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HomeMy WebLinkAbout0022 PINE CREST ROAD ��- �; � L . s , _ r d . y � �. _: ., . . ._ . . � �,,� . . �� . .. _ _ _ .. - C _. G � �. Town ®f Barnstable Permit# F-pires 6 atotttlts froin issue dote Regulatory Services Fee s • e BARNSfABLE ' r '�q v n"<ASS. �' Richard V.ScaG,Director IlY/1 t639. �0 plFD MAC 6 d Building,Division ' 4 Tom Perry,CBO,Building Commissioner ®CT 0 4 2017 200 Main Street,Hyannis,MA 02601. www_town.bamstable.ma.us TO K/N %BA � Office: 508-862-4038 it �-b230. EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid roithottt Red X--Press Imprint � Map/parcel Number �y 7 :�� 3 Property Address ZZ -pt he CrP-A r-R ❑ Residential Value of Work S r$,1?4/0 Yiinimum fee of$35.00 for work under$6000.00 Owner's Name&Address t j6e�t- 0�,e T�� 11 ,42 ;vie -rP s l(ems } Contractor's Name nJQJ 2�t/i /1 rSO� Telephone Number(!t-(O f Home Improvement Contractor License#(if applicable)� 732 115 Email: Construction Supervisor's License#(if applicable) O 7 O 7 [GKNorkman's Compensation Insurance Check one: ❑ I am a sole proprietor inthe Homeowner e Worker's Compensation Insurance Insurance Company Name F; r-Pam— n zL_LSUr 6t_N rQa Workman's Comp.Policy# W C A S 8 7 2-9 — 2-0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roofl ❑ Re-side ['Replacement Windows/doors/sliders.U-Value - 2- (maximum.32)#of windows 2— #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit.does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note' Property k0wner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require e- SIGNATURE: C:\Users\Decollik\AppData\LocaNMicrosoft\Windows\Temporary Internet Files\Content.0utlook\2P10I DHR\EXPRESS.doc Revised 040215 f Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England Robert DeVirgilio y Legal Name:Southern New England Windows,LLC 22 Pinecrest Rd " RI#36079,MA#173245,CT#0634555,:Lead Firm#1237 . Centerville;MA 02632 WINDOW 6E LAcernenr. :10 Reservoir Rd I Smithfield,.Rl 02917 H:(781)329-0765 - Phone:866-563-.2235 1 Fax:401-633-6602 I sales@renewalsne.com C:.7817529762 . Buyer(s)Name: Robert DeVirgilio. Contract Date: 09/21/17 Buyer(s)Street Address: 22 Pinecrest:Rcl,-Centerville,:MA 02632 Primary Telephone.Number: (781)329-0765. Secondary Telephone Number.:7817529762 Primary Email: rdevirgilio@comeast.net Secondary Email: Buyers)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 b the parties and'incor rated herein b .reference(collectively,this"Agreement"). y p y Buyer(s)hereby agrees to sign a completion certificate:after Contractor has completed all work under this Agreement.: Total Job Amount: $1$,940 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: $0 .' . . . Balance Due: - '$18,940 EstirnatedStart*: Estimated Completion . 6 to 8 weeks 6 to8 weeks Amount Financed: $18,940 Method of Payment Financing ' w. : 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.Ve will communicate an official date and.'tme at a later date.:Rain and extreme weather are the most common causes for delay. Notes: Plan 2521 12 month no pay no;interest 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 Agieernent: NOTICE TO BUYER: Do.not sign this contractif 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 09/25/20117 OR THE THIRD BUSINESS"DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEETHE ATTACHED NOTICE OF.CANCELLATION FORM FOR AN EXPLANATION-OF THIS RIGHT.. Legal Name::Southern,New England Windows,LLC. dba:'Rene',a A rsen of SoutherrrNew.England Buyer(s), • Signature of Sales Person : Signature. :: Signature Paul Conboy Robert;Del/irgilio"" PrintName of Sales Person. Print Name Print Name UPDATED:'09/21/17 Page 2 / 12' ' ___ f%.f_ If ij� Y , 1•F%Y fJ,.' F �i�e o� C�r,su er Affairs a'nd Business Re�;�tati® -_ -_ 10 Park Plaza Suite 5170 Boston, Massachusetts 02116' Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card Expiration: 9/19/2018 SOUTHERN NEW ENGLAND WINDOWS LL-< _ BRIAN DENNISON - 26 ALBION RD LINCOLN, RI 02865 - ` Update Address and return card.Mark reason for change. —!.Address Renewal i Employment F Lost Card — -Office of Consumer Affairs&gasiness Regu➢ation Registration expiration date.valid If found return to: only before the -�___ IMPROVEMENT CONTRACTOR office of Consumer Affairs and Business Regulatio -g HOME IMPROVE n Registration fi73245 Type: 10 Park Plaza-Suite 5170 Expiration gAi". 018 Supplement Card Boston,NLa 03116 SOUTHERN NEW ENGLAND WINDOWS LLC: RENEWAL BY ANDERSON BRIAN DENNISON 26 ALBION RD LINCOLN, RI 02865 Not valid without signature. ' ar— Massachusetts Department of Public Safety . Board of Building Regulations and Standard°s License: CS-095707 ; BRIAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA -01607 • fir: a , . Expiration: 09108/2018 Commissioner The Commonwealth ofMassachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-201 i www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PEPMTMG AUTHORITY. Applicant Information Please Print Le 'bl , !\Tame (Business!Organizeion!Incividual): e K) Address: .2 Ausico —PIJ . City/State/Zip: tJAJP Phone #: In - 2:�-8 Are you au employer?Check the appropriate box: Type of project(required): Xam e employer with ZO f-emplovees(full and/or part-time)." 7. New construction 2,71 am a sole proprietor or partnership and have no employees working for me in S. Remodeling any capacity.[No workers'comp.insurance required.) o ❑Demolition 2.F-]1 am a homeowner doing al work myself. [No workers'comp.insurance required.)t 0 D Building addition. S.O1 am a homeowner and will be hiring contractors to conduct all war](on my property. I will ensure that all contractors either have workers'compensation,insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions _.❑1 arr.a genera contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.�Roof repairs These sub-contractors have employees and have workers'comp.insurance.'- 14. . Other E.❑We are a corporation and its officers have exercised their right of exemption per MGL C. i 52.F 1(4),and we have nc employees.[No workers'comp.insurance required. I i Ile 'Any applicant thai checks box fl must also fill out the section,below showing their workers compensation police 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 trust attached art additionai sheet showing the name of the sub-contractors and state whether or not those entities have employees. Lithe sub-contractors have employees,they must provide their workers'comp policy number. I am an emplover that is providing workers'compensation insurance for my employees. Below:is the polio•and job site information. Insurance Company Name: Policy# or Self-ins.Lic. : tA/Cf'li [ '— �' Expiration Date: Ll r Job Site Address: 2 Z �,'✓!e—Gre s 4 /L „}C' City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the police 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 penalties in the form of a STOP)WORY, ORDER and a fine of up to$250;00 a day against the violator.A copy of this statement may be forwarded to the Office.of Investigations ofthe DIA for insurance coverage verification. 1 do hereby certif}°under th ains andpenalties ofperjuYy that the information provided above is true and correct. Si atone: Date: )—'7 Phone# Official use only: Do not write in this area.to be completed by city or town offeial. ' City or'Town: Permit/License 0 issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Citv/Town Clerk 't.Electrical Inspector.5.Plumbing Inspector 6. Otber Contact Person: Phone#: v ESLERCO-01 SANDERSO ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE'MMIDD"YYY) 06/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT CoBiz Insurance,Inc.-CO A"cNN,E.:(303)988-0446 FAIICC,No):(303)988-0804 1401 Lawrence St,Ste.1200 Denver,CO 80202 E-MAIL COMaii@cobizinsurance.com INSURERS AFFORDING COVERAGE NAIC tI INSURER A:Acadia Insurance Company 31325 INSURED INSURER B:Firemens Insurance Company of WA D.C. 21784 Southern New England Windows,LLC.dba Renewal by INSURER C:Liberty Surplus Insurance 10725 Andersen of Southern New England 26 Albion Road,Suite 1 INSURER D: Lincoln,RI 02865 INSURERE: 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 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP -- LIMITS INSD M DD MMIDD A X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR CPA3158728 01/01/2017 01/01/2018 DAMAGE TO RENTED 300,000 :::p PREMI ES Ea occurrence $ MED EXF A I ny oneperson) S 5,000 PERSONAL&ADV INJURY S 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑jED7 0 LOC PRODUCTS-COMP/OP AGG S 2>000,000 OTHER: I EBL AGGREGATE $ 2,000,000 A AUTOMOBILE LIABILITY EO acciciid D SINGLE LIMIT $ 1,000,000 X ANY AUTO CPA3158728 01/01/2017 01/01/2018 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS - - BODILY INJURY Per accident S HIRED NON gMED - PPReOPPEERa DAMAGE S ' AUTOS ONLY AUTOS ONLY S A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 ;EXCESS LIAB CLAIMS-MADE CPA3158728 01/01/2017 01/0112018 AGGREGATE $ - DED I X I RETENTIONS 0 Aggregate $ 1,000,000 B WORKERS COMPENSATION X I PE STAT LITE I I ERH AND EMPLOYERS'LIABILITY YIN WCA3158729-20 01/01/2017 01/01/2018 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIVE � E.L.EACH ACCIDENT S ppFFICER/MEMBER EXCLUDED? NIA 1 000 000 (Mantlatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,eescribe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Worker's Compensatio CA3158730-20 01/01/2017 01/01/2018 1,000,000 C Pollution Liability TIEDE654299117 01/01/2017 01/01/2018 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 17-18 Workers Compesnation Includes-All states except ND,OH,WA,WV,WY CERTIFICATE HOLDER ' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN a ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - IFOR InformationalPurposes ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Y � Town of Barnstable Regulatory Services Thomas F.,Geder,Director NAM Building Division ►Nd� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us I c,+ XA. m. Office: 508-8624038 ' Fax:P 5084790-6230 PERMIT# d�dV� O 1 FEE:.$ �! SHED REGISTRATIONCil z 124 square feet or less Location of shed(address). illage 14 a Property ownerl name Telephone number / 2 Size of Shed =Map/Parcel# - t'E ViignUl Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required). - 3 0' PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COADUSSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE CONIIMSSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-fonni-shedreg REV:121901. 2 a. # 135 . 119 12 MAP 2 7 ------- P 247 I 2 \Desktop\Conservation.dgn 5/30/2006 3:31:20 PM