Loading...
HomeMy WebLinkAbout0500 OCEAN STREET (38) QC)® Qcaa_y,-, S4-, C)LI O �M i s-Z�-7'(P P %ow'r! or, 13� � Commonwealth of Massachusetts 3a'i olo/o C� it l � yet .,,�a e leap j ) Parcel MAY j Date:. 5-0-1(0 9 to t TOIAVAI Estimated Job Cost: $ l 100 , Plans'Submitted YES NO Plans Reviewed: YES NO Business License# Y Applicant License _ Id-4 Business Inform,ation. Property Dwner/Job Location Information: -1 t ��. Name: 4 —T Name: �orh ��T1//z.Street: Street: /000, aevg city/Town: �V_ awmA A4 o2G73 CitylTown: tlrl/f, /W Telephone: 8. 775 -130 _ Telephone; 564J (/7.5/3—fad Photo I A required/.Copy of Photo I.D. attached: YES X NO staff Initial estricted license J-21 Mr2-restricted to dwellings 3=stories or less and commercial up�to l 0 000 sq. ft. /2-stories or less Residential: 1-2 family Muilti4amily Condo!`Townhouses Other Commercial Office Retail Industrial- Educational Fire Dept. Approval LL—Q v Institutional Other Square)Footage; under 10,000 sq. ft. over 10;00,0'sq. ft., Number of Stories: Sheet metal work to be completed' New Work: Renovation: HVA.0 Metal.Watershed Roofing Kitchen Exhaust System Metal Chimney[Vents: Air Balancing, Provide detailed description of work to be done: INSURANCE COVERAGE: I have a current mobility insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No ❑ if you have checked)LU,indicate the type of coverage by checking the appropriate box below: A liability insurance-policy..- _ :. . Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 By checking this box I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: iy ❑ Master r itle ❑ Master-Restricted ;ity/Town ❑Joumeyperson Signature of Licensee 'ermit# ❑Joumeyperson-Restricted License Number: ee$ h , ❑ Check at www.mass,govldal ispector Signature of Permit Approval . The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Rusty's Inc. Address:222 Mid-Tech Drive City/State/Zip:West Yarmouth, MA 02673 Phone#:508-775-1303 Are you an employer?Check the appropriate box: Type of project(required): 1.X I am a employer with 28 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "Any applicant that checks box#1 must also fill 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. :Contractors that check 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 employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Merchants Mutual Insurance Company Policy#or Self-ins. Lic.#:WCA49099225 Expiration Date:01/01/2017 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$1,500.00 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties of perjury that the information provided above is true and correct. Signature: N Date: Phone#: 508-775-1305 Official use only. Do not write in this area,to 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town o `arfs a k o: egu aOr Serytees Th6uias FF.'Geiler;Director FD 01 Building Division TOM Perry,Building Commissioner 200 Main Street,Hyannis,MA 0260.1, w�vw,toWA.bkrn"stab1&1ua.us Office: 5 8462-4038 Fax 508-790=6230; Propel Owner Must Cmpete"ad n.This Sect ® f Us no,A Wl er T, .I u1ca� �« ,as Owner of the subject"pxoperty: heteb authorize /ZU:y� it Y to act on my beef,: in all matters reladve to work authoried;by this-building"permit SO(� cem Sf (,IGJry- #l/2 �Q-4i73man (Addreis of job) -�-- Pool"fences and:alarrns are the responsibility"qf the applicant. I?ooI's are" P Pt,to be. filled before fence is installed and pools are not to°be Utilized until alt;final.inspections are performed anad accept d., S a e of Oc¢net Signature of Applicant 7 Al4v�-- hifitNName prixit Name 17 !� Dale Q Fox�SPWw gi SSrnNroOLS VU 73 g� ON6064 DR KERLEPRl1M l�NF tortes } E SANQ4yICH �171 02 37 1701 5 DD 05-2D-I013 Rev 07.1&4009 �` ® .�. Zf fCn�'� sp{ 4'{.tF�:.� � ✓ +"k i.� i"' ��jJ7i p,� � t t '; �}-v✓,;j'�► M`•k�-d'T %Tr`a v'.n *�'v'`�r*rT y,'� r � 1•�i,,�i�'r-'i�'�y �*' g,.�,y_ 1r i��,i'sS S i tis7. '4 ks ��% - ��+a` 3�`�'.zs S r F�'ast,•jpgt�u. y et d:y R.h z ,t AtN,� 51k w 7�yz - w.m"�'z P3}fit`zf�(+ � •hl'�. ��G "'�,7 ;�X 11,11Zip .r � jCN f h i �`ll�f �£ . " t�»�a�'�t��t• �,�tzt' o r'"r �F�'��'�, 7c ��, Bch 3, ; ' Sh s� .F4 t y� F �• . �,.3t� i a��SY5Y._ ua.�tEt±_� .�.�, :: d..v[.$....,s�X;t.....�., a t�..�.:s� _.•� r J Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DATE (Y)6 Q.a RE: Unit J —, 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 pro oral to be performed.as is delineated in the request we receive om a nl wners. Contractor; has been contracted by the Unit Owner to perform the work as defiized 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 c ` day of� 20�, ecre Board.of ees Condominium Trust 5000 Ocean.Street(c/o Manager's Office) Hyannis,MA 02601 Enc./File G 1 i � fl btaC i The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Yachtsman Condominium Trust PM Office: (508)775-1515 Requirements for Completing Improvements Requests 1. Requests should be in the form of a legible,written description of changes/modifications being requested. 2. Requests should include as much detail as possible,to expedite the process of approval. 3. For changes that affect the exterior of the unit, include a photograph of the exterior of the unit indicating where the change will occur and how it will look relative to the adjacent units. 4. Attach additional pages with documents and pictures to clarify what is being planned. 5. Submit the request directly to the Property Management Office(NOT to individual BOT members). 6. The Board will consider Unit Owner Requests submitted at the monthly BOT meetings. 7. Failure to provide details of a request may result in approval being deferred, pending required details. 8. If assistance is needed filling out the request contact the Property Managers. They will be happy to assist with any questions you may have and can provide guidance on what details are required for approval consideration. 9. For most requests the process to final approval can take a minimum of a month, if not more if required information is missing. When planning,please provide yourself the lead time. 10. All improvement requests MUST include a copy of the Contractors insurance,workman's compensation and liability,and their license,for requests to be considered for Approval. 11. All improvement requests MUST include a copy of permits for any work affecting plumbing,electrical and/or structure, based on the by-laws,for it to be considered for Approval. 12. It is the responsibility of the unit owner to make arrangements to get a key to the contractors for their improvement projects.The Property Management Office WILL NO LONGER be permitted to give out keys. 13. Per the Town of Barnstable regulations,copies of permits must be put in a window visible from the parking lot or street while work is being performed in the unit. 14. Contractors are responsible to remove all materials and trash from the property that is associated with your project.Trash should NOT be put in the Yachtsman Truck OR left out to be picked up by the Property Managers. 15. Once an Improvement Request is approved,the APPROVAL EXPIRES after 6 months. If a project is delayed the unit owner MUST resubmit the request to the Property Management Office for review and re-approval. 16. The Property Management Office should be notified of the schedule for Contractors being on the property. 17. 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. 1 Please confirm below your understanding of the above requirements to support the submissions of requests. Jaclyn P.Korb Personal Residence Trust 112 Unit Owner Name(please print) Unit k trustee _ 3/23/16 Unit O 3fgnature Date YCT Improvement Request Form (last updated Mar'2014) The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Yachtsman Condominium Trust PM Office: (508)775-1515 Unit Owner Improvement Request [, (we)Jason Korb,trustee of Jaclyn P.Korb Personal Residence Trustowners of unit# 112 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., permission for our contractor to carry out the following improvements/alterations: Contractor Name:: Place an"X"in the box to indicate type of improvement.Include below and in attachments the type of equipment&location of installation below © Windows/ Heat/Air Unit ❑Front Door/ ❑Other Sliders Conditioning Remodeling Front Screen Door Improvement Attached pages,where needed,to provide details of the improvement being planned. We request permission to complete the following improvements.Mass Quality Construction,Inc.,a fully licensed and insured contractor,will complete this work.An insurance certificate from a recent project is attached(a certificate naming the trust as an additional insured will be provided prior to work)and copy of the building permit will be provided to the Trust prior to the commencement of any work.At the completion of the work,a fully signed building permit from the Town will be provided to the Trust. 1. First floor slider:Remove air conditioner and wall adjacent to existing slider and add fixed pane to match existing slider manufacturer,color,and trim.See picture la.of existing condition and picture lb.of Unit 124 that shows proposed conditions.Proposed improvements will match Unit 124, including trim,etc.Structural engineer will be consulted prior to applying for building permit. 2. Third floor bedroom:Replace existing closet above existing bathroom with new bathroom(toilet,shower and sink).All plumbing and electric to code. Dryer duct:Duct er through second floor bedroom to parking lot side to meet code.Louvered vent,as specified by Trust,to be installed (5. ugh shingles. Skylight: interior mechanical shade to skylight. ird floor balcony facing beach:Add railing to match Karen and Steve Patalano's unit.We have pictures and plans of Mr.and Mrs.Patalano's rail so that we can match precisely.Structural engineer will be consulted prior to applying for building permit. 6. Air conditioner sleeves:Replace rusting air conditioner sleeves at contractor's and owner's discretion based on existing conditions.New sleeves to match material and color of exist' g sleeves. Yam- trustee _3/23/16 Unit er Signature Date Submitted: 617-513-6320 iasonh�n_kn�rh mail-com Unit Owner Phone Email Ad resd s Please submit this form to the Property Management Office(PMO)for Review Date received by PMO Date of I"Submission to the Board for Approval: Date final Board Approval Received: YCT Improvement Request Form (last updated Mar'2014) Handrail•,1Pg https://mait..google.com/,_/scs/mail stati:/ /is/k= mail.maiD.en.2Hb6... _ x h v jn C � S 4 c?2^ f• 4 Q � � 3 w x � a x� »� a q X � Y 1.of i 3/30/2,015 8 24 ANT _.. �..".-.1­1.-1,.4..­,-.­.."­I.1...,"-..-__...41.T-4­_ ..£ i € } —...,-:......I.1III;-.iz 1....::.iIz��-..*.-"1*..1.1..k...�.,_...1,.1."....;......1-............1 4...._.I...L;!-.'�.....1 r;.I.....L;I. .1-.1I.­�-,.�...—.­1...'_t—.4,...­..­.1-1........+I.I::.1:.....ric�,�... x j + _ i- Y"_j""'..,"'tw.` `<`,. ---' .�... ..^....,_ s,<x . -d^.b...,r-.�.au _.- "� ..M.<, r . . L. .:. Y r .- .. :,.i,....... ......, € . s .,€ E. t .€.. 3r: %<? � �' d? C .tee. ? ,_..i.x.. ..:..€, ,. .....� $ 9 , . s __ ....... .. ' =Y ; {.. .ia 3t .i t...,, .. x = _ ..... .. „." >_ 'f •'s. M 7 € 'S- _.."_..€ .r 3... F. .3_,..1. ..... > = s F £ , .-y ..... .«^.. "per (( J.. .. } -..e:.:. .; ._.. p =T .#.. ...i.... _ § ... ..i i.�W ..,,L .".. 8 1 }- , ...n 4 r' �... .......I 1 f 7 .... : r < .. .. _.. # . t.. } . f , i , I s ~r-. ..w III2 ,...". III...^ ..e d...a... '. f?{ tt I Y .,� 1.., ..w.3.._.F.. x '..... i 1-1.p. '. .... ... r I x -^.1 ;.. ..t.... > , _i 4 - ' - ... { _» 3 .:...# € ...__. a.._ . ..... Em ...g ., .: .. i 9 I . ..'r< ,.»sue.«£"' , x , ,....3 , # - t- i 1 g.::. ".>..x..... A m I I. "... _: . ...._ . ... i ... € 1 4 _. § l _b ... ...._ . : - I E .. .. F _. 3 1 a ' ; 7 f. -,^.�} z €., pj _ - •--_,n.- € b ^^. ...... .e.. , i _. €, < b 1 a e # € f : ._.r_ rz»ya�Rn^z5 I ,.«»_."^y""'&..">'.: 're*.- srw. j ._ p. :_..: ..i 4 € 4 .. t' ^s i,. !,. .-,y,.. r -'--=fi dE £ € .. 'w€^„-< s k < I F , .3f....^. .i. ..... :.: w" . ..4 E 3 '£ :.;, . „„,,, . . #. i t i I j i € p. # -r-.: d ....,. .: A.':' 'x i f I F. ....... f ....H «^.$-.. ....i E 3 # d 3 t d d. :,.. i r i. } t _.# i j ynN ',+ I i x .q s „..,». ...,. j €_a_ .,, w..,s .^.� 4 t � .� :,f i f.. }.. ,� „.,F,:, 1 4. ...y...^pI. - $ F d :. s i... € : '. t ! € i ' ....S. s._,4 £ -' } € S i - 3 ;. # 3 L_ ,,,..} ...f f.. y .f ...{. 3 Y:^.,p.,,..q#1-� F-�Tt � L.I....4 Y ' F 1.. _� ....,.... .y, i....... g.. e # I 111 ._y. x 4 ...1. ,r yj g t 77 1 i € �- k .:. `` i;er..§ a2Y' cr,}bjt `� i E € I I E - € .. .... ... 99 i ... .1 .:s :... „._.p , ..;... I i. ^.:..,e..L. } t i € �€ ^... s -, : _.. j 3"_- . .. _..; i 4 { , ..A «:,_ ., q .i.... .I. c.....t,.. f } ..b... t 1....,,$a,.,. 5 . 7' t .._.,..�." ^£ ( # ..� # b...... is .f....}.. i _ E i 4 {((( 3 S t ', , f . q s F ,.., j a < . i ._... I g .....? ."..... i i ..,..- ..^. .,. 1 . .._ t t ...€ „,.....h" x^,�.__€,,.,.. 1- ..... € 4 i # .. ,f,. f.. ..".µ....,,y r ....� Y. = t i i ..,i_,_s . x. ?. ...,....., ....._a,-.,.F..__:.,.... _j- b... f f 3 € _.._.L i S �..._f F ( h 4' f .....t,.... ....€� ..._b... ..a,........^ ......:... ......y 3 S F t Y. „. ... ; f j I ? # ...q.... .".. .}. S. ...N.. a. N„, >...,d, ...,a...` F j. i 2 i 3 3 € } i¢{^ B ji € ;,_ a 1i _.e...... :. ,.. €' x 3 € ' _ , r 3 t .... P T . §..... �. ..S. 5' n € .. 1. #,. 3 }j- i < jtg - Y ...p...-„„,..t-". ._.,... � i.....y. s"_c n._.i } 77 t { 3 3 f ..."�.. i. € �.. r € ,..n^,. ,...,..,y.,l.....,!w -i # 4.. Y D 4 d f # € ....,.v.". .b,..,,,"e.. ,. , . . 3 } . r. , t - , 9 '} .....i.. , E.„...F.. f ...........x„,. ......"... ......>... . "...:...w^ €.. €, 4 ... : t . : F 3 i : , , .§,..... F:..... .4 f . ... ,ty.. ..."q.,,k: ...y .... t ,.. 3 r ,,. , y , [ w 1 .. .. _... .....L " n ? , . s . . r f � r..... .. 1...,........ ...... I I a. ._ .,,...,..""'. .. ...,i ......a. ..i.. w, a 'I , t r f , i:.. n a< t 3 Picture 1a: Existing condition, add fixed pane and trim to match Unit 124 k r e axe r it t �n q Picture 1b: Unit 124, Unit 112 proposal to match Unit 124 Doc=1n263PS74 02-23-2015 2:52 BARNSTASLE LAND COURT REGISTRY YACHTSMAN CONDOMINIUM TRUST CERTIFICATE OF TRUSTEES We,the undersigned being a majority of the Trustees of the Yachtsman Condominium Trust under Declaration of Trust dated January 1, 1989 and recorded with the Barnstable County Registry District of the Land Court as Document#475622 and noted on Certificate of Title #C-2I,hereby certify pursuant to Article III of said Trust that the following persons are the current members of the Board of Trustees and hereby confirm the acceptance of the same: Name Term Expires Robert Am s June,2017 Ac ond Do cityJune,2015 T vin June,2016 Richard A.Gagne June,2017 s� Stcv n Potalano June, 2016 Executed under seal as of the Ll� day of ,J` r DOU .t S R,,CSASTREE `' Netr;y f�ubllC Mailing Address: t C00ONkA-::I6:;a, SACNUMM Yachtsman Condominium Trust M 'MY Cotnrtdssiorc FIreo Jtuwaty ti,201� c/o Crabtree CPA&Associates 426 North Street Hyannis,MA 02601-5132 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 'SIyQy\n Parcel OCV Application A 0 Health Division Date Issued — `� Conservation Division Application Fee 1 b Planning Dept. Permit FeeIZ12 0_ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis 'Project Street Address �_J cAr 11 hN W Village h K"I �Owner1c �N. on . roi p�5�rv�\406t 14 Address Cb ,�50^ Telephone �dl IBIS Permit Request !J c� " h r y p (�r,,, In ✓ �• \ S� i f a-v o I-e S -e �-t NO `CILL e C S k` ��,�. G ram- .a 4C 1 cL,1 v V Jr ►,Sim/% Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation pea.,•BJ 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 (s/q.ft) Number of Baths: Full: existing �- new I Half: existing / new Number of Bedrooms: - existing J new Total Room Count (not including baths): existing �new D First Floor Room Count Heat Type and Fuel: UdGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes LKl 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 ❑ ' n Commercial ❑Yes ❑ No If yes, site plan review # Current Use �. 2. s L�;l Proposed Use XN Zi �. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r Name 7 G: ` '1 �GD�wcr r� r' Telephone Number Address K(7 Ch/( ✓l �M'r �- �p� z License# 6 i U 0A 1 Iv54 1 � ��3 Home Improvement Contractor# { �k .cso &L. ' Email C_,A&Q uatflaGohS{T#&-hU11@gA* Worker's Compensation # IJ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE V fp FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE F INSPECTION:0 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 60 Wm*i3yfvw Sb-est • svfc�u rgr�rFu� - wcff- BugdersfC�o-uhma rsj'M¢cfrFciansfP =hers Apgdigmt Islfr rain P si Frind Lezihfy Name Are yen an etapInyer?Checktlm rzTpra r'ratE:ba= Type of 1pro ect I_El am a employer vrsfrt 4 ❑ I Sm a ger�z-I cc���r and I ItTe 3 = eazpiapees{€u3l.agdfflcgaLt-•t�e�* bav��i�fi�subE�s 2 I am a sdIe p orpartner- listed on the at#athed 6jmt 7- ❑R�ade�g I soxtai he iipadhavenoemploys - IemnmCL mug form$is my r_apac-dy ���andhave vro��' 9_ ❑Building addiiian [fVa�voi ' cflmp-;nsrrmce comp_rt,surar�X 5- ❑ We am a cotporaticnaud its IO❑EiPrinral�pg�ar addHtnns 3_❑ I am a hom5uuner doing ail ward afi=have e=rrised their I I-❑Plumbing n-Paim of additions ps' of eszmptioa per MCIL �3'�-� �oWar n �' �ISM§It4},and�eT�em3 12_[]Itnafn�xaizs iizsun=e requimd-I'F 13-0 other Mlploy�-[Nawa lMM' comp_zn�tance x�re3-� y�xy h�ibatcheri- 11=st also ffiouttheset-ffonb9awshacEh3r eawo�eaTrflam�satiouperTir3 i tm lio-menanetsui�Mbrat-Ib& is g fey MM dam,-=IIr.-4-•4 hLma azto&contiact�mnsi s�vr�aair x�d��t maul sadL a•thst c1,rY t xis bas must stoic ed m vMifi"O sh Mib-O=&ICtoa=isbdp whether urnaiilxise 2rai5esb,-vim ampIayees_ Ifthesafrcantadashaveempl theyffistgmuidetires tvarh�'tamg.pawmnnbrL t ri arz InyeF th6tisgrf v&hg tror&ers'cgwpanmd=trmzrzrrtcs for rrzy etsiplayrecs. Belot?is f lep�&cp trod job vita Fr�vrrrtQ£ic.�. p asu,:7Enm companyN 1IIC: P-0Rcy4 or Seif-ins UcJk Fmpiratio-mDate: Tab��Adder - CdgfState(�p: Attach a_cvpy Gf the-wGrlcere compe affim pv&tT lleclarstiou page-(showing thegoULT nu-nrbM7 and.crpiratioa'date). Fa-Ram to st=-coverage a&raTaire under Sectioct SA ofNIli-L c 152 ran lead to the peaaiHi S of a fig up to$L•5010}and/or a>L--yearimp ,as wen as d-vil peffalf; in t)1e foffi of a STOP WORK ORDER—and a fine of Up to S-250-00 a day against the violator_ Be advised that a Copy of this statement maybe fm-warded to tht Dff m of IaresEgstioas of the DM fur inssar r,�coverage vacation_ .I a Faereiy cerffp under tha pdw unepY fees fh uz-{vrnza#raa pratrzd�d¢bare t`s hiss and correct rt;smat W ]date 2 �//J 6zcur£ass rxn£•F. Z?•c tcat tRrif�s in tFzis area,to ha cirrrzpleted by�ar tntrn rr�cia£ - . Ci y or Tawm -- I'erc�sFflTareIISe� �g Aath�ity{circIt txne�: . • L Sward 4f Health 2.$mIding Ileppal tnzl--mt I afpTawm Clot 4..I:Iectiical E sp5c€ur S.Phurbing Etrtor 5.Ckbrr G . Mass•3r�fusqts Gen-eral Laws cater 152 regoires.eII emglay=to provide workers'compeusaion fine heir errcpIoyees, Pt�ant to this ,an anployee is demzeed as"__VVMY person in fhe service of another under any couir�ct ofbire, express or iMpIied, oral or WditC ." An ezrpL5yer is&Eaed as"m individual,parfnedsbin,associI'6on,corporation or other legal e tfi or any two or more ofthe foreggmg mgag-d in a joint and mchuiingthe Iega1 representatives of a deceased employer,-or the receiv=or trustee of an individual,partrim3htp,association or other legal etifjiy, _mploymg employee•,. Rowever the owner of adwelling-house having not mare than fiue:e apartments and who resides therein or the occupant oftfie - dwelliag house of another who employs pemons to do mairrmance,canstrziction or repair work on such dwelling house or on the grounds or building appurtenant&=to shaIl not because of such eoipIDyment be deemed to be-an employer." MGL chapter 152, §2.SC(6)also stains that"every state or Iocal licensing agency shaII withhold the'issuance or renewal of a Fieetise or permit to operate a business or to construct buildings in the coinraonwcalth for any applicant who has notprnduced acceptable evidence'of coiupliance with the i Lmmnce.coverage required.- Additionally, IVIGL chapter 152, §2SC(7)states"Neither the commonwealth nor any of its.polilical subdivisions shall enter into may cantrzact for the performance of public work until amtptable evidence of compliance with the;,,emance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your siivation and,if necessary, supply sub-contractors)name(s), addir_ss(es)and phone number(s)along with their cez--Enca'ie(s) of iiisu nce. Limited Liability Companies(LLC)or Limltnd Liability Partnerships(LU)with po employees Dozer than the members or partners,are not required to carry wormers' CoMptasatiDn insnra,ce. If an LLC or LLP does have employees;a policy is r(-_gnirech Re advised that ibis affidavit maybe submitted ti)the Department of Industrial Accidents for confirmation ofmnce coverage. Also be sure to sigu and date the affidavit The affidavit should be mtzmed to the city or gown that the application for the permit or license is being requested,riot the Department of Industrial Accidents. Should you have any questions regarding tie law or if you are mgnired to obtain a workers' compensation'policy,please call the Department at the number listed below. Self-insured companies should eatez their self-insum mce licz' -number on the appropriate Haee. . City,or Town Officials Please be surer tliat`tlie affidavit.is complete andprinthd legfly. The Deparhnenthas provided a space of the but i" . of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding to applicant Please be sure.,to fill in the pemit/Iieense number which-r,M be used'as a reference number. In addition-an applicant that must submit multiple penalit/ficense applications in any given year,need only submit one affidavit indicating current policy infb=at ion(ifnmrssary)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 fur fut ure permits or licenses Anew affidavit must be Elect out each year.Where a home owner or citizen is obtaining a license or permit not related tn'any business or commercial vent ze (i e.a dog license or permit to bum leaves etc.)said person is NOT required to completr this affida�7it The Office of Investigations.would like to thank you is advmmce for your cooperation and should you have any questions, please do nothesitate to giyeti§a call The Department's address,telephone and fax nttmber + Thy CDin - v TWa of Mas5achusrv� . D=_paz cat 6f Indaistrfal A(�aidcmt GM �astaa.,MA G21 I 1 Tel.9 f 17` 27- 905 4-06 ar 14 SAFE• . Revised 4 24-07 F=4 617-727- 4-4 .ems, �oVdia Town of Barnstable °} Regulatory Services ,t R�RTTC�'1SLfR s r ns�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 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using; A Builder I, as Owner of the subject property J P PAY hereby authorize OJ 1q rn d/v S���G�4�1 TV act on my behalf in all matters relative to work authorized by this building permit so (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. cia"4'o ignatare of Owner Signat&of Applicant LLD Print Name Print NaL Date QFORMS:OWNERPERIMSIONPOOLS 62012 . T T CD � x � a CDcz � 1l�lilill '� 07 / Xw w _ tf CL e--t- _ I i � as w O X r ` O /CD rF• " �'`"` Yv X N A,_ O . p. -- x 0 w tra qt,." ..y'i, .a.r=.,rr�r;,y. •� '.,- -, ,�`.., I' �+ , '` <X`..'�:k �rYd *` Y+� r ^ a r' ol 4-1 ,�. „, ., �2'= ' �f� ��."°�. /'' +. ,� +� s �• _. xY °.spy"; � `��' �` � ��F «Y ^.�f �� _ y A+' !°rEw %�1 .d',+„„,,.., <'gI'' '.r „.y. .+. .3 ' l..r, .i✓„ °` '".�'rr''s `+'` �I"''r'' '` %+"'"r F —rs`char.r�H' ,�, e •�'�,r yr .� ��+y i t .. � �� s. � A ��.. ��1 .�� ,�, # '`G � j . r ",,,� � � , '` �r^ ��•' m,..,. ' ma's .rr„t•r " ur" .Y.. »r€� }..�,,.'� a r n � � ..,f+e �.�"��.`�IY�,. ! �/'a�te•r �' i'tr r�'.+r � { PJ+N^ �a/' -'sue d/°�� �F•' 'r� .r o Awaifir..... t W . �, � ._ r� rr,� .�s � am- � � ~tom ,�.o•^�,rr !� � � *�, �w �" " "� /1V c � u s: , .,, • .� �,� -w=. ;:gar ? a� .r- - •r , • � ,� v,�.� car ....r.r� '% ��3���9�R� ,�= y�-,w,'_ �z,_�� �a r�, +� „ r rwa. � w 9'an. ,... ti: � wrpp ,4p_ k 'r+.,.. 4A `" � F.4 ". � w �•w - +e._:,•,. ....W ox n•y r�7, w., .,a'r 5^ �_ "^ 7����� a. f/A/ 0 :. =Y�°�. 44 4,1 +RAY'' /? l 1 ?YJ4i' T d�J �4►9(j rt ` fi t .�, a e T�p F nk, r ,,kd 4" ' r. `� • .>'- • ,t- m ^. O :rr5��,. w „ J'y r y + r i. E a .may r _ �" yr a - En n wad °0Ko , • y q � „ �i"yam► tro_ . b � i u w �. �r ��, �t. �. a, � F ., .. .�'"'� ,� _ !�•�.2`++��1>i1�'9£- �biy _ yy�� � w � TM J3./V �P ./r r�p✓� �, �r �� x w V. p � IJ A x O a ■■■■■■■■■ ■■■■■■■■ ■■■■■■■■■■■■.■■■■.■■■■■■■■■■■■■■■■■■■■■■■■S■■■■■■■■■■■■■■■■■■■■■■■■■. ■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ SEEN■■■.■/01MIN ti■iii!■■■■.■■■.iiAwna l�A11■i...■■■■■■■■.iii■i■■iit�J■■■■■■■■■■■■■■■■.i■■■ ME ■■■■■■� ■■ ■■■GSEOMEG �GG■■N■ ■�■AG■Ai■■1L�aM � MMMGG■MSG■it■■■MG■ ��MGlA■■■■S■■■■■■■■■■■ ■ ■SEISE%� uG�Uiy�ir�1'r/'i✓. .i��l� �r�. r��%� �� r�. � al�l� a� fL `�1� f.3 �r � ■r1Ji■■■�SEES■■■■■■■■�■■■■■ ■ SEES■■i i:�■■G.�iG■■■■OW5IEEEIEEE■■■■■■ill■■■Gi■■■i■■■■I�■i■■i■■■�; G�i■■■■ SEEMS ■■■.■E■■MIDI■M\M NNE■■■■■0■■ ISi■■■■■■■■■■■■■■■■■■■■■■■■M■■M■■■■■■S■i ■■��■■■■■M■■■M■■■!S■■III M■E■M■■SMI%I■■■■E\■E■OD■■■■� l■■■■■■■■■S■■■■■■■■M■■■■■■■■■S■■■■S■■■■■ S■�■■■■■■■■■■■■■■■■■■ ■■■■■■■.■IrA/f►.�I■■■■■ ■M■E■■MCI■■■■■■■■■■■■■■■■■S■■■■■■■■■.■.■■■S■■■■iI■■■■■■■■■■■■■■SM■■■■■ ■■■■■■■■■12No 0 ME a 6i■■■®®L�©■■■■■■ f1f■■■■■■■■■■■■■■■■■■.■■S■■■■■■■■■■S■■■■fir',■■�■■■■■■■■■■■■■■■■■■ ■■■■■■■■MDIMEGM■■■■■■■MD■■ I■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■M■■■■■■M■ ■■It■■■.i■MM■■i■■M■■■■ ■ ■ME■■■I �©' ii■�il V`� ■■■ 1�■iii�iiiiii�iiiiii�iiiiii�MENOM � 'io■iii�i NIMMIN ME M■ ■ ■■ _ 1•E■■MEN■.�■E■I� M�■■■■■■lA�!S■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■`��s■■S■■■■i■■■■■i■■S■■■■ No MEN IS ■■■■MEN■S%S■■IE■■iGIMGM■■■■■■■i■■■■■■■■■■■■.O■■■■■■■■■■■■■■■■■■■■■■ l■SS■■■■■■■■■■M■MS■■■■ ■■E■ONE■■'/iJ■■��M■tSir■■■■■■E■■■■■■■■■■■■■■■■■■■■■■■■■.■■■i■■■■■■■■■ ■■■■■■■■.■■■■E■■■■■.■ E■OM■O■■■%■■�Ilirr.®w.■■M■■■M■MM■■■■■■■■■■■E■■■■■■M■■■■■■■■■M■■■■■■■ ■SIB■■■■■■■■■■S■■S■■■■ IN lo1■11■■o 0 1 e IEW IMMIN ■EEOINy■G:01M=?=1■�4ia■i■■■■■■■■■■■■■■■■■■■■■■■■■■■i■■■i■■■■■■■■■■■■iE1[l■■�■■■■■■■■■■■■■ii■■■■� ■■►��ura�u■■��■I. :a,■i■r; ■ii■��I•■■■■■■■■■■■■■■■■■IEEE■■■i■■■■■■■■■■i■■�t�■■i■■■■■■■■■■■■■■■■■■■■ ■t� n1�.'Ti�li�lrlli■�®�iM�■■■■■■■■��i■■■■■■■■■■■■■■■■■■S■■■■■S■■■■■■■■■■■i■■ill�l■■rM■■■■■■■■■■■■■■■■■■ III MENEEM MON Ri iiiiii MENNEN iSEMMES iiiiii iiiiii moommalmolommom M NONE EMMEN ■ r�■�■■■�-=::.:��_- SEES■■ SEES■■ SEES.■ SEES■■ SEES■■ ■■■■■e � ■I■■■■■ SEES■■ SEES ■�r■■■■■ '�l��fe7 M� .■■■■■ ■■■■■■ ■■.■■■ ■■■■■■ ■■■■■■m■■■■■■ SIEMENS E■■■■■ ■M■■■ ■■■■■■■■I■IDS■■■■E■■■E■■■■■■■■■■■■S■■■■■■■■■■■■■M■■■■■■■■■■■■■■■■■l�rl"i■iS■■■■■■■■■■■■■■■■■■■ C■■■■■■■S�.■■■■■■■MS■.■■■■■■■■■■■■■■■■■■■S■■■■■■■■■■■■■■■■■■■■■■■SAS■1S■■■■■■e■■■■■■■■■■■■ i■�iiiiiii a :sommmma EMMENE ,■■ENWRI Ww"Pon FEIRMIRPMR WIRPROWw■■ 1■w � ■•� iiMENEM ■■■■E■■■■■IEEE■■■S■■■■■■■■■■■■■■■■■■■■■■■■■■■SS■■■■■■.■■■SEES■■SS■■S■■■■■■■■■■■■■■■■■■■■ ■ SEES■■ �l� �■r�� ��l�l��a■�� :. �� �r�:■■ ■■■■■s SEISE■ SEES■■ SEES■■ ■■■■■E SEES■■ SEES ■�■■■■■■�iiw■��■�Ii'�w■■■■■�i■.■■■■�i■■■■■■■�i■■■■■■�i■■■■■■I�i■■ii■■iii■■■i■■I�i■■■■■■ SEES■ ....................................................................................... �iiiiiii_iiiiiii■�iMENNEN�iMEMNON MEMEMIN iiiii■■iiE ii1m■i■iiiiii�iiiion ■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■SM■■■■■■■■■■■■■1 1■ENEN■■■■■■■■■■■■■■■■■■. ■■■■■■■■■■■■■M■■■■■■■■■■■■■■■O■■■■■■M■■■■■■■■■■■■■■■■■■■■■1 ■M■■■■■■■■■■■■■S■■■OMEN . ■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■i■■■■■■■■■■■i■■■■■■■■■M■■■■1 1■■■■■■■■■■N■■■■■■■■■M■■. ■■■■■■■■■■MM■■■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1 IM■■■■■■■■M■■■M■■ONE ■■■■. ■■■■■■■■M■N■M■.■■■■■■■■■■■■■■■■i■■■■■■■■■■■■■■■■■■■■■■■■■■1 , 1■■■■ME■■M■■■■■■■■■■■■■■■ Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 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 rformed as is d i d i the req st we received from the Unit Owners. Contractor, fieen contracted by the Unit Owner to perform the work asdTfin 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_]_L)day of f 8 , 20 14 Secretary Board oT rustees Yachts an Condom nium Trust 5-00 cean Street(c/o Manager's Office) Hyannis, MA 02601 Enc./File 21.13 Binding Effect. This trust agreement extends to and is binding upon my Executor,successors,and assigns,and upon the Trustee. Executed as of the date first written above. i CLYN P.KORB,Donor and Trustee 7 ON B.KORB,Truste ARRY SAC ,Trustee COMMONWEALTH OF MASSACHUSETTS County �k--- On this M day of � A�'"��,2007,before me,the undersigned notary public, personally appeared JACLYN P. KORB proved to me through satisfactory evidence of identification to be the person whose name is signed on the preceding or attached document,and acknowledged to me that she signed it voluntarily for its stated purpose. otary Public Personally Known Commonwealth of Massachusyas / Produced Identification My Commission Expires: Type of Identification p 4608579 v2 WSJ erg r�� 24 JACLYN P. KO" PERSONAL RESIDENCE TRUST JUntw"o k t , 2007 Prepared by Shari Levitan Holland&Knight LLP 10 St.James Avenue Boston,MA 02116 (617)523-2700 ARTICLE 15 PROTECTION OF INTERESTS The interest of any beneficiary under this Trust,in either income or principal, may not be anticipated,alienated,or in any other manner assigned by the beneficiary and will not be subject to any legal process, bankruptcy proceedings, or the interference or control of the beneficiary's creditors or others. ARTICLE 16 FIDUCIARY POWERS I grant to the Trustee full power to deal freely with any property in.the Trust.- The Trustee may exercise these powers independently,without the approval of any court. No person dealing with the Trustee need inquire into the propriety of any of its actions or into the application of any funds or assets. The Trustee shall,however,exercise all powers in a fiduciary capacity for the best interest of the beneficiaries of any trust created in this Trust. These powers, however, will not apply during the Initial Term except to the extent consistent with the qualification of the Trust as a Qualified Personal Residence Trust. Without limiting the generality of the foregoing,the Trustee is given the following discretionary powers in addition to `any other powers conferred by law: 16.1 Type of Assets. Except as otherwise provided to the contrary, to hold funds uninvested for such periods as the Trustee deems prudent, and to invest in any assets the Trustee deems advisable even though they are not technically recognized or specifically listed in so- called "legal lists," without responsibility for depreciation or loss on account of those investments,or because those investments are non-productive,as long as the Trustee acts in good faith. 16.2 Original Assets. Except as otherwise provided to the contrary, to retain the original assets it receives for as long as it deems best, and to dispose of those assets when it deems advisable, even though such assets, because of their character or lack of diversification, would otherwise be considered improper investments for the Trustee. 16.3 Tangible Personal Property. After the Initial Term,to receive and hold tangible personal property;to pay or refrain from paying storage and insurance charges for such property; and to permit any beneficiaries to use such property without either the Trustee or beneficiaries incurring any liability for wear,tear,and obsolescence of the property. 16.4 Specific Securities. As to any assets held as part of a Qualified Annuity Interest and any assets held in the Trust after the Initial Term,to invest in assets,securities,or interests in securities of any nature, including(without limit)commodities,options, futures,precious metals, currencies, and in domestic and foreign markets and in mutual or investment funds, including funds for which the Trustee or any affiliate performs services for additional fees, whether as custodian, transfer agent, investment advisor or otherwise, or in securities distributed, underwritten,or issued by the Trustee or by syndicates of which it is a member;to trade on credit or margin accounts (whether secured or unsecured); and to pledge assets of the Trust Estate for that purpose. 13 16.5 Property Transactions. To buy, sell, pledge, exchange, or lease any real or personal property, publicly or privately, for cash or credit,without court approval and upon the terms and conditions that the Trustee deems advisable; to execute deeds, leases, contracts, bills of sale, notes, mortgages, security instruments, and other written instruments; to abandon or dispose of any real or personal property in the Trust which has little or no monetary or useful value, after notifying the beneficiaries or their legal representatives; to improve, repair, insure, subdivide and vacate any property; to erect, alter or demolish buildings; to adjust boundaries; and to impose easements,restrictions,and covenants as the Trustee sees fit. A lease will be valid and binding for its full term even if it extends beyond the full duration of the Trust. 16.6 Borrow Money. To borrow money from any source(including the Trustee in its nonfiduciary capacity), to guarantee indebtedness, and to secure the loan or guaranty by mortgage or other security interest. 16.7 Maintain Assets. To expend whatever funds it deems proper for the preservation,maintenance, or improvement of assets. The Trustee in its discretion may elect any options or settlements or exercise any rights under all insurance policies that it holds. However, no fiduciary who is the insured of any insurance policy held in the Trust may exercise any rights or have any incidents of ownership with respect to the policy, including the power to change the beneficiary, to surrender or cancel the policy,to assign the policy, to revoke any assignment, to pledge the policy for a loan,or to obtain from the insurer a loan against the surrender value of the policy. All such power is to be exercised solely by the remaining Trustee, if any, or if there are no other Trustees then serving, by the person or persons, if any, named to serve as the next successor Trustee. 16.8 Advisors. To employ and compensate attorneys, accountants, advisors, financial consultants, managers, agents, and assistants (including any individual or entity who provides investment advisory or management services,or who furnishes professional assistance in making investments for the Trust) without liability for any act of those persons, if they are selected and retained with reasonable care. Fees may be paid from the Trust Estate even if the services were rendered in connection with ancillary proceedings. The Trustee may serve in any of these capacities and be compensated separately for its services in each. 16.9 Indirect Distributions. To make distributions,whether of principal or income,to any person under age 21 or to any incapacitated person according to the terms of this Trust by making distributions directly to that person whether or not that person has a guardian; to the parent, guardian, or spouse of that person; to a custodial account established by the Trustee or others for that person under an applicable Uniform Gift to Minors Act or Uniform Transfers to Minors Act;to any adult who resides in the same household with that person or who is otherwise responsible for the care and well-being of that person; or by applying any distribution for the benefit of that person in any manner the Trustee deems proper. The receipt of the person to whom payment is made will constitute full discharge of the Trustee with respect to that payment. 16.10 Non-Pro Rata Distribution. To make any division or distribution in money or in kind, or both, without allocating the same kind of property to all shares or distributees, and without regard to the income tax basis of the property. Any division will be binding and conclusive on all parties. 14 Unrestricted-Buildings of any use,group wbich contain less than 35,000 pubic feet(991m3)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing infgrmation visit: www.Mass.GovjDPS I MAssachusetts -Department of Public Safet Board of Building Regulations and Standard Construction Supervisor " License: CS-073212 BENaANmv S wo16D •` � JIR 11 MOCEINGBIRD LEOWNSTER M4 0 . Expiration 10/05/20.16 Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Vap Parcel C Permit# Health Division 1 I/!I wn wer Date Issued j l` 2 y®Q� Conservation Division Fee �1 Tax Collector Application Fee 0 Treasurer CONNE, YD SEWER ACCOUNT Planning Dept. ' Chliked fly Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address Village P I Owner 0 a fl8, Q , �� 1� Address&Ahii 50 3 t if Telephone — .f u Permit Request KELZ=0 c( ��. /hX Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new �rvaluation g2O "'� Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting docu entatiorh,, C�vl a f - Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) _ ' Age of Existing Structure Historic House: ❑Yes 1�1\10 On Old King's Hi g r y: ❑� Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing r; Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count_ Heat Type and Fuel: ❑Gas ❑Oil Electric 0 Other Central Air: ❑Yes ANo Fireplaces: Existing (Y-6 New Existing wood/coal stove: ❑Yes A No Detached garage:0 existing ❑new size—0�2b_ Pool:0 existing ❑new size NO Barn:❑existing ❑ size new Attached garage:0 existing ❑new size M.Al Shed:0 existing ❑new size (�&JZ Other: Zoning Board of Appeals Authorization ❑ Appeal# 4 Recorded❑ Commercial Cl Yes XNo If yes, site plan review# G� 1 f Current Use Proposed Use0/1 n BUILDER INFORMATION Name Telephone Number[ o� Address �� 22 License# J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN SIGNATURE DATE aO .y FOR OFFICIAL USE ONLY ti PERMf?NO. DATEJSSUED MAP/PARCEL NO. ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 0 PLUMBING: ROUGIV FINAL ~ m GAS: ROUG4; FINAL FINAL BUILDING ni DATE CLOSED OUT ASSOCIATION PLAN NO. P= oFE Town of Barnstable Regulatory Services sAxNs , t.e, 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 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: G v Estimated Cost C) d U U YP - ��AA Address of Work: ��(�V l �� Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 11 � 06 Date Contra r Name Registration No. OR Date Owner's Name Q:forms1omeaffidav a HE Town of Barnstable Regulatory Services MAS& Thomas F.Geiler,Director �Eo • Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property O%rner Must Complete and Sign This Section If Using A Builder I J ��C- ,as Owner of the subject property hereby authorize Walyl (QWA4 to act on my behalf, in all matters relative to work authorized y this building permit application for: (Address of Job) A/ �jdature of Owner D�te Tic t � M Print Name Q:FORM&OWNERPERMIS SION THE COMMONWEALTH OF MASSA4-uU5zl to OEM Board of Building Regulations and Standards Home Improvement Contractor Registration One Ashburton Place—Room 1301 Boston,MA. 02108 Mitt Romney OCT 31 2005 Governor Request For Du licate Re istration C Kerry Healey Lieutenant Governor y order for complete (print) this form in ink and mail it to the above address with a certified Please p (p ' th of Massachusetts. (NOTE:Personal or business checks will 8e accepted but will$25,payable to: Commonweal require an additional ten(10) days to process) REGISTRATION NUMBER(if known): REGISTRATION(COMPANY)NAME: 2 i 31 (7 irGC^� cS` Ur�cQ twh�c� A414 -43a N� BUSINESS ADDRESS: Q Sh acCo i✓ AAA MAILING ADDRESS(if different): D t?oL ( 0 rSIGANTURE IDUAL RESPONSIBLE FOR �tJ D o na a 'C3 v.N.. �w 5,r e J IMPROVEMENT CONTRACTS: .OFRESPONSIBL`E PERSON REQUIRED IN ORDER TO:PROCESS:ATURE:PHONE NUMBER: LOST CARD WAS: ONLY CARD ISSUED SUPPLEMENTARY CARD IF SUPPLEMENTARY CARD: NAME OF PERSON ISSUED CARD: SIGNATURE OF CARDHOLDER: FOR OFFICIAL USE ONLY I REGISTRATION NUMBER: BOARD OF BUILDING REGULATIONS 4 License:,hONSTRUCTIQN SUPERVISOR SSUED DUPLICATE BY F 4 �tumtler t958 021649 g�rthdate 448�71 DATE: 1 8315.0 uQ 0811 IZ007 Tr.no: rEp !4` � ' Re�t7�Eed 0t7 =pj NORMAN R GUNOER,S /J PO BOX 4043 MA 024'03� BROCKTON, Gommis'soner Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: r= AND C, OR XSearch w Search Results Reg. No. Applicant Street City State Zip Name Title Expirat 31 127277 NORMAN R. GREEN BRIDGEWATER MA 02324 GUNDERS NORMANN, OWNER GUNDERSON S.I. Total of 1 Records matched. Back,to._Home:Page BBRS Privacy Statement http://db.state.ma.us/bbrs/hic.pl 11/l/2005 cn , 70T 4„ 611 E 23 W2436 W2436 W3018 W3636 1 W332124 m T 82488 SL63633-R —EC 1 0 0 ( l ------------ � Lt3 Vz ' m m eef e . co The usan here is a evolvin one ; o m p� Cust mer may want o get a punter 0 de nth frid`e?�? cc Q I In T co L I V� I V o � k ... ....... �.� �. �{ '�:', , . D❑