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0500 OCEAN STREET (52)
Soo Dcea-n `T IC16 3 13R s� Town of Barnstable ¢e z z r^ Building f im ;be Retamd•on.Job antl.this-Car u , ., . . o �This.L�a.d.,$o<That�t�sVisible�From Lhe street. A roved�Plans:Mustbe � .MA6'A. y a coon%Has B err:Ma e r,. Posted Untrl:'F nal.Ins "e, �, v R 1� • �•<, � "' " Occu � d= "ntil•a'Einai Iris ectaon"h""s;been,.made. 111 eat W,here,a.,Cert�ficateo O,ccu anc ��s Re" uired,.such;B•u�ld�n shall Not,.be e `, -. �. ._ .:. 3., ..,;,,^��: . �a :� P , y., ;.ram q ,... .� Ma' �,,- ..�s g�,� .^m..... ..�.. ca <; _.»�..:>. ..�.,r. .; ��p r..., ,� :• � ...., ,,. Permit No. B-17-827 Applicant Name: Anthony Nese Approvals Date issued: 04/13/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 10/13/2017 Foundation: Commercial Map/Lot 324 040 ODF Zoning District: RB Sheathing: Location: 500 UNIT 132 OCEAN STREET, HYANNIS � y Contra m ctor Nae: Anthony Nese Framing: 1 Owner on Record: KOTSEAS, HARRY P ET AL TRS Contractor License; 090335 2 Address: 38 LORING ST r •• - t Est Pro ect Cost: $5,000.00 ( b Project Chimney: AUBURN, MA 01501 permit Fee: $160.00 Description: remodel 2nd floor bathroom, new tub/showeQ ari twltoilet etc-floor Insulation: FeePaEd' $ 160.00 Project Review Req: remodel 2nd floor bathroom, new tub/shower vanity/toilet etc Date 4/13/2017 Final: floor r � -- Plumbing/Gas E J � . 41 Rough Plumbing: Building Official Final Plumbing: ': . : s..�.. . g: This permit shall be deemed abandoned and invalid unless the work authoriiedby this permit is commenced within siz'months'after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this.permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by Iawsand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street dr r,oad 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 Bu lding and Fire Officials are,provided on this%permit. Service: Minimum of Five Call Inspections Required for All Construction Work..- � � • 1.Foundation or Footing ) _ Rough: 2.Sheathing Inspection -• 3 . � � »••�- 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to CoveringStructural Members Frame Inspection)( P ) Low Voltage Rough: g 6.lnsulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health ,. Work shall not proceed until the Inspector has approved the various stages of construction. Final: ,I?ersons contracting with unregistered,contractors do.:not:have access to:the guaranty fund"-(as set forth in MGL c:14.2A). ire D p m t F e art ` .. Building plans are to be available on site Final All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT-- 1 � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map JZ`7 Parcel 0 Application # fd / Health Division ��d Date Issued Conservation Division Application Fee Planning Dept. �® Permit Fee Date Definitive Plan Approved by Planning Board "�. Historic - OKH _Preservation / Hyannis �� a Project Street Address �� 0 0 S" n, � l 3 Village PLnr\, S NSA n(o Owner 0 7 zo/-,jl 5T n �f -�r � �C6 S Address� Ad Telephone -1S -- 15�3 (Skno- or. Z S7 - -7 /S6/ Permit Request Q ✓� rJ�, z fr oo r �,�- �.,� ��.r-mow -�✓� �s�,�� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new y Zoning District I L (1 Flood Plain k Groundwater Overlay eY Project Valuation 15:w6•o 6 Construction Type Lot Size Grandfathered: ❑Yes \M-No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes �J No On Old King's Highway: ❑Yes \b No Basement Type: ❑ Full O'Crawl ❑Walkout ❑ Other Basement,Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) l \ Number of Baths: Full: existing_ new Half: existing / new y Number of Bedrooms: Y existing —new Total Room Count (not including baths): existing I (` new k First Floor Room Count k Heat Type and Fuel: Ur6as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Q!I'No Fireplaces: Existing K New Existing wood/coal stove: ❑Yes�YNo Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size X Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size �`Shed: ❑ existing ❑ new size \% Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial dYes ❑ No If yes, site plan review# Current Use Z Proposed Use APPLICANT INFORMATION .(BUILDER OR HOMEOWNER) NameA7:ATelephone Number 7 S g Address � r. La — License # !.t/LSD �a/ns �a✓ �— , MA Oz66� Home Improvement Contractor# l 7-31 Worker's Compensation # a i w L 7 -,0 7 cf 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ';j _ DATE } r � ( FOR OFFICIAL USE ONLY ( ` © APPLICATION# ( \ � } DATE ISSUED f MAPZPARCELNO. \ } ADDRESS _ VILLAGE \ fOWNER a / DATE OF INSPECTION: . . � i FOUNDATION / FRAME R . / INSULATION / FIREPLACE . \ ELECTRICAL: ROUGH FINAL . . iPLUMBING: ROUGH FINAL ' { GAS: ROUGH ' FINAL FINAL BUILDING � . . DATE CLOSED OUT / ASSOCIATION PLAN NO. \ Bowers, Edwin From: Bowers, Edwin Sent: Monday,April 10, 2017 9:57 AM w To: 'anthonynese@gmail.com' Subject: Permit/Application:TB-17-827 at 500 UNIT 132 OCEAN STREET, HYANNIS for Building - Alteration INTERIOR Work Only- Commercial Hello Mr. Nese Please provide Info on location of unit 132 in complex( Map) And basic floorplan of unit Highlighting.area of work Thank You Edwin Bowers Town of Barnstable Building Inspector 508-862-4025 1 -I,;,`"�1"ii,,I-';-����1��,,---�x..'.-,I-:.::-.�..,.:i,-.,:1::..i:: x - ��, - t ; A - 1`^ -+• + why- .j. ..,s_,a.a..:M.n_ fi-�11.71t::....I.III��I...I�i:-��:ii..�.�::.,:.� �,:�-.I�:1 ti....�...:....II;.��: 11�:.:.1......1.;�:. ,:.�:1 -�:.1-.::.:.:.-�,,-�-:�IIN:..Ii..,::.,.I�..... r i:...1,�:.-I..I-.-:...,;1,I...1.,I,�,.....:;.zI....,;.,.�I-..-....�.-,,,,.II.-1��"I,-...-:,.!.I.-..1--:�,,II-I1.:....�I�"1II�..�I.-..- I.,,I!�.-1--.=I1.�-.1:....,-....-.-.I,I.�,L,",,..-:....�,1I,..-.:-,I 11.I-I-..:...,,I:I,I I....��.....,�.1.,I.11,.-1:-....,-.:I.�.,I.I,I--��:..-11..1-I.I;-k,;-,rI,.,.I,I:-:...�11:..1,I....I-I.;-,.II,.I,.II I"II:..I.:....I:�,...:,I.�-.I l-.I.I.,..I�I....,,I-:....-..�-...:.II.--I�:.II...I.,.1,...I-,f.....,.,I.,.....I6III-�I..II:I.".I.1,..I.I'�.....�I,I�..,I-II"...�,.:-.I..I:...k��:.1..-I1-1 1'..II��.......:......I.I,I�,II.�I1..II:1".-1-I-�:;....:....,.,n--��,1...I",.-....:n�11-I..I1.m.�1...II......1���.,-I-..--I�I.I-1-1�-��.,-1.............I I'r I:::�...,�t1.11;,--,.11-I-...,II...............:��1:�:..1l...V��1..:.II.....I,;.:..':.........,1i,I:::N.-:;1 I.�I;.;...j........:..1 1:::.-,71 I..".,.;...:.........I.:�1I,��..�.:�..--.:..N..:,1.-i,,---��II::.M:..:j........;.I,I,..-,,���II..:.,.11 I:;:.i..�..I::.:...:......I.... � t _ --::F III1-.1.:::.."4�:::..:.:..I�-�- 1:.-I,.�.�-..:�:.:..I�j�m:-N1-1:-�.-.!.�I�I1I:..,:�-���..�I Lt:.-.i.-.It::...-..,i,.11��:.:...E:��::�11-�I,.,-�.0-,I1IN:..�n....-.--:.: .I�.....:-...::.�-...1.���-:....:.-.i�n.,1"I.2..-.-.z-v,::.2:�.�....�;.:.�..I.!......:.:�z.,I:��.:i,-....�:�.In:-1l.�.1.�.ln::.I::�:.i.......t.:..-IIi......1:-.-..::-.;:1:...�.In�...:--.1i.�.11-.,...i1:..:::�.l......-.�:.t-i�......:,-�.;i.2,:::- -:I,7,I..,..:nn��n�.:.:..;1......:.:--;m,2:.l........:;,.......;Z��.".1:::-.:...I 1..i:::�..:�:�!.�.11I...:.�-Ti:.::.�........::.I�I.......dI%::-:I...:I,2:..:.:.F...t:1.1:::::::...::i-.- 1.:..... ,I.!:::......;!1.%....E;:�Iinii.�........:..:t....I;I-::.k..I im-i!.I:.:.!...:;I:I:I::::.....:.:;1-b:i...::..:1II:1;u::4I�........::..:.-:.......;I,:::...,.":i..:.:�:..:I:M::.....:i1%..:.F::..:1t,=u!itIi..II1...::..:;......-;q:...:;..;i�..:.:-:..;::::!::.....I:..iit:...:::..:.::::.!.--...::....-:I.,�...�.-:j4:...:;,:. in;..:I:....��2i::::....�....::::..:., t:!.�.I.::....,,:;�..�..!:=::...:.:t1!..:.::.1.;...t4:!:.....I:.:.:i:::.:.z,.,:�.t.]�.--1I..;....:.i..I.�.�-1.r::F�:...:.-oz:�v�-.:.::...:........�I.;.,.r:+:::::.:Hzi�!.:I...;i:i....N-....I.::iI�I:d..:;ptl....1,.;,:..1�.I....-1!:;:I�..II.;.tNr:i..:::::��2.I;:� .,�..:i1.....:m::..:.;.:pi:1.......1,... :.j:�.;-;i...1nN...:I�IF;t,1.;n::1i.........,..:.....1.t::-::- :;n..j;F::::....I.-:ni11..:�.�.:,::i::..i........:-..........:.:I.::::1 ii:i..:.::I.�z.,..I-.::u.....IIi :.i--I....:;.;3::,�q:::..i........:1�.-.......1.t4:::.::...'iIl�:�..:.:.:..: ".:::::.....II:�:i.I:.:.::.:-:;::.i.....I...1;...�.,I-..2:::.:::.;I,:�..:.:.:.,:-:...4:.....I..�...::.:jj l,".;t-...:!...::..1:,q�.::.;O�p::::.......;;.,�I�..1..�I:::.....II.�:;:!.I.;-::.zl:":;;;l..I..:i....::...;.ti-�.:'::::::......II R;�;,,:i.Ii,:.....- ;.".,.-...:i....::.....:;:,:..�::,::::.:....I,�:.,.,.I�;.-1..-:4:�....!I.::4:I..:::�Tz�::.-.�::..:i...::...,:t,I-::::.:.....II:.,..1.I.;nL.:-..�,��4q:2Ii..:.:"::w,1k.,:...rt:...:!..I14:..I-I�:.i::i:.I....,.II i..-....I-;::.i:::;:Ni..:I:,:�,:1,::;:::...-I -:;I.1,I.I;,�:.tl:=:::.l......II�,..�!vN.....,::.:,�:�Ni..:.: :z-"�:F:.....;..mi,,1IIII.-:.:i:::.l......I:-:r�..I.1-......�::.:::��� ":N......�I��i�I,,-..:..:i t:.l11.2�:.:......;,.11�::.�::.;,=:.�:.:,.-I1.i::r.....���-..:.�:::�, :.�,1.:...i...;II��li:.::.I-::.II�.71I...II. ,,:....:i....::II,��::.::.�.I,I�-:::.i...1�.E;.���-:II i,:...:-....;III ::.�,II:::.l,.""�,�.e-..,II-....:�...--.�i;IN...:....::I�--::.1'II1.�n:::.l..I i:II.I ..,�i:���1lI...�...:..I=:.;:::...,�ie,�.I;I......:�.�-�i lr m...;....;:II-,---7:-,.:,:::.:-..1I�1:.III,P.;I2i, e%K�.M.,.......=�.I.I�-..,T,:::.l,,..,,�;11,-:.I.:.:I::�1i� _v.I.1".......Mi.I.:....-�:,1�:�l"I-:..I.��:.::I%.�i; -:...,......---....ii� ,.:��:-..,,.l..,- �:,::.�.-...l.,:.....I����l.�-.-l�N�-�: -..�i�..,:�I.��.l-t.:.I-:.1 t���..1.;,...-I.I,�I�:-�.-�i:..�..�--::m-,.�,:.m.......;11�1.:..�,IIII.�:-��.+:%�:=�11i... ,Ii.,....lI1.::�:..:,�.....-.;!�....II:��,.i I,,n:llI:.i::.�:-t1-.::.:..l l...�.-,.::,;-.::.:..�:I,.....:.!::--..�.-:.�:., %::%�..i.i:..-.,:�Ij1.::.:..I,II:I...i.1.;1i�,. ;,..-�;;I�1i:::!l I�:��.:".i1�:....-�1.-::.:..�I:I...j:�-!!:.! 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P Massachusetts Department of Public Safety Board of Building Regulations and Standards �+ Satty mdHMM 36-004930868 �5 License: CS-090335 HA Construction Supervisor ± ti This card acknowledges that the recipient has successfully completed a ANTHONY M NESE 'y 10-hour Occupational Safety and Health Training Course in 84 MINTON LN ft 5 T7& Construction Safety and Health " WEST BARNSTABLE MA.02668 ohm. ` 1 Anthony Nese (�.�n CA— Expiration: deter Rice 6i5873 8/6/2014 f Commissioner 11/09/2018 (Trainer name—print or type) (Course end date) I C//ae�amrnn�aure�utt�a�C�/�usa�rs�cclet�� � �, " + 4 { Office of Consumer Affairs&Business Regulation ' . HOME IMPROVEMENT CONTRACTOR E 0. Registration-!l78731 ..Type:' '' SAFETY CERTIFICATE i t . 5/93/20.18Ex iratrort Corporation 86 Anthony Nese SANDY NECK BUILDING&REMODELING LLC " Has completed Excellence In Safety=s Elevating Work Platform 8 Construction Forklift 0 erator Training at She Wood Products, ANTHONY NESE . �.� P 9 l�Y , 84 MINTON LANE ;- r% Hyannis,MA. W.BARNSTABLE,MA 02668 Undersecretary Richard Hughes,C.E.C.M. August 17,2006 Trainer Training date 1 ' , Commonwealth of Massachusetts ® Department of Public Safety License: HE-128057 Hoisting Engineer ANTHONY M NESE 84 MINTON LN „I O� � IV WEST BARNSTABLE MA•02668 �^( OK CA.— Expiration: ' Commissioner 11/09/2018 r Ac V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED 11 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 f 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). I PRODUCER CONTCT Nancy y Bums CLEARY INSURANCE INC. PHONE E . (617)723-0700 A/C No: E-MAIL ADDRESS: nbums@Clearylnsurance.com 226 CAUSEWAY ST. INSURERS AFFORDING COVERAGE NAIC N BOSTON MA 02114 INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER B SANDY NECK BUILDING AND REMODELING LLC INSURERC: INSURER D 84 MINTON LANE INSURER E: I WEST BARNSTABLE MA 02668 INSURER F: COVERAGES ' CERTIFICATE NUMBER: 105117 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POL EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DICYIYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE REMI P REMISE OCCUR DAMAGES RENT ED- S Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY a JE Q LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED id N/A BODILY INJURY(Per accent AUTOS AUTOS ) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE E $ RRED I �RETENTION$ $ WORKERS COMPENSATION /� STATUTE OERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNER/EXECUInVE E.L EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? I NIAI N/A NIA R2WC760743 08/14/2016 08/14/2017 (Mandatory in NH) - E.L DISEASE-EA EMPLOYEE s 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT s 500,000 N/A DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees instates other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE W Hyannis MA 06010 _`± LL�'Daniel M.Crowey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD the Comnizorrivealtih o,f?F assachusetts Deparkrnuit o,f Irul=&ial Accidents u - farce of Investigations 600 Washurgion Street Boston, M4 02111 wivan ma,mg.rvIdia WGrkers' Campensatian Insurance Affidavit:Bu ilderslContractors/Flectricians/Plumbers Applicant Iufmrmatian Please Print Lmbl/y /f TVe(Busmerganizationflnddna3}. ✓i�hU►'�� �L 154,n( /t C� _ Address: ^A— CityfSta&Zip-k/ M4 6'? Phone-'W'-_ 9zo o Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with. 4. 2arn a general contractor and I 6. ❑New construction employees:(full antVor part-time).* Have lured the sub-contractors 2.❑ I am a sole proprietor orpartner- listed on the attached sheet. I [remodeling ship and haze no employees. These sub-contractors have g-,❑Demolition wodting fbc me in any capacity employees and have wodcers' [No workers' comp.insurance comp.insurance 1 �. ❑Building addition required-] 5. ❑ We are a corporation and its 10:❑Electrical repairs,or additions 3.❑ F am.a homeoumer doing all work officers have esercised their 1 L❑Plumbing repairs or additions. myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs ins,rzance required]B c.152,§1(4�and we haven employees.[No workers' 13.❑Other comzp.insurance required.] 'Any applicant dmt cheds hex is1 am€t also fille=the sectionbelovw shavring dneir workers'compensation policy iadoemauoa I Sameowners who submit des affidmat imd ratmg they are damg all want and then hie outsides contractors mast submit a new affidavk indicating sa L fConttactna that rhea ibis bwE must attached an additional sheet shouting the nuns of the sub-com mcom and state whether ar not those eadties bav employees.If the subtantactmshave employees,they mustpruvide their workers'camp.policy number. I am an empLaier drat fir prm,ding warkers coetgwnsrcituii insurance for niy entplq}ees ,Betaav is the porky anti jab;dYe inforrnalion Insurance Company Name: �' / art S'L�rOt r t�t� (10 Policy,or 01 l^)L-2�0 1 3 FxpirationDate: O /� �{ Job Site Address:.��40 0ejA n. S-l- y y 'A- 13 Z_ City/State/2.p: Aittach a copy of the workers'compensation policy declaration page(showing the policy member.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$1,500M.a>,dr'or one-yearimprisonm:end,as well as civil penalties.in the form of a STOP WORK ORDERand a fine of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of lnvestrgaff=ofthe DIAL.for insur` ce coverage verification. I do hereby cci,fy Lander the ns and penabyes of that the information abmw is true and correct Signature: Date: Z-7 7 Phone 0: 5�� 4/Z Official use only. Do not mite in tFd.area,ter be completed by city artown o iciat City or Town: PermitUicense 4 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cat )Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and T-n.structions ; Massachusetts Geheral Laws chapter 152 requires all eioployers to provide woIkcrs'compensation for their employees. piursilant-tD this fie,an employee is deemed as-'-every person in the service of another under any contract of hie, express or implied,oral or writftm_" An ernvloy�n'is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an mdividnal,partamship,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant ofthe - dweIIing house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building apprntenairtthereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct bnfldings in the commonwealth for any applicanttvvho has not produced acceptable evidence of compliance with the insurance.coverage reqused" Additionally,MCrL chapter 152,§25( (M states"Neither the commgowealth nor any of its political subdivisions shall enter into any contrast for the performance ofpublic woric until aoceptable evidence of compliance with the msura„ce. requirements of this chapter have been presented to the contacting avfhouty." Applicants Please fill out fie workers' compensation affidavit completely,by checlong the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone numbers) along with their certificate(s)of innu nce. Limited Liability Companies(LLC)or Limited Liabffity-Partneiships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidaYit may be submit to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date-he affidavit. . The affidavit should be rearmed to the city or town that the application for the permit or license is being rEgaested,not the Department of Industrial Accidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-msurance license number on the appropriate line. City or Town Officials Please be sore that the affidavit is complete and prirded.legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contract you regarding the applicant Please be sure to fill in the pen�it/license number which will be used as a reference nnnber. In addition,an applicant that must submit multiple pemlitllicense applications in any given year,need only submit Due'affidavit indicating current p olicy infbr i ation('if necessary)and under"Job Site Ad-lTess"the applicant should write"all locations in (city or town)_'A copy of the-affidavit that has been officially stamped or madced by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (if,-. a dog license or permit to bui leaves etc.)said person,is NOT regained to complete this affidavit The Office of Investigations would at to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number. Th�Camanwea lh-of Massachusz-tts Ipepattnent 4f 1ndush:ial AO(�i dents Of Qf111vestigatao= 6Q��ashin�tan t,• • Bostw-.,MA G2111 T(,-1.4.617' 7-4900 ext 4€lM or 1-977-MASSAFE Fax# 617-727 7M Revised 424--0 7 . ias.,�_govfdia Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DA3 C-O I7 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 lineated in ere uest c 'vad'f the Unit Owners. Contractor, 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 day o ' 20 7& YCT Trustee J Board o Trustees Ya man Condominium Trust 500 Ocean Street (c/o Manager's Office) Hyannis, MA 02601 Enc./File f . � . . I I I .. . . I � .�� I I I I I . I .. I I.I . I I I I I...I I . I . .11. � I . I .. � I � I ,�I � 1. . , .: - �: � I I I I I I. .�..... . . . ... -I. . , I I I I .I I . I I . I .I�I I . . . I . * I I.. .I ....., . . 1.. .. . � I 1. I 1 . ..... , I . . I.. . - . 11 , ...� I _... 1-1-...I.... � � . - I —— .1. I , ::.:. ,::�. , . I I . I . . I I I— — � I—— 1 . . �� 1. I.. .., I �.. . ...� 11 . 111 . I :� ... .. ... ..I.. ... I ... . . . I I I I —. 1. 1. : - .11:- _ ' ' . :_ ,: I I .. : . .. I—. 1. . ...... , ..I —— I .1 I 1. �1 . I... . _ � .. . . .. . I : .. I—.1.... ..... . l . .1 I . .. . . .. .. . . ... . 1 . .1 . .1 . � � I .. I I .. . . ..:;.. ...,��:''� .:, .. .. � � .1 . . m . . - - 1 . � . . .- : .. - I .. . 1. ...111.1 I ... I..,:,:::::: :: � 1: - . . - . ". I I I � I . I 1.1-- ' . I . I I 111 11 I . 1 . I .::.p::: p I —- :.z,:�.:::,:!�,�z::,::.,.,...;.. �.. . 1 I I . ,... i , I . .. . � � . .. . I . 1.11 I I. . . ...:.....,I..".�....- I 11... 11 1. � I ..., 1.11 1.11''..l. 1. I— . 1 1 . I .. 1. ..... .. 1. I .: .. :::_ ....:.:,::_ I I . .. .1 .. . I ...... 1..... 1 . 11.1 _ _...::_::. ::.I.I.. I I.. I I .l... I , �.. I I . -:., I I. . ...I I..I......I..�....I I.I. I �.I I � . I..I -�I..�-I ...,I..:..b I I.,I.,I I,.."I I I ,..I��I I� I...........I. ................. .I.:: �..:: :: p�:... � . . � .�.�� .. .. .. I.. . .. ." I 1, I.. .. .. . I :. I ..,..I� I...I..I.....,. I ,.I . . .. .�. .. I I .. I .I. ...I,I.I I..I...I ..�.�. ... ........I.....I...... .I:. . . oFx T®gin ®f" �rastahe M 1: Keg latory Services suss �,, _ Thomas F Getler,Ilireetbr s6s¢ .8_ a � B�aiidi�n Divisia>3 g m Tom Pier ;9 Building Commissioner. 20Q Alain'Ste t, Hyannis;MA�0266 f Www"Vvn.6rnstable.1.ma us ;:: Office:: 508-862-4(}38 ' Fax 508-790-623Q. ' . ,.a._ r . 'r perty Owner,Must r Complete�and S This;Section1. If�7sg'l� .�u1 .ld1 .e .: �, ,P Nt f� _ffi r 407MAe D'F✓ ,as Oa¢ner of the`sill Ject property hereby authorize /�'IIfD1✓ /✓ E to'act an':rup behalf, . .. .,,:� ry zn all natteLs relative to work authoa ized by this butldtng perintt apphcatran far.; s_ Ca n/ lJf✓�i l3� �i✓ S'� (Address of Job) : . r /f Dt 7 Signature o er Date . C, 11 . ��'�SG9S Prsnt.Narae r . . , If Property,4wuer;is applpvug for perrJnit please complete the Homeownem"Cense Exemption Form,on"me rev erse`siile. ,$:XV .. .... .. .... ...._ .... .. .. -:. .. ... .. :.: .::: :. . . . .... ::... .-... ... :, .... .. ..... ..- .: .. .. 4 t:: $' . .. ... .. .:. ."... ...... .. ... :.: ..;Z