HomeMy WebLinkAboutBld-20-003580 Office Use Only
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*`'"«•n• � '' jj /� /, Permit expires 180 days from
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EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department i 1! 1
1146 Route 28 ��
South Yarmouth, MA 02664' ?.
a (� (508) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: 2 i 1'�1 C 20 Yi2 G i otQ,Il'1
ASSESSOR'S INFORMATION:
Map: Parcel:
OWNER: KA- tSRPrL V fizi( RFR 22 =G94- 6.l77
NAME 11 PRESENT ADDRESS TEL. #
CONTRACTOR: )ZL4 ( .- -t316 eft at 3/ __
NAME MAILING ADDRESS TEL.#
❑Residential PICr ommercial Est.Cost of Construction$ WW C.
Home improvement Contractor Lic.# 17v� � Construction Supervisor Lic.# /Q Z6OO
Workman's Compensation Insurance: (check one)
C I am the homeowner C I am the sole proprietor +'I have Worker's Compensation Insurance
Insurance Company Name: Pu studzioZt&$ Worker's Comp.Policy# R2,.. Col c1 2-1-6
WORK TO BE PERFORMED
Tent Duration (Fire Retardant Certificate attached?) Wood Stove
Siding: #of Squares Replacement windows:# Replacement doors: #
Roofing: #of Squares -SC (X)Remove existing*(max.2 layers) Insulation
Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing
"The debris will be disposed of at: ,%' *n. 171
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 rev.. of m license and for prosecution under M.G.L.Ch.268,Section 1.
/Applicant's Signature: $ iI Date:. 12 2Y
Owners Signatu, (or attachment) Date;;,
A provved By: d% Date: I�- a It -)5
Building Official(or desi EMAIL ADDRESS
Zoning District:
Historical District: Yes 7 No Flood Plain Zone: 7 Yes ; ; No
Water Resource Protection District: Within 100 ft.of Wetlands:
El Yes 0 No Yes 0 No
The Commonwealth of Massachusetts
Department of Industrial Accidents
:. = 1 Congress Street,Suite 100
T:r= y 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):
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box:
Type of project(required):
I.❑I am a employer with 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 doingall work 9. ❑Demolition
❑ myself.[No workers'comp.insurance required.]t
4.❑I am a homeowner and will be hiring contractors to conduct all work on my10 Building❑ addition
ensure that all contractors either have workers'compensation insurance or property. I will
are sole MO Electrical repairs or additions
proprietors with no employees.
12.Q PIumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
These sub-contractor have employees and have workers'comp.insurance.t 13.❑Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box 41 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-contactors 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 pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
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):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
1
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68 Winslow Gray Rd
West Yarmouth, MA 02673
508-360-2749
e-mail: rsocc@yahoo.corn
HIC REG #170787; LIC # 102600
Job Address: SAME
Name: Bass River Motel Town:
Kaushal Bhatt Job Phone: 508-694-6177
Address: 891 Rte 28 Other Phone:
City: S Yarmouth E-mail: kaushalbhatt2@yahoo.com
State: MA Estimator: Dmitry Labkovich
ZIP:
10/28/19
We hereby submit specifications and estimates to furnish and install new roofing as follows:
1. Strip existing roofing and remove debris. Calculated(2 layers).
2. All gutters will be cleaned out, grounds cleaned up and nails extracted with magnets. We
utilize magnets so as to minimize your exposure to personal injure and/or property
damage from nails left behind at the job site.
3. After removal of roof, wood deck will be inspected for splitting, rot or other
deterioration. Owner will be advised of need for wood replacement prior to
commencement of wood replacement work.
4. Along all eaves of house. Ice & Water Shield waterproofing underlayment (36 " wide)
will be directly adhered to the wood deck. Waterproofing underlayment is installed to
eaves to protect against interior leakage and subsequent damage from wind-driven rain,
ice and snow dams, and freeze back conditions.
5. Install waterproofing underlayment in full width(36 wide)to all valleys and 6" to all rake
edges. Install waterproofing underlayment at all vent pipe collars and any other
projections and skylights. Underlayment adds additional protection against leakage at
critical terminations. Over remainder of house. 15-lb. felt paper will be installed and
nailed to the wood deck.
6. Install new white drip edge to all perimeter cave edges. Drip edge is installed to protect
from leakage and rot and to provide a neat and clean perimeter profile.
• 2
7. All existing vent pipes will receive new aluminum vent pipe flashings with neoprene
gasket collars, or copper if doing red cedar roof.
8. At all eave edges or roof, shingle starter strip will be cut an installed with sealing strip at
lower edge of roof in accordance with manufacturer's specifications. This provides a
watertight and wind-resistant termination for your roof
9. Storm nailing: Because we live in a severe storm region, additional (storm) nailing is
strongly recommended by Roofing and Siding of Cape Cod, LLC, the manufacturers and
the National Roofing Contractors Association. Secure new roof with 50% more nailing,
upgrade minimum standard (4) four nails per shingle to (6) six nails per shingle, 1 I/4 "
long. Nails will be galvanised with a rust-inhibitive coating. If red cedar roof, then using
stainless steel fasteners.
10. Shingle installation: Supply and install roofmg shingles according to the manufacturer's
specifications, according to the below selected material and warranty. All work to be
performed by insured professionals.
11. Install waterproofing underlayment surrounding chimney. Underlayment will extend up
vertical portion of chimney a minimum of (2) two inches. Caulk all lead flashings
together around chimney with Dymonic caulk. This is not a guarantee but a maintenance
procedure. We cannot guarantee chimney from leakage with roof job only. See chimney
proposal if applicable. We cannot guarantee existing skylights or venting units unless we
replace them with new ones.
The above s specifications are required to meet the National Roofing Contractors Association
(NRCA) roof standards, 4 Edition, as well as to meet manufacturer's specifications for warranty
requirements. Anything less than these procedures would be a substandard installation. Touch-up
painting may be required and is not included in this proposal.
Roofing and Siding of Cape Cod,LLC warranty: products and workmanship(100%Labor and
Materials)for 10 (ten) Years after installations.
CertainTeed warrants that its shingles will be free from manufacturing defects. Below are high-
lights of the warranty for LandmarkTM. See CertainTeed's Asphalt Shingle Products Limited
Warranty document for specific warranty details regarding this product.
Landmark Shingles, with Life-Time Warranty
Labor and Materials: $12,000.00
If acceptable, initial here Color:Birchwood
3
We hereby submit specifications and estimates to furnish and install new PVC trim:
All Rake-Boards(accept rake-board behind electric cable)
Fascia-board,Soffit-board and Bed Moulding in the back of the building.
Specifications as follows:
1. Strip existing trim and dispose of all debris.
2. Install new PVC trim.
3. Use"Coretex"screws and plugs system.
We hereby submit specifications and estimates for the following work:
1. Remove fascia-board and wooden gutter on one unit
2. Install new fascia-board using PVC trim.
3. Install new gutter with downspouts
Labor and Materials: $4,000.00
If acceptable, initial here:
Total Contract: 16,000.00
Job is estimated to commence approximately weeks after deposit received unless
otherwise noted here:
Work is scheduled to be substantially completed in approximately: days If acceptable,
(both) initial here:
Start and completion times are approximate and subject to change due to, but not limited to,
the following circumstances: weather delays, additional work on previous jobs, permitting
delays, etc.
This is the entire agreement. Any discussions or verbal agreements are superseded by this
agreement Such agreements, even those of the smallest nature, must be in writing to be
recognized.
. „ ,
4
Any work above and beyond the specifications outlined in this proposal will be priced on
request. All additional work, including travel time and lumberyard runs, will be subject to extra
charge. In the event of rot repairs, roof repairs or any related work requiring immediate
attention, we will proceed without customer approval.
We look forward to working with you;please call if you have any questions.
Sincerely,
ROOFING AND SIDING OF CAPE COD,LLC
ROOFING AND SIDING OF CAPE COD,LLC will provide cleanup on a continuing basis and
all debris will be removed from site. All products installed by ROOFING AND SIDING OF
CAPE COD, LLC will be to manufacturer specifications. All work will be performed by insured
professionals.
All material is guaranteed to be as specified and the above work to be performed in accordance
with the drawings and/or specifications submitted for above work and completed in a substantial
workmanlike manner. There will be no refund for special-order windows, doors or any other
non-stocked materials after three days from approved proposal. All warranties will be null and
void if account is not current and paid in full.
Owner to move all personal objects, furniture, etc., from work areas. All items against walls
should be considered for removal during any exterior siding jobs, additions, etc. to guard against
damage. In the case of any roofing and ridge venting, dust and debris should be expected and any
items in the attic should be removed. ROOFING AND SIDING OF CAPE COD, LLC is not
responsible for any damages if said items remain in place.
Curtains, drapes and window and door treatments may need proper reinstallation or replacement
by customer due to sizing on any window or door replacements and is not included in jobs
contracted with ROOFING AND SIDING OF CAPE COD,LLC
Any alteration or deviation from above specifications involving extra costs will be executed only
upon written orders and will become an extra charge over and above the estimate. All
agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire,
tornado and other necessary insurance upon above work. Workmen's Compensation and Public
Liability Insurance on above work to be taken out by ROOFING AND SIDING OF CAPE COD,
LLC. No lien or security interest will be placed on the residence as a consequence of the
contract. Owners who secure their own construction-related permits or deal with unregistered
contractors will be excluded from access to the guaranty fund
4,51 This Contract not valid unless signed by Corporate Officer:
5
Acceptance of Estimate
The above prices, specifications and conditions are satisfactory and are hereby accepted.
ROOFING AND SIDING OF CAPE COD,LLC is authorized to do the work as specified.
Payment will be made as such:
1/3 Deposit 6 t; 6)/ . ` 16'va
1/3 Beginning of work
1/3 upon completion
Date:
Signatures: - /3 1
Note: No work shall begin prior to the signing of the contract and transmittal to the owner of a
copy of such contract. You, the buyer may cancel this transaction at any time prior to midnight
of the third business day after the day of this transaction:
•
Office of Consumer Affairs&Business Regulation e9
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:LLC before the expiration date. If found return to:
anteregszn Expiration Office of Consumer Affairs and Business Regulation
170787 12/18/2021 1000 Washington Street -Suite 710
ROOFING AND,SIDING OF CAPE COD,LLC. Boston,MA 02118
DZMITRY LABKOVICH //
68 W INSLOW GRAY RD g44,14of a( /04 Not valid with t signature
W.YARMOUTH,MA 02673 Undersecretary
Commonwealth of Massachusetts
tDivision of Professional Licensure
- Board of Building Regulations and Standards
Con struCtitm SOperviso-
CS-102600 EA pires. 0312712021
DZM(TRY LASKOVICH
SS WINSLOW GRAY WI „... , •
•WEST YARMOUTh MA (12/313
Commissioner
Mee of Ca7r‘austat"41iirs Business Regulation
HOME RAPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:tic Wore the expiration daft. It iound return to:
Eissisiatio laittatian Office et Consorter Math%and Business Regulation
170787 12/18/2019 10 Perk Plus-Stairs 5170
ROOFING AND SIDING OF CAPE COD,Lt.C. Boston,MA 02118
DZSAITRY LABKOVICH - r\ 4: C.11'------
W.YARMOUTH,Wl d2673 Hot valid withodt signature
Undersecretary