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HomeMy WebLinkAboutBLD-19-003021 '0 4 cls-444gkg Omce Use Only t; ! p i Ferrell /�.� A. ' ti t Cit �► 4.'e Ammmt SC/ r Permit expires 180 days from • 3U)— q—OD3m / _ issue date RECEIVED .' EXPRESS BUILDING PERMIT APPLICATI TOWN OF YARMOUTHSIir NOV 15 2018 Yarmouth Building Department 1146 Route 28 Buil�iE� 14ENT South Yarmouth,MA 02664 aY — -----___ ,1 (508) 398-2231 Ext. 1261 • CONSTRUCTION ADDRESS: 3�6 \N o (p> 5 tj 6 S-c ‘'(y4.,QJ_cfro'ytQ 02613 ASSESSOR'S INFORMATION: Map: Parcel: OWNER: i2 &JAA EMO Is t. NAME (n1 PRESENT ADDRESS(� _ TEL.e # n CONTRACTOR: t(E.Q4 QO;}' uteri- �S 1�UIn)l= 1sL(�A.N qG +A(OUfl MA OutnS NAME MAILING ADDRESS TEL# �'/•DC6 So Cf 4640 6 Residential ❑Commercial Est.Cost of Construction$ LLIOOD — Home Improvement Contractor Lie.# 1 acs 9 57 Construction Supervisor Lie.# q I 7 Workman's Compensation Insurance: (check one) 0 I am the homeowner 0 I am the sole proprietor ® I have Worker's Compensation Insurance ��yy c Insurance Company Name:4r4c. 4/41,c11I GeriCi Worker's Comp.Policy#6~S62001014 t�%`'g rig!? WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares 114 ( 7)Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing • *me debris will be disposed of at 11404i Imi•N v Q. 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 ford. - -. r•, ation of my license and f�cution under M.O.L Ch.268,Section 1. Applicant's Sig ., �� _. Data ,l ( [ 5 / (.'i Owners Sigmam (or attachment) Date: Approved By: �.' Date: /A/.J-7, Building a i. al(o .. ign.. EMAIL KESS: • Zoning District: Historical District 0 Yes 0 No Flood Plain Zone: 0 Yes 0 No Water Resource Protection District: Within 100 fc of Wetlands: 0 Yes 0 No 0 Yes 0 No KELLY ROOFING PH. 508 509 4640 8 Rhine Road MA C.S.L. #099167 Yarmouthport MA H.I.C.R.#128957 MA 02675 November 2'2018 Proposal submitted to Mr. Jim Eno of 38 Nobby Lane West Yarmouth MA. We propose to supply all materials and labor required to remove and replace the existing double layered 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, in all valley areas 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) 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$4600 Payment Schedule;Balance upon Completion Proposal Submitted by:Oliver Kelly Proposal accepted by: n�.411 �, Date.II/�}r/2018 This proposal is valid for 45 days from date above, please call to verify thereafter. Ragerwao ci ( /cr handnvr/S l e ��e tontveah 10/laoac/ueJe : --..--al -j; Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Individual et OLIVER KELLY , -E ,--7,1,11—,14- Registration: 128957 s Expiration: 06/13/2019 8RHINERD i,` `"Cs YARMOUTHPORT,MA 02675 I'., ' = I ... Update Address and return card. Mark reason for change. SCA 1 0 20M-05/11 _.____.._ _.___..___._._—_—.--.----_—____--- n AAAn•• I"lo.npu.gl nvn,nlnymenf p Unit Card !� ie runnnrrrurir�/A n� '(e'n:;nr�rNa/(I :14Office of Consumer Affairs a Business Regulation P ,9 HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Individualbefore the expiration date. H found return to: r Registration �xolydtiort Office of Consumer Affairs and Business Regulation 128957 06/13/2019 10 Park Plaza-Suite 5170 R KELLY Boston;MA 02116 -� 1 s OUVER M.KELLY ,,,ccc6:2621\-- ��p,, a��._.. : CSLI ` a•O° YARMOUTHPORT,MA 02675UereNot valid without signature t Commonwealth of Massachusetts Eily1 Division of Professional Licensure Board of Building Regulations and Standards Construction-SUpeitlsor Specialty CSSL-099167 Expires:09/28/2019 1' f 7 • OLIVER M KELLYD •-•l/I; , C 8 RHINE ROA ',. • YARMOUTH PORT MA 02676 ';:* I 61\'v'I tot' .. - Commissioner VJ \ ...... ,..,..t • '.t., { 4 1 • • - V - Cesoalasseclosseifs mato, labra iJAca& - see Trainee=area a Boston,MA 02711 • lonnv.mmtgerjrlra. irmsfisse - ce n,F�.��g�-+ ,ter• ; . th . ArrerzonetTathinarrigaz PleasePr t.tatTv Ke•t ( k L' •- _ - e , q i Eio7$ C' - 50, s 5r� 46tiocIt-- ; .1.mi�z .;.? _3 Ixstat�i an Tppcofgmled• ----- Iste.hiretesub.caminciars 6- Liliewtonthucele 0I=a. �..._s----'-- , seI . S. 0nenntztra . -. ..Q-,., ., - camp- Svc ; �tK# - - 0 Weteacnif ; - O Heckled rp� • a ratreiee3.0larnat �sdriEgsII aa=se 38a ' 1g�•'D eagrad s^a aregranprimptriget "� algra'""S -Fen • c.1i7,§1t4jashsebaaeao .. employees.[Nam 13-II°tber . • eomp.imvffisere il:-:_ 4.E1Z . �s + sag - s¢a r/des. taa�of9r= _3mn �mtE�e baa ll -2 _. mares. :s i gas en=in fr i.a ,,..ettaa= for-, aerissis epo�and9cbsets �.: =� r:, ;;:i l \kk q5 S crc©G l% - apirasostat 5 -it)• "2-0tff = 3�5 �oaa� Lim. caratearEpgo0 02673 Adacimotet&t 'm cep ( policYamaberaaa a• rh...baxxaanedinsera-3"nenc#Dna¢152taa1®dinThei osition Qf praofa>stabs_57010�3ht- _- - ' rassofp +efefas1QPWOKLUa ltansa�a ms"wb . aa� BeBnthiee acopy s ntregybeimwardedfa9aSI cf r n s.t esariteDEL kw/v=2nm csrrrgenn. . d5r cria:ilerciperjkrytratariapreuemprositicaboreis taut SQ_ i. o tit . it is 2.t•t%, - O Sfne Zkizet.valaissesarea ter Be cavipreteibythy :Oda • • TssidogAIESEItity teazle one): s.s� t S.Caprra�ta a. rip 6.v€ie • s . easztactPe= \e„..-,le AC RD® CERTIFICATE OF LIABILITY INSURANCE DAD (MM/DD1DNs 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. M 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 DOWLING &O'NEIL INSURANCE AGENCY PHONE H(ONri s,n. (508)775-1620 FAX E-MAIL ADDRESS: isUUivanOdoins.COm 973 IYANNOUGH RD INSURERS)AFFORDING COVERAGE NAIC• 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 NS ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRIR WOO POLICY NUMBER (MMR)D/YYYYI IMWDD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S _ DAMAGE TO RENTED CLAIMS-MADE ❑OCCUR PREMISES(Es occurrence) $ MED EXP(Ary one person) $ N/A PERSONAL&ADV INJURY $ GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ RPOLICY n jE7 LOC PRODUCTS-COMP/OP AGO $ OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accideMl ANY AUTO BODILY INJURY(Per person) $ — AONMED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS — AUTOSED (Per accidenDAMAGE S _ S UMBRELLA DAB _ OCCUR EACH OCCURRENCE S _ EXCESS UAB CLAIMS-MADE N/A AGGREGATE S DED RETENTION$ S WORKERS COMPENSATION �/ AND EMPLOYERS'IUBILITY ^ OSTATUTE ER A O CER/MEM ERPEXCLUDEDE.L.EACH ACCIDENT $ 500,000 EXCLUDED? YI1 WA WA 6S62UBSH08580918 05/10/2018 05/10/2018 (Mandatory In NH) I ) E.L.DISEASE-EA EMPLOYEE $ 500,000 Xyes, PTION under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A • DESCRIPTION OF OPERATIONS/LOCATONS/VEHICLES(ACORD 101,AddIional Remarks Schedule,may be attached N more aped is regalrod) 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 if 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.gov/Iwd/workers-compensatlon/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David Bernstein Builders ACCORDANCE WITH THE POLICY PROVISIONS. 139 Nantucket Drive AUTHORIZED REPRESENTATIVE Chatham MA 02633 Daniel M.Cr y,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