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HomeMy WebLinkAbout0015 ALDEAS AVENUE �: _ .� ,._ _� .r ;, -- - � _��� ;; .. ..-. < - Application number..46.. 1.. .-1..,? .J.. Fee ........................... .................................... Building Inspectors Initials... ...................... �43g. 16� MAY 10 2019 Date Issued.....,5A1/.l.`. I Ulf N OF dAKIV6 TABLE Map/Parcel.......C>26 .........1!�.2................ TOWN OF-BARNSTABLE------_. .__ - - EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION �{ Cn�r Address of Project: / 5 �-�d�e�S• � J S �nNUMBER STREET VILLAGE Owner's Name: i�I Gl T iQ Phone Number —7 3 _ J Email Address: Cell Phone Number Project cost$ 000 , o v Check one Residential v Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: �L�C� /�• �. Date: %/ © I TYPE OF WORK Siding 0 Windows (no header change)#' ❑ Insulation/Weatherization 0 Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to d um p a e,. b v rn wood in wya�/s7`vv2 CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r APPLICATION NUMBER 4 *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions°can -attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provi a ite plan with the location(s)of each tent Fuel source being used LP tank 201bs. or>Yes No , 'f yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. Iffood is being served at your event lease obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COALTELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Marla via Telephone Number O SJ 5 -3 R ( Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.. Signature`"�t't�-� �/r�,/� Date APPLICANT'S SIGNATURE (N Signature f7`�� [�c c Date./"/ All permit applications are subject to a building official's approval prior to issuance. h' The Commonwealth of Massachusetts Department of Industrial Accidents Wr Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ` Please Print Legibly Name(Business/Organization/Individual): Q l/Q Ala Address: City/State/Zip: y�"�;j MA a Z 6 vi Phone#: f S -7 3 Z 1 Are you an employer?Check the appropriate box: _Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and L employees(full and/ofpart-time).* have hired the sub-contractors 6. ❑New construction . 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.,❑Remodeling ship and have no employees These sub-contractors havez .. 8..❑Demolition. workingfor me in an capacity. employees and have workers' y p �'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10.El repairs or additions required.] 5. ❑ We are a corporation and its p 3 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other 'I e 5 �*a r� �Q�� �Z v✓c��� comp.insurance required.] rtoa;r ally 1-a4eA l'` o o *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance.Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: . City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains anld penalties of perjury that the information provided above is true and correct Signature: �—�S � �v ` Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle.one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'.compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to 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 Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 wwwu.mass.govldia , Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 6/27/11 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, The contracted work at 15 Aldeas Avenue.Hyannis has been cancelled by HAC (see attachment) Sincerely, William McCluskey _- cn tr 46 Wes-_�tl�c��T2 slM`1 Y: HOUSING"s f -tin 6 ASSISTANCE E.NERku� lids . et �i s .4 �� -f"T � ��� Cj -Hl lines "L Li/Z ',ii�tGC2: C�7C'C Cl° C; k�. '` '•ems June 22,2011 Ms.Mia R.Walsh 15 Aldeas Avenue Hyannis,MA 02601 RE: The weatherization work you requested Dear Ms.Mia R.Walsh: On March 30,2011,the Housing Assistance Corporation(HAC)assigned the weatherization of your home to Cape Save,one of our licensed weatherization contractors. They have recently reported to us that they have been unable to successfully schedule a date/time for this job,because they have been unable to reach you,despite having left a few voicemail messages for you,and a"contact us"postcard in your door. As a result,I am afraid we will have to remove your name from our list of current weatherization jobs. Should you decide in the future that you would like your home to be weatherized,please call the Cape Light Compact at 1-800-797-6699 to get your name back on the waiting list,and we will start the process,again. Please call me if you have any questions. Thank you Sincerely, Mitzi Holmes 508-771-5400 x123 cc.William McCluskey Cape Save TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ;µ Map 'dam 6 Parcel . 0 3 1- ' Application # d� t Health Division Date Issued Conservation Division Application Fee SO Planning-Dept. Permit Fee, Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 5 d e S ye- Village 1 Owner atSh Address 50, Telephone Permit Request VC)0 v e-_ts /aura` ar-,�a�h,�a ti®n zc !H5 -f-&)) �1�x Soll , �lo� R•i3 ��S1�S�se. ,`n �x+, �afls , �- ,�®SSo b��y /�r��,�al � �o�� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatioAA D_)_6�onstruction 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: W 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: 3 existing - new Total Room Count (not including baths): existing 3 new First Floor Room Count Heat Type and Fuel: ❑ Gas N Oil ❑ Electric ❑ Other Central Air: ❑Yes )W No Fireplaces: Existing New Existing wood/coal stove:❑Yes; ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑;;existing L,new ize_ V C) ' 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 # � x3 Current Use n b► 1� ) Proposed Use 4-i 10, APPLICANT INFORMATION I,I (BUILDER OR HOMEOWNER) c�i Name W�% 1' CC US V-N I&K S&VC Telephone Number J U - OJT 0 v3 Address �C License # �tC 0 &*_Tb S004 Yo�sM004 MR a6 6 4 Home Improvement Contractor# �l Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Yo,C \0 044 SIGNATURE DATE FOR OFFICIAL USE ONLY • APPLICATION# » DATE ISSUED MAP/PARCEL NO. ; ADDRESS ! VILLAGE OWNER ! i i4 i • DATE OF INSPECTION: t I ' FOUNDATION FRAME ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organizatiowlndividual): micaAeA 14A s b(13/A- CrV Address: -C� {.};atJztnicaltst� AX_ City/State/Zip: S • YAJZA09-t I,l Al 6LU Phone M 3 i&- 0 3CM Are you an employer? Check the appropriate box: general contractor and I Type of project(required): 1.El ant a employer with t.i _ 4. ❑ I am a g 6. New construction employees(full and/or part-time).* have hired the sub-contractors ❑ 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. .7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in an capacity. employees and have workers' Y p Y. ' 9. [] Building addition [No workers' coriip.insurance comp.insurance: required.] 5. ❑ We arc a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[] Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y � P 12.0 Roof repairs insurance required.]' c. 152, §1(4),and we have no n employees. (No workers' 13.91 Other s- 01 e,,` 1 of) 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:���(W,*T 15 r L i t C- Policy#or Self-ins.Lic.#: �`�C- Q.�°1 3 • Expiration Date: 106�2-1 Job Site Address: d ( �e City/State/Zip: t'l 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 of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains toed penalties perjury that the information provided above is true and correct. at f �; Signature: � ` }y j_ i <.,.y Date: -- 4, — Phone#: Official use on<lr. Do not write in this area,to be completed by city,or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(QAW0OY M CERTIFICATE OF LIABILITY INSURANCE 11/1/2010 IS-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 terns 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 endorsements). PRODUCER NAME:CONTACT Shannon Sperrazza Risk Strategies Company ;PHONE (761)986-4Q00 - t�ti1l 963-fsa� 15 Paceilla Bark Drive ADDRESS:esperrazz&@risk-strategies.com Suite 240 PRODUCER 00018476 Randolph I CUSTOMER tD A: INSURED MA OZ368 INSURER(S)AFFORDfNGCOVERAGE -- NAIC —, �INSURERA:Seneca Specialty Insurance Co I INSURERS Aeating Groulp Ins Services Michael McCluskey, DBA: Cape Save INsuRERc Chartis Insurance7 C Huntington Ave INSURER D INSURER E: South Yarmouth MA 02644 wsURtsRF: V — COVERAGES CERTIFICATE NUMBER CL7011132675 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 ti CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. R' POLICY EFF I POLFCY EXP LTR; TYPE OF INSURANCE POLICY NUMBER MMl O/YYYY i MM/OD/YYYY ' LIMITS GENERAL LIABILITY I—' I EACH OCCURRENCE S 11000,000 g COMNERCM GENERAL LIABILITY PREMISES(Ea ooaurencai i$ 50,000 A i CLAIMS-MADE �( OCCUR )BAG1002608 10/16/2010 10/16/2011,M` EQ FxP(Any one persona $ _ 10,000 r— t i PERSONAL&ADV INJURY I S 11000,000 --- !GENERAL AGGREGATE $ 1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: I—' _PRODUCTS-COMPIOP AGG ;S 11000,000 X POLICY PRO LOC _.---- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2oeaoo 11/6/2010 I( accident)Auro 1 $ 1,000,000 ! ;BODILY INJURY(Per S -- ALL OWNED AUTOS _ i X:SGHEDULEDAUTOS j BODILY INJURY(per socw9M) S jPROPERTY DAMAGE i X HIRED AUTOS - (Per accident) '$ NON-0WNED AUTOS S i $ UMBMLIh iJAe OCCUR EACH OCCURRENCE !S 1,000,000 EXCESS LIAB CLAIMS-MADEI AGGREGATE _ i S 1,000,000 DEDUCTIBLE B ^RETENTION $ 023576601 ; 0/16/2010':10/16/2011 :S C '— NtORi(ERSCOMPENSATM chael McCluak eY WC STATU :OTH-I j ! ' ! AND EMPLOYERS'LIABILITY : X y/N TORY LIMITS". R sANY PROPMETOWPARTNERIEXECUTIVE I ! his excluded from coverage. OFFICERfUEMSER£XCLUDED7 Y j N I A I y E.L.EACH ACCIDENT S 500 000 {Man oryinNH) 9930951 10/21/2010;10/21/20i1; iFyyaes,desabeurdar ! ; E.L.DISEASE-EAEMPLOYES;S 500,000 DESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT!$ 500 000 - i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (A#uh ACORD 101,Additional Remarks Schedule,if more space is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (548)?90-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street AUTHORIZEDREPRESENTA71VE Hyannis, MA 02601-3698 Michael Christian/SM5 ACORD 26(2009t09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS026( ) The ACORD name and logo are registered marks of ACORD ' 14 ,�Oylge Office fce o�/^�f�Consumer onsumer A f�f"a i �f,{'aa-'Ran.�•d Business Regulation r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/612011 WILLIAM MUCCLUSLEY ___...............:_.._.____......_. .. . _ . .__ 8201 S. HQURD CT -- - CHAPEL HILL, NC 27518 Update'Address and return card.Mark reason for change. see,}- F .sc a? > Address Renewal " Employment Lost Card {i'U.lft.'l.,gssvlaYlcflli; z tvl._•/`CtLiX.t{fitfdl Office of Consumer Affairs&Business Regulation License or registration valid for individut use only before the expiration date. If found returns to: HOME IMPROVEMENT CONTRACTOR F Office of Consumer Affairs and Business Regulation _ ReBistration: 164432 Type: 10 Park.Plaza-Suite 5170 Expiration: jo/6/2o11 Supplement Card Boston,MA 02116 CAPE SAVE - WILLIAM MUCCLUSLEY:, .7C HUNTING AVE.S.YARMOUTH,MA 02664 Undersecretary Not valid without signature - Department 4)1 pllhlk Nafvl'. S<a;tt�l of 131fildinu d2vulil;t t+uii. anti tat;tlav�l ;:,r .. . :u,.r:r. �:.,- -, .ter-;.:a?:, ...::_:�'•�;. ' use?rrSe: S SL 102776 Restricted to. IC fiX. W1LuAM MC CLUSKY 37 NAUSET ROAD WEST YARMOUTH, MA 02673 E.r.twmiow 6/W2013, , c 08I25:2010 09:23 9193212935 PAGE 01/01 f :CAPE l'SAW Weatherization 508-3 8- 0398 August 22, 2010 To Whom It May Concern: William J. McCluskey is an employee of Cape Save. He is authorized to negotiate contracts and building permits for our.company. t Michael IMcCluskey Cape Save—Owner 919-593-5939 cell X Huntington.Avenue, South Yarmouth,MA 02664 r .Fr 46( `�l �:tii Tl t�L'Ci t ASS.FS T A'CE L-`Nl:RG`z' & H0A1i:- 1-2,I-iI A I1t T 771-540i 0 F (501)790-' 425 POR .f ION TT t on all HOME OWNER WEATHERiZATlON WORK PERMIT&FUEL RELEASE. PLEASE FELL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I M'A LJ Az_ti j hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation(herein after referred as "Agency") on the property located at:- The weatherization,work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping&caulking of windows and doors,insulation of attics, sidewalls&basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows.In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized uiiit on an ongoing basis for no more than five(5)years after the weatherizatiou work is completed. I have read the provisions of this agreement as listed and freely give my consent. Home Owner. (Signature) Date: %ft r ( �ature}ent:Agent- s' t .:. - ,1 Date: .1 it Z i; HAC approved Weatherization Company: �C&L SAV Caliber Building&Remodeling Cape Cod Insulation ape Save Creswell Construction Frontier Energy Solutions Lohr&Sons Peter Smith Resolution Energy Rock Solid Construction All Cope Insulation r , The Town of Barnstable Department of Health, Safety and Environmental Services 1 t ►atvsreetir, Building Division MAE& 1659. �e� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: / 7 Name: l Q G��a-�5 Phone#: 75-—e 3 rJ Z Address: I S l0'2 GJ S Ale . Village: ylm.1-7,11 S P� Ma Lor g 6 3 -7 Type of Business: /�Q 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 dwellingwhich 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,giare,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,have read and agree.with the above restrictions for my home occupation I am registering Applicant: -%% Date• y" G �� /