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HomeMy WebLinkAboutBLDSM-23-001652 RECEIVED SEP 2 8 2022 •f F__ SHEET METAL PERMIT Commonwealth of Massachusetts Buis � Tr5E2y By: \• Town of Yarmouth Building Department 1146 Route 28, South Yarmouth, MA 02664-4492 (y Svc! 8-ZZ-ZoZZ) Date: 1- 17- ' LZ.... Permit#: BID-�3-OOb 815 3v)Ii r I7 Estimated Job Cost: $ '2�vc7��: Permit Fee: $ 5D m ? - -2tD1c2st. Plans Submitted: YES/ NO Plans Reviewed: YES/ NO Business License# 3 0 Application License# (52-1-1 3 Business Information Property Owner/Job Location Information Name: 5S1 6r)1r?r1se5 1D s t"' Name: (lth,ire 4' 8Q,A Jou rne`t. Street: 376- Centre St MefiAL Street: 17 1'4-th4ryn. M)C14e,L Pt City/Town: 1A,n d d 1 P k f�l o z3 b 8 City/Town: `4 rri oil*)-,pa i±, l4 4 Telephone: 4,17-s47-s-RD Telephone: 78/ b-77 8 Photo I.D. required/Copy of Photo I.D. attached: age/ NO Staff Initial: J-1/ M-1 unrestricted license i.o J-2/ M-2 restricted to dwellings 3 stories or less and commercial up to 10,000 sq. ft./ 2 stories or less Residential: ()2 family ✓Multi-family_ Condo/Townhouses_ Other_ Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft._Number of stories: / Sheet metal work to be completed: New work_ Renovation: ✓ HVA Metal Watershed Roofing:_ Kitchen Exh`kust Sem: Meal ChOney/Vents: "✓Air Balancing:_ Provide detailed description of work to be done: delo(Ate. 4VAc DJCfu a K J gA.temeeir to t 6)ve ►it La.) g#Serneet t D/ur n)c I 1"5 * AD D Frei h 12 RAfenieif ' IOe rh 1ri ror'► .2 do PAn4Scrii t; fv— 1/62_LZ W I+U ee i 115 Dc ) A-Uti -" Add Ao a) bs T:e:1.1. £y h Aus t Fes/ Q et4 4cona it Fv-©y VE 1 g f Y- ire o 4 Y L *- A d a N e vwl a S Q pi? �r diS rr -Re-6t-o btcewent O Mc D✓cttwo/I- '_ 4S fwedtGl INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes I✓ No If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ✓Other type of indemnity Bond OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner V Agent Signature of Owner or Owner's Agent By checking here4 I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installation performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Inspections shall be called for prior to insulation installation. Duct inspection required prior to insulation installation: Yes No Progress Inspections Date: Comments: Final Inspections Date: Comments: Type of license: By: Master Title: Master-Restricted '1` Signature of Licens City/Town: Journeyperson Permit#: Journeyperson-Restricted License Number: 9.- 1 ;.- Fee: $ Check at www.mass.gov/dpl . '` , , 'at \ I` Inspector Signature of Permit'( of Permit Approval OMMONW. TH-OF MASSACHUSETTS DIVISION'OF PROFESSIONAL LICENSURE .BOARt):,Q€F SHEET METAL WORKERS ISSUES THE FOLLOWING{_ICENSE MASTER-UNRESTRICTED �`a STEVEN H HARVEY 35 THOMAS<[3LANCHARD DR PLYMPTON,MA 02367-1531 • 2432 11/28/2023 134303113I q 'yT DATE SERIAL NUMBER _ ASSACHUSETTS DRIVER'S ENSE NUMBER 1012212018 S54845205 . 1 DOB 110412023 11/04/1961 * ., '•'.CL9155 REST END DM NONE NONE STEVEN H 35 THOMAS BLANCHARD PLYMPTON,MA 02367-1531 t1/44�II EYES BRO SEX M FIST 6-00 (� DD 10122/2018 Rev0212212016 '}1/04/61 BSHENTE-01' JFINNERTY A R w DATE(MMIDD(YYYY) CERTIFICATE 4F LIABILITY INSURANCE 9/19/2022 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. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poltcy(les)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). I PRODUCER CONTACT ,NAME; McFinn Insurance Agency PHONE (Arc,No,Ext);(781)682-1000 i I ra,No);(781)337-0621 1594 Main St Weymouth,MA 02190 E-MAILADDRESS; INSURER()AFFORDING COVERAGE NAIL# INSURER A:Main Street America Assurance 29939 INSURED INSURER B:National Grange Mutual I 14788 B.S.H.Enterprises,Inc.dba Quincy Sheet Metal Co.,Inc INSURER C:Hartford Fire Ins Co 375 Centre St INSURER D: I Randolph,MA 02368 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. I • INSR ADOL SUER POLICY EFF POUCY EXP I LIMITS TYPE OF INSURANCEINSO,WVD, POLICY NUMBER IMMfDDIYYYYI tMM/DD(YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MPP6877G 4/17/2022 4M712023 DAMAGETORENTED 1,000,000 PREMISES IEa occurrencal $ MED EXP(Anil one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENII-AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I I j7 LOC PRODUCTS-COMP/OP AGG_ $$ 2,000,000 OTHER: B AUTOMOBILE LIABILITY lEa accicidentSIIVGLE LIMIT $ 1,000,000 ANY AUTO M1 P0085R 12/31/2021 12/31/2022 BODILY INJURY(Per person) $ SCHEDULEDAOX _ AUTOS ONLY UTSINJURY(Per accident) $ ooNN yWyNNEEDp PRROPER]Y DAMAGE X AUTOS ONLY X AUTOS ONLY (Peracc:dent)i $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE1 S DED RETENTION$ I $ C WORKERS COMPENSATION X i STATUTE OTH- ER AND EMPLOYERS'LIABILITY OBWECLF1036 6/1/2022 6/1/2023 1,000,000 ANY PROPRI ETORIPARTNER/EXECUTIVE Y(N E.L.EACH ACCIDENT $ OFFICER M!MB EXCLUDED? I1,000,000 andato n N!A E.L.DISEASE EA EMPLOYEE S If yyes.descr be under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below . DESCRIPTION OF OPERATIONS ERA I NS/INSTALLATION I VEHICLES (ACORD WI,Additional Remarks Schedule,may be attached If more space Is required) SHEET CERTIFICATE HOLDER CANCELLATION I 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. BUILDING INSPECTOR AUTHORIZED REPRESENTATIVEVE (ACORD 25(2016l03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD S -1.1 -► NI 1r . ,.. ri i O N ry F_ `I J algik— Y v I VI J Vt 2 ~1 Q / 4 ;J „a ,n o c3 s FL , •-Or .-� N } c Q j sr 4 -g i 0 �- \ 1 d V 'T-- .^ i -v 4i s 3 — A y{ X I .- '11 �'' 3 -:.5..' 3 0 c) } �9 ! b li 4. 0 m v irt j /1\ t __) ,a., cl V- !_ W 1.46111P =:awr -- ! N A +--