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Re: 1671 Falmouth Road, Centerville,Massachusetts-Proposed Uses
Centerville Chiropractic (presently in the Centerville Shopping Center):
Centerville Chiropractic is an owner occupied, single provider chiropractic practice. The office
operates with one Chiropractor, Brian Avitabile,D.C., and one Chiropractic Assistant. There are
no other employees as billing is performed by a third party agency(Andrews Billing Solutions).
Typical patient encounter time for each patient is about 35 minutes,which includes therapy
modalities and treatment with the doctor. As such,the practice is comparable to a physical
therapist's office. Currently, Centerville Chiropractic averages about 12 patients per day.
Ideal Health Center(presently in the Centerville Shopping Center):
The Ideal Health Center provides weight loss counseling services,using a specific protocol
called"Ideal Protein." Typically, clients come to the office to meet for counselling with a
weight loss coach; and they can also purchase proprietary food products at the Center as part of
the program. The average encounter time with clients is 25-40 minutes. There is one coach per
shift. Currently, the practice averages about ten clients per day:
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Re: 1671 Falmouth Road, Centerville, Massachusetts-Proposed Uses .
Centerville Chiropractic (presently in the Centerville Shopping Center): ,
Centerville Chiropractic is an owner occupied, single provider chiropractic,practice. The office
operates with one Chiropractor, Brian Avitabile,D.C., and one Chiropractic Assistant. There are
no other employees as billing is performed by a third party agency(Andrews Billing Solutions).
Typical patient encounter time for each patient is about 35 minutes,which includes therapy
modalities and treatment with the doctor. As such,the practice is comparable to a physical
therapist's office. Currently, Centerville Chiropractic averages about 12 patients per day.
Ideal Health Center(presently in the Centerville Shoppin- Center):
The Ideal Health Center provides weight loss counseling services,using a specific protocol
called"Ideal Protein." Typically,.clients come to the office to meet for counselling with a
weight loss coach; and they can also purchase proprietary food products at the Center as part of
the program. The average encounter time with clients is 25-40 minutes. There is one coach per
shift. Currently,the practice averages about ten clients per day.
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Page 1 of 1
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Anderson, Robin
From: Phil Boudreau [Phil@boudreaulaw.net]
Sent: Monday, January 09, 2017 12:08 PM
To: Anderson, Robin
Subject: 1671 Falmouth Road, Centerville
Hi Robin,
The address in the heading of my last email was wrong. I've confirmed that it is 1671 Falmouth Road and added
that to the attached description of the proposed use.
Thanks, Phil
Philip Michael Boudreau,Esq.
Boudreau and Boudreau,LLP
396 North Street
Hyannis,MA 02601
Tel: (508)775-1085
Fax: (508)771-0722
Email:phil a"boudreaulaw.net
This electronic message is intended only for the use of the individual or entity named above and may contain information
which is privileged and/or confidential. If you are not the intended recipient, be aware that any disclosure, copying,
distribution, dissemination or use of the contents of this message is Prohibited..Ifyou have received this message in error,
please note the sender immediately.
s
1/9/2017
Sign
TOWN OF BARNSTABLE Permit
* BARNSTABLE,
MASS
6 s
9$ArF A Permit Number:
Application Ref: 201006693
20070543
Issue Date: 12/08/10
Applicant:
Proposed Use: DEPARTMENT DISCOUNT STORE
Permit Type: SIGN PERMIT
Permit Fee $ 150.00
Location 1661 FALMOUTH ROAD/RTE 28
Map Parcel 209087001
Town CENTERVILLE
Zoning District SPLT
Contractor PROPERTY OWNER,
Remarks
REFACE AND RELOCATE EXIST SIGNS CENTERVILLE PIE COMPANY
14 SQ FREESTND &40 SQ WALL
Owner: DACEY, BRIAN T TR
Address: P O BOX 95
CENTERVILLE, MA 02632
Issued By: p
POST THIS CARD SO THAT IS VISIBLE FRAM TIDE STREET
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Town of Barnstable
Regulatory Services
BAWWML&MAM Thomas F.Geiler,Director
Building Division
Tom.Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 (7 b
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Permit# 11
Building Official approving
Application for Sign Permit
Appticaizti 1 �`��! --.Assessors
Doing Business As:� d✓7 iC��/, ,LOB_ 7 Telephone No. 77q- Y—/P-/ Vk6
Sign Location
Street/Road:
Zoning District:-,L-/-45-—Old Kings Highway? Yesp Hyannis Historic District? YeRnD
Property Owner
Name: ICI-CleY q_____-__Telephone:- --
Address:-Z..�a,--6-d ' --- Village:-aa ZZ -
Sign Contractor
Name: �_�— —/ �f /��- S_1�— ---Telephone: i y 2 �
Mailing Address: /�.?jo�-�Li/Tak-- p{2/�S° Zeal
--
Description
Please follow the cover directions.You must have an accurate rendition of sign with dimensions and
location.
Is the sign to be electrified? (15�/No (]Vote.Ifyes,a wntigpermitis required)
Width of building face ft.x 10-� p�x.10-
Check one Reface existing sign__or New Total Sq. Ft.of proposed sign(s) _5-
If you have additional signs please attach a sheet listing each one widi dimensions
If refacing an existing sign please provide a picture of the existing sign with dimensions.
I hereby certify that I am the owner or that I have the authority of the owner to make this application,
that the iiformatiou is correct and that the use and construction shall conform to the provisions of
§240-59 through§240-89 of the Town of Banistable Zoning Ordiiance,
Signature'of Owner/Authorized Agent L,v"
SIGNS/SIGNREQU revised l 03009
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DATE: Wednesday, October 27, 2010
- y
SIGNS CON-TACT- - •
FILENAME: APPROVED BY.
OJLHEL BOVEIDESIG.NIISXHEIRjROPERTY OF CAPE AND ISLANDS SIGNS AND MAY NOT BE DUPLICATED OR
USED WITHOUT EXPRESS WRITTEN CONSENT. CHARGE FOR DESIGNS USED WITHOUT PERMISSION. $500.00
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2 X, 7' 14 S T. To
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CLEANERS
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CENTERVILLE
PIE COMPANY
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::PHYSICAL THERAPY SOLUTiON,
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Sayside,
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DATE: November 23, 2010 CLIENT:
CONTACT: PHONE:
RLENAME APPROVED BY:
103 ENTERPRISE RD., HYANNIS, MA 02601 M03 .508-815-3431
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�t�ETti Town of Barnstable '
Building Department - 200 Main Street
EARNSTABLE, # Hyannis, MA 02601
MASS
9�A 1639. , (508) 862-4038
ifiOccupancyCert cats of
Application Number: 200900260 CO Number: 20080266
Parcel ID: 209087001 CO Issue Date: 03104109
Location: 167VFALMOUTH RD (CHRISTY S MA Zoning Classification: SPLIT ZONING
Proposed Use: DEPARTMENT DISCOUNT STORE
Village: CENTERVILLE
Gen Contractor: CECERE,STEVEN Permit Type: . CC00
CERTIFICATE OF OCCUPANCY COMM
Comments: eg�,j-7--EleVT-L-Lr prE
rya
ildmg Department Signature Date Signed
�t14E' TOWN OF BARNSTABLE �[ .
r ti Building
Application Ref: 200900260 BRN
ASTABLE, Issue Date: 02/09/09 Per 1 m I
y MASS.
Qp 1639• Applicant: CECERE,STEVEN Permit Number: B 20090179
Proposed Use: DEPARTMENT DISCOUNT STORE Expiration Date: 0.8/09/09
Location 1675 FALMOUTH RD (CHRISTYSAMMistrict SPLTPermit Type: COMMERCIAL ADDITION ALTERATION
Map Parcel 209087001 Permit Fee$ 50.00 Contractor CECERE,STEVEN
Village CENTERVILLE App Fee$ 100.00 License Num 95179
Est Construction Cost$. 2,000
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
TENANT FIT OUT FOR CENTERVILLE PIE COMPANY THIS CARD MUST BE KEPT POSTED UNTIL FINAL
TAKEOUT COUNTER INSPECTION HAS BEEN MADE. WHERE A
CERTIFICATE.OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: DACEY, BRIAN T TR BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: P O BOX 95 INSPECTION HAS BEEN MADE.
CENTERVILLE, MA 02632
Application Entered by: JL Building Permit Issued By:
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET;ALLY OR SIDEWALK OR AN ART THE IVCW
T RTEMPORARILY OR;PERMANENTLY:
ENCROACHEMENTS.ON PUBLIC PROPERTY,"NOT SPECIFICALLY PERMITTED UNDER THEBUILDING CODE,MUST BE APPROVED BY,THE JURISDICTION.
STREET ORALLY GRADES AS WELL AS:DE.PTH,AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.
THE ISSUANCE OF THIS PERMIT DOES NOT`RELEASE THE APPLICANT FROMTHE,CONDITIONS OF-ANY APPLICABLE"SUBDIVISION RESTRICTIONS'.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS. r
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION.
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).
5.INSULATION.
6.FINAL INSPECTION BEFORE OCCUPANCY,
WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS.
WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION,
PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF ,
DATE THE PERMIT IS ISSUED AS NOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A).
`Im1 ' ,dye ��'
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
g ✓� �3�y�09
2 �j�.t us rl .® Pr t z
3 1 Heating Inspection Approvals Engineering Dept
Fi a De 2 rd of ealth
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TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION
Map- Parcel,097 b0/ Applicatioti #Health Division
--Date Issued
'
Conservation Division ',"ApoRcation Fe lb il,
'A
Planning;Dept' `Permit Fee
Date Definitive-Plan Approved by Planning Board
Historic - OKH. Klk P ' ervation Hyannis
V.
Project Street Address '16<r� 16 9"f 0&_r1Q 'e0va
Village IYA, C?o)6 ?a_
po e /t?e;7r e'-4 Z A e Address 9
Owner C&A.�rev,11,0407..4 3
Telephone
Permit Request IL /e
'L2 L2� C I
Square feet: 1 st floor: existing TI 2nd floor: existing-g
proposed —proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size ' Grandfathered: U Yes; J No If yes, attach sly orting%cumentation.
Dwelling Type: Single Family : LJ Two Family U Multi-Family (# units) L111 i
Age of Existing Structure Historic House: Ll Yes Ll No On Old King'sl ighwa)jL]Y&I LJ No
co tlr
Basement Type: U Full LJ Crawl Ll Walkout LJ Other
co rn
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)I
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: LJ Gas Ll Oil *Electric Q Other
Central Air: s Ll No Fireplaces: Existing New Existing wood/coal stove: LJ Yes L] No
Detached garage: Ll existing LJ new size—Pool: LJ existing Ll new size Barn: Ll existing Ll new size
Attached garage: LJ existing Ll new size —Shed: Ll existing LJ new size Other:
Zoning Board'of Appeals Authorization Ll Appeal # Recorded LJ
Commercial /&'Yes Ll No if yes, site plan review #
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name . /T
2_-7
'& Telephone Number s - I-7 7&�l k -
Address 51L, I'L AZ1VC_LZ
License#
1&4 g2-7 f-3 Home improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
1
FOR OFFICIAL USE ONLY
APPLICATION#
j DATE ISSUED r -
MAP/PARCEL NO.
r w f
I
ADDRESS t VILLAGE
OWNER
y '
DATE OF INSPECTION:
.`y FOUNDATION
FRAME r v
iz INSULATION
-. FIREPLACE
ELECTRICAL: ROUGH FINAL.�
PLUMBING: ROUGH FINAL
11 GAS: ROUGH FINAL
ty FINAL BUILDING e
DATE CLOSED OUT
ASSOCIATION PLAN NO.
I.. ., ,�\ �(/RG liV/!LI'lRVIR!"1'Gl-1"LR.I1 VJ Al.i�+"U✓�✓� r.*u��r.. .. -
Department of Industrial Acddents
=w► Office of Investigations
600 Washington Street
Bostgtc, 14M 02111
_. �' www.inass.gov/dia
Workers' Colmpelasation'Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Nalne (Business/Organization/Individual):
Address: -77 Lam. L. Sz, r h ® _ � v-
City/State/Zip:L� i�t-C-aen L d kt} 4/ (Phone 6 el f
Are you an employer? Check the appropriate box: Type of project(required):.
❑ I am a employer with- 4. [] I am*a general contractor and 1
6; New construction
employees(full and/or part-tiuue).* have hired the sub-contractors
part icr- listed on the attached sheet .7. [] Remodeling
V1 am a sole proprietor oi.
ship and have no employees These sub-contractors have g• ❑ Demolition
workin for me in an capacity. errrployees and have workers'
1; Y P y 9. [� Building addition
[No workers' comp."insurance comp. insurance, .
required.] 5. ❑ We are a corporation and its 1-0:❑ Electrical repairs or additions
officers bane exercised their. 11. Plumbing repairs or additions
.❑ 1 am a homeowner doing all work ❑ g p
myself. o workers' co right of exemption per MGL
Y � mP• 12.❑ Roof repairs
insurance required.] t - c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
comp,insurance required_]
ny applicant that checks box#l must also fill out the section below showing their workers'compensation policy information.
lomcowncrs who submit This affidavit indicating diey are doing all work and then.hirc outside contractors must submit a new affidavit indicating such.
ontractors that check 0iis box must attached on additional sheet showing the name of the sub-contractors and state whether or not Lhose crititics have
,ployces. If ih'c sub-contractors have employees,they must prmZ idt their workers'conip.policy number.
ern an employer that is providing workers' compensationn insurance for my employees. .Below is the policy and jab site
Formation.
;urance Company Name:
licy#or Self-ins. Lic.#: _ hxpisatiorii Date:
Site Address: City/State/Zip:
tach a copy of the workers' compensation policy declaration page (showing the policy number- and expiration date).
dure to secure coverage as required under Section 25A of MGL c. 15.2 can lead to the imposition of crinzi-pal penalties of a
c tip to $1,500,00 and/or one-year imprisonment, as well as civil penalties in the ford of a STOP WORK ORDER and a fine
up to$250.00 a day against the violator. Be advised that a copy of this statement may be fors arded to the Office of
"estigations of the DIA for insura ce coverage verification.
o hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
�3 v
nature: Date; —
one#:
Vficial,use only. Do not virile in this area,.tb be cortrpieted by city or town official
ity or-Town: Permlt/hicense#
ssuing Authority (circle one):
Board of Health 2.Building Department 3. City/T•own Clerk 4.EIectrical Inspector 5. Plumbing Inspector
Other
;ontact Person: - Phone#:
UL v_9_,.L -J,xx v
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: A_ M
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual,partaership, 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
ership, association or other legal entity, employing employees. However the
receiver or trustee.of an individual,parbo
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; cbmtruction or i~epair work�on such dwelling house
or on the grounds or building appurtenant thereto shall not be cause4 of suh employment be deemed to be an employer."
MG chapter 152, §25C(6) also states•tliat"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 comrnonviealth for any'
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for,the performance of public work until acceptable evidence of compliance wdth the insurance
requ.xemezits of this chapter have been presented to the contracting authority."
rt
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), addresses) and phone number(s) along with their ccrtificate(s) of
insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are.not required to carry workers' compensation insurance. If an LLC or LLP does have
is required- Be advised that ibis affidavit may be submitted to the Department of Industrial
employees, a policy q Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city.or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to.obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
e that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office o'f,lnvestigations has to contact you regarding the applicant_
Please be sure to fill in the permit/license number,which will be used as a reference number. In addition, an applicant
that must submit multiple permit/liceuse applications in any given year,need only submit one affidavit indicating current
policy infortion(if and under"Job Site Address" the appIicatit should write "all locations in (city or
ma
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit roust be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax numbei:
The Common�vWth of Massachusetts
Department of Industrial Accidents
Office of Znvestiptions
600 Washington Street
Boston, MA 02111
617-_727-4400 ext 406 or 1-877-MASSAFE
Fax# 617-727-774 9
rised 11-22-06 www.mass.gov/dia
Z.
1 Board of Bm►d
t Construction Su Standards
w P rvisor License
» I F Lice s`e. CS 95179
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die-6�11/1953 !
P ratin
Restr coon 0 1/2010 Tr# 95179 f
STEVEN CECE
28 SQUIBNOKETT` <<
I EAST-FALMOUTH,MA 2536 i
--- Commioner
i
9�na end✓o�r. 0 7025. ,�7C �.a�.7�orvv .� O7�J.f
FP-6(rev.3/00) -PERMIT
City or Town CENTERVILLE, MA DIG SAFE NUMBER
Date: 01/20/2009
Start Date:
Permit No.(if applicable) 0 016 6 3
In accordance with the provisions of M.G.L.Chapter 148,as provided in Section l0A application is hereby made
to Falmouth Sheet Metal
(Full name ofperson,firm or corporation) .
For permission to install a -9 foot hood and small section of duct work in kitchen
area. Restrictions in accordance with CMR 10 & NFPA 96
at 1671 FALMOUTH RD/CENTERVILLE,MA 02632
Fee Paid$2 5.0 0 Check#/Cash 3 This a it wf expire on: 0 2/2 0/2 0 0 9
Signature of official granting permit Title Fire Prevention Officer
This permit must be conspicuously posted upon the premises
art
I PT
` THANK YOU
1
01/20I2009 8:56AIi 10
000000#1560 .
$25.00
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Centerville-Osterville-Marston Mills
Fire Rescue Department
1875 Falmouth Road
Centerville,MA 02632
508-790-2375
Permit Location: Occupancy ID•
CAPE COD CHICKEN ; "- 648
1671 FALMOUTH RD
CENTERVILLE, MA 02632
Permit Issued To: '
Falmouth Sheet Metal
Permit #: 001663
Type: Hood/Suppression System
Issued: 01/20/2009
Effective: 01/20/2009
Expires: 02/20/2009
Check No: 3570
Fee: $25.00
' s
01/20/2009 08:53
zrati Town of Barn-stable
' Regulatory Services .
BARNSTABLE
MA ES. �, Thomas F.Geiler,Director
i .jg
'den Imo'' Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 5087790-6230
Property Owner Must
Complete and Sign This Section
I_f Using A Builder
I
, S � Q as Owner of the subject
� G--c.� ec
�-- property
hereby authorize e 'L,CZQ to act on my behalf,
in all matters relative to work authorized by this building permit application for
7 �lil 66,1K
(Address of Job)
nature of r Date -
Print Name
If Property Owner is applying for permit please complete.the
Homeowners License Exemption Form on the reverse side.
Q:FO RMS:O WNERPERMISSION
���oFzt+t:ram,o
Town of Barnstable
Regulatory Services
BAMST.,BEF— : Thomas F. Geiler,Director
KA-9&' .
01 Building Division
PrfD �A Tom Pen"3' g,Building Commissioner
200 Maui.S eee., Hyannis,MA.02601_..
.._..
www.tow n.b arnstable.ma.us
i ,
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings.of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,.provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work Performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeowner .
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pmon(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities.of a supervisor(see Appendix Q.
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such.a form/certification for use in your community.
Q:forms:homeexempt
gown of Barnstable
BARNSTABLE,
'K"�
9� 1679. Regulatory Services
.��� �
ATFo �16 Thomas F.' Geiler,Director
Building Division
Thomas Perry, CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete,and Sign This Settion.
If Using .A Builder.
as Owner of the subject property
.eby authorize r�AV J/l°t, �> � � '1� / to act on my behalf,
Lll matters relative to work authorized by this building pernut application for.
(Address ofjob)
a1 -
Iature Owner Date
t Name
'FILES\FORMS\building permit forms\EXPR) SS.doc
;e020108
!L V YYJ1 VA xycax uJ.LtcLP_j-k
OF THE rpk
Regulatory Services `
• Thomas F. Geiler,Director
i MRN6TABLF- R .
KA-1a Building Division
�lfD µAl
Tom Perry,Building.Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
IOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: village
number street
"HOMEOWNER": work phone name home phone# p
CURRENT MAILING ADDRESS:_.__
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six riots or less and
possess a lice
nse, .rovided that the owner acts As
to allow homeowners to engage an individual for lure who does not p , P
supervisor.
Al'sP1NITI0N OR I]OMEOlI'NER -
Person(s)who owns a parcel of land on whicli he/she resides or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm stnrctu.res. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, drat he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1.)
The undersigned "homeowner'-' assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws, riles and regulations.
The undersigned"homeowner" certifies that he/she wrderstauds the Town of Barnstable Building Department
.-minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of.Horneowner
Approval of Building Official
Note: Three-fainily dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness oflen results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supen�isor 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/certifica6on for use in your community.
Q:\WPFILESTORMS\homeexempt.DOC
r t ,
i
FIRE DEPARTMENTS OF THETOWN OF BARNSTABLE
Fire Prevention Office - Hincldey Building
200 Main Street, Hyannis, MA 02601,
(508) 862-4097
BUILDING CODE COMPLIANCE FORM
e located at lco
d QiLt: U�
Plans dated _ for the rop y
-also kr� awn as [ C�. have been reviewed by
of the J Barnstable GOMM ❑ Cotuit I-] Hyannis LJ West Barnstable Fire Department.
THE CHART BELOW INDICATES THE STATUS OF THE REVIEW:
TYPE OF CONSTRUCTION DOCUMENT N/A RECEIVED REVIEWED COMPLIES
1. Narrative Report (�
2. Firefighting & Rescue Access
3. Hydrant Location & Water Supply
4. Sprinkler Systems
5. Sprinkler Control Equipment
6. Standpipe Systems
7. Standpipe Valve Locations
8. Fire Department Connection
9. Fire Protective Signaling System V
10. F.P.S.S. & Annunciator Location
11. Smoke Control/Exhaust
12. Smoke Control Equipment Location
13. Life Safety System Features
14. Fire Extinguishing Systems
15. F.E.S. Control Equipment Location
16. Fire Protection Rooms
17. Fire Protection Equipment Signage
18. Alarm Transmission Method
19. Sequence of Operation Report
20. Acceptance Testing Criteria
We believe this document to be complete and compliant for the issuance of a building..permit.
We have completed the acceptance testing for the occupancy permit and believe that within the scope
of the building permit, the above issues are in compliance.
a
YOU WISH TO OPEN A BUSINESS?
For Your Information,: Business tertificates COST $H.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:first obtain the ecessary signatures on this form
at 200 Main St., Hyannis.. Take tine completed; form to the Town Clerk's Office, V 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: ��t��sT�� rel� c��. �s• ric�v�e.�—
BUSINESS YOUR HOME ADDRESS: �,c� �c Y `2 P�„•r> 2
TELEPHONE # Home Telephone Number:
NAME OF NEW BUSINESS TYPE OF BUSINESS
1S THIS A HOME.OCCUPATION? YES NO
Have you been given approval from the building division? YES, NO
ADDRESS OF BUSINESS 1�4k rti� tea- tom, env\l� � . ca 3 MAP/PARCEL NUMBER D d0
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 COMMI 'S OFF1C opzj
This individual as b'ee r fo-rme o nit r uirernents at pertam to this type of business.,
f' o
Au`tho ' d Sig7tature
COMMENTS:
2. BOARD OF HEALTH
This individual has be inform, d ofhe per, it requirements that pertain to this type of business.
ut�i nature**
COMMENTS:
t
3. CONSUMER AFFAIRS (LICENSING AUT ORITY)
This individual ha e'n informed sing requirements that pertain to this type of business.
uthorizedS^'g�nature*
COMMENTS: l —r UZ CZ-�Y1�?/L V I ' l� l.�
I G �" lt, ,
.,7'. ••.^.�'.` :h, ,��Y•.y t. r`N'f7'.r� _ .»�;;,js+ 4�': �f,. f, — .- -i,.�.e-°s'"'.r'v^ ..
I .•.idy�,+) t ` .. ,.4...�;rR....i;,. ..�,P r�6.•i� t4:�-�. wX`:.n.��+.-�"r Pi.. .,r �'h�+3`9 ti-f"r'h� 'Wy,..t'^�'�1�'4Nw•'"'..\«,�,rY'..�,•ti1.r�,•t.
Assessor's office(1 st Floor):
Assessor's map and lot number MA/f A 2;2 d 2 'tb T:L FARC.'5�/—;:081_00/
Board of Health(3rd floor):
Sewage Permit number
Engineering Department(3rd floor): = DASl9MLL .i
� clue
House number /(oll °° 039:"
Definitive Plan Approved by Planning Board 19 �
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 PM.only 1 .
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO I/(/S%ALL RES n 1)R,4 ) / Y QL'l PA-,E0T
TYPE OF CONSTRUCTION MA)
L,� Q
// �y
// 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location / �Jb 6- �! .
;f !
Proposed Use R�yT�J RAA)
Zoning District_ Fire District
r Name of Owner -1���-� Address 7,AZ"1412AC,�-
1 Name of Builder SA vv, Address T
Name of Architect Address
Number of Rooms Foundations � -
Exterior 161D0b tJ/ri+ G<<• Roofing
Floors -7—)L Interior
Heating Plumbing
Fireplace Approximate Cost .Do0• ��
Area C .�
Diagram of Lot and Building with Dimensions Fee
1
S 4
� ` I 3
i.
-OCCUPANCY,P1,ERMITS,REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above::construction.
Name
Construction Supervisors License d""�--
DEAN, JERRY A=209-087-001
No 34063 permit For Install Restaurant Equipment
Restaurant
(PUT
Location Falmouth Road
Centerville
Owner Jerry Dean
Type of Construction Frame
Plot Lot
Permit Granted November 15 , 19 90
Date of Inspection 19
Date Completed 19
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