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HomeMy WebLinkAboutBLD-23-000410 ONE & TWO FAMILY ONLY-BUILDING PERMIT Town of Yarmouth Building Department of r 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 Onl Building Permit Number: D-d --CbOLI I U Date Applied: Building Official(PrintName) - ignature Date SECTION 1:SITE INFORMATION 1.1 Property Address: f, , 1.2 Assessors Map&Parcel Numbers 3 oote (ben V 1.1 a Is this 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 Y g g E l v E D Required I Provided Required Provided Required d iUt 2 6 2022 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal ystem Zone: Outside Flood Zone? Public 0 Private 0 — Municipal El On site di os4L steat-l------ Check ifyes❑ 11 WING DEPARTMENT SECTION 2: PROPERTY OWNERSHIP'2.1 Owner'of Record: i) �SAJ IAV t D if 64 �6GGAI G 'Attiwd tea(' 1!' 1t /7 6- Name(Print) City,State,ZIP 3 014 6'l 111 1f/L;4 t So( so-6137 yea a cds€C97x.egJ7l/j No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK-(check all that apply) New Construction Q I Existing Building El Owner-Occupied 01 Repairs(s) 0 Alteration(s)4.1 I Addition 0 Demolition 0 I Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: k GAe l f . -re in) la L.L°r- r SECTION 4:ESTIMATED CONSTRUCTION COSTS. Estimated Costs: Item Official Use Only (Labor and Materials) - v 1.Building $62 ( 7 5' 1. Building Permit Fee:S I SO _Indicate how fee is determined: r,�3 / Q �/� 'Rl Standard City/Town Application Fee C 2.Electrical $ g, uj, U v ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ ai 57 s,6 6 2. Other Fees: $ 35 C K - Z 1 Co 4.Mechanical (HVAC) $ 11 13-0, 0-0 List 5.Mechanical (Fire $ . -.. . - Suppression) Total All Fees:$ �/ ll Check No. Check Amount Cash • , lit.:6-Total Project Cost: $77��a�,�D ❑Paid in Full IR Outstanding Balance Du :\\0 5.C. /\\I"\1;1 s &--G /9_ '73S-1/ CiLL-e*-SO 39 V— /oa cU SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS—lI 636.2- 3-1-g'Jr Loh'/ t� �f( C,a tl/ License Number Expiration Date Name of CSL Holder 76 ,/►�yf Ei,f yp jp List CSL Type(see below) allo.and Street /V pvl�—� Type Description LU v( R4"W i,,/ 1 6 0j`7 S U I Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP�1 1 U" �-v R Restricted I&2 Family Dwelling Masonry RC Roofing Covering WS Window and Siding /� SF Solid Fuel Burning Appliances so-3? t/�� n 7 I g fo4 o 1(-.Q/It-c am 1 L, (. i Insulation Telephone Email addEss D ! Demolition 5.2 Registered Home Improvement Contractor(HIC) ,Fq 3 nb /i ILEA) Pp " Ay` vNC3-6bi1JKtufk HIC Registration Number Expiration Date FIIC Company Name or HIC Registrant Name %6 1414,80N Jam- .1-9 gn44J, riot yW,an Street1/2140i tl-tA 62 �3 �D��3q -g,6 Emailada4�ess City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(iVIG.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes 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 )( J )AM L.( LAJ to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER1 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 application is true and accurate to the best of my knowledge and understanding. LD 4/it1 PLL±A) ?-cu- Print Owner's or Authorized Agent's Name(EIectronic Signature) Date 1 NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not 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.sov/oca Information on the Construction Supervisor License can be found at www.mass.stov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 3�a (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) .13e1 a— Habitable room count Number of fireplaces g Number of bedrooms Number of bathrooms . _ Number of half/baths Type of heating system RACED An-D1t Number of decks/porches 4- Type of cooling system C A117XA(. Enclosed L Open ,; 3. "Total Project Square Footage"may be substituted for"Total Project Cost" z\ The Commonwealth of Massach usetts Department of IndustrialAccidents Office of Investigations 3. ' Lafayette City Center - --r1 4,-; 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): Loraine Killen Address:76 Hemeon Dr. City/State/Zip:West Yarmouth, MA Phone#:02673 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. Q I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp. insurance.: 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 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *My 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. tContractors 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: Hartford Casualty Policy#or Self-ins. Lic.#:08WECCU3392 Expiration Date: 10-4-22 Job Site Address: 3 Oak Glen Village City/State/Zip:YarmouthportMA02675 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 under the pains n penalties of perjury that the information provided above is true and correct. Signature: Date: 7-at- Phone#: 508-394-4020 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): 11:1Board of Health 2❑Building Department 3.❑City/Town Clerk 4.0 Electrical Inspector 5E1Plumbing Inspector 6.DOther Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 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 3 g ,611 L t Li4 Gf yA ie Pmtr Work Address Is to be disposed of oat the following location: Aid 1 g-F D JG zA 2- Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature of Application Date Permit No. ' DAVID RICARDI design — build PO BOX 1051 1582 MAIN STREET EAST DENNIS,MA 0264 I PROPOSAL Kitchen Remodel Submitted to: Sandy and Dave Young 3 Oak Glen-Kings Way L Job Name Young Yarmouthport, MA Date January 25,2021 Kitchen Cabinets Manufacturer: Showplace Cabinetry Door style: Full Overlay, Edgewater door style $36,857.71 Drawer style: Matching five-piece Wood species: Maple Color: Pure White- Uppers, Tall cabinets and moldings Smokey Blue- Lower cabinets and toe kick Box construction: • All sides, backs, tops and bottoms are 1/2" birch plywood with clear natural finish. • Face frames are 3/4" solid maple with mortise and tenon joints. • Doors and drawer fronts are solid maple. • Shelves are 3/4" birch plywood with natural finish. Shelves are adjustable. Drawer construction: • Drawer sides, fronts and backs are 5/8" solid birch with a clear natural finish. • Joints are dovetail • Drawer glides are full extension soft close. Molding: 2 1/2" Crown molding to the ceiling with soffit Toe kicks: Matching 1/4" plywood Glass doors: Yes- bar area Hardware: To be selected P: 508-619-7384 F_ 508-619-7385 davidricardidesigns.com X Page I of 5 'DAVID RICARDI design — b iickik PO BOX 1051 1582 MAIN STREET EAST DENNIS,MA 02641 Cabinet Installation: • Includes wall and base cabinets • Crown molding, light rail, toe kicks $7.937.00 • Adjustment of doors and drawer fronts; all nail holes will be filled to match. Kitchen Countertops Allowance: Manufacturer: Material: Quartz Color: level 7 color $5,336.85 Edge treatment: To be selected Backsplash: 4" loose Sink cut outs: Finish under mount kitchen Quote includes: template, fabrication, installation, finish sink cut-out and holes drilled for faucet. Wood Countertop Allowance: • Cherry wood top to be templated, fabricated and installed • Includes the mudroom bench, wall cap and dining room $2,700.00 sideboard Demo and prep: • Prepare home for renovation • Disconnect electrical and plumbing on appliances $6,831.00 • Remove existing appliances. • Remove countertop • Take out existing base and wall cabinets-save in garage • Remove tile backsplash and patch walls • Widen pass-thru window to approx. 60" wide • Remove pony wall • Remove paneling on wall in bonus room • Prep walls ready to receive new cabinets. P:508-619-7384 F 508-6!9-7385 davidricardidesigns.com Page 2 of 5 x ' DAVID RICARDI design — build 1.1111 PO BOX 1051 1582 MAIN STREET EAST DENNIS,MA 0264! Plumbing Allowance: • R/F for new double sink and faucet $2,575.00 • R/F for existing dishwasher • R/F for gas stove • R/F for wall oven and microwave • R/F for existing refrigerator • Permit required Electrical Allowance: • R/F for new microwave $8.910.00 • R/F for new wall oven • R/F for existing dishwasher • R/F for new vent hood, vented through the roof • R/F for new wine fridge • Upgrade new appliances to the electrical box. • Provide and install 10 recess lights • Provide and install under cabinet lighting • Install outlet in dry bar area • Permit required HVAC: • Vent new hood through the ceiling to exit through the roof • Supply proper roof vent $1,150.00 • Seal roof vent P: 508-619-7384 F: 508-619-7385 davidricardidesigns.com Page 3 of 5 X ' DAVID RICARDI design — build PO BOX 1051 1582 MAIN STREET EAST DENNIS,MA 0264 i Appliances: • Notes: Appliances will be supplied and paid by the homeowner. • DRD will install the refrigerator, dishwasher, gas range, wall oven $600.00 and microwave. Materials: • '/z" Drywall $375.00 • 2 x 4's • Miscellaneous Dumpster: • 8 yard dumpster supplied on site $875.00 Permits: • Permit required $675.00 Sub Total: $74,822.56 Tax: $2,637.16 Total: $77,459.72 P:508-619-7384 P: 508-619-7385 davidricardidesigns.com Page 4 of 5 X DAVID RICARDI tlt'Sifwtl lttttltl By; Date: lx 5 (nL Kimberly Tiiio Manager/Member David RicArc l Desiess LLt 1582 Main Street East Dennis,MA 02641 ACCEPTED BY DATE All knobs/pulls need to be on site the day of install for job or additional charges Neill be incurred. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements are contingent upon s les,accidents,or delays beyond our control. Owner is to carry tire, tornado,and other necessary i ranee. Our workers are fully covered by Workman's Compensation insurance. Authorized Signature: Note:This proposal may be withdrawn from us if not accepted within 30 days. Acceptance of Proposal:The above prices,specifications,and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment wilt be made as outlined above. Signature: I P 508619 7384 F.508619/385 clavtciHt.u11“1,-icl1t<<uni t'A(1t S ui S x AdD® MI® DATE(MDDIYYYY) Ad CERTIFICATE OF LIABILITY INSURANCE 6/13/2022 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 RogersGray, Inc.-Kingston Branch PHONE FAX 63 Smith Lane INC.No.Ext):508-746-3311 (A/c,No):877-816-2156 Kingston MA 02364 nooeess: mail@rogersgray.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Sentinel Insurance Company,Ltd. 11000 INSURED DAVIRIC-01 INSURER B:Arbella Indemnity Insurance Company,Inc. 10017 DavidRicardi Designs LLC POOBoxx1051 INSURER C:Hartford Casualty Insurance Company 29424 East Dennis MA 02641 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1013059196 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 OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD (MM/DD!YYYY) IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 08SBANW5605 10/5/2021 10/5/2022 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $1,000,000 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 MI: LOC PRODUCTS-COMP/OP AGG $2,000,000 JECi OTHER: B AUTOMOBILE LIABILITY 1020041310 5/6/2022 5/6/2023 COMaaxBINidEDenUSINGLE LIMIT $1,000,000 (E ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION 08WECCU3392 10/4/2021 10/4/2022 X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100,000 OFFICER/MEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Insured Location: 1582 Main Street,East Dennis,MA 02641 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. Town of Yarmouth 1146 Route 28 AU ED REPRESENTATIVE South Yarmouth MA 02664 '� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff .&Business Regulation HOME IMPROVE t, ONTRACTOR Re.istt Lv :F =•' tion 189 ' =Va KILLEN COMPANIES) tr yy ii a ',; •-7-"---;;:-." -___:--------::: ' LORAINE KILLEN _ 'r 76 HEMEON DR. �V — — 4 ✓ius'(.G WEST YARMOUTH.MA mi;,�` .9 k'" Undersecretary Commonwealth of Massachusetts 1,0I Division of Occupational Licensure Board of Building Regqulations and Standards `I Cons iotaI1 Srvisor CS-116362 E'�`cpires::3. /01/2025 LORAINE KILLEN 76 HEMEON DRIVE W YARMOUTi MA 02673 rti��f.L�'�1�,1 € Commissioner '-'crlat f. biFn , f B6, f t 361, f „ f ---, N , . //.I \ % Y. N_ 1 i � I o 0C < � „ I E.': s I f o CAa0 - o Ill 1 1 O co 9 1.r J1 N L84ZN1f1Z L 4 = c O O - v � F r�_ _ t . i ,O' . G t� 1 ., `, N . O CA Ii/ 81 /I CA 1 ' i NN Y ` I - C \ _! 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