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HomeMy WebLinkAboutBLD-23-000718 ONA ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 ■- '= Massachusetts State Building Code,780 CMR • Building Permit Application To Construct, Repair, Renovate Or Demolish " � C E I V E D a One-or Two-Family Dwelling This Section For Official Use Only I AUG 1 0 2022 Building Permit Number: // ";2-;(5 Applied: . U I L D I N C DEPARTMENT _..T�-_ Building Official(Print Name) Signa r Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 AssessorsJlap&Parcel Numbers 7 ci//Cc^J �� '1 /h 7 .,/ I.1 a Is this an accepted street?yes 41 no Map Number Parcel Number 1.3 Zoning Information: • 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yesO SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: uAG3H" IDYCZ in </I s Y4'/�r0 7i-1 , , 5a.dd7 Name(Print) City,State,ZIP 627 te/ j si No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 j Repairs(s) f,>Il Alteration(s) 0 I Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units /l Other ❑ Specify: Brief Description of Proposed Wolf: j ATE1,JO ` //4',/!i 71a./ 3` 5( /.01/2-v 6 4 d 0,2 a r L j� yTAj(/ili (G/.w , ACx •Q5 SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ SRO YJ I. Building Permit Fee:S Indicate how fee is determined: 2.Electrical g l$Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: L90.80 4 a233`717 • 5.Mechanical (Fire $ Suppression) Total All Fees:$_ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ s' S' y.37 ❑Paid in Full V'Outstanding Balance Due: tgcj SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) slEz1,5d 77 /_/( License Number Ex rati n Date Name of CSL Holder '/ f /l�E List CSL Type(see below) V No,and Street Type Description �21 19 1/ � - 3-J 7 9-4 U ( Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP 7 R Restricted l&2 Family Dwelling Ivi Masonry RC Roofing Covering ✓ WS Window and Siding r S rEP'L e I .. SF Solid Fuel Buming Appliances S ;7 3a (�5f.:2' O<6ANs7;94/4'C (_ 2/V) I Insulation Telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) ,, De' /eVir l cee,7.2 CCG,t' ).,1'I I� HIC Registration Number p ration Date HIC Company Name or HIC Registrant Name 9 7 : -i/Lrrjd'' ✓�/'. / v4v/1/S 'IM 0) ,0) srr feT rf cXrny5417 No.and Street Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize O. ti.i/c /IV to act on my behalf,in all matters relative to work authorized by t ' building permit application. Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accur t to e best of ray knowledge and understanding. Print Owner's or Authorized Agent's Name le onic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the IIIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open • 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts w mac_ Department of Industrial Accidents Office of Investigations ' il— . Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 a'� s ww>w:mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 0 ('c2✓15 fC€J -.L G1a i Address: ,42/ 7 -T/'7Cr-r7 p r�' LI . City/State/Zip: ,/a/7/7/5, Zn-"e 4Z.6)/ Phone #: .rJ'US - 771 .3 i%O Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 5- 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 0 New construction 2.❑ 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' [No workers' comp. insurance comp. insurance.t 9. ❑Building addition required.] 5. ❑ We arc a corporation and its 10.0 Electrical repairs or additions 3.❑ 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' 13.0 Other 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: '/n 55 9C--,��'E'C 7.-,--'14-105.T4 4-e-- a(/12Q55 /?lilt)al Policy#or Self-ins. Lic. #: VW /0Q(`,Q( c280vZ 0 L Expiration Date: //,t26'c , Job Site Address: 6 j) C(I/L�[) $f _City/State/Zip: S.yq igep 0,%j -J Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). / Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certif under the pains and penalties of perjury that the information provided above is true and correct Siunature: _�: '"�' Date: / /' r>© Phone#: 5-0 / — 3//Q 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 2❑Building Department 30City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#• §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223!1 ext..1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 77 cii./4&'4, Work Address Is to be disposed of oat the following location: 3.(X) 6,,ar 'd, /4I AO J d p51V415„ , Od M) Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature of Application Date Permit No. • Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Co nstructionSopervisor CS-055571 Expires:09/17/2022 STEVEN M TESSIER 18 DEE BEE CIR MIDDLEBORO MA 02346' r '1 oiss4:1l�\` Commissioner c ' THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer AffaihS and Business Regulation 1000 Washings'Street-Suite 710 Bosto ssac� 118 Home Impro t- carlor a istration 7 -_ --->i "�'. Type: Supplement Card t,,,' fte ation: 100121 OCEANSIDE, INC. ,�• _ ,,, _____ E Riation: 06/08/2024 217 THORNTON DR �, HYANNIS, MA 02601 - Y ,P, . : -_ , : ®,. l�'1:5'-- :..4, yea : -3...'- Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registratsgn Exoiretion 1000 Washington Street -Suite 710 100121 06/08/2024 Boston,MA 02118 OCEANSIDE,INC .:t � __::i ,l F. STEVE TESSIER y1) ''' . ' r� 217 THORNTON DR ,,. G..k HYANNIS,MA 02601 '';ATM'a; Undersecretary Not valid without signature AC ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `„/ 01/19/2022 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(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 CONTACT Tina Reeves NAME: Dowling&O'Neil Insurance Agency PHONE (800)640-1620 FAX (NC,No,Ext): (A/C,No): 973 lyannough Road E-MAIL treeves@doins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURERA: Arbella Protection Insurance Company 41360 INSURED INSURERS: Associated Industnes of Massachusetts Mutual Ins 33758 Oceanside,Inc. INSURER C: Colony Insurance Company 217 Thornton Drive INSURER D: INSURER E: Hyannis MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER: CL21122994904 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 1,000,000 TLD CLAIMS-MADE X OCCUR PREMISES(Ea occcurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A 8500066712 01/01/2022 01/01/2023 PERSONAL BADVINJURY $ 1.000,000 GEN'L AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEC LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED 102006166606 01/01/2022 01/01/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X Nei.N NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY ,(Per accident) X UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS UAB CLAIMS-MADE 462008968603 01/01/2022 01/01/2023 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION vl PER OTH- AND EMPLOYERS'LIABILITY /�I STATUTE ER Y B ANY PROPRIETOR/PARTNER/EXECUTIVE NN N/A VWC10060198022022 01/01/2022 01/01/2023 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 ,00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ , POLLUTION LIABILITY C CSP4223638 01/01/2021 01/01/2023 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Job:Oceanside/Officelnsurance 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 thecoverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Oceanside Inc ACCORDANCE WITH THE POLICY PROVISIONS. 217 Thornton Drive AUTHORIZED REPRESENTATIVE Hyannis MA 02601 s I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 01/19/2022 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(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 NAME: Linda Sullivan DOWLING &O'NEIL INSURANCE AGENCY (AJ No,E,t). (508)775-1620 (A/C,No): E-MAIL ADDRESS: isumvan@doins.com 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE _ NAIC# HYANNIS MA 02601 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B: OCEANSIDE INC INSURER c: INSURER D: 217 THORNTON DRIVE INSURER E: HYANNIS MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER: 735684 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. INSRT TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR'.. INSD wVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEr DAMAGE TO RENTED $ CLAIMS-MADE 1 OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED I SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS _I AUTOS (Per accident) _ 1 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED j j RETENTION$ $ WORKERS COMPENSATION X PER I OTH STATUTE ER AND EMPLOYERS'LIABILITY Y/N _ ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 W A OFFICER/MEMBEREXCLUDED? N/A N/A N/A VC10060198022022A 01/01/2022 01/01/2023 - - - ----- -"-- (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under — - - --- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Oceanside Inc ACCORDANCE WITH THE POLICY PROVISIONS. 217 Thornton Drive AUTHORIZED REPRESENTATIVE Hyannis MA 02601 �` k Daniel M.Crowjey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • ceanside. Restoration Fire • Water • Soot•Mold 217 Thornton Drive,Hyannis,MA o2601 P.508-771-3110/f.774-470-2211 www.oceansideinc,cof DATE: 4/8/2022 PROPOSAL SUBMITTED TO: JOB NUMBER: 20220066 Joyce Walsh Joh Site: 697 Willow St • same South Yarmouth,Ma 02664 WE HEREBY PROPOSE TO FURNISH ANY MATERIAL(LISTED BELOW)AND LABOR, COMPLETE AS PROVIDED FOR IN THE SPECIFICATIONS BELOW.ALL MATERIAL IS WARRANTED TO BE FREE OF DEFECTS,AS SPECIFIED AND TO BE WITHIN ACCEPTABLE CONTEMPORARY QUALITY STANDARDS. ALL WORK IS TO BE COMPLETED IN A WORKMANSHIP-LIKE MANNER,ACCORDING TO STANDARD PRACTICES. MATERIAL COVERED UNDER THIS AGREEMENT AND DELIVERED TO THE JOB SITE ARE THE PROPERTY OF THE BUILDING OWNER UNLESS OTHER ARRANGEMENTS ARE MADE IN ADVANCE. OUR WORKERS ARE FULLY COVERED BY WORKERS' COMPENSATION LIABILITY INSURANCE. THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN TWENTY-ONE(21) DAYS. THIS PROPOSAL SUPERSEDES ANY AND ALL PREVIOUS OFFERS OR ESTIMATES TO PERFORM THIS WORK. NOTHING STATED IN THIS PROPOSAL IS MEANT TO IMPLY THAT THE COST OF COLLECTION OR DISPOSAL OF ANY HAZARDOUS WASTE IS INCLUDED IN THE CONTRACT PRICE. INFRASTRUCTURE COSTS (E.G. HEATING FUEL,ELECTRICITY, PLOWING, ETC.)REMAIN THE RESPONSIBILITY OF THE OWNER AS A PART OF THIS AGREEMENT. WE HEREBY PROPOSE TO FURNISH MATERIAL(AS LISTED BELOW)AND LABOR - COMPLETE IN ACCORDANCE WITH SPECIFICATIONS BELOW, FOR THE SUM OF: $33,517.96 Thirty Three Thousand,Five Hundred Seventeen AND 96/100 DOLLARS PLEASE INITIAL HERE ACCEPTING ALL TERMS AND CONDITIONS SET FORTH ABOVE:x 4 t1j PAYMENT TO BE MADE AS FOLLOWS: $10,000.00 Deposit upon signing,prior to commencement $10,000.00 Payable upon 30% completion $10,000.00 Payable upon 75% completion $ 3,517.96 Payable upon substantial completion A FINANCE CHARGE WIT".BE ADDED TO ALL ACCOUNTS THAT ARE PAST DUE ACCORDING TO THE TERMS OF THE PAYMENT SCHEDULE. THE RATE IS 1 1/2%PER MONTH COMPOUNDED MONTHLY(ANNUAL PERCENTAGE 19.56%). THERE WILL BE A $25.00 CHARGE FOR ANY CHECKS RETURNED TO US UNPAID. THE CUSTOMER AGREES TO PAY ALL REASONABLE COLLECTION COSTS INCLUDING ATTORNEY FEES. Proposed work: Master Bedroom • Replace Insulation • Replace Drywall (as needed) • Replace Double Hung Window Sash • Screw Down Existing Sub Floor(to eliminate floor squeaks) • Replace Snaplock Laminate Floor(Material Allowance$4.25 sq ft) • Detach&Reset Baseboard Heat Covers • Replace&Paint Baseboard • Replace Window Trim/Casing • Replace Door Opening/Casing • Paint Ceiling • Paint Walls • Paint Door/Window Opening • Paint Door Slab Living Room • Screw Down Existing Sub Floor(to eliminate floor squeaks) • Replace Snaplock Laminate Floor(Material Allowance$4.25 sq ft) • Replace&Paint Baseboard • Paint Ceiling • Paint Walls • Paint Door/Window Opening • Paint Door Slabs PLEASE INITIAL HERE ACCEPTING ALL TERMS AND CONDITIONS SET FORTH ABOVE:x _ /01 / • Sunken Kitchen • Replace Insulation • Replace Drywall (as needed) • Screw Down Existing Sub Floor(to eliminate floor squeaks) • Replace Snaplock Laminate Floor(Material Allowance$4.25 sq ft) • Replace Cabinetry(Material Allowance$225.00 If) • Replace/Upgrade Counter Top(Material Allowance$45.00 If) • Reset Sink and Faucet • Plumbing(as required for above cabinetry related work) • Replace Trim Work for Step Down To Kitchen • Replace&Paint Baseboard • Paint Ceiling • Paint Walls • Paint Door/Window Opening • Remove&Reset Refrigerator • Remove&Reset Range • Remove&Reset Dishwasher Hallway • Screw Down Existing Sub Floor(to eliminate floor squeaks) • Replace Snaplock Laminate Floor(Material Allowance$4.25 sq ft) • Replace&Paint Baseboard • Replace Casing • Paint Ceiling • Paint Walls • Paint Door/Window Opening • Paint Door Slabs Entry/Foyer • Replace Insulation • Replace Drywall (as needed) • Screw Down Existing Sub Floor(to eliminate floor squeaks) • Replace Snaplock Laminate Floor(Material Allowance$4.25 sq ft) • Detach&Reset Baseboard Heat Covers • Replace&Paint Baseboard • Replace Casing • Paint Ceiling • Paint Walls • Paint Door/Window Opening • Paint Door Slabs PLEASE INITIAL HERE ACCEPTING ALL TERMS AND CONDITIONS SET FORTH ABOVE:x Stairs • Replace/Repair Drywall (as needed) • Detach&Reset Handrail • Paint Stairs Skirt/Apron • Paint Ceiling • Paint Walls • Remove&Replace Carpet and Pad(Material Allowance$4.00 sq ft) General • Dump Fees/Disposal • Content Manipulation • Protect Contents • Ongoing&Final Cleaning • Permits&Fees Authorized by: '•-/beme,CAlgioaaAtex Oceanside,Inc.(Owner or Operations Manager Signature) Estimator's Signature: ar Ewa., U61 Jonathan Bryan ____ Sign Print ACCEPTANCE OF PROPOSAL-the above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. DATE OF ACCEPTANCE: f.2 1 2/ OWNER/AGENT SIGNATURE: OWNER/AGENT SIGNA DATE SIGNED PROPOSAL RCVD BY OCEANSIDE: FOR OFFICE USE ONLY DATE DEPOSIT RCVD BY OCEANSIDE: FOR OFFICE USE ONLY PLEASE INITIAL HERE ACCEPTING ALL TERMS AND CONDITIONS SET FORTH ABOVE:x Eanside: Restoration Fire • Water • Soot•Mold 217 Thornton Drive,Hyannis,MA o2601 p.508-771-3uo/f.774-47o-22u www.oceu ideinc.com CHANGE ORDER Number: 1 DATE: 6/10/2022 NAME:Joyce Walsh JOB#: 20220066 ADDRESS: 697 Willow St-S Yarmouth Furnish all materials and labor as follows: • Upgrade Flooring: Supply&Install(based on owner selection)Snaplock Laminate Flooring in Master Bedroom,Living Room, Sunken Kitchen,Hallway,Entry Foyer • Install(2)6'(6-0 x 6-8)Sliding vinyl patio doors in Living Room Area (Including addressing any framing issues and install trim) NOTE: This Change Order becomes part of and in conformance with the existing Contract and therefore INCREASES the total. We hereby agree to make the change(s)specified above/attached for the following amount: Amount of this change order : $17,025.47 Previous Contract Amount : $33,517.96 Revised Contract Amount : $50,543.43 *Payment of 50%of change order amount above,due upon signing *Balance will be billed upon completion Date: Et f I V l g;.—Oceanside Authorized Signature: C....)..— Date: 6 b j i0 7iZ Estimator Signature: ACCEPTED-The above prices and specificat. ns this Change r are satisfactory and are hereby accepted. All work to be performed under same terms an onditions as specified in original Contract unless otherwise stipulated. A Date: oof2.-y Homeowner/Auth.Agent Signature. �f K:1Customers12022120220066 Walsh\co 22-06-10 chg order#1 floo . oc itt Main Level / /2E724 o v ""/Z e-°Z 19-CE 252-7-L4--r4t1. f /r✓S‘-'L01-7701V cgs N ENDED t-C ?a icw �-K- ae. cnn..eve` te. -pC.v°! c..c $'Vsq-,'coc..`[_ frees'° rr W f; !CT cav'Z_, b - 7z' 44,44 12'7' - D l[,a. nurv&/2 Cpc '1 cif / /Z-&/V C-/y •wz S cam` St- (0 en-5 to(./E 7D ci..417 7L OR,16 r n I TUtair 1 wire - ' to F,ntry/Foyer - � :� 1� ■ 1 r- v. 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FEMA Legend 70 12'28 W 41°39'32"N SEE FIS REPORT FOR DETAILED LEGEND AND INDEX MAP FOR FIRM PANEL LAYOUT u w _, Without Base Flood Elevation(BFE) o Zone A.V.A99 e SPECIAL FLOOD With BFE or Depth Zone AE.AO.AH.VE,AR '44111111* ✓,t + prw HAZARD AREAS Regulatory Floodway '� w" -el, �' " r iiii ,w1 . 0.2%Annual Chance Flood Hazard,Areas of 1%annual chance flood with average 4 depth less than one foot or with drainage # areas of less than one square mile zo„e x ` t,-. Future Conditions 1%Annual , 40,11' � , Chance Flood Hazard zonf x +ik, Area with Reduced Flood Risk due to ems. fA 0111FOTHER AREAS OF Levee.See Notes.zone x .• - � f ' 1 FLOOD HAZARD Area with Flood Risk due to Leveezone D x4 — ,r ,I: 'PCT ANNUAL CHANCE FLOOD HAZARD e A $' „. '�"�''' NO SCREEN Area of Minimal Flood Hazard zonex q "" '-r „,, Effective LOMRs it ii v ` " ,x _ OTHER AREAS Area of Undetermined Flood Hazard zone x 1 :, f1 .� GENERAL - Channel,Culvert,or Storm Sewer STRUCTURES 1 1 1 1 1 1 1 Levee,Dike,or Floodwall k U • r O 20.2 Cross Sections with 1%Annual Chance "`' P Z Water Surface Elevation +t Z'Ow Of 8II110IIt}l "f � t a- - - Coastal Transect ,, ,;�,,� /00 250015. „,, ~r.m . Base Flood Elevation Line(BFE) ' Limit of Study 4 {� �..Jurisdiction Boundary "F — Coastal Transect Baseline iMM ) " OTHER ..�._ fig ,.,or;a - Profile Baseline FEATURES ,,: Hydrographic Feature + _ 'I9 ` f ar' ❑ Digital rtal Data Available .. t 1 ' NoID t Available N Digita Data rr r G'Of7e AE MAP PANELS ® Unmapped (EL 11 Feet) 9 i , The pin displayed on the map is an approximate '' point selected by the user and does not represent e an authoritative property location. ' 00* ° a This map complies with FEMA's standards for the use of maps if it isnot void described below. f1M + The tbasemap shown complies with FEMA's basemap 1 a� l accuracy standards " IL The flood hazard information is derived directlyfrom the c .; authoritative NFHL web services provided by FEMA.This map s r } Zt?J71?AE ,.-, was exported on 7/14/2022 at 2:50 PM and does not reflect changes or amendments subsequent to this date and a (EL 12 Feet) time.The pens and effective information may change or ° iiiiii become superseded bynew data over time.li: p" ~--� F 1 This map image is void if the one or more of the following map OT F,Ni I F F ,,if: TE D F c A elements do not appear:baseman imagery,flood zone labels, ,, ' r„ "c \ I ,:I I`\ ' legend,scale bar,map creation date,community identifiers, • FIRM panel number,and FIRM effective date.Map images for 'Feet C 70°11'50"w 41°39'5"N unmapped 00o and unmodernized areas cannot be used for 0 250 500 1,000 1,500 2,000 regulatory purposes. Basemap:USGS National Map:Orthoimagery:Data refreshed October,2020 • Substantial Improvement Worksheet for Floodplain Construction (for reconstruction, rehabilitation,addition,or other improvements, and repair of damage from any cause) Property Owner: J dYCC WR5I1 Address: 6 q 7 L4il1LD W sr Permit No.: Location: Description of improvements: /^/;-/,'j()4S /J/j/Ab /361 Th WA1T6/ A� :WO*Value of structure ONLY{market appra►sal ar adjusted •assessed ixak,e,t31=FORE►mprovement,or�f llama ell befoi the damage ocx;ucred rant clud►ng land values $ 7D /dam fffi k� ��y�Y .may i Y .dual nflstf the c � {r } f; M , $ j—yg T�(.�E7d9 iL3�l r "St1�i #+� '� a - y j. t � Ratan Ovsf oftreprw2emei3t(ort st to Repairs "}Y; , � { 66 % . Market.'llalue If ratio is 50 percent or greater(Substantial Improvement),entire structure including the existing building must be elevated to the base flood elevation(BFE)and all other aspects brought into compliance. Important Notes: 1. Review cost estimates to ensure that all appropriate costs are included or excluded. 2. If a residential pre-FIRM building is determined to be substantially improved, it must be elevated to or above the BFE. If a non-residential pre-FIRM building is substantially improved,it must be elevated or dry floodproofed to the BFE. 3. Proposals to repair damage from any cause must be analyzed using the formula shown above. 4. Any proposed improvements or repairs to a post-FIRM building must be evaluated to ensure that the improvements or repairs comply with floodplain management regulations and to ensure that the improvements or repairs do not alter any aspect of the building that would make it non-compliant. 5. Alterations to and repairs of designated historic structures may be granted a variance or be exempt under the substantial improvement definition)provided the work will not preclude continued designation as a"historic structure." 6. Any costs associated with directly correcting health,sanitary, and safety code violations may be excluded from the cost of improvement. The violation must have been officially cited prior to submission of the permit application. Determination completed by: STC1't/t) TT`,f1/./5� Date: 7�5/ .1 c aF __ TOWN OF YARMOUTH 4-471)ci °1 ,: BUILDING DEPARTMENT % }'-"`* _ `` 1146 Route 28, South Yarmouth, MA 02664 �,�°, Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Owner's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: _ '9'7 LiJ/aC. 1'/ 57" Parcel ID Number: 6%.,V5-- Owner's Name: )O YQ C4/4<SJ/ Owner's Address/Phone: 4 7 7 61l/l'ck/ Contractor: OC•l,ii I ,}////-: 1/V '.725L73 /, P . Contractor's License Number: % 1 - Cis`;"; "J/ t Date of contractor's Estimate: ',/ ,'://). ;:, I hereby attest that the description included in the permit application for work on the existing building all improvements, rehabilitation, remodeling, repairs, additions, and other forms of improvement. I further attest that I requested the above-identified contractor to prepare a cost estimate for all of the work, including the contractor's overhead and profit. I acknowledge that if, during the course of construction, I decided to add more work or to modify the work described, that the Town of Yarmouth will re-evaluate its comparison of the cost of work to the market value of the building to determine if the work is substantial improvement. Such re- evaluation may require revision of the permit and may subject the property to additional requirements. I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals that I have or authorized repairs or improvements that were not included in the description of work, and the cost estimate for that work that were basis for issuance of a permit. Owner's Signat f2E Date: �'- ``1/ ' yz-� {y� Notarized: / NELENA ALYCE TERRI° ��,.�;I� Notary Public �! l Massachusetts �P ^A _' ✓ . /,) My Commission Expires y I. — 'M Yi Q \.. Jul 4, 2425 Y'k- iC iet ►55i6n CAP ( gay I, 20Z5— • TOWN OF YARMOUTH • BUILDING DEPARTMENT `'�`'•,lNATTA 1146 Route 28, South Yarmouth, MA 02664 `0'3 Q..� Telephone 508-398-2231 ext. -1261 Fax 508-398-0836 Contractor's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: 6, 77 tzi ze.,-)4i 5) Parcel ID Number: 6a/5'` Owner's Name: T Y CI�4<Si-r Contractor: (y ' /,12 Contractor's License Number: c: S 05 5 )/ Date of Contractor's Estimate: I hereby attest that I have personally inspected the building located at the above-referenced address by the nature and extent of the work requested by the owner, including all improvements, rehabilitation, remodeling, repairs, additions, and any other form of improvement. At the request of the owner, I have prepared a cost estimate for all of the improvement work requested by the owner and the cost estimate includes, at a minimum, the cost elements identified by the Town of Yarmouth that are appropriate for the nature of the work. lithe work is repair of damage, I have prepared a cost estimate to repair the building to its pre-damage condition. I acknowledge that if, during the course of construction, the owner requests more work or modification of the work described in the application,that a revised cost estimate must be provided to the Town of Yarmouth, which will re-evaluate its comparison of the cost of work to the market value of the building to determine if the work is substantial improvement. Such re- evaluation may require revision of the permit and may require revision of the permit and may subject the property to additional requirements. I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals that I have made or authorized repairs or improvements that if inspection of the property reveals that I have made or authorized repairs or improvements that were not included in the description of work and the cost estimate for that work that were basis for issuance of a permit. Contractor's Signature Date: QVID/� - Q.99/ Notarized: _ 1 f i rLoo i t) GG�-� Main Level .. r . - -svzo tr --/X.e`pe T9--CE jj/z.-7-44..,F}-c.L i. /r,,/5*4.+[-rg-77vn,) 4-5. /l16"�O e.D 7)c.,& ?o I.c w4'7'&`;r_.. bi4t6. - i wt.cve•/e "'7"'Lei. c.cE Srz/W-r°Cuc-a- t <e.o'k-'r-i .0 b iCT aceZ_. b _#- 7 t1 4.c.44't'-'rz b!it a.. .-- iz.6=rvtw'v&//Z e-P Lit CE Az.- iv C-// bc vYz 5 cIL/ Se-- ((S S p Lye- 7U i *T 04(6 ' �! i •, ii 3 „ „---�i H'Z, "„_ice , '„—A " R • 13 3 6'2„-- 7,9„ ` T T le F.. ..� in U• rStair s e 4 j - t' sop 1 ;., 'v, �^ Entry/Foyer I - • T 34 a'h"---i • I I. 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