HomeMy WebLinkAbout0015 HIGHLAND STREET -t:77.
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Town of Barnstable * 'errr it#
Cr.
Ezpir 6 morrt/u from issue date
ulatory SeMce5 Fe r
J`UW �� �� Thomas F.Geiler,Director
Building Division
'Aghe-ry,CBO, Building Commissioner
200 Main Street;Hyannis,MA 02601
www.town barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
EXPRESS PERIAUT APPLICATION - RESIDENTIAL ONLY
G Not Valid without Red X-Press Imprint
Map/parcel Number (��i l f
Property Address �,� •�f
124esidential Value of Work 1 Minimum fee f$25.00 for work under$6000.00
Owner's Name&Address ., ZI`iiell i q5" 5i 57� e,-7-
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)_
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
�I 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.
?ermit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
Re-roof(not stripping. Going over existing layers of roof)
eRe-side
[Replacement Windows/doors/sliders. U-Value �(maxim„m 44) `
'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 is required.
IGNATURE:
Tom s:expm
wise061306
Town of Barnstable
Regulatory Services
satuasTeat e ? Thomas F.Geiler,Director
1,twss.
Building Division
ArED MA'1 A
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
WwNy.tow n.b a rnstab le.ma.us
Office: 508-862-4038 Fai:�'508`790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: 410V
JOB LOCATION:
number street /village _
`•HOMEOWNER': r—LA d � U'M7%7-t0y`' (.5WJ72G-Wo-
name // home phone# work phone# .
CURRENT MAILING ADDRESS: 39S Scot
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units orless 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 fomi 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.
ature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control. .
` HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109:1.1=Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming,the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
i
,y
oFt Town of Barnstable
Regulatory Services
a a
BARMABL&AE& a Thomas F.Geller,Director
16yg6 A Building Division
Tom Pe �y,Building Commissioner
200 Main treet,Hyannis,MA 02601
www. wn.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Properly er Must
Complete and 7A�Auilder
This Section
If Using
as er of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building p 't application for:
(Address of Job)
Signature of Owner Da
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORM&O WNERPERMISSION
The Commonwealth of Massachusetts
' Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111'
wivw.mass gov/dia '
Workers'Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers
_Applicant Information .. � - .Please Print Legibly
Name(Business/Or, nintion&dividual): c/as0,,17 C'"f�K
Address:
City/StatelZip: .4 .`s 2 Phone.#:r<-,9?�7
Are you an employer?Check the appropriate box: :Type of project(required).
•
4. I am a general contractor and I
1.❑ I am a employer with 6. ❑New construction .
employees(full and/or part-time).*• have hired sub contractors •
2.El am a'sole proprietor or partner- listed on�'attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. []Demolition
for me in as c aci employee4 and have workers'
working Y aP t5'• 9. ❑Building addition
o s' CO inanranCe comp.insurance,$'
worker comp. 10.❑Electrical repairs or additions.
5. We are a corporation and its ,
required.] IP
I am a homeowner doing g1 work . officers have exercised their 11.❑Plumbing repairs or additions '
3' right bf rig exemption per MGL
myself:[No workers comp. • 12.❑Roof repairs
insurance.required.]t c. 152, §1(4),and we have no
employees.[No workers' 13.❑Other
comp.insurance required.]
*Any applicant dint checks box#1 must also fill out the section below showing their workars'compensation policy information.
t Homeowocm•&&o submit this affidavit indicating they are doing all work and tlien hire outside contractors must submit anew affidavit indicating'such.
tContractors that check this box mutt attached an additional sheet showing the name of the gub-=ttactors and state whether ornot those entities have
employees. rf the sub-contractors have employees.1heymot providb their workers'comp.polio),number.
I ani an employer that is providing workers'compensation insurance fur my employees. Below is.the policy and job site'
information.
Insurance Company N=e'
Policy#or Self-ins.Lic.P 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
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 thq violator. Be advised that a copy of this statement maybe forwarded to the.Office of
Iuvestiaations of the 1)IA for insurance coverage verification '
I do hereby certify under thepains andpenaltles ofperjury that the information provided above,is true and correct
Si at¢re: Date: ov
Phone .
Official use only. Do not wrHe in this area, to be completed by city or town:official
City or Town: ,Permit/License#
Issuing Authority(circle one):
J.Board of Health 2.Building Department 3.City/Town Clerk 4•Electrical Inspector 5,Plumbing Inspector
6. Other '
Contact Person: Phone#:
Town of Barnstable
oFt�ray,
Regulatory Services
1� Thomas F.Geiler,Director
• Building Division
w BMMSTnsr e,
9 MASS. g Tom Perry,Building Commissioner
1639. ♦0 fo 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Fee: i 06
Permit#: b
HOME OCCUPATION REGISTRATION
Date: a D
Name: Phone#: S1) '7 7-6,0 99/'
Address: /1%G/1 L 4,-)6 SIT village: S°19Gd��S
Name of Business: C4,00 Ca 6�s �i i✓�S T �L�o�Z S'
Type of Business: NA b W,90 D FLoalC �EGr�✓� Si��:NG Map/Lot: 361 1 L
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.
I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.
Applicant: Date:
Homeoc.doc Rev.5/30/03
TO ALL NEW BUSINESS OWNERS
DATE: r � :,��
Fill in please: YOUR NAME:
APPLICANT'S jP1 YOUR HOME ADDRESS: a�0
BU INESS .
SO 7 7�-�°9 ` Tele hone Number Home �� Aw
TELEPHONE
ES- Good ns TYPE OF USINESS .�Ru��u,l5
NAME OF NEW BUSINESS C YES �NO _
IS THIS A HOME OCCUPATION?______�--
you been given approval from the buildin division? — ",Sy NO Qa(,oIMAP�PARCELNUMBER___ _3—-� of
Have y L
ADDRESS OF BUSINESS
need. Once you have obtained the required signaturesn/IUST o to
When starting a new business th
ere are several things you must do in order to be in compliance with the rules and regulations of the Town
Barnstable.�This form is intended to assist you in obtaining the information you may
below,you may apply for a business
certificate at the Town Glerk's Office flat floor-Town Hall) or if you get the business certificate first yo
ts and licenses..
the following office to make sure you
Yarmouth Rdr& Main Streeequiredft) and you will find the following offices:
GO TO 200 Main St. - (corner of
1. BUILDING COMMISSID R'S OF rmit requirements that pertain to this type of business.
This individual has eon ' r ed of a y
Aut orized . i atura** u
COMMENTS:
2. O
BOARDRDF HEA
0has ee informed he e it re ui mants t . ertain to this pe of business..
This individual
A ized Signature*
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITYuirements that pertain to this type of business.
This individual has been informed of the licensing req
Authorized Signature* .
COMMENTS:
business certificate ONLY RE GISTERS YOUR NAME in the town (which you.must do by M.G.L.
Business certifi cotes cost$30.00 for 4.years). A h completion OP the processes from the various departments involved.
-it does not give you permission to operate•you must get that hroug COm p
t GNIF/F�A PRO VAL FOR BUSINESS UCH IIFICArf 0/V4
�l