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Home My WebLink About0319 CEDAR STREET -�� ,7- �_s. ._._ _�. __. �. ._....� � .. r • � �Z° • r Z .� • 0 • • pl YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates.(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you.permission to operate.) You must first obtain the necessary..signatures on this form at 200 Main St., Hyannis. Take the.completed form to the Town Clerk's Office,. 1 st FI., 367 Main St., Hyannis;MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: b IZ I ill in please: APPLICANT'S YOUR NAME/S: IIVg, 1 tag u BUSINESS YOUR HOME ADDRESSNAAV : yf^ti_c f,J(f ;Ifs"' '1 3Nu/ins; O IALLEPHONE SEC RIJY OR IN Home 2�epfloneNum er E-MAIL: NAME OF CORPORATION: NAME OF-NEW BUSINESS TYPE OF BUSINES \A UJ IS THIS A HOME OCCUPATI] ? ES NO ADDRESS OF BUSINESS. S MAP/PARCEL NUMBER .7 U (Assessing] When starting a new business there.are several things you must do in order to be in compliance with the rules:and regulations of the Town of Barnstable. This form is intend.ed'to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &.Main Street) to make sure you have the appropriate permits and licenses required to legally.operate your business in this town-)-b luitjd . f 1. BUILDING COM ISSIO ER'S OFFICE This individ al h en nf�dr�� f y r re ire exits het pertain to.this type.of business. MUST COMPLY WITH HOME OCCUPATION Ay oriz d i atur ** RULES AND REGULATIONS.. TAILURE TO COMMENTS UU a ' 2. BOARD OF H •LTH This individual has been'informed of the permit requirements that peitain to this type of business. Authorized Signature COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: . . t ' I a . ..... ...... ................ —..0 I0WH Ul DUFLISLaDle ^� Regulatory Services pFTHE tp� o Richard V. Scali,Director * a�vsTAR?�R Banding Division Paul Roma,Building Commissioner1639. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma,us Office: 508-862-4038 5 79 2. 0 Approved: � � S Fee: �_�� Permit#: HOME OCCUPATION REGISTRATION Date: Name: I Phone#: 6 Address: \ Q UI V Village. VI q IVY/ Name of Business: -pvtA-. Type of Business:' " \ MWILot: I U 6 r INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit' • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess,of normal residential vohimes. • The use does not involve-the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,.glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such-use shall be met on the same lot containing the Customary Home Occuupati on,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. I,the undersigns ve read agreewo the above restrictions for my home occupation I am registering. Applicant Date: fiomeoc,doc Rev.06l20116 �T.. Town of Barnstable Permit# 4 �5 O•� F.Virea 6 ntontha front laaue date MASS? : Regulatory Services Fe - . gul ry 163 Thomas F.Geiler Director a639� '♦08' � , 'Building Division Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 PERMIT EXPRESS PERWr APPLICATION - RESEDENIM9W - Not Valid without Red X-Press Imprint MAY 2 5 2005 Vlap/parcel Number,121 o aS TOWN OF BARNSTABLE ?roperty Address �/ C 2-fesidential Value of Work /D J*AA• a d Minimum fee of•$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance J Check one: ❑ I am a sole proprietor ❑ I an the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ��rofii o (strppng old shingles) All construction debris will be taken to �u� S 01N�•5C®PPss. ❑ zt Re-roof(not stripping. Going over existing layers of roof) d 0Re-side ALD � ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Hi e,Conq&tion,�. 1 M ***Note: Property Owner must sign Property Owner Letter of Permission. Home``Improvement Contractors License is required. Signature Q:Farms:expmtrg Revise063004 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, a Floor Boston,Mass. 02111 Workers'Corn ensa�tiion Insurance Affida_vitt;B�uilding/Plumbin /Electrical Contractors :�l��1)T7I1CaIL1�.11<IfOr�;m s��c�'` 4 � �� '". ��'e !:g'a'�:M1�,� r'�••4�F, [.i,'� name: a6 A 1 J L address: X city r&Z G!a e state: zip: phone# .work site location full address): I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel ❑ I am a sole proprietor and have no one working in any cappacity. [�BuildingAddition 5�!".�o' M "Z t�: r :rr'.':a;1< vim.•,{1}e '; A, 'D..r,�t' .•r.P[.; ,,...,.. is: [.• ,.. 5 - >.. _`tt._ " :..y� �' f�t o. �-.: . ::C'3 .. �.+.�.'•l':f.'[:E�?i:•i.:1,••i.n s :: .:::f:.:.4"_ ^,.k5.5'. . ...�:..`a..t�'u.'i'.7fVi%a�}Y:{b:A. ❑ I am an employer providing workers'compensation for my employees working on this job. company name: address:' city: phone#: insurance co. Doliev# taCid:.v:$x,�i'r."$�:i:Y..kfaa�'a$eb:�M_�u:a:'b3 'tw3r®�ia.""l'.,+fiaR:it s,:+ct'<�r: �Yir• . :!r«.x�..: .y1PP�,'.a,.e•:�":�`zuY=' 'F: ,<k,v� - '4'Kti. �. u. F-4. �;^l'- �..: .:��[=�:r4:�:c�..•._a_�.,. W. :.C;:xtw.., ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address. city. phone# insurance co. policy# .Z{2�?d r` ..,','1�.?4�ti�,•b"��P.±�n, ;.;�f�>$:.i'�;cr�•'ia'r.",:"' :4:<'%'2 i:;• :.r.�' g�pc:ta,3.�;,.:...,....•'Ko,,.s:�•'>::•-7:t•>•-:'r.:• `r'+: '.Iz 'company name: address- city: phone#•. insurance co. policy# •r.• y q:.. .� s'�y;dc„. ...i,�.jf5" + ?: � :,Y.:'- f:-.,,q C•6i(3.f.�?...,,:;,1g;..�;;., ��.. .. •.. ;:'+�. 'Pxy:^L..z{'.v�xr `kt��Ra�i7d�idna'F��,�.et.�tiee�s? '_•.� +,.. �:�aa�r..!'r+t�ar .ta�a��, �a;.r':��` .a'.1��+�:�• y-�r,:.,,..:�;s};;:is�% r�,�'�°�.:�- �.,.:,, Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of this statement maybe forwarded to the Office of investigations of the DIA for coverage verification. " I do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct. r s Signature -7�- ram_ Ar y' Date J�� c�� Print naive eAlej,' �/?�f_/Pi� t�i� . Phone# official use only do not write in this area to be completed by city or town official Lcheckif permit/license# ❑Building Department response is required ❑Licensing Board ❑Selectmen s Office ❑Health Department phone#; ❑Other e Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under.any contract of hire,express or implied,oral or writteq. . An employer is de' fined 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,partnership,association or other legal entity,employing employees. However-the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair 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 section 25 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 coverage required. Additionally, 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. y. »A, t¢p';�?v,�( pq^ ':-°.v=.s�x� ��,5e�• �y^+Rtf.G�., '�u�'ia�.+r�F.^� .��.:(",��r�"7Ct�a}�r 3�..e;!r;•'s�P_ _ �:]�P„' L r�("M1 Y.')iV�,,T 'tf' I 1.1M, :;.F � •hT. ``,��":;^t�••{ !. ::.. fv!.. �:.•1.1' .L k!�`J'... Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please . supply company name,address and phone numbers along with a certificate of insurance as all affidavits 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 regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. 5 `E ,;:W1.1 _ SZ. {{•°:: ., in.., trs-s: a ti "ti s" :3.. �ii��P':'=b. sla; ,i..:,��'.,��";Ser;s.,(�,;i. •°:^t�' �', r t }P .,� �' [�,,,.��{ t.' a,r N?..; �., ,! ;` ri m {� ' a Sit "" '�{.n "ti>•,r"".,E�`r3F �' �� "�"+.�"!f'K•sa�: ''r';':+e ,rP'..r:° ,k:'i', �,$:d.;r..y_ s8'>xi.,,.:. -c'..F. •.v,.c'!K/"::5'S 'x_rx° r City or Towns 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for.you.cooperation and should you have any questions, please do not hesitate to give us a call. .:t.;;j•.} 'C:N:. J ..qc r t {Ci. .G: �?�NSN:ff .4 ,�cc ..a�: L�W' S't;ii:..�^.+S?j: 37` %'PIS.irr. ..��i :.?:.;. .: ,4sii'`- "'''t.'7'..i r _ Y� °R`. ;65d Yet' '�{..,;. 4�+ } .6�1's!'i,�,.•,:,�j;n { ..�- �. ,rSU`�t v 7'.��-�'T�ti. C:c dy`a"a } if yam:' �^i��,n.^.1•'t.h% .: t �'a? �,t<:. }..• S��'. � `"' .r s�k.u•-S 3.q��Sn�'.�• .y...,:�; 3,, :,yi'�•. �{ { w�..4 ,krrtc.,v :fw'.'4}.i"•:�Su_t t'�::'u5:,, #� � y f':. vY°3Y+"•�Sy'iP�'rAIY:{- Y :a"' a � `� xSii, "I ,.i�• f xF's'xyromx� '��•�'f�" The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 Town of Barnstable pFTNE l� Regulatory Services anxxszne Thomas F.Geiler,Director 1 .0�" Building Division rFc Mop Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �/f �i �� S f� c s t- �J� i,s flc /-r z 7 number street village "HOMEOWNER": 1 erLh s� —� ti 5 ��0 S�1! �✓�Y�2 name home phone# work phone# CURRENT MAILING ADDRESS: �'city/town state tip 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. rignature 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 perfomring 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 personas 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:fomu:homeexempt