HomeMy WebLinkAboutBLD-19-2586 •
ONE & TWO FAMILY ONLY-BUILDING PERMIT
Town of Yarmouth Building Department o* r
1146 Route 28, South Yarmouth,MA 02664-4492 A� i
508-398-2231 ext. 1261 Fax 508-398-0836 • F+
Massachusetts State Building Code,780 CMR
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: AP—/9 - 0 6 2 C? Date Applied:
Ij ,:M Sells , _„,r, , . 11 ,e
Building Official(Print Name) Signature : Date
SECTION 1:SITE INFORMATION • •
1.1 Piopertydddrrees� D2 1.2 Assessors Map 4 Parcel Numbers
1.1 a Is this an accepted street?yes X no Map Number / Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
ront Yard dSYards Red
Requi4 , Provided Requiret Provided Require/(
Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Fl od Zone Information: 1.8 Sewage Disposal System:
Publi,,//�� Private❑ Zone: Outside Flood Zone? Municipal❑ On site disposal system '
7" Check if yes❑
SECTION 2i PROPERTY OWNERSHIP`
2.1 Owner'of Record:
10.41- DARSG� cA-2
Name(Print) City,State,ZIP
3 Kea CAae O/C- 2l0 _8Y6 .31Y°
No.and Street Telephone Email Address
SECTION 3:.DESCRIPTION OF PRQPOSED WORK2(check all that apply)
New Construction 0 Existing Building., Owner-Occupied 0 Repairs(s) 0 Alteration(s)% Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units_ Other 0 Specify:
Brief Description of Proposed Work'': f, • IP As - : ,r,gyp, „ • as . ,n€ .1 C, Ala
517WetettAil cuA-49c5 r OPoiori-e- txrsne g Afl . circa- oPIF a co abonA
t.v6 .: w
c • , ' E. as ko✓r • ;D a . ral , A sono
r/ Ceet?c oMSr i4 , Z GE,,2oontc UP £,rr3resii ^ (Atimfafr RCOReont MAUS ata-
SECTION 4i ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ r R E C E I LBuildmg Permit Feer$I'o Indtcate how fee is.determined-
2.Electrical $
--�-I•Standarit City/'1,'ewn Application Pee 1 I E C E I V S D
otN •
I P jest Costa tem 6)x multiplier
3.Plumbing $ NOV 16 Uoth°r Flees. $ {?I) 1
OCT..:9 2018
4.Mechanical (HVAC) $ L>st
i i iraw
lW w"Him;-.L---Ti
5.Mechanical (Fire � /yUV _ �' .OU; WING DEPARTMENT
'
Suppression) Iota $ ay'
_
CheckNo. Check Amount: Cash Amoun• '
t.76.Total Project Cost: $ 35,000 0 Paid in Full . . V Outstanding Balance Due: 1\c
SECTION 5:.CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 05101 o. / ,r
�L lQ l
/rl(I� MpV/rr License Number Expiration Date
Name of CSL Holder
i 3z G> �.Ci nen List CSL Type(see below) I)/J/t-e jl)urL CA
No.and Street t�'"J Type ,. Description
r^_ A�, 2 103 U Unrestricted(Buildings up to 35,000 cu.ft.)
Ciq+c,/'foMw7`nWState,ZIP f G�""J R Restricted I&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
���-83(.-033 loot,
SF Solid Fuel Bunting Appliances
�tn Eioot, 0 Alt,6,e^ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement� � Contractor(HIC) j 2q Z, • g-/5
ove"' /19
'" ' U c94 HIC Registration Number Expiration Date
HIC Compan Name or HIC Registrant Name
/ No.and Street 106 Aflotle R�aoifRfs® A)L.Co"1
Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AIVIDAVIT(M.G.L.c.152.§ 25C(®)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes No ❑
• SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
• OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT .,
I,as Owner of the subject property,hereby authorize rn TOW( (.ANI IAFT?t
to act on my behalf,in all matters relative to*,• k autho '•.ed by this building permit application.
K'F.nt.l
c DArlsct ti' ribn /Q
Print Owner's Name(Electronic Si a v Date
• • SECTION 7b:OWNER1 OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
• NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L. c. 142L Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
•
The Commonwealth of Massachusetts
t[1_—=
_ _r Department oflndustrialAccidents
'r =_ _ y
acct.= • 1 Congress Street,Suite 100
-: i Boston,MA 02114-2017
` .,;,, 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): p1r,(n.d2 ( A,,,P^-(4- �-ai,.s,fr GbO g
Address: I32 . Cfirp .fes 1q,rf(
City/State/Zip: scab iii ., f fl4 Phone #: 77 4 ` 836'633'6-
Are you an employer?Check the appropriate box:
Type of project(required):
I.ElI am a employer with 1 employees(full and/or part-time).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. I.Remodeling '
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t I. ❑Demolition
4.❑I am a homeowner and will be hiring contractors to conduct all work on m Yproperty. I will10 Q Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. .
These sub-contractors have employees and have workers'comp.insurance.t 13.Q Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any 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.
1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors 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 my employees. Below is the policy and job site
information.
Insurance Company Name: 04YG6(
1 Cr -0-41/411.--C
Policy#or Self-ins.Lie.#: rya-Luc q3 It') 1 ( Expiration Date: 3 /3/ I 9
Job Site Address: 3 01 co-e_ DaCity/State/Zip: /q(1.()%DUi ft
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
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 certi t • er the pains and pen alt!• • .- ury that the information provided above ' true and correct.
Signature: p r//Z 7 ' J
Phone 14: -2) i' 83- Date:
633
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#:
•
TOWN OF YARMOUTH
•
o y BUILDING DEPARTMENT
„ ? 1146 Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1261
\+w nP^ 6-
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE:
•
JOB LOCATION:
NAME STREET ADDRESS SECTION OF TOWN
"HOMEOWNER"
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS
•
CITY OR TOWN STATE ZIP CODE
The current exemption for 'Homeowner' was extended to include owner—occupied dwellings of one or two units
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such
homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1)
Definition of Homeowner:
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to
be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who
constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall
submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all
such work performed under the building permit. (Section 110 R5.1.3.1)
The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws,rules and regulations.
The undersigned 'homeowner' certifies that he/ she understands the Town of Yarmouth Building Department
minimum inspection procedures and requirements and that he / she will comply with said procedures and
requirements.
HOMEOWNER"S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL
Ch.142. Yes No
If you have checked yes,please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity Bond
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner Agent
h:homeownrlicexemp
•
• Information and Instructions • •
•
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MOL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
4.:21"."14t$. TOWN OF YARMOUTH
vg c BUILDING DEPARTMENT
oE.•• ;y 1146 Route 28,South Yarmouth,MA 02664
,7508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Chapter 40,Section 54 and 780 CMR, Chapter 1, Section 1113,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 3 1C o (2Qk 0(1-
Work
2Work Address
Is to be disposed of at the following location: A /tDFj'w CA4Sk
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 11 I, Section 150A.
o g67/(8
Signature of Application Date
Permit No. •
•
.
•
• °` TOWN OF YARMOUTH
�� ,1} ��c HEALTH DEPARTMENT
0, � 1 iy
keNt', �^% PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 3 kfti CAPE pa...
Proposed Improvement: Reyrtootl & j) 9' ( .l rc,i-€z gA-� ?-/Mvv� •
to V gp7M e'kuLL-J #h t o C.rrvi? L3 SP/t-OP . ONE SuL 4coAi
Locierlen On 6AStc Yin Mtn- (Atka ovr Sltott ft or pow, Ale 51ftw 4 wort
R( 40v't Z.CX,&Jfrdj FA¢1-01 MIS
Applicant: M( (3t1-nG 14 Tel.No.: 7)1/-936-°336-
Address:
0S6Address: /3 2 (�iZt i4 i 14-.'71 20 A-40(4474 Hit 026103 pDate Filed: /o7/Q//g
"Ifyou would like e-mail notification of sign off please provide e-mail address: Sc.'tom/o b m 0 Act. COM
Owner Name: Kg"!r DAO—.4
Owner Address: 3 K€€1 Gate CL �' YAC Owner Tel. No.: 2/0 -En( 31-`fb
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) -
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: Ri\ DATE: / °/748'
PLEASE NOTE
COMMENTS/CONDITIONS:
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CERTIFICATE OF LIABILITY INSURANCE os"ros,20,M'e""`Y"
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:B the certificate holder Is an ADDITIONAL INSURED,the policypes)must be endorsed. H SUBROGATION IS WAIVED,subject to
the teens 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 Paychex Insurance Agency Inc
PAYCHEX INSURANCE AGENCY,INC. PHONE FAX
150 SAWGRASS DRIVE I NO Fm- 877-286-6850 (plc.Noy 585.389-7426
ROCHESTER,NY 14620 E-MAIL Certs@paychex.com
ADDRFSS•
INSURER(S)AFFORDING COVERAGE NAIC I
VSURED INSURER A: NorGUARD Insurance Company 31470
MICHAEL S CANNATA INSURER B:
132 GREAT HILL RD
SANDWICH,MA 02563 INSURER C: •
INSURER 0:
INSURER E:
INSURER F:
:OVERAGES 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 CONDTION 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.
IR TYPE OF INSURANCE IANDSR WVDUPOLICY NUMBER POUCY(MTY Min LIMITS
GENERAL LIABILITY EACH OCCURRENCE S
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
`- PRFMISFS(Fe,Ysurm -Al
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GENL AGGREGATE LMR APPLIES PER: pRO0l1CTS-COMP.OP A00 $
Palo Loa $
AUTOMOBILE LIABILITY COMBINED SINGLE UNIT - $
(Es accident)
ANY AUTO
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ANY PROPRIETOIWARTNENEXECUTIVE
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DESCRIPTION OF OPERATORS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional RMnerke Schedule,K man spew le Mulled)
:ERTIFICATE HOLDER CANCELLATION
Proof of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,NONCE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY
- • PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR •
-
LIABSJTY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
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%CORD 25(2010/05) - 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
• CANNMIC-01 SMCNALLY
A�Ro' CERTIFICATE OF LIABILITY INSURANCE D 08/09/6"
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
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PRODUCER ME:
HUB international New England (A c,N,,Exth(508)548-1596 I FAX Nor(508)5404520
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FalmouthMain,MA 02540
INSURERS)AFFORDING COVERAGE NAIC
INSURER A:Main Street America Assurance Company 29939
INSURED INSURER 8
CANNATA;MICHAEL S. INSURER C:
132 Great Hill Rd. INSURER D
Sandwich,MA 02563
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.
INSR TYPEOF INSURANCE ADOLSUBR POUCY NUMBER POLICY EFF POUCYEXP LIMITS
:NSD WYDIMWDONYYY1 fMMNGMYYY
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 500,000
CLAIMS-MADE ❑X OCCUR MSP26483 09142017 09/142018 DAMAGE TO RENTED 50,000
•
PRFMISF41Fa aaosrenrwl 1
_ MED EXP(MY one person) S 5'000
_ .PERSONALS MN INJURY „5 500,000
GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000
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DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached x more specs Is resulted)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NCE
Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS WILL BE DELIVERED IN
ATTN:Building Dept
1146 Route 28
S.Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE
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• ACORD 25(2016/03) 0 1 988-201 5 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
•
Sears, Tim
From: Sears,Tim
Sent: Thursday, November 1,2018 8:58 AM
To: 'builder6@aol.com'
Subject 3 Keel Cape Dr
Mike,
I have reviewed your application for 3 Keel Cape Dr,and with the addition of a bedroom the code requires upgrading the
smoke/co/heat detectors in the entire dwelling.
Please submit updated floor plans showing the smoke/co/heat detectors locations as required by the building code.
Thank you
Timothy Sears CBO
Building Inspector
Town of Yarmouth
508-398-2231 Ext. 1259 -
mailto:tsears(Eyarmouth.ma.us
•
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