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HomeMy WebLinkAboutBld-20-1688 ""` S • �l:k� "'3 3��" 2`� ����v Amount Q ,Z• ;_Pt.R T Permit expires 180 days from issue date EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-22/ � 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: i 8eJ/e O /G�e GV e..S� J 2 44 p,�-II lj e ASSESSOR'S INFORMATION: VVV Map: Parcel: OWNER: •T•rit S?' 6.1/44 0 VZ, -So 3 73,C 7 NAME PRES ADDRESS TEL. # CONTRACTOR: Co!' Q-*i COr 6' 7 Se. S , `#4, ,YP o,,,,s __Co 8 7 7 802 <r Q NAME MAILING ADDRESS TEL.# C esidential 0 Commercial v Est.Cost of Construction$ Home Improvement Contractor Lic.# /Y3 a Construction Supervisor Lic.# /0 6'/0 Workman's Compensation Insurance: (check one) ❑ I am the homeownerC I am the sole proprietor I have Worker's Compensation Insurance Insurance Company Name: //f d pd/e t.. 1 C 0 /e 710 Worker's Comp.Policy# ---Tov E)/S OR/ 2 0/3 WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows: # Replacement doors: # Roofing: #of Squares 3 0 ( V)Remov existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( ' )Replacing like for like Pool fencing *The debris will be disposed of at: 717..)L-YLI w /1 Location of Facility I declare under penalties of perju the stab erein 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 denial or re ation of / • se., d/-r p .s cution nder M.G.L.Ch.268,Section 1. Applicant's Signature: Date: 1 3 Owners Signature(or attachment) Date: Approved By: Date: Building Official d e EMAIL AD SS: Zoning District: Historical District: I Yes -7 No Flood Plain Zone: Yes i No Water Resource Protection District: Within 100 ft.of Wetlands: r: Yes No 1. Yes No . , COREY & COREY " The Roofers " 67 SEA STREET APT#A4, HYANNIS MA 02601 PHONE 1-508 -775-8240 CERTAINTEED LANDMARK LIFETIME - ALGAE RESISTANT ARCHITECTURAL STYLE RE - ROOFING PROPOSAL July 23, 2019 TIMOTHY STRANO 1 BELLE OF THE WEST EM: bluepighotdogs@gmail.com YARMOUTH PORT,MA Tel: 508-437-3957 COREY & COREY hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old Asphalt Roofing Shingles(One Layer)and All Four Skylights from the Entire House. Re Nail All The Existing Sheathing as needed. REPLACE ALL THE ROTTED TRIM RAKE TAILS ON THE HOUSE Supply and Install CERTAINTEED LANDMARK AR: LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION,CLASS A FIRE RATED, COPPER;CERAMIC S ;'ONES for a FULL 10 YEAR WARRANTY AGAINST ALGAE CONTAMINENT,235 POUND,EXTRA HEAVY WEIGHT, 130 MPH WIND WARRANTY,CATEGORY III HURRICANE,STORM IHURICANE NAILED (6 NAILS PER SHINGLE), MULTI-LAYERED,LAMINATED ARCHITECTU STYLE,4:. BASED ASPHALT SHINGLES. COLOR: sb r us 4:.Supply and Install HICK'S VENTED RIP EDGE on All of the Eaves. Supply and Install CERTAINTEED WINTER-GUARD ace & Water Shield)WATERPROOF UNDERLAYMENT SYSTEM on Roof Eaves&Valleys Under the Step Flashings,on the Skylights and Chimneys. Supply and Install CERTAINTEED'S"ROOF RUNNER" SYNTHETIC ROOFING PAPER Supply and Install AIR VENT SHINGLE VENT II RIDGE VENT on the Entire Ridge. Supply and Install NEW ALUMINUM& NEOPRENE kOIL PIPE FLASHINGS Supply and Install 4 NEW VELUX SOLAR POWERED SKYLIGHTS WITH THE FLASHING KITS AND FACTORY INSTALLED SOLAR POWERED ROOM DARKENING WHITE BLINDS,REPLACING ALL 4 SKYLIGHTS ON THE REAR MAIN SECTION------------=--------------$12,000.00 Clean and Remove Debris from work area after job is completed. TOTAL PROJECT INVESTMENT $24,000.00 COREY & COREY " The Roofers )SSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood heathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement rill be done and charged for as an Extra: Materials Plus Labor at the Rate of$60.00 per Hour(For Each Laborer Involved). PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All the Roof Work is Scheduled for Completion Within 90 Days of Acceptance and the Deposits Received are Non-Refundable After a Three Day Cooling Off Period from the Date of Signing. Please Make Checks Payable to: COREY & COREY COREY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warranties the Shingles up to a CATEGORY III HURRICANE-130 MPH WIND WARRANTY. CERTAINTEED Warranties the Shingles to be Algae Resistant for a Full 10 Years. COREY & COREY carries Workman's Compensation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: 7. 2 S - It ACCEPTED BY: S 1TE �: STRAND A ' '► FARM HOMEOWNER COREY & COREY HIC # 183202 CSSL# 106102 mit Massachusetts Department of Public.Safety. - Board of Building Regulations and Standards -License: CSSL-106102 Construction Supervisor Specialty ARMEN SAFARYAN 67 SEA STREET APT A4 HYANNIS MA 02601 • • •' '"s7-4 Expiration: Commissioner 10/02/2020 PYL Woirvirtowevea&A o./&6/7/4,4. Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Individual ARMEN SAFARYAN Registration: 183202 D/B/A COREY AND COREY Expiration. 09/13/2021 67 SEA ST APT A4 HYANNIS,MA 02601 Update Address and Return Card. SCA 1 Fi 20M-05/17 -- 03;feWantnionweaS a/G'-'f1aasaduaet/. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 183202 - 09/13/2021 1000 Washington Street -Su" 710 ARMEN SAFARYAN _- Boston,MA 02118 DB/A COREY AND COREY ARMEN SAFARYAN 67 SEA ST APT A4 HYANNIS,MA 02601 Undersecretary Not valid gnature The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 021 -14 2017 wwwmassgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Busincss/Organization/Individual): .�J/'rvt e-e? am h5 4 Co i 1-6 CG r a Address: 0 ck S /i'` C. ' City/State/Zip: , sz 2 LS 4 Phone#: .J©2 7 Are you an employer?Check the appropriate boa: Type A of project(required): I. I am a employer with 1 employees(full and/or part-time).* 7. New construction 2.0 I am a sole proprietor or partnership and have no employees working forme in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3. I am a homeowner doingall work myself t 9. ❑Demolition ❑ yse [No workers'comp.insurance required.] 4.❑ my property. I will I am a homeowner and will be hiring contractors to conduct all work on 10 Building❑ addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.❑Plumbing repairs or additions These sub contractors have employees and have workers'comp.insurance? 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El Other 152,§I(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. 1_ Insurance Company Name: je(�,,/2 8', 7 G' � o 1� ,[ Policy#or Self-ins.Lic.#: - -> D 0 4/ 6.4 4/0 Expiration Date: 3, 1 9, of 0 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 ce nde itnss and penalties of perjury that the information provided above is true and correct. Si i s 4 1 - L 3 . 0? 3 , i • Date: Phone#: 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 Phone#:Contact Person: A�RD CERTIFICATE OF LIABILITY INSURANCE DATE i13ii 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 Ashley Paiva Eastern Insurance Group LLC- PHONE �: (800)333-7234 FAIL WC No)_ 233 West Central St :apaiva@easterninsurance.com INSURER(S)AFFORDWG COVERAGE NAIC a Natick DOA 01760 INSURER A Arbella Protection Ins. Co. 41360 INSURED INSURER s Associated Employers Insurance Armen Safaryan, DBA: Corey and Corey INSURER C: 67 Sea Street INSURER D: Unit A4 INSURERE: Hyannis MA 02 601 INSURER F: COVERAGES CERTIFICATE NUMBER:2019-20 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. LTR TYPE OF PISURANCE NNW MD POLICY NUMBER (MMIDD/Y1fYYY) (MIDDIYYYYYn LEYrITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES PREMISES(Ea occurrence) $ 9520046441 9/18/2019 9/18/2020 KED ow(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GE:N1 AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY J CT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL _AUTOS SCHEDULED BODILY MAY(Per accident) $ HIRED AUTOS AUTOS NON-OWNED PROPERTY(Per tDAMAGE ) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- ER AND EMPLOYERS'LIABILITY Y/N ANY PR M MBER PARINEEXCLUDEEEXEC�� N N!A EL EACH ACCIDENT $ 1,000,000 B (Mandatory In NH) NCC50050150912019A 9/18/2019 9/18/2020 EL DISEASE-EA EMPLOYEE $ 1,000,000 If describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY UNIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached if more apace la required) CERTIFICATE HOLDER CANCELLATION ~L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Display Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Koegel/APAIVA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 onlanll