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HomeMy WebLinkAbout0074 SHERYLES WAY ly �� Narragansett Bay insurance August 7, 2019 Town of Barnstable Building Department 367 Main Street Hyannis, MA 02601 RE: Policyholder: James A Bancroft Policy Number: 11091930 Claim Number: 01 MA11091930 Date of Loss: August 4, 2019 Loss Location: 74 SHERYLES WAY, MARSTONS MILLS, MA 02648 To Whom It May Concern: Claim has been made involving loss, damage or destruction of the above referenced property, which may exceed either$1000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 36 is appropriate, please direct it to the attention of this writer and include a reference to the above captioned insured, location, date of loss, and claim number. Title: Property Claims Adjuster ' On this date, I caused copies of this notice to be sent to the persons named above at this address indicated above by first class mail. Sincerely, Charles Ferrari rrarl Property Field Claims Examiner 401-495-8945 cferrari@nbic.com P6 Box 820 1 Pawtucket,Rhode Island 02862 t 401.725,5600 1 f 401.721.0700 1 www.nbic.com YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS Y R NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town H and get the Business Certificate that is required by law. DATE: Fill in please: APPLICANT'S YOUR NAME/S: Z b�f BUSINESS YOUR HOME ADDRESS: 505 (0434aj $ r 4v oar TELEPHONE # Home Telephone Number 5noK,41A 6 b NAME OF CORPORATION: NAME.OF NEW BUSINESS -rh G'a .s > cS 1 er ail Pa,-l r TYPE OF BUSINESS M.an Cu r i nc, 5horo IS THIS A HOME OCCUPATION? YES NO, j ADDRESS OF BUSINESS '7H S h l es Wa. 12v SMiPS MAP/PARCEL NUMBER d Lf 5 .5a [Assessing) When starting a new business there are several things you mu do in order to be in compliance with the rules and regultt.�-- s of the Town o v Barnstable. This form is intended to assist you in obtaining t information you may need. You MUST GO TO 200 Mai orner m Rd. &Main Street) to make sure you have the appropri a permits and licenses required to legally operate your b i t 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any things it requirements that pertain to this type of business. Authorized Signature* 4 i COMMENTS: l ' 2. BOARD OF HEALTH �� .\\x� This individual has bee/ormed of the permit requirements that pertain to this type of business �v Authorized Signature** Vl COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: 240 CMR 3.00: Salons By the Division of Professional Licensure • 3.01: Licensure of Salons • 3.02: Operation of Salons • 3.03: Equipment and Hygiene Procedures • 3.04: Advertising and Pricing 3.01: Licensure of Salons (1)References herein to"salon"shall mean a"shop,"as defined in M.G.L.c. 112,§87T and referred to in M.G.L.c. 112,§§87T through 87KK. (2)Types of Salon Licenses. (a)The following salon licenses are issued by the Board: 1. Cosmetology Salon 2. Manicuring Salon 3. Aesthetics Salon 4. Booth Renter 5. Booth Shop (b)A salon license may be issued to an individual,partnership or corporation. (3)No person shall operate a cosmetology salon,manicuring salon or aesthetics salon without first obtaining from the Board a license to operate such salon. (4)Every person contemplating the opening of a cosmetology salon,manicuring salon or aesthetics salon shall file the appropriate application for a salon license with the Board,pay required fees,and arrange for the premises to be inspected and approved by the Board.The Board will not issue a license for any premises if required local permits and certificates have not been obtained or if the Board's inspection reveals that the premises are in violation of 240 CMR 3.00. (5)A salon license is valid only for the location stated on the license and is not transferable or assignable.Salon owners must immediately notify the Board in writing of the contemplated sale or change in ownership of a salon.The purchaser of a salon which has previously been licensed by the Board must file a new application for salon license with the Board,pay required fees,and have the premises inspected and approved by the Board.A salon owner seeking to change the location of a salon shall notify the Board in writing at least 30 days before any such change in location.Upon approval of the new location by the Board,the license for the previous location will be cancelled and the Board will issue a new salon license for the new location. (6)Salon licenses must be displayed in a conspicuous place in the salon. (7)All cosmetologists,operators,instructors,manicurists,aestheticians,and demonstrators must conspicuously post their current individual license and health certificate at their place of employment. Top I. 3.02: Operation of Salons (1)Premises. (a)All new salons must have their electrical and plumbing installations approved by an inspector of wires and a plumbing inspector prior to being inspected by the Board. (b)After the floor plan for the salon has been approved by the Board and all required equipment has been installed and permits obtained,an applicant for a salon license shall notify the Board that the premises are ready for inspection by the Board. (c)All salons shall display a sign at their entrance,or a sign sufficiently large to be clearly visible from the street. (d)Every salon shall be equipped with proper and adequate lighting and ventilation and kept in clean,orderly and sanitary condition. (e)Home Salons. 1. No branch of cosmetology shall be practiced in any room or rooms of living quarters other than the room or rooms designated and licensed as a cosmetology salon,except for sick or infirm persons in homes or hospitals. 2. In every salon maintained in a home,a separate room or rooms shall be provided for the performance of cosmetology services.Every salon maintained in a home shall provide a separate entrance to such salon which shall lead directly from the front or immediate side of the home to the salon.Said entrance must be clearly visible from the street.A hard surface walk shall lead from the street to the salon entrance.Interior doors leading to a salon from an adjacent room or any part of the home other than the entrance of the building shall be securely locked and not used.The salon owner or member of the salon owner's family must hold a current license issued by the Board and reside on the premises immediately adjacent to the salon. 3. Every salon maintained in a home must be equipped with proper toilet and handwashing facilities which are separate from the facilities used by the residents of the premises adjacent to the salon and must be accessible by patrons without passing through any part of the living quarters. (f)All floor coverings,walls,ceilings,woodwork,furniture,fixtures,curtains and draperies in a salon shall be of such nature as to be washable or chemically sanitized and maintained in a clean and sanitary condition.All equipment installed must meet with the requirements of public safety regulations. (g)Every salon shall be equipped with proper toilet and handwashing facilities which shall be kept in a sanitary condition,and located in the salon,or conveniently adjacent thereto. (h)Every salon shall be equipped with a suitable and adequate supply of hot and cold water.The source of this water must be approved by the local board of health where no public water supply is available. (i)No animals(including pets)may be present on the salon premises. (2)Conduct of Operations. (a)Whenever an inspection of a salon is made by an investigator or other agent of the Board,the owner of the salon or his/her designee must sign the inspection slip. (b)No salon shall be operated or maintained in any room or place where food is prepared,sold or offered for sale. (c)Due to certain chemicals used in the manufacture of shampoo capes,lacquers and hair sprays,all cosmetology salons shall post a sign at least ten by ten inches,clearly visible by all patrons which states: SMOKING IS PROHIBITED WHILE WEARING A SHAMPOO CAPE,OR WHILE HAIR LACQUER OR HAIR SPRAY IS BEING USED. I - (d)All "Cosmetology" services,as defined in M.G.L.c. 112,§87T,including those rendered in connection with the arrangement of any wig,wiglet or hair piece upon the head of any patron,if offered for pay,must be performed in a licensed salon by licensed personnel only. i (e)Supervision Requirements. 1. Cosmetology Salon. a. Cosmetology services may be provided in a cosmetology salon when a hairdresser/cosmetologist-Type 1 is present to supervise licensed personnel. b. A person currently licensed as a hairdresser/cosmetologist-Type 1 may supervise a maximum of: (i)three persons currently licensed as operators-Type 2;and (ii)three persons currently licensed as aestheticians-Type 7. 2. Manicuring Salon.Manicuring services may be provided in a manicuring salon when a person currently licensed as manicurist-Type 3 or a hairdresser/cosmetologist-Type 1 is present to supervise licensed personnel. 3.Aesthetics Salon. a.Aesthetics services may be provided in an aesthetics salon when an aesthetician-Type 6 or a hairdresser/cosmetologist-Type 1 is present to supervise licensed personnel. b.An aesthetician-Type 6 or a hairdresser/cosmetologist-Type 1 may supervise a maximum of three persons currently licensed as aestheticians-Type 7. 3.03: Equipment and Hygiene Procedures (1)All cosmetologists,operators,manicurists,demonstrators,instructors,aestheticians and students shall wash their hands thoroughly with hospital grade antibacterial soap and hot water immediately before and after rendering service to each and every patron or model. (2)All cosmetologists,operators,manicurists,students,instructors,demonstrators and aestheticians shall wear proper attire that is opaque,washable or chemically cleanable.Footwear must be worn at all times. (3)A clean towel shall be used for each patron or model. (4)Closed cabinets,drawers or containers shall be provided for clean towels. (5)A covered container shall be provided for all soiled towels. (6)Whenever a hair cloth or cape is used for any purpose,including cutting hair,shampooing,.or any other hair treatments,a clean towel or other protection shall be placed around the neck of the patron to prevent the hair cloth or cape from touching the skin. (7)Dipping towels in receptacles containing water and using same on a patron is prohibited. (8)All hair must be swept from the floor and properly disposed of after services are provided to a patron or model. (9)Fluids,powders,emulsions and comparable cosmetics must be applied from sanitized containers. (10)The use of hair neck dusters and common powder puffs is prohibited. (11)Creams and other solid substances must be removed from containers with a clean spatula or similar article.The instrument used for the removal of such substances shall not be allowed to come in contact with any patron.Removing such substances with the fingers is prohibited. (12)Cream containers must be kept covered when not in use. (13)All permanent waving equipment,nets,clips,pins,rollers,brushes,combs,clippers,scissors,razors,tweezers,comedon extractors,cape coverings,files,spatulas,applicators and any other item which comes in contact with a patron or model must be thoroughly sanitized after each and every separate use.The use of any implement that cannot be sanitized is prohibited. i i (14)After cleansing and sanitizing,all equipment must be kept in sanitary containers,cabinets or sterilizers.Dry sanitizer must be used in drawers. (15)Pump-type dispenser cosmetics may be provided in make-up rooms for use by patrons. (16)Every cosmetologist must have a minimum of 12 brushes and 12 combs.Brushes and combs may not be re-used until properly cleansed and sanitized.The use of brush or hook and pile rollers is prohibited. (17)One of the following methods must be used to sanitize instruments and equipment after use on any patron or model: (a)Physical Agents. 1. Boiling water at 212°F for 20 minutes. 2. Steaming dry heat. 3. 70%grain or denatured alcohol for at least ten minutes. 4. Ultra-violet rays in an electrical sanitizer. 5. Immersion in 10%formalin for at least ten minutes. i I (b)Chemical Agents. 1. Antiseptics and disinfectants(hospital grade required). 2. Vapors,formalin and steri-dry. (c)Bleach. 1. Mix one part bleach to ten parts water(e.g.,four ounces bleach to 40 ounces water;any stronger could rust metal implement).The method to be used is as follows: Rinse the implements in water first,then immerse the implement in the bleach solution,shake the implement in the bleach solution,repeat the rinse/immersion/shake process described,rinse the implement in water a final time and wipe the implement dry with a clean cloth or paper towel.A hair dryer may be used to ensure that metal implements are dry and less apt to rust.Place implement in a closed cabinet or disinfectant solution.This procedure applies to plastic,metal,steel,or rubber implements.This is the recommended infection control procedure of the Centers for Disease Control regarding all bloodborne pathogens, which includes HIV infection. (18) (a)In cosmetology salons,there must be at least two covered waste receptacles and at least one air-tight container for storing sanitized instruments.Dry sanitizer must be used in drawers.There must be one shampoo bowl for each station of three licensees or less.Said bowls are to be used for cosmetology services only.There must be at least one dryer and one manicuring table in each cosmetology salon.Shampoo boards must be washed and disinfected on both sides after every shampoo. (b)In manicuring salons,there must be at least one sink which must be in addition to the sink(s)located with the toilet and handwashing facilities.There must be at least two covered waste receptacles and at least one air-tight container for storage of sanitized instruments. (c)In aesthetics salons,there must be at least one sink which must be in addition to the sink(s)located with the toilet and handwashing facilities.There must be at least two covered waste receptacles and at least one air-tight container for storage of sanitized instruments. (19)No cosmetologist,operator,manicurist,demonstrator,instructor,aesthetician or student shall provide services to a person who is afflicted with impetigo,pediculosis(lice and nits),or fungus infection of the face,scalp or nails(ringworm).Upon identification of any of the above,services must be immediately discontinued and all implements,equipment and areas be promptly and properly sanitized. I 3.04: Advertising and Pricing (1)No salon may use any advertising which is misleading or inaccurate,nor shall any salon in any way misrepresent any materials or services,or terms or values or policies.For example,if a"permanent wave"is advertised at a specific price,the price advertised shall include the price of all operations necessary for completing such permanent wave.Also,if a hair cut and styling is to be paid for separately,the advertising must so state. (2) "Advertising"as referred to herein shall include,but not be limited to,the use of newspapers,magazines,or other publications, books,notices,circulars,pamphlets,letters,handbills,posters,bills,signs,placards,cards,labels,tags,window display,broadcasts,or any other means or methods employed to bring to the attention of the public the practice of cosmetology,manicuring,or aesthetics or the sale of accessories incident thereto. (3)Gender-based pricing is prohibited by the Massachusetts Public Accommodations Act(M.G.L.c.272,§§92A and 98).Prices must be based on factors such as hair length or difficulty of styling. (4)A price list must be displayed in a conspicuous place in the salon. Iop REGULATORY AUTHORITY 240 CMR 3.00: M.G.L.c. 112,§87CC. Thank you for your feedback. Complementary Content ©2016 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. • Site Policies • Contact Us The Commonwealth of Massachusetts Division of Professional Licensure 1000 Washington Street Suite 710 Boston, MA 02118-6100 Board of Registration of Cosmetology and Barbering www.mass.gov/dpl/boards 617-727-9940 Cosmetology Salon License Type Guidelines Type 1 —Is for a cosmetology full service salon, which offers hair, skin and nail services. This type of salon must employ a type 1 cosmetologist as a manager. Type 2 —(Renter) is a single person who rents space in a type 4 salon. To be eligible for this type of license, you must have a manager level license (type 1, type 3 or type 6). The owner of the entire salon can only rent to one person per space (chair, table, room). Type 3—Is for a manicuring shop only(must be type 1 or type 3) Type 4— (Owner of entire space) is for a person who owns a salon and rents space/chair to other licensees who are independent contractors. All Booth Rental Salons (type 4) must have a single manager level licensee; no other employees of the shop owner may practice at this type of salon. See below notes for more information. Type 5—Is for an aesthetic salon which can offer services such as facials and waxing. This type of salon must employ a type 6 or type 1 manager. Booth Rental Notes: *If you rent out some of your booth space to others(Type 4)and you have employees in other booths (Type 1), you must hold both types of licensure and submit 2 applications. *If you want to rent space in a salon you must have at least a Type 1 (cosmetologist), Type 6 (aesthetician), or Type 3 (manicuring)personal license. Type 2 (operator)and Type 7 (aesthetician) licensees may not rent space in'a salon. *If the Booth Renter's(Type 4)License is not current,then an application for a Booth Shop(Type 2) license will be denied. *Booth Shop licenses—once you have received your booth shop license, it should be posted at the space you rented at all times. IlVIPORTANT INFORMATION FOR ALL SALON APPLICANTS • The shop must be completely setup with signage and ready for business in order to pass final inspection for licensing. • The shop license is NOT Transferable. The shop license only covers the shop at the location/space it was issued to. If you change location(even at the same address), you must submit a new application. • Some locations may be required to obtain more than one shop license based on services or staffing. If so,you must submit one application and fee per license required. Examples: (1)If you are renting out some of your booth space to others (Type 4) and you have employees in other booths (Type 1),you submit one application for a type 4 and one application for a type 1. (2)If doing manicuring and aesthetics, submit one application for a type 3 and one for a type S. • Bathrooms must be within the confines of the salon on the same floor the salon is located. However, if core facilities are on the same floor as the salon and are within 300 feet of the salon,those facilities can be identified on the floor plan and used for purposes of 240 CMR. The salon owner/manager will remain responsible for ensuring those facilities remain safe and sanitary. • If you alter the floor plan submitted at any time you must submit an expansion/renovation application with the board which can be found on the board's website. • If you are not choosing to provide all services allowed by your license type you are still required to have all required equipment stated in the rules and regulations section 3:00. • If you are changing ownership,you can remain open for 30 days while obtaining a new license. • If you are a new business or changing location, you must remain closed until you are approved for licensure at the final inspection. Summary of major policies that apply to salon applications: Dry sterilizers are no longer permitted as a method of sanitation. Policy No. 06-01 Salons cannot use names incorrectly suggesting the salon provides healing or medical benefits. Names such as"healing", "medical", "med", "clinical"or"wellness"are prohibited. Policy No. 06-02 Salon names using ethnic, gender,or age specific terms may violate Massachusetts law and may be rejected or delay processing of an application. Policy No. 06-03—Prohibited Practices-Revised Salons are prohibited from providing non-cosmetology services,that may endanger public health or safety: 1. Medical services,teeth whitening,use of cutting blades,and other such services may not be provided anywhere within a cosmetology salon. Applications with such services on them shall be denied. 2. Permanent makeup, electrology,tattooing, acupuncture,and tanning machines may be utilized in separate,distinct areas identified on the floor plan. 3. Salons may be located in other businesses if independently owned,operated, and separate from those businesses. Such circumstances must be clearly documented on the application for Board review. 4. Eyelash tinting may now be performed in licensed salons, using products that are not prohibited by the Food and Drug Administration (FDA). Policy No. 09-02—Certain New Procedures Intense Pulsed Light devices must be identified on the floor plan, may be used only by Aestheticians who have been approved for IPL by the Board, and the manufacturer's instructions and documentation showing board-approved training must be on the premises at all times. Policy No. 2015-02—Dual Use of Rooms for Cosmetology and Massage Therapy 4. A salon room may include massage therapy IF (a)the room is also licensed as a Massage Therapy facility to the salon license-holder; and (b)any person providing massage is a licensed massage therapist. I Salon Application Check List Please use this checklist to ensure your application is complete Incomplete applications will be returned and will delay your opening. You will be contacted by an investigator with an inspection date within 10 business days from the application's approval. Your application must include: ➢ 2 copies of a floor plan which must include the entire layout of the salon(8.5"x 11"Only). The applicant must retain a copy of the floor plan on the premises at all times. The floor plan must include all the following: *All stations,chairs,manicure tables,aesthetic rooms. For a booth shop,circle the space you are renting. *Additional sinks(cannot be located in the bathroom). Aesthetic and manicuring shops are required to have an additional sink located in a space that is accessible at all times to all areas. Example:Aesthetic shop with 3 rooms can either have a sink in each room or a minimum of one sink in a common area that is accessible at all times. *Shop sign *Label all rooms whether cosmetology or other,such as medical room,dispensary,lunch room,etc. *Bathrooms ➢ Original completed application signed by all required parties. ➢ Money order or check for$136.00 made payable to: Commonwealth of Massachusetts. *Application fees are non-refundable.* All money orders must be signed and dated. ➢ Copy of price list stating all services being provided. Gender Pricing is prohibited. Example: Cannot state Men's cut$18, Women's cuts $25. One 2x2 photo of each owner ➢ Copy of driver's license or photo ID for each owner ➢ Copy of manager's (if not owner)driver's license or photo ID and current cosmetology,aesthetic or manicuring license ➢ Copy of all employees' cosmetology licenses(not applicable if applying for a booth rental license unless the owner is not a licensee). For booth shop license,provide a copy of the booth rental license. ➢ Business Certificate from the city or town where the salon is located. ➢ An Original completed"plumbing and electrical"work form if work has been done. If no work has been done,the"no work required"form must be completed by the applicant. ➢ If the business is incorporated, submit a copy of the Articles of Incorporation; if it is a partnership or LLP,a copy of the partnership agreement; for LLCs, submit a copy of the Certificate of Organization. ➢ If a business is organized or incorporated, submit a copy of a certificate showing foreign registration with the Massachusetts Secretary of State's Office. ➢ Incomplete applications will only be held for a maximum of 30 days. After 30 days,the application will be considered abandoned. If you still require the license,you will be required to reapply. The Commonwealth of Massachusetts Division of Professional Licensure Board of Registration of Cosmetology and Barbering 1000 Washington Street Suite 710 Boston, MA 02118-6100 www.mass.gov/dpl/boards 617-727-9940 BOARD USE ONLY Investigator: Date of Inspection: Please attach one recent 2>'X 2» Received By: License Number: passport photograph here Type Class: _ Cosmetology New Shop Application Type of Shop applying for(See guidelines for salon type descriptions): ❑ New Shop(Opening date: ) ❑ Change of Salon Type ❑Additional License (Check one type only) ❑ Type 1 -Cosmetology(full service salon) ❑ Type 2-Booth Shop(renting a space in a salon). Booth Renter Shop lic.#: 11 Type 3 -Manicure Only ❑ Type 4-Booth Renter(owner of entire salon) ❑ Type 5-Aesthetic Salon Only ❑ Change of Owner(was previously a salon): Is previous owner's license attached? Yes No If no,list the shop name and license#of the previous owner: ❑ Change of Location: Previous location: Below to be answered and signed by person requesting the license: Name of Applicant: Last First Middle Name,License#and exp.date of owner or manager: Salon Address: No. Street P.O.Box City/Town Zip Code Salon Name: Contact Phone Number: Cell Phone Number: Location of Shop: ❑ Store ❑ Home ❑ Office Building ❑ Mall/Plaza name Business Structure of Salon: ❑ Individually Owned ❑ Partnership or LLP-List the partners: Note.Partners not named on the license as the applicant must also sign below,and in signing,they agree that the named applicant may represent all partners with regards to any Board business. i 0 Corporation—Name of Corporation: Name of Officer signing application: Position held by Officer: Note:If salon owned by a corporation,be sure to have the officer attach the articles of incorporation. 0 LLC—Name of LLC: Name of Manager/Member signing application: Note.If salon owned by an LLC,be sure to have the member/manager attach the articles of organization. Social Security Number: Pursuant to G.L.c.62C,s.47A,the Division of Professional Licensure is required to obtain your social security number and forward it to the Department of Revenue.The Department of Revenue will use your social security number to ascertain whether you are in compliance with the tax laws of the Commonwealth. Has any disciplinary action been taken against you by a licensing/certification board located in the United States or any country or foreign jurisdiction? No: ❑ Yes: ❑ If yes,a notarized letter must be submitted with this application. The letter should contain an explanation and description of the incident. Are you the subject of pending disciplinary actions by a licensing/certification board located in the United States or any country or foreign jurisdiction? No: ❑ Yes: ❑ If yes,a notarized letter must be submitted with this application. The letter should contain an explanation and description of the incident. Have you ever voluntarily surrendered or resigned a professional license to a licensing/certification board in the United States or any country or foreign jurisdiction? No: ❑ Yes: ❑ If yes,a notarized letter must be submitted with this application.The letter should contain an explanation and description of the incident. Have you ever applied for and been denied a professional license in the United States or any country or foreign jurisdiction? No: ❑ Yes: ❑ If yes,a notarized letter must be submitted with this application.The letter should contain an explanation and description of the incident. Have you ever been convicted of a felony or misdemeanor in the United States or any country or foreign jurisdiction,other than a traffic violation for which a fine of less than$100.00 was assessed? No: ❑ Yes: ❑ If yes,a notarized letter must be submitted with this application.The letter should contain an explanation and description of the incident. Salon owner or manager must notify the Board of Registration of Cosmetology and Barbering,thirty days prior with a new shop application,of any change in ownership or location. Shop licenses are not transferable. The new location cannot conduct business until approval at final inspection. I certify,under the pains and penalties of perjury,that the information I have provided pursuant to this application for licensure is truthful and accurate. I understand that the failure to provide accurate information may be grounds for the Massachusetts Board of Registration of Cosmetology and Barbering to deny me the right to sit as a candidate or to suspend or revoke a license issued to me in accordance with Massachusetts Law. I further attest that,pursuant to G.L.c.62C,§49A,to the best of my knowledge and belief,I and/or the business entity I represent have filed all state tax returns and paid all state taxes required by law. I further agree that I am responsible for ensuring that the actions of the above referenced salon will adhere to all applicable Massachusetts laws and regulations pertaining to the practice of cosmetology. Signature of Applicant Date Signature of Applicant Date Signature of Manager&License number Date The Commonwealth of Massachusetts Division of Professional Licensure 1000 Washington Street Suite 710 Boston, MA 02118-6100 Board of Registration of Cosmetology and Barbering www.mass.gov/dpl/boards 617-727-9940 INSTRUCTIONS: This form should be completed only if no plumbing and/or no electrical work has been done in the salon after purchase. No Work Required Form Circle all that apply: No Plumbing work done No Electrical work done Date: This is to certify that all electrical and/or plumbing work on these premises complies with the rules and regulations of state electrical and plumbing codes. There have been no changes in the electrical or plumbing systems. No changes will take place unless I first notify the Board of Registration of Cosmetology and Barbering and obtain and complete the proper forms. i NAME OF SALON NAME OF SALON APPLICANT ADDRESS OF SALON TELEPHONE NUMBER SIGNATURE OF SALON APPLICANT CRIMINAL OFFENDER RECORD INFORMATION (CORI) ACKNOWLEDGEMENT FORM The Division of Professional Licensure by itself and on behalf of boards of registration pursuant to M.G.L. c. 13, §9 [hereinafter, "Division of Professional Licensure"] is registered under the provisions of M.G.L. c. 6, § 172 to receive CORI for the purpose of screening current and otherwise qualified prospective license applicants and current licensees. As a license applicant or current licensee, I understand that a CORI check will be submitted for my personal information to the Department of Criminal Justice Information Services ("DCJIS"). I hereby acknowledge and provide permission to the Division of Professional Licensure to submit a CORI check for my information to the DCJIS. This authorization is valid for one year from the date of my signature. I may withdraw this authorization at any time by providing the Division of Professional Licensure written notice of my intent to withdraw consent to a CORI check. FOR LICENSING PURPOSES ONLY: The Division of Professional Licensure may conduct subsequent CORI checks within one year of the date this Form was signed by me. If subsequent CORI checks are necessary, the Division of Professional Licensure will provide me with written notice of the subsequent CORI checks. By signing below, I provide my consent to a CORI check and acknowledge that the information provided on Page 2 of this Acknowledgement Form is true and accurate. Signature Date Please provide the name of the board of registration and license type for which you are applying or currently hold: l Board of Registration License Type NOTE: DPL CANNOT ACCEPT THIS TWO-PAGE CORI ACKNOWLEDGMENT FORM UNLESS IT IS EITHER (1) SIGNED IN PERSON AT THE BOARD'S OFFICES IN THE PRESENCE OF A DPL EMPLOYEE WHO HAS VERIFIED THE APPLICANT'S IDENTITY THROUGH ACCEPTABLE IDENTIFICATION, OR (2) SIGNED IN THE PRESENCE OF A NOTARY PUBLIC WHO HAS LIKEWISE VERIFIED IDENTITY AND THEN MAILED OR OTHERWISE DELIVERED TO THE BOARD'S OFFICES AT THE ADDRESS SET FORTH ABOVE. Page 1 of 2 SUBJECT INFORMATION: (An asterisk (*) denotes a required field) *Last Name *First Name Middle Name Suffix *Maiden Name (or other name(s) by which you have been known) * Place of Birth * - Sex: Height: ft. in. Eye Color: or ID Number: State of Issue: Current and Former Addresses: Number Name City/Town State Zip Number Name City/Town State Zip SECTION A: VERIFICATION BY DPL EMPLOYEE: I hereby certify that I verified the identity of the above-referenced subject by reviewing the following form(s) of government-issued identification:' ❑Passport ❑State-issued driver's license []Military identification ❑State-issued identification card VERIFIED BY: Name of Verifying DPL Employee (Please Print) Signature of Verifying DPL Employee (Please Print) Date SECTION B: VERIFICATION BY NOTARY: On this day of , 20 , before me, the undersigned notary public, personally appeared (name of document signer), and proved to me through satisfactory evidence of identification, which was the following:' []Passport [)State-issued driver's license []Military identification []State-issued identification card to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) (she) signed it voluntarily for its stated purpose. Notary Public: Notary Commission Expires On: ' If a subject does not have an acceptable government-issued identification, his or her identity shall be verified by the other forms of identification documentation as determined by DCJIS. 803 CMR 2.09(2). Page 2 of 2 The Commonwealth of Massachusetts Division of Professional Licensure 1000 Washington Street Suite 710 Boston, MA 02118-6100 Board of Registration of Cosmetology and Barbering www.mass.gov/dpl/boards 617-727-9940 Plumbing Inspection Form INSTRUCTIONS: This form should be completed only if plumbing work has been done in the salon after purchase. Date: This is to certify that I am a Plumbing Inspector for and that the plumbing alterations or Name of city or town installations for Name of Salon Applicant Street Number Street Name City State is in accordance with the specifications of the state plumbing code found at 248 CMR, Name of Plumbing Contractor License# Exp.Date Address No. Street City/Town Signed: i Plumbing Inspector License# Exp. Date The Commonwealth of Massachusetts Division of Professional Licensure 1000 Washington Street Suite 710 Boston, MA 02118-6100 Board of Registration of Cosmetology and Barbering www.mass.gov/dr)l/boards 617-727-9940 Electrical Inspection Form INSTRUCTIONS: This form should be completed only if electrical work has been done in the salon after purchase. Date: This is to certify that I am an Electrical Inspector for ,and that the electrical alterations or Name of city or town installations for: Name of Salon Applicant Street Number Street Name City State is in accordance with the specifications of the state electrical code found at 527 CMR, Name of City or Town Where Shop is Located Name of Electrical Contractor License# Exp.Date Address No. Street CiWown Signed: Electrical Inspector License# Exp. Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# 31?0 0< � Health Division SG Date Issued Conservatio ision Yhh Fee /aq•DU Tax Collect Treasurer ' D� SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANC Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 9 Village Owner amxkA Address W Telephone qA4" 0 s_ Permit Request t$�C�-y �oA1CQJ1 � ��.on� cV1�2 � fG MIL I 6a L/_ L V Square feet: 1st floor: existing qa proposed 7Jct- 2nd floor:existing 76 proposed Total new O`er Estimated Project Cost o ��Oe� Zoning District Flood Plain Groundwater Overlay Construction Type 1n9 Vg&.%a Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure <I-© + — Historic House: ❑Yes U-N-6 On Old King's Highway: ❑Yes ❑No Basement Type: Mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) N 't Basement Unfinished Area(sq.ft) J�y Pk- Number of Baths: Full: existing - new t Half:existing O new O Number of Bedrooms: existing_ new r Total Room Count(not including baths):existing ri �I new Q First Floor Room Count �l Heat Type and Fuel: ❑Gas Q-Oif ❑ Electric ❑Other Central Air: ❑Yes M'�Jo- Fireplaces: Existing l New Existing wood/coal stove: ❑Yes Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Glexisting ❑new size ZoX Shed:O existing ❑new size W Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0V96'_ If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name? 4Telephone Number Address s License# d y 3 5-S6 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 0 SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. 2-5 _ DATE ISSUED MAP/PARCEL NO.' ADDRESS VIHLLAGE - r OWNER 4 DATE OF INSPECTION: FOUNDATION FRAME 7fq vile - INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH) ►� FINAL j y GAS: ROUGH-- + _FINAL , FINAL BUILDING � O to m DATE CLOSED OUT � ' Y t- d1 ASSOCIATION PLAN NO-, -r: �, TOWN OJARNSTABLE. LOCATIONLt�t,� n � 'IS SEWAGE # VILLAGE. "� ASSESSOR'S MAP LOT IN NAME Se PHONE NO.jejj � SEPTIC TANK CAPACITY 60 LEACHING FACILITY:(type) _! ��f�OsG�� (size) �� I NO. OF BEDROOMS_ PRIVATE WELL OR UBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: -7 '. 7 VARIANCE GRANTED: Yes No v , r s� N Q -Awl v I' 4 E CMO ®I IOIL JIL .b v i in JAL AT. .'{. .. AT•P 4ri. P.T. POyTs • ,':;�'. .. Yard �r .ATOP /O".f OMA'7bbG�S .. • :,:,s C3 '••} .. � rl,V�J� � � 1. ., 07 - a. -., ♦UCNT t Ay PER Coor W 40 eotjr- co) i � 3.O•jTLAP �. 1 CRAWL Is - � ta•,�T.rArw w O wAa. _Vtoo& PLAio ALE //v"-/'O �o ,u . . . „ � .. uo�1 no u AAA) I e.N: i • '�dIJ It E-T' ADD.T,e At. LID6Hl.LOdT.fo7r/f vc1jr • - _ilxlo RAPTB 2iYr OC. 3'TA4a ot, Go Ali .AsuM 'G-UTTea$f:y14w>j ' N UTCN : I`ROn7T' AOvGM cLAPOoAev, ' ....:3 yIDEf,WAG SNIlobLtf S"7CZt✓,f-'wrATIN. Ixs CAD') Rio V .IxS TRIM .. .. ,., -r VEK OVeRC %•ci7x• PL I/EATI!/NG �• --.. ' : _ ; ,Z •. '_. Ix$ FASCIA+ foFFlr /i-- �. . '�..: .. -'v,.. •• '...IXp'TRIEZF' wll J"r-'MIOb, rat,DBNTSL e a-a,xV- 7DP../LATE v t dx4 11 II A*TtW-F4V4JNT) ifs ,JOTk 0 l- . P.T.Rn _ :. '+ S�j•a/r�J16 R w 11 'ND •. iya' P.T. ixv P.T. . 3'//�•Co.JC.-CO.L�i°I URWL_.,yls!,CE- -.IV&Rr.-yLL oA0 e0b 60ty i ix oMbR. O� axL T• 1LL 1J JEv1L-' _.ATOP. (okf. P.T. Ao}rf 9 _CAP.;? /17VP W$O-a TVO-.$ L `••�CWO!- k3�LL 30•M.IO�XN�[oAY./AD•'`.�. '. � � ' r.1/lL41•i�NT F7f;L' �. • :�M r/Z DOT $��fJ F •+ ' I--. RA ILf l Air S EGTioa) d/NLiowl+.fh7taf'l01iL—�100� .ED-U.LfL—. � � � . NVNQEIC .O.•.____ .—_IFLAfJ._._-__..__ 1,17aT OTNB.t . Q dvv6 _.. D JW6 L3,69 Elf, J . i ne i own oY barnstaoie . s�arrsrA8r8 • 9 659- Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Cressen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. CIA Type of Work: M Estimated Cost Q �� Address of Work: 1 IN Owner's Name: `1«n� Date of Application: PP I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED j CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY [herebyapply for a pent as the agent o the owner. &ktW A"= — Date Contractor Name Registration No. `9—got +aG� OR S Date Owner's Name q:forms:Affidav r Dcpartll'rrut of Ittdicrtrial.4ccidents ;, 1- ,: Ofllc�allas�estlgatloas i 600 Maxhingtan Strrrt Bustnn.JfuAm .U3111 ` Wurkers' Compensation Insurance Afridn' it _ aiT6H :rnt tnf4r Tien- _ �Plcnsr PR(1VT''1 iK, , ryhnne M I am a homeowner performin_ all wort:mvseIr I am a sole proprietor and have no one working in any capacity am an employer providing workers' compensation for my=ployees working on this job. cnntn:tnr nnmr• �� UCH 4 VI �/JIJI/I 1/lAil� S nddrrcc. ' i ( z mn l N 5 1'�e.e-r. Ciro i i # I P. ci ( /,.-1 e rO I I-e, M A 02 Lyn/ nhnnc ll• LI zC,' " inciir�urcrn. Mr��V' L11/V nnlirt•t! aA5-L) JL-U �—C� _ ... _... ..... �. ...�....�...��.. _.— 1 am a sole proprietor. ,cncr2i contractor. or homeowner(circle one) and have hired the contractors listed bciou• ,A'nc the following workers' compensation polices: rmmn,inw -line, atirlrrcc- cin nhnnc N• inciir-inrr rn nnlirt tl cmmiinv nntnr- i .t'tiJrrcr in nhnnc N• ncunnrr rg Wolin•�► 1112ch additional sheet if r necesiari•• •� ^�i' L "' "0i�'+��'� _ :111urc It,secure cm-craec as required under seetnon•3A o(AIGL 152 can lad to the imposition of ertminal penalties of a lice up t S.I.500.UO anw ne %cars' imprt%onmcnr:t� it-ca as cit-if penalties in the form of a STOP WORK ORDER and a fine ufSI00.00 a day against me. t undersuad lh:& opt of itri.N %litcnic"t mad be furtwardcd to the ORcc of tnrestications of the DIA for corcrage t•erilication. do her 'r c . if)-tin � the pains and penalties of perjure that 1ltc information pros7ded above is true and correct i _•acute 4Y"` Date 'rint name 4e�5ZNAt��� _Phone# 506 92, 8 (r)iy5 n(rcial use unl%• du not it-rite in this area to be completed by ciq or town olncial citw or town: permitAlcense# ntluildinr Dcparrmcnr I t.tccasior. Owrd CD check if imincdiatc rmpunse is required C3!Seleetmen'3 Ofticr C1ln11b t)eparrweat contacr Prmon: phone#• r'1011ier -- - - -- -- w J� F p k w co ' o m 1 'd EFHFHI I EEHEEII I K� Itb I Ix ^3'.eA1:E %IDS a+COMI.f o7F,,s VCAjr iX III .RID.6F.. _ _.lx/o RAEIf 2.Y.00. .� • _.::..ALUM •mr Acj f.•J cLAps . D "•..'}IDIPf..,._FI[ON'I' AOUGN CtAPOoA4t>' .. • a dl 3y1PC).44)c fw'1Nbicj S'7rn✓r:.rw7tN. lid (x.N. ')its csot - v A961xS- TRIM . -/yyEK OVtK ;�o•c0„ PLysllE1T11/!dG i�lL.• ' � .' '�,•� '• .,. V'... � _:.�.1%p'=RIEZF rl�d"+-'Mtpb. +3�pE/.iTCL e v �'i1l e--1&"to 4o. /LATE M i p,.,. '. dx4jGYL'7�t. _1_T L a` /ykRN'.NEi6NTy Atj /JOTfD Sf j'+j6So6 it y-2 3yV.SNOE. Z d si' PT,. 'ixV P.T. p' •t•• R19 .p io t/1r"•OC 1}(L P.T. DECRiuG - 7//x Gait..cot_i7 GtRW4.Sf/KE. dx�RT._yct. 0-1 END ONty - __/1TCP. !Ok b P.T. Po}rj a>,t r•s�LL !J�SeV�L- 3'_dd}s_Chh/ A7DP /O•SO uA TU p�f s. ,I GWbl. k7NltS 30"xl0'x/.7�COAY./ADs PAN IROO= $&tOrJ �J� __ �aU/61tIV NT.F'1Gf _.6QADf - f - %2- ,, ELSVA„on/ ' .' � ! NVMG.Gt � .0..,___—_.. .._.._Q:LAff._.__._._ .�. 6/T'Y•'• OT/VE,t � I i O r P S ii c n m .12�N . a q a �� ` wy1 x, ri �• � �� 4 • u r Y A IE C 0 ti orri it ' e0 ' O• y# i R'M i is w • n.'Dx' I L r :e. 03/04/92 14:06 '0617 898 7091 AMER. SURVEY CO. Qool I t ti i At I p ;iX. / . • • �� 5FrsR.yrks +may w�Is • I i; �owa�ru:� ;K�►owa 4S KIALaA DRWc. o p. 4p. Ca381RC14 12 � o. `q0P scale: i I " D C� FERICAN•$URVr1flNG COMPANY ok J- wre-k I n Fturrrfor�d'A�eriue,silica#2 VVahtiam.AIIA 02154 (617)ss3.6477 A REGISTERED LAND'SUFWEYOR, DO HEREBY CERTfFY THAT THE ABOVE--MORtGAGE•,.IN:SPECTfON PLAN ' WAS PREPARED FOR tN�M •fP`"r1f�: -rh IN {V1 1'` a ° rispectron Plan 7 CONNECTION WITH AI NEW DATE a- y R=RDED•AT. ItA S JE COUNTY REGISTRY OF DEEDS MORTGAGE ANQ IS NOT IN'jE DED CLIENT• dcbk 71 M2 PAGE S (�L.C. CoR a OR REPRESENTED TO BE A LAND CLIENT REF N 4=c— PLAN'REFERENPE: - ag o A� /!'� OR PROPERTY'UNE'SURVEY. NO J.Q•0 2.00-19 0 T pRAyyN:PER TOWN OF ASSESSOR'S CORNERS WERE SET,IT CANNOT BE. MAP:0I PARCEL M DATED'— USED'FOR ESTABLISHING;FENCE. THE LOCATION OF THE ORIGINAL ADDRESS: '/¢ LZ - WAY HEDGE OR BUILDING LINES: THE DWELLINGSHOWN HEREON EITHER _ 1�1A�L3�'onl� MI cttifM A LAND AS SHOWN HEREON IS BASED WAS IN COMPLIANCE WITHIITHE LOCAL BORROWER: i1l1CKOFT ON CLIENT FURNISHED INFORMA- APPLICABLE. ZONING BYLAWS AN TION AND MAYBE SUBJECT TO EFFECT WHEN CONSTRUCTEO.(WITFi SUBJECT DWELLING LIES IN FLOOD ZONE FURTHER OUT-SALES. TAKINGS. RESPECT TO HORIZONTAL DIMEN- AS.SHOWN ON NAnONAL FLOOD Ij.1SURANCE PROGRAM FLOOD EASEMENTS AND RIGHTS OF WAY. SIONAL REQUIREMENTS ONLY),OR IS INSURANCE R/CE MAP DATED fl Uce• 19, 14 9 S NO RESPONSIBILITY IS EXTENDED EXEMPT FROM VIOLATION ENFORCE- COMMUNITY—PANEL N Zs04>0 i -o o%S"G HEREIN TO THE LAND OWNER:OR MENTACTION:UNDER•MASS.G.L TITLE FIELDED DRAFTED HECKEDI OCCUPANT.IT IS NOT INTENDED Tt� V.II;CHAP 4OA;SEC 7,UNLESS OTHER? BY -SC BE RECORDED. ! WISE NOTED'OR SHOWN;iiEREON.- DATE. , ,_ _Q _ F.B .PGE. 6T, �oyvr. uoeald o�✓�aaoac/z.�vek2 i BOARD OF BUILDING REGULATIONS d ' License: CONSTRUCTION SUPERVISOR y Numbef�CS O43656 3's" � ) • j' pf��ti�3/2000 Tr.no: 5486 , 'To: 00 f I SC:OTT E CROSiY ,_ 62 CROSBY CIR :. L OSTERVILLE, MA 02655' Administrator 1 ./.�•t '! Y'i't+"'✓/y!!, TIO!!t•At01tl1.1E1a[4►p` tldE�•d x„",�� �`" ` {HOMES IMPROVEMENT;CONTRACTOR , '':�. r egi`strati 03582 f ' ,TypeDBA Y:Ezpiration ",07/09/00 PEA000K'b,CROSBY BUILDERS t� S.co�t.E. Crosby'•: f BOX 151/ 1112. MAIN ST UNIT ADMINISTRATOR .� f Osterville'MA 026551,,; : i 0 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 Checked by /Date CITY : Hyannis STATE : Massachusetts HOD : 5973 CONSTRUCTION TYPE : 1 or 2 family , detached HEATING SYSTEM TYPE : Other (Non—Electric Resistance) DATE : 5-10-1999 DATE OF PLANS : TITLE : COMPLIANCE : PASSES Required UA = 100 Your Home = 82 Area or Insul Sheath Glazing/Door Perimeter R—Value R—Value U—Value UA ------------------------------------------------------------------------------ CEILINGS 432 38 . 0 30 . 0 7 WALLS : Wood Frame , 16 O . C . 480 13 . 0 3 . 0 34 GLAZING : Windows or Doors 40 0 . 400 16 DOORS 10 0 . 400 4 FLOORS : Over Unconditioned Space 432 19 . 0 21 ------------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans , specifications , and other calculations submitted with the permit application . The proposed building has been designed to meet the requirements of the Massachusetts Energy Code . The heating load for this building , and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code . The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1 r and J4 . 4 . Builder/Designer Date 6110 � ' . � . MASuheck INSPECTION CHECKLIST Massachusetts Energy Code MA3cheok Software Version 2 ' 0 DATE : 6-10-1999 8ldg . | ' Dept. | Use | || CEILINGS : r [ ] | 1 . R-38 + R-30 | Commente/Loca,tion ' | | | ' | WALLS : [ ] | 1 ' Wood Frame " 16" 0 . C ' , R-13 + R-3 | Comments/Location | . / | WINDOWS AND GLASS DOORS : [ ] | 1 . U—value : 0 , 40 ' ' > For windows without labeled U—values , describe features : | 4 Panee Frame Type Thermal Break? [ ] Yes [ ] No i Comments/Location | DOORS : [ ] | 1 ' U—value : 0 ' 40 | Commehte/Lmcatiun | ^ | FLOORS ; [ ] | 1 . Over Unconditioned Space , R-19 l Comments/Location \ AIR LEAKAGE : [ ] i Joints , penetrations , and all other such openings in the building | envelope that are sources of air leakage must be sealed . Recessed | lights must be type IC rated and installed with no penetrations | or installed inside an appropriate air—tight assembly with a 0 ' 5" | | clearance from combustible materials and 3" clearance from insulation . / . ( \ VAPOR RETARDER : [ ] \ Required on the warm—in—winter side of all non—vented framed ' ( ceilings , walls , and floors . MATERIALS IDENTIFICATION : ' [ ] \ Materials and equipment must be identified so that compliance can | be determined . Manufacturer. manuals for all installed heating | ( and cooling equipment and service water heating equipment must be \ provided ' Insulation R—values and glazing U—values must be clearly � ' ( marked on the building plans or epecificationa . ` | | DUCT INSULATION : | ' ' | [ ] | Ducts in' unoondition,ed spaces must be insulated to R—S . | Ducts outside the building must be insulated to R-8 ' 0 . . . . . � . ' . . | ' ' | f DUCT CONSTRUCTION : [ ] All ducts must be sealed with mastic and fibrous backing tape . Pressure—sensitive tape may be used for fibrous ducts . The HVAC 'system must provide a means for balancing air and water systems . TEMPERATURE CONTROLS : [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and /or cooling input to each zone or floor shall be provided . HVAC EQUIPMENT SIZING : [ J Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 . 4 . MISC REQUIREMENTS : ' [ ] Refer to 780 CMR , Appendix J for requirements relating to swimming pools , HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ----NOTES TO FIELD (Building Department Use Only)------------------------- F vv— oe fst loor): Assessor'smaP_andlotnumber•...........'...... • ST T 1� Board"of Health (3rd floor): Sy N. c� EM Sewage Permit;.number .......: .... ... ��... ..4.. .-•- C Z B9SB9TADLE, i 'Engineering Department (3rd'floor): 7-1/ 1 � SEPTIC t House number .................................... ................ ..............................}...................... - '; wNSTALLED IN COMP APPLICATIONS PROCESSED 8:30-9:30 A.M. and. 1:00-2:00 P.M. only _ r ,, WITH TITLE 5 &tfWAL COMM TOWN- BUILDING F B A R N S BUILDING INSPECTOR Aw 1x. APPLICATION FOR PERMIT TO .. ..:t....`..... TYPE OF CONSTRUCTION ..... .�n. .. ..N.. .�.p.G�..�............! �.L.!.: , �. ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �} Location .......................... .......!\.41 .4...... .........1...`9r�S.. azq........M.+...�.� 5............................... Proposed Use ......j�G��..!.. P.. .. ..t .. .......... Q. ...e........................................ lP�s cal ...........(. .. Zoning District 4 ........I Fire District cro .� Tdc� � ....... , Name of Owner // � .Address .. r ,a............z........_. _ �_..... .. ........ 4 Name of 'Builder s`T.�....G-. ..� e....... !✓.T ...Address ...�1..�ar✓.f'►L! ..........�i:... . .. .... ) 1. Nameof Architect ..................................................................Address ........................................................... 1 ............. . l , Number of Rooms ........... ..................................................Foundation ... Q.-�q... ...... Exterior .40.0..0.4... /l.%.4.9.zt�.4....:t:�...C.1666!nc.a.Roofing ....�7�.�.!l.�i.�.�....�.�.j.../.�t1/ � /�'�.......... I; Floors' ../ .1.... ...�lt.!c .(? fViC?..Interior . .C?. ..: *.!?!.fir.... ....F/� .r ............ 1# •l /0 �4 a r- e/e nl/ ' P Heating ... ...�'...1C.�-..c�...... .. .Q7....�.... ... g ...�..� ..... ................................... �r� 4 ./.` . �� Jr� �� ............Approximate Cost ....... .n� •.. .� 1 Fireplace ............... ....................... ................... .... ....... - Definitive Plan Approved by Planning Board -0_10______ _______19_cS__!a. Area Diagram of Lot and' Building Iwith'Dimension; Fee ....... ... ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH l 1 I; OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of B rnst le reg g t above k construction. • � I Name .. .. .... ... .....:.:.. Construction Supervisor's License ti.J .elq ` PENNAMPEDE, PAUL '64NCROPY . J,41P?ES 14,-107W-14 No .... 'Permit f'or ..........Single...F.ami.1y. Dwelling Location .... ...... ..................... Mills........................... Owner ...... Type of Construction ...........Frame.................... ................................................................................. Plot ............................ 'Lot .......................... Permit Granted .......Sept. 9 .............., ......... ....ig 86 Date of Inspection ......... .........................19, Date Completed ......................................19 -A No TOWN OF BARNSTABLE .permit No. ..2988.4..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ,.......... 7 Y\ 619• 9''r9u+ HYANNIS.MASS.02601 Bond ......NSA CERTIFICATE OF USE AND OCCUPANCY Issued to James & Cynthia Bancroft Address Lot 06,, 74 Kialoa Drive Marstons Mills,, Mass, USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. August 1, t9......90....... BuiI mg Inspector Assessor's office Ust floor): Assessor's map and lot number Board of Health (3rd floor): Sewage Permit number 7�— . c7 G 2 BABH9T11DLE �a7,"I Engineering Department (3rd floor): 9oc rb 9. House number 7� �L� S �0 .........................................:.............. ............. o�,p war°'• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO . .a�:�.`...... °t:... ��. '?C "�-:.1ADO ......f /l?[J:S C,,,.Y,,,,GCx s:Q ca Q........ TYPE OF CONSTRUCTION ........R.4`.'.S..l.I<�,!;�.:i11..�.!.!r� ' ............ ......................... r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location ...L.............oll ...........6.......f.�.!,./.4..�ra...�-+:...... .......... ....:...�...`...�..'..--�................................. &zr—C Proposed Use ......, f �.r r`X.F fi! ]C .!,Q . . r Zoning District ....... .. S..r...� !.. .!�.........!. ....�.. ::�".:...Fire District ...:.................::....................................................... e ,j (JUM 1 Name of Owner f4.,je: Address a CG fv T lle Name of Builder .. �. .��... ..R..ICC'........ .t.....Address 0.'1../....a ... 4 /Yt I� 1 0 ..L ....... .. ... Nameof Architect ...........:......................................................Address ............................................................. Number of Rooms ........... ?..................................................Foundation .:CQ.�...C...t - T �Pno r.e.d) / /.. /l L ....................�; Exlerior JO.(�c�....� ,t,.,n) ,®p.S..... ....C.144,??.r.;O..Roofing .... L'.G?..�.. .... .......1.�'r �e,.. ........... EH Floors ..� .�,CAi /„ ! C�L</G.c ..Interior G ...C.... 5 Heating li...c..e..........! ............ Plumbirig Fireplace /�.0 A. �! r�. J�... .... ............Approximate Cost .......0 .c.., ..a...... ,............... . Definitive Plan Approved by Planning Board _M-6)______ ________19_ 4�. Area �,. .... �.:.... ....-. ..... Diagram of Lot and Building with Dimensions g 9 Fee ......>.�</...`.-'..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH i j I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulation's of the Town of Barnstable regarding t e above construction. k { Name ,. ../�w ... , ... ......, ..................... Construction Supervisor's License 'a.........?.. . PENNAMPEDE, PAUL A=46-15 No .29884..... Permit for ..Remgdgl...Md.d—Garage Sin le fam' g..............?�.X...AW * ing..... .......... Location, ....L.Qt..9l.6.,......7.4..1a.. .xzus........ ......................Mars.ions..kIi.IIS........................... Owner ..... PPAPAIAP.d.2............................ Type of Construction Frame ... ............................................................................ Plot ............................ 'Lot .....:.................. Permit Granted .........Sept.....:9::..............19 86 Date of Inspection ....................................19 Date Completed ..............:...... ................19 r NW' ARTE9 . S o� , 20 FT. MIN. SOIL TEST EXISTING TOP OF FOUND. —" — EL = 79.8 10 FT MIN. OBSERVATION HOLE I OBSERVATION HOLE 2 OBSERVATION HOLE 3 CONCRETE — —4 SCH 40 PVC COVERS CLEAN SAND J dj,►•' DATE OF TEST ' ' " 14c+" � �`� DATE OF TEST DATE OF TEST —_ PIPE - MIN. PITCH �•, WITNESSED BY M WITNESSED BY WITNESSED BY 1/ 8" PER FT VCONCRETE r'� 9 PERC RATE `� 2 MIN./ INCH PERC. RATE MIN./INCH PERC. RATE MIN./INCH COVERS LQc,y , '' TF.S7 ?C 5,4-4. ELEV = "-� — ., 4 CAST IRON ( I d ELEV. = ELEV = EQUAL) PIPE - MIN. �--12 MAX i PITCH 1/4 PER FT , . ' 2'-0TOP q�,QBSOVL o / 2% MIN ti p o n. : __ . P LEVEL 34a EL.=67.0 p FLOW LINE H�.MiLIhCS 74.3 I 0 N z _ /fir---- l'ti�.`(V'+t A'{ t! Q" UNSUITABLE EL- _. ' MIN. o o: :.• o 8 EL.- 63.0 EL- 74.0_ EL= 7_._._s5L. EL =_73+2_ R1V ER. %-\EU1UlWN - 72.7 DIST EL- o WATER AT ..5 _ EL= j � WATER AT EL = WATER AT _ EL = BOX b b Op LOCATION MAP 1 ©a�:7 GAL PRECAST LEACHING o n ff SEPTIC BASIN OR EQuly. EL = 66-7— LEGEND � TANK _ EXISTING SPOT ELEVATION 00"o I 10` EXISTING CONTOUR - - --00 - - - - i�.l FINAL SPAT ELEVATION 00. FINAL CONTOUR � PROFILE OF _ i Q BOTTOM OF TEST HOLE - - - EL _ SOIL TEST LOCATION i SEWAGE DISPOSAL SYSTEM ADJUSTED GROUND WATER TABLE ( / / -) EL = TELEPHONE POLE -0- tIII� NOT TO SCALE HYDRANT TOWN WATER -- W— - - W=- 711 CATCH BASIN �Fl . �v FRAME 8� COVER SHALL BE C / V / Y SET WITH MASONRY UNITS ' / I CLEAN SAND IN HICH ARE To BE MORTARED to s S" `., t - - - - - - - - - - - - - - - - - - - GENERAL NOTES ' 2 LAYER OF I/2�� WASHED 1. ALL WORKMANSHIP AND MATERIALS SHALL �'. ,/� �� I I � . .. a STONE CONFORM TO D.E OF TITLE 5 AND THE �� �✓ J` ;` ' I as TOWN OF _BIRNLILB E RULES & REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE 4 2.ALL COVERS TO SANITARY UNITS SHALL. BE �I L = BROUGHT TO WITHIN 12" OF FINISHED GRADE I 3.EXISTING AND FINAL GRADES SHALL REMAIN WASHED STONE ESSENTIALLY THE SAME a ww G 4 NO DETERMINATION HAS BEEN MADE BY THIS LL-0 OFFICE AS TO COMPLIANCE WITH TOWN PRECAST LEACHING w BASIN OR EQUIV ZONING REGULATIONS. OWNER / APPLICANT IS 24" DIA COVERS d _ TO OBTAIN SUCH DETERMINATION FROM d APPROPRIATE AUTHORITY . PLAN VIEW 5. THIS PLAN IS VALID ONLY IF IT IS STAMPED "<. Z-o AND SIGNED IN RED. THIS OFFICE ASSUMES NO RESPONSIBILITY FOR INFORMATION CONTAINED 4 / i �, /,--FRAMES & COVERS SHALL , pe BE SET WITH MASONRY UNITS _ _ t 0 0 ON COPIES WHICH DO NOT HAVE ORIGINAL •' / �-� .-% /� ,, �' - � ''� , '''• ,< � WHICH ARE TO BE MORTARED I¢ STAMPS AND SIGNATURES _._.�_._ _ '�` � f .� �' �'d ,'` ;�` .• � IN PLACE J� � r' f 6. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 jf INLET �. LEACHING PIT DETAIL LOADING UNLESS THEY ARE UNDER OR WITHIN w OJGO? 3 MI N. OUT L E T 10 FT OF DRIVES OR PARKING AREAS. H-20 "V �''� ; '� I f P.k , "—"�" 6 MIN, FLOW LINE -- NOT TO SCALE LOADING SHALL BE USED UNDER OR WITHIN /--REMOVER LE COVER 10 FT F fir. `� ° 2 MIN. 0 DRIVES OR PARKING AREAS k' OUTLET TEE OUTLET PIPES Y"\ �``• `�... �t , , 10"MIN. / .1 r� .�:� AS REQUIRED LIQUID DEPTH TEE , DEPTH BE LOW FLOW LINE �. .' • �' % .? _# 4 FT. 14 INCHES INLET ° MIN. FRONT SETBACK ___ ' _ �'` 5 FT. 19 INCHES —� FLOW ° OUTLET MIN. REAR SETBACK r 4 FT MIN, 6 FT. 24 INCHES "'—'� LINE MIN SIDE SETBACK 1 ram' ado I /f f i LIQUID - /". �° ' �.: �� Y. Z . tA. T 7 FT. 29 INCHES a /�I t ` a/60 , DEP H 8 FT 341NCHES ° r 2' 6 APPROVED BOARD OF HEALTH P .0- ¢ 11O '`-�+ t C� 2;. DATEY AGENT F )as ' t1c ��. Y \000 K `r��r0 � �' /� I � � `'F c. `-INLET TEE PROVIDED GPI\- Z PN ', Q ,r, (� o PER SECTION 15.10.2 / c TITLE 5 PROJECT LOCATION . . ....... ' ' '� N0. OF OUTLETS: � a --- F�A�..'"� �"• � �1 ''�'�t �t,. '�. CROSS SECTION VIEW , , , , � I J EXIST. � APPLICANT 1 SHED �1 S�-�� �. 14�, LI:`� SEPTIC TANK DETAIL DIST BOX DETAIL/ Io.6.•, / i NOT TO SCALE NOT TO SCALE x R J O 'HfAmv, hic f` �' 1• A�L.L, � tt\R7t qo 4� _ `�.Hpttr� ' E Reg. Land Surveyors - Reg S anitorions I DESIGN CALCULATIONS t a�J FRS vN �� r*.►•a p 1!� 35 ROUTE /34 - UNIT 2 - P. O BOX 237 '�` ✓ - � / •"�' ,� �� . ,,�. , ., . , � � 7 Fi � i 1.t'C" DENNIS,NUMBER OF BEDROOMS � • ' SOUTH DENNI, MA . I _T ' �'" "r GARBAGE DISPOSAL UNIT i�d cn, �� "1 TOTAL ESTIMATED FLOW y ( _ll1Z GAL/BR./DAY x BR. ) GAL./DAY REQUIRED SEPTIC TANK CAPACITY 44 GAL. _ ACTUAL SIZE OF SEPTIC TANK i GAL. - - LEACHING AREA REQUIREMENTS SIDEWALL AREA . GAL./S.F. /3E x I $; 2 5 _,.' BOTTOM AREA . ;� GAL./S.F. Y LEACHING CAPACITY ( BOTTOM SIDEWALL) ` GAL. REVISIONS _._.._ 14 x 5 ,:5 3.14f 10 C, x 2.5 �LHnF��s�\ ��pLt�°�rsSy^ �- F:^ t^• � �;� �l�, :,� � SCALE � „ .-. : ... DATE' C, RESERVE LEACHING CAPACITY GAL. i g. Rrc�;A�D �� � RICHARD \ JAMES +, J' O'HEARN 1 ® DR. BY: �PPD. BY: 11 No.b9► ��� b. t /�2 J Mb G t�.� � C' JOB N0. . svnGz�P' t IAA- ® �+ SHEET OF FORM II/6/ 85