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ZP-17-423 - 0017 Catkin Drive 11/27/2017
Applicant: CITY OF SOUTH BURLINGTON Z O N I N G PERM IT APPLICATION Home Depot c/o Basia Leone Applicant Mailing Address: 908 Boston Tpk., Shrewsbury, MA 01545 Applicant Email: permitpull@gmail.com Property Street Address: 17 Catkin Dr., S. Burlington Property Owner: Gordon Zhang Property Owner Mailing Address: 17 Catkin Dr., S. Burlington Application No: _P N- A :;; 3 [office use only] Daytime phone: 508-335-3587 Parcel Size: Tax Parcel ID No. VT 05403 1. PROPOSED project including building dimensions (describe): Remove and replace 25 sq. asphalt roof shingles, ridge vent, flashing and drip edge. NO STRUCTURAL CHANGES. 7, Present USE(S) of the property: ❑✓ Single family home on its own parcel ❑ Other (please state the USE per Land Development Regulations- retail, general office, multifamily residential, etc.): 3. List all present structure(s) on property (describe including dimensions or square footage of each): 4. Does the project include a proposed change of USE? 0No (the property will still be used for the same purpose) ❑Yes (please state proposed changed or added USES per Land Development Regulations- retail, general office, multifamily residential, etc.): 5. ESTIMATED total cost of improvements (materials and labor): $ 1 6,132.40 6. Building footprint — i.e. size in sq.ft of main floor of house and all attached and detached structures including enclosed breezeways, garages, and sheds (describe): Existing: Proposed: 7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks) Existing: Proposed: 8. ATTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of existing roof, siding, etc. in the exact same size) I 9. APPLICANT/OWNER CERTIFICATION 4Thersi6ned property owner hereby consents to submit this application and understands that if the application is approved, the it and an ttached conditions will be binding on the property. Basia Leone/Home Depot 11-13-2017 ure PRINT NAME Date gned appl' a t here y affirms t at the information presented in this application is true, accurate and complete. Basia Leone/Home Depot 11-13-2017 natur / PRINT NAME Date OFFICE USE ONLY — ADMINISTRATIVVE�jOFFICER ACTION — OFFICE USE ONLY DATE Received: FEE Received: $ �" / Identification of zoning district: Identifiof proposed use:IrL &cation PROPOSED USE TYPE: Permitted Conditional Date of SITE PLAN approval/denial Approval Date Denial Date Date of SUBDIVISION approval/ denial Approval Date Denial Date Date of CONDITIONAL USE approval/ denial Approval Date Denial Date Date of appeal VARIANCE approval/ denial Approval Date Denial Date Date of MISCELLANEOUS approval/ denial Approval Date Denial Date Provided applicant copy of URBEC or VCBE Standards Handbook or©Not Applicable APPROVED Permit EFFECTIVE date DENIED Denial Date FINAL ADMINISTRATI OFFICER ACTION O N I N� P AdmM(.- tr tive Officer's Signa ure1//� L� Permit EXPIRATION date / REASON for DENIAL Notice of Appeal Rights: Any interested person may appeal this decision by filing a written Notice of Appeal with the clerk of the Development Review Board within fifteen [15] days of the date of this decision. The notice of appeal must be accompanied by a filing fee of $223,00. This permit does NOT authorize commencement of any development activity approved by the permit until the permit takes effect as set forth above. Site modifications and improvements made prior to this permit becoming effective may be subject to removal )nd site restoration if a timely appeal is commenced. NOTE: The applicant or permittee retains the obligation to identify, apply for, and obtain relevant state permits for this project. Call (802) 879-5676 to speak with the regional Permit Specialist. Is 11-07-2017 To whom it may concern, I, Gdrdon Zhang, of 17 Catkin Dr., S, Burlington, VT, give Basia Leone c/o Home Depot permission to sign any paperwork pertaining to the application and obtainment of any necessary zoning and building permits relative to the installation of replacement roof shingles at the aforementioned property. Gordon Zhang m . rome Depot Contractor License Numbers: #N/A Salesperson Name and Registration Number: Richard Bessette : R-1-073-13-00029 Home Improvement Agreement Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Gordon Zhang rew England North 10502698 First Name Last Name Branch Name Lead # 17 Catkin Drive SOUTH VT 05403 Customer Address City State Zip (215) 866-7096 Home Phone# Work Phone# Cell Phone# guojun.blue@gmail.com Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: )J8 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address City State Zip or Email CustomerCancellationNorthEast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: X 10/31 /2017 Customer's Signature Date A� O? CERTIFICATE OF LIABILITY INSURANCE OATEIMMIODrrrrY) u2: n1zo17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ELOW. 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 pol)cy()es) must 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 MARSH USA, INC. TWO ALLIANCE CENTER NAME: CONTACT PHONE ,FAX (A/C. No. I (AIc 3560 LENOX ROAD, SUITE 2400 ATLANTA, GA 30326 EA -MAIL --- INSURER(S) AFFORDING COVERAGE NAIC 111 INSURER A: Old Republic Insurance Co 24147 100492-HomeD-GAW'-17.18 INSURED HE HOME DEPOT, INC. HOME DEPOT U.S A., INC. INSURER B : Agn General Insurance Company 42757 INSURER C : New Hampshire Ins Co 23841 INSURER D : ---- 2455 PACES FERRY ROAD BUILDINGC-20 — --- ATLANTA, GA 30339 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-003746387-14 REVISION NUMBER:2 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MMIODIYYYY POLICY EXP MMIODIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAMS -MACE X OCCUR AGGREGATE LIMT APPLIES PER POLICY" ECT LOC OTHER MWZY 310022 LIMITS OF POLICY XS OF SIR: $1 M PER OCC 03101/2017 03101/2018 1 EACH OCCURRENCE S 9,000,000 PREMISES S1,000,000 GEN'L X _ _lEaoccurrence MED EXP (Any one person) S EXCLUDED PERSONAL & ADV INJURY S 9,000,000 GENERAL AGGREGATE S 9,000,000 PRODUCTS - COMPIOP AGG $ 9,000,000 S AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS MWTB310021 SELF INSURED AUTO PHY DMG 03/01/2017 03/01/2018 OM IN IN LE LIMIT Ea accident S 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Par accident) S PROPERTY DAMAGE Per ecddant $ s UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S DED i RETENTIONS S B C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA WLR C49112300 (TN) WC 023102423 (AK,NH,NJ,VT) WC 023102424 (WI) Continued on Additional Page g 0310112017 103/0112017 03/0112017 03101I2018 03101/2018 03/01/2018 X STAT TE ORH E L EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE) $ 1,000,000 E L DISEASE - POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedute, may be attached If more epees is required) EVIDENCE OF INSURANCE HOME DEPOT USA, INC 2455 PACES FERRY ROAD ATLANTA,GA 30339 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 of Marsh USA Inc. Manashi Mukherjee ©1988-2014 ACORD CORPORATION- All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD