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Home My WebLink Aboutbld-23-003071 iz//zz RECEIVED S T METAL PERMIT DEC 5 2022 C. monwealth of Massachusetts BUIL IN N7 By: ""'•` ESE % Town of Yarmouth Building Department 1146 Route 28, South Yarmouth, MA 02664-4492 Date: / Permit#: et v Z3 0b3( 7f Estimated J b ost:$$ Permit Fee: $ G- Plans Submitted: 1( 1 NO Plans Reviewed: YES/ NO Business License# 1q1ki Application License# Business Information 1 W Property Owner/Job Location Information Name: 44-1d4-I, /Lu ('iii ':, Name: Street: Pd /p(p Street:/ c t fry)City/Town: ,() 1 e,yef ki-,„ A4 -- City/Town:cc, �rvrlU,• � Telephone: '7J gglo Telephone: / 7— Photo I.D. required/Copy of Photo I.D. attached: YES/ NO Staff Initial: 1-1/ M-1 unrestricted licence' 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 t Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of stories: Sheet metal work to be completed: New work Renovation: HVAC: Metal Watershed Roofing: Kitchen Exhaust System:_ Metal Chimney/Vents:L.v it Balancing:_ Provide detailed description of work to be done: J S II s 5 /I oc. /n /J ` N -P--6,Le s ettf INSURANCE COVERAGE: I have a current liability insura ce policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes c 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 Bond 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 Agent Signature of Owner or Owner's Agent By checking here4. 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 installation 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. Inspections shall be called for prior to insulation installation. Duct inspection required prior to insulation installation: Yes No Progress Inspections Date: Comments: Final Inspections Date: Comments: Type of license: -(AL By: ./ Master Title: Master-Restricted '1` Signature of Licensee City/Town: Journeyperson L1 Permit#: Journeyperson-Restricted License Number: _ Fee: $ Check at www.mass. ov/d I IN Inspector Signature of Permit '1' of Permit Approval CO(H W/ A L H *F i ASSACH- ei DIVISION OF OCCUPATIONAL LICENSURE BOARD OF SHEET METAL WORKERS • ISSUES THE FOLLOWING LICENSE MASTER-UNRESTRICTED � ° WILLIAM P O'HEIR �1 2321 CRANBERRY HWY �f WEST WAREHAM.MA 0257'6,1233 • 7993 :cENS7 NUMBER 04/28/2024.:` 194:: • EXPIRATION DATE SERIAL NUMBER 'THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affalis.&Business Regulation HOME IMPROVEMENTCONTRACTOR TYPE:_ r�iorOion Regist►atipi��+;"Exoj�ation t15525`:- =+4 t12/2024 ATLANTIC CHIMNEY -4 A9 +�(`ty}�� k 1r . WILLIAM P.O'HEIR 2321 CRANBERRY HIGFi1At/e?-.:' 4.4 WEST WAREHAM,MA 0257c.j-<< ' _._ Undersecretary Atlantic Chimney, Inc. PO Box 668 W. Wareham, MA 02576 December 1, 2022 Wayne Johnson 122 Captain Noyes Road S. Yarmouth, MA 02664 RE: Contract 617-515-0854 wejohnson725@gmail.com Atlantic Chimney proposes the following: 1. Set up on roof(R/H) at fireplace opening&basement [gas boiler/hwh] 2. Remove mortar from damper frame 3. Install a Best Flex 316 alloy stainless steel liner kit (5"x 20')...will need to open up mortar mess on top flue tile to fit 5" liner 4. Install a 21"x 33"x 10"multiflued stainless steel cap Labor/materials $3600.00 Sincerely, Bill O'Heir J4(1,1,ttitAirx, bb11,60L William O'Heir Wayne John n Page 1 of 1 The Commonwealth of'Massachusetts Department of Industrial Accidents Office of Investigations 7scks‘4 Lafayette City Center U r 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Atlantic Chimney, Inc. Name(Business/Organization/Individual): PO SOX 668 W.Wareham, MA 02576 Address: City/State/Zip: Phone#: 7gri — 7 — 'i V-1 Are you an employer? Check the appropriate box: Type of project(required): Lam a employer with 4. 0 I am a general contractor and I employees (full and/or p -time).* have hired the sub-contractors 6. New construction ',.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp. insurance. t required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 1.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.P-Other et, (frvt,ta-1.1 comp.insurance required.] \ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have nployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site 'formation. f� isurance Company Name: l 1 l =2 c tt olicy#or Self-ins. Lic. #: 6-1-0 12 b7 Expiration Date: 81 I 10, )b Site Address: / ! (141.40 / ). 1 City/State/Zip:(.) • '0L4' [� .ttach a copy of the workers' compensation polici declaration page(showing the policy number nd expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. ignaturel L.U.- etirv. -� C.ti Date: /si / / hone#: `Z �✓ �� I 6 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 3DCity/Town Clerk 4.0 Electrical Inspector 5E1'lumbing Inspector 6.0Other Contact Person: _ Phone#: SPECIFICATION SHEET Phone:888-900-8106 FOR BEST-Flex Model "S" Fax:888 392 4432 �s STAINLESS STEEL CHIMNEY LINER Web:www.NewEnglandChimneySupply.com MIN34 Commerce Street,Williston VT 05495 MINI BEST-Flex Model "S" - _-,' STAINLESS STEEL CHIMNEY LINER .•O.�ri New England Supply BEST-Flex Model "S" Stainless Steel Chimney Liner is manufactured by New England Supply Inc. Located in Williston, VT. The BEST-Flex lining system is designed and UL listed to be installed inside masonry chimneys. BEST-Flex liners are used to vent the flue gases and combustion byproducts produced by appliances that burn oil, gas, or solid fuels. BEST-Flex Stainless Steel Chimney Liners are tested and listed by Underwriters Laboratories to UL 1777 & ULC-5635. PRODUCT INFORMATION FOR BEST-Flex Model "S" CHIMNEY LINER • The BEST-Flex Stainless Steel Flexible Chimney liner is designed to reline existing chimneys or to be used as a liner in new construction. Manufactured with the highest quality, mill certified Stainless Steel alloy. BEST-Flex Stainless Steel Flexible Chimney Liner has a high acid fighting capability. It has a corrugated exterior and a smooth interior which reduces the drag on flue gasses. This reduction in drag eliminates the need to recalculate the vent capacity based on NFPA 54 vent sizing tables (No drag factor means 20% more capacity over corrugated liner with same diameter). Listed by UL Laboratories to UL 1777 & ULC-5635 standard for zero clearance installation. BEST-Flex can be used to vent wood, wood pellet, coal, non-condensing gas and oil, making it the choice for venting all standard efficiency installations. BEST-Flex is available in 3"to 12" diameters to cover a wide range of requirements found in the field today. • The unique manufacturing systems used to make BEST-Flex utilizes a continuous strip of stainless steel, 6-ply interlocked and crimped to produce a gas and water tight lining system of superior strength and durability. BEST- Flex can be curved to go around offsets in chimneys to fit most any installation requirement. The corrugated exterior construction allows for expansion & contraction during the heat up & cool down periods. This removes any stresses on the system, while the interior can still remain smooth. • BEST-Flex can be insulated with either a vermiculite based poured insulation or with a foil-faced ceramic wool blanket to meet UL 1777 & ULC-S635 standards for chimney exteriors with zero clearance to combustibles. • BEST-Flex Stainless Steel Chimney Liner comes with a Lifetime Warranty for all fuels. • Refer to installation instructions for detailed installation information. • The smooth interior of Model "S" liner allows the B-Vent charts in NFPA54 can be used for sizing. (No 15% Oil or 20% Gas duration required SPECIFICATION CHART Metal Alloy 430, 446, 316L, & 304 Stainless Steel Thickness .0055" 10 Mill Certified Yes UL Listed Yes 3"-12" (UL 1777 & ULC-S635) . Available Diameters 3"— 12" 6-ply corrugated exterior& smooth Manufacturing Process interior Revised 9/7/2016 DATE(MMIDDYI'Y) 4CORF3 IY CERTIFICATE OF LIABILITY INSURANCE 07/29/2022 H CERTIFICATE IS AFFIRMATIVELY IARMAT VELY OR NEGATIVELY VELY AMENDA MAT1ER OF INFORMATION ,EXTEND OR ALTER AND CONFERS NO TIHE COVERAGE AFFORDED GHTS UPON THE ATE HOLDER. THIS BY THE POLICIES CERTIFICATE DOES NOT TF AUTHORIZED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is ari 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 a corsement(s). IRODUCER CONE; T Helen ONeill I ----------- PHONE 617 619-0204 I FAX No): KNAPP SCHENCK AND COMPANY IN SURANCE AGENCY INC JAL No E><t): ) — EMAIAQP8 honetll@kscins.com INSURER(S)AFFORDING COVERAGE MAC I One India Street BOSTON MA 02109 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA 26666 - NSURED INSURER B: — -- — ATLANTIC CHIMNEY INC INsueeRC: — - ---- INSURER O; ------- - — PO BOX 668 INSURERE: -- ----- WEST WAREHAM MA 02576 INSURER F: COVERAGES CERTIF ICATE NUMBER: 799536 REVISION NUMBER: THIS IS TO ERTIFY THAT THE NDCATED.CNOTWITHSTANDING ANY(REALIREMENTNTERM OR CONDIIT ION V OF ANY CONTRACT OR OTHER DOCUMENT WITH E BEEN ISSUED TO THE ISURED NAMED EO RESPECT TOR THE WHICH ICY RHOS WHICHTHIS 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. NSR) AD3Dl3UIR1— POLICY EFF POLICY OW I LIMITSLTR TYPE OF INSURANCE INN'. r POUCY NUMBER (MMIDD/YYYYI (MWDOIYYYY)I i COMMERCIALGENERAL LIABILITY EACH OCCURRENCE I$ DAhT/CTO�I=NT'S6 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ — ---- MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT AP_P LIES PER GENERAL AGGREGATE S POLICY I J CT (LTC PRODUCTS-COMP/OP AGG `$ OTHER: t AUTOMOBILE UABILITY COMBINED SING!E LIMIT $ (Ea accident) I- ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED I_ I AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ -- - HIRED NON-OWNED --- PROPERTY DAMAGE _ __ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLAUAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE 1 N/A AGGREGATE $ ( i DED ! I RETENTIONS I : WORKERS COMPENSATION PEII O AND EMPLOYERS'LIABILITY X STATUTE I ER A OFFICER MEMBER XXCTLNUDED? TIVE N/A NIA N/A 6HUB7898A54122 08/01/2022 08/01/2023 EL EACH ACCIDENT $ 500,000 (Mandatory in NH) E I E.L.DISEASE-EA EMPLOYEE $ 500,000 If es,describe under DESCRIPTION OF OPERATIONS below 1 i I E.L DISEASE-POLICY UNIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLE: (ACORD 101,Additional Remarks Schedule,may be attached itrnore space is requited) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authonzation is given to pay claims far benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. t!1!S rs t lCe,EN snSU!d!lc G_HtWS IFFY fNY11_:y n/i>ff_r.(Ai airs fi- tf ft+r MI..Gni 111H;ifif.,WAS IJSUGYI tUf MISS tilt:GAU11tlYUft Ucitb W I UI4 dUv,t'.w ec-:r:.-.. - _ .. n issue pate Ce ORS Geruncate Of insuli tue). t Ito MMUS Ut MIS WYtl1aItl L d N :dll U IIIVIIILUItItl U4tI uy dLA.G n Yt0 JJit4 riutm U w I Vold v V o ao- VGI CU ver III,.o uvl, 0041NIRlUI dL WWW.I 1108J.9U VI IWUt WW WI ewun ll CII,ea1O.u.v %Avow.IJ.. .:eK I It1UA I b.F/UWLK -- ----- - __. . trA1Vt�CLLAIrVrM -- - ( Aunt.}a. CI�iwtnna. h.+- ( ........................., ..,._, .,",.. , P O Box 668 AUTHORIZED REPRESENTATIVE West Wareham MA 02576 Daniel M.Crowley,CPCU,Vice President-Residual Market-WCRIBMA O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/031 The ACORD name and logo are registered marks of ACORD