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0072 TOWNHOUSE TERRACE
�a IOwn �aLE ,rr- 1,2 C Lp �.�a( TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION F. 164 QZMap Parc Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation / Hyannis Project Street Address ? a Y1 R rob Village 4 y OwnerUyk- 41Vrt ` to 5*Uhd1SQn Address 7 :) fOW' Y 0S- , Telephone Permit Request 'Inv aa) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 v C) Basement Finished Area (sq.ft.) Basement Unfinished Area (s ,) CZ o Number of Baths: Full: existing new Half: existing ` :;, new co Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Ro m Count (n F 5; Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other M 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 ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Numb q,@ erAddress I P (' 6 S r" License # a D 0 S o L 1�2-f— Home Improvement Contractor# o 3 J� 0 Worker's Compensation # �)C%37 G9 �,��g3gV ALL CONSTRUCTION DEBRIS RESPUVTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT RE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP PARCEL NO. ti ADDRESS VILLAGE OWNER DATE OF INSPECTION: it-2 FOUNDATION-, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH. FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' T'he Commonwealth of massach vsetts I Department ofindustriaal.4ccidents Office of Investigators kv 600 Washington Street Boston,MA 02111 wrvw-mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A Gcant Information Please Print Le 'bl Name(Bu4iness/Organi7ation/lndividual): �, � ` . Address: l 3 7 Par &s A!ve, Ci /State/Zi : Wt9&Aj5BcA-?,� k-J�-®;k1fSp hone#: Are you an employer?Check the appropriate box: 1. I am a employer with -2-0 4. ® I am a general contractor and I T�of project(required): 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 g Demolition working for me in any capacity. employees and have workers' [No workers'comp, insurance comp. insurance.2 9. ❑Building.addition required:] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions � 3.® I am a homeowner doing all work officers have exercised their 11. Plumbing myself ® g repairs or additions y [No workers'comp. right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.0 Roof repairs 3a.® I am a homeowner acting as a employees.[No workers' 13.MOther±- e IG04-rA 2n4- general contractor(refer to#4) comp.insurance required,] AO 'Any applicant that checlts box gl tmtst also fill out the section below t showing theirworke s'compeasaticgoliry information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tCDaum tors that check this box must attached an additional sheet showing the name of tbesub-contractors and state whether or not t6oae entities have employees. If the sub-contractors have employees,they must provide their workers'comp. polity number. I am an employer that is providing workers'compensation insurance or informadon. I m3'unploytes. Below is else policy and job site Insurance Company Name: D L) NS I.,P F� s r P.oli #or Self ins. Lic.#: (� �' ��rJ� 9�3�a 3 � 1 Expiration Date: 3 Job site Address: 7 a "r.w hoo•s-e- ��err.. IP nz l agL 0 D46 t cicyisrate/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.fine up to$1,500.00 and/or one-year imprisonment,as well 152 can lead to the imposition of criminal as civil penalties in the form of a STOP WORK ORpenalties DER 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 her certi undo Je pains and penalties of perjury that the informadon provided above is tare irnd come qbi- f Offleial use only. Do Trot write in this area, to be completed by city or town official CIty or'Towh: Permit/License# Issuing Authority(circle one): L Board of Heaith 2.Building De €rtment 3. Ci /T ty own Clerk 4.Electrical insp ector S..Plumbing 6. P robin Other g Inspector Contact Person: Phone#! Client#:30124 - SOUTNEW ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MWOD/YYYY) 10/02/2012 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Anita Little Willis of Massachusetts,Inc. "v"c"�, 856 914�600 FAX ac No: 856-914-1881 100 Huntington Avenue E-MAIL ADDRESS: anita.liftle@Willis.com com INSURER(S)AFFORDING COVERAGE NAIC 0 Boston, MA 02116 INSURER A:Argonaut Insurance Co. 19801 INSURED Southern New England Windows LLC INSURER B:Beacon Mutual Insurance Company 24017 . D/B/A Renewal by Andersen INSURER C: 1137 Park East Drive INSURER D: Woonsocket,RI 02895 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. L SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP IN SR WVD POLICY NUMBER MMIDD/YYYY MM/DDIYYYY LIMITS GENERAL LIABILITY pEACCH�OECCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES EaEocccurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JE� LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAR AGGREGATE $ � CLAIMS-MADE L DIED I I RETENTION$ $ A WORKERS COMPENSATION AIC927698352394 8/21/2012 08/21/201 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY B OFFICER/MEM ERPEXCLUDED?ECUTIVE® N/A 6SO2S(RI) E.L.EACH ACCIDENT $1 OOO OOO (Mandatory In NN) E.L.DISEASE-EA EMPLOYEE $1 000 000 If yes,describe under j DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 - t� DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Addidonal Remarks Schedule,It more space Is required) Named insured is a Renewal By Andersen Dealer CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1137 Park East Drive ACCORDANCE WITH THE POLICY PROVISIONS. rl Woonsocket,RI 02895 AUTHORIZED REPRESENTATIVE e e 6L •1, ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S212686/M212684 AXL ------- ---�-... Renewal NIT,, G � byAnddersen. . WI:NbOW REPLACEMENT anAndcrsenCompany WocidMnyl Composite IF Dual n - Argb Low.E Glider 100-00389833-002 ENERGY PERFORMANCE`RATINGS U Factor(UPS)/1-P Solar Heat.Gain Coefficient 30 . 0 3 2' ADDITIONAL PERFORMANC ■E'RATINGS Visible Transmittance 01111104 Manut§ctureratipuletee that trees raengs conform toappiicable NFRC'prvaoduro$fordetennlning:whole produa _ perfonnance.NFROrating$aradetennl"ad forefixedeetofenvlronmentarcunditloneandas eciflc ` NFRC does not recommend any produdtand does not wartant the euitablilty of any product for any spar,Rc use.$ once lnfoohallon. www.nfac.o" SM 4C Thfs product meets ore �tp 5eal's enylrpnmentai f ' - standards oyemin <. energy eftiolancy;heavy tO metals in the frame an sash materials packaging,and oonsum educetlonmaterial% DESIGN PRESSURE(PS'F) • MmuMcMer �� n • RbA.Noriz Slider ()(p) IN " ratedroNAFB or AAMMVpMIdf5A.....)A44n.{)}, Mnlndnclurer eli ulnle wafonne uto t6on ticable nlnodnnla Meets or exceeds M.E,C.;O,E.O,&t.E.C,C,Air InNittatfori eq,mants WDMA Halknatk Oertificstlon program. Massachusetts- Department of Public Safety Board of Building Re!-ulutions and Standards Construction Supervisor License License: CS 42926 i f - , -PAULH�THIBEAULT`�' *.► 1 • 26 LESTER'S ,t ',,N::SMITHFIELDFR102896 + 4. f Expiration: 2/16/2013 CbnuniwiunW ` Tr#: 9563 t V tom/ W O face o "on sumer Affair and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts'02116 Home Improvement'Contractor.Registration Registration: 173245 Type: Supplement Card z M Expiration: 9/19/2014 SOUTHERN NEW ENGLAND WINb.UVS : PAUL THIBEAULT 1137 PARK EAST DRIVE WOONSOCKET, RI 02895 ��{ ( S'a Update Address and return card.Mark reason for change. Address Renewal. Employment Lost Card i-CA1 ir.50M-04/04-G101216 - - -- ✓fie C�omvmaiuuea��i o�/�aoacre`u�oe�b Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs•and Business Regulation WRegistration 173245 Type: 10 Park Plaza-Suite 5170 " Expiration 9(19/2dA4 Supplement Card Boston,MA 02116 ter- �- - :,, SOUTHERN NEWIENG'IAND-WINDOWS LLC. RENEWAL BY AND,E,RSjONTM PAUL THIBEAULTr ' h/y' j� a - - •. C 1137 PARK EASTbRIV�E�Y WOONSOCKET RI'02895 "` Undersecretary Not valid without signature 25 Townhom Tam= Ma.02601 Telephone SM 775 7356 Fax SM 773-7356 . • 7 pinelxoodo .can ` The Assodation,or its'Management Company,grants permission to Renewal by Andersen to instaN custom-made r+eplaoament windows In the following facility: Name of Development Ca N 10 M,N 1 Q,,ire A_ Customer Name a yerl 14 ,t•- 11-e.(+0,.J � I�ry Address Unit# -7, State ��- Number of windows Lam! doors®' Style(Le.double hung/casement,etc.}-Al, ' t r�� Exterior window color ::•� CC r e- Exterior window trim finish. Yes M No[:j Color. _,Ln-a-_ Grids Yes(] No jg- Grids between the panes Yes M No 1 ., Color_,_ Grid corrRguration approvedYbs M No The proposed windows are approved /fbr installation In the above listM unit. Approved J`�t.L .{ C� LICP�LLC'__ Printname : 7�1�f ��ilh // . rtle .` ?A�► 1�� Phone# Date� /� -- Produet Specialisl--Xwr- .a t'ZI Kenewal . '\ � - RI Reg#12259/30839 • RENEWAL BY ANDERSE` "".0562725 byAndersen. .�� �/ MA HI#119535 WINDOW REPLACEMENT a„A„d• nCom 1137 Park East Drive•Woonsocket,RI 02895 .♦ Pa^v Lead Hazard Control Firm Phone 401.671.6401 •Fax 401.671.6262 License#LHCF-0059 ' A Southern New England Windows,LLC d/b/a Federal Tax ID#46-0566630 Renewal'by Andersen of Southern New England 7-'1 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name �G tf. � Dace of Agreement Buye^r('s7)Street Address,City, t nd Zip Code 1 s� !2- .'l/ 14 4NN1-5 IN;4 �v E-Mail Addren Home Telephone Number Work Telephone Number Q e, ee enWV. N Y •771 7I • 2.L( • 3797 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 on the front and the reverse of this agreement.and on the attached specification sheet(s)(collectively,this"Agreement"). Total Job Amount O O C7 Estimated Starting Date: Method of Payment•. O Check 0 Cash ❑Financed Deposit Received: 00 ` Credit Cards are accepted for deposit only-maximum 1/3 of the Balance at Start of Job(33%): —0^ project cost(Please see Credit Card Payment Form.)By signing this Estimated Completion Date: Agreement,you acknowledge that the Balance at Start of Job and the Balance on Substantial Balance on Substantial Completion of Job cannot be made by credit Completion of.Job 600 card and must be made by personal check bank check,or cash. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing any of the terms of this Agreement. Buyer(s) 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.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales Only)Notice to Buyer:(1)Do not sign this Agreement if any of the spaces intended for the agreed terms to the extent of then available information are left blank.(2)You are entitled to a copy of this Agreement at the time you sign it.(3)You may at any time pay off the full unpaid balance due under this Agreement,and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges.(4)The,seller has no right to unlawfully.enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement.(5)You may cancel this Agreement if it has not been signed at the main office or a branch office of the seller,provided you notify the seller at his or her main office or branch office shown in the Agreement by registered or certified mail,which shall be posted not later than midnight of the third calendar day after the day on which the buyer signs the Agreement,excluding Sunday and any holiday on which regular mail deliveries are not made.See the accompanying notice of cancellation form for an explanation of buyer's rights. Buyer(s)received the consumer education materials provided by the Rhode Island Contractors Registration Board. (Buyer's Initials) Renewal by Andersen of Southern New England 'Buyer(s) Buye ) lgnature of Pr Manager Signa re Si t ktv(� D�. L� 4 P Print Name of Prod anager. Print Name Print Name YOU,THE BUYER(S),-MAY CANCEL THIS TRANSACTION.AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS „ FOR AN EXPLANATION OF THIS RIGHT. NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date,of Transaction //- /6•/Z You may cancel Date of Transaction I I • Ito. I Z• You may cancel this transact'ion,.without any penalty or obligation,within this transaction,without any penalty or obligation,within three business days from the above date.If you cancel,any I three business days from the above date.If you cancel,any property traded in,any payments made by you under the I property traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed I Contract or Sale,and any negotiable instrument executed by you will be returned within ten business days following I by you will be returned within ten business days following receipt by the Seller of your cancellation notice,and any I receipt by,the.Seller of your cancellation notice,and any security interest arising out of the transaction will be security interest arising out of the transaction will be canceled:If-you cancel,you must make available to the Seller I canceled.if you.cancel,you must make available to the Seller at your residence,in substantially as good condition.as when I at your residence,in substantially as good condition as when received,any goods delivered to you under this Contract or I received,any goods delivered to you under this Contract or Sale;or you may,if.youwish,comply with the instructions of I"Sale;of you may,if you wish,comply with the instructions of the'Seller regarding the return shipment of the goods at the the Seller regarding the return shipment of the goods at:the Seller's expense and risk.If you do make the goods available X Seller's expense and risk.If you do make the goods available to the Seller and the.Seller does not pick them up within I to the Seller and the Seller does not pick them up within twenty days of.the date of cancellation,you may,retain or I twenty days iof the date of,cancellation,you.may retain or dispose,of.the goods without any further obligation.If you, I dispose of the goods without any further obligation.If you fail to make the,goods available to the Seller,or if you agree j `fail to make the goods avaiiable to the Seller,or if you agree to return-'the goods to the Seller and fail.to do to,then I to return the goods to the-Seller and fail to do so,then you remain liable for performance of all obligations under you remain.liable for performance of,all obligations under the Contract.To cancel this transaction, mail or deliver I the Contract.To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any I a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Renewal by I other written notice, or sen&a telegram to.Renewal by Andersen of Southern New England at 1 137-Park East Dr., I Andersen of Southern New England at 1 137 Park East Dr., Wo nsocket,RI 02895,NOT LATER THAN MIDNIGHT OF I onsocket RI 02895,NOT LATERTHAN MIDNIGHT OF 0 1_ .(Date) 2u•1 (Date) I HIEREBY CANCELTHISTRANSAC'TION. I HEREBY CANCELTHISTRANSACTION. X ' Buyer's Signature Print Name Date Buyer's Signature Print Name Date RbA Copy:White Buyer Copy:Yellow Buyer,Copy:Pink