HomeMy WebLinkAbout0170 LINCOLN ROAD � �d ,�,��z� ��
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r Town of Barnstable
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Permit No. B-18-1832 Applicant Name: BRAULIO BRITO
Approvals
Date Issued: 06/08/2018 Current Use: Structure .
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/08/2018 Foundation:
Location: 170 LINCOLN ROAD,HYANNIS Map/Lot 270-051 Zoning District: RB Sheathing:
Owner on Record: MACNAMEE,ROBERT T Co tractorFNaMe BRAULIO BRITO Framing: 1
XT
Contractor License: CS 110548
Address: P O BOX 64 �, 2
CUMMAQUID, MA 02637 a �, Est Profect Cost: $ 19,000.00 Chimney:
Description: windows,siding,doors and windows Permit Fee: $96.90
Insulation.
FeePaid; $96.90
Project Review Req:
Date€ r' 6/8/2018 Final:
10
Plumbing/Gas
.4 A Rough Plumbing:
. Building Official.B Final Plumbing:
F § a"^
This permit shall be deemed abandoned and invalid unless the work authored bythis permit is commenced within six months afterjssuance. Rough Gas:
All work authorized by this permit shall conform to the approved application a nd the approved construction documents for 4h cti th s permit has been granted.
All construction,alterations and changes of use of any building and structures�shail' a in compliance with the local zoning by laws and codes. Final Gas:
This permit shall be displayed in a location clearly visible from access street oe road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. a *\ �� Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials areprovided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work Rough:
M
1.Foundation or Footingk'
� �
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation
Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
i
:J
Application number..3�!--
4. .
�c. �.��' ................
Date Issued.................... ....
JU 0 7 2013
Building Inspectors Initials... .......... .:...................
1�19 IMF IJA H 8
{ i♦ �. Map/Parcel.tC .: ...�1 ..l.............................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project:
NUMBER STREET NaLAGE
Owner's Name: 90h a l a c n w PP Phone Number
Email Address: �r'h�hCnGa�'tQ�COdJoASaq,� ll P one Number 617 6Y-6 �
Project cost$ 143,WO vy Check one Residential ✓ Commercial
F- OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize 6,J-OL(1li
to make application for a building permit in accordance with 780 CMR J
Owner Signature: Date: Oio1fl�/l�
TYPE OF-WORK
Siding Windows (no header change)# Insulation/Weatherization
Doors (no header change)# 1 Commercial Doors require an inspector's review
0 Roof(not applying more than 1 layer of shingles)
Construction Debris will be going to` e br cal tS4(�
CONTRACTOR'S INFORMATION
Contractor's name &Q 01to t r rJ
Home Improvement Contractors Registration(if applicable) (attach copy)
Construction Supervisor's License# C S-f(0 5 00 (attach copy).
Email of Contractor `n +a
Phone iiuiber 1 1 N.-?,G�
ALL PROPERTIES THAT AVE STRUCTURES VER�5.,YEA SOLD QR�IFTHE SUBJECT PROPERTY IS IN
____ _._.. _ .!�.w.•�rw.11► .ncTnD r A�DDDD RFGnQF'`A, RMIT CAN BE ISSUED. ,
r
APPLICATION NUMBER
- *For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
Does the tent have sides?Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Check one: this event is a: for profit ' non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent
If food is being served at y-our event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval,
*WOOD/COAL/PELLET STOVES
Manufacturer,# Model/I.D.
Fuel T e t
3'l� Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name:
Telephone Number Cell or Work number
I understand my responsibilities under the rules and regulations for,Licensed Construction
Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand
the construction inspection procedures,specific inspections and documentation required by 780
CMR and the Town of Barnstable.
Signature Date
t �+
APPLICANT S SIGNATURE
Signature ,� Date
All permit applications are subject to a building official's approval prior to issuance.
�.I
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
600 WashingtOMStreet
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/ElectriicciIM/P lumbers
Plee Print Leg
A hcant Information
Name(Business/Organization/Individual): brIo Uf UIC'n
Address:
ity/State/Zip: e G Phone
C
Are.youan employer?Check the appropriate bog:
Type of project(required):
4. I am a general contractor and I 6 New construction
1.❑ I am.a employer with___. have hired the subcontractors
LIElIaa3mah0me-Dwner
ees(full and/or part-time).* listed on the attached sheet 7. ❑Remodeling
sole proprietor or partner- These sub-,contractors have . g. Demolition
d have no employees employees and have workers' 9. Building addition
g for me in any capacity. imp,;,,�,,,�„ce airs or additions
rkers'comp;insurance 10.❑Electrical rep
5. ❑ We are a corporation and its
required.] officers have exercised their 11.❑Plumbing repairs or additions
homeowner doing all work right of exemption per MGL 12.�Roof repairs
[No workers'comp. c.152,§1(4),andwe have * 13.❑nce required]t employees.[No workers'
comp.insurance r��]
*Any applicant that checks box#1 must also fill out the section below sbowing their workers'compensation policy informalion
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such
$Contractors that check this box must attach}d additional
dth o Ode their workers'camp. olicy a and state whether or not those entities have
employees. If the sob-contractors have emp oyand job site
I am an employer that is providing workers'compensation insurance for my employees. Below is theP olicy I
information.
Insurance Company Name:
Expiration Date:
Policy#or Self-ins.Lic.#:
Job Site Address: L''^C0`v1
City/State/Zip: 1 V Ail UII�
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 pe
nalties of a
fine up to$1,500.00 and/or one-year nnprlsonmem,as well as civil penalties in the form of a STOP WORK ORDER and a fine
the violator. Be advised that a copy of this statement may be forwarded to the Office of
of up to$250.00 a day against verification.
Investigations of the DIA for insuaance coverage
under the pains and penalties of perjury that the information provided above is true and correct:
I do hereby certify P
Date: C 0.
Si e:
Phone#: —
official use only. Do not write in this area,to be completed by city or town official
Permit/License#
City or Town:
Issuing Authority(circle one): ector 5.Plumbhtg Inspector
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Insp
6.Other
Phone#:
Contact Person:
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'Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partamhip,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three'
apartments and who resides$herein,or the occupant of the
dwelling house of another who employs persons to.do maintenance,construction or repay work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states 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 commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance covemge'required."
Additionally,MGL chapter 152, §25C( )states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
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 numbers)along with their certificates)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regardingg the law or if you are required to obtain a workers'
compensation,policy,please call the Department at the muriber listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
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 permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Addres§"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided,to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit 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 venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number.
The Gommauwealth of Massachusetts
Department of Industrial Aecidents
Office of I.uvestigats
600 Washington Street
d Bostoaa,MA 002111
T Tel.#617 727-490Q ext 406 or 1477-MASSAFE
Revised 4-24-07 Fax#617-7-27-774g
w .ma .gov/dia
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Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-110548
Construction Supervisor
BRAULIO BRITO
25 UNCLE STANLEY'S WAY':.:.._
SOUTH DENNIS MA 02660
,':
Expiration:
Commissioner 05/2312020
_°. Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE: individual
i ✓ Registration Expiration
3;
a187001:-;. 02/14/2019
BRAUL'IO BRITO`:
D/B/A BBRITO Senrzces,
Braul'lo Brito
25 Uncle*Stanleys Way '
SouthDennis,MA 02660' Undersecretary
I
Y
r{its_
Town of Barnstable g Building
"`' ,,-�" .>< � .� ..•�° .'� -.;:" ,'.,' b.�.,G ,�,;< 'fig ��, ,°�:":��u ..:�u fy.<," ,;• '' "'
PostThis.Card So.T.hatit isVisible.Fromthe Str.,eet Approved Plans Must be Retained o�n.Job and this Card IVl.ust.be Kept
::h^f".�' ;f.<"�„��. .,,> %z`ar"�i• _ H,: �¢ ` , '• �,�` �,� t» r s � /Y %'�i,:
*� Posted Until Final Inspection�Has Been Made3 ,
Where a Cert�ficate'.of Occw anc s Re aired;such Bulld�ngshall Notbe Occupieclunt�l a Fnal;lnspection;,-hasbeen made Permit
�.�.^v1i-.�. �.,,.�_.. c�.�.�„ b� �- p.�.�'.yf-.a,' %p. x .; .�, ,.�-:�_...z. a '� ,� .,. � .. ::�; ,_ ..� :�•; �„..n,:..�s.�, °„...., n .�.- �. '�o.�,�,�,, ._. �;�,.Y,:•'.�"�i +L
Permit No. B-18-1104 Applicant Name: BRAULIO BRITO Approvals
Date Issued: 04/13/2018 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2018 Foundation:
Location: 170 LINCOLN ROAD,HYANNIS Map/Lot 270 051 Zoning District' RB Sheathing:
Owner on Record: MACNAMEE,ROBERT T M Coritra for Name r BRAULIO BRITO Framing: 1
Contractor License CS.110548 2
Address: P O BOX 64 x fr
o mQ
CUMMAQUID, MA 02637 � Est Project Cost: $5,600.00 Chimney:
Description: re-roof stipping old Permit Fete: $35.00
Insulation:
i- Fee Paid $35.00
Project Review Req: b,. Final
4/13/2018
Plumbing/Gas
Rough Plumbing:
Building Official
4, Final Plumbing:
, , �.
This permit shall be deemed abandoned and invalid unless the work authdiriA by this permit is commenced within siz months after issuance. Rough Gas:
All work authorized by this permit shall conform to the approved appl cationand the�approved construction documents for whichAhis permit has been granted.
All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zon ngRby caws a d codes. Final Gas:
This permit shall be displayed in a location clearly visible from access street orroatl and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. R Electrical
' Service:
The Certificate of Occupancy will not be issued until all applicable signatures by�Ahe Building and Fire Officials aretprouR ed on this permit.
Minimum of Five Call Inspections Required for All Construction Work.iy ff '
• `� Rough:
1.foundation or Footing , • -
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation
Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
r
of W C;n of Barnstable *Permit I v I
PRO- ilding
i 6 monthsfrom issue date
Department
snrwsrnsLE, ; Brian Florence,CBO
9 MASS. 0g APR 1c� 201a Building Commissioner l�
'OTfo met rA p � �hi �l ain Street,Hyannis,MA 02601
►1,�! I�! www.town.barnstable.ma.us `�\`�
Office: 508-862-4038 v\` Fax: 508-790-6230
EXPRESS PERART APPLICATION - RESIDENTIAL ONLY
0 Not Valid without Red X-Press Imprint
Map/parcel Number I v
Property Address 4 O L n QA 14!1rjm i S MA
®.Residential Value of Work$ S 1699 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address RAG ilarlf'4
I`jO ff Li✓1C1��in /�C
Contractor's Name 6 c Cat ,[O a r aP Telephone Number
Home Improvement Contractor License#(if applicable) I j Q I Email:fn ti raut o�h i t o@ cj d C okn
Construction Supervisor's License#(if applicable) G S_j 10Sy 5
19Workman's Compensation Insurance
Check one:
�C] I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name S�I ��C►1' n Sur4�+C�
Workman's Comp.Policy# M PP 890qC
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box).
N Re-roof(hurricane.nailed)(stripping old shingles) All construction debris will be taken to
t�F .L all,
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Fl Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
*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 MPFILESTORMEXPRESS2017
?hie Commomveakh ofMassac usetts
D,epartwent o,fl"urrsttzalA.ccid-ews
- Offwe of 1mvstigatiotrs
600 Washi gton Mreet
Bosun,MA 021I1
mviumasagovIdia
Warlmrs' Campensatian Insurance Affidavit Builders/Confract6rslEIecfricianslPlmmhers
APPHmmt Information Please P'sint �
Name MusinEssf anii i i`t C� SQ�UiC2�
Address: 2- /i SIaAol O
Cityfsta-&Z*- l eAY11J p Phone-
Are you an employer?Check the appropriate bow ' Type of project(required):
I.❑ I am a employer.uith 4. ❑I am a general contractor and I 6. ❑New eonstr�
employrew(fall a:nNor pact-hme * have lriredthe sub-cmtractars
2. I am a sale proprietaf or part=- listed aathe attached sheet 't- �
ship and have no-emplayees These sob-confractars have g_,❑Deowlition
wadfing for me in any capacity. employes and have workers' 9. ❑Building addition
[Na W.Ud rms camp.imsurance comp-insaranml
_ ] 5_ ❑ We are a corporation and its 14❑Elwhical repairs cr additions
3-❑ I am a bomeoumer doing all work of have exem--sed their 1 L❑Plumbiagrepairs or additions
myseM o wa rlrers' _ right of emmmption per MGI. 7 repairs
ce regrrim. &]y c.152,§1(4k andwe have no 1�❑B oni'
employees.[No wodoers' 13-❑Other
cam.ksurance,required-]
;Any W i=tfat cbetJm boa R must also Moutthe secRoabeTaa slunt .g duftwodae cvmpensa&npeEcy iUrnemsaaa
SamewmrsWhosabmhdaisaffid2vAiad?xatiagtheyaredaiagallva&m4dmbimGUW&C0nbxCWMumstsubmitanewaffidx& irdinssacb-
TCaansci. that cbeAr ills boat mast amicbea ffi additi®s1 sheet sbovrmg tbeauae of @7e sob-caasr4ato-a state Whe2hec at oat those eu�tiesha�
employees.Iftbamb-can sbmemplafee%fiLeymastpmvide-their Warkere omp•palicFaumbM
I ani an elrepIo,�r fiirrtis pro�driircg�vurkers'coarpefrsta�an ursruarrce fur rrrs*empTaj�e� $eltrry is fiTteptriicy arui jeb sifa
information.
Insurance CompanyName:
Pa-ficy or Self-in.s.Lic. M PP OqU c FspiratioaDafe: 04
Job Site Address t-40 t.i P1 city/State :
Aftach a cop} of the workers'cornpensatienpolicf-declaration page(showing the policy number and ezpimflon.date).
Failure,to secure coverage as requiredundes Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a
fine up to$L54a 00 aadfor one-year imprismmnent as well as civil penalties m the fosses of a STOP WORK ORDER and a fine
of up to$250-00 a day aasiost the violator. Be advised that a copy of this statemesd maybe faswnded to the Office of
lavestcgations o€the DIA for insurance coverage on
Ida herasby csrf43T Ruder fhepains mrdpsnaltky ofpalmy fhatthe igforr uEffvnprociderl abm's is hus and correct
Date: n of tz ll g
Phone ik
t?,ofrd we only. Do not write in furs wea,to be evinpfieted by city artelrn officrat
City or Town: PerrmtlLicense 4
Issuing Authority(circle one):
L Board of Health 2.Building Department 3.Caty/rown Clerk 4.13ectrical Inspector 5.Pbnabiirg Empector
6.Other
Coact Person: Phout#:
— -- — 6
-formation and Instrue-lions :
M_c c usetts Geheaal Laws amptw M req=es aff employers to provide worl='caraPeusation for their empIoyees. .
P this stye,an Vrqtlayee is defied as."_.evmy person in fe service,of another nud=any coact ofhfi
express or implied,oral or vai teaf
An emplayEr is defined as"an inchviduaI,Parfnersb�,associad aim corporation or other IegaI eatiiy,az any two ar mare
of fie foregoing engagcdinajointcmtr s ,and inchuEng the legal representatives of a deceased Moyer,or the
receiver or trustee of an indiyidlral,parmetsh�,associafion or otherIegaI entiiy,employing employees. HOW the
owner of a dwelling house having not more than three apartmenis and who resides therein,or the occ upant of the -
dw gang house of another who employs persons to do maintenance,consftuction or repair woik on such dweIIing house
or on the grounds or bm'Idmg app thereto shaRnotbecanse of such eouploymentbe,deemed to be an employer."
MGL chapter 152,§25C(6)also sfzdns that'every state or local Rcensmg agency shall wIfiihold Ihe issaance or
renewal of a license or permit to operate a bncsnuess or to construct buldiags za the commonwealth for any
applicautw•ho has not produced acceptable evidence of cdmpfance,with the 4n mxznce.cove7rage required."
Additionally,M(H_chapter 152, §25CM slates¢Ideitb=the conmmwealtii nor rly of it's political subdivisions shall
enterinto any conttactfor tbzperfonnaaceofpablicworkuntd e acceptablevidence ofcompliance wishfhemsmrr,ace.
reTLdr tents of dais cbaptes.have been presented to the cont=�a avihomfy."
AppHcaats -
Please f l oiat the workers'compensation affidavh compleer,by chug a boxes tip apply to your sifnaiion a if
umessary�supply soh-co r(s)name(s), addresses)and phonennnber(s)along with their c t'Ecate(s)of
insurance. Limited Liabmy Companies(LLC)or LimitEd.Liabiility-Partaeishigs(LLP)with no employees other.than the
members or pmtaers,are not rf quired to carry workers'compensation insurance. If an LLC or LLP does have
t employees,&policy is required. Be advised•hatthis affi &maybe s bmith--d to the Depa-fmcnt of Industrial
Accidents for conf¢mafion of msarence coven g- Also be sure to sign and dale the afadavit The affidavit should
beriet=e,d to lae city or town that the application for the permit or license is being requested,not the Depar ned of .
L rAn s,raj Ac i Pats- Ssould you have MV gnestioos regarding the law or ifyou are rued to obtain a workers'
compensation policy,please call the Deparfineof at fhe immber listed below Self-fimued companies should ear their
s elf-h sorance license nmuhm on the apprapriztn line.
City or Town Of d-d2k
t
Please be sure that the affdavit is complete and priahtd.legibly. The Departmenthas provided a space at the bottom
of the affidavit for you to fill out in the event the Office ofInvesdgafions has to corbactyouregmdmg the applicant
Please be sure to fill in the penngi0icrose number which WM be used as a reference mznmber. In addition,an applicant
faat must submit multiple p=ItUcense applications in any given year,need only submit one affidavit indicating can .
policy fijb=ation(if necessary)and under`lob Sle Ad 1dre&*the applicart shouTld write"all locati--ns in (c'[Y or
town)_,A_copy of the•affidavit that has been officially s m3ped or marked by the city or town maybe provided to the .
applicant as proof that a valid affidavit is on fle for fbtare'permits or licenses_ A new affidavit must be filled out each
year.where a home owner or citizen is obtaining a license or pmmitnotrelated to any busmess or commercial ve t= -
(i-e. a dog license or petmrt to burn Ieaves etc.)said person is NOT regdu ed to complete this affidavit
The Of of Invesligations would like to thank you in advance for your cocpenaiion and should you have any questions,
please do not hcsR ate to give US EL calL
The Department's address,telephone and fax nnmbm:
Tha
Degartrnmt of 1u6mtdal Acrldent%
tCe of TXMe&tkA_ io=
M&o�l1F
-TeL 1617:' -4940 cmt 4-06 or l-4�77 MA SAM
Fax#617'27 M
Revised 4-24-D7 .mas �ug��
i
THE
Town of.Barnstable
CF Tp� .
~� Building Department
r r
&UNST LE, ' Brian Florence,CBO
v� .�� Building Commissioner
ArED��p
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.ns
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign'I'his.Section
If Using A Builder
as Owner of the subject property
•
hereby authorize V/-) /) 7Z . to act on my behalf
in all matters relative to work authorized by this building permit application for:
[10 L un co hi I IGd fl�CU-,16 Ak
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
ins ection/ performed and accepted.
Sign, e of Owner Signatate of Applicant
Print Name Print Name
Date
Q:FORMS:OWNERPERMISSIONPOOLS
Rev:10/17
Town of Barnstable
`OF THE r0 Building Department
,Y o� Brian Florence CBO
S - Building Commissioner
• snxrtsTA=, •
MAM6� 200 Main Street, Hyannis,MA 02601
i639 y ,��'ArFc 5g s www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION,
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the buildine 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 be/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 to amend
and adopt such a form/certification for use in your community.
•1
lint Massachusetts Department of Public Safety.
Board of Building Regulations and Standards
License: CS-110548
Construction Supervisor
BRAULIO BRITO
25 UNCLE STANLEY.'.
SOUTH DENNIS MA 02660 r
Expiration:
/Commissioner 05/23/2020
t '` die�pa7z7�onh2 o��Ci2 \`
f y
offyce of Consumer Affayrs&Busyness Regulat on 1
HOMIE''IMAROAv MIENT'C,AT eTOR
� f; `��, TYPE Intlyviclual I: '�
s ration Ezoiratyon �I
n Q2/14/201?9
'. B�,RAUILIO B'RIIT"I �=
25IUmcle'S,t it'll
South+ROM n$;
Undersecretary �-
I
i
7041ml
(M /DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE z/18
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME: JIM HINDMAN
Schlegel&Schlegel Ins Broker a/co"N Ell: 508-771-8381 A/c No: 508-771-0663
34 Main Street E-MAIL
West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA: NGM INSURANCE COMPANY
INSURED INSURER B:
BRAULIO BRITO INSURER C:
DBA BBRITO SERVICES INSURER D:
25 UNCLE STANLEY'S WAY
SOUTH DENNIS,MA 02660 INSURER E:
INSURER F:
COVERAGES 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 IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCEAUULSUBK POLICY EFF POLICY EXP
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 500,000
MED EXP(Any one person $ 10,000
A MPP8904C 07/10/17 07/10/18 PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY❑ PRO-
JECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COEa aMcBINED SINGLE LIMIT cident $
ANYAUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
[J
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SH OLD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TH EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ROB MACNAMCE A RDANCE WITH THE POLICY PROVISIONS.
170 LINCOLN ROAD
HYANNIS,MA 02601 40RIZED EPRESENTATIVE
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo Jeeg tered marks of ACORD
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cast$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 permissio-n—to—op—e—r-at—e.—i-13usiness Certificates are available at the Town Clerk's Office, 1'FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
ILI DATE:
Fill in please:
APPLICANT'S YOUR NAME:rr
S 7 YOUR HOME ADDRESS: � V
�- TELEPHONE # Home Telephone Number
NAME OF NEW..BUSINES I :97. OF BUSINESS
IS THIS A HOME OCCUPATION r YE NO
ADDRESS OF BUSINESS
MAP/PARCEL NUMBER :L
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 2 - (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 C7hb
R' FFICE
This indivormed any permit requirements"10WW{hySW9d-bf-QM&@CCUPATION
RULES AND REGULATIONS. FAILURE TO
zed Signat e** COMPLY MAY RESULT IN FINES,
COMMENTS:
2. BOARD OF EALTH
This individual has been infor th ei� r uirements that pertain to this type of business.
Authorized ignatur
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual hatmAnfugmed oft licensing requirements that pertain to this type of business.
Authorized gnature*
COMMENTS:
I :<.
J
Town of Barnstable
°F THE
Regulatory-Services
T°�
P� ti Thomas P. Geiler,Director
Building Division
* BARNSTABLE, -
y MASS. Tom Perry,Building Commissioner
c6;q.
�pt�or9.a 200 Main Street, Hyannis, MA 02601
www.town.b arnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved.
Fee:
Permit#:
HOME OCCUPATION REGISTRATION
Date:
y�
Nance - Plione #:
Address: Village:
Nance of Business - - � --- O
l y pe of Business. r Map/Lot: 2 0 /
INTI NT: .It is the intent of this section to allob, e residents of the'Foxvn of Barnstable to operate a home occupation
�Nitliin single Family dwellings,subject to the provisions of Section 4-I A of the 7,cniing ordinance, provided tliat the activity
sliall not be discernible fi'oni outside the&yelling: there shall be no increase in noise or odor; no slsual alterttion to the
premises which would suggest anything other thaii a residential use;no increase in traffic above normal resiclelltiat vohnmes;
and no increase iu air or grounchi-ater pollution.
After registration with the Building Inspector,a customary home occupation shall be perniitted as of right subject to the
Following conditions:
• 'I'lie activity is carried on by the permanent resident of a,single faintly residential chvelling unit, located cvithiii
that dwelling unit.
• Such use occupies uo more than 4.00 squa-re feet of space.
• 'Fliere are no external alterations to the chvelling iwiricli are not customary in residential buildings,and there is
no outsicle eariclence of such use.
• No traffic tariff lie generated in excess of uornial residential Volunaes.
• 'Floe use does not.involve the production of offensive noise, vibration, snioke,dust or other particular liiatter,
odors,electrical dBturbance, heat,glare, humidity or other objectionable effects
• 'f'liere is no storage or use of toxic or hazardous materials,or[famniable or explosive materials, in excess of
nomiat household quantities.
• Any need for parking generated by such use shall be niet on the same lot containing the Customary Honie
Occupation,and not within the required front yard.
• There is no exterior storage or display of niaterals or equipment.
• 'There are no conunercial vehicles related to the Custoniaiy Home Occupation,other than one tan or one
pick up true(:not to exceed one ton capacity,and one miler not to exceed 20 feet iu.length acid not to
exceed',f tires,parked on the saiue lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary I Ionte Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the stl eet address shall not be
inclucled.
• No person shall be employed in the Customary Home Occ•upatiou Who is not a permanent resident of(lie
dwelling unit.
I, the undersigned, have lea and agree nitli the above restrictions for my)ionic occupation I am registc-111g.
Applicant: Tate:
F SHE T°�
Town of Barnstable
ti
Regulatory Services
9 ,�sI E g Thomas F.Geiler,Director
A 1639. p�0
Building Division
Peter F.DiMatteo,Building Commissioner
367 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
PERMIT# ,�Z2 FEE: $
SHED REGISTRATION
120 square feet or less
�P7 D Z- 6�,,0-d /XJ gci RVM-k„AJ t s
Location of shed(address) illage
Property owner's name Telephone number
V -
/0 4c 57/
Size of Shed Map/P cel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required)
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
REV:083001
'�� Contact ID: 1 Order Date: 1 1 � •
• First Name: Last Name:
Eom an Adtlress
'ab City �Strlate Z p Work Phone:
Fax Number: . Email
Map Description: Eompleted: 1 1 File Name: 1.1 Completed By: Base Cost: 11
Lahor
: Shipping: 1 11 Tio
1_ 11 Amount Paid: 11
weld toWn aW Barnstable /s-nct-o�
Outside Request Receipt # Geographic Information Systems Unit
Buisness phone: 508-862-4G24
3456 367 Main Street, Hyannis, 1VIA 02GO1. Fax: 508-775-3344
a-OCA-FDON O'F RRC3RER-TY LANES MAY NO-F 13E ACCL P_^-FE Li
STANDARD LEGEND
NOTE:not all symbols will appear on a map
/ GOLF COURSE FAIRWAY
EDGE OF DECIDUOUS TREES
^ - ---^ EDGE OF BRUSH
r _i ORCHARD OR NURSERY
V-Y•-V-V EDGE OF CONIFEROUS TREES
MARSH AREA
EDGE OF WATER
DIRT ROAD
DRIVEWAY
\� I �PARKING LOT
PAVED ROAD
— - — DRAINAGE DITCH
- - - - PATH/TRAIL
PARCEL LINE
M P 270 Arno F----MAP#
21 F—PARCEL NUMBER
#1e60<HOUSE NUMBER
a2 FOOT CONTOUR LINE
—2� 10 FOOT CONTOUR LINE
0 Elevation based on NGV029
# 17 ��4.9 SPOT ELEVATION
` o0o STONE WALL
a
� -X—X- FENCE
RETAINING WALL
RAIL ROAD TRACK
H STONE JETTY
1 SWIMMING POOL
L PORCH/DECK
s ] BUILDING/STRUCTURE
s FLH=L DOCK/PIER
s HYDRANT
A VALVE 0 MANHOLE
AAA 97n
O. POST p" FLAG POLE
T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T p SIGN ® STORM DRAIN
H PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-mode features)were interpreted from 1995 aerial photographs by The James
1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0UTILITY POLE c TOWER
w e Q 15 30 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mopped to meet National Map Accuracy Standards
: t INCH=30 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from 2001 Town of Barnstable Assessor's tax maps. 4 LIGHT POLE O ELECTRIC BOX