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HomeMy WebLinkAbout0067 COACHMAN LANE Ca rI R UPC 12543 Now OR Ra, HASTING S.MN 1 YOU WISH TO OPEN A BUSINESS? y For Your Information: Business certificates [cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 'as Lo Fill in please: APPLICANT'S YOUR NAME/S: M BUSINESS YOUR HOME ADDRESS: (0'1 Coo c 1-�w�a� Lv.. W Fz.ms clo\e YY1P\ D2core 2� ��`i-49y•�7s� TELEPHONE # Home Telephone Number �Z`i - 99 �J'1 5co NAME OF CORPORATION: NAME OF NEW BUSINESS K, Srn*AH's Kn N-cess%V e.s TYPE OF BUSINESS e rc Pk / Hand ma 1/hUl,b ,,�/ Wi Aef i 4euoss—es IS THIS A HOME OCCUPATION? YES ----NO _ADDRESS OF BUSINESS c�a. - MAP/PARCEL NUMBER /�tJ(,� ��2 U vl 1 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO ER'S OFFI E This individu I ha e i fn or d of ny ermi r ui e ents that pertain to this type of busines�lUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO Auton Si riattrre** COMMENTQ, 4 COMPLY MAY HESULT IN FINES. J' c -ro m 2. BOA11ID-6 HEALTH �� l This individual has been informed of the permit requirements that pertain to this type of business. dLG Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable Regulatory Services �"' OptHE Tp� Richard V. Scali,Director EAMSTABLE Building Division v$ !MASS. ' Tom Perry,Building Commissioner AlFo .t° 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: 1 01 Name: n Phone#: Address: (03 C�°GcfA)mAn �-aly Village: '- bLeAf f Name of Business: / YY1" ti S// /h fL'�SSri/c�5 Or D►- k� Type of Business: Ills�L/�I4dF kDA /f12ni Map/Lot: —0 T 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 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 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 dwelling unit. I,the undersigned haver d agree with the above restrictions for my home occupation I am Applicant LD 0 Date:regis/ Homeoc.doc Rev.103113 i Town of Barnstable *Permit# Expires 6 mo the from isdate Regulatory Services Fee • sAxtvsrest.E. 9 16A Richard V.Scali,Director o� 4 Building Division %R%STAOLl Tom Perry,CBO,Building Commissioner Vd 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508`862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number � �� x,��'( Property Address esidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ���r..�a� Contractor's Name oy r ct3 �,,sj�.wltr,� ?r c• Telephone Number SJ�L`' 7,2,? /6 Z ' Home Improvement Contractor License#(if applicable) /yMY Email: Construction Supervisor's License#(if applicable) /1 ;';.7/3 orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance Insurance Company Name Frtw( wa �� ��a�I i Go- Workman's Comp. Policy# C;L bM i!;5ar 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) 5 —ke-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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 p{ SS.doc Revised 061313 The Comrnoraveakh of-Massachusefts f)epartnent oaf'fidusbial Accidents Office v,f lmlestigations 600 Washirtgla;rx&reet Boston,.AM 02111 www.massgmAdia Worlcets' Compensation Insurance Afffidavit:Builders/Contractors/Electricians/Plumbers An&ant Information Please Print Le ibly Name ocinr �tiondndviduao: v o Ad&ess: kX /4 y +city/State/Z.ip: ,14 Phone 47 Are you an employer?Check the appropriate bGx: Type of project(required): 1_[dam a employer with�_ 4. ❑ I am a general contractor and 1 6- ❑New construction. employees(full and/or part4ime)-* have hired the sub-contractots. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ ❑Remodeling ship and ha.,e no employees These sub-contractors have g- ❑volition. working for me in any capacity_ employees and have workers' 9. ❑Building addition [No workers'comp,insurance comp-insurano&I required-] 5. ❑ Vice area corporation and its 10_.0 Electrical repairs or additions 3 ❑ I am a homecriAmer doing all work officers ha-,,e exercised their 11_0 Plumbing repairs or additions myself [No workers'comp- right of exemption per MGL 12_❑Roof repairs insurance required_]t e_ 152, §1(4),and we have no employees-[No worms' 13_❑Other comp.insurance required_]' *Am applicant tbat checks boa#1 mast R1w fill out the:section belaw shooing their wadies'rnmprssation policy infflrmatioa T Homeowners who submit this affidavit indicating they are doing,all mock said then hire outside contractors nmst submit anew affidavit indicating such tCon%-Rcturs that check this boot mast attached an additional sheet sbawiing the name of&E and stage whether ornot those Mfil es have employees. If the sub-coatnictots hose employees,they must provide their workers'comp_portcy number. lam an employer that isprmidittg it�orke_rs'compensation insurance for my emplayem Berotc is the policy and job site information- Insurance Company Name:��trrc Policy g or self-ins_Lim#: Q/ Expiration Date: Job SSite Addiess:6 csre4,,—A" 4-4 tO City,State/Zip- - i¢ 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 ofcriminal penalties of a fine up to S 1,500.00 and/or one-year imprisonrnent,as well as civil penalties in the faun of a STOP WORK ORDER and a fine of up to$?50.00 a.day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Imr,estigations of the DIA for insurance coverage vacation._ I do hereby certify under thepains andpenatfies ofperjuty that the informationpratzded above is tnte and correct Si ture: Date: Phone#: <69 Z�y affWAI use only. Do not mite in this area,to be completed by city or town offi'ciat City or Town- Permitll icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityfTown Clerk 4.Electrical inspector S.Plumbing Inspector 6,Other Contact Person Phone#- 6 I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 IocaI 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 eompli.arce 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 certincate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required.. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will,be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of kvestigatiGmi 640 Washington Street Boston.,MA,G2111 Tel.A 617-727-4900 w 406 or 1-9 MASS.A.FE Revised 9-24-07 Fax#617-727-7749 www.raamgov/dia r ® DATE(MMIDDNYYY) A� CERTIFICATE OF LIABILITY INSURANCE 10/07/2013 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 IN$URER(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 WANED,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: Debbie Mark Sylvia Insurance Agency,LLC H, 508 957-2125 ac Nc:508 957-2781 404 Main Street E-MAIL ADDRESS:mark@marksylviainsurance.com Centerville,MA 02632 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Farm Family Casualty Insurance INSURED INSURER B: D&T Construction,Inc. INSURER C PO Box 168 Centerville,MA 02632-0168 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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 SUER POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MMIDD A GENERAL LIABILITY 2001X0485 7/21/2013 7/21/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 CLAIMS-MADE Fx—]OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 2001 W7501 7/25/2013 7/25/2014 Twrc STATuLIMIT- X oTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N N/A E-L EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑Y (Mandatory in NH) E.LDISEASE-EAEMPLOYE $ 1,000,000 If yes,describe under 000,000 DESCRIPTION OF OPERATIONS below E-L DISEASE-POLICY LIMIT $ 1, DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Carpentry The workers compensation does not provide coverage for Troy A Thomas and Shawn M Doyle- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D&T Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 168 Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ola&daol?.wc lil License or registration valid for,individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR Regulation ' and Bu siness R egistration: .14591.54 Type: Office of Consumer Affairs g Private Corporation 10 Park Plaza-Suite 5170 xpiration 3/15/2015 p Boston MA 02116 DOYLE+THOMAS CONST INC TROY THOMAS ---� 499 NOTTINGHAM DR ' g CENTERVILLE, MA 02632 Undersecretary N t v lid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialtl License: CSSL-099913 x TROY A 499 NOTTINGHAW' D :. CENTERVILLE NIA r02B32 ' 92— Expiration Commissioner 04/13/2016 The Cm m ymmM of Masst chmseffs Deparhnenf affi dpsfrualAccidearfs -- Owe of-Fuvesfigo-ans 600 Washington Street .$vstaq,MA0-7 UI r wnw.7masmgo-v1dut Workers' CompensatwitIusurance Affidavit:$mldersfCon#ractorsMectricmnsAR tubers Information Please Print Legibly Name akmin� mffiffi-� jlry Ci /St:atvJZip: Phone '?. O , .� Are you employer Cbetic diet appropriate bos: Type of project(regmred).__ .._ 1 I am a employer with `� 4_ ❑ I arrt a c onfractor anBI employees(full agdlorpart-#i�me�_ * have�hiredthe subcontractors. 6. [—]New�rn�n�tf� 7.0 I am a sole proprietor or partner- listed on the attached sheet: y- ❑ReTnndeling ship and have no emplayees These sub-coniracturs have g- ❑Demolition -moddng for me.in any capacitT employees and have workers' q_ ❑Building addition [N6 workers' comp:insurance comp-Msurancf req° ed] 5-❑ We:am a corporation and its 10-0 Electrical repairs or additions I❑ I am a homemmer doing all wort: officers have exercised their 11-0 Plumbing repairs or additions myself[No Workers'Map- right of em=pfionper MGL 12-0 Roafrepairs insurance required..]F c_152,§1{4} and we h23,-e na employees [No ems' 13_❑other comp-insurance reqIttred_I "Aay appYuDmt that checks box f1 xmst also fill out the section below shuuing their wodE e compensation polilry inEnmutR v t Hanmavmers vrbo sabmit Ibis affidavit mECX MK dui sM&Mg DR nD*and thealm-e outside C0ntraCtn15 nmst submit a near affidsrit mrbca4mg such_ Cffitrsetna thst cheek this hmc mmt sCaclt�as additional sheet shox>ng the nee of ff3e sn6 o€s and state uhetLer Drum tiaasg MTd6es fiaVe �npioyees_ I€the sub contractors lure emplaces,tired mast pmvide their worless'camp.policy,number_ -Tam an etrzgFayeF that isgrfx►�iditr tcrorke-rs'cotxrpgrrsrrtion irtsrtraigce far myK e-nrp£aycrcu Beiatw is fhepaEc}and}ob site Insurance Compan:YN=e: �►''t• t7 L�j'rw/fi f�i.t, Policy or5e11=ius Lim a'�Or GJ `�J FxpiratibnDa#e: —leiy Job Site Address: r.�►/a /':P4 citylStatelziip=e�l4 ( 6�2 Attach a copy of the workers'comp .usatiou policy declaration page(showing the policy number and expi&tion date}. Failure to secure coverage as reTuiredunder Sertiaix 25A of MGL c. 152 can lead to the imposition of"rriminal penalties of a fine up to$I,500.Oa andlor one-yearin3prisonment,as well as civil penalties in the.fbm of a STOP WORK ORDER-and a fine ofup to$250.00 a day against the violator- Be advised that a copy of this sfatemeat maybe ffirwarded to the Office of LiT.7cstigations of the DIA for marmtnrj--coverage-vrerfficadon- I do hereby coi fy under tke paijis and penalties nfger ury fltrttfha irr,j'vrmatian prmrz&d abase is hua and correct Sienatocre- Date: d Phone ff (WEciol use only. Do gat writ&in this are2,to be cratitgfeted by dop or town official afty or Town- PerruitUcense if Issuing Authority(drel-c ane): 1.Board of Health. I Building Deparhnent 3.Cityfrown Clerk 4_Electrical Inspector S.Plambbg ELTecter 6.Other Contact Person.: I,-hone ff Information and Instructions Massachus General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursamtto 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 de coed 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 checlang the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerificate.(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 in si„-a„=boverage. 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. Sell insured companies should enter their self-inciTrance 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 pem it/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense 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 is (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn Ieaves etc.)said person is NOT requ>red 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 Corm wealth of Massaahusct Depat#m-eait of hid-ustdal Accidents Q- ce 4f kvestigatiow, 600 WasbiVau Stt-e,�_t Rostmtz MA 02111 Tel A 617 727-4900 ext 406 or I--977-MASSAFE Revised 4-24-07 Fax#617-727-7-749 www mass ga­,-,/dza �a /zeor�,r,roozcvea,�G1 o�C/ aac/zcvreC License or registration valid foi-,individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration: 145954 Type: - = 10 Park Plaza-Suite 5170 xpiration: 3/15/2015 Private Corporation Boston,MA 02116 DOYLE+THOMAS CONST INC r- TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE, MA 02632 Undersecretary NA v lid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty- License: CSSL-099913 TROY A THOMAO'- - 499 NOTTINGILW r CENTERVILLE NIA Expiration Commissioner 04/13/2016 I 508-328-1635 SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com 1 ;0041. P.O. BOX 168 CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. Seth Peterson 67 Coachman Lane West Barnstable, MA 02668 Date on which construction should begin: Late Spring 2014 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ, and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $4,483.55 Above proposal to include siding on south facing garage area &house only as discussed In the event that while stripping the siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and $30.00 for a carpenters laborer, plus the cost of materials. Thank You For Givinq Us The Opportunity To Help You Improve Your Home r -Siding to be stripped and cleaned of all old siding&debris -Home to be papered with Typar house wrap -Maibec Grade A white cedar siding to be installed -5 Yard dump trailer will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions: the choice of repair of replacement shall be at the -nrinn ni rno rn nrrmrrnr _ tract are intended to comoiv with the applicable portions of the Mass. General Law Chapter 142A. such portion not in compliance shall be read and interpreted so as to have its intended meaning to the Cionnrl nc m cominrl inctriemnnt nn thic rintn- BUILDING � NN N N �� N �� �� INSPECTOR �� NNNN-�� N �� N� ~~ =~ ~ �~�~ � �� �� � APPLICATION FOR PERMIT TO ............... .I.m .--][��m��. —..-..y��r.�-...----------'— � � � TYPEOF CONSTRUCTION ..............&/,=�^.....t8.4m-tea........................................................................... __,.____.. &v ,}m TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according to the following information: � � � � LLocation --��C�u..--..m.�«----��...-....----.—'--.—..r._--../..�----.�� �,`_��-'�^t�����~~+f��.��/1�. P,opcse6 Use —.�� ...F,�Ml. ------------------~..---------,-------.- 8� �� Wai� l��Zonirg Dixtrid --^^x^--`���.--...—. .------R,e District —��y�\���....--.-'������'�����4�.-----' Nome of ,7 1 \y 479 Address .. ............ .R 00 K---^&A—' oma 'of8vi|6er � �K���� a"w~I.................A66,ea� — /—. ' .^'�u/�^—.^.�7^.k ^ Nomeof Architect -----�VIA.......................................Address .......................... ............................................ � Number of Rooms ----k ----------------Foun6ohon ............� ........................................................ Exleio, —' -------------------..Roofing --- ................................................. ^l | J '~~— F|oo-u .. ������^�*��---- °�j ..................Interior ........... -- NV=.'�-e-............. ____ Heating .......�:n tƒ�.....���.,L..—. .----.-----.Plum6ing .--------------_,,,_________.. Finez|ooe ............./ .....................................................................Approximate Cost ----� ................................. ' Definitive Plan Approved by Planning Board l9---------. Area .......................................... ' Diagram of Lot and Building with Dimensions ' Fee _______________ SUBJECT TO APPROVAL OF BOARD OF HEALTH - � . ~ - OCCUPANCY PERMITS, REQUIRED FOR NEW DWELLINGS | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable ,egmr6i "the above construction. .'_m�-v_'__----.�.--------.~—..~~~----~^-~ � ` Construction Supervisor's License ------------ STERLING TERN REALTY TRUST A=15 -0-94 —6, No ...22E7 .,, Per r ...Two... to Single„Family„Dwelling,................... Location .....Lot.,U.Q.......V..Qggg.hlgan„Laae,. ....................We.'s.�..Ba.��?;3.tauf:.......................... Owner .....Sterling.Tern..Realt.y,...T.V.iA s ,.,. Type of Construction ........Zname........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted September 4, 19 86 ....................................... Date of Inspection ....................................19 Date Completed ......................................19 }}' �j ) ` •AssesF.,s,map/bndd/lof number ......./ .�. .�� �C n` pGTHE T Sewage Permit number ............................ < c4 yIC SYSTEM M;, .. .. L c " INSTALLED � IN COMPLIA� i BAH99TADLE, House number ......................................(J.3.... ................. WITH TITLE 5 =,o 16`39. 1 ONMENTAL CODNE� TOWN OF BARIMMS O BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................[.P[.e' . ...i.eve).1�......... f3�r��... ....... ..5...:.................................... TYPE OF CONSTRUCTION .............. ....J.:1 .!.4e........................................................................... ..........................4?. .......19.. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informatiio�nn:� / Location ......//a—r.....av.............0 L..L?1a.�1 -v...��,.Q'!j.. ...........6�Ve&, ProposedUse .....yl.1 r L...f sp.,I... ...... ............................................................................................................... / Zoning District ....... ....:J qO................ Q.l.....:...............Fire District ...KJRN ► L ................. Name of Owner'M�'.�k.1 ... .�jzf .....�.04 dress ..�. -.... Ta.Vz: Rw!C.......Ka. ...a-l..•1.,t Name of Builder C f3j),/...�.�TA .................Address .... ......i,. of............... 1!.1. �. (- 1�4 Name of Architect ................'.K.,/ .......................................Address ......................... !��............................................ Numberof Rooms .............V.................................................Foundation ............ f�........................................................ Exterior .....(4V.A-'Z...........................................................Roofing ......... Floors ...... .APd.w&c*d.............C;a4l ,Ifs:]....................Interior ........... ............. ............ Heating �t .5..... u.J....... !.f3..................................Plumbing ................. ... ....... # .................................. Fireplace ............ ................................................. .............Approximate Cost ............ .0.0,s ........................ .1 _ Definitive Plan Approved by Planning Board _________ _ 19 Area /..�. ... . ..... .. Diagram of Lot and Building with Dimensions Fee ............�.,rir. . .. ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH �fQIQ ,ice � fig° 2- r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl/rega no'the above construction. Name .. .. .. .... .... .................... ...................... Construction Supervisor's License .... ..1../........ 61ERLING TERN REALTY TRUST t No .29874 Permit for .,,,Two Story ..... ..................... Single Family Dwelling ............................................................................... Location ........Lot...#.20. , 6.7...C..o.achman..Lane..... . . .......... .. . ............. .. ....... West Barnstable .................................................... ..Owner Sterling Tern Realty Trust . ................................................................ Type of Construction ,,,Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted .....$.eptsTnber...4,..........19 86 Date of Inspection Il .............19 ...................... Date Comple ed ... .5.1�'..:�1...�.��......19 a"a2 CL P �.a rr<; / �r v� c x � 9 off\ 60 p;pN;INlifll:Ja. - � 1577 •�`\ `tip A c I "AS BUILT " PLOT PLAN TO THE BEST OF MY INFORMATION, s'c (r MASS. KNOWLEDGE, AND BELIEF THE �OcJ�✓�,9T/onf SHOWN ON THIS , PLAN HAS BEEN L D ON THE R. J. 0 HEARN //VC. SWAN RIVER A GROUND AS INDICAY;ED90BIN 35 ROUTE 134, UNIT 2 w. SOUTH DENNIS, MASS. 02660 WIL OX / 0 o.3 341 � vl DATE : SCALE: Z JOB NO.-3�Z 9 " -`o CLIENT. DATE REGISTERED LAND SURVEYOR DR. BY - SHEET OF TOWN f F BARt S1�ABLE MASSACHUSEiTS s L�u 116&P RG PER=M`i ' A=I52,-.00,+ DATE .�_19 PERv11T,;I Q - F X"//1':` APPLICANT 'Atember DDRESStarry. FeTersoll IRO. TI _ IIl0 'EN LICE Y NUMBER OF -PERMIT TO I 1 STORY - DWELLING UNITS — -agwL T 1 .N6'. R 1 - ZONING 'AT (LOCATION). DISTRICT— _ BETWEEN AND (CROSS STREET) ` (CROSS STREET) LOT SUBDIVISION LOT BLOCK- SIZE -BUILDING 15 TO BE FT, WIDE BY FT. LONG BY FT.-IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OROUNDATION .. .. .. ..F - - (TYPE) - REMARKS: sevage - BOND AREA OR PERMIT ' VOLUME ESTIMATED COST $ 1:0BTOOo FEE 123'2 it$ U E FEE . . OWNER _ Sterling T6rn Realty fru5t BUILDING.DEPT, ADDRESS ° BY . s THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL "MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPRQVAL X9 v IVA 14 2 2 2 a� 3 HEATING INSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS INEE ING OTHER 2 G � .b�4 U`� h -^�'—'`.it�.�mil._ 2 i1 BOARD OF HEALTH WORK SMALL NOT PROCEED UNTIL THE " PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD II INSPECTOR HAS APPROVED THE VARIOUS, WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. I OR WRITTEN NOTIFICATION. 1 TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 laEa7T18L TOWN OFFICE BUILDING riu� tg i6J9. �F HYANNIS, MASS. 02601 �s r�r►. b7EMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #......... . .. _......................................................................._....................................................................................... issuedto ..........................................................:....................................................................................................................................................................... Please release the performance bond. TOWN OF BARNSTABLE Permit No. ................ _'- BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ...... .ate uv�� HYANNIS,MASS.02601 Bond ...... CERTIFICATE OF USE AND OCCUPANCY Issued to Address USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. , 19................. ..... ..... .... .......................... Building Inspector r TOWN OF BARNSTABLE Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash n659. HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Address USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 19................. ... ................. ....................... Building Inspector