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0073 VANDERMINT LANE
IC N, 7 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 7/18/17 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permit#B-17-1704 TO: Building Inspector(s), cn This affidavit is to certify that all work completed for 73 Vandermint Lane,Hyannis 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 Ohre Town of Barnstable .-, F �� ra-� BU11Cllil fz. W, 4� .. ' m ` ,.' z?.,3< x"� �s 'u � �� ��� " "` s e��Re-acne on•Job"and this Gard�Mus rbeKe t � 'h g Pos T i Ga_r So€T aT fit�s V�sit�Ig Frpmr tha Stree µApproved Plans Must b t F t ; •p M"� �Post�ed UntllFinai�ins ection Has�Been:Made €, � � � •�� . . � � .� ,n ,', � � 4 � �; E.X r2 - ' rep Ke Mica eofOccu and. .Re trued ch B.utldm Ashalt N.ot be Occu-ie„d-until a•F-.mal Ins ectron hasbeen made Permit ivhe d C rt fi P Y r q ,� B P I? ,.-. •,. . ..,.< �-<��:.»:�.�.,�-.�, ��.-�. �x�, ; may. .. %.;; •:�.., ,.r. �:< ., .�<;, r....�<;�., � � �.,,�. -� . Permit No. B-17-1704 Applicant Name: William McCluskey Approvals Date Issued:. 06/13/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/13/2017 Foundation: Location: 73 VANDERMINT LANE, HYANNIS Map/Lot 250 053 Zoning District: RC-1 Sheathing: Owner on Record: GIOVANGELO ROBERT&JOANNE � �ContractiiName: WILLIAM J MCCLUSKEY Framing: 1 >; Address: 73 VANDERMINT LANE IVA Contractor Lice tse CSSL-102776 2 HYANNIS, MA 02601 Est Project Cost: $5,000.00 Chimney: mm Description: Add R-19, R-30,and R-49 cellulose to the atti �Add R 19 fiberglass to3Pe m it Tee: $85.00 the attic.Add 2" rigid insulation to the basement Dense pack the Insulation. Fee Paid $85.00 walls with R-13 cellulose.Air seal the attic planeand basement with Final: expanding foam. Date 6/13/2017 T � � _. - t Project Review Req: Add R-19, R-30,and R-49 cellulose to thezatti ,.dx- , Plumbing/Gas fiberglass to the attic.Add 2" rigid insulation to the basement - � _ : Rough Plumbing: Dense pack the walls with R-13 cellulose Airsealthe'attic plane � : and basement with expanding foam. Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within s x`�months after issuance. Rough Gas: 1411,9' .. r g All work authorized by this permit shall conform to the approved appl at n and the approved construction documents'fci whit this permit has been granted. All construction,alterations and changes of use of any building and structures.shall be in compliance with the local zonindby laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetA�rad''an od shall be maintained open for pubIi` inspection for the entire duration of the work until the completion of the same. Aellm � � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bu�ldmg andFire Officials are provlded�on thipermit. Service: ,. Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing' Rough' 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: ;:Pecsons:contracting with-unregistered-contractors do not_have-access to the guaranty fund".(as set forth in':MGL c.142A). Fire Department,. . Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT tHE -Town of Barnstable *Permit# '4 Tres 6 months from issue date Regulatory.Services ee BARNSTABLE, v MASS. Richard V.Scali,Director039. t Building Division Paul Roma,Building Commissioner APR ] 4 2017 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us rr1 �� l N 1a S1 4B- V Office: 508-862-4038 +a 0 -7 0=6230 EXPRESS PERMIT APPLICATION_- RESIDENTIAL ONLY Not Valid without Red X-Press I4rint Map/parcel Number Property Address t/�l h �' ► t�T �l: y�„� P't�l G ii to / ` �]Residential Value of Work$ � � Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address R(jbe,+ -MR Z) L.;,141 S Contractor's NameFfT$ UN, Telephone Number Sb� � � �1 Home Improvement Contractor License#(if applicable) >�-1 d� -Email: v �Q C p�� eL�U��k30,(� Construction Supervisor's License#.(if applicable) �� �le j ❑Workman's Compensation Insurance ,; t Check one: _ I am a sole proprietor ❑ I am the Homeowner f have Worker's ComA ensation Insurance Insurances CompanyName GC Workman's Comp.Policy# �.'TJ �a �i� bq 13 t 2yO(I�((® 7 Copy of Insurance Compliance Ciffi taco a must accompany each permit. . Permit 11.quest(check box) , Re-roof(hurricane nailed)(stripping old shingles) All construction debris will.be taken to l�. ❑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: *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 I rovement Contractors License&Construction Supervisors License is r it 4, SIGNATURE: QAWPFn,ESTORMSUilding permit forms\EXPRESS.doc 01/25/17 ; 27ze Coznmornveah*,af Mass ar*=e#ts . pr�lrne�zt trf�n�z�s�iaj�ccide� pf-C,e offmWAkutfrrns 600 WaslTiuiom Street Boston,MA0211I --- tvrvxas.t�:ass=�v�r�ia . Workers° Cumpensafian Insurance Affidavit:Smlderm/CantractursJEIecEricianslPhnmhers AppHcant Infwm=finn Please Print E Iy Adam Pficne Arp you an employer?:Qrerk the appropriate box: Type of project{r . ): I. I am a employer with `"`!) 4 ❑I am a feral contractor and I ❑ . .. P employees an for part-ime * liave hired the sdb- scoabMd 6_ New oo trucEior� 2.❑ I am a sole propdetor argartaer- listed on the attached sheet, 7. ❑Remodeligg. slip and have no employees . IThese sib-contractors have S_ ❑Demolition wa d:ing forme is any capacity- employees and bnre worTners' 9..0 Building addition. [No wodne8'comp_rr=ance comp-ine'±!.zace required-] S:❑ We are a corporation anal its 10:0 Electrical repairs or additions 3111 am.a homeo=w doing aU word officers have exercised their 11-0 Plumbingrepaisa or additions myself[No workers'oomg. right ?0 R of emempfion per MGL 1oofrepairs insurance reqa red_]i employees..[No wodoers' 13_�Other cone.insarance required.] *Axcy sp H-mt&at chefsboa R nmst also f0lovtthe sw ioabd7owshuvdn BLei vmRes'a=penmtf=pmrk-yinftmmauaa- �ameva�ers udso sa6�t Ada[ mix g they*axe tlam�sil oco�sad ],Fse aatadg c�+*a(e,,,�amct su7amit anew sdF a 'mdies±k sow. rCo�cina thst chest ibis boas mast a#ached sa additumat sheer sbousng tyeensme of the sub-ca�c�¢ss and date whether�natthnse errtiRieshaee employees.Ifthe a enLpIo s,cfieymustpm4ide Yhea nor a'flomg.galicy mmnben I am an striplcrPer f7iat is pro�zdircg�vorlrecs'coarperrscdtair ucszirarrce�ar nrya carpfg}�ees BeT-oev is f9�e pmficy roil jib srte i formafran. lasmance company Name: I 131 Tolicg,orSelf-imLi�4: ExpimfionDate: l at%? Job Site A ,,,.,:j� �� �P✓!V1irL Attach a-copy of the workers'compensationpolicy declaration page(showing the policy mmber and expiration date). Failure to securer coverage as requiredi.under Sed4ibn 25A of MGL c�15 can lead to the imiposition of criminal penalties of a fine up to SUM 00 ar dfor o6iy6irimprisonmerd,as well as riVil penalties,ih the form of a STOP WORK ORDERand a fsme of up to Q_00 a day against the violator. Se a&ised that a copy of this statement snap be farumded to the Office of hrvesUgations ofthe DIA,for itis mce coverage verification Ida herezy ramify under&,00PI and r .t)?e ..r}`that the infarma€f U.Prm*i&i abar'a rs mid correct Sitntature: Date Phone i;�-- ` Z)6� 6(o(O d OfiTciaf use arnl�: Da]rat write in this area€cr be c ampfeted by city artown a,WaL My or Ta wn.: Permitff&ense 9n Issuing A ut1writy(drde one): 1.Board of$ealth r.BurTfng Department 3.Cityffown.Clerk 4 Electricdl Inspector S.Ptmbmg EupectDr 6.other Conduct Person: Phone 9: haformation and Ins actions , Mace 7i�tce fs Ge=nl Laws chaps I52 req=w all employers to pravide workem'compensE±ma far V=W employees- 1 pursrzaEIt"LD this stS±C[fB,an C2nPlayee is dcfined as.eve3y person in$te sraPice of another under any eontrazt of fir,, express or implied,and or wutfea" AiL zwpkyer is defined as ran incfiriffiA pm ne�,association,c oxporation or other legal sty,or auY two or more of the faregoiiig emgagedimajointentzpdso,and iacb&og the legal represea ha_ryes of a deceased employer,cr the receaver or t mst ee of aa.mdividm-LL parbxzsbip,association or offer legal entity,employing employees. However the owner of a.dweIIiirg house having not more than tbree agar meats and who rcZues therein,or the octet of the - dwalling house of ano$er who employs persons to do maintm=ce,r1rn*uc t on or repair work on sach dwelling how or on the grounds or bmZdmgappmEeuanftherein shallnotbecanse of such employmentbe deemedto be as employed." MM chapter 152,§25C(t7 also states at"every states or local Rcensiag agency shall withhold$ze issrrance or th renewal of a Ticerxse or permit to operate a business or to construct buildings in the commo :wealth for anp applicant:Who has notproduced acceptable evidence of cdm.Pr=cs WidL the hmurance cove;rzge required." Additionally,M(H-chapter 152,§25C(7)states-Neither the caonnouwcala nor a"uy ofits poIiiical subd3vi_sims shall an inin any contract for t1m perm=mance ofpublic work mmI acceptable evidence of compliance witfi the fi=raace.. raTaiirme nts of this chapter have Been presCZdCd to tine confra og anihozity.-" Applicants Please fal Out tbL5 woIIeas'compensation affidavit completely,by dxecTs:ing the boxes ffiat apply to your situation and,if necessazy,supply sub-contractors)name(s), addresses)andphone=nmber(s) alongw&their=tficate(s)of h,crnance- Limited Liabr7ity Companies(LLC)or Lmnted Liability Partnesslnps(LIP)WE&= es:EPIoyees other than the members or pmineas,am not regtmed to carry workers'compensation iasaranoe_ If an IJ C or LLP does have loyees,apolicy isrmpa-ed. Be advised that this a$tda�rtmaybe smbmrtie hdtotte Department of Indus trial emp Accidents for confirmation of insurance coverage. Also be sure to sign and data the affida lit The affidavit should be refrmmed to$e city or town that the application for the permit or license is being requested,not the D eP arhnent of Lndastuj A�:cide�s. Shnnldyon free any goes ohs regarding rite Ia�Y or ifyoia ate xcq¢a- ir ed is obtain a workers' comp=ationpoIiep,please,calliheDepartmeotatthemmmberlisfedbelow. Self-insuledeompaniessTionld enter th5 self-;,,CR-. ce license=bw on the appragaaiE lime. City ar Town Officials f _ Please be sere that the affidavit is complete,and prhcted-legibly. The Depa imemthas provided a space at the bottom of the afffidavit for you to fill out m the event the Office of lnvesfigaiions has to con aatyou regerding the applicant Please:be s=to fill ill the pe n/license rnmber which will be used as a refmmce number. Iu addition,as applicant $$at must submit multiple pemmtllicense apphtations m any gm a year,need only submit one affidavit MAIcatng cent policy information(if necessazy)and under`mob Site Adams"the applicant should v zhe"all locations in (cry or town):'A copy of the-affidavit that has been officially stamped or mimed by the city or mown may be provided to the " applicant as-Proo-fthat a valid affidavit is on file for frtm e permits or licenses Anew affidavitmust be filled.oaf eaCh year.Where a home owner or citizen is obtaining a license or pemlit not relatsd in any business or commercial vet (LD.a dog license orpermit to bum leaves eta.)said person is XOTreqiied to complete this affidavit The Office of Investigations wouldlilm to thank you in.advance for your cooperaEion and should you have:any questions, please do not hesh3fm to give us a call. The DeRartmemfs a ddxem.telephone and fax number: COMMOMVMaI*of MBS�r Dq=tMMt of 1 AwUenfa Bosom MA 02111 Tel.4 617-' -4 Wt*6 or NW-MA GAF Fax 617`27 7M revised 424--07 F 9Pg1d �"E Town of Barnstable Regulatory Services MAM Richard V.Scali,Director ►� Building Division, Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4039 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 0 L ✓��'�� , as Owner of the subject property . hereby authorize to to act on ray behalf; in all mattersrrelative 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 Lutilized before fence is installed and all final inspections are performed and accepted. Signature o er Signature o'Applicant Print Name Print Name Date QYORMS:OVINERPERMISSIONPOOLS Town of Barnstable Regulatory Services eOF Richard V.Scali,Director Building Division I . s Paul Roma,Building Commissioner NAM 039. �� 200 Main Street, Hyannis,MA 02601 fp 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 sgRervisor. 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 __ M 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 DN TE CERTIFICATE OF LIABILITY INSURANCE DA04/114/20117Y) 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 certiflcate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 endorsements. PRODUCER - NEE, Erica H.O'Connor HART INSURANCE AGENCY,INC. PHONE Fax 243 MAIN STREET AIC No): PO BOX 700 ADDRESS, eoconnor@hartinsuranceagency.com BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: SAFETY INSURANCE COMPANY 39454 INSURED Scott Lohr dba Lohr Home Improvement INSURER B: ACADIA INSURANCE COMPANY 31325 23 Grand Oak Rd Forestdale,MA 02644 INSURER C: INSURER D: INSURER E: INSURER F- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTRPOLICY NUMBER LIMBS A COMMERCIAL GENERAL LIABILITY SMA0024755 01/08/2017 01/08/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FV OCCUR DAMAGE 1(RENTED 100,000 PREMISES Ea occurrence) c unence) $ MED EXP(Any one person $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑jET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR Fl_CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION ASSIGN201704131240119687 04/13/2017 04/13/2018 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE R ANY PROPRIETOR/PARTNER/EXECUTIVE = E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 Use describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORQEDREPRESENTATIVE � I� 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I Massachusetts-Departmetit'of Public Safety Board of Buiidong Regul;ations:.and:Stantla�ds �OnStp'1I.CtitiA9s/111Cii49Sfi.t' .�.� License: CS-MO61-` `40':r,rs 4' SCOTT A LOI3R `• tiro 23 GRAND OAK. D limit. t. Forestdale MA QaW .y �j S Jri1�1`� Expiration Commissioner 06/09/2017 .. .... Y�rnerrirtivnara�/�r/C''.7lrt�rir�,eruG// b*lce ortonsumcr Affairs&Business Regulation License or registration yWid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If f6und return to: Regii'tratlon 1.72172 Type: Office of Consumer Affairs and Business Regulation Expiration 5131/2018 DBA 10 Park Plaza-Suite 5170 F' Boston,MA 02116 LOHR HOME IMPROVEMENT` SCOTT LOHR 23 GRAND OAK RD FOREST DALE,MA 02644 Undersecretary Not slid without signature i : R. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost $40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by.M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main-St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) required by law. and get the Business Certificate that is. DATE:7- l IJ Fill in please: APPLICANT'S YOUR NAME/S: E7ZT G/D/i + BUSINESS YOUR HOME ADDRESS: 7 3 �/�' N T LCr A, TELEPHONE #- Home Telephone Number 5--C) w NAME OF CORPORATION: CM NAME OF NEW BUSINESS il/ --E TYPE OF BUSINESS_ T2uck V IS THIS A HOME OCCUPATION_ ? YE5 NQ 14y '11; ✓17s4 _ _ ADDRESS OF BUSINESS 'A, .,Z- MAP/PARCEL.NUMBER BS `�j (Assessing) Whan starting aL new business there are;severel things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the.information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd_ & Main Street) .to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE . This individual has been informed of'any permit requirements that pertain to this type.of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has.been informed of the permit requirements that pertain to this type of business, Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY] This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS:- 71 1 / or) �� 4 _ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) � 9 DATE: cJ ' a I' C) P Fill in please: APPLICANT'S YOUR NAME S: -)06-n n e- C_ + o v 0,n ? r BUSINESS YOUR HOME ADDRESS: 73 VaT cte rh ' (_6L el 5`o8g5la�©039 kiCLV"ri bH 0a)_ r TELEPHONE # Home Telephone Number ��,c� Y, -7"7! - -1 5$5 NAME OF CORPORATION: NAME OF NEW BUSINESS7T"hp,"I�oTYPE OF BUSINESSC� IS THIS A HOME OCCUPATION?' l YES NO T— ADDRESS OF BUSINESS3 `- C -1=ar� i'� ►��a5s..' .; M4P/PARCEL NUMBER b` [gssess(ng) When starting a new business-there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. ,BUILDING COMMISSIONER'S OFFICE This individual has b of ed of y permit requirements that pertain to this ty"�`dt3MF,LY WITH HOME OCCUPATION Authorized Signature** RULES AND REGULATIONS. FAILURE TO COMMENTS: COMPLY MAY RESULT IN FINES. 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business.. Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: e0 sd ' Town of Barnstable Regulatory Services �SNE Tp� Thomas F.Geiler,Director BuildingDivisionsnrwsTesr.e. ; v M^-R& �,* Tom Perry,Building Commissioner �iDtEp ►�� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: 5�— Permit#: D HOME OCCUPATION REGISTRATION Date: Nanne: n V Phone Address: Village: Name of Business: "W Type of Business R-0't-'� Map/Lot: �`) INTENT: It is the intent of this section to allow the residents of the Tomi of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning orduiance, 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 prenises wlicln would suggest anything other than a residential use;no uncrease in traffic above normal residential volumes; and no increase in air or groundin,ter pollution. After registration Arith 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 dwellinng unit,located iaithirn 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 twill be generated ran 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 sanne lot containing the Customary Home Occupation,and not A itliin the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial velicles 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 iin length mica 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 mid agree n ith the above restrictions for my home.occupation I a n registering. s Applicant d2eDate: �6� I Homeoc.doc Re%- /3/08