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HomeMy WebLinkAbout0032 TOWNHOUSE TERRACE 016 i 1. �4D4F P • Application number y � Date Issued........1.011113 .................................... °oe,A,Tmis rABt Lz ) ' , . i� wl �i391% OC Building Inspectors Initials.... ...... ................... k 19 Map/Parcel..., .GI..Q...../o..`7-61S...7 'A ,JFB'A 1 SIABLE S ............. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ' ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 3.2 T n�to.ls� / 3L NUMBER STREET VILLAGE Owner's Name: �-�,►, -- ;1f i ha r n a( t Phone Number_ Email Address: Is ✓e �i„g;/c,,,,, Cell Phone Number Project cost $ Z 3 (� — Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Sep A- 4 cl,\a Cad,..-("" Date: TYPE OF WORK Siding 1EE Windows (no header change)# I Insulation/Weatherization Doors (no header change)# Commercial boors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to o a sfe-/yw4 l g .r eA CONTRACTOR'S INFORMATION Contractor's name -SoO .ern Afe i r1J1,•n Jow S. Home Improvement Contractors Registration(if applicable)# 17 3 2-q.5 (attach copy) Construction Supervisor's License# M S`7 0: (attach copy) Email of Contractor $wee- 9 q I. C brn Phone number q01- 2 Z R - ROLE ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Vents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand any responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State wilding Code. I understand the construction inspection procedures; specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICANT9S SIGNATURE Signature A Date /0 All permit applications are subject to a building official's approval prior to issuance. NNEMO y IU MOST, COMMUNITY BUILDING 25 TOWNHOUSE TERRACE ........_H-,I Nws MA.02601_. Management Company'S08=3$5-9499 September 25,2019 To:Town of Barnstable Building Department Re: 32 Townhouse Terrace,Hyannis Please be advised that the Board of Trustees have given permission to Robert Desharnais to replace windows at Unit 32 Townhouse Terrace of the Pinebrook Condominium Association. Please contact the property,manager at 508-385-9499 should you have any,questions regarding this matter. Sincerely, Marti er Chairp.',son,Board of Trustees Renewal Agreement Document and Payment Terms AnAk-dersen. dba:Renewal B Andersen of Southern New England Y g Robert Desharnals Legal Name:Southern New England Windows,LLC 32 Townhouse Terrace ARM RI#36079,MA#173245,CT#0634555, Lead Firm #1237 Hyannis,MA 02601 WINDOW NE uCEMENT 10 Reservoir Rd I Smithfield,RI 02917 H:(508)778-0858 Phone:401-349-1384 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Robert Desharnals Contract Date: 09/25/19 Buyer(s)Street Address: 32 Townhouse Terrace, Hyannis, MA 02601 Primary Telephone Number: (508)778-0858 Secondary Telephone Number. Primary Email: desharnaisbv@gmail.com 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 dre'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: $2,396 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: $]gg Balance Due: $1,598 Estimated Start: Estimated Completion: Amount Financed: $0 8 to 10 weeks 8 to 10nweeks 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: Taxes paid in Barnstable, Ma. 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 09/28/2019 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: ken A,nderse ySouthern New England Buyer(s) i�l+"._""�27is�-v Signature of Sales Person Signature Signature Gino Montesi Robert Desharnals Print Name of Sales Person Print Name Print Name UPDATED: 09/25/19 Page 2 / 12 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Nome Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS, LLC ...: .`. Expiration: 09/18/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 SCA 1 :i 20M•05/17 Update Address and Return Card. • Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Suoolement Card before the expiration date. If found return to: Reaistration Expiration Office of Consumer Affairs and Business Regulation inz45 09/18/2020 s 1000 Washington Street-Suite 710 y SOUTHERN NEW ENGLAND WINDOWS,LLC Boston,MA 0211 f BRIAN DENNISON !,Q 10 RESERVOIR ROAD SMITHFIELD,RI 02917 Undersecretary " d� without signature . Y Common' weafth of Massachusetts Division of professional Licensure Board of Building Regulations and Standards Constr _ ttri Supe , -0970 = _ - fires: 09/08/202.0 BRIAN ® DENNISON 8 BLACKWELL DRIVE CHARLTON MA=01507 � ,r Comr ftsioner The Coi7tmvweafdg ofi�imiaclousetts Deparfbwnt of1n&statia1 Aecidents 1 Can&rQss;Stt'ee4 Suite 100 Boston,MA 0YI14;017 www.amass,,,r ov1&a A ur&ers' Compensation insurance Affidavit:Bullders/Contractors/ElectriciansMiLmbers. TO BE 1:CLED W1TIi THE PERNIlTI'LYG AUTHORM. Anolicant Information Please Print Legibly Name(Business/Organization/(ndividual): (,�' ��►� Address: � CiWState/Zi : M f n t°1�r�1 O� l7 (� = p � �'t't 4 Phone#: Are yea an employer*Check the appropriate box: Type of project(required): 1.41411 am aemployer with ;W'I"empioyees(full andlor part time),° 7. []New construction am a sole proprietor or partnership and have no employees working for me in &: Remodeling any capacity.[No workers'comp.iasur3nce required] ❑ 3. I am a homeowner do' all work m self 9• ❑Demolition ® doing y [No workers'comp.insurance required.].* 4.C]I am a homeowner and will be hiring contractors to conduct all woriton my Property. C will 10®Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.[ Plumbing,repairs or additions S.®I am a-Meral,contractor and I have hired the sub-contractars listed an the attached sheet. These sub-coatractors have employees and have workers'comp.insurance.: I3.®Roof repairs , 6. we are a corporation and its ofl;iccm have exercised their ri 14.�ther 4k/AoB�/ bed 3ht of exemption per MGL c. 152,§1(4),and we have ao employees.[No workers'comp.insurance required.] f— *Any applicant that checks box#l must also 6n out the section below showing their workers'campettsation policy information. `— t Homeawrim who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that cheek this box must attached an additional sheet showing the name of the sub-contractorss and state whether or not those entities have employees. Ifthe sub-matractots have employees,dW must provide their workers'comp.policy number. I and an employer that is pralddin;workers'compeJWdtion insurance for my employees Below is the pa1/cy Wd job site information. /� Inmrance Company Name: Ii' O4400— a - a. Wk Policy#or Self-ins.Lic. #:�A/Ci��1��C7 ]off Ap?7 Expiration Date: Job Site Address:_ 3 Z TrAl,?h vy s Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penaltids in the form of a STOP WORK ORDER and a fine of up to$250.00 a day againtit the violatot.A copy of this statement may be forwarded to the Office of Iavestigasions of the DIA for insurance coverage verifi`catioa [do hereby ce under the p ' pews ies of perjury that the infenm don provided above is true and correct Si re: ! Date: A— ?—I Phone O cutI use only: Do not write in dtit area,to be completed by city or town of,�iclaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department I City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector o.Other Contact Person: Phone#• �- ACCC D� CERTIFICATE OF LIABILITY INSURANCE 71�(MMICD[yyyy) /28/2018 ' NIS 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 O ACT CoBiz Insurance, Inc. -CO NAME: 1401 Lawrence St., Ste. 1200 IAJ .P"c°N o • 303-988-0446 aic No:303-988-0804 Denver CO 80202 A ORE : COMail@cobizinsurance.com INSURERS AFFORDING COVERAGE NAIC INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Firemens Insurance Company of WA,D.C. 21784 Southem New England Windows, LLC, dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER 0: Smithfield RI 02917 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:787175890 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 ADD WEIR . POLICY EFF POLICY EXP L TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $1,OD0,000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one persons 3 1o.000 PERSONAL&ADV INJURY 51,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 1 S 2 0130,Deo X POLICY❑JEa LOC PRODUCTS-COMPIOP AGG S 2,000.000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/V2019 1/1/2020 COMBINED SINGLE LIMIT $t 0000 0 X ANY AUTO BODILY INJURY(Per person) 'a ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS Ix AUTOS Per accident $ 5 A X UMBRELLA LIAB [I OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,D00,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,ODo DEO I X I RETENTIONS g g WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 X STATUTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOWPARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000.000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1.000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT $1 0D0,000 C. Pollution Lability 7930073340060. 1/1/2019 1/1/2020 Each Occurrence $2=0,11D0 Gaims-Mads Policy Aggregate $2,000,000 Retroactive Date 06120/2013 Deductible S25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES'ONLY AUTHORIZED REPRESENTATIVE � ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division ( J -5 F DI "Hued �_/01. / r Conservation Division Application Planning Dept. _ Permiffeee DIVETON Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address s3Z- 64)�Q Village ,VA-LtJ!S n ,3Z ?Owiu�ctS� T Owner Address �'jA o L6o Telephone 7 7$ - d Permit Request _ /U STD` -- IU b Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District FI(iQd Plain Groundwater Overlay Project Valuati n /Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No. Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ Now If yes, site plan review # Current Use Re rc� nl i � Proposed Use JZe stJe,,t 1 J APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Sptrf '� N_ Ltd/N/ oW,S Telephone Number ��E4 Z 7- Address fez Low License# 0 -7 4a4 , �1 OW57 Home Improvement Contractor# T3 � Email Worker's Compensation # 416-g27r1r,3SZ3? ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE &—shl� _ FOR OFFICIAL USE ONLY APPLICATION# '4 DATEISSUED MAP/PARCEL NO. f ti ADDRESS VILLAGE r OWNER t DATE OF INSPECTION: FOUNDATION .F FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT F ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts Department&f Industrial Accidents Office of Investigations - 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbl Name(Business/Organization/Individual): /l j h&d4rA.6 16 Address: o`Z (o ;f lbl pI' 1-04--d City/State/Zip: L!A/CO/N /e,-r, 09449' Phone#: yo ;p g- ?goo Are you an employer?Check the appropriate box: Type of project(required): I.&I I am a employer with A 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner-, listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' y ❑Building addition [No workers' comp.insurance comp.insurance. required.] S. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I1.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c.152,§1(4),and we have no 13. Other �(l� �� employees.[No workers' 1�► comp.insurance required.] (atzmeQ *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. /1 Insurance Company Name: StJra•�v l., d,A/ Policy#or Self-ins.Lie.#:R'/e 7S 3 E9.3 Expiration Date: d� Job Site Addressz lanhoug rat' City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy n ber 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. l do hereby kerb under the pains and penalties of perjury that the information provided above is e a correct c' fiSignature: Date: Z� 'hone#: 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#: Client#:30124 SOUTNEW (MMIDDIYYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE8/o6no13 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(les)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 lleu of such endorsement(s). PRODUCER CONTACT NAME: Anita Little Willis of New Jersey,Inc. PHONE 856 914.4660 Arc No Eat): No): 856-914-1881 1015 Briggs Road,PO Box 5005 n oREss, anita.littleQwillis.com Mount BOX Laurel, INSURERS AFFORDING COVERAGE NAIC s Mount Laurel,NJ 08054 INSURER A:Selective Insurance Co of the S 39926 INSURED INSURER B:Argonaut Insurance Co. 19801 Southern New England Windows LLC INSURERC:Beacon Mutual Ins.Co. 24017 DB/A Renewal by Andersen INSURER D 26 Albion Road Lincoln,RI 02865 INSURER E: INSURER F: 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 CONTRACTOR 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 UB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE S �U8 POLICY NUMBER (MMIDDIYYYYI IMMIDDIYYYYILIMITS A GENERAL LIABILITY S202945900 D811012013 0811012014 pEAACMHH OECTCUR�ERENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea o au�nce $100 OOO CLAIMS-MADE Q OCCUR MED EXP(Any one person) $10 000 PERSONAL 6 ADV INJURY $1 000 000 GENERAL AGGREGATE s3,000,000. GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s3,000,000 POLICY PR LOC $ A AUTOMOBILE LIABILITY S202945900 8/10/2013 08/10/2014 COMBINED SINGLE UMfT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE AUTOS OWN X HIRED AUTOS XNON ED $ AUTOS Per accident $ A X UMBRELLA LIAS OCCUR S202945900 8/10/2013 08110/201d EACH OCCURRENCE $5 000 000 EXCESS LAB CLAIMS-MADE AGGREGATE $5 000 000 DED I I RETENTION$ $ C WORKERS COMPENSATION 0000068028-RI 8/21/2013 08/21/201 X "�BAN ER AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNERIEXECLRIVE YIN AIC927818352394 8/21/2013 08/21/2011A E.L.EACH ACCIDENT $1 00O 000 OFFICERIMEMBER EXCLUDED? NIA (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE $1000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If morn space Is required) CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE POLICY PROVISIONS. Lincoln,RI 02865 AUTHORIZED REPRESENTATIVE 01 S9886-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2151 ngIMi215088 AXL - :+* l�r��l���rr R�iA�C�lrki vie�lov�:�.tlmi�rnrsY,,, To whom ma�y co, r .:. h n �hAssodatrok or 1W..M "agarrt nt C��n �X,' r n# rM4is 6D to Renewal bv AndOfsen.to irIA6,41. CIiStdlh placement wjftw"Ih t116 fol6h,*g ficlllty: AaM6 of Odwillopme" Pot CML--'vp 0 tAr el Idss llpnIe# k�M o►�s� - ,-��yip3� r a .Wlee VA d'o0fe Ii'Ag/ousaftae- t etc;), z •' is ti 1 . $. 9 Tfi 'rod.Wind In lRt � roils# c! id ' od 71 • 13 — r: x,a 'f u W w' F II .a ` t r �,, evva se ICA-6 � Pgfld�8st�l�p "'-Nor* r� ilk i96 Cl�siq k�i $�2 i 4%11 M- Renewal _ .�� o� 1^ MAttix #ibzw byAndetsen. RENEWAL BY ANDERSEIV ( fi Rt ; is�s Gg 26'Albion Road i.Uicoln�R102865 s is d hrm nt23Z MINOOM'REV.LLCQN[M►_mAsima�(mpdq .. a Fhone SfiGa63 2235-Fax.401.633 6602: b ra tu:Nsi osi 30 l Sag�i�y Souther-kt vr�d LLC a/bYa _ Renewal Andcmiiii ofl.Southeru New Eu d qq' r CUSTOM WINDOW AND DOOR,REMODELING•AGREEMENT (u&ecT peso., iV_A s S euyer(s)Svice`i.Addiess..Gq Sate aNd Lp.GuQe/iQBwe 3 Z ��'^•' �'K"'`��: fi� .. is rliva"1g.bu bMAtt_ 77P v+ar�T.i y� Autrr(s)Neteb}�oititty and seVerallv.agrces to purchase thc:products and/or sernces of Southern Nev EtwlandlNindotvs.LLC A/.,b%a Rtnet�al by Andersen oP Southern'\ew England{"Contractor'} in;c¢otdancewth the terms and condutons descnlied;on the frtint and the"reverse of'' this rt etiicnt and oft the attached s "` ag _ _ pee�hcauon shcct s collccuvel this` en " . i)( _ ... X� � *� �, D;Aistoric Hilo :�110A7. Total JobAmount Fsanated Sarong Due:, Method of payme6t O deck O Cash 7.figanced Recgned 334E" — '�WIL' i _) t`redrc Cads arc accepted for deposrc only maximum1/3 0(d+ei Bafartce at 5tart'ct Job(33 � ` prole-cosc(&g.se see Cre'A fond P*nek fever.)By sivin ki Esennated t om�,etron Datagrpi Aadatowledge thatthe Bahnceat dart of Job and the Balance,on Substannal li/�(jG •:?Gt��Z. ®alartce on Subsonoal Compteoon of Job cannot be made by credtc Complevarai Jab(33%j: card and midst be made by persoral diedr:bank dtecli or.cash Buyer(s)'.agrees:"and und that this AWmemeni constitutes the:eniiee:undlerstandmg between the.parti _and thaf: I-here ate ao verbal uaderstaadmgs changing say of the terms of this Agreement Buyer{s)acicaowledges that Bier{s); (i)has ns § s, n, drad this dthe mfthismGa received a cosq feted its ed :nail dated',;, p r s Dopy of ebis Agreettsent,iacludmg the two atttarhed A1otItx<s of:Gancellaeaoa,oa.the date first wsi*ia above,aad(2)was orally; informed ct Buyer's right to cancel Plus Agreement DO NOT SIGN THIS CONTRACT IF*$ AREANYBLANKSPACES. (Rhode lalasid Sales Oi;6y Notace toBnyer:Q)Do ssotssgn this Agreement sf any'of the spaces intended for the agreed terms i to the extent of then available soformaiion are left bhink.(2)Xou are eutrttled to-;copy of this Agreement qt the t.me,'you sign': it 3 Yon: at as,tssne a oi£the full. cc.due under this ' ( ) may y p y unpaid balan Agreement,and m so doing you may be.entitled to; receive a pasKial rebate of die Soaace aad>fnsurasice,charges (4)The seller bast no right-to unlawfaBy enter yonr•premsses' o'r cosnwit nay breach of the peace:;to repossess goods purchased node this Agreement.(5)Yon,tray cancel this Agreement? if it has not been sigised;arthe strain oBice'or a branch oBice of the seller,provided you_sotifjt`Ue seller,at his oe,`her saain' offer or breach office shown m flee Agreementbyregistered or certified mail,vluch sisal(be posted not later thaw smdmght of the third calendar day aRer ehe`;day on which the Bayer sagas the Agreement,excluding Sundag and any hohday:oa which'; sail(deltveraesare imotsnade See the:accompanying•siotsce'.of'aaincellation form for aaeacplanationo£buyer's rights:• regular' Buytr{s)recen�ed.the;¢onsttmeeeducation'materials provided by the Rhode Island Contractgis RegisUauon:Board. (,Buyer's'%uituiLrJ -• Renewal by And` of Southern New Eagtaad Buyers) _ Buyer(sj $i ature:� Product iVtanager Stgnatare Signa�re l�$F1�T 1� iseens`is P,nnt AFame'of Froduct;Llanager Print.Name print Name:: YOU,THE BUYER{S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR;TO M MGIM OF THE THIRD: BUSINESS DAY AFTER THE DATE OF THIS:TRANSACTION SEE THE ATTACHED NOTICE OF,CANCELLATION FORMS:; FORAN:EXPLANATIONOFTHISRIGHT° OTIC OF T �( NOTICE'-OF CANCELLATION Date ofTrat►sacdon You may'cancel •�. iJate ofTransactton .You may cancel this transacLon,without y#ehal-q or obligadon;'•within " thistransactton,without any penalty or,obligation,within three business dars:from:tlie above.date.lf rou.cancei,arty !: three•business.days.from.thesabove date:•If you.cancel,any property:.-traded in,airy payments.made,by'you under the I. property,traded in,any:payments made'.by you_under the Gontiact,or Sale aand_any negotiable instrument executed I„ Contract or.Sale,and atiy negotiable tnstrumen;•`executed by you will be returned within ten business days following: t:: by you`:wtll rtted be iM*p .wsehin ollowi ten business days'fng.a receipt by the Seller of.your taritelladon'ciotice,and any-I receipt by the'Seller of,your,cancellation notice,'and any security interest arising out of the transaction will be '- security itterest arising out of the transaction will be iiii,Med..ifyou�ancel,yyou m�� ttst melee avatlatile to the;Snller'I t-Heeled liyou cancel,you mint[Hake available to the Seller.''' at?your residence,tii substandal1Y 4gii condition as;wlien. ! at your residence,m sr>b-SStan good condition'as when received,any goof delivered to you uttder this Contract tic;'.( received,any goods delivered to.you under this Contract or Sale or roil may,if`you wish;comely with die instructions of j Sale;or:you may,if you wish,comply with the tnsErvebons of= did Seller:regarding the return:shipMeitt of the goods at the the Seller regarding the'returwiMpmenta- [fie goods at tt e Seller's expense and rnk.ifyou do make the ggoods:araibible•. . Selietas.expense and risk;lf you do rnake the goods available to:ihe-Seller and the Sell'r-Aoes;not pick Zm'•up within to•liw Seller and the Seller;does.,not pickAhem,,up-within twenty d of tfie>date of'canceilation,you may retairi.or •l twenty.days of-the datw:of eaneellahon;.you may.retain or; dispose 4Oi!.goods without atiy foreher'obligadon:if you I dispose of the=goods without:as>)i further obUgation If„you fail to make the goods available to the Selle,'or if you_agrt e I fail to rnake the goods available to die Seller,or if you agree to return e-a goods to ehe;Seiler and fail to do so,then you I to return the goods to the Shcer:and tallM do so;then you remain liable Tor performance of all obligations under the remain liable or performance of aq obligabons.under the ' Cont!a To cant elthn transaction,mall or deliver a signed'I Condact.Totartcel this!'ansaction,mail or deliver-signed acid dated copy of'this cancellation notice'or'atiy'other I. and dated Dopy of this cancellation ttottce or any other wntten nottce,or send a telegram to Rene by f .I writleri rwtice;"or send a telegram to Renewal byAndersen o f Soutliero.New England at`.20: Oion:Ro ; ,�. SOutteM New.England'at 26AIW6 Road;Lincoln;R10286.5, NOT LATER THAN MIDNIGHT OF j! NOT,EATER THAN MIDNIGHT OF Date _ L.HEEBY CANC.ELTHISTRANSACTI N I 1 HEREBY CANCELTHISTRANSACTION. „.kR o-".. .., . Buyers Stgosdne; °r —a�tbit Name nab Bajnr's sigriaaire t?iIM Name. Oate;i RhA Penv.Ylhiio RiwarCenv Yalli�w BiwenGmr..Pink Southern New EngLandMindows rw d.b.a Renewal by Andersen of S14E Massachusetts Department of Public Safety r, eoarct:of Bufidtng'keg ulatans and Standards Constrartion Supers!"sir. License CS-095707 BRIAN D DENMS_ON - - 7 U POND EIR,. 1� i - Charlton MA 01507 7' 111L11' cofnmissioner 09/0812014 -...<''ifu.-.....rr.-..-x... wga...p.w F w..s v .p.+avr • -..: .+..,vw .s,r+.n..+i_.»+.ww'+.wM....M..n,vr�Rn^.... ...-.>•...q..L,..w ...ro-:.«-. .^w v r.F+r.,..h+u*.wvi.. �.. rr.:w.. ..�> I�p &o Office of Conn sumer A 1T'S Business egu atlon 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration:`IM45. ., 4 -.. w H .,.. �... t.•._, _•:,..�,TYpe: Supplement Cab SOUTHERN NEW ENGLAND WINDOWS LL DENNISON MAN 1137 PARK EAST DRIVE WOONSOCKET,`RI 02895 - Update Address and return cord.Marls«uun for change. Address [�Renewal Employment O Lori Card SG I O 10W4n _ E"Emplrdfion: oemeur Affairs&Bodaerr Reglatioa License or registration valid tar ladividnl meonly IMPROVEMENT CONTRACTOR before theexpiration data If found return to;TyPaOffice of Cossamer Affairs and flusiaeuRegulationtra0on: IM45 - 10 Park Plata-Suite$170 M912014 Supplement::ard Barton,MA 02116 SOUTHERN NEW ENGLAND WINDOWS U.C. RENEWAL BY ANDERSON DENNISON 13RIAN 1131 PARK EAST DRIVE WOONSOCKET,Ri 02895 V d—.ury. Not valid without signature