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HomeMy WebLinkAboutBLDR-24-417 RECEIVED AUG 09 2024 0 & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department pF Y`�44 , \ 1146 Route 28, South Yarmouth, MA 02664-4492 BUILDINV DEPARTMENT 508-398-2231 ext. 1261 Fax 508-398-0836 ( r " +IA d �Massachusetts State Building Code,780 CMR • Building Permit Application To Construct, Repair, Renovate Or Demolish 4,,•�*}OHC[S.e a One-or Two-Family Dwelling iRpp RpTEO � ,- This Section For Official Use Only c Building Permit Number: n Date Applied: IIIP Building O iff c'ial(Print NA Arlre A Date SECTION 1:SIT 'INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 107 Indian Memorial Drive,Yarmouth MA 69 ID 9975 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: R Garage Addition 44,486 69.31 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 69.31 80 110 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public El Private❑ Check if yes® Municipal 0 On site disposal system NI SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Joe and Louise McCluskey Name(Print) City,State.ZIP 107 Indian Memorial Drive Yarmouth,MA jmccluskey@egsawyer.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition I7 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:Add garage to primary residence. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $80,000 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $5,000 ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6) multiplier, x C.t 3.Plumbing $0 2. Other Fees: $ s 4. Mechanical (HVAC) $0 List: 5.Mechanical (Fire Suppression) $0 Total All Fees:$ - Check No. Check Amount: Cash Amount: 6.Total Project Cost: $85,000 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-074258 License Number Expiration Date Name of CSL Holder List CSL Type(see below) U Gordon M.Hatch No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) 175 Searsville Road Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry South Dennis,MA 02660 RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (508)364-3198 hatchrestorations@comcast.net I Insulation Telephone Email address D Demolition 5.2 Registered Ilome Improvement Contractor(HIC) 130856 6/21/2025 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name Gordon M.Hatch hatchrestorations@comcast.net No.and Street Email address 175 Searsville Rd.,So.Dennis MA 02660 (508)364-3198 A 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 0 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 Gordon M.Hatch to act on my behalf,in all matters relative to work authorized by this building permit application. 08/08/2024 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 application is true and accurate to the best of my knowledge and understanding. 08/08/2024 Print Owner's or Authorized Agent's Name(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 HIC 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" $85,000 The Commonwealth of Massachusetts —�— Department of Industrial Accidents Office of Investigations Lafayette City Center _. k. 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): hatchrestorations Address: 175 Searsville Road City/State/Zip:South Dennis MA 02660 Phone #: (508) 364-3198 Are you an employer? Check the appropriate box: Type of project(required): l.n I am a employer with 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 partner- listed on the attached sheet. 7. n Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. [' Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 11.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.1=1 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.1=1Other 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: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: 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 certi u er the a' s and pe ies of perjury that the information provided above is true and correct. Signature: Date: 9'/ 2-`t Phone#: (508) 364-3198 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): 10Board of Health 20 Building Department laity/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.❑Other Contact Person: Phone#: TOWN OF YARMOUTH 0 Office of the Building Commissioner V 1146 Route 28, South Yarmouth, MA 02664 tO 508-398-2231 ext. 1260 Fax 508-398-0836 7�OOgnoe�t[o�°A HOMEOWNER LICENSE EXEMPTION DATE: JOB LOCATION: NAME STREET ADDRESS SECTION OF TOWN HOMEOWNER NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS CITY OR TOWN STATE ZIP CODE Definition of Homeowner: Person(s)who owns aparcel of land on which he or she resides or intends to reside,on which there is or is intended to be, a one or two family attached or detached structure accessory to such use and/orfarm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of780 CMR 110.R5,provided that if a homeowner engages a person(s)for hire to do such work, then such homeowner shall act as supervisor. This exception shall not apply to the field erection of manufactured buildings constructed pursuant to 780 CMR 110.R3 The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations,and certifies that he or she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he or she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE 6 TOWN OF YARMOUTH `' Office of the Building Commissioner 1146 Route 28, So uth Yarmouth, MA 02664 �N`° '� 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. 107 Indian Memorial Dr., Yarmouth MA Work Address Is to be disposed of at the following location: Childs Inc. (Disposal Company) Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, §150A. £ Licant / D to Permit No. Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards Cons tcHit visor CS-074258 $ Spires:04/23/2024 GORDON M OAT l Mak 175 SEARS 1 F SOUTH DENNIS MA Wr ,4' �... l�� f(.Gvd11. CommiSS:Oncr ' '--�.....�, THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston,Massachusetts 02118 Home Improvement Contractor Registration Type: Individual Registration: 130856 GORDON HATCH Expiration: 06/21/2025 175 SEARSVILLE RD. SO.DENNIS.MA 02660 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs S Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date.If found return to: TYPE:Individual Office of Consumer Affairs and Business Regulation Reoishadon Expiration 1000 Washington Street-Suite 710 130856 06121/2025 Boston,MA 021 CORDON HATCH ir GORDON M.HATCM DATE(MM/DD/YYYY) AC()RL CERTIFICATE OF LIABILITY INSURANCE 07/30/24 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: George McKenna Insurance Agenc A//C,NNo, Ext): 508-892-8133 FAX No): 508-892-7322 4 Pleasant St E-MAIL Leicester, MA 01524 ADDRESS: chris@mckennains.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A : Norfolk & Dedham INSURED INSURER B : Travelers Decharles Plastering, Inc. INSURER C : Commerce 10 Harvest Hollow INSURER D : Harwichport, MA 02646 INSURER E : 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED 000 CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) S 50,000 MED EXP(Any one person) $ 5,000 A R0205978 01/22/24 01/22/25 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY f JE 0 LOC PRODUCTS-COMP/OP AGG S 2,000,000 _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) $ 250,000 C OWNED SCHEDULED AUTOS ONLY AUTOS RYW965 04/18/24 04/18/25 BODILY INJURY (Per accident) S 500,000 HIRED NON-OWNED PROPERTY DAMAGE g 100,000 AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION I STATUTE PER I I OTT AND EMPLOYERS' LIABILITY Y/ N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S 100,000 B OFFICER/MEMBER EXCLUDED? n N/A JPJUB 7H973631 03/20/24 03/20/25 (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE S 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Amorello Construction ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 'e. • 1988-2015'ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD • KLINMAI OP ID: KF ACORo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 08/06/2024 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 508-398-6060 ungpCT Bryden&Sullivan Insurance Bryden&Sullivan Ins Agency PHONE(NC 508-398-6060 I FAX 508-394-2267 of Dennis Inc. Ep,�NLo,Ext): (NC,No): 485 Route 134,PO Box 1497 ADDRESS: So.Dennis, MA 02660 Bryden&Sullivan Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company 14788 INSURED INSURER B:The Hartford 19682 Matthew D Kline Electrician Inc. 324 Oak Street INSURER C: Harwich,MA 02645 INSURER D INSURER E: 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. INSRXP T TYPE OF INSURANCE INSLSwtn POLICY NUMBER fMMIDOI CYYYY IMM//DDIYYY 1 LIMITS I TR A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MPT7893T 10/28/2023 10/28/2024 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ x Business Owners MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jEeT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: ,$ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ AAWNED UTOS ONLY SCHEDULED AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY AUUTOS ONLYD (Pea accidenDAMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X STATUTE ER _H AND EMPLOYERS'LIABILITY 08WECAAOBVK 11/16/2023 11/16/2024 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N I A 100,000(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ E yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION HATCHGO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Gordan Hatch Hatch Restoration 175 Searsville Road AUTHORIZED REPRESENTATIVE Dennis,MA 02660 Bryden &Sullivan Insurance ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 08/06/2024 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 Rob n Mays NAME: y y KNIGHT-DIK INSURANCE AGENCY INC PHONE 508 753 6353 FAX (A/C,No.Ext): � ) (A/C,No): E-MAIL ADDRESS: C 9s rmaY kni htdik.com 120 Front Street INSURER(S)AFFORDING COVERAGE NAIC# WORCESTER MA 01608 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B GREGORY WETMORE INSURER C: DBA GWW CONSTRUCTION INSURER D: 93 POND VIEW DR INSURER E: BREWSTER MA 02631 INSURER F COVERAGES CERTIFICATE NUMBER: 1033798 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 1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE 1 OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECTP 1 LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY ^ STATUTE ER Y N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A 6HUB6R42270A24 05/24/2024 05/24/2025 --- --- -------- (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 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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 states 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 date 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.govAwd/workers- compensation/investigations/. • Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN G. Hatch Restoration ACCORDANCE WITH THE POLICY PROVISIONS. 175 Searsville Rd AUTHORIZED REPRESENTATIVE S Dennis MA 02680 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 4 to v// �+/- \\\�\\1 1 10 5.6. LOT E i- �/ � 44,486 SO. Fr. ± ro_ 1.02 ACRES ± 4- i 46.23' ep6,,). \ PROP. 14' x 24' ` ATTACHED GARAGE , / " \ t Q l'W ,��,O. _�� 0000 `�}o'V e 124.9' v 74/ rp�P A lec.X ,``1` Q S (Ski ` 33.30' k o\ 602ood `'4S_ 69.31' Ps oss x i� \ 41 / O �).:\) h ., 2 Y hO r/ h i 1� �hh $�3 5p J y. V CERTIFIED PLOT l N 6� PLAN OF LAND IN YARMO UTH, MASS. AS PREPARED FOR JOSEPH & RITA McCLUSKEY PLAN REFERENCE- rcF�gj TO:JOSEPH & RITA McCLUSKEY PL.BK.96 PG.105 'F3" s5 ON THE BASIS OF MY KNOWLEDGE & PL.BK.111 PG.49 ��� �Iii;�' o PAUL INFORMATION, I FIND, THAT AS A RESULT OF A SURVEY MADE ON THE I� SrE GROUND TO THE NORMAL STANDARD PLAN SCALE- 4,,‘ qIT: 4a - OF CARE OF PROFESSIONAL LAND 1"=50' FESS OrP ,, SURVEYORS PRACTICING IN THE �gtio cuRv�°p COMMONWEALTH OF MASSACHUSETTS, DATE DRAWN- — THE LOCATION OF DWELLING 04/05/13 IS AS SHOW EREON. PAUL E. SWEETSER FILE: 2138-00 PROF. LAND SURVEYOR 04/05/13 F.B.: 36 P.O. BOX 1146 NOTES- DENNISPORT, MA 02639 DATE PROFESSIONAL LAND SURVEYOR REV. DATE- a 0 13 i0 = cN T— — 84. A 5TE, P.%177,911-� - 7rnv� ` , L - 1 4 4, 7 ON. 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PARTIAL REAR ELEVATION DATE:7/.31/2R4 PROJ.NO 2024-235 DWG.NO.: 0 I 0 COPYRIGHT 2D24p, � � 2O QC BY THOMAS A.MOORE DESIGN CO. 1--��--- - - m , o3 Fi r b I iz o rn nu, Pig (1(1 °gig g o A `o lNn NRN Q y� X '"p4 p rnY C1 Fyyn^2' N DN `aim e CW gm oig G _a N r�. @D , r • Co a i D 1 L z ti D \ ! M /"may ' 0 0 rn _Q r �D Q .. :' L-L ,3". ' ..,, �F y .-'''':,cl O Z N 0 p fJ ''' > c c vc 1VgirGARAGE ADDITION FOR: DESIGNED/DRAWN BY: STRUCTURAL ENGINEER: c —>g f rr" THOMAS A.MOORE DESIGN CO. McKENZIE ENGINEERING r.., z_m i,:il JOE&LOUISE McCLUSKEY W ? j3" •S2'� 107 INDIAN MEMORIAL DR.P• •Box 2124 949 ROUTE 137 44 UNDERPASS RD. UNIT'2 YARMOUTH,MA BREWSTER.MA. f50B1 a%-€403 BREWSTER MA. '774'353-2144 i • y v L. 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DECK z PARTIAL FRONT ELEVATION r m '8 —-_js.s.,...i-.—..--.-,-----,- cc 2 u zECI La N 17:11. f 5, ,...., ..1° , I ` 1JJ F o m • 0 Ca 0 X J • i Ln Q a FAMILYA NEW GARAGE - _ �'G Z U 0 ROOM OR . ",' .aril - v f GARAGE �. . ,,,,� ,,..,� F- ��Q ® �® CZ cn 1., < pZ U) • _ U -1 GI O . Z z .6 z 2 - w Lu IY Vim: �sAl \---c,vINT TXI<. va o' , R e A DRWN.BY PARTIAL FIRST FLOOR PLAN GENERAL NOTES: DATE 8 .`4 I.)CONTRACTOR IS TO VERIFY EXISTING CONDITIONS AND 5.)ANY DISCREPANCIES.ERRORS AND/OR OMISSIONS IN THE NOTES, '' --a ,�3 . LEGEND DIMENSIONS IN THE FIELD PRIOR TO THE START OF WORK DIMENSIONS,AND/OR DRAWINGS CONTAINED ON THESE DOCUMENTS vY?� Z��Q-;, 2.)CONTRACTOR TO REMOVE EXISTING DOORS.WINDOWS, SHALL BE BROUGHT TO THE ATTENTION OF THE DESIGNER PRIOR TO W I..:.T EXISTING WALL CONSTRUCTION TO REMAIN WALLS.t TOR TOG MREQUIREDVEEXISTING IC D NEW.WIND WINDOWS, COMMENCEMENT OF CONSTRUCTION.PROCEEDING WITH CONSTRUCTION -,�°r` 1 DWG.NO.' CONSTITUTES ACCEPTANCE OF THESE DOCUMENTS AND ANY DISCREPANCIES, 3.)ALL NEW CONSTRUCTION TO MATCH EXISTING IN MATERIAL. ERRORS AND/OR OMISSIONS BECOME THE RESPONSIBILITY OF THE / MR NEW WALL CONSTRUCTION EXISTING WALL CONSTRUCTION TO BE REMOVED DETAIL,AND FINISH. BUILDING CONTRACTOR. ® NEW/EXISTING HEAT DETECTOR 4.)ALL WORK SHALL CONFORM TO THE MASSACHUSETTS O 5 10 15 20 STRUCTURAL ©COWRIGM 2024 STATE BUILDING CODE(LATEST EDITION)AND ALL OTHER 7 BY TT10MA5 A MOORE DESIGN CO. APPLICABLE LOCAL CODES f T r N w LE- zEZ ,r LJ cd 0 ¢Liar a z o C Y = 5 N rrpikl: gl I F 1 a-ar o . 0 a Q N• LLi7 PARTIAL REAR ELEVATION 'CZ a 1+1 141 2 O z O F n: m >- • 4 Q 7 O u O � �¢ IAn cnr . 0 VI 42112 grear a. 0ZS �L ulamacac iakrawnrarlu:��. 4] O Q� Nu,�Wltli k�ralm tammu rRa nakr���1an.laanu�lwmanl,ta aaxnarc� Q olf Z: (�/�� a 111 if al i .,Li r nllak�l�Nl(NIN it NIg�Ni,ill lki ,,,,,� ,..i„,,,,;.1paO�l1 1:6��®1,aak 11,lnYq„,:.. n 41.r- < O O} `, 1,1�ry; ' IIII ' Nk i. 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RFOUIRFMFNTS STRUCTURAL M'R-4r[ETAL5INtfEn1(1 PE FELIflALHI55UEpN Pt, ..i 7-31-24 THIS REVIEW WAS COMPLETED ON PLANS SUBMITTED BY -•.,... --A,AND WAS BASED ON THE FLOOR I+A gt..vr BO'411AT t,.TTJIL(."IN ZEE II TvPOLINEM M EN AND Wnh.WD. I PLANS AND ELEVATIONS PROVIDED.ANY CHANGES TO THESE PLANS OR FIELD CHANGES MADE MAY RENDER THE 'f I .;R';,.I(MR :4ov SHEET -- !REOUIREMENTS OUTLINED IN THIS DOCUMENT NULL AND VOID AND COULD RESULT IN NON-COMPLIANCE WITH THE rnE `.5.1 0 REOUIREMENTS OF THE WIND DESIGN. L_ • • CHECKLIST SHEARWALL CONSTRUCTION STRUCTURAL RIDGE BEAM SHEARWALL HOLDDOWN SCHEDULE Lea•.Trnl,nN.41,10wwn1014,nurlcu1ral<..1 SECOND F ••R AND INTERIOR HOLDDOVYNS FOUNDATION • ••• (Avf1Ma:HA REAL.AaB<Tn,T.'.'!nrY1I rlr,RT,LLl K41rt NKR.. 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