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Home My WebLink AboutBLDX-25-667- Office Use Onlynl / !`} `' Pet& 2)) 456 �7 O,:oie. ,,,:?i,. ` (%y Amount J V 1 LX) __ r 411 EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: (>2t2 De b S f/, i/ ) C{ /FJ1Oc. /7A,)O;7/, /4A. O 9C 'S vS-s 6//, 76Y'2 (,iN,?A) OWNER: /4"/Z,13 � 3 0s 4 /i5 l5 07 De P S - t (I l'e1 . ---5 F 3 Fe-.So 916 de) NAME PRESENT ADDRESS TEL. # CONTRACTOR: eie,4�j7L� l� gAIW'Ac)/ 5 44Q/2S(("to R4, /41 RgIW 7 l* 7 3'44 a3i F AME MAILING ADDRESS ( evG6,+ TEL.# EMAIL: r/Ci<9oxr n ea LA & ( 1-1,4/i , (oni /Residential 0 Commercial ❑Est.Cost of Construction$ /( /f S 02•U-� Homeowner is Applicant? Yes Not/ !� Home Improvement Contractor Lic.# (3-CY092 r� Construction Supervisor Lic.# /6:�`/7 0 WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate required) Wood Stove Siding: #of Squares Replacement windows:# // Replacement doors: # Roofing: #of Squares Insulation Temporary Mobile Home Temporary Construction Trailer Demolition—Interior only Demolition Raze Structure Solar System ESS System Chimney Fence *Please submit utility disconnect letters for electric&gas—structures over 75 years old require historical review *The debris will be disposed of at: f y2d-S A/3/P /isn/S'f`/'C 5 I A . ri I Arr.- �1— 14/7S Ta./✓S PM/!f is 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 o oca'on my li and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: I / f C4 e-G( Date: 5.—c7.j7c9`j Owners Signature(or attachment) Date: Approved By: Date: Building Official(or designee) Rev 6/24 ., The Commonwealth of Massachusetts Department of Industrial Accidents n �= 1, Office of Investigations Lafayette City Center =:f; . 4,, 2 Avenue de Lafayette, Boston, MA 02111-1750 _ s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /C'cif X i:3 &i4zn/C it iJl Address: p�S///1 Vo)>sr r>C-' ��( , PD,,3ox 76 City/State/Zip:/(),, ? 1A ill E/ /v1,' , a Phone #: &C Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 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. ❑ 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 10.0 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.n 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. 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 ce ' under the pains a d penalties ofperjury that the information provided above is true and correct. • Signature: 7 i J _ G c'u 4 Date: (_5193/07 ) Phone#: 2 7/I 5,;? 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 31:City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: '5. Commonwealth of Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than Board of Building Regulations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. Const tonrSttp rvisor � J CS-009714 ecpires: 04/04/2026 RICHARD P gARNEAU,JR F 251 WOODSIDE ROAD O WEST BARNTABLE MA 02668 i O Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner C i e Contact OPSI:(617)727-3200 or visit www.mass.govldpl/opsi 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 RICHARD P. GARNEAU JR. ; t. t Registration: 166170 Expiration: 05/04/2026 251 WOODSIDE RD. _ ' W. BARNSTABLE, MA 02668 , 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: Individual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 166170 05/04/2026 Boston,MA 02118 RICHARD P.GARNEAU JR. RICHARD GARNEAU JR. , 251 WOODSIDE RD. ' 6('1,./ e r� W. BARNSTABLE, MA 02668 Undersecretary Not valid without signatu 3/28/25,3;27 PM 20250328_121823.jpg • RICHARD P. GARNEAU.JR_ POST OFFICE BOX 476 WEST BARNSTABLE, MA 02668 7 774._38.gG32 March 15. 2025 508-264-7682 508-380-5598 Susan.holskel :gmai l.com Herb it Susan Holske 22 Deb's Hill Road �� Yarmouthport,MA 02675 .410 r# RE: installation of Havey vinyl windows I,Richard P.Garneau,DBA Woodside Renovations,propose to supply the materials and labor necessary for the installation of eleven Harvey vinyl windows for the sum of Ten Thousand Four Hundred Fifty Two Dollars(S 10.452.00). r ti 4'_ ` Scope of Job Remove all existing windows(one at a time)and replace with Harvey vinyl classic windows like for like in configuration.ten double hung and one picture unit. All window units will be energy star rated double glazed,double Low I;; 18ORS,argon fi11ed. Performance package is sun gain plus,overall DP rating is DP40(135 MPH wind). &rids in between the glass with half screens Harvey warranty is a lifetime warranty on any defects in structure,parts,and mechanisms and 20 years on interior glass seal failures. For full details,go to harveybp.com/warranty. All materials are of first quality and come with manufacturers warranties. ri All workmanship to meet or exceed manufacturers and building code specifications and will be warranted for one year, Caulking,puttying and painting by others. https://mail.google.com/mail/u/0/?tab=rm&ogbl#inbox/KtbxLvhVhQVLHGsTIVdMJfrdQlXfjIBRPg?projector=l&messagePartld=0.2 1/1 3/28/25.3:26 PM 20250328_121836.jpg Herb& Susan Holske Page 2 March 25,2025 Richard P. Garncau, DBA Woodside Renovations,is fully licensed and insured and is responsible for disposal of all debris along with leaving a clean worksite. Richard P Garneau. DBA Woodside Renovations will not be responsible for existing alarm system, re-wiring,special permits,window treatments,existing unforeseen situations causing extra work or delays in work beyond his control. All extra work due to unforeseen situations will be charged as a time and material extra Deposit: S6,000.00 At completion of install $4,452.00 Total S 10,452.00 2)(75--g,Pg, Flerb liolske „/Jtoal g. Susan Holske Dated: __ _ Gg r • t:e664ti.L'—_ !1 Richard P.Garneau, hops://mail.google.com/mail/u/0/?tab=rm&ogbl#inbox/KtbxLvhVhQVLHGsTIVdMJfrdQlXfjIBRPg?projector=l&messagePartld=0.1 1/1