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Home My WebLink About0005 WHITEHALL WAY 1_ t' __ Town of Barnstable Building Department Brian Florence, CBO Building Commissioner- 200 Main Street;Hyannis, MA 02601 . .www.town.bamstable.ma.us ' Pre-application for,Business Certificate Date C2- _ Zl� hy ? Parcel .Applicant Information Applica�.Address• :'s 1�V V1�1�P'_n yq Telephone Nmmbea 4q)?)- 'S60`T Ll CI Z 1 Listed 0 Unlisted❑ Business Information NewBusmess? ----------------------------------------- Yes No Business is aregiskmd corporation? ---------- -----------:. Yes No if yes Name of corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ No If yes then a Home Occupation Registration is regdmd—See Building Division Staff Name ofBusiness� �lfl' (1P?C7\ Business Address Type ofBusiness Bmldmg Commissioner Office Use Only Conditions Building Commissioner Date I Clerk Office Use Only Town of Barnstable Building Department Brian Florence,CBO Building Commissioner sARNsresr.E, 200 Main Street,Hyannis,MA 02601 MA 039. `0� www.town.barnstable.ma.us AEG MA'1 A Office: 508-862-4038 Fax:,508-790-6230 Approved: Fee: Permit# HOME OCCUPATION RRGISTRATIO Date:02-V " Name: (r U l Phone#: � '�l 9 Z. Address: ko(` Village: H V CA ID V1 t S Name of Business: 3 b{TAh 1r5 Type of Business: �Q`�l �1� irn W� 1 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. E • 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 undersi ed,ha e r ad and agree with the above restrictions for my home occupation I am registering. Applicant: ' Date: _ V Homeoe.doc Rev.10117 X-PRESS PERMIT FEB 12 2020 TOWN OF BARNSTABLE , TOWN OF BARNSTABLE 200 Main St, Hyannis.MA 02601 08/24/2019 To whom it may concern, This letter is to request the creation of a business name under "3 BRQTHERS TRASH.&JUNK REMOVAL". We will pick up residential trash twice a week and then dispose it,at the Barnstable Transfer Station with a pickup truck, this=will-happeO. Ayf1�,',„ Thursday. J ,....,?;'.>>,L..a.r. ,�.:,u;r,7u;!c)•!.EI.V:i glj.:gSn;,aiV!i h;dY!pie f:;;r:.�A!:iy Our hours of operation will be: Mondays 8:00am to.10 OOa,m_and...Th.u.rsda<ys...8..;QQa.m h 10:00 am. I acknowledge the following: u5eS - Home office - 1 Vehicle only - No rubbish at home - No metal/junk, scrapping or storage - No employees a, Vehicle will be emptied daily No signs X-PRESS PERMIT FEB 12 2020 Warm regards, TOWN OF BABNSTABLE i Mario Lliguich zhca President The mmonw Ith of Massachusetts On this AA day of ,20 I�'1 before me,the undersigned.no public, r rA hu hxcc— _-- —---a— personally appeared,proved to me Wough z LL satlstrlclWry evld�npe of 1dNdlllcatiop,which were KARENINA FERNANDEZ to be the person whoss name Is " Notary Public,Commonwealth of Massachusetts signed.on an preceding or attach; document,and acknowledged �® Ply rr.mr.ission Expires March 30,2023 to me that 1410W signed it vol rly r Ms stated purpose. ��h otary Public my Commission expires o' �D 1 a c -1) Nk s ev"4 r '" ° ' , z z r TOWN OF BARNSTABLE 200 Main St, Hyannis MA 02601 02/12/2020 To whom it may concern, This letter is to request the creation of a business name under "3 BROTHERS TRASH & JUNK REMOVAL'. We will pick up residential trash twice a week and then dispose it at the Yarmouth Transfer Station with a pickup truck, this will happen every Monday and Thursday. Our hours of operation will be: Mondays 8:OOam.to 10:OOam and Thursdays B:OOam to 10:00 am. , I acknowledge the following uses limited to: - Home office - 1 Vehicle only - No rubbish at home - No metal/junk, scrapping or storage V Y@t S�. ,7",i R� 77,77F A�2 '' 4 4 ., • ria 4 x Vi V rV . ' tea •�Brae-� a �.,�, .o� �;-, �~�n �as . c = 4 i M �. ^:�. 0,1V a - No employees - Vehicle will be emptied daily, No signs X-PRESS PERMIT Warm regards, FEB 12 2020 TOWN OF BARNSTABLE CG. ube Lli uichuz ca President on tills (2 ' day of Qb Ua 20 20 n' before me,the undersigned notary public,personally appeared CR 6 1, L) Proved to me through satisfactory evidence of idanbticabo?f,which A KARENIN FE NIAN®EZ p�I� I Notary Public,Commonwealth of Massachusetts Were HA D(;VQ(lfn.� � My Commission Expires March30,2023 o be the Person signed on the preceding or attached document,and acicnowledg3e name is Ro me ttsat the)(she)signed.k voluntarily for tts stated purpose, ^ Town of Barnstable -� Building Department Z(9 S Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us MUST COMPS-y WITH HOME OCCUPATION LES AND REGULATION Pre-application for Business l �fcY RESULT IN FINES. Date M /1 ap �,J U Parcel Applicant Information Applicants Name I ► (0(r-t o JI C-43�, Applicants Address-5 �iA m�aiPA( ress 3b(P TC(, 1 j6 M6.\� Telephone Number cl�509-640 --Mo Listed ❑ Unlisted ❑ t . Business Information New Business? - es No Business is a registered corporation? ________:P______________. Yes , If yes Name of Corporation Does business-operate under the registered corporate name? Yes Is the business a sole proprietorship or home occupation? _-________ es) No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business 3 B f o Sh 4- Ao1\1L Business Address Type of Business '"Tr&,<L -\CJ!lg �Ut/YA�I Building CommissipAer Office Use Only Conditions , ✓ A c CIN ,, t 4 (c>>„t U M � s CC - c2 i a ✓d7-t a Building Commissioner Date - fs Z 1 Clerk Office Use Only Town of Barnstable ' MUST COMPLY WITH HOME OCCUPATION Building Departm*BtES AND REGULATIONS. LY MAY RESl�LT 14 FINESLURE TO �oFSHe ram, Brian Florence,CBOCOMP ti o� Building Commissioner . EAxNs•rnsLE, 200 Main Street,Hyannis,MA'02601 9 Mass. 1639. www.town.barnstable.ma.us �PIfD MAj A ' Office: 508-862-4038 Fax: 508-790-6230 Approved: /?)9 3 Fee: 3 S Permit#: PS ' ►1 —cR HOME OCCUPATION REGISTRATION Date: C9oC. l Z Name:Mal In L.LIpQtQ- UZ�CC* Phone#: Address: Jr �/l l t C'_� a tt W Q X Village: \ �`L Vl Vl l E`1Q Name of Business: 3'8 R -T«p— S P— l' 0 V OL Type of Business: 1 Y g s J ay Ve mp-yg .Map/Lot: �✓ D 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,subj ect to the provisions of Section 4-1 A 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 riot to exceed 20 feet in length and not to exceed 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 7andae th the boove restrictions foamy home occupation I am registering. Applicant: ,s,�s° r'L CDC .Date: Romeoc.doc Rev.10/17 'FS54 .j 3 `'a y3" ,,,Ff fi ,' +✓` ) >d r } _ ""x..'h a+ 'i L' St '��e ��*1#r6� fi �4�� 3�'�� '&at�r�` �' .�s �a• ��a" �_� �h'ai a �d§ �g�� a�� s _ ,�n# � t� f} :,+a s t� �,� •bad ��'�t},,k,.j,4xh .. 3 BROTHERS TRASH & JUNK REMOVAL : Whitehall Way, Hyannis MA 02601 � < � �y'?•. e d ?� r ;� w'• -a x;, raq $^4 � k� '' �� 4'�8# �€_�t 3E.c f�> . 3brotherstrash@gmail com t �'�1£'� i � x 4 Z f ��"'k ��q� va•;`� k '3h`'§R`�, .gpxT ,M �. w 1y; f y w F � jig s, Vehicle will be emptied daily No signs Warm regards, f Mario Lliguich zhca President The C mmonwe�Ith of Massachusetts On this day of.�LB 20 before me,the undersigned nota public, personally appeared,proved to"thiough' sat evidhenpe of Identification,which were KARENINA FERNANDEZ to be the person whose name is " Notary Public,Commonwealth of Massachusetts signed on Ow preceding or attached document,and acknowledged My Crmrrission Expires March 30,2023 to me that he/she signed It volt' rly r Rs stated purpose. 1 , =Ih4t6 f�lfr&M otary Public My ntm ss on Expires a' �Dla_ _ � rO ag M rd � }u4s 4.9 I t ma a a 3 TOWN OF BARNSTABLE 200 Main St, Hyannis MA 02601 To whom it may concern, This letter is to request the creation of a business name under "3 BROTHERS TRASH &JUNK REMOVAL". We will pick up residential trash twice a week and then dispose it at the Barnstable Transfer Station with a pickup truck, this will happen every Monday and , Thursday. Our hours of operation will be: Mondays 8:00am to 10:00am and Thursdays 8:00am to 10:00 am. Warm regards, /V67'o 14'- Mario Lligu�huzhca President 0 of Q19 RUG 23 34 w J (LL;er-CtIL fit 0r'a yD—�Z41AI TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' Map O Parcel Z Permit# � o� Health Division Date I sued Conservation Division f4 Y.- Fee G3 Tax Collector - Treasurer � t t/ l� - - APPUCPVT MAST OBTAIN A SEWER + Planning Dept. 4 Coy ; tr,R.TVIT FROM THE ENG" J DMSION PRIOR TO Date Definitive,Plan Approved by Planning Board CONSTRUCTION. Historic-OKHi Preservation/Hyannis E Project Street Address ad 4. Village VA a 1 S 94 d < ' Owner Aas-elj� 15 n C/k aA t Address b�- STreef U-)bra, Telephone �L ia— rF4 Permit Request &Oa \/ r 1 a i rt) 4jc te� Square feet: 1 st floor:existing proposeTa 2nd floor: existing proposed, —0 Total newer= Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Y'11�'Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: U/Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) "0' Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing ! new Number of Bedrooms: existing new n Total Room Count(not including baths): existing -/ new First Floor Room Count Heat Type and Fuel: 0- as Cl Oil ❑ Electric ❑Other Central Air: ❑Yes YNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0' 0 y Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:O existing ❑new size Attached garage: existing ❑new size (;�J Shed:❑existing ❑new size Other: l CA/.Z Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use J'n-ev to �f///Ne1� ��: BUILDER INFORMATION Name er1C12!A Se rvtcc S Telephone Number. Address, D ,94�.P��-�-C. 3�t i License# 9-3 Home Improvement Contractor# Worker's Compensation# 6X3/S / ;30 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 0.5�O 0 FOR OFFICIAL USE ONLY PERMIT.NO. DATE ISSUED i MAP/PARCEL NO. ADDRESS _VILLAGE OWNER` f-F DATE OF INSPECTION:` - 4 FOUNDATION FRAME INSULATIONYn > FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL } - GAS: - ROUGH - FINAL s ., r r{ FINAL BUILDINGS - DATE'CLOSED OUT ' ASSOCIATION PLAN NO. , -- ^r f The Commonwealth of Massachusetts Department of Industrial Accidents =-" Office o//n0e5 0899HS �. I ' 600 Washington Street 'a Boston Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: city __-phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole Pr rietor and have no one working in airV achy I am an em to er roviding workers' compensation for my employees working.on this job.: . :.`A ./�a:�.4i::::::i::..'•i2 '::>:.:.::;: :.:i::...`'' :::: .:......:................ k> `> :. f addre ;:.;:.::;.:.;:::.;::.::;.;:;...:.:.::::::.:::::.:::......... :.:: ::: ::.... :..:.. ::: :.:... cites l phone# ,. alien# tnsurance>co. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: com anv name:. ,:;:•;:.;.;;:: ;;:>;:::. ::.,..;:�: ........... :.:<.;::::»:«:>::>:>:<::><:::>::::::::::>:;«::«::::::«::>::< :: ::>:......::::<:::>::>::»:<:::»:>.:> city, ro ::>:<:: :. Insnrance:ca:;. :::: .... ::.:.:.,..,:. ......:, ...:.: .. . . _ X. ........._... XX address. >:: city- :: bneE. ....,... »:::<:.:«:>.: ::».< ;.:»>::>::>::>::::..:>::>>.::«:»»::>.:>::»::.:.<:<::»:.....:::::::>;:«: rev# intaranceco �:::: Fsflnre to secure coverage a'required m�der Section 25A of MGL 152 can lead to the imposition of crimnwi penalties of a Sue to SI,500.00 and/or one year'+imprisonment as well as dvfl penalties in the form ota STOP`WORK ORDER and a Sue of 5100.00 a day against me. I mtderstsnd that a copy of this statement may be forwarded to the Office otInvestigations of the DIA for coverage vetiScation I do hereby certi under the pains and penalti of perj that the information provided above is truo and correct L.,-- � ��/iU/o� Signature Date - Print name •IV v , Phone#y��8 �� 24 ON offlcial use only do not write in this area to be completed by city,or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Others_ (revised 9/95 PIA) f Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance 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. City or Towns 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. The affidavits may be returned io 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 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 _ 0MC6 of inllesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 M CMR Appendnt J f Table JLLIb(condoned) pmcriptive Packga for One and Two-Family Residential Buildings Heated with Fossil Fueb MAXIMUM MINIMUM Glazing Glazing Mfg Wall Floor Basaaeat Slab 1i ig/Cooli g �'(%) U-value= R vdUW R value' R value' wall � �� Package R value` R value 5101 to 6500 Heating Degree Days' Q 12% 0.40 38 13 1 19 10 6 Normal R 12% O.52 30 19 1 19 10 6 Now S 12% 0.50 38 13 1 19 10 6 85 AFUE T 15% 0.36 38 13 4 25 WA WA Normal U 15% 0.46 38 19 1 19 10 6 Normal V 15•/. OA4 38 13 25 WA WA 85 AFUE W 15% 0.52 30 19 19 10 6 8S AFUE X 19% 0M 38 13 2S WA WA Nominal Y 18% 0.42 38 19 25 WA NIA No Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18•/. . 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: SI- 4. %GLAZING AREA(#3 DIVIDED.BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J8.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 W of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus iinsulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `Tl:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned ba cements must be included with the other glazing. Basement doors must meet the door U-value requirement d..scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 �f THE Tp� The Town o f Barnstable {ASiVSTABI.E. MAS& g Department of Health Safety and Environmental Services 9�A s63v �.� Building Division lED MA{ 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissior.e: Fax: 508-790-6230 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. 7- s� PREIV f S timated Cost Type of Work: Address of Work: Owner's Name: �� r Date of Application: O I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law Job Under S 1,000 ❑Building 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 IMPROVEMENTG WAD DER HAVE ACCESS 142a. ACCESS TO THE ARBITRATION PROGRAM OR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as a agent of the owner. a 3 Z d Registration No. ate Contract Name OR Date Owner's Name q:forms:AfSdav rt -, BOARD OF BUILDING REGULATIONS ma License: CONSTRUCTION SUPERVISOR �► Number. CS 058893 *. Expires: 01/28/2002 Tr.no: 16970 Restricted To: 00 JACOB M PANEK 155 MAIN ST L•�� ACUSHNET, MA 02743 Administrator - <`� ✓/ie'C9omrnooei��eal�o�✓�Uiw�w.A��ld �\ HOME IMPROVENENT CONTRACTOR o Registration: 115103 . Expiration: 12/9/01 Type: . Individual KEVIN H. SHUTKUFSKI ' G� �o IN SHUTKUFSKI ADMINISTRATOR �y�H MacARTHUR BLVD POCASSET NA 02559 f ble *Permit# oFINE rqt, Town of Barnsta - �y ti0 Expires 6 months from issue date Regulatory Services Fee t l/ BARNS'rABM g Y 1"W. Thomas F.Geiler,Director Building Division t Elbert C Ulshoeffer,Jr. Building Commissioner. ' 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION f Not Valid without Red X-Press Imprint Map/parcel Number C�:,�® ('0 1 Property Address [ s.idential OR ❑Commercial Value of Work Gwttet's i�4i..o�.�-.ddress d -f 6-6-1- M; TelephonFN Contractor's Name ( umber7St? - Z� J -- r Home Improvement Contractor License#(if applicable) -' Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance g. " of Check one: ❑ I am a sole proprietor ❑ I am the Homeowner Ej_Lbave-W`"orker's Compensation Insurance Insurance Company Name lz7 ,e B Workman's Comp.Policy# C 7- 2 Permit Request(check box) �j Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) w ❑ Re side y �" (-Rep-facement Windows. U-Value (maximum.44) 1 ❑ Other(specify) 'OV G f . Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation..etc. { *Where required: ti 1 Signa expmtrg '^o The Commonwealth of Massachusetts Department of Industrial Accidents =_ Office offnyesffffin oos �14 _ _ ">'� 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidawit ro name: r- .) 6.S-P D I1 1K rr d� t� L location: I A) city so f -4414 ❑ I am a om owner performing all work mvself. ❑ I am a sole p roprietor and have no one working in any capacity =////%%%%/ % //////////////% %%%%/%%%%%%%%%/%��%////O/%////%%///%////%//%%//%/%//l/%%/%////��%%%//%%/%/%////%/lJ�'�l%%/%%%%��%�%%%%%�%%%%%%%�/%%/�%///.. �n employ er providing workers compensation for my employees working on this job. _ company no address. ,-7 phone# insurance co.::: ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: company>name: r ;:<: :.::: ;:::::::;;:.;: .........::......... .. .. .. .... _. - _. _. __.... situ phone#. .._..... . .... _... .......... -._. _. >.>:>:: :.::: ::::. tnsnranceca. ohcv# ... :...:.. ....:.: .: ::: �//l//I%% comnanvname: =' ------------- address: city: phone#. .. ...::.. :: .. ... ... nrance<co: ins olicv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criaonal penalties of a Sue up to 51;500.00 andlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.06 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do he enalties of perjury that the information provided above is true and correct l� Signa Date '�^ S 0 Q Print name Phone# official us:ondo rite in this area to be completed by city or town official city or tow permit/license 4 ❑Buildin Department g p ❑checke u re aired ❑Licensing Board 4 ❑Selectrnen's Office❑Health Departmentcontact pe phone#; ❑Other (rcmed 9/95 P1A) - - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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, 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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance 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. City or Towns 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. The affidavits may be retained io ... 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 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 i Office of investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 SOLD, FURNISHED & INSTALLED BY Sales: 1-866-466-3853 ® ® oo Bil-Ray Aluminum Siding Corp. Service/Repairs: ® of Queens, Inc. 1-888-245-7294 11 12320449 190 Cedar Hill Road • Marlboro. MA 01752 JOB# S� 73 I [MAINE LIC.NO.DD1893-NH LIC.NO. - •MASSACHUSETTS LIC.NO.120456•VERMONT LIC.NO. •RHODE ISLAND LIC.NO.13707 NEW YORK CITY DEPARTMENT OF CONSUMER AFFAIRS LIC.NO.0730686 • NASSAU LIC.NO.H2704150000 - SUFFOLK LIC.NO.21194HI•YONKERS 1397•PUTNAM.PC934 WESTCHESTER WC0613-1187 LONG BEACH GC2001 • NEW JERSEY LIC. NO. 9949269 • CONNECTICUT DEPARTMENT OF-CONSUMER AFFAIRS LIC. NO. 00532774 SOLD WINDOW :CONTRACT . TO ✓J /�/� �C / DATE ADDRESS / /I!/ /�/ -�� CITY Lt I r� G�k STATE �JJ ZIP l -f� . ell PHONE HOME( WORK h ) EMAIL J JOB SITE ADDRESS (IF DIFFERENT) APPLIE VINYL VANDO SYSTEMS General Description of Work Abov Address: � ' Type of House: Cframe ❑Masonry Approx Start Date - Approx Completion Date (WEATHER&MATERIALS PERMITTING) e ' Approved materials will be furnished and installed to these specifications. PLEASE READ CAREFULLY:ONLY ITEMS CHECKED"YES"ARE INCLUDED IN YOUR ORDER. YES YES NO 1. �� REMOVE WINDOWS from opening where they now exist on: 22. ❑ 'SPECIAL ORDER Windows(in Addition to Above) ( 2. lr'LJ FIRST LEVEL #Openings //� #New Window Units 3. per❑ ECOND LEVEL #Openings�_ #New Window Units 7 ® 4. ❑ GIRD LEVEL #Openings #New Window Units �/ clkz 5. ❑ I�A EMENT #Openings #New Window Units 23. El ❑ CLEAN UP-All job related debris will be removed from property 6. ❑ ER #Openings #New Window Units on completion of work;REMOVE AND DISPOSE of existing windows 7. ❑ REMOVAL OF METAL or other units requiring modified installation and/or storm windows #Openings • #of Units ;24._ INSURANCE-All workman's compensation and liability is maintained 8. ❑ Install new PAINTABLE MOULDINGS , 25. �A WARRANTY-Mailedto customer upon completion andfull payment is received Inside Stops. #of Openings 26 Ia PAYMENTS-(On non-financed orders)is payable to installer on P _ day:of installation f . amshell or Casing #of Openings 27 r Addition formation ✓e. 9. Install new MASTER FRAME ±' ❑ � ME #of 0 enin �s 10. New window units to have❑ FUSION WEL DED SASH 11. WeU New window units to have FUSION WELDED FRAME # 12. ❑ New window units include Insulated Glass 7/8"total thickness dh the following INSULATED GLASS OPTIONS: ❑ 112a.) Triple Glaze Double Low E Krypton filled R-10 rating(includes 28. ❑ Ut4ork Not to Be Done injected foam insulated sashes&frames) #of Units ❑ Ugell Triple Glaze Single Low E Argon/Krypton filled R-6 rating . #of Units 1 �7 ❑ 12c.) Double Glaze Single Low E Argon filled #of Units:--/--/ ❑ 2112d.),Sun Clean Glass_(on exterior)�❑ #of Units= 13. New window units to have CAM LOCK(s)or LATCH LOCK(s) 14. l&'❑ New window units to have NIGHTNENT LATCHES 2 15. p Wp T ew window units to have OBSCURED GLASS �AQ Full Ll 1/2 ��'�� INDICATE FGRM F PAYMENT 16. CV-Q New window units to have HALF(1/2)SCREEN Deposit With Order 33% $ (full screen on casement type window) a 17. iVLJ Windows to have GRIDS Colonial Dia and Payment on / III ❑1/2. Additional info 47 4�%F;JN 161�p :!�65A Measure or Start 3,A $ / r f 18. 916 Install PVC COPATED ALUMINUM to window frames . Balance Due on #of openings _ Substantial Com ; tlM 19. CA P 34% $ CAULK AND SEAL windows with 3 point system If financed, balance a able in month) � 20. Qr❑ COLOR OF WINDOWS to be It2'�/hite. ❑Timbertone OSandtone --P y y installments of approximately $ per month, payable by "Owner" to contractor, 21. V0 Total#Double Hungs J_ Total#Two Lite Sliders but if financed by Owner then Owner will pay said amount to the lending plus such Total#Casements Total#Three Lit eSliders = • interest--and credit service charge of said lending Institution payable directly to the lendinQ institution loaning such monies Total#Hoppers Total#Dead Lite/Pictures I All`Otscounts Have Total#Awnings Total#Basement Sliders o i Owner" and wi I execute a Retail Installment enen ApPltea. obligation and any documents required by such Deterred Payment . ` Standard or Equal lending institution in connection with said loan. Interasimlill Accrue *CANTRACTOR IS NOT RESPONSIBLE FQFt`ANY EXtSTING'SEGURtTXSYSTEMIS PLEASE FtEMAOYEALL St{kDES,VERTIG4LS; BLINDS, CURTAINS, DRAPES OR WINDOW MOUNTED AIR CONDITIONERS, PRIOR TO THE,INSTALLATION QPYOUR"NEW Vv WINDOWS. INSTALLERS ARE NOT RESPONSIBLE FOR THE REMOVAL OR INSTALLATION OF THESE TYPES OF ITEMS.... Notice: If financed, any holder of this Consumer Credit Contract is subject CONDENSATION INSIDE_THE HOUSE DOES NOT INDICATE A WARRANTY to all claims and defenses which the debtor could assert against the seller PROBLEM. of goods.or services obtained,pursuant hereto or with the proceeds hereof. _ __ Recovery by the debtor shall not-exceed.amounts paid by debtor hereunder. SALESMAN HAS NO AUTHORITY TO CHANGE ANY ITEMS OR MAKE ANY "OWNER REPRESENTS TO HAVE READ AND RECEIVED A DUPLICATE REPRESENTATIONS OTHER THAN CONTAINED IN THIS AGREEMENT AND ORIGINAL OF THIS AGREEMENT AND TO BE THE AUTHORIZED AGENT OF ALL "OWNER"REPRESENTS THAT NONE HAVE BEEN MADE TO OR RELIED UPON "OWNERS" OF THIS PROPERTY UPON WHICH THE WORK OR THE BY "OWNER".YOU ARE ENTITLED TO A COMPLETELY FILLED IN DUPLICATE MATERIAL S ARE TO BE SUPPLIED. NOTICE TO THE HOME OWNER( , 0 RIGINAL OF THIS AGREEMENT. GUARANTOR(S), LESSEE(S), CO-SIGNER(S).„ "YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR Contractor,at the expense of owner, shall procure all permits required bylaw. TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS blank 1. not sign this agreement before you read it or if it contains any TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN blank spaces or it it does not contain everything agreed upon. EXPLANATION OF THIS RIGHT. ON ALL ORDERS CANCELED AFTER THE 2. Any person who shall have co-signed, guaranteed or signed any RECESSION PERIOD, CUSTOMERS WILL BE RESPONSIBLE FOR A 45% credit application note relating to this agreement hereby accepts ADMINISTRATIVE AND RESTOCKING FEE." to be bound by thisis agreement. 3. Owner (s) represents that the contents on the back of this agreement SEE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS:`BY. y is a true part hereof and has been read and accepted by Owner. SIGNATURE BELOW, CUSTOMER AGREES TO THE TERMS OUTLINED ON.THE. 4. ALL INSTALLATION LABOR GUARANTEED 1 (ONE) YEAR. REVERSE OF THIS CONTRACT. DATE 4//3011 � Contractor Accepted Print ^o � �^�'L,�� (Sig natu Salesman's Named J Cl Signature X,9�� (Customer Sign Here) License No. Signature 02004 Bit Ray Group All Rights Reserved 0504 (Customer Sign Here) 9 1 , r1 u."gyp ,r �,MA1d1 � n • En�I ��will� •:�p��,,� �ac v�.- "�' 6 ��' pow 4 1 in ny poll OR WIF 4 YWRI ju b -`- .� !j ...}. ■ ` ..4 z 1 1 x41 ' 'k _ ,.... , • - - �-.. �,q_.t3�giu'Idiag�°I-'-COt�I'fR��QRr d: jZDq lament cgal , . -- - _ PAl7 Y . in OF .4032 OCT, + '�+s�, ':11 ` a Ii► 1 3 •.,, �� :, N C 4*.5 ul�Ap A gap 4RRx PVI, -Up r RMil91'a 1F N I Np pop, '1109 90Ov I I r R1 C490.Avonq S° lat �i°° � `1�" i `. 1�1 1d'PHD�I�1Rp k7q"T�1" FIX? 111� Nlap . �ia:�h� �rara� �' ��R�� I • I � T • , ��.>a�•,�:��,IaM+�1S��i��'�7 �� t��,�<��.�a j,i�,r ,-�� '�� }, I;x��'�� P Ihlf>118 I!(E11� hn+NmrnrYtlnne,lmtvn v v:. " W111 Arc 1%i�l9ll�1 7 Aa�a�I711 lap IJ�,, Frrn•.�••T•rtrwnrrt�m7! �nsgefT}�.. TrllsRtatipl��RAIN I� _ _ �l � to � a Ld HMI'._` ! 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AM . tocq un�ptT sf rACH t9ccUR Y D=IR L G,�Itd5ltilH?: RGGREph?E hEtl . - Yy-i � Li •t . ' WORKDi'ne�Q.t}6tp5N9�gT�QNr'4i�tli --- -- �[ TDRY 1 xmr1� Fs uwtl tTr nc�,oeNT s Su . � 1<L,LI.�'iEgBL-LR2`AIPLD 3�D:�i >:1.DD ' Et.n,sEAsP•POU UMI> i$vo,bob Of}i4R .e.nr. r "t,' t9 a�n�.bi�,�.y Y�a��:� �:7��.'p� ~ • .• ... Av�,�A��IJ�:�I " ',1.0�fl�;1"Ab �a��;�uanp. , _1(fr'vfSll'TIDNt�FgPfiFutTlGhidJIAC.a,Tf4N5N�iMIDI�T�FU�Ipf4l4.�PAf�p'ta�NGPJ�#►�MPf !'�'P(I;1t:HFipVlslq�a _ ..._ :_ . t? FITJFICATE+ICLL R:___ 2� AbplllC4i�1t(t?� ,1Mbrtllr:Rt�1'C IeT -:, !-b t� E1, 4TJ ( - ,- y•��,�r 3►lpD �1NY I�Ft< CdGOlrg 4DBGRIPfrG t+ot,IDIE911 CJtiNLELLDD BEFQRETHSZXpIWITlON - DPhjT(��2ti�U�N01N.gGRIci14M1ILLLNnFAVQR'fpMall �tPn7atirrttN i' . Tit;"DAMP-0 Ta'r-Ur LIFT,vur FA1LU►fY�7D DO�D 1;84L r t11F0 1DARL1p71t1DN 4f C1LITtvrANYKIHDUPDN THE W.URl R,ITSAGDN7EDR .ieCORD 3:i 5 g1117) o" IIeAGOFW COFiF+DRA 4ID4�1 i989 Town of Barnstable *Permit# S� X-PRESS PERMIT Expires 6 months from issue date Regulatory Services Fee � 1 APR 13 2006 Thomas F.Geiler,Director Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 25DI01/ Property Address Wif IT&ahi_L Ltf14` residential Value of Work.2l5 Dd Minimum fee of$25.00 for work under$6000.00 n Owner's Name&Address �10 tPf� "T , BO oJe "_1 7 ,rrfviT-* s?4 t i F e hl�9 �l6a Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I a sole proprietor frlr l�the Homeowner ❑'I have Worker's Compensation Insurance Insurance Company Name 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) 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,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. SIGNATUREI Q:Forms:expmtrg Revise071405 The Commonwealth ofMassachusetts Department of Industrial Accidents y 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 (Busiaess/or nization/Indivi&4: Address: b City/State/Zip: 1 ��AN 5' Phone#: L �� Are you an employer? Check the-appropriate bog; Type of project(required): 1,❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(fall and/or part-time).* havehired`the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet ❑ Remodeling ship and have no employees These sub-contractors have 8: El Demolition working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' Gump.insurance 5. ❑ We are a corporation and its • ed,] officers have exercised their 10.❑Electrical repairs or additions 1equ3. I am a homeowner doingall work right of ezeatption p er MGL 11.❑Plumbing repairs o additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t . employees.[No workers' 13.❑ Other comp.insurance required.] *Airy applicant That checks box#1 most also fill out the section below showing their workers'compensation policyinformation: t Homeowners who submit this affidavit indicating they we doing all work andthen hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name ofthe subcontractors and their workers'comp:policy i3 A -i otivn. I am an employer that Is providing workers'compensation Insurance for my employees Below is the policy and,t'ob sate Information. Insurance Company Name: Policy#or Self-ins'.Lic.#: Expiration Date: Job Site Address: City/State/4: Attach a copy of the workers' compensation policy declaration page(showing the policy number and eq.1ratfon 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$1,50QA0 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 cerfift under the pains and penalties of perjury that the Information provided above is true and correct Si ature: 9ADate: Phone#: Official use only. Do not write In this area.to be completed by city or town official 14 City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Reatth 2.Building Department 3.City/.T own Clerk 4.Electrical Inspector 5.Plumbing Iaspector• 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for theaicmplayees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,.oial or written." An employer is defined as."an individual,partnership,association,corporation dr 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 bean 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 ofpublic 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 m=ber(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 s7mM cater their self-insurance license number on-the appropriate line. City or Town Oillcials . 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 member. 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 off cially 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 notrelated 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 ae 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 mtmber: The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street Boston, MA 02111 Tel. ±11E 617-727-4900 ext 406 or 1 o77-MASSAFE Fax,"617-727-7749 Revised 5-25-05 w-ww.mass.gov/dia r _ Assessor's offioe (1st floor): �' TME Ft Assessor's map and lot number .. 4.'..�....�................ yo Board of 1-10'alth (3rd floor): fO�Q o� Sewage Permit number. ........ ��.......•�.�.....�. ....(••... Z BABd9TADLE, i Engineering -Department (3rd floor): 1— 'moo 039. 0� House number ............................ ......,:_...... 1�................. '.�o MaI a` APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ./7.S i.u..l�I C.j ��..�i'l a TYPE OF CONSTRUCTION .. .fart..J,®l'+ 1-1>.�ar17-............................................................................. ................. ...........19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. ......I!!�_. i!...0 . .r. 1._....... .t-l....(... ?//5.......................................... Proposed Use ......��........ .......... .......... ...................................................................................I......................... ......... r .......Fire District /1i1�.../7/J/.-� Zoning District .............................�..(.............................� ........... .....>r .. ............................................... Name of Owner ..... cnPi'1.. ...Address ....................... Nameof Builder :SG.....( �..P�.............................Address .................................................................................... Nameof Architect ..................................................................Address ........... ...................._-..../................................................ Number of Rooms .......... ..................................................Foundation ..„./-dC.IC�'�Jl,,..... � ✓�.Ce.. e..... .......... Exterior ... ! ..5'.... .! ?..LYLn./P....S....... .....(..!..�r't ..SRoofing ... ....:....5 .... 0 .../ .... .. ..5......................... Floors ....1 ../..! .. ...(...... ........... .��..� P.. ............Interior ....... ......�.e.......1 .L� .! ................................. 4/ Heating ................................. ._......... ...........Plumbing ....... J .. `. z......................................... Fireplace ...............................Approximate Cost �...5 i (�(� '................................................... ...... J. .............................. r Definitive Plan Approved by Planning Board ---- ecC_________________19 Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH a r, C( 6 X r-Z 1 . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLING S \� I hereby agree to conform to all the -Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........... . _ ...........�...,�/..... ,.............. Construction Supervisor's License . ./� GREENBRIER CORP. A=250-161 2.1'951 1 Story No ................. Permit for .................................... Single Family Dwelling y. ................................................................. Location ,.Lot #2, 5 Whitehall Way ............................................... Hyannis ............................................................................... Owner G.r...eenbrier. . ...CorpC .. ............................ . ...... . ...... ...... . Type of Construction Frame i r Plot ............................ Lot ................................ r Permit Granted ......Segtember,.23........19 86 Date of Inspection ....................................19 Date Completed ......................................19 TOWN OF"I§ARNSTABLE Permit No. .?.?�...... BUILDING DEPARTMENT { H.. TOWN OFFICE BUILDING Cash ........ ow HYANNIS,MASS.02601 Bond ....X.. CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #2, 5 Whitehall Waj, Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY'THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0'OF THE-MASSACHUSETTS STATE BUILDING CODE. August 11 , 8 7 ' �! - - Q 19................. . .............. ..... ..... Building Inspector °•, TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 aaaaa TOWN OFFICE BUILDING � ru& _ i 39'� r. HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy` Permit has been issued .for the building authorized by BuildingPermit #......... .9 J...`J ....._........................................................................................................................................... issued to .(/ G� .t1J//i31 .....�...u..`" .. i!.!.,.�r'„ Please release the performance bond. „q'n��. y r.p*;''lnsts"i+Z�?:�y:`�'q�ap,.k4, �.:,.'et>.955,'.`.,+36'�k'rit�rN�.yr4.ao�'•dt'� w� t`.fi��n5jdy'),�N':,t z ;® F' TOWN OF BARNSTABLE, MASSACHU.SETTS Bull, ING ■ �'��' i A=250 161' !� �' ... OATS of )fir 19 g� '.PERMIT I • �'= APPLTC/1N7 ADDRESS Z7atgCBP10W ';' nnlT �-� (NO.) STR T) '” 'ICON LICENSE) NUMBER OF, k. PERMIT TO „(7v.pE of IMPRovEMEN ( ) .STORY - �lklg �(P2 ��•u.b7�w .`, DWELLINGUNITS . - ZONING. .. AT-ILOCATION) T;. DISTRICT_}yn:-� .(_NO.) (S REE'T) ' BETWEEN.'. AND (CROSS STREET) (CROSS STREET) - . . LOT , SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT.AFT;. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION i:� 'TO TYPE USE,GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Sewage 950 f Sb� Boud AREA R PER VOLUME 1Z4-4 sq. fit. ESTIMATED COST $ 45.000 00 FEEMIT (CUBICR.SOUARE FEET) OWNER Q—plmuhrier COYT BUILDING DE PT, ADDRESS P O, BOX 5lO� ceriterville BY '3�� THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR ® i PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENTOF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED.ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO-IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS `' ca �- r 3 HEATING INSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS 71 OTHER 2 ' BOARD ALTH �anuaar�S WORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BE'-t3.M'gNULL AND VOID IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS CARD INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STAKTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. PERMIT IS ISSUED Al RIOTED ABOVE. OR WRITTEN NOTIFICATION. i�4• A ' 30/1 5�/S rETl3w�k5 ; `a AssuMeD L.o.T PAC.-rae-rep'...•' 777 ANI (r�\ I' /hvo l 0 20` ,. 0 t D v f' �'. \AkA OF +ELDREDGE No 19367 ( Q ��- CERTIFIED PLOT PLAN H t-rr-PA L.4- wn:x 'gyp IN ySAJIAS fAJ9,L A33* SCALEt DATE " ( I CERTIFY THAT THE FouNO/4TlaN LEVY & ELDREDGE ASSOCIATES INC. •CLIENTS I; SHOWN ON THIS PLAN IS LOCATED ( , ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. ON THE GROUND AS INDICATED AND PLANNERS LAND SURVEYORS �'� CONFORMS TO THE ZONING LAWS ggg-V/ . Yj OF BARNSTA®LE , MASS. 74-a MAIN STREET CH.BY� �° I HYANRIS, MASS. =__ _ SHEET._L,OF DA a _E RED. _LAND SURYEYO_R .�. Assessor's offioe Ost floor): ` Assessor's map-and lot number .s S�.�.. �.�................ r ' ' ..°ST"e Board of Health (3rd floor): SErTIB°e SYSTEM MUST .j Sewage Permit number .... ..?..........!.. ...... ..... ...r....• INSTALLED IN COIyPUA BA$d9TODL$ i Engineering Department (3rd floor): (� WITH 1rffLE 5 +oo r6 9- House number .............................. ..... .... '1�................. Ya. - ENVIRONMENTAL CODE A o�a APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00 2:00 7 P.M. only TOWN REGULATIONS, TOWN OF B-ARNSTABLE BUILDING el-N •PECTO-R APPLICATION FOR PERMIT TO ......ti,.C ... . . C. TYPE OF N T TI ll iT7 CO 5 RUC ON ....Cit/Ql'J /`'*1��.,......- .................................................... ....................... t ...................... - ... 19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ermit according to he fo wing infor ation: �. r Location .... ... ........ ......... !.... r�r..... ..... �-�4. . .. r /.�,1..... .......... Proposed Use .......... Zoning District Fire District ...... .�j�f/',,f• Name of Owner ...... 1C eP.�1.. ....Address ...... ... f/ Nameof Builder �.?. .� ..�.............................Address ..................................................................................... Nameof Architect ..................................................................Address ..............................................•...................................... Number of Rooms ............................ C� ... �. �..... .. ................ Foundation ........Q.....r4f.... e :... lJ I pp / l l l ...........�1;. .4!1.1..r1.. .(.�.,.?.......`. ....�..1.... SRoofin ,..1. .....�.. .. ..^..................... _ 1 r Exterior w g Floors .....C�.J.S►'1..... ..�.... .... .....Car. .i.j............Int.erior ........n.... e.�..�.l��.C.k -� .............................. Hieating ..... ............... ................ .C�.> ...........Plumbing ....... kxz -.... ..................................... Fireplace ............................:............................................•..........Approximate Cost ...... j.. J.:.0..Q...(2).................:........ Definitive Plan Approved b Planning Board _-_- AA ` E,� pp Y . 9 -�`ikf -19 Area f :/ :: . ...1.. Diagram of Lot and Building with Dimensions Fee . s 0................. SUBJECT TO APPROVAL OF BOARD OF HEALTH c 0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to. conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ... .. ..... .. ........f......... Construction Supervisor's License . � .. ..... GREENBRIER CORP. N 9951, o 2- ... Permit for ...1z..Story ........... ......... ................ Singl'e Family Dwelling................... .......... ...Single Location .......5...Wh i.t.e.h a I I...URy......... .. ...... . . ........ aio.....................O�Y�!W .................................I......... Owner ...... Greenbrier...Corp.,........................... . Type of Construction .................................. ........................................................................... 14 Plot ............................ Lot.................................. Permit Granted ......................... ......September 23.,.......19 86 Date of Inspection ....................................19 Date COMPI to d .......... 1.1.GI F-.'........ 1 9�7 6, ;> 3: 1� M C) At -r ru 0 a 0 7 I 1 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main.Street, Hyannis,MA 02601 , www.town.b amstab le.ma.us Pre-application for Business Certificate Date ��2 Map Parcel Applicant Information Applicants Name r`L zi - 5 W iC9J1�— R�A'n c t ( (1� . Applicants Address VJ Email Address `fib ' �(�C" Telephone Number SOS (jy,q —8$�Q Listed ❑ . Unlisted El Business Information New Business? -------------------- -------------- -- es No Business is a registered corporation? --------- - ' -- -------------. Yes , If yes Name of Corporation Does business operate under the registered corporate+name? Yes Is the business a sole proprietorship or home occupation? --------- es No If yes then a Home Occupation Registration is required—See Building Divisia6 Staff Name of Business Business Address �� U/�; r wcw Type of Business Building�,Commissioner Office Use Only Conditions f Building Commissioner Date Clerk Office Use Only . SN - „S, 1 s1�e.SSVA