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0500 OCEAN STREET (7)
3 CDq© ►� Town of BarnstableBuilding a ..%r ,r: ,. w t.�. �i ,:# Post°This,Card So:That:rt isrUisible From--the�5treet Approved Flans Must be Retained on Job andthis Cacti Must be,.Kept M yPostcl Until;Final I ection Has"Been IVlatlePermit � ea,aRe° Where a Certificate of Occupancy is Required,such Build�ngshallNot be�Occupied until a Final Inspection has beenmade Permit No. B-19-3744 Applicant Name: STEVEN HETZEL LEWIS BAY BUILDERS Approvals. Date Issued: 11/05/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 05/05/2020 Foundation: Residential Map/Lot: 324-040-OAA Zoning District: RB Sheathing: Location: 500 BLDG 2 UNIT 13 OCEAN STREET, HYANNIS Contractor-hame: STEVEN HETZEL LEWIS BAY Framing: 1 Owner on Record: HARRIS,CHRISTOPHER& KRISTIN BUILDERS 2 Address: 27 MORTON ROAD Contractor License I65119 Chimney: ARLINGTON, MA 02476 Est Project Cost: $4,000.00 I,. Description: Existing laundry-remove doors,extend wall to accomodate Permit Fee: $ 160.00 Insulation: storage. Install new louvered doors and shelving Fee Paid: $ 160.00 Final: Project Review Req: � Date: 11/5/2019 ' x r Plumbing/Gas j�� +•,t �r Rough Plumbing: spl w Final Plumbing: Mpfficial This permit shall be deemed abandoned and invalid unless the work a6thor zed�by this permit is commenced within six months�af er issuan 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 laws and codes. 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 Final Gas: work until the completion of the same. � 4 r Electrical The Certificate of Occupancy will not be issued until all applicable signatukrms by the Building an'Fire Officials aye pro ided on thigpermit. Minimum of Five Call Inspections Required for All Construction Work: t ' h Service: 1.Foundation or Footing b 3 y Rough: 2.Sheathing Inspection ..�;.. .,, 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 Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation , 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: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ------ ------ --------- ......... .. . ���INE h Application Number.../tNG (�i 4 .6..... BARNSTABLF, auDI MAS& i Permit Fee....................... ..............Other Fee........................ 03 NOV O's 2019 Total Fee Paid............. ............................... k-� 1 TOWN OF BARNSTABLE Permit Approval by.... on... ........... BUILDING PERMIT A7J— Map....... .................Parcel...........N............0........... APPLICATION L sT 6:� Section 1 - Owner's Information and Project Location Project Address 5760 o CAEA-yj jai S -5�m go�- C) i T- I Village Owners Name fz-A 5 rn A� kf-iEA Ac Owners Legal Address City State _zip OZI%, Owners Cell# E-mail Cf+/Zf5('—' Section 2 -Use of Structure Use Group 4 Commercial Structure over 35,000 cubic feet ❑ Commercial'Structure under 35,000 cubic feet El Single/Two Family Dwelling Section 3 - Type of Permit 0 New Construction E] Move/Relocate E] Accessory Structure ❑ Change of use ❑ Demo/(entire structure) EJ Finish Basement El Family/Amnesty ❑ Fire Alarm Rebuild El Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall Fj . Solar Renovation ❑ Pool El Insulation Other-Specify Section 4 - Work Description LY4 5�-M Ckv JV brej E--rAf.1e- bov 0X-t-;�O ftQ-- -0 lk-CA�W 2,\ (F-r- 1151NI-(- OC-,'VJ 1AUVC-9-CP2 NCK-5 Avg StM41Jr,6 i Application Number.................................................... ' Section 5—Detail Cost of Proposed Construction Square Footage of Project A/ Age of Structure �/b �-- Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑. Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal 'J91 Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8 ' Zoning Information Zoning District r 1, Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed ` Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated: 11/15/201 R The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 461—z r-L D64 LEAS 6P}Y 621&DCfkS Address'7? .-P/N6 Cd'y G D21 ��� �'�, Yfh2WVLk-- -24-?'� City/State/Zip:W 7� Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 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 shed shy V JE�Remodeling 'ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity.acitY• employees and have workers' r 9. ❑Building addition [No workers' comp.iro rance comp•insurance. required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions ] officers have exercised their 11. Plumb' repairs or additions 3.❑ I am a homeowner doing all work ❑ � 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 contactors must submit a new affidavit indicating such. tContractors 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-contactors 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: Policy It or Self-ins.Lie.#: Expiration Date: 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 certi under the an enalties of perjury that the information provided above it ee and correct signstore: . Phone#• ��t Z�� 75 7-- 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#: � F T Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer 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 individual,partnership,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 of the dwelling house of another who employs persons to,do maintenance,construction or repair work on such dwelling house or on the grounds or budding appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states 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 buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance 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 situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLCM or Limited Liability Partnerships(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 affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-;nmrance license number on the appropriate Tine. City or Town Officials Please be sure that the affidavit is complete and printed 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)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 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 (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 021.11 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 wwwv mass.gov/dia � lU It �� � � AA Q � ti s Of —77 A. .. - , 71, vi rKIC Nit � .. r� s a '�\ ..-~♦ .ate IM4 KIM 3�\Es- � ..,Vie' - Vim„`,... ` � a , . N a "` K t vol 32, a \A �. s 15, . ml q, a ate: c 3 CkV Rl � k\az4 .`, �$�` \. < a :.moo lZw �F�. a,' c\ @sue � . a.. ��E a�q - o, �� �a �..,. V a ��. -.O; o� w �. - 4 w - \ � ... �� e ��• � " - Ok �`• Al p. o y� <.> .., ..ter..: ... ....,.�� �. . ..,,...., ,,..�-.� .�.��•�* ,,,�,,.� ma., .�;..., aa:. ..r.� ... ._.�.. w.....�.. .� n��.._�, �, ._o,H�. ..� _.. �>... Commonwealth of Massachusetts r� ® Division of Professional Licensure Board of Building Regulations and Standards C o nstr4M$AiSpfr�i sor .� �i CS-104384 ti' �► { es:07/27/2021 STEVEN L HOZEl 72 PINE CONE DRIVE WEST YARAfi4T*, It, ",s Commissioner office of Consumer Affairs:&Business Regulation, I HOME IMAROVEMENT CONTRACTOR TYPE:.ndividual Ex ration STEVEN HETZ i DB/A LEWIS BAglBl x � I STEVEN HET EL 72 PINE_CONE OR. R 4 W.YARMOUTH,MA Undersecretary Application Number............................................ Section 9- Construction Supervisor Name 5 T 1 14C�Fr� Telephone Number 251-Z5q- �5 z6`L- Address-]& F06UY16 DWG City VU- j(CX M"M4 State MA- Zip OZ(e7 2- License Number ,Q-1C' License Type Expiration Date Z Contractors Email - �'1� _ ��� •C Cell # 509' 250/-�05_Z- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR ano the T of Barnstable.Attach a copy of your license. Signature Date / -6 Section 10—Home Improvement Contractor . Name Telephone Number VE Address City State Zip Registration Number iration Date 6/�06,�27006) I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR th To of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. i Signature Date APPLICANT SIGNATURE Signature Date G115�9 Print Name �7 Telephone Number E-mail permit to: 51-/+�z_ (4c7 im L evh r.aqt„neiarrtri• 11 n Snm A Section 12 —.Department Sign-Offs Health Departme t ❑ ring Board(if required) ❑ Historic District }J� ❑ Site Plan Review(if required) ❑ �/� T Fire Department ❑ �� Conservation ❑ ��11r For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization i 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: I 6CC/:N7J _75Tr,� U V I T 3 I �Alt5 Odd (Address of job) / ature of Owner date �f�fUS f�2elS Print Name i i i T+.-A.+.A• 11/1 C/MMO E dF Application number...........1. .�. .......... . Date Issued............�.b.�.Z.�� KAM _ Bey �� 2 2018 Building Inspectors Initials..ff...��....... ........... ow FF 1\1S1ASL� Map/Parcel.. 7 z .o.`,i°:y �.�.�. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER,, rr STREET VILLAGE Owner's Name: Cy-(?,A 5' Ct`�S Phone Number eg 33cf 3(oq '10((.? Email Address: � 4 �(�s � � Cell Phone Number Project cost $ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property'I hereby authorize f to make application for buildin ermit in accordance with 780 CMR Owner Signature: �� Date: 16 TYPE OF WORK ❑ Siding Windows (no header change)# I ❑ Insulation/Weatherization ❑ Doors (no header change) # Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name 517�-ZyjT-- Home Improvement Contractors Registration(if applicable) # �/ (attach copy) Construction Supervisor's License# 3 (attach copy) Email of Contractor Ce/MPhone number 5C9- q ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY OP RTY IS 1N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. I_ APPLICATION NUMBER 4 � *For Tents Only* Date Tent(s)""4—be{erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours . of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I.understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APP I T'S SIGNATURE Signature Date �d All permit applications are subject to a building official's approval prior to issuance. r ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly � �Name (Business/Organization/Individual): �1 Z D� �U 5 &*/ 140ogs Address: Z P o''� COYI oaA va- City/State/Zip: GV Ytklt Y1dLl 020�> Phone#: 509—2�5r Are you an employer?Check the appr priate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2K am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• # 9. ❑Building addition [No workers' comp.insurance comp.insurance. 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 11.❑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: Policy#or Self-ins.Lic.#: Expiration Date: 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 a p tallies perjury that the information provided above is tru and correct - ��( Signature-: Date: fa Phone# g/w9 (67z6z- 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer 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 individual,partnership,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 of the dwelling house of another who,employs persons to do'maintenance,cbrist�uction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states 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 buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence ofcompliance with the insurance 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 situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(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 affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)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 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 (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax 9 617-727-7749 www.mass.goV/dia T,h.e Yachtsman=Proper y.Ma�nagern mnt ,Manu-ai: The Yachtsman y ]Board of Trustees,imp:rovement Approval:. 500 Ocean Street HyannisMMA:02601 From The-Yachtsrnan Board,ofTrustees To: . Town of Barnstable.Building Commissioner, 'Sdbtec-.Unit O-w:ner.lr .provement Approval .at TheYachtsman' 500 Ocean Street; Hyannis The'96ard of Trustees.for the Yachtsman Condominium:Trust.voted and approved,the attached proposalto.be performed as is delineated inthe requestwe received:�from he--Unit Owners. Contractor, ` 'has,been:contracted by=the Unit:Owner to perform the work as defined in:the proposal: Th s:letter is.intended o serve as notice of the Board's vote:to approve the proprosal, which fias:been noted in:the Minutes of the Yachtsman's=Board of-,Trustees;Meeting. Signed under the Pains.and Penalties of Perlury.this day of Yachtsman Trustee:. Baa of Trustees ' achtsman Condominium Trust (%;Property M and ge►rrentOffice} YCTPMbr.ManuaI.Apr 2018 Property of The Yachtsman Condominium Trust Page,91 of 102 1 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constrrg6616n "'pervisor 3, CS-104384 E fires: 07/27/2019 _ f 4 STEVEN L HETZEL� 72 PINE CONE-DRIVE ` ` a WEST YARMOUTI I MA 02673 �F Commissioner Cj, ( U/LPG (Q0072/nLOIZIIfCCL�I�0���'�2C tlld6t� �- i office of Consumer Affairs&Business Regulation HOE IMPROVEMENT CONTRACTOR M t TYPE.Indj dual, x Rea�strafion Exa_ ration 16— 5t jg" OS,106/2020 STEVEN.HETZEL"' _ D/B/A L.EWiS BAYII a ,ERS y y STEVEN'.HETZEL } 72 PINECONE DR 02 ,3 - W YARMOUTH,MA Undersecretary k /f l r V �► �V Application Nimmber........ ..........................I..................... MASIL* � W Permit Fee................. .......Other Fee........................ 6 A1117 OTotal Fee Paid............................................................... ...... X TOWN OF B T,,ABLE Permit Approval by.................................On........................... co BUILDING PERIIUT Z 0 MV..S'...............................Parma........bC............ ........ APPLICATION Section I — Owner's Information and Project Location Project Address-T6Q ®C_IC7, 0 ��x i 3 village Y 7A -V MIS Owners Name Cwtw + 0-,kS7I 0 �Vkluz As Owners Legal Address City State Zip Owners Cell# E-mail 10<2 60# ` Section 2—Use of Structare Use Group ❑�v Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment El Sprinkler System Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify �--PC A-f— �5 1 r4 aT E�0 y-_. W Section 4 -Work Description ILJ 1 IV LOW ::5rM�a-yr6 y�/Z67 w 0-)DOVV T s+ct undated-2/9/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction d Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing dA- Total#Of Bedrooms(proposed) //�" 110 MPH Wind Zone Compliance Method MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney x ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway f Debris Disposal Facility: �•�/���4�t�(� I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation !� Within or adjacent to a wetland, coastal bank? Yestff No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning.Board in the past? ❑ Yes ❑ No Last undated.2/9/2018 Town of Barnstable Building • ' Post;ThiBAP MA s Card So That rt is Visible From the Street A r„oved P-.lans Must be Retained on Job and;;this CardMust be;Ke ,t NAM tit Fi al�lris ect on Has BeenFMade PF �� % P ' Posted Un n spa ' �. p ,- ', :` .. ;,` �,r.. ' �� ~: � ,. . �.: �+m W�here,'a,Certificate of.Occu anc, is Re u�red such 13uildin' shall Not be Occu ied,-untal a Final lns ect�on has been;made �l mit Permit No. B-18-626 Applicant Name: STEVEN L HETZEL Approvals Date Issued: 03/23/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/23/2018 Foundation: Location: 500 UNIT 13 OCEAN STREET, HYANNIS Map/Lot: 324-040 OAA Zoning District: RB Sheathing: Owner on Record: MARINI, KATHLEEN A TIR � Contrac or Name ' STEVEN L HETZEL Framing: 1 Address: 666 MAIN ST.,APT 402 Contr�actoLicense: GS;104384 2 WINCHESTER, MA 01890 Est Protect Cost: $2,000.00 Chimney: Description: remove existing window and replace and trim1with new same size ermitee: $ 160.00 window-replace 1 first floor window . ,E Insulation: Fee Paitl., $160.00 Project Review Req: Date 3/23/2018 Final: Plumbing/Gas -� Rough Plumbing Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authozed ri bythis permit is commenced within six months aftes n a suance. 3, ., - All work authorized by this permit shall conform to the approved applicationd tfie 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 zomng;by'Iaws and codes. This permit shall be displayed in a location clearly visible from access st er et or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. I ,: Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and F ri a Officials are provided on this.permit. Minimum of Five Call Inspections Required for All Construction Work Service: 1.Foundation or Footing ', 2.Sheathing Inspection �: € Rough: 3.All Fireplaces must be inspected atthe throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 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: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final I Commonwealth'of Massachusetts Division of Professional Licensure Board.of Building Regulations and Standards ConstrOAi jr%iS-pervisor CS-104384 sr E�pires: 0.7127/2019 04, STEVEN L HETZEL 72 PINE CONE-DRIVE y W, WEST YARMOUTH MA42673 r� Commissioner V'" a— ` �� zuee/ta — V�Le Qpo�rnmzarazaeu�l�a s Office::of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPEc=Ind'nridUal r 9A r fa en—r at�un� 01/06/2020 165119 STEUEN HETZEL + DIB/A LEWIS BAY BU:I S E ERS Q CGS+ STEVEN HETZELex , 72 PINE CONE'DR. ,267 - VV.YARMJUTH,MA 02fi73 WnderseCretary Registration valid for individual use only before the expiration date. If found return to: i Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature i _s 1 S The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/lndividual): Address: —7z, Pl N (2cmE (2 ku ir. City/State/Zip: Phone#: 50U-ZA�-6t� Z Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or.part-time).* have hired the sub-contractors 6. ❑New construction 2 am a sole proprietor or partner- . listed on the attached sheet. 7. ❑Remodeling rr 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.incnranceJ 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 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §](4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box 61 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 bave 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: Policy#or Self-ins.Lie.#: Expiration Date: 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 certi under e p"ins nd penalties of perjury that the information provided above is tr a and correct Signature: Date: Phone Official use only. Do not write in this area,to be completed by city or town off ciaL 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written."_ An employer 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 individual,partnership,association or other legal entity,employing employers. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states 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 buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance 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 situation and,if necessary,supply sub-contractors)name(s),address(es)and phone nunber(s)along with their certificates)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to caury workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city"or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)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 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 (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice 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: The Comrncinwealth ofMassaahusetts Department of Industrial.Aeoidents Office of Investigations 600 Washington Weet Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Fax#617-727-7749' Revised 4-24-07 mam,gav/dia F.'. Yachs»ta.a 1 Trust ' � Boa?d-,f Trustees 500,Ocev r.Street �a r�r is4 AM 02601 ;. DATE RE: Unit Yachtsman Condominium Trust, 500.Ocean Stroet,.Hyannis' Tn the Town of i3arnstable Building Con.missioner; 'i° Boazd of Trustees for the ''achtsr,'tar Condominium Trust voted and approved the attach .proposal to be performed as ; -fie 'nea<:ed.;ih the request we received from the Unit / has"been contracted.by the Owners. Contractor �.. _ -.�" 1?nit O`=ner"to .�r form the work as define osal. t3 ���� N A �l ElJ fiN N�L 4P ` I n! Otd. _ W^s.f� ' / UIT � (i.�y�( vStt�Er b�K i17�A7��� cgt!I , Gv�LD ,[� . 71'.1s,let:;r serves as notice of the Board's , e*,icy-approve'the proposal,which has been noted in themm {tes of the Board Meeting. k 20 } Si ��t =Jiider the Pains and Penalties "��F��� 'y tip.;,, 'day o-1 )L, � e I YCT Trustee Yac bb nan Condominium Trust S Q Oc.dan•Street(c/o,N€anager's Office,;' ? vaur=s,NSA 02601 JML JT A��® DATE(MM/DD/YYYY) A� CERTIFICATE OF LIABILITY INSURANCE F02128/18 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 NAME: Ben Chisholm Chisholm Insurance Agency,Inc PHONE /c No Ext: 508-358-6111 A/c No): 508-358-5324 PO Box 399 I=-MAIL Wayland,MA 01778 ADDRESS: ben@chisholminsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Western World Insurance INSURED INSURERS: Steven L Hetzel INSURERC: Lewis Bay Builders INSURER D 72 Pine Cone Drive West Yarmouth,MA 02673 INSURER E: INSURER F: 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 CONTRACTOR 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. L TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/LIDD E F MM/DD POLICY P LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE FXOCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any oneperson) $ 5,000 A NPP8477670 09/21/17 09/21/18 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER* GENERAL AGGREGATE $ 2,000,000 POLICY❑JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pera ccdent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Chris Harris ACCORDANCE WITH THE POLICY PROVISIONS. 500 Ocean Street Unit 13 Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ,Thomas B.Chisholm ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9—.Construction Supervisor Name Sit r_-m (� �Zi Telephone Number -152 cjy Address 7Z It 1461 CjN-t Mvc City State Va l- Zip- a24 7? License Number �( License Type V Expiration Date a 7 I C1 yP XP � � Contractors Email �� I'��%rZ� �� ` Mkt �— • �!�'►� Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 - d Town of Barnstable.Attach a copy of your license. Signature Date Q 'Nil Section.10 —Home Improvement Contractor Name �j'[ sY� l��� `�- Telephone Number� -Z��` S Z S`Z Address' R-(UO�-City bV,VLg ld"Ul`'(14-- State v�zip a r, ?3 Registration Number q Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required b 780 CMR and To of Barnstable.Attach a copy of your H.I.C... l r Signature Date �a�t Ti Section 11 —Home Owners License Exemption e Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date (19' Print Name � ( L Telephone Number E-mail permit to: _5L9C%ZL0-j-��/n,�!rr COWo T....r....,i..ava.11 m nn 1 0 a I Section 12 -Department Sign-Offs i Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ - U Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13-Owner's Authorization 1 I as Owner of the-subject property hereby authorize 5TC-t ,./__: to act on my behalf, in all natters relative to work authorized by this building permit application for: (Address of job) Signature of er date Print Name ` 9 I e Last undated:2/92018 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 3 q�� Map Parcel Application 4t Health Division Date Issued �� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �o Historic - OKH _ Preservation/Hyannis Fes►.�L Project Street Address G O Ct;e-J S'me n . U 'xuli 1-3 Village RV nyN15 OwnerCEW_aG/r,(_j S n 0 A*cif S Address g Telephone — 3(,Ao? — o 113 Permit Request P,6P 2,0 ID a�06f_, /3CV az-6YA ,W 9/U bd7N S 1� ��. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation of 5 Q d 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/coa s v • ❑Yes ❑ No � ��iNG DF-PT. Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size —Shed: ❑existing ❑ new size _ Other: NOV 2 9 2016 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ TOWN OF g ARNSTABI.F Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 5` Pr&T Ze2 Telephone Number Address �Z ��P 6r Cd-Mg) '57 -(:!� l License# (!�5 W ' �/ ` "�'r 0`7.G`73 Home Improvement Contractor# A6M Email SLL / �°/ /n �° Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO N ;.v - 0 GS PveAts SIGNATURE DATE K 114 In, FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED WP/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. 1' .77ze Commayrim-c h of-Massachusetts I� rt��e�it cr,� rtslrial�4cclr�ef�s . f}ffire of LzrIeslrgatfoirs { 600 Washington Street tG+�v�t�rrrvssgu��c�in , Workers' Cumpenswffim Insetmace Affidavit Bm*lder-1C�aafrartars/EIectdcianRThmlbers A�p�icaa#Iuf��uaf a Please Print.f euM NameinainP Address: -72- P/N e C6 0C Ib k k V 2 rir eyou an empIayer?dec the approp: ' to bow Type of project( �•� r . I am enteral canfiractar arxd I L❑ I am a emplayer vwfa ❑ a� 6- ❑New construction * Iiavehiredtfre=hLcor tmdors _employees(full arl�dlor part-time)-* 2 I am a sole proprielcm ar1. Il +?s er- Mted tile Wached sheet 7_ ❑Remodeling . These matt-contradors have slip and have nta empla�*ees. $. ❑Demolition w Q:Fix in employee'.,and,have wadcers' ad�b �capacity- 9. ❑Building addition L`�ET6 2&' CaIIl11.+�SS1T �� CE7Sllp_Sllii�[3IIL�E 1 rewire d j 5. ❑ We are a norpozation and its 10❑Electrical repairs or a d urns 3_❑ Ian ahomeowmerdoinganwork a:Ecershavoeo-ercisedtheir 1L❑Plmnbingrepaimoradditions tnysel£END-workefe Wrap_ right of exemption per MGL L_❑RDofrepairs em 7g5l2et,y§e els(4[k1�Taa dwe ehssv'e no-t= nce re airedj i 13 tei�l` �10 cosgp_insurance regaured.Z �.�1P 7 m-�� •A.my eppUc=t Cut cherjsbor#1 mad also ffio tthe seciianb9owshzWing dIdrw0IRe&'caM.P—sabnupmBzYiUffi=zdmL �H�'ameana�Srrha submit�115�3['7E i�ir�g t�(axe doing$u WaL���fhffi IIIS autsidecaatmctr�rsTm�SLhlllit a neW�d7mt iadi�.ting rnrTi rC,,t, €nFstb�t eha(A- ihis box must zttadmd sa additiona shea sbovdngtbennneof thg sob-contrzcta and stae-w thec arnot-ffime eafi-deshwe emplayees I€tBesnb{aatadnshaveemPlaS � Y�`tF��deth runrkes'mnip.palirjn�ber- I am are ewplgvr tbatisprm-za'itrg 17miraura for my employees $etojv is tAffpoZicJ and job refs` ia,�orrrratcan. . Insa ceCoutpamyName- Poacy 4 or pelf-ice_Iic_ ` FxpirativaDate: Job Site Addresx CifylStafetZEg: Attach a copy ofthewarkere eoampensadionpolicy declarafion page(shoeing the policy number and ezpu aidon date). Far=e to serum caveraage as re:quiredunder Section 2.5A of MQ.m 152 can lead to the impasxfiaa of criminal peaalt"ses of a fine up to$1-5.a14G andt'ar one yesr,�;�ormenk as we11 as civil penatfies.k the farm of a STOP WORK ORDER and.a fuse: of up to$250.00 a dog a aind the vioWur. Be advised the a copy of this statement maybe forwrded to the Office of IavesE ga i=of the DIA for insurance caverage ve6ficafi m Ida herzby c=6 tM:R pdas _r Pe' s of erjzur,fftattJae irt, arntrrfiarapro►irTed aba� .i�barE correct Si.ffiatuie_ Date- / 2-q Phone ig- 2—/ LEZ 0, aZ mrEp�. �Do atut errFta itt tFr .areff,to b�cttr�pTete�d 5}'rife rtrtnn�u afjr�zal 01i y or I•aww. Perm iffAcense 4 Issuing tuffiarffp(rude one): L Ba.atd,of SeaIth. 1.RufTZing DepaaIm.eat 3.CityITown.Clerk 4.EIeefricai Inspector 5.Pbmibmg Inspector 6.Offier Contact Person' Phone#: laformation and fnstructiolas. C`- - es Yn de wolf e �ensaflm far their empIoyee5- M,�s r j--tfS 06nelalLaws chapter I52 rDToits all�� ��,t ofbme, Pm s��nt�D this sf�,an�Tzy=is defined ar-` .everyperson m.ijie service of other under any express or=Plied,oral or wrhm." • axm associafivn,corporation or othCr Legal eay,a �Y trvo or more �qn employer is dexfined as an mdividBa],p ersh�. er,ar lfie of the:foregoing engaged is a jomt eutE r- ,andinclndmg ives O a deceased employ receiver or tros•teD of an iadividnal,pip,asoeiaii on or o$ier Iegal mtiLY,e hcMin,g rfaDOY�- However the owner of dwell�g�e�g not MOM than tbreeaparbnefs sndtivbo remdesi3le io,orthc oo t of�e- dweIImgborne of�o�erwhn®ploys pions fn do mamtI=3nGe,conskuction or repair work on such:dwelling Jiouse or on.tfie grormds or buradmg app na�tfieretn sba1Inotbecanse of such employme be deemedto be an employees." hIGL 152,§25C(6)also sf� tb es zt"eYerysfate arlocallicen� g agencysllallwi(3ib d the issuance Or DI renewal of a Ticmnse or permitto operate a business or to construct b-,adiags im the cormnonwealidi for=Y apglicantwho has notpmduc ed acceptable evidence of compfian.m Wn tIre amragce_mve_ragerequired_ ZS sfa{�S�TeatTiertbe co�tmwealtb nor aIIy ofits political subdivisions Shall Ad�ona]ly,MQ•chapter M,§ q7) enter ion any contract forfTie p��nin�ce of-gnblic�eo�3[�-I acceptable evidence of compIiance�*ith-i3�e ms�`��•_ reads oftlus chapterbave lieenpresenfedfo the��a a�.ozity:' �Plicaai� • Please till o the wodces'compensation affidava eomplef ly,by ffimIang-.eboxcs t�f apply to YDm sitnatron�if snb-conbracfnr{s)n=e(s), addresses)and Phone n—ber(s) aIong�*itliibe�cerfifrc7f--cs of ner�ssaiY,supply pie s with no employees othea the „su a„ce. Li�dLiabi7ity C=Pames(ILC)or LuedL'[4 ( ) members or parfn=s,are not req�'d�n carry vlorice compensation msRs�ce_ If an LLC Or LLP does have To ees a olio is Be advised f3iatthis a$dayitmaybe sobmitfedto file DepaL-Fmeat of Indnsfrial emp y p Y rego�ed Also besuxe to sign and dafethe affidavit The affidavit should. Accide�s for confirm won of fiLSI anoe coverage. not ffie D• arimeni'of b e retried to fie city or town tfiaf the applicafion for I.e perm>f or license is b emg eP scions regarjg tT e law or ifyon a m req�e:d to obtain a-wormers' Ir_dns'timl Accidents. Sbonldyon bane any qae nines SbonId e�i then' compcnsationpolicy,please call the Depart mat at ffien=b=Hsfedbelow. pelf-ins�ned comp s e1f-m crrr��_ce licemse amber On thD appmpr-mL-Liam City or Town Of _ Iete and rioted.Iegrhly_ The Deparfineuthas provided EL space at the bottom Please be sate that the affidavit is comp P has to coidactyouregmdmgthe applicant. of the affida�for you to fll oUt is the event the Office of invP� arts Please be surein fllmfhepe�i-flicrosemrmberwhichwMbeused.as arefereviceUmber. Inaddition,anappIIJ that must=bmit nz�ple p e�cease applications in any givenyear,need only sohmit one affidavit indicating c; ent policy ij� aatium(rf necessary)and under"job site Q dress"tie applicant should aaH locatbns R (�Y or tnwn)='A copy offfie-a$davitt3rathas ben officially sf=ped ormarkedhyjhe�Y m Townmay be provided to$ie " appH=t as proof that a valid affidavit is on file for fnfine p� or Tire races. Anew affidavitmvst be filed oT esar�l year.�bere aborne owam.or cities is obtaining alice�.se or PcLitnotieafrdp3 any business or commercials leaves etc-)said pesos is NOT regoacd to complete tivs affidavit a dog license or p®It in brain The Office of7nveshg�ions wovldh1atotTiankyov.marivance foryour cooperation and shouldyonha4e�y gaesi�ans, please do not hes-it�to give Os a call. TELe>I}eparimeni's mess,Telephone and fax number • _ a �e�a��t-t�ea�of Mas�hn�� Mom Tt,-L 617-' -WW Qxt.4Q6 ar 1477 MA.' Fax 9 617`27 7M lZevised¢24-D7 ���tz�. . . • tMME Town of Barnstable Regulatory Services HAS& Richard V.Scali,Director. 6 ►``� 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 T, as Owner of the subject property hereby authorize (� � %� Z Gt' to act on my behalf, in all matters relative to work authorized by this building permit application for. OCCh-i,)51tV v I � 13 �" of (Ad ess 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 Signature of Applicant Print Name Print Name Date Q:PORM&OWNERPMUMSIONPOOLS rry Yachtsman Condominium Trust Board of Trustees 500 Ocean Street Hyannis,HA 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 performed as is delineated in the request we received from the Unit Owners. Contractor, _ Z 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 of �� , 201,/, c Secr , Boar, of Trustees tsman Condominium Trust 500 Ocean Street(c/o Manager's Office) Hyannis, MA 02601 Enc./File V— Expirat' Office of Consumer Affairs&Business Re laiion.OME IMPROVEMENT CONTRACTOR egisttation 165119 Type;:on 1/7/2018 Individual. ` S.TEVEN HETZEL a y` Q [ r STE.VEN HETZEL 1 � , s 7.2 PINE CONE DR. ' INYARMOUTH,MA 02673 rJ jam" - UndersecretA17/ ' Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-104384 Construction Supervisor STEVEN L HETZEL - 72 PINE CONE DRIVEg-Q— WEST YARMOUJH MA 73 Commissioner Expiration: 07/27/2617 ASSACHUSE 'TIS— S , LICENSE�� 01 'BID`dd NIINBER h 2013 ;NONE a &NGT � �STEVE � ,; a 72 PINE CONE Dom' a RIPE r rx r N F / YARMOUTH MA 026735422x t 54 07 31 2013 Re 07:iS2p09 ��� �z� J- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel.V Application Health Division Date Issued l 3 l Conservation Division Application Fee h Planning Dept. Permit Fee `g Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis 6& Project Street Address f)00 0ceA-10 !S{YZ _ L) 0 I 3 Village . 01 S Owner e 1�-tsd S`��N S Address Z-7 l ORM Q.�A (-J�`TZY1. WA- Telephone ' r7 7/ ' �0 9 Permit Request Tb U QA�I� 1�1T�I � Cam) )U�'� , ROVIV 'e ��_ WK"(-_ , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation _Z0 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 stove3 ❑'.Rs ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: D1existing 0 new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:`" Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ i,a Y S47 Commercial ❑Yes ❑ No If yes, site plan review# � + Current Use Proposed Use _ - - -APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address f I N C 60ylE d2• W. elf OWW License Home Improvement Contractor# / Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. } ADDRESS VILLAGE 'i OWNER DATE OF INSPECTION: FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s r GAS: ROUGH FINAL FINAL BUILDING J 'S DATE CLOSED OUT t 4 ASSOCIATION PLAN NO. r .L The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly NaM-e(Business/Organization/Individual): � V�� � �� � Address: r7`L ?I NC_ C6Y?E kJ o E City/State/Zip: W G9( YAluival I A 62473Phone#: `79Z6Z Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2I am a sole proprietor or partner- These sub-contractors have listed on the attached sheet. 7.�Remodeling /X ship and have no employees 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 L EJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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 41 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u der/the pa' an pe es of perjury that the information provided above is true and correct. } � ` Signature: _Date: Phone#: �aZS'2-5q r 6� Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I� , THE Town of Barnstable Regulatory Services ELMMSTAS r SS. '$ Thomas F.Geiler,Director 1639. 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 as owner of the subject property hereby authorize____ ���� IZ`� to act on my,behalf, S in all matters relative to work authorized by this building pemsit sT` .' . it )3 — A-m +S (Address o Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of dwnet atare of Applicant Print Name Print Name 14za `z- Date Q:FORMS:OWNERPERMLSSIONPOOLS L ` t C � • a Yachtsman Condominium Trust Acceptance of Trust Ap roval The undersigned Owner[s] of Unit#13 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 anew sliding glass doors (Andersen) for the Living Room egress to the courtyard. • Renovation to the kitchen, including installation of new kitchen cabinets and installation of new floor in kitchen and living room. By acknowledging the Trustees'vote approving the proposal for Unit#13,the undersigned Owners 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 writt consent. 2. Approval b the Board in no way constitutes a waiver pp y y by the board of the Trust's, rights. Moreover,approval by the Board does not indicate that the Board accq'pts` liability or responsibility for the actions of the owners. 3. Any contractors [Lewis Bay Builders/Steve Hetzel] and any sub-contractors hired by said contractor 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/orvtegulation): 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. 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. This includes the contractor who is to install the sliding glass doors. 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. We assume responsibility for:any future costs associated with loss or damage related to the work -1- Acceptance of Trust Approval Page 2 of 2 The undersigned Owners of Unit#13 therefore accept the approval of the Trustees of the Yachtsman Condominium Trust subject to the above-noted conditions. Signed this _day of NO t12 MbR_( 2012 Si nature- n'g �t Owner Print Name-Unit Own r Signature- Unit Owner ri5J ) fl o Print Name- Unit Owner W' es an r chtsman Condominium Trust Documents Attached: Permits Received (Title and Date Received): Office of'consumer' 'air;�'i�u�mes"sYYe uan L►cense or registration valid for mdividul use only before the ex gyration date ,If found:rettirri to: g HOME IMPROVEMENT CONTRACTOR p' Registration:' 165119 Type:. ! Offce of.Gonsumer Affairs and Business Regulation ,-a 10 Parlc.Plaza Suite 5170. Expiratipn: 1/7/2014 Individual BQ.ston,MA 02116. S N HETZEL, y STEVEN HETZEL 72 PINE CONE DR W:YARMOUTH, M.A.02673 r Undersecretary Not valid without signature Matssachusetts- Department of Publ'i. 5 �fei� Boiu•d of Buildin Regulations and Stan(I:1rds „r Construction Supervisor License License: CS 104384 — -- i STEVEN HETZEL 72 PINE CONE DR � WEST YARMOUTH,MA'02673 Expiration: 7/27/2013 Tr# ,3r,03$4; c c � Q