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Home My WebLink About0500 OCEAN STREET (7) --- -- -- r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /� 3 V0 Map 3a / Parcel-0 Application #� Health Division Date Issued Z 2S—lS- T Conservation Division Application Fee • Planning Dept. Permit Fee Jk- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 1.2 Village r>.S Owner Address _,T—tZ Occei yi S/ 4z&.,� ear Telephone Permit Request" W✓a��,A�, o � if' ®c >�St Square feet: 1 st floor: existing proposed 2nd floor: existing proposed" Total nevi Zoning District Flood Plain Groundwater Overlay cn Project Valuation y/-2S Construction Type c� Lot Size Grandfathered: ❑Yes 14 No If yes, attach supporting documentation. Dwelling Type: Single Family UK Two Family ❑ Multi-Family(# units) Age of Existing Structure / Historic House: ❑Yes )'No On Old King's Highway: ❑Yes �No Basement Type: ❑ Full Q 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: .2— existing _new. Total Room Count (not including baths): existing Y 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 Y.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) Nam �/ zf��es Telephone Number =5;-Of' P-s-;Pra Address 9:�r <'e�/ri�� %�� License# ,r�s e"z2 Home Improvement Contractor# Email`/�/ Worker's Compensation # 7/ 6' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f�rg 1,4.h SIGNAT DATE iZ { FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED MAP PARCEL NO. L ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE �f !3 S { ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING Q. DATE CLOSED OUT ASSOCIATION PLAN NO. I The t ommanfwuith of Massachusetts Department+�f'b dmsft ital Accidents - - OKwe of Mestigutions 60+0 Washington&reet Boston,.MA 02111 wnw.rnass:gov/dira Worhel<s' Compensation Insaranc,e Affidavit:Builders/Conti-acfors/ElectricianslPlumbers Applicant Infarmation Please Print Legibly Name(Brrsine Organizalian/fndividnaq'i� � �� Address-. City/State/zip- eZ7,2 Phone 4-,,5VJ Are ya an employer"Check the appropriate box: T , o#. ect r 4- I arr7a contractor and I � �� - L I am a employer with ❑ 6_ ❑New cons€action employees(full and/orpart-crime).* have hired the sub-contraciors. 2-❑ I am a sole proprietor orpartner- listed on the attached sheet �+- ship and have no employees These -contractors have 8. ❑Demolition w for me many capacity_ employees and have workers' or�ng Y 9_ ❑Building addition [No workers' co;np: �rranr ine Comp-i - nsurancSP t reclrured] 5..❑ We are a corporation and its 10_❑Electrical repairs or additions 3_❑ I am a home ommer doing all work officers lm-e exercised their 1I_.❑Plumbing repairs or additions nrysef [No workers'comp- right of exemption per MGL 12_0 Roof repairs insurance required.]7! c_152,§1(4),and wehErVeno employees_[Na workers' 131:1 Other i Comp-tasIImmCE required-] *Aay apphomt that checks boa#1 most also fill out the section below showing rhea woders7 contpeasation policy infhrmation. T E[omeownem wbo submit this affidzm m fcsmtg they ate doing an uu&arrd thorn hire out d&contractors mnsi submit anew affidavit mfcatin such- T �tmaurs thst rfixY this bmc mast attached an addition/sheet showing the name of lhe!pmb-caaffwlon and Slate whether m not those Entities hM7;e awiayees. Ifthe sub-contmaors base employees,they m ut provide ter wakes'comp.policy number, .tam an employer that is prm iAag workers'compensation insurance f"or my emptoyem Below is the policy and job site infotma6git. Insurance Company Name- Policy fr or Self-ins-Lic-;h Expiration Date: Job Site Address: Citv/StataMv: Attach a copy of the workers'compensation policy declaration page(shovdng the policy number anal eapu-atian date). Failure to secure caintrage as regaireduuder Section 25A of MGL c. 152 can lead to the imposition ofrriminal penalties of a fine up to$1,500.OQ and/or one-yearimprisoament,as well as civil penalties in the foam of a STOP STORK ORDERand a fine of up to$250_DO a.day against the violator- Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLk for insurance coverage tiierification- I dv hereby c ur_ th s enalties of`perjury that the in,formation prm'ided abvue is true and correct Sign 7 Date: — - IS Phone#: Of Edo/use ari£}. Eka not write in fhis area,to ba Completed by cbfv ar town officiaL t City or Town: PermitUcense# Issuing Anthority(circle one): 1.Board of Health 2.Budding Department 3.rCitylrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.-O•the-r Contact Person: Phone#: 6 ' S Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an errployee 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 Iocal 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 insu_r-ance 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-contractor(s)name(s), address(es)and phone number(s)along with their Gerrisicate(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 clots 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 affid2ic t. 'nit affida-�rit 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 obt?.in a,vorkers', compensation policy,please call the Department at the number listed below. Sell insured companies sa.ould 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 permitllicease 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice 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: nc-,Gommaawealffi of Massachusetts Deparfmmt of Industrial Aaci:dent o fitee Of RivestigatFaus 600 Washangtaa StPeet Britons MA G21 1 I Tel.#617-727-49-00 ext 406 or 1-9 MASW-E Fax#617-727-7 749 Revised 4-24-07 www.raassgov/dia '4k"® CERTIFICATE OF LIABILITY INSURANCE �/2/2015`Y' 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 1 NAME: The Oceanside Insurance Group PHONE (508)775-0500 ac No:(508).790-7955 E-MAIL ADDRESS: 52 West Main Street INSURERS AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURERANautilus Ins Co INSURED INSURER B Am uard Insurance Company RS Jones & Associates, Inc. INSURER C: 206 Cedric Road INSURERD: INSURER E: Centerville MA 02 632 INSURER F: COVERAGES CERTIFICATE NUMBER:CL151203603 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 LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TOR NTED 5Q 000 PREMISES Ea occurrence $ r Pi CLAIMS-MADE OCCUR 508088 2/18/2014 2/18/2015 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Include X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N1 ER TO LM,ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500 QQQ OFFICER/MEMBER EXCLUDED? N/A WC526715 12/17/2014 2/17/2015 (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 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION J SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN "For Insured Purposes Only" ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C Murray CIC/MC ,ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INRn95 rgrrinnsi n+ Tha arewn nmma�nrl Inn^ora ranicf—arl mnrlre^f a&nnp 1 R. S. Jones &Associates Inc. PROPOSAL 206 Cedric Rd Centerville,MA 02632 Ph.508-221-8572 Fax.774-228-2458 DATE:1/23/2015 TO: FOR: ANDREW HOULE BATH&BEDROOM REMODEL 500 OCEAN ST UNIT 68 HYANNIS,MA 02601 DESCRIPTION CITY RATE AMOUNT Mater bedroom. Remove and dispose of entire ceiling. Install new%"sheetrock-tape,mud,sand and finish smooth. Install new trim 2350.00 detail along entire length of exterior wall over windows as drawn. Install 4 5/8" crown molding.Paint all walls and ceiling In owners choice of color. Install owner supplied light fixture - Master Bath. Demo and dispose of entire bath exposing all framing and sub floor.Relocate plumbing lines and drain to accommodate new tile shower. Install vinyl shower pan and pour floor. Apply tiles to walls,ceiling and floor of shower. 5075.00 Install new sheetrock,bathroom floor tiles,baseboard detail,vanity,&toilet with ; new shut off. Install 4 5/8"crown molding.Paint all walls and(non-textured)ceiling. Allowance for one ceiling fan,one LED centered in shower ceiling and wiring for new light over vanity included. *Builder to purchase all trim,sheetrock,hardy-backer,fasteners and adhesives. Homeowner to supply all fixtures,tile,and paint. Disposal fees 350.00 Building permit(commercial) 160.00 0&P 1190.25 Thank you for choosing R.S.Jones&Associates Inc. 9125.25 Accepted by: Title: Date: . s The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Yachtsman Condominium Trust P.O. Box 1283 Hyannis, MA02601-1283 (508)775-1515 Yachtsman Condominium Trust Board of Trustees 500'U&n Street Hyannis,MA 02601 DATE too YJ ,a RE: Unit Yachtsman Condominium Trust, 500 Ocean Street, Hyannis To the Town of Barnstable Building Commissioner, The Board of Trustees for the Yachtsman Condominium Trust voted and approved the attached proposal to performed ? delineate' in the request we received from the Unit Owners. Contractor, has been contracted by the Unit Owner to perform the ork as d n the proposal. This letter selves as notice of the Board's vote to approve the proposal, which has been noted in the Minutes of the Board Meeting. Sign Under the Pains and Penalties of Perjury this day of 20,�j' oBoard steesCondomini Trust Street(c/o Ma ger's Office) Hyannis, MA 02601 Enc./File �TME rO'�ti Town of Barnstable Regulatory Services * snxxsTws�:, y MASS. �, Thomas F.Geiler,Director yg6 Ik� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabIe.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, -- in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. ignature of Owner ignature of pplicant adkei✓ 9601e Print Name Print Name 2 Date QTORMS:OWNERPERMISSIONPOOLS 6/2012 4 j, - -- - V1ae. Tpvmvmaruuec��i a�G>�oczcfrcu�e%7a i. ..;. ---- ..,.�� _. .._4 . .. Office of Consumer Affairs&Business Regulation i. License or registration:validfor"individut use only OME IMPROVEMENT CONTRACTOR I, before the expiration date.!If found'return to:. . . .... egistration 174832 Type: Office,of Consumer Affairs and Business:Regulation Expiration 3/22/2015 Individual' 10 Park Plaza-Suite 5170 ®. E ^� 7� Boston,MA 02116 . 'ROBERTS.JONESi,F ROBERT JONES 206 CEDRIC RD — CENTERVILLE,MA 02632 Undersecretary I Not valid without signature 1 ; Jl. Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor . License: CS-103622 I IS ROBERT S JONE5i-` 206 CEDRIC RD CENTERVILLE 1 A I� "IiA�' Expiration Commissioner 03/19/2015 , xt .. V72P.. rpom7/nzo�I2cI�Ea�L12 a�C%l�Gc7�Jaacfu,oe,16 r ^ Office of Consumer Affairs&Business Regulation �. License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date.!If found return to: egistration: YP i,1,74832 T e: Office of Consumer Affairs and Business Regulation ;. `Ex iration:�--3122/20,15. Individual 10 Park Plaza-Suite 5170: p 5i z Boston,MA 02116 ROBERTS.JONES';f�4 + k,_- �:1 j ROBERT JONES 206 CEDRIC RDA y CENTERVILLE,MA 02632 Undersecretar y Not valid without signature Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991m)of enclosed space: i I I i Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS l j