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HomeMy WebLinkAbout0500 OCEAN STREET (43) 5 bo Ocaa-r) 3a Lf Dqc) i yj Town ofBarnstable. r .T.h .-i i -\/A From.th re t.-.A roved:PlaasM st,be=RetamedAan--Job.and-•this u t e gA ♦ .A , .t.;.�� Pos.#;;Thi*-a.d.So at t. s .sibl" a St. e pp .. Card M s be Dept_. . . . ,.., •.�;* �...... Posted UntihF.mal:Inspection Has Been:Made.. s', r 1b 0 s 79• .Where.a.'Cert�#itate,;,of:,Occ: anc`as:Re uired;.sueh.Buildm ahall-Not<be:Occupied untrl a.Emal Irw ns ection, as:been.made. , s. s P Y q g P Permit No: B-17 3448 Applicant Name: STEVEN`L HETZEL Approvals Date Issued: 10/20/2017 Current Use: Structure, Permit Type: Building=Siding/Windows/Roof/Doors Expiration Date: 04/20/2018 Foundation Location: 500 UNIT 90 OCEAN STREET, HYANNIS Map/Lot: 324-040-ODN Zoning District: RB Sheathing: Owner on Record: GELERMAN,WALTER TR Contractor Name: STEVEN L HETZEL Framing: 1 Address: 20 GAINES ROAD Contractor License: CS-104384 2 SHARON, MA 02067 Est. Project Cost: $3,000.00 Chimney: Description: replace 6'slider with same size anderson slider Permit Fee: $ 160.00 Insulation: Project Review Req: Fee Paid: $ 160.00 Date: 10/20/2017 Final: s , 'l Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized.by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location,clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service; Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation - 7.Final Inspection before Occupancy Low Voltage Final: Health Where applicable;separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall notproceed.until'the Inspector has approved the various stages of construction;',,' Final , Fire`De"`artment::: _.:-;!'PerY: sons,contract):ng-.Wlth:;u.nre"glstered co.ntractors:do;:not:have.access to the gu-aranty fund (ai saetforth;in IV1GL.c:142A): p:.,,_. Building plans are to be available on site -- .-. .- .. ._ Final " All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map3yParcel N _ Application # Health Division Date Issued 1,0 Zp 1 Conservation Division p5 Application Fee 201 { r� Planning Dept. ®c� S�Pg�E Permit Fee I�U Date Definitive Plan Approved by PlanninV@8"� Historic - OKH _ Preservation / Hyannis Project Street Address d (��Ci� ��2 D tQ Village� t Owner 6e Address &��yt� Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0c36 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) Name � � ton- Z4 Telephone Number -:! Address IJ� C�P� �� ( E License # C�S-/o 1)4f Ll •� . /V'1� 02(e- Home Improvement Contractor# Email ��-/��� �M�-1�' Worker's Compensation # IJ/A- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 6 / /� ,r FOR OFFICIAL USE ONLY 4 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. - 'Ii �olstFnaTtreatrc��r�seft .7��rti�eut�,� `zzttriat�c-cir��rt.� 600 MashfzzeoFt,�treef _ Bbsfcn.MA 07HI Wurke& Cuxpens3ffmInsaraaice Af Eidavit BmWer-J cfmrsJEI clan&Thmibers ApplicmA,hfa LmAbu Please.print. Nr7T' B c8minam �am"ratircnlLnrT na4 7C V C V' ( (..�� eftt �#re go=a an employer?f�ecTcttie apgrvgriaf�bow T e of ro ect r L❑ I am a v*iff� � ❑I am a,general cord=actat and I Yp project C �`��'- �P1 l velvretlfae 6- ❑New consazCtion employees CTUU andlor paddme). 2)KJ am a sale progriaof arpartnees- Pisfed On the at#ached fit. ?= ❑RemCidesuig slop and 1Mvie as emp1-QYees. , These canlrac ars have 8. [j I7emol ioa WoiffU f� many ripaci4y: employees and have V-M&ers' 99. ❑Suilclmg addifiag w d e camp.ussn=e cep-mAtraa $ required) 5. E] Wearea-corpordii=andifs 10:[] ' Prfaicalrepairofa3 sorts 3.QTam.afiomeuym-ar&inff2fl udc 0±9=31MVaexErcisedtlm-r ILE]Plumbiagrepaissarad&Hom myself-[No wo&ee Mnp tigbi of exemp6bn per MGL L.❑Roafrepaim i1mr =a rez;ed j i c.I52,§I(4k andwe have na emgleyem LN16 ors' 13 []Otter comp-inert==, squired Z �$aryLpppE�Cmtdfist(bedc3T�as�l um�ells ffiac�t5e sectFoahrlasysh�g c�ea•aso�d'sexs''®pessaSaapnfiegiafnffisa�.t F��GIDE�SYIR4i3Vf17C SIlbIDft I1SII a[S IDf��AfC�IIL1F.C � S�WLS�t��h]eII l�P OR15]�Cr^'^+rnrfrnrIllASt SIl�-IIIItaIIEW2{III '6 7Dd] ^�s=cFL '4QIL•II9C{II6�].c"'[CbfCYT�IFS IYmCiapst�tadsed ffi9d�finn915ixPPt Sbnn�tLen�Of t17E S4�!-Cffi�CRCJ�II4S.�S�E�BO(LCtT7]DSEQ�SbS'C£ empIIQyees.I€thesnTrtautadn�sh=ceEmP7a�S.4beYz�st-Ixmtide-f�.�u uvrke�top.po-i�a�,bFs 1�arn as strepl�rtlt(cfisprm-zdirig�i��rke-rs'camlrerfsaizart arsrirartca for�a�eurplQJ.�ees Selrs:Q is iffapoFicp arrdtaf�srf� €t�prmcrrion. ' Iasrnce:Gompauy prams: Paticy,or f-say_Iic. abate= Job oe Addressp1S . Affacha copy oftbf---Wo-rkerecoxmpensa&Mpol€cydec]'araf mpage(shave.ingthepolicyuumberanalempnaiioncTafe). Fagme to secures coverage as req*edun&r Secfiom 25A of MCM a 152 caa lead to fhe imposid=of crimiaal pennies of a fIr1P.up�$F,SQ�0:00 avd,'ar sue�earimpfisazn�8:s we;1l as civil penaliiies is the fcm2 Cff S S'IY7P�Tt?l�QRDEI�sad.a fine ' of up is$250.00 a day as'nd the viohdar. Be advised ffid a copy of11 i staL= t maybe fors ded ig tim Of Hce of Iavesftgaft ns ofthe DI&fay mssrancz cavesage vetEffmhnm Ida Cid afperlw r ffiattfra i for7Tza araprusuzdrabvtg.Eslrusazi'carrect � Sure= Date- lD/ � t3,Ok-al ass,airy. Do jwt irrrta in tfas.mica,to be=tgpfetesd 5y'c4 artowu afficraL City Taw= FeruriflLicease� Lw,"Mg AuffiDT4(dale one): LSosrd1ASeaIfli 2. thugDeparhnZ- d ICayI£mrnClerk 4.ElectricalIuspecter 5.PbmbmgFnspectur 6.Ofhuer C4ntact Person: PhOIIL� : r• TMforlia air "de warkes'��imifart beir�oy=s P. i ~ Laws152 es aII enzpl�fa Pravi as�Ioyee is defined as _evelyp�on nt die se$vire of ather ffide r - oral orwr�u-r' or -� - a assDGT 6mx coipotatton or a$ier legal e±iiy,or�-Y two or more tl�e Ie s ofa deceased emplDY�or fhe Art�Ioye�-is defined as an m�idmI,P 'andin lridmg . oft3�eforega maJarnf c e o loyee- goweverth5 Of an in�vld P��,associafon or ACrIegal ent'dy,� Ymg of$e- receTYer or trash azfineots andvvbo zEsi des fb¢rm,ar Elie occap owner of a dw•..11ingh0iWe haymgnotm aLe man aQ Work on such dwe�g bye d�yeIIlag bnnse of Haof]ierwbo employs pm saw to do mai aan�,won ar rep ds orburZdmg &=to sballnDtbecanse ofsarh�IDymm the daemedtn bean ensploY�" or OIL the groffi ffie fiance ar MCA..r_bapt,-r 157-2§2 q6)also siafes that"eye7�psi�ar Iooal g Z9MrY sTraIEwi$ihald rA fiie"":"rt�ealfli for anp r�-e�al of a 1d�ease or ge��in operafe a T��ess orfo cnl�.sfruct b�V• . apg7icaat-Who has notpradrlced aocepfahle evid�ce of cdmpHahr-wifli t "^ r��rAv�Mge=eq�- f r ISZ,§25C`(n sfafrs`�Ie licrf f- nor�y ofifs poIlfical snb si®s shall A,d�anally,M(� of ficmziil apfable evidemce of complianeewith�e insm� •. enter ink My fact farthep � Jam' ,i,g antho r �s of-firis cbap�rba4e tieengrese�dtn the cz��ra Y=' 'c eusafon affidav��leinl5',by checlCmg`-b'eboxes iliaE aPpI9 tO y°ur s�°n'and'¢ " PIS fa D�$ic woa � s addresses)avdpIianenmmber(s) alongwithffir r mrfifillf'Cs)of necessary,sapplY snb-confractm(s)nine(). l'ar�eHgs(�)wnna empTnyees offer tb.an fb e �Emce. LimiEd�?�Y�Pmnel�C)o=DisotedFiab Ifanli Gor11LY dDeshave ' members or partacia,are.notreqaalDdta=Iywa]±c&=Mpmsafiariinsar'� a oli is Be advised-fbaftbis a$day±maybe snbm> t°flle Depa-finenf of? �onld empIoye�s, p �Y ALsD be stye to sigxc and daf�the affidavit the affidavit �ccideufs for con�on offtL& =coverdgt: nottlieDeparbnm&Cl be ref�ed to-Le city or tn'WR thaf the appHcaiion for thep�or license is Tbcingrr Elie briv or Win•are r�edta obt a awoll=m L,Jm� ,Aems- Mgaldyonbave any qt��s�� yes sboald rdiets ..p safionpofioy.plmsecall'thmDeparfmc�BUD. =mbm On Z-pl z�b¢l�sfzdbeIo�rP. pelf-msared� Jice�se p line. City ar Town Offfdals - •Icfaand legibly- TheDepmtnce thasprovideda-spa=E±thebDbmm Pleasebe sore$tat the a$tdav is comp am hm to co�y�mg�gthe agplim offlze.a$idavitfor Pat"fa onf in.tl�.o Mm±the Office ofInvestig� � cr.a aiia&n,BnaFP�� Pleas6 be sm-e fo 511 mthm PCU�OHc=e der wbicb w�l bt used.as ar &Only �onen—n affidav¢=adi�� Ie �ce�se applic di®s m any gives Y�need only sabmit thatSt submli m P c and der`�Db A�-�T�ss"the applicant shun]d `�sII Iacatli-ems ia__C er p olio info�tion�(¢necesaiy) ed ar mated bytl�.e e±y m townmaY be Provided fa$� - town)--A copy of-&e-a$dav=tthathas bey officially s e��at hcenscs_ Anevt affidavit=lst be:E led out each appl-i as proof thd a vfd affidavit is on ED far fatm css ar�rmn=ial veDnr� . year.VZheze a bonze owne[.ora is obfa�ng aense or pemsitnotzela�d to any bnsm (ie.a.doglic=f--orpe�.¢tob=leavers eta)saidpesanisNOT�dtn Meinthisaffidayst fBVV� ig WoIIdClhletotl riv� �kYDUiaa � oo YDnrop=a icm=.dsbcUIdgotlh&Vr The Offce❑ �. please do notb.esiLEi tD giVM'=a call_ . `I1�Dep�m-ems address,in1�Ph�e and ia7c uu�br,� . • . '}���a�o�t�ea�of .� � Stt M•(Al ZZ TeL tpt 496.or 1477 M Fag 617-727-7749 Op THE Tp� + BARNSTABM + MASS. ,.� Town of Barnstable ra Building Department Services Brian Florence,CBO 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, lX 6a— as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: r— (Address of Job) 7 Signature of Owner Date C- MT7lJ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILESTORWbuilding permit forms\EXPRESS.doc 08/16/17 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction£Supervisor CS-104384 Expires: 07/27/2019 .# . STEVEN L HETZEL 72 PINE CONE-DRIVE WEST YARMOUTH MA 62673 Commissioner Liccnr;c-oi registration valid for individul use only before the expiration date. If found return to: 00ice of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA.02116 Not valid without signature - C��e�i���em�o�itve�u�!�a��/l�ra,trcc�t�IcCla Office of Consumer Affairs&Business Regulation f4OME IMPROVEMENT CONTRACTOR ._ e gist ration: 1t5119 Type Expiration 1/7/2018 Individual STEVEN HETZEL STEVEN HETZEL 72_PINE CONE DR. >W.YARMOUTH,MA 02673 Undersecretarl./. Board of AUS&O DATE Yachts C g&mi4m.Trust,W.Ocean Street;Hyannis TO he T! JwVyf:ftn-qbblBufl&tg C:,,mj,sioner', Bold of:Trustees foe � od iurn Trust vo d:hxC a pro ed the .` atta i opa to be performed„as is deliri�,�:ted in the vie recei�r�d m tine } t ,Q ^4 taOw� Offi.the wm a5 defined in C�a prOpOsa�. This iet�a Jcrves::as notice of the BoaTrd's Grote. approve,he praposai,which has been noted in the: mu.. o` �e Bmd Meeting. Sig L;u ,dz_?Wns= PexWt es-of PetmT day.of 20� L - YCT Trustee B s YacWMA i ',ondama Trust 5€�e'14ce (c% ex's D cry ; 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map \ Parcel b I— pp icatidrf#"' Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street AddressC Village 0 Owner `fi Address ✓ `��� 0-X �a Telephone 7 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �l s Project Valuation `l Construction Type Lot Size Gran, Yes No If yes, attach supporting c`r rting donenl n, ❑ ❑ ion. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) , Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑=Yes 5,211 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other =: ZZ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new°` rn 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) 4.1 Name 4�fa*J S Telephone Number , Address License#- 6 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lu",k e SIGNATUR' E c DATE `i — 13 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. { ADDRESS ' VILLAGE f OWNER - { DATE OF INSPECTION: FOUNDATION t{ FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL { FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i r ' r The Commonwealth. of Massachusetts Department of Industrial Accidents Office of Investi;ations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le2ibl Name(Business/Organization/Individual):hea Address: 02 (esI0AJ City/State/Zip: L lA/612& , Ile. Phone#: //D/ Are you an employer?Check the appropriate box: Type of project(required): 1.511 am a employer with A Q 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 g. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. [� We are a corporation and its 10.❑Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their 11.❑Plumbing q airs or additions repairs myself.[No workers'comp. right of exemption per MGL 12.❑Roof re airs insurance required.) t c. 152,§1(4),and we have no employees.[No workers' 13.9"Other comp.insurance required.) Lj,4L 4- 4; 8 P *Any applicant that checks box#I 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 thepoliey and job site information. Insurance Company Name: 5(J!'r1/!V �✓ Policy#or Self-ins.Lic.#:Ale of �d /0 3 So2 3�� Expiration Date: d o� " y" 0�,j �4t (/Nam`I 10 City/State/Zip: /State/Zi Job Site Address: h' P:— pa-68 j 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 die pains and penalties of perjury that the information provided above is true and correct. Si nature: c Date: ;3 _ Phone# 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 Inspecto 6. Other Contact Person: Phone#: f Client#:30124 SOUTNEW ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 8/06/2013 THIS-CERTIFICATEI5=ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS-NO=RIGHTSUPON 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 C E, T (Anita Little Willis of New Jersey,Inc. NAME: PHONE 856 914-4660 FAX 856-914-1881 A/C No Ext: A/C No 1015 Briggs Road,PO Box 5005 E-M Bess:,'anita.little@willis.com PO BOX 5005 INSURER(S)AFFORDING COVERAGE NAIC# Mount Laurel,NJ 08054 INSURERn Selective Insurance Co Of the S 39926 INSURED INSURER B 1,Argonaut Insurance Co. 19801 Southern New England Windows LLC INSURER:Beacon Mutual Ins.Co. 24017 D/B/A Renewal by Andersen INSURER D': 26 Albion Road INSURER E E Lincoln,RI 02865 ' INSURER F i 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 COIiITRACT 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DDIYYYY MMIDDIYYYY A GENERAL LIABILITY S202945900 8/10/2013 08/1012014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES EaEocccuErrrence $100 000 CLAIMS-MADE a OCCUR i MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATELIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY PECOT LOC $ A AUTOMOBILE LIABILITY S202945900 8/10/2013 08/10/201 E°accidentSINGLE LIMIT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS i $ A X UMBRELLA LIAB OCCUR S202945900 8/10/20.13 08/10/201 EACH OCCURRENCE s5,000,000 HI EXCESS LWB CLAIMS-MADE ': AGGREGATE $5 OOO OOO DED RETENTION$ ' $ C WORKERS COMPENSATION 0000068028-RI 08121/2013 08/21/201 X J WC STATU- OTH- AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N AIC927818352394 8/21/2013 08/21/201 E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L:DISEASE-POLICY LIMIT $1,000,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) - CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE POLICY. PROVISIONS. Lincoln,RI.02865 AUTHORIZED REPRESENTATIVE ©1988--2010 ACORD CORPORATION.All rights reserved. 'ACORD 25(2010/05)"- 1 of 1 The ACORD name and logo are registered mark's of ACORD - #S2151091M215088 AXL F Southern New England Windows d.b.a Renewal by Andersen of SNE Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-095707 ,- f BRUN D DENMSON 7 LAMBS POND EIRCLE s Charlton MA 01507 I\ \ Expiration Commissioner 09/08/2014 O �pa �1����6r�uare� Office of Consumer Affairs n Business ego aUon 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Egllration: 9119/2014 DENNISON BRIAN 1137 PARK EAST DRIVE ' WOONSOCKET,RI 02895 Update Address and return card.Mark reason for change. sos I 0—W11 - ❑Address ❑Renewal 0 Employment 0 Lost Card mee ofCmvomer Al4irs&BosiamHeaahtioa License or registration valid for lndividul me only % RoglaVatlon: OME IMPROVEMENT CONTRACTOR before The expiration date.If found return to: Office of Consumer Affairs and Business Regulation - 173245 Type: IOpark Plan-SOBt S170 g EaPiraWn: 9/1912014 Supplement Uard Boston,MA 02116 SOUTHERN NEW ENGLAND WINDOWS I.I.C. RENEWAL BY ANDERSON DENNIS BRIAN 1137 PARK EAST DRIVE WOONSOCKET,RI 02895 Uad,-,.tnry Not valid without signature - CL cK as CL I ,� , ' �+ Lo LA jj -„ j. al Ll4 vow all rr,'� tea'` �' a gg j� qt ,�f1 g � � �Nt cr,, Ff ME. rl d �z 0 bad .� _ y z TAf WE �3 f mg For R g ® [y T Apr'�+•am 3► Ire �' t 9 cell iffi7 "q� , .! " ,,, .�. '� •� de - t � ' '-'4 ''- ..'�. + - RjL 'a rMIL s a� OR gg cl V, -- 3tits, A �q C Lr C �. J� � �+ � � ct 4�3 --. � - ".,: D w R � ia. all S, "4 C E'.. �'�aw -+ � •t � tea; �� � � � �' �` Fit � ,� r� �1 The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Yachtsman Condominium Trust P.O. Box 1283 Hyannis, MA 02601-1283 (508)775-1515 DATE j3 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 performed as is delineated in the request we received from the Unit Owners. This letter serves as notice of that 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_4—day ofTx: ,20J3 0 C e- Secr to Boar o Trustees Yach sman Condo `nium Trust 500 cean Street(c/o Manager's Office) yannis, MA 02601 Enc./File i "' *The Yachtsman 500 Ocean Street, Hyannis, MA 02601 Yachtsman Condominium Trust Hyannis,Ma IMPROVEMENT SIALTERATIONS TO UNITS (508) 775-1515 of unit#... �....( )• •� ?�. 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. , for permission for the following: --LocWon(s) ... :4 ..: �6� ..� 1 .. . .. . x7 jtr/�. �1+ � � :5......... Type(s)..... Smry art for �� = - 5 %, °GIs �V c AIR CONDaLTj0ffFJ I: ,d �— Location(s)`& Type. ',,, e"' 3 `l t ............... .............................................. ..... . . ........................................................... ................................ ................................... .... ............................. ................. .................. * CONTRACTOR: .. �,�?4:: :4�1..... �t .��.[ .C;',-ca)a............................. Ail° Signature Daie / M= Contractors must have a valid license and have both workman's compensation and liability insurance. .No work may commence in any common areas until a valid certificate of insurance is delivered to the resident manager. . Proper permits as so required by the town of Barnstable are also requested to be on file with the: resident manager. � 7 a i 13