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HomeMy WebLinkAboutBLDSM-23-003918 RECEIVED [- SHEET METAL PERMIT JAN 18 2023 tg 41 Commonwealth of Massachusetts BOILA r-� `$ I i sJ By. - c` , Town of Yarmouth Building Department 1146 Route 28, South Yarmouth, MA 02664-4492 Date: i- l - & 3 Permit#: h L5YY1-Z 3-(ADr3 (� Estimated Job Cost: $ rj`K Permit Fee: $ ,' 7j.�O Plans Submitted: NO Plans Reviewed: YES/ NO Business License # Qa,q _c,y - G /l a Application License# Business Information Property Owner/Job Location Information Name: ClivltosA CQSSQr‘O Name:C8O,0Jier I / fflarls + Nayicy Street: t©fo Bay PjckQ,Q d,r. Street: G3 W`ic3QCr (`e G C City/Town: , '0e4\ d0,2640 City/Town: T'y n S 13OCG t (1r)C� Telephone: j 0g - 7 3 7-67�'I Telephone: 6-v6 - qt4 - s-3 3 7 6) 10 �ot3S t4C.z i eif1-. ,ie 3 O L I tA;?S - Dr, Son Vour-m. Photo I.D. required/Copy of Photo I.D. attached: i( YES NO Staff Initial: J-1 40 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.N4 over 10,000 sq. ft. Number of stories: 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: - -Thstalt s y arc, Morn ptyt1 e 'tr1 r aroly c'elnovatid a - �-Iocr. Ootl Q13 cvv\ o j' , e x' 11 `(1eC1�`�t\ 6 y biOrvt had d c c is Wr\ L,p 'O� toiv e R- g- aixik- we aid e dill beuSd„ 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- ,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: Y' Master (OI,L,j aCPLIIVA Title: Master-Restricted Is Signature of Licensee City/Town: Journeyperson Permit#: Journeyperson-Restricted License Number: L.c)a D, Fee: $ Check at www.mass.gov/dpl '1 Inspector Signature of Permit '` of Permit Approval ACORD® DATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 12/14/2022 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). __J PRODUCER Benson Young&Downs Ins CONTANAME:CT Janice Sawyer 565A Route 28 PHONE Fat). (508)432-1256 IA CAC No):508-430-1532 (AiP 0 Box 158 E-MAIL janice@byandd.com ADDRESS: Harwich Port MA 02646-0158 INSURERS)AFFORDING COVERAGE NAIC# INSURER A:Hartford Fire Insurance Company 19682 INSURED INSURER B: Clinton Cassano Cassano Heat&Cooling _INSURER C 106 Bay Ridge Drive INSURER D: South Dennis MA 0266D- INSURERE: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE uNgn wvn POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY)A X COMMERCIAL GENERAL LIABILITY 08SBMAC7640 02/16/2022 02/16/2023 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED 1,000,000 CLAIMS-MADE OCCUR PRFMISES(Fa occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 _ X POLICY JECT I LOC O- 1PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Fa accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Par accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE /GGREGATE $ _ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATIJTi FR -.__ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Heating and Air Conditioning CERTIFICATE HOLDER CANCELLATION Al 11500 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 1 COMMONWEALTH OF MASSACHUSETTS ‘1. DIVISION OF OCCUPATIONAL LICENSURE MASSACI1USETTS DRIVE1T_$ :.::..if•..:f.- • BOARD OF ,,,-, ' L, ,,, LICENSE ,_ ._,_ - • Jr f,fe, PLUMBERS.ANDGASFITTERS ISSUES THE FOLLOWING LICENSE ::''. .' ' - 0411812018 S99330416 , Exp :i DOB JOURNEYMAN PLUMBER m - 04118/2023 0411811969 1.- < gAss 12.4.5, . END NONE ..C.UNTON R CASSANO 0 • -th. .....-:: ..*.106 BAYRIDGE.Mt: w -w 1 CLINTON T, SOUTH:DENNIS,MA 02660-2843 A z 106 BAYRIDGE DR .,. IA ivitan S-'-) -,,, 1 s. S DENNIS,MA 02660.2843 bem Goty)...ell rEtxsmBROHGT .:)4.1N631,:r3 DD 04/1812018 Rev 0212212016 31978 05/01/2024 ...-.--..b. '.: 240349 , ::.:::: LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER •