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Home My WebLink AboutB-09-554of TOWN OF YARMOUTH Building Department BUILDING _ _ _ _ _ _ (508) 398-2231 ext.261 PERMIT NO � - _6-09-554 _ � - - - - - - , PERMIT ---------- ,� ISSUE DATE 11/10/2008_ PROPOSED U IP---------- APPLICANT ' ----------------OB WEATHER CARD Niall Hopkins Ti"z ----------------------------- ___ ___ PERMIT TO Alterations ------------- AT (LOCATION) 0361 GREAT ISLAND RD ZONING DISTRICT R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 014.2 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE 4 squares siding, five replacement doors, nine replacement windows REMARKS AREA (SQ FT) EST COST ($) $3,000.00 PERMIT FEE ($) $75.00 OWNER SWEAT, MICHAEL D BUILDING DEPT BY ADDRESS 0361 GREAT ISLAND RD (West Yarmouth MA 02673 PHONE CONTRACTOR LICENSE 084916 Hopkins, Niall POB 231 South Yarmouth MA 02664 5083944986 INSPECTION RECORD FIELD COPY Date Note P gress - Corrections and Remarks inspector, EXPRESS BUILDING PERMIT APPLI TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 261 CONSTRUCTION ADDRESS: vuRc vx aira,� Permit, _d 9�S Fee S ffro'm Permit Cep 6 m 69aUC datC. r. .. E.',• .AA NOV 1, 0 2,408 CONTRACTOR: NAME MAILING ADDRESS r) M TELL # 14 U Residential 0 Commercial Est. Cost of Construction S XWO Home Improvement Contractor Lic. # ' J� D Construction Supervisor Lic. # 94916 Workman's Compensation Insurance: (check one) U I am the homeowner U I am the sole �p`ropnet I have Worker's Compensation Insurance l , ` W / �! 64 Insurance Company Name:_ '1'11' 1�1� Worker's Comp. Policy# 2W ` X 59, WORK TO BE PERFORMED ❑ Tent (Fire Retardant Certificate attached) Duration Wood Stove-_—_ — Shed____ uding: # of Squares_ XReplacemerd windows: #_ eplacement doors: #-- 11 Re -roof: # of Squares () Stripping old shingles* ( ) going over layers of existing roof ❑ Old Kings HighwayiHistoric District 0 t Roof'mgiSiding (Like for Like) *The debris will be disposed of at: I o ation of acility I declare under penalt' p ury that the statements herein contained are true and correct to the best of my know aIbLdi,f. 1understand that any false answer(s) will bejust cause for or ocation of my license and for prosecution under M.G.L. Ch. 268 Section 1. applicant's Signature.. Date: Owners Signature (or enl) _ _Date: Approved By: Data Building Official (or designee) "Lotting District: Historical District: rl Yes �No Water Resource Protrx)tcm District: 1 Yes No Flood Plain Zone: Yes Within IW ft. of Wetlands: Yes 1� No Cl No 3-U1 r The Commonwealth of Massachusetts Department of Industrial Accidents Offlce of Invesdgadons kvi 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affldavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organizationllndividual): Are u an employer? Check the appropriate box: Type of project (required): I . I am a employer with �_ 4. 0 1 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.*fRemodeling ship and have no employees These sub -contractors have S. 0 Demolition working for me in any capacity. employees and have workers' 9. [] Building addition [No workers' comp. insurance comp. insurance.$ required.] eqs] 5.0 We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 1 l.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, 11(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required] Any applicant dot checks box 01 must also till out the section below showing their worker' con Venation policy information. t Homeowners who submit this affidavit indicating they aro doing all work and tum hire outside contractus must submit anew affidavit indicating such. tContractors 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 subcontractors have employees, they must provide their workers' comp. policy number. I ars an employer that is providing workers' compensation lnsuraace for my employees. Below is time poucy and job sigs informadoa. l- r l Insurance Company Name:, Policy it or Self -ins. Lic. M: 9,M1 Q b l Expiration Job Site Address: SOt 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 51,500.00 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 dayagainat the violator. Be advised that a copy of this statement may be forwarded to the Office of Ida hereby cerdI 1hd Olike pains and peneldes of perjury that the information provi j4d aaove Is true and coned use only. Uo not write in 1ft& area. to be completed by city or town official City or Town: Permit/License 4 Issuing ,Authority (circle one): 1. Board of Health 2. Building Department 3. Cityltown Clerk 4. Electrical Inspector S. Plumbing Inspector b. Other Contact Person: Phone #: Niall Hopkins Builders 21 G Fruean Ave South Yarmouth, MA 02664 I Name / Address I Micheal Sweat 361 Great Island Road West Yarmouth MA 02675 ESTIMATE Date Estimate # 10/16/2008 8 Phone # Project E-mail Description Qty Rate Total Niall Hopkins Builders to fumish Certificates of insurance upon acceptance of proposal (both liability and workman comp) Acceptance of Contract The above price, specification and conditions are satisfactory and hereby accepted. Niall Hopkins Builders is authorized to do the work specified. A 50% non-refundable deposit is required for all work. Deposit will be refunded if permits are not obtained, net costs incurred at apply for said permits. Weekly progress payments to be made upon substantial completion. Make all checks payable to Niall Hopkins Signature: At I MicheedrSweat WI? JO Niall J Hopkins: r / I Price Good for 30 Days Total $29,590.82 Phone # Fax # E-mail 508 394 4986 508 394 9202 Nhopkins@grangeconstruction.com ayc " 92L � , Board of Building Regn�nd Sta dard!'s Construction Supervisor License License: CS 84916 Birthdate: 4/2/1970 Expiration: 4/212009 Tr# 12392 Restriction: 00 NIALL J HOPKINS BOX 231 SO. YARMOUTH, MA 02664 Commissioner J/ze � »zJnnncuerzl� a`'� , llrz�rac� Board of Building R'!9ulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 133862 Expiration: 8/20/2009 Tr# 132800 Type: DBA GRANGE CONSTRUCTION NIALL HOPKINS 118 LAKEFIELD RD. S. YARMOUTH, MA 02664 Administrator