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Home My WebLink AboutBLD-19-001518 . I .e o f,I,qR !Office use Only 9 : :fir p Permit# O $ 1 F : 'Amount 0 tJ ` •.... 'r-.1' Permit expires 180 days from issue date Siub— [Cc-vaS� � RECEIVED EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH SEP 13 2018 Yarmouth Building Department 1146 Route 28 8 u 1 It : • ire T South Yarmouth,MA 02664 By• — - r n (508) 398-2231 Ext. 1261 / ' t �`f`' ^7 CONSTRUCTION ADDRESS: 90 Sect.✓t etj /Wes - . Yo.rnt,jevit iy(L}- Oni T y f )/ ASSESSOR'S INFORMATION: //�� Map: Parcel: OWNER: 6Cofr s /3 ect vcuj Ion ?O 3 ee -✓ (mit(mit `. yaatouvig f/ti l r� 78'-3a 2—7#" 72 NAME PRESENT ADDRESS TEL # CONTRACTOR: f`/! 1 SCV r a!1 �7 Scot Svt iaaKt') lin �$- 77!1;700 NAME MAILING ADD S TEL# tteeisidential 0 Commercial Est Cost of Construction$ 7, 75-0 Home Improvement Contractor Lie.ft /'S 3Zo 7 Construction Supervisor Lic.# I 0 6/ 0 Workman's Compensation Insurance: (check one) ❑ I am the homeowner b-nrn the sole proprietor 0 I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp.Policy# WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares 7 Replacement windows:# Replacement doors: #_ • Roofing: #of Squares ( )Remove existing*(max.2 layers) Insulation Old Kings Highway/Historic Dist. D("D—Ilieppl/acing like for like Pool fencing 'The debris will be disposed of at: 7a/�Lt.QLL_/i ` /l fT Location of Facility I declare under penalties of perjury that the dements herein contained are true end correct to the best of my knowledge and belief. 1 understand that my false answer(s) will be just cause for denial or revoc o n o/ y i r1enseandforrpprosecution under M.O.L Ch.268.Section 1. Applicant's Signature:( Q - Date: 713-/8 Owners Signature(or attachment) Date: � . Approved By: ./: 9Date: 41 .. 1 d Building Official(or designee) EMAIL ADDRESS: Zoning District: Historical District: 0 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 Si-\ The Commonwealth of.►fassachnsetts n=ab t Department oflndustrialAccidents Office ojInvestigations E _ ei�,$ 600 Washington Street '� = Boston,314 01111 ``t• -a. tnvn:mass.gos/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information e n Please Print Legibly Name(Bumess'Otganintionlndividml): 4(P1 en Solar r fern Address: ‘7 Sem S V City/State/Zip:F5annres ?tit 0Z4J1 Phone if: Seg_" 776- 2?DO Are you an employer?Check the appropriate box: Typeofproject(required): 1.12-1 am a employer with t 4. ❑ I am a general contractor and I e employees(full ands p�-time)• have hired the sub-contractor 6. ❑New construction listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees su�OII�ciorha -e S. 0 Demolition working for me in any capacity. employees and lint workers' 9. Buildingaddition [No workers'comp.insurance comp.insurance.: ❑ required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.0 Roof v insurance required.]1 c.152,§1(4),and we have no [fl ,rte.( employees.[No workers' 13. other S, r U comp.insurance required.] *Any applicant that checks box el man also fill out the aectioa below showing their waken'compensation policy Information I Homeowners who submit this affidavit indicating they an doing all soak and then hire outside contractors mut submit a new affidarie indicating such. tontnctors that check this box must attached en additional sheet showing the name of the sub-conuactoes and state whether a not those entities hare employees. lithe subconuacton have employees,they must provide ter 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: Policy#or Self-ins.Lie.It: Expiration Date: Job Site Address- Ci /Stat ty dZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c-152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certzfr un th s and penalties of perjury that the information provided above is true and correct Signature.y ALI Date- 9—j f—41 Phone#: Sb B — 7 7 6 Z PO C Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License 0 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#: 6 • 3Z ga�2moiMieioi.�%'�, / - 4- Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvemgnt_Corjtractor Registration g-_ Type: Individual rf ARMEN SAFARYAN Registration: 183202 Expiration: 09/13/2019 67 SEA ST APT A4 e HYANNIS, MA 02601 % IV L �_ ,. tt MI' Update Address and return card. SCM 0 20M-05/17 B'nnurran tetda.°rry/'ddentacr a5& .1 Office of Consumer Affairs&Business Regulation _ HOME IMPROVEMENT CONTRACTOR Registration valid for individual use oily TYPE:individual before the expiration date. 0 found return to: pealstratiorl��_ rxoiration Office of Consumer Affairs and Busine Regulation _ 10 Park Plaza-Suite 517# 183202-__4 r 09/13/2019 i,-,_-„,.rr- 0,,y Boston,MA 02116 ARMEN SAFARYAN;.,Yr-. D/B/A COREY*ND COREYI; I ( I I ' >,� - f__3,,. 6 S EN SAAPTXAN; ._;�� 0 87 SEA ST AFT A4`_ HYANNIS,MA 0260THA's Undersecretary Not valid w thout ',Aria nure Massachusetts Department of Public.Safety Board of Building Regulations and Standards • -License: CSSL-106102 Construction Supervisor Specialty 0 ' ARMEN SAFARYAN 67 SEA STREET APT A4 '14.1,,r #irr1AY HYANNIS MA 02601 • • /jrt4. ) �%r , 4•-- Expiration: Commissioner 10/0212020 .A • • COREY & COREY "TH ROOFERS" ROOF NG,SIDING&MORE 67 SEA SIRE: T#A4, HYANNIS, MA 02601 PH o NE: 508-776-2900 SMI PROPOSAL. September 4,2018 LORI BECKINGTON UNIT: #17 90 SEAVIEW AVE. EM: Ijbeckington@gmail.com S.YARMOUTH,MA TEL:978-302-7472 COREY & COREY will perfo the following services in a neat and professional manner and in accordance with the m. ufacturer's specifications and local building codes. Remove and Haul Away All of the Id Wood Side Wall Shingles from the Entire Cottage#17 Only.Re Nail All Plyw o od Sheathing as Needed. Supply and Install WHITE CEDA CLEAR B R& R SHINGLES - - - at Average of 5" Exposure with Galvanized Staples and/or Stainless Steel R ng Shank Nails Supply and Install TYPAR SYNTH TIC UNDERLAYMENT PAPER. Supply and Install WHITE ALUMI UM WINDOW& DOOR FLASHING Clean and Remove the Debris from ork area after job is completed. TOTAL INVESTMENI $7,750.00 POSSIBLE EXTRA CARPENTR : Any Rotted or otherwise Deteriorated Trim Boards, Plywood Sheathing,Missing Metal Flashing, Side Walling or Any other Carpentry Needing Replacement Wil be Done and Charged for as an Extra: Materials Plus Labor at the Rate of$60 per Ho r(per person). PAYMENT SCHEDULE: A Depos t of One Half is due at the Signing of this Siding Proposal and the Final Payment for e Balance is Due Immediately Upon Completion. COREY & COREY "T II ROOFERS" ROO ' NC,SIDING&MORE 67 SEA SIRE T#A4, HYANNIS, MA 02601 PH•NE: 508-776-2900 SID G PROPOSAL WORK SCHEDULE: All The W rk is Scheduled for Completion Within 60 Days of Acceptance and Deposits Receive. are Non-Refundable After a Three Day Cooling Off Period from the Date of signi g. Plea a Make Checks Payable to: • TREY & COREY COREY & COREY Warrantie• the Shingles and Labor for 5 years. COREY & COREY Carries W rkman's Compensation and Public Liability Insurance on the Above Work. DATE OF ACCEPTANCE: 9/4 2.0/a--- 0/ - SUBMITTED BY: Armen Safaryan ACCEPTED BY: i C1 v/ 11 �t cite/0 .. LORI BECKINGTON) ARMEN SAFARYAN HOMEOWNER COREY&COREY