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HomeMy WebLinkAboutBLD-19-001419 pl-*Yetett TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.1261 3 : „" , 7.cPERMIT O y PERMIT NO -BLD-19-001419 ACI??t6).. ^45.g ISSUE DATE 09/1012018 kIRJOB WEATHER CARD APPLICANT ,JOHN H FERGUSON J PERMIT TO New AT(LOCATION) 136 MATTACHEE RD,SOUTH YARMOUTH, MA 026 1 ZONING DISTRICT 1 1 Bldg.Type: !Residential SUBDIVISION MAP BLOCK LOT 033.277 BUILDING IS TO BE: CONST TYPE V B USE GROUP R-3 REMARKS Repair: Install Insulation(508-695-8222) CONTRACTOR LICENSE CSFA-104439 Construction Supervisor 1 JOHN H FERGUSON JOHN FERGUSON AREA(SQ FT) 758,989,440. EST COST($) 5549.00 PERMIT FEE($) 35.00 Danvers,MA 01923 OWNER ,BIANCHI MARIANNE TR BUILDING DEPT BY ADDRESS THE 36 MATTACHEE RD RLTY TRUST, 31 KE NEWTON MA 102158 ! HONE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STRE , A Y OR SIDEWALK ANY PART THEREOF, EITHER TEMPORARILY OF PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED 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: 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 ARrI\/F r 7 . p4•�,qR Office Use Only 't t ° Permits{ nI 7 Permit expires 180 days from BLD-19- 0 '919 aissue date BUILDING PERMIT APPLICATIONU TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth,MA 02664 n(508)398-2231 Ext 1261 Rivera//� y'- /� /l�/n/ CONSTRUCTIONADDRESS:SU H( ff chet . 1W1 & � Rive a H 1 (Wdotf ASSESSOR'S INFORMATION: //''�I �t Map: Parcel: OWNER:193UI LI(ff) /1 i g(Q HCUQr/IP2 )) 666s ei ver MIt (q 172 01 NAME PRESENT ADDRESS TEL. N —1L 7O CONTRACTOR: 7rlan UI gen Loa MTHv2 Nf-Hern Mil- 50 cogs AME MAILING AD RESS TEL.# g7-7-12 7 . Residential ❑Commercial Est.Cost of Construction$ .15 N' I q C _ .2 Home Improvement Contractor Lie.# f O`7� Construction Supervisor Lie.# o 35 Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑ I nam the sole proprietor ave Worker's� Compensation Insurance �7 Insurance Company Name: R •3 V l I rn O rt TYlSurlL ter's Comp.Policy# U77o D L7�-26! WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares ( )Remove existing*(max.2 layers) Insulation Old Kings Highwayyflliistoriic Dist. ( )Replacing like for like Pool fencing / *The debris will be disposed of at:11 I /to1"I Ie— N Se J Ilt ol re 1 /I* 027 (e0 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 den i., •r revocation ofmy '= ////or prosecution under M.G.L Ch.268,Section 1. QQ ��''77��,,�� p' Applicant's Signature •I�L ' _�s-/� Date: ?'(/t U G-(�J Owners Signature(or attachment) 51€0 �r • C Q/ IT- Date: Fla Ip/n 1 O Approved By: �/--�+• Date: q -10-/g Building Official(o • ign e) EMAIL ADDRESS: Zoning District: Historical District: ❑ Yes 0 No Flood Plain Zone: ❑ Yes ❑ No Water Resource Protection District: Within 100 R.of Wetlands: 0 Yes 0 No 0 Yes 0 No DoseSign Envelope ID:3CD46B7C-58564FFA-BD18-255355E0D579 Page 1 of 1 Customer Name:Paul A Bianchi CONTRACT ----- Email:pabianchi51354@gmail.com Phone:6I7-201.7228 Premise Address:36 Maaachee Road,Bass River,MA 02664 RISE Project ID:3443395 Date:July 26,2018 ENGINEERING' EfficicncyEnergised_ RISE Engineering 5 Dupont Avenue,Suite 2 South Yarmouth,MA,02664 Applicable Customer Required Actions: Notes: Storage Removal Storage in attic should be removed prior to weatherization work. .Inh Ilacrriptinn Measure Description Quantity Unit Total Cost Customer Cost AIR SEALING 8 hr $640.00 $0.00 REMOVE EXISTING INSULATION-INCENTIVIZED 720 SF $698.40 $174.60 CRAWLSPACE:R19 RANDOM 720 SF $1,555.20 $388.80 FSK PAPER AIR BARRIER OVERHEAD 1280 SF $1,241.60 $0.00 CRAWLSPACE:10 MIL GROUND COVER 1458 SF $1,414.26 $0.00 Total: $5,549.46 Program Incentive: -$4,986.06 Customer Total: $563.40 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "'Five Hundred And Sixty-Three And 40/100 Dollars $563.40 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES e—eoweian.d by: e—Docutlan.4 by: Pbiamiti `FYftt,far native ' B t5Ii4idP?3t?iature 7/28/2018 19:05 AM EDT Sign Date NOTE.THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND 30 DAYS CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE DocuSign Envelope ID:3CD46B7C-5856-4FFA-BD18-255355E0D579 Nye- Permit Authorization mass save Form Site ID: 3443395 Customer: Paul A Bianchi 1 Paul Bi anchi ,owner of the property located at: (Owners Name,printed) 36 Mattachee Road Bass River, MA 02664 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. D«.)w..d ey Owner's Signature:Etta. l5iAa titi 7C55BCBC8D65416.. Date:7/28/2018 I 9:05 AM EDT FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: k . I ornfir Di11120Iir Participating Contr ctor Date Name: RISE Engineering Phone: 401-784-3700 Email: For Office use Only Rev.102015 CLIENT II:3443395 BARRIERS TO WORK:Y/N SIDING:WS HIGH VENTILATION: NONE/RIDGE/GABLE/ROOF VENTS ROOF WORKABLE:Y/N LOW VENTILATION: NONE/CONTINUOUS/VENTED DE/SOFFIT VENTS SOFFIT WORKABLE: Y/N ROOF MATERIAL:MPH SOFFIT MATERIAL:PINE ,—No Access to ' this ate space 11.1 .• Storage 8 HRS AIR SEALING(6 ATTIC FLAT,2 CRAWLSPACE PENETRATIONS/PERIMETER) 1458' 10 MIL POLY VAPOR BARRIER CRAWLSPACE FLOOR(ENTIRE AREA,TO RELIEVE HOMEOWNER CONCERNS WITH MOISTURE AND HIS FLOORS) 0 720'REMOVE INEFFECTIVE FG/R19 FG REPLACEMENT ®1280'PSK PAPER CRAWLSPACE CEILING(ENTIRE CRAWLSPACE CEILING AREA,HOMEOWNER VERY CONCERNED W/FG FALLING DOWN AGAIN.PLEASE USE PSK AND NOT FSK) *WORK TO BE DONE AT A LATER TIME" 52 VENTILATION CHUTES (8)4"X16"SOFFIT VENTS(4 FRONT,4 BACK) 160'DAMMING(STORAGE,RECESSED LIGHTS,EAVES) 912'13"CELLULOSE OPEN ATTIC FLAT INSTALL THERMADOME 4Q Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: Corporation BRUIN CORPORATION OF ATTLEBORO Registration: 104439 Expiration: 07/13/2020 479 MOUNT HOPE STREET N.ATTLEBORO,MA 02760 • Update Address and Return Card. :a 1 0 20M-05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expirattffi Office of Consumer Affairs and Business Regulation 104439 07/13/2020 One Ashburton Place-Suite 1301 BRUIN CORPORATION OF ATTLEBORO Boston,MA 02108 ,y(�� /�J J//(/�� p BRIAN K OLSEN �2 col--� SAA-41-74._.) i (_ '`Le'�J479 MOUNT HOPE STREET \ • N.ATTLEBORO,MA 02760 Undersecretary Not valid without signature �( Commonwealth of Massachusetts i`WI! Division of Professional Licensure • Board of Building Regulations and Standards Construction SO pe ry i s o r CS-066339 - • ires: 06/15/2019 BRIANKOLSEN s, • 479 MT HOPE ST NORTH ATTLEBORO MA 027Br 10/ v.1:1LCA ,. ..+ Commissioner l t • ' The o .imoiuwealth of Massachusetts I `wok t .Dep r Miert jof IndustelalAccddertts a fifth ongress Street,Suite 100 --` 7 , rastotj,MA02114-SOX7 0.1%4440,• wwrv,nutss.gov/Aida Workers'Compensation Inst at ce Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE Fit:D ITH p HE PERMITTING AUTHORITY apnllctptt kformation ___. __thug_ Fieq a Print Legibly Name(Business/Organization t,dividuat): 6 n .Cc�v�p (DP 1' � ���"'_ Address; "' City/State/Zip: ) a Al S Phone#, :`GjQ ib-�.�sr Are you an employer?Check the appropriate box; t,t )ant a employer cold, / Type of project(r anon d): J1.e iL�..employees&till aro/oi part-time).* 2.©I ata asole proprietor or partnership and have no em.lo,'eea wor$ing for me m 7. 0 New construction any capacity.(No workers'comp.insurance require..] $ [r^�fit Remodeling 3.01 am a homeowner doing all work myself[Na workas comp.inbnrnnce required.]° 9. L�Demolition • 4.01 am a homeowner and wilt be hiring contractors to c.ii suet all Work on toy property. I will 1 ]Building addition ensure that all contractors either have workers'camp-n anon insurance or aresola proprietors with no employees. 11.0 qq Electricalrepairs or additions 5.01 am a general contractor and 1 have hired the sub•co n Actors listed on the attached sheet. 12'u Plumbing repairs or additions' These sub•connactors have employees and have woe et 'comp.insolence.' 13.0Roof repairs 6.0 We are a corporation and its officers have exercised t e night of exemption per MGk c. 14, Other ' j))U '� 152,$1(4),and we have no employees.[No workers'c rap.insurance required.] *Any applicantthat checks box#1 must also till aur the seen in below showing their workers'compensation policy information. t Homeowners who submit this affidavit Indicating they are..i g all work and then hire outside contractors must submit a new affidavit indicating such ;Contractors that check this box must attached an additional s t showin:the name of the sub•contractots and state whether or not those entitles have employees. If the snb•contractors have employees,they must p ovide the r workers'comp.policy number. 1 nun an employer thatis previdhtg workers'cola emotion insurance,for my employees. Below is the policy andJob site information, r�^'� Insurance Company Name:y'�r, 5 ` a •,emn' / /1 ,_ Policy#or Self-ins. Lie.#:_ "j ,{3' r �' �,�8 lei I. �. .._._•__••_••. Expiration Date: '�j�`I y Job Site Address:_ City/State/Zip: Attach a copy of the workers'compensation p r i cy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under MG . 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil pet .lties 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 ay be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby cent)a:Wer thepains and penalties r perky that the information provided above is true anti correct Signature' /'1a _y Phone#: _ =s c8 els Q— M Way use only, Do not write in this area,to 7e cooked by city or town official, City or Town: __ Permit/License# Issuing Authority(circle one): """ """— I.Board of Health 2.Building Department City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6,Other Contact Person: ��_� Ph.ne#; _ . BRUICOR-01 AKAHANOWITZ ACORO• CERTIFICATE OF LIABILITY INSURANCE n DATE YYYY) `/ 07/18/22 018 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 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 p endorsement(s).N7p :. PRODUCER tlBME;CT R.S.Gilmore Insurance PHONE FAX 27 Elm St (NC,No,Eat):(508)699-7511 VA,no(508)699-7511 North Attleboro,MA 02760 MASS. INSURER(S)AFFORDING COVERAGENAIC# INSURER A:Arbella Protection 141360 INSURED • INSURER a: Bruin Corp.of Attleboro 'INSURER C: I 479 Mt.Hope Street . . INSURER D: North Attleboro,MA 02760 INSURER E: 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. III TF {ADDL. POLICY NUMBER IYPOLICY EFF POLICY EXP I TYPE OF INSURANCE (NSD W D IMMIDDYYYI I IMMIDD/YYYYI( LIMITS A i X I COMMERCALGENERALLIABILITY I EACH OCCURRENCE I$ 1,000,000 18500059006 , 03/29/2018 03/29/2019'DAMAGE (RENTED CLAIMS-MADE 1 X 1 OCCUR I DAMAGES(ReNLarrenCel I S 100,000 MED EXP(Any one Demon) I$ 5,000 '�.� I PERSONAL&ADV INJURY I$ 1,000,000 IGENT.AGGREGATE LIMIT APPLIES PER: ' •GENERAL AGGREGATE I$ 2,000,000 POLICY E LOC PRODUCTS•COMP/OP AGO I$ 2,000,000 OTHER: $ A (AUTOMOBILE LIABILITY I !COMBINED SINGLE LIMIT 1,000,000 1,000,000 II(Ea accident) s I ANY AUTO '1020019117 03/29/2018'03/29/2019 IT OWNED ^l SCHEDULED I BODILY INJURY(Per person) $ • _yyyX���II AUTOS ONLY I X I AUTOSUyy ORM 1 ! BODILYgINJURYp (Per accident)!S 1 AUKS ONLY � X I AUTOS ONLY (Pa Lcident)AMAGE $ $ AIX UMBRELLA LIAR I )(!OCCUR EACH OCCURRENCE �I.i 2,000,000 EXCESS LIAR I CLAIMS-MADE: I 4600059007 103/29/20181 03/29/2019 2,000,000 AGGREGATE DED 1 X RETENTIONS 10,0001 . I $ A WORKERS COMPENSATION PER i ERK AND EMPLOYERS'LIABILITY YIN ', 15iATAC I ER IANY PROPRIETOR/PARTNER/EXECUTIVE 4220053526 106/1112076106171/20191 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIM�MBER EXCLUDED? `_ NIA i l antlalary nNN). 1,000,000 Nyas,describe under ' I E.L.DISEASE•EA EMPLOYE$ DESCRIPTION OF OPERATIONS below I ! I E.L.DISEASE•POLICY LIMIT 5 1,000,000 • ! , DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 1/more space Is required) CERTIFICATE HOLDER' 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. AUTHORIZED REPRESENTATIVE` SSC ACORD 25(2016/03) ®1988.2015 ACORD CORPORATION, All rights reserved, ' The ACORD name and logo are registered marks of ACORD