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F, l ,1 (f -` - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1]Map Parcel O 0 b P Application # Health Division Date Issued Conservation Division Application FdX Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address��0 Q 0CSC _ �� Village H Y rf)t)/S5 Owner Address Telephone Per it Request _V, �OR�'aT M 16ue, �:V)IL �Zyyw Q, 4,N_ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type r = Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) v Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's ighway:!>0 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Othera m Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name EY404— _ 1-e"_Ct1 -J4_4C'Telephone Number Address 6-7 :5� License # 7 Wct,14,0,4, M4, 6 4 rz-- Home Improvement Contractor# i� Email _ c7-�'o ron����,C� vk T n . C4 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO kz� dPdl( 1 SIGNATURE DATE FOR OFFICIAL USE ONLY ` -APPLICATION # y F , ` DATE ISSUED - MAP/ PARCEL NO. ADDRESS VILLAGE } OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 g Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 183006 Type:. Corporation Expiration: 8/17/2017 Tr# 269753 EXTERIOR HOUSE RENOVATIONS IN'_ JOHN O'BRIEN ,> 257 TRAPELO RD WALTHAM, MA 02452 Update Address and return card.Mark reason for change. ❑ Address Renewal Employment ❑ Lost Card SCA 1 % 20M-05/11 U,eeoa,rnaa�acaecclCl df C�/�aaoac/ccoe%/i, License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration:, '"18.3006 Tye' 10 Park Plaza-Suite 5170 Expiration-_ :`BLOT/2.0�,7 Corporation Boston,MA 02116 R EXTERIOR HOUSE RENOVATION$.INC. JOHN O'BRIEN 257 TRAPELO RD WALTHAM,MA 02452 Undersecretary Not valid wit out signature a) d O -� O N 0o Massachusetts Department of Public Safety LO ® Board of Building Regulations and Standards q License: CS-105517 CD rn Construction Supervisor JOHN IF O'BRIEN 257 TRAPELO ROAD WALTHAM MA 02452 0 f Comr^+ssioner 0410712018 v= rZ O N Og _ 03 0 N •A d x ` T 0 93 .. fO CD J 07 O O � I ;LO i co Construction Supervisor Restricted to: 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. DPS Licensing information visit: WWW.MASS.GOV/DPS .r b `"" r' ❑ El 0 �J Er �'� � '\ � W �`� � f Yy 'fi'�•'Y;M1. 1+� ,n 15 'Cr Cl P, to �j O"k UUp6SlI. Q{A� rn , Pz ITS El VA G ro V� ry O " D pn7 Pft k�p� p ro W LtCa ; C7�nP4 S7 if-ti 0 p, Im p III —J � p I N� Zi �• tx1 �7 cAt ' CD ►TM± ;c El El q cn Iv4-assach s�General Laws chapter 152 mquires all employers to provide workers'compensation for their employee Pm s�to this sratut,an MT10yee is darned as' __every peson in the service of aaother under any contract ofhn e, e_r or implied, canal or written_" An.m p&yer is dafm-ed as ran individual,partaersh�,assocfi6an,eorporafioa or other legal.cntdy, or any two or mare of the foregoing engaged in a joint and iaclndingme legal repres=iafives of a deceased em-ployer,-or the receiver or trustee oz an mdiyidia �partmabig,association or other legal entity,employing employees. 1=Lowever the owner of a dwelfmg'hDuse having not more than t rezb apartments and who residcs therein or the occupant of the dwelluig house of another who maploys persons to dD maintenance,construction.or repair work on such ftcliiag house or on fhe grounds or building appurtenant fhereto shall not because of such employment be deemed to be-an employer." 2vfGL chaptnr 152 25C also states that aevery state or local licensing agency shall withhold the issuance or ranewaI of a license or permit to operate a bmsiness or to construct buildings in the comsnonwcalth for auy applicant who has not produced acceptable evidence of compliance with the insuranr.coverage required." ; Additionally, MGL chaptex 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall ent�r into any cone act for theperformance of performa of public work uutl acceptable evidence of compliance with the in�ce r(-_q ements of fis chapter have been presented to f3o-e contracting authority.' Applicants Please fill out the woikers'compensation affidayit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s), addresses)and phone numbers)along with their cerdfacaie(s) of insurance, Limited Liability Companies(LLC)or Lim to d.Liabiay Partnerships(LI.P)Whhno employees other ihan the members or partners,are not required to carry workers' compensation in:sUrance- Han LLC or LLP does have employees;a policy is requiem Be advised that ibis affidavit may be submitted to the Department of Industrial Accidents for confirmation ofiDS anee coverage. Also be sure to sign and date the affidavit. Thu affidavit shout-d be retrimed to the city or town that the application for the permit or License is being requested,not the De tm parent of Industrial Accidents. .Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insuu<e�d companies should eater the' seIf-insurance license uumlier on the appropriate lime. _ City or Town.Officials . Please be sure t iat'tht affidavit is complete and prmt5d IegEily. The Department has provided a space at the bot m. o f the affidavit for you to fill out in the event the Office of Jnvesfigafions has to contact you regarding the applicant Please be sure:to fill in the penmit/lic; se nummber which will be used as a reference number. In addition-an applicant that must submit multiple pe hJIicense applimfions in any given year,need only submif one affidavit indicating current policy infornation(if necessary)and under"•.Job Site Address"the applicant should writes"all locafions in. (city or town)."A copy of the afliLvit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses Anew affidavit must be Elled out each year.Where a home owner or citizen is obtaining a license or permit nat related to any business or commercial veatpre (i_e.a dog license or permit to bum leaves et-)said person is NOT required to complete this affidavit The Office of Investigations would at to thank you ia adyance for your cooperation and should you have any questions, please do not hesitate to give n§a call_ The Department's address,telephone and fax number: ` Th. Cow Itlt ofMassachusz# Depailmz at o-f J ilrtdal Ac,-_idMt& WG Wasbinaa Stt �aeQaD,MA G2I I I Ta t4 61 7-727-49-�O-�4-06 ar I4 h • . F A 6I7-727- 4-4 IZavised 4-24--07 I THE rqy, Town of Barnstable ti i o ' Regulatory Services • BARNSTABM • 9 MASS. �, Richard V. Scali, Director �p 1639. �0 ren�u�" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF CONSTRUCTION SUPERVISOR j Downer of property located at SOO cect q- i` d hereby certify that ✓U I is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# (1-2, issued on 20 f I understand that the project under construction must cease until.a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 411 /,�c � PROP R Y OWNER DA q/forms/newcontrowner reference R-5 780 CMR rev:040414 4�FTHE r�Y 'Town Of Barnstable Regulatory Services Yam" LE'�; Richard V.Scali; Director Apo i6gy. �� - p�ot+���' Building.Division . Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma'.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Construction Supervisor License # CS_ jp 5j/-7 ,hereby certify that I have assumed responsibility for the project under r construction, as authorized'by building permit# �� �� , issued to (property address) ,500, o(.2ce✓1 (/ on , 201 The following dqcuments are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form (if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) =:::44 �a C4 N 131/4 LICENSE HOLDER DATE i gdonms/newcontrb rev:040414 -YACHTSMAN CONDOMINIUM TRUST CERTIFICATE OF TRUSTEES We, the undersigned being a ln.ajority of the Trustees of the Yachtsman Condominium Trust under Declaration of Trust dated January 1., 1.999 and recorded with the Barnstable County Registry District of the Land Court as Document#475622 and noted on Certificate of"title #C-21.,hereby certify pursuant to Article III of said"Trust that the following persons are the current members of the Board of Trustees and hereby co.nfinn the acceptance of the same: Name Term Expires Robert Am s June, 2017. aond Do erty June, 2015 avin June, 2016 r'71 Richard A. Gagne June, 2017 Steven Patalano June, 201.6 Executed under seal as of the day o#' e ',� , 201 r DCFUGL.4S M. CF.e E MEE Not "d Public Mailing Address: COMMONWF^_a; kt;_ACNusE7S hiy Commission Expires Yachtsman Condominium Trust January 11,2Oi9 c/o Crabtree CPA.&Associates 426 North Street Hyannis, MA 02601-5132 .2016/04/08 09:06:1 7 2 /2 ACC- CERTIFICATE OF LIABILITY INSURANCE °ATE(MM!°°"YYY' `� 04/0 812 0 1 6 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 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 NAME: Patricia Geer PHONE FAX EASTERN INSURANCE GROUP LLC AIC No EXt: (508)620-3357 A ,No: E-MAIL ADDRESS: pgeer@easteminsurance.com 233 WEST CENTRAL ST. - INSURER(S)AFFORDING COVERAGE NAIC# NATICK MA 01760 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 25674 w INSURED INSURER B: { EXTERIOR HOUSE RENOVATIONS INC INSURERC: ' INSURER D: 257 TRAPELO ROAD INSURER E: WALTHAM MA 02452 INSURER F: COVERAGES CERTIFICATE NUMBER: 43110 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 CONTRACTOR 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 - 7ypE OF ADDL UBR POLICY EFF POLICY EXP LTR IN D WVD POLICY NUMBER MMIDDlYYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY, _ EACH OCCURRENCE $ -MADE D OCCUR DAMAGES(RENTED CLAIMS PREMISES Ea occurrence) $ MED EXP(Any one person) $ NIA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PET LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO - BODILY INJURY(Per person) $ ' ALL OS OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUT AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS - Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $,. DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE' OERH' AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN - - E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED?- NIA NIA NIA 7PJUBOG08483515 06/06/2015 06/06/2016 (Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATI DNS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. r This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov4wd/workers-compensationfiinvestigations/. CERTIFICATE HOLDER CANCELLATION' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The,Yachtsman Condominium Trust ACCORDANCE WITH THE POLICY PROVISIONS. 500 Ocean Street, AUTHORIZED REPRESENTATIVE Hyannis F MA 02601 Daniel M.Crow,iey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . �J r Map " `I Parcel D Application'# �3 Health Division Date Issued In Conservation Division Application Fe �1 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 600 0 Ge.a/L ti CR-Q�+ ) t� 41 in AA a& DC>/ No Village ar Owner Address ` Telephone -7 -7 1 }R , Permi Request A AA 2�a,04(1- MICAQp CJ m. ate,� PY9 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ge1pk6k- - llephone Number Oil- 73S01 Address Z S �yu� � License # e S- I O SS t WcAeww 04 OaVC- . Home Improvement Contractor# /Boo a Email o 141,S e dw, Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1:A11-44fe_ 1044 Ott SIGNATURE�''\� DATE FOR OFFICIAL USE ONLY APPLICATION # 3 DATE ISSUED, -- MAP/ PARCEL NO. ADDRESS VILLAGE OWNER r y '. DATE OF INSPECTION: FOUNDATION FRAME F' INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r. FINAL BUILDING i DATE CLOSED OUT f ASSOCIATION PLAN NO. P Office of Consumer-Affairs and Business Regulation. 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co or Registration Registration: 183006 Type:. Corporation = = !w Expiration: 8/17/2017 Tr# 269753 P 1� EXTERIOR HOUSE RENOVATIONOINC: T-0 - ' JOHN O'BRIEN "" - �� �;. ..- 257 TRAPELO RD ° WALTHAM, MA 02452 �t. - �f Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SCA 1 Co 20M-05/11 _. -—_-.--._---- --- e oa��nnoauaealCl ane��aaation License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. 1f found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration::-°' g3006 Tye' 10 Park Plaza-Suite 5170 Expi rat ion=^`$L=72017 Corporation A Boston,MA 02116 EXTERIOR HOUSE`RENOVATIONSi INC. JOHN O'BRIEN stir ; 257 TRAPELO RD WALTHAM,MA 02452 Undersecretary Not valid wi out signature M Ol 0) C d d7 "O 'N co Massachusetts Department of Public Safety Cn Board of Building Regulations and Standards ,q License: CS-105517 CDConstruction Supervisor � JOHN F O'BRIEN 257 TRAP ELO ROAD WALTHAM MA 02452 0 0 r - -O Commissioner 0410712018 x a S N l0 ^ O N r O ' �4 Q O 03 N O_ O N 2 0 d ' ?1 0 (D 7 O O ' 7 LO _0? N O b rn cn „ o0o N O O d to iN Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,00o cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWw.MASS_GOV/DPS BasAwx,Mi t2. �u 7KMMgaV1d=- Workers& ceders}Canfrac€fi fecfricia ROumbers Amficznt fnfurmation Measa Frhaf Leeffily Name E _ k r1Y "s-e E ii a ya`�e-vk.S -P2G Are ycpn an employer4 Cbeckffia,&ppropri ifabe T � of p eCt 4-❑ I��ge�$I cc�uiracfix a�I } l�� �'���= * fravghi eg,62 subra�fas ❑New coal esrr}slopees{felt andlorgar�#ime�_ - _ �_❑ I.am a sole prop�r}r orparEner- Listed on the aftached sheet F- ❑Bcnmdeli,; ship and hate no employees These sub-ooniradnss have g ❑DemaSitioa an$have wow' • Ong�mE is agy capacity- � �PIQ� � 9, ❑$uildiag addifion CflIIIg.tnsarranrR coII}p_mcT�rara� 1 5. ❑ We are a corporaticnand ifs I4❑ElectricaL regains of a an ddifis I❑ I am a homr�er doiag Z wtxk ourse have rr+sed their 11_❑Plumbing repairs or additions myself [No wcrk='coal- rigbt of eseapfioa Per MCR, nlp�lf repairs amuu ff reTlireaj f c-15Z§I(4),andwe have.go employees.[Na worIss Bay�pb�that che[�s bon�I amst also�L aoti�se�fion�cTa�sh�mg�rswo$cexs�mmn�tsstiou perTi[�-a #ffo-me�vrneis'vrbz srbnti dais a:fid.Y i�^tr�3>Ey:�chins.II r a t> h;E tauYside contrscta¢mast snhcr�it a atnr dscst ir,^� mdL -('=n�t mt r:h -k this b=mast xtische3 in vidid"O shed shun-thz=mw_a Mp s m3 statavthetber ocnmt nse E esT, �luY�. IftheMff2-ca�dmsJ='MennT they tpun�iaethem�l�tamp.paIs�avmbec .�iuri rEt��rrir�IvJ�ihrrtis pms�rg f�orlrers'r-oarr�rrc�sRtnr,trrsr�rrcrtce far ttr�ett�Ipyees, �eiarr is fFtepa&cf cuid job sits Llsu7AT1rP companyNatue C&g c0 P-0 RqY:9 of SeFf-irzs: 0� 8 ��l c� FxgirafzoTLT}ate. ZO Iofr rt Atictiess s" i (�Ge l�r� CitylStatelTrp_ cw,r rS ZG O 9 At'3Cfi X COPY of the:WGr-kers`cnmpenxatiXan,poo-I'rcy decYarstlon p2ge-(shOlYing the P mGbzy ntrmlxer and ezpa-ation dste): Failures to strum rouge as reVireduzzder Section SA oflUL c- 152 can lead to the imposition of criminal pmalfies of a fine up to�L OIGD atWor one year imprira as even a;cirR pe aa.Ifies in the form of a STCFP'WORK ORDER-and a fine of up to�250_00 a day against the violator_ Be advised that a copy of this statement maybe fort ded to the Office of InresEtgations of�ffie DIA fnr irsmmnch coverage vcc�Ec at bn_ I da fkerebj,crtft;ff under-&rpddnx wid ppafies r f dserjirq ftratt e it j`vrrardign prcnidgd ubzwe7 u•h-ua awr correct sip, - �(- Bate. E jfrctal aw ran£,, Do-xat wriir in tfdss arei;to b T cr nTL-W by c�p ar trrwn afficlkl city or Town PerS`Iiceuse# Fc�.#��afharit�{�cic aue�: . • L Da2•d if Health 2.$uifUngDgmrtng t I afpTuwaOsk 4_EIeLt. _c:HIb spetiur 5.PfumbmgEmsptctor i Qtht-x Coact Person.: Fhtrne� . 5 Vlassachugeifs General Laws chapter 152 requires all employers to provide worker'compmsafma fortieir employ=ss Pu-stra�'to this sty-,an anpfoyee is da5ned as'--Very pesoa in the service of mother under any contact of bu-e,• ems or implied, anal or wri-ttea_.' Ain=pTzy'ez-is defined as``an individual,partamsh p,association, corgorafioa or other Iegal=bfy,or any two or more of the foregaiag engaged im a Joint enterpIIse,and including the legal rt-_presenfatives of a deceased employer,-or the receives or trastiee of an individual,parinmbip,association or other legal entity,employing employees. However the owner of a a-wdIing hawse having not more than three apa dmeufs and who resides therein,or the occupant of the dweIli g house of another who employs persons to do mahit ance,construction or repay work on such dwelling house or on the grounds or building appm mnarit•thereta shall not because of such employment be deemed to be-an employer." MGL chapter 152, §25C(6)also states that'every state or local frcenging agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for auy applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,lvlGL chapter 152, §25C(7)stat`Neifher the commoawc,althnor any of its political subdivisions shall ent-_1 i UtD any contract for the performance of public work until acceptable evidence of compliance with the 1n s ance requircmmts of this chapter have been presented to the contacting authority.' Applicants Please fill out the-workers'compensation a.ffidayA completely,by checkiag the,boxes that apply to your sitnzldon and,if necessary, supply sub contractors)name(s), addresses)and phone numbers)along wi h their certncaic{s) of Easu ance. Limited Liability Companies(LLC)or Lim trdLiabDity Partnerships g22)withno employees other ihan the members or partners, are notrequir�d to carry workers' compensation in�ce_ If an LLC or LLP does have ' employees;a policy is reuired_q $e.advised that this affidavit maybe submitted to the Dertm paent of Industrial Accidents for confirmation anc ofincme coverage. Also be sure to sign and date the affidavit The affidavit should be ret=e�d to the city or town that the application for the peuo3t or license is being requested,not the Department of Industrial-Accidents. Should you have any questons regards the law or if you are requred to obtain a workers' compensahoa policy,please call the Department at the number listed below. Self ii=ed.companies should enter their self-in.s rran=license number on the appropriate line. City or Town Officials ':'•:: Please be sure that the affidavit is complete and primed legibly_ The Department has provided a space at the boom . of 1Tle affidavit for you to fill out is the event the Office of Investigations has to contact you regarding th e applican"t please be sure.to,fill in the penmitllieense number which will be used as a reference number. In add_i or- an applicant that must submit multiple pcmDLitllimnse application in any'given year,need only submit one affidavit indicating current policy information(if necessary)and under`•`Job Site Address"tine applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture ( i_e.a dog license or permit to born leaves etn.)said person is NOT required to complete this affiidavit stio The Office of lmvestigations would like to thank you m advance for you:caopeatt ron and should you have any quens, please do not hesitate to give ni§a cal The Depadment,s address,telephone and fax number: y Thy CoMM4aa T&of Massachusf t DE ap f e�Et Gf Ia&n±aalAQaidmta Fax: 617-727- 4 TZe ed 4-24--D7 _ vrs �IF_ma,�go�rc$a R� Town of Barnstable Regulatory Services g Y • snxrtsrna[.E. v MASS, 8 Richard V. Scali, Director n;o.�"tee Building Division Tom,Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF CONSTRUCTION SUPERVISOR A y �J IR0S , owner of property located at �``) U(0 Q C:�e�lt ��� �-e P ���•r�(1 .S , /�,hereby certify that M M ` OCA�L'o L"L L ill i is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# " W , issued on 20_L(o } I understand that.the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. RO ERTY OWNER DATE C)J YC-7— q/fornis/newe'ontrowner reference R-5 780 CMR rev:040414 OpIME TO+� 'Town ®f Barnstable ,gam ti Regulatory Services Richard V.Scali; Director i6 39. - r�p �a Building Division . Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma'.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Construction Supervisor License # C�S / J�51.7 ,hereby certify that I have assumed responsibility for the project under f construction, as authorized by building permit# — , issued to (property address)�dO C)L4-5,Zj,-L (' on , 201 . The following dgcuments are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond (if applicable) LICENSE HOLDER DATE q/forms/newconfrb rev:040414 YACHTSMAN CONDOMINIUM TRUST r CERTIFICATE OF TRUSTEES We, the undersigned being a majority of the Trustees of the Yachtsman Condominium Trust under Declaration of Trust dated January 1., 1989 and recorded with the :Barnstable County Registry District of the Land Court as Document#475622 and noted on Certificate of`Title #C-21.,hereby certify pursuant to Article III of said Trust that the following persons are the current members of the Board o:f Trustees and hereby confirm the acceptance of the same: 4 Name 'Term Expires Robert Am s June, 201.7 tnd Do erty •_.._..._ June, 201.5 AL Joyc I, avin June; 2016 ' Richard A. Game June. 2017 r Steven Patalano June, 201.6 Executed under se � �e al as of the� day of �i'�-� ?Q Ejt�, Dt 17LAS R. CRASTREE Note•r Public Mailing Address: cor���oNwrA_::;c n.;'=:1eNusms My Commiasion Expires Yachtsman Condominium "Trust January 11,201,9 c/o Crabtree CPA &Associates 426 North Street Hyannis, MA 02601-5132 2016/04/08 09:06.1 7 2 /2 �•® acoRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) �. 1 04/08/2016 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 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 NAME: Patricia Geer EASTERN INSURANCE GROUP LLC (A No Ext: 508)620-3357 A"I'c` No: E-MAIL ADDRESS: pgeer@easterninsurance.com V 233 WEST CENTRAL ST. INSURERS AFFORDING COVERAGE NAIC A NATICK MA 01760 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: EXTERIOR HOUSE RENOVATIONS INC INSURERC: IN SURER D: 257 TRAPELO ROAD INSURER E: WALTHAM MA 02452 INSURER F: COVERAGES CERTIFICATE iNUMBER: 43110 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 ADDL UBR POLICY EFF POLICY EXP INSD WV13 POLICYNUMBER MMIDDIYYYYI (MMIDDNYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE PREMI OCCUR ES(RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JEa LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED AUTOSSCHEDULED NIA BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS - Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE OER� AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNEPJEXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? I NIA NIA NIA 7PJUBOG08483515 06/06/2015 06/06/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE s 500,000 - If yes,describe under' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 NIA DESCRIPTION OF OPERATIONSI LOCATIONS VEHICLES(ACORD 1D1,Additional Remarks Schedule,may be attached Irmore space Is required) Workers'Compensation benefits Will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensationfinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Yachtsman Condominium Trust ACCORDANCE WITH THE POLICY PROVISIONS. l 500 Ocean Street AUTHORIZED REPRESENTATIVE Hyannis NIA 02601 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Barnstable Building Post This Ga d So That it rs Uis�blefr>om the Street-A ; roved Plans,Must bes Retained on.:Job and=this;CarduMust be Kept, (1 Posted Until;Final Inspection HasBeen Made a :- �' 4' . ° 3, ;r-... �:_ :.3. . .., ` .. . .- s ,...�,�, 3...: . , ... Permit R �Where.a Certificate;of...Occu anc,, s Re aired=,such:.B nldm shall Not,be�Occupied•until agFinal Inspection:has been ade :MOB g � ���; ,,.: �.,.� Permit No. B-19-494 Applicant Name: FABIO PRETTI Approvals Date Issued: 02/28/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 08/28/2019 Foundation: Location: 500/condowork OCEAN STREET, HYANNIS Map/Lot 324 040 OOA Zoning District: Sheathing: Owner on Record: FORD,THOMAS A&ELAINE M �f „Contractor Name ,FABIO PRETTI Framing: 1 Address: 20 JOHN HALL CARTWAY Contractor License GCS 108659 2 r FP } YARMOUTH PORT, MA 02675 EstProJect Cost: $7,800.00 Chimney: Description: install new 26: Ivl,using timberlock screws-on�exesting bridge- - Prm�it F e: $ 170.98 Insulation: beams, located between building 3E&3C Fee,Paidy $170.98 Dat� 2/28/2019 Final: Reviewers Note: No deconstruction,adding to structure -- � x Plumbing/Gas engineers drawings. RMCK Rough Plumbing: Project Review Req: ^, ... �✓: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. All work authorized by this permit shall conform to the approved applitaticiiiah6thelapproved construction docume t for hichhuthis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws-and codes. This permit shall be displayed in a location clearly visible from access street�or road and shall be maintained open for public, pection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the�Buildmg and Fire Officials are'provided on thi",rmit. Minimum of Five Call Inspections Required for All Construction Work: S � z Service: 1.Foundation or Footing 2.SheathingInspection — fl Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons c cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). c<• Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ---------- - HE Application Number.......... a .......... MASS. g Permit Fee........... ......Other Fee........................ 165 TotalFee Paid................................................................ ...... 0oo1!�.,,,o;,00t,,e;j!( TOWN OF BARNSTABLE Permit Approval by.................................On.. BUILDING PERMIT Map.......�.,3 q..................Pamel.......41.Y4.....Oe. ............ APPLICATION Section 1 — Owner's Information and Project Location Project Address- 425D 6Kr�64) C57- Village hftAJJU v-� Owners Name-E A104 r6MP(A) C-0619QM14JIL�= Owners Legal Address ( oe-oe 1 r) ST city. A-)Ivl State Zip odzol Owners CellE-mail (2 #6 08 CQL�- FSection 2 —Use of Structure Use Group_ Commercial Structure over 35,000 cubic feet Commercial Structure under 35,000 cubic feet El Single/Two Family Dwelling Section 3— Type of Permit F-1 New Construction ❑ Move Relocate ❑ Accessory Structure ❑ Change of use El Demo/(entire structure) ❑ Finish Basement El Family/Amnesty 0 F arm xb Rebuild EJ S Deck Apartment p er SystE& ❑ Addition E] Mainin9 wall E] Solar 2El Renovation ❑ Pool El Insulation Other-Specify VZ P�L F Section 4 - Work Description F A Z6W JJ* Awp 36 , Last updated. 11/15/2018 r Application Number.................................................... ; Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics h - ❑ Wiring " ' ` ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility:��/-� .(CIS&AC P964 I am using a crane ❑ Yes U No Section 7—Flood Zone Flood Zone Designation .Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information s`Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage ' #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard ? F Required Y Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 E � ? . rA CSL 108659 HIC 182418 Proposal Date: 02/04/19 To: Yachtsman Condominium Trust David Landers 500 Ocean-St. Hyannis — MA Work to be performed at: same address above Scope of work: Bridge LVL installation o Install 02 LVLs 20' and 17' according with provided engineered drawings; 0 Finish outside walls (plywood) and trims(PVC) as it original conditions; o no painting is included in this proposal; o Fabio Inc will pull permits; o Yachtsman condominium Trust will provide any and-all necessary engineered drawings for the project; o Fabio Inc will provide all materials; All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted and completed in a substantial workmanlike manner for the sum of : ($ 7,800.00 ) with payments to be made as follows: Deposit: $ 0000 $ 7,800 at work completion 38 Wendward Way —W. Yarmouth — MA 02673 508-360-3412 Y' 1q r� w nc., +. CSL 108659 HIC 182418 General Provisions: Any alteration or deviation from the above specifications,including but not limited to,any such alteration or deviation involving additional material and/or labor costs,will be performed only upon a written order for same,signed by Owner and Contractor and,if there is any charge for such alteration or deviation,the additional charge will be added to the Contract Price of this Contract. If payment is not made when due,Contractor may suspend work on the job until such time as all.payments due have been made.A failure to make payment for a period in excess of 4(four)days from the due date of payment shall be deemed a material breach of this Contract. Unforeseen Condition: Unanticipated or unexpected circumstance or situation that affects the final price and/or completion time of this contract or project,will became an extra cost,and will be charged a rate of S 70.00h/worker. Acceptance of contract Name: �� d ,qtjDF -AS ' Title te. VQ Signatur I I I 38 Wendward Way —W. Yarmouth — MA 02673 506-360-3412 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Llectdcians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address:��� 6M City/State/Zip: Vl ft one#: 3 �' Are you an employer?Check the appropriate box: Type of project(required): 1.P I am a employer with— 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp'insurance.: 10. Electrical repairs or additions - required.] 5. ❑ We are a corporation and its ❑ rep 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.[�LOther, 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 hue 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. ' L Insurance Company Name: /�pi 0J 1 L G c�K �f�]l Policy#or Self-ins.Lic.#: Expiration Date: ' 4 Job Site Address:<�'� EYE 5� City/State/Zip: A— �� 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. 1 do hereby certify under the and penalties of perjury that the information provided above is true and correct Si ature: Date: 0-�A Phone#• 74 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political.subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."-'A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's,address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street i Boston,MA 02111 - Tel.#617-727-4900 ext 446 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia f SMassachusetts -Department of Pub it Safe `y Beard of Building Regulations and Standards t.:,;rMI'llction super-,isur L ;use: CS 108659 FABIO PRETTI Mae 38 WENDWARD WAY :•a West Yarmouth MA 02673._: .G Commissioner 04/19/2019 �_/GJ-- p e`�rzv�r�rnizwe�c�/�c�(��jl�ai�ac�cc;;ell� Office of Consumer Affairs&Business Regulation 9 o HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only SEFF TYPE:Individual before the expiration date. If found return to: Rea�stration �iration Office of Consumer Affairs and Bu 'ness Regulation - 182418 - 06/18/2019 10 Park Plaza-Suite 5170 Boston,MA 02116 FABIO PRETTI D/B/A FABIO HOME IMPROVEMENT FABIO PRETTIG - 38 WENDWARD WAX, YARMOUTH,MA 02673 Undersecretary N ail tthout signature z I A`RDATE(MMIDD/YYYY) " CERTIFICATE OF LIABILITY INSURANCE 02H5/19 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 Wrl NAME; PAUL SCHLEGEL Schlegel&Schlegel Ins Broker a/c°NN Ell: 508-771-8381 ac No, 508-771-0663 34 Main Street E-MAIL West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: NGM INSURANCE COMPANY 14788 INSURED INSURERB: ATLANTIC CHARTER FABIO INC INSURER C: 38 WENWARD WAY INSURER D: WEST YARMOUTH,MA 02673 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any oneperson) $ 10,000 A MPS6863R 11/19/18 11/19/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE P$ 3,000,000 A EXCESS LIAB CLAIMS-MADE CUT6863R 09/08/18 09/08/19 AGGREGATE $ 3,000,000 ID D I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 B OFFICERIMEMBER EXCLUDED? N/A WCV00935903 09/09/18 09/09/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) FABIO PRETTI HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. ATT BUILDING DEPARMENT 200 MAIN ST.HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE DAIANE BENFICA @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9- Construction Supervisor Name 1� 10 Telephone Number O- w Address,36 U Q (VXLCity I P09VAUState ✓- Zip ®��O License NumberG5—10860 License Type( o iration Date 0 Contractors Email 6610 P9&j_r/ (-I aj' 22. r,2ffl Cell # 3 h0 / /Z I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 k CMR the Massachusetts State Build g Code. I understand the construction inspection procedures,specific inspections and documentation required by 78 and the Town of Barnstable.Attach a copy of your license. Signature Date F_ Section 10—Home Improvement Contractor Name 6)�Ba? � � / Telephone Number Address � ((� �(j�f j^ 17n City jV. ,yM �- State X . : Zip 696 ' Registration NumbVy Z Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Buildin de. I understand the construction inspection procedures,specific inspections and documentation required by 780 CIS d the Town of Barnstable.Attach a copy of your H.I.C... w Signature Date Section 11 -Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPL ANT SIGNATURE Signature Date Print Name Telephone Telephone Number &t), -'3yx� E-mail permit to: 60& Last updated: 11/152018 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) 1 Historic District ❑ Site Plan Review(if required) ❑ Fire Department - •`❑ a- ;: Conservation For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature%of Owner' date Print Name 1 i h , Last updated: 11/15/2018 � ii � s tt� . NOW cons ultll q...S-truCt. ral Er gineer 22ltott6nwood la' teriterville,Massar-,husetts 626324979•j5dg)337-8521* mtud to@comcast.net DATE: January 10,.2019 Yachtsman Condbmintum:Trust 500ocean St: . Hyannis,MA 02601 Attention: ;Nir;_RobertAice,PropertyManager RE: S RtTCTtSRAL REPAIRS TO: iMSER$Rf,DGE YACHTSi C*ONpt3 INIUM5 SOO Ocean Street Hyannispott:M l DearMr.Rice; At_yaur prior request,l uient to the above captioned location.on January:3,2619 to observe the as-built bridge:conditions; in.particular the rotted rood and edge bear construction(set:photasprovided by your office). 10-.:Basted, , The air ngtjts tsridge ss located on the ocean side.of the parking.lot,as:shown on SKA.. The rotted edge:beams caused concern a .to.Remedy,folkawZng removal:or deteriorated architectural finish(painted.- lywood:). 241 401�ans and Recomntendafths in reviewing the condominium bridge construction,the:course of repair to reinforce-and improve the structural'integrity of the n er;tarnin while:no.t4ha prig the steel.connection plates,at the building walls attachment points are located€s s#owri oitSlt t;The timber 2x2ti framing atop:2x12 was only joine i by one.face of:plywood: Therefore,asingle full:depth izfply of t se total'de tth-usrng any available lamlr�ate_d veneer f6tuber,-LVL,such•as pressure treated,PT;Parallam; RSL;or Timberstrand Z:SL,ete.is recominentiet9.The rot;is not excessive enough ih the,existing members is warrant re rioval instead:t#te crew<inemoer ys Tmiserlok=ed-from both-sides to each existing 2x .in areas;of.the lumber:where the u iod grain is solid,:nest to._exceed. 6"on;center;top and.battorn ofeach:N. The syste n.ls then flashed,to prevent the sfrt filar csccyrrence of water-oversfowing from above ieadi;ig to future wood rot. Stiou[d.yauhave airy question on the above;please call; Sincerely, �� MicheZe.CudiZo P:E. #11r11Ec. lea s-as _ f a STRU . RAt ,r f adn 34774, m i PL %LA. li ; 3 j s f .�� ?. +.'..mom. TTaa T}�� a!y r ` _ ansuft+n `� Struaturaf En �r���:r lw CsntervkNe Ia user. t{s 0 £3'2 174 SS2t. Oraam, 8 Date 01/tJ9J19 ale a ,i$AS t�t1TED. Rev. a _ File NameYAL'liTSt�AN, ;Project, 1�a20"1:9 0& . }} Vlt 71, L it b � - . �: lof- t € Ak . R g� r � - a.aaii . � .. iL WCHFI LE 7- Gasuit€nI Str n uctural Eng€Weer `. - �ent�rw'31e d€�emss�re +se�s"a�32 #;$79. .SQS 737—�p2y Ekan By; MCHAS Data a i j09�'9 l a Boa sir , t , File Narne,XACHfSMAN- rofect:No. 019-os .� � Town of Barnstable_ Building s Po' teThlU Card SoT,hat it;s Visible From the�Street A rovedPlans IVlust.beaRetatned on,Job and this,Card Must,be°Ke t , O. a, �Posd� nttl�Ftnal a ''' a.Certificate of " nc'" is Re aired"such<Butldm' =shalhNotbe Occu ied untila-Finaf Ins ecttort has b"een`made . , ei 1t e r Whe Occupa y q g p _�,,.a. ?. Permit No. B-18-3645 Applicant Name: MICHAEL S MEAGHER,JR Approvals Date Issued: 11/02/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 05/02/2019 Foundation: Location: 213 COMMON AREAS OCEAN STREET, HYANNIS Map/Lot _326 035-00A Zoning District: Sheathing: ., Owner on Record: -ContractorHARBORVIEW HOTEL INVESTORS LLCrNarn .,MEAGHER CONSTRUCTION INC. Framing: 1 Address: 28 JACOME WAY x �� ContractorrLicense 162938 2 MIDDLETOWN, RI 02842 "= Est Protect Cost: $ 18,000.00 Chimney: Description: REPAIR ROTTED TRIM AND MAKE-NEEDED REPA R&J,&.LEAKY AREAS Permit Fete: $ 160.00 OF RUBBER ROOF '` , Insulation: FeeMPaid $ 160.00 Project Review Req: t Date 11/2/2018 Final: Plumbing/Gas Rough Plumbing: _. ... m , z��_ Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work a i onzed by this permit is commenced within six months"a'fter issuance. All work authorized b this permit shall conform to the approved application:and theca roved construction documents`for which this permit has been ranted. Y P PP PP f , PP P g Final Gas: All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for psublic in for the entire duration of the work until the completion of the same. ��" f� Electrical u Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Build g and Fire Officials are provided onI is permit. Minimum of Five Call Inspections Required for All Construction Work: ��� ¢" Rough: 1.Foundation or Footing "tea." ' `" a 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction: "Persons c'ontr cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department �`1 Final: �_ Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 3S Map 3� � Parcel �` � Application oL� Health Division . Date Issued 1 02118 I?A Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannix 4 Project Stre t Address � 3 Village Owner ��R c1-cr� s Address lJ Telephone A &_Wocch Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation i 00 C Construction Type b_30C�&,Quao.� Lot Size_ '1 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) /AO 4-0— . 10-0 � Age of Existing Structure Historic House: ❑Yes �k o On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ( Yes ❑ No If yes, site plan review# r -Current Use �� -- ® Proposed Use ` Q d APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name `i1� �� Telephone Number so (( aA-6J Address �� o License # J EN�L.'\ t� Home Improvement Contractor# of Emailf�"OAVaLC, Worker's Compensation #�,�) TT744 ALL CONSTRUCTION DEBRIS RESULTING F OM THIS PROJECT WILL BE TAKEN TO T SIGNATURE DATE w1 �. V FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - . " -TOWN O ARNSTABLE BUILDING PERMIT APPLICATION Map- Parcel � Application #� Health Division Date Issued R Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address � ��ay..� 4: TVT Village /;`�`,'kcvv"_.(-!J j � .p.- Owner Address s Telephone t(o / - 6q " 0900 Permit Request � 171.+�, ,A D � " ,uv� �►.-c`-- �U� �Z Q . Q. , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new -4 f Zoning District Flood Plain Groundwater Overlay j Project V luation 12, 06 � � � � Construction Typed t.0�c� �. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) /110 ' 3-4,-A cb /0 n f Age of Existing Structure 4(0 Historic House: ❑Yes �'q-'o On Old King's Highway: ❑Yes ❑ No Basement Type: O Full . ❑ Crawl 'Q Walkout ❑ Other J Basement Finished Area (sq.ft.) t1 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing `new Number of Bedrooms: existing _new Total Room Count (not including baths): existing i new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑-Electric ` ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: .❑Yes ❑ No Detached garage: ❑ existing 0 new size=Pool: ❑ existing ❑-neW size _ Barn:..❑ existing _.❑ new size_ Attached garage: ❑ existing ❑ new "size _Shed: 0 existing ❑ new size Other: ; Zoning Board of Appeals Authorization ❑ Appeal # '!Recorded ❑ Commercial YYes ❑ No If yes, site plan review.# ) Current Useb -� `�' Proposed UseL '-6 C� APPLICANT INFORMATION (BUILDER,OR HOMEOWNER) ,;. Name C ud1LuC, Telephone Number �: �� J t, Address_ �v .u�-- License# C \ram , F ..� 0._ e?o , Home Improvement Contractor# Z Email I �1 1 �`,J1G�(� -C. 0-M Worker's Compensation ALL CONSTRUCTION DEBRIS RESULT-IING FROM THIS PROJECT WILL BE TAKEN TO P l� 9 V SIGNATURE DATE �� 1 h K FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. c Le 20 40 CA r yam. y�yyw�{ IyF�g A \1 p ye j 1 Massachusetts Department of Public Safety Board of Building Regulations and Standards Construction Supervisor CS 102260 Restricted to: License s Unrestricted-Buildings of any use group which contain '`• „r. n F° }• , X less than 35,000 cubic feet(991 cubic meters)of x enclosed space. MICHAEL S MEAGHER JR 97 EMERALD LANE MARSTONS MILLS Mk" x , Expiration: Failure to possess a current edition of the Massachusetts Commissioner 11/05/2018 State Building Code is cause for revocation of this license. DIPS Licensing information visit:WWW.MASS.GOVIDPS _a, ✓J!P t!cinJ/Is•/7!(te:(t/�/J l/l7rJ(ff'Xf",i"m T > Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Individual before the expiration dete. If found return to: �:,,', Registration Office of Consumer Affairs and Business Regulation 16 04/26/2019 10 Park PI -Suite 5170 MEAGHER CONSTRUCTION,INC. Boston, 02116 M16HAEL MEAGHER JR. � ,., p 776 MAIN STREET OSTERVILLE,MA 02655 - Undersecretary t valid without signature a ?Ite Commonwealth of Vassachnsetts Departrttent of Indnstraa!Accidents Office of Znvestigatiorls r* 600 Washington Street Boston,. A-.02111 y etvMmass gmldia . . -&l'Phers Workers' Compensation Insurance Affikvit r�s/Con.fra , Please Print Le 'b ll InfsanN2titm Name MusinessiOmani atiotuMli"l). � City/ tatelZi : — Are employer?Check the appropriate box: Tdge of project(required): am a employer azth_ 4. ❑ 1 am a general contractor and 1 6. New camsttuction employees(full andlar pact-timed* have hued the sub-contractors Iistedmn ched L2, Remodeling 2.❑ I a3m.a$mle:psopsietsu :eau er- sub-co�attors i9itioa iala3sve ing addition wading for nee in any capacity. I . [No worloecs'comp.insurance cep iastuance. rical repairs or additionsd j $. ❑ 'fie sre a cocporatian and its ,3.❑ 1 qu a homeowner doing all work officers lave eaearcised their bing repairs or additionsmyself[pVo wtukecs'carte. eight of exemption per MGLFr c. ploy m.[ andwehave noins�ce required.] � rempltmyees.�To wotit!ers' comp:insurance mqwTe&1` .A,a"litaat rider cbrkshstt#f ass Mmeotvaers who submit¢his af5datft indiodur,&ey are&Mg W1 WaA aid rhea hire muuida c"=can mmst submit a am affifty t ftftaft such: �o==wrs that deck this tame Maur attecbed M sddiduud sheet shhteing the panne of the sate crostrsctors and state whe*ffi a mot those entities have employees. If the smlb can actors have employees,d wy new Provide tLsir wakes'ramp.yaq number. : r t. i I am an employer that isprosviing workers'acougwns 'rasrtranee for my en�w is nee you Y u��r,a� informadon y air' F tton Date dress: f �-�`" Gity/Stateizip: � 0, O C Job Site Ad Attach a copy of the workers'compensation policy declaration page(showing the policy numb e d expiration date). Failure to secure coverage as required under Section 25A of MCL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andlar one-year imprisonment,as well as ciTryp penalties to the form of a STOP WORK ORDER and a fie of up to$250.00 a day against ft violator. Be advised that a copy of this statement may be forwarded to the Office of lairestigations of the DU fro InrMce coverage v I clo herehy�c�erirfi'antler this "its anrt penaWes -p tt tla+i f i+ta n vse ig ortrl ea art Y ate: (� 3 si ttmre: Phone#: official rise only. Do root tt'rite in this area,to be contpketed ky d or donvi official, :. r PeMm t0yiceatse-;ai Issaing Authority(circle one): 1.Board of Health 2.Building Department 3.CityiTowa Clerk 4.�:lectrical Inspector rv.Plumbing Infector h O�et Mane g Contact Person: : Client#: 16665 2MEAGHERCO AC®R& CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 06/13/2018 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 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 NAME: Dowling&O'Neil Insurance Agy PHONE 508 775-1620----- -- � 7�---5-----— a/C No at: Arc No)'. 087781218 973 lyannough Road E-MAIL ESS:ADDRESS:P.O.Box 1990 INSURERS)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Penn-Americainsurancecompany 32869 INSURED INSURER B:Associated Employers Insurance Company 11104 Meagher Construction Inc. INSURER C: Timothy Meagher ------------- ------- ---- --- ----- ---- — 776 Main Street INSURER D_: Osterviile, MA 02655 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 CONTRACTOR 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. IN SR ADDL UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WV D POLICY NUMBER MM/DD/YYYY MMlDDIYYYY LIMITS A GENERAL LIABILITY PAV0146331 10/16/2017 1011612018 PEACH OCCURRENCE $1 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES RENTED NT.uE ante $50,000 ------ ao------) — — CLAIMS-MADE L-X]OCCUR MED EXP(Anyone person) X BI/P_D_D_ed:500_—--- I PERSONAL&ADV INJURY $1,000,000 _- _ GENERAL AGGREGATE $2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: ( PRODUCTS-COMPIOP AGG $2,000,000` X JECT POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ A14Y AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED ; PROPERTY DAMAGE $ AUTOS If Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE -- EXCESS LIA8 CLAIMS-MADE AGGREGATE $ DED I i RETENTION$ _ $ B WORKERS COMPENSATION WCC50050054422018A 6/2312018 f 06/23/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITYTQ13Y LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y E.L.EACH ACCIDENT $100,000 OFFICERIMEMBER EXCLUDED? CN J N/A j ------ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 if es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE L.,-- ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S213066/M213065 RPSW1 0 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ConstrM." A rvisor � $ CS-102260 ES sires; 11/05/2020 MICHAEL S lIEAGHER;JR 0 97 EMERALD LANE MARSTONS MILLS MAN02648 4" 1, �Av, Commissioner �e�pn�srinroizraenCl�of��aJarrc/z��an,Ct —_ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration . 62938 04/26/2019 MEAGHER CONSTRUCTION,*,C: MICHAELMEAGHERdR._ry ,r,;' 776 MAIN STREET�,E ' OSTERVILLE,MA 02655- Undersecretary i o Construction Supervisor Unrestrncted-Buildings of any use group which contain less than 35,000 cubic feet cubic 991( b�c 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/dpi Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park PI -Suite 5170 Boston, 02116 valid without signature it Client#: 16665 2MEAGHERCO ACORD. CERTIFICATE OF LIABILITY INSURANCE D10131ATE 2018YY) 10/31/2018 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 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 NAME: Dowling 8r O'Neil Insurance Agy PHONE 508 775-1620 FAX 5087781218 AIC No Ext: A/C,No 973 lyannough Road E-MAIL ADDRESS: P.O.Box 1990 INSURER(S)AFFORDING COVERAGE NAIC tr Hyannis,MA 02601 INSURER A:Penn-America Insurance Company 32859 INSURED INSURER B:Associated Employers Insurance Company 11104 Meagher Construction Inc. Timothy Meagher INSURER C: 776 Main Street INSURER D: INSURER E: Osterville,MA 02655 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 CONTRACTOR 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 ADDL'SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YW A GENERAL LIABILITY PAV0186320 10/16/2018 10116/2019 EACH�OC7CURRENCE $1 00O 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea RENTED $50,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5 000 X BI/PDDed:500 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PROECT LOC $ J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WCC50050054422018A 6123/2018 06/23/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100 000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below _F E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2224761M221069 RPSW1 y �- �`61 • BUILDING DEPT YACHTSMAN CONDOMINIUM TRUST (YCT) MAY 112018 500 Ocean Street, Hyannis, MA 02601TOWN OF BARNSTABLE (p) 508-775-1515 (e) yctpmofcgcomcast.net Contact: David Landers, YCT Property Management Office April 2018R R item 7 only SPECIFICATION for: wall and stairs project between YCT Condo Bldg. 1 and 2 Scope: replace existing wood piling retaining wall and interconnecting wood stairs with concrete wall and interconnecting concrete stairs. Concrete to be finished with veneer stones and steel railings—all to match existing opposite courtyard side concrete/stone veneer walls and stairs. Integral documents: YCT detail sketches, plot plan section at Bldg. 1 &2 Detail: 1) (per sketch) Wall: 27 feet northerly to southerly length, with integral 2 foot 6 inch west to east right angle to join foundation at YCT Bldg. 1; wall to be 12 inch thick above footing, 44 inch total wall height(on top on footing); (ref: wall 2 inch above upper turf surface); depth of wall including footing below lowest turf point to be 3 feet; steel 3/8 nominal diameter reinforcing rods spaced 12 inch apart horizontal and vertical interconnected; each end of wall is to be keyed into the Building 1 and Building 2 existing foundation with rebar 2) (per sketch) Footing: 24 inch thick by 24 inch deep with rebar connecting up into wall 3) (per sketch) Stairs: four steps (including top landing which is flush with existing brick walk approach) are to be finished with blue stone one piece slabs to match opposite existing stair treads 4) Railings: steel—painted with durable black—design to match opposite wall-stairs railings; lead encased where steel is in concrete 5) All existing brick walk—to stairs walking entrance are to be level for safe walking entrance to stairs (no projections, depressions, or gaps) 6) All masonry including concrete walls, stairs,treads, stone veneer, to be of high quality and to be guaranteed for 10 years against crumbling, water-ice deterioration, and veneer stone and grout loosening 7) Drainage: wall to have 2" diameter through holes to prevent hydrostatic pressure buildup. Holes to be located 8 inch above lower elevation turf line and spaced 12 inches apart for the full length of the wall. Screen: on the inside covering the holes, f t. Stone: 1 inch crushed stone 2 feet from and behind and the wall ; and from the footing top up -to 8 inches below the upper turf line. Reference footnotes: i) Wood pilings on left side of construction area(left facing easterly) are to be untouched—and to remain in place ii) All existing wood walls, gates,turf, in ground irrigation and brick walks that need to be disturbed for construction must be put back in prior condition DUILDING ()EP7 MAY 112010 TOWN OF BARNIST,q3j � �r I , -.. I i ' L i t _ _ t � , I 1 , a , 01� 4 I f , , , i _ t• , t _ r , I. w t ! I I I r _._.. i i , IA 1-7 , I r i i Town of Barnstable Building �Po t>�ThCard�So ThatArt�asU�sible�From•the Street-�A raved:�Plans�Must;be•Re#am,ed on Job and,this Gard Must;be Kept enxsatmABLE, ..-�x �`i � : f. � M"� Posted�Untl Final Inspection Has�Been�Made � �� � -� �� x���' � ��` � u; ° - sb3A: Permit • � �a � � '"= ' " `'°` � "� � '`" '' ' ' m�k- hallNot�beOctu ied untda:Ftnal liis��'eetionhas:been made ,.. "" 1 ei illy Where�a Certificate of Occupancy�s Required,such Build g s � p p Permit No. B-18-1227 Applicant Name: FRANK DONOVAN Approvals Date Issued: 05/18/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 11/18/2018 Foundation: Location: 500/condowork OCEAN STREET, HYANNIS Map/Lot: 324 040 OOA Zoning District: Sheathing: Owner on Record: CONDO COMMON AREA Contractor Name FRANK DONOVAN Framing: 1 Address: 500 OCEAN . Contr�acto�r license: GS,091391 2 Est Project Cost: $ 18,000.00 Chimney: Description: replace existing wood pilings wall &wood stars with concerete Permit Fee: $263.80 Insulation: � � finished stone.work area between bldg 1&2- `� ' FeePaid b, $263.80 Project Review Req: Date 5/18/2018 Final: 4--- Plumbing/Gas �x Rough Plumbing: w m ;x Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six mo A nths after issuance. ' 11 < All work authorized by this permit shall conform to the approved applicatio n and the approved construction documents for1which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoningby laws�and codes. This permit shall be displayed in a location clearly visible from access street or roadand shall be maintained open for public inspection for the entire duration of the Final Gas:. work until the completion of the same. 44 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the is Jig ndsFire Officials are rouided on this permit. Minimum of Five Call Inspections Required for All Construction Work Service: �' 1.Foundation or Footing g 2.Sheathing Inspection z Rou h: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the.guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ApplicahonNumber.. { gAg1�I6'PASL,E, f �....04ier Fee........................ Permit Fee.......��.�.:... .:. 16,3 M... Q Ep M� Total Fee Paid.............. 13 Permit Approval by.Il. k. .................._ TOWN OF BARNSTABLE ' � B❑,, G PERMIT L ' R ........Parcel...... DIN ....... ... �,V* APPLICATION Section 1-- Owner's Information and Project Location Village Project Address owners Name (1 MA ® �� ( Owners Legal Address 1 S State 'A zip r � �S "7 i Frmail ►moo sC �� s # Section 2—Use of Structare Use Group-—. ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use 1.='j`New Construction ❑ '' Famil /Amnesty Fire Alarm ❑Y ❑ Finish Basement ❑ Y `memo/(entire structure) ❑ Deck Apartment © Sprinkler System . Rebuild a g wall ❑ Solar 0 Addition [21-Renovation [I Pool ❑ Insulation Other—Specify Section 4-Work Description 1�t9�a� T►r. ccs '�T7� TES y , T acr nndated_21912018 L_ _ Application Number............ Section 5-Detail Cost of Proposed Construction 18� Ocd �� Square Footage of Project A Age of Structure r Dig Safe Numbor a 10 #Of Bedrooms Existing a 1A Total#Of Bedrooms(proposed) MIA, 110 MPH Wind Zane Compliance Method ❑ MA Checklist 0 WFCM Checklist ❑ Design _ r Section 6—Project Specifics J n Wiring ❑ Oil Tank Storage * t , ❑ Smoke Detectors Plumbing Gas �< t, ~6 Fire Suppression ❑ Heating-System , Masonry VVkhawy Add/relocate bedroom i PU`MIAltNG U)SU-l-STEPS Water Supply` . 4` -0 Public `°` ❑ Private Sewage Disposal tEl Municipal d. On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility.:_J�; r� OF VAkM/)r& I am using a crane ❑ Yes'K No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ . No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. " Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) 1 Setbacks Front Yard , 'Required, Proposed Rear Yard Required Proposed + i Side Yard Required Proposed Has this property-had relief from the Zoning Board in the past? ❑ Yes ❑ No , 1 Last tmdated 2/9/2018 a J r D.spartment of Industrial Accidents Office of Investigations 600 Washington Street. -- Boston,MA. 02111 www.mass.gov/dia Workers' Compensation hisurance Affidavit:Builders/Contractors/Elecfricians/PIumbers Applicant Information please Print LetTib� Name(Business/Organizaiion/Individuan: Ar 2 1. Address: t,v� J A - City/State/Zip: P 6.A rl i S MA D ZkO l Phone#: 509 4 25 2 3 ?n Are you n employer?Check the appropriate bow • _ Type of project(required): 1. I am a employer wii"h � 4. ❑I am a general contract 6. ❑New c or and I • � have hired the sub-contractors onstrvcfion" employees(full and/or part-time,). 2.01 am a sole proprietor or partner- listed on the attached sheet . 7. ❑Ramodeling ship and have no employees These sah-contractors have S. []Demolition worlang for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.insurance comp.Mmrance.T' required] 5. [] We area corporation and its 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all work • officers have exercised their 11.❑Plumbing repairs o�additions myself[No workers'comp. right of exemption per MGL 12[]R.00frepairs insirance required.]t c. 152,§1(4),and we have no 13 � � employees.[No workers' TAP S comp.n+� ncerequired.] *Any applicantthat ebecks box#1 mnst also 511 out The section below showing thefrworkors'compensation policy information. 1 t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attmbcd an additional sbect showing the name of the sub-aoutractors and static Wbetbcr or not those cvtitics have cmployces. If the sub-contractors have cmployecs,they mist provide th* workers'comp,policy number. I am an employer that is providing workers'compensation insurance far my employees. Betow is the policy anal job site information. Insurance Company Name: G ' C ii gelca, )eL. �►�� - Policy_ #or Self-ins.Lic.#: 1 q 4 14' Expiration Data: 2 1—+ b sq Ov �,j S ►`. IAa�1 *W 6wws state/ ' : H-i5krtims �A P 2rvd Job Site Address: 8 �Y/. 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 impris=ont,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against ed that a copy of this statement may be forwarded to the Office of Investigations of the DIA msorance coverage v ation. I do hereby certify u er the p s aloes of p " ry that the information provideeAd above is true and correct Si e: Date: if zo ��llc3 Phone pffzcial use only. Do not write in this area to be completed by city or town official City or Town: PerinitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.PlmnbmgInspector• 6.Othow Contact Person: Phone#: TOWN OF BARNSTABLE MAM PERMIT CHECKLIST. Sign Off hours for Health and Conservation are $-9.30 am. and 3:304:10 A compkto ferwlt nppl cafion includ0flffing all seadons 1-13 1. NEW STRUCTURES/REM=ODELING/RENOVATION/ADDITIONS ❑ Site Plan showing setbacks of proposed and existing structures Commercial—Qne complete set of full sized plans one reduced 11"xl7" (plans may require a stamp by an architect or engineer). ❑Residential-4 Sets of floor plans no larger than 11"x 17" smoke/co detectors marked ❑ Worker's Comp. Affidavit and policy(if required) Y ❑ Res Check or COM check from the 2015 International Energy Cod Council(IECC) ❑Letter of financial'Interest for new houses only(not required for rebuild after teardown) s ❑Performance bond'ma_de out for$4.0d/foot of road frontage (new construction only) �^ 2. DEMOLTION OF A BUILDING (NOT PARITIAL) 0 -Everything above plus shut off letters from following utility'companies: ❑ Gas { Electrical Water ` ❑ Sewer(if requis(--d)R 3. DECKS/PORCHES/GAZEEBOS/INSULATION/SOLAR/POOLS/SHEDS ❑ Site Plan showing proposed location ❑ Construction plans showing framing detail (if new framing), ❑ Pools—Barrier details,pool specs (engineers design) ❑ Workman.'s Comp Affidavit and policy(if required) FAMILY APARTMENTS ❑ Section 1 Plus: ❑Family Apartments are subject to approval from the Building Commissioner. Agreement must be signed, notarized and recorded at the Registry of Deeds and returned to the Building Department. y3 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations.and Standards Const�rgtf►'on Sdpervisor CS-091391 Expires: 10/28/2018 FRANK DONOVAN 104 CARLOTtA AVENUE 1 HYAIVNIS MA 02601' ' l Commissioner , TPT Vlie�pammzQrzureal CJ/�aa cfc�aelta ^ ' b Office of Consumer Affairs Business Regulation HOIIflE,iMt?ROVEMENT CONTRACTOR ;r Registratro vi u�orj rfdY„4i i TYPE:Individual 333` Fierore Ehe exp��A' date. if found-,N urn 0: *' f Registration Ex s piration Office of Consumer Affairs and Business Re uiation69 10/18/2019 10 Park Plaza-Suite 5170 9 FRANK DONOV ston,MA 02116 e! FRANK J.DONC)V ' 164 CARLOTTA AVM e Y NYAP,!MS;1'AA t02E�t <" °� j Not Valid Witho ft signature t)ndersecretar 11 :UTAM No, 1U34 N. 1/1 _A16,�CC> Dr - CERTIFICATE OF L.IA��L:ITY INSURANCE DATE(MM2DfYYYY>18 THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER'nFICAT'E HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TM CERTIFICATE OF INSURANCE DOES NOT CONSTME A'CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the po,lky(is)rnust be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statomant on this certificate does not confer rights to the certiflcate holder in lieu of such endorsame s). PRODUCER NNAAMET' JIM HINDMAN Schlegel 5 Schlegel Ins Broker PHONE x 508 771-8381 . (5DB) 771-0663 34 Main Street EaYIAIL West Yarmouth, MA 02673 , schlegalinsurance@qmail.com INSURE 9AFFORDINGCOVERAGE NAIC# INSURERA:UNITED SPECIALTY INSURED 1 NsuRER B:PROGRESSIVE Izaiss Silva Deoliveira .w;.iRnic:LIBERTY b!i?TUAL ciba c S a landscaping INSURER D: Ex 94 .; W Yarmouth,'4s7+► 02673 01941 i+ni3�IRERF: COVERAGES .-•CERTIFICATENUMBERt REVISION NUMBER: THIS IS TO CERTIFY THAT THF_'POLiCES''CF INSUFV E LISTED BELOW HA1IE:EEN ISSUED TO THE INSURED NAMED A90VE FOR THE POLICY PERIOD INDICATED. NOTWiTHSTANDIYG°ANY REQLAREfNENT TERM-OR CONDITION OF'±WY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY'.PERTAIR THEdNSURANCE AFFORDE>BY THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITiO6*S OFSUCH I'OUCIES.Limrrs SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, .. _..._..._... ... . p L TYPE OF INSURANCE POU'CY NUMBER MICR MNLMD/YYYY Y$LIM k A GENERALLABILITY . USA• 4109614' 12/14/17 12/14/12 EACHOCCURRENCE S 1,000,000 X COMVIERCIALGENE"LI7Y DAMWE TO RENTED $ OO O 5 00 CLAM-MADE„,OCCUR MEDEW(Aryorrpesa,) S 101000 PERSONAL&ADVINJURY 5 1 OOO 000 GENERALAGGREGATE $ a 0OO 000 GEN'LAGGREGATELuWTAPPUESPER PRODUCTS•COmP/OPAGG s 2,000.000 POLICY PECT.RO- .. .._.....LOO- _._.._. ..._ .._. $ $ AuloMO8lLEuaeIUTY _ 064029230 12/13/17 12/13/1B 88wI�'SINAILIMIT $ 1 000 000 X ANYAUTDALL .. .. ......_ BODILY INJURY(Perpeison) 9 AUTOS D X/'AUT0�8�LEq:.r. .,.....;: BODILY INJURY(Per awident) $ NON-OWNED OP AMAGE HIRED AUTOS AUTOS.s;. - - era ent $ UMBRELLA LAB OCCUR EACH OCCURRENCE 8 EXCESS LIAE3 CLAIMS MADE-., j, AGGREGATE $ DID R •_i _ $ C WORKERS COMPENSATION WC5 J S=36 .03804:: 11/s/1T 1116/18 WCSTATU- OTH- AND EPdPLOYERB'LIp81LYfY - ... , ANY PROPRIEIORIPARTNEWEXECUiTUE YIN ..+ E.L.EACH ACCIDENf SOO OOO OFFICE MEMBER EXCLUDED? (A1ofttwy in NN) E L.DISEASE-EA EMPLOYEd 9 500,000 p DES MPT:ONOFOP_RATIONS 40%6, " E.L.D E•POLICYLIMIT 9 SOO ODO f I:- ,• DESCRIPTION OF OPE]iA.=;L 'mON$'IVBG= ACORD 101,AddtionM Remo is se widuie,if nwe space is re4dred) a IZAIAS DEOLIVEZRA_-HAS EL•EG2'ED:-NOT, TO BE COVE°RED :IJNI}ER HIS CURRENT WORKERS COMPENSATION POLICY YATCHMAN CONDC611NIUM TRUST;•._LZSTED AS>ADDITION?IL INSURED BY WRITTEN CONTRACT INCLUDES SNOW PL0WING,1IJBILITX SKID STEER LOADER i- . __..,. . CERTIFICATE HOLDER CANCELLATION L �. SHOULD ANY OF 13.R ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'TIC. EXPIRATION`fj11E YWEREOF, NOTICE WILL BE DELIVERED IN YATCHMAN CONDONXNIUM TRUST ACCORDANCE WITH SHE POLICY PROVISIONS. 500 OCEATT Ate` HYANNTS.MA 02601 AUTE+owzaD REPRESENT' 0198 -20 0 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) : ;; The ACORD name and logo are registered marks W ACORD Phase; Fax::.:E5,08): -41$-:5017. E Mail: Y . Yachtsman Condominium Trust 500.Ocean Street Hyannis,MA 02601 YCT Property Management Office Phone: 508-775-1515 Fax: 508-418-5017 entail: yctpmofc@comcast.net Postal mail: P.O. Box 103, Hyannis, MA 02601 Date: April 20, 2018 RE: Yachtsman Condominium Common area wall and stairs project Reference: (separate) ToB Application for Permit delivered April 20, 2018 To: Town of Barnstable— Building Commissioner's Office The Board of Trustees of the Yachtsman Condominium Trust (YCT) voted and approved the wall and stair replacement project as detailed in the April,20 , 2018 submitted "Building Permit Application". YCT has selected C&Z Landscaping as the contractor for this project. The wall is in the landscaped "common area" between Building 1 and 2. This letter serves as notice of the YCT Board's vote to approve the project , which has been noted in the March 2018 YCT Board of Directors Meeting Minutes. YCT Board of.Trustee Secretary Joyce M. Flavin . Date 8 ................... ..... .... Page] 1 Application Number............................................ Section 9—,Construction Supervisor Name - � Telephone Number Address 10y al t(o 41,1L City State c,, Zip License Number L.S -fyg/, !yy License Type ``vi� rnc�Expiration Date o Contractors Email CG eCp c�CfCc 3►n\, cm. I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section-10—Home Improvement Contractor Name ,..( 1 S L)cm-d-,ham- Telephone Number Address /4C/&Ao A IV6 City' , State A-t� Tap Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your HZC... Signature Date Section 11 —Home Owners License Exemption = Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the constriction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name -{{�,q�K (�� �/ Telephone Number V z 3 0l019 E-mail permit to: Cy cb r4L9 4 4a Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ ` El Historic District El Site Plan Review if required) Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval er's Authorization Section 13— Own f the-subject property ereby ' to act on my behalf 1n all author matters relative to work authorized by this building permit application for: (Addresls of job) T 4 D igna e of Owner C date Print Name o `L � ov Last undated:2/92018 „ . Town of Barnstable Building �a, 'PostTh�ssCard-So;That.�t-is�/�sible#:Frorri;the Street `A „roved Plans Must beRetamed onJob andahis Card Must be Ke t�__ .: MRN'3rA�LK 6 Posted Unt�14Final InspectionHasBeen Madeg £ k v FfPermit Where aCert�fica'teof Occuancs Re wired }such Buildm shall Not;,be C1ccu ied until;a.Finahlns. ection has beenmade Permit No. B-17-4162 Applicant Name: David Cooper Approvals Date Issued: 04/30/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 10/30/2018 Foundation: Location: 500/condowork OCEAN STREET, HYANNIS Map/Lot 324 040 OOA Zoning District: Sheathing: Owner on Record: LOCKHART,CHARLES F ET AL TRS Contractor Name:` ,DAVID COOPER Framing: 1 Address: 296 WINTER ST � Cont`ractor License,: ,CS-108961 2 HYANNIS, MA 02601 Est Project Cost: $25,000.00 Chimney: Description: AT&T proposes to add a P6480i Galtronics small cell ante"na to the $f Permit Free: $327.50 Insulation: top of the Utility pole located at 499 Ocean Street(behind � ' `Fee Paitl $327.50 Yachtsman Condo Rentals and before The Yacht Club) The pole#is Final: #1063-1 1/2.Also proposed on the pole is a 12”x 32,Cabinet to be ' *K Date 4/30/2018 mounted on pole;with cables running from th46x to the ant�e'nna �a 1 Plumbing/Gas proposed meter for power reading onpole;daw attache f in s are Rough Plumbing: outlining the proposed design. Building Official Final Plumbing: Project Review Req: ,� � � ems. Rough Gas: This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within six montghs after issuance. All work authorized by this permit shall conform to the approved application and'kthe^approved construction documents or which thi"s permit has been granted. Final Gas: All construction,alterations and changes of use of any building and str.'uctures.shall be in compliance with the local zone g by laws§and codes. This permit shall be displayed in a location clearly visible from access street or roatl and,,shall be maintained open for pu blic inspection for the entire duration of the Electrical work until the completion of the same. , Service: The Certificate of Occupancy will not be issued until all applicable signatures by he Building and Fire Officals are'prouided on this permit. Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 5 .` 500 Ocean St.#19 Hyannis,MA 02601 =� Yachtsman Condominiums MARC ROBINSON RESIDENT MANAGER Off.508-775-1515 gell -0878f508!-7!3!7-;6%227 ti - ail marobin@mediaone.net L. TOWN OF BARNSTABLE 1BUII�DING PERMIT APPLICATION cow ga4, Oq 01--. Map Parcel 0(�" ew,- Permit# /3 C&56 a : �5 f Date Issued (O a 7 30( L onservation:Division' e /aa�G� Fee Collector (� 0�/��0/ U,L - ; �Treasurer--_�,' 4.LIL� Gam'' l��iz�z1 i i Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address cD o refs Village ��S - 4 Owner VAT NAW (Z Address ��t/ dLE41L,S% ¢96/,9 Telephone IS 7 7 r. � r— .Permit Request �'� L� d . ) 77D (/iuc ��` 2 / a 3 O� Square feet: 1st floor: existing lroposed �nd floor: existing roposed ''�—Total new Valuation 6,birlb Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ?�No On Old King's Highway: ❑Yes ;6 No Basement Type:XFull ❑Crawl " ❑Walkout ❑Other Basement Finished Area(sq.ft.) 3&-o Basement Unfinished Area(sq.ft) tr Number of Baths: Full: existing new Half: existing t/ new %, mber of Bedrooms: existing o�--- new .w� tal Room Count(not including baths): existing new Est Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air: ❑Yes VNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: t Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION C Name A3 Telephone Number License# Address: � n � � — Home Improvement Contractor# S�,6 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO1 SIGNATURE DATE OP" I � - - FOR OFFICIAL USE ONLY PERMIT NO. t < R � DATE ISSUED 4=4 •_ � -_• t r'' i :� - MAP/PARCEL'NO-' • +may 3 + � 'r ; -��.� �~. r • `/y,¢ ADDRESS , r rr: `. VILLAGE t _ s r • P OWNER " s ' ., '. DATE OF,INSPECTION FOUNDATION- FRAME INSULATION - y FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL • t GAS: _'_ ROUGH FINAL - FINAL BUILDING` 4 DATE CLOSED OUT, ASSOCIATION PLAN NO. ' r� d. : . The Town of Barnstable 9 'AM �,$ Regulatory Services Eot• Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair.modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: lf c—BulL'I IMe k Estimated Cost Address of Work: O %- r Owner's Name: 01 C&O Date of Application: G �a C� 16 / I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law C]Job Under$1,000 ' OBuilding not owner-occupied ❑Owner pulling own permit ' Notice is hereby given that: OWNERS PULLING THEIR OWN PERAUT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby ppiy for a permit as the agent of the owner Al Al l f Date Contractor Name Registration No. OR Date Owner's Name q:forrm:Affidav f The Commonwealth of 3fassachuse= —' Department of Industrial Accidents = � 01tIcr0.ULW95tl9MOS 600 Washington Street Boston,Mass. 02111 Woricers' Compensation Insurance Affidavit NM•/N!. 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'fa Perrriit No , B-17-31'72' Applicant Name: FABIO PRETTI Approvals n.. _ ..__... ._ Date issued.:' 09/21/2017 Current Use Structure Permit.Type ;"building=:Siding/Windows/Roof/Doors Expiration Date: 03/21/2018 Foundation: Location: .500/condowork OCEAN STREET, HYANNIS r Map/Lot: 3247-040 00A Zoning District: Sheathing: Owner on Record: VALLATINI JOSEPH L&GILEAU,ELEANORE L 5z Contractor Name: FABIO PRETTI Framing: 1 J � r Address: 15 FOREST STREET, '; ` ,m Contractor license;;182418 2 BRAINTREE, MA 02184 Est Project Cost: $0.00 Chimney: Description: Re-Siding Back of Building 313 and 3C. 3 Permit Fee: $160.00 �� Insulation: Fee�Pa Project Review Req: Re-Siding Back of Building 36 and 3C �. i&1 $160.00 Date 9/21/2017 Final: , Plumbing/Gas Rough Plumbing: " Building Official Final Plumbing: This permit shall be deemed.abandoned and invalid unless the work authonzed by this permit is commenced within six months after�issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documentt fior which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning y laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetor road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. _Electrical The Certificate of,.Occupancy will not be issued until all applicable signatures by the Building ancRFire Officials are provided onthis permit. Service: Minimum of Five Call Inspections Required for All Construction Work:,. t- 1.Foundation or Footing Rough: 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy . Low Voltage Final: Where applicable,.separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall nQv proceed until the Inspector has approved the various stages of construction Final: P sons cQntactmgwlth unreglster�d:contractors;do.;not.have access to the guaranty,fund has setforth ln.MGL'c.142A).: er Fire Department Building plans are to be available on site Final: :AII.Permit Cards are the property of the APPLICANT-ISSUED.RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION L �- Map- Parcel Application # T I Health Division Date Issued 9 Z/ Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic -'OKH. _ Preservation/ Hyannis Project Street Address Village � �/�1 d Owner Cj- 60 JQ> Ti UcSf Address S&n/U L- Telephone Permit Request . - 21616; &6tG oe 8c//L.010A S 43 jk Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot.Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other BUILDING DEPT Basement Finished Areas ft. Basement Unfinished Area s=. A 9Q11 Number of Baths: Full: existing new Half: existing_.... �. „ �.�;-new:. R- l)VVlV lr tJ� r tv?•J: eve �. Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) - Name ✓ I Li Telephone Number Address s r!�C J (�� � License# IN . J M,!n6U,r'1'f —n n a leg S7 Home Improvement Contractor# &C �cJ Email �� �'c 14W L0I'V1 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ra SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME Ilf INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING DATE CLOSED OUT I ASSOCIATION PLAN NO. i 71 0 M -4 . w • � � �1• �• � qua � � � '� - - Ji i coy rp � 1*11 't;, l� ul Pd ON Y • �. g' � y �� � r. • � n � � 2 � ■ ■ a [ 1 � Z i. f �V � 1 T ■ J ■ i � 9 1' 1' 1' • • � i i • � � : � : 1' :� • �• • �� C � � ■ • � r \ 7 � � l C 1' � p t s r r � - - e r ■ ■ ■• L ■ 1 � � �` ' 1 • ■ 1 • � i + r " � 1 r 1. f .V 1 _ • 1 •� 1' � 11 • \ �� \ 1 . nr ■ i � • . • '' • � � .' f ■ ■ .� i � ■ 1 .1 • !. 1' 1 � ■■ •• � 1 � • U : : r 1. — ! 1 • 1'. ■ OF THE rp� • IARNSMBLE, 9q, 16 9 ,�� Town of Barnstable ATf° �a Building Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder c-T I, J 'XC77^/ TQ,as Owner of the subject property hereby authorize—Ef O .22 6-, to act on my behalf, in all matters relative to work authorized by this building permit application for: bo a OCe.,d V IA- (Address of Job) Signature of er Date �0 6-e AT- �• ���� Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WN LESTORMS\building permit forms\EXPRESS.doc 08/16/17 1 - P H ro off: �• � � � � g' � , Eli ON to �, g: � o a tn- b o ►� . W ° ° g : . y O � d • No O �: AC®Ri?. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) U NCE 9/11/17 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 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 NAME: PAUL SCHLEGEL _ Schlegel & Schlegel Ins Broker PHONE 508) 771-8381 FAx (508) 771-0663 34 Main Street / NO E-MAIL schleqelinsurance@gmail.com West Yarmouth, MA 02673 , _ INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA:NGM INSURANCE COMPANY 1147_88 INSURED INSURER B:ATLANTIC CHARTER _ FABIO PRE TT I ---- — I NSU RER C: FABIO HOME IMPROVEMENT INC - ( --- - INSURER D: I 38 WENWARD WAY WEST YARMOUTH, MA 02673 INSURER E: -�--- -- I NSU RER F: COVERAGES CERTIFICATE N UMBER: 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. INS12 AODRISUB_ LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS II A ! GENERALLIABILITY Y MPS6863R 11/19/16� 11/19/17 EACH OCCURRENCE j$ 11000,000___ X! COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ! P�MLSES(Ea oc�Pne $ 500.000 j CLAIMS-MADE OCCUR nce f `MED EXP(Arryore person) i$ --10 -000_ --------. PERSONAL&ADV INJURY $, $O 900 -- — } GENERAL AGGREGATE +I$2,O00,000_ GENT AGGREGATE LIMIT APPLIES PER I ( PRODUCTS-COMP/OPAGGG IS 2 000,000 ! POLICY'— PRO- ff i - c —_._ 1 i CT I LOC $ AUTOMOBILE LIABILITY ! � +COMBINED SINGLELIMIT I� $Ea acciderd— ANYAUTO I BODILY INJURY(Per person) S ALLOWWD SCHEDULED i AUTOS AUTOS I BODILY INJURY(Per accident) $ -O WNED —a HIREDAUTOS AUTOS I f PRO PERTYDAJIAAGE I$Per accident — A X I UMBRELLA LIAR I _OCCUR , Y i I CUT6863R ! 9/8/17 9/8/18 EACH OCCURRENCE $ 3 OOO OOO l EXCESS LIAB CLAIMS-MADE j f , ---! AGGREGATE $ 3,000,000 I DED RETENTION$ i $ B VVOAND EERS COMPENSATION !WCV00935903 11/19/16 11/19/17�WC STATU- IOTH- ANDEMPLOYERS'LIABILITY Y/N I X TOB1Li B- _ ANYPROMEMBR/PARTUDED?ECUTIVE i E.L.EACH ACCIDENT $ 100,000 (Mandatory in H)EXCLUDED? 7'�N/A _ (Mandatory in and E.L.DISEASE-EA EMPLOYEE!$_ 100,000 If Yes describe under DESCRIPTIONOF OPERATIONS below IE.L.DISEASE-POLICY LIMIT 1$ 500,000 I I ! 1 { DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regri red) FABIO PRETTI HAS ELECTED NOT TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY LISTED AS ADDITIONAL INSURED: YACHTSMAN CONDOMINIUM TRUST AS PRIMARY AND NON CONTRIBUTARY BASIS CERTIFICATE HOLDER• CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN YACHTSMAN CONDOMINIUM TRUST ACCORDANCE WITH THE POLICY PROVISIONS. 500 OCEAN STREET 16 HYANNIS, MA 02601 AUTHORIZ ENTATIVE ©198TW0 A ORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: ERIBEIRO@HHSI.US r ID I Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvemel6ItContractor Registration } ± N'( ? Type: Individual Registration: 182418 FABIO PRETTI t _ = Expiration: 06/18/2019 D/B/A FABIO HOME IMPROVEMENT ; 38 WENDWARD WAY YARMOUTH,MA 02673 3s ` .fit, `' --• "`x Update Address and return card. Mark reason for change. SCA 1 Ei 20M-05/11 2�/r.e�mt.tttanuaca�l�a`P�llcc.iJrcc�ttan,/,fi - . Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: p Registration Expiration Office of Consumer Affairs and Bu 'ness Regulation 182418 _ 06/18/2019 10 Park Plaza-Suite 5170 F 0 PRETTI '� _ Boston,MA 02116 D/B/A FABIO HOME:lMPROVEIv1ENT FABIO PRETTi 38 WENDWARD WAY YARMOUTH,MA 02673 Undersecretary NAII!iiOUthout signature 9 Massachusetts -Department of 'Rub i- Safety S �-- Board o;Building Regulations and Standards i Construction SuperiNor License; CS-108659 FABIO PRETTI - 38 WENDWARD WAY `, West Yarmouth MA 02673 I f� 04/19/2019 � Gorn:nissiorles . t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION F Map Parcel Application# a O Health Division Conservation Division Permit# Tax Collector ®wa Date Issued O Z-C OF i Treasurer Application F� Planning Dept. Permit Fee O Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -D G Lr,,4 A.) &-6-7- Village VIVA/ lA/rs 1",4 ' Owner YiT L OG r— ��, r- Address P e),8e" 128.y Telephone W li Permit Request �_ t7L__2 4_ 81Z'i,o 4 U Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay o� Project Valuation f �' U d Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) o Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Hio'ay: ❑YL2§ U.No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other ' > M Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) � co Number of Baths: Full:existing _new Half:existing new . _ Number of Bedrooms: existing new Total Room Count(not including baths):existng new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 12c ics 0/—y Telephone Number :5-d'9 7 75- -Address Z y P4 License# C lop 17 U/ cry p>✓ P9 OZ I Cj Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE A � D�9 ~ FOR OFFICIAL USE ONLY I - r 1 PERMIT NO. DATE ISSUED i 1a MAP/PARCEL NO. i ADDRESS VILLAGE OWNER- DATE OF INSPECTION: t FOUNDATION FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL t s - ' PLUMBING: ROUGH FINAL jGAS: ROUGH FINAL 3 FINAL BUILDING j P DATE CLOSED OUT ASSOCIATION PLAN NO. j The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston, M4 02111 www.inass.gov/dia Workers Compensation Insurance Affidavit:-Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizadomUdividual): On C. + (l U e,., Address: Z 10,# zr City/State/Zip: U)a-s roW 2/41 Phone.#: �.�'® 6. 72 Are you an employer? Check the appropriate box:. Type of project(required): 1.❑ I am a employer with 4. R?1"am a general contractor and I employees (full and/or part-time). * have hired the sub-contractors 6. New construction 2.❑ 1 am a'sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have g. [Demolition working for me in any capacity, employees and have workers.' [No workers' comp, insurance comp. insurance. $ 91 ❑ Building addition required] 5. ❑ We are a corporation and its 1.01-1 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' 13.0 Other comp.insurance required] IJ *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavitindica6ng they arc 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 ant an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: 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 tip to $1,500.00 and/or one-year 4risonment, 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. De 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 certif y under the pains and penalties of erjury that the information provided above is true and correct Signature: Date: Phone#: Offcial,use only. Do not wrile in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: a a M zm :U w , Z A is o 'Rol" n�a ram' cop wid 4 . � � f�■ � ^ � . «�© 7 b - A $ % . ; a ¢ • # $ƒ : ) � I IKE rp� Town of Barnstable r snxxsTnsi.e, x MASS. .�� Regulatory Services Arfo �n Thomas F.Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A.Builder. id9 as Owner of the subject property hereby authorize r-'6 Z. 101/,e:�� to act on my behalf, in all matters relative to work authorized by this building permit application.for. (Address of Job) Si afore of Owner Date I 0LYJi17 W via, Print Name Q:IWPHLESTORMS\building permit forms EXPRESS.doc Revise020108 Town of Barnstable , VHE TQjY o Regulatory Services * Thomas F.Geiler,Director + * + IARNSTABLE. MASS. 1639. A,m� Building Division Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623,0 HOMEOWNER LICENSE EXEMPTION Please Print . DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or,less and to allow homeowners to engage an individual for hue who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building pernnt. (Section 109.1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by. several towns. You may care t amend and adopt such a for n/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC OCT-14-2008 03:04P FROM:SCHLEGEL SCHLEGEL IN 15087710663 TO:15084185017 P.1 ACORD ,a CERTIFICATE OF LIABILITY INSURANCE DATE INMOD/YYYY) 110/14/2008 PRODUCER THIS CERTIFICATE S ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND CONF RS NO RIGHTS UPON THE CERTIFICATE 34 MAIN ST HOLDER. THIS CE ITIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVEF AGE AFFORDED BY THE POLICIES BELOW. WEST. YARMOUTH, MA 02673 INSURERS AFFORDING I(OVERAGE NAIC it INSURED - _.._.._.. Izaias Deoliveira Dba C 6 Z Landscaping INSURERA, COLONY INS CF. INSURER B: LIBERTY MU IIAL P.O. Box 941 INSURER C. INSURER D. W. Yarmouth, MA 02673 INSURER COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FC THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Taw LTR WSRO L P TYPE OFfNBURANCE POLICY NUMBER OICY EFFEGTWI7 POLICY E% RATION DATE tMMIDDff/) DATE I O/YYI LIMITS A GENERALLIABILITY GL3594682 9/18/08 9/18/0 EACHoccuRRENCe $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea RTEITce) $10O,000 CLAIMS MADE Fx OCCUR I MEO EXP(Any one person) S S,DOO PERSONAL S ADV INJURY 51,000,000 GENERAL AGGREGATE f2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGO V s2,000,000 POLICY JEGaT LOC ....... +AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea ecddenp : i ALL OWNED AUTOS I $CHEDULEDAUTOS BODILY S (Par parsonon)) HIRED AUTOS —"— BODILY INJURY f NON-OWNED AUTOSI (Poraccidenf) PROPERTY DAMAGE S (Per mcklenl) GARAGE LIABILITY AUTO ONLY-FJ ACCIDENT f ANY AUTO OTHER THAN EA ACC S AUTO ONLY AGG S EXCESBNMBRELLA LIABILITY EACH OCCURRENCE I S _.._1 OCCUR CLAIMS MADE AGGREGATE f DEDUCTIBLE S"—"'—"— S RETENTION S _....---....__._._-_..._... S WORKERS COMPENSATION AND X TORYUMRS ER B EMPLOYFRS'IUABBJTY WC2-31S-363036-017 g/22/O8 8 ANY PROPRIEPOR/PARTNERIEXECUTIVE 9/22/O E.L.FACH ACCIDENT f 100,000 OFFICERIMEMBER EXCLUDED? If yea,deacnee Under YES E.L.DISEASE•EA EMPLOYEE S 100,000 SPECIAL PROVISIONS Debw OTHER E.L.DISEASE-POLICY LIMIT 6 500,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES!EXCLUSIONS ADDED BY ENOOR8EMENT I SPECIAL PROVISIONS THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR IZAIAS DE I,IVEIRA THIS POLICY HAS BEEN MODIFED TO INCLUDED CONSTRUCTION WORK CERTIFICATE HOLDER CANCELLATION YATCHSMAN CONDOMINIUM TRUST SHOULD ANY OF THE ADO DESCRIBED POL CANCELLED BEFORE THE EXPIRATION 500 OCEAN AVE DATE THEREOF, THE 18SUI p INSURER W1 OR TO MAIL 21 DAYS WRI77EN HYANNIS, MA 02601 NOTICE TO THE CERTIFICATE] HOLDER N TO LEFT, BUT FAILURE TO DO 80 SHALL 1 IMPOSE NO OBLIOATION i LIABILI OF KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, FAXN 5 08—418-5017 AUTHORIZED REPREBENiMI . ACORD 25(2001108) ®AC RO CORPORATI N 1888 I i i _ Shea, Sally From: Dean Melanison [dmelanson@hyannisfire.org] Sent: Friday, October 17, 2008 8:59 AM To: Shea, Sally; Roma, Paul Cc: Perry, Tom Subject: 500 Ocean Street Hi Sally, I Just j of a call from the Yachtsman's Condo Assoc. lookin g f gfor our endorsement on the removal of the connector bridge at his location. Apparently Paul Roma is holding the building permit until he hears from us. We are an favor of removing the bridge as our ladder truck barely makes it under the structure. With snow and ice we may not be able to get through. The Condo Assoc. is willing to remove it. I went over the situation with Tom Perry in detail, if there are any questions please check with Tom or give me a call. Deputy Chief Dean L. Melanson Office 508-775-1300 Fax 508-778-6448 dinelanson@fiyannisfire.org 1 TOWN OF BARNSTABLE BUILDING PE _ ICATION Map G/ Parcel `f U ��1 Application # ,. Health,Division ��� Date Issued Conservation Division s 06 v�l• � Application F ' " Planning Dept. Permit Fee � Date Definitive Plan Approved by Planning Board (� Historic - OKH Preservation/Hyannis f Project Street Address Village E-( V A ►J Owner 4 c N t c.m/I j ,, 162 092 17&L2 sT Address o c (L m 3 Telephone SO 46 - 7 -7 - I S I S O z G a Permit Request 7 i 2 •✓ /G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ _ Commercial ❑Yes ❑ No If yes, site plan review# a cun =f Current Use _Proposed..Use APPLICANT INFORMATION o r-- (BUILDER OR HOMEOWNER) rT' Name 12o6es.;t ,r- l d Fd.ti Telephone Number .5,v -7 7 S- /S/,S' y Address Z y J44 tF /� 1�y License# C S 5 7 [w��sr�r✓,. IyJ! D Z 9 3 Home Improvement Contractor# Worker's Compensation # ( ' CC �y0 ALL CONSTRUCTION DEBRIS /RESULTING FROM THIS PROJECT WILL BE TAKEN TO � �I'f1ltGCf/y �� �rw r�n211//Glr� SIGNATURE _._� 4�� � �� DATE s ,e FOR OFFICIAL USE ONLY 33 a PLICATION# a DATE ISSUED MAP/PARCEL NO: i ADDRESS VILLAGE f' 4 OWNER Y r y X DATE OF INSPECTION: FOUNDATION FRAME: ,R-- '' INSULAT ON FIREPLACE � ELEC�TRICAL: ROUGH FINAL { , PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL g T FINAL BUILD LNG DATE CLOSED..OUT ASSOCIATION;PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street . Boston, AM 02111 www.mass.gov/dia Workers' Compensation Insurance A-ffidavit: Build ers/Contractors[EIectricians/P.lumberg Applicant Information Please Pant Le�zb� - Name (B,isincsslorg�izaLion!Individual): Address: City/StatclZip: 1!�mL jm. Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I 6 ❑Ncw construction employccs(full and/or part-time)-* have hired the sub--contractors 2❑ I am a sole proprietor or partncz- fisted on the attached sbaet 7. ❑Rewodeling ship and have no employees Thcse sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. El Building- addition • . No workers' com}i,inc�rr�ncc �mP.insurance.$ [ [No-workers ] 5. KWc arc a corporation and its 10_❑Electrical repairs or additions rbqam a homeowner doing all work officers have exercised their ILEJ Plumbing repairs or additions 3.El I myself:"[No workers' comp. right of exemption per MGL 12.0 Roof repairs P. 152' §1(4), and we havt no ! incr7rancc regtrard_] t 13.❑ Other (.yam d/3-(, ITGU^ employees. [No workers' comp.insurance rcguirciij I/e- *Any applicant that checks box#1 must also fill out the sxtion blow showing their workcrc'eorNx=satjon policy information. t Homcowoas who subnit this affidavit indicating they arc doing all work and tbcn hire outside contractors must submit a new affidavit indieiring such. tCuntiactors that cbccktl i box must atlacbcd an additional shoot cbowing thc name of the sub cantracto, and stale whether arnot thosd cntitirs have eaiployerx. If the sub-contractors have employcca,thry must providb their workers'comp.policy number. f am an employer that is providing workers'compensation insurance for my employees. HeLatu is the policy and jab site information. Ins>u- ncc Company Name: Policy#or Sclf--ins.Lic. #: Expiration Date: Job Sitc Addrrss: City/Sta-te/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tmdcr Section 25A of MGL c. 152 can lead to the imposition of cr nainal penalties of a 5na up to $1,500.00 and/or one-year imprisonment, as wril 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 adyiscd that a copy-of this statement maybe forwarded to the Office of Invcsti ations of the DIA for innu-ancc coves e verification. I do hereby ecru under the pains-andpenaltt:es ofperjury that the information provided above is true and carrerL Datr: 1 �� r� Phone# Offuinl use only. Do not write to this area, to be completed by city or town offcciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written-„ An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing.engaged in a joint enterprise, and including the legal represcataiivcs of a dcccased employer, or the receiver or trust=of an individual,partnership, association or other Iegal entity, employing employees. However the owner of a dwelling hDUSe having not more than three apartments and who resides therein, or the occupant of the iwclling house of another who employs persons to do maintenance,construction or repair work on such dwelling house )r.an tha grounds.or building appurtenant thereto shall not because of such employment be deemd to be an employer." viGL chapter 152, §25C(e7 also states that"every state or Iocal licensing agency shall withhold the issuance or -ejarwal of a license or permit to operate a business or to construct buildings in the commonwealth for any Lpplicant who has notproduced-acceptable evidence of compliance with the insurance coverage required." Wditionally,MGL chapter 152, §25C(7) states`Neither the commonwealth nor any of its political subdivisions shall ;rater into any contract for the performance of public work until acceptable cvidcacc of compliancL R'ith the in-urn-'tee cgrurcments of this chapter have beenprescntr-d to the contracting authority:" ,pplicants lease fill out the workers' compensation affidavit completely, by checking the boxes that apply to.your situation and, � ecessary,supply cub-eant<actor(s)name(s),address(cs) and phone numbers) along with their ccrtificatc(s)of mn.a_nce. Limited Liability Companics.(LLC) or Limited Liability Partnerships (LLP)with no-cmployecs other than the icmbcrs or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have Mployecs, a policy is required. Be advised that this affidavit may be submitted to thr Dcpa-L-(mcnt of Industrial ccidcnts for confrmation of insurance covcragc. Also be sure to sign and.date the affidavit The affidavit should returned to the city or town that the application for the permit or license is being rr_qucstcd, not the Department of idustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' ,ropensation policy,please call the Department at the nurrtber listed below. Self-insured companies should enter their :lf ins ranrro license number on the appropriate line. ity or Tow;r Officials case be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant case be sure to Fill in the permittliccnse numbcr which will be used as a reference number. In addition, an applicant it must submit multiple permit/lic:nse applications in any given year, need only submit our,affidavit indicating cuaent trey information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or vn)."A copy of the afdavit that has been officially stamped or marked by the city or town may be provided to the plicaat as proof that a valid affidavit is on file for fiit,irc permits or licenses. A new affidavit,roust be filled out each 3r.Whero a home owner or citizen is obtaining a license or permit not rclatcd fo any business or commercial venture IL dog license or permit to burn leaves etc.) said person is NOT required to cornpletc this affidavit e Office of Investigations would h1m to thank you in advance for your cooperation and should you have any questions, ase do not hesitate,to give us a call Department's address, telcphon.e•and fax number. Tha C6mmanwWth of Massachusetts print of Industrial Accidents Office of Investigations 600 Washinn Street Boston, MA 02111 Tt;I. # 617-727-4.90.0 ext 4-06 or I-M-MASSAFB Fax# 617-727-7749 . 11-22-06 www.masR.gov/dia zKE � ` Town of Barnstable aaxNsrnsLa, 9� Regulatory Services ATE p �A Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, A,/;e- d �/ / & / , as Owner of the subject property hereby authorize eva&,n.4 L. to act on my behalf, in all matters relative to work authorized by this building permit application.for. S'd a (2 f lsl�is/ /1lfYf �it/Ji/� f j►�/J, (Address of Job) �nature ner Date Print Name Q:\WPHLESTORMS\building permit forms EXPRESS.doc Revise020108 r Town of Barnstable . OF THE Regulatory Services anxxsrnai e Thomas F. Geiler,Director Muss. 1639. a,m� ]Building Division alEo MAC Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use.and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedure's and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official _ Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." ` 1 • • . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILFS\FORMS\homeexempt.DOC I *Board of Building Regulatio sand Standar s Cbn`sthictlon;supervisor License m tic 4-6: C5 9897 &. Ex ira ion 724/2tl10 tr# 16248 RestncBon b0, r i ROBERT.L DUF�1' t 24 PAG5-RDA` iJ- W,ESTON,'MA 02193 ' Commissioner N s r I CONSTRUCTION CONTROL AFFIDAVIT I� PROJECT LOCATION: NAME OF PROJECT: . PROJECT NUMBER: p 7-� SCOPE OF PROJECT:T: P�i&S 1 � 1 of submit that our office will perform a following brofessional services,as specified in Massachusetts State Building Code Section 116.2.2 and as related to the structural portions of the work: 1. Review for conformance to the design concept,shop drawings,samples and other submittals, which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review an approve the quality control procedures for all code-required controlled materials. 3. To be present at intervals appropriate to the stage of construction,and complexity of the project,to become generally familiar with the progress and quality of the work,and determine to the extent practical acid possible the work is being performed in a manner consistent with the structural construction documents. Signature: 0�4L , Massachu s Registration No. : i Our observation during site visits will not relieve the Contractor or its subcontractors of their responsibilities and obligations for quality control of the work,for any design work,which is included in their scope of services(i.e.design delegation),and for full compliance with the requirements of the Construction Documents and applicable building codes.Furthermore,the detection of,or the failure to detect deficiencies or defects in the work during our site visits does not relieve the Contractor or their subcontractors of their responsibility to correct all deficiencies or defects,whether detected or undetected, in all parts of the work,and to otherwise comply with all requirements of the Construction Documents. I NOTARY STATEMENT: f Subscribed and sworn to before me this / day of1)r(U C20 • I DESOgAH A,P001-4 Notary Public Commonwealth of Massachusetts My Commission Expires March 26,2015 NOiA4ZL C MY COMMISSION EXPIRES ON 7 � C) 0 ,i�/ � Engineering Dept.(3rd floor) Map P ® e/ 't House# Date'Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee 00 Conservation Office (4th floor)(8:30-930/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) TNE rq Definitive Plan ADRraved by Planning Board 19 RNSTABLE. MASS TOWN OF BARNSTABLE .Et619. Building Permit Application Project Street Address d �.- - Village f; s Owner C1j,,,1�'lnm�v,.i,:yw�r QVSIAddress �}C�c w� ���- Telephone Permit Request /%�Y First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ C3p� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Areas .ft. Basement Unfinished Areas .ft Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) r Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name FRASER CONSTRUOTiay Telephone Number Address 71 TARAGON CAR, License# CUM MA 02635 Home Improvement Contractor# �/.-S3 6 Worker's Compensation# &C/--> 50363®/7 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Y. SIGNATURE DATE— /&/�o BUILDING PERMIT DENIE FOR THE FOLLOWING REASON a . 00A l l 1 1q FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED w MAP/PARCEL NO cz ADDRESS r VILLAGES' " OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE f*ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING , DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Afassachusetts Department of Industrial Accidents office of10FOS fgMONS 600 11 ashini;ton Street Boston,Mass. 0 111 Workers' Compensation Insurance Affidavit �pphcant information. Please PRINT IZ-Hil :._a,s_. ,:._ .. •... _ } name: t location: � ��� T� R���'� /.�z city l�t'�Tt )1 /Y?)019 Phone I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .....25,iw'.•'uq !ll^�'s�p'�"7l nx._.`• S77i7E[PMT' .T. n"!. MA`*+^�!"MT{1e:1",^rr�.`v.C� ..44wwiias�L ,,{.....'diY.. _�:""�_.+fa. _ ... .`Jm�N� vim. ..U.... ,.y,w�.}'L... .:._.. .:...•..-_ •:1.�..ti...i< ..�f -�i' _ - L�J_ I am an employer providing workers' compensation for my employees working on this job. company name address: '� l /�121�5G^�'1 city Co 7(-I� phone#• insuranceco, twu/ uc policy# WC,!`�/o� '��ca� 0l0 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors Iisted below who have the following workers' compensation polices: company name: address: city: phone#• insurance co. of licy# y;....H.oe'a-r.•s•: ."r.Y.° 7I company name: address, city phone#• insurance co policy# . •..- --------�+•-- :Attach add�honsl sheet itnecessa ,.... :.. ,� F ,w , r;,*s ._.:.r;.c, :,tf.:,....�.,.._J, Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SU00.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verification. I do hereht•certif the ants d e talties of perjury that the information provided above is true and correct. Signature Date Print name 6:7 G-.a.Z-A Phone# official use only do not write in this area to be completed by city or town official city or town: permitAicense# r111uilding Department EJ Licensing Board check if immediate response is required OSelectmen's Office �liealth Department ' contact person: phone#• rlOther 4 wad`• Ireised V95 P)A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an cmplitme is defined as every person in the service of another underany contract of hire, express or implied, oral or written. An cinplitrer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a•joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwcllino house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an emplover. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the common-wealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Go, or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ; I 1 lyl . HOLE IMPROVEMEM CONTRACTORS REGISTRATION Board of Buildin ION R ulatiana and Standards j One Ashburt�,n Place Boston - Room 1301 s Missachusetts 02108 - T HOME IMPROVEMENT CONTRA e•T,6R � Registration . 112536 Type - DBA Expiration 04/06/99 FRASER CONSTRUCTIa DEAN C MORE Ff4P VEHE t CONTRACTOR ERASER ! Registration II2536 t 71 TARRAGON CIR f COTUIT MA 02635 ; Type - D& F Ex¢iret�$s 04/06!g9 FRASER COMTRUCTI6H § i tom , C. FRASER I TARRAwN CIR COTUIT RA 02635 .J + f - , 1 . . ; The Town of Barnstable a�trrsT,�stE, • '& ��' Department of Health Safety and Environmental Services 1°�ri�o Me't" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost—1119,eeP-e5 Address of Work: Owner's Name: ` Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby 7,; ly for a permit as the agent of the owner: D e Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav Pt Iti Assessor's Office 1st floor Ma C4W Lot a Permit# Conservation Office 4th floor Date Issued T�O L� Board of Health Ord floor) ova n ineering Dept. Ord floor) House# Definitive Plan Approved by Planning Board 19 (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) ; TOWN OF BARNSTABLE Building Permit Application Proiect Street Address JOD A W, Village Fire District Owner VA&fM.dA.,,s 6,vo a 141ssau a-4 Address' Seo 6Z�,o y S_ �ia�✓.+i�s Telephone ' 7'7S lSIS Permit Request: Zoning District Flood Plain Water Protection Lot Size Grandfatheied Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type /,c-/c O'D Existing Information Dwelling Type: Single Family Two family Multi-family >/ Age of structure Basement type x/e/V25 Historic House /!/ Finished o/ Old Kings Highway 4e! Unfinished Number of Baths �a�t,' - Coe,r,38-Is No.of Bedrooms Ag/_1_Ti Gam►Or`s Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air >46 Fireplaces Garage: Detached Other Detached Structures: Pool /e..9 Attached Barn None � Sheds Other Builder Information Name C, 1:59a-L4,6LtE 444-4 &y-o, -'tiG• Telephone number S-629-�0cl, 6--06is' Address 7 76 2,QQAQ UA&I License# 033 7o A VZeZYA i-? 6�9 7 b 7 Home Improvement Contractor# Worker's Compgnsation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .�� �LG oolc Prolect Cost F l 12P), SIGNATURE a'4 DATE_ �.vz - S/ zp95 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY j 324.040 ADDRESS 500 Ocean Street VILLAGE Hyannis _ Yachtmans Condo. Assoc. _ + OWNER ! DATE OF LNSPECTI/�`�lN: FOUNDATION $ .� FRAME - t INSULATION I FIREPLACE ELECTRICAL: .:ROUGH FINAL _ PLUMBING: ROUGH FINAL 3 i i f GAS: ROUGH FINAL 41 FINAL BUILDING: DATE CLOSED OUT: ASSOCIATE PLAN NO. , t #1 eI . .�" �, Mare to poaaeaa a oemsat .. COMMONWEALTH :DEPAR;TMENT OF PUBLIC SAFETS R. r dloeeachrsetda3tabBelldlaq OF O►dE"ASHRORTON PLACE QddelecaaseYorrerocat/on MASSACHUSETTS BOSTON,MA 02108 �.: of tAie 11400&80. LICENSE CAUTION j EXPIRATION DATE CONSTR. aUPERVISOR I FOR PROTECTION AGAINST YKIW 99S EFFECTIVE DATE LIC-NO'. THEFT PUT RIGHT THUMB j R NONEN '11 / 0/'1 93 nS37 PRINT IN APPROPRIATE ; Io ' y�y�� ENSE r �- 14-IONEL. A LARIVEf ^ 7.5 QRAI�FL�RD ST BLASTING;OPERATORS z . TAUNT, QN MA ..027.8 . TI UDE PHOTO. I "�"t1 , "1993 f OPR ONLY) FEE: 1 0 0.,00— NOT VALID ONTIL SIGNED BY LICENSEE AND OFFICIALLY` { y HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONE(i;: 1 - -�. .[ - kl t THIBDOCUMENT'MUST B aye « SIGN NAME IN FULL ABOVESIGNATURE LINE I' f '... CARRIED ON THE PERSON O ATU THE HOLDER WHEN EN O .. -THUMBPRINT GAGEDINTHISOCCUPATIO i` ! l e I s I 11/02'94 17:02 'a6177277122 DEPT IND ACCID; _ Y! (-0t;WW1UVea1t/11 of {' lajjachu-iettj �LJaPartmenE o��nd�friaL�ccidan� 600 !/i/aIyLoa Sht 1 James J.Campbell [0 ton, //l wad-u& 02f f f Commissioner Workers' Compensation.-Insuranee davit ... (aoeascr�Qcmiaee) - with a principal place of business at: (Gcristatizip) do hereby ce.,rify winder the Pains and penaltiers of pe- ur„ that: Q I am an employer providing workers' compensation coverage for my employees working c this job. Insurance Company Porcy Number O I am a sole proprietor and have no one working for me in any capacity. () I am a sole, proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Numbei Contractor Insurance Company/Policy Numbe; Contractor Insurance Company/Policy Numbe: O ( am a homeosner performing ail the work myself. co;y of t`s c_;e..-rcnt will be forv:zrrcd tc ti;e.0`ice of lnveyd7,dons of the DIA for eowrage verific2tion and thzt t1lure to u cc.rage as ree_::ed under Scc::en 2=A of MGL 152 czn lend to the lnipesition of criminal penalties eonsisdn¢of a fine of up to s 1,500.00 znc, yez.s' imprL<c-went as WE1l as civil penalties in the form-cf z STOP WORK ORDER and a fine of 100.00 a day apinst me. Signed this day of 19 S� 01 Licensee/Permittee Building Department Licensing Board Selectrnens Office Health Department 1O V"P.IFY COVEF.tiGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 4a9, �7� A1:OHIO. ��;CERTIFICATE�OF�INSI�JRAN ��E � ISSUE ATE(MM/DDIYY)✓ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, k Brown & Sons Insurance Agency, Inc.. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Dean' s Plaza-Rt. 44 Raynham, MA. 02767 COMPANIES AFFORDING COVERAGE COMPANY CODE SUB-CODE A LETTER Commercial Union Insurance Co. _.,.._....._,.. _.._ ....,. _ __._....._..-------------__...._ ......_._._..._..... ...___._._._._._._........_...._._. _ COMPANY B Royal Insurance Group INSURED LETTER COMPANY C G. Broulllette & Son, Inc. LETTER 770 Broadway COMPANY LETTER D Raynham Ma 0--2767 COMPANY E I LETTER THIS IS TO CERTIFY THAT THE POLICIES OFINSURANCE 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. __...,._....._. _..,._,__ __... . _.._-. __....._ ._,_.._ _.........__ ...___.,,.._..__._._ _.....,.. __ -- CO POLICY EFFECTIVE POLICY EXPIRATION' LTR TYPE OF INSURANCE POLICY NUMBER ALL LIMITS IN THOUSANDS DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY --....__._.__ ---..__..._ X PRODUCTS-COMP/OPS AGGREGATE O O 0 # ;CLAIMS MADE'X ;OCCUR i GSP—11 61 3 2* ' 119 5 I PERSONAL&ADVERTISING INJURY l� B OWNER'S&CONTRACTOR'S PROT / / 1/1/9 6 EACH OCCURRENCE 1 i _.. __.. .. _.......__.L_0 0 0 ..._. FIRE DAMAGE(Any one fire) $ f MEDICAL EXPENSE(Any one person) $ AUTOMOBILE LIABILITY - COMBINED •'- - ANY AUTO SINGLE $ - LIMIT ALL OWNED AUTOS BODILY f I INJ A RY X- SCHEDULED AUTOS (Per person) .$ 250 ,X HIRED AUTOS - - CFi 1,04465.9 '12/15/94 ` 12/15/95 BODILY 'INJURY $ 5 O O - NON-OWNED AUTOS - _ ;X (Per accident): - GARAGE LIABILITY PROPERTY . DAMAGE $ 500 EXCESS LIABILITY EACH AGGREGATE OCCURRENCE ` N/A $ $ i OTHER THAN UMBRELLA FORM 1 zI WORKER'S COMPENSATION STATUTORY .. A AND CB95H563311 �6/30/94 '6/30/95 $ (DISEASE POLICY LIMIT) EMPLOYERS'LIABILITY 500 OTHER $ 500 (DISEASE—EACH EMPLOYEE)i _._ , N/A E DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS i *$2500 . PD deductible applies. CERTIFICATE HOLDER CANCELLATION i Mr.. Matt Walsh SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Lln].t #1g EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO j Yachtsman Condo Association MAIL 2 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE yl yannisnis M Street H LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Hyannis MA C� bL�1 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I THORIZE REPRESENTATIVE ACORD 25-S (3/88) ©ACORD CORPORATION 1988 i TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING PERMI A-324.040 9 NQ 37720 DATE �y 10 19 5 PERMIT NO. APPLICANT 'Lionel A. Larivee ADDRESS 15 Bradford..St,,,, Taunton 033789 IN0.) (STREET) (CONTR'S LICENSE) PERMIT TO Reshingle STORY Multim-family NUMBE-DWELLR OF NG UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 500 Ocean Street, Hyannis ZONINGDISTRICT- (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) t LOT SUBDIVISION LOT BLOCK ' SIZE .BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Sewage N/A AREA OR VOLUME No area change 19,000.00 PERMIT 1,120.00 ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER Yachtmans Condo- Association ADDRESS 500 Ocean Street, Hyannis BOIL BY TOWN OF BARNSTABLE, MASSACHUSETTS LDl ` P RN ' A-324.040 �Ii� f� ' DATE y 10• 19 95 PERMIT NO. NQ _877.20 APPLICANT Lionel A. Larivee ADDRESS 15 Bradford St. , launton .033789 f, > (NO.) (STREET) (CONTR'S LICENSE) t,r PERMIT TO Reshingle (_) STORY multi-family - NUMBER OF DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) Soo Ocean Street, Hyannis ZONING DISTRICT (NO.) (.STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE ' BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION �/TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION ' (TYPE) REMAR s: Sewage N/A VAREA OR OLUME No area change �, 19,000.00 PERMIT 1,120.00 ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER , Yachtmans Condo Association 00 \� Elt ADDR 'SS S00 Ocean Street, Hyannis B, r.. THIS IPE'RMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY, THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF.PUBLIC SEWERS MAY BE OBTAINED FROMITHE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE-APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS :WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE .A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREC,SUCH-BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CAR® SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 � I 2 2 2 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT i 2 BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF Il WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE, ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. 1 PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. ` r � W me � r � � - z � � . APR _® 1 im As p Parcel Permit# A/`7 7 3 Date Issued - . Fee Engineering Dept. Qrd floor) House# ��� ��y BIKE • 'I ' • BARMAN LE• 19 , i - rEo n,o+• r TOWN OF BARNSTABLE Building Permit Application' ; Prol eet Address oceA.c Village ' ' I � , t Owner t/AL'kt l�o tars 1�gSC .� Address Cr—SA., -- tvt?/,.V.� - Telephone' t Cq-6,e — 7 7,T /Sl- "* Permit Request /e$5&A40LE ( l-5&aL. g&'F fZcg11-tt J* /gn.l{D JeAS RL� i r First Floor _ 'Vli4 square feet /0-0 S u.,-s%e3 Second Floor N,,� square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family ulti-Famil i Age of Existing Structure Basement Type: Finished, Historic House Unfinished Old King's Highwayj} Number of Baths oAgiffS i v UM.x No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached A&YA R _ Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name (�,(g wr fit.IE Trk •b S l}y. iVZ Telephone Number Address -7 -7 6 License# Cl)-3 �/��,u►., ��.A 6 7 Home Improvement Contractor# Worker's Compensation# di CP, 4 S��31► -� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO to?> "rctb T-- SIGNATURE XL,,,4 40, � DATE BUILDING PERMIT DENIED FOR THE FOLLO ING REASON(S) FOR OFFICIAL USE ONLY -- PERM. N. DATE S D r f 4 MP/ AR", EL NO. ADRESS VILLAGE r' ' � �' , ;,y " f , 'tl � t '. , j aYw y'V s• r ' , r� ^ei I i _ +. 4 _ OWN 1 r € , • DATE INSPECTION: FOU ON FRAME' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' t PLUMBING: ROUGH FINAL GAS: _ ROUGH e FINAL FINAL BUILDING 1 ! DATE CLOSED OUT t - € ASSOCIATION PLAN NO. t r r d PU',T TC Ck?FrV � DEPARTINEV OF CONSTRUCTION SIIPPERVTSD?. jl—S' Ni ' Eires: -'' o u " CS 033789 '2N2199; : Restricted To. 00 Fa:lure to possess a current edition of the Massachuse ts Slate B!iiild'nr,, Code HONEL A hARIVEE cause for rmcation of tb.is license, 15 TRADFORD ST TAUNTON F,,k 02780 t The Commonwealth of Afassachusetts I 1� Department of Industrial Accidents " " ` - �" �� Oflfce ol/ovesilgaUons 600 Washington ton Street Boston,Mass. OZIll Workers' Compensation Insurance Affidavitcity . nhon I am a homeowner performing all wort:myself. rJ I am a sole proprietor and have no one working in any capacity •4 w an employer providing workers' compensation for my employees working on this fob. compiny nnmel . ,iIdrs - city phone#• . insurance co, l� •# - 0 1 am a sole proprietor,gknerai contrac r homeowner(eirde one)and have hired the contractors listed below who have the following workers' compen on polices: company m►me + M=9u wt I Ir ie -6 a3c= SrIk.t address `7 O eDA (,cam citx. b rzsr•� VY�(J S�6 33 i1 0 tnsunncc co "t-'�� policy#� �� 7'��� _t�T_,•.�� m- r.-r.- company name -��N� � 'O[ ins �0 seJ2 iddress /3 ei cith . 406USg= , M A G/L—& phone#• insurance co Arvin C-t S •.--------r ;Attach additis'6' sheet if necessa �- - •ram` "�w.tr t soMr "'""''�' ���,.r.. rr .r w d~s�owl3oi Enilurc to secure coverage as required under Scetion 25A of hJGL 15 th .2 can lead to Fe imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. l.undcrstand that a copy of this statement may be forwarded to the Office of investigations of the DIA for coverage veri6catioa. I do hereby certifj•under the pains and penalties of petlut t•that the information provided above is true and correct. Signature Date Print name 4 6.tl8 �gP1vls Tr _Phone# `S Poo'fRP� td' official use only do not write in this area to be completed by city or town official city or town: permit/license 0 riguilding Department Licensing Board date response is uire d OSclectmea's Office check if immediate rcq � p liealth Department (7 p phone**, nOther r contact person �. trivasedV95 rtA) sue' emu* tee' Engineering Dept. (3rd floor) Map - Parcel ; Permit#, House# _ Date Issued ZUie_ tW3rRoor)(8:15 -9:30/1:00-4:30) e J O Conservation Office(4th floor)(8:30-9.30/1:00-2:00) Planning Dept. (1st hool Admin. Bldg.) 1H1 Definitive PI Approved Planning Board 19 - J BARNSTABLE,MARk eft659. TOWN OF BARNSTABLE. Building Permit Application ' a Projec tree resssl- Village t tCA_"y`1,5 ' Owner Address SRO Oac /v-� Telephone Permit Request --� &442 1 ' • ` ---------- First Floor square eet Second Floor square feet Construction Type J Estimated Project Cost $ ywo 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No , On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes . ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name l FRASER CONSTRUCTION Telephone Number. Address 71 TARAGON CIR. License# COTUIT MA 02635 Home Improvement Contractor# /J as'a 6 - - 292 Worker's Compensation#.lK-C°j ai cis a 3 6 3i 0 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOioe7o✓ SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY I PEIaM T NO. x , DATE ISSUED MAP/PARCEL NO. ADDRESS r VILLAGE, OWNER DATE OF INSPECTION: 'FOUNDATION ' FRAME INSULATION - FIREPLACE . ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH t- , FINAL GAS: 1 ROUGH FINAL t FINAL�BUILDING ,� S DATE CLOSED OUT ASSOCIATION PLAN NO. ; The Town of Barnstable KASL. • .nsivernie � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 f Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost Address of Work: S Z!7-) 6 C12 saw �� j�c, �A,,,�,, An Owner's Name: .!2 k-,/ a y wa c�' -FAA Date of Application: I y L I hereby certify that: Registration is not required for the following reason(s): (:]Work excluded by law OJob Under S 1,000 OBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. l ! 5 19s CL12 q,�v% C RZA opt-► Date Contractor Name Registration No. OR Date Owner's Name g1orms:Affidav The Commonwealth gfMassachusettc ='-Iz Department of Lidustrial Accidents O11ice01ioUst129oos '• __.i 600 11 ashington Street is to B t ,A1ass. t'l..11l ` Workers' Compensation Insurance Affidavit Antillcant Inform tinn �""'- Please PRIIVT`1`` Y �• asaas ee ��e� name: location._ I' Tf9 d7 QCQ cite l n± I Al-)/4 phone# ac')SD I am a homeowner performing all work myself. I] 1 am,aassole proprietor and have no one working in any capacity L.:.'..`d.�" ---!..:3s:+rf-'-'-`-' '" �„. .,>.�.y,_ '- --- _..A.._..ice.- w._.. --- '*•e �i�"�.'C"- - ..•,.,.,,.a.,,,� 2 l am an employer providing workers'compensation for my employees working on this job. conwanx name: Fn0,1 S 2/? p'yjShZA.)C,+t ' address: a! n Q citx: Co phone#• insurin e co. lic•# (dJ C. `",•.w....rr...'r.:,..;,� 1 'iCs•o7..w .. -.tr.r .sr.,..�......y.�n;..,,...�.... .0 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnanv name: mess• phone a• insurnnee co. nolicx# S•.. ... - 1..4 :1 !•�—u:...._.�.-- -•y.:.._._.;,,wY•✓ .T-:H�av-s•.�.ri•� .Y.«er+. •s.• �.T"'w ••r •�e%••;:. e•w�.• 7rci'•T4?I.-•.ter., z."Var-..'.�-^sT comnnn•name: address: cih• phone a• iasurnnce co. olic}•# ,Attach additioaaishcet if necessa_�r Failure to secure coverage as required under Section 25A of 51GL 152 can lead to the imposition of criminal penalties of a fine up to$1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a COPY of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification. I do hereht•certrfj the ains enalties of peduq•that the information provided above is true and correct. Si_na[ure ate Print name 7-t>e r-7 G 4,&-x Phone# r •'r official use only do not write in this area to be completed by city or town official city or town: permitllicense# nBu7wrd t pLi p check if immediate response is required OSelectmen's Office pliealth Department contact person: phone#: nUther (wised 3,195 P1A) M 04'A—) w� 3 011 / Y ryN 1 =:HOME-- IMPROVE,JlENT- C . 4TRAC'FORS �REGISTRATIiJi1� Esoar°d of E3u1 ding, Regulationsaihd St,and86 -ds -766 oZ one AshRUrton Place ;- Rocin 1301 � x E3ostb 99k .. Massachusetts `02108 a r t HOME I MPRO�/ f�lE-NT COqi "RAC T OR Rego-'stration 11253621' Expiration 04/06/97 ---- ` ' . IMPROVEMENT-HOME CONTRACTOR 1 . N NE Registration 112536, #BEAN C,. FRASER .a i Type DBA i r d .. _' .. '•& �' .DEAN .0 . FRASER' ... C . i Expiration 04/O6/97 71 T'ARRAG_ON CIF.; " # ' COTU11- MA . 02635, DEAN C x. :FRA SER DEAN C. FRASER � to�71 TARRAGON CIR. � ., � ADMINISTRATOR_ COTUIT NA 02635 1 3�' Lo f XN% O�Engineerigg Dept. (3rd floor) Map 324 Parcel 4 Permit# .i ~• House# SOD 2-Date IssIled 2 Board of Health(3rd floor)-(8:15-9:30/ 1:00-4:30) Fee gas- o�. Conservation Office.(4th floor)(8:30- 9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) IHE rq Defiofte,Nh Approved by Planning Board 19 ; BARNSTABLE. TOWN OF BARNSTAELE Building Permit Application VProjecttreetress J5 60 0CP_AN ST Village ,;dAl va s 'l Owner ��147'DrNtA.iu cove Address .�`G� i:1 S�' Ny�n�iyls I Telephone � Z)v - � ?�`— tS� Permit Request !v�I`j� y1r:{"s r o ) to First Floor /Y�i square feet Second Floor square feet Construction Type J Al s Estimated Project Cost $ o Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No e Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths):Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization ] Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name Telephone Number 6_6 Address 7-7 License# C-S YU ,Etw, YY,4• ✓ '7 J Home Improvement Contractor# Worker's Compensation# C—8 � ��� / NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CON RUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P�►nn SIGNATURE 4 /��'-�= DATE mj l BUILDING PERMIT DENIED FOR THE FOLLOWING REASON( FOR OFFICIAL USE ONLY i - PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ` OWNER DATE OF INSPECTION: - FOUNDATION FRAME " INSULATION FIREPLACE f . f ELECTRICAL: ROUGH FINAL " PLUMBING: ROUGH FINAL GAS:y ROUGH FINAL ' ' FINAL BUILDING - DATE CLOSED OUT - ASSOCIATION PLAN NO. r • �` The Ca►nn►onwealth of Afasvachusctty U , . Dcp(rrt»tc►r1 of ludt►strial.-;lccr(lcnts 1 office allaves 92flans •�\�';'_'.::%'�' 6110 1f lJsll(UIS�'t(!n Street Busto►t.Man. 02111 Workers' Compensation Insurance Affidavit Plc�se PRINT Ie�t lily Ai IE t information'• b-�y name CP > is '?o)3 i_L e- frm -4, ��f\ ( -oQ r=i via Incntion• 70 lei}IO t71��A i 61N iO t4A)44A rn t I�7� � nhonc H,,9)A L21_152bS 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity -.... .�-L-•�_. __..__,...-.A_.,..,-..,.•..�.��--�...-n.•..+-ate-_ _ _ --�,...--.�..�•r- �.z.��-.....` .......---._-- I m an emplover providing workers compensation for my employees working on this job. T enumnrn• name! ^✓�-- odd rcts• - cin•• nhonc t!• incurnncc cn C(� MIE'L t6c� (�l�llf�t`S noiict t! Gj� 97� �� 3rl [1 I am a sole proprietor. ral contrac . or homeow�nerr(ct'rcle one) and have hired the contractors listed below who h: the following workers compensation polices: comnnnv nntnc• lddrest cin•• nhonc�• noiic� in�urnncc rn d_ _ .�... .=y `��.— ._ _ ���T'•._r�ir•. _-_'_ "•1• l _ __ --.�.:i�`_._ .ram_ com p.1m• name: nddresc: rite nhonc ft• incur•tnce co nniic�• Attach additional sheet if neeessa_ry :a.."' ; ^• +_..• �-J.....:«y. : . .. .r. "��r`'.'r.• a '""'v: ':''..`=: .�.a`,�'� "�.: .. Fa lure to secure curerace as required under Section SA of 11IGL 153 can lead to the imposition of criminal penalties of a line up to S1SOU.UU andruc unc%cars'imprisonment:rs weil as civil pCn21tics in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that cop -of this statement may be forwarded to the Ufrrce of Investigations of the DIA for coterare vetification. I do hereby certift•rutdcr t/te pains and penalties of perjure•that the information provided above is true and correct. Si:naturc /^ a, Date 13 I r17 �. Print name Phone; .r..�r�Yrrrrr _ s" _•� official use unit' do not ii rite in this area ao 6e completed b} city or town o(i'icial a city or town: permitilicense# t'ttluiiding Department ❑Licensing Board c3 check if immediate response is required ❑ Scieetmen s Office ►_ ❑Health Department k- contact person: phone rt: r 01her tntormatton anu inmrucnons Massachusetts General Laws chapter 152 section 25 requires all empioycrs to provide workers' compensation for their employees. As.quotcd from the "Ia��". an cmploree is defined as every person in the service of another under anv contract of f.iire .express or implied. oral or written. An e»tphorer is defined as an individual. partnership, association. corporation or other legal entity. or anv two or more . the foregoing_ en�_aged in a.joint enterprise. and including the legal representatives of a deccascd emplover. or the recciver or trustee of an individual , partnership. association or other legal entity, employing employees. However the ,caner of a dwelling_ house having not more than three apartments and who resides therein. or the occupant of the house of another who employs persons to do maintenance , construction or repair work on such dwelling_ hous )r on the urcunds or building appurtenant thereto shall not because of such employment be deemed to be an employer. 'AGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or •enewal of a license or permit to operate a business or to construct buildings in the commonwealth for un• applicant who has not produced acceptable evidence of compliance with tite insurance coverage required. ldditionall}. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the crformance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha een presented to the contracting authority. Pplicants 'ease fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and :ppiy in-� company names. address and phone numbers as all affidavits may be submitted to the Department of dustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The •fidavit should be returned to the cite or town that the application for the permit or license is being requested. ,t the Department of Industrial Accidents. Sliould you have any questions regarding the "law' or if you are required obtain a workers' compensation poiicy. please call the Department at the number listed below. ,ty or •rowns _ase be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of : affidavit for you to fill out in tite event the Office of Investigations has to contact you regarding the applicant. Pleas sure to'fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc Department by mail or FAX unless other arrangements have been made. Office of Irtvesti=atioils would like to thank you in advance for you cooperation and should you have any questions. zse do not hesitate to uive us a call. Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents -, r i Office of Investigations .a.. 600 «'ashinbton Street Boston,Ma. 02111 fax #: (617) 727-7749 phone ;r: (6I7) 727-4900 ext. 406, 409 or 375 i . x y Cn G G F3 Cn _ _ ..... ,- .� ,. � -w � - •fig b _ [n 7 A ?G cHi� C cn oa . ti �, r0 rD CTVl lL m A a _ �M P• !r. Y 'a. �F R• . � o tv .. a r.) o rD Hi - m MAll W co ISSUE DATE(MWDD/YY) CERTIFICATE OF INSURANCE, ,, , 1PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS BROWN&SONS INSURANCE NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, AGENCY,INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW { DEAN'S PLAZA RTE.44COMPANIES AFFORDING COVERAGE RAYNHAM,MA 02767 COMPANY Arb A j LETTER ella Protection Ins. Co. CODE SUB-CODE _ _... COMPANY B INSURED LETTER Royal. Insurance Co. G. Brouillette & Son Inc. COMPANY LETTER C Commercial io 770 Broadway __... Un__.. _ n.. ...._.I ns. Co. P.0 BOX H COMPANY LETTER D Raynham, MA. 02767 COMPANY E i LETTER ' COVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE(MM/DD/YY) DATE(MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE $2, O O 0 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPS AGGREGATE $2,0 O 0 B CLAIMS MADE X OCCUR. GSP-11613 2* 1/1/9 7 l/1/9 8 PERSONAL&ADVERTISING INJURY $1., O O O OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $1,O O 0 FIRE DAMAGE(Any one fire) $ 50 MEDICAL EXPENSE(Any one person) s r, AUTOMOBILE LIABILITY COMBINED ANY AUTO SINGLE $ LIMIT ALL OWNED AUTOS BODILY A X SCHEDULED AUTOS INJURY s2 5 0 (Per person)......_...._.......... X HIRED AUTOS Q3P000525 12/15/96 12/15/97 INJURY s500 X NON-OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $5 0 0 EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM N/A i WORKER'S COMPENSATION STATUTORY i AND .$ 500 _ (EACH ACCIDENT) C CB97H563311 6/30/96 6/30/97 $ 500 (DISEASE—POLICY LIMIT) EMPLOYERS'LIABILITY f $ 50 0 (DISEASE—EACH EMPLOYE OTHER 1 N/A I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS *$2500 . Property damage deductible applies. CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. A HORI2ED RE ESENTATIVE ACORD 25-S(3/88) CACORD CORPORATION 1988 RPLST 7 Listing of Parcels for a Specified Road Index Street Address Parcel Number 467 OCEAN STREET 324 034 001 Own: MCGEOGHAN, SARAH Status : C Date : 052596 479 OCEAN STREET 324 037 Own: GEORGE, THOMAS N & ALICE TR Status : C Date : 083196 480 OCEAN STREET 324 038 Own: BARNSTABLE, TOWN OF (BCH) Status : C Date : 071396 490 OCEAN STREET 324 039 Own: POWERS, THOMAS J Status : C Date : 050695 500 OCEAN STREET 324 040 OOZ Own: HANFLIG, PHYLLIS Status : C Date : 050695 500 OCEAN STREET 324 040 OOY Own: MOLAN, HERBERT D & NADENE I Status : C Date : 050695 500 OCEAN STREET 324 040 OOX Own: MACKEY, JOHN J Status : C Date : 050695 500 OCEAN STREET 324 040 OOW Own: TORRESYAP, FORTUNATO C Status : C Date : 050695 Cancel Press XMT for more data Next screen RPLST Next Index 1133 Next House 500 Next Road Name RCV F (G3) 1 RPLST 8 Listing of Parcels for a Specified Road Index Street Address Parcel Number 500 OCEAN STREET 324 040 (OOZ Own: HANFLIG, PHYLLIS Status : C Date : 050695 500 OCEAN STREET 324 040 OOY Own: MOLAN, HERBERT D & NADENE I Status : C Date : 050695 500 OCEAN STREET 324 040 OOX Own: MACKEY, JOHN J Status : C Date : 050695 500 OCEAN STREET 324 040 OOW Own: TORRESYAP, FORTUNATO C Status : C Date : 050695 500 OCEAN STREET ' 324 040 OOV Own: CONROY, MARTIN E Status : C Date : 050695 500 OCEAN STREET 324 040 OOU Own: VALENTE, PASQUALE & MARIA Status : C Date : 050695 500 OCEAN STREET 324 040 OOT Own: CASEY, HUGH F & PHYLLIS A Status : C Date: 052596 50% OCEAN STREET 324 040 OOS Own: OTOOLE, JAMES B JR & Status : C Date : 050695 Cancel Press XMT for more data Next screen RPLST Next Index 1133 Next House 500 Next Road Name A �/� RCV F _ ) 1 32 �Zu�- t L ---� lJl�' �.S -�J 6--• � -� � \jj O �' 4•C P/�" /8.96"-" m Pr CPr/ n /8-96 F /S C / do /7 /B�, `/B /8 9 L. C. Plan /8964 F 009 OC �.C.� 2� Cent. No. /BZ/B N , F 6 5 O G0 30 p C 96 / 18` ` `4 392 ¢3 3 e J d.h• L.C. P/on /8954 B 1 20 E Ge. S TREE T C B. Cent. N a 8638 I 22 O 17 S�96 -" '- 172.00 24 r� /9 BOG zs N/904407'E-------' ) 26 21 vt,/T No ze 23 s i ry 30 25 /6 32 �� 27 tv) b 3 34 29- pOl 3 6 0 of q, 42 5 C3 _ 44 �� 37✓ O � �� �I o LC, Plan /8964C — 4 9 Q O O O Ceil. Mt 8760 C.8 11 i I Ito �! MIMI�I�I� OJ o I --_j I Nj�ININI�I� I f,� SIN h WI 5 8 hhI� A �� �. 3 0 LQ _ 60 �I� BL.DG• No dA 125.25 _QI� „ S.B. SPk• 0 6 4-- S/Ba59 20.,lY Ci CZ 7 0 O \ � �.I ca I'�I� ►� �f- V O 72_ m �INI��M 8 O 7A O INid ININ'� o No. 3 ;god D -Sp �0 BLQ6• Disk• y. L.C. P/an ,8964 Cent Na 9883 io 1 tc) ^ O �o �}- s 41ST' 29 d.h• ���_ 8� �' Plan /8964C L.C. CB h % Ceil. o. /82/8 AR K 0 _l 7 C E 1 1 L.C. Plan/8964 ti � A�N f '7 Cent No./0696 (11 MCALp Modification of Lot 311 Shown on Plan 18964N-9 Filed with Cart. of Title No. C-21 Registry District of, Barnstable Countv TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel = Permit# Hsalt#Qmaien f M A,U iA esze °� fit;• Date Issued Conservation Division Fee ���' � Tax Collector ,. Treasurer � � • ~- Planning Dept. AL-/ Ocl Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis { ; � t Project Street'Address S+ Village r' w in)ay"IS (7n►A _. . Owner V4CL47 M 6,0 Coy,d 6 Address 4 Telephone -Permit Request ololls — 1`C0 ry CL--e mac s`F i y►5 Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost � b00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling.Type: Single Family ❑ Two Family l& Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing, new Number of.Bedrooms: existing new Total Room Count not including baths): existing new First Floor Room Count ( 9 ) g •Heat Type and Fuel: ❑Gas' ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: - Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No f If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name FUEL GlINSTRUCTION Telephone Number Address =1 TARAGON CIR. License# COTUIT NSA 02635 Home Improvement Contractor# 416 428-2292 Worker's Compensation#/i VA11clCf/33 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE vzw r FOR OFFICIAL USE ONLY PERMIT NO i. - .. _ P, " � '• .. t, - DATE ISSUED _ - y a; MAP/PARCEL NO. 1 . CA ADDRESS= ` ' VILLAGE r`' CA , OWNER DATE OF INSPECTION: s _ FOUNDATION FRAME f • `' s f, — ` • I INSULATION f 1 F , FIREPLACE ELECTRICAL: ROUGH FINAL° , w e PLUMBING: ROUGH FINAL; — I GAS: . _ ' rROUGH FINAL' ° , � • ` � '- ' _ M1 - _ • .. FINAL BUILDING' DATE CLOSED OUT ASSOCIATION PLAN NO. 'x i The Town of Barnstable • aearrerea�. _ "%� Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date 36 aoo AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 1�_e wai2j Estimated Cost CNI,3 Address of Work: S 0 Owner's Name: y6CA� to 60y4000. Date of Application: LC I hereby certify that:. Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL co 142A. #v SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. O O ate Contractor Name Registration No. OR Date Owner's Name q:forrns:Affldav gas & HOME IMPROVEMENT CONTRACTORS REGISTEtATION and of Buildins Regulations and Standards One Ashburton Place - Rom 1301 Boston, Massachusetts 02108 HOME IMPROVEMSENT CONTRACTOR _-----------__-- -_-•_-. __-- _ Registration 112536 Expiration 0+4/06/01 --- --- Type - DBA t. ! WwVMT 1AWTOR A 4 *. w � '; Ra��six�to�' 112536 FRASER CONSTRUCTION Co Y� - DEAN C. ERASER -- - -- - e TARRAGON CIR COTUIT MA 02635 COlSTRiXTIN co em C. FWD �x�RRR6�! 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Q L4 THE ARNSTABLE TOWN OF 'B i BAHHSTABLE. "b BUILDING , INSPECTOR Q M a APPLICATION FOR PERMIT TO ... ..4..lft.G�.Q.l!!!1.1.F��.(I�!l?!I �.....................C��`l f. TYPE OF CONSTRUCTION ......Cl4..V4F............ ... � Tav,uoY 3o t97h. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....lr7A 0......QC.<°R'.n.....�)?.e ............................................................................................................................. ProposedUse ULV .(.fl. '?.. ......u.. ./. ......................................................................................................................... � L Zoning District ......... ..~•..`.:�..................................................Fire District ........ ............................................ Name of Owner . l C..A r..........................Address Name of Builder .....Address �r .r...P1eg5..qp .... ,......wcl R Name of Architect ffl...Cal.^l. v.!..o..�S ,P.(t' U.4 S te.�..Address .7a. '.N4.y!•�S• a1?.... <..... q.t a.).q.....�ygs� Number of Rooms F!VQ...?-:51..X.....rvm. .....w7d4- ......Foundation pG.ne..Pd... CB/?���4�'... Exterior .1(!!.l .P.....C�.. 4YY....S'f?�Y!r�.I. S..........................Roofing ...(.1� �'!a..�........................................................... j n _/ Floors ....�6a Yrp '��..............................................................Interior ....a?..aN ......8........�/.R.I.1 Q.QY.ol....................... le r , 931 • Heating .............(�.....�............_..........................................Plumbing--. ............ 1 Fireplace ...�;;Otla.pzq./.......................................................Approximate Cost ... / .........:..... Definitive Plan Approved b Planning Board _-__-____--__ /Q. 'v � pp Y 9 - --- - 19- -- Area ............. .�................. ... . Diagram of Lot and Building with Dimensions Fee ..s .�f . SUBJECT TO APPROVAL OF BOARD OF HEALTH `• i i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .... ...zl, ........................... July 3► 1969 _Yachtsman Xotor- Inni inc. t � :F F ,500 Ocean Street R ,8 annis,- Massachusetts Attn: Per. John Braden Dear Sir: r E have inspodted the* building: known as tie'.Yaelit:smar�"6tor Inri , and fot?nc that'tkie'exit -signs are not accepta.ble'. x3t signs must `'be on all doors that.exit from the bar, eating-areas,; lobby-acid corridors. These signs must be 'Qf red letters five inches (5°") high on a white background. Also, the door"to the unused room below the 166 must � kept- locked. Very '.t2u y.yours, Camille A. Houde r Assistant to the Rd1ding Inspeetor . CAH/gr ._