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HomeMy WebLinkAboutBLD-23-004342 BLD-23-004342 - 79 Eldridge Road ;zrt+.a Help File Date: 62/06;2023 Application Status: Description of Work: door weatherstrippi>g,cellulose in exterior walls,rigid hoard on crawlspace walls.pQly on crawlspace ground crawlspace access door Application Detail: Detail Application Type: Residential Express Permit Address: 79 ELDRIDGE RD SOUTH YARMOUTH.MA 02664 Owner Name: ELAINE M COURURE TR Owner Address: VENITA YERAGOTELIS TR.11 SEAVIEW DR,KINGSTON MA 02364 Application Name: • - Parcel No: 025.159 Contact Info: Name Organization Name Contact Type Relationship Address Contact Primary Steven Hebert Elite Energy Se... Applicant 225 Shove St#4... Licensed Professionals Info: Primary License Number License Type Name Business Name Business License# Job Value: $.4,121.42 Total Fee Assessed: $35,00 Total Fee Invoiced: $35.00 Balance: $0.00 Custom Fields: ADDITIONAL INFORMATION Total Job Cost Type 4121.42 USE GROUP AND CONSTRUCTION TYP Construction Type Use Classification WORKERS COMPENSATION INSURANCE Workers Compensation Insurance Insurance Company Name Workers Comp I have Workers Comp Insurance Atlantic Charter Insurance Company. WCV01488802 TENT Tent WOODSTOVE Wood Stove CHIMNEY REPAIR Chimney Repair Detailed description of work SHED Shed 1 SIDING Re-Side WINDOWS AND DOORS Replace Windows andlor Doors FENCE Fence Fence for Pool Enclosure Fence over 6 Fe Linear Feet Fence Height ROOF Re-Roof INSULATION Installing Insulation Yes SOLAR SYSTEM INFORMATION Solar Service ID Meter ID Type of Use Job Cost Total Inverter P, Number of PV Modules Number of Inverters Total Roof Area Roof Coverage Type of Roof Roof Material Roof Layers DEMO Demolition Detailed description of work OTHER Other Detailed description of work GENERAL DETAILS Construction Debris will be taken to(Name of Disposal Facility) Electrical Drop within Area of Work? Gas Meter or Regulator within Area of Work? ZONING INFORMATION Zoning District Historic District Historic District Historic Building Endangered Species Zone Description Supplier Wetland Description Total Land Area INSPECTION RESULTS Inspection ID Inspection Type Inspection Result Inspection Date Result Comment Inspector Record ID Record Type Workflow Status: Task Assigned To Status Status Date Action By Application Acceptance Linda Cipro Initial Review Linda Cipro Building Review Tim Sears Issuance Linda Cipro Inspection Tim Sears Close Out Linda Cipre Condition Status: Name Short Comments Status Apply Date Severity Action By Application t:romments: View ID Comment Date Initiated by Product: ACA • Scheduled/Pending Inspections: Inspection Type Scheduled Date Inspector Status Comments Resulted Inspections: Inspection Type Inspection Date Inspector Status Comments DocuSign Envelope ID:9CAD2D1F-48C9-4A16-A058-963CBB588E7C Customer Name:Jack Couture CONTRACT Email:ecout@aoicom Phone:781-953-7911 Premise Address:79 Eldridge Road.South Yarmouth,MA 02664 RISE. Mailing Address:11 Seaview Drive,Kingston,MA 02364 Project ID:4713989 Date:Jan.16,2023 ENGINEERING RISE Engineering 765 Attucks Lane, Hyannis,MA,02601 Roadblocks: Notes: • Moisture-current Although your home could benefit from weatherization, • Asbestos-Vermiculite due to height restrictions of the crawl,work cannot be done at this time.Until the crawlspace can be safely,all planned weatherization measures for your home will need to be put on hold until the proper control of the crawlspace moisture. -Irsh ristqpript Inn Measure Description Location Quantity Unit Total Cost Customer Cost WEATHERSTRIP DOOR&ADD SWEEP 1 each $57.92 $0.00 WALLS:EXTERIOR DRILL&PLUG 860 SF $1,926.40 ..,:1.60 CRAWLSPACE WALL R10 RIGID BOARD 195 SF $893.10 $223.27 CRAWLSPACE: 10 MIL GROUND COVER 100% 950 SF $969.00 $0.00 CRAWLSPACE:MAKE ACCESS DOOR 1 each $275.00 $68.75 Total: $4.121.42 Program Incentive: -$3,347.80 Customer Total: $773.62 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Seven Hundred And Seventy-Three And 62/100 Dollars $773.62 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF I%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS,SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES n.o.e..Cignocl by ) ,/ citssi flamsseatative DocuSigined by. : Mum 1/18/2023 I 11:28 AM EST Sign Date NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND 30 DAYS CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE Page 1 of 1 Commonwealth Rat assachti ett 0vt rsasa of ProtestsIntiai Lrcenstar± Board et Hiritoiag Regulations arid Standards ConstroOTrehShratertrisor CS-t 1 67 Expires',06107,2023 STEVEN P HEBERT 22$SHOVE STREET APT 4 FALL RATER MA 02124 r Com r ner x.+t, aL.arrt, "'.....N ELITENE-01 LBROWN ARE) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/8/2023 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 Loretta Brown NAME: 12n' e I PHONE FA"8DeaStet (a/C,No,Ext):(508)824-8666 (A/C,Ne):(508)880-0142 Taunton,MA 02780 E-MAIL ADDRESS:loretta@fbinsure.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of South Carolina 19259 INSURED INSURER B:Commerce Insurance Company 34754 Elite Energy Services LLC INSURER C:Evanston Insurance Company 35378 225 Shove St Apt 4 INSURER D: Fall River,MA 02724 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR S2574612 2/27/2023 2/27/2024 DAMAGE TO RENTED 500,000 X Blkt Ade Ins PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 X Blkt Waiver PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000 000 (Ea accident) $ ANY AUTO BDJH26 3/11/2023 3/11/2024 BODILY INJURY(Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident)_ $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE S2574612 2/27/2023 2/27/2024 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution Liab CPLMOL107350 7/13/2021 7/13/2023 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,AdditionaRema rks Schedule,may be attached if more space is required) Professional Insulation/Winterization Services Contractor.Pollution Liability coverage includes a$2,000,000 Aggregate and$1,000 Deductible. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of Yam ACCORDANCE WITH THE POLICY PROVISIONS. 1146 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE 40411,frei.`o' • to 41,., I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts - Print Form Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 • r Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Informatiion Please Print Legibly Name (Business/Organization/Individual): Elite Energy Services , LLC Address:225 Shove St City/State/Zip: Fall River Ma 02724 Phone #: 774-360-7658 Are you an employer? Check the appropriate box: Type of project(required): 1. ✓❑ I am a employer with 18 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction listed on the attached sheet. 7. ❑ Remodeling 2.III I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no Insulation employees. [No workers' 13.❑✓ 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. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Atlantic Charter Insurance Company Policy#or Self-ins. Lic. #:WCV01488803 Expiration Date:2/28/2024 Job Site Address: 79 Eldridge Rd City/State/Zip:Yarmouth MA 02664 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: __ S/m., �f Date:4/3/2023 Phone#:774-360-7658 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t as c.) c .. ...• a) ce ces -a cv C c 0as .2 ..zr sa to' g3 0 -4 as co 13 CC E. a c a▪ s at )...- 0 .— II Z : 4P, as = c o 0 c 4... _c ta = CC c) as Cidn N. 00 .(f) 0 w lz= co g o •••er .11 . 5 CC 5 i to.7 .0 Q) C1) ,— (D ••••• •••• 13 % 0 ... C N rf ▪" C))(i) 0 I: .. ... G, 0 ek". 4. ,A,4". 11 13 — = .= .,co .... " CCI > 0 CCc(i) v) ctS ..... = .- I z 4- 0 0.c 0 0 2 . •Fis ...... (,) c = o) as a) tilt 8211 < c,-:: 2 E ,..... .--,,,. _ Q) (1) RIV 1 C > — '- = C (:) CO — 0 0 (I) NT a5 *- 0 .....- o c...) c 0 0 .... 0 a) -J 2 0 C.) Cfi Et RI -0 c ...".' w 0 ..zt• 4 — 0 0 0 5 P' t w 0 co < ao o o o >. 1— M •ss I—7.1 __1 -.4 CD U) a Z Cr w ce 1,4 2 a. Li, 4 •ct, t Z 0 w — I N 0 71 'CVI < C a Ti 2 cr w w u. 0 w I > 8 x z 8 w w = EE F- UJ in -I W U) N U- . DocuSign Envelope ID:9CAD2D1F-48C9-4A16-A058-963CBB588E7C Permit Authorization ass .ve Form Site ID: 4132281 Customer: Jack Couture John Couture ,owner of the property located at: (Owner's Name,printed) 79 Eldridge Road South Yarmouth, MA 02664 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. p—DocuSigned by: Owners Signature: jetikt, (ham, E7D84CE2B70F487 Date: 1/18/2023 1 11:28 AM EST FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Elite Energy Solutions Participating Contractor Date Name: RISE Engineering Phone: 508-568-1926 Email: Page 1 of 1 Fos Office Use Only Rev.102015 DATE(MM/DDM'YY) AC R© CERTIFICATE OF LIABILITY INSURANCE 03/08/2023 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 FBINSURE LLC PHONE Loretta Brown O (A/C.N .Ext): (508)824-8666 (A/C,No): ADDRESS: loretta@fbinsure.com 128 DEAN ST INSURER(S)AFFORDING COVERAGE NAIC#TAUNTON MA 02780 INSURER A: ATLANTIC CHARTER INS CO 44326 INSURED INSURER B: ELITE ENERGY SERVICES LLC INSURERC: INSURER D: 88 ARCH STREET APT 3 INSURER E: FALL RIVER MA 02724 INSURER F: COVERAGES CERTIFICATE NUMBER: 868837 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DCDY/YYYY) (MM/DD/YYXYPY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC GENERAL AGGREGATEJECT $ PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY Y/N X I STATUTE I I ERH A OFFANYCER/M MBER XCLUDED? N/A N/A N/A WCV01488803 ECUTIVE E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) 02/28/2023 02/28/2024 If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 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 Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD