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HomeMy WebLinkAboutBLDSM-23-000498 Ref:Building Permit#BLD-22007111 RECEIVE ® SHEET METAL PERMIT JUL 2 9 2022 �-L/ ' Commonwealth of Massachusetts ��,5i tA ;_ BUILD a 1 „ ...r. I I Town of Yarmouth Building Department By - _- '=' 1146 Route 28, South Yarmouth, MA 02664-4492 Date: 2/26/2022 Permit#: e{, 6m-'2 3 -DUeyq O Estimated Job Cost: $ $120,000.00 Permit Fee: $ 60.00 Plans Submitted: YES/NO Yes Plans Reviewed: YES/NO Business License# 108 Application License# Business Information Property Owner/Job Location Information Name: E.Amanti&Sons,Inc Name: Owner:Town of Yarmouth Street: 390 Highland Ave Street: 1175 Route 28 City/Town: Salem,MA 01970 City/Town: South Yarmouth,MA 02664-4463 Telephone: 978-745-4144 Telephone: Photo I.D. required/Copy of Photo I.D. attached: NO Staff Initial: J-1/M-1 unrestricted license J-2/M-2 restricted to dwellings 3 stories or less and commercial up to 10,000 sq. ft./2 stories or less Residential: 1-2 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: 2 Sheet metal work to be completed: New work Renovation: ✓HVAC: Metal Watershed Roofing:_ Kitchen Exhaust System: ✓Metal Chimney/Vents: Air Balancing: ✓ Provide detailed description of work to be done: Remove and replace or add new: 13 unit ventilators,4 AHU's, 1 makeup air unit.and 2 exhaust fans with associated intake air ducts and louvers. INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ✓ 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 Agent Signature of Owner or Owner's Agent By checking here-3 ,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 Licensee '(` City/Town: Journeyperson Permit#: Journeyperson-Restricted License Number: Fee: $ Check at www.mass.gov/dpl I45). '1' Inspecto ignature of Permit IN of Permit Approval "'. EAMANTI-01 MVERTENTES A�CO-- a1612 E CERTIFICATE OF LIABILITY INSURANCE DAT/16/2D22YY) 022 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 License#1780862 CONTACT Maria Bala HUB International New England PHONE II FAX 222 Milliken Boulevard (NC,No,Ext):(508)235-2216 I(Arc,No): Fall River,MA 02721 Uiss:maria.baia@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Liberty Insurance Corporation 42404 INSURED INSURER a:Liberty Mutual Fire Insurance Company 23035 E.Amanti 8 Sons,Inc. INSURER c:Employers Insurance Company of Wausau 21458 390 Highland Avenue INSURER 0 Indian Harbor Insurance Company 36940 Salem,MA 01970 INSURER E:The Continental Insurance Company 35289 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 ADMTYPE OF INSURANCE INSD SUER POLICY NUMBER IMMIDDIVYFYYI IMIDDIYEYYY) LIMITS LTR INSR SUED A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAMS-MADE X OCCUR X X TBZZ11259976061 7/1/2021 7/1/2022 Kt SES(EaEoawE°noel $ 100,000 MED EXP(Any one person) $ 15,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X jECT LOC 2,000,000 PRODUCTS-COMP/OP AGG $ X OTHER:$0 Deductible EMP BENEFITS AG $ 2,000,000 B AUTOMOBILE LIABILITY COMBINED(E 1,000,000 SINGLE LIMIT $ X ANY AUTO X X AS2Z11259976021 7/1/2021 7/1/2022 BODILY INJURY(Per parson) $ OWNED SCHEDULED AUTOSRE� ONLY AUTOS yy Ep BODILY INJURY(Per accident} $ _. DAMAGE AS S ONLY _, AUTOS ONLY (PeracEciident) $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS CLAIMS-MADE X X TH7Z11259976121 7/1/2021 7/1/2022 AGGREGATE $ 15,000,000 X DEO RETENTION$ 10,000 $ C WORKERS COMPENSATION X S7pTUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YrN X WCCZ11259976131 7/112021 7/1/2022 E.L.EACH ACCIDENT $ 1,000,000 pFICER/MEMaER EXCLUDED? N N/A 1,000,000 andatory In NNHH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Pollution/Environm PEC003704509 7/1/2021 r 7/1/2022 Each Claim/Aggregate 5,000,000 E Excess Umbrella 7017753637 10/1/2021 7/1/2022 Each Claim/Aggregate 10,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Job:Cape Cod Collaborative Charter School-Plumbing-1175 MA 28,Yarmouth,MA CJM Services Inc.;Cape Cod Collaborative and Rowse Architects Inc.are included as Additional Insureds on a primary and non-contributory basis for ongoing and completed operations where required by written contract.Waiver of subrogation applies in favor of the Additional Insureds where required by written contract.A 30 day notice of cancellation applies to ail policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C.J.M.Services Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Charles J.Morris ACCORDANCE WITH THE POLICY PROVISIONS. 50 Kerry Place P.O.Box 424 AUTHORIZED REPRESENTATIVE Norwood,MA 02062 gfi.99b.g—f I ACORD 25(2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: EAMANTI.01 MVERTENTES LOC#: 1 ACO$ REY ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License#1780862 NAMED INSURED HUB International New England E.Amanti&Sons,Inc. 390 Highland Avenue POLICY NUMBER Salem,MA 01970 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability insurance Equipment&Installation Policy#YM2Z11259976100: Equipment Leased or Rented from others,total Limit$400,000 Deductible$2,500 Installation Floater: Jobsite/Temporary Storage Limit$2,000,000 Deductible$5,000 List of Underlying Coverages for Umbrella Underlying Schedule: Auto Liability:Liberty Mutual Fire Insurance Company General Liability:Liberty Insurance Corporation Employers Liability: Employers Insurance Company of Wausau The Umbrella is Follow Form for Additional Insureds and Waiver of Subrogation per policy form#s: LC000010118 and LCU24070118 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Fold,Then Detach Along All Perforations i M WEALTH OF MASSACHUSETTS BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE BUSINESS THOMAS'A AMANTI . E AMANTI AND SONS INC +. 390 HIGHLAND AVENUE SALEM,MA 01970 #�#" J 108 11l10t2022 40695 E.. LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER„ E R o rW LEI4 7 Cl) crow° e t� o 07W 0,:,,,:i::,........,..'ili 4 :L G; .,......:xci3,,, 2.0 wili.h.„:„.„.:,:,..: .c:,..i.„:,-;i.:,,.,k::\,,,i,:.,',.:41,..i:,::i!ii:l..f!.:;::.,:.;'{:„,-:i,j‘,,,u.Dz Z >. J