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Home My WebLink AboutBld-20-001273 TOWN Burs,i Ltd, *II 1 �° t . OF YARMOUTH g p BUILDING (508) 398-2231 ext.1261 0 ,I PERMIT NO BLD 20 001273 PERMIT kA "* r" JOB WEATHER CARD ,` _ ISSUE DATE 09/06/2019 APPLICANT TROY THOMAS PERMIT TO Repair AT(LOCATION) 18 ERIKS PATH,YARMOUTH MA 02675 s ZONING DISTRICT R-40 ' Bldg.Type: ;Residential SUBDIVISION MAP BLOCK LOT /128.11 2 , BUILDING IS TO BE: ;CONST TYPE j 1V B 9 USE GROUP IR 3 REMARKS Repair-Strip and re roof 46 sq ft(508-328-1635) CONTRACTOR LICENSE 185422 : I s Home Improvement 1 1TROY THOMAS HOME rr u ;IMPROVEMENTS, LLC ... , µ jM TROY THOMAS AREA(SQ FT) 910,796 040. EST COST($) 119792.00 $ PERMIT FEE($) 50 00 I ' P.O.BOX 177 OWNER YEAPLE CAROL ANN '/CENTERVILLE MA 02632 BUILDING DEPT BY ADDRESS /,8 ERIKS PATH s SOUTH YARMOUTH ;MA 102664 /' / ONE I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWAL R ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE CONSTRUCTION WORK: 1)FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL SEPARATE PERMITS ARE FOOTINGS.2)PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE. REQUIRED FOR ELECTRICAL MEMBERS(READY FOR LATH OR FINISH WHERE A CERTIFICATE OF OCCUPANCY IS PLUMBING/GAS AND COVERING)3)FINAL INSPECTION BEFORE REQUIRED,SUCH BUILDING SHALL NOT BE MECHANICAL INSTALLATIONS. OCCUPANCY 4)REFER TO DETAILED INSPECTION BEEN MAD UNTIL FINAL INSPECTION HAS BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS OTHER: I WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS SIX MONTHS OF DATE THE PERMIT IS ISSUED AS OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION NOTED ABOVE. ,YRR Office Use Only �,w 4 ; Permit# Q - -+,xr!'1• F . y Amount l7 nwtrA n cs� - �," �° �6d Permit expires 180 days from EDuzo�4Z7� :(issue date EXPRESS BUILDING PERMIT APPLICATION �` E $` . v TOWN OF YARMOUTH �... Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 �r (508) 398-2231 Ext. 1261 ` � ! Q 9 CONSTRUCTION ADDRESS: 9 ,r3,ckf P k {- C, ' - / 104 C )&'7 ASSESSOR'S INFORMATION: Map: Parcel: OWNER: 41-C/ I/Np) 4s �'e NAME r PRESENT ADDRESS TEL. # OrJ CONTRACTOR: OAINIS //vin.e f!f'i ,t'lk'4 // 04.44/� 00165 / Jo°/'3r NAME ✓� MAILING ADDRESS / TEL.# da esidential ❑Commercial Est.Cost of Construction$ /% lJ , Home Improvement Contractor Lie.# /F /) Construction Supervisor Lic.# M/1 Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑ I am the sole proprietor •B'1"�ve Worker's Compensation Insurance Insurance Company Name: 74-frvt /4 'i'•fvs/.j� :_;Worker's Comp.Policy# a[Lrlj $1 WORK TO BE BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares 0 ( �)Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at e7✓Ai t fr /-..0^QLocation of acility 6 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 revocation of my 1' nse and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: Date: j'"� d�'%`% Owners Signature(or attachfr►ent) Date: Approved By: ? Date: / 'ti// Building 0 al d ignee) E ADDRESS: Zoning District: Historical District: ❑ Yes ❑ No Flood Plain Zone: ❑ Yes ❑ No Water Resource Protection District: Within 100 ft.of Wetlands: ❑ Yes ❑ No ❑ Yes ❑ No .164A1,41ei .-e,P6«evzm4,--}s 0 erf.reAt/. • The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street, Suite 100 %rr,_' = 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/Individual): 741714Af Address: x4 ire City/State/Zip: Q.�. ,.,/4 110 W fa Phone #: OJ „2,51 Sr Are you an employer?Check the appropriate box: Type of project(required): I.❑-l-am a employer with 5 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. 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 These sub-contractors have employees and have workers'comp.insurance.* 13.Erl oof repairs 6.❑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: flirt✓4. r,i,/9 CS✓.a rf, Policy#or Self-ins.Lic.#: '/ iJ j p'J Expiration Date: s / Job Site Address: 69 0 tt4.c City/State/Zip: ii t,",44 444 rdiTa- Attach a copy of the workers' compensation policy declaration page(showing the policy number add 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: Date: / Phone#: 9? 5I) /<< 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#: -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier,Synthetic roof underlayment,and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8" drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges -Timberetex premium ridge cap to be installed -A 10-yard dump trailer will be needed on site;and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start;and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the workmanship completed under this contract for a period of ten years from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties, Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form, content,and notices contained in this contract are intended to comply with the applicable portions of the Mass.General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance, only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: off / Homeowner /" 09a7 Contra •r 61,(4 r7e (Gm manaveall Office of Consumer Affairs Business Re HOME IMPROVEMENT CONTRACTOR Regulation Re i Corporation R r io TROY T 1854�2 E �r I 0 THOMAS HOME IMPROVEMENTS, ROVEMENTS INC. TROY THOMAS 499 NOTTINGHAM DR. CENTERVILLE,MA 02632 r �� Undersecretary tie _ Commonwealth ealth of Massachusetts Board of B n of Profe, onal Licensure uiiding R lions and Standards , Con.?trlicti� _ CSSL-099g13 'visor Specialty Expires: 04/13/2020 TROY A THOMAS ; 499 OTTINGRAM Dh ERVILLE MA 026. 3 i ENT l/ — Commissioner I • Aco CERTIFICATE "a'OF LIABILITY INSURANCE DATE' DD"Y'") 04/30/2019 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 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER ! Jon Davis Mark Sylvia Insurance Agency,LLC ,ram. (508)957-2125 iArc,Not: (508)957-2781 404 Main Street ADDRESS: mark@marksyiviainsurance.Com Centerville,MA 02632 INSURER(S)AFFORDING COVERAGE NAIC s INSURER A: Farm Family Casualty Insurance • INSURED INSURER B: Thomas Home Improvements).LC mum c: PO Box 177 INSURER D: Centerville,MA 02632 INSURERS: INSURER F: COVERAGES CERTFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES 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.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS EXP LTR y R TYPE OF INSURANCE go CI POLICY NUMBER IMMAPOURI YYYY1 IY EFF MDJDnY1 LIMITS X COMMERCIAL GENERGENERALUABIUTY I EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED oaamencel $ 100,000 MED E)P(My one person) S 5,000 A N N 2001X1416 5/01/2019 5/01/2020 PERSONA.aADvINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE ' $ 2,000,000 X POLICY ri JrECT n LOC i PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: I s AUTOMOBILE LIABIUTY ( SINGLE LIMIT $ accidentl ANY AUTO i BODILY INJURY(Per Pawn) $ VANED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accdent) $ HI_ RED ONLY AUTOSONLY NON-OWNED N- PROPERTY DAMAGE HI $ (Per accident) $ UMBREUA LIAB _ OCCUR I EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION • ST TUTE ER AND EMPLOYERS'LIABILITY ANY PROPRETORIPARTNERIEXECLmVE Y!N EL EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EX•"I ICED? YO NIA N 2001 W8053 5101/2019 5/01/2020 (Mandalay In NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 y DESCRIPTION OF OPERATIONS below I EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,way be attached Ninon space Is required) Carpentry Insurance coverage is limited to the terms,conditions,exdusions,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 i CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTNOREED REPRpBSTATIVE • I Hyannis MA 02601 Fax: Email: 61988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD