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HomeMy WebLinkAbout0500 OCEAN STREET (33) 3�y D-yD e;2)m Gtn 4 9 71; Ab, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q R [ l Map Parcel D Ya 0 2M Application # /w�— ,��� Health Division Date Issued Conservation Division Application Fee l Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address XASPr14YA Village td^7 kMi'\r S Owner A-2 R Y LO (�'�\�i �S Address �ov� Telephone 7a g,( 52-33 Permit Request 7( 6gN_e6y( I)0 5 ) S O��-ate (3) GAS Z_7�m L,-J ).0 6_'�5cztas 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) A00 '� Age of Existing Structure Historic House: ❑Yes *o On Old King's Highway: ❑Yes XNo Basement Type: ❑ Full ❑Crawl 0 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: 0 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 ❑ 1W Commercial ❑Yes ❑ No If yes, site plan review# _ cn Current Use Proposed Use �'' rn APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 5t-jtnJ�� 1+eFj2a, Telephone Number �50cf_ - -Z Address 1Z PIN6 60VE beLJ UC•- License#415"``04_ $q ( 710 fad/7) W , Home Improvement Contractor# Email . LACTZ� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AMSIGNATURE DATE I i 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. Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DATE RE: Unit g g , 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, has been contracted by the Unit Owner to perform the work as de fined m the roposal. 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 day off , 20k, Secre Board of Trustees -V achtsman Condominium Trust 500 Ocean Street(c/o Manager's Office) Hyannis,MA 02601 Enc./File d S 01r an A�® CERTIFICATE OF LIABILITY INSURANCE ��` 9�13/)16 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 endorsemen s). PRODUCER NONTACT AME: Ben Chisholm Chisholm Insurance Agency, Inc PHONE (508) 358-6111 (508) 358-5324 PO Box 399 E-MAIL ADDRESS: Wayland, MA 01778 INSURE S AFFORDING COVERAGE NAIC# INSURERA:Western World Insurance INSURED INSURER B: Steven L Hetzel INSURERC: Lewis Bay Builders INSURERD: 72 Pine Cone Drive INSURER E: West Yarmouth, MA 02673 INSURERF: COVERAGES CERTIFICATE NUMBER: 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 SUBR POLICY EFF POLICY EXP LTR IYPEOFINSURANCE INSR WVID POLICY NUMBER MIDDY MMIDD/YYYY LIMITS A GENERAL LIABILITY, NPP8291055 9/19/15 9/19/16 EACH OCCURRENCE $ 1,000,000 }( COMMERCIAL GENERALLIABILITY DAMAGE TO RENTED RE I E ce $ 100 000 CLAIMS-MADE Fx_1 OCCUR MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $ 1,000,000 POLICY PO- LOC $ AUTOMOBILE LIABILITY CONE INEEDtSINGLELIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _AUTOS eraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTNE OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENIT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Isregrired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Barbara Tomkins ACCORDANCE WITH THE POLICY PROVISIONS. 500 Ocean St Unit 88 Hyannis, MA 02601 AUTHOREZED REPRESENTATIVE THOMAS B CHISHOLM © 1988 2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: t Massachusetts De Board of B Department t of Public Safety - ^-.�� Building Regulations and License: CS_10�4 Standards Construction Supervisor STEVEN L HETZEL`` 72 PINE CONE DRIVE €`YARMOU WEST e° -A- TH MA 02673 is �•�+ - rn• 'G l)'149 6'� corpmissioner`-- Expiration: 97/27/2647 11,1otearrmectIllba/bAl��er�clicJeGGt f _ Office of Consumer Affairs&Business Regulattow — $OME IMPROVEMENT CONTRACTOR Type:; registration: 165119 xpiration 1(TI2018 Individual: jr �1t �y ' STEVEN HETZEL .:;ST.EVEN HETZEL t ^3 - 72PINE CONE DR W.YARMOUTH,MA 02673 Undersecretary "1 he C672xmouive-alth of-Massachusetts Demwtrra,-jrt afraulrfstrialAccideTrts 600 Washington kreet y nYvt-v nzassgvv1d a W"kcere Campensa<fan.Insurance Affidavit BmlderslContractorsiFIedricians/Plmbers Applicant Informadu r / r Please.Print 1&agii iI 1V q amBncinP c? 3I]5231�II(Tnd - na�_ �'l/�� ✓�c�G� �l�'J lJf IJ �01(J^ J Address. (20Y)� D Q( � E Cit 24 3Plrant; ®s Are you an employer?GTteckthe appropriate.bow T project . eral contractor and I YI}e of F ]ect(r ��- I.El I am a employer u ith ❑I am aeu g 6- ❑New construction employees(full an-Wor part-time).* hai a luredthe sub contractors 2�I am a sale h b etor or fisted on the attached sheet, 2- ❑Remodel ng F Pen.er- These so -contractors have slop and havee n no s ememployees. Th $_ ❑Demolition wort:ing far isle in any capacity employees and have work-ere 9. ❑Building addition [No Worlous'camp.iirsmanc0 comp.insuranoel rewired I 5. ❑ We are a corporation and its 10,❑Elecfucal repairs or ad&sons 3.❑ I am.a homeawner doing all;work of'rrcen have exercised their 1L❑Flnmbingrepairs or additions ex front per MGL myself[No workers' right of comp- � 12.❑Roafrepairs . insurance required,]i c.152,§l(4X andwe fsxve no employees.[Na wo-IjEffs' 13Other � comp-insurance required.Z 'Aar a ppEimrffiatchet csboxPimast also Uoutthesectionbe7aarshuwkZffi& uoiRexeeompevsa npo&cginformauoa_ I gnmeosvners who submit iris dfiidz%,R m&cxGng&-y am data;alF-at and,t5ea.hire outside contmctars nmst submit a new affidaYit indicatia scacSL rC'anitmabrs tfist rhw1 thin box must attached as additional sheet shown ag the acne of the sub-contwUaa and swawhether ornotTImse eat¢tieshase employees Uthestt5tantnctmshaceeanpIofees,t6ey=ntpm-!detheir nrorke a=p.policy number. I am an euepF�jr t7srrt is prax2dvzg,workers'caatp eresaharr irrsrirarice for m}encp£vy�ees Beloav is the pnficy�arrd jabs information Insurance Company Name- -P•ohcy 4 or Sew-ins.I ic_ ExpirationDate_ Job Site Address: CivistatetZY01 Attach a copy of the worlrers'coanpensalionpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as requuedunder Section 25A of MGL c 15,7 can lead to the imipositiau of criminal penalties of a fine up to$1,500,00 aadlar one year imprimnment,as weal as civil peualties.in the form of a ST.OP WORK ORDEILazrd.a frtre of up to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DI,A for insurance-coverage v-erification.. I do he reby c&Y rye the pears prrjne}'t7iatf3te urfbrrria€imrprw'Ukd abo�ns Ear:d correct S�i.ffiature_ Date: `� Phone A- tl f Mal use aury. Do not a€rite in tfds area,to be compkdd by city Qrtanrli ofj'rctat City or T'onw. PermitUcense 4 Esuing kathority(ci dle one): L Bom.A-of Health 2.RuMing Department 3.CRylrown O1erk 4:Electrical Iuspecto€ S.PPIumbmg Inspecter 6.t3&W Con-tact Person: Phone#: --- —- — 6 r. -Worm a�ad last efion& , ,. Maccar3setts General Laws chapter 152 requires all empIoyers tD provide workers'compensation for flieir employles. p=ani-tn this ,an employee is deed as"_.everypersonin the service of another under airy cordract Ofb'M, 1 express or implied,Oral or veriEfem" arts assD�ion,corpora ion or other Iegal�y or my two or more An�aplayer is defozed as"an indrvidnA p mmh�, Of the foregoing eng�m adomt enteipnse,a udincln.dmg tho legal re presentatives of a deceased employe,or the receiver or trustee of as iafividnal,parta.�p,association or other Iegal mf tL employing employees. However the owner of a dweIling house having not more than tlrree apa dments and who resides therein,or the occapa ut of 1he - dweHiag house of another who employs persons to do mahfimm=,construction or repair work on such dweIIing house or on the grounds or building app thereto sh-MnDtbecanse of such eaeplaymmtbe deemed to be an employer." MQ.chapter 152,§25C(6)also states that"every stag 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 commDnwealfh for any applicant who has not produced acceptable evidence of compIiah�witTi the iIIsurance cov�ragerequired. the cor�onwealfhnor nay ofifs political subdivisions shall SZ 25 states"Neither _ . Additionally,MQ.chapter I ,§ C(� - mt�r intD any confrdct for the performance ofpublic work until acceptable evidence of compliance with.the msmance._ req uentn of his cbapterhave been pry ntedto the cntracting auh0iV-' , APplicanLS Please fill obit the workers'compensation affidavit completely,by rhecki gl-e boxes ffia±apply to your sitnation and,if necessary,supply sob-contcactor(s)nam(-,(s), addresses)and phonenumber(s) along withtheircerifficat*)of i o, cb. L-Iro d Li;-c linty Companies(LLC)or Linited Liability Partaersbips(LLP)Wn no employees other f m the members or pal Enema are not required to cagy wormers' compensation mswan=. Fran LLC'or LLP does have emp cc loye=s,aPolicy is required. Be advised t3�atthis a$idayit may be mbmitfed to the De of Indushial ould Accidents for confnmaiion of in�nce coverage. Also be sure to sign and date-t-he affi-davit The affidavit sh be ref�ed to$e city or town brat the application fur the pewit or license is being regnesfrd,not file Department of Indnstrial Accidents. Shouldyou have any questions regarding tTie law or ifyou.are required to obtain a workers' compensation policy,please call the Dep amine t at the nmober listed below. Self-insured companies sTionld mttr their self-insmmce license zrnmber on the appropriate Imo. City or Town Officials Please be sire that the affidavit is complete andpridea.Ieg 1y. The Department has provided a space at the bothom ofthe affidavit for yours El out tatbe event the Office oflnv'estigafions has to conactyoumgardingthe agpIirana tnt Pleasebesureto Ell m the pennit aensemm�ber which wMbe used asareferencenumber. Inaddition,anaFPli that must submit multiple pennWHcense applicafions in any&MYe-ar,need only submit one affidav>t indices g can',-at policy inl�r matioa(>f necessary)and under"Job ShD A-Caress"the applicant shoLld v rite 'all locations n ( 'or town)-"A copy ofthe•affidavittbathas been officially stamped ormarked bythz city or town may be provided fo the applicant as proof that a valid affidx&is on fie for fafm-e pmnifs or licenses A new affidavit must be ffiIed out each year.,Where a home owner or citizen is obfaainmg a license or pennitnct related to any bnsiness or commercial vent rem Cie. a dog license orpezmitta buin leaves eta.)saidpersm is N0Treqqb:edto complete this affidavit The Office of Investigations would ac to thank you in.advance for your cooperaiian and should you have any questions- please do not heskate to give us a calL The Depar[ment's address,telephone and fax number: . Thu Cc anWealth of Massa.ahn.&tt�-- ' Degartmmt cif Iidustial AQP-id�ut�--' Mace at l otio-u� 64��as]zin�tan t $wton,MA( I11 D,1.4 617' -49OG cxt 406 4r 1477 MA SAFE Fax#617`27 7M gevised¢24-o7 .ma��ug�dia. . , . Town of Barnstable w Regulatory Services MASS ` Richard V.Scali,Director Building Division. Paul Roma,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 I. 3prC�(dj(� - �jOY1� K r S , as Owner of the subject property hereby authorize S'YC-VCO ZcL._- to act on my behalf, in all matters relative to work authorized by this building permit application for. 500 eC6RVJ -s� + gg (Address.of Job) **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 Owner C&igdatore of Applicant Print Name Print Name 91114 Icy Date QXORMS:OWNERPERMIISSIONPOOLS