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Home My WebLink About0888 PHINNEY'S LANE z:r«+�i �r°,�'St`''�a i�.-`y' tr7 ey� w,,' ��` bF �`' �.'g i rP''" .',�• ?�y'ca.r ,> r .tr,.: ,.n •.� :a .:. i'v' "y..r ,T!, ,. �i. .r;yya... i'f, �> y >w 'n a:�M �y;.�aeJ,y�3r... .}, i•:�y,.rr}, �' �.. �F K.Y �,U �.` r f 4 .,n yaw, ' n F.f. Tat `.;Y � iM.e' ,�, y:•�-� -�:3 O� ,;f ,�i«a�G. ��3z� �� Fn �.. �� .. Y a a a e o . . ' �v �■ as v i ....� .a.a u��.aa v.iv THE Building Department Services -ar T� ' ti Brian Florence,CBO o* Building Commissioner - +� . ` 200 Main Street,Hyannis,MA 02601 suss. 1639tAWn.barnstable.ma ns Office: 508-862-403 8 Fax: 509-790-6230 Approved: Fee: ^ Pernut-9: HOME OCCUPATION REGLSTRATI N Date:JJ Z0) V . l 3 Name: I�e(X��J 0�wn Zd T V Phone#: Address: vh)6l h_ Lon(f Village: GLIB/ +r'V 1_ ' Name of Business: lln�('l ��{ IcA ( (�1�,, J Type of Business: Ln Cr`d'..� Map/Lot: 2 S� f. I 0 y 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 ofright subject to the following conditions: , • The activity is carved 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 ofnormal 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 bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and agree with tFie above restrictions for my home occupation I am registering. Applicant -- /,✓r� Date: Homeoc•doc Rcv.06t20116 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.I,.-it dohs not give.you permission 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. I� Ffi •,:� ,- DATE: 1s.J`3 Fill in please: a APPLICANT'S YOUR NAME/S: Y7��'�r� �n�y�.,�_n �llt"�E�'J��ldlfa �'�n a ��`'— �—F—'�H ry) 2- c, .��:� BUSINESS YOUR HOME ADDRESS: A� � � w 3 TELEPHONE # Home Telephone Number C'�C 3 6 ntG 'lwi�aa7rx�r s EIN OR - E—MAIL: C> 1(CQh Se! GG� NAME OF CORPQRATION: P 6F c-" Ck NAME OF`NEW BUSINESS TYPE OF BUSINESS 161 IS THIS A HOME OCCUPATION? YES NO 1 ADDRESS OF BUSINESS lUP✓ G 02t1)3 /f`-�AP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &'Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usiness in this town. MUST COMPLY WITH HOME OCCUPATION 1.. BUILDING COMMISSIONEV OFFICE ` This individual has been d of an p mit requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO _Onn,pl_.Y MAY RESULT IN FINES. Autho ized Si atune* COM ENTS: CrZ C' • 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 1 Parcel I O O' F pp Map. ARNSTABLE Application # . -75 Health Division �?'7 j 7; Date Issued 3` Z ZZ � Conservation Division Application Fee Planning Dept. Permit Fee (`,rT J ti T Date Definitive Plan Approved by Planning Board . 0p4" Historic - OKH _ Preservation/ Hyannis C / e✓yl w l rod Project Street Address \ N Nc.., LN raA) MA2— Village �( Owner �?A LEA r Address Telephone �S�Sr� g�7 - 2 ?Z- 9 Permit Request CD f 4,�e lzs,,,. D c.)or 1--U 6 b- L.-C A e \< 20 4 Q e A/+ ' Sr —�c F/ t� �L c�C1� � Z tl S �l.d►a� Square feet: Tst floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 Mo,7 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New 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# Current Use Proposed Use APPLICANT_INFORMATION t (BUILDER OR HOMEOWNER) Name V b o-, uQ-t-.t rb"PuV Telephone Number a , Address License # l G z S L�.7 vc �E 6 "7 7 Home Improvement Contractor# `� L Email 4 ��nnA��_ o Worker's Compensation # �s �01 loc.) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE J ` 2) 1 i FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP.%PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT �' ASSOCIATION PLAN NO. 4 1 To of Bmrastable P uer Mu t O w oaf Ce, : d axe die fl-Sp6tSib li—,6f ifie app any:. <)& Si Of th�ni�r. Si r-Of Appk t 11i'm Name: r The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 U1 . Boston,MA 02114.2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leidbiv Name(Businessl0rganization/Individual): 'Z 1 t`u 1n Z—N L'Jt a!j1 &N.) Address: b- o City/State/Zip: oA-,k ILN9 Phone#: Areyou an a ployer?Check the appropriate box: o-1,77 ) Type of project(required): I employer with employees(full and/or part-time).* 7. ❑New construction . 2.M I am a sole proprietor or partnership and have no employees working for me in 8.•.Q Remodeling any capacity.(No workers'comp.insurance required.] 3. I am a homeowner doin all work 9. El Demolition ❑ g myself.(No workers'comp.insurance required.]t 0 lam a homeowner aid will be 10 Q Building addition 4. hiring contractors to conduct all work on my property. I wAk ensure that all contractors tither have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.C]Plumbing repairs or additions 5.❑I an a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-corttractocs have employees and have workers'comp.insurao t 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. I4.71X 152,§1(4�and we have no employees,[No workers'comp.insurance required] •Any applicant that checks boot#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the ors and state whether or not those entities have employees. If the subconnctors 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.#:�,J (f C7 S�02. y 10 C.) Expiration Date: Job Site Address: City/State(Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirationhate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th pan4penalties,qfperjury that the information provided above is true and correct Si ature: Date: 7 / Phone#: aZ) official use only. Do not w)4e in this area,to be completed by city or town offidd " City or Town: PermWIAcense# Issuing Authority(circle one): 1.Board of Health-1 Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ' Q' o of Cm$t>m AMS&d Bili Rnuufim IQ P' _wte 517o 021.16 v � R�e�stta�.cm Rom. low'! IWW. Prima co�ltoat � 7Q00'!8 no489584 RETRCFrr MULA7 ONt INC. L t�E LLY P.0 105 r, SEEKONK,MA 02711 V Vaed" LW Cud tsce�a�. iar sr�, � ate►+, » GlAs%-WMUWS"�dEwdd� VAN for bawlsn 000at �d&Oath nikapAadaa orr baiaesiisara�c8laoala�e.�i�3raeotiaso, •tom: aa� •p�a[,t�omnmei�dsaameD,iieama :w•• pffift In lol�T�s-ardie��.zor *vIMAOUU FXtIlIVP3t,if�i»�=- VaaAe�7 �+►3ilras�t Massachusetts-Departml Pub lic,:SafetY Board of 5uiiding Regulatians and Standards. c.utau u�:wu'•'a}uaa r550i' License- CSSL-102771 PO Box 105" Seelnonk:MA,027�1..: % - . ;:.... ' �. �'� S' sc•�a''''.- Farpiratio,'�:�.' �.G.. •� •coissiorter 06 mm l513047`=`s RETAINS-01 RBLACK1 CERTIFICATE OF LIABILITY INSURANCE °ATE 8/11/2016112016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poliey(ies)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICenSe#1780862 CONTACT NAME: - HUB International New England PHONE 676 222 Milliken Boulevard a Ext:(508) -1971 ac Na:(508)678-2150 Fall River,MA 02722-9946 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Selective Insurance Company of South Carolina 11920 INSURERS:Star Insurance Com any I18023 RetroF-rt Insulation,Inc: INSURER C: PO Box 105. INSURER D Seekonk;MA 02771 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEROIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITiONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR POLICYFF POUCV EXP A TYPEOFINERALLIE IN SO D POLICY NUMBER MMIDDNYYY MMIDD/WVY LIMITS A X COMIdERCIAI GENERAL LUIt3tL1TY EACH OCCURRENCE $ 1,000X0 CLAIM -MADE FY]OCCUR X S2187653 08/15/2016 08/15/2017 PREMISES Me occurrence $ _ 100,00 MED EXP(Any one person) $ _ 5,600 PERSONAL&ADV INJURY $ 1'000,000 GEN'L AGGREGATE UMITAPPLIESPER: GENERAL AGGREGATE $ 2,060,000 POLICY a PRO. a LOC JECT PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY EOMENNED SINGLE LIMIT $ 1,000,000 A ANY AUTO �10018200 08/1112016 08/1112017 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOSN-O NED PROPERTY DAMA $ lTiOS (Par accden t X UMBRELLA LiAs OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR HCLAIMS-MADE S2187653 08/1512016 0811512017 AGGREGATE $ OED I X RETENTION$ 0 WORKERS COMPENSATION I PER 07H $ 1,000,0.00 AND EMPLOYERS'LIABILITY YIN STATUTE ER B ANY PROPRIETORIPARTNERIEXECUTIVE C0845201 08/0212016 0810212017 E.L EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? �MIA � - (Mandatory in NH) EL DISEASE-EA EMPLOYE $ 1,000,000 if Es RIPdesTION under E.L DISEASEr POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mare space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 Washington Street ACCORDANCE WITH THE POLICY PROVISIONS Westborough,MA 01581 AUTHORIZED REPRESENTATIVE 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD c03 61)5111_5�A� Town of Barnstable *Permit#jD/,!�ro 3 l �v �'p r Expires 6 montl S rom issue AgeN Regulatory Services Fee t &UMSTABLEMAM r 0 Richard V.Scali,Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint , Map/parcel Number / Property Address � kt ,d /,Z& Residential Value of Work$ �� ` Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name ;T . `r/0O1 as Telephone Number 1�2��9�'T Home Improvement Contractor License#(if applicable)' t Email: wtc.fcea e E c K Construction Supervisor's License#(if applicable) 1]Worn's Compensation Insurance Check one: ❑ I am a sole proprietor e� Q ❑ I the Homeowner I have Worker's Compensation Insurance Insurance Company Name /o Ulf AYh01 /Workman's Comp.Policy# N OF BARNSTABLE /�.�!/k• ��(,t'�,w`( .,��,�^,� n,, Copy of Insurance Compliance Certificate must accompany each permit. Permit Request eck box) /1 e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken-to V�eA" 66w;:zlV,�ItV4, AC ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value. (maximum.32)#of windows . #of doors: ❑ Smoke/Carbon.Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the H me Improvement Contractors License&Construction Supervisors License is requ•,ed. r' SIGNATURE: QAWPFILESTORMS\building permit fo \02RESS.doa Revised 040215 ' • t x �tNE tom,c • RARMABLE • MASS. Town of Barnstable Regulatory Services Richard V.Scali,Director a 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 I, (/ ,as Owner,of the subject property hereby authorize I&Ic AJ to act on my behalf, in all matters relative to work authorized by,this building permit application for: � n ; (Address of J b) / Signature of Owner D to Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. , QAWPFILES\FORMS\building permit forms\EXPRESS.doC Revised 040215 Town of Barnstable Regulatory Services oFt Richard V.Scali,Director Building Division WRNSTABIX ` Tom Perry,Building Commission Maas i639. �� 200 Main Street, Hyannis,MA 0 01 www.town.barnstable. .us Office: 508-862- 038 Fax: 508-790-6230 HOMEOWNER LICENSA EXEMPTION DATE: Please P ' t _ JOB LOCATION: number street village "HOMEOWNER": name home phone work phone# CURRENT MAILING ADDRESS: city/ 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 ' who does n possess a license,provided that the owner acts as supervisor. DEF ON OF HOMEOWNER Person(s)who owns a parcel of land on whic he/she r ides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structur acces ory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be consider d a meowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she sh 11 a res onsible for all such work Derformed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsi ility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/ he understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she w• 1 comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings con g 35,000 cubic feet r larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S TION The Code states that: "Any home caner performing work for hich a building permit is required shall be exempt from the provisions of this section(Sectiontog .1.1-Licensing of constru tion Supervisors); provided that if the homeowner engages a person(s)for hire to do such wor that such Homeowner shall a t as supervisor." Many homeowners who use this exem tion are unaware that they a\ ssuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Lice n •ng Construction Supervisors, 2.15) This lack of awareness often results in serious problems,particularly when the omeowner hires unlicensed.p�rsons. 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215