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Home My WebLink AboutBld-20-001687 � 40t,r4 C £1 . F...I . ;Alb 0 *i H Amount �`ft."� c r� T"�� / Permit expires 180 days from k � ,`�f `� zU7;; s issue date EXPRESS BUIL PE-R I—'T-APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 ' CONSTRUCTION ADDRESS: 3/ 764.S /V/�,z £q. 6PI t/2 j �i2Ir_y?.s 0 te. M Po`t ASSESSOR'S INFORMATION: Map: / Parcel: OWNER: Lee Pa eSecw /(//l S0z3G4 a33J) NAME PRESE '1 ADDRESS TEL. # CONTRACTOR: CV'.e. ill.ey CI CD('te+/ C7'Se a, S)4/9ly Icl.,,,,H,S O 7 7s 8.2 4 v NAME [� / MAILING ADDRESS TEL.# 4Residential 0 Commercial v Est.Cost of Construction$ /S, .S 0 Home Improvement Contractor Lic.# / S...- o2 0 Construction Supervisor Lic.# /0 6(tom o Workman's Compensation Insurance:,,(check one) C I am the homeowner V I am the sole proprietor have Worker's Compensation Insurance p J Insurance Company Name: it b e //q 130 71e'C ij,' 0 f, Worker's Comp.Policy# So c•S Co#' O 3 t 2 0/3.2 WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacementpl windows: # Replacement doors: # \goofing: #of Squares a 3— V)( Rem ve existing*(max.2 layers) Insulation Y.-..,, Old Kings Highway/Historic Dist. Replacing like for like ( ) p g Pool fencing *The debris will be disposed of at: YQ.%Yl O c.c.7% 6 UL P14 p Location of Facility I declare under penalties of perju that ments herein contained are true and correct to the best of my lmowledge and belief. I understand that any false answers) will be just cause for denial or ati li nse and for prosecution under M.G.L.Ch.268,Section 1. Q Applicant's Signature: Date: �J 02 2: / Owners Signature(or attachment) Date: Approved By: /,. - Date: �� Building Offici r de ' ) EMAIL SS: Zoning District: Historical District: Yes 1 No Flood Plain Zone: ' Yes !_ No Water Resource Protection District: Within 100 ft.of Wetlands: Yes No = Yes No Massachusetts Department of Public.Safety • Y Board of Building Regulations and Standards -License: CSSL-106102 Construction Supervisor Specialty ARMEN SAFARYAN 67 SEA STREET APT A4 HYANNIS MA 02601 • Expiration: Commissioner 10/02/2020 ^ /1L �_?d v a� 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 DB/A COREY AND COREY Expiration: 09/13/2021 67 SEA ST APT A4 HYANNIS,MA 02601 Update Address and Return Card. SCA 1 err 20M-05/17 --------- e 6ninaanuvea/tAe ofc+.tlatsacAivaehs 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 'CLl HYANNIS,MA 02601 UndersecretaryNot valid gnatute A�QRD® CERTIFICATE OF LIABILITY INSURANCE DATE 9/13/2019 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 POUCIES 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 CMITACT Ashley Paiva Eastern Insurance Group LLC PHONE ) (800)333-7234 FAXWC. _ 233 West Central St E-MAIL mxme sP a oa aiva@easterninsurance.cn �) INSURERS)AFFORDING COVERAGE NAIC s Natick NA 01760 INSURER A Arbella Protection Ins. Co. 41360 INSURED INSURER B Associated Employers Insurance Armen Safaryan, DBA: Corey and Corey INSURER C: 67 Sea Street INSURER D: Unit A4 INSURER E: Hyannis MA 02601 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. Y LTRR TYPE OrNIIURANCE INSO WVD POUCY NUMBER IMMNDDIYYYYYYI BMA YYYYY) MATS X COMMERCIAL GENERAL LIABILRY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ 9520046441 9/18/2019 9/18/2020 MED E (Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY J ef LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS _ AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AUTOS (Per PROPERTY DAMAGE $ (Peracident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER 0Th- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY FICERIMEM ER�EXCLUDED?XECUTNE (N I N(A EL EACH ACCIDENT $ 1,000,000 B (MaendatoryInNH) 5CC50050150912019A 9/18/2019 9/18/2020 EL DISFA.CF-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I YEMICL.ES(ACORD 101.Additional Remarks Schedule.may be alladwd N mere space is requited) CERTIFICATE HOLDER CANCELLATION 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 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INs025 oniam m .\\ 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 June 18, 2019 LEE PARESEAU 31 TASMANIA DRIVE EM: dressblue2@yahoo.com YARMOUTH PORT,MA Tel: 508-364-2338 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 t sgs ., and The Skylight from the Whole House Only.Re Nail All Plywood Sheathing as needed. Supply and Install CERTAINTEED LANDMARK AR: LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION, kt, = a" , COPPER/CERAMIC STONES for a FULL 10 YEAR WARRANTY AGAINST ALGAE CONTAMINENT,235 POUND,EXTRA HEAVY WEIGHT, 130 MPH WIND WARRANTY,CATEGORY III HURRICANE, STORM/HURICANE NAILED (6 NAILS PER SHINGLE), MULTI-LAYERED,LAMINATED ARCHITECTURAL STYLE,FIBERGLASS BASED ASPHALT SHINGLES. COLOR: WEATHERED WOOD Supply and Install 8" WHITE/BROWN ALUMINUM s .9.1 on All of the Eaves Supply and Install CERTAINTEED WINTER-GUARD 4 ; ;..3tY .5111elit. WATERPROOF UNDERLAYMENT SYSTEM on Roof Eaves & Valleys Under the Step Flashings,on the Skylights and Chimneys. Supply and Install CERTAINTEED'S "ROOF RUNNER" r g ROOFING PAPER Supply and Install AIR VENT SHINGLE VENT II 11z on the Entire Ridge. Supply and Install ALUMINUM & NEOPRENE SOIL PIPE FLASHINGS Supply and Install ALL NEW VELUX .,? :� �.�� _ g ; d WITH THE FLASHING KIT,REPLACING Tflt SKYLIGHT ON THE REAR SECTION Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT $12,950.00 COREY & COREY " The Roofers " ROOFING THE GARAGE WILL BE ADDITIONAL $3,000.00 2 POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Materials Plus Labor at the Rate of$ 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: ACCEPTED BY: SUBMITTED BY: 1, E PARES AU ARMEN SAFARYAN HOMEOWNER COREY & COREY HIC # 183202 CSSL# 106102 The Commonwealth of Massachusetts a9 i Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 Y'�1M www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aaulicant Information Please Print Leeibly Name(Business/Organization/Individual): �1 rt dis7 v 4441 h,S 4 Co,- d Co �Jw r Pay Address: b e ck £1r e 4t 7 . `,14 City/State/Zip: tp..ti L15 pi,9 Phone#: 5 0 2 7 7 S t l 0 Are you an employer?Checti the appropriate box:.f Typeof project(required): am a employer with .s, employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 4. I am a homeowner and will be hiringcontractors to conduct all work on my10 Building❑ addition ❑ property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑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.: 13.❑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. :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: (GUz ` ro c71,`0 yl .2 si-c f,7c,a c e Policy#or Self-ins.Lic.#: -33-a D 0 4 64.410 4 Expiration Date: 3, 19, 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 iryinde t. as and penalties of perjury that the information provided above is true and correct. Signatu /`` Date: 3 -a 3 - 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 Contact Person: Phone#: