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HomeMy WebLinkAboutBLD-22-006351 o ' ' , TOWN OF YARMOUTH Building Department BUILDING , * (508) 398-2231 ext.1261 t—.. - 1 PERMIT NO BLD-22-006351.f^„'tl- PERMIT MATT0;.0 JOB WEATHER CARD * awe. ISSUE DATE 05/03/2022 APPLICANT Ubaldo Miller PERMIT TO Repair AT(LOCATION) 135 CAPT DORE RD, SOUTH YARMOUTH, MA 026 ZONING DISTRICT Bldg.Type: Residential SUBDIVISION MAP BLOCK LOT 067.171 BUILDING IS TO BE: CONST TYPE V B USE GROUP R-3 REMARKS Repair-Siding 10 sq (774-245-6455) CONTRACTOR I ' LICENSE 1186306 'Y 'Home Improvement L 11______ ) ''''Ubaldo Miller 28 Leslie Lane AREA(SQ FT) �' Oak Bluffs, Ma 02557 (550,249,920. EST COST($) 21320.00 PERMIT FEE ($) g50.00 1 OWNER SKOG DARLENE E BUILDING DEPT BY ADDRESS , 35 CAPT DORE RD , 7 SOUTH YARMOUTH MA 02664 , _ - �Aa' PHONE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, E OR SIDEWALK Oft ANY PART THEREOF, EITHER TEMPORARILY ( PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST I APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY I OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE CONSTRUCTION WORK: 1) FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL PERMITS ARE REQUIRED FOR FOOTINGS. 2)PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE.WHERE ELECTRICAL PLUMBING/GAS MEMBERS (READY FOR LATH OR FINISH COVERING) A CERTIFICATE OF OCCUPANCY IS AND MECHANICAL 3)FINAL INSPECTION BEFORE OCCUPANCY 4) REQUIRED,SUCH BUILDING SHALL NOT BE INSTALLATIONS. REFER TO DETAILED INSPECTION SCHEDULE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS OTHER: JVORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE 4PPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ARM/F , - 7 ,7 .-/.., (life{r 1'sr toll t "1 -ram u f 1. , ' �' Permit mires.180 dar's twat a t ,..,r,tptr 13Ub-a) -0)( 3S-7 EXPRESS BUILDING PERMIT APPLICATI _ TOWN OFYARMOIml RECEIVED Yarmouth Building Department ~� 1146 Route 28 1 022 South Yarmouth. MA 02664 - (508) 398-2231 Ext. 1261 .__— 0 :uI�P TMENT CO ]ItI ( i IO %Dittos SS: 35 Captain Dore Rd 'y ._ IIIIIII ASSt_S 11It ' t\t'I:ot1 Ili i\ V ill 67 ' Parcel' 171 owNER. Darlene Skog 35 Captain Skog (774) 810-5070 NANII I'RI\I\I \+))RI ss It l u CONTRACI(li; Ubaldo Miller PO Box32380akBluffs0255' 774-245-6455 n NA. --__ MAILNG M)DRtais _ _._. . . I I a Res.::tentia3 DCommecrciral Fn.Crst af rtrtsrictit><t S 21.320.00 i Home Improvement Contractor Lit.*186306 Construction Supervisor Lic.a CS-109205 V orknran's Compensation insurance (check one) 0 I am the homeowner 0 i am the sole proprietor 0 I have Worker's Compensation insurance in t:•;,ncc C'ttn+pam Namc Gaslamp Insurance Services Workers Comp.Policy*VWC 100-6024964-2022A WORK TO BE PERFORMED rent ` t)uration (Fire Retardant Certificate attached?) Wood Stove jp Siding: #of Squares 1 2 `0 Replacement windows:# Replacement doors: # Roofing: #of Squares (1:1)Remove etisting•(max.2 facers) Insulation._ OldKings Highway/Historic Dist. a)Replacing like for like Pool fencing El rise debris skill hedtsFx�sed of at Coastline Disposal Services I oration of Facility ,3 ` ivt. ntnnaltsc.,f perjury that the is herein contained arc tiro and correct to the best of my knowkdnc and bti cf I understand th.0.ant fake utsarrr;t d41>e t+K':sts<e h denial i r resocatiotrof ceme and fur prosecution under M G.t. Ch 268,Stctiw I ppfitant s Srenanrre /..,. y Doc 04/27/2022 ___ t)warrs Sitnat (ur atlarhment)y Date: — __.. A otitti th .-._ _ ..-...n-__. L Date _... :funding Official la de]it:IA"- EMAIL ADDRESS ._....___.-- Zoning District ____ Historical Disuict: Yes No Flood Plain Zone. Yes No Water Resource Protection District: Within I DO ft.of Wetlands: I Yes No Yes No i .k!LiA ?ACHEcc� f MiLi_c a.n'S eGrtAA1L. Coo ✓V1 '_ The Commonwealth of Massachusetts P - ,i, Department of Industrial Accidents 1 Congress Street,Suite 100 8 1 1 Boston, ?4f,4 02114-201 7 www.mast gowdia \1 orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY, Applicant Infonnatign Please Print Legibly Name (Business/Organization/Individual): Miller's Pro Roofing and Siding, LLC Address: 105 East Falmouth Highway City/State/Zip:East Falmouth, MA 02536 phone#: 774-245-6455 Are you an employer?Clerk the appropriate hoz Type of project(required): I D am a employer yeti 10___employees(full and/or part-time)' 7. 0 New constmc6on 0:atrn a sole proprietor or partnership arid have no employees working for me in 8. Q Remodeling any capacity [No workers'comp.insurance required] 3 1 am a homeowner doingail workr 9. ❑Demolition ❑ myself.[No workers'comp insurance required) 10 0 Building addition 4 Q 1 am a homeowner and will be hiring canuactors to conduct all work on my property 1 will ensure that all writs o,-s either have workers'compensation insurance or are sole 11.0Electrical repairs or additions pnpr,otors with no employees 12.(Plumbing repairs or additions c am e.general coothictor and'have hired the crib-contactors lism on the atthehed sheet 13.®Roof repairs These svb-;ontracrors have c.:,;!eyees and have workers"comp it:.curanu.t 60We are a corporation and its officers have exercised their right of exemption per MGL c 14.✓Other Siding Replacement 15',;:(41,and we have no employees.[No workers'tromp.insurance required.] •Any applicant that checks box e 1 met aso fill out the section below showing their workers'eompansat on policy information. Homeowners who submit this at5davit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such =Contractors that check this box munz attached an additional sheet showing the name of the,sub-con'sutors and souse whether or not those entities have employees if thesub4minometors have employees,they must provide their workers'torn;policy numbs I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Gaslamp Insurance Services Policy#or Self ins.Lie.4: V VC 100-6024964-2022A Expiration Date: 01/06/2023 job Site Address:35 Captain Dore Rd City/State/Zip: S Yarmath. MA 02664 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance ccveraee verification. I do hereby certify undo e p and penalties of perjury that the information provided above is true and correct. Signature: Date: 04/27/2022 Phone#: 774-245-6455 _ fficial use only. Do not write in this area,to be completed by city or town official 1 _____________7......_ City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityfTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other it Contact Person: Phone#: AC CERTIFICATE OF LIABILITY INSURANCE DATE( OIYYYY) 01/24/2 2ar2o22 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(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 I CONTACT Customer Service Deaprtment i NAME: Gaslamp Insurance Services PHHCON No.Est): (800)920-4125 FAX( No), (800)920-4107 2244 Faraday Avenue,#125 E-MA ORess: i INSURER(S)AFFORDING COVERAGE 1 NAIC it Carlsbad CA 92008 i INSURER A: AIX Specialty Ins Co 12833 INSURED INSURER B: Associated Industries of Massachusetts Mutual Insurance 33758 Millers Pro.Rooting 8 Siding LLG INSURER C: 105 East Falmouth Highway INSURER 0: INSURER E: East Faknouth MA 02538 INSURERF• COVERAGES CERTIFICATE NUMBER: GL 21-22/WC 22-23 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 IINSO WVD POLICY NUMBER D/POLICY EFF POLICY EXP LIMITS {MAYDYYVY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES iEa occ rrencel $ 50,000 II MED EXP lAnv one oerson) $ 5,400 A SIZGI2247A257636 12/09/2021 12/09/2022 PERSONAL&ADV INJURY $ 1,D00,000 GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 1,000,000 PRO- XI POLICY JE T LOC PRODUCTS-COMP/OPAGG $ 1,000,000 if OTHER $ AUTOMOBILE UABIL(TY i COMBINED SINGLE LIMIT $ IEa acadeM! ANY AUTO I BODILY INJURY(Per cerson) $ ^. OWNED I-SCHEDULED I AUTOS ONLY ,_„_• AUTOS BODILY INJURY iFer accident/ $ ,__• HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY 1,___ AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ ^~ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO RETENTION S S WORKERS COMPENSATION xi PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER 000 ANY PROPRiETOR/PARTNER/EXECUTiVE N/A VWC-100-6024964-2022A 01/06/2022 01/06/2023 E.LEACHACCIDENT $ 1'000, OFFICER/MEMBER EXCLUDED? (Mandaray In NH) Et DISEASE-EA EMPLOYEE $ 1,OOQ000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1.000,000 I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule.may be attached If more apace Is required) Verification of Coverage 'Subject to all policy terms,exclusions and conditions' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Verification of Coverage ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �'/ LGt^ 4e/4,4r4i. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD . • •:' ;14, • „.44A qt-4", Vv.1;`,41.4! ; A iA.Z1 • ".P. 7;1 I:„.#1.1 7:1 14°--'A'7, • ,t 7 ;11117A•of.+=Tv,J't r 4 - 7:`' •- . ---. '" • 1#4 Sot, „„ - • km • • • ..- 1 2 . . , . P".• • _ . --. • - - , 4 7-6 t ;.1 4•, - , cfr • Commonwealth ot Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS - 109205 Expires: 07/24/2023 UBALDO C MILLER 28 LESLIE LANE Cvv, PO BOX 3238 OAK BLUFFS MA 02557 A Commissioner ,-„ [ . [ . [ t „ t. Ilisii 4 1,0 03 a) 0 73 1 A.441 Cry, - cn .. . . 00 1 3 vt -ri I st, 'SIC. -,-. .,,, . , • . :. 4.n • Y) 4 r - . --- 0 il P.M . CA A 54 "4 IT1* - fr: 71 .... M 01 i I a I )14 2 g a it , 0 X7 rs.) Ca i 4 I c irz, (A 0 § Ait 9 I Cii Z ii [ CO a a " it 1 ‘ ' z. rk---, , . A ,.„,, • -.„.„,_ n C i ...4 fpi ,, -„, . t Z \, N.., - , C I t 1 'il 4,.. ,.t. / l\P . . , . ', :. . , Millers Pro RnS&Remodeling LLC 105 East Falmouth HWY 'h\ East Falmouth,MA 02536 US (774)245-6455 millersms@gmail.com MILLERS PRO. ROOFING &SIDING ADDRESS SHIP TO Darlene Skog Darlene Skog 35 Captain Dore Road 35 Captain Dore Road Yarmouth,MA Yarmouth,MA Siding Replacement: 1 16,990.00 16,990.00 Option 1;All White Cedar Shingles: 16,990.00 Option 2;White Cedar with Hardie Plank in the front side of the house:17,990.00 SCOPE OF WORK A.Complete permit application from the local town; B.Set up proper staging for safety precautions; C.Cover all windows,doors.decks,porches,plants,outdoor light fixtures,etc.to ensure no damage during work; D.Strip existing siding,nails/staples and paper barriers,if applicable; E.Install breathable barrier between exterior sheathing and new siding: F.Install aluminum caps over windows and doors for flashing system; G.Install white cedar shingles(A-grade)fHardie Plank as specified by manufacturer; H.Disposal of all generated debris(dumpster(s)and dumping fee are included in the above price); I.Remove all covers and clean the lob site. (Price only includes the above mentioned items) NOTE: •Above price does not include any electrical work that may be needed; *We cannot guarantee our prices for more than 2 weeks from the date of this quote due to extreme changes in market prices. Please 1-Make checks payable to: Millers Pro. Roofing &Siding Co. 2-Write your invoice number on your check. Thank you for your business. Exterior Trim Replacement:$2,880.00 1 2,880.00 2,880.00 See pictures attached for work scope(marked in green) SCOPE OF WORK A.Insulate windows and doors with water shield,paper barrier,window/door caps; B.Replace corner board; C.Replace window&door exterior trims(details to match existing); NOTE: PVC trims will be used for all trim replacements and screws with plugs,as required by manufacturer; •Windows and door will be insulated with underlayment,waterproof tape and window/door cap. Window Replacement:$1,450.00 1 1,450.00 1,450.00 See pictures attached for work scope(marked in yellow) SCOPE OF WORK A.Replace current window for casement window. THE WORK WILL BE COMPLETED IN A WORKMANLIKE MANNER 1 0.00 0.00 1.We,MRSR,will furnish materials,labor,equipment/tools and stagings necessary to perform the above services: 2.Job site to be cleaned daily: 3.Any alteration or deviation from the above scope of work involving extra costs will be executed only upon written approval of a new estimate.Additional work will be invoiced separately; 4.All agreements are contingent upon strikes,accidents,and other circumstances that are beyond our control; 5.There may be delays in the commencement and completion date due to poor weather condition; 6.MRSR has a strict policy that if invoices are 7 days overdue,work will be stopped immediately until payment confirmation; 7.The above estimate only includes the mentioned items and is valid for 2 weeks from the estimate date: 8.Customer agrees to promptly notify Millers Pro Roofing&Siding and Remodeling LLC.in writing,of any dissatisfaction with the work,to ensure that the service is performed as agreed. Your satisfaction is our future! 50%Upon Agreement 1 0.00 0.00 5 ° Pa, meat Upon Completion of the Work 1 0.00 0.00 Accepted By ' Date:0 J 2 Please 1-Make checks payable to: Millers Pro. Roofing &Siding Co. 2-Write your invoice number on your check. Thank you for your business.