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Home My WebLink AboutBLD-23-000837 /n eti iiX g1zq/zZ__ ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department •;:• . 1146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 ' '' .. '• Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only S; V Building Permit Number: BL,b-23'ot)37 Date Appli . '6--1.- - AUG 5 ZUZZ ►'`^ -'Q,p��y �Building Official(PrintName) Signature BUILDING DE--teaTMFh T SECTION 1:SITE INFORMATION 6''— — --_ _ ltirppertylAd �s r u� 1.2 Assessors Map&Parcel Numbers 1.1 a Is this an an accepted street?yes ✓no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private❑ Zone: — Outside Flood Zone? Check if yes❑ Municipal© On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2. caner'o ecord: \/ c a f r 1°an �rOl,11G1� pvr rn—�U14' Y�-• V t.� lvh/ ame Prmt 1 t.ovitAr iel.\ Ci State,ZIP esn,ZcvncA d 31• gS 1•')-;)a t564A. uptv\_ alb.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 f Existing Building a-;/ Owner-Occupied Repairs(s) 0 Alteration(s) ❑ I Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brie Description f Proposed �Voork S ns-kwA� rxe- 11 01 s . r ()Alt -crolt,,� SECTION 4:ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: (Labor and Materials) Official Ilse Only 1.Building $ i/ I l '� 1. Building Permit Fee:$1.5 6 Indicate how fee is determined: 2.Electrical $ 1.e r 1 41 Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ '35 • 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire ff Suppression) $ Total All Fees:$ " '\' 6.Total Project Cost: $ I ( 11� Check No. Check Amount: Cash Amount �� l LQ ❑Paid in Full NI Outstanding Balance Due: SECTION S: CONSTRUCTION SERVICES 5.1 Cos uct" n Supervisor License(CSL} l 3 J p J ')Yi o�s s's a t( Name of CSL Ho r tense Number Expiration Dale (o I 0,( �f,( / ef2kList CSL Type(see below) N . d Street Type , Description �(,�LG D3� o U ( Unrestricted(Buildings up to 35 00 4 cu.ft.) City/Tow ,State,ZIP R I Restricted 1&2 Family Dwelling (� �j M Masonry 1 o ' i►��/t�j _'P n1 RC I Roofing Covering /� WS Window and Siding qal' (0 e' O v�} SF Solid Fuel Burning Appliances Telephone Insulation Email address D Demolition i 5.2 R gistered Home Improvement Contractor(HIC) Bi ftm e o gistrant' Name HIC Registration Number Expiration Date arar yth i ''k [/i Ur'1l l .g3.3•[)0V Email - City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result inr the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes C No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize C6 n n orS to act on my behalf,in all matters relative to work authorized by this building permit application. AlckiK ero-Y\ck: S ) i i-)j) Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this plication is true and accurate to the best of ray knowledge and understanding. ja n OYS 5'Print Owner's or Authorized Agent's Name(Electronic Signature) t , Date NOTES: 1. An Owner who obtains a building permit to do bis/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will nor have access to the arbitration program or guaranty fund under M.G.L. c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) including( b garage,finished basement/attics,decks or porch} Gross living area(sq.ft.) Number of fireplaces Habitable room count Number of bathrooms Number of bedrooms Type of heating system N of halfibaths Type of cooling system Number of decks/porches Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" §TOWN OF YA'' " OUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231. ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at (.1-_ 1\ cLckOwil Work Address Is to be disposed of oat the following location: ( ,, . \C & MU) &4 I nvI\ke., k 1 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. 3 ` \, ' 21 )/ OAAIVIA,P\i- Sti ture of Application Date Permit No. Page 1 of 11 CT Reg#0605216 MA Reg#146589 RI Reg#26463 HOME SOLUTIONS 26 Cedar St Woburn, MA 01801 800-242-9974 Federal ID #20-2625129 Kohler Shower Contract Customer Information Alan Francis (Alan Cell): 239-281-2788 Date: 06/14/2022 Peggie Francis (Peggie Cell): 239-281-2787 Rep: Ryan Gaucher 6 Wildflower Ln (Peggie Email): Office# 401 829 5983 Yarmouth Port MA 02675 peggiefrancis99@gmail.com Location Agreement NEWPRO hereby agrees that it will, for the consideration hereinafter mentioned, furnish all labor and material necessary to install the goods purchased by Owner in accordance with the terms described on the following pages of this agreement (collectively, this "Agreement") at the premises located at: 6 Wildflower Ln Yarmouth Port MA 02675 Shower Details ,/ Package Kohler Shower to Shower Wall Color 1\ o White Base Size Non Kohler(36"W x 60"L) Center Drain Walls to Ceiling YES Threshold (Single Threshold) Base Color Non-Kohler White Fixtures Contemporary TrimNalve Q 1 Brushed Nickel Kohler 9"Shower Locker QTY 1 White Kohler 18" Straight Grab Bar QTY 1 Nickel Kohler Kohler Door 60" Barn Sliding Door w/Curved Towel Bar/Knob Handles(78" Height) Brushed Nickel Kohler Installation & Promotion Details Newpro will remove any demoed or installation debris from the property in relation to this contract. All promotions were applied at the time of purchase and can not be combined with any future offers. Discounts Senior Discount Applied Payment Total Price: $16,112 Deposit: $5,400 Due Upon Completion: $10,712 Payment Method: Cash Estimated Start&Completion Page 2 of 11 Estimated Start: 14 to 16 weeks Estimated Completion: 1 to 3 days Customer understands they will be contacted to set a firm installation date once all product is received. State MA Year Home was Built 2000 LSWP NO This space intentionally left blank Page 3of11 Renovate Right Pamphlet Receipt Alan Francis Peggie Francis 6 Wildflower Ln Yarmouth Port MA 02675 Your family's health and safety is our top priority! I hereby acknowledge receipt of the pamphlet, "Renovate Right." This pamphlet informs me of the potential risk of lead hazard exposure from renovation activity to be performed in my home. I confirm that I have received this pamphlet before any work began on my home. /.7%r g • Alan Francis Peggie Francis 06/14/2022 06/14/2022 Date Date Residential Exemption Clearance Form ENVIRONMENTAL PROTECTION AGENCY RENOVATION, REPAIR, AND PAINTING RULE Alan Francis Peggie Francis 6 Wildflower Ln Yarmouth Port MA 02675 The type and scope of the planned remodeling project is described further herein. On behalf of Newpro, the undersigned individual hereby states that the following exemption from the Renovation, Repair, and Painting Rule is applicable to the planned remodeling project: Work Performed on Paint-Free Surface. To exempt the work area as paint-free, BOTH of the following must be completed: On behalf of Newpro, the undersigned individual has personally examined the specific areas upon which the remodeling work will be performed, as well as any adjacent or adjoining areas (interior and exterior)that are expected to be impacted by the remodeling work. Upon such examination the undersigned has determined that there is no painted surface that will be disturbed, damaged, or otherwise affected or impacted by the planned remodeling project; AND By initialing after this line, the undersigned states that to the best of his and/or her knowledge, the areas upon which the planned remodeling project will be performed do not appear to contain any painted surfaces that will be disturbed, damaged, or otherwise affected or impacted by the planned remodeling project. Customer Initials Ar- NEWPRO Representative: I certify under penalty of law that the above information is true and complete to the best of my knowledge as of the date first written above. Ryan Gaucher 06/14/2022 Date ..... • .. . .. , Commonwealth ot Ma , fip Division of Occupation ure Board of Building Reaulations and Standards „ ! HIT ' Cons • ion S tiv - rvsor CS-110763 '--- '-/ -i spires : 05/05/2024 g4'ir • '' ii i 4, JEFFREY C(1111NOR-S..,„‘.". . .. *- , 64 OLD FIELD- ''' RD •• - SOUTH BERWJCK ME.:':;039C38 , , , . .... 'e4'1 74 - ' ' ' '') 4 IP:6 1. T..,..1/4,71::,I- ..„„ _ .., ..., .,,--t. . r,,, Commissioner 0-451o. i,r‘i'Lt I/1, 0 Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 021 110 Rome Improvement Contractor Registration Type: Supplement Card Registration: 146589 NEWPRO OPERATING.INO.LLG_ Empiration: 05104/2023 26 CEDAR ST_ WiOBURN,MA 01801 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR R6QI5iT360R valid for individual use only TYPE:awl:meat Card before the expiration date_ If found return to: _Registration Expiration Office of Consumer Affairs and Business Regulation 146589 05[0412023 1000 Washington Boston; Street -Suite 710 iJ1A 02,1 8 �7, 41 IPRO OPERATING.LW. 2 �3� 1 =R6'(CONNORS - fI lidi• without signature 3t�RN.ivii? 01801 Undersecretary / U 7j/j AC E, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/30/2022 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 NAME: Marsh Affinity PHONE FAX Marsh Affinity (NC,No,Ext): 866-237-4079 (NC,No): a division of Marsh USA Inc. ADDRESS: ADPTotalSource@marsh.com PO Box 14404 Des Moines,IA 50306-9686 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: New Hampshire Insurance Co. 23841 INSURED INSURER B: ADP TotalSource CO XXII,Inc. INSURER C: 5800 Windward Parkway INSURER D: Alpharetta,GA 30005 Alternate Employer. INSURER E: Newpro Operating LLC INSURER F: 26 CEDAR ST Woburn,MA 018010000 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 TYPE OFfNSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LTR W INSD VD (MM/DD/YYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO POLICY ECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAR _OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? N/A WC 024509800 MA 07/01/2022 07/01/2023 A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 (f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) All worksite employees working for NEWPRO OPERATING LLC,paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy.NEWPRO OPERATING LLC is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Newpro Operating LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 26 Cedar St Woburn,MA 01801 AUTHORIZED REPRESENTATIVE 111110 ACORD 25(2016/03) ©198t1-2015 ACORDtCOR O ION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4�' tom© CERTIFICATE OF LIABILITY INSURANCE DATE(htMtDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE72l3012021 CERIIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYT EaPOLICIESIS 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 CO TACT Melissa Pflug The Hilb Group of New England PHDNE (AID,No.all: (508)366-6161 ARC.No): 120 Turnpike Rd.Ste 300 massa mack)ntire.corn SS: Meli P@ SouthboroughINSURER(S)AFFORDING COVERAGE NAIL e MA 01772 INSURER A: Employers Mutual Casualty Co 21415 INSURED INSURER B: Newpro Operating LLC _ 26 Cedar St. INSURER C INSURER 0: INSURER E: Woburn MA 01601 INSURER F: COVERAGES CERTIFICATE NUMBER: 21-22 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 AUJL SUER LTR I TYPE OF INSURANCE INSO 1VVD POLICY NUMBER (1M/DDDYIYEYYY) (MM!OD�1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 CLAIMS-MADEXI OCCURDAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) 3 A MED E) (Any one person) $ 10,000 6D15090 12/31/2021 12131/2022 PERSONAL&ADV INJURY s 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER: 3,000,000 POLICY PRO- GEPtERALAGGREGATE s JECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER. EMPLOYEE BENEFITS I s 1,000,000 60MBI NE9 SIN6 AUTOMOBILE LIABILITY 6ELIMIT,,i ANY AUTO (Fa accident) $ 1,000,000 OV;RJED SOYkDULcD BODILY INJURY(Per person) II s AU A TOS ONLY xt SCHED 6Z15090 12/31/2021 12/31/2022 BODILY INJURY(Per accident) I$ X HIRED X NON•OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE I S (Per accident) X Uninsured motorist BI 15 250,000 UMBRELLA LIAR OCCUR u♦,.,,,. EACH OCCURRENCE I$ 5,000,000 A EXCESS LIAR Ct A Ms-htADE 6115090 12131/2021 12/31/2022 AGGREGATE I s 5,000,000 GED X RETENTION 5 0 WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY Y!N STA XI PERTUTE I I ER OTH- ANY PROPR1ETOWPARTJEDIM,ECUTIv2 A O r10ER/F:,Etd3ER EY,CLUDED? N N!A El.EACH ACCIDENT 500,060 (Mandatary in NH) dyes,describe under EL.DISEASE-EA EMPLOYEE 5 500,)00 DPe describe OF OPERATIONS below E.L.DISEASE-POLICY LIMIT _s 500000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Contractor/Carpentry/Siding Install 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. AUTHORIZED REPRESENTATIVE I ' r . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • Department of Industrial Accidents F7 Office of_investigations , ' Lafayette City Center • �' ;; 2 Avenue de Lafayette, Boston, 0 -17s0 ;.,,�,a' www inassegov/€pia Workers' Compensation insurance Affidavit: B riers/Contractors/Elec cim s/Plumbers Applicant information Please Print Legibly Name (Business/Organization/Individual): NEWPRO OPERATING LLC Address:26 CEDAR.ST City/State/Zip:WOBURN, MA 01801 Phone.:781-933-4100 Are you an employer? Check the appropriate box: Type of project(required): 1.Q I am a employer with 20 4. f( I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. Ok_emodelin0o. ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. nBuilding addition [No workers' comp. insurance comp.insurance.= required] 5. 1 i We are a corporation and its 10.0 Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their 11.D Plumbing repairs or additions myself [No workers' comp. right of exemption per MMGL Roof repairs insurance required.]"t c. 152,§1(4),and we have no L . Other employees. [No workers' comp.insurance required.] 1Any applicant that check box#1 must also fill out the section below showing their workers'compensation policy information. 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. Tana an employer that is providing workers'compensation Bi2,urna"ic for 312y employees. Below is the policy and job site information. ` Tnszrarlce Company Name: NEW HAMPSHIRE INSURANCE CO Policy#or Self ins. Lie.#: WC 024266477MA Expiration Date: '-01-202L Job Site?address: Le W1 at �� City/State/Zip:lia,✓V1ilm(/ LP.047' l� At ach 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 cep j z d th d naities of petzzry that the i formaz'ioiz provided above is Erne and correct. Signatur • e1,✓ ''� -� Date: 5.-` Phone#: 781-933 .100 Official use only. Do not write in this area,ea,to be completed by city or town official City or Town: PermitLicense ` Issuing Authority(check one): 1DBoard of Health 20 Building DepaL Latent 3004/Town.Clerk 40 Electrical Inspector 5.Phhi bing Inspector 6.0Other Contact Person: Phone#: ATTN: Building Dept. To Whom it May Concern, I have attached a pre-paid return envelope with this building application. Once this permit has been issued, please send the permit back to me in the enclosed self-return envelope. I appreciate your help with getting these permits back. In case you can not send the original permit back, would you be kind enough to send me a copy of the issued permit, as it is very important to me to obtain a copy of the issued permit? If you prefer to scan a copy of the permit and email it back, that would be fine also. Whichever is the easiest process for you. If you have any questions or concerns with the above request, please do not hesitate to reach out to me directly to discuss. Best Regards, Cathy Bedard Permit Services LLC 224 Broad St. # 2-L Cumberland, RI. 02864 cathy@permitservicesne.com Office: 401-601-7400 km- I '51‘ I 14 6. a Pi . .ci,,bel f \ P - cill1/4. • '?, 1 ? tit 1 1 i 1 1 i) ( ? i 1 1 1 \ ", ...i,..... N„, 1 A ' i . 1 i , t t' N 1 . i t I i 4 1 { 1 . . , 44:01t- .., t N . Cr- 1543f4N ,... ,1,_:, BUILLiNCi QFFICIAL __, Page 1 of 10 HOME SOLUTIONS Kohler Shower Work Order Customer Information Alan Francis (Alan Cell): 239-281-2788 Date: 08/02/2022 Peggie Francis (Peggie Cell): 239-281-2787 Rep: Ryan Gaucher 6 Wildflower Ln (Peggie Email): Rep#401-829-5983 Yarmouth Port MA 02675 peggiefrancis99@gmail.com Bathroom 1 Package Includes 3 Walls, 2 Inside Corners, 2 Edge Trim, Drain, 3 Wall Repair, Floor Repair, Drain Conversion 1 1/2" to 2" (on Tub to Shower only), Shower Base (except on walls only) Shower Measurements Package Kohler Shower to Shower Wall Color White Base Size Non Kohler(36"W x 60"L) Center Drain Walls to Ceiling - Room Height YES - 92 Threshold (Single Threshold) Left Side Wall Width 30 Base Color Non-Kohler White Left Surround Width 30 Opening Length x Base Width 60 x 30 Right Side Wall Width 30 Additional Details Right Surround Width 30 Fixtures Contemporary TrirnNaive QTY 1 Brushed Nickel Kohler TLS97077-4-BN,23938-BN, (23937BN/Tub) 9"Shower Locker QTY 1 White Kohler 97630-0 18"Straight Grab Bar QTY 1 Nickel Kohler 80001018-N Panels&Connectors 38"to 48" LuxStone Panel Swap QTY 2 White Kohler Door 60" Barn Sliding Door w/Curved Towel Bar/Knob Handles(78" Height) Brushed Nickel Kohler Installation Instructions .eft Wall Wall Repair- 9" Shower Locker Back Wall Wall Repair- 18" Grab Bar Right Wall Valve - Shower Fixture - Wall Repair Additional Details Please confirm locker& bar location on install day Page 2 of 10 Pre-install Checklist Variance Required NO Property Type Condo/Townhouse WITHOUT Own Shutoff Parking Options Street -Visitor Parking (Condo) - Small Driveway Fixture Install Shower Head Only Curtain Rod or Glass Doors to be Installed Glass Door Bath Location 1st Floor Existing Base Type Fiberglass Existing Walls Fiberglass Is there access behind wet wall or below base? NO Ceiling Panel/Soffit NO Window Within Wet Area NO Wainscoting/Accessories NO Second Full Bath YES Additional Items to be Installed None Are there any existing problems with the plumbing? NO This space intentionally left blank Page 6 of 10 'ma•e: 1.4 _ . ,,,r,..,, ....,. Jf.,,,,,,,-.:_,,,.::;.„... . -....'.1:',..:,:g.:;.::::,-7,-,:-:-1,...1-.: . ...„....,. ..,„.„....- .,-....,- :.,,-. ..„.::..„. `. do-' ' = _ - '2, 1 4 ,P h R�'S �.�a 7 3.. - sx - al l%t - 1 —� __ t 0 \ \ a � 1 Page 7 of 10 Image: 1.5 ,,, '1,--;,,,I...,:',.'",::::.,..,ii:,,,,‘:„.,,.1.4.7....:7„,„:,-,,,,,-1:-..."......‘.,...•-'-'-,--•:,:-;„-..,,-„,„,._,-.,,....,,_.. , } sP r'. ea ,',":„...:-..i,',.'',':,:,?1,„.',.:';..,-'''..,,.:',...::...,.;.;:;f1;1.;:;1- r b N `e F P S. \• li i l.!.::''''-'' - :--ir';1-: ., % . . 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