HomeMy WebLinkAbout0319 STRAWBERRY HILL ROAD �. ,, . � r%
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of r Town of Barnstable *Permit# C)
� o
' Regulatory Services Expires 6mouthsfrom issue date
anxxsrwarz±,
9 16 9�. Thomas F. Geiler,Director
Fc Mr►t
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address 27 5-772<I rc I-It l /2�04
esidential Value of Work 7aG� Minimum fee of$35.00 for work under$60100.00
Owner's Name&Address /Zi' 4 26 h ti-
Contractor's Name 1�lv�nc� Telephone Number_ l Z ZZ//
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) lv G:13
"oran's Compensation Insurance Jr
Check one:
REF b
❑ I am a sole proprietor �- _
❑ ] am the Homeowner
❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name f�1!'I�Ft�� ��j•{ s
Workman's Comp, Policy# Z/,L)C
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box) +
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side 0,27
2'-Replacement Windows/doors/sliders. U-Value #of doors
_(maximum .44)#of window_s
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A co of the Home prove nt Contractors License&Construction Supervisors License is
red7,
SIGNATURE: ZZ
Q:IWPFILEST0RMSIbuilding permit formsONPRESS,doc
Revised 070110
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): D✓_ 0
Address: G
City/State/Zip: WC) 3C r( Phone
Are yo n employer? Check the appropriate box:
Type of project(required):
1.EI am a employer with 4• ❑ I.am a general contractor and I
employees (full and/or part-time),* have hired the sub-contractors .6• ❑.New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling
ship and have no employees. These sub-contractors have g, 0 Demolition
working for me in any capacity. employees and have workers'
[No workers' comp.insurance comp,insurance.$ 9. ❑Building addition
required.] 5. ❑ We are a corporation and its 10:❑ Electrical repairs or additions
3.❑ I am a homeowner doingall work officers have exercised their
11.❑Plumbing repairs or additions
myself. [No workers' comp, right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.❑Other
comp.insurance required.]'
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. /
Insurance Company Name: �/Ig�1, -1 c✓L� �S L
Policy#or Self-ins. Lic. #: (,Jc C� �� Expiration Date: —1 Z
Job Site Addressj/� 4�F, A&J�VWAI City/State/Zip:_C ' �����
Attach a copy of the workers' compensation policy declaration page(showing the policy number.and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP.WORK ORDER and a fine
of up to$250.00 a day aga' t the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the D r insurance coverage verification.
I do hereby ce u r the pains nd pe al s of perjury that the information provided above is true and correct
Si attire- Date: ✓' �� �(!
Phone
. Official use only.'Do not write in this area, to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3. City/Town Cler
k 4.Electrical Inspector
6.Other 5.Plumbing Inspector
Contact Person: Phone#:
vgoo0CE?. S08;366.6161 FAK 508,366.5202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Mackinti re Insurance Agency, Inc, ONLY AND CONFERS NO RIGHTS UPON TNE.CERTIFICATE
11 West Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEN OR
Westborough, MA 01591-1931 ALTER THE C VERAOE AFFORDQ BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INsuRED-Newpro Operatting LL - INSURER A; PeerlesS Insurance Co. 2419
26 Cedar St. INSURER e:
Woburn, MA 01801 INSURERC:
INSURER D:
INSURER 2:
C V
THE POLICIff8 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING
ANY REOUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
i BR DO' TYPE OFIN6URANCE POLICY NUMBER PDLICY FECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILM COP 8588-370 2/31/Z010 12/31/ 011 EADHOCCURRENCE IS 1,000.Op
X COMMERCIAL GENERAL LIABILITY. DA IIITORE101D g 10 00
CLAIMS MADE a OCCUR MED EXP(Any one pereon) I 1S 0a
A PERSONAL A ADV INJURY 5 1 000,0
GENERAL AGGREGATE Is 2 000 0
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG t 2 000,(j0
POLICY M P •
JECTRO LOC -
AUTOMOBILELIABILITY HA 8SS4174 12/31/2010 12/31/Z011 ;COMBINED SINGLELIMIT
ANYAUTO (EawciUenl) ;
1,GOO,O.Q
ALL OVvNED AUTOS BODILY INJURY
A
X SCHEOULEOAUTOS (Parperwn) f
X HIRED AUTOS
BODILY INJURY S
X NON.OV010 AUTOS (Per iawldanll
PROPERTY DAMAGE s
(Per acclden)
GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S
ANY AUTO OTHER 1HAN EA ACC I{
AUTO ONLY; - AGG I
EXCE6SIUMBRELLA LIABILITY CV 6582578 12/31/2010 12/31/2011 EACH OCCURRENCE s 5 000 00
OCCUR ED CLAIMS IrADE AGGREGATE i S r 0OO 0
A
s
DEDUCTIBLE 6
1i RETENTION s 10,00 s
WORKERI COMPENSATION AND WC8645974 OS/01/2011 05/01/ZO12 WC STATU- OTH•
6MPLOVERS'UABILITY
A ANY PROPRIETOR/PARTNERIEJ(kCVTIVE E.L.EACH ACCIDENT i S00 000
OFFICER/MEMBEREXCLUDEO'I I( E.L.OIBEASE-EA EMPLOYE i S00,000
SPE,Rs,oeSnibe under CIAL PROVISIONS aalow E.L.DISEASE-POLICY LIMIT S• S00 000
OTHER
OESrheCcity of a�borocis additionalC nsu eNithrespectltoCGeneral Liability as required
oy written contract
CERTI CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE 16SUING INSURER WILL ENDEAVOR TO MAIL
10 DAY6 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH2 LEFT,
BUT FAILURE TO MAIL IUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS ADENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
1'imdth MQ na h .
1CORD 26(2001/08) CACORD CORPORATION 1:988
lIass.tcliusctts- Depau-ttnent of Pulllic safer%
Beard of Buildiu2 Re ulations unjl Standat"ds ;
Construction Supervisor•License
License: CS 96093
Restricttd to. 00
THOMAS PEACOCK JR = _
38 OAKLAND AVENUE
SEEKONK, MA 02771
Expiration: 4/8/2012
unui«inn,r Tr#: 20816
q/
0 fice of Consumer A�ffai and Busuiess Regulation
10 Park Plaza- Suite 5170
Boston, lVassachusetts 02116
Home Improve 'r ontractor Registration
Registration: 146589
r; Type: Supplement Card
Expiration: 5/5/2013
NEWPRO OPERATING, LLC. f l ;= 1 -
TOM PEACOCK
26 CEDAR ST:
WOBURN, MA 01801
y �(M
Update Address and return card.Mark reason for change.
—— Address ❑ Renewal Employment Lost Card
BPS-CAI 0? 50M-04/04-G101216
,,`s+,` ✓fie�omanw"nu�,dl�fi a�"G�c¢iaacfureel�$
Office of Consumer Affairs&Business Regulation. License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found'return to:
Office of Consumer Affairs and Business Regulation
Registration,.-146589 Type: 10 Park Plaza-Suite 5170
!y Expiratitnj �aj3 Supplement Card _ Boston,MA02116
NEWPRO OPERA-. LLC
-y-
TOM PEACOCK,';.l r
26 CEDAR ST. 77
- ` � —
_..
wnRI IRN m n1Rni
09-09E-'11 08:37 FROM-Newpro-Wheeling Ave, 1-781-932-0860 T-584 P0001/0001 F-066
\.O r mug+fvovac 10
RI Reg#26463 Wh1*%s5idagaedararf 62843
Corporate Headquarters,26 Cedar St Woburn,MA,(P)SDO-342.2211(F)781.933-9626,www.newpro.com
THIS CONTRACT MADE THE—�Q — of �J 20 a between e `v
(Home Owners) (Home Piton
1(Bus/Cell Phone)
of
(Address) (City) (State) P)
the"Owner"and NEWPRO Operating, LLC, "NEWPRO". ❑ The job address is a condominium.
NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,famish all labor and material necessary to install the foll
described work at the premises located at c
Jv�•y1� G.S G'i�v�
Job Address) (E-Maffl for proprietary use only
TOTAL Additional Model TOTAL
Windows Purchased NEWPRO Work Number QtyCASH !�
Window Color In: a�h� Out Sliding Glass Door--- PRICE 6_ r
Capping COlOr / @ Steel Secu.
Door Color n: ut: DEPOSIT
Model Name Model Numbers Sidelites WITH �a
Double Hung ew Construction Unit ORDER
Pi indow Storm Door BALANCE
Casement Obscure Glass T P BOTTOM • DUE AT / &1� �Q
to 'te Slider Soreens F INSTALL (O1c
Bay/Bow Frame =7 Please ln;661:
Roof ❑ sotpL Customer understands that NEWPRQ@ does not CASH
Garden Window do any painting or staining, (ie:when removing 901anw.paid to Ins at ineWletion
Awning or replacing interior stops or trim)
Hopper NEWPROS is not responsible for conditions or
Shaped circumstances beyond its control including con- CINANCE
Other densation resulting from or due to pre-existing (MAX form signed at inetwi 'or'
GRIDS nial DL I o conditions.
DESCRIBE WORK:
/ G G Us d5 ,0" <ju
Yo i S " Q el :.Y U
Est.Start Date: Customer understands this is an"estimated date" ESL Comp.Date: Mro
rma
Initials ustomer un h d installed over existing threshold.
It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent, The Owners who secure their
own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A_ All Home
Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registratic
should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)727-8S98. If the
Owner is obtaining financing by way of a Retail installment Sales Agreement,such Agreement shall include a time schedule of payments to be made undo
said contract and the amount of each payment stated in dollars,Including all finance charges. The Retail installment Sales Agreement shall be incorporate
herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving
line of credit Including interest rate and payment terms,shall be clearly set out on the credit application, The portion of the credit application referencing
a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be
incorporated herein by reference.
NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$1 OD,000-$300.000.
If the Owner refuses to permit NEWPRO to Proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason
whatsoever Shan cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed,
liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage.
NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable Control.
Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authofzed on behalf of the owners to ente
into this agreement
This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and
NEWPRO.
You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We,the
aforesaid owners,certify that immediately after'the signing of the aforesaid agreement,a copy was furnished to us
You may cancel this.agreement if it has been signed by a party-thereto at.a place other than'an•address of the
seller,which may be his main office,or branch thereof, provided you notify seller.in writing at his main office or
branch by ordinary mail posted,by telegram sent-or by delivery, not later than midnight of the third business day
following the signing of this agreement. (Saturday is a legal business day). See the attached notice of eancellatioi
form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
" Z...
e owner has seen"sample"warranties that will be provided NEWPRO u p p by pot inspl�tion. Sample w rarities pr 'clad to Owner.
WHE EOF a pa have hereunto signed their names this ��'' day of ✓ 20�_
ot✓ oyl/ � EIN# Signed \
•
Marketing Representative Printed Name Owner
Accepted: NEWP rating,LL�
By v
e - Signed
Owner
CORPORATE OFFICE WAR BRANCH OFFICE
26 Cedar$t Office o(Coastmoier A$'airs and Busiaess Regulation 24 Minnesota Ave
Woburn,MA 01601 Tea Pazk P1e2a,State 5170
(P)800 242-9974(From NE) Boston,MA.02116 Warwick,RI 02888
((F)78 -974(Fr 7 ftme, (617)973-8700 (P)800-356-3312(From NE)
(F)401-732.1371
WHITE; Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance CoP1
us.�s
RM
Town of Barnstable *� ;a
R( gulatory Services
oFtt+e ram,
P� ti Thomas F. Geiler,Director
* E Building Division
rt BARNSTABLE, * -
r MAss. Tom Perry,Building Commissioner
A ,.
• tfop�p�a � 200 Main Street, Hyannis, MA 02601
vyww.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
j Fee: . —
p Permit#:' �O '{
HOME OCCUPATION REGISTRATION
Date:
Name: R e6&Cs� }� ' Phone f#: $!o Z $Z 3�
Address; S4r4uVillage V l
Nanie of Business:------_-- ------ -=-=---------------------- --=
Type of business: 14f \So(U1544 _Map/Lot:
INTENT: It is the intent of this section to illo�i,the residents of the To.i-n of Iiarnst�ible to operate'a hoiiie bcciipatioii '
cxithin single family dwellings,:subject to the provisions of Section rl 1-A of the Zoning ord,inauce, provided that(lie acti6ty
shall not be discernible from outside the dowelling: there shall be no increase it,noise or odor; uo visual alteration to the
premises which 4vould suggest anything other than it residential use;no increase in traffic above normal residential volumes;
and no increase in air or groundwater pollution.
After registration iiith the building Inspector,it.ciistonialy home occultation siiall'be permitted;as of right subject to the
following conditions:
1'lie activity is tamed on by the permanent resident cif a:single fartiily iesidential chvelling unit, located Withii1.
that chvelliug unit..
• ,Such use occupies no more than 4:00 square feet of space:
•_ There are.no external alterations to the chvelling.Nducli.are notcustoniary,in residential huilcltugs,lint(there is
to outside evidence of such use;
• NotiafficiNillbe generated in excess of normal resideutialvolumes.
a "Tile use does not involve(lie production of offensive noise,6bratiori,sniuilce,dust or oilier partic•ularuuatter,
odors,electrical clisturbanee, heat,glare,huniidity or other objectionable eflec•ts.
• There is no storage or use of toxic or hazadcLIS n mor' c r'explosii1e materials, ini`excess of
nornial Ito use liold`quantities.
• Any need for parking generated lay sueli use shall be imet on[lie saiue lot c•ontaiuiiig the Customary Home
cc•tipatioil,and not within flie required flout yard.
O
• There is no exterior storage or display of materials or equipment.
• , 'There are no corn inertial vehicles related to [lie Cus(oniary Honie Occupation,other.th;ui one%,an or olie
pick-up truck riot to exceed one ton capacjty,and hire trailer not to'exceed 20'feet iii leiik lh and not tci'.
exceed,f tires,parked on the Sallie lot coutainingthe Customan} Home Occupaitioii:
• No sigh shall be displayed Indicating the Customaiy'Honie Occupation:
If the.Customary Home Occupation is listed or advertised as a business,_the street address shall not be`
included.
• No person shill be employed iu the Customary Home Occ•uliation who is not a permanent resident of,tile
drivelling-unlit.
I, the undersigned, have read and agree with the above restrictions for my home occupation I ani registering:
Applicant: ems+ 7� � � Date: / 8'
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 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 are available at the Town Clerk's Office, 1'`FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
i DATE: Fill in please:
r ,:, APPLICANT'S YOUR NAME/S: 19,J �Rp
B�U�SIIN�E�SS�. YOUR.HOME ADDRESS: t
TELEPHONE # 3
x , : Home Telephone Number 5j2g $�Z
` NAME OF CORPORATION: 3
NAME OF NEW BUSINESS ^+ .S
IS THIS A HOME OCCUPATION? : " NO
4
. _ YES TYPE.OF BUSINESS NR-rSI`p—V LC
3l
ADDRESS OF BUSINESS - -t t s Cew6ruifig, MAP/PARCEL NUMBER 2146'-Z�
(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
q d to,legally operate your business'in this town.
1. BUILDING CO ISSI ER'S OFFICE y
This inc al htis n i M. of n ermit�r e ire ment •st Y that- pertain
i q n to this e of business. ,
P sines
tYP s.
Au h
MUST COMPLY WITH HOME,OCCUPATION
iz d;�i e** '
MM NT ` RULES AND REGULATIONS. FAILURE TO
2. BOARD OF HEAL
This individual has of he permit requirements that pertain to this'type of business.
Authoriz
ed Signature .
COMMENTS:
•
3. CONSUMER AFFAIRS(LI NSI A THORITY)
This individual has b info m f he licensing requirements that pertain to this type of business.
Authoriz d Signature*
COMMENTS: &55112Q5 CGL �S�G! //r) 200 9, / D
.pew Space_
Q .
Town of Barnstable
Regulatory Services
W Thomas F.Geiler,Director
Building Division
MASS Tom Perry,Building Commissioner
�Ep 9.y aim 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Approved:
Fee: -0C?s-
Permit#: K7Q
HOME OCCUPATION REGISTRATION
Date: 1i 164jos—
Name:' P e f ,M 0 ,k) A Phone#: S0'9—76 a- - S�3 (5
Address Village: Ca,% -Q-...L.) t((,r., .NJP6,
n
Name of Business: W�p N tr c `mod t d
Type of Business:A a A'( 6
Map/Lot:
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 is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pickup 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.
I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.
Applicant: � — Date: # d
Homeoc.doc Rev.5/30/03
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 are available at the Town Clerk's Office, 1st FL., 367 Main
Street, Hyannis, MA 02601 (Town Hall)
l :Ki OVA 00
DATE:
Fill in please: ' d-
O RA� APPLICANT'S YOUR NAME: �C_belcc�a_ 1��GC,rUY 0-mums i t�
BUSINESS YOUR HO E ADDR SS: .3 I ct S-�rOt Q.c)bPr�
e AAA oa63P -
1 TELEPHONE # Home Telephone Number 5-0`d-9'6 -1 -22 3 0
NAME OF NEW BUSINESS Q 0--`S i o TYPE OF BUSINESS_,/ wf 4- o Q ra to us i c_
t� IS THIS A HOME OCCUPATION? iw ' YES NO
Have you been given approval from the building division? YES NO _
ADDRESS OF BUSINESS• r Q 14 ' 11 MAP/PARCEL NUMBER
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 NER'S OFFICE
This individ al h e ncnfo e o anypermit requirements that pertain to this type of business.
Au horized Si 'ature"'
COMMENTS 0 P.(Yt`4io c r)t)
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.(LICENSI AUTHORITY
This individual has been n r d of t e licens ents that pertain to this type of business.
Au ized)Slignature`*
COMMENTS:
Ir rr
Ft rowti Town of Barnstable, *Permit# n /2 2
�, O* Expires 6 months from issue date
,�r� , : Regulatory Services Fee
ov
I �q Thomas F.Geiler,Director PRESS�o
e
p'FO N10�`a Building Division
Tom Perry, Building Commissioner JU ®r
IFP
200 Main Street, Hyannis,MA 02601 T®� N �f " `Q43
Office. 508-862-4038 N or
L
Fax: 508-790-6230 BAR�STA�
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY E
Q Not Valid without Red X-Press Imprint
Map/parcel Number�i/f.15 ! — 3 '
Property Address
residential Value of Work
Owner's Name&Address
U 17
Contractor's Name /v ® � Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ am a sole proprietor
IRI am the Homeowner
'I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit 7Re
check box)
roof(stripping old shingles) All construction debris will be taken to U /0 75 2
❑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,etc.
***Note: Property O r must sign Property Owner Letter of Permission.
Signature ( G
Q:Forms:expmtrg
Revised121901
n
°FI►W r Town of Barnstable
Regulatory Services
• URNSTABLE. •
9 MASS. $, Thomas F.Geiler,Director
SATED 39. p Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I � / ��
as Owner of the subject property
hereb uthorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Sign of Owner J Date
Print Name
Q:FO RM&O W NERPERMLS S ION
Assessor's map and lot number .. .. .."........... ! r
lI/CPe
- PEPTIC MTEV
MUST BE
_ INSTALLED IN COMPLIANCE
9
1 Sewage Permit number .............. ..............I......... ...... WITH ARTICLE 11 STATE
r SAP41TARY CODE AND TOM
�Py�F TN E'T�� TOWN :. Of. B A R N S TGX99u-is
.* B9flB9T013L' i �y „
16 9a�e�� �RUILD'IHG INSPECTOR
G� ems _APPLICATIONrv,FORGPERMIT TO� ...... ..... . ............... .. .......................................................
TYPE OF CONSTRUCTION .......... ..... .. .......:................
......... ........:19.. .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permi according to the following informatiorw:
/ a.-A i J
Location / ...... ......
ProposedUse ......................................................................................................
Zoning District ......> (o:.............................. .....Fire District ......... . .. .. . ... . ............ . ........
a
Name of Owner ..... .. ..�.--iLo....Ad dress
`......�C�... ........ ...... O �
Name of Builder
l (
....................................................................Address ........... ............,................................... .
Nameof Architect ........�...I.......................................:..............Address ........................................`............................................
Number of Rooms ...............�........... ................... ...............Foundation
.........................................................
Exterior .... ..............:........Roofing ........
Floors ......Interior ......... ........ ...................
Heating '.. ,l.... ..... ......Plumbing ..... '—'- % .. yt�
Fireplace ...................... ..........................................................A Approximate Cost ...--
p Pp �?. ........ .r�...!....d...�........
Definitive Plan Approved by Planning Board ________________________________19--------. Area ..... 1 ....... .:...............
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH n
/Y_
l
f0
f hereby agree o a t e RuI and Regulations of t et own able regarding the above
construction.
Name . .. ..... .. .. .
t
Monzeglio, Felix
No ..,17205... Permit for .•,one story,
single family. dwelling......................
t Location .........319 Strawberry! Hill Road
Centerville
Owner Felix Monzeklio
. ........................ .........................
' Type of Construction
frame
....... (1..................................................................
Plot ............................ Lot ................................
` Permit Granted J L 12.............19 74
Date of Inspection ..1. °? . ............
p2 ��
Date Completed ...,r.......
PERMIT REFUSED
........................................................'........ 19
i .............................................................................. 1
....................................... . ..................................
' ...... ............................................................... .. .
{ ........... ... .............................................................. t
"Approved ........................... 19
4- -,
................. . ........................................................ w -
............................................................................
Monzeglio, Felix G I U
r'n U
17205 '" �7N one story,
No ................. Permit for ....................................
single family dwelling
...............................................................................
4.
Location ... 319 Strawberry Hill Road
...........................
Centerville
Owner ........Felix. Monzeg1io. . . . ........... .................. .... . . ...... . .
Type of Construction ....... rame
f.ram.e.........................
...............................................................................
Plot ............................ Lot ................................
Permit Granted ............J.u1y.12..............19 74
Date of Inspection ....................................19 -_
Date Completed ......................................19
PERMIT REFUSED
................................................................ 19
f
...............................................................................
................................................................................
...............................................................................
............................................................................... -
Approved ................................................ 19
...............................................................................
...............................................................................