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HomeMy WebLinkAbout0025 DAISY HILL ROAD 6i�.n! � i�`� �. �� I I i �,j I�'� i ,� il� '.I 1 Application Number.................................................... Section 5—Detail Cost of Proposed Construction tLS—Wti I Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design. Section 6— Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District - ❑ Old Kings Highway Debris Disposal Facility: I am using a crane C Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8 — Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. r Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks' Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No ,l Last updated: 1/31/2020 �TlIE Application Number......1�..� ..:.. ...c�. ............ _ BARNMABLE, _ 1. 1..:.. � MASS. Permit Fee...... .....Zoning District........................ Total Fee Paid........ TOWN OF BARNSTABLE Permit Approval by..: ..D..............onl.-d.`"N. ad BUILDING PERMIT M �—g ...�..........Pamel......... ................. APPLICATION Section 1 — Owner's Information and Project Location Project Address S (-* Village [� S Owners Name Owners Legal Address City ry ry L S State 0) Zip Q Owners Cell # E-mail Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Q Ce Single/Two Family Dwelling �Z Section 3 — Type of Permit m Q® ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ® Sprinkler tem W ❑ Renovation ❑ Retaining wall ❑ Solar z C o r Renovation ❑ Pool El Foundation Only M � 0 Other— Specify_ ; w co o Section 4 - Work Description o M 61 r`' Y�1 r N f Last updated: 1/31/2020 10/14/20?0 Details Licensee Details Demographic Information Full Name: EVERETT R ELDREDGE Owner Name: License Address Information City: Harwich State: MA ipcode: 02645 Country: United States License Information License No: CS-010614 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 6/1/2020 Issue Date: 5/27/2010 E)piration Date: 5/27/2022 License Status: Active Today's Date: 10/14/2020 Secondary License Type: Doing Business As: Status Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents https:Hrnadpl."i cense.comNerificatiorVDetai ls.aspC?result=165dOfcb-2e94-412e-bd53-8a2dab3c22ce 1/1 The Commonwealth of Massachusetts Deparbnent of IndusbWAccidents Office of Invesilgadons . 600 Washington Street' Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Buffders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Businessiorganizwon/individual): AI� Co Address: :nl ( . City/State/Zip: fln rc-&V : Oa Phone M Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I a employer with- 4. I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling shipand have no-employees These sub-contractors have g, ❑Demolition , workingfor mein act employees and have workers any capacity. gyp. _ 9. ❑Building addition (No workers'comp.insurance insurance.: 10.❑Electrical airs or additions required.] 5. We are a corporation and its repairs 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right o exemption per MGL myself[No workers ihtf ti comp. 12.0 Roof repairs insurance t c. 152,§1(4),and we have no ] employees.[No workers' ME]Other comp.insurance required.] *Any applicant that chocks box#1 mast also fill out the section below showing their workers'compensation policy iaformadon. t Homeowners who submit this affidavit indicating they am doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-outractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c under the pains an ofperjury that the information provided ab is true and correct Si mature: Date' C77 Phone#: V—t a• Oj,ficial use only. Do not write in this area,to be completed by city or town ofj'icia[ City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an emM/oyee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs perms to do maintenance,construction or repair work on such dwelling house or on the grounds or building appmtenai t thereto shall not because of such employment be deemed to be ea employer." MOL chapter 152,§25C(6)also states that"every state or local licensing agency shad withhold the issuance or renewal of a license or permit to operate a business or to constrict buildings In the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MOL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the pea kninance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contracto (s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confnmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple penuit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Depaftmd of Industrial Amidemis Office of Investlga&= 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877 MASSAFE Revised 4-24-07 Fax#617-727-7749 wwwxaLw.gov/dia 10/14/2090 Office of Consumer Affairs&Business Regulation-Mass.Gov t ass.g oy Office of Consumer Affairs Business Regulation (OCR ) HIC Registration Complaints Registration 183505 Registrant EVERETT ELDREDGE DBA MALABAR CONSTRUCTION Name EVERETT ELDREDGE Address 29 BIRCH DRIVE City, State HARWICH, MA 02645 Zip Expiration 10/20/2021 Date Complaints Details ,No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. hops://servi ces.oca.state.ma.us/hicl icdetai Is.aspx?wsearchLN=183505 1/2 I� ♦A Application Number........................................... Section 9—Construction Supervisor Name RVI L� 1-5:D36-03 Telephone Number Addressaa 51P.,C R, City RW CH State lt�- Zip License Numberal License Type Expiration Date Contractors Email L:LlO 6 0 9 L,. MA 65 w2 Cell # I I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation fired by 780 CMR and the�wn of Barnstable.Attach a copy of your license. , R Signature Date Section 10—Home Improvement Contractor �. Name Telephone Number s Address City State Zip Registration Number _l&3 Expiration Date ­(_(1 lad I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation q ' ed by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C.:. n Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor tin accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Si afore Date P� - Q Print Name �L�yQ� �t 1��t7Ujn6i Telephone Numbe Glr� E-mail p ermit to: �`� L(J 4gj:- d� (� ��l ��'��r �G'm < <r ,� Last updated: 1/31/2020 Section 12 — Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approvak Section 13 — Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: j { (Address of j ob) ignature of Owner ate �. 1 Print Name Last updated: 1/3 l/2020 � ,. Town of Barnstable Rdin _-I Bul 9 Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted Until Final Inspection Has Been Made. �e � 1L Jl Mo+ Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. ICICIl"IlIl Permit No. B-20-990 Applicant Name: BRIAN DENNISON Approvals Date Issued: 04/10/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/10/2020 Foundation: Location: 25 DAISY HILL ROAD, HYANNIS Map/Lot: 326-095 Zoning District: RB Sheathing: Owner on Record: CLEARY, DONALD J TR Contractor SOUTHERN NEW ENGLAND Framing: 1 WINDOWS LLC Address: 25 DAISY HILL ROAD 2 HYANNIS, MA 02601 ----- Contractor License: 173245 1 Chimney: A Description: INSTALL(9) REPLACEMENT CASEMENT WINDOWS NO Est. Project Cost: $28,592.00 l Insulation: STRUCTURAL � Permit Fee: $ 145.82 INSTALL( 2) EXTERIOR ENTRY DOORS NO STRUCTURAL Fee Paid $ 145.82 Final: Project Review Req: Date: 4/10/2020 Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within s months after issuan2. icia Final Plumbing: h a roved construction documents for which this permit has been ranted. Rough Gas: All work authorized by this permit shall conform to the approved applicationand t e pp p I; All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) . Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT _ e� Town of Barnstable Building Post Th�s;CardxS�o°'That rtw sU�sible Fromthe:Street-A roved.Plans Mustbe;Reta�ned on Job and this Card Mustbe'Kept i- v4xxSCABLLT. ' .f„ ',�Y;^.Faa '�"�'`;. �;' %'^ ,c ';. � F. ,, si PP � T � �, � � � s. � '�, � ��,,, M^� Posted Until Final Inspection�Has Been Made 4Permit i639, tW�here a Certificate afOcc panty sRequiredsu h Buildngshall otbe Occupeduntil a Final Inspection has been made Permit NO. B-19-386 Applicant Name: RetroFit Insulation Approvals Date Issued: 02/06/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/06/2019 Foundation: Location: 25 DAISY HILL ROAD, HYANNIS Map/Lot: 326-095 Zoning District: RB Sheathing: Owner on Record: CLEARY, DONALD J TRa Contractor Name RETROFIT INSULATION INC.- Framing: 1 Address: 25 DAISY HILL ROAD Contractor Ucense 160461 2 HYANNIS, MA 02601 � � . �� Est Protect Cost: $3,000.00 Chimney : Description: Crawlspace-10 ml poly over open ground,Weatherstrip door kit& Perm�t F e: $85.00 sweep,Crawlspace Wall-R10 Rigid Board, Insulate Rwkhead Door, � o Insulation: Basement Sills:R19 Fiberglass Batts Fee Paid $85.00 g 2/6/2019 Final: / e Dat Project Review Req: 3 " Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author zi edby this permit is commenced within six'months aft""r issuance. All work authorized by this permit shall conform to the approved application ancl#e^bpproved construction documents;fo hich''this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall b'e in compliance with the local zonirigzby laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspe cttiion for the entire duration of the Final Gas: work until the completion of the same. , 11�1'13 N`3 IT 7 eAlf � Electrical The Certificate of Occupancy will not be issued until all applicable signatures b`,the Building and ire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing is .• Rough: 2.Sheathing Inspection ' ` ? ; K ?• g_ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: 4 Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 14444k Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 1 Town of BarnstableBuildin Post Thu Card SoThat�t�is Visible From the StreetApprovetl Plans Must.be Retained on Job and this Card Mustabe Kept i •AILNSCAYL6. - �.� r v s" Posted Until Finalxlispection Hates Been�Made _ h ®4 -Qp 39.a1. , e r v l+la, Where a Certificate of Occupancyis Requred,suchBuildmg shall Not be Occ' ped until a Final Inspection hasybeen made Permit No. 6-18-3914 Applicant Name: RetroFit Insulation Approvals Date Issued: 11/28/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 05/28/2019 Foundation: Location: 25 DAISY HILL ROAD,HYANNIS Map/Lot 326 095 Zoning District: RB Sheathing: pq Contractor Name RETROFIT INSULATION INC. Framing: 1 Owner on Record: CLEARY,DONALD J TRH g ! = Address: 25 DAISY HILL ROAD ' z Contractor License:,160461 2 ; ...,., " HYANNIS, MA 02601 } u! Est% 4ect Cost: $2,738.00 Chimney: Description: Crawlspace 10ml poly ground cover,Weatherstrip Door&Add Permit Fee: $85.00 Sweep,Crawlspace Wall R10 Rigid Board, Insulate Bulkhead Door, insulation: Fee Paid $85.00 Basement Sills: R19 FG Batt °: Final: Date 11/28/2018 Project Review Req:- Installers certificate required to close permit Remove ally debris from crawl ; Plumbing/Gas i Rough Plumbing: 74 Building Official v > Final Plumbing: Rough Gas: Nz -Final Gas: Y This permit shall be deemed abandoned and invalid unless the work authorizes permit is commenced within sixmonths after$ssuance.d b thi All work authorized by this permit shall conform to the approved application and the-approved construction documents'for-whichit 11 his permit has been granted. Electrical All construction;alterations and changes of use of any building and st uctures shall b�p compliance with the local zoning;by laws and codes. This permit shall be displayed in a location clearly visible from access street or,road and:,hall,'be maintained oper;for public�nsgection for the entire duration of the Service: work until the completion of the same. Rough: ti The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire OOfficials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Final: 1.Foundation or Footing 2.Sheathing Inspection Low Voltage Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 7.Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). of �ti Town of Barnstable O Ekpires 6 manilrs from issue dare ; t .I Regulatory Services Fee NAM Richard V.Scati,Director r� Building Division APR 0 4 2018 Tom Perry,CBO,Building Commissioner TOWN ��� 2fl0 -fain Street,Hyannis,MA 02601 TO �9 www-town.bamstable-ma-us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid witlrorit Red X-Press Imp►nt i-lap/parcel Number Property Address r (Residential Value of Work S_1 Z, / 3 Minimum fee ofJ$35.00 for work under$6000.00 Owner's Name&Address C( . Clear Z Z s— i`s y ; 1 ( ��O, 1-1 van,1 t'S MA nz(,2o I Contractor's Name ^ n�v„J r�/i ! rSo ( .Telephone Number[L{O 1 2-Z FjTQ'6 [Tome Improvement Contractor License f(if applicabie) 17_2 4 5. Email: Construction Supervisor's License#(if applicable) (2q-5 7 O 7 MWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I m the Homeowner Ltr I have Worker's Compensation Insurance Insurance Company Name F;f a t23&_ n !,- In-s tj Woo,e 4a Workman's Comp.Policy# W C 8 315R 7 2-9 — 2 o Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane Waited)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ R�-side eplacement Windows/doors/sliders.0-Value • 2-67 (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 olthis permit does not exempt compliance%.%4th other town department regulations,i.e.Historic,Conservation,etc. ***Note: PrqpertykOwner must sigh Property Owner Letter of Permission. A copy cAthe Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\iiticrosoft\Windows\Temporary Internet Files\Content.0utlook\21`10I DHR\EXPRESS.doc Revised 040215 1 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England Y g Donald Cleary A�. Legal Name:Southern New England Windows,LLC 25 Daisy Hill Rd RI #36079,MA#173245,CT#0634555, Lead Firm#1237 Hyannis,MA 02601 wiNDDw 10 Reservoir Rd I Smithfield,RI 02917 H:(508)778-9177 Phone:866-563-2235 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Donald Cleary Contract Date: 03/21/18 Buyer(s)Street Address: 25 Daisy Hill Rd, Hyannis, MA 02601 Primary Telephone Number: (508)778-9177 Secondary Telephone Number: Primary Email: djcbu49@comeast.net Secondary Email: 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: $12,130 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: $4,042 Balance Due: $8,088 Estimated Start: Estimated Completion: Amount Financed: $0 7-9 weeks 7-9 weeks Method of Payment: Cash/Check 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: 1/3 deposit,1/3 at start,1/3 at completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the 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.Buyer(s)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 03/24/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Rene I B n ersen Southern New England Buyer(s) Signature of Sales Person Signature Signature Paul Sandrey Donald Cleary Print Name of Sales Person Print Name Print Name UPDATED: 03/21/18 Page 2 / 10 r r a:d Business Re, ation �� - ��ae ai,C®l�suer Affairs r --_ 10 Park Plaza - Sete �170 Boston, Massachusetts 02116 1E o e er r®ver t Ccatraator Reg stratIo Registration: 173245 Type: Supplement Card Expiration: 9/19/2018 SOUTHERN NEW ENGLAND WINDOWS LL BRIAN DENNISON = 25 ALBION RD LINCOLN, RI 02$55 Update Address and return card.Mark reason for change. Address — Renewal = Employment = Lost Card Office of Consumer Auff2irs&Business Rea►lat➢on ReD stration valid for individual use only before¢lte _ expiration date. If found return to: HOME iPAPROVE�ET CONTRACTOR of Consumer Affairs and Business Regulation zoq Type: 10 Park Plaza-Suite 5170 Registration: 173� 5 Expiration. go912l 18 Supplement Card Boston.M,4 02116 SOUTHERN NEW ENGIAND VONDOW S LLC. \J RENEW AL BY ANDERSON BRIAN DENNISON �,- 26 ALBION RD Not valid without signature LINCOLN, RI 02865 �-I:udersecretary - Massachusetts Department ofa d Standa:rd� 01C Safety Board of Building Regulations License: CS-095707 . S }eyws , BRIAN D DENNISON 7 LAMBS POND CIRCLEPRIM r.. CHARLTON MA -0150 ..ten Expiration: 09l0812Q18 Commissioner ,i The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 ' www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNIITTING AUTHORITY. Applicant Information Please Print Le 'bi Name (Business/Organization/Individual): E e kwz Address: City/State/Zip: Lwdp Phone#: 1P1 _ 2 L8= Q Reo Are you an employer?Check the appropriate boa: Type of project(required): 1�I am a employer with ZL employees(full and/or part-time).* [7.. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, Remodeling any capacity.[No workers'comp.insurance required.] 3. I am a homeowner doing all work myself 9. ❑Demolition ❑ g y [No workers'comp.insurance required] 4.❑I am a homeowner and will be hiringcontractors to conduct all work on m 10 Building addition y property`- d will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.! 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.2Other n 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'LAP Q f-e� *Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information if t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. !Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'camp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy dhd job site information. _ Insurance Company Name: 1!'e PletI $ APS. 69M Policy#or Self-ins.Lic.#: .W CA 31Se 7 z [ — Z 0 Expiration Date:- 7- Job Site Address: ZS L4t S,/ d; j�� City/State/Zip: n 3 Attach a copy of the workers'compensation policy declaration page(showing the policy number and eapii ation date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under th ains and penalties of perjury that the information provided above is true and correct T Signature: a Date: 1� Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12,29,2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT CoBiz Insurance, Inc.-CO PHONE FAX 1401 Lawrence St, Ste. 1200 •303-988-0446 AIc No)-303-988-0804 Denver CO 80202 nooRIESS: COMaiI cobizinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 - INSURER B:Firemen$Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. INSURER C:Homeland Insurance Company of New York 34452 dba Renewal by Andersen of Southern New England 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY CPA315BT28 1112018 1/12019 EACH OCCURRENCE S t.ODD,000 CLAIMS-MADE �OCCUR PREMISES SES(Ea GE TO RENTED ccccuE ence $30D,000 MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000.000 POLICY❑PRO ❑ LOC _ PRODUCTS-COMP/OP AGG $2.000,000 X JECT $ OTHER: A AUTOMOBILE LIABILITY N CPA3158728 1I12018 1/12019 COMBINED SINGLE LIMB S Ea accident 1.000 000 X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS N X NON-OWNED (PerPDAMAGE S HIRED AUTOS AUTOS S A X UMBRELLA LIAB rd OCCUR CPA3156728 1112018 1I12019 EACH OCCURRENCE_ $10,000.00D EXCESS LIAB CLAIMS-MADE AGGREGATE $10.000.000 DED X I RETENTION$n $ g WORKERS COMPENSATION WCA3158729-20 .1/112018 1112019 X STATUTE ERA AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT 51.000,ODD OFFICER/MEMBER EXCLUOI N I A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $1.000,000 ff yes.describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 51.000.001) C Pollution Uabirdy 7930073340000 1/1/2018 1112019 Each Occurrence S1.000.000 Claims-Made Policy Aggregate S1,000,000 Retroactive Date 06202013 Deductible S10,OD0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE I III ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Assessor's Office(1st floor) Map Lot ��f- '�P�t# Conservation Office(4th floor) Z qy-, Date Issued Board of Health(3rd floor)(8:30-9:30/1:00-2:00) Ab-tub, Fee , ® Q c Engineering Dept.(3rd floor) House#1 ��j' , -� C4�; ��Npp„OItA p 9 Planning Dept.(1st floor/School Admin. Bldg.) 0 0 &0�` • BARNSTABLE. ` Definitive Pla ved by Planning Board �^ 9 $ e 9 EO MA'S� TOWN-OF-BARNSTABLE Building Permit Application Project Street Ad dress Village Loj) Owner baNvt?_b eL �c�\ Address S bA- s W 1y/L�1_ k�_ Telephone 7 7 Permit Request RPA41 E, 5 C/_6 AA b tS ell L jb Total 1 Story Area(i decks square feet -°� Total 2 Story Area(total of 1st&2nd stories) i(/ square feet Estimated Project Cost $ p�, 0 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use WtAeff- 6�1 577A)G 50/t1 D --ec - Proposed Use Construction Type Commercial Residential 4 Dwelling Ty Single Fami Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House IVIj Unfinished Old King's Highway /�� -- Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name S016109v40_ DPA- t kwo,~ Telephone Number C3I lls5 l�o`���313 Address 79 F�2MAr'.¢ A9hb . License# G *V*7V VI- ah- 0�2d(31 Home Improvement Contractor# f 7 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 9hW17V GL2-_ SIGNATURE I C�` r DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) t FOR OFFICIAL USE ONLY - a 9309 y PERMIT NO. DATE ISSUED 7/2 5/;9 5 MAP/PARCEL NO. �`3 2 6 095 ADDRESS 25 Daisy Hill, Road VILLAGE Hyannis.` _ �IER - John E, & Mary E.= Fallon 5 �: i DATE OF INSPECTION: _ FOUNDATION Z r" FRAME41 D 1 ' INSULAFtIO ,; FIREPLA � '�. ELECTRICA 10, OUGH FINAL �MBING: UGH FINAL GAS: IGH FINAL FINAL BUILDING DATE CLOSED OUT • e ASSOCIATION PLAN NO. i i WJ co 00 U.Po�A1 5 C)Aj P�PCiK _ �� P-r ©&CK ovc LI-7ICr-- 3 Fp.Q oel r 9 � l ��. p _4F,-A\JYloll P.5 FtoFulu { I �l T Z po .f i I $`0 `M' 44 , P�RI 16 0C - IV lV v A*11v r S At A- O a-( O 1 lz 5 Q-- /ll G/ O 5 UG► r,,� lV&U) 5C-c 4-W- AJ rS�1NG F/1,L <Av oP�� �,P�2s f�{o n O &400.SE D sg-Y (.E�G� h iq��(lblrfU�S /�l�- Qa6o l THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA � •��y" — .n..p.¢..r i:f z 3Ji�''.,",. ,+Ft:{��� ✓.4ti v1�L �✓�'-✓,3...�.,�:iG2�.':'?"t..., • CONTR�i(,'TQRS +IK4 tsI . f Air swa-d of Mulations and Standards + ExpirationL/a., r Type e i •i Y • f{ v =err EVs's =k7 r Pt 7Y151J r ' e ^-e-a C Tl` 61 Fulcra G i t r rf7 If 're+ +i i+ �� t.-7' xY ';f r Y°6? �1°. ;ac 'P3,. t`";,� 1 i -.� s ar ..�. .fit,}+ a5- .. .35.J .d E'a"and; JE EFFE0T-V E r/,c'a'_' _{�i- IJ. �-(�f � .e TP gym.,....... -""e'e:. ..,. ? .. T , RiAT D" £ta EEMD • WP 4 r a1 e .,NFTL .n . .kr.a JI,F_ J r r ea Oil r F TIE HOLDER WHILt, x4, ef OTLr'cR� A(Gtir Tnt+ao..,;>+:1 S CJ-.a�.•.,yi .., r s -N 7 -P n ,.'L..•f' rc�' r �J; e Ted! C27 DEPARTMENT OF PUBLIC SAFETY ONE ASHBURT,ON PLACE, RM 1301 60570NA; tIA 02106-161£3 CONSTRUCTION SUPERVISOR LICENSE ? Number: Expires � Restricted To 00 it JOHN K OROURKE w^ Oetich bottom, fold sign on 163 MAIN ST POBX 272 buck, and laminate license card. YARMOUTHPORT, MA 02675 ;, —" �, Keep top for receipt and change Hof address notification. _ 07. Panvnzareuieall�c a�./l/laaaac/uraetta Restricted To: 00 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION.SUPERVISOR LICENSE 00 - None Number: Expires: 1G - 1 & 2 Family Homes Fariare to pe.ssaras a current Restricted To: 00 Aeaasaanu�atr*,°c++ol�1w� �ra, Cade le csv,ac for revocation JOHN K OROURKF of this/:Canso. � �� 168 MAIN ST PO8X 272 YARMOUTHPORT, MA 02675 f tz ot��►o , . . . . BAPJMM the Town of Barn ible KAS& tee$ Department of Health Safety:and Environmental Services 1659. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 , Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: T2EP -to—F— j Est.Cosh Z �� Address of Work �- Owner Name: Q Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work exclu by law Job under 1,000 Buildi not owner-oocupied Oti r pulling own permit Notice is hereby given that: ' OWNERS PULLING THEIR OWN PERMIT O EALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's name 11%02'94 17:02 *&61772.77122 DEPT IA'D ACCID Q001 Conunoiuvea tli o WaJJacla..udetb aU�artntertf o�J'rtdu�tria[„�lcccden� 600 Wuk�Vton Shy l /� * aeac lte 0211 f James J.Campbell Uoston, a Commissioner Workers' Compensation Insurance Affidavit 1, �o ffk) Q v lro�& (Qomtcrlpe:miate) with a principal place of business at: 7, Fes-0t ov 7 4 20 M> CIA-AIiI IS MA-, (GLY/so"izip) Xeby certify under the pains and penalties of perjury, that: I am an employer providing workers' compensation coverage for my employees working on this job. #101 cAk) f dz-1 ` G / (A1CC 217; 7- Gf-�y Insurance Company Policy Humber 0 I am a sole proprietor and have no one working for me in any capacity. 0 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/P i Number Contractor Insurance C96h,pany/Policy Number Con actor lnsur ce Company/Policy Number 0 l am a homeowner performing ail the work myself. I understand th:t a copy of dais s:aternent will be forw=rded to the Office of Investir2tions of the DiA for coverage verification and that failure to secure cove-age is recjired under Section 25A of MGL 152 cal lead to the Imposition of criminal penalties consisting of a fine of up to s 1,500.00 and/or cr.- years' imprLonr.,ent as well as civil penalties in the for.of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this �j S day of ensee/Permittee =;; Building Department Licensing Board - Selectmen Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT #