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HomeMy WebLinkAbout0366 CAP'N LIJAH'S ROAD t x. r .. . 6 .. � ,. - .. � .. Y � � ° INE Application number...... ..................................... BUILDING DEPT. Date Issued........... tARySI'.1BLE, MASS, z6 s�. FEB 2 6 2020 Building Inspectors Initials......b.................. TOWN OF BARNSTABLE Map/Parcel..........Z1'.1..3...../06 .......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: SCANNED ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION FEB 2 8 2020 PROPERTY MORMATION Address of Project: 'S ��rd. NUMBER STREET VILLAGE Owner's Name: -rw d r Phone Number p-0 11 Z Email Address: enQ 1d,idclvn k,r(Ce ad &,-, Cell Phone Number Project cost$ �i-��1 Ss — Check one Residential V1 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: 5e . 04-4-l4 - Date: F- TYPE OF WORK Siding [2 Windows (no header change)# ❑ Insulation/Weatherization 17 Doors (no header change)# Commercial Doors require an inspector's review J Roof(not applying more than 1 layer of shingles) / Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name (�t�an `74���sc✓� So„k�2�n �,/ ��� �rv,� i'n Jow S Home Improvement Contractors Registration(if applicable)# 17 3 L.L[5 (attach copy) Construction Supervisor's License# 0J 5`7 07 (attach copy) Email of Contractor $L)e q C M Phone number �(01- z Z R -9 ROLE ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS 91V A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER. ............................................................ *For Tents 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 I 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 Boars 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 HOMEOV;NER'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 CAM 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 F- PLICANT9S SIGNATURE .Signature Date 2 All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England_ Y g Tawanda Eger Legal Name:Southern New England Windows,LLC 366 capn lijand rd ,t4; RI#36079, MA#173245,CT#0634555, Lead Firm #1237 Centerville,MA 02632 WINDOW ME wCEMENT 10 Reservoir Rd I Smithfield,RI 02917 H:(508)420-0929 Phone:401-349-1384 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Tawanda Eger Contract Date: 02/04/20 Buyer(s)Street Address: 366 capn lijand rd ,Centerville, MA 02632 Primary Telephone Number: (508)420-0929 Secondary Telephone Number: Primary Email: englanddunkirk@aol.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 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: $8,998 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: $3,998 Balance Due: $5,000 Estimated Start: Estimated Completion: Amount Financed: $0 6-8 weeks 6-8 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: $3998.00 received as deposite, $2,500 due at start, $2,500 at compl. Barnst Buyer(s)agrees and understands that this Agreement constitutes the enure 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 02/07/2020 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:=ew England Buyer(s) Signature of Sales Person Signature Signature ` Kevin Desmarais Tawanda Eger Print Name of Sales Person Print Name Print Name UPDATED: 02/04/20, Page 2 / 12 Office of Consumer Affairs and Business Regulation 1000 Washington Street--Suite 710 ,Boston, Massachusetts 02118 'Home Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS LLC_-* Expiration: 09/18/202Q 10 RESERVOIR ROAD . SMITHFIELD, RI 02917 iCT t 0 20-MT05/77 � - Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR" Registration valid for individual use only. TYPE::swolement Card before the expiration date. If found return to. Registration. . Expiration Office of Consumer Affairs and Business Regulation 173245._ 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS,LLC Boston,MA 0211 BRIAN DENNISON `,Q 1 10 RESERVOIR ROAD L) SMITHFIELD,RI 02917 ibv Without signature Undersecretary r k _ Common, wealth of Massa .'Div.isio,h of Professional Licensure Board 'of Building Regulations and Standards q Cori stru�:- t 6n Supervisor CS-0s5707 E IS i res: 09/08/2020 BRIAN ® DENNIS®N ` 8 BLACKWELRIVE , ;: r` ���> �D ry CHARLTON MA=01607 Commissioner The.Cowwnwealth of Massachusett s Department o f In&strid Aecidents 1,Congress Street;Suite 1 D(? Boston,M4 02114 2017 www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO Be t!ILED'WITH THE PERDU i MN- C AUTHORITY. Aaali¢ant Information Please Print UAW r Name(Business/organiwion/Individuat): e d Address: City/State/Zip S M t�-�j eld,J�1 02Q /7 Phone#: 5/4/—ZZ r_ y Are you an employer?Check the appropriate boss Type of project(required): 1. I am a employer with �'remployees(full and/or part time).° •7. New construction 2 am a sole ro rietor or c • a P P partnership employees vrorkut, For"me in ' _ $: Remodeling any capacity•[No workers'comp.insurance required] _ ❑ 3. I am a homeowner doing all work m sel£ 9. ❑Demolition ® ing Y [No workers'. insurance required.]t 4.[]f am a homeowner and wit►be hiring contractors to conduct all work on my property. I 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. (2.[7P[umbing repairs or additions S.❑1 am aseneral contractor and I have hired the sub-conoractors listed on the attached sheet These sub-cantractors have employees and have workeers'comp.insurance= 13. EtpOf[epatt5 6. We are a corporation and its ofrcers have exercised their ri 14. Other G✓trr Lt rrht of ecemption per MCL c. 152,§t(4).and we have no employers.[No workers'comp•insurance required] *Any applicant that checks boxfxl must also fil out the section below showing their workers'compensation policy information t Horneownets who submit this affidavit indicating they are doing all work and then hire outside caatractars must submit a new affidavit indicating such, tCoatractors that Check this box mot attached an additional sheet showing the name of the sub contractors and state whether or not those entities have employees. If the sub•coatractors have employees,they mast provide their workers'comp.policy number. I am an employer that is proWding workers'compensation insurance formy employe=.Below is the polio and/o6 site informagon. Insurance Company Name. 't'l rP,J111 � �yr t�W'�/tt 00 Policy#or Self--ins.Lic.#: G1C,g131 = a Expiration Date: Job Site Address: ; 36 4 e cr fl'✓1 /"—4 A Is City/Stawaip: ¢rt� ✓i l�� HA Attach a COPY of the workers'compensation policy declaration page(showing the policy number and expire on date). . Failure to secure coverage as required under MGL c. 132,925A is a criminal violation punishable;by a fine up to S1,500.00 and/or one-year impdsonment;as well as civil penaltids 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. I do hereby ce under the p penaldie9 of perlmy that the information provided above_is true and correct D`te 2-L6' -ZO Phone 4- 101 2�- 9 j 7 Official use only. Do not write in dds area,to be completed by city or town offrcirtl City or Town: Permit/Licease# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 3.Plumbing Inspector 6.Other Contact Person: Phone li: 'IC C?R ® CERTIFICATE OF LIABILITY DATE(MWOD/YYrf) ILITY INSURANCE 12/30/2019 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(*). PRODUCER C ACT BOKF Insurance CO Risk Management PHONE 1600 Broadway,9th Floor A/c o -303-988-0446 A no:303-988-0804 Denver CO 80202 AoDRRm: insure bokf com INSU S AFFORD"ERAN;IC# INSURER A:Acadia Insurance Corn325rdba RED Est ERc0-01INsuRERB:Firemen's insurance C784uthern New England Windows, LLC Renewal by Andersen of Southern New England, INSURER c:Homeland Insurance C452 Reservior RdINsuRER D: ithfield RI 02917 INSURER E: INSURER F- COVERAGES CERTIFICATE NUMBER:1098683046 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 A0' SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER tMMIDONYYYl IMMOR"MLIMA A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1=20 1/1I2021 CLAIMS-MADE OCCUR p CHOCCURTO RRLANCE S1,000.o00 TEff P EMI a o=rrancel $300.000 }:+ MED IXP(Anyone person) S t0,000 PERSONAL&ADV INJURY• 91.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S2,000,000 X POLICY E]JECT ❑LOC PRODUCTS-COMP/OP AGG S2,000,000 OTHER: $ A AUTOMOBILE LIABILITY t, CPA3158728 1/1/2020 1/1/2021 COMBINED SINGLE LIMIT $ Ea acrid q• ppp 8 S X ANY AUTO A BODILY INJURY(Per person) S , LL OWNED SCHEDULED ;: BODILY INJURY(Per accident) S AUTOS AUTOS � X HIRED AUTOS X NON-OWNAUTOS ED PROPERTY DAMAGE $ Per accident $ A X UMBRELLA LtA6 X OCCUR CPA3158728 1/1=0 1/1/2021 EACH OCCURRENCE'. $15 00D,000 EXCESS LIAB ri CLAIMS-MADE AGGREGATE, $15,000,000 DIED I X I RETENTIONS $ _. a WORKERS COMPENSATION WCA315872922 1/12020 1/1/2021 ,' X AND EMPLOYERS'LU1BILnY YIN ST TUTE OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE ` " " OFFICERIMEMBER EXCLUDED? ❑N N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) + E.L.DISEASE-EA EMPLOYE S 1,000,00D If yyes,describe under DESCRIPTION OF OPERATIONS below F DISEASE-POLICY LIMIT S 1,000,000 C Pollution Liability Po 7930073340002 1/1/2020 V 1/1/2021 Each Occurrence S2,000,000 Retroactive Policy Ag9re9 $2,=.000 Retroactive Date 08I20/2013. DedualDie SZ5,0W DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule;may be Mated if mole space is required) Subject to all policy terms and conditions.' ti CERTIFICATE HOLDER CANCELLATION - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF;-NOTICE WI-LL BE,DELIVERED IN -ACCORDANCE WITH THE,POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENrATTVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable Building f Post.This Card So,That it is Visible From:the Street ,Ap"prove'd Plans Must be,Retained on lob andthis Card Must.be Kept rrtiS7PnBl E Posted Until;Final Inspection Has Been Made f ernll Jl 1liJll raa�° here a Certificate of Occupancy jsequred,"such Building shall,Notbe Occapieduntil a.Final Inspection;hasbeen made Permit No. B-19-4183 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC Approvals Date Issued: 12/20/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 06/20/2020 Foundation: Location: 366 CAP'N LIJAH'S ROAD,CENTERVILLE Map/Lot 193-105 Zoning District: "RC Sheathing: ' Owner on Record: EGER,TAWANDA ' ContractorlName .SOUTHERN NEW ENGLAND Framing: 1 WINDOWS LLC Address: 366 CAP'N LIJAH'S ROAD 2 CENTERVILLE, MA 02632 -�----Contract&1icense 173245 � ?�- Chimney: Description: 16 replacement windows Est Project Cost: $28,986.00 Permit Fee: $ 147.83 Insulation: Project Review Req: Fee Paid' S 147.83 Final: Date,: 12/20/2019 Plumbing/Gas Rough Plumbing: Final Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. - r- Final Gas: 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 Electrical work until the completion of the same._ , '- ` Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire OfficWs:are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 P,,94- Final: .N` All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 'S os�IME? v � Application number.....E 71 BUILDING DEPT t oat amgsrASLE a Issued.......................1.....�.......�.. ................... o. MAss. �ar:6 9. a�0`g DEC 19 2019 Building Inspectors initials........... ..................... TOWN OF BARNSTABLE Map/Parcel.......43.../...05................................ TOWN OF BARNSTABLE #-P-0, 8 3 EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 3,6C 6/) �4 . - L p �n ' NUMBER STRkT VILLAGE Owner's Name: , iG f'�e� Phone Number _og Email Address: ens(a,,,��u.,lei IC a l n r-, Cell Phone Number Project cost $ ,Z 8, L I 8& 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: 5 e ckNa OT,.-(-4 Date: "TYPE OF WOE ❑ Siding U Windows (no header e char # ❑ Insulation/W g ) �_ eathenzatton ❑ Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) n Construction Debris will be going to W a s4e-/rwat CONTRACTOR'S INFORMATION Contractor's name -Swo -ecn +fP,"! Frrs Irv4 ,r,n Jc w S V Home Improvement Contractors Registration(if applicable)# 17 3 2-q-�- (attach copy) Construction Supervisor's License# 015 7 07 (attach copy) Email of Contractor Q$.,)ee- 9 q 5@ Cyr+- ; �. C 6 M Phone number qo I- 2- 2 9 -IRoo ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents 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 hovers of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES x 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 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 required by 780 CMR and the Town of Barnstable. Signature Date PLtCANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England Y P,1 Tawanda Eger Legal Name:Southern New England Windows,LLC 366 Capn Lijahs Road RI #36079,MA#173245,CT#0634555, Lead Firm#1237 Centerville,MA 02632 wixoow RE LACEMENi 10 Reservoir Rd I Smithfield,RI 02917 H:(508)420-0929 Phone:401-349-13841 Fax:401-633-6602 1 salesCrenewalsne.com Buyer(s)Name: Tawanda Eger Contract Date: 12/09/19 Buyer(s)Street Address: 366 Capn Lijahs Road, Centerville, MA 02632 Primary Telephone Number: (508)420-0929 Secondary Telephone Number: Primary Email: englanddunkirk@aol.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 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: $28,986 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $9,661 Balance Due: $19,325 Estimated Start: Estimated Completion: Amount Financed: $0 6-8 weeks 6-8 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 paid now, 1/3 paid at start, 1/3 paid at compl.Taxes Barnstable 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 12/12/2019 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:Renew n of Southern New England Buyers Signature of Sales Person Signature Signature Kevin Desmarais Tawanda Eger Print Name of Sales Person Print Name Print Name UPDATED: 12/09/19 Page 2 / 16 4 r Office of Consumer affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Horne Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS, LLC; Expiration: 09/18/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 Update Address and Return Card. Win. �cv�zi�zanrcea,�l"�,r' -l/m:-itu%to1eGG: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SUoplement Card before the expiration date. If found return to: Reaistratign Expiration Office of Consumer Affairs and Business Regulation 1i73243=__ 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGFAiVD WINDOWS,LLC Boston,MA 0211 BRIAN DENNISON; Q 10 RESERVOIR ROAD SMITHFIELD,RI 02917 Undersecretary out signature Commonwealth of Massachusetts Division of Professional Licensure Board € f Building Regulations and Standards Uonstru_ 66n' :Supervisor CS-09 707 i res: 09/08/202.0 BRIAN ® DENNISON 8 BLACKWELL DRIVE CHARLTON MA =01607 � i l a Comm-rissioner The C'onnraaomweal'di oftl'fassaclsusetb Departar ant ofladusbialAecidents . 1.Cca ress s treg Suite 100 Boston,MA 0,7114 2917 www.®B ms a olufdld8 ., Workers' Compensation insurance AMdavit:Builders/ContractorsMectricians/Plumubers. TO BE FILED WITH THE PERtii TMi G AUTHORrrY. Apolicant Information Please Print Legibly Name(Business/Or;anization/Individual): q,L-fhe_fr�, L?�} Address: o �! CiWState1zi : M t t°1c� OZ l P � �� t � � . Phone#: Iq®/—Z?,�— Ara you an employer?Cbeck the appropriate box: Type of project(required): 1. 1 am a employer with �"�employees(full and/or part-time).' 7. ❑New construction 2 am a sale proprietor or partnership and have no employees working for me in $ ❑Remodeling arty capacity.[No workers'comp.insurance required] 3.0l am a homeowner doing all work myself:[No workers'comp.insurance required]' 9 1.J Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work oa mY property. I will 10,®Building addition ensure that all contractors either have workers'compensation insurance or are sole I I.❑Electrical repairs or additions Proprietors with no employees. ` Q S.®I am a;eneral contractor and I have hired the sub-contractors listed an the attached sheet Plumbing repairs or additions I 12..�Roof repairs These sub-contractors have employers and have workers'comp.insurance.t 6.0 We am a corporation and its officers have c excised their right of exemption per MGL c. 14.�-+DthBr G✓�ll� IA J 1(4),and we have no employees.[No workers'comp.insurance required.) /r °Any applicant that checks box#1 must also Mi out the section below showing their workers'compensation policy infomation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, gContractom that cheek this box must attached an additional sheet showing the name of the sub-contractors and slaw whether or not those entities have employees, Ifthe sub-coaMtors have etnplayeM they must provide their workers'comp.policy number. I am an employer that is praiddina workers'coarpensadon insurancefor arty emtplayees Below is the policy and jab.site infornurtion 'q Insurance Company Name: l�'�IP�'LS� r�rS l.t'UY�/lam Oh .W f r/��. b. a . 9 Policy#or Self-ins.Lic. Expiration Date: 0"20 2-0- Job Site Address: 3 ( cnq ii City/state/tip: ,-r/ `w= Attach a copy of the workers'compensation policy declaratioie page(showing the pokey number and expiration date). Failure to secure coverage as,required under MGL c. I S2,§25A is a criminal violadoa punishable by a fine up to S I.S00.00 . 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 against the violat:of.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage veriMcadon. F do hereby ce under the p ' penalties of perlruy that the informladen provided above is true and correct Si tore: a Date: Phone#: Official use only. Do not write in tdds arm to be completed by city or town official City or Town: Permit/License# I ssuing Authority(circle one): 1.Board of Health 2.Building!Department J.City/Town Clerk 4. Electrical Inspector 5.Plumbing inspector 6.Other -Contact Person: Phone#• _ N Y 1 e „y CERTIFICATE OF LIABILITY INSURANCE DATE(MPNDDIYYYY, 12/28/2018 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 CoSiz Insurance, Inc.-CO PHONE NAME: 1401 Lawrence St., Ste. 1200 co Ext. 303-988-0446 aIc No:303-988-0804 IL Denver CO 80202 ADDRESS: CoMail@cobizinsurance.com INSURERS AFFORDING COVERAGE NAIL INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Firemens Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURERD: Smithfield RI 02917 INSURERE: 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 ADD SUER - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE iNS13 VjVD POLICY NUMBER MMIDD/YYYY MWDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/112019 11112020 EACH OCCURRENCE $1,000,000 CLAIMS•MADE a D OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person), 51o•000 PERSONAL&AOV INJURY $1,090,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 5 2,000,000 X POLICY❑JECT LOC PRODUCTS•COMPIOP AGG S 2,000.000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1/1/2020 BINED SINGLE LIMIT $ COa accident 1 0 m 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS Ix NON-OWNED PROPERTY DAMAGE $ AUTOS Per acciden $ A X UMBRELLA LUIB X OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,000,000 EXCESS LIAS CLAIMS-MADE AGGREGATE $15,000.000 DED I X I RETENTION$ S B WORKERS COMPENSATION WCA315872924 1/112019 1/112020XSA TTUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000.000 OFFICER/MEMBER EXCLUDED? FN7 N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000400 OFeIfEsdci unr CRaTDPId OPERATIONS below E.L.DISEASE-POLICY UMIT $1.000.000 C Pollution Liability 7930073340000. 1/1/2019 1/1/2020 Each Occurrence $2,000,o00 Claims-Made Policy Aggregate $2.000.000 Retroactive Date 06/20/2013 Deductible 525,000 DESCRIPTION OF OPERATIONS/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'ONLY ' A �UT JHORIZED REPRESENTATIVE �/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014M) The ACORD name and logo are registered marks of ACORD /cam �' /�I, - 1?1 - 7 7, `/ Assessor's map and lot number ...L�1.: .....-J.. 1. iN EMC 8 MUST BE C7 AUM IN COMPLIANCE Sewage Permit number .......................................................... WITH TITLE 5 ENVIRONMENTAL COCD:: AND , yO*THE TO�y F BAR 'XBLEV))k,)5 .�TOWN O NET Z BABHSTABLE, "39 t639• BUILDING INSPECTOR �p \00 �F Q mm a• ) APPLICATION FOR PERMIT TO ..........Suffolk Realty Trust TYPE OF CONSTRUCTION ..........Single :.amily .res.idential --November 16, 1979 .......... ..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .........Lot..#...19 Cap n Li jah Road.....c.Qnt.erV.�.�.J..�.�...MA ............................................................. ProposedUse x.es de_atia.I........................................................................................................ Zoning District ...Sln_gj.(;�... dD j al ,Fire District ...Centerville—Osterville ........................................................... Name of Owner ....SU.�`olk...Real.ty. T.rust.............Address .... ..4.....J3QX...3.Q.8........ .�zlt.E;z�7.1 11.�........... Name of Builder .......... ....same..........................................Address ........5.�tMQ................................................................... ........... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..........seven..........................................Foundation ......Pour,ed.....coneretQ.............................. Exierior .....cedar...shingles..........................................Roofing ....?. bPcl.t.... ...................................... Floors carpet...over...underl.ayment.....................Interior .. ]�7Lm...G.Oft...p],.as.t.�z...................................... Heating ................forced...hot...Wat.r:...k?y...Q.JA .....Plumbing .......P`IC................................................................... Fireplace .....brick & block. , . ....... ...............................................Approximate Cost .......................40..........000...........00........................ Definitive Plan Approved by Planning Board _____________19________ . Area 1840 . . f` Diagram of Lot and Building with Dimensions Fee .........1. �'.... ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH S�d "Bo I,)j 1 , �97 570 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam ................ Suffolk Realty Trust i . 21867 one story No ......... Permit for .................................... single family dwelling ........................................................................... Location ......,,,366 ' Road ..Cap.........n....Li.....jah............................ Centerville ............................................................................... Owner ..............Suffolk. . . ...Realty. ...Trust....... . . .... . .......... ...... ............ Type of Construction frame .......................................... ................................................................................ Plot ............................ Lot ................#19.......... Permit Granted December .. 19 79 Date of Inspection ....................................19 Date Completed ......................................19 a,P i-iL - ?,o PERMIT REFUSED — ..... .. .......................................... 19 . .. ... ...................................................... �.. . ............................................................ ArW(Aed ................................................ 19 '"..cMr��s................................................................... ...................... . _ _ _ v -_.- Y _ - • - ... _ --..� ...� �', •/�,C�in. - - l;'- may_ ��•-] � = 4 Assessor's map and lot number ...1 N L7)9, 7(c6 Sewage Permit number .......................................................... i �Q°FT"E TOWN OF BARNSTABLE Z BASHSTADLE, i Mb BUILDING INSPECTOR .e IMK" APPLICATION FOR PERMIT TO ..........:......... o1k.......'?ltv.....x:U.::t:............................................................. TYPE OF CONSTRUCTION ..........`.?.'--..na 1 e ami J_v r-P,; .r1 Pnt-i a 1. .................................................. riNovember 1C, 197.9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the ,following information: Location ...............?.....*..�1. Car �.n..is?..1a�....-oarL....CPnt-prv...1 1.�'.....`:a.............................................................. 1. Proposed Use .....inn. .......a m i...J... .P..i r1 Pnt..-:.�......................................................................................................... Zoning District ...::.incrl,P ami lv rr�c�rlr?nt,; a1 „Fire District ...t nte�'vill@-GStPtv111F .. ............ ........................... ... ... ..................... ..�tt.....01 R .:.ea ltv....'.. U st Address t X r Any �np Name of Owner ... ................................................................................... amr� �a Name of Builder ...............`�.....................................................Address ............x?'!'a................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..........st.en..........................................Foundation ......t ©urpd.....can " P.................................. 5 { r shlnalos �shnaJ.t s1� nal,P Exterior .............................................Roofing ....................................... ...................................... ........................................... Floors ' ' `c o . uridFrlavment s1Jjn gnat nj,aat,Pr :...........................................................................Interior .. Heating ......hv...(-J..1......Plumbing .......?.N '................................................................... Fireplace .. ' ` ' bloc ,,,,,,,,,Approximate Cost 1 4t1'Coe. CC ............................................... .............................................. Definitive Plan Approved by Planning Board ___--__'____-------------------19--------, Area 1.i%1U a Diagram of Lot and Building with Dimensions , i Fee ....... !...'`�.......................... r ` } SUBJECT TO APPROVAL OF BOARD OF HEALTH I t 1 I � 1 I ` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ` Name .................................................................................. i Suffolk Realty Trust A=193-105 , 21967 'done sto y No ................. Permit for ...................... .. ... ..... y single family dwelling ........ 366 Cap'n Lijah Ro Location ........... 4 Centerville ............................................................................... ` Owner S.uffolk. . ..Rea.lty. ...Trust. ..................... . ........ .. ...... . .... . ........ `t Type of Construction ..........frame................................ /........os;� ......... Plot ......... Lot /December 5 Permit Granted ........................................19 79 Date of Inspection .........................t ...........19 Date Completed ......................................19 PERMIT R, FUS D ... f . �:1. 1-- `19 ....... ..... .. .... ... �.............. { ... .................... ......... Approved ..........'...................................... 19 ............................................................ i ................. .. .......................................................... _l i �•""'. TOW OF BARNSTABLE N Permit No. ------------------------- c ,..,n.n SiL Building Inspector i .... Cash -- -----------•--- ' oO,rG IRY.\� - OCCUPANCY PERMIT Bond -------------- !�6/ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ali Ci i-: . Gsuiy. !'I". a Address • 4i lx JuQP 0"i::.1 V]IlaE Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .....................................................1 19......_ _ ............................................................................................................ Building Inspector 4.1v G�,orz�a�.i✓ �RI��, f1 Drat�;�•f >`c.�w � 1 ib � 3 < �,3p G•P•ty ` � . ISO % = 4-9 S 6.P.o. use- t 04C� GAL— IjA DISPOSAL TWIT - USE IooC� (r.AL. r Mca/ALL AZEA = (50 S.P. ISo SF )c 2.S + 3 7S 6.9-t). BOTTOM lA.ee-A,z Sa SST'-=. 1� CE:0 s+s=. 3c I .o SO CI.P D. ToTA L 'TJ ESIC-14 TOTAL- T:)Adl L-f Pl2GOL&Tl0 LJ tZkTF-- : C IQ I-m l W 02 LaS6. .... 4 n4. 10 Piz or. pIr cite �iv-�ST To!' F'wv s ' �oo.o 10�1� "1� .9b.P 4- rL. tL ' si - r p� •r IL -BOX' U-P Sepne . ,. 3 �yrAl.. s . , To +. i�rAuc�a O� } S ,�t) SToNF-- ' � Lz=2TtF�Et7 pt_c�`r' PL./Sir..1 ; his 83 ' (Z ►.ao ScesLi~- (.11 A6 nAT L 10j1141,7 241 I10 WATSIZ- Rr> 1 1 GGiZTIF=,q T"AT' TNF. �;VODAT1004 5&40%4J►J Pt`AtJ _ R�l''`RE►�.1� I i-•1F:1,'tt�1J G��t�L�(S W ITI••� ."CN►::� �jID�,L4►-�� j �.�.. �q� PATG A>'.!D SC-Tt��GIG �C-Qt3i�EN�ci•.lj'tt �F TNC i--�' E 1 • la A,YlTG 11 14�, IT t2CGI-;mazETa LAWO 5vev��roes Tilt i L/s�-i i LJOT I5aS�t'3 �c 14 A" t�stezV, -Lc— • v il�SreJ�nc=N ��uc;.ic=�{ 4• Ti4c: - t lr LOT l_11Jir�� t7Q.TA. UO Tyr��•! �L.Ww � 1 tb � 3 �• �3U G.P.D ! �1 nc T�IK 33G�.r tSG "jo 4q USf t00C-.) 6QrL. �- ,r)►�Pc)sb,L PST use t000 G,&L. ' 1 •8aT-r'��vl Zit= .� � SZ=. � �� TOTAL 'pESIG►J = .Q25 G..P.D. '� , ToT4 . -C>/st t_-f FL.Ow R�t2CDf�,TIOtJ fzlaTE : �����.! Zhtlu`OtZ lam. ''-' ` nAXTER K. c Tor Pwo s ioo c. �. S•o - .. .. . q,, P. rA tZ, +�Y Lodi .J'Pp� ►000 erns Ir•tu-94,SS, PIS 'Box R .o S�rrc f ti Z'Z 100 GAL- '• 3 O rwv, ►'N' t• t D PIT p. To WASMS-0 p� t j 191.{�j STO W E-- C aV-Ttr-tE1D PLcbT PL.av Ptzo1=tL� lbCATIo�•J. ' -b/j"� F1s 83 12 r,.J o Sc e.�+� c A - r T�A,T fl AT �t 141.1 GG IZ T 1 t=*--1 T t-!AT T 14 r-- q UODATI Ott St.low►J PL 4►..1 R C 1•LE t,.l'G r 1-aF:t�'t=�5�.1 GiaNlPL.�IS V�/ITF�1 TWr:• �jiDt�c.Lf►-�� - Akit> SE7�ACtG �C-QUI�EMc�-lT�r OF TNT ��; -Toww OP: -�34zhh Z•`l!"• BLS .: %V. WI-I P& CJATf.� _� 8 h.XTC1Z. � 4J�lf ►tee. • 11 14� tzcGts'r�.2�� t..n.► o �uev`YvV-s `j'1-�15 t7t_Al•.l !�5 -JOT ZA >GV 0-4 AN' oSTE :�/1t S.0 v I�rCA S• 1t IIJSretj AACzW i l�t�`/C�y' � TRIG UFc_i�T�i �,i�GWtD ANPLI C_A.h1T_. 1`k�r CC ."�>e" Tu t�t�T� t`Mt•d�- lo'c' t_1►,1 �>- ^ ----r t .-