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HomeMy WebLinkAbout0029 HITCHING POST LANE �� r 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. i is�' �, ,ail.rv• � , , - DATE: /D �. 7 Fill in please: ry, Ift r a APPLICANT'S YOUR NAME/S: iV)fl K �023 a,�5U",t h�'"ca `�v �� �' � � BUSINESS � YOUR HOME ADDRESS: rTCN/.vc: / 05 % N �DO.SN � � �w `� � fkr TELEPHONE # Home Telephone Number NAME OF CORPORATION: a NAME OF NEW BUSINESS 14toV 6S 10C . /C(!F- TYPE OF BUSINESS VICE_ IS THIS A HOME OCCUPA2I(�N? YES NO ADDRESS OF BUSINESS 77 L o.-57Mvi �MAP/PARCEL NUMBER /7. - �3oZ (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. MIIUST COMPLY WITH HOME OCCUPATION 1. BUILDING COM SSIO ER'S OFFIC RULES AND REGULATIONS. FAILURE TO This individu I h s o any ermit requirements that pertain to this type of busin7r?h!\flI�LY MAY RESULT IN FINES. Aut rized Signature** OMMEN S 2. BOARD O EALTH .� This individual has been informed of the permit requirements that pertain to this type of business. -l� Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that,pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable FTHE Regulatory Services )p� do � Richard V. Scali,Director. Building Division NAM Paul Roma,Building Commissioner En39. a�0 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' 1 Office: 508-862-4038 , Fa : 50 8-790-6230 Approved: � } Fee: S� Permit#: HOME OCCUPATION REGISTRATION Date: 2bb&017 , Name: Y Y/L&it k, �, 1.o'er- Phone#: 0q<- `7 Z,,- Address:�� 1 01-C H( ®ST Village: n6or:lyzo 6 5 Name of Business: 'A-L&4V690,pt- Type of Business: ; ✓9Ce Map/Lot 03 " INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: The activity is carried on by the permanent resident of a single family residential.dwelling unit,located _ within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There 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" dwelling unit 1,the undersigned,have read and agree with the above r strictions for my home occupation I am registering. Applicant: i / Date: ® d 7 Horneoc.doc Rev.06/20/16 3 via w"c7s- � I C- a1 7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 030, Application # ®ISM Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis u � Project Street Address CT� Village C E 11+8f Y'I"k�� Owner C, Address Telephone Permit Request - 3o C el1 o 1 � f e Va I I Td Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 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 Total Room Count (not including baths): existing new First Floor Room Count r Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other cn Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: gNes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: existing ❑ rie size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other: ' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes KN 0 If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - - _ (BUILDER OR HOMEOWNER) T Telephone Number Name Inse,C 5 0 p Address ��D ��+r ny 7W R'ye License # -C [ oki3b so VA )�Wd LA aw Home Improvement Contractor# t q_1 3 No Worker's Compensation # W WC 3 0 IR 5b 33 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lp4 T SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER F< DATE OF INSPECTION: ,j�FOUNDATIONq_, illtvy �u �-t FRAME A tINS.ULATION,,_, FIREPLACE - ELECTRICAL: ROUGH FINAL w E PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 4 FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 s r ^ Tie Co nmonwealth ofMassochusetts Depat"Mt.-of Industrial.Aeciclents a _ Office of Investigations ,y tir Z Congress Street, Sw a -00, ,.; Boston,MA 42114-201 www.massgovldia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly; Name (Business/Qrgani?ation/Ind vidual} Cape.Save,Inc.., Address: 7D Huntington live - City/State/Zip;,_ South Yarmouth.MA 02664 . Phone#: 5087398-0398 Are you an employer?Check the appropriate box: Type.of proiect(required):. 1. 1 am a employer with Q , 4. [ tam a general contractor d"1 an employees(full and/or part-t ine). have hired the sub-contractors 6. New construction 2.0 1 am a-sole propricior or partner.- listed oft-the-attached-sheet. 7. ❑Remodeling; ship and have.no employees These sub-contractors have $; Detnalition;. emplyeesndhav wokers' working forme n an ca acity o1. 9. [ Building addition [No workers comp:insurance comp:insurance.t required.) 5. [] We are.a.corporation and its 10. ,Electrical repairs or:additions 3.[J lam a.homeowner doing all'wark officers have exercised their l!.,El Plumbing repairs or:additions myself'. [No workers comp:,, right;of exemption per MCL 12 0 RooF:repairs insurance required]fi c. 152, §1(4);and we have no employees. [No workers' 13.[✓] Other Insulation; comp. insurance regtnred.]; *Any flppi leant that check box#l,mast also fill oat the section below:sho%ring their workers'compensation.pohcy In-PIMA.Me t Homeowners who suhmit this 2tlidavit intfitcafing..they are do ing all.tiyork and.then hire o utside contradOm.mustsubmtt a new'a, wavit'in.lest+ng_such, Contractors'that check this box must attached Mi additional sheet sho%v ngthen5nie of the sub.-contractors and state whether or clot chose eAdies{cave employees. if the sub contractors have employees,they must provide their workets'.cemp.policy tittmber: I ant air employer prat is Providing wurkers'.conipensution insurance f©r my employ es. Below p'tilepotXy.and job site inforination. ` Insurance CompanyNa-me:., Wesco Insurance Company.. Policy#oz Self_ins:,Lic.#_. WWC3085633 _ Expiration Date: •04/09/2015 _. Job.Site Address: o�.7_!1'G I n.. QstP_ Ciry/State/Zip;; Ce4 2t-Yt fe Attach a copy of the workers'cumpensatfon policy declaration page(showing the polwy number and expiration date). Failure to secure coverage,as required under Section SA of MGL c. 152 can lead to the iMposition of criminal penalties of a fine'up to$1,500�.00 and/or one-year tmpri onment,as well as eiuil penalties in. he form o£a STOP WORK ORDER and a.fine c fup to$250.00 a day against the violator. Be advised that a.copy of this statement may b&f-brwardetl to the;Oftice of Investigations of the WA for insurance coverage verification. do.laereby certi .;under the ants and enalties;o er' that fhe in`orind-it:orovided above iktrue and correct. _. .. ,.. S ' nature:. . Date Phone O eiul;use only. Do n©t►price in tlr s;area,6 be colrapleted by city or tbwo official Gity or Town:'._ __ Permit/License:# 15suing Authority(circle.one) l;Board;of.liealth 2.Buiitiiitg Department 3:GitylTown Clerk: 4 Electrjcalnspector 5 Plumbng.Inspectoir 6:Other:. Contact Person: _ .:_. __ __ .. Phone#• .._<. _._ . I ACOMD CERTIFICATE OF LIABILITY INSURANCE DATE(Mtq,9Ot�YYY) `...--''" 11/10/2014 . 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 CER'nF1.CATE HOLDER. IMPORTANT: If the certificate holder Wan 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 endorsements. PRODUCER ;VMNTE�cT: Colleen Crowley j,Risk Strategies Company PHONE (781)986-4400 C No:(781)983-4420 15 Patella ParlcDrive L ccrowley@risk-strategies com Stilts 240 INSURER(S)AFFORDING COVERAGE - NAIC* Randolph Hh, 02368 INSURER A:Selective Ins. I QLP 'America IhSU ED INSURERB:Allmerica. Financial Alliance 10212 Save Cape P Inc INsuRERc:Wesco Insurance Company, 7 D Huntingtonr Ave INSURERo: f INSURE-RE: South,Yarmouth, _ Hit 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL141110.85532 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 CCNTRACT 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. I� TYPE OF INSURANCE POLICY EF POLI .EXP - POLICY NUMBER MMID !DD LIMITS GENERAL LIAmury EACH OCCURRENCE $ 1,000,000 X rCOMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Es occurrent $ 100,000 A CLAIMS-MADE Q OCCUR 199448.0 0/16/2014 0/16/2015 MED EXP An one person) $ 10,000 PERSONAL&ADV INJURY $ 1,0001000 GENERAL AGGREGATE $ 2,D00,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,0001000 POLICY X PRO- X XCT LOC $ AUTOMOBILE'LIABILrTY MSINED SINGLE LIMIT Ea accident' 1'0 000 000 _ - B ANY AUTO BODILY INJURY(Per person) $ UTOS OWNED X SCHEDULED 5796600 1/6/2014 1/6/2015 BODILY INJURY(Par accident) $ NOWOWNE0 PROPERTY DAMAGE ' X HIREDAUTOS X AUTOS P7ecddent $ $: X UMBRELLA LIAB fX 18CCUR EACH OCCURRENCE $ 1,000,000 AXCESSLIA6 CLAIMS40DE AGGREGATE $ 1,000,000 REED RETENTION$�: S1994480 `0/16/2014 O/16/2015 C WORKERSCOMPENSATION Officers Included for X WCSTATU OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIFXECUTIVE Y/N overage. E.L.EACH ACCIDENT 5OO OOO OFFICER/MEMBER EXCLUDED? a NIA 3085b33 /9/2014 /9/2015 (Mandatory,in NH} E.L.DISEASE':EA EMPLOYE $ 5.00 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE 7 POLICY LIMIT $ 500 .D00 DESCRIPTION OFOPERATIONSI LOCATIONS►VEHICLES(Attach ACORD 101,Additional Remarks Schedule;II'more space Is required Issued as evidence of insurance. Issued as evidence of insurance. T.hielseh Engineering, Inc: is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msongftapelightconpact.Org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE,POLICY PROVISIONS. Cape Light Compact Attn: Margaret Song AtlTtlORIztDREPREsI?NfrAT1vE PO Box 427/SCH 3195 Maier-Street' Barnstable, MA 02630 � ��� chael Christian/CLC ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD Building Permit Authorization if Mark & Cynthia Corbett , as owner -- hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office: 508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 29 Hitching Post Lane Centerville, MA 02632 Signed Date l - i Office of Consumer Affairs and Business Regulation rtl 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY U. 7-D HUNTINGTON AVENUE , ' SOUTH YARMOUTH, MA 02664 ---- ----- ,.Update Address and return card.Mark reason for change. Address E] Renewal a Employment Lost Card SCA 1 C. 20M-05/11 . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only TOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 1171380 Type: Office of Consumer Affairs and Business Regulation $`Expiration�3/4 201,6. Corporation 10 Park Plaza-Suite 5170 ' ga 1 W ., Boston,MA 02116 CAPE SAVE INC. ` K r WILLIAM McCLUSKEY �f ' 7-D HUNTINGTON SOUTH YARMOUTH, MA 02664 Undersecretary Not vali tthout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Super0sor Specialty License: CSSL_102776 f,. W ILLIAM J MC C3,US ' 37 NAUSET ROAD West Yarmouth MA 02G73, r `J14— Jj�. '� "" Expiration Commissioner 06/28/2015 410-5j-11L Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 3/23/15 ` Thomas Perry CBO Town of Barnstable Building Division ` 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 201500903 Dear Mr. Perry This affidavit is to certify that all work completed for 29 Hitching Post Lane has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCloskey } TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7_3 Parcel 03.2_ _ Permit# (o Health Division ;Z0012z cD$'a at 4,10-1 Date Issued 0 4— Conservation Division 2—I I6`� 4 ' ° '� 6 j' i.-Application Fe o Tax Collector o holccq Permit Fee Treasurer k- �.. �T't °i�-" & � � ;. SYSTEM MUST OF. Planning Dept. INSTALLED COMPLIANCE Date Definitive Plan Approved by Planning Board E"0PWIMALCOCEAND Toll EG TIONS Historic-OKH Preservation/Hyannis Project Street Address S & n . Village Owner i&IJZ 9e_ Address e Telephone Permit Request ur�� 7LG</U SA eW d,01Wel'5 elz A&4 Square feet: 1st floor: existing Y/ proposed —&— 2nd floor: existing .�5� proposed Total new /Of Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size 0,351 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 W44 V Historic House: ❑Yes XNo On Old King's Highway: Cl Yes XNo Basement Type: )(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 600 Basement Unfinished Area(sq.ft) .216 Number of Baths: Full:existing new -t9-- Half:existing new Number of Bedrooms: existing_ new -'$'- Total Room Count(not including baths): existing new - First Floor Room Count Heat Type and Fuel ❑Gas ❑Oil 9 Electric ❑Other Central Air: ❑Yes A No Fireplaces: Existing f New -L9"- Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name `O�r a r� C�r�l/�i�i�.-n Telephone Number /f 70 Address Dg-,e We e-c License# 3 4/ Home Improvement Contractor# 1.7 7 DOCK Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `Y — 0 7 FOR OFFICIAL USE ONLY PERMIT NO. r DATE ISSUED MAP/PARCEL NO. " ADDRESS VILLAGE a OWNER r DATE OF INSPECTION: '- FOUNDATION �/1i �..2w Gcevr�,�l.�-���� c�� vn�e,• S�crc� FRAME C _ C' Ii �'" Sc�'� ►'� INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROU FINAL co GAS: ROUT~ Q~ FINAL FINAL BUILDING �� at S r cr DATE CLOSED OUT 0 Al �1 in N ASSOCIATION PLAN N�.$r� r The Commonwealth of Massachuse#s _ -- 'Department of IndushzalAccidents 600 Washington Street - Y Boston, Mass. 02111 Workers'.Corn ensation.Insnrance Affidavit-General Businesses • name `�'ri'�» _�! '� •C.�+�''�/r/�s rsi ti "� address: , �s�G1�i1 G n e State- workzip Da(,, 5�phone# ,�`-�B'' y�� I f 7® site location &II address 04:I am•a sole proprietor and have no one BMiness 1`ypes []Retail[]RestaurantJBai/Eating Establishment worldng in any capacity'. []Office[]Safes(including Real Estate,Autos etc.) ❑I am an ern to er with . ern to ees full& art time. ❑Other /�%/%%% I am an•ena_ployer providing vtorkers' compensation for my employees working on this job. '1,. ..4.,'•1:.5:1' ,. •:P' •.,4:•::,•� .:j'. � — ?:i••i i.+' ''•7,�•r ••.1 i�' .._+,: :..�\w t•.• com an ernes. J �'. �,,::.. '.,'::•�'.:5 a� . :['. :.T1' ...•.!•: i�1:Ali•• 'r' ' atliiFess:` .r•-Vf• �{. :.:i,•; r ::•`•: , 4 •' •insurance.co�+ • I am a sole proprietor and•have hired the independent contractors listed beltiw'who have the following workers' • •• .compensation polices: • • •- • :hti•,;i: to-•t-• 'i:' 1;�,.;.,. ,<' �e •"r t,:.�;.',�..5}:"' .:i�t+::Y'�;`',r'',�+ I'�; :t;• address:. Cl• 71 :41ail,y sy.at i., wf r:;,4 �:•R..+ i1surance Co coin % f: 110riE#: ' :i. 1• ::: 41i:;. ::s..; �t.;•: lnsurancrsoF+:•'_ Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years$imprisonment as well as civil penalties 1n the form of a STOP WORK ORDER and a fine a of$100.00 a day against me. I understand that R copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains an pen alt' of perjury that the information provided above is true and correct Signature / Print name Phone# °�2-42 I 70 official use only do not write in this area to be completed by city or town oirciai city or town: permit/license# ❑Building Department ❑Licensing Board check if immediate response is required ❑Selectmen's Office ❑Health Department , contact person: phone#; ❑Other (revised Sept 20 3) Information and Instructions Massachusetts General Laws chapter�152 section 25 requires all employers to provide workers' compensation for'their. employees: As quoted from the 'law". 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 mare 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 bf the.dwelling house of another who.employs.persons m to do. aintenance, construction or repair work on such dwelling fiouse"or on the grounds or building appurtenant thereto shall not because of such.employment be deemed to be an employer. MGL chapter 152 section 25 also'staies 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.cor monwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the, commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work unto acceptable evidence of compliance with t�e insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fill is the workers"eoupensat�affidavit completely,by checking the box that applies to your situation.. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department-of Industrial 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 regardb the*"lave'or if you are required to obtain a:workers.'compensation policy,please call the Department at the number listcd:below. . City or Towns . Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license?���.which willbe used as a reference number. The.affidavits may be returned to the Department by-mail or FAX unless other*arrangements have been made.' The Office of Investigations would like to thank ybu in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents efffce of hinsfigatlens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 ill nhnna#- (617) 77,7-4900 per::406 o��'E r°� Town of Bar nstable `, "o Regulatory Services Thomas F.Geller,Director v 163 ��� Building Division �''lED MP•l� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-740-6230 pffice: 508-862-4038 permit no. Date • AFMAVIT HOME IMPROVEMENT CONTRACTOR LAW SUppLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"Fee o onstruction of an addition to mypreexisting,modtM� eroccupied conversion, -improvements removal,demolitions budding conte invdg at least one but not more than four dwelling units or to structures which are adj&cent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost Type of Work: Address of Work: Owner's Name• Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: R DEALING WITH UNRE GISTFRED OWNERS PULLING THEIR OWNLERMIME IMTROVEMENT WOORKD0 NOT HA•YE CONTRACTORS FOR APPLICAB ACCESS TO THE NITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A• SIGNED UNDER PENALTMS OF PERJURY I hereby apply for a permit as the agent of the owner: Contractor N e Registrationl�Io. Date OR Owner's Name T-fie Town of Barnstable °^ Regulatory Services s BSTAe Thomas F.Geiler,Director auss. ��pT�c •`� Building Division _ Tom Perry, Building CommMoner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Budder -•.;.as.Oa'net..of the.subject prop etty ...._..._. .: hereby authorize ,� � tJ� �� .. .: . .to'act On my..behalf,. in all matters telative to Work autho=` ed•by.this building•pe=nit-application for: 27 A�Rwco 2o-� 1 L � (Address of Job) ; 12co� Signature of Owner Date 'print Name F t y � 34 �a� r € EXS/,ftaR q Li Al- - \ 7 t } • Y i id __ TYPICAL a00P C018TlwC'fjoll._ on,CDx.a,.rNn.T Olt COIN Ni-A VLH7 RAI,Tt"6 N-O.C. 9..(N-po MleeggLk10 0ATT TO MATCH fix. AY, 'v'`hY��.YY�?Y'�A:/I"(1PA- D 6 Iv/AwM a Lpp yI1 �•�p�p ��,1,•� TO MATCH gX. VEW r l'a TO M4TCN •�i`• I ( \ JJLIFAL W I L L \ W.C,6FIHfaL6D lfd! 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I.... ..,:.. ��r� _t: ..a:./a:... ;'.. ':. .. ....:..i.l .. ...,........ .. . «.:. . .... .. .. . ...: .. -CERTIFIED;.` PLAT. ,. 'FL ., r ..... Tt - *� gSSN .. .r 1 ;• r ,RtW CONSTRUCTION ONLY = —. °"`r ,` h r; . 0 OF FQNDATION IS FEET �� ,. r` : Y .. SOW.. POLM -i OF.. ADJACENT . : . �'. %�� .► ��`� 1.1i :.... W. :,_.: , SCALE. r:.,,-; � D:A t - I : f NGINE'ERING CO.IN -- . . I CERTIFY THA' 7 i '�. � ' CLIENT 3AY .. w SHOWN ON.. TH1:9 P"At1. tS� .t? 'IIt' » ` fla� ER�R1 �_E t31STEAE� % JO8 NO.� ON :.T#iE GIROUNC A'9. �1dtO: 1 '.Cl ��Zlt_._ -- — -.1AND._- _.- . . ..__ . . _ _ __._ . nnuf'Abu9t.__Tn . THE'." �I�I� .� �r:Y�A. 11 ' _- —_ �_. !J�e�omzea�t �✓�aooacfeuae� l BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR : 1 Numbed G 072354 Bit�yafeQ �fi4 1968 All 4fi24? 4 Tr.'no: 27348 ry BRIAN P COUGH II Ir ,. 82 PRUDENCE L � - COTUIT MA 0263 = .: _._ _•_ _Administrator ✓fie-Coomvrno�uuecr.� o�✓�daaac`euael�a / • Board of Building Regulations and Standards HOME k VEM'ENT CONTRACTOR RegJPratrdl 2rn7006 912004 COUGHLIN PRORI1N APRON COUGHLk����9� 82 PRUDENCE LANE COTU'IT,MA 02635 kdm'uer �THEA The Town of Barnstable Department of Health, Safety and Environmental Services KAM I Building Division s��• � 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph MCmssen Fax: 508-790-623-0 Building Commissioner Home Occupation Registration Date: ' G Name: Phone!�• 7 0 Address. a — y 1�/LOL : Type of Business• �/g, �-�«, 17.3 ®�.Z INTENT: a is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within sit*family dw Mngs,subject to the provisions of Section 4-1.4 of the Zon ng ordinance,provided that the activity shall not be discernible frown 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 gioindwarer pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of ngbi subject to the following condWons: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelingunit • Such use occupies no more thaw 400 square feet of space. • There are no external alterations to the dweIGngwhich are not castomary.in residential buildings,and there is no outside evidence of such use. • No aaff c writ 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. • 'here is no storage or use of toaac or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shalt be met an the same lot containing the Customary Home Occupation,and not within the mqu fired finest yard. • There is no exterior storage or display of materials or equ ipmmt • There is no counner c al 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 eontaini ng the Customary Home 0aupation. • No sigh shall be displayed indicating the Customary Home Occupation. • Nthe 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 penranent resident of the dwellingunit. I.the undamped, read and agree with We rtsttictions for my home occupation I am registering Applicant: Date: Homooe.doc Assessors map and lot num .. ...... ......... ........... . - THE T� Qy �° Sewage Permit number' ... .............. SEPTIC SYSTEM MUST 6................:.............. ' ' INSTALLED IN COMPUAN BAsasTADLE, House number. Ap i.?h..... . r i MA86 WITH TITLE 5• 9 1639• s ENVIRONM KM CODE AN fl?M a TOWN 'OF `BARNM;MUIONS BUILDING INOPECTOR APPLICATION FOR PERMIT TO :... N.S'411. k �A° ... "`' � .. �.... u" ... ......•. « r TYPE OF CONSTRUCTION ....... ,!A....F.W.�Z.......................................................................................... ... �J.V ...... 3..............9 �... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for �aa permit according to the following information: Location . ...... ......�=��.V.4!'! -.......................:........:... Proposed Use '`!.h4/...:1. - 4,.1.!�j................................................. ZoningDistrict ........................................................................Fire District tr-�^/ 4� s.... ....... ........................................................ c.Name of Owner � ... ► AL KS........................Address ...046'r- C .... ......�1aw. Name of Builder ....... ? .. I I�'.. . . .!•^ .. .......Address ..r:�..°J ... \,� .. 4?` AV!. ..�'".!'°.� ...... I .l� M �,p Name of Architect .1C1! .!(....4..�Pt^....... .....................Address ..!.:..!� �. I� ( Number of Rooms ............ .!5'............................................Foundation ec....�. . 6z..i c•;_zL. Exterior I"►h—G.4 A.f't o.4j.. f.V&NRoofing 1"a.. .........�.......................................... p �/ ,► 3/ r� A ,r l Floors 4�1�►'�.� !1 nn .:�--1?L+��.l .. ..1.. '.�'?y� "�"�.:.. ........ .��..4 !lh?1 .��.!-4��........ Heating g "fir" a. ... � 1... --7 P. Fireplaceo'-wE..................................................................Approximate Cost .................................................... ---1 9--------. Area P tJN�ty , Definitive Plan Approved by-Planning Board ----------------------------- .... . ..�.L.5 ,.�' `"............��s( Diagram'of Lot and Building with Dimensions Fee G� �:¢. ......... ............ SUBJECT TO APPROVAL OF BOARD OF HEALT r C 60 I herebytagree to conform to all the Rules and Regulations of the Town of Bo stable regarding the above construction. Name .....� .. ........................ -- ---_ - ` - _..Sd'D�I���..]� ----'.' .`. --' ---- Locution ...Lot...#3l-2g—Bi Hitching.. ��oe�,' -'—' --'' —' -----. ......�� �iIl� ' ---,----~—~.—~.—.-----------. � Z' �io�oI— a Owner —..�������-- ----a--..---.—.-- r ~ Type of Construction .....����gl�.-------.. --..--.-----..--------------.. Plot ----.--.--. Lot ._---------' ' ' MarchI7' ' 81 ' ` Permit Granted ................................!....... g Dote of Inspection ............................:....... g - uo/e Completed ^ - ` ERMIT REFUSED - . ' 19 ww tv --.------.----- --.----..�------.. ' --.—.—..--.---..—.—.' ___---------.���--. l9 Approved ` : —..-- . -------.------...--. ,�—:'. . .. .� ' ....................................... .. . 1��07 �� ^ Assessor's map and lot number_..,�.�.: ........-' vF?HE...........:..>.... ropy Se page-'Permit number .......: .............................................. ro li EAHBSTAILE, i House number ` p 1639. \00 �FE MPY a• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...�.; t.:<1 ?`n_- n &t, . .7 ,I r.�l, c h .. ry.................... ....................?. . .................:�, .... TYPE OF CONSTRUCTION ....... . ' : .'.?...t.. ...'? :.......................................................................................... .......................... .......:............. 19....�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1.,ti `r �.................................. c7..'. ... ...::..........!..` .:: f.......: :............................... ... ................................... .. ProposedUse .........:....................:................................................................................................................................................ Zoning District Fire District ... ! J .' Name of Ownern: .. r t .�. `.........................Address ..'..: :1O!::' r' t....P.. ....... .:.'^.. ....:.......` Name of Builder �r aAt)....................Address `1 .. • ...,j k.... .t ........I. •..... t "•. .. ........................................ ,... Name of Architect �..�...:.� rru K.�. ' ��e l� ........................Address ..�...�:'�C� Vie. , .. ..." Numberof Rooms ..................?...............................................Foundation ..:.....................................�................................... -M---t . 4..' f� n��i + -� ,�i tl �vc'al ( QiJ�. �% ... Exierior ........:.........::.............................................................Roofing ..,...... ......................A................................................ Floors ..: ............r................................................... ..Interior ......................f `�:`l, i ................... .r. :..`'....��� Iz , Heating g � r Fireplace . ' `' � -� p �* .................................................................Approximate Cost ....:�..... k ............. ................................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area ....�................ ................ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r� r 1 r t � jµlx, ! 2-c! C u i.f`--- i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... .. ........................................................ NICKULAS, LARRY A=173-32 No 2Z917... Permit for ....One l/2 Story Ingle Family Dwelling............. Location ...Lqt,,,4.3.1... 9,,,Hi,tch ng.,Post .jane ................Qt;.e,.ryi I.Q.................................. Owner ..Larry,.,Nickulas ............................... Type of Construction .....F Me........................ ................................................................................ i Plot ............................ Lot .......... . ................. Permit Granted .....,,March 1�7, 19 81 Date of Inspection ...................................19 Date Completed ................... ..................19 s PERMIT REFUSED ....................................... .j. .................... 19 ........................................I...................................... ........................................I...................................... ........ ..... .................. ................................. Approved'................................................ 19 ............................................................................... ................................................................. TOWN OF BARNSTABLE `�. Permit No. -------------------------- 1 »n.X Building Inspector ...� Cash -------------- - 00 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 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 Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date 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 \ REQUIREMENTS. .............................................. 19...... .............................,........................................................................-- Building Inspector i r r , 1 77, iA - ',''',� 'i„- '"`^---.:.,._•„ '4 a +$ 4 >fc )t a 7 a Y r r ss c L ,•t ' �a7' w 1 � ' A f) 1 y _ ,.r E t Fr r.; •.�e•.tibYo.a..c+u,.vaw<N+,+kwvn ww•r �. ^g v..nnwe.+.,e mvr+wrr+•. v. — y, t S ; 4. }t ; K.(=:<Jt� �•_•_ ?• J.a fo I .�® , ..f6 '� G7 T., . S?"N' /'7.1 •'..� - a :..'i 'S �/� X f 1 -- CERTIFIED PLOT PLAN � aT A^NE' ,N£W CONSTRUCTION ONLY : IN r TOP OF FOUNDATION IS - , I FEET �, d 90VE 'LOW POINT, OF ADJACENT r� ` �c ' 8A9hS tA,8L AS R0A0 SCALE ...l"x- ` E"D 0 G£ .ENGINEERING CO.INC) I CERTIFY THAT THE �uuwr� :r�an : CLIENT =A` 5 Dr. -z' LRkSHOWN ON THIS PLAN IS LOCATaOISTEKED ISTEREDJOB N0. - ON _THE GROUND AS INDICATEILAND CONFORMS TO THE ZONING LA.'* ENGINEER RVEYOR DR.BY: ��� _�.�, _ OF JANSTABL , MASS'. ' ?12 MAINST. CH. BY � ,. HYANN.IS, MASS. SHEET l OF AYE REC. : LAND 8UI'tV