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Home My WebLink AboutBld-20-001073 ONE & TWO FAMILY ONLY-BUILDING PERMIT Town of Yarmouth Building Department or \ 1146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 .5 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: ,AO' OO/073,Date Applied: IMN AC5 • Building Official(Print Name) Signature Date SECTION 1:Si'11 INFORMATION 1.yrIerAtt.dlets:iztt,(0 1.2 Assessozap&Parcel Numbers1.1a Is thisann acceptted street?yes 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) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? — Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' t ll 2 er o- d. I,, ��,ti ot Z "i 5c5a Z VIwkv7't( gal2 Name -t City,State,ZIP r ` No.and Street Telephone I Email Address SECTION 3 DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s)) Addition 0 Demolition 0 j Accessory Bldg.0 Number of Units Oth • . •• Bri Des tion of Proposed Work2: iNS(/ 4cL] (� /l r "'1 i� j r� f ,- ,.. , i, A 2 0 201' SECTION;4:ESTIMATED CONSTRUCTI a e a " . . s ARTMENT Estimated Costs: Item • O i 4U- E abor and Materials) , 1.Building �� 1�Building Permit Fee:$;150 Indicate he . 2.Electrical $ li Standard City/Town Application see: ' ❑Total Project Cost'(Item 6).x.multiplier. . x SEP 43 V ��1 3.Plumbing $ 2: Other Fees: $'3S _ /►-� 4.Mechanical (HVAC) $ List: BU4LDING DEEP 5.Mechanical (Fire v — -- Suppression) $ Total All Fees:$ . Check No.. Check Amount: Cash Amount 6.Total Project Cost $ © I p Paid in Full Si Outstanding Balance Due:�lS ,.. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 8 JeQSit, - c CGbC t 5 1.( License Number irati Date u Name of CSL Holder /Z mil' BrayL/ Type Description —/)r, LIst CSL Type(see below) LiNo. d Street [/ � ��zo vG V tf ,; ( o U Unrestricted(Buildings up to 35,000 cu.It)) // t 7 R Restricted l&2 Family Dwelling City o ,State,ZIP M Masonry RC Roofing Covering WS Window and Siding fORc7 SF Solid Fuel Burning Appliances '—!1i'. Shrad iai 3eCitd. At i I Insulation Telephone Email address D Demolition 5.2 Registered Home Improovepentt CCorltractor(HIC) /{`,//) 5 $t !L2mbu •Judi"on Date , HIC Co yr,HlC,&egaa not Name _ No. Street ..5. i cvce zJ -7 Email address City/To State, Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) 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:OWNth AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT .. I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'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 acc to • •est a :e and understanding. J/t/ti c5%-Z6-( -- piprir,,IPP.- Print Owner's or Authorized Agent's N ectronic Si_.... Date NOTES: 1. An Owner who obtains a b ' 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. 142A.Other important information on the HIC Program can be found at www.mass.gov/oc4 Information on the Construction Supervisor License can be found at www.mass.gov/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 r '/ Department oflndustrialAccidents _i�r►I= 1 Congress Street,Suite 100 _ y �_ • Boston, MA 02114-2017 • www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A licant Information Please Pri t Le ' 1 Name (Business/Organization/Individual): tl CC—as(it � �� , 6 ZC7 S 4 t Q riv`c Address: /)(yei// t/reil `� P ' City/State/Zip: e#: , d ''7Z -i fJo Are you an employer?Check the ippropriate box: Type of project(required): L❑I am a employer with employees(full and/or part-time).* 7. New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9 ❑Demolition 4.a my property.I am a homeowner and will be hiring contractors to conduct all work onI will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.01 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.: 13.[]Roof repairs 6.1We are a corporation and its officers have exercised their right of exemption per IvIGL c. 14.Q 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. :Contractors 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 cer' ' nder the ; nalt'• o perjury that the information provided above is true and correct. �, afore: _ f Date: #• - i Offi If 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#: :y• or Y,��o TOWN OF YARMO UTH �' =y c BUILDING DEPARTMENT • F "'-i • ,x 1146 Route 28,South Yarmouth,MA 02664 �, :-� 508-398-2231 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 I, Section 1113, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at d ! `le /;tf fri a/!'i 5`C C Work Address Is to be disposed of at the following location: / 4C `S544. Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. L- Zz "( cf gnature of A 'cation Date Permit No. Con monweatth of Massachusetts Division of Professional Licensure Board of Budding Regulations and Standards ConskeettistilAilpAry isor CS-086537 �' Kepires:07t16t2021 JAMES M SI17103 ; 129 SCARLET.1R 1 PLYMOUTH MA Commissioner ! X Tff rvri�nonu era •� suirc�pll� Office of Consumer Affairs&Business Regulation_ HOME IMPROVEMENT CONTRACTOR TYPE olement Card Registiedioti Expiration 04/03/2020 EMM-NIC CONS w SIGN INC. D/B/A SKY'S TH We JIM SITTIG 129 SCARLET DR �j PLYMOUTH,MA 02360 Undersecretary A • DATE(MM/DWYYYY) CERTIFICATE OF LIABILITY INSURANCE 08/13/2019 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(ies)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 endorsement(s). PRODUCERS CONT Mary Ellen Ross NAMG.H.Dunn Insurance Agency PHONE FAX P.O.Box 330 (NC.No.Ext): (508)322-3213 J(ArC,No): Buzzards Bay MA 02532 ADDDRLES,s: rnarYellen@ghduxn.com INSURER(S)AFFORDING COVERAGE NAIC S INSURER A: Main Street America Assurance Company 29939 INSURED EMM-NIC CONSTRUCTION&DESIGN,dba SKY'S THE INSURER B: LIMIT JAMES SITTIG 129 Scarlet Dr INSURER C Plymouth,MA 02360 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT TI-E POLICIES OF INSURANCE LISTED BELCMI HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CR 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 OF INSURANCE ADDL SUER POUCY EFF POUCY EXPMI UNITSLTR INSD WVD POLICY NUMBER (MDDIYYYYI (MMIDDIYYYY) A ✓ COMMERCIAL GENERAL LIABILITY MPP8344V 06/29/2019 06/29/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 CLAM-MADE V OCCUR PREMISES(Ea occurrence) $ MED EA,(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$ 2,000,000 POLICY ,SCOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTI-ER $ COMBINED SINGLE LINT AUTOMOBILE LIABILITY (Ea accident) ANY AUTO BODLY INJURY(Per person) $ OWNED SCI-EDULED BODLY INJURY(Per accident) $ AUTOS ONLY AUTOS BRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLALIAB OCCUR EACH OCCURRENCE $ _ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N SP OTH- TA UTE ER ANY PROPRETOR/PARITERIEX£CUTNE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER ElCLUDED7 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY MT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Carpentry operations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Yarmouth-Bolding Dept ACCORDANCE WITH THE POLICY PROVISIONS. 1147 Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ) i �r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Construction Contract Proposal We herewith submit proposal for materials and labor to be supplied at the sole request and order of: Stephanie&Anthony Manzella 38 North Main St South Yarmouth, MA 02664 hereinafter referred to as"OWNER"for work to be performed at premises set forth below, according to the following terms and specifications: 38 North Main St South Yarmouth, MA 02664 (Specifications are in a separate section of this proposal.) All materials are guaranteed to be as specified and to carry manufacturer's warranty. All work will be completed in a neat and workmanlike mariner, (conforming to and remedied as per the NAHS "Residential Construction Performance Guidelines"manual). Owner agrees to pay for all work in this proposal. If the owner defaults, Owner agrees to pay all costs of collection, including attomey's fees, in addtion to other damages incurred by contractor. Our labor carries a ten (10) year warranty. Any alteration or deviation from above specifications involving extra labor and/or material costs will become an extra charge over the below agreed amount. Agreements made with mechanics or subcontractors on the job are not recognized. No statement, arrangement or understanding, expressed or implied not contained herein will be recognized. Sky's the Limit is not responsible for delays due to back ordered materials or circumstances beyond our control. We propose to furnish and install the above complete in accordance with the above specifications for the sum of$4380 dollars. Payment to be made as follows. $1450 upon execution of the contract and special orders, $2930 balance due upon completion, plus any agreed upon extras. The foregoing terms, specifications and conditions are satisfactory and are hereby agreed to. You are authorized to do the work as specified and payment will be as outlined above. The owner upon signing this agreement represents and warrants that he/she is the owner of the premises, and that he/she has read this agreement and agrees also to pay, after thirty (30)days of completion, a 1-1/2%service c rge per month on any npaid bale . O r for, Sky's th imit phani ony Manzella te: 6/29/2019 r.<. -1/6) (7- 3 / g �=7C` Item Description Qty Unit Price 1 VS M02&solar blind VS M02&solar blind Base Dimensions: 13 WIndows and Trim S2.245. MANUAL VENTILATING SKYLIGHT * Frame and cut in opening in ceiling between beams * Remove existing asphalt shingles * Install double 2x6 header&sill * Cut hole through roof * EDL M08 Aluminum flashing * Wrap entire frame onto deck with ice&water barrier * Patching roofing as required with new shingles TO MATCH AS CLOSE AS POSSIBLE TO EXISTING * Top hung ventilating skylight * Aluminum clad exterior white wood frame interior * Insulated Laminated Lo E3 NEAT glass * Insect screen * Trim out skylight opening with primed pine * NO priming/painting to be done by contractor * Crank handle for in reach application 30"x 30" ventilating skylight VELUX 1.00 EA 13.L17.00 VELUX SOLAR BLIND FSCH M02 1045 factory installed double pleated room darkening blind in color white VELUX Solar blind 1.00 EA 25 Clean-up 25.005. Removal of scrap lumber, shingles and tear-out debris. Take debris and haul to our dump trailer. Cleanup 1.00 EA Phase Total: 4,380.00 Grand Total: 4,380.00 Manzella VS M02&Solar blind new install Page 1 of 1 Total Price and Quantity 6/29/2019 12:13:03 AM jj� �� /� C Lifq t Cs:Pita Dc,ubNZ?(C rgrWtr/7 14-Goa- 2- 6 4F-4 .�,, Q✓clio/ SW D kt/ Z..,xco aud� el hj� zx 4G rcih7s. C► a- ,:r )o'rk 36 `t. i0 Lek otekra/i/fr • TOWN OF YA Miti y H REVIEWED FOR Bt!ILCINC AND MN:N:3 CODE COMPLI- ANCE. ERRORS OR C:..,.;ISSI NS DO NOT RELIEVE THE APPLICANT FROM THE RESPONS;BILI1 Y OF'AS BUILT' COMPLIANCE. fs DATE: -c-I4 /��,f,jQ ZK�ct�// BUILDING OFFICIAL LE cop � 6� 3K ,'cS #attL¢l1c 44 Astf 147 1(2-4-eit7 3� lC lol'c`tiiZc(