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Home My WebLink About0500 OCEAN STREET (26) ADO d��N ST R P 7- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 Map Parcel 040 - Application # Health Division Date Issued uu d Conservation Division Application Fe r 00 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 5 0C_fZA10 '!Z-�z cr'C-� /�- �5 6 Village 610 1 Owner ��U�U�%�'(-�- �"l�L�S Address // gQ)C WQ0 !' 66Q_CL45_ Telephone -C ro 14 5�� - 00 GAL Permit Request )2 fz�1/�Lfi.'� fz�t-}�c,�Zrl�!�- �Ulo f r UJ/rN bo S (3 ;2J� fz.ly O U. ~p ti} , �rc.�t✓+G.C�) •- .-►' ,� 3��Gzfi� � r.(-rJ-t'-�,'�v--t is �ItC2�'�w►Ei.• .7 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type ULMOv% of Lot Size Grandfathered: ❑Yes Ukl o If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes '._ E. g 9 �o On Old King�sHighway: `0 Yes ❑ No Basement Type: ❑ Full Crawl ❑Walkout ❑ Other _} Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft Y fi r Number of Baths: Full: existing 3 new Half: existing 1 nevd Dr Number of Bedrooms: existing —new : + M Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: eGas ❑ Oil ❑ Electric ❑ Other Central Air: 2"Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes TN"o 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 R/No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name :5(OAJA4"1\J C. CA 4U)_M_iZ Telephone Number 6`092 2 Z f- 8� Address AivFZ, License # <L;S 0 _�-(3 Home Improvement Contractor# &02_3 Email GAzGo� ,2�( ,GOr��`r'N "1" Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR C DATE�_J-/S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The ConimonweaXth ofMassachureftr Deparbnent oflndu h-kdAcciden;s `;r Oirwe of Invesfggations ' 600 Washington Street Boston,MA 02111 wwmmass govlika Workers' Compensation Insurance Affidayffi-Builders/Contractors/Electricialls/Plmnbers Applicant Information Please Print LepiblY' vName-(Busmess/C rgantim fndividu : �0� 'L!✓�n, C. U1,2�i y �f 1. _ Address: Pi�1'C.L !� • City/State/Zip�"�tJt,��f�a?�,'L� u�'oz��j Phone#:(SJ��2Z' c'�'�'�'c�J Are you an ployer?Check the appropriate bmc Type of project(requu-ed); employer with 4. ❑I am a general contractor and I loyees(full and/or part-time). * have hued the sub-contractors 6 [-]New construction a]sole proprietor or partner- listed on the attached sheet 7. El Remodeling r�ship=and have no employees These sub-contractors have 8. (]Demolition working for me i'a any capacity. employees and have workers' COMP msrrrance. 9. Budding addition [No workers'comp.i 1sum ce P regnired.I 5. [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑PI-ranbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 Roof repass insurance requ ired..I t c. 152, §1(4),and we have no employees. [No workers' I3.[]Oilier CoMp,incrtranCe required_] *Any applicant that checks box##I mast also fill out the section below showing their workers'compensation policy information_ t Homeowners who submit this affidavit indicating they arc doing all work and then him outside contractors must submit a new affidavit indicating such. tCoutraetom that check this box must attached an additional sheet showing the namn of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have cmployccs,they must provide their workers'comp.policy uambcr. lam an employer that ispraviding workers'compensation insurance for my emplayees. Below is the po$cy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.# ExpirationDate: 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$1,50.0.00 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 statemeat may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c�Zfy under the pains and penalties ofperjury that the information provided above is true anal correc4 CSi ".` - C e:,Dat -2 �IJ jj'' e: — Phone# .�'d Z°t°-S7 � Of use only. Do not write in this area, to be completed by city or town ool aL City or Town: PermitlLicense# Issuing Authority circle one 1.Board of Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions ` Massachusetts Genm-al Laws chapter 152 requires all employers to provide workers'compensation for their employees. pmnmutto 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 apprufenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(t7 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 ofpublic work-until acceptable evidence of compliancewith the insiiranc9. 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-contractor(s)name(s), address(es)and phone number(s)along with their certificates)of i isulauce. 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-insm- ce license number on the appropriate lime. City or Town Officials t 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 permi icense number which will be used as a reference number. In addition, an applicant that must submit multiple permitlIicense applications in any given year,need only submit one affidavit indiratng 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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew 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 Y(ie. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to drank 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 Deparhnmt of industrial Accidents Oface of fnvestigatio= 600-WashiVon Siz-Qtt B aston,MA Gl I I I Td,#617-727-4900 ext 406 or 1--977-MASSAFE Fax#617-727-7744 Revised 4-24--07 wwww m=.gov/dia Town of Barnstable Regulatory Services MAss. �, Richard V.Scali,Director .i6g9 �� 'moo 39 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 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authonze' JJ NA�'}{ N c. �i}2�i n� to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Adige of�ob) , T '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. Signature of 1 :w �er-4. afore o Applicant Name P�rintName "`Date Q YORMS:O VJNERPERMISSIONPOOLS Town of Barnstable Regulatory Services ��oFe rOity Richard V.Scali,Director °^ Building Division anxrASS"� ' Tom Perry,Building Commissioner 163�v- �� 200 Main Street, Hyannis,MA 02601 RFDIa 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: citytown 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 buildings 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 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,RuIes &ReguIations 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 Iicensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fuIIy 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. QAIATFILESWORMS\building permit fbnns\EXPRESS.doc Revised 061313 Massachusetts -Department Of PublIC Safety Board of Building Regulations and Standards Construction S4.eniso' License: CS-070396 _�- Vs JONATHAN C CAP 8 PINNACLE LA15tE 7. YARMOUTHPORT ' Expiration commissioner -477 03/1012015 e a��m�a0�u0eull/z.0/014e uiationeCta Office of Consumer AffairsCONTRACTORg OME IMPROVEMENT Type: egistration: :180231 Individual Expiration: _10/2712016 �vw JONATHAN C.CARPENTER JONATHAN CARPENTER 8 PINNACLE ,MA 02675" Undersecretary YARMOUTHPORT unrestricted-Buildings of any use group which. �ntaln than 35,000°cubic feet(991m3)of less enclosed space. 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 f'\ am;eu;h ;notimm Pliee;ON 9I1Z0 VW`uo;sog OLIS al!ns-vzvia?11ea OT um intag ssau!sng pus sits d lamnsnoa;o aa►9Jp :o;u1na1 puno;��I -a;sp uot;B1!dxa aq;alo;aq ,quo asn lnpwpu!�o;p!ien uo!;g1;sl2al.to 3su3311 * 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 Ocean Street Hyannis, A 4 02601 DATE & ,,P.D 1 RE: Unit�a _, 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,J70N Pr+t-IArJ C: C�Z��nl� n. _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 d day of_ , 20 /\6 2Secre a d of Trustees Yachtsman Condominium Trust 500 Ocean Street(c/o Manager's Office) Hyannis, MA 02601 ' Enc./FileAuk