HomeMy WebLinkAbout0132 GREAT MARSH ROAD io►i t 'F dW
r H d
i t'� 4 + ► fir
t
■ar" ��d- i-0 i , i_ A Ai`! � �' �' �" �fll�. isi�i�t�i�4t !it�"��M�rtl � su±s f� ;� � �z� .i ! � �'��
� � .. C...� .... "lln,J 1 y Y e
' �i. t'
f u. ' ,
_. a
1.
P
F.' e+ F :i
;'� 1:- < �' wan ' ' , '
14
1.
..e �� :,1._ a Y 4
1. t -J a .i, J� b
., "� o "" �IwAM �"` 'd
�'
Y =
,.� �p .a' ��� a ��
�'tu v
'� a ; B � fa ,. a . `A 'q "yid ��y'v�� ®' .
e, a 3! ,,,. . :v11 t d.
{ r _R y ^r'r; 9
I, 5I. °! C a 'q'• N
'hw'�y _ k
:�
'c, dr 1. 0 pµ t E .
F! s H 9
,. ,, , _ - d_.,. ,
"b' ° p
r
t A i d t Y , r ,r' P t .tl.. d. •�
q. a e ,al N �+.,}' 1. �
i o °a
'-' + P " tR
u % r 4 e P,
Y `k at a ; a. .t �� 'y. 'a o 4
y .`9v,� C
S
:,
." z
- '" .� ,' n
a e ' g
y S Y�: M. ti
P
u a y. r n n _ ip Y .p,.
Ili _ _ _ x+.ia .O •� - b. �^ , b 6 l' ct !' ..�.. I
IP ', �aP N. .iB q; n 0 V
', pep to v , - =4. x a
P 'k N S ��
�a t e�
l7 vt
�y.
pis
33o 383
ns ,;), �oli O lmcl-�
BUILDING DEFT. i
MAY 15 2018
TOWN OF BARNSTaBLE
TOWN OF BARNSTABLE Permit No. N/A
BUILDING DEPARTMENT N/A
TOWN OFFICE BUILDING Cash
�� i6}9• `
>tow+ HYANNIS,MASS.02601 Bond
T E M P O R A R Y
CERTIFICATE OF USE AND OCCUPANCY
Issued to THE MAY ItSTITUTEIMAY INSTITUTE HYANNIS
Address 132 Great 'Marsh Road
Centerville
USE GROUP. R4 FIRE GRADING OCCUPANCY.LOAD
THIS PERMIT' WILL,NOT.BE.YALID,'`AND`THE BUILDING SHALL`:_NOT�BE,OCCUPIED UNTIL
SIGNED BY THE BUILDING,.INSPEDOR UPON SATISFACTORY COM,PL`IANCE WITH `TOW.Ni
CT
REQUIREMENTS'AN IN ACCORDANCE WITH.SECTIO;N 119 0 OF THE MASSACHUSETTS'STATE
BUILDING CODE.
.Tune 26.... .. .. ���„ �p
19.' .
Building Inspector
,. .•� �,. .. - •�_ ... r
,,Twr TOWN OF BARNSTABLE Permit No.
.. . ......:N/A.
BUILDING DEPARTMENT N/A
TOWN OFFICE BUILDING Cash ................
7 Nl
•� HYANNIS,MASS.02601 Bond ................
VEMP01( ARY
61
CERTIFICATE OF USE AND OCCUPANCY
Issued to THE MAY INSTITUTEIMAY INSTITUTE HYANNIS
7- -
Address 132 Great Marsh Road
,
Centerville
USE GROUP R4 FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL-NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON "C SATISFACTORY OMPL'IANCE .WITH `TOWN
REQUIREMENTS AND IN ACCORDANCE WITH.SECTION I19.9 OF THE,MASSACHUSETTS STATE
BUILDING CODE.
.June 26 51
19
Building Inspector.
y ; DE�A.F!T W' 7 0rAt
" r._.. .._... _
a
ArrL'. 'A;iO!; t0F iirr*;Sl'F /Fr1�E'. A� : irr1;c��r,r
(lf Fenewal Application , enter rresent
License lrumber and Expiration Date)
License f' Expiration Date
I. Applicant Information (PI ease type all responses)
"Applicant" must be a corporation (business or not-for-profit) , sole
proprietorship, partnership, ioin,t venture, trust , or other ent.t':
organized in an% legal business form which has legal responsibility
for the administration and conduct of the program.
A. Applicant Tame: The May Institute
Office Address : 100 Sea View ` '•-reet, Chatham MA 02L33
y Street io'-M Z.p Code
C. Executive .Director
Walter. P. Christian , PhD
D. O.- --'ice Telephone : 508 / 945- 147
Area Code ?umber
�Tcg_a �: / CC&I
A. .oca _cr. c: -
prcgra- c: e Nz-e (_: ar,) May Institute Hyanni
C Add_ess cf . rograr; Site :
132 Great Marsh Road
-,tree
Centerville, MA 02632
io' =. -C e
D. prog:a- Site Tele-,hone : 508 / 778-1330
?.rez Cc-e tiI.r_ber
Site D_-e s" . Ann McNauahton
Derartre _ uen_al e-a-czt ._.. Con_72ct -.der .
r s -a-. site _S cC -e-.._'v recei� i,.g .Cuts
..._ - t' a^ _ c_c'J2, ra� _
-Cs.,;e ( __ `.•'�..` ' `^�O A-ea Ct .ce ,iia p
. ProcraT c; e Cr kc0T1 1-1ut : J
G , is this �^r- -
ca . 1Cn f Cr c . -^t.-a'" ,a: has "E7" -E .C'�:a:E_ c
' F::e thzt %'as pre%•icus:� . _censer er hac p-e� _cusl�' a;;liec fcr
ensure' des he X (-f ves, cow.;^fete next line)
r�Evia.�<_ `prCgrar.. t�'rE
-e•. -cus prc;.rac Fcdress
r.. is this APr-
i' catior, for a preE-ar. that has been eaeratec rre� ousi�'
�'es Ae X (if ves , cor,;lete next 1inE1
b`• another vendor?_�
r
Previous prcr-a-• :pE
Previous vender
"roc-a^: InfCr--,a• ion
� . Tvpe of Prog-a=: (Cheri: only cne prog-zT,, t ' Pc)
1 . Mental Fetardstion
a . X Cc-�un'_ Residence
b . ed Cr cu.p Fes.dence
c . Sta``ed Apa7tmen.
d . Cocpera:ire .pa-.teen
e , Soc_al/Pre-%1oca: _ona: Tra _ning Prog-a
S. Care 7,acemen: Alen:?'
Ca:emen.
are . .
Alt ern a:_fie ?rc_'a •
C^_. E
E7.1 FL': . .._ ':C :Ct
C.- E2SE he a^a. _R1en, ur,. .
�,Gs F-v client cr -
cF1E _s:CES � ec _
(,: %•es Fiease _ _ S:
c: -S2 U S
c=ier,.s , EE1�-r. ese. .'a-.
E :ne SC�7esS , '1'J .'tee: c. _ i
c_P< < ' ` _cz .icn e_` c:ler._s and ,ele?hone r,uc.oe . .`er esc..
- "- j `^G_
a a::-me:. ur,i . -_ - ._n :'ne ;:C�.-zr.,: (attach ac__
7a es necess27_')
c . . __
ieiD_:)hCne c` c-
e-"
.J2 17 e C � -
7.
_- --:a:ec ca:e -- �- ca_Z __ - 8-1-91
-ce- o` C, .En:s `" e7 `' _ :lie . = c-. 3
�. -
3
-- =^39 -=-- 67= _- _ _
4 cS 5
nu-._e: of clien E c... re-._ e 77 E 77 o-E
reciients : —
C . C .a , _ FC , i . TE eC' c En - ,
... . _ 7 ,
knc'r-:, plEase project :_ o.
r DoeS .ne .,
Zra se7%,e Cr . .er:d tC se rve Pne ( C. E C. . E7l s
SlbS .an _al r" --- �• - c rn�^,.5� ies 1�: x
I . PrCZ72M size is :
Cc-.c_ E .ely accessible tc the mobili aired r'Erson
In pa . z accessible _o I nobility .repaired ^erscr,
_ Xi;ot accessible
J . Does the prc•sra provide res74-te beds' es ;;p X
A a7^a iv e ^a-
p . ,_ . c _he Does .ne nDV_ iCa inLe .c ear .^er•_ `cr
O Ga: 'ec'
the7C� :E es M.
1Q�C"L._2. 65 - 22. 6:' 10= `•'es 1:o X
LC.c_ C^e.C ._ 1^ DuGEe _ _Cr .. a'a-. 5 _.___
S 407 , 128 . 50
c_ _far_-nEr. _ "'_...E: r.ea: _,. _.. _-a _
-
-.._er a!_ SCL':"=25 a7'; c ,CU7,_S C_ .C' r _ -`G
_ude . an}' c_-eat ,coarr_ _ •.s . (1 -c .aI _ _ �.
s ecua: SEc.:C
- �.. )
c� -
DMR Contract $383 512 50
Client contributions 23 , 616 . 00
f
the A . _ Can . CCn: . a. .e _le;a-.^er• _ Ir: ifiE ^a5 .
c
X )•eG
: . vex Yea
-s
C. iaes the A"^lIC2r, in ten t0 CCntTacC ti-'lttil the JEMa.. men . In .iie
next .u'e ( 1 yea-s ? hes X 1;e
--- . -leer F12n C ` ^7^c727, e
A. �'. th this Ap^'_ication, re:u-n a :1007 plan of the ,:rn—aT, si
to induce . lc . ion and dimensions C` windo'.:s , ha_l -a. s , s .a_--a s ,
Crux s,crage areas , bathrce^s bedroc^s , IiVin d...inz -s ,
dens and barrier-:ree areas , if they exist .
It is hc: necesSa7V to a:taCh a :`icon plan to the A : iCa: :07.
:cr rene aI lace^sure , un.iess changes cr re nova: Ions h2 e bee-:
-,ace :n the pr.siczl pier.: )
1:u-ber 2'_1 rac-.s and iden__`� rooms b� rune ._en.
LeZnl
t a5- the r.^.liCa t .OT a-MY Cr __s er:p1C"ees been the
�-oce0^_;1•Cc su^ieC . C: any _ega'_
e CTela he care .-Ea E
S•„ -
: ,
nSi„ 'es : is etC
persons
^er _sicn or en. -rcrment c_ s - -=--
`
X '
_- Cep , a Se:p7ate Ca_e CL ._-.._nZ
_ -_ ec _fir. _ _
_ -he -:c--.a icr c- ,_a_ne= Here-.. -
_ c_ . . __ _
CE' -- -,. ...
` _e Cti• _-10''a:_Cr. t0 - E JE:'cr .'cr.. :'•c: a
n C E.a c0' _ v. '
be Tec _red L^der sta _ _e cr -eZ�_acn .cr _he ;.'. - se ,,_
__-gat•,:-E
Date
9C c /� /d Pam'! /6'/ -G f
1
K
i
T
In it
t
F, Ho
t
c
v
v
11
j Fi Rr aoa(Z
ALARM
NC>„�. �� �
rr
i 4 CENTERVILLEOSTERVILLE MARSTONS,MiLLS
FIRE DISTRICT..
p .1875 ROUTE 28
t {CENTERVILLE,MA =02632. -
` 790-2380%FAX7r.(5O8) 790-2385
e
r;fF }r 'FIRE PREVENTION,INSPECTION REPORT
A,
Di�q a:'"� �/ I �• f� ��a x^"`. 4. _" a; .x n_�
T E
��:„ 'tr`'` ! � }t �:.'s�, � } #t. �}� z,ay�i se *M��o-<':t t>1,, '�. r #Y. t t �q '•-� $,�
�j4�.\) y/) ',7,./ {(-/�j '�`g/
1 �#r t t !' r'..r`/ �'/ / l/ i -hr-r •� MC, PROPERTY QCCUPIED BY ��� � � r� L � �x
ty �H.
-..`J - �'m'9 • _t�����:�V A:. }'$ 3 �.. ix,"' y {1 ��.:'k" �¢:v -+t�+� ' j y;. e'/`.\ �• 5�,..�.t"�.�`�S�F"n„l �� �-"t�,{5-��, t T J•
ADDRESS
'�`s w {.: { y a r �'¢, �''Rti�`• �,ae^-..�' �r�`flta^u J ^s* � ++" „:. t � � ?r _.xf� `� 1' � �i �"*�r t
4: } s l H�a ixsr#" �;' r��t' kY� ��
COMPLEX t. u ,.� x, �LOCK 64X:�Y
{ �,'R.cif'"`s ,, 'k Y •?`a * rs � s -2e^^,,� rT,�?, :;r r�r.. J x '"f ,f`Z--fr LOCK BOX LQCATIQN. s.
...�
' 3'.� a.•.# 4..., t'+r i -
�^...
/� a�J:al�` < 't r�(/t=t �J <7x rs ,5a �/y®)
Fr"BUSINESS OWNER {• / /�/ 5/ ' ~/ �*04'W T4h 9 't"- / V t
PHONE v
x :� 4 a- e ,• ,�'.. T a £'. d y. r.y r 3�s Ye�.,� k rev 'rt ,�, v 3..� x ,x,.
Bt1ILDINGOWNER `' �- 514- 1C' n11 S �' her*'PHONE Y(�/;Ld'�
.. a
';a .z, . •yf*�, a d�"3 a' itaay"'•3�'r�� s a• y,?k�'*'op",
yt . .t�. �4 ....'"7 '`tS;z*"
EMERGENCY PHONE NUMBERS A: r�r
wa. �,�r +*a.•s rM; y,•..,,. �y v�;;Y J,+ �ti- 'i,a� :YC� �f�..a ��gy asap u� a. __,' •W _;1� 1,t�X�t �:r
` „'� P7 as'r' �r"�..sf+t t m eG 4 4 } N ns:a` "ss an^
„ r s M >PHONE x
::�" g .s..yu''� � . es 1 H r k•.� r , .Y'.. k t»xiS k ''ay;^� ar+.k•
j.:i� w 'a, �"i. ,r sa::+},:. � 2�,L �'•.< Q fir;?;�r7'k''+3,'!`�'s s}�r..1?`.^r .-z"`� '�: 't• � .r;=
wt q,. 2r / -l/lar /iS:G :•,'a- a "Eu„- rr�,.-ir r• Mr}Y ..a' �rx.•k "#,}'is, = I
<.,� HON w - x f
E: a�.
�/r. ..}€. 'f,'��'tY.'• �v}� C11
Iy e' F, t2 ,s SZ ,,i.C..: 1. 3 { `s4Y �,y '�T[, 'M'f'-1 't+ � fiµ !j.Jn- '�-w ,.y}� '.w�1,Y' ?f' r# t.� .�
L_P Wt Y. e iY. P 1"t' T+ k 3A:S�"'[ Y f 't�,,R 3� -
` .fin•-.-, W' .. '� �''A}Y" i.',� FY°Y` f wr ht�+..,
-. F+r><.`3". T •� :Ni J
-i i ... :.. . ,,, - • ;: -`' .'. .-' 1.r n.. .' t4 53.... -Y '.' .r� .< r' r��ti a ,a, � �h p s:
� T
FIRE ALARM SYSTEM x LCX;AL r �N. �SYST M," � 26C BLDG. YES ° � 'NO. `y
' ' s s
-SPRINKLER SYSTEM. F.D. CONNNECTION: - � ` 1
SHUT OFF LOCATION:
HOOD SYSTEM YES: . NO: r :,EXPIRES.
FIRE EXTINGUISHERS: _ YES: ' NO: ' ` EXPIRES:_ J!f
EMERGENCY LIGHTS: -YES: NO:= tiryUPIRES: -
'sas.:233saa3sss_rmascmas—g=mxr:^saaxs3s sass a =SSCi^t:,33Tx ssc 3
✓ELECTRIC SHUT-OFF (MAIN): 4'S•►
: `GAS SHUT-OFF.
5PECIAL HAZARDS 1 = -
/C/���"Lj��)�SjJj
r!!J rl/M'L..�� .� � ... �. ..r►3 S.:Z'es53`�t33�..—.w
VIOLATIONS. F ou: 5 i 7) `rc � ���� `0,4 g2cj39»'L
y CORRECT.VIOLAT IONS BY:-
FIRE INSPECTOR: 'nC� S 4P.f_d
OCCUPANT: -- Mf,
WHITE COPY/ DEPT. YELLOW/F.P. OFFICE PINK/OCCUPANT
.. .TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
Date -.. _-
�'-� a ' /--------
r
.94wer -------5- "------ -- ---- - Tenant - ------ -
Address --- - -----� ------M- ------------ Address ------------- -
Compliance ;i Remarks or
Regulation $k Yes No I' Recommendations'*.
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities
i
7. Lighting and Electrial Facilities I -
i
8. Ventilation
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use
i
12. Exits /' f
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
I.( I _
16. Sewage Disposal
17. Temporary Housing II
PART II l
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
I�
Person(s) Interviewe
----- --- -- - - - - - Inspector --�--, --------------------------------
If Public Building such as Store or Hotel/Motel specify here ____._-__.._..____-__-._______________________________________________-.____.._-...__-__-.._____-___
3
aammvnirfpalt� of rmassar�usetts
TOWN OF BARNSTABLE
In accordance with the Alassacliuscits state building code, section 120.0, this
CERTIFICATE OF USE AND OCCUPANCY
is issued to THE MAY INSTITUTE
� (gertifV that lhave inspected the.,-.q!pn.imunit.y..-Residen ce known asCenterville Residenm
locatedat 132 Great Marsh RA', Ihe —V—i—1 of Centerville
County of Barnstable Commonwealth of Massachusetts. The building is hereby certified to be in compliance
with the Basic Code and for the purpose stated below.
USE GROUP R-4
FIREGRADING (X'C.111,ANCY
August 16,_1991.
Date Certificate Issued.......... likling Offic'iall
771c building official shall/P(-twiiiii-d ofany changes in the aboWinforina-,
COMMONWEALTH OF. MASSACHUSETTS
• CI•TY/TOWN OF BARNSTABLE '
• APPLICATION FOR CERTIFICATE OF INSPECTION "
.Date . 8/16/91 ( Fee Required (Amount )
( X) No, 'Fee " Required
In accordance -with .the provisions' of the Massachusetts State Building
Code, Section 108 ,15, There* apply for a Certificate of Inspection for
the below-named premises located at the following 'address :
Assessor's Map and Lot / 132 Great Marsh Road
Street and Number May INstitute Community Resi ence
Name of Premises Group Home for mentally retarded adults
Purpose for Which Premises is Used
License( s) or Permit( s ) Required for the Premises by Other Governmental
Agencies :
License .or Permit Agency
('nmmnnity Residence Department of Mental Retardation
Certificate to be Issued to The May Institute
Address 20E Camp Op'echee Road, Centerville, MA UZbJZ
Owner of Record of Building Poyant
Address 282 Barnstable Road,-Hyannis, MA 0
Name of Present Holder of Certificate
Name of. Agent , if any N/A
. Vice President May Institute
SIGNATURE OF PERSON TO WHOM TITLE "
CERTIFICATE IS ISSUED OR HIS
AUTHORIZED AGENT 8/16/91
• ./P
INSTRUCTIONS : DATE
1) Make check payable to: . N/A
2) Return this application with your check to: BUILDING COMMISSIONER
367 Main Street, Hyannis, MA 02601 (4th Floor)
PLEASE NOTE:
1) Application form with accompanying fee must be submitted for' each build-
ing or structure or part . thereof to be cer
tified.
2) Application and fee must be received before the certificate will be issued
3)' The building official shall be notified within' ten (10) days of any change
in the -above information.
CERTIF CATE
� EXPIRATION DATE:
� FORM SBCC- � •
3-7i�'p
' s
May 17. 06 ,06: 30p RMOS VICENTE _, , . 15084204334 p. 1
l
q •�
\� 10.
}
May 17 OS 06t3Op AMOS VICENT.E 15084204334 p. z
Cc'rnmornsnwealth of Af
r A.Ss8ch4lf,eYiTS {*Depar#►znc®f Ire Se oe� Uso oai
BOARD of FIRE P �rlces pemaitNo.
R�V!~N710N R'ECIUl.ATION.S occu
p•g, f��oo��yyg- //--yy prutcy and Pee -"
APPL lrPi I 4J ��� PERMIT Rev. l 1/99) leave b ckc@.arm '
All work to be �� ���� dA�
(PZEAS.EPRAT 11VIN perfonreed in hcccrclance with the Massach oR ELECT
OR 7q'�EAa IxFO usetts mecwcQ Code ��C AL. WO
B ��'Ot'xOW11 Of: A RMATION) C)° 7 Ch'IR 12,00 ��
Y tfi:s applicadon the urdersagned arst�bzt ��te:,��
"Catioia(Street& gives Lice 4f is or h ro the
Numbex) in on m foraleeta'of�Yires: �--
Owner or Tenant a ctrica'Fork
"` described below,
OwOer+s Address
Mm
+: Parcel
Is this perndt in Cq Tcsephonc No._ �-
Purposc of$ n)uactior�with$I�atilding pernI aildi:aS
E*ting Service fIp (Check Appropriut�.i3ox
ew �'? Ainps t VOItS VtRity Autthoriz®Lion ly o. c )
� u �._ Amps l�;Q / � �erlRead�^ I1'iY
01
Number of Feeden and Aonpact dolts ��� No.of meters
O"11hend '" Uru3 -t,
Location tlon arrd Natuu c of pia `�' grd C1 No.of "b
,posed lElectric$I Work -�..tt3FhLp/ Meters
No.of '"�
tccssed Futures �"' -- -�_C lerwn o rho odlowrn
No.Of[,(ghtin No.Of Ceil.-Soap.(Paddle)F table Ge avaive�b t!u Ins actor a Wires
g Outlets ) ans 0.0
_._ No-of LightingNo.of H_0ot nibs Transformers ���A
fYmh�res Generators
No.of Ileceptaeie Outlets S1111,&X'ool ave n• OVA
rod. Jmd. (� v.o 'mery erx.
No•4PSwitctaes INo.Of Oil lsurraers Bane Unith
No.4f Ra No.of Gas'Burners
'I Af,AIt S No.of?,ones
ages _ a.o ate
No.of No•of Alr Coa�d. o.ta
Waste Disposers Initiatin
Devices
ishwatshe eat Tons
.�� er orlc ds Na.of Alerting,Devices
No.of D' rs .. o.o�on
lYo.of jp Space/Axes U.,Ping KW Detectioa�lAlcrtirt l�ejices
rYors
0.0 Rter fXeatirlg Appliances ILocai Q unIcjp _. _
k7feate. �r o. Conntection l0*4e .
0 XW ecurity � : i
CIO.Hydro WkSUge Bath� Si .,. IY0.0 No.of� b
t
Ballasts Data Wirinngg "� uivalent�
OTHER: IVo.u1<11xoCc., No.of dfe
_ 7C4tul7P c ecotn�mu vices orb uivaieat
Na oFlC9evicea est' artag:
XNStlRA!`iCE COVE �.. ...... Etrivalet�t
the"coraece GE' U'niess w r.,k ad.�tional detr�t!tf�rSired,or Q r 1
provicics a�ucd by r,:l�•,t,.a,:;,a, ;yn , ��
un�Iersigned certii<es tphat suc,�lia ilia iZsu c IM'«lliit for the s equired by rh
)' [suet ;). lradi r • t d A�for,xiexee of eleetrica yr I�tPector ofire.c
c:ai �,
ONE: INS?,'lZ,e Nam. &e is in.4rre,;t„n L c DLL °Aeration'°covcraBe Or its subsr Qri issue unless
Estirueted Value of 1✓leoRtical Wp
+-y 4 c:.` 'c of of same to the Pcnniit issuing off Icnt. The.
4LEe
�
Work to Start: r
�Sr,_. (�:�:•„(l re aired I cep ft utrder P kspe_ct omq to be r 4Y otuaic:p$l poliCY.) /Jc'(
r an d pe s v cc�e e'red)a accordance with /FIRM N� t tY ✓peti"Y,that th r In orrn Un this a IBC 1ge'lo 10,erd n
on ion complct-on,
Licensee: - f ,PA1ze z&n is rrue and complete,
t'6l applicable,etrter"exempt-tic the tic"Ut mcm6er l;n�y Signature �--—._. LIC.No,
Address; LIC.NO.
SIIdEIR'SNSURAIYCE WA 6 Bus.Tel.No.•
required by law. R: T nwure that the Lice Crt 4$ does notliave the liability insura>1e
awnerlA,gent 1}Y ary signature below,C hereb w ' Alt:Tea.11'o.k
5IL'�ehtre Y aavc thzsrc�ufrcmrrit, � , 4 GonFllc�ot 11
(checx OIZC)
�'elephone Nn. ..,,W,0"t'1' I- f
L., Town of Barnstable
oFTHE r Regulatory Services
1% Thomas F.Geiler,Director
I x Building Division
anxivsTnsLE,
MASS. $ Tom Perry,Building Commissioner
16;9. �0
iOrEp Mpl A 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-7 0-6230
Approved: rI f0 3L15
Fee: C20
Permit#:
HOME OCCUPATION REGISTRATION
Date:
Name: Phone#:,Q 0
Address:l-?,,,,2 V l at4- z,`Li a`j Village:
Name of Business: -C
Type of Business Map/Lot: t�I D Clip
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there
is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
•, No person shall be empoy d in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
1,the undersigned,have re nd agree with the above restrictions for my home occupation I am registeri .
Applicant: Date:
Homeoc.doc 0/03
TO ALL NEW BUSINESS OWNERS
DATE:
Fill in please:
APPLICANT'S vx" YOUR NAME: /
BUSINESS YOUR WOM ,ADDRESS:
C
TELEPHONE Telephone Number Home
NAME OF NEW BUSINESS TYPE OF BUSINESS i ✓ G
IS THIS A HOME OCCUPATION? YE 0
Have you been given approval frnxn the building division? YES NQ�— 6per g�
ADORESS.OF BUSINESS O Z'-P o l ,�Lw MAP/PARCEL NUMBER v
When starting a new business there are seve al things you must do in order to be in compliance with the rules and regulatiQ& of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed
below,you may apply for a business certificate at the Town Clerk's Office fist floor-Town Hall] or if you get the business.certificate first you MUST go to
the following office to make sure you have all the required permits and licenses..
GO TO 200 Main St. - [corrjeri of Yarmouth Pd. & Main Street) and you will find the following offices:
1. .BUILDING CO MI SIC
ER'S
This.individual h b in rme rmi requirements that pertain to this type of business.
ho d teat re**
COMMENTS:
2. BOARD OF HEALT
This individual has been informed of the permit requirements that pertain to this type of business.
Authorized Signature
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L.
•it does not give you permission to operate.you must get that through completion of the processes from the various departments involved.
919A INNS A PROYAL FORA BUS/NSSS ORIIFIGArf P/R Y
Building Departm
Complaint nquiry Report
a R
Date:
— / ec'd by: (4� Assessor's No.:
�'
Complaint Name:
Location
Address:—
WP
.7 71 �1Z7�
Originator Name:
Street:
State: zip'
Telephone:D/E
Complaint
Description
Inquiry a
Description:
For 0 ce Use Only
Inspector's &Zt
Action/Comments Date:_
a Inspe`ti°r.
yo
Follow-up
Action
Additional Info. Attached
Cop}'Disuibuaon: White-Dcpa=cut File
Yellow-Inspector
pink-Inspector(Return to oince Manager)
J
i�
I O /71
4-0
7c
Town of ]Barnstable i
i s
h�°FEE 'ti�, Regulatory Services .
Thomas F.Geiler,Director
163 Building Division
ED�'�► Tom Perry,Building Commissioner
200 Main Street,Hyannis;MA 02601
)ffice: 508-862-4038 Fax: 508-790-623 _
REQUEST FOR ELECTRICAL INSPECTION
• - ELECTRICAL PERMIT NUMBER ,
(Permit required in order to process inspection)��Gl-
Today's Date Requested Date of Inspection
hereby request as inspection under Massachusetts
General
(Electrician)
Law chapter 143, section 3L and 237 CMR 4.020).
The installation will be ready for inspection at
(Property Location)
Type of inspection requested: �?
❑ Temporary Service ❑ Service Re-inspectio
❑ Excav ri ❑ Rough Re-inspection`
Service Inspection ❑ Final Re-inspection
❑ Rough Inspection for ($50.00 Re-inspection Fee)
❑ . Final Inspection for
❑ Other
...Owner or tenant
Licensee's name, address,and phone . gg
License number . o .� Licensee's Signature
This section to be completed by Barnstable Inspector of Wires
Inspection date []Approved, ❑Not Approved
This work was not approved for violation of the following Articles and Sections of the MA
Electrical Code:
t
QmPriles.fonmAectmquest
Commonwealth of Massachusetts '
•, Official Use Oni
/ Department of Fire Services
Permit No.
/ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee C
[Rev. 11/99] pecked -------
APPLICATION FOR PERMIT TO PERT ea"eban�`
All work to be performed in accordance with the Massachusetts EIOe RM ELECTRICAL WORK
(PLEASE PRINT IN INK O 52 R TYPE ALL ). 7 CMR 12.
INF o0
ORM
City or Town of: ATION) Date:
Barnstable '
By this application the undersigned gives otice of is or h in a ion to erfor
To the Inspector o
Location(Street&Number) .f Wires:
e electrical work described below.
Owner or Tenant - Zma:) Parcel
Owner's Address Telephone No.T
Is this permit in conjunction with a buildingermit.
Purpose of Building p Yes ❑ No ❑ (Check A
ppropriatilcBox)
Existing Service 100 Am s / Utility Authorization No. I
p /�U Volts Overhead❑G" Und New— S�Ce �� Amps l dD / '{v grd❑ No.of Meters
Number of Feeders and Ampacity�Volts Overhead®` Und rd
/O G 7, g ❑ No.of Meters
Location and Nature of Proposed Electrical `
Work:
Con letion o the
No.of Recessed Fixtures ollowin table m be waived b
No.of Ceil.-Sus o.of e Ins ector o Wires.
No.of Lighting Outlets P•(Paddle)FansTorid
No.of Hot Tubs Transformers KVA
No.of Lighting Fixtures Generators r I KV
S A
wimming.Pool A' ove In-. o.o me enc
No.of Receptacle Outlets rnd. rnd. ❑ � $ Y ig m9:
Battle Unrts --�,
NO-of Oil Burners
No.of Switches FIRE ALA S Nogof Zones
No.of Gas Burners
No o.of Detec on an
of ds
: Ranges Initiatin Devices-
No.of Air Cond. Total
No.of Waste Disposers . eat Pum Tons No.of Ale g Devices
p umber Tons
Totals: - _ _ .K - __ K o.of elf- ontaine
No.of Dishwashers -�-" Detection/Alertin Devices
Space/Area Heating
No.of Dryers Local -
No.
Heating Appliances Connection El Other
o.of ater KW Security Systems:
Heaters KW o.of o.of No.of Devices or E uivalent
Si ns Ballasts Data Wiring:
No.Hydromassage Bathtubs No.of Devices or E uivalent
No.of Mote:,,.OTHER; Total HP elecommumcations Wiring:
_ No.of Devices or.E uivalenf
INSURANCE COVE l�Ye1 h additional detail if desired,or as required b th
RAGE: Unless waived by the c:ar.,the licensee provides proof of liability insurance innludia :r".io perihit for the performance of electrical wor Spector of Wires.
undersigned certifies that such coverage is in forge and has Fn2*�1et,�d operation"coverage or its substantial a issue unless
CHECK ONE: INSURANCE , R01" g. �'t proof of same to the permit issuing o lent, The .
L'1 BOND �...� OTI�F�� (� rify:)
Estimated Value of Electrical Wor �®� G�
Work to Start: /�,� (�°:'gin re sired by municipal policy.) /J�((E Date)
Inspections to be requested in accordance with MEC Rule'10,and upon complet on. 3lht y
I certify,under the ains and pe 'hies operjury, a
FIRM NAM f , tha;the in ormation on this application is true and complete.
�� i
Licensee: LIC.NO.: !r
(If applicable,enter"exempt"in she license number line.) Signature
Address: gk� - LIC.NO.:
OWNER'S INSURANCE WAIVER: -Bus.Tel.No.. /
required bylaw. B I am aware that the Licensee does not have the liability nsurance overage normally
Owner/Agent y my signature below,I hereby waive this requirement. I am the(check one ,
Signature ) ❑owner ❑Owner's agent.
Telephone No. PERMIT FEE:
y�fTHET��� TOWN OF BARNSTABLE
33ARNST'ABLL
PAS&
1639- BUILDING INSPECTOR
7/,—, de
APPLICATION FOR PERMIT TO ...... ..... .......... ... ........... ......... ..................................................
TYPE OF CONSTRUCTION .....e.p...q.. ....................... .........
..... ...................
710
..................... .......1 q..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .... LA
...... . ...... . ..... ..........................................................
... ... ....... ...
Proposed Use ......... ......................................
...........6..........................
Zoning District ... . ... ........ 7..... ..Fire District ... .... ..
Name of Owner .... ...16.1.ta..... Address .... ......
...... . ......... .. ........
sir mac=
Name of Builder 0 ...... .........Address �... ...... ....................
4� .......................
Name of Architect ...... . 10-? .........Address ..,.............................................................................
Number of Rooms .............11f...............................................Foundation //
.......................................1......................................
Exterior ......L
..........
/.-o. ..................Roofing ............................................................
Floors ....................................................Interior
/y,
Heating ..............Plumbing ...........9— q
.......................................................................
Fireplace .........--.tz.............................................. Approximate Cost . .....?02
......................................
Difinitive Plan Approved by Planning Board 0
4704-'y-----------------19 LL., U)
0
Diagram of Lot and .Building with Dimensions
U)Uj
Z
0 0
U-
U- 0
Lj- LLJ 0 0
0 U) 0
Of
z
<
0 0
04
UJI0
M U)
LLI
<
WSW
N
V)
<1 tn
< z
IL
V1.
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. 12
.............
Name
`ell"^""" John 1�r�U����� ,� �
u*�= ^^
'
No —q-��VL Permit for .......�—e—. --..
. .
le
� ---�+*u���..�e���u..���������--.----' `
� Location /��� . --Marsh Rod
.^-------'
�J ^
,.~--.---.. .--------.—
Owner --.--John. ________..
�
� ` ^
� ' |
Type of Construction ���g�. . '
�
PERMIT REFUSED
Approved
�
. `
�
\ '
/
'
U -
� ^
. .
� / \
/
)
! ^
^ -
................................................... 19
�
___.._____,.__,,,,___,.,,,_,_
� . .
—.------.----.--...—..~..^~..' \