HomeMy WebLinkAbout0013 GENERAL PATTON DRIVE i 3 c����
__
Town of Barnstable
Building Department
Brian Florence, CB0
Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barmtable.ma.as
Pre-application for Business Certificate
Date Y f l Map Parcel
Applicant Information
Applicants Name r
Applicants Address I3 a Vl —9 Mai
Email Address Y►°( �i�lf7 / jrr.C
Telephone Number Listed ❑ Unlisted
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Business Information
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New Business? No
------- ------ ------- - - OY -
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Business is a registered corporation? -------------------------- Yes No Z)
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If yes Name of Corporation } w rr
� cc >-
Does business operate under the registered corporate name? Yes No O ® 2
O � >
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Is the business a sole proprietorship or home occupation? --------- Yes No U) 0
CA w c'
If yes then a Home Occupation Registration is required-See Building Division Staff
Name of Business 1 hL rl �/
Business Address I l a n: dJ -�Vin6 '
Type of Business [slIfJ
Buildia Commissioner Office Use Only ,
Conditions 7 V'L6
O ! V le
Building Commissioner `� Date
Clerk Office Use Only
'
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Town of Barnstable
Building Department
pp SHE rp�
.�, Brian Florence,CBO
0
Building Commissioner
f BARNSTABLE, * 200 Main Street,Hyannis,MA 02601
mass.
v 1639• ��� www.town.barnstable.ma.us
�PTED MP'�A
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Fee:
Permit#: —
HOME OCCUPATION REGISTRATION
Date: yk//q
Name: �h Phone#:
Address: . Village: gb6/
—7 (5
-- -
Name of Business: t k AT UVD{^ C &7
r / n
Type of Business: t 1n1 6 Map/Lot: o� g
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: Z
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located _O
within that dwelling unit. F— O
• Such use occupies no more than 400 square feet of space. a- LLJ
• There are no external alterations to the dwelling which are not customary in residential buildings,and there U
is no outside evidence of such use. U =J
• No traffic will be generated in excess of normal residential volumes. 0.LL w
The use does not involve the production of offensive noise,vibration, smoke,dust or other particular - to Z
� U)
matter,odors;electrical disturbance,heat,glare,hurnidity or other objectionable effects. Q Z
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess M 0 —
of normal household quantities.
_ ~ J
• Any need for parking generated by such,use shall be met on the same lot containing the Customary Home w
Occupation,and not within the required front yard. W pG
• There is no exterior storage:or display of materials or equipment, a cc Q
• There are no commercial vehicles related to the Customary Home Occupation,other than one van or one �.
pick' truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to 0 Z >-
exceed 4 tires,parked on the same lot containing the Customary Home Occupation. U) F,k
• 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 cc
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
1,the undersigned,h ve rea and agree with above restrictions for my home occupation I am registe
Applicant: Date:
if
Homeoc.doc Rev. 10/17
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
c�
Map 1 Z Parcel OMM-PJ, OF 'A MBLEgpplication # aol S O � 7
Health Division ,r. g ; ? , %Date Issued
Conservation Division Application Fee
Planning Dept. - Permit Fee
Date Definitive Plan Approved by Planning Board
Historic = OKH _ Preservation / Hyannis
Project Street Address 13 C-eyenl f a7 i r..
Village a
Owner AAddress
Telephone g"^
Permit Request 15 1r MoAd, rz)® A1111i
a
Square feet: 1st floor: existing roposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Imo Construction Type 17
Lot Size Grandfathered: 0 Yes G/No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure /9Y6_ Historic House: ❑Yes l/No On Old King's Highway: ❑Yes C1N0
Basement Type: ❑ Full ❑ Crawl ❑Walkout UY60ther 'S`P��
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing_ new 0 Half: existing 0 new
Number of Bedrooms: existing I new
Total Room Count (not including baths): existing new First Floor Room Count J
Heat Type and Fuel: 2 Ga ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes C>Ilo
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 + Telephone Number �?`�
Address (?p 6611 �rl License#
f� 0 Home Improvement Contractor#
Email Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
sue, Z
AroSIGNATURE DATE /�
` FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
/3DDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
' 1
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
ti
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t
The Commonwealth of Massachusetts
Department ofInditstrial Accidents
.. Office of 1westigations
600 Washington Street
Boston,CIA 02111
impi mass govIdia
'rarkers' Compensation Insurance Affidavit~Builders/Contractors/Electiicians/Plumhers
Applicant Information Please Print Leidbly
Nama(Business organizationadividual): 7trodami
Addtess:_.. 1 e qDr,
City/Stat&Zip- tivann
t6 0,2& one 9--
Are you an employer^Cdeck the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑I am a general contractor and I
employees(full andtor part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees. These sub-contractors have g_ ❑Demolition
Ycapacity.for me in an
woddng employees and have workers'
9. ❑Building addition.
[No workers' comp.insurance comp.insurance.f
/equired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3. I am a homeowner doing all work officers have exercised their M❑Plumbing repairs or additions
myself [No workers'comp. right of exemption per MGL 12.❑Roofrepairs
insurance required.]i c. 152,§1(4j and we have no
employees.[No workers' 13.0 Other
comp.insurance required.]
*Any applicant.that checks box K mast also fill outthe section below showing their woakere compensation policy information.
Homeowners who submit this afidavit indicating they are doing all what and then hire outside contractors umst submit a new affidavit indicating sncih
'Contractors that check This box must attached an additional sheet dwuring the name of the sub-contractm and state whether or not ftse entities have
employees. If the subcontractors have employees,they mustpmuide their workeas'comp.policy number.
1 atre au etrrployer tltat is protdding workers'conrperrsation insurance for my earpiof-ees Below is the policy and job site
informadom
Insurance Company Name:
Policy,4*'or Self-ins..Lic.4,': Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy mtmber 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 anc for 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 veriEcatiem.
I do hereby cerli ur t the ils an allies ofpedury thatthe ircformatimi prodded ab71o
eru and correct
sienature: Date:
Phone
Ofja"cial use onty. Do not write in this Area,to be completed by city or town official,
City or Tcm n: PermitUcense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cl*lTown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instru
ctions ,
P•
Massachusetts Geacral Laws chapter 152 requires all employers to provide workers'compensation for their employees.
pm-suantto this stafofr,an arployee is defined as."_.every person m the service of another under any contract of hire,
express or implied,oral or writtr_ .'
An empooyrr is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a Jom-t enterprise,and including the legal representatives of a deceased employer,or the
receiver or trust=of an individual,partoersbip,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the .
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or oa the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(S)also sues 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 cornmonvPealth for any
applicant who has not produced acceptable evidence of compliance with the insurance.coverage require(L"
Additionally,MGL chapter 152, §25C(7)states"Neither the commgnweahh nor any of its political subdivisions shall
enter into any contract for the performance ofpublic wont until acceptable evidence of compliance-with the inettrancd.
requirements of this chapter have Been presented to the contracting authority"
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(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 cagy workers' compensation i lTrance. If an LLC or LLP does have
employees,apolicy is required. Be advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confumation of in T Ce 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
Dad,,trial 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 lime.
City or Town Officials
Please be sure 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 of Investigations has to contact you regarding the applicant
Please be sure to fill in the permidlicrose number which-90 be used as a reference number. In addition,an applicant ..
that must submit multiple perm-itlIicense,applications in any given year,need only submit one affidavit i adir_a iv current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations i a (city cr
town)."A copy of the affidavit that has been officially stamped or marked by the city or tow?.may be provided to the
applicant as proof that a valid affidavit is on file for fu ti re permits or licenses A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial vent a e
(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 ne to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Departmeafs address,telephone and fax number.
The CGnmMWe lth of Massachusf-tl s
t
D:eparlment Gf Midi al Accidents
office of kvestfgatioui
600 washiuzou St=t
Eostaa MA G1 I II
Td,4 617-727-49W c,xxt 406 car 1-M MASSAFE
Fax#617-727-7749
Revised 4-24-07
• .mass_gQvfdia
ATYO Gzaae to i�ad Cortstruetiorr in Higlr Wirtd Areas:110 tuph EYind Zarze•
Massachusetts Checkiis.t f6r COMP iaRCe (7.80 CnIfR53012.1.1)r
E Ch=k
1.1 .SCOPE
Compva,cr
Wind Speed(3-sec. gust)..................
......... .............:.........._..... ........_--......................_.._..........110 mph
Wind Exposure Category_...-......._..._ •
Wind Exposure Cafegory................Engineering Required For Entire Project.......................................
12 APPUCABILITY
Number of Stories(a roof which exceeds 8 in.[2 slope shall be•considered a story) stories s 2 stories
RoafPitch.....................................................................(Fig 2) .............-----------------:........... 512:12
MeanRoof Height*............._.._............................-----------:-_(Fig 2)................................:................. ft _<33'
BuildingWidth,W...................•--•---.._.._........._....... -(Fig 3)........................................ ft s 8-a'
Building Length,L ................. _......
.........................._....(Fig 3)------------......__:_.._....................... tt 560`
Building Aspect Ratio(L/W) .--............_..............................(Fig 4)._--------------------- ---------
. <3:1
Nominal Height of Tallest Opening2 ..................._.
..._..-...-.(Fig 4).......-........................................ 56'B"
1.3 FRAMING CONNECTIONS
General compliance with framing o6nneeetions._... --.--•.__...(Table 2).........._...............................
2.1 FOUNDATION
Foundation Walls meeting requirements of 78D CMR 54D4.1
ConcreiE............................
.....................................................•-•------•-••--- ....._.........._'
ConcreteMasonry................>.....__.............-_.--..-----._.._..._._....__.._...... --:.._ ........._,--..::........_..:...
22 ANCHORAGE TO FOUNDATIONtl
5/8`Anchor Bolts4mbedded or 5/8'Proprietary Mechanical Anchors as an'altematfve in concrete only
Bolt Spacing-general...................................__:.(Table 4)................................................ in.
Bolt Spacing from endfioint of plate_......_....................(Fig 5)--_..�.._._.-..-:.......:.-....__. in.<_6"-12
Bolt Embedment-concrete.........._.............................(Fig 5)..._.. ............_.............__._.__... in.y 7"
BogEmbedment-masonry...................:...........4.......-•(Fig 5)---....•----.............................. in _>15"
PlateWasher......-................--•--•--......__..-•--•.................(Fig 5)...........------------------------ •-----'-3"x 3`x Y"
3.1 FLOORS
Floor•framing member spans checked ----------------
-------
780 CMR Chapter 55) ......-....._.............
-.-•
Maximum FloarOpening'Dirnension.............................. (Fig 6 ...........____.._ _ ' .
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6).................................
Mk)dmum.Floor Joist Setbacks
Suppoiiing Loadbearing Waifs or Sheanvall...._..........(Fig 7)..........____.........-.........................._f{ <d
Maximum Canfilevered Floor Joists
. Supporting Loadbearing Walls•or Shearwall................(Fig B)-----_-------------
._----------------....... ft <d
FloorBracing at Endw-As.............................--•.............._..(Fig 9)... =----•----------•-.__._.....__...........__ .........
Floor Sheathing Type .::--.---------.-_---
----------
-=-------------
-------(per 780 CMR-Chapter 55)...........................---
FloorSheathing Thickness........................._............_.:.----(per 786 GMR Chapter 55)------.__..:.----_--• in.
Floor Sheathing Fastening_...................................:.......:..(Table 2)- __d nails at in edge/_in field
4.1 WALLS
Wall Height
Loadbearing wags..........._......_.......... -----------(Fig 10 and Table 5)......... --. ...... ft <10'
Non-Loadbeadng walls--------------------------------------------(Fig 10 and Table 5)___........ ............... ft-s 20'
Wall Sind Spacing ............................_...._._....._....._......(Fig 10 and Table 5)..................._in.<24'D.C.
Wall Story Offsets _. ......................................(Figs 7&8)............................_..._. c
ft d
42 EXTERIOR L►ilALLS'
Wood Studs
Loadbearing walls:..._......._.................................. ble 5
....(Ta ) ..................mac fit rn.
NonLoadbearing.walls............................................... able 5 ..............................2x _ ft
—
Gable End Wall Bracing' — .
Full Heidtrt Endwall Studs..._.......................................(Fig 10)......................
,.--------
_......._......
........_...
_. .
WSP A1iiC Floor Length._---•--------:-----•-•---.....--' _ -(Fig(Fig 11)- - - .._.......--•--._...._........ ft�:W/3.
Gypsum Ceiling Length(if WSP not used)....:............:.(Fig i1)..._...___._-._.-__--------------------
—ft>_0.9W
and 2 x 4 Cbntinuous Lateral Brace @ 6 ft.o.c.-(Fig 11)........:......................--•---------.-----•-.__.._ r
or 1 x 3 caging furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ff.spacing in end joist or truss bays
Double Top Ptah?
SpFrce Length -._-_-._.--.,..:.------------...........---------Fig 13 and Table 6)................._................._ft
Splice ConnecflDf (no,of 16d common nails).._..........(Table 6).._..:...._.........................
_..__-_.
ATMC Guide to [Voo d Constr-uetlou N High find Arefs: 11,0 trtph li rrld Z01le
Alfassachusetts Cheek2st_ for COMPLjaHce (790 C11 1253at.z.t.r)t
Loadbearing Wall Connections
Lateral(no.of 16d common nails)..................................(Tables 7).............................. .
Nan-Loadbearing Wall Connections
Lateral(no-of 16d common nails)......................._...._--(fable B)..........._.........................................
Load Bearing Wall-Openings(record largest opening Sut check all openings for cotpffance to Table 9)
Header Spans ---............__.. ..........(Table 9)...:............................... ft_in.511,
Sill Plate Spans ' .....(Table 9)........... . ...... ft_in.-<11'
Full Height Studs (no.of stu ...ds)............................... ..(Table 9)..........._.....__._.....----•-.---• ----. -...
Non-Load Bearing Wall Openings (record largest opening but check ail openings for compliance to Table 9)
HeaderSpans.................................................._.........(Table 9)............................_.... ft in.512' .
Sill Plate Spans......:........... .--.--..--:- ...(Table 9)...................... _._. ft rn. 12'
._.... able 9 ............ ..............
<
Fuil Height Studs(no.of studs)......................•._-_- (f )•---•---....._.._--••---
Exterior Wall Sheathing to Resist Uplift and Shear Simultanbously4
Minimum Building Dimension, W r
.Nominal Height of Tallest Opening 2 ..............................................................-.....................
SheathingType..............0..._..........................(note 4)...-................................................
-Edge Nail Spacing....................................._..(Table 1 D or note 4 if less)...................._. in.
Feld Nail Spacing.........................-...............(Table 1D)...........--------............................ in.
Shear Connedion(no. of 16d common nails)(fable 10)-------------- -------------------------------------
-_
Percent Full-Height Sheathing......:.............:...(Table 10)---------------------------------------------- °
5%Additional Sheathing for Watt with Opening>6'8`(Design Concepts)....................
Maximum Building Dimension, L
Nominal Height of Tallest Opening2............._..._...... ............. _<6'8`
SheathingType..............................................(note•4).................................................... —
Edge Nail Spacing---------................_....._........Table 11 or note 4 if less)......_................
Field Nail Spacing.._......................................(Table"i 1):----.--_----.-................-.......�......... in.
Shear Connection(no. of 16d common nails)(Table 11.).....................................................
Percent Full-Height Sheathing------,...._.__......(Table 11)..........................._............_._------—%
5%Additional Sheathing for Wall wifh'Opening>SW(Design Concepts).................... .
Wall Cladding
Ratedfor Wind Speed?-........................................................... .....------------_........................-•--•------••-•
6.1 ROOFS
Roof framing member spans checked?.......................(For Rafters use AWG Span Tool,see BBRS Websb)
Roof Overhang ...................................................(Figure 19)............. ft s smaller of 2'or 113
Truss or Rafter Connections at i oadbearing Watts
Proprietary Connectors
Uplift...........:...........................-------(Table 12)........-..._...-------------------------U- plf
Lateral..........................-------------------(Table 12)......-......-........-...........-......L= pff
Shear................._..........................(fable 12)...................................- _ S= Pff_
}ridge Strap Connections.if collar ties not used per page 21... (Table 13)..............................T= pif
Gabe Rake Outlooker............................0-------------(Figure 20) ............. ft 5 smaller of 2'or L12
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift_...............................•--.---.._...(Table 14)•--•--------•---••---------------------•-U= lb.
Lateral(no.of 16d common nails)...(Table 14).......................................L= . lb.
Roof Sheathing Type---_--...-....:.........................._......(per 78D.CMR Chapters 5B and 59).............
Roof Sheathing Thickness.....................................:........:..____.....__...._......._.__.. in.>_7116`WSP
Roof Sheathing Fastening.......................................... (fable 2)_...................._..................................
Notes:
1. This checklist shall be met in its entirety, excluding the specrf•rc exception noted in 2, to comply with the requirements of
78D GMR.53D1.2.1.1 item 1. If the checklist is met in its entirety then the following metal straps and hold downs are:not
required per the WFCM 11D mph Guide:
a. Steel Straps per Figure 5
b. 20 Gage Straps per Figure 1 i
c Uplift Straps per Figure 14
d_ All Straps per Figure 17
e. Comer Stud Hold Downs per Figure 1 Ba and Figure 18b
Exception:Opening heights of up to 8 ff_shall be permitted when 5% is added to the percent full-height she
requiranients shown in Tables 10 and 11.
The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#Z-grade.
AfYC Gii de to Xood C,onstruetiori hi Hi41 141ind Areas_ 110 uzph Wind Zon
Massa-chus6tt� Cheeldist for Compliance (7sa Cr}iR s301 2.J'I)'
4.
/ a. From Tables-10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percept Fufl-Height
Sheathing and Nail Spacing requirements
b. Wood Structural Panels shall be minimum thickness of 7116"and be installed as follows:
1. Panels shall be installed With strength axis parallel to studs.
1. All horizontal joints shall occur over and be naled to framing.
if On single story construction,panels shall be attached to bottom plates and top member of the double
top plate.
iv. On two story construction, upper panels shall be attached to the top member of the upper double top
plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist
and lower attachment made to lowest plate at first floor framing.
v. Horizontal nail spacing at*double top plates,band joists,and girders shall be a double row of ad
staggered at 3 inches on center per figures below:Vertical and Horimntat_'Nailrng for Panel Attachment
5. .Glazing protection: a)new house or horizontal addition—required if project is 1 mile or closer to shore(generally,south of
Rte.28 or north of•Rte.6)
b)vertical addition—not required unless there is extensive renDvation to the first floor
c)replacement windows'-needs energy conservation compliance only(chap 93)
S.Wood Frame Construction Manual(WFCM)for 11D MPH,Exposure B.rnay be obtained from the American Wood Council
(AWC)webs'ite.
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See Detail on Next Page
Vertical and Hortzontal Naling Detall
for Panel Attachment Vertical and Horzontal Nailing
for Panel Attachment .
11
Ty Town of Barnstable
o�
Regulatory Services
i F '
E F
E B�ANCPIRr.4. i
9 mum $ Richard P.Scab,Director
Building Division
Tom Perry,Bmlding Connmisdoner
200 Main Street Hym is,MA 02601
www.townlarnstable m2 n
Office: 508-862-4038ax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A.Builder
L , as Owner of the subject property
hereby authorize to act on my bebA
in all matters relative to work authorized byt bis budding pemait application for. ;
(Address of Job)
`Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or ui7ized before fence is installed and all final
inspections.are perfoJmed and accepted.
Signature of Owner Signat ar-of Applicant
Print Name Print Name
Dare .
Q:FORMS.OWNEUMUMSIDIeDOLS
'down of Barnstable -
Regalatory Services "
off r � Richard V.Sca1%Director
�' °-* Bl��g DTVISIDII
t
Tom Ferry,Building Commissioner
p sue¢ 200 Main,Street Hy�ms,MA 02601
16 www towmbarnstable—us .
Office: 508-862-4038 Fag: 508-790-MO
HOMEOwIIMR LICENSE EXEMP'IYON
J�J y PlersePtint
DATE: /o` /f'� �`� •�
IOB L O1_
FiOMEOWI`IEft �.-
namc - bomcphonc# woicphon
tV
CURRENT NEA=G ADDRES S: sun a5 W6 /0�431Ju _
city/tawn slat zip code
The current:exemption for"homeowners"was extended to include owner-occupied clwellinE of six units or less and to allow
homeowners to engage an individual for hire-.who does notpossess a license,ptoyided that the owner acts as supervisor_
DFF=ON OF ErONMOwNM
person(s)who owns a parcel of land oa which he/she resides or intends to reside,oa 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 submittn the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible fur an such work performed underthe building permit (Section
109.1.1)
The rmdersigaed`.`homeowner"assmaes responsibility for compliance withthe State Building Code and other applicable codes,
bylaws,rules and regalations_ -
The undersigned`bomeownm-pertiffes tbathe/she uadeslands the.Town ofBamsiable Building Deparimentininimum inspection
promd. Uan requirements he/she will comply with said procedures and mqui emeuts.
• 5i' of amcowncr
Approval ofBnilding Official
Note: Tbree-fmmily dwellings containing 35,000 cubic feet or larger will be required to comply with tho State Building Code
Section f27.0 Construction COntroL
HOMEOwIZE$'S EXEMPTION
The Code states that: a9ay l ameowner perfarming work for which a building permit is requited shall he exempt
from the provisions of this section(Section 109_I1-Licensing of construction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall art as supervisor."
Many homeowners who nse this exemption are unaware that they are assuming the responsibifrties of a supervisor
(see Appendbc Q,Rules&Regulations for Licensing Construction Sbpervisors,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 personas it would with a licensed Supervisor_ The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fkUy aware of his/her responsibr-Lazes,many conaunifies require,as part of the
permit application,that the homeowner certify that he/she understands the responsiiblUdes of a Supervisor. On the last page
of this issue is a form currently used by,several towns. You may caret amend and adopt such a form(eertiff afina for use in
your community.
Q1�7PFa.EStiFORM51bm7dmgpe�itfo�slE4FRF5S.doc •
Revised 061313
Town of Barnstable Geographic Information System December 11,2015
292101
#9
292040
#s5FN211
292125
292126
292276 Q #12
#75 Jc/
2103
' #13
0
-,� 4 s
Y
292127 .
#14
292104
#15
292275
#85
292128
0 13 Feet 292105 #16 $,
#17
DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:292 Parcel:103
boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:HENNING,THEODORE R&HEIDI R Total Assessed Value:$122000 Selected Parcel
1-=100'may not meet established map accuracy standards. The parcel lines on this map
are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner. Acreage:0.18 acres Abutters
boundaries and do not represent accurate relationships to physical features on the map Location:13 GENERAL PATTON DRIVE t
such as building locations. Buffer ._"
f
Parcel Detail Page 1 of 3
awe g¢ 3
S '1el' H
An
Logged In As: Parcel Detail Friday,December 11 2015
Parcel Lookup
Parcel Info
Parcel ID 292-103 _I � Developer Lot
Location 13 GENERAL PATTON Pri Frontage 467
Sec Road Sec Frontage
village HYANNIS r, I Fire District HYANNIS I
Town sewer exists at this address rNo —1 Road Index
Asbuilt Septic Scan:
292103 1
292103_2 Interactive Map I +g S
2921033
W Owner Info
......... .................. ......... ......... ......... ......... .......... ............._.. ......... ......... ... .....
owner HENNING,THEODORE( CO' W �
Owner
streets 13 GENERAL_PArf6N_jl Street2
city HYANNIS I state AMA Zip 02601 I country I
Land Info
Acres�0.18 I use Single Fam MK-01 I Zoning B.VN771rvghbd 0104
Topography jLevel � � Road Paved I
Utilities PubliiaWater,Gas,Septicl Location
Construction Info
......... .._.......... ._...... . ..................... ... ....... ............... ......... .............. ......_... ........ .... ........................................... ....... .........
Building 1 of 1
Year Roof Ext r
,o .
Built 1945 struct aGable/Hip wail Wood Shingle
Living 887 Roof Asph/F GIs/Cm AC`'None
Area ( Cover�,, —a - p I Type
Style Ranch Wald Drywall m. Rooms2 Bedrooms
Model Residential Floor Hard Room
s 1:1 Full-0 Half
Grade verage Minus Type Hot Water R oms�r Rooms
stories 1.2 FuelHea s �F ation G�nC.Slab
Gross 1�864
Area
Permit History
Issue Date Purpose Permit# Amount Insp Date Comments
6/30/2015 RE-SIDE AND
6/26/2015 New Siding 201504004 $5,500 12:00:00 AM REPLACE
WINDOWS .27
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=22974 12/11/2015
� / I -�
/ a � � �'
,/ Uf�
' � ,
. ,, , ,•
'Town of-Barnstable _•� ,
y� lieg ulator' SerYices . . . , • • : . •
-
' 4oumEas F. G-e�•i�]er,DirE�tor - . •
ding
Th omas P enj -G3 0,B uj]ding C ommissi o n Er ,
200 Main Street, H-y -Ls,MA 02601
_ ., wWSi'.town.barns•tablama.us .
0$ic•e: 50 8-862-:403 8
Fax: 508-790-6230' '
- -PLAN REVEL :.
Owner �o�c / {1'lnin S Map/Parcel:
• l D�� ..,Builder: • �'/
Project Address 131P1�t
The i'oHowing items :sere noted on reviewing:
' S c- a eeea/
/ c1� loQ•'k /1�Pr� � � .
Z l. 1._ 5l /;. 7►" n-T Sr�7 YI G�t�Gt T
ZYrr 3 ZX`o Or --zXIZ
a
-3) -second me,ti't St-
�_ a
R-zY-iew.ed by:
D #at1Z-- Z z rS '
EVE Town of Barnstable *Permit#
D
Expires 6 months from issue date
-ffv9 AQ NM01 Regulatory Services Fee
•;BA—STABIX�+
16 Richard V.Scali Director
Fp MA'I
Building Division
OWsTom 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 �(j� 1 03 -
Property A dress
esidential Value of Work$ � Minimum fee of$35.00 for work under 000.00
Owner's Name&Address
Contractor's Name (� / elephone Numberj���
Home Improvement Contractor License#(if applicable) 1 9 Email: C-6164 f 14 ('-j1by. ii 4 JW 6
Construction Supervisor's License#(if applicable) C 5 — ®09'9 T 7
"oran's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ 11AM the Homeowner
have Worker's Compensation Insurance
Insurance Company Name_ �Sor� `[19J t�q fi hownS
Workman's Comp.Policy# R1LJ C 15 1(o1 9 (a
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re- oof(hurricane nailed)(not stripping. Going over existing layers of roof)
e- '
Af
eplacement Windows/doors/sliders.U-Value n_4_1 (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*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 copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 040215
t
1 THE tp�
* BARNSTABLE,
,' ,�� Town of Barnstable
ArfD INA�A
Regulatory Services
Richard V.Scali,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 Section
If Using A Builder
I,—Led — , as Owner of the subject property
hereby authorize�� I ( d ll��� to act on my behalf,
in all matters relative to work authorized by this building perrnit application for:
L
(Address of Job)
i�nature of Own Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
QAWPHLESTORWbuilding permit formsEXPRESS.doc
Revised 040215
Town of Barnstable
Regulatory Ser0ces
��7HE�Yyr Richard V.Scali,Director -
Building Division
snx LAS& a
Mass. Tom Perry,Building Commissioner
1639• ��� .200 Main Street, Hyannis,MA 02601
'°rEn www.town.barnstable.ma.us
Office: 508-862-403 8 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 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 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 040215
a �
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a .A tom.
•'�"�- •C���r„�„� �aei�'F���P•�•�t�m�Ct�I�Q•c�.�(Pfru���
Address:. 67 0 5
tite}fitairc In er?{fir f �bcr Type �i�C -
I Iam aemploy�t 7/ ❑T�agrzndl ItFeu�
=vlapees CE311 a flcga �* ha m
❑ I am a sole propflefar orgarEuer- Iisfe3 on �#atdied s � �- ❑ g
ship End have nG emplay=s Them =ha-m g- ❑ a
•€ood ng forme ra my mpac�y- �8adhave vai='
�Vmlimm.
Comp.M-T=M ce comp-k nrMxx=l g- ❑
1 5. ❑ W5 are a wtparaiian aad ifs If?❑EledHCaI n?aim or additians
J_❑k am a homes d4inb aII wad °ffi ham m*�eu flier11_❑Pinmbmg nrpaim ar addili=
MySeTf LNo Workers'comp- rtgi tOf4-Tfltn per MM
c-1'�^}'••, 1zm �-�$nofn rags 4
mcrtrnn rE 1•F � � (J�\�r aadwehama
employ 3-LKaWa6me
# ��,�t�•�s�:u i �:��rIIr.�._.r�*�*e oshi�cw �ct s�aaQsr r�rd�"m^�+' e src�
fCnatc.�•fistdi-CYt1z4sb6c must stt ch ra y*h+ TsLeeYs thtn�eof s rm3sialLubttarttsmt9mstL esh,pa
emplapers. Iftot mB-ca�ixxmmmIrrmi mt7 i provide th& ciima erg.puay=bez
• :' firtu'm�'�zr�xIvperik�ispr�i�gt�orl�ers'r_���+s�K�fart¢ e�yEsr. Be7vty is fhepu�aru�3oh�ta '
Isspriare CompaYI£ame:
1�ar"Tg CIE self-in:r�Iic-f- C�I b 1q� fsortT}ai� t I ^� r
-16bSite (3 G, aQ-C"t.-I PQ*U, C)C c64-
At ac7�a-c mf t� urkerf campeusdiian p aIrt�dzt�xti,on page-(s�gi¢g f3rC Fa�3'21 l-a V-I a- D ilste}:
Fzp=fo stc=r-cull= easxevire6 mderSec•Emrr25AofMMc- I52 Can leadtotTMimposli=ofram;7Ap=mBiLs ofa
Ham up to SI�5DG OD ancllor- as W&as aril p—lb.e$sa$ie fSn of a STGP WORK ORDFR-and a fne
ofmRtc S250-00 a dayapi3s ffieviobdt Be sty maybe cededtvlhe C fEm of
It ZomofticDIAfhrrnqxanmc6rmpT$1EStztII7w
.T rfa;F��.F cer�p rrrtder titsgttius irtsr�psa�ar r� rrp ffi�g ir�vr-xra#iva pra•vi��aha��Ls trmg>md carrecf
E, WLTE lime rr* lk trot trribr Lu 9LEr great Be cr RTL- d by d�y-r fawn vfficiaL
C•dy ar Tomi �Ceasc
T�rsg•c�-'afharifg t�e nuc�: . • '
L Soard.�f$caTt�2. ng�sv-trr�+�-t�t�f�{�a�aGIs� •�.I:IeriricalF�slxectur ate.P�in� t-or
-6.Gtlb=
. rr,,,f F ✓fie �oarvnzomurealUa o�"✓!/CaaaacfuroeCCa
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
Registration::- 153905 Type:
Expiration; -1_f2412017 Individual
PA L F.COLBURN
PAUL COLBURN
11 GOSPEL PATH
TRURO,MA 02666 Undersecretary
',lassac . tis-Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor. ;
License: CS-009887 5
PAUL F COLBURt
11 GOSPEL PATKIPO OX,I
TRURO MA 02666
Expiration
Commissioner 11/09/2015
� 1
Nov. 10.' 2014 2,55PM SY&G PROVINCETOWN No. 6203 F. 1/3
>
' ACORR CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDMM)
1111012014
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 HY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(tes)must be endorsed. if SUBROGATION IS WAIVED,subject to
the terms and condl(lons 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.
PRODUCRA Benson Young&Downs Ins coNTACT Cad Govela
56 Howland Street PNON o (508)487-0500 FAx ),(508)487 4135
PO Box 660 r+ i carlgovelR(c BYandD.com
Provincetown MA 02657-0559 INAURB G COV90GE HAIC S
INSURLIR A.Amguard Insurance Co 42390
INauRED
Pauf Colbum
PO Box 606
Truro MA 02666-
INSURER F
COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, 1
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR NSR TYPE OF INSURANCE ADDL SUER POLICYNumpE POucY EFF PQucY EXP LIMITS
COMMEROIAL GENERAL UA131UTY EACH URRENCE
CLAIMS-MADE OCCUR DAMAGE YO RENTED e t
MEDEXP eraon
PEASONAL&ADVINJQAY
L AGGREGATE LIMITAPPUE$PER: GENEftLLAGGREGATC fs
I
POLICY❑JET LAG PROD $- MP/OP 8
OTHER
5
AUTOMOBII.SLIABILITY . COMBINED SINGLE LIMIT 3
Ira t
ANY AUTO BODILY INJURY(Per person) 5
ALLOWNED SCHEDULED BODILY (Per $
AUTOS AUTOS ( )
NON.OWNED PROPERTY DAMAGE $
HIREDAUYQ$ AUTOS
- S
UMBRELLA UAB OCCUR _
OCCURRENCE
I:XGESS LIAO CLAIM • c AGGRGOAYE S
DED N3 5
A WORKERBcomPERSATION R2WC516796 9124/2014 J91241201,5 PER OTH•
AND EMPLOYERS'LIABILITY
ANY PROPMETOWlPARrNt:MtAtCUTIVE V L.EACH A D 100,000
OFFICER1MEMOkR EXCLUDED? N I A
(KmdataryInNH1 EASE-EA GM=EE 1001000
!r es,68sGS6e undef
4RATIONS h6bW E. EASE-PO Y 5001000
bSBCRIIPT10N OF OPERATIONS/LOCATIONS}VLNICI-S$IA00R016f,AddhI6A9I Remarks AChadals.may in sigichad If mare*gaad It r69(dred)
CARPENTRY S REMODELING OPERATIONS;
SOLE PROPRIETER,PAUL COLBURN,IS EXCLUDED UNDER THE POLICY;
CERTIFICATE HOLDER CANCELLATION A1065522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TOWN OF PROVINCETOWN THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERLD IN
6��
BUILDING DEPT ACCORDANCE WITH THE POLICY PROVISIONS.
260 COMMERCIAL STRIrET
PROVINCETOWN MA 02657, AUTHORIZED REPRESENTATNE64a'
01988-2014 ACORD CORPORATION. All rights rsseryed.
ACORD 28(2014101) The ACORD name and logo are registered marks of ACORD
s
Y W 1SH TO OPEN A BUSINESS?
For Your hforcn atbn: Business certifca (cost$4 0 0 0 for 4 ars).A business cert�ate ONLY REGISTERS YOUR NAM E n town W hnYi}.ou
m ustdo byM G L.-tdoes notgae 1.ouperm bn to operate.) Y u must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's 67 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
_ DATE: /' r 1�1-/Z-�C' 1 C FflLh O.��ai: O✓ 1'V l�
APPLI✓ANTS YOUR NAM E/S: 1-� _L 'I
u, BUSINESS HOM EADDRESS: f 3 Fj YjC-/2A
TELEPHONE # Hom e Telephone Num ber
NAMEOFcbRORATDN AM E O F N EW PBU S N N ___C /S.__/ CZ L✓..L C '2 /�_ / - -- ------------ - - - --- — -- ----- - -
ESS-- --- - --'- ---- - -- - - -------- - --TYPE OF BUSINESS�� l�`�.� �/2f Ize—L l-e�
ISTHISA HOM E OCCUPATDN? _ _YES ADDRESS OF B.US:NESS M AP/PARCELNUM BER A -!03 lkssesshg)
w hen starting a new busness tizere are severalthizgs tau m ustdo n order to be h com plane wth the rubs and reguht has of the Town of
Bamstabh. Tht form is htended to ass43tWu n obtaizi-ig tine reform at hn you m ayneed. You M UST GO TO 200 M ain St.- (comerofYarm ouch
Rd.& M an S treet) to m ake sure you have the appmoprhte perm is and Menses requked to hga1V operate yourbusness n the town.
1 . BUILDNG COQ:SSD ERS OFFr-E
Ths nd� e f p trequ�em enter thatpertan to tins type ofbusizess. MUST COMPLY WITH.HgME OCCUPATION
RULES AND REGULATIONS. FAILURE TO
Au COMPLY MAY RESULT IN FINES.
COM M EN Q-0�41/k
(� S i
Ain -tp be z4tmt-
2 . BOARD OFH LTH
Ths ndarEualhas b form ed of the t m enter thatpertah to this type ofbusiiess.
�L MUSTQI OMPLY WITH ALL
or dStnature** 7-
HAZARDOUS MATERIALS
COMM EN TS
3 . CON SUM ER AFFAIRS (Lr, ENS G AUTHORIPY)
Thi h be n o e ng t hatpertan to tins type ofbusness.
AuthcVtei3natire
COM M EN TS:
�t Regulatory Services
Thomas F.Geiler,Director
Building Division
MAQr
Tom Perry,Building Commissioner
A a 200 Main Street; Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-700-6230
Approve.
rr
Fee: 4�3.!�7-,
Permit#: a 0/Q 6 6 Y. I/
HOME OCCUPATION REGISTRATION
Date:
Name: P .f P 41119 hlv4f//Q7t Phone#: sod
Address:�C9 /2Ci 1 ✓V fY0A_J- D/z Village:
Name of Business: C 2 1 S � l �- 6 I'7j z c,
Type of Business � _1l-i�Gl�/'�r -/p Map/Lot:
INTENT: It is die intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
n2thin single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity
shall not be discenhible from outside die dNvelling: there shall be no increase in noise or odor;no visual alteration to die
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 tie Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carved on by the permanent resident of a single family residential dwelling unit,located«adhin
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 ui residential buildings,and there is
no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• Tlhe use does not involve tie 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 tie required front yard.
0 There is no exterior storage or display of materials or equipment.
• There are no commercial vehicles related to tie 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 tie same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary y Home Occupation is listed or advertised as a business,die street address shall not be
included,
• No person shall be employed in die Customary Home Occupation%,ho is not a permanent resident of the
dwelling unit.
I, die undersign have read and agree vita die above restrictions for my home occupation I aun registering.
Applicant: fi L2 l /� 1�- 4A,119 Date: /d /8•J Z
Homeoc.doc Rev.01/3/08
r
r_ 71I
TOWN OF BARNSTALE
I Luiz Carlos P.Ovando
testify I'm buy granite from Skyline Marble&Granite,located in]Middleboro Mft OCT 18 P! 8: .' 8
They fabricated it all and I'm get all the product finish, for installation in homeowner.
And I do this job all the time someone call me for a job done.
D1VIS 0I
i
TOWN of BARNSTABt E
101? OCT 18 "1 8: 18
Q's Marble & Granite DIVISION!
Installation of Granite &Marble Countertops
I Luiz Carlos P. Ovando obtain granite and marble from SKYLINE Marble
Granite located at 391 wareham St. (Rt.28)Middleboro,MA 02346: The material
is stored at the same location,and I obtain it all the time someone call me to do a
job.
The Skyline Marble&Granite do the total fabrication and CJ's Marble&Granite
only do the installation.
Date: /v
TOWN OF BARNSTABLE � sTT or) �
TOXIC AND HAZARDOUS MATERIALS ON-SITEVREENITOW
NAME OF BUSINESS:
BUSINESS LOCATION: /R_ /�� INVENTORY
MAILING ADDRESS: rO T 0>,/ /O z z A/ /GIB 04 0z 6 9 3 TOTAL AMOUNT:
TELEPHONE NUMBER: Sn 8 &
CONTACT PERSON: L U C o f O U 19 why
EMERGENCY CONTACT TELEPHONE NUMBER: 451- 7,z MSDS OWSITE?
TYPE OF BUSINESS: er( Ilr�yF lYI,�/1-P '2- Ir—
INFORMATION/RECOMMENDATIONS: _-Fire District:
'
r ^ 1 I /
Waste-Transportation: Last shipment of hazardous waist`
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The.board of health and the Public Health Division have determined that the following products exhibit toxic or
haSprdous characteristics and must be registered regardless of volume.
O "'served / Maximum Observed / Maximum
Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road s�a t (Halite)
Hydraulic fluid (including brake fluid) Re. ' erants
Motor Oils Pesticides
❑ NEW ❑ USED :7(insecticides, herbicides, rodenticides)
Photochemicals (Fixers)
Gasoline, Jet fuel,Aviation gas /
❑ NEW ❑ USED
Diesel Fuel, kerosene,#2 heating oil /
Miscellaneous petroleum products: gre ee, Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED
Degreasers for engines and me Printing ink
Degreasers for driveways & "arages Wood preservatives (creosote)
Caulk/Grout j Swimming pool chlorine
Battery/de }ate)/Batteries Lye or caustic soda
Rustpr Miscellaneous Combustible
Car wa Leather dyes
Car wahes Fertilizers
Asph/aJ PCB's
Pal/ s, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
KNEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's aCPI nt's Signature Staff's Initials
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BOTH SIGNATURES ARE REQUIRED FOR PERMITING
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13 General Patton Drive
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