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HomeMy WebLinkAboutBLD-23-001834 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 w ,<<:- Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 811.)-23-(.)1$'3y Date Applied: RECEIVED l:� SeAc s ,-- W )4\ OCT 05 2022 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION BUILDING DEPARTMENT . By 1.1 Property Addr s 1.2 Assessors Map&Parcel Numbers A 3'.' /R-Widivc,< S/ 3 Y 3 I - S i sit 1.1 a Is this an accepted street?yes --e no Map Number Parcel Number 1.3 ZoPg Information: 1.4 Property Dimensions: / . sr.//1/64:''fri;/14).g/ i 7(1' 1 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) RECEIVED 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard OCT 1 8 2022 Required l Provided Required Provided Required Provided _ __- BUILDING BUILDING DEPARTMENT 1.6 Water Supply: (lvi.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal Sysi. Public 0 Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: ,MeJ/11/ ,M1gi 1 %%Z ,� Y/i�/04/ -)// ti `i 0 at‘6 V Name(Print) City,State ZIP 6- 4.4,C�a� 51 "4-,V- ?;10 Sall 499n yeiiia2.- /v1 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building- Owner-Occupied ❑ f Repairs(s) 0 Alteration(s) 0 I Addition 0 Demolition ❑ 1 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work: £ 4't7�i.%� S/14I.L Xj/7" "�/ 0'✓'/ ,.VeiZer(( 1.t9 /N` //V/ //J/C,/Yc ✓% /'r✓6 S©/✓,l i ,/ '<GGLI c O / c.�/ '//i /i o t.// �.'cfrl.T JC e. ii- . (c,4J1 i41 k c4,. i/iY.,�< F G/rL 1,, '-:/ ' / 1e-li n/ d z2ii/6 /20A/A AY /,C'4lt c'C1/,,'-4/ a SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only 6 (Labor and Materials) 1.Building $ 1. Building Permit Fee:S I SO -Indicate how fee is determined: 2.Electrical $ le Standard City/Town Application Fee ❑Total Project Costa gItem )x multiplier x 3.Plumbing $ 2. Other Fees: $ IJ / 4.Mechanical (HVAC) $ List: R '3 St) f 5.Mechanical (Fire $ Suppression) Total All Fees:$ 1 1� n ,�, Check No. Check Amount Cash Am t: �1 1' 6.Total Project Cost: $ �;���e/� ❑Paid in Full I$Outstanding Balance Du : ` 1 o\\° SECTION 5: CONSTRUCTION SERVICES ' 5.1 Construction Supervisor License(CST..) Ccs65 s-)/ xpi/, 7 `''�I TeJ 5i�� License umber Expiratto Da1te Name of CSL Holder /, �6 C` AR-6- ��� List CSL Type(see below) v No.and Street Type Description 4/ 1,0,0449(k- Zd it 0 ?3 5 U i Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP „/ R Restricted 1,k2 Family Dwelling M Masonry RC ( Roofing Covering WS Window and Siding S�C�1'� -,� , /'k'/c (� SF Solid Fuel Burning Appliances l _45 c3cb /6/4 n /'k' I Insulation Telephone Email address D Demolition 5.2 Registeredre Home I>rovement Contractor(HIC) • /.1 i (led.„4_ CY✓ ' `1J'ii ml`� HI Registration Reg str io Number Expiration HIC Company Name or HIC Registrant Name 3 1 7 Ttioi2/s'/o'Y ji/� $)Z�1/, ,7 ) 4)—/&/-xte c,6,>47 No.and trees rn/ _ 4;1'; p /,,o j l,�cP t,�e t� Email address &u/Z 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 1 No 0 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 Gc'„ 4/;�'// jc/e. to act on my behalf,in all matters relative to work authorized by this building permit application. Li-4/ti/ef ez0-41,,,, (5-(5-_,-- 47-nre/o-d /i; 7,)-,)-, Print Owner's Name(Electronic Signature) D e • 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 accurate to th st of my knowledge and understanding. ,.3Y -.0,ziii' i r45(5e/R",see i'‘ _..,--., 06/2 ---, Print Owner's or Authorized Agent's Name(Electronic S G ature) 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 HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.nov/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" §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 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 6/a0I /( Work Address Is to be disposed of oat the following location: /1/ C4' MID ;j`. ,5,1/C'/ 2, ' < 5:9404✓&,il,44, o d-5`C,3 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. 2/' Signa re of Application Date Permit No. The Commonwealth of Massachusetts w Department of Industrial Accidents Office of Investigations Lafayette City Center ^`�" 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information -�t Please Print Le�2ibly Name (Business/Organization/Individual): O e eel 1-15/C�i / j 7 Address: ,Q/ 7 77--)orr? r i G/e___, City/State/Zip: ,//i a/7/7/5, !' ' 2Z)/ Phone#: ___ - 77/- '.3 /10 Are youn employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 1 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' co comp. insurance.t 9. ❑Building addition mp.insurance required.] 5. El We are a corporation and its 10.0 Electrical repairs or additions r 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.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.0 Other employees. [No workers' comp. insurance required.] *My 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. l` n Insurance Company Name: ,)5 C-1 a tE'C / //afe�TvZeS O 1 /1/QSS /i7 i!YJ aJ 7 i-j Policy#or Self-ins. Lic. #:_ 1/We--/o 7 D( J$C', ©vRe.R Expiration Date: /// /.7 L)6-9\-3 5 Braddock Street S. Yarmouth, MA. 02664 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 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,ynder,ihe pains and penalties of perjury that the information provided above iss true and correct Si.!t iature: Date: i ;f / v?c c� Phone#: ,,�67 / - 3//O 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): lDBoard of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other _T Contact Person: _ Phone#: • • Substantial Improvement Worksheet for Floodplain Construction (for reconstruction,rehabilitation,addition,or other improvements, and repair of damage from any cause) Property Owner: /�/V C /+�14Q'�/4'/ Address: ? s- Permit No.: Location: Description of improvements: sent' •ket value of stmacture.ONLY(tr arket appraisal.or adjusted assessed ualae,BEFORE improvement or f damaged before the damage i ccurred) riot including land value; 'j 7C�t �oSt lmprovemerrt ctual'Cott of the sonstroc ""lsee" emS to:�� �, Include vokrinteerJaborand donated Ra3t10 'i"CSt OfrQ�T2Rlert3fr�:05t t{1epa f�� kr " � a ar�et 37Slue•, 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 after 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: Si 6 Date: C/ /c9-:� TOWN OF YARMOUTH prt e' �p5 BUILDING DEPARTMENT - SG 1`FRouteSouthYarmouth,..r. 1146 28. Yth. MA 02664 7 Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Owner's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: t:/(, -s Parcel ID Number: 57K Owner's Name: T /�% - /7" ,2774 . Owner's Address/Phone: 5 tq ^riVez S�! . YlC )G',T// v,=c C' 7- 7;7- F. ? Contractor: (.� //',,,,V / Contractor's License Number: C, r5> 7:7 Date of contractor's Estimate: 7/ Ji r ,`;)' 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. ( 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. X Owner's Signature: ��/'v61il, /247a X Date: Oc_/-t. X Notarized: ' CHRISTCPHER SECOR UV 41.14 . Notary Public � _ Commonwealth of Massachusetts ddd77 My Commission Exoires Nov.04 2n2? 4 Q RYA ,., TOWN OF YARMOUTH fr .. .,,„ °\ BUILDING DEPARTMENT \-,MAT.... e,i-� 1146 Route 28, South Yarmouth, MA 02664 5 , '��'"'��''�" Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Contractor's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: 5 L4' S Parcel ID Number: S/Yc Owner's Name: gI7,A i/Cle n/V 7/1/,J Contractor: GCE/at/At' /hh', ... .. Contractor's License Number: CS -O ✓' 7/ Date of Contractor's Estimate: / "t/"c 0)-2 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. If the 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. j ,,,, 1, 10,, Contractor's Signature A ' ,. q Date: `1 b 2' i OPOZDA fi ` Notarized: Notary Public .i�%,i �� COMMONWEALTH OF MASSACHUSErfS \ Expires My Commission ,r ", -• "7' / January 20, 2023 - t ` l a ;j. National Flood Hazard Layer FIRMette Legend 70°12'32"W 41°39'14"N (' SEE FIS REPORT FOR DETAILED LEGEND AND INDEX MAP FOR FIRM PANEL LAYOUT a• 1 ` Without Base Flood Elevation(BFE) Zoo { ° �'�" " With"BFE Or Depth Zone AE.AO,AH.VE.AR ,,,.� SPECIAL FLOOD e uwM ar a HAZARD AREAS Regulatory Floodway f� I 0.2%Annual Chance Flood Hazard,Areas "�' 0 2 PCT tirifuA�CHANCE FLOOD HAZARD of 1%annual chance flood with average t'% " + depth less than one foot or with drainage Zone X * t. �- - areas of less than one square mile zonex ., t ; _ �� , Future Conditions 1%Annual •'*� ' zone x t t{ �, Chance Flood Hazard e 1 t �! & Area with Reduced Flood Risk due to t F.'" , 1 :ivy \ OTHER AREAS OF Levee.See Notes.Zone X t " rr FLOOD HAZARD Area with Flood Risk due to Leveezone D ,•; 4l • -• , NO SCREEN Area of Minimal Flood Hazard zonex , . Effective LOMRs ' .141 411 , Zone A iE t ° ,,pf 4 l 12 Feet) \ • 'r OTHER AREAS Area of Undetermined Flood Hazard zrne o ' "` "\ -—-- Channel,Culvert.or Storm Sewer STRUCTURES 1 1 I I I I I Levee Dike,or Floodway a l' • • II O zO.2 Cross Sections with 1%Annual Chance t:"+ �P , v ,` , \ _�Ls4. Water Surface Elevation ` Ai* Town Of c'11Iri0IItZ1 .\ , e- - - Coastal Transect a- ' ' ' G A G -;., ga -, "' ♦ `". `. _ —Sit ^ Base Flood Elevation Line(BFE) tt . 25001'S '' `,� ♦ r Limit of Study \ r Jurisdiction Boundary 1 f --- Coastal Transect Baseline 25001G05891 ♦ . I OTHER - �— Profile Baseline FEATURES Hydrographic Feature Zone AEy =_ ;eff. 7/16/2014 \ \` I t _ 1 ,` . ♦ \ 1 (EL 11 Feet) \" + \-,' .\ \, ' , ' ti \\ \ \ , 1 [ Digital Data Available N •\ \ \ \ - [ No Digital Data Available '>, \ S. \ ITHE:',V1 E FR !TE.;lED AREA,♦ `, , \ . ♦ \ \ \ `� Zone' MAP PANELS Unmapped ' t ,r ,t'" . t ♦ , \ \\ \\ • \ •, `\♦ `\ ♦:\ ; , \.. _ t Feet . ♦ \ \ \ v \ The pin displayed on the map is an approximate \ ♦ \ \ ` � ♦' �,,,rFa�`'• \ �} point selected by the user and does not represent \ \ \`'' ' ' • an authoritative property location. t ♦ 1- ,\ (EL13 FFeet) \♦ • I •<-, „, "%+ -,�-t 'vr6 -* \ ` This map complies with FEMA's standards for the use of digital flood maps if it is not void as described below. -° -'- \ \ `` ,\' , The basemap shown complies with FEMA's basemap t ,,:\ N. \ accuracy standards ♦ \ tr ► I 'p'°= 4. ' \ ti \. \ The flood hazard information is derived directly from the t � �> ` \ \` \' authoritative NFHL web services provided by FEMA.This map 1> / g 1 ♦ was exported on 9/22/2022 at 9:52 AM and does not .- •,t it ". k:\ ♦` l\. \ reflect changes or amendments subsequent to this date and time.The NFHL and effective information may change or ;g f . - pOr' ti♦ \♦ ` become superseded by new data over time. t 0 Y. \ ~ \ \`'` ` This map image is void if the one or more of the following map �• . ♦ „ ` `.` elements do not appear:basemap imagery.flood zone labels, _�,yamI � 4 { _ -•, t.\, \ \EA''\ ti legend.scale bar,map creation date.community identifiers. 70°it'S5"VJ 41°38'47"N FIRM panel number,and FIRM effective date.Map images for —.. Feet unmapped and unmodernized areas cannot be used for 0 250 500 1,000 1,500 2,000 1:6,00� regulatory purposes. Basernap:USGS National Map:Orthoimagery:Data refreshed October.2020 5 BRADDOCK ST Location 5 BRADDOCK ST Mblu 34/201/// Acct# 5148 Owner MARTINI THOMAS J TR Assessment $346,000 PID 5148 Building Count 1 Current Value Assessment Valuation Year Improvements Land Total 2023 $212,500 $133,500 $346,000 Owner of Record Owner MARTINI THOMAS J TR Sale Price $100 MARTINI JANICE M TR Certificate Care Of Book&Page 34850/185 Address 5 BRADDOCK ST Sale Date 01/24/2022 Instrument 1 F SOUTH YARMOUTH,MA 02664 Qualified U Ownership History Ownership History Owner Sale Price Certificate Book&Page Instrument Sale Date MARTINI THOMAS J TR $100 34850/185 1F 01/24/2022 MARTINI THOMAS J $229,000 16718/0084 00 04/09/2003 BLOOM PATRICK G $195,000 15764/0098 00 10/18/2002 PETRARCA VALERIA A $126,000 13266/0171 00 09/28/2000 ROSSI PHILIP&VIRGINIA $78,000 10848/0237 UNKQ 07/14/1997 Future Owners Ownership History Owner Sale Price Certificate Book&Page Instrument Sale Date MARTINI THOMAS J TR $100!._,_ 34850/185 1F 01/24/2022 Building Information Building 1 : Section 1 Year Built: 1965 Building Photo Living Area: 960 Replacement Cost: $262,091 Building Percent Good: 80 ' 441 Replacement Cost Less Depreciation: '.209,700 Building Attributes Field Description Style: Ranch Model Residential Grade: Average Stories: 1 Story Occupancy 1 (https://images.vgsi.com/photos2/YarmouthMAPhotos/A00\02\07\47.jpg) Exterior Wall 1 Wood Shingle Building Layout Exterior Wall 2 Roof Structure: Gable/Hip BAS CRL Roof Cover Asph/F Gis/Cmp Interior Wall 1 Drywall/Sheet Interior Wall 2 Interior Fir 1 Hardwood 24 Interior Fir 2 Heat Fuel Gas Heat Type: Forced Air-Duc AC Type: Central Total Bedrooms: 2 Bedrooms — — . mn Total Bthrms: 1 Total Half Baths: 0 32 Total Xtra Fixtrs: (ParcelSketch.ashx?pid=5148&bid=5406) Total Rooms: Building Sub Areas(sq ft) Legend Bath Style: Average Gross i Living Code Description Area Area Kitchen Style: Modem BAS First Floor 960 960 Num Kitchens 00 CRL Crawl space 768 0 Cndtn 1,728 960 Num Park Fireplaces Fndtn Cndtn Basement Extra Features Legend Extra Features Code Description Size Value Bldg# EOS " End Outs Shwr 1.00 UNITS $0 1 HTL HEATILATOR VEN 1.00 UNITS $2,000 1 Land Land Use Land Line Valuation Use Code 1010 Size(Acres) 0.11 Description SINGLE FAM MDL-01 Frontage 0 Zone Depth 0 Neighborhood 0060 Assessed Value $133,500 Alt Land Appr No Category Outbuildings Outbuildings Legend Code Description Sub Code Sub Description Size Value Bldg# - I SHD1 SHED FRAME 96.00 S.F. $800 1 Valuation History Assessment Valuation Year Improvements Land Total 2023 $212,500 $133,500 $346,000 2022 $168,900 $119,400 $288,300 2021 $142,900 $119,400 $262,300 (c)2022 Vision Government Solutions, Inc.All rights reserved. r'`.. -4 C\ . - .4 nski iL _„,,,.,._:.,. , ., -4,... ..:., _ __ _ :'' -i.e. Fire a Water .. Soot o_Mold 217 Thornton Drive,Hyannis,MA o 26 01 p.508-771-3110/f.774-470-22i i «wvi-nceansideinc.corn DATE: 9/8/2022 PROPOSAL SUBMITTED TO: JOB NUMBER: 20210618 Janice Martini Job Site: 5 Braddock St same S.Yarmouth,Ma 02664 WE HEREBY PROPOSE TO FURNISH ANY MATERIAL(LIS FED 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 ACCEP FED 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: $22,069.10 Twenty Two Thousand, Sixty Nine AND 10/100 DOLLARS PLEASE INITIAL 1-IER.E ACCEPTING ALL TERMS AND CONDITIONS SET FORTH ABOVE:xr PAYMENT TO BE MADE AS FOLLOWS: $7,000.00 Deposit upon signing,prior to commencement $7,000.00 Payable upon 35% completion $7,000.00 Payable upon 65% completion $1,069.10 Payable upon substantial completion A FINANCE CHARGE WILL BE ADDED TO ALL ACCOUNTS THAT ARE PAST DUE ACCORDING TO THE TERMS OF THE PAYMENT SCHEDULE THE RATE LS 1 I/2%PER MONTH COMPOUNDED MONTHLY(ANNUAL PERCENTAGE 19.56%). THERE FRU BE A S25.00 CHARGE FOR ANY CHECKS RETURNED TO US UNPAID. THE CUSTOMER AGREES TO PAY ALL REASONABLE COT.I.FCTION COSTS INCLUDING ATTORNEY FEES. Proposed work: See attached scope-"exhibit A" t Authorized by: �-..� �� Oceanside,-h .(Owner or Operations Manalcx$i nature) Estimator's Signature: 1-- C f------ .— -- -- - - sib ----------_-__ 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. DAI"h OF ACCEPTANCE: (f�� / OWNEV'-"--"'N.--Ir iiik.__), ILL\ ,,_. 111: , 1 '- OWNER/AGENT SIGNATURE 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 In. ceanside; Oceanside Inc. .r,,,„rton 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 Client: Martini,Janice Property: 5 Braddock St South Yarmouth,MA Operator: JOEK Type of Estimate: <NONE> Date Entered: 9/9/2021 Datc Assigned: Price List: MABO8X_AUG21 Labor Efficiency: Restoration/Service/Remodel Estimate: 20210618 MARTINIREP ceansider Oceanside Inc. Restoration 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 20210618_MARTINIREP Main Level Kitchen Height:8' Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Door 2'6"X 6'8" Opens into Exterior Missing Wall 17'4 13/16"X 8' Opens into LIVING_ROOM DESCRIPTION QTY UNIT PRICE TOTAL Batt insulation-4"-R15-paper/foil faced 80.00 SF @ 1.46= 116.80 Drywall Repair 1.00 EA @ 900.00= 900.00 Paint walls and ceiling 545.59 SF @ 1.61 = 878.40 Paint crown molding 41.73 LF @ 1.93= 80.54 Paint door/window trim&jamb 3.00 EA @ 39.49= 118.47 door 2 windows Baseboard-3 1/4" 8.00 LF @ 3.46= 27.68 Paint baseboard 8.00 LF @ 1.89= 15.12 Wood Flooring Installer to weave in flooring 1.00 EA @ 1,000.00= 1,000.00 Material Only Oak flooring-select grade-no finish 100.00 SF @ 8.50= 850.00 Sand&finish wood floor(natural finish) 211.71 SF @ 5.25= 1,111.48 Add for dustless floor sanding 211.71 SF @ 1.00= 211.71 Plumbing 1.00 EA @ 2,600.00= 2,600.00 disconnect,move and reattach gas range,sink,faucet, dishwasher,refrigerator Electrical 1.00 EA @ 1,200.00= 1,200.00 Microwave,dishwasher Living Room Height:8' Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Door 2'6"X 6'8" Opens into Exterior Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Missing Wall 17'4 13/16"X 8' Opens into KITCHEN Missing Wall 5'X 8' Opens into HALLWAY Door 2'6"X 6'8" Opens into CLOSET_LIVIN DESCRIPTION QTY UNIT PRICE TOTAL Paint walls and ceiling 693.43 SF @ 1.61= 1,116.42 20210618_MARTINIREP 9/21/2022 Page:2 ceanside, Oceanside Inc. R'''ter i 'o" 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 CONTINUED-Living Room DESCRIPTION QTY UNIT PRICE TOTAL Paint crown molding 47.93 LF @ 1.93= 92.50 Paint fireplace mantel 6.00 LF @ 6.90= 41.40 Paint door/window trim&jamb 3.00 EA @ 39.49= 118.47 Paint door slab only 3.00 EA @ 47.10= 141.30 Paint baseboard 37.93 LF @ 1.89= 71.69 Sand&fmish wood floor(natural finish) 309.97 SF @ 5.25= 1,627.34 Add for dustless floor sanding 309.97 SF @ 1.00= 309.97 closet living Height:8' Door 2'6" X 6' 8" Opens into LIVING_ROOM DESCRIPTION QTY UNIT PRICE TOTAL Sand&fmish wood floor(natural finish) 7.99 SF @ 5.25= 41.95 Add for dustless floor sanding 7.99 SF @ 1.00= 7.99 master bedroom Height:8' Window 2'6"X 4' Opens into Exterior Door 2'6"X 6'8" Opens into HALLWAY Window 2'6"X 4' Opens into Exterior Subroom: CLOSET MB(2) Height:8' Door 2'6"X 6'8" Opens into MASTER_BEDRO Subroom: closet MB(1) Height: 8' Door 2'6"X 6' 8" Opens into MASTER_BEDRO DESCRIPTION QTY UNIT PRICE TOTAL Sand&fmish wood floor(natural finish) 154.73 SF @ 5.25= 812.33 Add for dustless floor sanding 154.73 SF @ 1.00= 154.73 20210618_MARTINIREP 9/21/2022 Page: 3 ceans cie Oceanside Inc. `1 ''"ii ' 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 Hallway Height:8' Door 2'6"X 6'8" Opens into MASTER_BEDRO Missing Wall 5'X 8' Opens into LIVING ROOM Door 2'6"X 6'8" Opens into BEDROOM Door 2'6"X 6'8" Opens into BATHROOM DESCRIPTION QTY UNIT PRICE TOTAL Paint walls and ceiling 131.15 SF @ 1.61 = 211.15 Paint door/window trim&jamb 4.00 EA @ 39.49= 157.96 door 2 windows Paint door slab only 3.00 EA @ 47.10= 141.30 Paint baseboard 6.00 LF @ 1.89= 11.34 Sand&finish wood floor(natural finish) 21.21 SF @ 5.25= 111.35 Add for dustless floor sanding 21.21 SF @ 1.00= 21.21 Bedroom Height: 8' Door 2'6"X 6'8" Opens into HALLWAY Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Subroom: Closet(1) Height:8' Door 2'6"X 6'8" Opens into BEDROOM DESCRIPTION QTY UNIT PRICE TOTAL Sand&fmish wood floor(natural fmish) 141.49 SF @ 5.25= 742.82 Add for dustless floor sanding 141.49 SF @ 1.00= 141.49 GENERAL DESCRIPTION QTY UNIT PRICE TOTAL Temporary toilet(per month) 1.00 MO @ 190.04= 190.04 General clean-up 16.00 HR @ 45.84= 733.44 ongoing and final clean General Demolition-per hour 4.00 HR @ 60.86= 243.44 Any demo needed to remove drywall behind the cabinets,wood flooring Residential Supervision/Project Management-per hour 15.00 HR @ 80.91 = 1,213.65 20210618_MARTINIREP 9/21/2022 Page:4 � 1 Oceanside Inc. Restoration 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 CONTINUED-GENERAL DESCRIPTION QTY UNIT PRICE TOTAL 30*.75 Taxes,insurance,permits&fees(Bid Item) 1.00 EA @ 300.00= 300.00 Haul debris-per pickup truck load-including dump fees 1.00 EA @ 245.78= 245.78 All boxes from cabinets,drywall and section of flooring Grand Total Areas: 2,907.82 SF Walls 1,880.38 SF Ceiling 4,788.20 SF Walls and Ceiling 1,880.38 SF Floor 208.93 SY Flooring 425.48 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 425.48 LF Ceil.Perimeter 1,880.38 Floor Area 1,994.35 Total Area 2,907.82 Interior Wall Area 1,767.61 Exterior Wall Area 252.70 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length 20210618_MARTINIREP 9/21/2022 Page:5 ceansider Oceanside Inc. Restoration 217 Thornton Drive Hyannis,MA. 02601 www.oceansideinc.com Phone 508-771-3110 Fax 774-470-2211 Summary Line Item Total 18,111.26 Material Sales Tax 127.61 Subtotal 18,238.87 Overhead 1,823.91 Profit 2,006.32 Replacement Cost Value $22,069.10 Net Claim $22,069.10 II 20210618_MARTINIREP 9/21/2022 Page: 6 Cape & Island Kitchens Inc. 153 lyannough Road Hyannis, MA 02601 Phone : (508) 775-3664 Fax: (508) 775-1162 QUOTE Salesperson: Mark Dupont / Mark@capekitchens.com PO# Date: 11/20/21 To: Martini, Janice Project Manager: Joe Kennedy @ Oceanside Restoration Address: 5 Braddock Street Not part of Oceanside contract but City/St/Zip: S. Yarmouth, MA is part of the project being handled Tel#: 617 797 8580 directly by the homeowner. E-Mail: jama220( yahoo.com CIv1U 10 Job Name: Martini Location or Manf. Qty Description/Specifications Tax? Price Ext Price Schrock Ingalis Full-Overlay Shaker Kitchen Cabinetry per Design Y Framed Drawer Fronts/Plywood End Construction Y White or other standard painited finish DoVat PP' J Y 1 Wood Dovetailed Soft-Close Drawers & Soft-Close Doors Y $13,621.60 $13,621.60 1 Kitchen Cabinetry Only Professional Installation per design N $2,080.00 $2,080.00 32 Decorative Hardware Allowance for Knobs and/or Pulls Y $6.00 $192.00 Granite Kitchen Countertops in any Price Level 1 Color per design Y 1 Includes any Standard Edge Profile/No Backspalsh included (tile) Y $3,236.20 $3,236.20 1 ZP2516 Oversized Single Bowl under-mount stainless steel kitchen sink Y $267.00 $267.00 Includes Template& Installation for Countertops Y Y 3 1/2"Steel forward-L hidden support brackets for overhang Y $83.00 $249.00 1 Support bracket installation charge N $195.00 $195.00 Y Y Above cabinetry pricing expires on 12/6 because of manufactuer increas Y Y Y Total: $19,840.80 Tax: $713.61 The above does not include plumbing,electrical or any other Design Fee: Included installation charges or materials not specifically described. Grand Total: $20,554.41 Any labor provided by Cape& Island Kitchens includes a 1-year good workmanship warranty. We propose to furnish material in accordance with the above specifications for the Total Sum of: T al: $20.554.41 Any retainer fee for design services or release of plans will be non-refundable and will be applied as a deposit once an order is placed. Retainer: Any additonal carpentry labor required due to a buyer request or a delay will be charged at$95/Hour. American Express, MasterCard, Discover&Visa accepted. Vendor fee applies 2.5% after$10k Deposit:A 50%deposit is required to place your order. Payment is due upon scheduled delivery date. Installed countertops are due in full when scheduled for Deposit: $10,278.00 installation. If customer changes scheduled delivery date, customer will be responsible to pay for balance of material on that scheduled delivery date. In the event that it is necessary to pursue any legal action to collect any outstanding balance the NET 15 DUE ON customer shall be responsible for the total balance plus all legal costs. DELIVERY $10,276.41 ACCEPTANCE OF PROPOSAL: Signature: '� Date: Salesperson: Mark Dupont/Cape&Island Kitchens Inc. Page 1 of 1 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affafs and Business Regulation 1000 Washingt _S_ tr_eet- Suite 710 BostoreAassachusett=04118 Home Impro f C rad Registration - , Type: Supplement Card f+te�ation: 100121 OCEANSIDE, INC. , E pi ation: 06/08/2024 217 THORNTON DR r, HYANNIS, MA 02601 t - /n i-eI 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 Registration Expiration 1000 Washington Street -Suite 710 100121 06/08/2024 Boston,MA 02118 OCEANSIDE,INC. STEVE TESSIER -1 217THORNTONDR - � HYANNIS,MA 02601 Undersecretary Not valid without signature ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/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,Est): (NC,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 INSURER B: Associated Industries of Massachusetts Mutual Ins 33758 Oceanside,Inc. INSURER C: Colony Insurance Company 217 Thornton Drive INSURER D: INSURER E: Hyannis MA 02601 INSURERF: 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE 10 REN rho CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A 8500066712 01/01/2022 01/01/2023 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECTPRO- LOC PRODUCTS-COMP/OP AGG $ 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 _ _ HIRED NON-OWNED PROPERTY DAMAGE �$ X AUTOS ONLY X AUTOS ONLY (Per accident) $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 — A EXCESSLIAB CLAIMS-MADE 462008968603 01/01/2022 01/01/2023 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION NA PER OTH- ANDEMPLOYERS'LIABILITY 0'N STATUTE ER YIN 1 B ANYETOR/PARTNER/EXECUTIVE N N/A VWC10060198022022 01/01/2022 01/01/2023 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ POLLUTION LIABILITY C CS P4223638 01/01/2021 01/01/2023 $1,000,000 DESCRIPTION OF OPERATIONS/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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACIOPREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/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 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 PHONE 508 775-1620 FAX (A/C,No.Ext): (_ ) _ - (A/C,No): EDAAIL ADDRESS: iSuillvan Q@doinS.com 973IYANN000H RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B: OCEANSIDE INC INSURERC: 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. INSRR ADDL TYPE OF INSURANCE INSD SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDIYYYY) (MMIDD/Yl'YY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE 11OCCUR DAMAGE TO RENTED _PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ _ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER ` OTH- AND EMPLOYERS'LIABILITY „ STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A 1OFFICER/MEMBEREXCLUDED? N/A N/A N/A VWC10060198022022A 01/01/2022 01/01/2023 -- -- - - — (Mandatory in NH) E.L.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 "" Daniel M.Crowley,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 Main Level ^"p F 7 n;--) ,. REV; ' COMPLIANCE. DATE: I-' 13 •I t..-, -,T I — 7 11" BUILD! OFFICIAL 17'5" —� 2'2 "1 11'6" 1. closet 10- rs T fit I = Paint room and sand and I -r Se 1 1 Bedroom - - finish existing floor I I c iving Room } 6„ 1 T t48 5 �-4, i l Sand and finish existing - floor allway I � Bathroom I I- Remove and replace 80 sq.ft. _ j 1 1 of drywall and insulation. .x L�, 7'R"—I-2'4' y Paint room,install new r- I I'6" -= 2' hardwood floors. Provide cl•:-t is (1 ) Electrical and Plumbing services to remove and reset 1 kitchen fixtures. Q �, I-2'6'la Kitchen :. master bedroom Cabinets donated to Habitat, they will remove them. - 1 _ Customer has kitchen CLQ.ET 1i:. (2) company doing the new kitchen installation. -"- mot- , �L 29'7" 1 2'10" M W IP • Main Level ,/0210618_MARTINIREP 9/23/2022 Page: 1 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construdtitbni tSpervisor CS-055571 Expires:09/17/2022 STEVEN M TESSIER i 18 DEE BEE CIR • MIDDLEBORO MA 02346 .rt 1 E 11SS'•1:1k5..' Commissioner : �It K. BlEol fi,tri i14 /iG kBc)L&'D ii > ISII.0- ,.Licensee Details • Demographic Information Full Name: STEVEN M TESSIER Owner Name: License Address Information City: Middleboro State: MA Zipcode: 02346 Country: United States License Information License No: CS-055571 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 9/28/2022 Issue Date: 9/17/2010 Expiration Date: 9/17/2024 License Status: Active Today's Date: 9/29/2022 Secondary License Type: Doing Business As: Oceanside Inc Status Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents