HomeMy WebLinkAbout0500 OCEAN STREET (6) �'�a ������, ��
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map r a9 Parcel Application`_# _ ��(o J q l
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee ,
Date Definitive Plan Approved by Planning Board C _
Historic- OKH _ Preservation/ Hyannis
Project Street
iiAddress
`` �� 500 (JG5A� 5TI°QST (J 1) IT �0
Village l �N i E
Owner&q* FgrR' 'L' J- 1 MAC*-6/ > " Address
Telephone I- 914 bPmor'Terz. -- 6A-1L -P,f��
Permit Request �- P 3 �6 e�S /d-� �U b/IV C ()pf1 at:r,
SA-M 6 S+ 2 c C-_Puy ra?OW( < U/4a71S/ny C�j W
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 491om Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) o'C4-
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
owl
Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing o mew 0
77
Number of Bedrooms: existing _new .ate ,v
Z? CbO
Total Room Count (not including baths): existing new First Floor R(9m Lunt
y
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
� a
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 7GUG) ��—LC�S( " bkM Telephone Number A-b e-ZS 5?s Z
Address Z P��� Cl�1 � License # A
Home Improvement Contractor# �65'11
n
Email s C_I�G t Z (�D M��- C�'� Worker's Compensation # 1���' ' � rkod P'
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE MO ` �°
'i
FOR OFFICIAL USE ONLY
P
i
APPLICATION #
DATE ISSUED
MAP/ PARCEL NO.
St
g ADDRESS VILLAGE
+ OWNER
N
DATE OF INSPECTION:
N:' FOUNDATION t
ta' FRAME
INSULATION
? FIREPLACE
ELECTRICAL: ROUGH FINAL
S
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
ti FINAL BUILDING
4
DATE CLOSED OUT
t
ASSOCIATION PLAN NO.
i
r
�VE Town of Barnstable
Regulatory Services
HAM Richard V.Scali,Director
I Building Division.
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder '
I �� I �I' I �t , as Owner of the subject property
hereby authorize �'� �S �^'� i1 i�c�' $Tt 1"2 to act on my behalf,
in all matters relative to work authorized by this building permit application for.
500 OcEft 5L(r?2FfE WVJ' ot�;- --0tV i 4
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner e of Applicant
Print Name Print Name
I1 t 116 ,
Date
QYORMS:OWNERPERMISSIONPOOLS
Yachtsman Condominium Trust
Board of Trustees
500 Ocean Street
Hyannis,MA 02601
DATE UV 0 V-
RE: Unit LQ Yachtsman Condominium Trust, 500 Ocean Street, Hyannis
To the Town of Barnstable Building Commissioner,
The Board of Trustees for the Yachtsman Condominium Trust voted and approved the
attached proposal to be performed as is delineated in the request we received from the Unit
Owners. Contractor,-! U>,� �4 has been contracted by the Unit
Owner to perform the work as defined in the proposal.
This letter serves as notice of the Board's vote to approve the proposal, which has been noted in
the Minutes of the Board Meeting. 1/ /
Signed Under the Pains and Penalties of Perjury this---/ day of[00 �/ , 20 (�
n
Secreta
Board f rustees
tsman Condominium Trust
500 Ocean Street(c/o Manager's Office)
Hyannis, MA 02601
Enc./File
' ,3�xeCQl�rnarrf�eat;f#c nf?��sc€�irr�etts
Dep ar&rrmt a,f rndr serial Accidefdg
Effi-ce oflFnvesfigatiou
600 Waslifrrgiou j, reet
_.=y Barton,M4 0Z111
� 1G'fV1is711ASS�FF�dt(I ,
Wank-ers' Campensaf nn Insurance Affidavit:$ Idet-slContr-ac_tars�EIectricians(Plmbers
ARpUcan#InfaLmat'ian Please-Printf eerily
3iTTeasi>te ,'DrganizatiGn '�� ' nxaT�'1/�i� �'TCi'I Zc'C� L��S'(�►'-LLW 1 S •&i�7X�25
PIS
�it�ffat€'1g:�t Vi�1v�( 0 02�`73 Pony 6'0 8'-
mireyou an employer?Checkthe appropriatebo=
Type
Ty e of project r
�e�.:
1.El Iamaemployerwih
6- ❑New cons mction
employees(full angor part-fime)* 'havelairedf&.e sub-conimcfors
I a sole grolxieter Grpartrler- listed an the atta-shed slit. -2.� am - ElRemodea's
f and have no employees. nese sob-confradors have S. ❑Demolition
w a forma in ci i y eaTloyees and.have,woiicess"
„ �� � 9. R B.uitding addition
Rib, camp.ii *chance comp.insuranc�el
required I 5.'❑ We are a-corpozafion and its LO_❑Elecfdcal repairs cr addifions
3_❑ I mn a Homeowner doing all;-'Vorl€ officers have rcisad their 1L❑131umfringregairs or additions
set£ o Workem, right of exemption per MGL .
MY!--If[N. - L_O RcGfregairs .
in�ce reqnired-I F c.1,52,§1(44k audwe have ua
employees.[No wotkers'
comp-insurance required.]
'6'aY app�ttFiatr�iedcstwx�l mad aIsa SIlan�ft5.e sectEoa'hclawstxvtsiag i�eiru+o�'s�''cr�pevsatinapnTicginfaffisa�
I Sameoaaers wha mbmft ffm affidn a mffc=.g thq err£&ing slIwal sad ffm ham autadecoutractorsnmd sul}mit a new affidX&indiestiag MC13
fC'anhyct3mfut checYiLi.Lrmc must attar3xea aIIadditiaoal sheet shoucmgfl�namg of the snb co�rcrus and staPewhetl�ec arIIOt base��tieshSre
employees I€thesnTxautractncshsce empIastes,tbegmuSstgsoU�3rEheit nvrke v•mmp.polio mm +er.
I am afi arrtp��r flrrrt isprm2driig u�arkers'cattslrgrtsrtftort insrirarzce for rrz}T eirrplaJ.�ees $etvrQ is fiEsgaFicy�rrr�d tab s��
€rr,�armaiiar� .
Insumnca,Company Name:
Poptcy-or Self-ins.Iic_:g: Fxpiration Date:
Job Sife Addn= CitylStafelzip:
Attach a copy of the warkere compenszdonpolicy declaration page(sh-owing the policy number and erpiratiou date).
Fail m fa secure coverage as.requu'edunder SecEioa 25A of MGL c I5'J can lead to the imposition of rrimiaal pe>salties of a
fma up to$L5.00,00 and,'Gr Gae-year impxdso as-w6ll as civil peaalties.in the fora of a S'p[OP WORK ORDER and.a fine
of up to$250.00 a day against the violator. Be adiised-that a cagy of this statement maybe forwarded to the Office of
Iu�resfiaatirsna of a DIA fG3 ihsl>rnce coy erage vedflcatindL
I do£remby c upardgr the ' s art p�rtaWks a.fFerjujy iratfJie in omiatimi pram ed aborg` harE and carrect
Siffiafure- Date: i 1 1 14
t�•,�'zcIaI use az�£��. ,i?a atat e1^rita in fFel�.arsrt,�x be crrt�ptefe�d b}�'rity artair-rr a,�ctat ,
City or Town: Fermitucense#
Emning Aufhoarft),(carIe fine): 11
L Roam.-of HeaIfii. I.Budding Department 3.Cityffown.Clerk 4.Eleefrical Inspector a.PlumbiaLk Inspecfer
6.Othw
Contact Persam :Phone#:
-- — 6
formation and bastruiefiffas.
Mkcar- r-f Geneaal Laws h piy-r 152 requires all=TIoyers in provide workers'compensation for their empIoyees.
Pm�to
this s��,an�Ioyee is defined as-`�everypersQni a file service of another uadm airy co�ract Ofbire,
express Or MIphect oral or Wt
u co orafOn.or other Iegal e�Y,Or Ea-y two or more
Ai m-q,&TE"is defined as an mdividz<aI,partnership,association, rp
ofthe foregoing engaged in a-joint fie,andmclucag file Iegal represcutatives Of EL deceased employer,or the
recerV-r-r'or trastee of an individna);parin=SSP,
association ar otlier Iegal entdy,employing employees. HOwever the
owner of a dwe]Zmg hawse haymgnotmore Iha a three apartzme±s andwho resides therein,or the occupant ofthe -
dwelimg horse of another who employs persons to do Taus ce,con*acdon or repair wow on such dwelling hoIIse
or on the grounds or building app thereto anse shallnotber of such employmentbe deemedto be as employer!'
MGL cbapttr 152,§75C 6)also sues that"everyState or10 cal Iiren•i„g agencyshalEwithTiald the issuance ar
renewal of a licease or permiitto operate a business or to constrict buffdmgs is the commonwealth for any
applicantwho has not prodneed acceptable evidence ofcompli=m with tTze am-ance-covE�rMgerequired
Additionally,MGZ chapter 152,§25C(7)states-Ieitberfhe connngnwealthncr airy ofits political subdivisions shall
enter ink any contractfartheperfo rceofpubliaworlCu3tlacceptableevidenceofcompliancewiththeinso c6'.
req Clffs of this chapterhave be apresenfedto the ooniracting anihozity_"
APpffcants ,
Please fill ovt the Worker'compensafion aiEduit completely,by checking i3ie boxes apply to your sifnaiion and,if
necessary,supply�-coniractor(s)name(s), a&dress(es)a -dphonenvmber(s) along v*i$ithea ceri cate(s)of
M=auce. L=ff.,-dLiability Campanes(ILC)or UmitedLiablayPartnerships(LLP)withno enpInyees other than the
members or pmt[:Lms,are not required to cast'worke& compensation fiu;=ce- If an LLC'or F LP does have
employees,apolicy is required. Be advisedthatthis a$dayh may be snbmYff3--dto the Department Of Tndiistrial
Accideids for confluna ion of m�=cove Berage_ ATso sure to sign.and dafethe affidavit The affidavit should
be refrrmed to fae city or town tip the applicam i.On for the permit or license is b eing regaesbA not the Department of
nn c the law or ifyon are reed to obtain a workers'
rnrTnciziaT Aecide ST�nldyonhave any q g antes shonId enter their
compensafion policy,please,call the Departmeofatthent�bezlzsfEdbeIo� Self-insrn�dcomP
s eIf-m n ce license amber on the appropnafe line.
City or Town Offidals
Please be sine that the affidavit is complete andpriab--d IegEy_ The Department has provided a space at the bottom-
of
the affida for yonfn fill ant in the event the Office oflnvesfiga O=has to cozdactyoumgardmgthe applicant.
I� Please er. 7n addition,an aPPh Emt
b e=e,to fill ip the pemlit/Iiceme munbm which vM be used as a reference ferce numb cusent
that must saber m_uhiplepenmit H=osa applications m ny givauyeat need only submit One affida:Vit mdicatmg
and under`fob Site 4 �ess"the applicant should waEe"aII Iocafions in (city or
policy infer ation Cifnecessag) be rovided to Le "
town)-"A copy ofthe-affidaV tthatbm b=a officially s'tmIIped ormadtedbyAhe City or ta7m P
applicant as prooftl at a valid affidaYh is on file far fie permits or licenses_ A new affidavitmust be hued out each
year.- nea-e ahome owner.or ciE=is obtaining alicm=orpezmitnctrelatECltD aaybusiness or commercial veatse
(ie.a dog license or permit to bum leaves eta.)said pesos h NOT regnaed to complete this affidavit
The Office of lnvesdgaffi=wouldlilc to ihankyDn-hl abmce for your cooperation and shonldyonhave aay gQesflom,
please do not hesitate to give is a MM
The Depa�tmenYa address,telephone and fax number.
'h�Cammcuwe31ft of MassachuRdf;
I�egarEmmit of1�d€a ia1 A�ci� n
• �tc��f J����
Brans MA Ei111
T(�-L 617- - .M Qxt4Gf or 1477-MASUOR
Fag R7 727-7749
xi-,vised4-24-07 ww masg-g!av[dim .
DFtIMm,o �
F ; x,LICENSE �
\
,� ,, 4:xo aa:tiuusanec �.
REST,--
�s r. iTSIEYEN � r
e 72 PINE CONE DRIVE
W YpRMOUTH MA 02673-5422 � 1
Massachusetts Department of Public Safety
Board of Building Regulations and Standafds
License: CS-104384
Construction Supervisor l
STEVEN L HETZEL�
72 PINE CONE DRIVE1'�,+�
WEST YARMOUTH MAQ2G73
r
�/►L..�n tJ�.- Expiration:
Commissioner 07/27/267
�e�a��urrzarecaealG�a��C��l�cttaa�rrteCL,
'% _ Office of Consumer Affairs&Business Regulation
OME IMPROVEMENT CONTRACTOR
egistration 165119 Type
— Expiration 1/7/2018 i Individual.
T VEN HETZEL
ti
STEVEN HETZEL
72:PINE CONE DR.
W.YARMOUTH,MA 02673 Undersecretar
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