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1564 MAIN ST./RTE 6A(W.BARN.)
NO. 152 1/3 ORA Jz- i Alan E. Brown Northside technology 1564 Main Street W. Barnstable, MA 02668 774.330.8868 BUILDING DEPT. Brian Florence Town of Barnstable FEB 2 2 2021 Building Commissioner 200 Main Street TOWN OF BARNSTABLE Hyannis, MA 02601 February 16, 2021 Dear Brian, My name is Alan Brown and I'm trying to obtain a Business Certificate and a Business License for my home based business Northside Technology. I am retired from the IT Department(18.5 Years) at Barnstable Public Schools. I started a part time business(labor only, no retail sales)out of my leased home at 1564 Main Street,W. Barnstable, MA 02668. I have submitted the on-line the application for a Business License and paid the$40.00 fee to the Town Clerk's office. I have also sent you a check for the$35.00 fee for the Home Occupation license. I am on the state highway 6A and there are several businesses in the area. An Acupuncture Studio across the street selling herbs etc., IT works around the corner with a fairly large business and 2 doors down was the Crystal Pineapple, (now the Barnstable Land Trust)which was a retail business for 50 years. My business involves repairing desktop and notebook computers and is labor based. No retail sales are involved. Please let me know how to proceed. If you need a reference,you can contact Dan Wood at the Town of Barnstable IT Department or Bethann Orr, IT Director for the Barnstable Public Schools.They are both available on the towns e-mail. Best Regards, Alan E. Brown i Z/9/2021" Record BL.-392.-ViewPoint Claud A Business.License BL-392 Your Submission Attachments Business License Fee Business License AdminPlan Review Building Department - Zoning Plan Review Home Occupation'Registration on Record Business License Your submission Submitted Feb 9,2021 at 10:17am. Contact Information Alan Brown Email address. northsidetechalan@gmailcom Phone Number 774.330,88618 Mailing Address PO. Box651564 Main St. W. Barnstable 02668, Cummaquid, MA 02637 .Location`, W4 M i14 St/RTE.6A(W.BARN h sJ/barristablema.,iewpointcidud:corrd racW196775/submission 1/3 ttP_,.. 2/glpz1`. Record BL-392=ViewPoint.Cloud West Barnstable, MA 02668 fir`.. N Frz y4 try,7, � o rv"�+-�.7•Y.. ' :fV�• 31s.1':'0.f%{kaeCOP'•WCc.up. Business Information Business Name Northside Technology DBA Northsidee technology Business Structure'*' individual r, Type of Business Service 6 Computer Repair Phone Number 774.330 8868 Is this.a New or Existing Business Existing If existing is it-at the#�.same]ocation Yes Is this a Home Occupation Yes. � a . Applicant Signature I hereby cerfify that ail ofthe details and information'I liave=submitted or entered,.regardingfhis application are true and-accurate to.the best of my knowledge: Appllcant.'Signature- Alan E, Brown Feb%2021 htfpsJ/bamstatitemaViewpoln4Cloud:com/lrack%19.6775/siitim'ission viz tg/2621` Payment Receipt THE'rC R SM �9 m,. i i BAIfNSI•ABLE; + MASS. m i 9�p _1639: 10� grfD Mp. W. i Town of Barnstable, MA t $4,2. 19' Paid. via Credit Card ending in 7851 Thanks for using the Online. Service Center d �I Alan E. Brown Business License#BL-392 February 9, 202.1 Business License fee $40.00 Processing Fee $2.19 Total Paid $42.19 Powered by the ViewPoint Cloud platform Receipt number#185138 i 1N BL-3.32, _ I Details � � Alan Brown Submitted on Feb 09,202110:17 AM ® Attachments Did you receive my 0 tiles Activity Feed Latest activity on Feb 12,2021 Robin Anderson p Applicant Alan Brown This location is in tt of Appeals. I am un Location 1564 MAIN SURTE 6A(W..BARN.),West Barnstable,MA 02668 4 Timeline .. Robin Anderson 0 M Q Business License fee am unable to appr Paid Feb 9.2021.at 10:23am a spec'il permit issu Business License Adrnrn Flan Review , Please contact the Completed Feb 9,2021 at 10:30am Feb 13 referral to the the Z. c. Home Occupation Registration on Record90 � Rejected Feb 12,2021 at 153pm Feb I3 s 1 a Qid you receive my message? Robin Anderson Fbb 12th,2021,1_53pm This location is in the RF zoning district which requires a special permit from the Zoning Board of Appeals. I am unable to approve this without the special permit.Please contact Planning. .........................................................................................................................................._................................................_........................._..............._.._................................_........_.._...._...................................................................................................................................................... Robin Anderson 0 Feb 24th 2021.10.17a:m 1 am unable to approve this application as the location is on the RF zoning district.that requires a specil permit issued only by the Zoning Board:of Appeals. I have no discretion over this. Please contact the Planning Dept_at 508-862-4679 to obtain site plan review approval and a referral to the the Zoning Board of Appeals. ...................................................................................................................................................................................................................................._......._..................................._......__............_...................................................................................................................................................... ..................................................................................................................... Comment Internat Note Say something about this — ........................................................................................................................................................................... ....................................................................................................._............................_.._.........._................................_.........................................._....... Town of Barnstable Building Department Services BUILDING Ch�- Brian Florence,CBO cr�• Building Commissioner FEB 16 2Q21 enEuvsTaete 200 Main Street,Hyannis,MA 02601 F639. s�e� www.town.barnstable.ma.us TOWN OF BA"STABLE Office: 508-862-4038 Q N D Fax: 508-790-6230 Approved: Fee: p Permit#: 1-1- o?6 HOME OCCUPATION REGISTRATION Date: Name: N .. �esz V`�N Phone#: 7 74.Il a6 Address: 'groq- I M l4ovk%l S 1 • Village: W . Name of Business: KI clo n.).S 1 0e Q%-JZ1 &y Type of Business:1*40 4A 1PVTV!2 !R=—&I(C-- Map/Lot: 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,have read and agree with the above restrictions for my home occupation I am registering. Applicant: /M LIT Date: Homeoc.doc Rev.06/20/16 { Town of Barnstable *Permit# Regulatory Services E Fee 6 monthsfrom issue date 2 • anatvsrAet& • �� MAM �. Richard V.Scali,Director --%% . 00- ED�` Building Division Paul Roma,Building Commissh ftp 200 Main Street,Hyannis,MAGI 6VJ EI SS;. � www.town.barnstable.ma.us kI Office: 508-862-4038 , AUG 1 1 �� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - IALn'ONLY Not Valid without Red X-Press Imp I Y 5'TA BL E Map/parcel Number �/ t ` r1D Prop Address 156 L M ci( 1 �S-J-_ &3e_C"E �.t'n Residential Value of Work$ oo Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Z+-e 1/Q t q p S°f f A-e 19 0ea-f-�mot-✓c�n� l C,n.e o S G,,��✓c�. J4 A Contractor's Name �LrG��ro� cSU( �/�� Telephone Number 7F/ a Home Improvement Contractor License#(if applicable) J(p l�p 5'7 Email:_ 0.(J Cr�P-e Q r0 p�Ca vicaS+�� Construction Supervisor's License#(if applicable) /O 3 d 65 ❑Workman's Compensation Insurance Check one: ❑ I sole proprietor ❑ the Homeowner have Worker's Compensation Insurance Insurance Company Name I Workman's Comp.Policy# Copy of Insuran "Compliance Certificate must accompany each permit. Permit Req st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to --,/d w� rc,_�'t` ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. "Where required: Issuance of this permit does not exempt compliance-with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is rWuired. SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc 06/20/16 The Commompeaitic a,f 3assadr=et& Department ofrndia riat Accidazts Office ofbrWz*Wi0ns 600 Waskvrgton Jtreet Boston,AA 02111 1PFP14L MaSSMgV91dia War.Icers, C Insurance davit Builde17slCtlntra-ctGrs/EIectriciansThm3bers AWhcam#Infurmat Qn r Please Print f ly -Nm= - I �S�t-ter (0 ZZL Ad&essti )4/ PO or-,, ',day City/S �n Jr - © Phone-44: Are >s an employer?Check the appropriate bam 'type of project(re��ed}: I. I am a 1 with 4. ❑I am a general connector and I 6. ❑New cons a s employees andfor part,• = * have biredthe sub-contractors 2.❑ I am a sole proprietor orpartner- listed onthe attached sheet. I- ❑Remodeling. ship and have no employees . Them sub-contractors have g- ❑Demolifioa wod-k6a for me in any capacity. employees and have svml=s' 9..El Building addition wodoers'comp.insur= a Camp-msaratxce I repaired-] 5. ❑ We are a corpomfiaa and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1L❑Fh=biagrepairs or addihaus myseLf[No workers'oomp. right of eae mpfion per MGL L.❑Roof repaim im=anc,required.]y C.152,§1(4�andwe have no employees.[NO woks' 13_❑Other Co=p-ins wm--ro{lmted-) ',tap apy5m&&atchedsbo=91amstalsofMo�1hesectiaabdawstresongtheirwodcerecmipensati a•paficpiafarm 6— I H=aeownexs wba subs dais dEdWif i—l:�catiag they axe doing zU wa l anti then I&e autside cautnct=w- submit anew afiadal&indiartir sack. ICM=xt a 1=checl[tW box mast alteched>m addilianal sheet showing the az>ae of the snb-c�and state wbethet ar=flmse e=ddes bare employees.I€the mib<=txaa=bavemgZuv,--%d =srymvidethek warkEM'—=P•Palmy atnx0ser- I am art eaiplayer flint is prouiriing�vrrri�ers'eotnpertsrdiair uisrirattca,jer acy earPFp3�ees $etvev is flte parity arm job she inforrnalram lttsumnce Company Nam- Policy,45'or Self--ins.Lies# FxpimtionDate: Job Site 34ddre= CitylStaiet2.tp: AL#2ch a-copy of the workers'compensationpolicf declaration page(showing the policy number and expiration date). Fargnm to secure coverage as requimdunder Section 25A o€MGI.m 157 canlead to the imposidon of crimisral pezalHes of a fine up to$Uda 00 and t6r on.:year impdsonmeat;as w6U as riv2 p—nlfi in$e fb=of a STOP WORK ORDER and a fhe of up#s 0-00 a clay against the`riokdor. Be a ised&at a copy of this statemetlt may be forwarded in the Office of Isve stugations of1he DIA,for iastaance coverage verificahnn- I Zro kerzby undw&-e pains and pmaWm afpedW7 thatthe informatiouprtvid ahm c is true and correct r Sitmatm�: 11 Date: Ph O,oWal am an4r Do not write in fhrs area to be completed by city orlown ajoidaL My or Taw): PerrmW sense; Lnuing Audwrity(dimTe:erne): L Board of$ealth r.BwI fing Department 3.Cdyf rorwn Clerk 4.Electrical hmpector S.Phanbing Inspector 6.Other Cetntaet Person: Phone#: - 6 ormation and lastnctions Ma&sachoseft Gebezal Laws chapter 32 regmrw all=rP10Y=ID pr M&wMIX&Compensation fir their=q)laf'=- PMM=DttD tliS sf&lh:,an 0"PI7=iS defined as-c.C9erp person in die service of a uffier uader any ofbirr,, express or i mpliect oral or wr>tcn." An.mTkyer is-defined as=air individnAl,pm nenb.p,assooiafia a;omporation or other legal eddy,or any two or more of the foregoing=agaged is a joint eatE�.and mchidzag the legal=p=errtgjves of a deceased employes,or the receiver or trastee of an individnal,partnership,association or otherlegal entity,employing employees- However the owner of a.dwelling house having not more than I iree apartmeuts and who resides therm a,or the o=4=t of the - dwelling house of another who employs persons to do mace,ramdrric on or repair work on such dweIIing bouse or on.the grounds or bm- mg appurten.-,*$eretn shall not because of sack employment be deemed to be an employer." i MGL cbapter 152,§25C(6)also stems that-every state or local licensing agency shall withhold the isssaan ce ar renewal of a ticennse or permit to operaate a business or do cony. cf bw7 dio�gs fa the commonwealth for any applicant-Who has notproduced acceptable evidence of compliance with tIre b surauce coverage required." Additionally.MGI.chapter 152,§25C( )stafo s¢ldeiffimthe corm anveaIfhn.or any ofifSpolifical subdivisions shall eaiinr into any contract for the perb anw ofpnblio wmkmn it affable evidence of compliamcewith the inMrance._ req==eEts of this chap{nz have been.presented to the contracting aufhozity." A pp4czu-ts Please El oizt the wor3='compensation affidavit completely,by g the booces that apply to your situation anti,if necessary,supply sub-contractors)na ne(s), address(es)and phone nv m(s) along with their certificam(s) of fi==ce. Ljr[4 Liability Campanies(LLC)or Limited LiabRity-Partnesbips(I I P)wilhno c3ployees other thm the members or parfneas,are not requm7ed to carry worker' compensation i nsarance. If an TLC or LLP does have employees,a policy isregnfied. Be advised that this athdayk maybe snbmhh�dto the Department ofIndustrial Accideat for conffimaiim offinmm=coverage: Also besore to sign and dameithe affidavit The afEidavitshould be retained to the city or town that the application for the permit or license is bung rEquestxL not the Department of ; TndncfriaT A rr; mtg Should you have any gnastions regard the law or ifyou air repaired to obtain a work=' compensation poRcL please call the Department at the rmmber listed below. Self-msued companies sha aId enter their self insar-ance license number on the aggrapr ate line. City or Town Officials t - Please be soar,that the affidavit is complete and priced legibly. The Departmenthas provided a space at the:botiOM of the affidavit for you to fI'out in the event the Office ofJuvestigatuous has to contact yoaregm ding the applicant Please be si=to f M in the pesmWEcrose mnnber which will be used as a rafts eo ce number In-addition,an applicant that must submit multiple P=MWI =M applit aG=in aay givem year.need only sabmrt one affidavit indivatmg eat policy information(if necessary)and nndrr"Job Sits A. &=r ffie applicant should wzift-all locations in—L—CcitY or town)"A copy of-the-affidavit that has been officially stamped or ma iced by the city or town may b e provided is the applicant as-proo-fthat a valid affidavit is on file for fie pe=#s or licenses- A new affidavit must be faZIed ovt each year.Where a home owner or cites is obtaining a license or pezmif not zz7a�:d trs any business or comraea cialatae (ie.a dog license or pert to bin leaves eta.)said person is NOT regaircd to complete this affidavit The Office of Inyesfi gat►r,n s would Ile to thank you in advance,for your cooperation and shouldyouu have any gaes'iicros, please do not hesifa2 to give us a call The Deparimmfs address.telephone and fax rmmber: e t ofMassachuseM . - Deparbnrt of IziriES±dal Accidents . ice�.f�.v'e�g�tio� • Bosom-.,MA Q�III 2`a#617-' -49W mt 4€6 4r 1-977-MASS,� Fax 9 6.17 727 7M R j--vised4-24-07 - �� t . � $ Town of Barnstable Regulatory Services NAM ` Richard V.Scab,Director ►�� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized beforo- fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name '- Date QYORMS:OWNERPERI&SIONPOOLS Town of Barnstable Regulatory Services p1P Richard V.Scali,Director Building Division IMANIMAJE= Paul Roma,Building Commissioner PIAM ,19. &�� 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: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one. home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Client#:44947 2ALLST1 ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(M-MDIYYYY) 8/1112016 THIS CERTIFICATE IS'ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling 8 O'Neil Insurance Ag A/CONN IF,):508 775-1620 ac No: 5087781218 973 lyannough Rd,PO Box 1990 E-MAIL ADDRESS: Hyannis, MA 02601 INSURERS)AFFORDING COVERAGE NAIC A 508 775-1620 INsuRERA:Acadia Insurance INSURED All Star Renovations,LLC INSURER B:Associated Employers Insurance P.O. Box 775 INSURER C: Sagamore, MA 02561 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DD UB POLICY EFF POLICY ExP LTR INSR wyn POLICY NUMBER MWDDIYYY MM/DD/YYY LIMITS A GENERAL LIABILITY BOA507775913 1/02/2016 01/02/201 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMASE'r RENTED PREMISES Ea occurrence $50 OOO CLAIMS-MADE 5XI OCCUR MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $1 OOO 000 ' GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ac.dent ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY Pereaitlenl AUTOS AUTOS ( ) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per ec ident $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION WCC50050116252016A 1/02/2016 01/02/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITYFR Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500 000 OFFICERIMEMBEREXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Insurance coverage is limited to the terms, conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of BarnStbale SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S174993/M163283 CBD r o � i^ N ° 0. 0 .% c d a Lu C Ca p c l�.0 O E j w W co 0 M 41 ;Q DN70 l7�' O r:(A;;i;i.l:;i;a;:Y. �:10 _ d) h Q' C '':.::;Z`•frii:;i;::.:. }.'M r- c' Q > > U O ti=W w o Lu N 2 ....> j Z < E u G O J L m O) a+ d W J I u O N K Z J 0 p c ` Ili> O 0 2 p: W W (n. J '^ u in Q O F- y,E U Q 0 p 0 J O V d Z - 1-J Q w m U lY V LU V a w Q tr � U Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 36,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS License or registration valid for individul use only j before the expiration date. If found return to: .Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 ' i i��rZli.A� _ ,ems t i Not valid without signature R Name- steve agostinelli Job address- 1564 main st Date- 08/08/16 west bamstable ma Phone- 239-777-4663 Home address- Cell- Email- P.O.box- Job description: new roof (will be stripping off old roof) (1 layer rip) 14 We hereby propose to perform the following services in a neat professional manner in accordance with manufacturers specifications and local building code. 1.Supply and install Certainteed brand/Landmark line(limited lifetime warranty ten year surestart protection 10 year warranty algea resistance 130 MPH wind resistance warranty)These shingles are heavy weight self sealing multi-layered fiberglass reinforced architectural style shingles featering copper-ceramic stones. Supply and install Certainteed Winterguard ice and water shield at all eves walls roof vents skylites valleys and roof penatrations 3.Supply and install synthetic water proof under-layment to entire roof deck 4.Supply and install new stink pipe flashings 5.Supply and install 8"white drip edge along all fascias(unless vented) 6.Supply and install vent along the ridge In addition to the above work we will also clean and remove debris from the work area daily, re-nail roof deck as needed,and clean all gutters. replace cedars in contact with roof I-ern Home Improvement Contractor registration #164857 all the,office at: 781-217-8123 Construction Supervisor License#103265 I' ALL R Name- steve agostinelli Job address- 1564 main st Date- 08/08/16 west bamstable ma Phone- 239-777-4663 Home address- Cell- Email- P.O.box- Office I material and work is guaranteed to be as specified and all work will be completed in a ee, substantial workmanlike manner for a total sum of y fOD with payments made as outlined. Deposit 1/2 $0.00 Remainder due immediately upon completion! Please make check payable to All Star Renovations If paying by credit card please note that there will be an additional cost of 2.75%in addition to any APR that you may already be incurring. If you would like different payment options please ask. II workmanship is guaranteed. Factory warranties apply to all materials used and we Stand by the products we use and also our customers. In the event of a problem with any product used we Pledge to stand behind our customers to resolve the issue. ny alteration or deviation from the above specifications involving extra costs will be executed only upon written order,and will become an extra charge over and above the estimate. This proposal may be withdrawn by us if not accepted within 14 days. y issue of mold in the building will not be our responsibility during or after the project: Signature Date of acceptance a f v posa The above prices,specifications and conditions are satisfactory and are hereby accepted. I as the owner of the property hereby authorize you to do the work as specified. Payments will be made as outlined above. Home Improvement Contractor registration #164857 Call the office at: 781-217-8123 Construction Supervisor License#103265 i P�oFIKE�oy� Town of Barnstable *Permit#_70174 Expires 6 months from_issuue date RARNSTASIX = Regulatory Services Fee e�'C U2� HAM v� s639. Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner .200 Main Street, Hyannis,MA 02601 X-PRESS ESS PERMIT Office: 508-862-4038 r 1� Fax: 508-790-6230 AUG 12 2003 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Presslmprint TOWN OF BARNSTABLE p Map/parcel Number 1 17 611 Property Address {s��I M4,- S\ W , d�it--S-�otk,�e E31kesidential Value of Work Owner's Name&Address a tk Contractor's Name S e-l_ Telephone Number 5 0`b Home Improvement Contractor License#(if applicable) construction Supervisor's License#(if applicable) OWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor r I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over . existing layers of roof) 2"Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservatioa,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. ` 1 J Signature Q:Forms:expmtrg Revise053003 i Application to Old Kings Highway Regional.Histgric District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK Ka'av�- S'Z 1,J, �a \- ASSESSORS MAP No'. OWNER _ o�:.�. �-C«L ASSESSORS LOT N0. �_- HOME ADDRESS tNo'kLS TEL. NO. 5,61% L x' o - -4SL AGENT OR CONTRACTOR ADDRESS TEL. NO, This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission: (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition is involved,show• ing location of existing building. S i kC Sire- wa-�(S Lv:tlti. W :tL CeO v- S�i�� I e5 SIGNED Space below line for Committee use. . Owner-Contractor-Agent Received by H.D.C. The Certificate is hereby Date Time BY Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. Engineering Dept. (3rd Poor) Map Parcel 8 ` Permit# 2_479 6 S House# Date Issued Z �' (8:15 -9:30/1:00-4:30) Fee to?. 30-9:30/1:00-2:00) ��►� n. Bldg.) rb, oard 19 � � SA- �� BARMSTBLE. . OK w. 'A OV� P BARNSTABLE lE0 MP�> Building Permit Application c treetAddress '.S^lI Village Vl e:S; Owner —so�Ivh Z13 \IT" Address LA')3 Telephone L-l'a.� '�q S to Permit Request _ r o c, u-.a: e`g ��. \"C �n�.moo►`e / � � G • First Floor square feet Second Floor square feet Construction Type b t CL t-e..rn P__ Estimated Project Cost $ (m 5-0 ^— Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family p' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Bl o On Old King's Highway Yes ❑No Basement Type: Lgfu-ll ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 'Z New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas &Oil ❑Electric ❑Other Central Air ❑Yes 8'No Fireplaces: Existing N opt gNew Existing wood/coal stove ❑Yes ®'No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) f<ttached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED.STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE '2 BUILDING PERMIT DENWD FOR THE FOLLOWING REASON(S) F: FOR OFFICIAL USE ONLY u PERMIT]VO DATE ISS,'UEI r MAP/PACE NOlop . ` ` IFV �D • ADDRESS VILLAGE _ OWNER . y DATE OF INSPECTION- FOUNDATION R FRAME INSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ' FINAL- GAS: ROUGH FINAL: FINAL BUILDING DATE"CLOSED OUT ASSOCIATION PLAN NO. : 'i . °F WE ` The Town of Barnstable KAM• .�aNsr�s�, • �0 Department of Health Safety and Environmental Services '�i�o Mo►�'' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: y e'COo+ Est. Cost �. Address of Work: _I-T(09 Marti Owner's Name T UTIVa& Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. yByilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date 'Contractor Name Registration No. OR Date Owner's e The Comntonivealth of Massachusetts Department of Industrial Accidents �- ;;,; office oflnvesligallms ;" 6110 Washhiq on Street �'F �`� .• Boston. A1a:v. 112111 Workers' Compensation Insurance Affidavit Applicant intormatton: • ' Please PRIIVTaebj�( -' name: �1 h�n locition• l5 (. q Mtk'\v, S\. ZI am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an emplover providing workers' compensation for my emplovees working on this job. cnntpanv name: •address- city: rhnne N- insurance co. nolicv It I am a sole proprietor. general contractor, or homeowner(circle are) and have hired the contractors listed below who have the following workers' compensation polices: comnanv name: address: cirv: phone ri: insurance cn. nnlicv N __...-._.... ..- ....�__....... _I.V__/.►L.—_... rY�:a.r...�.r-1�.. __—__ II �• _ .lam-� � r_.��i.Y`_• .�.--� cmmnnnv nntne: address• gin: Phnne 0- insurance co. nolicv a dditional sheet if Attach a •. ,- _.,u••. - _ .,.T.T'. .�..•.......s......»...-"'�'.^�_ •:ice"__ . , __ __..... ._..---...._..- -.it—►. __� •f�.r�rJl.'t�'J� __ - rJw�-' _.—..1o�ti�— i14!'iJ.2�lf.••Wc'wi lL Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur unc years' imprisonment:ts well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement map be forwarded to the Office of Investigations of the DIA for coverage verification. i do)rerebr cerrijr uncle the pains and penalties ojperjun that the information prorided above is true and correct. Signature Date :/ Print name Phone# ' ritc in this area to be completed by city ton official ioflcial use un1% do not%% ' city or tmvn: permit/license tt I'1tluilding Department Licensing Bourd 0 check if immediate response is required C]Sclectmen's Office t 011calth Department contact person: phone#: r'IOther 5: n..; riv i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for their employees. As quoted from the "law". an emplitree is defined as every person in the service of another wider any contract of hire,,express or implied. oral or written. An emplurer is dcf incd as an hidividual,:partncrship• association. corporation or other legal entity. or any two or more the foregoing cnLa�_ed 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 dwcllin, house of another who employs persons to do maintenance , construction or repair work on such dwelling hou. or out the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that ever, state or local licensing agencl• shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for an} applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. 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 It:: been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits 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. C,;tv or towns Please be sure that tiie 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. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t' the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and shbu]d you have any question 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 • R 600 Washington Street °* Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 l •a TOWN OF BARNSTABLE • BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. /DATE f Z �OB LOCATIONST Number Street address Section of town "HOMEOWNER" Name Home phone Work phone - - PRESENT MAILING ADDRESS Li'7`3 CZ\e , i-1 q _. 1"\atSTQ V.S t\,`�S-*" City town State Zip code The current exemption for "homeowners" was extended to include owner-occupiec dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, 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 Offici on a form acceptable to the Building Official, that he/she shall be responsih for all such work performed under the building permit. (Section 109. 1. 1) The -undersigned "homeowner" assumes .responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The .un4ersigned "homeowner" certifies that he/she understands . the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comp with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICI Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. i HOME OWNER'S EXEMPTION :��. The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that such Home Ownez shall act as supervisor4 " Many Home-,Owners� who 'use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This aIack of awarene-s_ ' often results,., in serious problems,{ `particularly when- the Home Owner hires unlicensed persons. In this case our. Board cannot proceed against the inlicensedperson as it would with licensed Supervisor. The Home "Owner actin as supervisor is ultimately iesponsible,-;F,, N To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permmit application, that the Home Owner 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. to amend and adopt such a form/certification for use in your community.