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Home My WebLink About0800 BEARSE'S WAY (20) O� �jE�ld� s' G(//4' i Town of Barnstable Building Department` Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town..bamstable.ma.us Pre-application for Business Certificate Date . . Z Z (9 Map ; Parcel Applicant Information Applicants Name �� CA_e Applicants Address Wb Email Address Telephone Number(;70 R ) Fs LP 0 2 d 31 Listed ❑ Unlisted ❑ Business Information New Business? ----------------------------------------• Yes No Business is a registered corporation? ------------------------- Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? -------- ,Yes No If yes thewa Home Occupation Registration is required—See Building Division Staff Name of Business P LA CIO N n Business Address Sob C.V--C S I A; r Type of Business 'ld'ng commisAoner Off ce Use On Conditi ns ( - r U r �— Buildinrommissi ate Clerk Office Use Only Town of Barnstable . Building Department oF'THE r Brian Florence,CBQ or Building Commissioner _ BARN BEE, 200 Main Street;Hyannis,Na 02601 - r Mnas, $ 1639• �� www town.barnstable'.ma us Office; 508-862-4038; Fax: 508-790-''6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION -" Names �,�� -- �Vte - Phone.#: 5��gUcO Address: 10D. (ecic se s > 1n/A`/ ` Z 14V 17 Village: Name of Business: C)CCl Type of Business: ✓� Pf \/C'YLiC��1 Map/Lot -� O �'7+ 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 Section4-1.4 of the Zoning ordinance,provided that the 4 . 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 unif. ' • Such use occupies no more than 400 square feet of space. - There are no external alterations o 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 ofoffensive noise,vibration,`smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. . of -,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 restrctia home occupation I am registering, Applicant: %5�1n Z� VA e Date: O - 22 20 Homeoc.doc Rev.10/17 fAIUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO - n� r v A, RESULT-IN FINES. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Df/6 Application #OWlc 10 1 a f 5 Health Division Date Issued �-t Conservation Division Application Fee d Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address c-> _Village 14 U A to to t'5 Owner t'! Lb 6f,�,_ Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 mob' Construction Type OP Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) c")0 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ier y 1-,fil 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 Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New 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 ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name DI STD / L/S7 Telephone Number Address g �� ,�s �4 License # CS 621 y��- �1 G LC Home Improvement Contractor# A�� h C_G 4 A__.,, Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 2 DATE /(pItl a- FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL t _ PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ;E • The Commonwealth of Massachusetts Department of Industrial Accidents kv' Office of Investigations ' 600 Washington Street Boston, MA 02111 wwmmass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLibly Name(Business/Organization/Individual): ( U,:Lb2 DI WA lI<,nc_�IQr--- $peLo,_1f8-1:s Address: Py , Roy 4ROI q : `� h .l)T t ue.) City/State/Zip: Sandw (-Clh Phone#: $ 8 / 13 Are you an employer? Check the appropriate box: Type of project(required): 11 I am a employer with 10 _ 4. ❑ I am ageneral 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. [a�emodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' insurance.* 9• ❑ Building addition [No workers com comp, insurance p• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I alp a homeowner doing all work officers have exercised their I L❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] fi c. 152, §1(4),and we have no employees. [No workers' 13.0 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: Policy#or Self-ins. Lic.#: )VORP700 Expiration Date: Job Site Address �S�-t/ City/State/Zip: 4 /— Attach a copy of the workers' compensa 'on poll declaration page(showing the policy n ber and expiration date). Failure to secure coverage as required tinder 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 against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the.DIA for insurance coverage verification. I do hereby cer if tin a the pains and penalties of perjury that the information provided above is true and correct. Signature: 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i RightFax N1-1 12/22/2011 7:19:42 AM PAGE 3/003 Fax Server r 1 ...` .. �:s ., A::..:'aY �. ,s •,.: i,. �u �a ,;w.�:,z"'rx`�'.ar?sa s .:� 12122I2011 THIS CERTIFICATE 18 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 BX THE POLICIES DELOW,THIS CERTMCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 19BUING INSURXWS�)A.UTHORIY,ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT;tf the certiflcale holder Is an ADDITIONAL INSURED,the poNcy(los)must be endorsed,If SUBROG TION 13 WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate d es not confer rights to the certificate holder In Neu of such endorsements. PRODUCER CONTACT OCEANSIDE INS GROUP NAME` 52 WEST MAIN STREET PHONE Ext: A/C,No): HYANNIS,MA 02601 E4AL ADDRESS: PRODUCER CUSTOMER ID r INSURED INS S AFFORDING COVERAGE NAIL A BENABBY INC DBA INSURER A ZURICH DISASTER SPECIALISTS INSURER g P 0 BOX 480 INSURER SANDWICH,MA 02563 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TW-INSURED NAMED ABOVE F R TU POLICY PERIOD INDICATED. NO-TwnwTANDINO ANY REQUIREdMTI,TERN OR CONDITION OF ANY CONTRACT OR OI M DOCVMII`M WITH RESPECT TO CH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY TIM POLICIES DESCRIBED IMREW is SUBIECT TO ALL THE TERMS, CLU31ONS AND CONDITIONS OF SUCH POLICIES,LWTS SHOWN 1fAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY E LIMITS LTR INSR WVD I GENERAL LIABILITY - , FACROCCURRENCE S MAMACETORENTED 0 C01,11Mi OLILOENERAL1IABILITY PREMSES(Each S occurrence) 1 MID.EXPENSE(Any mse S E Q CLAIMS MADE O OCCUR tum 0 PMOONAL&ADV S INJURY D GENERAL AGOREOATE S i GEN'L A00REGATE L243P APPLIES PER D POUCY 0 PROJECT 0 LOC PRODUCTS-COlRsfOP S A00 AUTOMOBILE WATIM)TY COMBnGED SINOIE S Labor , ch scclden O ANY AVID BODB,YINJURY f M Person) S 0 ALL OWNED AUTOS BODB.YBUURYerAcciead) 0 SCHEDULED AUTOS PROPERTY DAb1AGE S er umdmt 0 RMAUTOs S , 0 11021•OWNTD AUTOS D D UMBRFLLALIAB 0 OCCUR EACH OCCURRENCE S U EXCESS LLAB 0 CLAIMS-MODE AGOREGATE S 0 DMUCIIBLE f 0 A£rENP:GN s S W ORXERS'COMPENSATION WC A AND EMPLOYERS LIABUTCY NIA STATUTORY YIN LMM ANY PROPRISTOILSARTNER/ I EXECUIIVE OFFIC R114aIBER N NIA 6ZZU84102P700 0l/01/12 01/01/13 ,..EACH ACCIDENT S500,000 (b9nNDAT0RYIN2+tn (XAnATO L DISEASE-EACH $500,000EbOLOYEE , 1 Iryes,describemdmD]iSCRIPJTONOF LDIrdAs POLICY OPERATIONSbelow LR&F 1500.000 DESck]PTIONOFOPERAT10N8hOCAIYONSATMCLES(ANseh ACORD101,Additiond Remsrks Schedule,irmorespscetsrequlreo THE.WSURED'S MAVJORrERS COMPENSATION POLICY AND RS LIMBED O'THa STAI-a L*ISUAANCE INDORSEMENT AUIHORIZE3 THE PAYMEHT'OF BENEFITS FOR CLAMS MADE DY THE NSVTIED' E2L.OYEES IN STATES O ITER THAN MA NO AUTHORIZATION IS ONM TO PAY CLAIMS FOR BENEFITS IN ANY STATE UMER THAN MA IF TAE Urn=HIRES,OR HAS KRED,EbOLOYEES OUTSIDE MA M POLICY DOTS NOT PROVIDE COVERAGE°OR A1TY STATE OTHER THAN MA THIS REPLACES ANY PRIOR CMnIFICATE ISSUED TO TIIE CERTIFICATE HOLDER AFFECTING WOR=C MP COVERAGE I `-„�ERT.��`,�>��R Fsr,,.i�.,,,�A,Sxr,:...,,a:..i �.::�i ..;sC`: ,.:.`�.�'^.I G)#19WssE. ,4i .0: , :,.. '°',s.�.;'_... ,'";�=jek3° `�ej':;_tir7,''�y'`:`�.✓S-Pii=• I SHOULD ANY OF THE ABOVE DESC ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,N TICE HALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PR VISIONS. - - AUIHOMM PI'SRP]9UATIVC 8rlary McccCuwv �Aeco�lz� .ho9ra..�� .�r.�%�..,��::.n..r. .,. ..:, s . .:. �� s�s�sk.�e�"'?�,.4 .zses-2�3a�t;o c�1�t�'rr;�►n.r I�a�Dr�� i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction SupervLsor License: CS-071402 JOSHIIA L CQ�EN 1082 OLD STAG. CENTERVIIfLE � iij'"X Expiration Commissioner 12/31/2013 c— �a &211�porwr�waacueaLG�o -- ftice of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR License or registration valid for individul use onlyA. !- before the expiration date. If found return to: egi ration::._.,1;48642_._ Office of Consumer Affairs and Business Regulation ®.. Expiration Type: `g/20/2014 10 Park Plaza-Suite 5170 BENABBY INC/DISASTER._ Supplement Gard Boston,MA 02116 SPECIALIST JOSHUA COHEN Box 480 Sandwich,MA 02563 Undersecretary Not valid without signature