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HomeMy WebLinkAboutBLD-23-005872 ;Oi*YAR' Office Use Only i" ! G Permit# Y" O !t -Amount `vt7 � '':� TT „. 3 �.: "- Permit expires 180 days from issue date 60 023 -o/). 2._ EXPRESS BUILDING PERMIT APPLICATI E C E ! E D TOWN OF YARMOUTHW Yarmouth Building Department 1 '/' APR 21 2023 1146 Route 28 South Yarmouth, MA 02664 BUILDING DE--et AC NT (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: 269 Old Main Street ASSESSOR'S INFORMATION: Map: 60/223 I Parcel: 060.223 I OWNER: Patricia Newell 10 Cocheset Path 508-360-2515 NAME PRESENT ADDRESS TEL. # CONTRACTOR: Muto Inc. 1621 Orleans Rd Harwich 508-945-0300 NAME MAILING ADDRESS TEL.# 0 Residential 0 Commercial Est.Cost of Construction$21000.00 Home Improvement Contractor Lic.# 183111 Construction Supervisor Lic.#CS-109029 Workman's Compensation Insurance: (check one) 0 I am the homeowner 0 I am the sole proprietor 0 I have Worker's Compensation Insurance Insurance Company Name: Associated Employers Insurance Worker's Comp.Policy#WCC50050071002022A WORK TO BE PERFORMED Tent LI Duration (Fire Retardant Certificate attached?) Wood Stove El Siding: #of Squares Replacement windows:#4 Replacement doors: # Roofing:� #of Squares 27 (E)Remove existing*(max.2 layers) Insulation I I ( I i Old Kings Highway/Historic Dist. Replacing like for like Pool fencing F- •The debris will be disposed of at: S+J Exco 200 Western Road Dennis Ma 02660 Location of Facility I declare under penalties of perjury that the s ents herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial or revocation of y cense and for prosecution under M.G.L.Ch.268,Section I. Applicant's Signature: Date: Owners Signature(or attachment) ` ::. 7 ,/, .-za Building Official(or si EMAIL ADDR SS: Zoning District: Historical District: a Yes i No Flood Plain Zone: L Yes L No Water Resource Protection District: Within 100 ft.of Wetlands: Yes LI No ❑ Yes C' No , ; 1 ne L-ommonweattn of Massachusetts - '" Department oflndustrialAccidents t. ,.. .., `" .... Office of Investigations „� .,� :Y Lafayette City Center El j 7., 111111the'MOW, 2 Avenue de Lafayette, Boston MA 02111-1750 u►. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Muto, Inc Address: 1621 Orleans Road City/State/Zip: Harwich, MA 02645 Phone #:508-945-0300 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 10 4. 0 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.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' comp. insurance.: 9. 0 Building addition [No workers' comp. insurance required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doingall 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: Associated Employers Insurance Agency Policy#or Self-ins. Lic. #:WCC50050071002022A Expiration Date: 04/25/2023 Job Site Address: 269 Old Main Street City/State/Zip: S. Yarmouth MA 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the pains and penalties of perjuty that the information provided above is true and correct Signature: 04/20/23 Date: Phone#: 508-945- 00 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 51alumbing Inspector 6.0Other Contact Person: Phone#: AR I$ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/24/2022 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 RogersGray, Inc.-Kingston Branch PHONE 63 Smith Lane INC.No.EMI:508-746-3311 FAX No):877-816-2156 Kingston MA 02364 E-MAIL ADDRESS: mail@rogersgray.Com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Selective Insurance Company of the Southeast 39926 INSURED MUTOINC-01 INSURER B:Associated Employers Insurance 11104 Muto Inc.and Jasen G. Muto 1621 Orleans Rd INSURER C:Arbella Protection 41360 Harwich MA 02645 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2140386168 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 (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY S 2207035 4/25/2022 4/25/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO D CLAIMS-MADE X OCCUR PREMISES Ea Eoccurrence) $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ C AUTOMOBILE LIABILITY 1020067250 9/22/2022 9/22/2023 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) BODILY INJURY(Per person) $20,000 OWNED x SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $40,000 X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WCC5005007 1 002022A 4/25/2022 4/25/2023 X AND EMPLOYERS'LIABILITY ,,,/N STATUTE OTH- ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Muto Inc 1621 Orleans Road AU ..: D REPRESENTATIVE Harwich MA 02645 . _ 401111 • ; „, I 7 - - / ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Office of Consumer Affas 8 Busfne'ss l(egu(ation HOME IMPROVEMENT CONTRACTOR TYPE: orporation Restistrati Expiration 183111 08/27/2023 ,It; MUTO INC. JASEN MUTO r 1621 ORLEANS RD. c.;;6-4'-ott , HARWICH.MX 02645 Undersecretary Commonwealth of Massachusetts ItDivision of Occupational Licensure Board of Building R``e�ulations and Standards Constt;l;letI ervisor CS-109029 . ,Y E ires: 10/22/2024 JASEN MUT , y 1621 ORLEANS HARWICH MA, 4 h• Commissioner i i111 • ;;f Muto, Inc. 1621 Orleans Rd Harwich Ma 02645 CONSTRUCTION CONTRACT This Construction Contract(hereinafter the "Contract")is hereby made on by and between , , (hereinafter "Client")and Muto,Inc. (Jasen Muto Construction)of 1621 Orleans Rd Harwich Ma 02645 (hereinafter"Contractor"), collectively referred to herein as the"Parties." Article I ENGAGEMENT/DESCRIPTION OF THE WORK A. Contractor shall provide the following construction services(the"Project"): The contractor will be removing the existing Asphalt Shingles,4 Skylights. Then the contractor will be installing new CertainTeed Landmark Shingles,Close/Frame in Skylights openingsas specified in the attached estimate from Muto,Inc. Contractor is responsible for all materials, labor, disposal, and permitting. B. Client engages Contractor and Contractor agrees to provide to Client all necessary services,materials, and labor necessary for the completion of the Project including,but not limited to,all building and construction materials,requisite labor and site security,and all necessary tools and machinery needed for project completion. All construction materials should be new and of the highest quality,unless previously specified by Client. a. In the event that Client is responsible for providing materials and fails to do so,Contractor will supply vendor invoices along with invoicing, including a 20%markup for profit and overhead. C. Contractor shall provide the construction services for the Project at the property located at, D. This Contract shall be comprised of the following: this Construction Contract,Plans,Specifications,Addenda,Drawings, Photos or other visual representations of the proposed work,and the written Modifications attached to this Contract, properly signed and witnessed,all of which are attached hereto as exhibits. E. In the event that skylights are replaced and interior finish is required,the interior finish will be excluded from this contract and the total due for the items listed in this contract will be deemed complete at the time the specified items in this contract are finished. Final payment will be due upon acceptance of all items in this contract. Article II SCHEDULE AND TIME OF PERFORMANCE A. Contractor will begin work on 5/2/2023 and complete 5/16/2023. B. In the event that Client and Contractor agree on changes to the Project after this Contract is executed,the Parties will agree to new time deadlines that are reasonable in light of the modifications. Article III PAYMENT SCHEDULE Digitally signed with JobNimbus, Document ID: 398ACDAD-A0F6-4D8D-845E-FF0E8DD62COE Page 1 of 4 A. In consideration of the performance of this Contract,Client agrees to pay Contractor the sum of twenty one thousand dollars($21,000.00)(the"Contract Price")on the following payment schedule for the services. B. Contractor shall be paid as follows: The first 10%or$to be paid upfront as a deposit for the materials,disposal,and permitting. A second payment of 40%or$upon start of specified work. The final 50%or$upon completion and satisfaction. C. In the event that the Client opts to use financing,the payment terms will be as follows: 1. 100%financing will be paid in full by the financial institution once work is complete and accepted. 2.Partial financing will be paid as follows: The portion of the finances provided by the Client will be paid in accordance with Article III Section B(as in project cost$10,000.00, Client provided funds$4000.00, first payment of$1,000.00 provided by Client, Second payment$3,000.00 provided by client and remaining$1,000.00 and final payment of $5,000.00 provided by financial institution at completion and acceptance of the project. A. In the event that there are any items left to bill at the end of the project for substantial project completion, double the cost of those items will be left unbilled and the remainder will be due. Article IV CHANGES TO THE WORK A. All changes or modifications to the work ordered by Client must be made in writing,with appropriate adjustments made to the total payment and payment schedule. The approval of both Parties shall be required for substantial project changes such as the date of completion,project price,and substantive modifications to the project itself,and notification of these changes must be made in a timely manner. B. If these changes should require additional expense to Contractor,Contractor must make a claim for increase in payment, in writing,to Client,in a timely manner. Client must approve this claim for increase in writing prior to any changes to the work,project,or schedule. C. Changes made to color choices after the initial choices has been made must be done via phone with the Contractor's main office. The color change will be confirmed via email from Contractor to Client. Article V DELAYS A. If Contractor is delayed from completing required work due to unavoidable casualties, Client shall grant Contractor an extension for the completion of work equal to the delay. Unavoidable casualties include,but are not limited to, fire, flood or natural disasters,delayed acquisition of materials or material delivery,and negligence on the part of Client. B.In the event of unavoidable casualties,Contractor shall properly document both the event and the impact of that event on project completion. Documentation shall be presented to Client in a timely manner. Article VI RIGHT TO STOP WORK A. If Contractor fails to correct defective work or persistently fails to supply materials or equipment in accordance with the Contract Documents, Client may order Contractor to stop the work,or any portion thereof,until the cause for such order has been eliminated. Article VII ACCESS AND CONDITION OF PREMISES A. Free access to the work and project site shall be granted by Contractor to Client,the designated agents of Client,and all necessary public authorities. B. Contractor agrees to keep the premises clean and orderly. Contractor shall remove all debris as needed during the hours of work in order to maintain work conditions free of health or safety hazards. C. Contractor will take all reasonable precautions to protect shrubbery and gardens while work is being performed. Contractor will not be responsible for incidental,unavoidable damage. Article VII WORK PERFORMANCE AND WORK QUALITY Digitally signed with JobNimbus, Document ID: 39BACDAD-AOF6-4D8D-B45E-FF0E8DD62COE Page 2 of 4 A. Contractor shall conduct its activities in a professional manner and adhere to the reasonable wishes of Client in relation to its working schedule. Additionally,Contractor's work shall adhere to and be in compliance with both the Standard Practices of the Trades and any relevant Manufacturer's Specifications. B. Contractor shall protect all work adjacent to the Project site from any damage resulting from the work of Contractor and shall repair or replace any damaged work at its own expense. Contractor shall take all precautions to protect persons from injury and unnecessary interference or inconvenience. Article IX WARRANTY A. Contractor hereby warrants that the work performed and the Project completed will meet the standards set forth and agreed upon by the Parties. Contractor agrees to fix and otherwise remedy any defects found by Client in the work within "five(5)years"after the date of final completion at Contractor's own cost. This includes defects caused by natural phenomena. B.In the event that Contractor replaces a roof but leaves the existing skylights,any roof leakage originating from those skylights is not covered by this warranty. C. Contractor is only responsible for damage resulting to the Project from negligence,dangerous activities,intentional disregard of professional standards of care normally exercised within the industry,or breach of any governmental statute, ordinance,local rule,or law. Article X INSURANCE A. Contractor shall be responsible for insurance to protect against any property damage,bodily injury,death,or other claims for damages that may result from the commission of the work, including general liability insurance,builder's risk insurance and workers' compensation insurance for its employees or subcontractors. Article XI LICENSES AND PERMITS A. Contractor will be responsible for obtaining the necessary permits and licenses to fulfill the services specified in this Contract. Article XII FINES A. Contractor is responsible for maintaining proper work, safety,and environmental protection standards. Contractor agrees to hold Client harmless for all fines from federal, state,or local agencies and regulators. Contractor will work in compliance with all standards required by the EPA,OSHA,and other applicable federal agencies. Contractor will be responsible for paying all fines and judgments levied by these agencies resultant from the performance of this Contract. Article XIII RELATIONSHIP OF PARTIES A. The relationship created between the Parties shall be limited to that of independent contractors. Neither party shall undertake any actions that would imply or seek to establish, any partnership,ownership,employment,joint venture,or trust relationship between the Parties,except by amendment to this Contract. B. Contractor shall have exclusive authority to execute the work included in this contract. Article XIV GENERAL A. Both Parties are expressly prohibited from assigning this Contract or any rights or interest flowing therefrom. Assignment will only occur with the express written consent of both Parties. B. This Contract contains the entire agreement and understanding between the Parties and supersedes any prior or contemporaneous written or oral Contracts,representations, and warranties between them respecting the subject matter of this Contract. C. This Contract will be interpreted and enforced under the laws of the State of MA,without regard to conflict of laws. IN WITNESS WHEREOF,the Parties hereto execute this Contract: a Digitally signed with JobNimbus. Document ID: 39BACDAD-AOF6-4D8D-645E-FFOE8DD62COE Page 3 of 4 CLIENT CONTRACTOR Authorized Signature fitkediv Patricia Newell 02745d6b-3bcc-4eae-b9a1-9ab... 04/13/2023 Name Representative Authorized Signature Name and Title License Number: MA HIC# 183111 CSL Number: CS-109029 -N/A- Digitally signed with JobNimbus, Document ID: 39BACDAD-AOF6-4D8D-B45E-FFOE8DD62COE Page 4 of 4