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HomeMy WebLinkAbout0500 OCEAN STREET (39) - 'G 1 V �JO 8 Z ay -C)L4 p CAS r Z i F _ `, . " � �� .S! �1 0�, �. ;q� � o � �► , C _ ' ' �� c� ��;, � r TOWN OF BARNSTABLE• Building � " 20.1503152 EMMSTABLE, * Issue Date: OS/27/15 Permit 9 MASS. �ArF0 A39. A� Applicant: Permit Number: B 20151293 Proposed Use: CONDOMINIUM Expiration Date: 11/24/15 Location 500 OCEAN STREET Zoning District RB Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 324040OBF Permit Fee$ 60.00 Contractor TULEIKA,VIKTAR V Village HYANNIS App Fee$ 100.00 License Num 91854 - 1-1 0� �!Est Construction Cost$ 5,000 p ) 12,C Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 3RD FLOOR DECK ALTERATIONS THIS CARD MUST BE KEPT POSTED UNTIL FINAL UNIT 120 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: BALIESTIERO,MICHAEL&LAURA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 33 RED PINE DRIVE INSPECTION HAS BEEN MADE. CARLISLE,MA 01741 Application Entered by: PF Building Permit Issued By: /fZ��n= THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR-SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACRMENTSObWrJBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDINGCODE,MUST BE.APPROVED.BY THE JURISDICTION: STREET OR ALLEY GRADES AS WELL AS,DEPTH AND LOCATION'OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.`JHE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE•APPLICANT,FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION. RESTRICTIONS. MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). AA wr BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health ,t F 4t Yachtsman Condominium Trust ; Board of Trustees ` 500 Ocean Street Hyannis,MA 02601 DATE, RE: Unit�Q Yachtsman Condominium Trust, 500 Ocean Street,.Hy__annis To the Town of Barnstable Building Commissioner, The Board of Trustees for the Yachtsman Condominium Trust voted and approved the attached proposal to be pe ormed as is delineated in the request we received from the Unit Owners. Contractor, k R bl--b co L c 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,,OW day of i9 , 20 / Secretary, Board of rustees Yac an Condominium Trust 500 Ocean Street(c/o Manager's Office) Hyannis, MA 02601 Enc./File 'I C'`� v �� � -�-��.✓ _ \ ^~ �,./` � v _ -��: � , h V �� � �J �.�. �' � �� � �. �� V QI`J '� r� �, � (''� . c ��„_J .,.f, � '�. h _, � �� `�-- ! n -� J -- o � � �. � .�. �- n TOWN(IF BARNSTABLE BUILDING PERMIT APPLICATION (62—) - _ i)Z �iGtap Parcel Application lication # b b/ S Health Division Date Issued `Z7 Conservation Division Application Fee Gam' Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village /Z l/��`L � Owner Address Telephone /'? Permit Request aP' OM- �/ R AVe, At906� igs AQA) Square feet: 1 st floor: existing proposed 2nd floor:iexisting proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatiQko� 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 (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) l� elm /�� �Pi)idflioxf Name �x-//e/. Telephone Number Address kv�l License # Z44 �i�� � <W Home Improvement Contractor# / 3-ID Email zwwo. Worker's Compensation # 619'2(1 ALL CONSTRUCTION DEBRIS ESULTING FROM THIS PROJECT WILL BETAKEN TO STJ SIGNATURE DATE ✓ Zv JJ FOR OFFICIAL USE ONLY -•APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE .r OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r — Eq-(1�t4°fx� $ IOQTS Aesfam,MA 021H rvt4m�x�asxgrna��rr= Wcwke.rse CampensafiuInsmcmceAffidavit-g ersfL:a�ectriciansff%m hers vFk7nt In�fmmafimt Please Front Lt Of ws : W, O ON2 Pimm 6P--5gg Am YUa axt emplo-yer7 Me&Me mpgrapriafe ba= •ram of Prom VI am a employerwift _ 4. ❑I=agmmattc fmL*xandI employees(loll agdforpazt:ime)- ❑ I am a sole proprietor osparEncr- Esfed an the d sheet 'L ❑R=mdelmg ship and have no employees These vab-eooftactats have g- ❑D emalifina WoAiug forme in auy capacity: euspinyees and have wmkm,- Bnih g addition [triowadcc&comp: e camp-i,=,� .t5T,;,T;- I 5_❑ We am a cmpGr2 cnznd ifs IG-❑kcal repaim cr addifians 3_❑I am a hommwner doing all wodr offices have eom=ed fb= I LD Plamhing mpaim or adds iaas myself[No wczb�'c=P- zit ofemm2ptimperMGl. s.�, mct!��1I r-152.§I(4} and we have no I?❑$oof=Pam =TI [era VDd32& 13-P Od. W(k&4,W b v comp-;.,m xar� mwell, !ARY-FED�thit chi j c Tx 11=st&Isaffiov[thrse�cahcTose axiaf�ra rs�mmp�ari�Pa mn iM=wwnemvr]msabmitfxk T gmeye�t�cmgsFhredtsad$�eaI ta�3ecaa��sm�tssab�$a�cc�dsritm�srst +sarSt ld=ft.•-t=tb3dcl—k%bhhmXmgststterhedmxdrliumsI sheet rhtrrm6-tjm offleMb6 innsaadsffi�xhett�nEnnttf�nse fiava emgIQyees. I€tbtt sob-caohad�ah:•zt empla�xrs,th�3umt provide t3�a ti��`txissg paLLymmbez - Iaxt am cmpZgjwttiatisgravidiag a ar7iers'cojnpgmsagba€rc4traaar ar m.y a,pf U,6m zeram ir$cegQVcj7 anejob vita irEftrmQtiaa. Tnsmr nrF.Companym m .: Poa3'orSemius_ a6206 --2E & 4/ 3/J wfi=Date= 4{ lob Sztm Agdress Bch a copy of the-vmrhms'compensation poScf dwi-Anation page(showing ffieporLcy nmaber m d emotion date). Fa�.uxe�secRte:caveiage as zequirednuder Secki�511.o€ffiGI.c Li2 ca>z lead to t5e inzposi5nn of caminal penalties of a fine up to$L-5DD OD andlor onLyear- - as W(A- as c irR penalties im fbe foffi of a STOP WORK ORDER-and a fnm oftcp to,$250_0+0 a dzy against e _ Bc a$vise$that a c afthis skatmn=t no�be ceded to tine Office of IuvccEgatiam of the DIES coverage vmiEcaticaL I da h9mbl'cerlf.fP andpsaaMex ufpar x7 fbatth in ormrdcaagral LW 4ave a hire tmcf correct - aim at� F3ate` 5 Z 6 S 5� Pbnr�e#_ E} iz'aL use uMF}: I?a net s4r efa i tkir aree,fa-ba cQvple&d by cify ar fam a,fjSciaL Cif or Town: # TSsuing Aathexiig{arde an* L Board of Health W Ba dk;Ilegar(menEt I C.ifyYrcvm Cterk 4-Electrical hispec#oF {.P�umbmg ffiSgc�tor 6.Glthcr Ca�ct Fersan: ph,��: . 6 r, 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 pe ormed as is delineated in the request we received from the Unit Owners. Contractor, 11( P� D'L:l Co L L c 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 thiscAb day of -� , 20 Secretary, Board of rustees Yac an Condominium Trust 500 Ocean Street (c/o Manager's Office) Hyannis, MA 02601 Enc./File I I N x , owlw 57 Z��gg 770 fb, oil 40 WOW �11 r a, p, w yy qq .. y y.. "6'-.. �^� ry ... �'!'�: •m.� � �S. -s t �� 4 ��sY eN 'Po A" kr �.aMd''M.•S.'1T M w s s c qa e � zf a _ .yJ"1.3.tl= +t4b"eM � :^4• v y ry + .'i w . e M r W k : x v tA va y , FITW „�— • n .°e v rr n r t ... a fa b` * r r' e. p 1 ur 3 �o r ^x` e vw n Datai(s 5/17/15.5*D8 PR Tf,,e"ffi6a'! Qteb ;,te f.the�xec,"Itiv,:Offic_ 'i�vLok i f t -nv.f"C'.i`y Gov Home --eAg�mdes- Uemo9raa'� hic Information p Full Name: VIKTAR V TULEIKA ender: er Name: LicenseAaaress inTormalion Address: Address 2: City:. Cotuit State: MA ipcode: 02635 o nt : Utted gtates icense inTormation License No: CS-091854 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 3/12/2015 Issue Date: Expiration. Date: 2/20/2017 License Status: Active Today's Date: 5/17/2015 Secondary License: Doing Business As: ISlatus Chan e: ice se Renewal rerequisi e n orma ion No Prerequisite Information uiscipiine No Discipline Information uocumentum Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact U; NOTICE N NOTICE TO u a TO EMPLOYEES �WEMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22&30,this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ACE GROUP NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO, MA 02344-1450 ADDRESS OF INSURANCE COMPANY (6S62UB-2E83341-3-15) 04-04-15 TO 04-04-16 POLICY NUMBER EFFECTIVE DATES s - SCHLEGEL & SCHLEGEL INS 34 MAIN STREET r- WEST YARMOUTH MA 02673 NAME OF INSURANCE AGENT ADDRESS PHONE# o� TULEIKA BUILDING COMPANY LLC 44 EATON COURT ' 0® COTUIT MA 02635 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE � MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably '— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the I NAME OF HOSPITAL ADDRESS 009587 W20P1G02 TO BE POSTED BY EMPLOYER i V111V� Vl %-%JjjJU.111V1 !"111U.11J 1&1114 LI.LJLi1V JJ A\Vr 11 Y 10 Park Plaza Suite 5170 Boston, Massac , etts 02116 Home Improvement C t for Registration Registration: 173709 Type: LLC Expiration: 11/1/2016 Tr# 260787 TULEIKA BUILDING COMPANY LL VIKTAR TULEIKAC^ --- 125 BERKSHIRE TRAIL W. BARNSTABLE, MA 02668 / sue Update Address and return card.Mark reason for change. SCA 1 0 2OM-05/1I [] Address Renewal F-� Employment F� Lost Card C-lfee�po7v�moryuoe¢/.GI�z o�6aclzuael�a . Office of Consumer Affairs&Business Regulation ; License or registration valid for individul use only ME IMPROVE ENT CONTRACTOR before the expiration date. If found return to: Wegistration: ;, 0g Type Office of Consumer Affairs and Business Regulation xpiration: - t�5 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 TULEIKA BUILDING VIKTAR TULEIKA 125 BERKSHIRE TRAIL W.BARNSTABLE,MA 026.81 Undersecretary Not Ad UthdVut signature i �X'T . Utz k q 36 pop oqf, eeow nq Abe _�� ofqvcAen e . _ r 'max fir' dal m" o 4e,&3�� is ,�? a Ted/.�✓L.��� ��.'-�`��'-� �2/ it TOWN OF BARNSTABLE .�,� APPLICATION PROFILE Application ref 201503152 Fee Effective Dt 05/26/2015 Department BUILDING DEPARTMENT Location N STREET Parcel 324040OBF Cross streets Add'l loc desc UNIT 131 Municipality n,)©` rer�rn 6 subdivision t0 Q / V Existing use CONDOMINIUM memo Current Zoning RESIDENCE B DISTRICT Flood zone �� Applicant HOME IMPROVEMENT CONTRACTOR _1 lf!/ Pro)/Activity COMMERCIAL ADDITION ALTERATION C/1 Class of work ADDITION/ALTERATION Description 3RD FLOOR DECK ALTERATIONS - UNIT 120 Proposed use CONDOMINIUM memo Proposed zoning RESIDENCE B DISTRICT Flood zone Non-conforming N Applic received 05/26/15 Estimated cost 5,000 Estim start/end Actual start/end Impervious Surf Assigned to Status ACTIVE Status code desc ACTIVE APPLICATION Multiple submissions N Next action Government owned N memo ordinance ref Reason for app Parent app Point in time fee effective date Fee expiration date Role Name/Address PROPERTY OWNER BALIESTIERO, MICHAEL & LAURA CID : 380848 33 RED PINE DRIVE CARLISLE, MA 01741 GENERAL CONTRACTOR TULEIKA, VIKTAR V CID : 377692 125 BERKSHIRE TRAIL Phone: 508-685-6585 WESTBARNSTABLE, MA 02668 Tradesman Name Lic Type License number Class NAICS Expires TULEIKA, VIKTAR V CONT SUPER 91854 02/20/13 HIC 10/27/12 VIKTAR TULEIKA - Report generated: 05/29/2015 11:48 Page 1 user: permit Program ID: piappent � 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapes` t Parcel 6`7 d t/ Application #c-,�O 13 0-17 Health Division Date Issued 3 Conservation Division f Application Fee 41do Planning Dept. Permit Fee �b Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis r Project Street Address ) C a Village V OLV\h-�S Owner Cy y\\ -�a Address ZrReAe-\ -CT 06a9 Telephone - (-"C)7 3 1 `� ��`� Permit Request W ah y zi fps tl..ed Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District _ Flood Plain Groundwater Overlay (-Project Valuation 3, 0013 Construction Type � hs�IX c-\oln Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including bathe): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use - — - - - ---- — - - __ - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) QNam c, ev' �e Cl c�3 Telephone Number (,S Og) '7 3 7- 3 / 2 Address 3 3 Carla License# CQ�61 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ayX1A1 GVJ�� �(3NS�eV'01Z)�C�\,Z I SIGNATURE DATE 3 1,2 0 -13 j t. E _ FOR OFFICIAL USE ONLY ,'-.APPLICATION# k DATE ISSUED MAP/PARCEL NO. i <, ADDRESS VILLAGE r I OWNER j DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE a ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL k r 1' GAS: ROUGH FINAL r , FINAL BUILDING r ,q 5 DATE CLOSED OUT ASSOCIATION PLAN NO. Office of Irzvesfzgafiorzs. . _ .. 660 Wishingfarz;street stork MA N".mass.gov/dia Workers' Compensafion Iuswraitce Affidavit: Blinders/Contractors/Electrician.s/Plumbers , . Legibly. t e A hcant ilaform ation Pl ease Prim Name(Bvi,,ess/Organizadontfn&viduan: ' •Address: 3 � �'u�� c� �y r� '- _ •� • •: - . . • •. . .. f'City/StateJZip: �:� o�nw+s �. O�G I Phone.#: p�� ti°Are ou an employer?Check.the apprapria-te box: ' :'' _ :Type of project(required);_ 4. [i I am a general contractor and I 1. I am a en�loyer with'. Q : 6. ❑New cons frnction . employees (fall and/or part time).*.. have hired the stab-contractors 2:[�I am a•sole proprietor or partner- listed-on the'attached sheet 7• �� " Q ship and have no employees These G6-V)ntractars have •g. Demolition working forme.in any capacify. employes and have workers' 9. Rml�addition [No workers' Comp.insurance Comp.inctTrance. - 5. [] We area corporation and its 10.0 Electrical repass or additions regtrned] officers have.exercise .their : l l.❑Phm3biagrepairs or additions - 3111 am a homeowner•doing 0 work - right of exemption per MGL myself [No workers' comp. ' 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.0 Other - employees.[No workers' comp:insurance r0q=ed-] *Any applicant that cheeks box#1 must also fill out the section below showing their works'compmsafion policy information. t Homeowners who submit this affidavit indicating they are doing all work and them hire outside contactors must submit a new affidavit indicating such. $contractors that chock this box.' t attached m additional sheet showing the name of the sub-contrad=and state whether or not those entities have employees. If the sub-contractors have employees,they mustprovidt they works'comp:polidynumbcr: Jam an employer tkat is providing workers'compensation insurance for.my employees Below 1s the policy and job site information. Issuance Co an Name: NVA(�?6cc�1 _.U`c u.hn oyy— - Policy#or Self ins.Lic.# A Q_y '1'� y-C/_ Expiration Date: Job Site Address:��� �c eeif�� see C `Q rn�� l a C, :C WState/Zip: ty�eT h Attach a copy of the yPorkers' compensation policy declaration page'(showing the policy number and expiration date). Failure,to secure coverage as=Fri a mder Section 25A of MGL a 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 tliaf a copy-of this statement may be forwarded to the Office of I' Invesfii ahons of the DIA for insurance coverage Vrg fication. I do hereby certify under the pains-andpquddes ofperjury that tha information provided above is true and correct � ��-::. . . . Date: •����� : . Si atare:( — Phone# C� `7 Official use only. Do not write in this area, tq be completed by c' town ojj ccial City or,Town: PermitUcense# 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#: VDAC ace group WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6S62UB-4477P34-9-13) RENEWAL OF (6S62UB-4477P34-9-12) INSURER: ACE AMERICAN INSURANCE COMPANY NCCI CO CODE: 12165 1. INSURED: PRODUCER: LACEY CONSTRUCTION INC OLDE CAPE COD INS AGCY 38 CARLA RD 296 WINTER ST HYANNIS MA 02601 HYANNIS MA 02601 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 02-1 1 -13 to 02-11 -14 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit 0 Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, If any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A d� D. This policy includes these endorsements and schedules: o SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o� 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. i DATE OF ISSUE: 02-04-13 WC ST ASSIGN: MA OFFICE: ORLANDO DA ACE 24M PRODUCER: OLDE CAPE COD INS AGCY 236RC 014863 Doo -1 217 p`17 t]3— 5-2013, 10 c r67 C+,T4 4 C21-120 MARNSTADL..E: LAND COURT :REGISTRY QUITCLAIM DEED' We,John M.Horn,Everett B.Horn,III.Dini611.1 Horm and Cynthia H.Whettep in consideration paid of FIVE HUNDRED EIGHTY THOUSAND AND 00/100($5809000.00) DOLLARS„ grantto Cynthia H.Whetten andNathan Whetten,husband and wife,as tenantsby the entirety, having 11a mailing address of 22 2infandel Circle,Tolland,.CT, -with quitclaim;covenants, the dwelling unfit,(the.Unit),located in that,part of Barnstable known as Hyannis,Barnstable County,Massachusetts,known as Unit No. 120 in Building 3D,(the Building),of a Condominium known as The'Yachtsman Condominium,created,pursuant to a Master Deed. p� dated December 9, 1974,filed with>the Barnstable Registry District of the Land Court as $o Document No. 192651 as amended and noted on Master Condominium Certificate C-21,(the; Master Deed),in accordance with and subject to the provisions of Chapter 183A of the General Laws.of the Commonwealth of Massachusetts,together with a 1.4809°lo undivided interest in the common areas and facilities,(the Common Elements),as described in said Master Deed. In.the. event that,and at such time as a subsequent phase'or phases are added to the Condominium by „ amendment of the.Master Deed,the'undivided interest of the Unit in the Common Elements sha11 be and become that specified respectively in Schedule A of the Master Deed. The Unit is shown. on the floor plans of the I Building filed simultaneously with the Master Deed_Amendments thereto,as the case may be,in said Registry District. The Unit is conveyed subject to and with the benefit of all rights,xestrictions and easements;of record,insofar as lhe>sarne are in force and;applicable. For title seez Certificate of Title No...C 1 r1960.. Property Address:Unit 120,500 OceadSt.,HyannisNA, Executed as'a sealed instremunt this, day of ;. 2013 IL whets � STATE OF CONNEMCUT County; "f 0 fl :ss. 3r►this° x day of. Cs44 2013;trofoc s me,the vaned notarlr P C. y Y. Wit tt>me or moved to.ucie through satiawoly evIdt of i ienttficut un,wi►ich was r ✓ t pto be tbe;pexsot►whtsse'a a is s gn lon thaFrcced gag or atiacbcc3 docnmrnt,and aalorowledged,:: to me that she signed it voluntarily for its stated purpose. Notau 'Public'. My comrussion expttes: d No uabard u' u t . sty v �L. MASSACHUSETTS` STATE EXCISE TAX BARASTABLE.LAND COURT REGISTRY Date., 03=25-2013 6 10s47am GUl0.406 Doc:: 1217171: Fneie. 'tl.Y98340 Cans: 080, P000 001 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE LAND COURT.'REGISTRY Date; 03-25-2013 7 10'.47am C.til".. 406 Doc 1217171 Fees OYU6.00 Cons, 1-580r000.00. H. +d Rt �� I CD Q+ o �. 'Jn CA a 1 � o 3w La Executed as i sealed instrument Ws&T4ay of 2013. w rr/ �verett:B.Flom;, COMMONWEALTH-OF MASSACHUSI2'T'fS County��12c-�-u�ss• On ms x Q of t 26i3,before MIbe underiiped.uatary public,personally gpeared'Everett B.11oM U,PMWn,m knowrilo e, proved to mo through satisfactory evidence of klentiEcatiou,,which L*tas to be the person whose mime is sued on the pieceding oar attached document,and Qcknovledged„,� � � ►�. ! i,.r to me w he;signe<3 it Volunni iEy far lts:sWted purpa Notary Public My commission expires � �:�_ ,r• � � c v 8`1 is DIANff M. NANEGRk ��, ,�►r,s'oot�Y �i. E GQM�ONWEAItNOFMA59,ACHU hty Coniinlsa{gtn xpirv6 EvDruary,201.,2020 t _ tj ILQw .� o. t as a it M k. `: r : ..TOWPI1=OY�iarII5tRDlL. :. V. .Re xaes . T_hoinss T.:Geiler;Director :- - a Building Division = Tom Perry,Building Commissioner. ' 200 Main Street,Hyannis,MA 02601 wwwaown.barnsta ble.ma.as 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 authorize to act on m7 behal� in all matters relative to work authotized by this binding permit 0�cec)N .(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. . tore of Owner Signature of pIicant � . P ' t Name Print Name i`z Date . . : Q:F0RMS:0WIERPER1MS10NP00LS.62012 : , Uclrirtment of P Board of Buildin�� unlit Saf'ct} ` Re rulations and Standards Construction Supervisor License License: cs 5140 WALTER J LACEY 38 CARLA RD HYANNIS, MA 02601 !'unm1issiuner• Expiration: 7/25/2013 Tr#: 21-172 4 l b L Yachtsman'Condominium Trust Acceptance of Trust Approval The undersigned Owner[s] of Unit#120 of the Yachtsman Condominium Trust, 500 Ocean. Street,Hyannis, Massachusetts, acknowledge[s] that the Trustees of the Yachtsman Condominium Trust have approved the following proposal: • Installation of a new window for the master bedroom three-paned window(Andersen brand, color to match existing). Any shingles and trim that are replaced on the exterior shall match existing. Placement shall mirror the;location of window in Unit#118. By acknowledging the Trustees'vote approving the proposal for Unit#120,the undersigned Owner[s] agree that: 1. The specifications provided to the Trustees for approval (copies of which are attached and incorporated hereto):are the final drawings and specifications of the improvements. There shall be no additions or variations to the said drawings and/or specifications without the Trustees' prior written consent. 2. Approval by the Board in no way constitutes a waiver by the Board of the Trust's rights. Moreover,approval by the Board does not indicate that the Board accepts liability or responsibility for the actions of the owners. 3. Any contractors (and sub-contractors) [Walter Lacey] hired to work on the proposal shall obtain the necessary approval and permits from the appropriate local authority or statutory body required under-any law (including any statute, , ordinance,by-law and/or regulation). The Owner(s) specifiy that any and all Contractors and/or sub-contractors shall not commence,continue or complete any work without having the appropriate permits and approvals secured. Contractors and/or sub-contractors shall provide the Manager of the Yachtsman with copies of all approvals and permits, contact information,including emergency contact numbers. 4. Any work undertaken shall comply with all relevant local, county and state codes, by-laws,regulations and statutes. 5: Any contractors (and sub-contractors) hired to work on the proposal shall maintain the appropriate liability insurance. Contractors and/or sub-contractors shall provide the Manager of.the Yachtsman with copies of the relevant insurance binders. 6. Any work undertaken shall be completed by Memorial Day and no,work shall be undertaken again until Labor Day,unless approval is sought.from and received from the Trustees. ' 7. I/We assume(s) responsibility for any future costs associated with loss or damage related to the work: 8. Other: As stated above,the materials must match existing exterior materials. -1- w Acceptance of Trust Approval ' Page 2 of 2 The undersigned Owner[s]of Unit#120 therefore accept the approval of the Trustees of the Yachtsman Condominium Trust subject to the above-noted conditions. Signed this day of r� 2013 S., a/tu er 44 Print Name-Unit Owner Si ure-Unit Owner I Ael+e L-) Print Name-Unit Owner J Witness/Manager Yachtsman Co minium Trust Documents Attached:. Permits Received(Title and Date Received): _ f I,t a