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HomeMy WebLinkAboutBLDR-24-370 ONE & TWO FAMILY ONLY-BUILDING PERMIT Town of Yarmouth Building Department o Y``4' 1146 Route 28, South Yarmouth,MA 02664-4492 .$ 508-398-2231 ext. 1261 Fax 508-398-0836 ;� - y Massachusetts State Building Code,780 CMR -._' ,' Building Permit Application To Construct, Repair, Renovate Or Demolish ,ti�o.rrAc�EEs.b�" RPORA7E0 a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: JbLbj2_,,z4 --3"7 D_ Date Applied: Building Off ' rint Na Si re Date SEC N 1: TE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers a 9 Chess St 70 //-2./ 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: RECEIVED Zoning District Proposed Use Lot Area(sq ft) Frontage ft) it gi 83- 4, 1.5 Building Setbacks(ft) J U L 1 0 2024 Front Yard Side Yards Rear Yard Required Provided Required Provided Required I. B U I L Ci,I N G u N' 1-i 11A E N T roved 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owneri of Record: --lay., f ,'14-Ry G.' 2Etc SwI yiF2..,0c.4 atll. Name(Print) City,State,ZIP a? C.rtzt-zg S 5-1--. Ste-9R/-4/a9% noicxgrziEz.aDxfru,s00 A' No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Cl Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s)' Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: i.r•,. -114 k; .ctty -k k\--c. .—ct t (a_e_m,c0 Lief Cc cl 2 ` I/-fe r...awl o - Pre_t C.' &J iv s, e_vi-vv , Aio2 P-' c e, . SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 30 acr. 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical $ 60, S 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ :: t}Vt 2. Other Fees: $ 3 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees:$ Suppression) Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ L�� ' 1 0 Paid in Full CI Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) &),./%,ram SC-4,s t r 7/ License Number Expiration Date Name of CSL Holder �, - w zJ Q/� List CSL Type(see below) ✓l • No.and Street Type Description Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) E LS/Rxr= `bsi S HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 9'9 SA /2d. CO s- -C -k_ No.and Street Email address S4401.toat. ,3` et . d'f- 5W8'- "t 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 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 �.�,� njc�,�.�..�,4- to act on my behalf,in all matters relative to work authorized by this building permit application. S C� 4 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby att- t under the pains and penalties of perjury that all of the information contained in'' . : is true a i< . curate to the best of my knowledge and understanding. Print Owner's or Authorized Ag- (Electronic Signature) Date NOTES: 1. 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 H1C Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts Department of Industrial Accidents urnHl= Office of Investigations Lafayette City Center 2 Avenue 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): ( 4-PE. 1Z �.C�L Address: ?9' City/State/Zip:5960/0Z et4di ( )5 ) Phone #: �76-2- Are you an employer? Check the appropriate box: Type of project(required): 1120 am a employer with / .-- 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. ❑ Remodeling 2.El 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P ty. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ElWe are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.0 Plumbing repairs or additions 3.El I am a homeowner doing all work 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.] *Any 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. *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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: '}l Policy#or Self-ins. Lic. #: 6( )c 3/.S3fg9e t'Oe / Expiration Date: C �,Q P Job Site Address: 2' CAi4-24-S $E City/State/Zip: Sow f/ 2 ,4! . ,414 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ai s and penalt es of perjury that the information provided above is true and correct. Si azure: Date: 0 7T- LU j/��io2�f Phone#: OS'$S'gS -4c o 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): 1❑Board of Health 2❑Building Department 31:City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone #: ga TOWN OF YARMOUTH �p - r ;47.ti\ Office of the Building Commissioner O kH" � ro �� 1146 Route 28, South Yarmouth, MA 02664 �FnOEO� a� Ht ` -i 508-398-2231 ext. 1260 Fax 508-398-0836 DEMOLITION DEBRIS DISPOSAL APPLICATION Pursuant to M.G.L. c.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. o '7 C -rz/£S 517' S, 4 2,--c c:,c1-4 1,,,q. Work Address Is to be disposed of at the following location: ON- 5--r Z. 1-`2 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 1 l 1, § 0' . / lir 0` -/0 Signature of App i Date Permit No. / 272„" / Top Trim Detail / 43' / 38=" / O2-" X 42' f 85" 1 g• a 1/4FCR CROWN __________._.__._______._ ___.__.__. .. 41/4FBP N. \ �•� --__------------- \ lay over 1/2•TO 3,4' �FOR FRIEZE BUILD-UP W2739 \c��OII j W3039 W3039 I\' ' FLS I ( <--INSET CABINET ,,, TRU241T9 T 1 .,j_ DOOR C48L-WS ( -SRX8631NB5frB12R B30-3 �I + B18-3 627-FRO a I 'tom _i PYE22KYNFS I' I N m CI- CEILING HT.IN THIS AREA IS 98" w , w d a MARY&JOHN GREICO O O 29 CHARLES ST. O SOUTH YARMOUTH O (7 a :LL,La 8330 827-3 B27-3 < VAULTED ;I_ , � m i2.. �� ,�„ � CEILING I m �, NOTES TOlNSTALLER: CD a 21 f !-I _.1 N 1. INSTALL 41/4FBP FURNITURE BASE AT ALL _ _ FINISHED ENDS TO FLOOR. \ _ L I 2. CUT 4 1/4FBP FURNITURE BASE DOWN TO j 1 •1•' TOE KICK HEIGHT AND INSTALL ON ALL SIDES OF ISLAND. = i _ 3. 3/4UC TO BE INSTALLED AS LIGHT RAIL. Q o — 4. INSTALL CHROME DIVIDER IN TB12R 5. INSTALL 6"FILLER PULL-OUT SPICE RACK IN ISLAND. N h \ I 6. CENTER FLOATING SHELVES ON WALL 1 UT3693-RT HM850152UC••. 047-61024 , 836. �, \ ! N SPACE. 'I ,_ '" 7. HARDWARE: TO BE DETERMINED W3639 W3639 j 8. APPLIANCES: N N. ,, .-. T —___.... N GAS RANGE-GE PROFILE PGS960YPFS 30" I r SS HOOD-ZEPHYR TEMPEST!!AK7500CS 30"WX18"H / 145+" 43$" it' �a-' DISHWASHER-BOSCH SHP78CM5N / 272 FRIDGE-GE PROFILE PYE22KYNFS 36" MICROWAVE-BOSCH HMB50152UC 30" PLEASE CALL OR TEXT JANNY @ 260-410-7601 OR EMAIL TO janny@capekitchens.com WITH ANY DESIGN OR INSTALLATION QUESTIONS OR CONCERNS I All dimensions_size designations This is an original design and must Designed: 6/6/2024 1•iCj11-124). given are subject to verification on not be released or copied unless Printed: 6/11/2024 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. GRIECO KITCHEN POPLAR 5-8 DRAWER All Drawing#: I No Scale. / 272f," / / 131:" 36" 1' 36" ii 31=' I 37=" / QT POOP TROY /llt'/PF/OF.R.S OM3N/293 CUSTOM QUOTE#43 9 04 04 7-61024 co .. t, /NFlSDEP/ �I� IPr_ _ _ � W$339 W3639 N -I1 Ll -t_ ill UT3f53-RT INnenen ' _ _ 836-3 836-3- n I n n rt 1 / 131' / 36" / 36" / 31:' / 37_"—V QrY 2IRAUERS QTYS BELOW MICRO ROLLOUT TRAYS All dimensions size designations This is an original design and must Designed:6/7/2024 given are subject to verification on not be released or copied unless Printed:6/11/2024 U,Z job site and adjustment to fit job applicable fee has been paid or job �}') j_. f l� 1- conditions. 2020 order placed. GRIECO KITCHEN POPLAR 5-8 DRAWER picture I El 3 I Drawing#:I I No Scale. / 162 34" / / 69 4" // 18" / 30" / 45" / N N N 49 - F636 INI'WDEP Th------cv---- .---, DO / ri NOT co q� HOOD30-6 PULL 1 W1839L WIBC4539R NN Lo LI Ll I 111L N. ... ,CO LoL.L' C:1 O UT3693-RT SWING-OUT CHROME LO SHELVES VES qN INFBDEP '> �.... PGS964YPFS _B18-3� __ . BBC48L-WS CO NN oN _ 1 i / 24" / 45 43 " / 18" / 3 li / 21 " / 24" / i / 102 ;6" / 60 ,' / t. All dimensions _size designations This is an original design and must Designed: 6/6/2024 given are subject to verification on not be released or copied unless Printed: 6/11/2024 job site and adjustment to fit job applicable fee has been paid or job 1):9C-- q ia 4 conditions. - �i C,' order placed. GRIECO KITCHEN POPLAR 5-8 DRAWER El 1 Drawing #: 1 No Scale. / 272a" / • f13"f 29" f 42" I' 30" f 30" I' 861 f 39" 1 3/ F. co .). a QTr/ I r W /Al TWEP QD JJv �W3C453 W21739 W3039W I FLS I _ _ r �� IJI _ JIJ ii_ FLS _L• — 'SA•ill lli, \ .SWING-OUT KL�� — 1 PYE22KYNFS ri i • „ CV CHROME II - O SHELVES 1--- ... q'Jc— RFICaleWS SB3-1 DR S�HX863WBSiTI812R—B30-3— B18-3_ y J I A��I 0�� lJf �ft 1 _ I��II'I II 0 / 48" / 3 ' / 2" /12"30" / 441" / 39" / 18" / 2T' / / 63" 271" 118 " 64r / TItiY Qn'_---HIGH RASE ROLLOUT TR I1'.S All dimensions size designations This is an original design and must Designed:6/6/2024 given are subject to verification on not be released or copied unless Printed:6/11/2024 job site and adjustment to fit job applicable fee has been paid or job '774-- Lj)`t l Z'T conditions. 2020 order placed- GRIECO KITCHEN POPLAR 5-8 DRAWER I El 2 "Drawing#:1 I No Scale. 6" FILLER PULL-OUT SPICE RACK _ _ 1111111.111111.11111111.1 < INFBDEP INFBD P Q B24-FHD-2D_B27-3 B27-3 F6&BWDMW18 COOKBOOKS / 13" / 27" / 27" /"� 18" / 91 " DOUBLE WASTEBASKET All dimensions size designations This is an original design and must Designed: 6/6/2024 given are subject to verification on not be released or copied unless Printed: 6/11/2024 ` ! �p�Z job site and adjustment to fit job applicable fee has been paid or job l�F- conditions. 2' W w�,2® order placed. GRIECO KITCHEN POPLAR 5-8 DRAWER El 4 Drawing#: 1 No Scale. INSETBB B24-FHD-2D L rr 78" /12l ! rt • 91tr ISLAND BA CK All dimensions size designations This is an original design and must Designed: 6/6/2024 given are subject to verification on not be released or copied unless Printed: 6/11/2024 /))AC qq)244. job site and adjustment to fit job ,� - applicable fee has been paid or job conditions. j t placed. laced. GRIECO KITCHEN POPLAR 5-8 DRAWER El 5 Drawing#: I No Scale. 4 4 .J .. ..- • li• g .! - t it, 1 !� ,s , -{ SST-- •. l !'.' F- i , ,: • t• _ Itsolootwi • ` i • • ♦R , SFr - t•: t t! �, 1 •I1'i,t171 0. . . yet`" r >fy 4... i I . - a i i� 7 r 1 /� , r r - r Y • _ 3rr 1 R [ — t I jt 1a ....its-i%:::-.1:1;,,,'''1::il'ir,l',,,,,t,::ik,...:::„'4..'11,,,Iir..,,.:..:4','-?:1', i1 5 R Ii1I ,Tf '.iCi °25 1 10 �••C 1� .. ti 1� 1 1 t s is .'1 • 1 f i.�EX.'•. I : ,••.. , 1i . t 1 ��-_ �• ( .IAA.I • • .1 ! }, 1 p-.:0; • pt • . ,\,:::::,..:.:,,.',7,::::\\ ''''',,, _ _ ____ . • ' fffjjj Oi#-.-.1*'--:''''_ :V\ ty' ,1) ui'1/.4y`//f ''P.w 1� Ntd°.. J t \ \i . ''...'\ ' . '''': ' . , Y 4 _ t' i ' w l '1.1::,` ,.\'.,,,,i,L'it-4,243,,-..1,4111,?,,iili•:,0 \ \ \ , e\', - ', '• , . -,•:„\, \ 1 k " ' ''.,''..!! ;` t t . .. ,• hh ,}_S \�, t s _- }S\ S.A' - -•. 1 \,�V\ 1,• ; i_ { � r h ti n t p - . THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation • 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card CAPE&ISLANDS KITCHEN&BATH REMODELING,INC. Registration: 70266 0 99 STATE ROAD Expiration: 7/06l2026 SAGAMORE BEACH,MA 02562 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street-Suite 710 160266 07/06/2026 Boston,MA 02118 :APE&ISLANDS KITCHEN&BATH REMODELING,INC. NILLIAM SCHMITZ 39 STATE ROAD tAGAMORE BEACH,MA 02562 Undersecretary Not valid without signature Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Cons ikf' u rvisor CS-076571 E ,pires: 09/09/2025 WILLIAM L S6HMITZ 66 CARAVELI0R HATCHVILLE'MA 02536 J Vd. Commissioner // .'11 Construction Supervisor Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617) 727-3200 or visit www.mass.gov/dpl CAPE&ISLAND KITCHEN AND BATH REMODELING INC. 99 State Road, Route 3A Sagamore Beach, MA 02562 Phone:(508) 888-4762 rax: (508) 833- 1442 ter Contract ide,p'26-2) Date: 3-14-24 r j To: Mary Grieco )(9 29 Charles Street S. Yarmouth, Ma. 02664 508-981-4291 marygrieco@verizon.net Cape & Island Kitchens & Bath Remodeling Inc. will provide the following renovations as per plans provided. Included in this proposal are as follows with respective allowances: Plumbing: o Disconnect all existing plumbing in kitchen. o Provide all rough and finish plumbing per code. Provide plumbing inspections. • Provide new water lines, shut off valves and pvc drain. o Connect new sink and faucet as per plans. • No kitchen faucet allowance carried. TBD 4 Sink included in other contract with counter top. O Connect all owner supplied appliances. Electrical: 9 Provide rough and finish electrical for kitchen. m Supply and install a total of[7] recessed led ceiling lights throughout kitchen. To be placed as needed. TBD Lights are $300.00 per light installed. o Supply and install a total of[7] under cabinet lights. • Provide GFI receptacles as required by code. Prep outlets for Full Height stone splash. ® Install all owner supplied appliances. O Remove other ceiling lights as needed and repair ceiling. © Relocate electrical as needed to comply with new design and code. • Provide receptacle in island as needed. Q No upgrades to service panel at this time. • Color of all devices: White • All recessed lights on dimmer switch. • Install owner supplied track light. c\ 15\onA I!`J11l'^� o No upgrade to existing service panel. To be reviewed by electrician. Page 1 of 3 CAPE&ISLAND KITCHEN AND BATH REMODELING INC. 99 State Road,Route 3A Sagamore Beach,MA 02562 Backsplash: • Supply and install new tile splash. • Tile allowance:$10.00 per sq.ft. • Please select tile from Bellew Tile Yarmouth. 1 • Select grout color and end molding.[Metal j J • Standard tile install patterns included.Subway,stacked or random. ,/ • Please have pattern info on selection sheet. Flooring: S(J" • Remove existing flooring in kitchen,living area.Dining area and entry. • Supply ands install new 3'/4 oak flooring. • Either Pre finished or Appalachian Pre Finished flooring.Same cost either way, • If natural wood?Sand and poly finish on site.No stain included at this time.TBD General: • Provide all necessary permits. • Provide trash container on site. • Provide Porto Poddy. • Provide dust protection as best possible. • Remove existing appliances as needed. • Remove existing cabinets. • Remove all existing base board moldings in same area as new floors. • Provide all necessary blue board and plaster repairs. • Install owner supplied appliances. • Paint kitchen walls-where-necessary. • Paint kitchen ceiling. • Paint all new base board moldings. • Total job:$66,319.00 Not included: • Cabinets/Tops • Appliances • Service panel Page 2 of 3 CAPE&ISLAND KITCHEN AND BATI-I REMODELING INC. 99 State Road, Route 3A Sagatnore Beach, MA 02562 Payment schedule: o Deposit required upon signing: $5,000.00 • Payment required upon completion of all demolition and pre work: $15,000.00 U Payment due upon completion of plaster repairs and wood flooring install: $25,000.00 o Payment due upon completion of tile splash. Just for a time line. $16,000.00 o Final payment due upon completion of work: $5,319.00 We propose to furnish material and labor in accordance with the above specifications for the sum of TOTAL OF$66,319.00 All material is guaranteed to be specified. Any unforeseen shall be discussed with owner prior to execution (i.e. house out of level, bringing any non-obvious work up to code, or faulty wiring,framing, insulation in walls). All work to be completed in a workmanlike manner according to standard practices.Any alterations 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 contingent upon strikes, accidents, delays or damages beyond our control(including weather). Owner to carry fire,tornado, and other necessary insurance. Our workers are fully covered by Workers Compensation Insurance."Covid Awareness Clause" Due to the uncertainty of material costs and availability, Cape &Island Kitchens/Remodel, reserves the right to alter pricing to contract to accommodate"Todays Pricing"whether it is"More or Less"from original contract. In the event that it is necessary to pursue any legal action to collect any outstanding balance the customer shall be responsible for the total balance plus all legal costs. ACCEPTANCE OF PROPOSAL: SIGNATURE I 1L. Q\r-c`�__--.-- DATE 4l 15.:/z�1 -- Michael Heinrichs Page 3 of 3 A( c)R17 CERTIFICATE OF LIABILITY INSURANCE DATE(MIAODNYYYI OW2912023 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 pollcy(les) 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 NAMIE: Linda Sullivan THE HILB GROUP OF NEW ENGLAND LLC .L _NNn F.9. (508)957-4239 ;c-Owl; ADORL Isuflva ins.com DMlE55; n�d0 120 Turnpike Rd wsuRER(s)AFFORDING CONERAGE NAIL it Southborough MA 01772 INSURER: LM INS CORP 33600 INSURED INSURER 8 CAPE & ISLANDS KITCHEN & BATH REMODELING INC INSURERC: DBA C&1 KITCHENS INC INSURER Di 99 STATE ROAD ROUTE 3A INSURER E' • SAGAMORE BEACH MA 02562 INSURER r COVERAGES CERTIFICATE NUMBER: 908182 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. L TR TYPE OF INSURANCE •e W) POLICY NUMBER (WTYTT)I(MEIDDJYYTTI• UMn COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ AR.15 MADE OCCUR 'DAMAGE TO RENTED - S ilS.E?I+}SE$tfou cctrrerae}.._ IMO EXP(Any one person) $_. N/A PERSONAL&ADV wA1R'Y $ GENT AGGREGATE LIMIT APPUE PER: I1 GENERAL AGGREGATE POLICY l_,JE 4 I-1. LOC .PRODUCTS=COMP,'OP ADD $ OTHER I S A t11UNOBIIE LIAHII ITV COMBINED SINGLE LIMIT S ANY AU Tp I BODILY INJURY(Pal penan) I$ OWNED SCHEDULED BODILY INJURY(Per accident) S AU1OSONLY AUTOS I NIA I HIRED NON-OWNED , PROPERTY DAMAGE _ AUTOS ONLY -__. AUTOS ONLY ! 1 {Pet gcciOent) $ UMBRELLA UAS OCCUR EAGIOCCURRENCE $ EXCESS LIAS ,CLAIMSMADE N/A AGGREGATE ('•ELT -i `FNTIONS - $ I'A'ORKERSCOMPENSATION xl STATUTE I I ERµ BI AND EMPLOYERS'LIAUTY ---- -------- - ANYPROPRIE TOR;PARTNEEXECUTIVE YIN RI ELE_ACH ACC IDENT $ 500,0 00 DM A OFFICEREMBEREXCLUDED? WA NIA WA WC531S369904023 07/03/2023 07/03/2024 --....__ .---_--_. (Mendatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes.describe under �--- DESCRIPTION OF OPERATIONS below E 1,DISEASE-POLICY LIMIT i$ 500,000 N.A. DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES (ACORD 1e1,Addulonal Remarks Schedula,may be attached M mare spec*is requarsdl Workers-Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B.no authorization is given to pay claims for benefits to employees in stales other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue dale of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govrtwdlworkers-compensationtinvestigatlonsl, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1 146 Route 28 ALIT MOWED REPRESENTATIVE ;nu^I Yarmouth MA 02664 Daniel M. Crowley.CPCU,Vice President-Residual Market-WCRIBMA 1988-2015 ACORD CORPORATION. All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD