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HomeMy WebLinkAbout0029 CAPTAIN LUMBERT LANE . ! V ry) o , r. o � Town of Barnstable Building Department -Brian Florence, CB O 'MUST C Building Commissioner. CC) WITH BIOME OCCUPATION 200 Main Stme I4 annis MA 02601 RULES-ANO PEGUL. TIONS, �, n - _ � COMPkY MAY FAILURE T wv��vvtown.bamstable.ma.ns ����1-T I(41 EON��.. - � Pre-application for Basiness Certificate Date Map Parcel �I 603 Applicant Information Applicants Name Applicants Addres 66n t U yn bef 1 4*W, G--n+e(% L1 f F-ma-l_Address -rvle neki, �r e`�c�d T i c U,�'1 cLG G�✓10¢.► cow) Telephone Number 77Y 99 t/v25 5 Listed 0 Unlis d Business Information New Business? Yes No Business is a registered corporation? ________':A_________ _____. es No If yes Name of Corporation lu )UC1A%►6r 1M1 c le G f IC l Corl Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ •Ye No If yes then a Home Occupation Registration is mquirecl—See Building Division Stag' Name of Business WrA shy C_164f 1 C' n Business Address_ . i n L la vv►�jB("� �an C C�w�er�1 ��P Al rqZb 3 Type of Business Ifiec f�CCj C( �*C►C-LY B g Commissioner Off Use 0 Conditio Building Commissi li-t ate Clerk Office Use Only Town of Barnstable Building Department Services Brian Florence,CBO MUST COMPLY WITH HOME OCCUPATION Building Commissioner RULES AND REGULATIONS: FAILURE TO Y MAY RESULT' IN F-INES. �x 200 Main Street,Hyannis,MA OKAM MPL 039. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: -�' HOME OCCUPATION REGISTRATIO Date: 7 -V- 9 Name: Ji oh 47Abcx Phone#: 77 /- 79Y-6e255 Address: ,k I CD6JD:h!Ld h Luvhyjrf+ Lan a Village:G',�1r► c'_f V ��2 Name of Business: �TAe �La4yckyl Type of Business: Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external'alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. + No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned ave read and agree with the above restrictions for my home occupation I am registering. `i V Applicant: ' .(/NuNt� Date: 7 L 9 Homeoc.doc Rev.06/20/16 f �1 L�La 1 s t 1 • A '_ f s �� � 0 1 i l s . • , s �• -� �.� ._ � �. • �s • .� -� � � � . � �� z� _„ � . . �. • _� _-� -� - , - , t �.�, .� F. �1 { � u COMMENTS: _ � y is t — I r r Inspection Report - Building Department Date Address (29 �,r�-E— Referred B /�/ Purpose of CaMnspection �W-b a�e� Reported to Site with Observations & Notes Town of Barnstable Building ,2• -.r.+--...,.. v�,�--w-.sr r...�r....."`"^• -1,ae. .-+}.... -:. ... ... .,, .•w""C ? BAINSCABLE Post This Card Sc That it is Visible From the Street Approved;PlanskMust be Retained on Job and this Card Must be Kept iPosted Until Final Ins ection Has Been Made 4= Whe�rea Certificate of Occupancy is Requiredsuch Building shall NotbesOccupied until a Final Inspection has been madev Permit ,. Permit No. B-18-11S Applicant Name: DOUGHERTY,JOSHUA J,SIERRA F& DAVID J Approvals Date Issued: 01/18/2018 Current Use: Structure Permit Type: Building-Restore to Single Family Expiration Date: 07/18/2018 Foundation: Location: 29 CAPTAIN LUMBERT LANE,CENTERVILLE Map/Lot: 147-011-003 Zoning District: RC Sheathing: Owner on Record: DOUGHERTY,JOSHUA J,SIERRA F&DAVID J k + Contractor Name`. :., Framing: 1 d 4 k Address: 29 CAPTAIN LUMBERT LANE Contractor License 2 ti' a o CENTERVILLE,MA 02632 ;r, £ ' ""`""°` Est Project Cost: $ 100.00 Chimney: Description: restore to single familyhome by removing wet barsnk on first floor ' Permit Fee: $85.00 F Insulation: with cabintry Fee Paid,:` $85.00 Project Review Req: x "* Dat 1/18/2018 Final: � +�., .,^ae++•r...�ram, � ,r p Plumbing/Gas fv Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siix`months after"issuance. All work authorized by this permit shall conform to the approved application:a'nd'the�`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and Structures', be in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this-permit. Minimum of Five Call Inspections Required for All Construction Work " " `' '� ' Service: 1.Foundation or Footing 2.Sheathing Inspection s Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 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: "Persons 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 - All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Appficaion 1+Ivmber.....J. ...zf..../.l J................... # ELMIN.I'A= f PcoartFee.........Y.�..................0&=Fee........................ NAM Total Fee Paid......................... UIL 111G D PT TOWN OF BARNSTABLE Y- ,_,,,,..,.on..... .. .�`�.. .1�..... P==it Approval by.......... ....... .... BUILDING PERMIT JAN 12 20 8 APPLICATION MV.......................................r=.................rO.v N-G A TABLE Section 1— Owners Information and Project Location Project AddressC29LVillage Owners Name , Owners Legal Addressh rnbey city N&c6n,'L, state - Tip 0240) Owners Cell# �" C �'� �� � E-mail , h&�- ��&MAQA,(A ft� Section 2—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3—Type of Permit ❑ New Construction ❑ .Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(ere structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment 0 Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ hodtation Other-Specify t- On Section 4—Detail Cost of Proposed Construction 416n.W Square Footage-of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updattd:1012017 Section 5 -Work Description loo ia n�� Section 6-Project Specifics ❑ Wiring ❑ Oil Tank Storage . ❑ Smoke Deflectors. Plumbing ❑ Gas ❑ Fire Suppression ❑.Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Waxer Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District [] Old Kings Highway Debris Disposal Facility: I am using a crane C Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No i Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yazd Required Proposed Side Yard Required Proposed Has this properly had relief from the Zoning Board in the past? ❑ Yes 0 No Last updated:1117rzo17 Section 9—Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I imderstmd the construction inspection procedures,specific inspections and do=entadon required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number r Expiration Date I understand my responsil0ties under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and doctnnentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signauwe Date t7---Section_11-Home Owners License Exemption Home Owners Name: Telephone Number Cell orWork Number I understandTRW s and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Mthe construction inspection procedures,specific inspections and doc ntentatTown fB Signature Date l �i-APPJJCANT SIGNATURE Signature Date Print Name S'xl ey Telephone Number E-mail permit to: .&MbMNT& % s � Last updated:iin2oi7 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required Historic District ❑ Site plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire deparanent for approval Section 13—Owner's Authorization L , as Owner of the subject property hereby authorize to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date . Print Name Last updat 4-11/7/2017 1 Floor Plan 29 Captain Lumbert Lane Centerville MA, 02632 Prepared for Barnstable Heath and Building Dept. Basement floor plan First floor plan-. t Second floor plan I January 15, 2018 Town of Barnstable - Building Division Building Inspector 200 Main Street Hyannis, MA 02601 Thank you for approving my recent application for a Building Permit. It has come to my attention that in addition to the completed plumbing inspection passed on 1/12/18 that I also need your inspection to be done to verify the cabinetry has been removed. I have includedifor your reference all of the documents I have pertaining to the building permit and plumbing permit as well as photos taken to show the area in which the wet bar sink and cabinetry were removed. I am so sorry I missed you and will call to set up an appointment for this week as we are due to close on Friday 1/19/18. Thank you for your time. Sincerely, Sierra Dougherty (774)238-1989 29 Captain Lumbert Lane Centerville, MA 02362 l ° Town of Barnstable RECEIPT > KAM n 200 Main Street, Hyannis MA 02601 508-862-4038 s439a Application for Building Permit Application No: TB-18-115 Date Recieved: 1/12/2018 Job Location: 29 CAPTAIN LUMBERT LANE,CENTERVILLE Permit For: Building-Restore to Single Family Contractor's Name: State Lic. No: Address: , , Applicant Phone: (Home)Owner's Name: DOUGHERTY,JOSHUA J,SIERRA F& Phone: DAVID J (Home)Owner's Address: 29 CAPTAIN LUMBERT LANE, CENTERVILLE,MA 02632 Work Description: restore to single familyhome by removing wet bar sink on first floor with cabintry Total Value Of Work To Be Performed: $100.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the;best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: DOUGHERTY,JOSHUA J,SIERRA F 1/12/2018 & DAVID J Applicant Date Telephone No. Estimated Construction Costs/Permit Fees 1 `5 Total Project Cost : $100.00 Date Paid Amount Paid 3 Check#or CC# Pay Type Total Permit Fee: $85.00 1/12/2018 $85.00 i 1405 Check Total Permit Fee Paid: $85.00 a THI�S4IS��NQT�A PE4RMIT�����a �x� �'�r:,.z�' ,�:u«.v> hK�'^,:,�ae%4c zaw�a �s�a✓s k'.«` '�,.,.�:..w,-...,a.a;-' ��,`,a l �� E ,. �.�. Y��{ a „t' R:. >'/.� • t . .�. y �. ,. V � AY i !/ �� a Inge: 0 75 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA.DATE PERMIT# S JOBSITE ADDRESS C - OWNER'S NAME rG` ✓ POWNER ADDRESS SA M II TEL a-j: 'Z'7-12 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL Mr PRINT PLANS SUBMITTED: YES® NO[] CLEARLY NEW:❑ RENOVATION:[l REPLACEMENT: FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE - -- - DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER - DRINbNG FOUNTAIN FOOD DISPOSER - - FLOOR/AREA DRAIN ! INTERCEPTOR(INTERIOR) r— I4TCHEN SINK �---LAVATORY ROOF ROOF DRAIN SHOWER STALL SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES y a a I WATER PIPING INSURANCE COVERAGE: i have a cuiTznt ilabilit insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO [] IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY D BOND El - - r— OWNER' IN RANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Char 14 the Z Massachus General La t my signature on this permit application waives this requirement. COco CHECK ONE ONLY: OWR AGE SIG RE 0 T to C= I hereby certify that all of the details and information 1 have submitted or entered regarding this application are true and accurate to best of my ledge and that all plumbing work and installations performed under the permit issued for this application will be in Mpriance with all Pertifar�rt provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. . PLUMBER'S NAME, /i- � (1f1�/ _LICENSE# SIG RE MP* JP® CORPORATION#PARTNERSHIP®# LLCD# COMPANY NAME A4A ADDRESS CITY ` STATE ZIP La z66 TEL FAX CELL -a3 EMAIL hivJ � Cie �w� c�Ppec1 Capp\ Pipe S ay $bb PeNNy /��}�� ( oyn� e,✓ I F� s-� lay � � rl clql t-(, nbe,,e-4- j n Ce]-kA�,I Le irna,. G2 32 OCONCRETE SLAB FOUNDATION, NO ACCESS J W Co ® N Z z C mLL , J O --� z a) 48"BULKHEAD ACCESS 0 LAUNDRY 10'X 15' 1 STAIRS BASEMENT36'X 9' 3�' I STORAGE ROOM.14'X 15' ZZ � All dimensions_size designations 20')n® This is an original design and must Designed: 1/8/2018 given are subject to verification on TECHNOLOGIES M not be released or copied unless Printed: 1/12/2018 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. basement.kit All Drawing#: 1 I No Scale. t - ----' - EXT"SIDE DOOR— SIDE ENTRY CLOSET &P-n4uvi'k Ina- \ 14' 14' FAMILY ROOM+21'X 13.5' 2' if rCASED"OPENING J t \ -SHEET ROCKED OPENING 32" m a C= Q IFULL BATH'13'X 7.5' Q N Z OFFICE 13'X 13' ; Q \( 14' Z e—I m 5 BI-FOLD DOORS m Qj LINEN CLOSET 1 \' PANTRY CLOSE ` 36"FRONT DOOR ! -,BASEMENT[ `S{51f �St 36' KITCHEN/ .DINING ROOM, 23''X 12' t I j 22' LIVING ROOM ( . 1 23'X13' 36"BACK DOOR t \\\ F -7'CASED OPENING 12'X 12'BRICK PATIO; 1 • tb I { All dimensions_size designations 26' a� This is an original design and must Designed:1/8/2018 d00f S be—Awa1/1 I given are subject to verification on TE`v L� not be released or copied unless Printed:1/12/2018 job site and adjustment to fit job applicable fee has been paid or job �•-1 1(X� n conditions. order placed first floor.kit All Drawing#:I No Scate. SOLD TO SHIP TO 376628 Sid v � i rah ADDRESS �, � // ,�, � 792 c l l lu v m alf z u� Lo/ /5 4 CITY,STATE,ZIPCITY,STATE,ZIP �'V' v � t� ; i) 5i i � CUSTOMER WW611140. SOLD BY TERMS F.O.B. DATE �� u ORDERED SHIPPED DESCRIPTION PRICE UNIT AMOUNT 8840 0048 _ Z CLOSET I ; 02Xg32 1 y. ' I BED.,3- 13'X 9' ' col ; , UJ I 1 IDEN 27'X 10.5'AN 8.5' L� N X GAP < iBED.24'- 12.5'X 9' ,pp ILL i, J Q 'Q ''Z \ I INE OF ROOF PITCHING INTO ROOM HEIGHT i� CLOSET ly !Er ' ¢ STAIRS . � \!y FULL BATH;8 X 7 . I LANDING I[CLOSET BI FOLDIIII!DOORS/ATTIC ACCESS _ — .VAULTED 1 ST FLOOR CEILING " Jb' #BED.1.,15.5'X 11' Z� , All dimensions-size designations 20��6.���, This is an original design and must Designed: 1/8/20.1 given are subject t0 verification on TECHNOLOGIES not be released or copied unless Printed: 1/12/2011 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. gl,Ooy'/ 2nd floor.kit All Drawing#: I No Scall `x� k TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` Map / -/7 Parcel r 003 Application # 06 Ps_ a�� Health Division Date Issued Conservation Division Application Fee S Planning Dept. Permit Feel"55.Od Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address J 9 C����"` LCIIII�Z � L"V1.1, C"�Zvd& VnA Village Cgk�OLL-1, Ise Owner "&cccen Address 9� vts Q_ CLw�wul�Le,tit A . Telephone 503- `-loo-a5Sa Permit Request Cog_4 a-,k 2¢tnflt� 0CV?- � OiOLf_ o wi rLoVa k1.1 ©gyp QLn\,LA-A y�ti Ll 51Mo�/.e,� �c�C�i2S S F. Square feet: 1 st floor: existing I 1 I 1� proposed 2nd floor: existing 95D proposed Total new 36(�l0 Zoning District Flood Plain Groundwater Overlay JZ� �5 ee P-rojectsValuat� Lion /•�'�n Construction Type Lot Size a3,3l y of. Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family (# units) Age of Existing StructureJ_&y_-s Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: OdFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) SS60 Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing I' new First Floor Room Count Heat Type and Fuel: lta Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes UrNo Fireplaces: ExistingiNew Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# J Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name M CA_C ,_,,� Telephone Number Address C9,3 2 �v;5 ( License # ��vv`/��vvi"`�� l/✓lf4 Home Improvement Contractor# Email aa>@ cow«a.51 . 9,-t Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOUF y WWI- �SIGNATURENy _ �. _...,.........DATE Y(,�,LIJ. �'S"RRe-vxr- T FOR OFFICIAL USE ONLY- APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL fi FINAL BUILDING t- �j 4 �' D � -- 7 DATE CLOSED OUT ASSOCIATION PLAN NO. t- e I \ :. �T • s, � N 7.a SMO'K DETECTORS VIEI�IED SARI STABLE BUILDI`� NG DEPT, *" 1', 116 , ��i��`�5���`�' JCS tjiil' � FIRE DEPARTMENT DAT 5� vtG BOTH SIGNATURES ARE REQUIRED FOR PERMITTING �-��.:n a9 V c"4vk- Ce,•��ev� lie VV ✓A f s , E a r 1 J The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street — Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers C plicant_Information Please Print Legibly Name(Business/Organization/Individual):_ (_4-G\e_ C L..ct;t c.P_ Address:,Q,? 6 )q '\No City/_Statel2ip:�C'�„ vt ,��1Q MA/-{ ®bG3 Phone#: S'0,- `/00 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 I employees(full and/or part-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 have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition Zworkers' comp.insurance comp.insurance.: equired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions '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 13.❑ Other employees. [No workers' comp.insurance required.] *Any applicant that checks box 91 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: eob-Site Address: u,r c crZ12 � City/State/Zip: Cv,�•�c,v ((c— MA ®a6,Sa 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 hereeby ertify under the pains and penalties of perjury that the information provided above is true and correct. S�ienatur C Dom' ate/�(ce f fS ' 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, §25CO 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-contractor(s)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 s' Industrial Accidents. Should you have an questions regarding the law or if you are required to obtain a worker Y any g g Y q 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 f e affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. o the YY g g PP 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)andunder"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 Briton,MA.02111 Tel. 617-727-4900 ext 406 or 1-877-MASWE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia « BAM"ABLE, �A,.�' Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner , 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 } Property Owner Must Complete and Sign This Section If Using A Builder e I ,as Own the subject property_ to act on my behalf, hereby authorize in all matters relative to work authorize y this b g permit application for: (A4dress of Job) \ Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWHILESTORWbuilding permit formslsmokecarbondetectors.doc Revised 050412 Town of Barnstable Regulatory Services Richard V.Scali, Director Building Division snarrsrns , # Tom Perry,Building Commissioner y Mnes. � . 16;9. 200 Main Street, Hyannis,MA 02601 �pjED MA'I www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE: �!f(p/!S JOB LOCATION: o?� c �t!/t Lwn�e� G�v=2 GP�w���y t(Le numbei street village "HOMEOWNER': B."u6[, me l.w,,�e TV -Ll60—a`S-ya name home ppphone# work phone# CURRENT MAILING ADDRESS: c%��o lct✓L �Qu t 5 �' iJC city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and re eme its. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. TOWN OF BARNSTABLE Permit No. --2,507P------- Building Inspector SAW7TAX Cash --------------------- OCCUPANCY PERMIT Bond - ------- Issued to Bayside Building Go. Address In- 4,71 Lanp- Cer--4-4,illr Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. ......................................... 19........... ............................................................................................................... Building Inspector r z i- 7s Q ' L a - - //'•�d�ryy /A� +tf 1'r k R' .F ` - 1 tt `'t ti. n 1 y' 9 : s - V. ob r , r }c� � rOrk;sf rti ' - { ,�{ � L. S #C{�+�,F' �5 �...•v�y`15 "'ra'fKs { k.ar - I ! - �.: r n <Z> � . t t a 9 ZT' F t _ T q 4- r ;Y •.V 0� n�Y 4 y� 1� I."a !T J'�{y U ///J j////�� . IV - F k � ti PLAN CERTIFIED PLOT Cq pT. L aJi'1 lj C>z T L/i NE �L�T ,4Olt IN r w o s�� SCALES fa ' DATES S"' iG S3 CD REDGE ENGNEE CERTIFY THAT THE F0vn/D-4`Tft1i✓ O IENT.. EGISTEREO RE0I.STIEItI�q SHOWN - ONE THIS.. PLAN IS LOCATED. . ,r �O (�p� Str.,= �. ON THE GROUND AS INDICATED AND CIVIL LAWD =yhr; aq fq• y�l 'CONFORMS PTO THE ZONING LAWS. .,. ENGINEER SURVEYOR ,x� ; DR,�IY� -. — 4F: ®ARNST�B E , ASS. r ss h 712 MAIN ST.r ' re HYAN DATE G. LAND SURVEYOR . . , . r `.Assessor's map and lot number ........ .......... k� y0F THE r0� Sewage .Permit number .... �....... ..-.... .... . Vic. ' � ^ $4 ,f V1,11NAt t BJHBSTABLE, i House number ..................................,jl�..49...........................E S. I rs► a 9 rasa C!317 f TOWN OV }B IRN-S-: �"A"BLE BUILDING 'SIN' PECTOR APPLICATION FOR PERMIT TO .....\..&T!i1. T!L4,Llss..t........-���� � ...... v�n.`..`. ........ ............ t.?�t: ..... _ TYPE OF CONSTRUCTION lts.l..C�. -4.....�..... ri .E.............................................................................. ........................,91 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informs 'on;, r Location .....inAt...4.03.......... . ..........(:7;An6 !4.....)A'K.0. ....... Z&e................... .................. Proposed Use .....Et!:Vldy.... ....................` .... .......... ......... .................... Zoning District ........!• ............................................................Fire District ..... ...-... .!:................................. Name of Owner ......�/}�/�..1�. ....4?.�?i .�D• ddress ..........C'e.!!tT!e .�1�.�. ......................................... Name of Builder' .... .+Y-5 KbF ... 4t).dJ.9�.4.0.,.j;!:.CtAddre'ss .......... 'eh � .1.1.................. .................. P8 . � .............Address ............ St�:..... a Name of Architect .... ..t... r...... �....................................... Number of Rooms .........&..........................s..................... ..Foundation .......F".. cl.......1 d1!Z Q2o�............ Exterior .l �Gt .P��t. K.............lN c..........................Roofing ......... ./. ......::........................................ Floors ! /�......... GA ....................................Interior .......S, II.. .�.1... .�.0. ,........fat'..- 1/ hr' Heating �#../•T. Q" .?......... ............................Plumbing ....... Y... ..:....... gee. �-G .. Fireplace ......!U.l�./..G JI...... ..U..ldl .... .. �5TApproximate Cost / ......... ........ -Definitive Plan Approved by. Planning Board ___________________-----------19_______. Area /./........................1. Diagram of Lot and Building with Dimensions Fee ,...... .............................. SUBJECT TO APPROVAL, OF BOARD OF HEALTH 0 A t � � w 1 A 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 ... ..�i�;� ................... %' a BAYSIDE BUILDING CO. INC. 25077 12' Story No .�.. ............. Permit for .• •••••••..•• Sin le Family Dwelling • � � + Location �# t ••.`) m e...r...t.. Lanes. Centerville � •�� , " ..;�, � • Owner ....BdXside .Building...Co Inc. - 'y Type of Construction Fram ............................ ............................... ...................................... 'Plot ........ ... `�........ Lot............. ................ h _ e Permit Granted ...May...17.!. 19 83 ,Date of Inspecti ` ��1..�a..19 V. S Date Completed .. � fi�................19 ! , i Assessor's map and lot number ..... .. ....... E bpi Tp� 7 E ; Sewage Permit number ....A... Z.�.��� Z BAHd9TADL i House number .............. .................. a ��y O 39• \0� t GN" C YPY a' TOWN OF BARNSTABLE BUILDING INSPECTOR f APPLICATION FOR PERMIT TO ... ... ? i : Z r _,€ }, �-r� ....?.... tuft t ......... ...........................cV r � TYPE OF CONSTRUCTION :.'.�j �., ?€rta t F J I ...............I 1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to to the following information: k Location ..... ..... �.�`.. ... i...'-r ? ....6... ,N� t L€ t� ..:. r`1,�€C` �..........� l E. ....r /1.. .°f` ................ tt' Proposed Use ....: �. i�, .... r •► 1 !. €✓.... .i.:.:: '. k.c.v1<..................................................... ....... ............ •�.j Zoning District ........c.l...t::-:................ .............................Fire District . C. ..................... ................................. Name of Owner ....... `�. .: b. ....g�11c l3� _ �T�„ r�Address �..��.!.\�..': .♦� Ill. r _ . ... Name of Builder' ,i.... p�l�_.........J.".�±Address ` r i r? U'4 1 ,� ................................ Name of Architect ... .t... ......::..?...G��r ............ .........Address ........................ ...'E tZ.0 1 �, ,........................................... .7 r . Number of Rooms .....................................Foundation !: !c C � t (�<" , .............................................................................. Exterior ! r ...........L{! �.................... ..Roofin .`x�'.!f�. Floors �:..! .ii•......... /�. .. ::.. .....................................interior ......: (.......... fl �„ -�l Heating . !.. . !.........t ............ Plumbing ...... i!f ... ( t ,Cr {r.' ..�.�.... JJ / /, ti Fireplace .. � . 1..' .... .......•�.... 7, f)<. �..... . ....., ff C, Approximate Cost .... �?'... ti f�t....... ...................................... Definitive Plan Approved by Planning Board --------------- _-------------19_______. Area .............. ...... . � Diagram of Lot .and Building with Dimensions Fee .. . ................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Gr w Ej ; y 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. 9 f Name . :: to ' �' -��``- ' BAYSIDE BUILDING CO. INC. A=147-11 l"I�'ll No !2 5.� �... Permit for 1 S tO bO� ... ..........xy............. Single...Family Dwelling........ Location Lot 23, 29...Capt,....Lumbert Lane Centerville ............................................................................... Owner ..BaY.s.ide...Buildinq„Co Inc. Type of Construction ...........Frame .... ....................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ..,,.,.May 17, 19 83 Date of Inspection ....................................19 Date. Completed ......................................19 A Y M t 5 it + CPiSG MQA+ r I 3 yy�Yt�l a , 0 re �N t) ; Zc, fL' ' Z Rx i f: ... -._....._w._._.. f EacAS�arA q�OYer�ntA� •t. r � AIX(O- { - �x Assessor's office(1st Floor): Assessor's map and lot numb r /7/71 a 9C T U cf twf>o Conservation `�- MIS ALLED IN COMPLIANCE Board of Health(3rd floc--- WITH TITLE 5 i sesasT�ti Sewage Permit number = �8� _NV1 0M��Ek1TAL CODE AND � ■"& Engineering Department(3rd floor): �1 t j —,41���"gyp, °o t639. \�d� House,number ` ' J-OOHS '�o air►. Definitive Plan Approved by Planning Board 19 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 G a V 2�(`� G A O PP., - TYPE OF CONSTRUCTION Ls,y c�o� 'F t'A/M(Z, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: A� Location �.� C. A®-t�. N. �.y m��r C� C e.rl\-9—K' y \Vle— /' `A Proposed Use Zoning District Fire District Name of Owner O U Address 'aq C A V Name of Builder Address "3S� Name of Architect Address Number of Rooms Foundation � � S, ExteriorRoofing Floors Interior Heating C Plumbing t I Fireplace X_� I Approximate Cost y Cg C)® Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst reg ding the a ons ucti Name i Construction Supervisor's License 03 LITHWIN, ROY f No 35821 Permit For CONVERT GARAGE TO LIVING .SPACE Single Family Dwelling Location 29 Captain Lumbert Road �f Centerville �. Owner' Roy Lithwin Type'of Construction Frame - 4_ Plot < Lot { Permit Granted April 2 8, 19 93 Date bf.lnspection 19- Date Completed �b 19 r CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DEPARTMENT 1875 Falmouth Road Centerville, MA 02632 508-790-2375 ext. 1 FAX 508-790-2385 January 5, 2018 DOUGHERTY, JOSHUA 29 CAPTAIN LUMBERT LANE CENTERVILLE, MA 02632 An inspection of your facility on Jan 5, 2018 revealed the violations listed below. ORDER TO COMPLY: Since these conditions are contrary to M.G.L. Chapter 148 and/or 527 CMR 1, you must correct them upon receipt of this notice. An inspection to determine compliance with this Notice will be conducted on Jan 5, 2018. If you fail to comply with this notice before the reinspection date listed, you may be liable for the penalties provided for by law for such violations. Violations R314.1 Photoelectric smoke alarms Note Replace 2nd floor right rear bedroom ionization smoke alarm with photoelectric only. All smoke alarms must be photoelectric only and same brand. TOB ORDINANCE 95-014 Posting of street numbers Note Add house number at end of driveway (mailbox)visible from Lumbert Mill Road side. May also replace number on front of mailbox. Must be minimum of 3" numbers. 1.7.6.2 Failure to abate dangerous or unsafe conditions Note Found separate living space on 1st floor with locked separation from main area. Space has partial kitchen, full bath, and possible sleeping space. Online listing states separate living space with bedroom. Referred to zoning officer. Homeowner to contact Robin Anderson (508)-862-4027. MGL 148 SEC 26E Smoke Detectors in Dwelling Units Note Replace defective smoke alarm in unfinished section of basement. Inspection Note Pay fee If you have any questions or concerns please contact Fire Prevention at 508-790-2375 ext. 1 C-3 8310 MICHAEL GROSSMAN NA Inspector r i i SCHOOLS 1 WEST VILLIAGE ELEMENTARY Barnstable- 0.41 miles • � �• -•. • . 2 MARSTONS MILLS ELEMENTARY Barnstable- 1.58 smiles 3 INTERMEDIATE MIDDLE Barnstable - 1.67 miiles 4 BARNSTABLE HS. • • • • Barnstable HS. -3.06 miles 5 BARNSTABLE MIDDLE Barnstable - 3.06 mi'les e Goggle ' http://www.exitcaperealty.com/mIs/21716066 The a=ta relating to real estate for saie on this site t o r res from the Broker Reci ty(6R)of the :roe CDC v Isianas ;vault ple Listing Set-vice,Inc.Summ._ .or thumbnail_e3l estate iut-;n4s held by brcjL;erGge firms o_r-er than,EXIT Cape Re a,Y are marked vvith the BR Logo and detailed mformation abo.t them includes the name of'he listing broker. Neil cr the luting broker nor EXIT cape; Realty shall b responsibleO any typos 2phical error i +nfor matior7.or misprints and shall be held fora".�r ~armless,Tra,s.e was last.. dated 2018 G�_0 11:40:0 , .il p,operties are subject to orior sale.chances of w,hfArawal,2018-01-08 11:40:03!ties chosen to.isolay only -;taiD towns and.pr t+. es or styles of properties.This site may not ho',jl ail listings that are available ti:rough the Cape Cod&Islan-ds Multiple Listing Service;Inc. r L aJ r HAS FIREPLACE, HAS BASEMENT r Fabulous Centerville Cape! This 3+.bedroom►, 2.5,both home has so much space and so many ways to enjoy it! You will'love the open floor plan with soaring ceilings in,the living room, updated kitchen and baths, beautiful built-ins and custom millwork, hardwood floors, large, private backyard and so much more. In addition to the living room, kitchen and dining area, the first floor offers a huge separate living space,first floor bedroom and a full bath and half bath. There are two finished _. rooms_in.the basement and two sheds.:Upstairs,:there are 5 additional rooms and another full bath! This Cape has great space and room for a growing family There is SO MUCH POTENTIAL HERE! 16Photographs PHOTO GALLERY r.. is r 9 l x.. 10 - `} a _ a 1 a k°� a n e 29 Captain Lumbert Lane Centerville, MA, 02632 PENDING 2 BATHROOMS 3 BEDROOMS 2,006 SQ FT r 0.54 ACRES M LS # 21716066 PRICE: $375,000 29 Captain Lumbert Lane, Centerville, MA, 02632 - Photos, Videos & Mo... Page 1 of 9 48 Login Q Contact EXIT CAPE REALTY LESS TYPE PRICE Lane Pending $ 375,000 terville,,MA Bed( oo�. s � Back = "> Save Chat with us now ? Ask agent a question ® Go visit this property f Share on Facebook PROPERTY ATTRIBUTES M LS# 21716066 County BARNSTABLE City Centerville Area Barnstable Zip 02632 Style http://www.exitcaperealty.com/property/23 6-21716066-29-Captain-Lumbert-... 1/8/2018 YOU WISH TO OPEN A BUSINESS? t r 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, 1st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. DATE: 6/�1 6 Fill in please: i ✓ .: APPLICANT'S YOUR NAME/S: ,f' Ge I"y�Ne BUSINESS Y NOME ADDRESS: �.9 imi/1 L .v by I-a,�e OaC 72 j O •a�.'�D " ai;.i��;;ia:T`llil 45� TELEPHONE # Home Telephone Number. O { :.:,: ; ',";,�.>,�-- , L' h a o� c e r✓��e t s' s o 2 O!6- Sr-77s5 3 NAME OF CORPORATION: ` NAME OF NEW,BUSINESS` ¢ get r cal e e TYPE OF BUSINESS IS THIS A HOME OCCUPATION?• YES N , - 70 DU t - ADDRESS OF BUSINESS. Q' c n e— MAP/PARCEL NUMBER (Assessing) " When starting a new business there are several things you must do in order to be incompliance with the rules and regulations of the Town of t '� -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 MUST COMELY WITH HOME OCCUPATION This individual has ROLES AND REGULATIONS FAILURE TO be��gginfo e f any permit requirements that pertain to this type.of busi . 7_ n COMPLY MAY RESULT ' Authorized Signature** IN FINES. COMMENTS: =2. BOARD OF HEALTH ., This individual has been informed of the permit requirements that pertain to this type of business. ` Authorized Signature** COMMENTS:. s 3 ':CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to,this type of business. Authorized Signature** 'COMMENTS:--'- Regulatory Services �pTHE Tp� ' o Richard V.Scali;Director i fARi�STi�BLE, : Building Division v 16 Tom Perry,Building Commissioner "rEn nnnt°' 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: o Name: ( VI D Phone# Address: 6a.pfal'o L.G&:4 Ze oe— Village: �'. �T2✓`V�,��e Name of Business: See(/!ICZ Type of Business: ,/ l OL 6o 0 r:/ Map/Lot L a-7 0110 03 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation. within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity . shall not be discernible from outside the dwelling. there shall be no increase in noise or odor,no visual.alteration to the premises which would suggest anything other than a residential use,no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within . that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • 'There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such'use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup 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 lofcontaining the Customary Home Occupation. s . •, 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: � Homeoc.doc Rev.103113 t