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HomeMy WebLinkAboutBLDX-26-576 RECEIVED yA 08 r_ Office Use Only /, . �a0' r JUN 2026 Pem,it#&"-DV-a!o-51(04 q qi 4/ 5© {0'� . . �]; Amount � BUILDING DEPARTMENT �`� .•rr.c�cua gq , By ___ \c°Pop AT. ' EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: 23 Oyster Cove Rd SOUTH YARMOUTH, 02664 OWNER: Paul Riker Same as above (774) 836-8119 NAME PRESENT ADDRESS TEL. # CONTRACTOR: Karner Home Improvement LLC dba DaBella 300 Crown Colony Drive Ste 504 Quincy, MA 02169 NAME MAILING ADDRESS TEL.# EMAIL: karnerpermits@dabella.us X)Residential ❑Commercial Est.Cost of Construction$ .�I b) ! - G la CC) Homeowner is Applicant? Yes No X Home Improvement Contractor Lic.#1981 18 Construction Supervisor Lic.#CS-119210 WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate required) Wood Stove Siding: #of Squares 16.10 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: Dumpster will be provided by installer 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 or revocation of my license and for prosecution under M.G.L.Ch.268,Section I. Applicant's Signature: Date: 5/27/2026 Owners Signature(or attachment) See signed contract Date: 5/27/2026 Approved By: Date: Building Official(or designee) Rev 6/24 DATE(MM/DD/YYYY) • 12/15/2025 .4CO Rv CERTIFICATE OF LIABILITY INSURANCE Acct#: 3036373 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 AON RISK SERVICES SOUTH,INC NAME: PHONE FAX 3550 LENOX ROAD NORTHEAST,SUITE 1700 (A/C,No,Ext):844-398-0470 (AIC,No): ATLANTA,GA 30326 EMAIL ADDRESS: CERTSOPEOPLEASE.COM INSURER(8)AFFORDING COVERAGE NAIL 8 INSURER A:FEDERAL INSURANCE COMPANY 20281 INSURED INSURER B: KARNER HOME IMPROVEMENT LLC 110 TURNPIKE RD STE 108 INSURERC: WESTBOROUGH,MA 1581 INSURERD: 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 ADDLTYPE OF INSURANCE IN8D SUER POLICY NUMBER (MWD/YY YYY) (M IDIV EXP LIMITS LTR INSD MD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ DAMAGE TO RENTED CLAIMS- OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY �RO- LOC PRODUCTS-COMP/OP AGG $ IFrT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N Ni STATUTE ER ANYPROPRI ETOR/PAR TNER/EXECUTIV E OFFICER/MEMBER EXCLUDED? N/A C74318083 01/01/2026 01/01/2027 E.L.EACH ACCIDENT $ 1,000,000 A (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 3036373 PmotofCoverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AFRO® CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDOIYYYY) 12/03/2025 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 Talia Ellison NAME: Integrity Insurance 8 Bonding Inc. PHONE (503 777$655 F'ix -8418 INC.No,EMI: ) WL,NP): (503)607 9201 SE 91st Avenue,Suite 220 EA-DMONRess: taliae@integrityibi.com Happy Valley,OR 97086 INSURERIS)AFFORDING COVERAGE NAIC INSURER A: Associated Industries Ins.Co.Inc 23140 INSURED INSURER B: Ohlo Security Insurance Co 24082 Kamer Home Improvement LLC,DBA:DaBelie INSURER c: 400 E Anderson Lane INSURER D Austin,TX 78752-1224 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20251203 REN GL 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. LLORR TYPE OF INSURANCE INST.� POUCY NUMBER P�CYEFF POLICY W� IYW POLICY (POLICY Y, X COMMERCIAL GENERAL LIABLRTY EACH OCCURRENCE f 1,000,000 DAMAGE TO RENTED CLAIMS-NUDE OCCUR PREMISES(Es°cadence) S '°°° MEDEXP(Any one person) S 5,000 A AES1193526 07 12/03/2025 12/03/2026 PERSONAL SADV INJURY f 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 POLICY El JEcT 0LOC PRODUCTS-COMP/OPAGG f 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f 1,000.000 (Ea accident) ANY AUTO BODILY INJURY(Per person) B OWNED X SCHEDULED BAS65523629 06/01/2025 06/01/2026 BODILY INJURY(Per accident) f AUTOS ONLY -AUTOS Xcoven v NON S NFD PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY (Per accident) f UMBRELLA LAB OCCUR EACH OCCURRENCE f EXCESS LIAR CLAIMS-MADE AGGREGATE S DES I I RETENTION S f WORKERS COMPENSATION I`ATUTE I I ERX AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S N yea,deaaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT f DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Addinonel Remarks Schedule,may be enriched N more space le required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Insured's Copy ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ©1988.2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Home Improvement Contractor Registration Card Registration valid for use type,only before the expiration date. Type:Limited Liability Company(LLC) Number:198118 Expiration:03/05/2028 Issued to: DaBella Karner Home Improvement,LLC Zachary Barry 110 I urnpike Road Suite 108 Westborough,MA 01581 Office of Consumer Affairs&Business Regulation Layla R.D Emllld 1 Federal St..Suite 0720.Boston,MA 02110-2012 Undersecretary Commonwealth of Massachusetts T ;ff' Division of Occupational Licensure Board of Building Re ulations and Standards Cons 4 rvisor IP CS-119210 Tres: 10/04/2027 ZACHARY B - R . -) 5 30 RIVERIN A -,- D 6-1 ANDOVER Mt 01810 Commissioner S6,,,cLevihl 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 The Commonwealth of Massachusetts , A Department of Industrial Accidents !grit Office of Investigations ^ ; I_ 1. .: 11 ' Lafayette City Center I � . k 2 Avenue de Lafayette, Boston, MA 02111-1750 \rat:,s' y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Kamer Home Improvement LLC dba DaBella Address: 110 Turnpike Road STE 108 City/State/Zip:Westborough, MA 01581 Phone #:508-659-4177 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. El New construction listed on the attached sheet. 7. ❑■ Remodeling 2. El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. 0 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 10.1=1 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ 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: Federal Insurance Co Policy # or Self-ins. Lic. #:C74318083 Expiration Date: 1/1/2027 Job Site Address: 23 Oyster Cove Rd City/State/Zip:S. Yarmouth, 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 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 ertify under the pains and pen, es of perjuty that the information provided above is true and correct. Signature: te: 5/ 6/2026 Phone • %08-659-4177 b O r al 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 6.1:1Other Contact Person: Phone #: DABELLAQUINCYOFFICE SIDING CONTRACT - HARDIE • 300 Crown Colony Drive Form 038 (Reverse 005) - Effective Date -6/1/2024 Quincy,Massachusetts 02169 DATE: 05/14/2026 JOB# 4554466 Phone i-855-A77-35s2 REPRESENTATIVE l: Ethan Bent Fax i% 8169 REPRESENTATIVE 2: DaBellaM F9am 5pm BRANCH NAME: DaBella Quincy Office HIC19a1,3 GENERAL.CONTRACTOR'S AGREEMENT I/We,the owner(s) of the premises described below, hereby authorize you as contractor to furnish all necessary materials, labor and workmanship to install,construct and place the improvements dcrribed herein according to the following specifications,terms and conditions on the premises described below. OWNER NAME1 Paul Riker I OWNER NAME2 1 COUNTY I Barnstable County ADDRESS 23 Oyster Cove Rd CITY SOUTH STATE Massachusetts ZIP 02664 YARMOUTH CONSTRUCTION SITE 23 Oyster Cove Rd CITY SOUTH STATE Massachusetts ZIP 02664 YARMOUTH PHONE EMAIL 7748368119 I oldparamedic@hotmail.com BESTTIMETO CALL PREFERRED CONTACTMETHOD Afternoon Cell Phone � STANDARD PRAC110ES TO BE DONE:I- I Inspect surfaces work area, renail loose wood, and replace rotten surface Caulk and seal around all windows and doors with OSI quad max sealant wood (as necessary) in work area (extra charge) 15 year warranty). ❑✓ Flash all horizontal surfaces with High Back Z Metal flashing. `� Follow James Hardie Best Practices for installation. 0 Prepare walls with James Hardie system including tape flashings. CI Cleanup and removal of all job related debris. n Each job is over-shipped to avoid delays. Remove excess materials and re- 0 E-Mail customer warranty after satisfactory completion. stock 0 DumpBox DaBella will do its best to use the preferred location, however D Caulking at HarciePlank lap siding butt joints is not recommended for this is at the discretion of the dumpster company. aesthetic reasons as,the caulking will weather differently. For the same Preferred Dump Box Location: Driveway reason, we do not caulk exposed nail heads unless they are overdriven. Additional details of Job/Work: SHEATHING: If wood fascia and/or barge board is required,it will be installedata rate of per linear foot(includes labor and THIS PROJECT INCLUDES 30 SHEETS OF PLYWOOD. materials). If sheathing is required,1/2"CDX plywood will be installed at the THIS PROJECT INCLUDES 0 LINEAR FEET OF WOOD FASCIA AND/OR BARGE BOARD. cost of$150 per sheet(includes labor and materials). Customer will be informed if wood fascia and/or barge board are required during install. p /N/TIAL HERE) Customers will be informed if dry rot or other damage is found. 77�� Location: Driveway pk (INITIAL HERE) YEAR HOME BUILT:-976 ESTI MATED START DATE: 07/07/2026 ESTI MATED END DATE: 07/11/2026 CUSTOMER WILL USE FINANCING LOAN TO PAY FOR THE PROJECT pk (initial here) (initial here) NO ORAL AGREEMENTS ARE ACCEPTED. pk (initial here) (initial here) DO NOT SIGN CONTRACT IF BLANK Da Bella is neither a broker nor a lender.Financing is provided by third-pa rty lenders unaffiliated with Da Bella,under terms and conditions arranged directly between the customer and such lender,all subject to credit requirements and satisfactory completion offinance documents.Any finance terms advertised are estimates only.DaBella does not assist with,counsel,or negotiate financing,other than providing customer an introduction to lenders interested in financing Da Bella customers. pk (initial here) (initial here) SIDING PRICE: $46,148.00 DEPOSIT: # $4,179.00 WARRANTY INFO 0 30 Year Non-Prorated Siding Warranty covers the cost (James Hardie) Color Plus 8 CASH BALANCE TO BE ! _ Prime TAX CODE: PAID ON SIDING $0.00 .V 15 Year Finish Warranty (James Hardie) Color Plus Only*** COMPLETION: % 15 Year Caulking Warranty (OSI Quad) SALES TAX:(0%) 0,00 - - - - % 10 Year Weather Resistant Barrier Warranty (Tyvek) $ ../ 1 Year DaBella Labor Warranty BALANCE TO BE ; - ---- -- —_ -- $41,969.00 . FINANCED: See Warranty Disclaimer below TOTAL DUE: -- i $46,148.00 — _— —�N — �_+ ""'7ames Hardie Prime has no finish warranty A—'_ __i — "There are no express or implied warranties other than those stated in writing by the manufacturer of the goods provided or by Da Bella.Some states do not allow limitations on how long an implied warranty lasts,so the above Imitation may not apply to you.Warranties will not be effective or enforceable while a balance due remains outstanding on anyjob. It is agreed and understood that this Agreement constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms of this Agreement.I acknowledge that I have read the front and reverse of this Agreement and have received a completed,signed,and dated copy of this Agreement,including the two accompanying Notice of Cancellation forms,on the date first written above.I also acknowledge that I was orally informed of my right to cancel this transaction. You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the Notice of Cancellation form provided to you herewith for an explanation of this right. ACCEPTED BY: Eiii4 fill— X P k DATE L 05/14/26 DABELLA REPRESENTATIVE CUSTOMERS SIGNATURE X DATE CUSTOMERS SIGNATURE MAKE ALL CHECKS PAYABLE TO DABELLA-ADDITIONAL ADDENDUM MUST BE APPROVED BY CUSTOMER Kamer Home Improvement LLC Is a d/b/a of Da Beila and will hereinafter be referenced as DaBella.6 2024,All rights reserved. DaBella Quincy Office - Agreement - 2797019 - Page 2 of 26