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Home My WebLink About0500 OCEAN STREET (8) Sov Oc.�Q.�, 5 � i �� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application Fee ►iP 400 Planning Dept. Permit Fee l d Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address -- Village L4 Owner C,y'r. L Z r 14 /2 Address A�x•�4awa4 Telephone 2, 7 — G a'3 Permit Request i>2 145 6 /'-/GP,_�1_ 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 s porting"documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) K can 9 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King' Highway ❑)V3 ❑ No cw.> rn 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 CCU/.��2�ES �� e �✓O Telephone Number Address =)69 113e�� l2, G License# L r4-ti ��®✓L� .�'�� o ��' Home Improvement Contractor# 7F,�5"3 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO iq SIGNATURE DATE ` � FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: tufOUNDATI.ONa="ix,a'4:*. FRAME :INSULATION-i+t,s .• . FIREPLACE ELECTRICAL:.. ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. . J ,,,• The Commonwealth of Massachusetts i Department of InduytrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationtbdividual): (� `�}/1 h C—S /�j �? �l✓IJ Address: /< 0• 13 & az q7 City/State/Zip: �� 5 � � Phone#: ��O�' 7 7l `{-/G6/ Are you an employer?C eck the appropriate ox: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.X I am a sole proprietor or partner- listed on.the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, employees and have workers' [No workers'comp. insurance comp.insurance:I 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.[1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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�]c' Other P2yC,!�, try . comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing thew workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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 up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties of perjury that the information provided above is true and correct Si mature: d, z,;Z1 ae ems, c Date: Phone#: 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#: Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DATE RE: Unit /U 5 , 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 be performed as is delineated in the request we received from the Unit Owners. Contractor, 45 s/7 U has been contracted by the Unit Owner to perform the work as defined in the proposal. This letter serves as notice of the Board's vote to approve the proposal, which has been noted in the Minutes of the Board Meeting. Signed Under the Pains and Penalties of Perjury this_5----day of- / / , 20 lJ f. Board of Trustees Yachtsman Condominium Trust 500 Ocean Street(c/o Manager's Office) Hyannis, MA 02601 Enc./File ciP TOW.0 of Barnstable `3 Regulatory �� Services Basis Th&uas.P.bellor,Direntor BuRding'Division Tom PeM,)3audlhg Commisslou ar 200 Mum Sftmat;7Ezyauuis,MA 025,11 YFwwAO'%m.b=stabtc ma.us ME= 5108-8624038 Fwpefty Ow net I1 wst Coaxplete and Sign'.-rhis Sec.ij}fi, /_; �R'Jl�(' �5�.:�''' ,us :jw-icr of the subject�Sxu]>cjty to uct an UAY behf,4 i ;xt an ttlatt=zciwdvr to wo&auihu&e;d by this buil&i g p u ait r i O'Cld Zees 0 0b) 1 '*Fool fences and alann.s ate the zespomsibil ity of the applicme. Pools ,,Lee not to be filed or uelized before feuce is iwtalled and all£roll iUspecdOU$ue pe�.rfonne d ,-md accepted. y Slguature o£Owaex Signature c-f.A,)Plk .t JV p4at Name P&t Name i Z0'd 6Z£OO9tZ9T99 a6aOV Wti ZT= •bO •rTOZ-80—A0N Massachusetts -Department of public Safety M Standards sa n d 'o n _ *Board of Building Regulat �. 33 7 ., License: CS-086.. • � IS A C O CHpRLES P BO X pO X 26 V�VC4, S POR I�MA - IiY ANNI �' a ,riti�•` Expiration 071291 015 ` Commissioner i