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HomeMy WebLinkAboutBLD-19-000779 7n rt-C7ion� 2Eta)hea
ptYA/� TOWN OF YARMOUTH Building Department BUILDING
k. i.„ (508)398-2231 ext.1261
0 _.41, C PERMIT NO ;BLD-19-000779 PERMIT
y _
��":.,,�. ISSUE DATE 08/08/2018 x k JOB WEATHER CARD
APPLICANT ;Undercover Tent&Party PERMIT TO : New
IAT(LOCATION) 111 COCHESET PATH,WEST YARMOUTH,MA 026 1 ZONING DISTRICT I 1 Bldg.Type: !Residential 1
SUBDIVISION MAP BLOCK LOT 064.15 BUILDING IS TO BE: CONST TYPE V B USE GROUP R-3
REMARKS Tent-erect temporary tent 20 x 60 for wedding 8/23/18-8/27/18(Laurie CONTRACTOR
Martin) LICENSE
AREA(SO Fl) 1,764,659,16 EST COST($) 97500.00 PERMIT FEE($) 40.00
OWNER MCBRIDE KEVIN J BUILDING DEPT BY
ADDRESS MCBRIDE JANICE M, 11 COCHESET PATH
WEST YARMOUTH MA 02673 J ! _ I HONE
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, L OR SIDEWALK O PART THEREOF, EITHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PER ED UNDER THE BUILDING CODE, MUST BE
APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE.
OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM
MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE
CONSTRUCTION WORK 1)FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL PERMITS ARE REQUIRED FOR
FOOTINGS.2)PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE.WHERE ELECTRICAL PLUMBING/GAS
MEMBERS(READY FOR LATH OR FINISH COVERING) A CERTIFICATE OF OCCUPANCY IS AND MECHANICAL
3)FINAL INSPECTION BEFORE OCCUPANCY 4) REQUIRED,SUCH BUILDING SHALL NOT BE INSTALLATIONS.
REFER TO DETAILED INSPECTION SCHEDULE OCCUPIED UNTIL FINAL INSPECTION HAS
BEEN MADE.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTIONS APPROVALS
OTHER: I
WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD
UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE
APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION.
STAGES OF CONSTRUCTION ARCIVF
>b� 3(o(-137Zy
f Sob 77g YssC,
-'� r y 0 Use Only
•
`a c-� Parton expires ISO daysfrom
issue date
EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth,MA 02664
,,1 (508)398-2231 Ext 1261 �/
CONSTRUCTION ADDRESS: 1\ Lcc3n 5c+ 94th (A't5? f�tYM'tot.t
•
ASSESSOR'S INFORMATION:
kevlA� Map: , 6y Parcel: / 5
OWNER: Lctvr:<- *Veath zt6 Atelolo.. 9 -774 315 603a
NAME PRESENT ADDRESS TEL N
CONTRACTOR: V 'Uf(AVe! "'Cm•1" SeekemtiI 3 ( hk-ef cK, 609 ;Rg 100u
NAME !LING ADDRESS TEL.P
'Residential D Commercial Est.Cost of Construction S Ck 75.CC)
Home Improvement Contractor UC.# Construction Supervisor Lie.M
Compensation Insurance:.(check'ono)-0— .--- .-. _ —
O I am the homeowner 1 C,,I�ant the sole proprietor D I have Worker's Compensation Insurance
L
Insurance Company Name: v{C o t tkSt,rot 1 K- Worker's Comp.Polity/ 4/i✓L 3 3r 4 7z 7
WORK TO BE PERFORMED
Tent Duration g(t,-$It? (Fire Retardant Certificate attached?) Wood Stove
•
Siding: #of Squares Replacement windows:# Replacement doors: #
Roofing: #of Squares ( )Remove existing*(max.2 layers) Insulation
Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing
'ttiw4- l'''Slog JI Za )(6o
*Tile debris will be disposed of at
Location of Facility
I declare under penalties of . the statements herein contained we true and correct to the best of my knowledge and'belief.'belief. I mtdernad that any false answer(:)
wil(bejust w ,
oe Por ial . • P i ion f my license and for prosecution under M O.L Ch.268,Section I.
Militant's Slgnmurc //, 11 Date: S DI IS
Owners Signature for artachm t) GL Sic •
Dahl `a/�jg//g ,(� •
Approved By �'n/� Dene: zj/ v
'din rci (or designee) / L ADDRESS:
Zoning District: --'— —�
Historical District: ❑ Yes [I No Flood Plain Zone: ❑ Yes II No —:a f'. C, L: K, EE D
•
Water Resource Protection District: Within 100 ft.of Wetlands: I i----'
❑ Yes CINo ❑ Yes D No A060 4 271-1-31 81
F;JTit Di:PARFMr'NT
UNDER-1 OP ID: MIKE
AOORD, CERTIFICATE OF LIABILITY INSURANCE DATE
A EIMMAI05/23/1a
PRODUCER Phone:617-479-5500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
DPS Insurance Group,Inc. Fax:617.4795761 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
500500 Granite Ave.,Suite 2 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
iltOn,MA 02v86 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Daniel P Sullivan COMPANIES AFFORDING COVERAGE
COMPANYArch Insurance Company
INSURED Undercover Tent&Party
ANY
Tony Prizzl co b Quincy Mutual
31 American Way
South Dennis,MA 02660 COMPANY
C Wesco Insurance Co
COMPANY
D
COVERAGES
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION UNITS
LTR DATE(MMIW/YY) DATE(MMIDDIYY)
GENERAL LIABILITY BODILY INJURY OCC _ $
A — COMPREHENSIVE FORM PRPKG0008601 11/21/17 1021/18 BODILY INJURY AGG S
PREMISES/OPERATIONS PROPERTY DAMAGE OCC $
UNDERGROUND
EXPLOSION&COLLAPSE HAZARD PROPERTY DAMAGE AGG $
PRODUCTS/COMPLETED OPER BI PD COMBINED OCC $
CONTRACTUAL BI S PD COMBINED AGG $
INDEPENDENT CONTRACTORS PERSONAL INJURY AGG $
BROAD FORM PROPERTY DAMAGE _
PERSONAL INJURY
AUTOMOBILE LIABILITY BODILY INJURY
B ANY AUTO AFV206208 11/21/17 11/21/18 (PER PERSON) S
ALL OWNED AUTOS(Private Pass)
BODILALL OWNED AUTOS (PER
ACCIDENT)
X (Other than Private Passenger) (PER ACCIDENT)
X HIRED AUTOS
PROPERTY DAMAGE S
X NON-OWNED AUTOS
GARAGE LIABILITY BODILY INJURY a
PROPERTY DAMAGE S 1,000,000
COMBINED
EXCESS LIABILITY EACH OCCURRENCE S
UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM S
WORKERS COMPENSATION AND X VJCSTAIT OTH-
TORY LIMITS ER
EMPLOYERS'LUIBILT' EL EACH ACCIDENT S 1,000,000
C THE PROPRIETOR/ INCL WWC3314727 11/21/17 11/21/18 EL DISEASE•POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTIVE —
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE S 1,000,000
OTHER
A Equipment Floater PRPKG0008601 11121/17 11/21/18 Equipment 600,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Party Goods Rentals
CERTIFICATE HOLDER CANCELLATION
LAURIEM Should any Mthe'boys ascribed policies be cancelled bettors the
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Laurie Martin 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
11 Cocheset Path ba failure to mall such notice Ma Impose no obligation or liability
West Yarmouth,MA 02673
Many kind upon the company,Na agents or representatives.
AUTHORIZED REPRESENTATIVE //
'moi(,//
ACORD 25-N(1/95) ®ACORD CORPORATION 1988
•
• The Commonwealth of Manachusetts
•aaat' '/ Department of IndustrlalAcddents
• e� 1 Congress Street,Suite 100
';�ice_ :` •• Boston,MA 02114-2017
•`.,.,_•'' www.matxgov/dla
Workers'Compensation Insurance Affidavit BuilderatContnetors/Electriclans/Ph:mbern.
TO BE FILED wan TUE PERMITTING AUTHORITY.
Applicant Informs.on Platy Print Ledbh
Name(8mine s/OrpniuSoortndividod): ' Undercover Tent&Party Inc. •
Address: 31 American Way
City/State/Zip: South Dennis MA 02660 Phone#: 508-398-9000
Are yoe as employert Cbeak the appropriate bas Type of project(required):
1.®I am a weclone with 20 employes(fun on orpatbthee}• 7. 0 New eonstincdon
• 2.01masolemerino'ap pWlrrenoengroyeesvotigforsb E. DRemodeling
any •(No worts Gomm Senn required.] 9. Demolition
emoliDemolitionon
3.D I am a hotnenhotnessdehm an wort mynah(Neva tens'comp.bnaursrequired-II IO 00 iBuilding addition
. 4.D l mas Immeonen sed Intl be Whig contractors matt all work ore my popery.l wnl
se that an&.cine either have wettest compms ion Irownoe et ere sole 11.0 Electrical repairs or additions
poprIewevah no rhyme.
senora m011..ekkeadreeuammaamtswmamamntheddeee 12.0Ptmnbbtgrapdrkaadditions
iem.
Thensuboormmrt have aemployees and have woman'camp.inane& 1'.0Rnofeepdrs
e3Wemaompmdonand haofficers have exadeedMoir risk ofeampjanperMOt.o. 14•5110thec Tent Install
132,i1Aand wehave roemploye*(No mortar?camp.MennennNdrart]
*Any spoliate that neon bar It mum aln fel on the mann below showing their workse' , ., __.tlm policy kdbrmadon,
thamsownen ea°Ste teie Indkaling they en doing all eat and than We cenSie assmuttank■nwvMartbettiesnate
%CoanaeonOMcheck Webox musramend anadditional sheet Sam the aset Me 0*p.Soata*n andstate whe eraaotemaaetltksbn
emplonei umearboomemonhave emploren,theymust provide their ats polley maim.
I am an employer that tr providing workers'compensation tnsurence for my employes Below Is the policy*Slob stte
tnforntatton.
InsummoeCCompenyName Wesco Insurance Co.
Polley NorSeif-ins.Lk.1: WWC3314727 bzonfionGate; 11/21/18
Job Site Address: l` L oC.Iv e$rj ea}Lt (^'t57 Efre" e'f'City/StstrZlp:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Faller,to secure coverage a required under MGL a 152,*23A is a criminal violation punishable by a fine up to 51,500.00
and/or one-year imprisonment,as well as civil penalties in thetbym 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 lnsersnee
coverage verification.
I do hereby anti&under the pains and pawkier of perjury that the information provided above IIts use and cornet
,imatnra Pa4rum., ("O t.- Date: b( $ (�$
phone p: 508-398-9000
Official use only. Do notwrite In this area,to be completed by dry or town o,Oidel
City or Town: Permit/License 0
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Penn: Phone Y:
r e
..__f
l'1r ‘,At lN,INA iV\f\/ (‘;V?/\I.t1 V\ICVV11ti\1vv‘ 1....IYV\f. !\a V V\ fat\f 1r /.VV"V' .`
Certificate of frame .e5i tance 2
Date Manufactured AZTEC TENTS Invoice Number. 0227212-IN 'y'
2665 COLUMBIA ST Customer P.O.:
2/20/2018 TORRANCE,CA 90503 . r.
- (800)228-3687 E Customer Number: UNDE026
,<.
?:
This is to certify that the materials described below have been flame r tardant v..., "`•`^`•'• u•-•
• treated(or are inherently flame retardant). , 01 "--c= Lin ''v°""
:k:•�.,-,: .".\ Emw. F2220. '.f-
( '.r `..'�<",'. •
Gaily,.Come. ul].14,16,o. F-41901 ,
• Undercover Tent& Party F ; 1 tasted Fames vinyll°9,/2091 (5700:
Y'Y. l'1 ON Omar 1.9./2094 659101 'y�
Undercover Tent& Party �' t
' �Y / _., ErtIu.I.Hy Enpa PolySenn1/M NN01 'y,.
31 American Way > _ ,-- Prmantn,.503 °I
South Dennis,MA 02660 „;,, , ,,, -ehe'ret'" ;moo,
NC
Soyd., pm Oun/VYm 150..01 i
Y Sn VEn Irr,p-n F-I.005
Certification is hereby made that the articles described below hereof are made `""° pit.sp0 pn1` F.12121 �'
M
�• . from a flame-retardant fabric or material registered and approved by the T.Vince c. "no P.2110
• California State Fire Marshal for such use.The fabric has been tested and TM"ankel V"'°""Witten i 06901
Tri Vantage 'Mwlm/Cnalm. F46901
✓ passes NFPA 701 Large Scale.See chart to right for trade name of V« •,. .9 Duni.BIM 91515 1-5w 01 ti
flame-resistant fabric or material used and additionally referenced on the label of C
the fabric panel.
C. THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING
David Bradley General Manager-Manufacturing
re Name of Applicator or Rodman SupemMkecn Tele of Applicator or Production Superintendent
.<.
\,i,,v/"r1AA;` AAin A/iiiA,i. '.t /EJ 4/yi41AAAAAA/kik 1'',JrA41'A) 1j /x.AAi -/1 AC
ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED
2221DV20CF2002 120x202pc-DV-SFUteToothN EACH 1 1
w/Double Valance
. SN4P Blackout White-w/8 Ratchet Tensloners
#10"Indiana Scalloped Double Valance
With Rope Line#To Match R217078#
Z221DV20CM1002 #20x10 Mid DV-JT/JTliteTop{PM EACH 4 4
w/Double Valance
SN4P Blockout White-w/2 Ratchet Tensioners
#10"Indiana Scalloped Double Valance
With Rope Line#To Match R217078#
Z221DV20CM1502 #20x15 Mid DV-JT/JT Lite Top t1W— EACH 2 2
w/Double Valance
SN4P Blockout White-w/2 Ratchet Tensloners
#10"Indiana Scalloped Double Valance
With Rope Une#To Match R217078#
Z293F0017020 JT Lite Assembly Cable 20x EACH 6 6
Z293JT21006 JT Lite JT2 10'6" EACH 12 12
Z221DV30CE3002 #30x30 2pc DV JT/JT Lite Top UW EACH 1 1
wl Double Valance
SN4P Blockout White-w/8 Ratchet Tensioners
#10'Indiana Scalloped Double Valance
With Rope Une#To Match R217078#
Z221 DV30CM1002 #30x10 Mid DV JT/JT Ute Top UW EACH 4 4
w/Double Valance
SN4P Blockout White-w/2 Ratchet Tensioners
#10"Indiana Scalloped Double Valance
With Rope Line#To Match R217078#
Continued
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47
Laurie Martin10
' ._ t? ,c, 11 Cocheset Path
. z West Yarmouth
IM £ 4C ,n 11
N ski.
� 65 Guests
August 25th 2018
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