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� � I � � �r�5�-O�� �'����t e� i + TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Ma x: t �0 p Parcel �� "'D Application # SvCp Health Division 20 01 = _ Date Issued 1 Conservation Divisions ' Application Fe b Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH Preservation/Hyannis Project Street Address Z0 Village Owner ; YI1d� ' Address - Telephone 7 Rd — 11 9& Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed TO new Zoning District Flood Plains Groundwater Overlay `l A-Project Valuation IVd Construction Type � Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su porting docur'ri;entation. Dwelling Type: Single Family 4d' Two Family ❑ Multi-Family (# units) Age of Existing Structure 40un- Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout Other Basement Finished Area (sq.ft.) © Basement Unfinished Area(sq.ft) �a Number of Baths: Full: existing_ new Half: existing , new Number of Bedrooms: existing _new Total Room Count (not including baths): existing IQ new First Floor Room Count 'L Heat Type and Fuel: ;dGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes �No Fireplaces: Existing_ New Existing wood/coal stove: A/Yes ❑ No Detached garage: ❑existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: U1 existing 0 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 it) 1l�� Telephone Number 2 rAddress Arl5t-61 Ave_ License# Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7-6 0 s ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ti MAP/PARCEL N0. R ADDRESS VILLAGE OWNER Y DATE OF INSPECTION: FOUNDATION FRAME 'r INSULATION 0��' ! a f '► FIREPLACE ELECTRICAL: ROUGH FINAL i' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING s - `q DATE CLOSED OUT ASSOCIATION PLAN NO. _a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washineon Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El ectricians/Plumbers A_pplicant Information ' /,, f r Please Print Le6bly Name (Business/Org�izatid pn/Indh6duaI): /j CU am_ 4 V- t'`17l - Address: l 4a BINS I A'V -e- City/State zip: i' &-Vw us &-- Phone 0 — 7 Z' Are you an employer? Check the appropriate bo Type of project(required): 1.❑ I am a employer with 4.; am a general contractor and I employees(full and/or part-time). * ve,stab-contractors 6 ❑Hew constxvction hae hired th 2.❑ I am a sole proprietor or partner- ��on the attached sheet 7�}Zemodeling . These sub-contractors have g, Demolition ship and have no employees employees and have workers' working for mein any capacity. 9. ❑Building addition [No workers' comli.•inKurarce comp.insurance.t r6quimA] , 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I1.❑Plumbing repairs or additions Myself-[No workers' comp. right of exemption per MGL 12 ❑Roof repairs in cnran[�rCgLIIICd]t c. 152, §1(4), and we have no etloyees. [No workers' 13.❑Other coa p.insurance requzirre&] *Any applicant that eb=kr box#1 Mart also fiIl out the section below showing their workers'eoropmrnrion policy inforrvatiorL t Ham=,Am s who subrE t this of dxvit indicatmg they m-c doing all work and than hire outside cant macTs must submit a new affidavit indicating such. t--Mtraet=tUat cbxk this box must attacbcd an additional sheet showing the name of the sub-:aahmctors and atabe wbcther arnot those rntitirs have employers. if the sub-ccnhaetors have employees,thry must pravidC their word us'comp.policy nurnba. I am an employer that is providing workers'compensation insurance for my employees Belaw is the policy and job site information. , Insnrancc Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fins vp to$1r500,00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for m' su nec coyeraoc verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct Si ahae / Date: C / `l ZOO Phone# Official use only. Do not write in this area, to be completed by city or town offz.claL City or Town: Permit/Liceme# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: ��11�11^1Ci L1U11 UjU LL MNLi LJLULIUJ t3 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 hiie, 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 dcccased employer, or the receiver or trustee ofanindividual,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, §25C(6) also states that"every state or IDC21 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 pro duced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) 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 compliznrz RZth the imsIII'8T�0 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-contractor(s)name(s), address(cs)and phone numbers) along with their certificates)of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the nembers or parbacrs,are not required to carry workers' compensation insurance. If an LLC or LLP does have v policy is r ed. Be advised that this affidavit may be submitted to the Department of Industrial to GCS a Y -mp p cY �r ccidcnts fo r confumation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should >e returned to the city or town that the application for the pemrit or license is being requested,not the Department of ndustrial Accidents. Should you have any questions regarding the law or if you arc required to obtain a workers' ;ompcnsahon policy,please call the Department at the murpber listed below. Self-insured companies should enter Muir ;elf in=aar,e license comber on the appropriate line. :ity or TowA Officials . 'lease be sure that the affidavit is complete and printed legibly. The Dcpartmcnt has provided aspare at the bottom ,f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant 'lease be sure to fill in the permiVbccnse number which will be used as a reference number. In addition, an applicant oat must submit multiple permitllimnse applications in any given year,need only submit oar,affidavit indicating current Dlicy information(if necessary) and under"Job Siie Address" the applicant should write"all locations in (city or officially s ed or marked b the city or town may be provided to the awn). A copy of the affidavit that has been ffi y tamp y ty Y pplicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each ear.'J hcre a home owner or citizen is obtainin a a license or permit not related fo any business or commercial venture _e. a dog license or pc=it to btim leaves etc.)said person is NOT required to eompletz this affidavit- he Office of Investigations would b3m to thank you in advance for your cooperation and should you have any questions, [case do not hesitate to give us a call ie Department's address, telephone-and fax number. Thtt C6mmonwean of Massachusetts Department of Iadus dal Accidents Office of lnvestigatxans 600 washington Stme-t Boston, MA 02111 Tel. # 617-727-49-00 text 4-06 ar 1-M-MASSAFI✓ Fax# 617-727-7749 :d 11-22-06 www.mass.gov/dia I ' The Commonwealth of Massachusetts Department oflndustrialAccidents w Office of Investigations y d 600 Washington Street Boston,MA 02111, www.mass.gov/dig ' Workers'-Compensation Iusurance Affidavit: Builders/Contractors/Electricians/Plumbers .4-pplicant Information Please Print Le M Name (Business/Organization/Individual): . / Address: �S - t��l Jt ._,_ l�a�� Phone.#: 6-D-9 2-�54 (316 City/State/Zip: � . Are.you an employer? Check the appropriate box: .Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑ loyees (full and/or part-time). * , have hired the sub-contractors ew 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 -;workingfor me in an capacity. employees and have workers' Y P tY� 9. ❑.Building addition [No workers' comp,insurance comp. insurance,$ required.] 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions '3.❑ I am a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance,required,]t c. 152, §1(4), and we have no employees. [No workers' 13.El Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers compensation insurance for my employees. Below is-the policy and job site'' information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 3b Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration,date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK;ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of _Investigations of the MA for insurance coverage verification. I do hereby certify.under the pains•and penalties of perjury that the information provided above is true and correct. Si mature: ,429 Date' Phone#: Official use only. Do not write in this area, to be completed by city or town official, City or Town: ' Permit/License# Issuing Authority(circle one): .1.Board of Health 2.Building Department 3, City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780 CMR 61.00) Applicant Narne: Site Address: print Town: Applicant Phone: Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Basement Slab -Option 1: Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE I�SPF SIsLR R-Value R-Value and Depth National Applianeo Energy 35 R-3 8 R-19 R-19 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or teeter ns applicable Note: This form is not required if you choose either of the two versions of REScheck.as.listed below. Option 2: �. REScheck Version 4.1.2 or later variant software analysis must-be completed (780 CMR.6107.3.2 REScheck—Web which can be accessed at http://www.energycodes.goy/reschecld ADpXTIONS=OxZ AZ.TERATIpNS TO!EXISTING.BUILDIV S:`:O.V as YE,,A.RS OLD* *Buildings under S years old must use option#1 or 42 in New Construction section above: . Complete the following formula to determine'the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b-a) SF 100 x — _ % of glazing (b) Glazing area equals. SF b Q f glazing is'<:401%-use.the chart below. If,glaziri &:is>-:40-'% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIlVfUM Ceiling andIN;R-19 Floor Basement Wall Slab Perimeter Fenestration Exposed floors R-Value U-factor R-ValueR-value R-Value _ and Depth .39 R-37 a R-10 R-10, 4 feet R-30 ceiling insulatio may used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compress.ed over exterior)Nalls, and including any access o enin s).- SUNROOM—An addition or alteration to an existing buildink/dwelling unit where-the total glazing area of said addition exceeds 40% of the combined gross wall anti ceiling area of the addition, Note:. Owner to fill out Consumer Information Farm (found in Appendix 120.P) f k Town of Barnstable �oF THe r � Regulatory Services ` Thomas F.Geiler,Director BARNSTABLE, .p MA55. $ - �{, 039. Building Division pTED MAi a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vtrww.towa.barnstable.ma.us Office: S08-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB*LOCATION: I S number lM l street village .'HOMEOWNER": J►/QG�Ct' D , // 1t �6�I` dog-7Qo� `i'�$� 3��- Sa73 name o home phone# work phone# U CRRENT MAILING ADDRESS: SO— IA-4-- — city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and ' ual for hire who does not possess a license provi ded that the owner acts as o engage an individual ,P to allow homeowners tP 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 permst. (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. �( Sig�-fwner 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 Cod-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 aie 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 writh 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 responsibiliti-s 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 forn/certification for use in your community. I_ oFZHEr Town of Barnstable Regulatory Se-rvices ` ''` S. .ss. Thomas F. Geiler,Director � rFoivta Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-740-6230 Property Owner Must Complete and Sign This Section If Using .A Builder as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption.Form on the reverse side. °pIHE r 'Town of Barnstable *Permit# � 63 50S Expires 6 months rom iss�re date Regulatory Services Fee 20 swRx Thomas F. Geiler,Director 94, 14a ESS PERMIT Building Division PK_ prEo JUN 3 ® 2008 Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address /,Uo Etfs,h,_- d e_ 15 residential Value of Work /eoo Minimum fee of$25.00 for work under $6000.00 Owner's Name&Address /V4G7e-61 ,D, M,,I!e r f�7j1 �! Contractor's Name D!M e o co dl`e r Telephone Number , o5_7�10 —q! f� Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑.I am a sole proprietor ler, am 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) ❑XRe-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side �Q�ICQcfG 2 OG1 WIt2tQaLC�'S CC! evu Replacement Windows/doors/sliders. U-Value (maximum.44) Y�rc .� door -�-no QG a,(, 17� *Where required: Issuance this pe oes 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 is required. SIGNATURE: ef Q:\WPFILESTOR-MS\building permit forms EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please print Letribly Dame(Business(Organization/Individual): Address:-461® /5� City/State/Zip: Phone.#: �fo Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I 6 0 New contraction . employees(full and/or part-time).* have hired the sub-contractors 2111 am a'sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-confractors have g. 0 Demolition working for me in any capacity. employees and have workers' 9 0 Building addition [No workers' comp.-instiraace comp'insuranqumce - mi) 5. 0 We are a corporation and its 10.[]-Electrical repairs or additions I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or.additions 4 myselL[No workers' com 0 R p. rigbt of exemption per MGL 12 oof repairs insurance required]t in. 152, §1(4),and we have no employees. [No workers' 13.0 Other f4 comp.insurance required.] *Any applicant that chmks box#1 rnust also fil out the section below showing their workers'mu p=m4on policy infmn ation. t Homeowners who submit this affidavit indicating they a,z doing all work and than hire outside contractors must submit anew affidavitaidia ing such. YContractors that chmk this box must attached an additional sheet showing the name of the sub-contracturs and state whether or not those entitirs have employers. If the sub-conbwtors have eraployces,they must prmvi&their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/Statc/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to scctffe coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statcmerit may be forwarded to tha Office of Investimtions of the DIA for insurance coverage ycrificatim- I do hereby certify under the paixs•and penalties of perjury that the information provided above is true and correct r 6 0 0 Signature: Date: Phone#' —9C D O fwial use only. Do not write in this area, to be completed by city or town offcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: oFtHEr Town of Barnstable t Regulatory Services aARNsiE Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA'02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A. Builder as Owner of the subject property . hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of Job) r 6 -30 Signature o wner Date Pant Name applying for ermit lease complete the Homeowners License If Property Owner is p p p Exemption Form on the reverse side. - Town of Barnstable �pF THE Tp�� Regulatory Services Thomas F.Geiler,Director BARNsrABre, ttAss. ,639. ,e� Building Division PIFD �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 w".town.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street t� �/ village "HOMEOWNER": /'/dM C J�S —Z?d 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 k 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 permst. (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. , f Signature of H owner 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 foravicertifrcation for use in your community. BARTSTAX TOWN OF BARNSTABLE MASSACHUSETTS Solid Fuel Stove Permit C DATE OF APPLICATION JJ YJ:.ij..�P.V.............. _—V44FrDEPT. ISSUING PERMIT .................. NAME (owner) ............ .0t.'etazc...................... NAME (Installer) ..................... ......................................................... ADDRESSI..Yja 6V.5.W.An XA............V�41-1-.'Ab ADDRESS ........................................................................................................................... STOVE TYPE W1.0.0.0..............................................7''"*** CHIMNEY: NEW 4 EXISTING ........................ Manufacturer ............6�_ xj.50.1:�....................... CHIMNEY: Masonry .............................I............................................................... Mass. Approval ....................?..r ..:z ................................................ CHIMNEY: Metal ...........".. . ................... This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the ................................................................................................... Fire Department, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. IssuedBy: .................................................................................................................................Title .................................................................................... Date .......................................... Permit to install expires 60 days after issue date Stove .............WaOD....................440..' ' . .............. ..............C .............................................................................................................................................................. I. .Stove Clearance ...................... 6..................... ...... ............. If............._ (I L .............. . .....................y ... . .Floor . 4. ............ ...........I....................................................................................... .................................................................... ................................................................................................................................................................................... Smoke Pipe ........................�0 Smoke Pipe Clearance ............................ ........................................... .......... ...................................................... 4 ')...................I..................................................... Chimney ..........................................k WA A....................(..............................................................I..........................I..............I............................................................................. SmokeDetector ...........................Y.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ...................................................... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto ........................................................................ Installer INSTALLATION APPROVED If By:.. 4 'aJ 4� Qa i ................. Title: date WHITE: FIRE DEPARTMENT CANARY: BUILDING INSPECTOR - PINK: APPLICANT 0 0 , TNEtO�o TOWN OF BARNSTABLE t ]MARTST"L i 6 q. MASSACHUSETTS am Solid Fuel Stove Permit Icy`. DATE OF APPLICATION ....::�..�......A���!�� ,..! � FIRE-DEPT. ISSUING PERMIT ...!�'� ........................................ .......U......... . NAME (owner) .... ...3- *!.......... .��.►. :<..................... NAME (Installer) ..................... ......;.."t?...........:............................................ tt ADDRESS 1.YQ...I...,'..,(- td),:... AJ-A l';—Asi ADDRESS .......................... ....................... . ............................................... STOVE TYPE :.:.....LJMI.)................................ ! .. CHIMNEY: NEW ........k'�... EXISTING ` Manufacturer . �:.... � --!'� �..a )� CHIMNEY: Masonry Mass. Approval ....................... r �� CHIMNEY: .Metal t� .... � ... ...:........ ... ......... ........................... .................... .. This is to certify that the above installer has permission.to install a solid fuel burning appliance. at the listed address in accordance with an application on file with the ................................................................................................... Fire Department, ti and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made .under the authority thereof. t Issued. By ................................................................................Title .................................................................................... Date ........:................................. Permit to install expires 60 days after issue date a f , StoveA. .....................................................� , t{, ( sv� >r�.j t..:..............::.............................................................................................................. Stove Clearance -�41 -+JJ A ' ;, t�� frk. r r l Is (/r� r,l ........ ..� . ....... .a.. :�....:...... .............................. ...... Floor ................... �.. t n,a �l ,`� ............ ........ ...................................................................................................................................................................................... gym Smoke Pipe ...:.................:... ...... .................................. ...................r... :....G.......................................`.`........ ............................................................................................................... Smoke Pipe Clearance .3 1 O A j................... �........... f � Chimney ' ... �n SmokeDetector ...........................:. ............................................................................................................................................................:......................................................... ...... The undersigned hereby certifies that .the installation of solid fuel burning stove and equipment made under au- thority of permit dated ........................:.:........................... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto ........................................................................ Installer I � + `� `rBY: h -�4 (ter i INSTALLATIONAPPROVED ............................................................ ......................................................................................... Title: ..............................................,y,;p 'date i U %.WHITE: FIRE DEPARTMENT — CANARY: BUILDING,INSPECTOR — PINK: APPLICANT Town of Barnstable - Regulatory Services OF 1HE Tp� Thomas F.Geiler,Director T OWT! BARNS i 1BLE Building Division + BARNSTABLE, r� MAC• Tom Perry,Building CommissioJ 5 MAR 28 AM 11: S8 i63q. ♦� '0�eo Myr a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax- 508-790-6230 Approved: �W . Fee: qc-9-570e) Permit#: HOME OCCUPATION REGISTRATION Date: Name: _01;r—PTO L€. P_— Phone#: -,5-a 79 o " 1 It 196 Address: 140 0 J�F_f S T-0 L- 79-0, Village: �YAW /V�S Name of Business: Diew'(.rG l L LL5 �/-�D'I—U Cs Uk'q A Type of Business: I I-1O7-Q GE Map/Lot: ! D INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or,use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one 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. 17 I,the Lundersi; , ave rea nda i e above restrictions for my home occupation I am registering. Appli Date: Homeoc.doc Rev.5/30/03 TO ALL NEW BUSINESS-OWNERS DATE: '3-2 8 Fill in please: � � ��o� M1l LEf� APPLICANT'S YOUR NAME: YOUR HOME ADDRESS: `14 BUSINESS �R�STo t, J�J• �P HYAN30.►s MA 02601 TELEPHONE . k Tele. hone.Number Home .SOB- 790 -.9l 86 NAME.OF NEW BUSINESS ALA O M MI" PHoTe c2A PHy TYPE OF BUSINESS^ PNaTa�R A ANT IS THIS A HOME OCCUPATION? YES �NO Have you been given approval from the building division? YE NO _ d y q�. ADDRESS OF BUSINESS 14-0 5R_1S-rbL- -AV-, 44)/4N/JIS NA 02�� MAP/PARCEL NUMBER When starting anew 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. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and..licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S FFICE This individual Illee informed f a y.permit requirements that pertain to this type of business. Aut rized Signat re* COMMENTS: C —� 2. BOAR OF HEALTH This individual has bee i formed of the pe/rmitre.quire�ents that pertain 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: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. it does not give you permission to operate-you must get that through completion of the processes from the various departments involved. . **SIGNIFIES APPRO VAL FORA BUSINESS CERTIFICATE ONLY.