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0046 RIDGE ROAD
UPC 12543 No. 53LOR HpSnNrC BAN Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399- u o 0 Y--e CO 4/19/18 o o -n � o � D Brian Florence CBO =D cn Town of Barnstable w n Building Division e rn 200 Main St. o Hyannis,MA 02661 RE: Insulation Permit 18-872 Dear Mr. Florence: This affidavit is to certify that all work completed for 46 Ridge Road,West Barnstable has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey 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 AM Posted Until Final'lnspection Has Been Made. Permit 1 `1 +` Where a Certificate of Occupancy,is Required,such Building shall Not be Occupied until a Final Inspection has been made. Per Permit No. B-18-872 Applicant Name: William McCluskey Approvals Date Issued: 03/29/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 09/29/2018 Foundation: Location: 46 RIDGE ROAD,WEST BARNSTABLE Map/Lot: 216-023 Zoning District: RF Sheathing: Owner on Record: ARVANITOPOLOS, DIMITROIS N& I Contractor Name: WILLIAM J MCCLUSKEY Framing: 1 Address: 46 RIDGE RD Contractor License: CSSL-102776 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $2,700.00 Chimney: Description: Dense pack the walls with R-13 cellulose. a Permit Fee: $85.00 � Fee Paid: $85.00 Insulation: Project Review Req: r Date: 3/29/2018 Final: —6, 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 within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and therapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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 work until the completion of the same. Electrical Service: 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: Rough: 1.Foundation or Footing _ - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 vz_ Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT f�� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- PP l a` 6 Parcel Q a3 Application # W �7 Health Division Date Issued Conservation Division eUiLDINO oepr Application Fee Planning Dept. JUG 11 2016 Permit.Fee L Date Definitive Plan Approved by Planning BC 1 / � r ARNSTggLE � Historic - OKH Preservation/ Hyannis r 11 �i Project Street Address Li6 ��d58o�d Village WeO Owner D 11 M rvtf Ac�fr%n_M 06�os Address C06m e Telephone 5 0 8 3 b 3 5 9�1 . Permit Request ��d R'3$i IZ,'�3 �Ierjlogs QLha 1`Z-35 C_r,1L 05r. --0 tie \G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes �(No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �A, Ap. SAvOTA C Telephone Number () 3 9 g Address -D [+4A+1"p Ave/ License # a L o a T�� S. ) f(A f w4 Home Improvement Contractor# ( 3g Email Worker's Compensation # WC K 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yci SIGNATURE DATE t ` FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED �- 5 MAP/ PARCEL NO. : ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION ` FRAME INSULATION F. FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL a FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. rustable �' � ';TtiCti�reE`'V:Sca'ti,Direc;toc To�on�perry,�iiiilding Comiwssioner 20Qiria 3ftj�annisf7 U26Q . Office; 5084.6-Z-489 fax ,:50$`79.0-623p •�r��e�t��Own�er �_t, � -• i i all vqn hex.�bpaukfio�i.�e; .. - - . � YC �a'ace a • iII aII t aftexs:FeJative:to woik.a�rt3ioiizedb th s L ili permii a plicatio�.Tw {Alf. .S^ "' bo'. ences:..and :� atrims':a die x�sittie r t lrcar:;Pa are�o� �e_ ar ui�ed;'��t�r� �irs �t3'°�,d"alb.� • . cif.der .-Sgnaai�eo Ap�ic, af n IV I JeJA Z niit dame / Date Qi�aivas:o�v �tt�rssxor�Y:nai�s: � • AC/ & CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 4/12/2016 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(les)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 Ileu of such endorsements. PRODUCER CONTACT NAME: Risk Strategies Company Risk Strategies Company PH,0!1 E (781)986-4400 FAx Ne:(781)963-4420 15 Pacella Park Drive ADDIESS:randolphcld®risk-strategies.aom Suite 240 INSURER(S)AFFORDING COVERAGE NAICs Randolph MA 02368 INSURERA:Selective Ins. of America INSURED INSURER Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc - INSURERC:Star Insurance Co 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1641211375 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. IMSR TYPE OF INSURANCE POLICY NUMBER MM CY EFF LTR MMI ICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS{dADE OCCUR PREMISES Eadooumence $ 100,000 X 91994480 10/16/2015 10/16/2016 MEDEXP oneperson) $ 50,000 PERSONAL&ADVINJJRY $ 1,000,000 R NL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICYff]PERCOT- E]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea BINErOdSINGLE LIMIT $ 1,000,000 8 ANY AUTO BODILY INJURY(Per person) $ TOS SED X AUTOS SCHSCHEDULEDAVEA46796600 11/6/2015 11/6/2016 BODILY INJURY(Peroocident) $ NON-ONNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Pereodderd X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS4 ADE AGGREGATE $ 1,000,000 DED X RETENTIONS NIL 81994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION - Officers Included for X- STATUTE OOTTH- AND EMPLOYERS'LIABLITY ANY PROPRIETOR/PARTNERIFCUTIVE YIN NIA Coverage E.L.EACH ACCIDENT $ 500,000 C OFFlCERJM tMB F�CLUDED7 , (Mandatory In NH) WCOSS540700 4/9/2016 4/9/2017 1.DISEASE-EA EMPLOYEE $ 500,000 If s,describe Under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LNIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101 Remarks,Additional Schedule,maybe attached If more space Is requlred) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of named insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable County 460 West Min Street AUTHORIZED REPRESENTATIVE Hyannis, Mh 02601 _ ]Michael Christian/CLC 'd O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 c www massgov/dia NVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ i am a employer with 15' employees(full and/or part-time).* 7. New construction In I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.C3 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. Demolition Q 4.�I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.'- 6.❑We are a corporation and its officers,have exercised their right of exemption per MGL c. 14.❑✓ Other Insulation 152,§1(4),and we have no employees.[No workers'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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Star Insurance Co. Policy#or Self-ins.Lic.#: WC085540700 Expiration Date: 4/9/2017 Job Site Address: 46 Ridge Road City/State/Zip: West Barnstable Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th pains and penalties of perjury that the information provided above is true and correct Signature: Date: 6/10/16 Phone#:508-398-0398 Official use only. Do not write in this area,to be completed by city or town official City or Town; Permifticense# 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#: - Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor.Registration Y_ = Registration: 171380 Type: Corporation 5 y, Expiration: 3/14/2018 Tr# 419291 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH-YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. Address Renewal ❑ Employment ❑ Lost Card SCA 1 h 20M-05/11 r✓/lC 'Q9)G771677LOCCfI,��-Q�� �[GJICCC�CC�C Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ^ _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:- Registration:,'�'171380 Type: Office of Consumer Affairs and Business Regulation Expiration: 3/14/2018 Corporation 10 Park Plaza-Suite 5170 = Boston,MA 02116 CAPE SAVE INC. WILLIAM MCCLUSKEY`2; 7-0 HUNTINGTON AVENUE-- SOUTH YARMOUTH,MA`02664 Undersecretary Not valid i signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards �,Onr+u ucirirTi ouriEi i iiOT oilQCiarn_� License: CSSL-102776 c1XTS 7j[ WILLIAM J MC Iptu%lox. 37 NAUSET ROAD West Yarmouth MA Expiration Commissioner 06/28/2017 t 200 60)�) oFsKEE r Town of Barnstable *Permit# 1 pire o the from e date Regulatory Services ee _ - aARNs-rABLE, Thomas F. Geiler, Director truss. 9� =639• ,�� Building Division ^� Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 1' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Numbe"al(0 03 Property Address �� ► �tA6j'Q �C� WIf(�5��'✓�Q ,Residential Value of Work : t DOD Minimum fee of$2S.00 for work under $6000.00 Owner's Name & Address J�Mr�(ic�S C�«��.5'ISL,�I 11G✓1; tdP0,)/ 6 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) ❑Workmari's Compensation Insurance Check one: ❑ I am a sole proprietor -PRESS PERMIT I am the Homeowner I have Worker's Compensation Insurance OCT — 2 2009 Insurance Company Name :r()1AJN OF RARNSTABL Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. 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) N—Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum..44) *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 is required. :6 NV Z- ,ao goo,. SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revise020108, t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Bostam, M,4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectrician.s/Plumberg Applicant Information /� I•c Please Print Ledb Namr, (Business/OrganLnEon/Individual):�—� Address: , City/State/Zip: G. g C�((1STG.�� Phone.#: Are you an employer? Check the appropriate bo-.c r7. of project(required): 1.❑ I am a emplaycr with 4. I am a general contractor and I OJT canstnaction employees (full and/or part-time).* have hired the sera-contractors 2❑ I am a sole proprietor or partner- listed on tine attached sheet Remodelingship and have no employees Thesesub-contractors haveg, 0 Demolition employees and have workers' wotjang far mein any capacity. 9. ❑Building- addition [NO workers' co ."m�tranre comp_insurance.t � 5. We are a corporation and its 10.0 Electrical repairs or additions j LIC officers have exercised thcit ll.[]Plumbing repairs or additionam a homeowner doing all work myself [No workers' comp_ right of exemption per MGL 12.0 Roof repairs incnranCC r c. 1-52, §1(4), and we have no egn>zui]t en:rployees. [No workers" lthcr�2-SiC� comp,inrnrance rc;TII cd.] *Any applicant that checks box#1 must also fiU out the section below sbowing their workers'comper=tian policy information t Hmncowacn who submit this affidavit in&aa ing they are doing zI work and then hire outside contractors must rubmit a new of aavit indiraling wcb_ tr—ontractnrs that ebealc this box nmst attached as additional sheet showing the name of the rub-coolractara and slate whether or not thasd entities have cmployccs. If the sub--ont:actnm have crnployecs,they must provide their workers'cn-np.policy number- I am an employer thid is providing worlrzrs'compensation insurance for my employees Below is the policy and job site rrcformffdort. Insi-x�rancc Company Nun Policy#or Schf-ins.Lic.#: Expiration Date: Job Site Address: City/5tatc/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 bYpositiori of crimiial pcnaltics of a fine tip to $1r500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fi of up to$250.00 a day against the violator. Be advised t3iat a copy of this statamerit r y be forwarded to the Office of Inycstigiftions of the DIA for'Tn6lira=DOVMMLTC verification. I do hereby certify un the allies of perjury that the informatiox provided above" true and correct Si c: Date: l] U — Phone t: a ' 3S a Officid use only. Do not write in this area, to be completed by city or town offcciaL City or Town: Permit/License# TsstfLagAuthority(circle one): 1.Board of Health 2.Building Department 3. City/To7rm Clerk 4.Elecbr-ical Inspector 5.Plumbing Inspector 6. Other r• E F ve ... Phone A. Town of Barnstable �oF SHE ray Regulatory Services - BARNSrABLE ? Thomas F.Geiler,Director 9 MASS 0.19. Building Division pTFD �a Tom Perry,.Building Commissioner . 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: G v 1 ( L JOB LOCATION: �S I`— number '1-,, �r street village ..HOMEOWNER"6f Q 1�/1 ✓ 'I 10-0:4O)4�lv5 6p�-3 5�i a name home phone# work phone# CURRENT MAILING ADDRESS: Y� 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 inspectio rocedures and requirements and that he/she will comply with said procedures and requir is Signahrrc 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 Io9.1.1-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 arc unaware that they are assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Ucensing 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 Writh a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is filly aware of his/her responsibilitics,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responnbilitics 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 fomi/certification for use in your community. oFjHEr Town of Barnstable Regulatory Services �s1xKAS& � Thomas F. Geiler, Director reoMt,�a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder r , as Owner of the subject property hereby authorize to act on my behalf, in altmatters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name if Property Owner is applying for permit please complete the Homeowners License Exemption Form on th:e reverse side. r+ r 'Wj . Town of Barnstable Approved Regulatory Services Fee Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 ©� Home Occupation Registration Date: Name: Phone#: 08 Address: Village: Name of Business: Type of Business: /A/77�L6 60 Map/Lot: Ny a, J Zoning Districtz!6E� _Zoning Districts RF and RC-1 require Special Permit from Zoning Board of Appeals. c� 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 is 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,hav read and agree with the above restrictions for my home occupation I am registering. r Applicant: �tP Date: Homeoc.doc TO ALL NEW BUSINESS OWNERS DATE: 7-1-0 3 aou01,,a I Fill in please: M"0511MINIF f 1 ` / n l ,. APPLICANT'S YOUR NAME: ArUOq� cP V 1 vl t�Ne- D4.S/LV) BUSINESS , YOUR HOME ADDRESS: Z4 ro C, vtof ye-r MEMO- wes+ .aA&K S A-b I-e_- - !+ TELEPHONE Telephone Number Home 50$ 5:q —O S 0-- NAME OF NEW BUSINESS / e-1 S TYPE OF BUSINESSPAIIV7/ IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the buil ' g divisi n? YES NO ADDRESS OF BUSINESS - # e -77,4 MAP/PARCEL NUMBER J 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. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses... GO TO 200 Main St.—(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has been info a of any permit requirements that pertain to this type of business. i orized Sign re* COMMENTS: c-<, / vpocg L/ 2. BOARD OF HEALTH This individual haten inf of t i requirements that pertain to this type of business. iied Sig ure** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual d of thAceLlingerequirements that pertain to this type of business. Authorized Signature** (���C// COMMENTS: Business certificates (cost $20.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY.