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Home My WebLink About0359 CHURCH STREET �IIII /)O `J�gE�iitEptpZ UPC 12543 No. 53® T•CONSJ�� HASTINGS, MN Application number Fee ..11 e5..... . t � 1 1;I �. ��I Building Inspectors Initials.. Milt Jlr- t AK11S[ABLE Date issued of,1 ............................................ .:...� .1 ..��. 1� K2 ^ D6 � Map/Parcel.............:.................................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY:INFORMATION Address of Project: 5q S�— 61�m!a6bta ER STREET VILLAGE Owner's Name: � Phone Number Email Address: l � `Cell Phone Number Project cost$ ,(Ye> Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ti Siding 13 Windows (no header change) # Insulation/Weatherization 0 -Doors(no header change)# Commercial Doors require an inspector's review E5 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to � !�IOA Q �i CONTRACTOR'S INFORMATION Contractor's name M Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN A I a nld-m-nei+r 1,00%I 0 AAI Irr 0%/srA/AI IJIrr^n1/- A nnnm 1A I nL'r/1nL* A nCSAA/r/-A A/ I+#-'/rrI IN-^ JW' j APPLICATION.NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No - (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COALMELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION -cHoineowner's Name: CCU 1 Telephone Number Cell or Work number �{j C005 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection rocedures,sp cific inspections and documentation required by 780 CMR and the n of a table. SignaturekquP---- Date.. ibi 19 APPLICANT'S-SIGNATURE "� • Signature- Date (6 All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly C Name(Business/Organization/Individual): rorN a6C� � 1 b Address: S�lv_ • S o`- e3'�Sor.�O— City/State/Zip: hone#: �7q—t�� S `Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the subcontractors 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• ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [N orkers'comp.insurance comp. insurance.: 10.❑Electrical repairs or additions uu�] 5. ❑ We are a corporation and its P J officers have exercised their 3. I am a homeowner doing all work 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: ZW Ch rrJ_1� 11� �nVV4,9 City/State/Zip:_-MA l9 . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certifyyun r e pains and penalties of perjury that the information provided above is true and correct Signature: L - Date: 6 Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number,on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia i �I Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept SAM ss6MA Posted Until Final Inspection Has Been Made. Per 39. ��' `1 uet° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until'a Final Inspection has been made. er Permit No. B-19-2945 Applicant Name: Matthew Russell Approvals Date Issued: 09/11/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/11/2020 Foundation: Location: 359 CHURCH STREET,WEST BARNSTABLE Map/Lot: 176-007 Zoning District: RF Sheathing: Owner on Record: JOHNSON,CARL A Contractor Name: Matthew Russell Framing: 1 Address: 359 CHURCH STREET Contractor License: 195,309 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $3,225.00 Chimney: Description: Insulation,;See contract Permit Fee: $85.00 fl Insulation: Project Review Req: Fee Paid.; $85.00 Da 9/11/2019 Final: te: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withinNsix months after:issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st 5uctures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT c, Final: r Application numb S� Fee....................... .. . ............ sp Building Inspectors Initials..... QQ .ems �uN Date Issued.:. ....�.........1...1.................................... Map/Parcel.........i. .. .. �D�. .. ..................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: s nNUMB ER STREET VILLAGE Owner's Name: (CG(' 1ffl"ekn5(hngaThone Number Sb�5-' e — Eff5 �- Email Address:Ce cc-,Sue ' Cell Phone Number 4 Project cost S Check one Residential V� Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK J M Si ffi # 0 Insulation/Weatherization 1� g 0 Windows (no header change)g 0 Doors(no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* . °:"Datelent(s) will be erected Removed on number of tents total I ` t Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No____, if yes, a gas permit is required. Natural Gas Yes . No , if yes, a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: C(- Telephone NumberQ �1292=2— �L4 S Cell or Work number 27q" C-C 05 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date 5- All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information c e ^ Please Print Legibly X, Name(Business/Organization/Individual): >1 ,al 36W 7c \ Address: '3 S� C 1�C .'\ City/State/Zip: Phone#: '6" 3 — Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition workers' comp.insurance comp.insurance.: quired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.P I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce nder th ains d penalties of perjury that the information provided above is true and correct �S_ianature: Date: Phone#: Ag2t J — q /X Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia I 7�� s �'7 Barrows, Debi From: Florence, Brian Sent: Tuesday,January 02, 2018 11:13 AM To: Barrows, Debi _Subject: FW: [ Probable SPAM] Request#2018-0116: New Request Received Hi Debi, Can yo.0 please process this request? Thank you, -Brian Brian Florence, Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Brian.florence@town.barnstable.ma.us From: admin=barnstable.foiadirect.gov(&townforms.com rmailto:admin=barnstable.foiadirect.gov(cbtownforms.comI On Behalf Of admin(abbarnstable.foiadirect.gov Sent: Tuesday, January 2, 2018 10:32 AM To: Florence, Brian Cc: Quirk, Ann Subject: [ Probable SPAM ] Request# 2018-0116 : New Request Received Barnstable,MA Public Record Request Number:2018-0116 Requester: Todd Everson Request Date: Tuesday, January 02,2018 10:30:40 AM Response Due Date:Tuesday,January 16, 2018 Request Detail: Building Department records for three (3) properties. 1) 311 Church Street, West Barnstable. 2) 339 Church Street, West Barnstable. 3) 359 Church Street, West Barnstable. Hi Brian Florence : We just have received a new Public Records Request. The request details are shown above. By design you are receiving this request first. Please evaluate and assign to the proper department and personnel in order to start working on the response. Please click the following link to arrive at your log in screen. https://www.townfonns.con-L/FOIADirect-BarnstableMA/ i r n Rev 1 Town of Barnstable BAMS rAHM �AMAS& Stable Permit Application lFc � Stable Regulations Town Code§376 1. Name of Applicant: OIL�CP.En 2. Name of Owner of Property (if different from Applicant) 3. Address of Stable: �� 4. Map/Parcel 1 7G / C07 Farm Name 5. Mailing Address of Applicant &r^,� 6. Phone Number:5E�' '- `L�; (cell) So-&4 _.. email: QAr\L v .(Uhcx) C.cr--\- 7. New Application:(Y� N If existing stable, year license was first issued: 8. Lot Size (in square feet/acres): ,3S ;Number of horses to be stabled: 3 9. Stable/Barn size: ft. XZft; Number of stalls: 10. Size of stalls: -ft X ( C� ft(8 ft x 1Oft minimum size required) 11. Please attach a sheet(s), labeled "Exhibit A".-The applicant must sketch the lot and locate the following items with dimensions in feet and inches. Include all setbacks in your sketch. A certified plot plan may be substituted if available: A) Site dwellings B) Habitable structures within 50 feet of stable C) Private drinking water wells on applicant's and abutters' lots (if applicable) D) Stable location (must be at least 50 ft. from all abutters' dwellings). E) Manure storage area(must be at least 50 ft, from property line and 100 ft. from private drinking water wells): F)`Compost area (must be at least 50 ft. from all abutter's dwellings and 100 ft. from private drinking water wells). G) Paddocks and turnout areas. (H) If your property is not connected to public sewer then the location of the soil absorption system and components (septic tank, distribution box, and leaching area) must be noted, with proper measurements, on the site plan that you are submitting. C:\Documents and Settings\mckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc F Rev 2 i 12. Setbacks from All Private Water Wells and Manure Storage (100 ft. min. required) a. Map and Parcel: 17& / i) ; gi,n ft(On—Site) b. Map and Parcel: 176 / 00 ; ft (Abutter's) c. Map and Parcel: / ft(Abutter's) d. Map and Parcel: / ft(Abutter's) e. Map and Parcel: / ft (Abutter's) 13. Setbacks from All Private Water Wells to Stable (50 ft. min. required) a. Map and Parcel: 176, / CO 7 ; ?W, " ft b. Map and Parcel: 17G, / vim; 9 y ft c. Map and Parcel: / ft d. Map and Parcel: / ; ft 14. Setbacks from All Water Wells to Turnouts/Paddocks (50 ft. min. required) a. Map and Parcel: /'-7( / U)7 /"0 '— ft b. Map and Parcel: /tom 7 <C, ft c. Map and Parcel: / ft d. Map and Parcel: / ft 15. Setbacks from Abutter's Dwelling to Turnouts/Paddocks (50 ft. min. required) a. Map and Parcel: l 7& /60 n 7 5-0 4— ft b. Map and Parcel: / ft c. Map and Parcel: / ft d. Map and Parcel: / ft 16. Setbacks from Abutter's Dwelling and Any Type of Manure Storage (50ft. min. required from property line) a. Map and Parcel: -71, / CGS S—r✓` f ft b. Map and Parcel: / ft c. Map and Parcel: / ft d. Map and Parcel: / ft e. Map and Parcel: / ft 17. Setbacks from Abutter's Dwelling and Onsite Stable (50ft. min. required from property line) e. Map and Parcel: 176 /ejo:Z Ste' ft f. Map and Parcel: / ft g. Map and Parcel: / ft h. Map and Parcel; / ft e. Map and Parcel: / ft ** If applicant has more abutter's then lines allotted, please add them to the application** C:\Documents and Settings\mckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc I Rev 3 18. Size of stall(s): ft. X IDft. (8 ft. by 10 ft. min. recommended) If stalls differ in size, describe below: 19. Number of paddocks/turnouts: _ 20. Size of paddocks/turnouts 7� ft. X ft.; 1C' ft. X ft. **Please note individual measurements of regulated setbacks on the site plan that you are providing**. 21. Type of bedding to be used: J'� QDS l 0 22. Amount of manure and bedding disposed of per day: pD To calculate use the following calculation: A) Approx combined body weight of horses-1000 2 x 2.5 cu/ft= LC.4-7iTotal waste produced in cu/ft per day �a0a [For example: 2000 lbs -1.000 lbs x 2.5 = 5 cu.ft per day] B) How many days do you plan to store manure " ** Note: Manure must be removed from the property on a regular basis** C) Total storage neededfanswer from 22. A) x t✓��(answer from 22. B) _ total cu. ft. of storage required) [For example: 5 cu.ft per day X 5 days =25 cu.ft of storage needed] 23. Please indicate your manure management plan by calculating the appropriate waste storage containment you will be providing for your property. The storage containers or area (composting)must be able to accommodate the waste generated by your operation for the specified amount of days. Also, please identify the storage or composting area on the site plan that you are providing with correct distances from setbacks. OPTIONS INCLUDE: (A) Storage in water tight containers: Refuse containers with lids are usually sold by storage capacity in gallons. Please use the following to calculate the number of containers needed to hold the waste: cuft of storage needed (22 (C)) x 7.48 cuft/gallon= (a) S 7S-gallons of waste produced CADocuments and Settings\mckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc Rev 4 Example: 25 cu ft x 7.48 cuft/gallon = (a) 187 gallons of waste produced (a) gallons of waste produced_ gallons provided per container= containers required to hold waste [Example:187 gallons/50 gallon containers = 3.74 or 4 containers to be provided for storage of waste] Number of containers with lids to be provided: "The applicant will have on site enough containers to hold the waste produced" B) Storage in a trailer Size of trailer: (L) ft. x (W) ft. x (H) ft. = Capacity in cubic feet The trailer must be covered with a tarp Q Storage in a truck bed Size of truck bed: (L) ft. x (W) ft. x (H) ft. = Capacity in cubic feet The truck bed must be covered D) Storage in a dumpster Size of dumpster: (L) ft. x (W) ft. x (H) ft. =Capacity in cubic feet Dumpster must be covered with a lid or a tarp. If the dumpster is not water tight, it must be located on an impervious surface. E) Storage on impermeable pad for composting (L) ft. x (W) ft. x (H) ft. =Capacity in cubic feet Area must be able to accommodate the waste generated by your operation for the specified amount of days (answer to 22 C) The storage area will be on a non-permeable surface such as: concrete, stall mats, tamped t-base, hot mix, etc. Drainage will be contained by walls or slope. The pile must be covered by a tarp or a roof. "The compost pile shall be stored for no more than 6 months to allow for continued use. Material used for surface: Method of covering area: C:\Documents and Settinas\mckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc Rev 5 F) Composting Please contact your local Natural Resources Conservation Service or refer to the On-Farm Composting Handbook(NRAES-54). 01992 by NRAES (Northeast Regional Agricultural Engineering Service). This handbook is available at the following website: http://com-oost.css.comell.edu/OnFan-nHandbook/cover-pg.html. An area of appropriate size will be required. The compost pad size will depend on the type and amount of material to be composted and the composting method chosen. The area must be on an impermeable surface such as concrete, hot mix, clay,tamped t-base. Runoff will be contained by slope. This method will require a minimum of a 5 ft. buffer area surrounding the pile to allow for management such as turning and aerating. Setbacks will be determined from the buffer line. Please state on site plane the type of buffer that is in place. The applicant shall demonstrate the ability to manage the composting process with equipment on site or ability.to rent as needed. Other materials may be added to compost such as leaves and grass, as long as these materials are generated on site and are considered when sizing the composting pad area. Briefly describe your composting method (include the length of time you expect- one batch to finish): If bins are used, specify dimensions: (L) ft. x (W) ft. x (H) ft. = Capacity in cubic feet Machine on site: Machine rented: 00ocuments and SettingsCmckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc I • Rev 6 The information in this application is accurate and true to the knowledge of the applicant. The manure management plan selected will be followed as specified. Any variation to the agreed plan must be approved by the granting authority. If the applicant fails to follow the agreed plan or is found in violation of any regulation the granting authority shall notify the applicant by certified mail of such non-compliance and allow thirty days from said notice to alter the application and seek approval. After the thirty day period,the.granting authority may revoke the stable permit for non- compliance and notify other agencies of such action. Applicant may be subject to fines and penalties. 25. Applicant Signature: _. Date ------------------ FOR ADMINISTRATIVE USE ----------------------- 26, Reviewed by: ram- Date: i 27. Maximum Number of Horses Approved Per Zoning Vj 28. Zoning Approved By 28. Maxilmun Number of Horses Permitted Approved by Health Division: 29. Method of Proper Manure Storage/Disposal Approved: If denied, state reason: C:\Documents and Settings\mckenzim\Desktop\STABLE PERMIT LONG APPLICATION revised 2015 3.01.11 Rev.doc i rok, Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department 1 Public Health Division sAv_NsrAHm KAss. Thomas A.McKean,CHO 639. q 200 Main Street,Hyannis,MA 02601 Payment Receipt Stable Permits Payment received: $150.00 (Check) on 5/6/2015 Check number: 790 Check amount: $150.00 Name on check: CARL JOHNSON Owner: MAUREEN JOHNSON -Address: 359 CHURCH STREET,West Barnstable .Note: $100 FOR NEW ACCOUNT, $50 FOR 3 HORSES Asses#Fr's n*p and lot number / � �i� /dCl- 7— 22 ?Of,THE Tp�♦ Sewage Permit number ... ,yam. J.&' SEPTIC SYSTEM MUST U 'NSTALLrED iN STABLE, i House number ...... ?........................................... V11� WITH TITLE 5 LiA oo Ob3Y............... E"Y ONI ENTAL Cool: MP TOWN OF BARNSTABt-E---. ��:;x :..: BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. ^ CA- S 14 C L L- �QQ t�0�-( :1q X A0 ............................................ ....................................... TYPE OF CONSTRUCTION 7/a� ....19.s TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit according to the following information: Location ..J`?.`j......,C.-/+UIZ.c..... ....�...........�4,....13l rC.L4lS? ? L ........................................................................... ProposedUse ........ n.................................................................................................................................I......................... Zoning District .....1 �?.+ ..................... AV;'.+...............................................Fire District .............................................................................. Name of Owner ✓cf1.....fi� k.�`'. r.........................Address 3...T. L'�,Jrc�. S4 .... ..h n Name of BuilderY1 ......."^ l�u� ........... �?........ !''!c^A ccc� Address A5....- ��!^ '�......�..... 4�Ih�S Nameof Architect ......�l/�...................................................Address ....N� ........................................................................ Number of Rooms ...../...........................................................Foundation .. fl.... ?................ ..................... Exlerior .......w. .......C. ......................................Roofing ...... 5� � ...'77. 4�3....... Floors .........5s tL.....Ac.. r.... ?riLy........................................Interior .....!V / ..................................................................... - - Heating /f ...............................................................Plumbing .....!U.t4.................................................................... Fireplace ..............1A. .........................Approximate Cost ....a�o Definitive Plan Approved by Planning Board -----------_______-----------19 . Area `�� .. ............... ...................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH cl.0 r-c L. S!r l �o��- P4,-> 51 A. 3p-F I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .... ...... ....... .. -.............................. FANCHER, LOWELL No 2 2 3 6 0... Permit for Addition.............. S i n cr 1 e..F gkiAj 2,y..D.w.el.1jag......:....... ...................... Nobtion ... Q.uw.cll...S.tr.eet................ West Barnstable .................. ............................................................ Owner Lowell Fancher .................................................................. Frame Type of Construction .......................................... .......................................................................... Plot ............................ Lot ................................ Permit Granted ........qq1Y...22,,.::.........19 80 Date of Inspection ......................................19 Date Completed ..............4 .........19 PERMIT REFUSED . . .......M ..... 19............................ s. TZ: ..............................;...................... ....................................................... e, .........S.GJ— ,........................................................ ............aff. .................................................... ' ApproVid;-.*..................................... 19 ............. .................................................................. ............................................................................... Q A a f v � A Irk # 0 `Ll fr 1`. a49 n lo IFF t�l- f ; 4 ��-�_.'-1Y't''.�� ..S�.Lr .•Y.�:�i�:;i�t:�i'rl�h�l• •.i—_ ..��. �_ ram_-_,y.-- _ - __ ..... -- - _ _'�".:!✓.#ra�'.=�- vr� aan..-. .. :r.,r- Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee �. • •watvsrARL& MASS.��`0�' Thomas F. Geiler,Director Building DIvDivision /�y�PRESS PERMIT Tom Perry,CBO, Building Commissioner JUL 10 2013 200 Main Street,Hyannis,MA 02601 /V www.town.barnstable.ma.us , Office: 508-862-4038 TOWNV STABLE EXPRESS PERNHT APPLICATION - RESIDENTIAL ONL Not Valid without Red X-Press Imprint Map/parcel Number Property Address 35 Chknl _rl ��ef/ L"�/kl /t' /"��—0��ie RResidential Value of Work$ s�� ® Minimum fee of$35.00 for,work under$6000.00 Owner's Name&Address ( (��` _ ,6'62r1 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ZI am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-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) 2-Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked wiih 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 r red. SIGNATURE: Q:\WPFILES\FORMS\building permit forms S.doc Revised 061313 The Commonwealth of Massachusetts Deparhnent of Industrial Accidents O,fce of Investigations a 600 Washington Street Boston,MA 02111 wwminass govldia Workers' Compensation Insurance Affidavit Builders/Contractors(Electricians/Phumbers Applicant Information Please Print Legibly Naive Musi on&dividnal): Address: 4 City/StateJZip: A Ve, Did Phone.## _:7 7 e/- Zia'''D DOS" Are you an employer?Check the appropriate box. Type of project(required): 1.❑ I am a employer with 4. ❑ I am.a general contractor and I * have hired the sub-camtzactats 6_ ❑New constructionemployees(full and/or putt-time).2.❑ I am.a sole proprietor w part 7.partner- listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' 9. Buildingaddition [No workers' comp.insurance comp.insurance I ❑ required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.® I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workm'comp- right of exemption per MGL 12.❑Roof repairs insurance required.]i c.152, §1(441 and we have no employees.[No workers' 13.❑Other comp-insurance required.] •Any app)ica�Poac checks bra#1 mast also fill out the section below showing their waders'campensa6ou policy mformatiaoL Hnmeoavaers who sobuait this affidatirit iadicatiug they am doing all woA and then lux outside conaactan=u submit a new affidavit mdicatmg such. ICanWutors that check thus book must attached an additi nil sbeet showing the name of the sub-canuxton and stagy whetw or mat those entities bave employees. If the sob-cantr Mrs hue empllayees,uey mow provide*w workers'comp.policy number. I am an emptoyer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: Policy#of Self-ins-Le.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u der a pains an roles ofpeduty that the informationprovit£d above is true and correett 'Si true: Date: - -/ Phone 9: t✓ — 3 8 -GDO S- OBTcial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Inning Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 Town of Barnstable Regulatory Services Thomas F.Geiler,Director 1639. •``� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 3S"/ CNarC�i :S f• W Pf� �illTti�/L� number / street village "�HOMF.OWNER": ��1 A- t).440, -771/ name /,home phone# work phone# CURRENT MAILING ADDRESS:/j�7 4f4"_ S-J cityttown 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 and si d"ho eo er' certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce s d re a is d that he/she will comply with said procedures and requirements. -Sibdum ofHomeown 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 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. C:\Users\decoUflc\AppData\LomiMcrosoft\W-mdows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRMS.doc Revised 053012 EVE� Town of Barnstable Regulatory Services HAMianss"g Thomas F. Geiler,Director z6;p. 10 . �c Nay'' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, , as Ownex of the subject property hereby authorize to act on my behalf, in all matters relative.to work authorized by this building permit (Address of Job) **PooT fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date . I QFORM&OWNERPERNMIONPOOLS 62012 r. Assessor's map and lot number ........ .. �� /dC�- 7' 22 � T►+e 1 TO Permit number ...Sewage, �.A�• .:.!�!t.a7%<�-c....��!�.:< ��' �� 9 ��u•r•��/p/ ram„cu, _ ., �/ .. -✓ � � ,�� BAHHSTADU. i House number ..... .......................................................:.: 90.. rasa . pe,1639. 00 'FOVA a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. ^..�.T'r � .....S L �- A-00 (71O) -j 1Ll ... .................................................................................... I„1t d� �.z ...,�_ TYPE OF CONSTRUCTION ........................... ........................................................................................................ /a19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..-7`?.` ......C!- uKIct� �. �1 I�¢�t2,nrc7RiLLr:......................:..... ...............:..................................... .................................................. ProposedUse ...............:............................................................................................................................................................... ZoningDistrict ........................................................................Fire District ...........................................:.................................. ✓ Name of Owner S Address .... `� S ��rr� S e L.. �........ ............. .............................^ ....................................... ' Name of Builder .P...•• Z�"sp/L7 uC�1 q!7� et cc��; Address .5.....-LC.G�,.�-?C ... d. ...... A.�Gf�1n r S Name of Architect .............Address ....: Number of Rooms ...../........ Foundation ...��`.. ? � ................. .........: Exterior w>�\ 94c .........Roofing ��-� �� ...... s . .................5�...5.......................................... Floors .........5.b..... ........................................Interior ..... ,f ....................................................................... Heating ........ � ............ .....:.............Plumbing ..... ..Q ...............ZJ ............. Fireplace ..:.............1.A ............I..........................Approximate Cost 0 C.. ................................................ Definitive Plan Approved by Planning Board -----------______-----------19--------. Area .................. !.................... Diagram of Lot and Building with Dimensions Fee V S'Q7 SUBJECT TO APPROVAL OF BOARD OF HEALTH a�u rcL. 5�-� 1 1y 4 v O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name�� !i........�:......!� .. ` �=� 76- I,7 . F&0CBEIl, LOVVELL - � ' , ' . . . ^ . . . No .2.236.Q... Permit for - ........... ' ^ � ! Single Family Dvvellincr � -------------------^-'-----' 359 Cborob Street � Location --------------_------ West Barnstable----'-------------'-`------- LmweIl- ....Faoohe-- -�� - ~~'~ ----- - - -''~------' / z .,'. .. Construction. ` � ^ _ ^ / Plot . . - . -----' ' ' ^ ^ ` Permit Granted . � Date of Inspection ..................... ......19 - ` | ' uo/e Completed ' PERMIT EFUSED ` ___... lV - ----..1-��.. -.��-�.�.~................... ' -..~---..�-~. .--------------- -.------.-,'. .----...,.-.--.-~--- ' ~ ----.-.-------~-...----...-.----. ~ . ' ..------------.--. lA ' Approved ^ - --------------.-..,-------.- . ' --------------------_....--- � . - . . � r I ZF9E Town of Barnstable TOVpj Or- •� r°"rti Regulatory Services �". Richard V.Scali,Director P;�� '. ; - pE't ' aniwsrnat•E. 9�, MASS. �0g Building Division �f0 MA'S A Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 D -51% www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTAN UIRY REPO Date: t Rec'd by: Complaint Name: � CA (� Map/Parcel Location Address: Originator Name: 1 1 Street: —15 i C ftqz2-A t" 15 Village:l �� State: Y t R Zip: GZ6-6 Telephone: b'— U ^a s% o l � 7 Complaint Description: VE-C 1 Oyr v e m e o <-f �c fnc�s from U FOR OFFICE USE ONLY Inspector's Action/Comments Date: 110 6115 Inspector: S/k 1/<s•f oob//S=/too Dne nswer�cQ iCJoo/r.�irelulGs: Iye hxpre�►t bbvitws mr-re e-e^-f cls-rijes 4o S/f ok--WJS- C�rc�G/ai �rrae �w�/�o/f fn�rangf6 o it le, Ave 64;Aer e'onSt� lay 2A� yc�cr�Ysd9• &ce &e, on 3e%✓-b-1 &eUeA"05 o�V,-,Mce 40 nol `t 6keW �l/J � corder so�i<Y�- �ocd�rL» �i s�ie •lerlc� /� � ci vi�ts�ue�D�o�ae�fT i►es,) • �c�� e�fa�a� ��e• . f�AIBOIdGI��"C/t�/� �/o�i�� y-bOIS� ��a!!e� /�/�mt�►HZ�fi�So� 6 cCr�. � 1�oke 64IIcY�'nu ors z-vnivlc V�v/atinn o�serUQj a+ Trbl��MaB•�'�,Iw`' Q:forms:complaint ea/,�J�+ r�eyLec�is wev� ` tiouse i� ILt)• Revised 040414 Town of Barnstable Geographic Information System January 5,2015 178006 #0 153010 #339 178007 176008 0 16301 DISCLAIMERS:This ma is for planning purposes only. It is not adequate for legal Map:176 Parcel:007 p p t p p y g Selected Parcel N boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:JOHNSON,CARL A Total Assessed Value:$353000 1"=100'may not meet established map accuracy standards. The parcel lines on this map W are only graphic representations of Assessors tax parcels. They are not true property Co-owner: Acreage:1.35 acres Abutters 4 boundaries and do not represent accurate relationships to physical features on the map Location:359 CHURCH STREET such as building locations. Buffer Aerial Photos Taken April 19,2008 .' (11111140%Wle Y YOU WISH TO OPEN A BUSINESS? For Your Information: ,Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR 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 on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: ollr Fill in please: APPLICANT'S YOUR NAME/S: t, T r 1hxecr, S BUSIN S �5 ^oMS � YOUR HOME ADDRESS- 3�( e 1i��GI:q S1- �' TELEPHONE # Home Telephone Number NAME OF CORPORATION: (n L c)e NAME OF NEW BUSINESS TYPE OF BUSINESS G IS THIS A HOME OCCUPATION? V YES NO ADDRESS OF BUSINESS. d%rMAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSIO ER's OFF E MUST COMPLY WITH HOME OCCUPATION This individ al h irrfor:nfed of aerrqit requirements that pertain to this type of busineAULES AND REGULATIONS. FAILURE TO J, ,Auto e Signatu COMPLY MAY RkSULT IN FINES. OMMENT, 1 an 2. BOARD OF ALTH � .. - :� � �,Sc,_c ;un s �-o -dam Vic_P to-d-C AA This individual has been informed of the permit requirements that pertain to this type of business. 7.s Authorized Signature** BUJ Vv 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: main S-k-�Cne� G� rvlo rrAs III S w rn i own of tsarnstable OpTHE rqy Regulatory Services o Richard V. Scab;Director • 4Axrtsrnsis, Building Division HAS& �' Tom Perry,Building Commissioner 9 i63 • �0 ' prED a. 200 Main Street,Hyannis,MA 02601 www.town.ba rmtable.ma.us Office: 508-862-4038 Fax 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: of Name: Phone M -34�6—U Address: 35cl e- c rC4-1 wage: .Name of Business: Type of Business: Map/Lot: _ 7�/ C-'o INTENT. It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation. within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided 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 with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within 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 in 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 front 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 dr one pickup 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 the 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 dw ve I,the unders. agree with the above restrictions for my home occupation I am registering. Applicant: �ML� Date: U11A Homeoc.doc Rev.103113