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Home My WebLink AboutBld-20-001418 0, 1•Y` O ce Use—" ssee Only 'y� yO - • r • Amount k le In CS � ° *A.0Ord Permit expires 180 days from issue date EXPRESS BUILDING PERMIT APPLICATION. �. �- �: TOWN OF YARMOUTH ' 0 Yarmouth Building Department 1146 Route 28 '*1. I. r 20N , South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: CS Zjlb POSY' c-T f U�1 y ....... ASSESSOR'S INFORMATION: Map: Parcel: x OWNER: LY UDA Wei Q CUB DC4t sr 4 2 7 ( f4 NAME �/ P 0 PRESENT ADDRESS TEL. # CONTRACTOR: {`QRA > C,Q4St C'D s 0i C O 3 1 '4\01 'S S--647 NAME MAILING ADDRESS TEL.# Residential ❑Commercial Est.Cost of Construction$ "VAC C ,OD Home Improvement Contractor Lic.# t(0;22,0 Construction Supervisor Lic.#05 4 146 Workman's Compensation Insurance: (check one) ❑ I am the homeowner YI am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp.Policy# WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# 1 Replacement doors: # Roofing: #of Squares ( )Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at: g4J$ TIC &i`d{ _. 9\ tt) `\) Location of Facility I declare under penalties of perjury that the statements herein 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 revocati rl of my license and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: ® — Date: OC? 06 1 l Owners Signature(or attachment) Date: Approved By: Date: ?`/2 / Building 0 or ee EMAIL AD SS: Zoning District: Historical District: ❑ Yes ❑ No Flood Plain Zone: 0 Yes 0 No Water Resource Protection District: Within 100 ft.of Wetlands: 0 Yes 0 No 0 Yes 0 No The Commonwealth of Massachusetts Department oflndustrialAccidents _ifi- 1 Congress Street, Suite 100 • _F`E-s Boston, MA 02114-2017 '��;5••`' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LezibIY Name (Business/Organization/Individual): V A� TT� G7 d Address: gv C,\E O City/State/Zip: Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.1]I am a employer with employees(full and/or part-time).* 7. ❑New construction = I am a sole proprietor or partnership and have no employees working for me in 8. E Remodeling any capacity.[No workers'comp.insurance required.] 3. I am a homeowner doing all work myself. 9. ❑ Demolition ❑ y [No workers'comp. insurance required.]` 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my 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 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.E Roof repairs These sub-contractors have employees and have workers'comp. insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E 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. 1-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 certify under the i and penalties of perjury that the information provided above ' true a d correct. Slanature: Date: C.) cl ' 19 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#: Commonwealth of Massachusetts to Division of Professional Licensure Board of Building Regulations and Standards Constru6tO:Sn'Supervisor E pires: 09/06/2021 CS-054146 • • 0 DAVID G KAFtAS ", J 80 CHERRYWOOD LAND MARSTONS MILLS Mk,02848 % // \()ll\`��' Commissioner .7 ,e q ea c/&6r2.4,-. c i e Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:LLC Registratign Expiration s 03/01/2021 KARAS CONSTRVG 3N COMPANY LLC / / DAV K RRAS \.F CGG -- 80 CHERYW OODL1' ci MARSTONID MILLS.MA-02648 Undersecretary i 1 IARVEY Manufacturing E rr.ac�v�'r �EJ� ACKNOWEEDGEMNI' - ' BUILDING PRODUCTS 'E O teL PC-10 r Harvey Industries,Inc. Il 1400 Main Street.Waltham,MA 02451-1689 46, I rp/"'w'1 Q� (781)899-3500 harveybp.com ,/ V 1V f Window Drawing V/ f CAS Hyannis v 186 Breeds Hill Road HYANNIS,MA 02601-1186 Phone:(508)775-7788 Fax.(508)771-3217 BILL TO: SHIP TO: KARAS CONSTRUCTION KARAS CONSTRUCTION 111111111111111113111111111111111PO BOX 144 PO BOX 144 PO BOX 144 MP30140464994600 COTUIT MA 02635-0000 Phone: 401-265-5647 Fax: 5083367609 Phone: 401-265-5647 Fax: (508)336-7609 _QUOTE NBR CUST NBR CUSTOMER PO DATE CREATED DATE ORDERED ORDER TYPE 4649946 1019270 8/2/2019 Quote Not Ordered Charge ORDERED BY STATUS SHIP VIA DELIVERY AREA DAVID None Whse Pickup _ HYANNIS WAREHOUSE CLERK JOB NAME COUPON MD -Mark Dayton HURLEY 1) LINE# QTY 10000-1 1 r L , ___ - ,i, ia . . . , 1._.! _ _ , 4.,,, , , r--- � tI li f`‘' \\\\, \ ii/ 21" --- 34.25" ►- 21'' 71.5 Room Nbr: None Assigned Last Update:9/6/2019 11:55 AM Page 1 Of 1 Printed: 9/6/2019 11:55 AM ispivaisE -6*-44-„, • Karas Construction Company LLC Lic. # 054146 Contract for work; Lynda Hurley #8 Old Post Court, 'Yar mouth Port, Ma 08/29/2019 Job; Bay Window Replacement We will supply the materials and necessary labor to remove, supply and replace the front bay window. The new window is a white all vinyl window. It is a 30°Angle bay window. The two outside windows are double hung units with a full-screen with white grids in between the glass. The big center picture window has no grids. We would remove the vinyl siding as needed, remove the old unit, prepare the window opening with proper flashings, install the new unit, properly seal the new unit against air, water, and insect infiltration. The inside would receive new wooden trim, finished to match the existing trim in the room. • All the debris will be removed from your property. • All work is guaranteed for one year after completion. Total job materials and la $ 5,305.00 Payments; '/ due upon acceptance of this proposal $ 2,652.50 Balance is due upon completion of work $ 2,652.50 \\ Accep ted by;Yr4,14,c7-7-4,1"/ Date; g/c7Z1 /i7 Dave Karas; 0&129 ) 2_otcl Karas Construction Company