The URL can be used to link to this page

Home My WebLink AboutBLD-19-000814 `�],e/e�se yyy- Og'YAR y d Pte__ '.< i ''n .�' G� y //0 * to /� Amowt Sr s Neisia � /i/� c- Permit expires 180 days from t issue date 1 EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth,MA 02664 (508) 398-2231 Ext. 1261" CONSTRUCTION ADDRESS: f/f POra 21 , 6 . � / ccv `L ASSESSOR'S INFORMATION: • Map: I 4 9 Parcel: �/3 OWNER T� ori t// vn S NAME PRESENT ADDRESS TEL if '` �COONNTRACTOR NAME ai!`�or Ji7ipraye.MAILING ud027-N,'U Pa S £4 W, Yp�� 9 o l 2. H Residential ❑Commercial Est Cost of Construction S O /c+ D.0C1 C Home Improvement Contractor Lic.i# 7 610 1(3 Construction Supervisor Lia if loO t) PD Workman's Compensation Insurance: (check one) i/ 0 I am the homeowner 0 I amthe sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: (O Ct k r L Worker's Comp.Policy# 9(10123 WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares np�-� Replacement windows:# Replacement doors: # Roofing: #of Squares o�0 ( )/Remove existing*(max.2 layers) Insulation Old Kings Highway/Historic Dist ( )Replacing like for like � Pool -fencing ''The debris will be disposed of at V e. 1! c15, J)�,"N Location of Facility I declare under penalties of perjury that the statement herein contained are true and correct to the best of my knowledge and belief I understand that any false answers) will be just cause for denial or revocation of my license and msec :.n under M.G.L.Ch.268,Section 1. i Applicant's Signature: Date: 084/0V4687 �d Alf Owners Signature(or attachment) GOA"Ot / Date: 06(23/ � sa Approved By: ...h." " i 0 Date: '/O'1 ac Building Official(or designee) EMAIL ADDRESS: Zoning District: Historical District ❑ Yes 0 No Flood Plain Zone: 0 Yes 0 No Water Resource Protection District: Within 100 ft.of Wetlands: ' 0 Yes 0 No 0 Yes 0 No The Commonwealth ofMassadhusetts A' tg ]_,A/ Department of Industrial Accidents is =e1= .1 Congress Street, Suite 100 • Boston, MA 02114-2017 • ,,,, www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): etQ leon-Ct 7 cod- Address: e2.7 /t4 j( R)frtel tied City/State/Zip: le,Y0 f'v],(,p(, Phone #: 3 'tit 69S/ OZ Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required] 10 I am a homeowner doing all work myself[No workers'comp.insurance required]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addItioII ensure that all contactors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contactors have employees and have workers'comp,insurance.t 13.E]Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required] *Any applicant that checks boxk1 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 a new affidavit indicating such :Contractors 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 subcontractors 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: 11-ti Caa.4S' p Policy#or Self-ins.Lk.#: fe 12$ Expiration Date: / 06!0 3 Job Site Address: ii f Portig74-� City/State/Zip: S. Y' -0 CL-1-4 Attach a copy of the workers' compensation policy declaration page(showing the policy 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 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 certify under the pains penalties of perjury that the information provided above is true and correct Signature: / Date: 0 elo��il Phone#: 1{ y69 0/ 0Z 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 Commonwealth of Massachusetts •• IC'cr")► Division of Professional Licensure Board of Building Regulations and Standards Constructiory.:8110Ri sor Specialty CSSL-106040 _ -- ' EXpires : 05/14/2020 -I, 1, ANATOLI SIVITSKI rij ,j 27 MILL POND'•'RD < * ti WEST YARMOII,TH MA 02673 ``" r--- _ > n s Commissioner CAL Q%e ?ognmtvfteoea4 a/Q/7aac/ueae • Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusett's 02108 Home Improvement Contractor Registration E ^_ - Type: Corporation xy� Registration: 168043 CAPE COD HOME IMPROVEMENT,INC. I -__-.Y;i `I' '4 Expiration: 12/08/2018 27 MILL POND AD { ;.r- }. .� WEST YARMOlITH,MA 02673 _ i 1F—Wf �' -,Ei \-_-1'.111 3`==` iz , .Jy? y -I'S— Update Address and Return Card. SCR 1 Co 200M� [05/11}_ • __ -- - _ GIFT rom.0Nweezia/ n Ii3M!AGJem Of flee of Consumer Affa!rs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:.Qoruu:xation before the expiration date. If found return to: Registration as Fxniratlon Office of Consumer Affairs and Business Regulation 168043-t-- =12/06/2018 to Park Plaza-Suit. CAPE COO ttO".IE IMPROO/EMENT;INC. Boston.MA r • ,,, q N ii JoFlhATOL191V11SKI !,?,�,"'�I+I .�':fh.� �.e,,CC�l-- 27 MILL POND RD • - 4 C-1 Not valid wit out signature WEST YAFId0.1 i4,MA-92073 Undersecretary . 4 t1 CAPE COD 17"-Prmaimcvemen CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD,WEST YARMOUTH MA 02673 (617) 710-1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME PROVIDE MAXIMUM INTAKE VENTILATION FOR THE FULL ATTIC VENTILATION SYSTEM. • REPLACE ANY DAMAGE FASCIA-BOARDS OR RAKE-BOARDS AT AN ADDITIONAL COST. • ALL GROUNDS TO BE CLEANED UP ON A DAILY BASIS.ALL BUSHES,SHRUBS,AND FLOWERS TO BE PROTECTED.HOMEOWNER IS ASKED TO SUPPLY ELECTRICAL POWER IF NEEDED. S 'TION 1 CERTAI ED LANDMARK SHINGLES 50 YEARS NON-P- ' ;ATED TRANSFERA= -RANTY LABOR AND M • ' ALS: '• : 50.00 DUMPST ': '•650.00 TOTAL: i. 9 ' • 0.00 OPTION 2 GUeage,ed woof ,a001- CERTAINTEED LANDMARK SHINGLES 40 YEARS PRORATED WARRANTY(10 YEARS NON-PRORATED PERIOD) LABOR AND MATERIALS: $7,550.00 DUMPSTER: $650.00 TOTAL: $8,200.00 '•WE WILL MATCH OR OUTBID ANY LEGITIMATE COMPETITOR* CAPE COD HOME IMPROVEMENT TM IS PROUD TO PRESENT YOU WITH SUPERIOR 1 O YEAR WORKMANSHIP AND SERVICE WARRANTY.THIS WARRANTY IS IN ADDITION TO,BUT RUNS CONCURRENTLY WITH ANY MANUFACTURERS'WARRANTIES. IT COVERS ALL SERVICE CALLS RELATED TO WARRANTY REPLACEMENT AND/OR INSTALLATION ISSUES FOR THE FiRST TEN YEARS AFTER PRODUCT INSTALLATION Please. and sc e4. roar weeko' .tet, 8yg Ctiecir-0A CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT TM WITH ANY QUESTIONS OR CONCERNS f 10 I PLEASE INITIAL THIS PAGE A '/'1A k A...s.„001 CAPE COD Home CAPE COD HOME IMPROVEMENT TMImprovement 27 MILL POND ROAD,WEST YARMOUTH MA 02673 (617) 710-1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME PROPOSAL 06.23.2018 TO ANNA AND JIM ASTUTO LOCATION: 1 15 POND ST, SOUTH YARMOUTH WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR MAIN COMPOSITION SHINGLE ROOF: • REMOVAL OF ALL EXISTING ROOFING AND FLASHING MEMBRANES TO THE PLYWOOD DECK SURFACE. • REPLACEMENT OF ANY DAMAGED OR DETERIORATED PLYWOOD DECKING AT AN ADDITIONAL COST.DECKING WILL BE REPLACED IN WHOLE SHEETS ONLY IN ACCORDANCE WITH RECOMMENDATIONS BY BOTH THE NATIONAL ROOFING CONTRACTORS ASSOCIATION(N RCA)AND THE AMERICAN PLYWOOD ASSOCIATION (APA).NEW DECKING SHALL BE APA RATED FOR STRUCTURAL USE.DECK FASTENING WILL MEET OR EXCEED LOCAL BUILDING CODE REQUIREMENTS. • REPLACEMENT OF FOLLOWING FLASHING MATERIALS:STEP FLASHINGS,PIPE FLANGES,PERIMETER DRIP EDGE MATERIAL AND ALL SKYUGHT FLASHING MATERIAL ALL MATERIALS TO MEET OR EXCEED MANUFACTURER'S REQUIREMENTS. • ONE ROW OF ICE AND WATER PROTECTION MEMBRANE SHALL BE INSTALLED IN ALL VALLEYS AND AROUND THE CHIMNEY. • ONE ROW OF ICE AND WATER PROTECTION MEMBRANE SHALL BE INSTALLED ALONG ALL EAVES AND SHALL EXTEND PAST THE INTERIOR WALL LINE A MINIMUM OF 18INCHES TO PROVIDE PROTECTION AGAINST DAMAGE FROM ICE DAMS. INSTALLATION OF ONE LAYER OF ROOFING UNDERLAYMENT ON DECK SURFACE NOT COVERED WITH ICE AND WATER PROTECTION MATERIAL • INSTALLATION OF NEW,ARCHITECTURAL-STYLE ALGAE-RESISTANT CERTAINTEED SHINGLES.SHINGLES WILL BE INSTALLED IN STRICT ACCORDANCE WITH THE MANUFACTURER'S SPECIFICATIONS AND SHALL BE FAS I LNED USING SIX NAILS PER SHINGLE. • COLOR OF ROOF PENETRATIONS AND FLASHINGS TO BE CHOSEN BY OWNER. • INSTALLATION OF A SHINGLE-OVER RIDGE VENT.VENT IN THIS AREA IS CONTINUOUS AND WILL CAPE COD HOME IMPROVEMENT" GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT" WITH ANY QUESTIONS OR CONCERNS /‘ Ai PLEASE INITIAL THIS PAGE J • . ,\ • 1 PI CAPE COD HomeH"me 1 CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD,WEST YARMOUTH MA 02673 (617) 710-1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME COSTS OFF COLLECTION.INCLUDING ATTORNEYS FEES WILL BE RECOVERABLE,IN THE EVENT OF NON- PAYMENT. WE LOOK FORWARD TO WORKING WITH YOU: PLEASE CALL IF YOU HAVE ANY QUESTIONS. SINCERELY CAPE COD HOME IMPROVEMENTTM THIS CONTRACT NOT VALID UNLESS SIGNED BY ANATOLI"TONY"SIVITSKI ACCEPTED BY Tel ei4 ct b i Cf 0 4-0 LT72_ SIG '��.. ( ahiATE 1////I eJ ACCEPTED BY 1)G'r' Q U As- I/ a lits DATE 71 //if Ce ACCEPTED BY rA.1'�172t Vit1 SIGto.. DATE Og.a3� A CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT TM WITH ANY QUESTIONS OR CONCERNS A PLEASE INITIAL THIS PAG • I, , , • • reil CAPE COD Home Improvement CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD,WEST YARMOUTH MA 02673 (617) 710.1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME PAYMENT TERMS: 50%AT DEPOSIT; 1((00 50%UPON COMPLETION. JOB IS ESTIMATED TO COMMENCE APPROXIMATE2 TO 8 EKS AFTER DEPOS E WORK IS SCHEDULED TO BE SUBSTANTIALLY COMP l cIN PPROXIMATEL 1 TO 2 WEEKS. ANY WORK ABOVE AND BEYOND THE SPECIFICATIONS WILL BE PERFORMED AT 56.00$PER MAN HOUR PLUS MATERIALS OR PRICED ON REQUEST.ALL ADDITIONAL WORK,INCLUDING TRAVEL TIME AND LUMBERYARD RUNS,MOVING ALL PERSONAL OBJECTS,FURNITURE,ETC.FROM WORK AREA,WILL BE SUBJECT TO EXTRA CHARGE.IN THE EVENT OF ROT REPAIRS,ROOF REPAIRS OR ANY RELATED WORK REQUIRING IMMEDIATE ATTENTION,WE WILL PROCEED WITHOUT CUSTOMER APPROVAL CAPE COD HOME IMPROVEMENT"'WILL PROVIDE CLEANUP ON A CONTINUING BASIS AND ALL DEBRIS WILL BE REMOVED FROM SITE(PROFESSIONAL CLEANING DOESN'T INCLUDE).ALL PRODUCTS INSTALLED BY CAPE COD HOME IMPROVEMENT"'WILL BE TO MANUFACTURER SPECIFICATIONS.ALL WORK WILL BE PERFORMED BY INSURED PROFESSIONALS. ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED,AND THE ABOVE WORK TO BE PERFORMED IN ACCORDANCE WITH THE DRAWINGS AND/OR SPECIFICATIONS SUBMITTED FOR ABOVE WORK AND COMPLETED IN A SUBSTANTIAL WORKMANLIKE MANNER. OWNER TO MOVE ALL PERSONAL OBJECTS,FURNITURE,ETC.FROM WORK AREA.ALL ITEMS AGAINST WALLS SHOULD BE CONSIDERED FOR REMOVAL DURING ANY EXTERIOR SIDING JOBS,ADDITIONS,ETC.TO GUARD AGAINST DAMAGE.IN THE CASE OF ANY ROOFING AND RIDGE VENTING,DUST AND DEBRIS SHOULD BE EXPECTED AND ANY ITEMS IN THE ATTIC SHOULD BE REMOVED.CAPE COD HOME IMPROVEMENT TM IS NOT RESPONSIBLE FOR ANY DAMAGES IF SAID ITEMS REMAIN IN PLACE. CAPE COD HOME IMPROVEMENT"'IS NOT RESPONSIBLE FOR ANY DAMAGES THAT MAY OCCUR DURING CONSTRUCTION TO LANDSCAPING OR ANY FINISH GROUND WORK,PLANTINGS,ASPHALT OR STONE DRIVEWAY, ETC.FLOWERS AND SHRUBS AGAINST HOUSE MAY NEED TO BE REPAIRED OR REPLACED BY HOMEOWNER. ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN ORDERS,AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE.ALL AGREEMENTS CONTINGENT UPON STRIKES,ACCIDENTS OR DELAYS BEYOND OUR CONTROL OWNER TO CARRY FIRE,TORNADO AND OTHER NECESSARY INSURANCE UPON ABOVE WORK.WORKMEN'S COMPENSATION AND PUBLIC LIABILITY INSURANCE ON ABOVE WORK TO BE PLACED ON THE RESIDENCE AS A CONSEQUENCE OF THE CONTRACT.OWNER WHO SECURE THEIR OWN CONSTRUCTION-RELATED PERMITS OR DEAL WITH UNREGISTERED CONTRACTORS WILL BE EXCLUDED FROM ACCESS TO THE GUARANTY FUND. CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT"' WITH ANY QUESTIONS OR CONCERNS / ii PLEASE INITIAL THIS PAGE 1 V e,J P