HomeMy WebLinkAbout0500 OCEAN STREET (16) (t ni~f
(75-5S
Y
4, y Town of BarnstableBuilding
, Y
r Post This;Card$o>That it.is:Visible From:the Street nApproved:Plans Must be Retained on Job and this Card.Must be Kept
r Posted Until.Final Inspection Has Been Made.
s9�
Faa'J f>aWere.a CertificateoffOccupancy::is Required;swch,B.uilding shall Not=`be Occupied until a Final Inspection has been made. Termit
Permit:NO 1347 3447 Applicant Name: STEVEN L HETZEL
Approvals
Date Issued'; 40/20/2017 Current Use... ..tr ° Structure
Permit Type .'Building-Siding/Windows/Roof/Doors Expiration Date' ' 04/20/201g Foundation: .
Location:I560-UNIT 32 OCEAN STREET, HYANNIS Map/Lot: 324-040=0BS Zoning District: RB Sheathing:
Owner on Record: NEVILLE,JAMES P TR Contractor Name: STEVEN L HETZEL Framing: 1
Address: 2 GARDEN LANE UNIT 2 Contractor License: CS-104384 2
CAMBRIDGE, MA 02138 Est. Project Cost: $7,500.00 Chimney:
Description: replace 3 exterior windows with new,same size Permit Fee: $ 160.00
Insulation:
Project Review Req: SAME SIZE REPLACEMENT Fee Paid: $ 160.00
Date: 10/20/2017 Final:
j ------ Plumbing/Gas
Rough Plumbing:
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 Rough gh Gas:
All work authorized by this permit shall conform to the approved application and the approved construction documents for 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 by-laws and 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 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 and fire Officials are provided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work: Rough:
1.Foundation or Footing -_
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:
-5Prior to Covering Stru
ctural ural members
tiers(Frame Inspection)
0•6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
i .
Health
r Where applicable;separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall.not proceed until the Inspector has approved the various stages of construction Final:
_.__._.._4_.___.._._ .
i ..f !':Persons contractrng:wlth-Linregistered;contrac-torgAo.not'have access to tt a g'0'ra'nty-fund" (as set forth-.in M G L c.142A). Fire Department
'- Building plans are to be available on site - - . . .. '
Final:
'" .All Permit.Cards are the property of the APPLICANT=ISSUED RECIPIENT
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION '
'�
Map y Parcel O y 4S Application # ��
Health Division Date Issued / D _.
IBUILDING DEPT.
Conservation Division Application Fee
Planning Dept. OCT 0 5 2017 Permit Fee
Date Definitive Plan Approved by Planning Board T01AIN c)E gARNSTABLE
Historic - OKH _ Preservation/ Hyannis
Project Street Address (-D C�� � c) IV I��Z
Village
Owner J I `'h �J&vI Address
Telephone_
Permit Request 22 6CO�rUr ayt— l,O 11� DO-W S LO ( _rW
�I 6W S Irrvl 0 5:1 Z.�r_ W/ AJ b S
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation � �aa Construction Type
Lot Size Grandfathered: ❑Yes 0 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 G - Telephone Number 561 9- Z 6C1'!5Z5`2_
Address <ft�Al& DRIIU6� License#
f ! Home Improvement Contractor# (z5
Email SL[415r-Z�_C,A!�7-M 411,• Oyyl Worker's Compensation # MIA-
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
/ f
SIGNATURE DATE U I �i l / 7
FOR OFFICIAL USE ONLY
?� 'APPLICATION #
DATE ISSUED
r MAP/ PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
s FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
f
I
DATE CLOSED OUT
ASSOCIATION PLAN NO.
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OFTHE 1p�
r BARNMBLE, +
v� 1639 Town of Barnstable
plE� .t a
Building Department Services '.
Brian Florence,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.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 application for:
(Address of job)
7
Si ture of Owner pate
. ( VV\- Gu!c.L C"
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side. `
QAWPHLESTORMS\building permit forms\EXPRESS.doc
08/16/17
Commonwealth of Massachusetts
Division of Professional Licensure
w...7 Board of Building Regulations and Standards
Construetf0n'S Fvisor
CS-104384 = Expires: 07/27/2019
$
STEVEN L HETZEL
72 PINE CONEPDRIVE 'td
WEST YARMOUTH MA 02673
Commissioner
_w
j Licens2�or registration valid for individul use only
before the expiration date. If found return to:
'0=ffice of Consumer Affairs and Business Regulation
10 Park Plaza-Suite 5170
Boston,MA.:02116
Not valid without signature
�/e�iu�ce�cza?zcuerc�l/a`�U'llaJ:irce/ccrelt
_Office of Consumer Affairs&Business Regulation-
gis txOME IMPROVEMENT CONTRACTOR
e 165119 tration Type:
piration 1/7/2018 Individual:
STEVEN HETZEL
STEVEN HETZEL
72.PINE CONE DR. -
W.YARMOUTH,MA 02673 Undersecretary
r
err,
.. • >:. �ia:uL4ssear+46i~ Z"rsvy
Board of Traom
Hyaxnrs,MA 1
DATE
Yap^lsinm Comdomi um'frust,SOQ Ceau,St�eet,Hya its
To,the T6,m of:Bontable Wd ng Commissioner,
*P4rW4.& rust6es for.the:Y achUmanCaidomimum'.Trust voted,asid approvied1he
pI to beperfprmed as is delinea#£d•• she request we:receives from the Unit
C; Off, �• y u IJ IL �$'beef fAi1 aC by th
Ifom:the work•2S defined iu propOSal.
This ketLer' rues as aohce of the Board'.s vote i o approve the proposal,which has been noted in- .
the A4#�;of tbp.Bomd Meet ng-
S L tbe ga ns aid_Penalties:of Pei�ury, this day of
—�-= T Tres
Boat ofVmtees
Y � Trust
5 Doet � s 04Pfire'f
A 1
Fa .fF�e
t
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,
TUN PN! )
Map Parcel Application # _ (P
Health Division ;'`' _ I `f 1``'' (' '-
Date Issued 3—
Conservation Division Application Fee
Planning Dept. Permit Fee C
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address O® d G �57►&aL- V /0 i t 3 -Z
Village /4,+V pl S (\P�C4;ts in A�o C_-M
Owner M M I���E-JI(PLC Address 2 4����G� �'►�aYLi� /i}
Telephone Q 6 1 — 7 S
Permit Request T?, o u� ��15T/X�K gl f -TGJ tG�J ' 'i61 iv C TS e Au,o Tel'0 PS
At)a C-04-06, Q0-/J 2ZbE-9-46b 41a 646c'-P rl) -Nao C&/C-iA;t ,
S`►' CJl'�3/r _/�'�'r�y/J'�7C�5 AvA s�7 S 4_Z-C ff-470woc 63
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new O
Zoning District Flood Plain Groundwater Overlay
Project Valuation�' Z Construction Type z Mobe L—
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 5',c�.c,-J he-_--T7e—L 0 Telephone Number
Address '7 Z 21 N E k-fU& License#
��7/1'/N"�imd�i r M/� own> Home Improvement Contractor# 166g C;x �
Email SU�GTz Worker's Compensation # I�
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO /ZOAC--
CM CPS M 11-��757L
> a[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
DATE CLOSED OUT
ASSOCIATION PLAN NO.
i
the Comniorrivealth of-Massachusetts
D'epartrrrerrt cq,f rnd-rstrid Acciderr#s
O re of1mwfigadom.
600 Washington Street
}6YP #IaTmga'1dla
N11'orkers' Campensat an Insu mace Affidavit:SudIdei-s/CunfractursfEIectricia�lumhers
Applicant Information Please Pilaf Le�lly .
Na=(susireSSi Ig3nQati4Il L'i11Da1 S`G-Cat U 1�C�i�iL 194 Leui(S / ,+q /
Ai&ess: '72 ram/ N E E 17 rZ- V C
City/Statel Phone-twk �8
Areyou an employer?Cheektheappropriatebox: Type of project r
I.❑ I am a employer uith 4. ❑I am a general contractor and I e ] { egnu e
• employees(fu11 an�d(or part-time),** have luredthe sub-contractors �- ❑New consirucfzon
2. I am a sole proprietor orpartner listed onthe attached sheet 7- M Reemoc,ling
These sub-contractors have
slu�i and have no emplo��ees. 8_P Demolition
woririnc for in any capacity employees andhave work ers'
[No rvarkees'comp.insurance comp-insurant�I 9. Br3ildmg addition
rerp3ired] 5. ❑ We are a-corporation and its lb, Electrical repairs or adaions
3.❑ I am a fiomeov mer doing all work officershave-emarcised their I L Plumbing repairs or additions
mysdf- o workers �t of exemption per MGL
+nmce required-]i
- c.152 §1(4�and we have no 13_❑Rflafrepairs
�n
employees.[Nowodoess' 13.0'Other
comp-insurance required.]
*Any W5cnrtdst checkstaox t`l must also Moutthe sectioab9awshaising theirwo&Ee campmsatinuporrcyinfoamauon_
t liomeomuemwho submit dais af5daerz huEcItb g they are doing RUwax sad dim hire oatadecontmctorsnmst snhmita new afdavit indicating socTi
fContrscwmlf st claecir tdi boa must attached sa sddiiianal sheet slaowing the mmne of the sub-canicxcto-sssnd state whethet or not fuse entideshave
enployees.If the slab-contactorsluve employees,they=uStpamade then workeW camp.policg number-
I an[are entpl�oJ�r tlirct is prauidirrg n�rrrkers'caniperesr r�rt i�rszirarrca for�c}�enzpIv}'ees Serviv is Ylte paucy and job site
ircformrrtion
htjsurance Company Name:
Policy 4 or Self-im-Lic. Mxpirationlute:
Job Site Address City/State/zip.
Attach a copy of the workers"compensationpolicy der laration page-(showing the policy number and expiration date).
Failure to secum coverage as required under Section 25A of MGL c l5'1 can lead to the imposition of criminal penahies of a
fine up to$UOD 00 andror one—year imprisotm ad as we11 as civil penalties in the form of a STOP WORK ORDER and a fine
of up to 0-00 a day against the-violator. Be a-dvised that a copy of this statement maybe forwarded fn the OfHce of
Investigations of The DIA for insurance coverage verification.
I do hersby certify ender the pains ar it 's ofperjury thatAe info rmafianpt invW abmv is Gus and correct
Sienature: Date v711 11&
Phone ik J6
Ookial use anTy. Do not ayrke in tids area,to be completed by city artotrn o,, fc-ial
City or T•awn.: PermitUcense#
Issuing nflmrity(circle one):
L board of Heal& 12 BmTTing Department 3.City-frown Clerk 4.Electrical]'nspeetor S.Plumbing Inspector
b.Other
Contact Person: Phone 9:
Taformation and Instructions
hfassac,huselis Getmal Laws cmpt=152 regoaes all employers to provide workers'compensation far tbeir eMPIoyees.
pm:Mm3f-to ties sib,an eimqrlayee is defined as.'.every person in the service of another under any colftact ofhire,
express or i mpliec%oral or win-"
An Moyer is defined as."an mdzyidnaI,pmtamaahip associafi&A corpm on or other legal entity,or any two or more
of the foregoing engaged in aJoint entr_rprlSe,andinclnding the Legal FepresenteflvBs of a deceased employer,or the
receiver or trostee of as individual,partnership,association or other legal entity,employing employers- However the
owner of a.dweJIing house having not more than three apartments and who resides therein,or the occapant of the-
dwelling house of another who employs persons to do maintenance,conshuction or repair work on such dwelling house
or on the grounds or building appm�thereto shallnotbecause of such employment be deemed to be an employer_"
MGL chapter 152,§25C(6)also sues that every stafa or local Rcensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct bindings in the commonwealth for any
applicant:who has not produced acceptable evidence of c6mplian.ce with the insurance.coverage req¢ired."
Additionally,MGL chapter 152,§25C(7)states aNeiiher the cow cnwealth nor 2�qy ofits poIitical subdivisions shall
enter inb any contract for the perfozzaanee ofpublic wont uabl acceptable evidence of compliance with the insurance..
rat f= ens of tivs chapter have been p=mtf-,d to the coriracting arrihozh}*_"
Applicants
Please fi11 oirt the workers'compensation affidavit completely,by checI the boxes that apply to your sitnat ion and,if
S atidress es and one numb s along with their certifrcafe(s)of
s nam �)
soh-contracto Ph
s I ) .e() ( )
neces rC
art,�P Y
insurance. Lhm Liability Companies(MC)or LimitedLiabrTrtyParfnemhips.(LLP)withno employees Other than the
members or partners,are not required to carry workers'compensation inmrance. If an LLC or LLP does have
employees,apolicy is required. B e advised that this affida:vR may be submitto the Dep&-finent of Industrial
Accidents for confirmation of insurance coverage. Also he sure to sign and da-fe he affldzY The affidavit should
be rettnned to the city or towntbaf the application for the pem3it or license is being requested not the Department of
h1dastm,Aceid�. Shouldyou have any questions reg�mg the Jaw or ifyou are re:q=ed to obtam a workers'
compensationpolicy,pinsecaatheDepartra=tatfiem=beriz,ti�:dbelow. Self-insrsedcompaniessbouIdenLtrlh5ir
self-;,,cnran ce license n�bel an the appropriate Ime.
City or Town.Ofzcials
f -
Pleasebe sore that the affidavit is complete and pridedlegiibly- The Department has provided a space at.thebotfom
of the affidavit for you ti)fill out is the event the Office ofInvestigations has to contactyouregmdmg the appl`ant_
P lease be sure to EU in the p eunitllicense number which will be used as a reference number. In addition,an applicant
that must sabmiL multiple per dVHcense applications in any given year,need only submit one affidavit indirafmg cmrent
policy info=aation Cif necessary)and under"Job Site Address"the applicant shoTsd write all locatins n (cry or_
town)--A copy of the-affidavit that has been officially stamped or marl--d by the city or town may be provided to the
applicant as proofthat a valid affidavit is on f1e for futmi.pmm s or licenses A new afffdavitmust be filled 0it each.
year.Whew a home owner or citizen is obtaining a license or pemit not related tG any business or commercial vent
Cie. a.dog license or pemZit to bum leaves etc.)said person is NOT regoired to complete this affidavit
The Office of Investigations would like to thank you m advance for your cooperation and should you have any questions,
please do not hesfiate to give us a call-
tel one and fax mmber:
The Departments address, eph _ -
'ht CD=MMWa1t1E Of Massachnstm
Depa dmMt cif 1iclustd l AOCUenta
-
�4 man Suet
Bwton,MA Q�i 11
Ta#617- -490G Qxt 4-06 or 1 MAS9AFE
Fax 617 727-7M
Revised 4-24-07 mas-gOvldia
of s"e tp�
9� ,�� Town of Barnstable
Regulatory Services
Richard V.Scali,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, T i Yet 9J�U R LL� , as Owner of the subject property
hereby authorize y 1 � to act on my behalf,
in all matters relative to work authorized by this building permit application for:
5'C� dc� 5772' 13 2-
(Address of Job)
ell
S' e of Owner ' Date
_J—i m JJ;5 iJc
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
QAWPHLESTORMS\building permit forms\E G`RESS.doc
Revised 040215
J
Yachtsman Condominium Trust
Board of Trustees
500 Ocean Street
Hyannis,MA 02601
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DATE
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 be performed as is delineated in the request we received from the Unit
Owners. Contractor, 42 w i uj'j "-5 has been contracted by the Unit
Owner to perform the work as de rined 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 S day of 20)6
I
Sec ry, I
Boar of Trust es
tsman Condominium Trust
500 Ocean Street(c/o Manager's Office)
Hyannis, MA 02601
Enc./File ;
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1 Massachusetts Department of Public Safety
Board of Building Regulations and Standard
License: CS-104384 s
Construction Supervisor
STEVEN L HETZEL-
72 PINE CONE DRIV,,,g
WEST YARMOUTH MA
Mt
oe
2 .4
Commissioner Ekpira. n;-\
^07/27_ 017
dlleaa�v�icancaecc �a�C/Llu�tccc�u�eLtd
Office of Consumer Affairs&Business Reg
ulation
TOME IMPROVEMENT CONTRACTOR
eegistration: 7165119 Type:
xpiration 1/7/2018 Individual
STEVEN HETZEL
STEVEN HETZEL
72 PINE CONE DR. d ,
W.YARMOUTH,MA 02673 ^U ersecretary
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
icaib 0Map Parcel V2 pp ti
Health Division Date Issued /0
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _Preservation /Hyannis
Project Street Address C�6 CSC � u � 1 T- ?j 2
Village gY")UI S
Owner 'l n1 Address �2k1'hA CATIC . —IrM M
Telephone (, (7" q1 G ` 73 7r1
.Permit Request ROM b V E A4 7 Q.C.P 1) 5Z4 DM, d' 3� W 10 Dd71A)5
A4_L_ S 1 Z55 .S ar-?c As inQ_s 7 PJ C
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type3 v
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting dQ6
Vme' tion.
Dwelling Type: Single Family U. Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes &No On Old King's Highway: O`Yes No
Basement Type: ❑ Full *Crawl ❑Walkout ❑ Other X__
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)
fame �1��1�� � Telephone Number
Address 2 l46 0)9F License # CS /f q'&q
Home Improvement Contractor#
EMU: SLK&T��/46TMLI C'dM Worker's Compensation # �Y
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
VNV
ou 14
SIGNATURE DATE 16/ 76 1_5
x„.
4 ` FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED F
� x
MAP/PARCEL NO.
x
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
;r FOUNDATION.
FRAME
INSULATION
.i
FIREPLACE
ELECTRICAL: ROUGH FINAL
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PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
k
i
"x FINAL BUILDING
4
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R t.
DATE CLOSED OUT
ASSOCIATION PLAN NO.
rF r
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4
600 Washbgtan Street
Boston,AL4 02111
_ www.inaNS.gov/4`a
'Porkers' Compensation Insurance Affidavit:B•ailders/Contractors/FIecfricL ns/Plumbers
Applicant InfornQation -Please Print Leeibiy'
(Bnsmes victual): 1Tl Z�� Lew LS'P 01(S U 1e—Dzed:
Name sl
Address: r1 Z ! p 7. 67 ' !'IZ-1 y� ;
City/State/Zip: V1 ESTft-LM PhOMA.
Are you an employer? Check the appropriate bo= -Type of prof ect'(regoirec1):.
1.❑ I am a employer� '4.X I am a general contractor and I
employees(full and/or part�me).* have bred fe strb-cofactors 6. Q.New consfruz a
2..Q I am a'sole proprietor or part=- • listed onthe•attacbcd sheet': 7. Q Remodeling
ship and have no employees These k6-Mntac m have ' 'a. Q Demolition
wrg forme in a� PY e�lnyees and have worlorrs' 9. ElBtu7rting addi3ion
(NO WDZIMvS' camp.*nsur�nr_e-. $
��T�J 5. Q•We are a muPorafion'and rtss 10.❑Electrical repairs or additions
`3.❑ I am a homeowner doing d-work officers have excised tlleir 11.❑Plumbing rcpain;or additions..'
myself [No workers' comp. - of ezemptinn per MGZ 12.Q Roof repairs
MSMM=regt�ed.]t c. 152, §1(�, and we have no
MTinycc;•No Wow, 13 Xofficr IZ (ne
comp-insurance retpi ed.J (N/
kAny applicant that cheep box#1 must also$C ad the section below.showa n !hair w•a k='eompmsafion policy infxroalion.
Homcownen who submitthis affidavitindi—fmgfhey are e ca doingaU wa±and thmhnz outride must submit anew affdavitindicating such. -
Contractors that check this box must affached an additional sheet showing the name of the sub—cant uchas and sbb wbcthcr or not those cnf m have
mployees. If the sub-conha bin have craployers,fhey must providt their wogs'comp.policy numbs.
ant an empdo�er that is providing workers'compensation insurance for my employees Below is the policy and job site
xformafion. • . ' .' .
rasurance Company Name:
olicy#or Self-ins.Lic.#k ExpndonDate:
:)b Site Address: Gfty/Stafelzip:
ltach a copy of the workers' compensation policy declarafionpabe'(shoWing the poficynIImber and expiration date).
Mltne.to secure covezage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a
oe tip to$1,500.00 and/or one-year imprisonmcu; as•weII as civil penalties in the form of a STOP WORK ORDER and a fine
tip to$250.00 a clay against the violator. Be advised that a copy-of this stt=n* maybe forwarded to the Office of
yestitzations of the DIA for insurance coyeLaae verification.
io-hereby >`Fce p of perjury f uzf the information provided pabove is true
iz d correct
Date:
loneM .
Otjcciffl use only. Do not write in thtc.arer,2 be completed by city or town 0-07rid.
'City or Town Pet�nit/License#
Imdng-�iutho&y(circle one):
L Board of Health 2,BmldingDepartment.3. Citygown Clerk 4.ElectricalInspector 5.PlmnbbjIuspector
fi. Other
�antact P1erson•
i
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i� E:.
Yachtsman Condominium Trust
Acc6lptance of Trust Approval
r .
The undersigned Owner[s] of Unit#32 of the Yachtsman.Condominium Trust,.500 Ocean
Street, Hyannis, Massachusetts,acknowledges] that the Trustees of the Yachtsman
Condominium Trust have approved the following proposal:
® Installation of replacement windows for the unit (Andersen Teretone -
Windows only, color to match existing). Any shingles and trim that are replaced on
the exterior shall match existing. Replacement windows shall match existing
windows, both as to size and placement.
By acknowledging the Trustees'vote approving the proposal for Unit 432, the.undersigned
Owner[s] agree that:
1. The specifications provided to the Trustee`s for approval (copies of which shall be
attached and incorporated hereto) are the final drawings and specifications of the
improvements. There shall be no additions or variations to the said drawings
and/or specifications without the Trustees'prior written consent.
.2. Approval by the Board in no constitutes a waiver by the Board of the'Trust's
rights. Moreover,approval by the Board does not indicate that the'Board accepts
liability ar'responsibility for;the.adions of the owners y
3. Any contractors (and`sub-co`tractors) hired to work on.the proposal shall obtain
the necessary approval and permits from the appropriate local authority or
statutory body required under any law(including any statute,ordinance,by-law
and/or regulation). The Owher(s) specifiy that any and all Contractors and/or sub-
contractors'shall not commence,continue or complete any.work without having the
appropriate permits and approvals secured. Contractors and/or sub-contractors
shall provide the Manager of3the Yachtsman with copies of all approvals
'and permits,
contact information,including emergency contact numbers.'
4. .Any work undertaken shall comply with all relevant local,county and state codes,
., 'by-laws, regulations and statutes. -
5. Any contractors (and sub-contractors) hired to work on the proposal shall maintain
the appropriate liability insurance: Contractors`and/or sub=contractors shall
provide the Manager of the Yachtsman with copies of the relevant insurance binders:
6. Any work undertaken shall be completed by Memorial Day and no work shall be
undertaken again until Labor Day,unless approval is sought from and received from
the Trustees .y
7. I/We assume(sj,responsibility for any future costs associated with loss or damage
related to-the work.
• 8. Other: ` I
As stated above replacement3lwindows shall match existing both in-'size and location, E
and all exterior materials-used during installation must match existing exterior j
conditions:'
(f
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i
• The undersigned Owner[s],of Unit#32 therefore accept the approval of the Trustees of the
1
Yachtsman Condominium Trust subject to the above-rioted conditions.
t;r�e
is of ISE i� 't_,2®13
f -gJni wner
5t
Print Name-Unit Owner
Signature-Unit Owner
Prin e- nit Owner
itnes j.Madger achtsman C dotninium'Trust
Documents Attached:
Permits Received(Title and Date Received):
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f Vr oiiymeness egu anion
nffceJt onsumer airs
HOME IMPROVEPfENTCONTRACTOR."Type l
Registration: �165119
Expiration
4P7I2014` Individual •,
S N HETZELT� "�13
STEVEN .HETZEL -� %
72 PINE CONE �
MA 02673
DR ndersecre rY
W:YARMOUTH, N j'
-Department of Public Safety
setts P
chu Standards
� 'Board of Building Regulations and Standa
Construction Sup
cn-isor
License: CS-104�,t38,4`)
STEVEN L 1IETZf L
72 PINE CMODi H MA 02G3
WEST Y
Expiration
-� 0712712015
Commissioner