Loading...
HomeMy WebLinkAbout0278 PRINCE HINCKLEY ROAD � �, o u . � ., . ,� 1 _ . �. .. . . ,k. . . . . � . . . .� � . F Y . . o� 4 :;. � - .. -. � _ _,. r ,, .. L _ � - � .. ;a .a'� .. ,.PRApplication number...,.22....�.....c./ �7......... _ 11 r.. a Date Issued........:....* .......1.. SEP 2 2Qi9 ......................... tARNSCAB � C,E. � MASS. a C� In r)�= BARNST ABLF Building Inspectors Initials... ......... Map/Parcel......... 71....15.2'.............................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY MORMATION Address of Project: c 2 7 f' hr;e%c e- i i c k(e y NUNMER STREET VILLAGE Owner's Name: Phone Number ;I) 36 D -,/G 5 7 Email Address:cr.,a� e r ^c4%4-Ae4- Cell Phone Number Project cost$ 6 k 44 7 Check one Residential ,/ Commercial ONVNEWS AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CVM Owner Signature: See Mad L e � r���- Date: TYPE OF WOE ❑ Siding Windows(no header change)# 3 ❑ Insulation/Weatherization Doors (no header change)# ! Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to w ( J-e mo„fit, MA CONTRACTOR'S INFORMATION Contractor's name A��re� ' P o�e ( VS A Home Improvement Contractors Registration(if applicable)# 11 Z7 S (attach copy ) Construction Supervisor's License# &D S4 (attach copy) Email of Contractor Swe,,-1 f2 S�e ma • c Phone number -4/o /- 7IV- G 3`7 9 ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUE®. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. F- *WOOD/COAL/PELLET STOVES Y Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOM EONVNERIS LICENSE EXEIVT TION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT S SIGNATURE Signature Date /1f=Zl All permit applicatio are subject to a building official's approval prior to issuance. Home Improvement Agreement: Pagel Home Depot License#'s - For the most current listing www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Janice Campbell Salesperson Name: Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/ or service the equipment listed below at the price, terms and conditions as outlined on this form. Caughey Cindy New England South 1-MLJMZXT Customer Last Name Customer First Name Store #/ Branch Name Customer Lead/ PO# 278 prince hinckley road Centerville MA 02632 Customer Address City State Zip (508) 360-4 1 71cindycaughey@Comcast.net Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address City State Zip Or Email' I customercancellationnortheast@homedepot.com Service Provider Email Address BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGNj!UIRIGHT TO ACKNOWLEDGE T OU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF TO CANCE Acknowledged by: 08/26/2019 Customer's Signature Date Contract Price and Payment Schedule : Payment o6— lntract Price is a upon signing unless a different payment schedule is required by law, specified below or in a payme addendum. Contract Price: $ 6647.00 1 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(99%) Dep. 125.0 % Deposit Amount $ 11661.75 1 Remaining Balance $ 4985.25 The Home Depot-2455 Paces Ferry Road, N.W.Bldg.B-3,Atlanta,.Georgia 30339-Customer Care:1-800466-3337 460FI HDE Customer Agreement(24 Jul.18) v 0.1.8 1 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,ALL 02114 2017 - www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AL TTHORTTY. Applicant Information Please Print Ledbly Name(Business/Organization/Individual): N n r,-\c--- �—�- Address: q Q S �oS-Ft7n Tt,r•�r,i K e City/State/Zip: CejAl S 6v 1' MA Ot Sy S— Phone#: -7-L4 -,�_-7 5 - L i ,S Are you.an employer?Check the appropriate box: Type of project(required): LQ i am a employerwitl,__ lemployees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling; any capacity.[No workers'comp.insurance required.] ❑3.�I am a homeowner doing all work myself[No workers'comp-insurance required.]t 9. Demolition. 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole l l.0 Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.�I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs ra These sub-contractors have employees and have workers'comp.insunce. (/ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other /✓/n Q St d O r 152,§1(4),and we have no employees.[No workers'comp.insurance required.] r pp 4 tf n e,- 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing 0 work and then hire outside contractors must submit a new affidavit indicating such. tContiactors 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 n:y employees. Below is the policy and job site information. Insurance Company Name:. 4&e Ial UYIiQ1 1�"G �P�(a/1cP ��,,�a�✓ Policy#or Self-ins.Lic.#: X 11('_ S (0 5 5 01 `7� � ` Expiration Date: 3 — ( -2- O n Job Site Address: Z �' ' `��n t' H,i,�(f'��/ ��/.'City/State/Zip:CP�a-,,,-t/� ti t Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirfition date). Failure to secure coverage as re aired under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonm as ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. py this statement may be.forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un an enaldes o information provided above is true and correct. Si mature: Date: Phone#:,.403 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 if: 1�eptaa�e�t� rl�ia�`1�crida�s ' Office 00"C&TO&OM 600 WaSbfi ion et B4rstvY4 M4 02HI WFP'R4 mamgm1dia WOrlmm' CGwpeasaEm 1nsurmmceAfrdavif-Raiex Cnn �.0 a�t =-i �ers .Nagre � ,qkaroma ftj A 64,w Ph.,-- &V�f-QbL-6 yyZ Arc Ym an=gllayer?Crieck the appragriate b= Tyke of project(regua.,e4-- L❑ Ia na employervda 4. ❑I am<a general ccen tmandI * have l�ued:&eM*-ca�actom G. pNew� la�rees(�a�forgat#lime. 2XI am a sole groprietw orgarfuer- Hsted anthe ached she& 'I- ❑11—adev=g and hwo na emplayees . These sub-casdract=hwm 9- p Demalifion wod=6cr forMel M-Aay C2PaC4g employs andhave wodmss- 9. ❑Bm atTriifitm LNO tvo�'Comp.iusurmce amp.msmznmt recpzired_j 5. p We are a rrparafi=and jts IbL[I Electdcal repairs oradcEEMM 3.p I am.a h=w-wnw&6g aI1 wmk officets3mm emarcised ter IL E]Flumbrugrepaim ar md&fiam ' niyself[No warke6'omp- of a mnp ian ger MGL n❑Foafregais in required­]i c_M,§I(4k aadwe hwena employees[No wadoe s' 13 0otiier ca=lx mmmnm l • agp€�td&a5cfiec sfios�1mastaisasnouE9�eswf"saabe7awsiza=gei=wa&eze�pA.m�;o.�a infaFms'aoa I Hmneavrmsvft sabaft das.Effidaef in ft7 zm dOing e7F sad thea}ure=MideCVn=C9=MMst sab�tanewa�d t iodiczuna rnrh rCoatmdvsst5ztehec3:thsbasmustffttm mtsddi CM sshadS1OVC*gthea—ofthe SandstKmwbsffmarnaMmee shas� ' eemniiayees.IEthesn6-cv�d�sbareemgIay�s,tfieyamstgm�,�tb� S'�omp.paTicga�bet am an erhpZ*w ffLat&pr4vh fng tsnrkers'coatperrsrdiiori hLmraRce for mY enrglu}Tes Berow is Ma paNcy sail jab s Frc,�arrrsaiinrA . Iam=ceCamPmyN2111e_ , PORCY 41,or se f iw,I.ic;k Job Site Ad&e= -C4/Sw&zi7-- Affach a copy of ae warltiers'compensaflaagolicg decbralioa page(ShOMg the paficg amber and•erp1r2tio1X date)- Failure to secure coverage as requrseduader Sedan 25A of MGL c�I5'7 can lead to Sic imposilim of criminal perm ies of a fine np tag$uooi Oo andfor me-�rimpfison�as well as civil genalfies.in the farm of a STOP WORK K ORDFRand a Hue of up to$Z50 DG a sag a�rad fe violator Be advised gig a cogy offik shkmatmmaybe fo-rwu&d to the Office of Invvest4p iom oftize DIA.for hmmance coverage verfficaficdcL �rla Frer�p rcudBr i3rs pains ��asrta�xs�F�7�F�atf7re i�arnm#iut�prntded abar�ig has mld cxrrxec� i Siesatat� Date- Phoae A- �0 2-A Y2-- a Ass rrar£y. Do not�rrrfa in t arany tax be a mpLabed by city arfiaim�, I CRy or Town: Perndff icensef Leg Ajd orftT(carte one): L Board of Real& 1.Bmffirmg Deparimea 3.cAy1rawn Clzrk 4 Ecdfrical hmp=tnc 5,PkmbmgInspFectar 6.C"hw: . Canbct Person: p � 6 Commonwealth of Massachusetts It, Division of Professional Licensure Board of Building Regulations and Standards Construction-Stip040&or Specialty CSSI-100846 GaXpires: 06/18/2020 ERICSSON TORRES ' P P.O.BOX 673 SOUTH YARMOU,TH MA1326644 Commissioner �. f t r Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home ImprovemedLGo_ntractor Registration Type: Supplement Card - Registration: 112785 HOME DEPOT USA INC ==' ', —__-- _. Expiration: 04/22/2021 P O BOX 105451 ATTN: LICENSE MGMT TEAMi` ATLANTA, GA 30348 -- - _ -- -- Update Address and Return Card. SCA 1 0 20M-05i17 .mho Gimi�•ontceii�%/"�f`.•��ii;.iic�/%ui�//y Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:_�rJonlement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 04/22/2021 1000 Washington Street Su' 10 HOME DEPOT Q_ Boston,MA 02118 ANDREW SWEET 2455 PACES FERRIC&f -Y1 HSC ATLANTA,GA 30339 J Undersecretary N® alid It Ut sl nature } ACCORL? OAi'c(Mh1100/YYY'!I CERTIFICATE OF LIABILITY INSURANCE 92106;2c1� 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 policy(ies) must have ADDITIONAL INSURED provisions or be andorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an andorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA,!NC. NAME: PHONE FAX PNO ALLIANCE CENTER A/C.No.= A/c No 3560 LENOX ROAD,SUITE 2400 '-MAIL A I LANTA.GA 30326 aooREss: INSURER(S)AFFORDING COVERAGE NAIC S CN101642069-HomeD-GAIN-19-20 INSURER A:Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER B:New Hampshire Ins CO '23841 HOME DEPOT U.S.A.,INC. INSURER C:HomeRisk Ca live Insurance Company 2455 PACES FERRY ROAD INSURER o: BUILDING C-20 AFLANTA.GA 30339 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-28 REVISION NUMBER: 21 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO-n/VITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN.MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I -AODL'SUBR; POLICY EFF POLICY EXP i L TR TYPE OF INSURANCE I INVD POLICY NUMBER MM/DD/YYYYI fMMiDD/YYYYI. LIMITS X I COMMERCIAL GENERAL LIABILITY MINZY 114574 03101/2019 :03I01/2022 - EACH OCCURRENCE i 1.000,000 i CLAIMS-,MADE t K OCCUR DAMAGE 0 REN t i 1.000.000 PREMISES'Ea accurrence X SIR:S1,000.000 MED EXP(Any one?ersanl i EXCLUDED 'PERSONAL i ADV INJURY i i 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE i 1:300.J00 'POLICY jE 'OC PRODUCTS-COMP/OP.AGG i I,000.900 OTHER: AUTOMOBILE LIABILITY MINTB314$73• '031O112019 03/01i2022 OMBINED31NGLcLIMIT ! i 1,000.000 _ iEa accident) X :ANY.AUTO 30DILY INJURY IPerpersonl i OWNED SCHEOULED SELF INSURED AUTO PHY OMG BODILY INJURY(Per accident): i AUTOS ONLY '..AUTOS i HIRED .VON-OWNED PROPERT'!DAMAGE i AUTOS ONLY :.AUTOS ONLY .'Per accident ii UMBRELLA LIAR OCCUR EACH OCCURRENCE i EXCESSLIAE3 —'CLAIMS-MADE; AGGREGATE 3 DED : `RETENTION i i 8 :WORKERS COMPENSATION NC 012717099(AK,NHAJ.VT) I / 03/01/2020 X ';T,RTUTE �RH AND EMPLOYERS'LIABILITY B 'ANYPROPRIETOR/PARTNER/EXECUTIVE Y N ' 'NC 012717100(INI) 03/01/2019 '03101/2020 E.L.EACH ACCIDENT i 5,000,000 'OFFICER/MEMBEREXCLUOED7 N (Mandatory in NH) E A EMPLOYEE' 5,000,000 DESCRIPTION OF OPERATIONS oeiow Continued on Addlli0nal'3ge E.L.DISEASE-POLICY LIMIT i 5.000,000 C :Excess Auto 291110011002019 0310112019 0310112020 Limit: 4.000,000 A Excess General Liability MWZX 314580 0310112019 03/0112022 Limit 8.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455?.ACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Nlukherjee _1�Lauao ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 101oa?069 LOC r/: Atlanta A`GIR D ADDITIONAL REMARKS SCHEDULE Page of 3_ AGENCY NAMED!NSURED +HARSH,SA.INC. rFiE HOME DEPOT.INC. _ ---__—_-- HOME CEPOT U.3.A..INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 -------- _— ArLAr1TA.GA 10339 CARRIER - NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORO FORM, FORM NUMBER: 25 FORM TITLE: Cartificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity!nsurance Company of North.America . Policy Number INLR C65890549(AL.AR.PL,ID.iA.KS.KY.LA.HS.MO.NE,NM.ND,OK.SC.SO.rN;Nk/.'N'() Effective Date:03/01/2019 Expiration Date:03101/2020 (EL)Limit:i5,000.000 Carder New Hampshire Insurance Company Policy Number:WC 012717098 (DC.DE,HI.IN.,MD:NN.,MT.NY.;Rp Effective Date:03101/2019 xpiralion Date:03101020 (EL)Limit:;5,000.000 Carder:ACE American Insurance Company Policy Number.INCU C65890586(OSI) (AL.CA.IL.NC.0R.1/A,'NA). Effective Oale:03101/2019 'Expiralion Date:0310112020 (EL)limit:S4.000,000 SIR:S1.000.000 SIR for the Mates of AZ,CAAAC,0R,1/A.1NA Cartier:National Union=ire Insurance Company Policy Number:XWC i565596(OSO(CO.CT.GA,,ME,MI.NV.OH,PA.UTI Effective Date:0310112019 Expiralion Date:03/01/2020 (EL)Limit:S4,000,000 SL000.000 SIR for the;tales of CO.MEAV.MI,OH,P.A.UT 3750,000 SIR for the;tale*GA S350,000 SIR for;he;(ale of CT Carder National Union�'ire Insurance Company Policy Number.XWC 5565597(OSI)(MA) Effective Oats:03101/2019 Expiration Date:03/01/2020 (EL)Limit:i4,500.000 SIR:;500,000 rX Employers KS Indemnity: Carrierlllinios Union Insurance Company Policy Number.TINS C65221019 JX) Effective Date:0 3101/20 1 9 Expiration Date:03/01/2020 (EL)limit:S10,000,000 » SIR:31.000,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 i must do by M.G.L.- it does not,give you permission to operate.) You must first rbtain.the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: APPLICANT'S YOUR NAME/S: USIN�SG� YOUR HOME ADDR S:e2 TELEPHONE it Home Telephone Number So - 3 0 - � ��4vr�al�j! ?- E-MAIL:.. �.!// !l/x / NAME OF CORPORATION: NAME OF NEW BUSINESS e n TYPE OF BUSINESS e�> 15 THIS A HOME OCCUPATION? YES NOS/D/O ADDRESS OF BUSINESS. ; MAP/PARCEL NUMBER / 1 (Assessing] c/�vi/ e , ,' as V 3oZ When starting a new business there are several things you must do in-order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth . Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town, 1. BUILDING CO ISSIO ER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individ I imtDFm.d f a y rmi re uireme is that pertain to this type of businessRULES AND REGULATIONS. FAILURE TO Au on i natu COMPLY MAY RESULT IN FINES. O MEN' in P 2• BOARD OF EALTH 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. i Authorized Signature** COMMENTS: , IUWII Ul DarlIsLaDle ~ SHE Tp Regulatory Services pp � o Richard V. Scab,Director r • Building Division Paul Roma,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us' Office: 50 8-862-403 8 Fax:. 50 8-790-623 0 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: Phone Address: / -A, oC Village: Name of Business: r7yo Type of Business: 7 J 1 Map/Lot: 11WENT: 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 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 extermal 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 . dwe i g I,the uadersi d, read d agree a above restrictions for my home occupation I am registering.- Applicant: Date: Romeoc.doc Rev.06/2011. Town of Barnstable 00HE rok Regulatory�Services Thomas F. Geiler,Director, t HARNSTABLE, ]Building Division w y MASS. $ Tom Perry, Building Commissioner i639• �� °reanw(a 200 Main Street, Hyannis, MA 02601 www.town,barnstable.ml.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: t HOME OCCUPATION REGISTRATION Dale: lql Name: v Phone#: Address: rl ��,h c 2 [�� C�(� / / Village: del. l l/!•Z� Nanie of Business:-____- _�� - Type of Business: .V(G c-��✓1' INTENT: It is the intent of this section to allow(lie residents of the'Tolvn of Barnstable to operate a hollle occupat1011 vi'itlltn snigle fancily dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible front outside the dwelling: there shall be no increase ill noise or odor,,iio visual alteratioli to (lie premises li•Itich would suggest uiytliing other Ili-,ui a residential use;uo increase in Ira e above tiornial residential volumes; , and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary Home occupation shall be pernri(ted as of right subject to the following Conditions: • The activity is carried on by file ocrimuletit resident of a single family residential divelling unit,located within that dWellingMilt. • Such use occupies no niore than 400 squw-e feet of space. • 'There are no external alte.ratious to the chvelling which are not customaty in residential buildings,''irid there is no outside evidence of such use. No traffic will be generated in excess of nornial residential volunics. • The use does not involve the production of offensive noise, idbration,smoke, dust or other particular lilatter, odors,electlical disturbance,Beat,glare,humidity or other objectionable eflects, • There is llo storage or use of toXlc,ot'harirclous lMtteri;lls, or fl,unniable or explosive materials, in excess of nomi;d household quantities. • Any need for parking generated by such use shall be-niet on the same lot containing the Custontaiy Home Occ•upatiou,wicl not within the required front yard. • There is no exterior storage or display of nateiials or equipment. • "There are no commercial vehicles rela(ed to (lie Customary Honie Occupaticni, other than one van or one pick-up truck not to exceed one toll capacity, and oiie trailer not to exceed 20 feet in length and not to exceed 4 tires,liarkul on the same lot containing the Customary Honie Occupation. • No sign sliall be displayed indicating the Cusfornary Honie Occupation. • If the Custonl;uy Hoitle occupation is listed or adverlised as a business,the s(ree(address shall ncil be included. • No person shall be eniployed in the Custoni�uy Home Occupatior who is not a penTlallent resident ol"Ille dwellin r nit, I, (he undersigned ave read and t the above restric(ions for my holne occ•upatioll I ant registering, Applicant: Date: !� 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 Iwhich you must do by M.C.L.-it does not give you permission to operate:] Business Certificates are available'at the Town Clerk's Office,"l FL., 367 ' Main Street, Hyannis, MA 02601 QTown Fall] z DATE`. Fill in please: .w APPLICANT'S YOUR NAME/S: Se n.' C'�}000 BUSINESS YOUR,HOME'ADDRESS:. . �}-1 }tli"� ,(�r'1S,!11�P,frF c! ,S4z x C.J�— p '"a-10 �.. �e-�tT•�'rUl,��-� /�„t�' ll.�c� 4-StE�l+h { rt r{Tf r i,,ns t TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS OF BUSINESS l/ �c7 �zJ GT7 IS THIS A HOME OCCUPATION? ?c ' YES NO C/c, MAP PARCEL I�IUMBER J !1 '� (Assessing] . ADDRESS ®F BUSINESS �� �-��,�� v� / 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 O®TO 200 Main St. - scorner of Vermouth. Rd. & Main Street] to make sure you have the appropriate permits and licenses required to legally operate your business in this town. BOIL®II\IQ�CO 110lISSIO ER'S OFF CE MUST COMPLY WITH HOME OCCUPA' This individual h s h ionfor e i of nya per It requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE T --- - COMPLY MAY RESULT IN,FINES: 4 AuG oriz. S'gnat -__—-- MMNTS r 0 to C s o s i 2.. BOARD OF HEALTH ; This individual has been irj,rMQ i�f.the permit requirements that pertain,to this type of,business Authorized Signature**. COMMENTS: 3. CONSUMER AFFAIRS (LICENSINQ AUTHORITY) This individual has be9lgnfor& , e licensing requirements..that pertain to this type of business. , Au i orized Sgnature** - �oFTN r Town of Barnstable Permit# 10 1`6 u Expires 6 months from issue date ,ARttsr,BM : Regulatory Services Fee 9� , Thomas F.Geiler,Director A'ED MAC A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number n i ie5 'o� Property Address �l� �C\n C '� �-�t C��l,�� ("' <, Ce A t Residential Value of Work (WB© a Z) O Owner's Name&AddressC Contractor's Name ����� e �5 Telephone Numberd� '�6 6,3(3 1 1D Home Improvement Contractor License#(if applicable) \:9 LA Construction Supervisor's License#(if applicable)_ J5 �74 Workman's Compensation Insurance Check one: X-PRESS PERMIT ❑ I am a sole proprietor ❑ I am the Homeowner D-Thave Worker's Compensation Insurance MAY 2 8 Z003 1_ Insurance Company Name 2,>p C .1/� TOWN nF [3 a RNSTABL6 .Policy Workman's Comp .y# 6F act \'o I(a X 2 67—, q"6-0 Permit Request(check box) Q e-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side F ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this t do of exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: P e O e ust sign Property Owner Letter of Permission. Signature '.. Q:Forms:expmtrg Revised121901 MARK HERBST 35 Peep Toad Rd. Centerville MA 02632 (508) 420-6216 PROPOSAL SUBMITTED TO: WORK PERFORMED AT: Gil&Nancy Johnson 278 Prince Hinkley Rd SAME Centerville MA 02563 508-420-2314 We herby propose to furnish the materials and perform the labor neccessary for the completion of the following; New Roof on house and she Remove existing shingles Install 8"white drip edge Install ice &water shield at edge and in valleys Install shingle mate paper Install eertainteed 25yr fun=buster shingles Colorzkost blend Change plumbing boots Cut ridge and install cobra vent all debris cleaned daily Price includes material,labor and dump fees All material is guarnateed to be as specified, and above work to performed in accordance with specifications submitted for above, and completed in a substantial workmanlike manner for the sum of Five-Thousand Eight-Hundred&Seventy-Five Dollars(5,875.00)with payments as follows; Full amount due upon completion * Any allteration(s) from above involving extra costs will be added under written agreement, and become an extr ch ge over and above signed estimate/agreement RESPECTFULLY S IT Signature ACCEPTANCE OF PROPOSAL The above prices specification & conditions are satisfactory,we herby accept you are authorize �Wo p en will be as specified above. Signature(s) � Date: l�s'"-- 6�/ * This proposal may be withdrawn by said company if not accepted within 30 days K 4 Assessor's map and lot n url"' ........... ... . ...... THE PyOf f Sgwage-Permit number ...................................... 33AWSTAX E. House number .............t:2 MAB& . ........................................................... 1639- -h 0 TOWN OF BARNSTABLE 0 -1 BUILDING ;, INSPECTOR APPLICATION FOR PERMIT TO ..... .......... .... ...... 4 ...... TYPEOF CONSTRUCTION ....... ............................................................................................... ........... ............. .....19AY TO THE INSPECTOR OF BUILDINGS: The undersigned hereby apfes for a permit according to the following . .I.............. ............................i.n.f..o..rmation..: Location ...... ...... . .. . . y. .. . .. 'V5D ,.�e��../..././...e ........................................ 7e' ProposedUse ............................................................................................................................... Zoning District ........................................................................Fire District ............... Name of Owner zsslq. ....... 1)e4lel, .....................I..........4?�T4dress ..............I........... ....... Name of Builder .../....... . Address le.".. .3....7,.o..x...x....e.....? s.....e...'e.1..0...4..1...--..e..w...A................................. ......... Nameof Architect ..................................................................Address ............................................I........................................ .....Number of Rooms .................... ........l..............el .........Foundation . .. .......I.................................................................... Exterior ....................................................... fing 4, /- s/ ............ .......... Roo ..... / ......................... j�terior -K... ........................ Floors ..... ...................... Heating ......... Q, .... ....................:....................Plumbing .................................................................................. Fireplace .............................. Approximate Cost ...... . ......................................................... Definitive Plan Approved by Planning Board -------------------------------19--------- Area ...... .//49�. O.................... Diagram of Lot and Building with Dimensions Fee ....... -e.............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH a b regarding I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable le a rding the"above construction. Nam 6�) ......... .....—. ............ ADAMS, EVERETT V. & JESSIE g No ,23042, permit for 'BUILD. ADDITION .............. i i rid $1. 7:e; r.';am 3....D.n�.. ;l n9. ...1 ....... Road Location'. :�2.7..� �r nC. .Q...'Hric;�leY........... u.... ..:fie .t.P V.�.a,a.� ...... . . r ..........Everett V. & Jessie Adam, f � ^ Owner ....r.:............................................................ - - / ,r �,. .• . Ty.pecof Construction ..Frame.............. ........... ............................ .............................................. # " f'/ .y`• / • r -a I • .i Plot /............. .".... Lot .............+.................. F . .�✓ f +: .'�, �... i f � # - � - - r — ----- - -----; - S - ` Permit Granted ..P, ril...24.�...... 1,9 81 r Date of Inspection .................. ... ..:19' Y Date Completed .................... 1 19 �, PERMIT REFUSED ` ................................................................. 19 ................................................................................ ............................................ ....................................................... ............... ............................................................................ Approved ........:....................................... 19 a a ............................................................................... f 6 r t 22 �^6Assessor's map and lot number .1...21.:' /.*"" ....: / T y11_IQ OF Sewage Permit number ..........�.....�. .............. s ro INSTALLED IN CONIPIL f`J ` `f WITH TITLE 5 9 STIIDLE, i House riomber` ... ? . ................. 'tea ♦� ...... ................................. .. M ENVIRONMENTAL COD 39 `e pY a.*r � TOWN OF BAI NST' "�'L` ' _ . (10 y M r BUILDING 1_N-SPECTOR i try (1 c t APPLICATION FORS PERMIT TO ...... .. :...........:. ..............................:.. .....:.... . ............................... TY�_,'E OF CONSTRUCTION .................................................................... -64 Q.. Hi TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin information: Location ........ ........Z.C�..Z..... .. ................. ................................. ....... ...................... ProposedUse ...�. ................... ........................................................................................................................................... ZoningDistrict ................................................. .....................Fire District ........ ....................................................................... Name of Owner Address.....................f-.n..r.. ........... .........&— at".. Nameof Builder ....................................................................Address .................................................................................... .Name of Architect ..................................................................Address .................................{................................................... Number of Rooms .......�......................................................Foundation .....L�. �7.................................................. Exterior ... ..........................................................`.. Roofing Floors ................................................Interior ......1. .. ........................................ ....... !4-........... . Heating .......1:... ..l !'.r...........................................................Plumbing .......`..Zr..................................................................... Fireplace ..:.. .....................:..............Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -----------_______-----------19________ . Area �.��'. .. ..Q /........... Diagram of Lot and Building with Dimensions Fee SUBJECT TQ APPROVAL OF BOARD OF HEALTH 1� 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardi the above construction. Name ...... ....................................... Small, Alan E. w21984 Sin le No .................. Permit for ......... ........................ ............... ........................ Location ..#292.:.2.78...Prince. H.inckley Rd. Centerville ............................................................................... Owner .....................Alan ....................E 1 Sma1.......................... Type of Construction ....................Frame...................... ............................................................................... Plot ... ........................ Lot ................................ 'February 12, 80 Permit 'Granted ........................................19 Date of Inspection ..... 19 .-,Date Completed ..............19 P, 4 o%p PERMIT REFUSED ............. .......>....................................... 19 4 ............ .....................��l M................................................. ......................,1-M................................................ ....................... ................................................. -Approved .... ........................................ 19 .................................... 1 TOWN OF BARNSTABLE Permit No. -------------------------- 1 BAUSTAU Building Inspector Yua Cash ------------------ eO'r0 YPY � OCCUPANCY PERMIT Bond ----__----_- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor e first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address iJeilCeitllle Wiring Inspector Inspection date e� Plumbing Inspector ' Inspection date Gas Inspector Inspection date 1� Engineering Department 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 REQUIREMENT$. ............................. ....................................... .........................__._........................._........_._ Building Inspector LUO GA284r-E E;,RI 4JPE17- o b oO �dl L-e ;7L.Aw a Ito .c 3 t sso G.F.V. / 330,, (SO % * 4-9r?6.R0. USte- IOOb CIAL-. 12I5Po54L P1T - usE�IOoo G4"- rAO T��e. SUX-WALL AZEA : (5o s-1=. Ci et IC-7c) sI= 2.s = :�;-75 6-P.D. F I TAIdU- ?_ o To-r,AL ESIGI.I = .42S G.Pr->. fl 40 ToTQ 6.PD. PE!dGDLQTIOQ Vhl-= iIJ SAAI►J OlZ L>c`Fs. ZI - - at P 3CHARD ?prcl Top F'u o s i WoLf:-- rc.= 9g t ,, 4. 99, SJ$�1L. 4' IW. GAL. 4G Q 2 -Sox 90 G SepnC i INV. T-AWIC 9' l 000 q16 •° 1W ;. LH PIT � ' ' _5'0,voO w I rw 1, r, �"' walsuafl • 5'q'o�.IE 90.0 1 CEV-TtFiED PL C:>-r PL./A.;-] P�ZO'F"t L.� L vCA.TI O" W o Sa&.L-�-- c1�L.C— I 1 L'A,6 T,&. Z(G o CGIZ-rl =l( T14A-r Tt-IF-- F0,)Ql>A.10,Q 5tAowQ Pt -A" t•-If:omot , CcDAAPL%�lS W 1TIA T"i: 0413Z- /FWD SETBACK VGQutCEAAE."TS OF T►tE 7ow►.1 OP t'ZN�iTA�3 L� G N- z.V►t.L I�lr t��4 5 IVIA•7G r��O �� �,L-�,' �, / � �')�� B A)CTC tiZ, t;, t.1�C I�.J G- - RCGts rc_R�D i AWO 5uzva: 'olzs Tt-115 t�c_A�-t 1 uoT ZAScv 06-4 AW OSTEeV1L_L.C-- MAsS. ,I.1owL.a ANPLI �AtiJT u:ca; ru LoT