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Home My WebLink AboutBLD-10-345of ,. TOWN OF YARMOUTH Building Department (508) 398-2231 ext.261 BUILDING PERMIT NO _B-10-345 _ ISSUE DATE ; _ 9/18/2009 _ ; P@QWSED USEP E R M I T _ _ _ _ _ _ _ _ _ . APPLICANT Stephen Restaino JOB WEATHER CARD ---------------------------- ------------ PERMIT TO Alterations AT (LOCATION) 10030HATCH RD ZONING DISTRICT R-40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1089.19 BUILDING IS TO BE: CONST TYPE 5-7B USE GROUP R-3 LOT SIZE E::= CONTRACTOR 16 replacement windows REMARKS AREA (SQ FT) EST COST ($)I$11,000.00 PERMIT FEE ($) $40.00 OWNER ICOX, CAROL D BUILDING DEPT BY ADDRESS 10030 HATCH RD South Yarmouth MA 102664 INSPECTION RECORD LICENSE I CSSLWS99560 jRestaino, Stephen 345 Greenwood Street Worcester MA 01607 5089626942 PHONE 15083943856 FIELD COPY Date I ,) Note Progress - Corrections and Remark I Inspector 1 RECEIVED SE PI%8 2009 EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2211 Ext. 1261 CONSTRUCTION ADDRESS: _. 0 ASSESSOR'S INFORMATION: Urnee Use Untomontfisfftrom pentvt Fee Permit expires 6 issue date. / Map: Parcel: OWNER: G" p LU 3o L' !YC!/t1'� ^U �✓ 7 '.S ��, NAME PRESENT ADDRESS TEL. # CONTRACTOR: T// _ S1 P ��EN CSf 1 /1�G 35 Vt 1fft'si%iUt%l� �� i.orC . 7MAILING ADDRESS _ , 1 TEL.# �/ (©a Residential Commercial Est. Cost of Construction $ / Home Improvement Contractor Lic. # 7 - I—, � � p G Construction Supervisor Lic. # Workman's Compensation Insurance: (check one) I am the homeowner I)am the sole proprietor I have Worker's ' Compensation Insurance Insurance Company Name: 1" t"U / /►�1/�� ' fit'' �I/ LAG Worker's Comp. Policy# ? WORK TO BE PERFORMED Tent (Fire Retardant Certificate attached) Duration Wood Stove Shed t=] Siding: # of Squares Replacement windows: # Replacement doors: # Re -roof: # of Squares ( ) Stripping old shingles* *The debris will be disposed of at: O going over layers of existing roof J Old Kings Highway/Historic District Ni Roofing/Siding (Like for Like) Location of Facility I declare under penalties of perjury that the statements herein contained are we and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for denial or rem of my license and for ution under M.G.L. Ch. 268, Section 1. Applicant's Signature: --— Date: Owners Signature (or Approved By:. Building Official (or designee) Zoning District:_ Historical District: Yes )4 Water Resource Protection District:: 7s No Date: L/ Flood Plain Zone: Yes Within 100 ft. of Wetlands: , ) Yes XO 3101 Are you an employer? Check the appropriate t 1. I am a employer with __ 4. employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.} 5. El 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance) We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' tomo. insurance required.1 Type of project (required): 6. []construction 7. emodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13 . ❑ Other `Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I 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: sAi �2091ffl� Policy # or Self -ins. Lic. #: l�?C i Expiration Dater 1 ], o r (� n City/State/Zip: Job Site Address: ! "' 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 certify yujide3 the pains and penalties of perjury that the information provided ab Ye is true and correct. Date:— Cinnatnrr- Official use only. Do not write in this area, to be completed by city or town of City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: Licensee Details The Official Website of the Executive Office of Public Safety and Security (EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Home Improvement Contractor License # 153140 Restriction Company Nu -vision Installations Name Stephen Restaino Address 32 Oval Drive City, State, Zip West Yarmouth, MA, 02673 Expiration Date 10/31/2010 Status Current N; complaints found For this Licensee. Iii k To Search �uSupervisor Sotacialty License License: CS SL 99560 yM", , 4 +w� Restricted to WS . h; STEPHEN RESTAINO.. x 32 OVAL DRIVE.r, WEST YARMOUTH, MA 02673 t � il1J)I l��ll tlil'd' v,. Expiration: 1/22/201,2 Tru: 99560 �ti5� Page 1 of 1 ACORD STEPH- CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MM/DD/YYY2 07 15 099 RooUfaw, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ilde Cape Cod Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE lartha rindlay HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR !96 Winter Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (yannis HA 02601 ?hone: 508-771-3300 Fax : 508-775-3821 INSURERS AFFORDING COVERAGE NAIC # JSURED INSUIRERA: Safety Insurance Co 39454 INSURER B, 9e hen M R®staino INSURERC: DB A Nu-Hisxon Installations val Drive ya=outh MA 02673 INSURER D; West INSURER E: _ `AVRRACRS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TC 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TR NSR 1-01(10411 CE POLICY NUMBER DATE (MNUOD/YY DATE MM/DDIYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE F-1 OCCUR X Business Owners GEN'LAGGREGATE LIMITAPPLIES PER; POLICY n JPERCT n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NowowNFA AUTOS -GARAGE LIABILITY I 1 ANY AUTO EXCESS/UMBRELLA L(ADILITY —1 OCCUR 7 CLAIMS MADE DEDUCTIBLE RETENTION t6 WORKERS COMPENSATION AND EMPLOYERS' LIABIl Y ANY PROPRIETORIPARTNERIEXECUTNE OFRCERJMEMBER EXCLUDED? If Yes, daw1be under EP00004763 1 07/13/09 1 07/13/10 EACH OCCURRENCE $ 500000 PREMI ce $ 100000 MED ECP (Any one person) *10000 PERSONAL& ADV INJURY S500000 GENERAL AGGREGATE IS1000000 PRODUCTS -COMPIOPAGG 15 500000 COM�tl SINGLE LIMIT & BODILY IWURY $ (Per Person) BODILY INJURY = (Per sadden) PROPERTY DAMAGE $ (Pet seddent) AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: AGO S EACH OCCURRENCE S AGGREGATE S S S E.L. EACH ACCIDENT Is 6,L, DISEASE - EA EMPLQ , $ _ I E.L. DISEASE - POLICY LIMIT 16 PROPERTY 3510 )ESCRIP'nON OF OPERATIONS I LOCATIONS I VEHICLES I EXGLtISIONS AUUEU UT U14WKMMME Y I r armor Certificate Holder is an Additional Insured CID r -zs '.ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C�NCELLED 13E NRE PIRATION �. oATE THEREOF, THE ISSUING INsuRER WILL RNI)FAVOR.Dro MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE BOLDER NAM® TO THE LEFT, BUT FAILURE TO DO $0 SHALL The At -Home Services, Inc DBA IMPOSE ND OBUGATION OR LIA NUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR The Home Depot at the Service 2690 Cumberland Parkway THO REPRESENTATIVES. RLITH° Atlanta GA 30339 ® ACORD CORPORATION 1988 ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE 0 /00IYYYY) oa/2o/o9 PRODUCER 1-404-995-3000 Marsh USA, Inc. homedepot.certrequest®marsh.com THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-0902 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Steadfast Ins Co 26387 THD At -Home Services, inc. INSURER B: Zurich American Ina Co 16535 INSURER C: NATIONAL UNION FIRE INS CO OF PITTS 19445 2690 Cumberland Parkway Suite 300 Atlanta , GA 30339 INSURERD:New Hampshire Ins Cc 23841 INSURER E: Illinois Nati Ins Co 123817 EACH OCCURRENCE $4,000,000 r•nvcoencc v 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DD' R POLICYNUMBER POLICY EFFECTIVE M POLICY EXPIRATION T LIMITS GENERAL LIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACH OCCURRENCE $4,000,000 _UA_WA_U9 TO RENTED PREMISESte,ocarence $1,000,000 rA X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXCESS MED EXP Any one person) $EXCLUDED CLAIMS MADE a OCCUR "OF SIR: $1,000,000 PER CC" PERSONAL&ADV INJURY $ 4,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'LAGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OP AGG $4,000,000 X POLICY PRO- JECTLOC B AUTOMOBILE LIABILITY HAP 2938863-06 03/01/09 03/01/10 COMBINED SINGLE LIMIT $1,000,000 X (Eaaccidenl) ANY AUTO ALL OWNED AUTOS BODLYINJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ - (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ X SELF INSURED AUTO PHYSICAL DAMAGE (Par accident) GARAGE LIABILITY AUTO ONLY-EAACCtDENT $ OTHERTHAN EAACC $ ANY AUTO - AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACHOCCURRENCE $5,000,000 _ AGGREGATE $ 5,000,000 X OCCUR 0 CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ C WORKERS COMPENSATION AND 3566916 (CA) 03/01/09 03/01/10 X WC STATT OTRH- E.L. EACH ACCIDENT $1,000,000 D EMPLOYERS'LIABILITY 3566915(AOS) 03/01/09 03/01/10 E.L. DISEASE - EA EMPLOYEE $1,000,000 E ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? 3566917 (FL) 03/01/09 03/01/10 E.L. DISEASE -POLICY LIMIT 000 If yes, describe under SPECIAL PROVISIONS below D OTHER Workers Compensation 3566918 (KY, MO, NY, WI, ) 03/01/09 03/01/10 F TX Employers Excess TNSC45694422 (TX) 03/01/09 03/01/10 ccurrence/SIR 25M/2M C Workers Compensation 4801323(QSI) 03/01/09 1 03/01/10 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE UtKI It- IUAI t ML)LUtK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THD AT-HOME SERVICES, INC. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 2690 CUMBERLAND PARKWAY SUITE 300 REPRESENTATIVES. �. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE USA ,� � nnnn nr�nn�n ATIA�1 A[fOe ACORD 25 (2001108) ckomraus hd 11172180 Board of some" aftwediss aed Sdadardi r HOME &V*OVE1IENT CONTRACTOR •. .? 12f�93 t } d E, n- M42010 Type: Supo"em Owd TM Home Depot At -Home SwIl" DARREN DEMERS 3240 COBB GALLERIA PKWY 620 .►.` ATLANTA. GA 30339 Adi iaistrat" �e. r istmtiOn Yand fer mdtvfdltl an ORJy �..lCeafe Or ea'r before the expiration date. Kfound reftra t* - Board of Bailding Regulations and Statduds One Ashhurtoe Place Rm 1301 Boston, Mi s. 02108 Not ve id witho d d9w"t'e �_ SEP -03-2009 19:22 Branch Nmne: Bed oil Branch Numh—, 10 ON. 33 � uth 31 . Installation Addresf HOME DEPOT HYANNIS P.001 HOME IMPROVEMENT CONTRACT PLEASE MEAD THIS (� 'Sold, Flunishod and Tnsraliod by: Date: A31 Q . �. TTID At -Home Services, Inc. d/b/a The Home Depot At-Homc Services -```SSA Greenwood Strect,-Umt 2, Womcsiter, MA 01607 Toll Free (800) 657-5182; Fax (503) 756-8823 Federal LD # 75-2699460; ME Lie # C 02439; RI Cont. Lic# i 6427 CT Lie # 565522; MA Rome emeat Contractor Reg. # 126893 7in Who* Phoney . Home Phone: • Cell Phone: Home Address: _- (If different from Inst dlafion Address) . City State Zip E4UQ:Address (to r xeive prvjw oommanicatiohs and Home'Depot updates): i'DO`NOT,wish a -receive anymat9cetu+g ernails from The Home Depot' Byect Tnf a on! • Undersigned ("Cristome�"),'the owners of the property located at the above installation address, agrees to buy, THD Al -Home rvices, Inc. (`"The Home Depot'[ agiew'to'fatmsb, •deliver rind arrangc7for the installation ('Installation-) of all ruaterials• describe l:on: the below and'.on the,refercnced Spec -Shoct(s), all"of, which are incorporated into this Contract by this reference, along with any -applicable State,Supplement and Payment.Summary.attached hereto and any. Change Orders (collectively, "Contract"):.. . .lah 0- P - . _ u -..a....... - Sece Shullal #e Proiect Amount ( bfit a Roofing clsiding V✓indowS '1nsu1ntiOu ❑GuttcisICavge'©EmxyDoots ❑ {� b $ ng , siding Windows andation .. []G=m /�overc DEntryDoors ❑ $ . Roofing iding 1 Windows 0Insulation 1 OGntters./'Cown OEntry Doors Q . . $ . - - ir8xSiding 'Windows InsUiati*n QG•utters /, Covets ❑Entry Doors : [] • M1nimmn 25% Depod -of Coutract Amount due upon esecatipn of this eoUbmM... MainePmrhw4tam) notdepoOtnWetbumono-*WofdteCbnhpetAmomt Total Contract Amount : S Customer agr=. that; immediate 'upon completion.of the work -for 'each. Product, Customer will execute a.Cofiaplt tion Certificate (one for`cach Product as defined by an individual, Spec Sheet) and pay any batancc..due. As applicable, each Customer under this Contract agrces to be j »ntly and severally obligated and liable bereunder. The Home Depot reser ves.the right to .issue a Change Order or terminate this Contract or my individual Products(s) included herein, at is .discretion,. if The Ht me Depot or its author zed.service-provider determines that it cannot perform its obligations due to a structural problem with the hom ,, . environmental hazards socb as mold,asbestos ,or: lead paint, other safety .concerns, pricing errors or because w.orkrcgmred to comp !etc the. job was not included n C0 6 PavmAnt Summarv: The Payment Summary # ,included as part of this Contract, stir forth the total %Contracteamount and•p tyments required for the deposits and final payments by Product (as applicable). NOTICE TOCUSTOMElk You are entitled to a, ompletely Shed -in copy Of the Contract at the time you sign. Do not sign a Completion Certificate (note: there is one Completi >n Certificate for each listed Product as defined by individual Spec Sheets) before work on that Product Is complete. in the event of termi, cation of this Contract, Customer agrees to pay The Home Depot the costs of materials, labor, evenses and services provides by The Home Depot or Authorized Service Provider through -'the date of termination, plus any other amounts set forth in t his Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE H )ME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LI vInING THE HO d E DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceotauce and Autb �ri�ation: Cuctotner agrees and tmderstands that this Aeemcnt is the entire agreement between Custarncr and The Home Depot � nth regard to the Products and 1nStaliatian services and supersedes all prior discussions and agteemettts, either oral or written, relatial :to said Products and Installation This Agreement cannot be assigned or ar:nendcci except by a writing srgrod by Customer and The : Iotne Depot Customer acknowiedgcs and agrees that Customer has react, rnaderstamds, vohu+tarily accepts the terms of and has receiv cel s copy of this Ag ooment Customer's Signature Date X Customer's Signature Date Saies.Cenis�iltantIs Signature r Date t Telephone No. Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS (°S appbpblk) AGREEMENT WTTI :OUT PENALTY OR -OBLIGATION BY DELIVERING R RITTEN NOTICE TO THE HOME r DEPOT BY lti IWq :HT ON THE THIRD BUSINESS DAY AFTER SIGN INC THIS AGREEMENT. THE STATE SUPPLED CENT ATTACHED HERETO CONTAINS A Ft )RM TO USE IF ONE IS, SPECIFICALLY PRESCRIBED BY LAW IN i CUSTOM WS STATi E. i NOTICR: ADDM )NAL TERMS AND CONDITIONS ARE STATED 014 THE Rxvtf:RSE SWE AND ARE PART OF THIS CONTRACT