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Home My WebLink AboutBLD-19-003333 r • Cliental:117951 JOHNMCCA. ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE 10//23/2023/2018 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 any lights to the certificate holder In lieu of suchooendorsement(s). PRODUCER NAMEACT Rollie Archetto Starkweather 8,Shepley TPN�PNE 401 4353600 FAX 401 431.9351 III ,No Ertl: LAIC PO Box 649 EMAIL harchetto�,gq,starshep.com Providence RI 02901-0549 ADDRESS; harchetto@starshep.com INSURER(S)AFFORDING COVERAGE NaiC3 401435.3600 INSURER A:Associated Employers Ins Co/AIM 11104 INSURED INSURER 0: John McCarthy INSURER C: 322 Acapesket Road INSURER D: East Falmouth,MA 02536 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 USS ADDLSUBR. POLICY EFF POLICY�A� LTR TYPE OF INSURANCE �, POLICY NUMBER JMMIDDIYYYY)jMMIDDFYYYYJ, __,__„__ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE i CLAMS-MADE 7OCCUR ppM�Eeowce) "$ _ MED EXP(Any one person) $ PERSONAL I ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY 1-1 JECT I I LOC PRODUCTS.COMPIOPAGG $ i _ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I (Ea Fcdden0 ANY AUTO BODILY INJURY(Par parson) $ OvJ BODILY INJURY(Per model) $ AUTOS ONLY AUTOS S HIRED NONAIM1NED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLYPeraccldenit UMBRELLA LIAR _OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE -S DEO I RETENTION A WORKERS COMPENSATION WCC50050169982018A 03/08/2018 03/08/2019 Muir OT AND EMPLOYERS'LIABILITY ANYPROPRIETOR!PARTNER!EXECUTIVE YIN E .EACH ACCIDENT 5100,000 OFFICERAIEMBER EXCLUDED? I NI NIA (Mandatory hi NH) E.L.DISEASE-EA EMPLOYEE$100,000 If yes.describe under DESCRIPTION OF OPERATIONS beIoy E.LDISEASE_POUCY LIMIT $500000 DESCRIPTION OF OPERATIONS/LOCATIONS(VEHICLES IACORD 101,Addition!Ramat'Schedule,may be flatbed it mere space la required) CERTIFICATE HOLDER CANCELLATION Neel Hannon SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 320 Circuit Ave ACCORDANCE WITH THE POLICY PROVISIONS. Pocasset,MA 02559 AUTHORIZED REPRESENTATIVE 01988.2015 ACORD CORPORATION.All rights reserved.. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #51206759/M1206754 HEK. f}-ppt,:c2n.r • • =�tD TOWN OF YARMOUTH /RECeIVE® • : r 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 Telephone (508) 398-2231 Ext. 1292—Fax(508)398-0836 ALT 5 208 A �. (i O�D flG'S HIGHWAY HISTORIC DISTRICT COM DRMOUTH NGsHIGywgY OMT 09 2018 APPLICATION FOR CERTIFICATE OF EXEMPTION TOWN CLERK Applicatisot heretaFWa 2T!rh}°e issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs • accompanying this application. Type or print legibly: ger yr b Address of proposed'' f work: g e ` 2 L 4 - A /� �^ Map/Lot# Owner(s):gel. I Q aylon,10.,stet. Co Y.. se,lafpu�✓Teti s+ Phone#: ggag- Z'-/ -o 7'(0 All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: Po %x 3a 13 YoA s-eT 744 C ZS $R Year built: 175Z 4 Kil 2 Email: Vt to fin on +b Q eyna,i i ,Ge nl Preferred notification method: en Email Agent/Contractor: f(e COM //G3tkrjy/ LCL' Phone#: -I `8,743.490 04 Mailing Address: $1 Oast DJ 26t. t'pp re.ei-v/ O 1 et 4i 3 Email: G�YI 5 t1 544 m.pnwitese.lyytn,1, Preferred notification method: Phone r/Email co m The Project includes the replacement of windows, re-shingling the building,the replacement of the main entry door and frame on the Union Street side and the construction of rain guards over the Union Street entry door and the South facing side entry door. - The Building consists of two distinct parts:the Historic building fronting on Route 6A built c 1752 and the Addition at the rear built in 1972.The overall intent is to maintain the current features of Building. (continued on additional sheet) Signed(Owner or agent): e/ar.w--(fG.1,41ce Date: /0/5 fig > Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.) > This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. . For Committee,use only: Date: /O$'/ Y Approved _Approved with chant _ Denied Amount 021I1�b1 10 n Reason for denial: APPROVED ED Cash/0. LI . - OCT s LJiu Rcvd by. 41/ YARiviUuTrl OLD KING'S HIGHWAY Date Signed:/0/9/20/C Signed: "" APPLICATION#: 8 - El 10