HomeMy WebLinkAbout0500 OCEAN STREET (29) 3�jy � ��
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel J 6 / Application # 96
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee _49�-
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address
Village 0Z(=,o
/
Owner �/a AAk'nd ��i,�an�., &D e Address z!r7a i i_ .9 ,'SA/am d AlY
Telephone
Permit Request 6!c!p acc47
_
�A�u_. /au�v-+� a S ,GNP �;y►<
Square feet: 1 st floor: existing.oproposed Y 2nd floor: existinoO proposed X Total new
Zoning District — Flood Plain k Groundwater Overlay x
Project Valuation O 0 c0 Construction Type��
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) (J /
tj
Age of Existing Structure Historic House: ❑Yes 9 No On Old AIGi uty�; ❑Yes C!�No
Basement Type: ❑ Full Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinil #rsp sq.ft 0�6
Number of Baths: Full: existing new / Half: existing 9p/VSM l�r Bmew
Number of Bedrooms: 3 existing �new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil 5-glectric ❑Other
Central Air: ❑Yes L*1<o Fireplaces: Existing New Existing wood/coal stove: QYes ❑ No
Detached garage: ❑ existing 0 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 /2"
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name A& Telephone Number Oki 7 7b n
Address /'►��2a 4a n4— License # C/7
n7 .4 A d Home Improvement Contractor# 17� 731
Email ') - 60 Worker's Compensation # 12Z u� (9 y 7 Z 96
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7�rmo � �tnns
SIGNATURE �' i DATE ///Z Z //
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 i Z7�!`7
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Deparhment afludaybfal Accidm
00we O0VFeS*
600 FFashuWox Sheet
Boston,HA,02HI
•. . kv�vt�.m�gov��ra
Warlmrs' Caml3ensafimInsa-2nce wit EanderslCuu rs/Ekc&► ianslPh tubers
APPEcaid Iufmrmaf mn Please Fri&
1�Taffie RU, 1 Ale-
WILL
Ad&e
CityfS esS Ph0n0
Are you an emplager?Checktbe appropriate bo= Type of project(recpaired):
I.L�'1 oat a emplt s 1 4. ❑I am a ge&tal confmctar and I 6- ❑N oonsfr Ei
employees(full amlbr part-time).* Itave h;red1he
2.❑ I am a stele propii0as orpartner- listed On.the att9ched sheet. I Reasode3ir<g
and have no 1 These sub-coafractass have
� eraplayees a�have tvo�rs' 9- ❑DemoIitiflrt
wo r�-ing for me.in airy capacity l 9. ❑Building ad3itioa
ENP 'oomp.fits ame comp-fill arrrr
reTzie -1 5. ❑ We are a cmpaiatil=and its 16-❑Elechical repair or addifious
3.❑I am bomemme r doing all wink officers have<mercised th,Er 1L❑Plutabiagrepaiss or adcEfians
mysdf o - ssglsf.of ea etagficn per M(M L❑
repaim
Man-Mce aj T c-M§1(4� and we�hweno R°of
employees.[NowosDs' 13_0mer
wrap.insum me required-)
'Aap"Pacwtaat cbecis boa A mast also ffirn the sechoaheTaw�sauiug fhe¢ ens`ca®pA'�++�+*poTicgia an
�1�eoarn�two sah�dris.af5davu im�g�+p sre�oia�sg�roifc aad.H�eahae amide cont<n�tsamst submit s net�a�da�iadiEnliao sacIL •
rGanaacros*deb d.this1=maststta aasddiiionsYsireeisbouaagthensmeoENze �dstste�hefhecatnotthaseea hsve
' emplay2es.Ifthes�-crra+m�I�ceemgtoSers,tfieYamst'Fmuidrthg'v 'imp-FaTcFa�h'e� '
lam�a eriipl gar ffiaf is pras�durg rcrorkets'aaarlrerrsafiun irrsrirarres jot eaipFa} Eehnv is Ae paZIcy=d jab srte
ig,�ar-rn�rl. .
Timm e,Company Dame: C
P4ficy 4 or in:L vc. 7_ t..:r C_ 6`-i Z Z
Job Site A,ddress_ 5Z D aCA-*•^ S-; N Cztg1S# el;.tg: /-1 Na✓rh.S AM
AL#•ach a copy of the workers'cbmpensationpoHey declaration page(showing the pDRcy somber and elpiration date)-
Failrire to serum coverage as required nudes Sadien 25A of MQ.a 15 can head to fhe imposition of coal peualfses of a
fide up to$150D-00 a=Vca-arse-yearin4k ism menf as will as ciO peuafties in the form of a STOP WORK ORDER and a fine
of up to$251LW a clay apt the viDL-dar. Be advised that a copy-of this statement maybe fkwarded to the COke of
InvesEpfiom of the DIA far ge ceriffcafinn_
Ido he-afry cgt&y under thie pains penaTtiw ajper kuy fhethir in}ar=afiatrpr rs&dabvn L;true and carrect
phoneme
aid aw anfJ: Da sat;vats in ffds mwa,ta be campieted by city ar6jrn a,O'rcfat
City or Tawsz:
lisming A.aflarity(carle one):
L Saard of health I Bmilirng Dgmlmeat 3.CitylTow.Clerk L Electrical hupecbr 5.PlnmWmg Iasgecfior
6.Other
COE"ct Person:
6;
ormation and hastructions '• ' -
tD praVI '�o��easZ'=fWfEC r emplayees-
7ysaccar7�mee CPdal Laws chapt�d 5 reties aIl Y��*'�"�' .
p �ibis ,an errployre is defined ss¢.every persdain$le se�vicc of Wffi==I=Ray caafrad ofhfir-,
=pr=or m3plied,oxal or' a
,j
An,=Vkyer is dd"med as'man incFvidaal,per,asncfifloa,cnpoxataon or atber IePI entity,ar any two or snore
of tho fategni ag in aJb = Pa•e andfaCb jFmg tine legal esenlafives of a deceased employer,or$an,
receiver or hasten,of an fi ffvidaa�p�iA amoc�tion or other legal entity,employing� �loY - l�owe ves tfze
ownea of a.dW'MM13g house havmgmt more tbEm three apartments and resides tbereaz,or fhc oc ofthe -
�IM P to do�ancr:,coris,rarfi-- -arrep2frwoxic.ons=h dwr ngha=e;
dwenmg house of �w� '�
or om the grounds or boiltfmg flMr D.in notbetaase of snch.emplaym=the deemedtn be an e3.ploye."
MCH-'cbapte r If2,§25C(6)also stains that LDeYerp sib or local sin *►a ag cy shall ixhold ffie issua�ace or
reaew,il of a&ceixse ar'per to,operate a business or to construct buildings is the co—Dnwt2I&for any
applic n•�Who has producednot acceptable uddencz of coxapL-mcm wig fhe insurance-rovezge rega
Add anaIly,MCrL cbapinr I52,§ ¢NMffi=the nor-- of3f3poIticalsubdivisions shah
enter izxto any caatract forthep�aace ofpnbHo�icmml a�ptable evid�ace of coznpiienc$with the msm�ce•
recpm extents of tixfs rizsgsEer havE bees pxeseoi�d in the c�* �a aaouEY-" :
AgpIicaats
Please El oirt tfie wo3�s'compensation affidavitcoxxrple#e1y,by g the boxes�apply to your situation and,if
necessary,amply sub�tar(s)nsine(s),address(es)andph=mmbe(s) alongwrththaz cc t[fjcate(s)off fha
m nthe
insurance. LauitedLiabiMty Companies(ILL)orLm t[edLiaHEdy?mt==hgs.(IU)wino empIoye s
mext&=or pates,axe notrbgmred.to easy works' comp�m ice- If an LLC orLLP does have
ployees,a cpoliy isreed. Be advisedtliatthis a$day¢maybe mbmiffad to flan,Department of InAxshid
em
Accid for confMnaf.�of mttr�=e s coverage Also be sin a to sign and daFE
� the afdapit Thu aidavit should
be ret=t-,d tD the:c:tr 0r tawn that the application for ff z putt or license is being iequest not the Department of ;
InhLsirid.A-c;cLdctg- Shouldyon have any gaestions regardmg the Jaw or tfyou are required to obtain a workers'
=mppensaH policy,please call the Depmt=z f atf c n=abrr listed below. Self-kS=;d eampanies sbnold eafet their
self-mace license nninber aza the approprl r IiIIe-
CYty or Town Officials
Please be s=that tine affidavit is cample#a andprhtrdlegihIy- The Depaximenthas provided a space at.tbe bo-ff=
of the affidavitfor,you to fM out intfae event the Office ofhmmfigafloos has to codmctyoarega¢-dmgthe applicant
Please be sure to fill in the pemtl'/licm=number wbich wM be used as a xrfe=co=mber- Iu-adciif nn,an applicant
ffiat must sabmt mvlliple pmmifficense applft�in any&M-year,need only �one affidavit bad
icai�g can:= :
pohcy information.Cif ne=Mary)and under`Job St-,Ad&c&-'fbe applicant shoudd..wiifm--aR locations to (may or-
fnwn): A copy oftheczfftdavitffiathas been officially stamped ormadcedbytht ci. ortovminaY beprovided in the
applica as proof that a valid affidavit is on Elm for fotme permits or licenses- A new affidavft=ast be fMcd.oirt esacfi
year-'Where a hDnie owner or tifzea is obtaining a license or perintnot im atrA to any business or commercial
(-in,-a dog license or pew to bran leaves etp.)said pe3san.fs NOT re[Jai d to C0113PICID this affidavit
Ibe OfEm of Inv W0r3AhIDeto:dm3kpauiaad mmforyovr c ooperatiamand.sbanldyaahave anygnestim
please do not hesifalm to givo us a c-
The,Department's ad&tss,telephone and fax -
T commmwmah of MaRsarlcusem ' < ,
Daarimmt ofJ&TjE�. t
_Ted.. x 617-' -WQO mft406 or I-4' 1&ASSAFR
Kevised4-24 D7 -7
S
1 +
� > Town of Barnstable
�^ Regulatory Services
3 'SS } Thomas F.Geiler,Director
. Building Division
Tom Perry, Building Commissioner'
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 �1 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I_ *VAa 00� , as Owner of the"subject property
hereby authorize "oh��N C�01&Aleck U I gzy,/ to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Ov#r D to
+�Olfy RV lI�
Print Name
If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on the reverse side.
r
Yachtsman Condominium Trust
Board of Trustees
500 Ocean Street
Hyannis,MA 02601
DATE
RE: Unit <S , 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, �, �On a /(�25�_ has been contracted by the Unit
Owner to perform the work as deft ed 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 d Penalties of Perjury this l day of , 20�
Se ry,
oard of T ustees
achtsman ondominium Trust
50 c Street(c/o Manager's Office)
Hyannis, MA 02601
Enc./File
AC40RV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
11/21/2016 i
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
NAME: Nancy Bums
CLEARY INSURANCE INC. PHONE (617)723-0700 FAX
AIC No):
E-MAIL
ADD Ens: nbums@clearyinsurance.com
226 CAUSEWAY ST. INSURERS AFFORDING COVERAGE NAIC N
BOSTON MA 02114 INSURERA: AMGUARD INSURANCE CO 42390
INSURED INSURER B: _ I
SANDY NECK BUILDING AND REMODELING LLC INSURERC:
INSURER D:
84 MINTON LANE INSURER E: i
WEST BARNSTABLE MA 02668 INSURER F:
COVERAGES ' CERTIFICATE NUMBER: 105117 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 ADDL SUER POUCY EFF POLICY EXP
LTR TYPE OF INSURANCE I=WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS
COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $
CLAIMS-MADE OCCUR DAMAGE TO RE
PREMISES Ea oaurrence $
MED EXP(Any one person) $
N/A PERSONAL&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY 0 PRO-
JECT LOC PRODUCTS-COMP/OPAGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $
Ea accid nt
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $
HIRED AUTOS NON-OWNED PROPERTY DAMAGE S
AUTOS Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LAB HCLAIMS-MADE NIA AGGREGATE $
DED RETENTION$ �/ $
WORKERS COMPENSATION /� STATUTE OERH
AND EMPLOYERTLIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 500,000
A OFFICERIMEMBEREXCLUDED? I N/Al NIA WA R2WC760743 08/14/2016 08/14/2017
(Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000
NIA
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay
claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts.
This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the
issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification
Search tool at www.mass.govAwd/workers-compensaflonAnvestgafions/.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I
Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. I
200 Main Street AUTHORIZED REPRESENTATIVE I
Hyannis MA 06010 �" 0 L v{`
Daniel M.Croy,CPCU,Vice President—Residual Market—WCRIBMA
@ 1988-2014 ACORD CORPORATION. All rights reserved. I
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
Massachusetts Department of Public Safety _ • __-
� Board of Building Regulations and Standards _I ~�T �� y gS $�License: CS-090335 OS� 1 °' ' t -
Construction Supervisor
This card acknowledges that the recipient has successfully completed a
ANTHONY M NESE , ` 10-hour Occupational Safety and Health Training Course in
84 MINTON LN ,, f� G Construction Safety and Health
WEST BARNSTABLE MA 02668 -
# = Anthony Nese
1 Expiration: Peter Rice 66873 8/6/2014
Commissioner 11/09/2018 (Trainer name—print or type) (Course end date)
c wowz,wto......eul6/z,alC 6zoaceu.Iell3
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR y t
Registration. 178731rpe t SAFETY CERTIFICATE
Expiration 5/13/2018 Corporation
Anthony Nese
SANDY NECK BUILDING&REMODELING LLC
Has completed Excellence In Safety=s Elevating Work Platform 8
ANTHONY NESE I ' "; `' ,Construction Forklift Operator Training at Shepley Wood Products,
Hyannis,MA.
84 MINTON LANE
W.BARNSTABLE,MA 02668 Undersecretary Richard Hughes,C.E.C.M. August 17,2006
Trainer Training date
Commonwealth of Massachusetts
[i GO Department of Public Safety
License: HE-128057
Hoisting Engineer
ANTHONY M NES
E
84 MINTON LN
WEST BARNSTABLE MA 02668
Expiration:
Commissioner 11l0912018