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HomeMy WebLinkAboutBLD-22-007180 Couve- Lfis/L 0.,--:1�4>. Pa (///7/12_ Office Use Only A.,: 7.,„ Pennidt dill/ 5 � P 0 `' Qc� Qp •+�a�_• Iy Amount ,5—), ) ....0,,,,.......:,,,-_,,, +. .,u y Permit expires 180 days from issue date 1 -- _ M ?/ EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department RECEIVED 1146 Route 28 South Yarmouth, MA 02664 JUN 1 o 2022 (508) 398-2231 Ext. 1261 BUILDING DEPARTMENT CONSTRUCTION ADDRESS: 'G(.r br]W t' By.- ---- ASSESSOR'S INFORMATION: Map: c� Parcel: OWNER: jc tj: `e_ ;,AS' 4�-( PeEr ✓ c) t'-1 ve S /q rYl~.?,u4 /1* - NAME PRESENT ADDRESS TEL. # CONTRACTOR: ( f2i/0 (?d i MCf7'1 /s daltj 4t//- 10I/11 rer At-L /Z t /%16//333 NAME MAILING ADDRESS TEL.# esidential ❑Commercial Est.Cost of Construction$ ( Home Improvement Contractor Lie.# ft /'Z 75 Construction Supervisor Lic.# S /o(9-9/Z Workman's Compensation Insurance: (check one) 0 I am the homeowner 0 I am the sole proprietor 111/fhave Worker's Compensation Insurance Insurance Company Name: C IV Ac Worker's Comp.Policy# to i2 e/ /6 7 7/ 7 WORK TO BE PERFORMED Tent II Duration (Fire Retardant Certificate attached?) Wood Stove 111 Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares a to.t/ (0)Remove existing*(max.2 layers) Insulation n n Old Kings Highway/Historic Dist. (Q)Replacing like for like Pool fencing n ♦ *The debris will be disposed of at: Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial or/yocc�attii n�of�my license and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: � %a��'� Date: /G/,2 b 2 Z.- Owners Signature(or attachment) `�' " Date: 6,23., Approved By: Date: Z� 2_ Building Official(or igne EMAIL ADDRESS: Zoning District: !'/U/'f/til(J ti-Yii Historical District: Yes _ No Flood Plain Zone: IT Yes No Water Resource Protection District: Within 100 ft.of Wetlands: 4 J 7— 02 9/ - - Yes No 7. Yes No The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Corolla Contracting Name(Business/Organization/Individual): ,INC Address: 15 Bates Ave . City/State/Zip:Winthrop MA 02152 Phone #:617-561-1333 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 30 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or listed on the attached sheet. 7. ❑ Remodeling partner- shipand have no employees These sub-contractors have g ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. El Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.D(Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.®Other comp. insurance required.] 'Any applicant that checks 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 :mployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. ram an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: C.N.A. 'olicy#or Self-ins.Lic.#:6081169717 Expiration Date:6/23/2022 fob Site Address: a ( ` CII c 3 [IOC City/State/Zip:5- la iwA:t 1 14 -- kttach 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 one 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 )f up to$250.00 a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. r do hereby certify u de the and penalties of perjury that the information provided above is true and correct. Signature: Date: 4 /, 2/2 02_2_ 'hone#:617-561-1333 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: juNSO COMMERCIAL & RESIDENTIAL ,410 COROLLAROOFING SPECIALISTS Customer Satisfaction Is Our First Priority RO: oJiii : - 15 RATES LLAR PH: (617)561-1333 WINTHROP, MA 02'152 PH: (617) ,561 4726 WWW.COROLLAROOFING.COM SALES(q�COROLLAROOFING.COM Steve& Roula Kerins June 1,2022 21 Par 3 Drive So. Yarmouth,MA 02664 skerins123( gmail.comr Subj: Roof Replacement ,I nJ�( 21 Par 3 Drive T /ii?Z So. Yarmouth,MA 02664 Corolla Contracting, Inc. proposes to furnish all labor,materials, & equipment necessary to perform the following scope of work at the above subject location: 1) At the Main Shingle Roof, front and rear shingle roof sections,rip and remove existing shingles & flashings down to wood deck substrate 2) Replace any damaged or rotted wood deck at a unit cost of$4.50/LF. Re-secure any loose deck boards. If existing roof deck is plywood,replacement cost is$140.00/Sheet. 3) Furnish& install new 8"white aluminum drip edge at all outside perimeters. 4) Furnish& install Ice& Water Shield 3 Ft. @ eaves,and 3 Ft. @ valleys 5) Install new Synthetic underlayment over the remainder of the wood deck. 6) Install new Certainteed 30 Yeac Lifetime Architectural Style shingles. Re-flash 1 chimney which will include new step flashings and lead counter flashings& 1 plumbing vent 7) Install new hip&ridge vent at the peak 8) Install new PVC Trim @ the roof to wall details 9) Clean up and properly dispose of all debris caused by our work 10) Proposal includes Contractor's 3 Year Warranty on Workmanship. All materials are guaranteed to be as specified and the above work to be completed in a substantial workmanlike manner for the Lump Sum Cash Price of Thirteen Thousand Two Hundred Dollars($13,200.00). With payments to be made as follows: 50%Upon Mobilization& 50%Upon Completion,30 Days from invoice. Note: Existing gutters & downspouts are not included in price Note: Existing Sun Awning on back porch is to be removed by Owner Respectfully Submitted: Robert J. Corolla Jr., President ACCEPTANCE OF PROPOSAL Signature: te: f: i. Commonweattn or Massachusetts Construction Supervisor Division of Protessional Lkcensure Unrestricted -Buildings of any use group which contain Board of Bund�ng Reguiahons and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed •-: ;iion Super.,isor space. �29 t u Exp,r� ROBERT J COROLLA 15 BATES AVENUE WINTHROP MA 02152 111161116 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner For information about this license Call(617)727-3200 or visit www.mass.govldpl k 0 ) ¢ / ; \ 0 c E \\ ) \\\ § jX 7 a a,5 2 _ k§ k co 0 O o �_ ®k\ D k�k/ 9' k $ k W \{]\ 5 e @ 0 Lnf o • o �\k2 k « G' m \ koi-# 13 C " } §/\ k % -. = XC 0 CO 0 Z$ 0 % - E c ® er )ƒ ° • \ o �/�jE E / \0 I- co c§ \ = 2a. ko � ° / 7 ¢ / d� • \ 2 CO _R / 0 R w ■Ce \ D ( ;1- . CO J®\ 2§» x& R/ 20# C. 0> 0za / O<0 .uJo / 0// /�� ® � 0 \ G �c2 ;��—G / um§ or- c§ � e ©_ O�¥ G& 0 0w2 \< 00 £ I \ ebE o IX 0 E2a