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HomeMy WebLinkAbout0491 MAIN STREET (COTUIT) I � i i Cl ^��� su TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel DyWc'�I Application # ( Health Division Date Issued Z L Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address S4- Village (_ )Ez y) +(— 0II C__(1?3 S Owner ����ra�i7av1 Address Telephone Permit Request I/� yCam! Ot`-. r�-so �& �.d--�%oni vLG and t-s Square feet: 1 st floor: existing M proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 00 Project Valuation 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 o Total Room Count (not including baths): existing new First Floor Rood Count Heat Type and Fuel: .❑ Gas ❑ Oil ❑ Electric ❑ Other a Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/ al stovq;❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ -Msting hew ize_ 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 (BUILDER OR HOMEOWNER) Name C Vic?�. Telephone Number 7 Address c) ��`4�Cb 61-4 i — License # [,P Home Improvement Contractor# 7� f Worker's Compensation # o?t a. (aom ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN SIGNATURE ATE l I FOR OFFICIAL USE ONLY i . (' APPLICATION# I,1 ' DATE ISSUED r MAP/PARCEL NO. ADDRESS VILLAGE ' r, OWNER :w DATE OF INSPECTION: FOUNDAT.ION3� +�.1 -_ -c ' FRAME ,x INSULATION FIREPLACE ,i ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL v` FINAL BUILDING; 27 DATE CLOSED OUT ASSOCIATION PLAN NO. o vYTw-Ctmlrzrrsf€ rrtlt n ? asscretrts "�e�rtrrerxf a���zds�st�urt.4cci.�lerrt.€ - 0juke-Of bmla igoofrs 600 ffiz—h rigton Street Bmfaq,,M,4 021-1I wn-mmas-sgc-1dia ' urke.is' Cumpensatioxtlns=—ace Affidavit:BuilderslC-onfi-actorslEIechicians[Numbers Apyficant Infermation Please Prof Leib Namo ousinetislOaganizafinal�ividna�_ LAK � rbue/Uli9i Address: Ci /statei " �� �l t�`� Phone-� � Q 9 7�1- lire you an employer?Gbeck the appropriate bow 4 T of. o-ect r a:: . confmctor and' l_�I am a employer tivitfr � I gma f I 6_ ❑hear caaTftuctioa Io ees fu11 an&os -time. * have hired the sub-cont=to s. Y {' P� � '7_ Res�odeliag 2.❑ I am a stile puprietor or partner- listed on the atlaohed sheet ❑ ship and haze no employees , These sub-confractore have g_ ❑Demolitica . w ci employees and have r.�or--ers' e orkmg form.e in any cages. �r- ii7ci�rani�1 - ❑Building additic:* [K4workeis'coMp: +tr to ance comp. M-q°ice(L 5-❑ We area corporation aud ifs 10_❑Eltctrical repairs cr ai>ri:�or�s officers hav�a exercised fneir 3_❑ In m.a hame,r�u�ner doing all wror�: 1 I--❑Piumbing rqpaj Nmyse er aci;iiu:x�. right of e�tnpfioa per 1AGL 1€ [No workers'comp_ � 12-❑IZDoPreprii1� i�t�t a,t�e 1 e- 152,§l(4,and.we .^s'e,ao- req� .-] 13_❑od er employees_[No worl`ers comp-insurance required.1 *Any agg $tat cbehs boa fl most also fll oa th--sizhua below dwwbxg fli&woxRen'comptnsadQn poliz- mafiun- Homeowners vrbi3 submit this affxdsvif inn r xtatE dZy are doing 39IMA anal them huE outside coat--ctns nmsi subalA a a--w€m—ii r=r<n�_Mea- = ctnrs that cltgk this bax must sttadsed sa sddition, sheet sho he,—the mmne ol lase a&s-mhf-<bx3 rod s'ab-uhethec ocnot t�sa��fi s fi�� empIoyees" If the sob-conttact=have employees,th,2ymust p=Ae that warkrss'comp_pa}�cp nunhes -lam art employer ihatisprmidLmg ttorl=ers'cD rtarrliD.tr uu�trrutca for r� e,9xplDl yes eats is thopo q and job xao iri�`ormDh`ra.n i Insurance Comp.,lame: Ace6(�C-Q, _ Policy-or Self=ip,Uc-k yaCD C) Expiration}date: Iob Sift Address: 1-1 V FJII N � iG Cib"'Staf eLizip `��1 �� ty � Attach at copy of the workers'compensation polity-dedarstion page.(showing the lioH4 number anA fnTi-ati on date). Failure to secure caverage as required under Section 25 A of MGL c- l52 can lead to the impositi m of comma/pen-fti.es of a fine up to$1,500.00 and/or on--year—imprisonment,as well as cizal penalties in$e form of a STOP WORK OiMER and a Em of up to 250.0{i a day against the violator_ Be advised that a cry of this statement r ay be fnnuarded to the Office of hrvedi�dom of the DIES for insmance coverage�Wiflcation- r F dtz fter,4 ct*rti the prunr aides Dfgar urp fltatf3te in ormcd&n prcn i&d ubrttre i- nrtrf correct` `' Date: Phone if: 7 4 , (}f tciicL use ataF}. Da not wit in this arerc„to be completed by cit} or tag n a tczaL City or Towa• ra-Miduccuse m Issuing Authority{circle one: : I.Board of llealth,2 Building Department I f i€y/Fawa Clerk 4-Electrical b speetor S.Plumbing P� ctor .6.Other Contact Person. Phone 9: b Informafion and Instfnefions Massachusetts Gene-ral Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 comu_on rc�lth or. =uy applicant who has not produced acceptable evidence of compliance with the insurance.corer. ge required." Additionally, MGL chapter 152, §25C(7)states"Neither the co=oawealth nor any of its politcal subdivisions shall enter into any contract for the perfo_imance of public work until acceptable evidence of compli.a�, c_c the insurance requirements of this chapter have been presented to the contracting authority_'' Applicants ---- Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their cti n catc(s) of insurance. Limited Liability Companies(L LC)or Limited Liability Partnerships(I.LP)with no cn,'ployees other i an the members or partners,are not required to carry workers' compennsaton insurance_ If an L L.0 or LD?goes have employees, a policy is required. Be advised that this affidavit may be submitted to the De;:ari raent of indtir ial o conf=atlon of incirr-ance to e e c e ii ` -�i i� , t Accidents for v rag . Also b s_re to sign and date the au,d2, i: i�_e�,._c_�jZt sbo�d be returned to the city or town that the application for the permit or license is being requested, not the Dcpariineni of Industrial Accidents. Should you have any questions regarding the iavt or if you are required to obtaID a atorkers' compensation policy,please call the Department at the nu.aber listed below. Sell insured companies slwuld enter their self-insurance license number on the appropriate at. City or Town. officials Please be sure that the affidavit is complete and printed legs-bly. The Department has pro vid.ed a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact yo:a regarcLL_g,L> e applicant Please be sure to fill in the permit/liceuse number which val be used as a reference number. L a?d iZr.,n,an.applicant that must submit multiple peimitllicense applications is awj given year,need only submit one affic avi.t indicating current policy information (if necessary)and under"Job Site Address"the applicant should write"ail locan-ors>ln (city or town)."A copy of the affidavit that has been officially stamped or narked by the city'or town may be prop ided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new arl datii 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 bum leaves etc.)said person is NOT required to complete this aiida;-it 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_ no Corsrmonwi--al&of Massachusttt b Depaitme t Glndustdal Accidents Office of kv=esf gato-xzs 640 W sh ngtaa gtc t Boston_14A 02111 Tel.9 617 727-49-QO Qxt406 or 1-9777-MASS Y Revised 4-24-07 Fax 9 617 ` -7-7-749 7jWr Ma..s,-.- oWua t ' ® h ACORU CERTIFICATE OF LIABILITY INSURANCE 5;M""°°'4"' 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($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder is an ADDITIONAL INSURED,the policy(les)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 endorseme s. PRODUCER CONTAcT Erica H O'Connor HART INSURANCE AGENCY,INC. 4WAL .--- —_...._-_--__--.-.-__— 243 MAIN STREET PHONE 608-759-7326 x205 ac 508-759.7366 PO BOX 700 E NWIL ADDRESS: ._��..—_. - BUZZARDS SAY,MA 025320700 INSURERUAFFORDING COVERAGE NAIL 0 INSURERA: PENN-AMERICA INS CO - 32859 INSURED Scott LDhr dba Lohr Home Improvement INSURER e: ACADIA INSURANCE COMPANY 31325 23 Grand Oak Rd Forestdale,MA02644 - • 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 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 SHSUER! OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRTYPE OF INSURANCE POLICY EFF PO EXP' --'- •- LIMTS POLICY NUMBER A GENERAL LIABILITY PAV0027252 10511512014 05/15/2015 EACH OCCURRENCE S 1,000.000 DAMAOiE R COMMERCIAL GENERAL LIABILITY i MIdIU5AEa sewlrranr $ E2,000',O 50000 CLAIMS-MADE I OCCUR I I I .1 MEOEXPLnYane arson S5,000 PERSONAL B ADV INJURY S00,000 - ! - ----- GENERAL AGGREGATE S00 GEN%AGGREGAT_EUMITAPPLIESPER: I I - I - I PRODUCTS-COMPIOPAGG S 1,D00,000 POLICY PRO- i LOC - S AUTOMOBILE LIMUTY - ' COMBINED SINGLE LINIM- 1EILOC- ANY AUTO I 1 _ - BODILY INJURY(Per person) S _ ALL OWNED -- SCHEDULED - AUTOS AUTOS I t i BODILY INJURY(Per aWdenU S NON-OWNED PROPERTY DAMAGE _ HIRED AUTOS AUTOS - I� � (Per i I --• S - UMBRELLALIAB OCCUR i EACH OCCURRENCE S EXCESS LIAR JCLAIMS-MADE I (L ... ---- AGGREGATE S DIED RETENTION E B WORKERS COMPENSATION WC202000536000 05/15l2014 05/15/2015Yrnru• OTH s AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIFXECUTIVE I OFFIC NIA E.L.EACH ACCIDENTS 500,000 ERIMEMBER EXCLUDED? _. . (Mandatory In NH) E.L DISEASE-EA EMPLOYEE S• 5W.000 n yes•de9aibe undef ( . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S. 500,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addi loml Remarks Schedule,B more space Is required) ERTIFICATE HOLDER CANCELLATION Fax#:(508)775-3344 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE.' TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 230 SOUTH STREET ACCORDANCE WITM THE POLICY PROVISIONS. HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE 0 1 988-201 0 ACORD CORPORATION. All rights reserved. CORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Housing kin Assistance Corporation cW CW HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE APPLICANT HOME OWNER. I hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation '( herein after referred as "Agency ) on the /property located at: 4 The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: - Weather-stripping & caulking of'`windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission'to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. ,-I have read the provision this agreement as listed and freely give my consent'. e Owner: (Signature) c I Date: ' t Agent: (signature) -VIV Date: �L �1 Massachusetts -Department of Public Safety sach Standards Mas and Sta � Regulations , - Board of Building Construction Supervisor License: CS-053961 y SCOTT A LOHR a • 23 GRAND OAK RD 02644� STDALE NIA . FORE , Ir,���,� Expiration Jam,, 06/0912015 Commissioner toomvn�yre�reai ��l�credaury�udPk6 License or registration valid for individul use only Office of Consumer Affairs&Bdsmess Regulati on a Y i before the expiration iration date. 'If found return to: HOME IMPROVEMENT CONTRACTOR Registration: a.172172 Type: Office of Consumer Affairs and Business Regulation Expiration. .5/31,/2016 DBA 10 Park Plaza-Suite 5170 -- - Boston MA 02116 LO HOME IMPR,OVEMI:NT 3 r r, gm SCOTT LOHR � t,`� �_ 23 GRAND OAK RD+ FOREST DALE,MA 0264, w. Undersecretary i. Not valid without signature • i �`l d e Charted Mermaid s u. y Deborah A. Va (774)238-8449 dwatson02635@gmaii.com Town of Barnstable OF SHE Regulatory Services Thomas F. Geiler,Director sexivsr.�sr.E, Building Division v� MASS. Tom Perry,Building Commissioner 1659. 200 Main Street, Hyannis,MA 02601 - www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: �- HOME OCCUPATION REGISTRATION Date: Name: 0 Y 1 SO y\ Phone#: —0 g �o� O Address: 1'` l0.\� `� ti+� PIA ���'3� I � Village: Name of Business: a- Type of Business: 0 D Y Map/Lot �z 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 dNvelling: 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 Builduig Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: a The activity is carried on by the permanent'resident of a single family residential dwelling unit,located 1•1athnn that dwelling unit. a Such use occupies no more than 400 square feet of space. a There are no external alterations to die dwelling which are not customary ui residential buildings,and there is no outside evidence of such use. a No traffic will be generated ui excess of normal residential volumes. C The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,huiridity or other objectionable effects. a There is no storage or use of toxic or Hazardous materials,or flammable or explosive materials,un excess of normal household quantities. a 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. a 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,auid 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. a No sign sli<all be displayed indicating the Customary Home Occupation. a If the Customary Home Occupation is-listed or advertised as,a business, thee street address shall not be included. a No person shall be employed inthe Customary Home Occupation who is not a permainent resident of the dwelling unit I,the mnders• ned liave read and agree with the ab e restrictions for my,home occupation I arm registering. Applicant: Date: r ` Homeoc.doc Rec.01/3/08 YOU WISH TO OPEN A BUSINESS? - For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR,NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis: Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: A,EiS1 kYN ra ' APPLICANT'S YOUR—NAME/S. c� r a�. • �� 5 0 BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number Z K) © O 9 NAME w NAME OF CORPORATION Q:: y .. TYPE OF BUSINESS A r t�.dr OF NEW BUSINESS iS THI$:A HOME OCCUPAT SION YES NO ADDRESS OF,BUSINESS .:' �-�-✓� 1�l N( ARCEL NUMBER assin 7 C� .Z Ass : - ( 9) 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 COM ION 'S OFFICE This individu ha be fo'rme c of pe mit equirements that pertain to this type of busine UOST COMPLY WITH HOIIAE OCCUPATION Aut ized S' a ur ** RULES AND REGULATIONS. FAILURE TO CO MENT COMPLY-MAY f4I*,Q_ L�4, - V 0 �3- 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: 7/0��Z - Town of Barnstable Regulatory Services OF THE P� ti Thomas F.Geiler,Director �8�>� QF 8 �4STBLE Building Divi o * BARNSTABLE, y MAC Tom Perry,Building Co s iQpe 0;} Pti 1639. ,0 i,,t4 �ztI J�Jt1 Cll �� �� �AtFp r�.t a 200 Main Street, Hyannis,1V1'A'0260T www.town.barnstable.ma.us Office: 508-862-403$ � I-A Fax: 508-790-6230 -72 Approved: 2 Fee: o��. — Permit#: HOME OCCUPATION REGISTRATION Date Name: 32 e \o o�A t, IOA,-C S o r Phone#: 77Y S o9 1 • 9 18 y Address: c( I YVI fA �e� Village: Col LA Name of Business: O ------- 1S --------------------------------------- To Lo^ cow `hype of Business: Lk v \,o 2 r V 1 C_ e— —Map/Lot:— 0� � INTENT: It is the intent of this�section to allow the residents of the Town of Barnstable to operate ahome occupation iagtliin single family dwellings,subject to the proArisions of Section 4-1.4 of the Zoning ordinance, proWided that the activity shall not be discernible fi-oni 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 grounchwater 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 4.00 square feet of space. + There are no external alterations to the dwelling wwhich are not customary in residential buildings,and.there is no outside exidence of such use. • No traffic«rill be generated in excess of normal residential volumes. • The use floes not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. O 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 mthin 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 Occupationi,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 fire Customary Home Occupation. • If the.Customary Home Occupation is listed or advertised as a business,the street address-shall not be included. • No person shrill be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, have rear]and agree with the above restrictions for my home occupation I am registering. q Applicant: (/ vv Date: % a 0 ` 0 / Homroe.doc Rev.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 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.) Business Certificates area vailable at the Town Clerk's Office, 1 s` FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) =Z!,k u , , mod. DATE: oZ 0' `� Fill in please: APPLICANT'S YOUR NAME/S:__�—o o,rFkTS O v1 BUSINESS YOUR HOME ADDRESS. Lk`t m, s A t // r C TELEPHONE # Home Telephone Number a � NAMEOF CORPORATION: NAME OF NEW BUSINESS__ ( i� tits ' TYPE OF,BUSINESS S`r V r C IS THIS A HOME OCCUPA ION. �/YES Nol. ADDRESS:OFBUSINES9 MAP/PARCEL NUMBER 0 .U [Assessing] When starting a new business there are several things you must do in'oraer 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 COMMISSIONER'S FFICE This individual has be rmed o a y permit requirements that pertain to this type of busineso.UST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO Xluthorized Signature** C MPLY MAY RESULT IN FINES. COMMENTS: CA- o 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: BUIMM9 ComplainOkViry Report Die, 7' O ` Rec'd by: Assessor's No: Complaint Name: Location Address: .WP Originator Name* C Street: vruage: ` Telephone:D/L Complaint ❑ Description: Inquiry ❑ f Description: For 011rce Use Only Inspector's Inspe Action/Comments Date: �/7 X � or. Follow-up Ll a Action Gam!'✓ Additional Info. Attached Cop}•Distribution: White-Department File Iraoiv-Inspector Pink-Inspector(Return to Office Manager! Y 1 1. N 1 f l � R OL +l � Y ' •,A+ +ems,1'S.Li �`_�� fI j ,yy va �t ,�� � �t• � ��} �^ ;'. .• . '' rid .��se�� � : �' .6 t: +f -_ '-• � - SX_ � y ril r` '.;.�_ �Yr � _ -:.ems �Q W t� i Jfea'71 �p r Y tot r L 1 la � Expires 6 months from issnc c Jtr ,,, Regulatory Services Fee EL#r "" . $ Thomas F.Geiler,Director ;7 1 s6�¢ �O 'W1i`I s,X7 �'°rEo tom' Building Division ` Elbert C Ulshoeffer,Jr. Building Commissioner a"; -"Vnast 367 Main Stint, Hyannis,MA 0260tb Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PER5UT APPLICATION 1 , Not Valid without Red X-Pras Imprint N Mapiparcel Number /c),z Property Address 1/�� /6/rl�i� -ST �o"TU 7— Residential OR ❑Commercial Value of Work �/ w Owner's Name&AddressDr.✓n(�D ✓�`i7-�aJ Contractor's Name GR 4/ / 1��—�/ v��-�4nLIr Telephone Number Home Improvement Contractor License#(if applicable) /CO Construction Supervisor's License#(if applicable) 24rkman's Compensation Insurance Check one: (] I am a sole proprietor I am the Homeowner E-fhave Worker's Compensation Insurance Insurance Company Name Z1 D uwG e-.,JG $ Workman's Comp.Policy# � CFt S UYJ Ilid C° `k (7G91.S7 V Permit Request(check box) Re-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) ® Re-side Replacement Windows. U-Value (maximum•44) [] Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.M. Signature i expmtrg