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Home My WebLink About0048 CARLOTTA AVENUE Ll FV Town of Barnstable goy O Expires 6 nrorr!!rs from issue date Regulatory Services Fee d enuvsraata. Iq Richard V.Scali,Director �� Building Division40 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 /s'f®Z�.. www.town.barnstable.ma.us %,a _k' Q8-790-6230 el,Office: 508-862-4038 EXPRESS PE&MIT APPLICATION - RESIDENTIAL ONL I,' 461) 11 Not valid without Red X-Press Imprint Lfap/parcel Number Zo"1 A Properly Address �'r�� Ct �l t/� yCl/I ( S I [Residential Value of Work$ 16f, Z S?j 'Minimum fee oft$35.00 for work under$6000.00 Owner's Name&Address Aai o a, c.ar bt, R e-S N Ll �� JA Contractor's Name -, E 1,1 'n4/v,,J A-327/1 ( /rspl( Telephone Numbe 2— Home Improvement Contractor License f(if applicable) !' 7�2 44 S Email: Construction Supervisor's License#(if applicable) QCj �;_ 707 21"kman's Compensation Insurance Clieck one: ❑ I am a sole proprietor m the Homeowner I have Worker's Compensation Insurance Insurance Company Name F; r°am I")_Su a-,a�C�• Workman's Comp. Policy# tit{C 31 a 7 2-9 " 2—L Copy of Insurance Compliance Certificate must accompany each permit_ Y 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 roof) Pee-side Reeplacement Windows/doors/sliders.0-Value ' 2-9 (maximum.32)#of windows/Q #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance or this permit does not exempt compliance with other town department regulations,i.e_Historic,Conservation,etc. ***Note: Property Owper must sign Property Owner Letter of Permission. A copy cRthe Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary intemet Files\Content.Outlook\2PI01 DHR\EXPRESS.doc Revised 040215 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England Aaron&Carolina Lopes Legal Name:Southern New England Windows,LLC 48 Carlotta Ave RI#36079,MA#173245,CT#0634555, Lead Firm#1237 Hyannis,MA 02610 WINDOW NE LAOrMENr 10 Reservoir Rd I Smithfield,RI 02917 : - - Hi(774)487-2357 _ Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com {:7742122784 Buyer(s)Name: Aaron & Carolina Lopes Contract Date: 11/22/17 . Buyer(s)Street Address: 48 Carlotta Ave, Hyannis, MAD2610, Primary Telephone Number: (774)487-2357 Secondary Telephone Number: 7742122784 . • ctlo es2013@hotmail.com . alo esclo es@hotmail.com li Primary Email: P Secondary Email. p. p Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement").* Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $19,253 By signing this Agreement;you acknowledge that the.Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $9,626 Balance Due: $9,627 Estimated Start: Estimated Completion:. Amount Financed: 8 to .10 weeks 8 to. 10 weeks $19,253 Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date.Rain and extreme weather are the most common causes for delay: Notes: Depo gsky bai gsky tax Barnstable. Buyer(s)agrees and understands that this Agreement constitutes the entire understandings betweenthe parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will.be valid without the signed,written consent of both the Buyer(s) and Contractor:Buyers)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER:Do not sign this contract if blank.You are entitled to a copy.of the contract at the time you sign : YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 11/27/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEETHE ATTACHED:NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC. dba-'Renewal y Andersen of Southern New England 'Buyer(s) G Signature of Sales Person Signature Signature Cory Scanlon Aaron Lopes Carolina Lopes Print Name of Sales Person Print Name Print Name UPDATED: 11/22/17 Page 2 / 12 Massachusetts Department of Public Safety �l Board of Building Regulations and Standards WI; License: CS-095707 ` Construction Supervisor BRIAN D DENNISON 7 LAMBS POND CIRCuLE CHARLTON MA 01507 a Expiration: Commissioner 09/08/2018 f z20jMV" a/ eG - Office of Consumer Affairs and Busmess.Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improven e Contractor.Registration _ Registration: 173245 - - 1 = if Type: Supplement Card e Expiration: 9/19/2018 SOUTHERN NEW ENGLANDWINDOW_SsLL� BRIAN DENNISON ; `� 26 ALBION RD r� q..-- LINCOLN,RI 02865 Update Address.and return card.Mark,reason for change. scar 0 20M-05111 ❑Address Q Renewal Ej Employment ❑Last Card of Consumer Affairs&Business Regulation Registration valid for individual use only before the - expiration date.If found return to: OMEIMPROVEMENT.CONTRACTOR Office of Consumer Affairs and Business Regulation Registratlon-1l,f 5�. Type: 10 Park Pim-Suite 5170 iratlon `—Exp. 9/19/2D18;. Supplement Cab Bostou,MA 01-I16 SOUTRERN NEW ENGLAND WINDOWS LLC. RENEWAL BY ANDEPSONrr_ BRIAN DENNISON 26 ALBION RD IINCOLN,'RI 02865 LBhdersecr Not valid without signature r ` The Commonwealth of Massachusetts Department of Industrial Accidents 0 1 Congress Street,Suite 100 Boston,MA 02114-2 01 i www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information iv G Please Print Le "b write (Business/Orgarvzation'Individual): e Lj Lt1j Address: 2(a ALZiCAD 1U . City/State/Zip: P Phone 4: *1 - Are you ad employer?Check the appropriate box: Type Of project(required): 1.,K1 am a employer with ZO templovees(full and/or par-time).' 7_ New construction 2.❑I am a sole proprietor or partnership and have no employees working for me it! S. Remodeling any capacity.[No workers'comp.insurance required-1 9. ❑Demolition OI am a homeowner doing al work myself Rdo workers comp.insurance required.; 10 Building addition 4.❑I am a homeowner and wili be hiring contractors to conduct all work or:my proper:?'. I wilt ensure that aL'contractors either have workers'compensation insurance or are sole I I_Q Electrical repairs or additions proprietors with nc employees. 12.0 Plumbing repairs or additions 5.7 1 am a general contractor and 1 have hired the sub-contractors listed or.the attached sheet 13.RRoof repairs These sub-contractors have employees and have workers'comp.insurance.> t;.Elwe are a corporation and its ofacers have exercised the right or exemptior.per MGL c. 14.[�ther 1.� ✓� i,(4),and we have ne emplovees.f.No workers'comp.insurance requirec.j I t (-P�tLi--e/"\ e�t S 'Any applicant that checks box r1 must also fill out the section below showing then workers'compensmoc policy information. Homeowners whc submit this affidavit indicating they are doing all wort:and ther hire outside contractor-must submit a new affidavit indicating such. ;Contractors that check this box must attached ar.additional sheet showing the name of the sub-contractors and state whether or not triose entities have employees. Lithe sub-contractors have employees,they must,provide their workers'comp.policy number. I am an emplover that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: ire pie s fps. -UPMW . — Policy#or Self-ins.Lic.#: Expiration Date: O Job Site Address: q S CA(' kd A City/State!Zip: Ct S Attach a copy of the workers' compensation policy declaration page(showing the policy number and expira 'on date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51-500.00 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.A copy of this statement may be_forwarded to the Office of Investigations ofthe DLA for insurance coverage verification. 1 do hereby, certif} under ih ains andpenalties ofperju T that the information provided above.is true and correct 5i afore: a Date: 1 2 Phone# Official use only. Do not write in this area,to be completed by civ or town official ` City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Deparnnent 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: - ESLERCO-01 SANDERSO DATE(MM1D� CERTIFICATE OF LIABILITY INSURANCE Fos►07i2o17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 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 INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER PHONE _(303 988-0446 Fw,Not:(303)Z CoBiz Insurance,Inc.-CO (AIC,No,Bd-( ) 1401 Lawrence St,Ste.1200 E-MAIL COMaiI eobizinsurance.com Denver,CO 80202 ADDRESS: INSURERS AFFORDING COVERAGE INSURER A:Acadia Insurance Company INsuRED INSURER B:Firemens Insurance Com an of WA D.C.Southern New England Windows,LLC.dba Renewal by INSURER C i Libe Su lus Insurance Andersen of Southern New England INSURER D: 26 Albion Road,Suite 1 I Lincoln,RI 02865 INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR i ADDL SUBR POLICY NUMBER POLICY IDD EFF IP�DY EXP LIMITS L TYPE OF INSURANCE IN D WVD 1,DDO,DDD A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1l2018 DAMAGE TO RENTED s 300,000J CLAIMS-MADE FYI 01/01/2017 0110 OCCUR CPA3158728 PREMISES Ea occurren I ce c 5,0001 MED EXF An one erson - 1,OD0,000 - PERSOtJAL 8 ADV INJURY s 2,ODD,0001 GENERAL AGGREGATE 5- 2,000,OOOj GEN'L AGGREGATE LIMIT APPLIES PER: RODUCTS-COMP/OP AGG X ! POLICY❑JECT FI LOC P S EBL AGGREGATE s 2 OD0;000 I OTHER: COMBINED SINGLE LIMIT s 1,ODO,ODD� A AUTOMOBILE LIABILITY Ea acadent , { X ANY AUTO CPA3158728 01101/2017 01/01/2018 BODILY INJURY.Per erson s r iOWNED SCHEDULED BODILY INJURY Per accident s AUTOS ONLY AUTOS PROPERTY DAMAGE s HIRED NON OWNED, Per acutlent AUTOS ONLY AUTOS-ONLY 5 1,000,Oool A X I UMBRELLA LIAB X DCCUR EACH OCCURRENCE s - CPA3158728 01/0112017 01/01/2018 AGGREGATE s EXCESS LIAB CLAIMSaV1ADE Aggregate f s 1,000,0001 DED X RETENTION 5 0 . . X PER OTH- B WORKERS COMPENSATION STAT E FJ2 1,000,ODO AND EMPLOYERS'LIABILITY Y i N WCA3158729-20 0110112017 01/01/2018 E.L EA ACCIDENT 's ANY PROPRIETORIPARTNER/EXECUTIVE I NIA I I 1,000,000 �FFICER/MEMBER EXCLUDED? � E.L.DISEASE!EA EMPLO i 5 (Mandatory kn NH) 11000,000 If yes,describe under E.L DISEASE-POLICY LIMIT s 1,000,DDD DESCRIPTION OF OPERATIONS below B Worker's Compensatio CA3158730-20 01/01/2017 01/01/2018 117 01/0112017 01/0112018 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 17-18 Workers Compesnation Includes-All states except ND,OH,WA,WV,WY I I I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i THE EXPIRATION DATE I ACCORDANCE WITH THE PO THEREOF, CE WILL BE DELIVERED IN O O NOTICE I I i AUTHORIZED REPRESENTATIVE FOR Informiltonal P r 4D1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD