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HomeMy WebLinkAboutBLD-23-001266 �''YA G t� 1 Office Use Only O / / % /zJ i Permit# e,4 5 76 O . ►i L�j/ ;Amount /� C ' •....tA-lnwriscn csaJ,z. ' ;,-.y;.;,,,: (Permit expires 180 days from j issue date 6/.--P -A3 -0d0-6,A, EXPRESS BUILDIN G PERMIT APPLICATkO TOWN OF YARMOUTH tTC ' p Yarmouth Building Department ____a__. ___.._-__ 1146 Route 28 SEP 0 6 2022 South Yarmouth, MA 02664 _ (508) 398-2231 Ext. 1261 BUILDING DEPARTMENT By: _ �2c CONSTRUCTION ADDRESS: /2 5 cOQO (A -, ( c- ASSESSOR'S INFORMATION: Map: Parcce_l:, n ,(� OWNER:)OM CONOQj‘.j a STOAT�� W . q_f QQs IAA tJ)-(9v)5- NAME PRESEN DRESS _TEL. # CONTRACTOR:a-4A)J'�IL VCI ' L6 Mk ii.r.i.S 44A (0)-)s NAME MAILING ADDRESS TEL./ # �S Li 64t0 L9 Cidential 0 Commercial E .Cost of Construction$ ! //300 Home Improvement Contractor Lic.# 1 1 S7 Construction Supervisor Lic.# o ( / [6 7 Workman's Compensation Insurance: (check one) ❑ I am the homeowne ❑ I am the sole proprietor 'Cl I have Worker's Compensation Insurance Insurance Company Name Ce 4.11/144VJC44A) Worker's Comp.Policy# 6Sekt!&S410 8A O9 WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows: # I Replacement doors: # Roofing: #of Squares -3 0 ( V Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( V)Replacing like for,like Pool fencing C)AL ''h/nonn __ (f fv I \ - 43' 4 j 5 L, ./c U_Kpt✓ 1/ *The debris will be disposed of at: �� Y dl l�i.N��J" )-e (-)q 3 Location of Facility I declare under penalties of perjury that the statements herein - .. ed are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for de' . .J...tion of. licens- . . 1 . . cution under M.G.L.Ch.268,Section I. Applicant's Signature:it AL � _ ` Date: ` L/ Owners Signature(or attachment) Date: Approved By: ,47.--'------2 -77— — ; Building Official(o signe Date: EMAIL ADDRESS: Zoning District: Historical District: C Yes ❑ No Flood Plain Zone: ❑ Yes ❑ No Water Resource Protection District: Within 100 ft.of Wetlands: 0 Yes 0 No 0 Yes 0 No Ac R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/17/2022 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 DOWLING &O'NEIL INSURANCE AGENCY NAME; Linda Sullivan PHONE lA/c,No,Earl; (508)775-1620 1 FAX I(NC,No)_ E-MAIDRL ADESS: ISu Iliva n@doins.corn 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO INSURED 22667 KELLY ROOFING INC INSURERS: INSURER C INSURER D: 8 RHINE RD INSURER E YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 775628 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 ADOL SUBR LTR TYPE OF INSURANCE INSA..wvo POLICY NUMBER (MM/DO//YYYY) (MMIDD/YY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE i I OCCUR DAMAGE 10 HEN I ED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADVINJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- GENERAL AGGREGATE $ JECT 1LOC PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED SCHEDULED • BODILY INJURY(Per person) $ AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) $ UMBRELLA LIAB OCCUR • EXCESS LIAB i EACH OCCURRENCE $ CLAIMS-MADE N/A AGGREGATE DED I I RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY Y/N /� STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE ' A OFFICER/MEMBEREXCLUDED? N/A N/A N/A 6S62UB8H08580922 05/10/2022 05/10/2023 E.L.EACH ACCIDENT $ SQQ,QQQ (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 N/A I 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 Town of Lakeville 346 Bedford Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL •BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • AUTHORIZED REPRESENTATIVE Lakeville MA 02347 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACOI�D CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD :d The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ` Lafayette C"� Center 2Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): i C1- -1-(1& C Address: C.) -U 3E City/State/Zip �f `'' #: -J` SO 6-1 CA. L-{,CJ Are pm an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. El I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 Q New construction listed on the attached sheet. 7. ❑Remodeling 2.❑ 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' 9. addition [No workers' comp.insurance comp.insurance.t ❑Building required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3_Q I am a homeowner doing work officers have exercised their Q S r or additions 8 ll_ PJPmhin myself. [No workers' comp. right of exemption per MGL 12of repairs insurance required]t c. 152,§1(4),and we have no employees. [No workers' 13.0Other 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: 0 Policy#or Self-ins.Lic.#: `F�2 Q � Expiration Date:. 5 t 0 - Job Site Address: 12 >%-4-4 z P ozo q�,� , � city/State/Zip:��--fi'1©d� ��� a'{� OG1771 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 and a ns and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 0 (3/_.l . 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): 11:3Board of Health 20 Building Department 31:City/Town Clerk 413Electrical Inspector y rluntbing Inspector 6.DOther Contact Person: Phone#: .-74/240-,4111eC4M/4 0-// Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Individual Registration: 128957 OLIVER KELLY Expiration: 06/13/2023 8 RHINE RD YARMOUTHPORT,MA 02675 Update Address and Return Card. SCA 1 0 20M-05/17 Office of Consumer Aftr '8 business Ne!Uf5tion HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 128957 06/13/2023 1000 Washington Street -Suite 71d OLIVER KELLY Boston,MA 02118 OLIVER M.KELLY / C— (13_2 8 RHINE RD. (rvrvaf� YARMOUTHPORT,MA 02675 Not valid without signatkre Undersecretary Commonwealth of Massachusetts Division of Professional Licensure Board.of Building Regulations and Standards ConstructielrSuepr Specialty CSSL-099167pires: 09/28/2023 • OLIVER M KELLY -- 8 RHINE ROAD # YARMOUTH PART MA 02675 -- .. t f itsf.;.110 t` Commissioner daia " KELLY ROOFING PH. 508 509 4640 8 Rhine Road MA C.S.L. #099167 Yarmouthport MA H.I.C.R. # 128957 MA 02675 INSURED July 1, 2022 Proposal submitted to Mr. Tom Lundquist of 12 Stratford Lane Yarmouthport, MA. We propose to supply all materials and labor required to remove and replace the existing asphalt roof on the house at the address above. Protect all walls, Windows, shrubs, plants etc. during roof strip. All debris to be removed to town transfer. Install 8" White Aluminum Drip Edge on all Eaves, 5" White Drip Edge to be installed on all Rakes. Ice and Water damage protection membrane to be installed on first six feet of all Eaves and In All Valley Areas Remainder Of Roof To be Covered With Synthetic Roof Underlayment. Install limited lifetime warranty Landmark Architect style Shingles, color to be Specified. All shingles to be storm nailed (6) We Generally Use Certainteed Products with All Accessories to maximize available warranties. This proposal is based on their Limited Lifetime Warranty Landmark Series Shingle Replace plumbing vent pipe boots with new. Repair/ Replace all flashings as Necessary. Install Certainteed Filtered Ridge Vent with hand nailed caps. Complete Clean up off all areas including all gutters and all nails after project complete. Obtaining of Town Building Permit. At a total cost of $15,400 For Landmark Pro Shingles Add $700 For Skylight Replacement Add $ $1250 Per Velux MO8 Venting Unit Or $1100 Per Non Venting Unit Solar Options available include solar operated venting and or factory installed solar blinds which qualify for 26% Tax Credit Add $800 Per Venting Unit And A Further $450 Per Solar Blind. Payment Schedule; Balance upon Completion Proposal Submitted by: Oliver Kelly Proposal accepted by: ''.P^ Date. / /2022 This proposal is valid for 30 days from date above, please call to verify thereafter. Best Contact Number: °` TOWN OF YARMOUTH � d t � " 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 RECEIVE `-"w;: • Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 Auu 2 9LD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE tAAMOu"i r APPLICATION FOR L i .0 •Rir I OLD KING'S HIGHWAY ? immullimmimmin _ Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as amended,for proposed work as described below&on plans, drawings, photographs, &other supplemental info accompanying this application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S), ELEVATIONS PHOTOS,&SUPPLEMENTAL INFORMATION. Check All Categories That Aopl : Indicate type of Building: Commercial 1 J Residential 1) Exterior Builcriligt Construction: INew Building EtAddition terations [✓ Reroofri Garage Shed Solar Panels 'Other: 2) Exterior Painting: nSiding Shutters n Doors ❑Trim j10ther: 3)Signs/Billboards: I-I New i n Change to i ting Sign 4) Miscellaneous Structures: Fence Wall Flagpole 1 !Pool Other: Please type or print legibly: Address of proposed work: 12 Stratford Ln Map/Lot# 143.47 owners): Tom Lundquist Phone#:508-737-4090 All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 12 Stratford Ln Year built:n 1972 Email: tomlundquist@hotmail.com Preferred notification method: 1- ' PhoneFi-il Email Agent/contractor: Kelly Roofing Z'e- Phone#: 6 - 77S - yz.27 Mailing Address: 8 Rhine rd Yarmouthport Email: Kat rZt.'c'4 `.iN (1,. 1-C/e .d' c>n�t. Preferrednotification method: ✓ Phone n Email Description of Proposed Work: New Roof, replace existing skylight. Signed(Owner or agent): //11 Date: "c�'„- f > Owner/contractor/agent is aware that a permit is required from the Building Department.(Check other departments,also.) ➢ If application is approved,approval is subject to a 10-day appeal period required by the Act. ➢ This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. ➢ All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections. For Committee use only: /Approved Approved with Modifications Denied v Rcvd Date: +��A V-9- Reason for Denial: Amount N APB _ - DF Cash/CK#: Rcvd by: /• 5 Signed: �°l7 v'ri.�1 Z C���c 1 ) AUG 9 3 7(122 45 Days: YARiviC?t i i t: I OLD KING'S HIGHWAY Date Signed: r 17? 1 APPLICATION#: 00`E 3 L ///\s‘ 0 139 Queen Anne Road ., FROMTIER vrto Harwich, MA 02645 : Q . " "w" En�r �� Solutzons, Inc. Office: 774-237-0410`� c.�. `s u:'� z,r>^3. ; ��x< ,��„ kr Web: frontierenergysolutionsinc.com SvV Certificate of Insulation Work Jo(fite Ail¢ Cl + /0-$5ern >1 Crew Members on Site: red Su�4•11 (1.r-u40,1-k,) 44Pt 0z,H4,y Description of Work Location: Square Feet: Material/Inches: Manufacturer: R-Value: IV\L-t( P715 - -Rh".r 0 ie.(S ka t.,....2f) 2-1 1L9 Lit r g. itcs t414./uf 21 R-Values per inch:Cellulose,loose:3.7,Cellulose,Dense Packed:3.2,Fiberglass:3.0,Poly-iso board:6.5,Closed Cell foam:7 Air Sealing Completed: Attic Access Treated: Blower Door Results: ❑ Attic ❑ Pull Down Stairs Pre-Work Test: ❑ Basement ❑ Hatches Post-Work Test: _ ❑ Living Space ❑ Doors ❑ No Blower Door Test ❑ None Notes: I certify that the address listed above was insulated as described on this certificate, and that all work was performed and installed in accordance with state and local buildin co Job Foreman g(3 0�/2-3 Date