HomeMy WebLinkAboutBLD-19-1166 t.01.Yq�'r ,r- c Use O y j
Oi (Amovat Z.JU
ATTKM 53
�4°"",„0/„._ K Permit expires 180 days from
,l Issue dare
EXPRESS BUILDING PERMIT APPLICA
"' CEIVEi
TOWN OF YARMOUTH AUG 2 7 2018
Yarmouth Building Department
1146 Route 28 BUILD • e .. • •f.mt'+.af
South Yarmouth,MA 02664 By — - S
(508) 398-2231 Ext. 1261
a.
CONSTRUCTION ADDRESS: 3- CDc3 74 v.1 7 atrim(7t.tkAn �oVT ( 1424- D2Cea5-
ASSESSOR'S INFORMATION:
Map: 1 is- Parcel: 19 (
OWNER` OLit%r% Lr�n 9-3C049t4.re .A t,,,�t„e£c.tr,44 rcJs►•► t,tsftaKt.
NAME PRESENT RESS TEL # Email Address +
CONTRACTOR: Ui trd hi'kim c — '441 lja,r cla9• S. -Defe is 744— :58 348(+5(1 Vascrttz.€9vnwQ
NAME GADDRESS TEL# Email Apdress:
CelCommercial • Est.Cost of Construction$ 4i?2 . CO
Home Improvement Contractor Lic.# ('?LF'1C3 - Construction Supervisor Lic.# Cif,2 L.$e'
Workman's Compensation Insuran •
I am the homeowner I am the sole proprietor I have Worker's Compensation Insurance
Insurance Company Name: (\IL7 VA-IS Co ceJlr-s)�Policy# MP()Si n-,
WORK TO BE PERFORMED
Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove
Siding: #of Squares Replacement windows:# S An ti“CO Replacement doors: #
St lid
Roofing: #of Squares ( )Remove existing* (max.2 layers) Insulation
1:7141d1�I� /
d Kings Highway/Historic Dist. ( 4j Replacing like for like •
'The debris will be disposed of at l Ca,twti<..> "5epK-rt,a- kat(
Location of Facility
I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or vocation of..y ' ease and for prosecution under MG.L Ch.268,Section 1.
Applicant's Signalize: 1,1 . Date: s'- 23- 20(9
Owners Signature ii= ?IAEA O, _ it I'- a . if , It- ' t Date:
Approved By / <, %` ' Date: '�7 eg
Buil.'.:„ rci/.•.esiw--)
Zoning District
Historical District Yes No Flood Plain Zone: Yes No
Water Resource Protection District Within 100 ft.of Wetlands:
Yes No Yes No
_ &:::\ The Commonwealth of Massachusetts
1v�II 't Department of IndustrialAccidents
=Eels fy 1 Congress Street, Suite 100
' ' Boston,MA 02114-2017
l
==4,,Lar www mass.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): Vile5C0 �1kvl47
Address: % q ,i
/ Ra
City/State/Zip: Sn , 3 a44/5 194- 0&D Phone #: 5-68 35S 15/(
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. 0 New construction
2.(y}•1'am a sole proprietor or partnership and have no employees working for me in
��-r any capacity.[No workers'comp.insurance required] 8. El Remodeling
3.0 tam a homeowner doing all work myself[No workers'comp.insurance required.]t 9. ❑Demolition
4.0 I am a homeowner and will 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.
JO I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.0 Plumbing repairs or additions
These sub-contractors have employees and have workers'comp.insurance.; 13.0 Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 140-Other 9?jte G- tut
152,§1(4).and we have no employees.No workers'comp.insurance required.] �r(V�''-�~
"Arty applicant that checks box#1 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 contractors must submit a new affidavit indicating such.
;Contractors that check this box must attached an additional sheet showing the name of the sub contactors 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 nip employees. Below is the policy and fob site
information.
Insurance Company Name: CA-0 t ,,tai r
Policy#or Self ins.Lie.#: MPD S/ f %------1- ,3 Expiration Date: 9 - 1 Z - Za(3
Job Site Address: 0; CM., Ac City/State/Zip: ettr to L r y-4- (1
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). c'E.4-4C
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 ains and penalties of perjury,that the information provided above is true and correct
Signature: V .r.1--‹ , A4-C Date: k- 2.'4-7ntfi
Phone#:
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#:
Clients;647900 2NUNEZVA
ACORDe, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDa'YYY)
11/08/2017
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(les)must be endorsed.If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require en endorsement.A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER NOONaTACT Dowling&O'Neil
Dowling&O'Neil Insurance Agency PH°NE 20 508 775-16
973 Iyannough Road (A/c,""•Ea') (AAA am:5087781218
EMAIL col@dolns.com
P.O.Box 1990 ADDRESS:
Hyannis,MA 02601 IN8UIIER(S)AFFORDING COVERAGE NAICI
INSURER A:NGa Mamma Cmmpany 14788
INSURED
Vasco E.Nunez III D/B/A INSURER B
V.E.Nunez Carpentry INSURER C:
79 Mayfair Road INSURER D:
South Dennis,MA 02660 INSURERS;
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 MOVE 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.
LTR TYPE OF INSURANCE ADDLSUBR POUCY EFF Tag;
INSR WVp POLICY NUMBER (MMAKINYYY),(A1MATdYYYY) LIMITS
A GENERAL LIABILITY MP05117J
09/12/2017 09/12/2018 ppEAACL�IH�TO,EECTCTppURgqR��ENCE $2,000,000
X COMMERCIAL GENERAL LIABILITY PREMISESMEATerco $500,000
CLAIMS-MADE OOCCUR MED EXP(My orepemon) (10,000
PERSONAL S ADV INJURY a 2,000,000
GENERAL AGGREGATE :4,000,000
TGENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG $4,000,000
PDLXW fl JFK I I LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
— (Ea ANY AUTO BO ILY INJURYll $
ALL OWNED ��SCHEDULED
BODILYJ (Partenon) f
AUTOS NAUTOS
ON.O BODILY INJURY(Per accident) :
HIRED AUTOS NONOWNED
-� AUTOS
PROPERTY
ROPE accident)
DAMAGE
$
UMBRELLA Late OCCUR
EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE
AGGREGATE $
OED I (RETENTION$ —WORKERS COMPENSATION f
AND EMPLOYERS'LIABILITY TORY
STATU- I
OTH-
ANY PROPRIETOR/PARTNER/EXECUTIVE
Y/N EACH AC D ER
OFRCERMEMBER EXCLUDED? n N/A EL.EACH ACCIDENT $
(Mandatory In NH)
X decrnbe troy L DISEASE•EA EMPLOYEE S
DESCRIPTION OF OPERATIONS below
EL DISEASE•POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Addilonal Remarks Schedule,a more apace la required)
Insurance coverage Is limited to the terms,conditions,exclusions,other limitations and endorsements.
Nothing contained In the certificate of Insurance shall be deemed to have altered,waived,or extended the
coverage provided by the policy provisions.
CERTIFICATE HOLDER CANCELLATION
Town of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Main Street,Route 28 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
South Yarmouth,MA 02664
AUTHORIZEDREPRESENTATIVE
"RAIL
XJ14: 4U,
®1988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
OS200971/M198108 CBD
,nes r•
- PROPOSAL 788
o .. MA tic. +069680
4 1�T� 79 Maytag Q
SaaUJ Dennite,, MA 02
t„w�,mdow*tom H.t-C. =124793
(508) 398-1511 • Dennis. MA
(866) 398-1511 • Toll Free - _
TO: Mr. Robert C. Lawton 774-994-7705 +1( 7/29/2018
Art
27 Cobb Ave. Y._Uy
.�AI{.11'l.Ara t 4` n• —
Taraouth Port MA 02675 Andersen windows
E !:'y NilFrit _ - .......!1--77.0
1 7705/TW - 1,H 508-362-3274
'y 11.4..,+'I ecte'war.Aad..10•trn.for .
We hnrwt
y
2. Remove five wooden double hung windows from living room and front corner bedroom, and
replace with five Andersen 'Tiltwash• double hung windows in same locations. Locations are,
( two in living room and three in front corner'bedroom ). -
* New Andersen 400aeries_�'Tiltwashe windowa_will-haven white-vinyl-clad-exrerior with a
"'""`"clear pine interior, stone colored hardware, full screens, and grilles between the glass with
a 6/6 pattern. New Andersen window will have Low-84 argon gas filled insulated glass, and are
energy star rated.
2. Insulate the cavities of new windows.
3. Supply interior/exterior trim. New interior trim will be clear 2 1/2- colonial casing
with clear Andersen stool cap. New exterior trio will be PVC plastic 1 x 4 square stock with
PVC plastic historic nosing.
4. Take old windows and any debris from this job to the town landfill.
5. Make arrangement for delivery of new Andersen windows.
6. Supply town of Yarmouth building permit end historic CYR certificate of appropriateness
per letter enclosed. -
• This proposal does not include any other work not described above.
• All Andersen products described above will be prepaid by the home owner.
• Any changes to this proposal must be done in writing and accepted by both parties.
•* If this proposal is satisfactory, please sign the YELLOW copy and return with payment
schedule.
•' Pleas., nake a check payable to Vasco Nunez Carpentry in the a.-mount of $ 2,572.97 for your
new Anderson windows described above and please include this chock with your signed proposal.
Allow 3-4 weeks for delivery, this is'a factory order.
We Propose byaythr5ryftJ:r.
anai dlata.(-- r-rt•t.erenar---m,;ryewt.toai..?✓rrp.r .,'.'-rn.Pit r'4Suri!J —
Four Thousand Six Hundred Twenty Two and 97/I00 Dollars .mar ch 4,622.97 ,
' Pnimemilet=•rwru yP ow`s _ —
, —
Labors 50t n:. payment to start at tire of start - - - $ 1,025.00 --
Labor: 509 Upon corpletion at tire of corpletion $ 1,025.00
-otal labor due . .. _ $ 2,050.00
.1-•�.,'..d.t x:tam.?Y.:e.�,•r✓a41 1!v. •-,1,., .n-n n a»w;t.ra _ 4. --
il•.Iet,,^."r1ji.rY:awt.-f rtl:.} it
r n,r.-., ,Ct• '�tt1 p l n i a p;...- aro N,y..'rh':e-yl..Y '411P•^,nand / J
t.*CI I.. il.70.]1, e.r..•r.r vl-•h ant we r..Yt.7r i Z.Y. /t�"1
-1a£Y:t...-:14-44..M N.enn.l. A dtrry :YT:ir1.YY (-' . - ('�-�tf{r,y
F aa�Y4 t.J..irr;RT 1 i.a;hi•s.: .i.',.1.cry r'1 - 4
let r"-u.?•tits•CS;rtw .l tr/a+y Intlr-.xx all fY.rrc-rary i-,(telt Oar 11dte.Tin: r .{oa t• .,y h* f
+n.4."4177.44:7..-..l tts nln,.vbc..-te.:uh•e rw.'.r..e P• f
e:'winos LY L.if^n(ext hil wmin • 5 dA:A.
Acceptance of Proposal-n.at-s,(..w. .t.;LI r,,Mt
it ridl-aartor .•43.41,4k:a:'..f]..C1tirtt.". p:]'^G.fspr:LI CO r4 grit t: ti,
•ff^cul r•45^'!'•f wrl'..nye Jt a .rv..JYi^m (Y sl•• _ -. �� v
fl-.n Cf 0.}.r•.tlr.r
,--,45,6,,,,,,,,g),-", - 04, :,.PCn. —
�,� _ ✓
t f •. .r.w1 .•.•ct--- ..+...I.r•f r.n....n.IA,.4.l♦ .-n.. ....
•
Massachusetts Department of Public Safety 4
Board of Building Regulations and Standards Construction Supervisor 1 82 Family
License:CSFA-069680 Restricted to:
Construction supervisor 1 ti 2
•
Family
: ,.
':rVASCO E NUNEZ,10 ';"` r
79 MAYFAIR ROAD .. `. .�• '
SOUTH DENNIS MA 02660 .1-:.?::t..,�- " :A
•
"^x `-A--- Expiration: Failure to possess a current edition of the Massachusetts
missloner 1010312018
picaState Building Code Is cause for revocation of this license.
• DPS Licensing information visit:WWW,MASS.GOV/DPS
•
ei7.V;m nen amnia%Il('/4ab4/ajrla ' I
)::.% Office of Consumer Affairs a Business Regulation'
!'-T-` '^J( HOME IMPROVEMENT CONTRACTOR •
rig--it ' r Registration valid for Individual use only
C P "I TYPE'IndMduel before the expiration date. If found return to:•
I
-4rN'/ll lleatram Exalratlorl
10 ice of Consumer Affairs and Business Regulation
-ry;,;. •• .124793 08/24/2019 10 Park Plaza-Suite 5170
VASCO E.NUNEZ,III _ Boston,MA 02118 ,
•
VASCO E.NUNEZ III` ,,�.C�¢— ` .l y/ • I
79 MAYFAIR N U r '- t 0.L.7' r ,
S.DENNIS,MA 02660 —_______--...,-
Not
�" S�•k
Undersecreta Not valid without i nature 1
9
Anders/
ii:T en. Andersen Windows-Abbreviated Quote Report
Project Name: Lawton 27 Cobb Ave
Quote#: 2096 Print Date: 07/23/2018 �Y.
Dealer: Shepley Quote Date: 07/23/2018 IQ Version: 18.0
Customer: Vasco Nunez
216 Thornton Drive Billing
Hyannis,MA Address:
508-862-6200 Phone:
Sales Rep: Candice Giantonio Fax
Created By: CLG Contact:
Trade ID: Promotion Code:
Item Qty Item Size(Operation) Location Unit Price Ext.Price
0000 1
S 0.00 $ 0.00
RO Size=N/A Unit Size=N/A
Not Applicable
Andersen 400 Series Windows
White Exterior
Pine interior
HP Low E4 Glass
3/4'Finelight grilles between the glass
Full Screen
White Hardware
! 1I 0001 ,15 TW2446(AA) Living Room $
RO Size=2'6 1/8"W x 4'8 7/8"H Unit Size=2'5 5/8"W x 4'8 7/8"H
VOW IOW
400 Series
1 Unit,Equal Sash,White/Clear Pine,High Performance Low-E4 Glass,Finelight Grilles-Between-the-Glass,Colonial,3W2H,White/White,3/4"(Each
Sash)
Insect Screen,White
Viewed from Exterior
U-Factor.0.30, SHGC:0.28
Quote#: 2096 Print Date: 07/23/2018 Page 1 Of 3
IQ Version: 18.0
r,