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Home My WebLink AboutBld-20-002997 ermidi t/ 0 *i . Amount •} 1 c� 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) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: /di 4/1 CCj Q /QI O r 1 /c i i' e__ ASSESSOR'S INFORMATION: Map: Parcel: 15- OWNER: Phr/1Ago /fac kg—y 7S77. 7.2 4/0s/�'- NAME l PRESENT ADDRESS TEL. # CONTRACTOR: COne.y m.ei 4' ep !`Qy C 7 Sea srl j4 Affl.k^gr' S S-O 2 7 7J 3'.Uy Q NAME / /MAILING ADDRESS / ' TEL.# Residential 0 Commercial Est.Cost of Construction$ 3 5.O , O c Home Improvement Contractor Lic.# /9 3 ' d o2 Construction Supervisor Lic.# /0 6/O .2 Workman's Compensation Insurance: (check one) I am the homeowner I am the sole proprietor \II have Worker's Compensation Insurance Insurance Company Name: ir ee// R.0 7 eC 1 o,n Worker's Comp.Policy# h fcC. o o S D/.S 05/2 0/3 fr WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove (Siding: #of Squares Replacement windows:# Replacement doors: # V Roofing: #of Squares / ( V)Remove existing*(max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at: )/'c2"Lrn Ou 7!7 Location of Facility I declare under penalties of perju at the e ents 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 r ation I. s and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: Date: /;• e2 0 - Owners Signature(or attachment) Date: /,G Approved By: Date: 4 / 2 Building Official( esi EMAIL ADD . Zoning District: Historical District: Yes No Flood Plain Zone: Yes No Water Resource Protection District: Within 100 ft.of Wetlands: I Yes - No Yes I No b • 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 September 3, 2019 PHILIP MACKAY 31 WIMBLEDON DRIVE EM: pmack914@yahoo.com W.YARMOUTH,MA Tel: 781-724-0515 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)from the Entire House. Re Nail All Plywood Sheathing as needed. Supply and Install CERTAINTEED LANDMARK AR: LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION, 5.: :_,,L: .':. _ ,._ .:, 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: C_.h cL t c 0� S j a c Supply and Install 8"WHITE ALUMINUM t,i Ar . i ;.N C, on the Eaves and Rakes. Supply and Install CERTAINTEED WINTER-GUARD (icc . *- atel S11iti )) WATERPROOF UNDERLAYMENT SYSTEM on Roof Eaves&Valleys Under the Step Flashings,on the Skylights and Chimneys. Supply and Install CERTAINTEED'S "ROOF RUNNER" S 1 ii 1111 IC ROOFING PAPER Supply and Install AIR VENT SHINGLE VENT II _'___ _ on the Entire Ridge. Supply and Install ALUMINUM& NEOPRENE SOIL PIPE FLASHINGS REMOVE AND RE-INSTALL ALL THE NECESSARY VINYL TYI SIDING TO INSTALL NE\ FLASHINGS ACROSS THE ENTIRE AREA WHERHE PORCH ROOF CONNECTS WITH THE MAIN HOUSE ON THE BACK SIDE Clean and Remove Debris from work area after job is completed. ROOF INVESTMENT $6,350.00 COREY & COREY " The Roofers 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 Roof Work is Scheduled for Completion Within 90 Days of Acceptance and 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: 3_ t ACCEPTED BY: SUBMI ITED BY: PHI Ir MAC • i' ARM =AFARYAN HOMEOWNER COREY & CORE HIC # 183202 CSSL# 106102 • The Commonwealth ofMassachusetts Department of Industrial Accidents =raw= 5., 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individue1): 4 ,n se n S St it t )fa A CrO su-i el Co r Address: C 7 ...c/re. / f : 41 City/State/Zip: /j) .f,c, ,, , S / /7 Phone#: O S7 7 7 44. 0 Are you an employer?Check the appropriate box: Type of project(required): k am a employer with employees(full and/or part-time).* 7. ❑New construction 2.gal 1 am a sole proprietor or partnership and have no employees working for me in any capacity-[No workers'comp.insurance required.) 8. Remodeling 3.0 I am a homeowner doing all work myself(No workers'cornP-insurance required.]t 9. ❑Demolition 4.0 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.[i Plumbing repairs or additions 5.0 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'romp.insurance.: 13.ViRppf repairs 5.0 we are a corporation and its officers have exercised their right of exemption per MQ.c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp insurance required.] *Any applicant that checks box 4 i 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 nice of the sub-contactors and state whether or not those entities have employees. tithe sub-contractors have employees,they must provide their workers'comp.policy number. Iam an fob employer thatis providing workers'compensation insurance for my employees. Below is the policy and job site Insurance Company Name: 4 4//a. Pr() 7l�r' T,' Policy#or Self-ins.Lic.#: AIC r= 'O O V.77 ZS-0 r/. D/3/'Expiration Date: .3_ / . a (...3 Job Site Address: C Attach a copy of the workers'compensation policy declaration page(showingtheCity/State/Zip: 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 Ili pans and penalties of that the information provided above is true and correct Si azure: 1f 4/'✓'1 Date: //- a D. / Phone#: _ 7 S .,)-5,1 lj 0 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): I.Board of Health 2.Building Department 3,City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • • Ara, Massachusetts Department of Public.Safety Board of Building Regulations and Standards -License: CSSL-106102 Construction Supervisor Specialty 00, ARMEN SAFARYAN 67 SEA STREET APT A4 HYANNIS MA 02601 • • ' t Expiration: Commissioner 10/02/2020 CJ��ie �p Oraladdaditaet6 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 0 20M-05117 e` ammanevealllt oj'c i(acta4 uael* 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 D/B/A COREY AND GOREY • ARMEN SAFARYAN 71 67 SEA ST APT A4 HYANNIS,MA 02601 Undersecretary Not valid gnature ACORD CERTIFICATE OF LIABILITY INSURANCE °A'E`MN1p°/Y"'"' `..----"- 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 CONTACT Ashley Paiva Eastern Insurance Group LLC PHONENo�). (800)333-7234 No)_ 233 West Central St E-fitAIL Ammul:apaiva@easterninsurance.com INSURER(S)AFFORDING COVERAGE NAIC F Natick MA 01760 INsuRERAArbella 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 ENSURER F: COVERAGES CERTIFICATE NUMBER:2019-20 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. SUM POUCY EFF POUCY EXP LTRR TYPE OF INSURANCE INSDSR IN WVD POLICY NUMBER (MMIDDIYYYYI (MM LYYYTY) LINTS X COMMERCIAL GENERAL LABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE I X I OCCUR DAMAGE E TO RENTEDte 100,000 PRREMI SES(Ea a ) $ 9520046441 9/18/2019 9/18/2020 MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENL AGGREGATE UMIT APPUES PER: GENERAL AGGREGATE $ 2,000,000 POUCY J ACT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COPED SINGLE UMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED — SCHEDULED ( accident) $ BODILY INJURY(Per HIRED AUTOS NON-OWNED (Per accident) DAMAGE $ $ UMBRELLA L TAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER O7H- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETORIRIEXECIrIVE ELEACH ACCIDENT $ 1,000,000 BEXCLUDED? OFFICER/MEMBER EXCLUDED? N N/A - yea In NH) 5CC50050150912019A 9/18/2019 9/18/2020 EL.DISEASE-EA EMPLOYEE $ 1,000,000 be under DESCRIPTION OF OPERATIONS below El.DISEASE-POLICY UMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is requked) CERTIFICATE HOLDER CANCF L.ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Display Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY 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 INS0251On14n1t