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HomeMy WebLinkAboutBLD-19-3022 .O�.yqR 8 OInce Use Only N44, $ Amount �V Permit expires 180 days from issue date B 1) —Iq_ CO3i.2 RECEIVED EXPRESS BUILDING PERMIT APPLICATIO TOWN OF YARMOUTH NOV 15 .2018 Yarmouth Building Department 1146 Route 28 aY' ` f "r South Yarmouth, MA 02664 (508)398-2231 Ext. 1261 • CONSTRUCTION ADDRESS: 40 CAFAM ax.), . r 024:3 �/ b 1 ASSESSOR'S INFORMATION: Map: Parcel: OWNER:'{ .+yt04- Lace /�S t +{SArEciL NAME PRESENTADDRESS - TEL. # CONTRACTOR: i�Aua Qo©l=traor IN:.- ' Qu p... . qct itounk Ma ea ti7-5 NAME MAILING ADDRESS TEL.# .SoK SUef 1/441:21(1) H Residential 0 Commercial Est.Cost of Construction$MCC Home Improvement Contractor Lie.# lags 9 97 Construction Supervisor Lic.# coo l b 7 Workman's Compensation Insurance: (check one) 0 I am the homeowner 0 I am the sole proprietor lc have.Worker's Compensation Insurance/ ry e �.C� p Insurance Company Name:4f^.t: 4M gY' I C4N Worker's Comp.Polio?,6567 o e- N U A 5 o S 17 WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares 2$ ( ✓)Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist y ( )Replacing like for like Pool fencing *The debris will be disposed of at 'f[ 0_ " -+t4 I li r' 1t. 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 d,,::. ,, ation of my license and los cation under MG.L Ch.268,Section 1. // Q Applicant's Sign.. .• , _ • L__� (a Date: 1,1 t S / 1O Owners Sign. e(or attachment) Date: l Approved By. - ' �- Date: // �_j ' BuildingOfficial. �• cc) EMAIL t e.'• S: Zoning District: Historical District: 0 Yes 0 No Flood Plain Zone: 0 Yes ❑ No Water Resource Protection District: Within 100 ft.of Wetlands: ' 0 Yes 0 No 0 Yes 0 No • • b I . Q 'e O0.• it : . t' t. {gryp9Atly . .. . El - :71 I I 1 . . ill :rit p . 11Iv 0cT ;: • ri ill . Q •p 1lJ •a :. ❑ ❑ aa❑ ❑ RIME •• :3 . I �� , . . . . j . , 1,1 ,iiti. 1 : I 1 . .4 Ai . 1 . . . 3 ' i: .. .••••---, : . 1.1i .. i m ii II p .. , : . ;1 . .1 pi!' I., .,. ..., . tjh . r i. . .. • ... ..... . .. ... . r .. . , . eii , . . I . 1 ii 10 141 1 .- . • :el • g! .11 ...... ?, :.::—. . ...-. ..,' 1. : ' 1 • .11 .. 6 13/41 °41 d A j H / .. . 111 $ 1 °. 1 i 4 . . . . . • . • : .• .• , 8 .to c‘•J LI . .0 ' . 1. . • c3i• '41 C l1 i ,i t ' m : '• . 1 ill • . i .. • . sii pf, a . . , . :I . f.... : ..% ' , 1 t $ . . ,' �,� icc '( lLJfl y� Hest `.� Fro �. 3,1 • I CT' it I II'Si ' p N , ' N , )11 , rpfi .10 r w hl 1w 1 � :144 t „ ppppp 11 . 1;74. IIII KELLY ROOFING PH. 508 509 4640 8 Rhine Road MA C.S.L.#099167 Yarmouthport MA H.I.C.R.#128957 MA 02675 May 22'2018 Proposal submitted to Mr. Frank Anastasi of 40 Cedar Street South Yarmouth MA. We propose to supply all materials and labor required to remove and replace the existing asphalt roof at the address above. Protect all walls,Windows,shrubs, plants etc. during roof strip. All debris to be removed to town transfer. 8"White Aluminum Drip Edge to be installed on all eaves. Ice and Water damage protection membrane to be installed on first Six feet of all eaves and around all protrusions. Remainder of roof deck to be covered with synthetic underlayment. Install limited lifetime warranty Architect style Shingles,color to be specified, All shingles to be storm nailed (6) We Generally use Certainteed Products,This Quote is based on their Limited Lifetime Warranty Landmark Series Shingle. Replace plumbing vent pipe boots with new. Repair/Replace all flashings as necessary including Chimney. Install Shingle Vent II ridge vent with hand nailed caps. Complete Clean up off all areas including all gutters and all nails after project complete At a total cost of$8900 Payment Schedule;Balance upon Completion Proposal Submitted by:Oliver Kelly )1113118 Proposal accepted by: Date. / /2018 This proposal is valid for 45 days from date above,please call to verify thereafter. • A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MW201�8 n 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 an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; Linda Sullivan ax DOWLING&O'NEIL INSURANCE AGENCY PHONE Eym (508)775-1620 ,FAD,No): ADDRESS: Isullivan@doins.com 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE NAIL• HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURER C: INSURER D: 8 RHINE RD INSURER E: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 316737 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. INSR TYPE OFINSURANCE ANL SUER POLICY EFF POLICY EXP LIMITS LTRINSD Two POLICY NUMBER (MM/DD/YYYY) IMWDO/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED CLAIMS-MADE fil OCCUR PREMISES Me occurrence) S — MEO EXP(Any one person) S — N/A PERSONAL IADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S _ POLICY❑jE& []LOC PRODUCTS•COMP/OP AGO $ _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea accident) — ANY AUTO , BODILY INJURY(Per person) S ALL AUTOS OWNED SCHEDULED AUN/A BODILY INJURY(Per accident) S NON-OWNED PROPERTYAGE $ _ HIRED AUTOS _ AUTOS (Per accident) dentl , S UMBRELLA UAB _ OCCUR EACH OCCURRENCE $ _ EXCESS DAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTIONS �/ $ WORKERS COMPENSATION X STATUTE ETH AND EMPLOYERS'LIABILITY ANYPROPRIETOWPARTNEA OF ICERNEMBE EXCLUDED??ECUTIVE WA WA WA 6S62UB8H08580918 05/10/2018 05/10/2019 E.L.EACH ACCIDENT s 500,000 (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE $ 500,000 S yss,desaihe Under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more spec Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states other than Massachusetts H the Insured hires,or has hired those employees outside of Massachusetts. This certificate of Insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the Issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govfwd/workers-compensatlon/investigations!. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David Bernstein BuildersACCORDANCE WITH THE POLICY PROVISIONS. 139 Nantucket Drive ' AUTHORIZED REPRESENTATIVE Chatham MA 02633 Danlel M.Cro My,CPCU,Vice President–Residual Market–WCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • \. c LoQn4noltwect�!//'& c/PA/lamacl e&/ ' Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 . Boston, Massachusetts 02116 Home Improvement Contractor Registration ./Id Type IndMidual • Registration: 128957 OLIVER KELLY I= i It{ Expiration: 06/13/2019 8 RHINE RD YARMOUTHPORT,MA 02675 , { r ... Update Address and return card. Mark reason for change. SCA I 0 20M-05111 ---- —.__--------____. /—' ...__�_(7 Arldr... n o.-.0.,l rl Pmninw nant 0 Lost card / Office of Consumer Affairs&Business Regulation t1289Sql HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individualbefore the expiration date. If found return to: _ Regislra sort 1`xoiratIort Office of Consumer Affairs and Business Regulation -erg 57 06/13/2019 10 Park Plaza-Suite 5170 OLIVER KELLY - Boston,TMA 02116 .s"`��� 1 !mss F OLNER M.KELLY - 8 RHINE D. YARMOUTHPORT,MA 02675Undersecretary~-_ Not valid without signature d, Commonwealth of Massachusetts %I Division of Professional Licensure Board of Building Regulations and Standards Construction-5U0iVisor Specialty CSSL-099167 oElzpires:09/28/2019 sL _ :M, ! J OLIVER M KELLY 1 I C 8 RHINE ROAD ' YARMOUTH PORT MA 02676 ' 11>....C1As x Commissioner t