Loading...
HomeMy WebLinkAbout0048 STARLIGHT DRIVE .._ ...., _ . _ 0 ._.. - _ - ��:..:._., _s .� _ ____ _ .__._�� Town of Barnstable *Permit#.6 _ (a '7mul C Expires 6 months from issue date o fi Regulatory Services Fee �inztxsrARM 163 Richard V.Scali,Director 00 Building Division Q �QF p Tom Perry,CBO,Building Commissioner �Q�►� v11l y�� 200 Main Street,Hyannis,MA 02601 1` S � www.town.barnstable.ma.us Office: 508-862-40338 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /N) 1 _ Property ess � �� / Ae - Residential Value of Work$ S;9OD C'O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ,�f�lJ.�/,9 zz-oo —9 Contractor's Nam e_/c�a r Telephone Number-1-0 ]- Home Improvement Contractor License#(if applicable) 0 Email: /��U/J/cl ti j ,d> ,,�lpJyy2,Qj Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I e Homeowner have Worker's Compensation Insurance Insurance Company Name QL,,Q Gi9W,!6 6?40 d Workman's Comp. Policy# 4 &zl d l 9 i �24-? 7, ?jam Copy of Insurance Compliance Certificate must accompany each permit. Permit Request k box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\E)PR.ESS.doc Revised 040215 e 9LOZ/£Z/90 Jauolssiwwo3 uoileiidxq ���.��-4��Aer- u 4aodsluuvX]q lsab Z69 XOR Od I V7'IIA G"MIR 09DLO-SO :asuaoll -iost"uadnS uoUan.tasuoO spiepue;S pue suol;ein6a�l 6ulPling.lo pieog 44ales ollgnd;o;uaw}iedaQ- suasnyoessew 2 �fzepomairnoauueh o�C aa I Office of Consumer'Affairs Sc Business Regulation License or registration valid for indiyidul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 4 Type: Office of Consumer'Affairs and Business Regulation egistration: ';128560 10 Park Plaza-Suite 5170 xp".tion:.472;T'/2q_17= Individual i Boston,MA 02116 ' RICHARL.VILLANI RICHARD VILLANI ; 109 WAGON LANE HYANNIS,IVA 02601 Undersecretary Not valid without signature I j r Ile Comuromvea1fh u,f-Vassaclr=etfs Department of Indusfrial Accidmax 00ke o,f.£nvestig limu 600 Washington Street Boston,M4 f12111 fvrvrutnamLgovfdia Workers' tlompensatian Insurance Affidavit:B.nilders/Cantractars/EIe,ctrlcians/Plumbers Applicant Infmmi-atian Please Print Leg bIv Name(BnsMesstDrgmimtimVMvidad): /////&I h j GOh S"J Address: �.[iQ ci e �, . citp/S.tatel -. _ �lv ( /n G4. I - - ��'a y5 Are you employer?Check the appropriate box: * Type of project(required): I. am a employer with 4. ❑I am a general contractor and I' employees;(full and(or part�me)_-* have Hired the subcontractors 6. ❑New consfmction 2.❑ I am a sale proprietor orpartner- listed on the attached sheet. 7. ❑Remodeling slip and have no empkyees These sob-contractors have 8. ❑Demolition work-in,- for me in any capacity- employees aad have woricess' INo workers'comp.Msurance comp.msu=-Ck--l 9-.❑Building addition required] 5. ❑ We are a corporafifln and its 10:❑Electrical repairs cr addifions 3.❑ I am homeowner doing all Mork officers have essrcised their 1L❑Plumtbingrepairs or additions myself o workers' right of exemption per MGL ens' -insurance required]i c.152,§1(4h and we have no1.2_❑Roofrepairs employees.[No workers' 131❑Other comp-insurance required.] 'A¢y WEuaatdwt checks box gl umist also fM outthe swfianbefowshmdng dmkwodeis'compensahcupolky uafmmugaiL Rameownemwho sebmft dues aftidm n imd5r=g they aredaing elf wank am:d&Mhim o•'¢M&contcactorsamst submit a new affidsu t'ndw=g sacb. ZCamactots that chea this box mns[attached aui addXmnat sheet showing the name of the sub-coat zdars.and state whethet or not those entities bsve employees.Iftbe sub-contmchns hwe employees,they must provd&their workew comp.policy number. I out err euepI per f7eatis prouiriir;;workers'canrperesahiatt insrirance for eny�enrploy=ees. Seroev is the policy and jab site information Insurance:Company Name: e/ V C/ti.o9F-,670 Po•1icy-,,L or Self-ins.Lic * Expiration Date: /0 Job Site Address: y0e S7,gl 1, cj/V City/Stafel7.tp:_�h Q.p� !� J'I l/L iw s koeAttach a copy of the workers'compensationpolicy declaration page(sh-awing the policy number and expiration date). Failure to secure:coverage as required.under Section 25A of MGL c-15-can lead to the imposition of criminal nal pt-naltses.of a fine up to$1,50Q OD and for one-Dear imprisoz�eut,as well as civil penalties in file foam 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 mrifrcation. Ida hereby esrti and the ' sand ]ties ofpetfuey tleattlee inforinadwrprmm-zrled abm-a_ ue is b and ccarrect Sitmature: Date: yge-�'` %�G Phone ai 5 Official use only. Da not ivrite ire thb area,to be completed by city artown ofjreial, City or Town: PerrnitlLicease 4 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CY1yirawn,Qerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone it: ormation and Instructions ; yl,-, c_1 setts General Laws chapter 152 regoaes all employers Yn provide woII-eas'compensation for their employees. p=mlantto this fie,an.enp&yee is defimed as."-.every person in the service of another under any contract ofhiie, express or implied,oral or wry." An errpioym-is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged In a joint ettcrprise,and incTn�the legal representatives of a deceased employer,or the rrc;eiver or trustee of as individual,partaership,association or other legal entity,employing emPloyeM 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 anofer who employs persons to do mah:fEmaace,construction or repair work on such dwelling house or on the grounds or building appur enzntthereto shallnotbecause of sach employment be deemed to be an employer." MGL cbzptor 152,§25C(-6)also sfd:es that"every state or local licensing agency shall withhold the issuance or renewal of a Iicer:se or permit to operate a business or to construct buEdiags in the commonwealth for any applicantwho has not produced acceptable evidence of compliance with the insurance.coveragerequa ed" Additionally,MGI.chapter 152, §25C(7)states"Neither the rumor cmwealth nor nay of its political subdivisions shall enter Into any conirad for the perfoaaaace ofpnblic work unfit acxeptable evidence of compliance with the filsur e. requirements of this chapter have been presented to the confracting authozity-" Applicants Please fill oirt the workers'compensation affidavit completely,by checking!he boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), addresses)and phone m mber(s) along with their certificates) of inc z-mce. Limited Liability Companies(LLC)or Limited Liability partnerships(LLP)withno employees other than the members or padne:ras,are not rbquirDd.to carry wolicers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of in naance coverage. Also be sure to sign and date-.he afdavit The affidavit should be ret=--d to tine city or town that the application for the pemlit or license is being requested,not the Department of h d s fti ai Accidents. Should you have airy questions regaTImg the law or if''you axe required to obtam a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance Hcrose number on the appropriate hue. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Departnenthas 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 sine tb fill in the penzut/license mrnber which will.be used as areference number. In.addition, an applicant that must submit multiple pe=itlIicense applications In any given year,need only submit one affidavit indirzfiag current a olicy information Cif necessary)and under"Job Site Address"the applicant should v;ate"all locations n (city or town):'A copy of the-affidavit that has been officially stamped or ma ke;d by the city or town may be provided to the - applicant as proof that a valid affidavit is on file for fitnre pmmi�or licenses A new affidavit must be filed out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial vie (i.e_ a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Inves-lig'aEons 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 Deparfruenfs address,telephone and fax number. The CtIMMMweala of Mwmchust us D:egariment of ladusftdal Accidents ��4£Txtve�frg�tio� f�4 WasbiVGI-L Street ` Bwto-u,MA G�I I I Tf,-1.4 617 727-4900=t 4-06 QX 1-977-IAA-SSAFI� Fax 9 617-727-774-9 Revised 4-24-0 7 WW �Q g� a a • sARRN9tASLE, 9� 6 163g. Town of Barnstable `0� . prED MA't� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner' 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder L , as Owner of the subject property hereby authorize to act on my beh4 in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAW MESTORMSUilding permit forms\E)TRESS.doc Revised 040215 Town of Barnstable Regulatory Services ��5 tti Richard V.Scali,Director Building Division S BAMSEFra LF. Tom Perry;Building Commissioner KAM 1631,%, 16 200 Main Street, Hyannis,MA 02601 QED MA1 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval ofBuilding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons.'In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 VILLANI CONSTRUCTION INC. Roofing& Siding Specialists PO Box 692 West Hyannisport, MA 02672 508-778-2495 1-888-766-3043 Member of the Better Business Bureau—Insured—Licensed—Free Estimate Laura Woods March 20, 2016 48 Starlight Dr. 508-317-4040 Marston Mills. lwlazar@comcast.net DESCRIPTION Furnish and install the following, labor and materials to re-roof building at Ma.As follows: Remove existing asphalt roof shingles. Supply and install: 30yr.Landmark Series AR: Lifetime warranty, 10 yr. sure start'protection,class a fire rated Copper ceramic stones for a full 15yr.warranty against algae contaminant,250 pound extra heavy weight, 110 mph wind warranty.Multi layered,laminated architectural shingle. Supply and install: New aluminum drip edge to eves and rakes. Supply and install: Synthetic underlayment paper. Install certainteed ice and water shield to eves,valleys,penetration and low pitch ares. Supply and install: Cobra ridge vent. Supply and install: Aluminum neoprene pipe flanges. We propose hereby to furnish labor&materials complete in accordance with above specification for the sum of: Main Roof $4,900.00 I � G AC O CERTIFICATE OF LIABILITY I DATE(MMIDD/YYYY) `.� INSURANCE 10/13/2015 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 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 CONTACT NAME: Erica Barrett OLDE CAPE COD INSURANCE AGENCY INC. (PHO AiC N Ex • (508)771-3300 FAx (A/C.No E-MAIL 296 WINTER ST. ADDRESS: ericab@OCCIa.COm INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: VILLANI CONSTRUCTION INC INSURERC: INSURER D: PO BOX 692 INSURER E WEST HYANNISPORT MA 02672 INSURERF: COVERAGES CERTIFICATE NUMBER: 4926 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LT R TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP NSD MM/DD/YYYY) (MMIDDINYYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F—IOCCUR DAMAG O ENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:POLICY E PRO- LOC GENERAL AGGREGATE $ ❑ JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN N X STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBEREXCLUDED? NIA N/A NIA 6HUB9982A27315 E.L.EACH ACCIDENT $ 500,000 10/02/2015 10/02/2016(Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYE $ 500,000 DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 230 South Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 3--t" L�'J Daniel M.Cr ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I f } f CAPECOO „ INSULATION N P4 IIYYY OIAff f[Aaf[if fMA1 FOAM fYf Y[NO[0 YAKS S0R[Yf u/i YaPtION C[IIINOf 1-800-696-6611 o c � � 'Town of Barnstable Regulatory Services CO Building Division 200 Main St ' cn Hyannis, MA 02601 w Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod 7. Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP-1) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village -40-A -I 57Aa## 41-DO- ;Nmt4 as r71As Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted A Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors W'1'-tlwAll Walls ( ) ( ) ( ) ( ) ( ) Sincerely ( He ry E Cas y Jr, President �� C e Cod I , ulation, Inc. I TOWN OF BARNSTABL-E BUILDING PERMIT APPLICATION vu i � Map . - Parcel Application4 l/ Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OK _ Preservation / Hyannis Project-Str2lit Address ' Village Owner Address Telephone :~Permit Request vGI UJ4 ! C hevr &AA lba, 1t) JfN) -3acu! -t7d Squ®re feet: 1-bt floor: existing proposed 2nd floor: existing proposed'= Total ne3 'Zoning District Flood Plain Groundwater Overlay o Project.Valuation - dTJ Construction Type 14 .. w Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s porting-cua� ntation. N54. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) M 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 Typ6.and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air;.., ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing •❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals�Authorization' ❑• Appeal 9 Recorded ❑ Commercial ❑Yes UeNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 6dlft&hbu Telephone Number O 7?S'/Z/ Address Rjmut6il6l� License # � c`c IRIA Home Improvement Contractor# Jb7 Worker's Compensation # 4dSZS�O/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE All DATE r FOR OFFICIAL USE ONLY APPLICATION# i TDATEIISSUED MAP/PARCEL NO. ADDRESS VILLAGE ; OWNER DATE OF INSPECTION: wF,OUNDATI.ONi�uK�; - FRAME - - - - �INSULATLON.tx i �.-� �z FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:_ _ ROUGH FINAL FINAL BUILDING= - DATE CLOSED OUT ASSOCIATION PLAN NO.. Massachusetts -Department of Public Safety r _ 1 . Board of Building Regulations and Standards Construction Supen'isor License: CS-100988 1 II, HENRY E CASS110 . ' 8 SHED ROW f WEST YARMOUTH 2 7 Expiration Commissioner 11/11/2015 I ,:Li,:':I . � ��'' �.�C:�:��1..-`iG'C.a:fy,(l.'�'l"l'l•��1..- C��'l`L:CZJ�IC�L°�l.'l.-1.-.1C'��J C:11.1icy. ��L C,orlslarne.r Affairs and BLISiness Pe.gt.11atIll 10 Park Plaza - SU'Re 5170 Boston, MassacllLI.Setts 02116 Fh'.)me 11-r1Provenlerlf Cotaractor Registration 13e9lSVE10011: '153567 1-ype: Private Curporatioll Expiration: 12/15/2014• 1rit ?J;IUJI t:.ifJl= COD INSULATION, INC 11t _NI0` LASS DY Iti NCI hCI...E YAIRfVI0u--I-H, MA 02664 __. . .._-_-.. ._..... UprlatcAtldress and retur'u cnr(I. 11'larl: rcusuu rut dwilge. Address L I Renewal 1.a Eniplu)'111011L I I Lustlnrd h.'�/ra�li��J ... •• ��,, ,ru,umr r:\tlnirs Itusiness Itegulalin„ License or registration riilitl for indivirlul use.only lilumr.IPr1NKOVEME.NTCON1-RACTOR ItcIUrC(lit c.epiratiun(laic, Ir1'uwlrl r•,aurn tu; Type: 01'kc of Cunsuu,cr Affrtirs and tlusincss ltc gu'luliuu P;u•k P wza-Suilc 517U ,y l rivale Corhoratic'n liusluu,MA 02116 c. l lnticrsr crcuiry uC Pal w,Iiio 1 n;ll r(� i The Commonwealth of Massachusetts Department of Industrial Accidents OJ) ce of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicaut information Please Print Legibly Name (BusinessiorbanizatiorVIndividual): V. 71 AtllllCJS: R" c='ity/State/Zi Phone #: .5� ���% 2- / :U•e you as employ r? Check the appropriate boz: Type of project (required): l.�.l atn a employer with. ..,lJ 4. ❑ I am a general contractor and I rtttployccs (full anctoe part-time).* have hired the sub-contractors 6. ❑ New construction ❑ l am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. ❑ Building addition required:] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions �.❑ I ant a homeowner doingall work officers have exercised their ;>1 l.❑ Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.[DRoof repairs insurance required.] 'r c. 152, §1(4),and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13.90ther f,ice general contractor(refer to #4) comp.insurance required.] 'AitY appkaul that checks box#-I must also fill out the section below showing their workers'compensatiotipolicy information. t Huutcowocts who submit this affidavit indicating they are doing at work and dien hire outside contractors must submit a new affidavit indicating such. :Cuuum:wta that check this box must attached an additional sheet showing the name of the sub-coatracton and state whether or not those entitim have CllIPIUycC9. If the sub-contractors have employees,they must provide their workers'comp.policy oumbcr. lam an employer that is providing workers'compensation insurance for my employees. $elow is the policy and job site infurmatiun. • lasurancc Company Name:__Z�2L/�,//,L Policy#or Self-ins- Lic. #: vGl / Expiration Date: Job Site.address: it r(.f City/State/Zip: ' Alt&Ch a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to 3ccuMcoYcrage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine 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 5250.00 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. 1 du hereby certify rtder the nd penalties of perjury that the informadon providedhove is true and correct Date: 1136114,1 uJc only. Do not write in this area, to be completed by city or town official City or'Towu: 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#: . t• CAPECOD-27 MYOUNG `Cki 1:>` I Dore INMIDD/ryyyl CERTIFICATE OF LIABILITY INSURANCE' 71t11- - ------- - 82 ]'I-IIS CERTIFICA'I-E IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,T1111 CERTIFIC�'II_ DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE: AFFORDED BYTHEPOI.ICIES L1L'LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:-: If thu certificate holder is an ADDITIONAL INSURED,tho policy(Ies)must be endorsed. If SUBROGATION IS WAIVED,Subjecrto Utc turms and conditions of the policy,certain policies may require an ondorsement. A statement an this certificate does not confur rights to the <t:IWICUIU holUcr in lieu of such endorsements .I '1,10MUt Licun,L i NC-514062 CONTACT --- NAh+E: _-•- Mar aret YOLmg - -__...._.__._ _._........_._.—_._ Rugun S Glay Insuranco Agency, Inc. PHONE I FAk_..---.._ 434 Rtu 134 JAIC o Exit: _._..L.tA1C,Not:...__ 'MAII Ovrinia,NIA 02660 EMAIL ADD i RESS:nl OLI IIQ C�Y f-O C]LfSQf .0011'1 --_....___.__.___........ ....._._...—. INSURERS)AFFORDING COVEI<AGE NNC Y, I _._.__...__........_....-_.._. INSURER01EERLESS INSURANCE COMPANY--- -' - """" T INSURER B:COMMERCE INSURANCE COMPANY l.(IpU COLI 111SU1atIOn, InC. e1SURERC:Eva nston Insurance Cornhany la RUardorl Circl4 INSURER 0:ATLANTIC CHARTER INSURANCE GROUP �OULII Yarmouth, IVIA 02664 INSURERE: INSURER F: ...-.._.__...._— COVERAGLS n CERTIFICATE NUMBER: REVISION NUIVIBER: lul5 Iti 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER1UD 1,A) AILU NorwITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOROTHER DOCUMENT WITH KESNECI'fUWHICHTHIS t'EH'LII-ICAIL' MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS-SUBJECT T'OALL'I1-IETERh1S, IACLUtiIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AbIS-SDaR� — P�ICITEF� POLICY EScP LIMITS t 1 fR I'YF%E OF INSUYANC F_ POLICY NUMBER IM&iIDDNrA MID Y Y UCNkIWL1_IAdIIITY 1000,OO I:AChI OCCURftLNCt: b _ ____. iA X CUhlhlkhCWL GENERAL LIAUILI rY CBP8263063 41112013 411/.?D'14 - AMACIE TO-RENTED - - 100,00 Ct AIMS-MADE I_X..) OCCUR MC,U EXF'(AnY u_nv ElOrWn)•.._,.5.... 5,00 PEIYSONAL x P1JV INJURY S 1,000,00 _ 1 GENERAL AGGREGATE b ),000,00( 2,000 00 t rrrt t;ta�r.UA1;k UMIT APPLIES PER: PROOUGIJ-COMP/OilAGG $—- _— i1101.1:Y PRO- II II LOC b —--. L_._.�..1L•S�T..__l____L__.—....__...� 1000,00 AUIUMObiLr IJAnILITY U ANI AMU 13MMBCKVMK 41112013 41112014 BODILY INJURY(Par palsan) b - -- 1 nU I.Mil)EU SCHEDULED BODILY INJUh'Y(Par accJdant) b AOrus X AUTOS I .. ... NON-OWNED CIDEN71 A Itlhl'1.1 AU rO NE FfI.. S X AUTOS }' X UMUNcLL A I.IAb X OC:CUIZ EACH OC'.CURRL"NCE b 1,000,00 C tn<:E5 LIAu _ CLAIMS-MADE XONJ453512 41.112013 4/1/2014 AGGREGA'rE _ UtLr X ItkiENi-ION 10 000 y�,s'I-�jj•j). OTI'I- M)10,4RS CON1/'EN SATION _•_ „^ 1'AND EMPLOYERS•LIAtjIL11Y Y/N ) '1,000,0U0 D Ar+'r I'K(JI' lklOh1t AHTNEWEXECU'f IVE '--' WCA00525904 6130/2013 61301�0'14 E,L.EACH ACCIDENT b t!rth:cWMENIBER EXCLUDED? �� NIA _.^........._1 OOO,OO (Mantlalury hi NH) E.L.DISEASE-EA EMPLOYEE- b_ _ _t..--_ w.. 1,000,00 Juaawc urelar l:.L.DISEASIT-PUL0.:Y LIA11T -5 - tl[l%R1f I ION OF:OPERATIONS Unlaw nca�lnl'IIUrI Ub i+NL-HA I'IONS I LOCATIONS I VEHICLES (Attocll ACORD let,Attatnanal RmuarH*Schcdulo,If Mora*pact lu ragwh'adI— -- Molhe+*Comp.w;ation includes Officers or Proprietors. iAdDuunnl Incurvd Status is provided under the General Liability when required by written contract or agreement with the Certificato Holder. CERIIFICAf E HOLDER CANCELLATION _-- SHOULD ANY OF THE ABOVE❑ESCRIDEO POLICIES Or_CANCELLED DEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tape Cod Insulation, Inc ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 6U ^ 01988-2010 ACORD CORPORATION. All rights reservod. ACORL)25(20-I0I05) The ACORD name and logo are registered marks of ACORD i OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) (Property Address) hereby authorize �. cC-)I> (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my-property. I O*er'i Signafure Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel . "\ Application # �� Health'Division Date Issued Id, Conservation Division Application Fee Planning Dept. _ Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address L C::W r l'(*1 l Ut Village Owner Address 11 Telephone Permit Request i Le._ C _A== Room in -f►0. b r1 Lam/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation � Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0-" Two Family ❑ Multi-Family (# units) Age of Existing Structure -Z5 Historic House: ❑Yes alo On Old King's Highway: ❑Yes QFlo Basement Type: Qct Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: exis N new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new _First Floor Room Count CD Heat Type and Fuel: was ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes dNo Fireplaces: Existing New Existing wood/coal stove.,❑Yes ® No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0--existing O.new'size_ Attached garage: 0'existing ❑ new size _Shed: ❑ existing ❑ new size — Other: � w Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ;NO Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION I (BUILDER OR HOMEOWNER) n Name �aolA J 'A v a ® Telephone Number D- >-3I-7'/101�� Address ` ( `I License # Ir J Home Improvement Contractor# Worker's Compensation # ALL CONSTRUC` O DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# �. rDATE ISS_UED:, .�- ��MAP/PARCEL NO. l � 1p ADDRESS VILLAGE OWNER <j s DATE OF INSPECTION: FOUNDATION,x)t A FRAME i _INSU.LATIOR,: FIREPLACE f; t ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS!,'. ROUGH , ,, ,::, — FINAL ;.a,:FINAL.BUILDING ' . .. .DATE CLOSED.OUT 1. ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts Department of Indust id Accident s Office ofInveskgadons 600 )Washington Street Boston,MA 02111 K'► W-Mass govItUa Workers Compensation Insurance Affidavit: Builders/Contractors/Electricia.ns/Plumbers Applicant Information �, Please Print e(��° =dnamdual): Address: City/State/Zip: Q S ' IDS— Phone --�() Are you,an employer? Check the appropriate box: �� 1.❑ I am a employer with 4. ❑ I an a general contractor and I Type of project(required): . employees(full and/or part-time).* have hind the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g ❑Dean working for me.in any capacity, employees and have workers' [No workers'comp.insurance comp.insurance., 9. ❑Building addition . �( grrired] s. ❑ we are a corporation and its 10.❑Electrical repairs or additions 3v I am a homeowner doing all work officers have exercised their 11.❑Phrmbin g repairs or additions myself [No workers' comp. right of exemption per MGL insurance requaed.]t c. 152, §1(4), and we have no 12.[]Roof repairs employees. [No workers' 13.❑ Other comp.insurance required,] *Any applicant that checks box#I�rst also fill out the section below showing their wmknrs'compensation policy information. t Homaowners who submit this affidavit indicating they am doing all work and then hire outside contractors must s'abmit a new affidavit Indic such xCentrachors that check this box mast 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,th,7 must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the poficy and job site information. Insurance Company Name: Policy#or Self-ins.Uc.# 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 imprisomnent, as well as civil penalties in the form of a STOP WORK ORDER and a fine a a Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office Iuvestigati of the DIA for insurance coverage vexi5cation of I do her c ly u pains an allies o e fPv7�'that the information provided above is Prue and correct S�� Phone#: - 1 1� `—t V 1 Dffuial use only, Do not write in this area to be completed by city or town official City or Town: PermitUcense# Is 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 ff: Town of Barnstable Regulatory Services RARNSTABLE, : Thomas F.Geiler,Director KAM 9�b .�� Building Division RFD MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ' HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1`�1 I2. JOB LOCATION: L 1 `` J number street village "HOMEOWNER': (MroJWo<)7_) S _ D 'nYme home phone# work phone# CURRENT MAILING ADDRESS: .(' Es city town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. A' ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department nspectio ce ures and re ements and that he/she will comply with said procedures and ts. SiV atfre of Homeo er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner perfomvng work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt Town of Barnstable FmE ram, • ti Regulatory'Services rMWMABLF, Thomas F.Geiler,Director Fn.9 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 WW WAown.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 to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QTORM&O WNERPERMISSION r r `dam S a 3 X � A)o Q)\J j.. �,�� � . _ . . � � . . :� - - dt i .a, V.1 } J era.,�- � � � . ��-'►:' �;y/ � r f !M' .� a y■ • - b� ,�i,r�r�tNUl/r .. h •, _ �V I �. ■� r '� . ,, ,. -` � I i �> �' I i , „ _ _ _ ,- r �, ,: �� IPdSTALLFI A JWUST gls WITH ARTICLE PI COMPLIANCE STATE REQu�T CODE AND TOWly . T 101�3„ �FTHEtO�` TOWN OF BAfi STABLE 1✓ BASBSTADLE, i - °° RUILDIAS INSPECTOR �0 M APPLICATION FOR PERMIT. TO ............ 'G !a ��- •............................................. TYPEOF CONSTRUCTION 4- ?.F e .::.......:.::.............................................................................................. 0 w .....Illej...........,97.y. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit fa`cc7orrding��to the following information- - Location .....�4.G..% ��,...... / �/.. /�./..... /.,/ 1. �.. .,,'�/.�! a /'�.f' f/.LDS............ ProposedUse ....... .. ................:.................................... Zoning District ...........R-D....Z�....................:..............Fire District .... ... ....4o••t+r. .....a.................................... Name of Owner .. . . . G . .:......Address ... .�: .. Name of Builder .+..:...Address ...................... /f�7 fPr......................................... Name of Architect . ::...Address .....................5 1.....e............................................. 0 _ Number of Rooms ...... 'e '......................................................Foundation ..... ..'/...1.. ' ...........................:....... Exterior ..." �7/.�V.C7.....:.........................................................Roofing .............�j��l/ .LT.,✓..IT. , .e.......................... FloorsrS..(1. ........................................................................Interior ........... e.e�/` / ...................................... Heating /7.a�... ... :..C7.��F�.................Plumbing cr^...�.� .e'/ Fireplace ....... .. ..............................................................Approximate Cost ......Z.2 ..06.... .?`.. Definitive Plan Approved by Planning Board ---------------_____._________19 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH LOT GAR House �G -c 986 C*4 Peer I is ff 1000 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above -� construction. Name Cammett Builders, Inc. � 18937 I I/2 story ` No ................. Permit_ for miogIe. lli , -..~.~--~--._--~—.—.--.. ' Y9 Starlight Drive ` Location ......................................................... ��.— _ / _ Darotqns Mills .~.~—..---.—..—.~—..—..--------- ~ / Cuonoett Builders, Inc. Owner —.— ..................................... ` fraoe Type ufConstruction ...... v~ _.—.—.—..—..—.—.—.—~—.----...-..--.. p ���Plot __.___._~_.. Lot .--.:�,�-----' _ � �� Permit Granted ' | Date of Inspection Do!a Completed &` —/�.WA6, 9 � ' PERMIT REFUSED ......................... lq , .—.^..~—..—~.. -..—.--.'�......—.---~—. ~ .~~..-.---...—.—..—,-'�—~.—..—... ^— - ^.__,___~____~,~,._,.,,_,_.~..___..�r -----.--.-----_._—.—.—.—.-----' / Approved ................................................_ . ---__ ............................................................ � . -------------------.—......—... YOU W EH TO OPEN A BUSNESS? ForYourhfonn atiDn: Business certiEcates (cost$40 00 br4 years).A business certiE ate ONLY REGBTERS YOUR NAM E is town Whrhyou mustdobyM G L.-i.doesnotgie youperm hsnn to operate) You must first obtain the necessary signatures on this format 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FL, 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. �. . �.� DATE: I a I/ ` ^ F2Lb please: �• APPLIrANT'S YOUR NAM E/S: ;!: X BUS ESS (OUR HOM EADDRESS: c) r I vo Vvi �C� H ON H om e Tehphone N tun ber NAM E OF CORPORATDN NAMEOFNEW BUSNESS _ ) TYPE OFBUSNESS � )S THIS A HOM E OCCUPATDN? )(ES NO ADDRESS OF BUSNESS VVI MAP/PARCELNUM BER I - y kssessiag) when staring anew business there are se,.eraltnngs you m ustdo n order to be h com plane w 3h the rul?s and reguhtbns of tine Town of Bamstabb. T Lt f un is intended to assstyou iz obtaining the nfonn atnn you m ayneed. You M U ST GO TO 2 0 0 M an S t.- (comer of Yarm outh Rd.& M an S t reet) to m ake sure you have the approprate perm its and lbenses required to hgaIl�(operate yourbushess h th-s tow n. 1 . BUILDNG COM SDN 5 OFFZE Thy ndirl3 lha hbu""t ed&fr%-t m t� tpe n to din type ofbusiaess. MUST COMPLY WITH HOME OCCUPATION Au rized ** RULES AND REGULATIONS. FAILURE TO OM M ENT MAY RESULT IN FINES. 'J . _ G 2 . BOARD OF rEATH Thh indiri3ualhas bee nn ed of the perm itrequirem enter thatpertaia to d-ih type ofbusness. MUST,�>OMPLY WITH ALL Y\/Iyl HAZARDOUS MATERIALS REGULATI NIR Authorized S#ia=e* COM M ELT TS: 3 . CONSUM ER AFFARS LZENSNG AUTHORITY) Thh ndirrlualhas been iaforn ed ofthe 17-ensiag requkem ento thatpertan to the type ofbushess. Authorized S i3na=,e* COM M ELT TS: Regulatory Services P Thomas F. Geiler,Director Building Division MASS. Tom Perry,Building Commissioner A met" 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: 94 3S�. �--0 Pernut#: HOME OCCUPATION REGISTRATION Date: I l I-ai I k/ f Name:�V1 D 1� Phone#: Q c>> , 5 Address: Village:�.�S�{��1 Name of Business: ( 5;' r Type of Business: i INTENT: It is the intent of this section to allow the residents of the Toiim of Barnstable to operate a home occupation Within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,prmided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration xizth the Building Inspector,a customary home occupation shall be permitted as of right subject to the follo,Aang conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located«atlin that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary ui residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required fi-ont yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton.capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating tine Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1, the enders' d,li-,we read wmd aaree vvith the above restrictions for my home occupation I am registle ' ig. 1 Applic<unt Date: ' I / Homeoc.doc Rex-.01/3/08 ,.