLE To THE
SELLER.OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND SELLER,OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND
` THEN FAIL TO DO SO,THEN YOU REMAIN LIABLE FOR PERFORMANCE OF THEN FAIL TO DO SO,THEN YOU REMAIN LIABLE FOR PERFORMANCE OF
ALL OBLIGATIONS UNDER THE AGREEMENT OF SERVICES. ALL OBLIGATIONS UNDER THE AGREEMENT OF SERVICES,
TO CANCEL THIS TRANSACTION,MAIL,FAX.OR DELIVER A SIGNED AND TO CANCEL THIS TRANSACTION,MAIL.FAX,OR DELIVER A SIGNED AND
DATED COPY OF THIS CANCELLATION NOTICE,OR ANOTHER WRITTEN DATED COPY OF THIS CANCELL,4TION NOTICE OR AND THERWRLTTEN
NOTOE STATING THE SAME,TO:RENEWAL BY ANDERSEN.I137 PARK NOTCIE STATING THE SAME.TO:RENEWAL BY ANDERSEN.1137 PARK
EAST DRIVE,WOONSOCKET.Rt,02895.FAX 401-671-6262, EAST DRIVE WOONSOCKET,Ill,02895.FAX 401.671-6262,
NO LATER THAN MIDNIGHT OF: b—9 w L (date) NO LATER THAN MIDNIGHT OF: 6•-,?-7—J.(/-. (date)
I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION.
DATE: _ DATE:
P t u,,u rr VM-t!nr•,nM1 tr m r rtl•,nt Post!o,?!J?;,>l
.t r'r'1[-rrnv <aA t,tIO,INPn( .,r:(r tltY(•..< ,/1".Cq,n Pr-e
i
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Office of Consumer Affairs ntA I msctvss R ;ulation
Boston, Missachusem 02116
Home Improvement 06mractor Re gisraat.ion
�� •. TyaFF. �rit'.� GcrPcx�al;��
EX&MIM 7*4ja 013 W 2I M 1 t
MOON ASSOC INC . �i.4, , i
JAMEs MbdN r-y
113! PARK,I=AST DR ' ° f
WOONSOCKET, RI '289S
r ,
Update A.d4ms and vv;nro tvrd.Mark reason fer cAaa;e-
j Address ; RtttMA ErWOU}k-MI at I..ust Card
USPirt b>"coosnra�rl\'�ri�`n�u��ncci E1i�uGY�v l.icepse or regislratiaa VOW Cox 6�iIch9nl nsc or�G+
HOW IMPROVEMENT CONTRACTOR before the eipiraPiou dot.. Ir lucitid reFuvtt to:
Registrstiost: S0535 Type: Office etfo'surn,4-Af�aiv3 and tiocin¢ss Regaiadier-
Pipiratior-, 712V2J13 Pmatti!Carparabon Id Part f lua-Suite g17p
Boston, A 02116
\9,30.1SSOC,INC M
JAMES WON
9137 PARF EAS1 OR ` 4 ✓.rs
11rCxQtvSt1CKE1 F?02$34 t oJerurrrtary '' Net intal tvulwni ssf�aatara
Massachusetts Deponmt►r)1 Of Public sa�teYy
Board of ®uttding Raguiattons and stendarcis
t
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1.teellSo' CSSL4)SMQ !
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48 PAINE RW e
Cumbtriandju
C�tttrrN3 storll!r E x ptr ttt to n
03173MOU
F'iflsirlCtotf `To CSSI-WS-Windows end Siding
CSSI.•RF o Roofing
f
Failure to possess Q current edition of the Messaohusans
State Bultding code is cause for revocation of this ltf: nse. ,
kw UPS Ueenring Info#matron oin ww*.M4ass.G0vjUvS
IOPID:JV
CERTIFICATE OF LIABILITY INSURANCE F °"; °" "'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THM
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 INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT: M the cortfllcAp holder Is an ADDITIONAL INSURED,the polWles)must be andolsed. N SUBROGATION IS WANED,subject to
the terme and conditlona of the policy,certain policies may require an endorsement A statwnent on this certificate does not confer rights to the
cartMcab holder In lieu of ouch endomem s
P11ODUC6L 4014s9.9W0
Hunter Insuritnce,Inc. 401.7 rNDR! PAX
31M Old River Road P.O.Box 1
Marnrine,RI 02e36-a001 A
MOONA 1
DISURM111 AFFORDNOCMRAOG NAI6a
IrsuRED litoonAasociates Inc. INSURERA:Nadonal Gran -Insurance Co 14788
Renewals By Anderson mswm a:Beacml Mutual hnurance,Co.
1137 Park East Drive
Woonsocket,RI 02895 01�LSUR411 M1110:
tr D:
USURER!
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED EBOW 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 POLKfCFES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUCES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN TYPIOFIN%URANC!
POLICY NUIle9lAham LaaRTt
Da NaRAL I LGL rY EACH OCCURRENCE S 1,000,0
A X CONMER=GENERAL LIABILITY MPSM19 09118H1 09116112 pgEpamlE.2530m, i 60010
CLAIW MADE ❑X OCCUR MED EXP(Am a*pe on) 4 10,001
PERSONAL&ADViNAW a 1,000,0
GE#ERALAGOREGATE S 2,000,0
CRL AGGREGATE LWr APPLIES PER: PRODUCTS-COMPIOPAGG 3 2,000,004
17 POLICY o LOG $
AUTOMOBILE LIABILITY COMSINW SINMELIMIT(Ea=d*M) ! 1,000,
A X AHYAUTO SIS26819 09116/11 DR/16l12 BODILY INJLR2Y(Perpun) I
ALL OWNED AUTOS BODILYWJURr(PeracddmO i
SCHEDULED AUTOS PROPERTY OA&ME S
HIREDAUTOS (Peremd rA)
NON-OWNMAUTOS 6
S
u MELLA UAe X OCCUR EACH OCCURRENCE s 11000,00
A E(CEaauAB CLAIMS�iPAE CUS26619 021101 09MG112 AGGREGATE t
DEDUCTISLE S
X RErENTIoN s 10000 s
WORKER4 COMPENRAr" WC STATU• OTH
AND EMPLOYPRS MILm
B ANY PROPRIErOMPARTNEREXECuTNE Y� NIA WC 47 731 830427 1o/o1111 IMM2 E.L.EACNAcaDeNY a 300,00
OFFICERi4E1 ndktWy NljEXCLUDE07 EL.DISEASE-EAEMPLOYE S SOOAO
ff ,dtrar'D►:tltlar
IPTI N OF OPERATIONS below E.L.DISEASE-POLICY LMIT I S ,��
pE3CRP170NOPOt6GTlONStLOCATIORSJVEIifCLE®(Aftds"arm IN.ModaulMrmft&WOkiRmmaMmtor"alme
CERTIFICATE DER CANCELLATION
DEPARTMI
SHOULD ANY OF THE AttOVE DE5CRIND POLICIES BE CANCELLED BEFORE
THE EMRATION DATE THEREOF, NOTICE 1MLL BE DELIVERED IN
Department Of Administration
Department
ACCORDANCE VATH THE POLICYIONS.PROVIS
Contractors Reg.Board
One Capitol Hill AVrdONOWMWFMCKTATNE
Providence,RI 02908
01191111-2009 ACORD CORPORATION. All rights naerved.
ACORD 25(9009102) The ACORD name and logo am registered marks of ACORD
Town of Barnstable *Permit#
r ' Fxphw 6 monthtfrom issue date
z BAFJWDJ= ? Regulatory Services Fee
""SS' Thomas F.Geiler,Director
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
office. 508-862-4038 - X-PRESS PEP-%
Fax: 508-790-6230
EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY -AUG .n 7 2003
Not Valid without Red X Press bnpnxt
>/parcelNumber TOWN OF SARNSI"hu-',
,=ty Address IqT. 1Q wVPv Hill O'd
kesidential Value of Work
ner's Nance&Address_ .o.� �Aus..V.
tractor's Ngme �A(e��l i- Telephone Number 7`JS �eT �/�
ne Improvement Contractor License#(if applicable) e 4 to.
a
istruction Supervisor's License#(if applicable)
Vorkman's Compensation Insurance
one:
I am a sole proprietor
❑ am the Homeowner
(rl have Worker's Compensation Insurance
Qance Company Nam 'Tlt�✓r.(.r` 'S
rkman's Comp.Policy# / X-I �LOA19AA_')
mt Request(check box)
❑ Re-roof(strip*g old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
•Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
lature
' � � �/ze �o�rvina.uoeall/ o�.�aaaac/zuaella
Board of Building Regulations and Standards
o i HOME IMIrRqVEMENT CONTRACTOR
Registry on:_�36066
Ex ration-=61 /04
.;i i �
COREY&COREI��F,iOI�ilt� 0
MRLES COREY � �%
73 LAFRANCE AVE.
HYANNIS,MA 02601
Administrator
I
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