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HomeMy WebLinkAbout0500 OCEAN STREET (11) ��©o oceo-?" S+, Town of Barnstable �� uildiri �,:; .,. .: fir» . . ems,: , .,. . ..� :.�a.=� � , . �. , . . ., ., � � . b.a�ndth, Mustbe Ke t- ,. ` , Stbl _- b ih Str e a rc5ved:Plans Must be Retairtedon-.Jo s and° This.Car ha �t;i K e: a ... . Pp . , s L�. �£;.. i.<r,. �: ,.,. . E. „ .,> „ �. a< H, i n..H s Been Made :. Posted Untll Final.Ins ec o <. . 3 .,., ,. , .. ;, po'rrriit a i e u�red uch;Bu ld�n shall No Abe Oecu "red until a Final In: ectign.ha been,made, ., , + Where a Certificate.of Qc upa�icy sR ncl ,s, g ~t.. p �p Ilk .. Applicant Name: STEVEN HETZEL Permit No: B-17-1278 Approvals Date Issued:: 05/31/2017 Current Use:: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/30/2017 Foundation: Location: 500 UNIT 11 OCEAN STREET; HYANNIS Map/Lot 324 040 OOY Zoning District: RB Sheathing: Owner on Record: MCALLISTER,SCOTT A i F Cont�raetor Nme STEVEN HETZEL Framing: 1 Address: 8767 VALLINGBY CIRCLE �� Contractor'ILicense 165119 2 BALDWINSVILLE, NY 13027 ,,,Est Project Cost: $4,000.00 Chimney: Description: Replace 1st Floor Slider 8x6x8 Anderson ) 'Perini Fee: $ 160.00 Insulation: Project Review Req: Replace 1st Floor Slider 8x6x8 Anderson Fee'Paid $ 160.00 Final: ate 5/31/2017 ��"z D _. , 1,2 Plumbing/Gas l __ _ _ ... Rough Plumbing: BuildingOfficial Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzeedd bey this permit is commenced within' ,fh— the after issuance. � � Rough Gas: All work authorized by this permit shall conform.to the approved application'and the approved construction documents forwhichgts permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by la nand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspect1 n for the entire duration of the 411 work until the completion of the same. w Electrical (: ri The Certificate of Occupancy will not be issued until all applicable sign�tt4 by t e Bui ding and Fire O orals are providifth,this'permit. Service: Minimum of Five Call Inspections Required for All Construction Work., 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 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). Firebepartme nt Building plans are to be available on site Final: AII.P.ernnit Cards are the property of the APPLICANT-ISSUED RECIPIENT T , i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l / ' Map\ Parcel Application Health Division Date Issued 3 1�/7 Conservation Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic -.OKH _ Preservation/ Hyannis I�l'►'►l�yl_ S�'�� Project Street Address Village �J/s Owner Address �✓ Telephone :SOPS q51 — 12_0 i Permit Request _ (Z�P�/'s /5-1 FLOQ C- SL-1 bO& Sfx e�� 8 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 o tsa01,� Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑Other pR28�01 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing T v9&V/�aI stove: �Yes ❑ No R Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing�674Fsize_ Attached garage: ❑ existing 0 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 2,T eA) �t��7�Z�L Telephone Number Address 7� (�/N C�j itl �12.1 V License# C y 3y Intl V- I AX--0 M-19 (g A- 62423 Home Improvement Contractor# _50/I Email 644-6!'ZOJ�i t M n IL . C04A Worker's Compensation # /1/4- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C&— SIGNATURE DATE 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 t j DATE CLOSED OUT ASSOCIATION PLAN NO. t Yachtsman Condominium:Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DATE �' J RE: Unite_, Yachtsman Condominium Trust, 500.Ocean Street, Hyannis s To the Town of Barnstable Building Commissioner, The Board of Trustees for the Yachtsman Condominium Trust voted and approved the attached proposal to be p ormed as is delineated in r quest we;received from the Unit r o Owners. Contractor has been contracted by the Unit Owner to perform the work as d fined 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. A Signed Under the Pains and Penalties of Perjury this y day of , 20 YCT Trustee Board f Trustees achts an Condominium Trust 5 an Street (c/o Manager's Office) Hyannis, MA 02601 Enc./File YA-s COMM-arr?V--*- i Of rr xrrsett5 De arar£ent e*,f Indastrial Acddads '- - fie afrw. atftu 600 Wmshhwtow Street Boston,4.0',7111 " ens Ie�c�.slPl>m�b �kers C ensaii-n�.Ias�-�tce r'�M�-��dexslCa�act�rs�E AppVca4tIufaLM3tEug Please-Print NaiT1P,(gncinaR. Address: r#re Sro¢an es¢play�er? ecktbe apprap ' fe bow Type of project Cregaited}c A ❑I am a general confmctor and I L❑ I am a em-plts�ef Keith. 6- ❑New consirctffoa employees C:ffia andlor part-iime)* havehiretithe Sub-conbcact= 2�I am a sole prDpizielof ar . er- TisfEd oathe aft6ed sheet. 7 ❑Remodeling ha Thee s�canfr.actors v. e slug and l��ffa empl��ees. - s 8. ❑IJemalition: w afar!Ci P ltl En iployees andhxm wa&ere Sb aQY caPa�. -0. []Building ad:difion: [IIo Fcud a comp.L2SU =5 comp_meuraut�$ 1O Elecfxical r nradc iom rewire j . . 5. ❑ Wearea-corporafimandits ❑ eP 3_❑I mna homeovmer doing an Wo& oI5cers Barr;exa- ad their ME]Flumbiagrepaiss or adcuti-on% myselE[go woikere CZMP- right of exempfion per UGL L.❑RDafrepaiss fnsarance reg3iced j i c.152,§I(4k andwe have no, employees.[No ice& camp-insurance required.] *Amy spp t5atcbetffaTiarPlmaAalsoMautthesKe aabr7,axsbmcimgdeirwadses'•=3pessaSnupua7ia5ffisuca �u�,,F,:,martvrhasabmEt3ris�davuimz�r�iiagdiepsa� ia s3Iwca3caa�t5enlraeoutsidar,+nrnamstsaItmmtanewa�dtindicztin�sarb_ fCan:�s$�tc�7cihrTs6mcmastattarhedruadditi�nalsSzetSTiascmgtLen�oftbEsa$-cwdircl4s�st�eiarhe4he�arant3inse�tittle£SbSC£ �pIIoyees.I€thesnTrtaatradnsb�epmpIuff25,�Fieyrmrst'gmvidetiles norke�imp.po-T�sumbeL . IainanenfpIgerflsatfspratiVing,iwrkets'camperu&ortursriraureformye=Frapees $eZoivisAigpv Scy and job sife €rc•�armrriwrL .. IlasmanceCompanybr - — Paficy¢cr.Self-ina.Iic_ E aDafe= Job 5da Address CitylStafefTs rif Ach a copy of the-w&rkffe coxapenszdiaapolky decl!arafion page(shoumg the poTicy numEber and expiation date). Fa 7rire fix secant carenge as requirednuder Se-di=25A of MGL a 152 cm lead to the iraposrliaa of c imhml penalises of a fine up#�$1 f}O:f70 aadrar aue eari�prisan ,as we4l as civil penalties is ffie form of a STOP WGRX OMEKmd.a Erne o€up to$250.00 a r#ay agdnd the violator. 3a adi ised that a capT affl i sfatemennt maybe forwarded fo the Office of , Elmstiigations afffi.e D7A far i m=nc-coverage ceriflcafim Ida heererrp catixfj�wtrdezr&g ar a,f p r thLEttiw hTorartagonpros d aboi .is bzf rarrect Si res_ Date: lisT-7 - Phone A. OAZ id usj,-an4l. Do tat irate in ffr3-area,to be awApretcsd bp'rity artowu a,�ici.L City or Tom.: Permwucesase Lgsn�MgAnffiaritg'faL deone): L Board of Sea & 2.Ru Tiling Depar—timat 3.CitylToy.Clerk #Electricd Inspector S.Phm-bmg Iuspecfx►r 6.afhw C'ontactP'ersoa: Phone;#: - 6 i laformatioln and TRstructions. chvsefts General Laws chaVt�r 152 ad cmpI07=t"provide wore eomp=&adnn f❑r tfacir uf ,s- eson is 13ie service of a aaacr under ally o Fin-su��o$us sty,an.�Taye�is defined as`�.evetyp . cr miplied,oral cr wrrt " - co oraizon or ofher legal�Y.or any two or more ��Ivye3-is d:�fm�d as an m�vidn~aI,parfnrash�,ass❑®iion, rP. s of a decease$employ,or tb.e of tie foregoing engag�ina3o�fie,andinclnrTmg•die Iegal�pres�ve or of an to Inye� However flee J,C, x �dividual,parEo P�assoclafzon or=tsarIega1 e=sjff�P y notmorethanf3n�apa�Em.eots andwho residestlierem,ortbe occ¢pa�offhe- Dye of adwcl1mghousc�g coasfrod3onorrepa=rwoIkonsuchdwcllmghouse doghouse of anofe<who employs pegsons to do maims , or on the grounds orbur�mg apperfena�therein sballnotbecamt:❑fsuch employmetbe dseme$fn be an employees" . MCL chapter 152.§25g6)also sfaf�s ffaA vetgstafe 1 10 cal lir�a�CyshaIlwi�iholcl$ierssrxanceaz MC ten ev7aI of a licease❑r permitfin op=afe a Dusss❑r f❑cnnsfrui�b�dmgs is$ie c❑�mnos�eali3i for any apglicant-fflio has notpradnrsd acceptahle evid=C:e of cumpfiahLM Wn the me roY�ragereq -" Adcionally,MG2 cbapi�a ISZ,§250(�sbfrs`2`TeerficT' manor�y ofifs poIifical y�bdiyi`cions shall enter i❑iv any contract for-die pmn�„cP ofpnblio wo�=.fff acerptable,evidence of compliancewifhthe iosm-duce. rcots oftisis chapferbaye lieenpresedin the c❑nftactmg authority:' - �gppxcaats if Please f01 opt tiie wo�crs-compensation.affid&TA complei�ly,by checlong�-eboxes apply to your sifn�ion and, I sub-coafract❑i(s)name(s), addresses)andphonenvmbm(s)aIongwithIhME mItcEca�(s)of necessary.Supply parfn=hips(LU)Wltlln❑ =PBye:es other f�ao �it�dTiabi7ifyCozaPanies(LLC)orJ d Liahility members or parfn are not r to cagy woic&cOMpenssation insurzacc- If an LLC'or LLP does have to ass a olio is Be advised.�Ihis affida-Vitmaybe snbixxil u tiie Depa�iment of � amp y P y - Also be scare to sgn and dafE the affida4it The affidavit should Accidents forcon�afionofins¢rM= .tee b notdieDepare&finof for die e¢❑it or Iz r _ e c or town 13�the appficaiion p be returned to�i ?iY fiie law or if u.are regr�edto obtain a workers „ •siiial A ccirT� ��yon bate ally q�oesfr�s rc�g �'D antes should err ihea compensaHonpoficy,pleasecalltheDeparaettati3 numb¢lis�dbeIoFP. pelf-msmed�P _ the zppmpridn line- self-m.��celice�senumbet on City or T❑wn Of EErials Please be sa=$hat the affidavit is=np,Ic#e a adpri�jeIe Iy- The Depa tnmthas provided a space of the b❑tfnm o=thm affidavitfor yonto fill out-inthm event the Office❑fTnv ons has to cozy yonre &Hdimg applicant Please b e sore in fll.in the pe0J!'ieease mr❑bes w ch w&be used as aced ����ff�g�t fiat=a2st submit nz�lep�ceose appl-i�ons in aup glveuy� my - policy M3:Eb=a-fion-Cif nccessaty)and under-lob SSb-Agee fie applicant shorldorate°`aII Iocati.ns R (�3'o? town)_"A copy ofhe-affidavitfl h bees officially stamp ed or marked byffie city or townmay be provided to appH=±as proofs aM VBHd affida&is❑n fle for 5:dlll pew s or ftcenses_ Ane�T a$idavitmr commIle d V each year.V7here ahome owner.or is obtaining a.fioense orptLanotzelatedtn anybusiness or commercials - ea CLD.a dog license orpennIt to b�.leavcs etc)saUp=acL is NOT to r� aav� IetM this affid • -ons, T7ie Office ofTn�woul _hIMtof3iankyon.madv�mce foryour cooperafianand sh❑uldyou ha4e please do noth hMto to give m a call The DcZp 1[m enfs aZ&=4 tale r-.and fax=Mbcr: • . ���z�o�:�a�of Mash Niece Qf Trr� fiaA Fag a7`27 770 THE Town of Barnstable s Regulatory Services ` "'F — Richard V.Scali,Director �`�� Building Division. Paul Roma,Building Commissioner 200 Main Street,$yaunis,MA 02601 www.town.barnstable.ma.us office: 508-862-4038 Fax 508-790-6230 r A Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize - � � to act on piy behalty f' in all matters relative to*work authorized by this building pe=ait application for. (Address of Job) ._ **Pool fences and alarms are the responsibility of the applicant Pools ate not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner; ignature of Applicant Print Name Print--Name Date . ,; ' Y, Q:FOR2&:0VNERPERMISSI0IQ00L5 i re�pd�nrraararuec��l�i oh�j/fcr,,,,nc�r�ae%tt ulation pace of Consun►cr Affa►rs&Business OME IMPROVEMENT CONTRACTORType: egistration: 165119 Individual j;Expiration 1171201;8 STEVEN HETZEL STEVEN HETZEL 72 pINE CONE DR. Undersecretary„ ~ W..YARMOUTH.MA 026 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-104384 - Construction Supervisor STEVEN L HETZEL 72 PINE CONE DRIVE .. WEST YARMOUTH MA 02'673 '�/►t �— Expiration: .Commissioner 07/27/2017 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 0� �I L5 p pp Ma � Parcel: A licationd—� " Health Division (7 f 6� Date Issued l Conservation Division .Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis — Y , Project Street_Add�'�ress� c a 0 L04--,-- 87 Nil CH ES n, Jt Villagey �t.S Owner `vw ft 13 X-t-J y Address 6 S u rp.a.,,Ae utac4/gs, pr,D#O lee 4$S Telephone 1 g 40 7 0 O S Permit Request R C f L"o C iF r=, T Xftee Square feet: 1st floor: existing/proposed CO 2nd floor: existing proposed Total new 10 Zoning District Flood Plain —_ Groundwater Overlay Project_Valuafio�/. s Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,'attach,supportingy documentation. Dwelling Type: Single Family %I Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old K'ing'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 knew z; Number of Bedrooms: , existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil .)i.Electric ❑ Other Central Air: ❑Yes P1 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 PAC 46 C0 Telephone Number p Address p•0 X License # �� 6 6 oZ aae--m-f-VtLsL-C- SS C%).G) J- Home Improvement Contractor# j0 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGr� URE c: '� DATE g 1 r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` ..MAP./PARCEL NO, x f ADDRESS VILLAGE j OWNER DATE OF INSPECTION: 2 FOUNDATION FRAME INSULATION.,I FIREPLACE ELECTRICAL: ROUGH FINAL �a PLUMBING: ROUGH FINAL GAS ROUGH '' FINAL d,Z[FINAL BU:ILDJNG' DATE CLOSED OUT a ASSOCIATION PLAN NO. y y, The Commonwealth of Massachusetts Department oflirdustrial Accidents Office of Investigations UV600 Washington Street Boston, MA 0211.1 ivww.m ass.go v/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumberg Applicant Information Please Print Legibly Name (Business/Organization/Individual): (�(�`�`b�Wt. � 6�' .4yo gC4 Address: Ciry/State/Zip: cc'-T)m2✓iuL,, Phone.#: Sv � -7 6 `�'"S9 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a em to er with 4. ❑ I am a general conjaand I P Y 6. ❑New construction employees(full and/or part-.time).* have hired the sub- rs ..2.�I am a'sole proprietor or•partftcr-' listed on the'attachT. ❑Remodeling ship and have no employees These sub-contractg_ '❑Demolition worlan for the in an ca aci employees and hays'g y p ty. � 9. ❑Building addition [No workers' comp.•insurancecom}i, insurance.required] . ❑ We are a corporatio 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exerci 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs in aired_ q ) insurance re r c. 152, §1(4), and we have no employees. [No workers' 13.[ROther AZ0L GC- wgw/eDws comp. insurance required"j C k *Any applicant,thatehecks box#1 must also fig out the section below showing their 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. tContractors that cheek 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 employccs,they must provide their workers''comp.policy number. Iarri 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/Statdzip: 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. B e advised that a copy of this statement maybe forwarded to the'Office of Investigations of the DIA for insurance coverage verification. Ida hereby certify under the pains penalties of perjury that the information provided above is true and correct. Date: �� 1 Si afore: — Phone Offu aL use only. Do not write in this area, tb 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 S. Plumbing Inspector 6. Other t' information and Ins' ttuctions 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 contact 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 ajoint 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,�vzth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checlang the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),•addiess(es)and•phone numbers) along with their certificates)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 rn 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"rob 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 maybe 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 fo any business or commercial venture (Le. 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, telcphone•and fax-number: The C6mmonwe0th of Massachusetts D partment of lndustii, J Aceide:nts Office of 1nveSti9atians- 600 Washington Street Boston, MA 02111 Tel. # 617-727-49-00 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 w Zevised 11-22-06 www.m ass.go v/di n x 'THE Towne of Barnstable ` Regulatory Services uxr►srAsr.E. Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 509-862-403 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 AAA— QACh�r—CC to act on my behalf, in all matters relative to work authorized by this building permit application for. boa aCEA,,J 51-. - YAee/3 t^J /J� !1 (Address of Job) SignatwWof Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. f)•Ff1R M.0•II VJhiFR PFR 6.fiCC1(lU 'THE roy Town of Barnstable of Regulatory Services rf Thomas F. Geiler,Director ' MAIRS. All,$� Building Division rEni Tom Perry, Building Commissioner ' 200 Main.Slreet, Hyannis,MA 02601 v rV1rW.to wn.b arnstabl eana.us Office: 508-862-403 8 Fax: 508-790-6230 110R'1EOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village -HOMEOWNER"* name home phone# work phone# CURRENT MAILING ADDRESS: , city/town state zip code TL<le current.exemption for"homeowners"was ex nded to include caner-occupitd.dwellings of six umts.or less and to allow homeowners to engage an individual for e who does t possess'a ic`ense provided that the owner acts as supervisor. DEFINMO OF E MEON ER Persoa(s)who owns a parcel of land on which he/she resi or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached s as accessory to such use and/or farm structures. A person who constrgcts more than one home in a two-year, Brio shall,not be considered a bomeowner, Such "homeowner"shall submit to the Building Official on a orin acc table to the Building Official, that he/she shall be res onsible for all such workperformed,under the b• 9 PC=t ?�action 109.1.1) .i S#4.<',i t-,- �#.•Y.�` ': 4i1�..�-«rah r - . r a 4 a The undersigned"homeowner assumes responsibih for compliance the State Building Code and other applicable codes, bylaws,rules and regulations. h , The undersigned "homeowner"certifies that.be/ e understands the Town of B table Building Department minirnu .inspection procedures and requirem is and that he/she will comply wi said procedures and requirements. Signatiirc of Homeowner Approval of Building Official ,• Note: Thrce-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMMOWR'ER'S EXEMPTION The Code states that'"Any homeowner performing work for which a building pcmtit:is required shall be exempt from the provisions Of this sccGon,(Scction 109.1.1 -Licensing of construction Supervisors);provided that if the homcowncr engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption an 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 homwwneris fully awarz of his/her m' spon.nbilitics,many communities require,as part of the permit application, that the bDmenP'ner acr*that he/she understands the rrsponnbilitic's 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 fom/certification for use in your Community. Q:forms:homccxcmpt The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Resident Manager Unit 019 Hyannis, MA �+p �v (508) 776-1515 IMPROVEMENTS f'�T�.' rF e�Na9 TO NIT I (we)........................ �3r�Y A� 6 AI �� .owners of unit#...«..... do hereby apply to the Yachtsman Condominium'Trust, pursuant to Article V, Section 5.6.2 of the By-Laws of the Y.C.T. , for pennission for theffollowing: YMOMISLIMAS Location(s) . ...1�.'.I-c�tF-�, ....... .. ..................1............ ......... Type(s). ... ............... Tan! , c u � .......................... Location(s)& Type.............................................................................................. ff=° ................................................ , ........................ ; ...........,...... ......... �.5....... U.-;. �✓le,��'o;� .�..��TG� ..................... , ....... r'nN?'RdCTOR: ... ..... ... ............... .... ... .... Gam, 3 aG fl ignature Date ± °Contractors must have a valid license and have both workman's ®� _ compensation and liability insurance. No work may commence in any coffin areas until a valid certificate ®f insurance delivered manager. Proper permits as so required by the town of Barnstable are also requested to be on file with the resident manager. - Massachusetts- Depai-trnent of Public SafetN ANNEL Board of Building_ Re�ulations and Standards Construction' Sttper~,r.isor License License: CS 31802 d ARTHUR M PACHECO P.O. BOX 223 CENTERVILLE, MA 02632 Expiration: 6/15/2012 Commissioner Tr4: 26808 °� License or registration valid for individul use only Office of Consumer Affairs&B� siness Regulation g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:=Y105488 Type: Office of Consumer Affairs and Business Regulation TARUR Expiration: •7.17/2012 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 M.PACHE&-- Foy '--7; Arthur Pacheco { r _ 133 ASHI:EY DR. CENTERVILLE,MA 02ti32 Undersecretary Not valid without signature