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0022 POND STREET
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FOWNO� 6AHN6IABU TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROP-ERTY INFORMATION Address of Project: j�M� �t NUMBER STREET VILLAGE Owner's Name:20 n f--( Q pia,-tea Phone Number 7 -02 8 - �2 Email Address: rslAfPa �cor�,ca S� nP- Cell Phone Number 7 Project cost$ 1 5 p — 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 OTI- r4 Date: TYPE GE WORK Siding Windows(no header change)# Insulation/Weatherizatiot Er Doors (no header change)# 3 Commercial Doors require an inspector's review El Roof(not applying more than I layer of shingles) Construction Debris will be going to Grl a s4e-/�'�Gi1a g�,�•��� _ �,y, o/r t /� L CONTRACTOR'S INFORMATION Contractor's name 1 ( a,, -S�, -e<,, aft Fr. (ev4 1,ft'n do,,w S Home Improvement Contractors Registration(if applicable)# 17 3 L y (attach copy) Construction Supervisor's License# 09 S 7 07 (attach copy) Email of Contractor q�la��o` Q S a7 0.40, • Go►k Phone number ALL PROPERTIES THAT HAVE STRUCTuR&OVER 75 YEARS OLD OR IF TIME SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT C4N RE ISSUED. APPLICATION NUMBER............................................................ *For 'dents O> lv* 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 8000am-9e30 am or 3.30 pm-4.30pnL 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 nay responsibilities sander the males 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 PLICANT9 S SIGNATURE Signature A Date 7 - gill permit applications are subject to a building official's approval prior to issuance PIWrknewal Agreement Document and Payment :Terms bylll lder$en' dba:Renewal B Andersen of Southern New England Y A. gl Ronald Lareau Legal Name:Southern New England Windows,LLC. 22 Pond St. RI#36079,MA#173245,CT#0634555,Lead Firm#1237: Centerville,MA 02632 WIM00W RE IACEMERT -- 10 Reservoir Rd I Smithfield,.Rl 02917 - - H:(774)282=0822- Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com . {:(774)282-0823 Buyer(s)Name: Ronald Lareau Contract Date: 07/12/18 Buyer(s)Street Address: 22 Pond St.,Centerville,.MA'01632 Primary Telephone Number:.(774)282-0822. Secondary Telephone Number: (774)282-0823 Primary Email: rslarea@comcast.net Secondary Email: Buyer(s)hereby.jointly and severally agrees to.purchase the products and/or services.of Southern New England Windows,LLC d/b/a' Renewal By Andersen of Southern New England("Contractor') in accordance with the terms and conditions,described in this Agreement . Document and Payment Terms,any documents listed in the Table of Contents,and any.other document attached to this Agreement Document,the terms of which are all agreed to b pp the parties and incorporated herein by reference(collectively,this"Agreement'). y Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed,all work under.this Agreement. Total Job Amount: $11,050 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'cmh. Deposit Received: $51525 Balance Due: $5,525- Estimated Start. Estimated Completion Amount Financed: 8 to 10 weeks 8 to 10 weeks $11,050 Method of Payment: Financing 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.; ; 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 contraa.ifblank.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 07/16/2018 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 dlia:Renewal Py Andersen of Southern New England Buyer(s) Signature of Sales Person : :.'Signature Signature , _ Gino•Montesi Ronald Lareau: Print Name of Sales Person Print Name Print Name UPDATED: 07/12/18 Page 2./ 12 e Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Lorne Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERIN NEW ENGLAND WINDOWS-LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD =- . LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card ==-Office of Consumer Affairs&Business Regulation Registration valid for individual:use only before the HOME IMPROVEMENT CONTRACTOR expiration date. if found return to: Office of Consumer Affairs and]Business Regulation Registration: 1 33245 Type: 10 Park Plaza-Suite 5170 Expiration: gij91,,pl8 Supplement Card Boston,MA 02116 OLITHERN NEW ENGLAND WINDOWS LLC. ENEWAL BY ANDERSON , RIAN DENNISON � i 6 ALBION RD INCOLN, RI 02865 Q-Uadersecreiary Not valid without signature :..: .. 'J !' ailr, w. "= �C z ru of Ei6did913a RegtAd @t•.'.J± s 2:;rnd Stan lear ds xn�. .., OS-095707 3RIAN D DENNISON L ANISS POND CIRCLE C-ARLTON MA 01507 The Commonwealth Of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 Workers'��orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LegriN Name (Business/Organization/lndMdual): EjlJiTe tk) -�aq Address: City/State/Zip: p Phone#I: Are you an employer?Check the appropriate box: Type of project(required): I,kI am aemployerwith -ZO femployees(ful]and/orpart-time).* 7..❑New construction 2.[:]I am a sole proprietor or partnership and have no employees workine for me in any capacity.(No workers'comp.-insurance required.) g• a Remodeling 3.0I am a homeowner doing all work myself.[No workers'comp.insurance required.); 9• ,❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property.ro t . 1 will 10 F1 Building addition � - ensure that all contractors either have workers`compensation insurance or are sole 11.1Q Electrical repairs or additions proprietors with no employees. 5711 am a general contractor and I have hired the sub-contracmrs listed on the attached sheet 12-[]Plumbing repairs or additions These sub-contractors have employees and have worker'comp-insurance.1 13. R of repairs 6. We are a corporation and its officers have exercised their right of exemption per MGL c. 14• Other 152,§1(4),and we have no employees[No workers'comp-insurance required.] r io /Q Ce i"i efis *Arty applicant that checks box#]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 contactors must submit anew affidavit indicating such 4Contractors 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. Insurance Company Name: t I rf MQ n S r1 Policy#or.Self--ins.Lie.#: xpiration Date: / 1 I Job Site Address: 2- 2— ',Cr S f- City/State/Zip: 6B Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir lion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation ptuiishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator_A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ - I do hereby cen*under the airs and penalties of perjury that the information provided above is true and correct Signature: a Date: 7- 2- s--/ k Phone#: CIO I-2Z�'�f'f{ev 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#: r ACOOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 1212912017 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 endomement(s). PRODUCER COKTACT CoBiz Insurance, Inc.-CO NAME- PHONE 1401 Lawrence St, Ste. 1200 No.Extl-303-988-0446 Flu-No:303-988-0804 Denver CO 80202 E-MAIL D RES& COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC @ INSURER A:Acadia Insurance Com an 31325 INSURED ESLERCo-01 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: - INSURER F COVERAGES CERTIFICATE NUMBER:1252851165 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER Y EFF POLICY EXP LTA POLICY NUMBER MM/DDPOLIC MM/DD LIMITS A X COMMERCIAL GENERAL u4B11JTY CPA3158728 1112018 1112019 EACH OCCURRENCE S 1.000,000 LjLAIM$-MADE OCCUR DAMAG 7 RENTED i PREMISES Meoccurrence $300,000 MED EXP(Any one person) $10.000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- GENERAL AGGREGATE $2,000,000 X POLICY JECT LOC t PRODUCTS-COMP/OP AGG $2,000,DOD I - OTHER: $ I A AUTOMOBILE LIABILITY N CPA3158728 virw18 1/1f201S COMBINED SINGLE LIMB Ea accident $1 0D0 0D0 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS I Per accident $ I $ A X UMBRELLA LIAB X OCCUR CPA3158728 1/1/2018 1112019 EACH OCCURRENCE $10.000.000 EXCESS LIAR CLAIMS-MADE AGGREGATE $10,000.000 DED X RETENTION$, $ B WORKERS COMPENSATION WCA3158729-20 1111201B 1/1/2019 X AND EMPLOYERS'LIABILITY YIN, STATUTE ERA ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N 1 A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E If yes describe under L DISEASE-FAFJdPLOY $1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMB $1.000.000 C Pollution Liability 7930073340000 1/12018 1/12019 Each Occurrence $1,000. 00 ODO b�Cms-Made Policy A99regate $1,oD0,0 Retroactive Date 06/202013 Deductible $10.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) CERTIFICATE BOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE wITH THE POLICY PROVISIONS. For informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ho Town of Barnstable *Permit Expires 6 mo the fro issi a date MAY Regulatory Services Fee. d U uaxeTaBLF. : Thomas F.Geiler,Director I TOWN 0 LE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ,�.. Not Valid without Red X-Press Imprint V Map/parcel Number a 3 �. �ry t Property Address fC A Residential Value of Work /400 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address1171�-( �, Contractor's Name Telephone Number 4��f- •�" , tr Home Improvement Contractor License#(if applicable) AWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 5KI have Worker's((C��ompensation Insurance ! Insurance Company Name Yfyeos' Workman's Comp.Policy# &le Copy of Insurance_Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles).All construction debris will be taken to - ❑Re-roof(not stripping. Going over existing layers of roof) . X_,Re-side Replacement Windows/doors/sliders.U-Value a (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Rome Improvement Contractors License is required. - SIGNATURE: Q:Forms:buil dingpermits/express Revised 123107 CONTRACT TERMS AND REQUIRED NOTICES Notice:All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by the provisions of Chapter 1 42A of the general _ v laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and status should be made to the Director,Home Improvement Contractor Registration,One Ashburton Division of K war 1004M MA 17166 w Place,Room 1301,Boston,MA 02108. est 1959 50 Getchell Way,Canton, MA 02021 781-963-7900 I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the specifications,terms and conditions,on the premises below described,which I/We represent that we have good record title in our own name. Owners Names 12®Y*\ e. ar e CLU Home Tel.No. 015r QelS--1SclI Bus.Tel.No. `?,' i 2�2, c;.�s-L2-e-mail Job Site Address -�>O y A Cit C A ��_ ST 'Y1 p y �;� a f1!� �zip d-L( ,_ Massachusetts Contractor Registration# 100468 Rhode Island Contractor Registration# 17166 Work Specifications described attached on pages: '2— of -2— , ® of of �-- Permits:The contractor agrees to apply for and obtain all construction related permits(Building/Electrical/Plumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting or inspection agencies,authorities or individuals. Notice:The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. Price:The contractor agrees to do all work described by the contract for the total price of $ ��� 4 CC) Notice:No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever is greater. Payment Terms: Advanced Deposit $ '7 Uc Payable on signing of contract Interim Payment 1 $•-1-Soc; Payable Ak Skcck. o Interim Payment 2 $ Payable Final Balance $ Payable ` Security Interest: Yes No-To be held in the form of a UCC-1 form to be filed only if payment is not made on completion. Notice:The contractor does not have the right to request payments in advance of the times set forth in this agreement,although,by agreement,the parties may jointly agree to escrow any portion of the contract amount.In the event that it becomes necessary for the contractor to employ an attorney to collect any balance due hereunder the owner agrees to pay in addition to the said balance,the costs of collection and reasonable attorney's fees. Work Schedule:The contractor will not begin work or order materials before the third day following the signing of this agreement unless specified in writing.The contractor will begin work on or about S /�/(date).Barring delays caused by circumstances beyond the contractors control,the work will be substantially completed in ee cs ys.The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the contractor.shall not be considered as violations of this agreement.The contractor shall not be liable for any delay or non-performance caused by strikes,accidents,weather or any other contingency beyond its control. Insurance:The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cover the acts of its employees and or agents. Warranties:The contractor warranties its workmanship for up to a period of seven years and assigns the rights to any manufacturers warranties to the homeowner after the substantial completion and payment of the contract terms. You may cancel this agreement if it has not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or delivered,not later than Midnight of the third business day following the signing of this agreement.See the reverse side of this form for an explanation of this right. This instrument and any and all other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by a written instrument executed by both parties. Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. HOMEOWNER: Do not sign this contract if there are any blank space . IN WITNESS WHEREOF, the partie, ere nto ned their names this ay of 200 . Alumabilt, Inc.Representative �/ Home�iner try �✓f ��f . Accepted Alumabilt, Inc. HomeYwner ��-- Page 1 of HOMEOWNER:You have a right to a copy of this contract.