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HomeMy WebLinkAboutBLSM-25-18- cif Y SHEET METAL PERMIT i4If 0) Commonwealth of Massachusetts MAR 26 2025 -:y Town of Yarmouth Building Department BUILDING DEPARTMENT '''re.` K.+rAc eist- .51 1146 Route 28, South Yarmouth, MA 02664-4492 BY ,...,,, RATIO Date: Permit#: j LSin-�5-1 Estimated Job Cost: $ .,`D o ,°' Permit Fee: $ Plans Submitted: YES/ NO Plans Reviewed: 0E / NO Business License# Cc7Eg 709C, Application License# cl I3a Business Information Property Owner/Job Location Information Name: ii-tc-Vi ti•+ c'o.��,+� C�.�C e e1•s in( Name: L<v Ps 64 ,1 6„; I a4,s n Street: 1 G CG p Sr Street: °3 ; c.re„1) g cl City/Town:w,y�f w1,: -� 0.$N C,a(,-13 City/Town:t,a-. y r,r; vy),:,}\,, n1q Telephone: S"an- ‘-I'i `p--)a--<} Telephone: Sc, , LI l3(a2, Photo I.D. required/Copy of Photo I.D. attached: ' / NO Staff Initial: J-1/'I I-1� unrestricted license J-2/ M-2 restricted to dwellings 3 stories or less and commercial up to 10,000 sq. ft./ 2 stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of stories: Sheet metal work to be completed: New works" Renovation: HVAC:v'-Metal Watershed Roofing: Kitchen Exhaust System: Metal Chimney/Vents: Air Balancing: Provide detailed description of work to be done: ),-,51- 11 i 1-113,,5 5o' ys1-{M ) j• clo.4r 2 H Pti-4- p v-r. p S C it) S 'ti41e l )-tom-ct cool 2 a) Cool<<?5- ,+ 14 INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ✓ Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner Agent Signature of Owner or Owner's Agent By checking here- I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installation performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Inspections shall be called for prior to insulation installation. Duct inspection required prior to insulation installation: Yes No Progress Inspections Date: Comments: Final Inspections Date: Comments: Type of license: By: ✓Master /` rk_(31„Title: Master-Restricted J\ \ T Signature of Licensee '(` City/Town: Journeyperson Permit#: Journeyperson-Restricted License Number: 4)3 Fee: $ Check at www.mass.gov/dpl '1` Inspector Signature of Permit of Permit Approval MASSACHUSETTS DR LICE SE NOT FOR FEDERAL ID • PS " 0512012024 $M 3 62808 01123/2029 ' 0612311961 - S CLASS 12 REST 9e END p. NONE NONE + " 1 .1 NAPOt A O z NUNZI L 76 CAMP ST WEST YARMOUTH,MA 02673.3207 1SEYES HAZ 06/23/61 ��/_-) 1ssEx M 16NDT 5'-07" tt""'' 5 OD 0512012024 Rev 0212212016 it COMMONWEALTH OF MASSACHUSETTS DIVISION OF OCCUPATIONAL LICENSURE BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE MASTER-UNRESTRICTED NUNZIO L NAPOLITANO 76 CAMP ST W YARMOUTH,MA 02673-3207 z 4132 06/28/2026 607191 LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER NOI1V31311833 809 `dd3 j uedgns-ZB Vied dd3 OF 909 uonoas 5ov/IV uea13 wei6ad uoqonpaa suoIssIw3 pue 6ugo%oa2A leuoIleN s a 3 i s s.tld3 Aq paipbaw se sweja6i 4eJ alpueq nlgisuodsaJ of, oq uo wexa 1VS213AINI1 d e passed A1In4ssaoons seq ONV.IIOdVN SZLL8Z9L IZNt1N :oN uo!le31B-183 5 /D D/ CERTIFICATE OF LIABILITY INSURANCE DATE(MMosrM/DDTYYYY) CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 1FICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 1W. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED :ESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. RTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 3ROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on ertificate does not confer rights to the certificate holder in lieu of such endorsement(s). :R CON fACT NAME: JIM HINDMAN D INSURANCE ASSOCIATES LLC (A/CONf o,Extl: 508-771-8381 (A/C,No): 508-771-0663 -I Street E-MAIL armouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: NGM INSURANCE 14788 INSURER B: LM INSURANCE COMPANY Nunzio L Jr Napolitano INSURER C HEATING&COOLING CONCEPTS INSURER D PO BOX 247 YARMOUTH,MA 02673 INSURER E: INSURER F: :AGES CERTIFICATE NUMBER: REVISION NUMBER: S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS IFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, JSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDLBUBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY)JMM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 100,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 MPJ5811A 02/28/24 02/28/25 PERSONAL BADVINJURY S 1,000,000 N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 _ OTHER: $ TOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ _AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ _AUTOS ONLY _ AUTOS ONLY (Per accident) S UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION S iRKERS COMPENSATION X PER OTH- D EMPLOYERS'LIABILITY STATUTE ER rICER/MEMBER EXCLUDED?ECUTIVE YYN 100,000 N/A WC531S626937012 05/16/24 05/16/25 E.L.EACH ACCIDENT $ indatory In NH) E.L.DISEASE-EA EMPLOYEE S 100,000 =_s,describe under 500,000 SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 'TION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 10 NAPOLITANO HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKER COMPENSATION POLICY LANCE COVERAGE IS LIMITED TO THE TERMS,CONDITIONS,EXCLUSIONS AND OTHER LIMITATIONS AND ENDORSEMENTS OF THE :Y FICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE `)qt THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN TOWN OF 6KEVVSfE-R ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT BREWSTER MA AUTHORIZED REPRESENTATIVE h?)v\ N ©1988-2015 ACORD CORPORATION. All rights reserved. 3 25(2016/03) The ACORD name and logo are registered marks of ACORD