Loading...
HomeMy WebLinkAboutbldsm-20-002795 Commonwealth of Massachusetts Sheet Metal Permit Date: 10/07/2019 Permit#g�. )-21) -00279S- Estimated Job Cost: $35,577.00 Permit Fee: $ DU ) Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 801 Applicant License# 4323 Business Information: Property Owner/Job Location Information: Name: Coastal Mechanical Name: Derek Johnson Street: 21 L Fruean Ave Street: 37 Moss Road City/Town: South Yarmouth, MA 02664 City/Town: West Yarmouth, MA 02673 Telephone: 508-737-8747 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES V NO LW Staff Initial J-1 /M-1-unrestricted license J-2 /M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family V Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. V over 10,000 sq. ft. Number of Stories: 2 Sheet metal work to be completed: New Work: V Renovation: HVAC V Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing r;; Provide detailed description of work to be done: 4 -Zones 2- American Standard Gas Fired Furnaces 2-American Standard Condensing Units for Central Air Conditioning Venting of(5) Bath Fans, Dryer and Kitchen Hood Supplies and Returns / 01 / ho- r INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes® No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ® Other type of indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner 0 Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ® Master Title / of((/�N /2(� - 0 Master-Restricted City/Town DJourneyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: 801 Fee$ ❑ --c-- Check at www.mass.qov/dpl - .1, Inspector Signature of Permit Approval The Commonwealth of Massachusetts Department of Industrial Accidents 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 Leeibly Name (Business/Organization/Individual):Coastal Mechanical Address:21 L Fruean Ave City/State/Zip:South Yarmouth, MA 02664 Phone #:508-737-8747 Are you an employer?Check the appropriate box: Type of project(required): l.Z I am a employer with 30 employees(full and/or part-time).* 7. EiNew construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. El Remodeling any capacity.[No workers'comp.insurance required.] 9. oDemolition 3❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.DI 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 1 1❑Electrical repairs or additions proprietors with no employees. 120Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.1-1Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.EI We are a corporation and its officers have exercised their right of exemption per MGL c. 14.1-1Other 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. tContractors 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:AIM Mutual Policy#or Self-ins.Lic.#:MKLV1 PBC000152 Expiration Date: 1/04/2020 Job Site Address:37 Moss Road City/State/Zip:W.Yarmouth, MA 02673 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: 2/1-31.4", /t%d ZM.. Date: /0/07/1.0i9 Phone#:508-737-8747 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# • Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: T ya - 1. ,� R VEE -- 4AS$.AC ,-0 r`r4. s,,,,, , IL, s „... .:,. _ ._ 7,„.,-' --_-..__.„,....4 4.... 1;2, s •,..7*,.,--' 610 _ N , ..' !,1� 't N1'' _ -1 69 _ u z,k _.. r �, `• 1,' ❑❑ • 12. d 5 - _1 r e``,. 4 f'bill lira $ Y. '� C•syrAN• �,�r�;, t �.. ` , ,' t • , ' •, r _ t 4 ©� 0412416! t 4 J • f J. 4 `v COMMONWEALTH OF MA 'ACHUS ,:.- ,a=r DIVISION OF PROFESSIONAL LICENSURE SHEET METAL WORKERS „��� ISSUES THE FOLLOWING LICENSE , BUSINESS ROBERT D VIVOO URY COASTAL PLUMBING AND HEATING LLC 46, WHITES PATH 1 ; YARINCWTH, INA Cra$4.01214 'a 421872 ,.' I t F g E`4 t bF t ._......_,..' !: DALE `i(I IAL NI IMtit 11 Client#:764315 2COASTALPLI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 01/07/2019 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(les)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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil Insurance Agy PHONE 508 775-1620 FAX 5087781218 (AIC,No,Ext): (AK,No): 973 lyannough Road E-MAIL P.O.Box 1990 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC C Hyannis,MA 02601 INSURER A:Evanston Insurance Company 35378 INSURED INSURER B:Associated Employers Insurance Company 11104 Coastal Plumbing&Heating LLC Dba Coastal Mechanical INSURER C:Safety Insurance Company 39454 299 Whites Path INSURER D: South Yarmouth,MA 02664 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. POLICY EXP LTRR TYPE OF INSURANCE IINSR WVD POLICY NUMBER (MMIDD/YYYFY) (MMM/DONYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY MKLVI PBC000152 01/04/2019 01/04/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISES? Noc urrence) $100,000 X BI/PD Ded:5,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY BINDER459951 01/04/2019 01/04/2020(Es accidenBINECTINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ — OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED ONLY X NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per accident) S A X UMBRELLA LIAR X OCCUR MKLVI EUL101746 01/04/2019 01/04/2020 EACH OCCURRENCE S1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE S1,000,000 DED RETENTION$ $ B WORKERS COMPENSATION WMZ80080074082019A 01/04/2019 01/04/2020 X :Mum OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT S1,000,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 01,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Hall ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 134 South Yarmouth,MA 02664 AUTHORIZED`REPRESENTATIVE L ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S227153/M227101 LS1 . 0RIGHT-J SHORT FORM Entire House CLIMATROL HVAC DESIGNS Job:CL182 8-10-2019 3170 MATECUMBE KEY ROAD UNIT 127,PUNTA GORDA,FL 33955 Phone:508-364-5198 Fax 941-575-0013 Email:MILLERHVACDESIGNS@GMAILCOM Project Information For: COASTAL PHC-JOHNSON 37 MOSS ROAD, WEST YARMOUTH, MA Design Information Htg Clg Infiltration Outside db(°F) 10 88 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD (°F) 60 13 Fireplaces 0 Daily range - M Inside humidity (%) - 50 Moisture difference(gr/Ib) - 28 HEATING EQUIPMENT COOLING EQUIPMENT Make Make Trade Trade Efficiency 80.0 AFUE Efficiency 0.0 EER Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 °F Total cooling 0 Btuh Actual heating fan 2112 cfm Actual cooling fan 2112 cfm Heating air flow factor 0.020 cfm/Btuh Cooling air flow factor 0.036 cfm/Btuh Space thermostat Load sensible heat ratio 87 % ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) ZONE 1 n p 752 22180 - 15493 449 565 ZONE 2 n p 1003 32438 20823 656 760 ZONE 3 n p 492 15994 10632 323 388 ZONE 4 n p 1305 33831 16289 684 595 Entire House d 3552 104443 57865 2112 2112 Ventilation air 3300 715 Equip. @ 0.93 RSM 54480 Latent cooling 8855 TOTALS 3552 107743 63335 2112 2112 Printout certified by ACCA to meet all requirements of Manual J 7th Ed. -tr- wrlghtsofit Right-Suite ResidentialTM 5.0.14 RSR20780 2019-Aug-10 09:44:14 ACA C:1My Documents\Wrightsoft HVACICL HEAT CALCS.rsr Page 1 , . RIGHT-J SHORT FORM ZONE 9 CLIMATROL HVAC DESIGNS Job:CL182 8-10-2019 3170 MATECUMBE KEY ROAD UNIT 127,PUNTA GORDA,FL 33955 Phone:508-364-5198 Fax 941-575-0013 Email:MILLERHVACDESIGNS©GMAILCOM Project Information For: COASTAL PHC-JOHNSON 37 MOSS ROAD, WEST YARMOUTH, MA Design Information Htg Clg Infiltration Outside db(°F) 10 88 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD (°F) 60 13 Fireplaces 0 Daily range - M Inside humidity(%) - 50 Moisture difference(gr/lb) - 28 mimmimimiimmliIMMMIMIMNMIMNSINMIMMIMINMNNMNMNMMmmimiMmlmmimmmimmmmim HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 °F Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Space thermostat n/a Load sensible heat ratio 0 % ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) BED 4 224 5199 3981 105 145 BATH 3 60 817 103 17 4 BED 3 192 7041 6149 142 224 BED 2 132 2985 3110 60 113 HALL 2-ENTRY 144 6138 2151 124 78 ZONE 1 n p 752 22180 15493 449 565 Ventilation air 0 0 Equip. @ 0.93 RSM 14408 Latent cooling 1956 TOTALS 752 22180 16364 449 565 Printout certified by ACCA to meet all requirements of Manual J 7th Ed. wnghtsaft Right-Suite Residential"'5.0.14 RSR20780 2019-Aug-10 09:44:14 C:1My Documents\Wrightsoft HVAC\CL HEAT CALCS.rsr Page 2 . * RIGHT-J SHORT FORM ZONE 2 CLIMATROL HVAC DESIGNS Job:CL182 8-10-2019 3170 MATECUMBE KEY ROAD UNIT 127,PUNTA GORDA,FL 33955 Phone:508-364-5198 Fax 941-575-0013 Email:MILLERHVACDESIGNS@GMAIL.COM Project Information For: COASTAL PHC-JOHNSON 37 MOSS ROAD, WEST YARMOUTH, MA Design Information Htg Clg Infiltration Outside db(°F) 10 88 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD (°F) 60 13 Fireplaces 0 Daily range - M Inside humidity(%) - 50 Moisture difference(gr/Ib) - 28 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 °F Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Space thermostat n/a Load sensible heat ratio 0 % ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) ENTRY 70 4542 1476 92 54 FAMILY 340 8122 6403 164 234 BED 1 143 3526 3002 71 110 BATH 1 60 850 112 17 4 HALL 1 78 3637 1079 74 39 MUD ROOM 216 7432 5098 150 186 LAUNDRY 48 2165 2320 44 85 POWDER 48 2165 1333 44 49 ZONE 2 n p 1003 32438 20823 656 760 Ventilation air 0 0 Equip. @ 0.93 RSM 19365 Latent cooling 2074 TOTALS 1003 32438 21439 656 760 Printout certified by ACCA to meet all requirements of Manual J 7th Ed. C wnghtsoft Right-Suite Residential"'5.0.14 RSR20780 2019-Aug-la 09:44:14 Ac C:\My Documents\Wrightsoft HVAC\CL HEAT CALCS.rsr Page 3 . illRIGHT-J SHORT FORM ZONE 3 CLIMATROL HVAC DESIGNS Job:CL182 8-10-2019 3170 MATECUMBE KEY ROAD UNIT 127,PUNTA GORDA,FL 33955 Phone:508-364-5198 Fax 941-575-0013 Email:MILLERHVACDESIGNS©GMAILCOM Project Information For: COASTAL PHC-JOHNSON 37 MOSS ROAD, WEST YARMOUTH, MA Design Information Htg Clg Infiltration Outside db(°F) 10 88 Method Simplified Inside db(°F) 70 75 Construction quality - Average Design TD (°F) 60 13 Fireplaces 0 Daily range - M Inside humidity(%) - 50 Moisture difference(grub) - 28 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 °F Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Space thermostat n/a Load sensible heat ratio 0 % ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) MASTER BED 238 10932 9324 221 340 MASTER WIC 84 1144 144 23 5 MASTER BATH 170 3918 1164 79 42 ZONE 3 n p 492 15994 10632 323 388 Ventilation air 0 0 Equip. @ 0.93 RSM 9888 Latent cooling 1331 TOTALS 492 15994 11219 323 388 Printout certified by ACCA to meet all requirements of Manual J 7th Ed. .: vvrightsoft Right-Suite Residential"'5.0.14 RSR20780 2019-Aug-10 09:44:14 q C:1My Documents\Wrightsoft HVACICL HEAT CALCS.rsr Page 4 0 RIGHT-J SHORT FORM ZONE 4 CLIMATROL HVAC DESIGNS Job:CL182 8-10-2019 3170 MATECUMBE KEY ROAD UNIT 127,PUNTA GORDA,FL 33955 Phone:508-364-5198 Fax 941-575-0013 Email:MILLERHVACDESIGNS(GMAILCOM Project Information For: COASTAL PHC-JOHNSON 37 MOSS ROAD, WEST YARMOUTH, MA Design Information Htg CIg Infiltration Outside db(°F) 10 88 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD (°F) 60 13 Fireplaces 0 Daily range - M Inside humidity (%) - 50 Moisture difference(gr/Ib) - 28 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temperature rise 0 °F Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Space thermostat n/a Load sensible heat ratio 0 % ROOM NAME Area Htg load CIg load Htg AVF CIg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) FAMILY 2 484 9873 4159 200 152 KITCHEN-DINING 550 17566 10248 355 374 HALL 3 105 2226. 707 45 26 POWDER 2 56 1691 652 34 24 PANTRY 110 2475 523 50 19 ZONE 4 n p 1305 33831 16289 684 595 Ventilation air 0 0 Equip. @ 0.93 RSM 15149 Latent cooling 2555 TOTALS 1305 33831 17704 684 595 Printout certified by ACCA to meet all requirements of Manual J 7th Ed. wnghtsoft Right-Suite ResidentialTM 5.0.14 RSR20780 2019-Aug-10 09:44:14 /c, C:\My Documents\Wrightsoft HVAC\CL HEAT CALCS.rsr Page 5