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Home My WebLink About0569 MAIN STREET (HYANNIS) (31) �to� �).4r n/ S 7" I.�r�iT" � �. .• �a�'-- ►� I � o alp, \ �� r� i YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS 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, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. t � E Fill in please: Date: /0r2 /O.7 APPLICANT'S NAME: ��r � YOUR HOME ADDRESS: -- ' � BUSINESS TELEPHONE # HOME TELELPHONE #: NAME OF CORPORATION: NAME OF-NEW BUSINESS_"' ri,. �r, -a�,�:. i��✓.I�e�S1.�� TYPE OF;BUS1'NESS l/j� IS THIS A HOME OCCUPATION? YES X NO ADDRESS OF BUSINESS .5 �' r�cg -� �'`: MAP/PARCEL NUMBER` (Assessing) 'n When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is 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 town. 1. BUILDING COM IONER'S OFFICE This individ d al �a eer+inf r e o any permit requirements that pertain to this type of business. Au orized-_-Signs ** COMMENTS: ✓3-,,�` ? J _., 2. BOARD OF HEALTH This individual has been informed of the permit requirements 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: �`"E' � Town ®f Barnstable Building Department - 200 Main Street ASTABLE. ' Hyannis, MA 02601 MASS 9�A 1639. . (508) 862-4038 - Certif icate of Occup ancy Application Number: 200905212 CO Number: 20092135 Parcel ID: 30811100K CO Issue Date: - 11/02/09 Location: 569 MAIN STREET (HYANNIS) Zoning Classification: HYANNIS VILLAGE BUSINESS DIST Proposed Use: Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: PCCO PRECODECERT OF OCCUPANCY Comments: Building Department Signature Date Signed TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel UK Application /Us (Z Health Division Date Issued Conservation Division Application Fee -- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic _OKH Preservation/ Hyannis Project Street Address SG%' /�Js,, �v Village p Owner Address Telephone G�� -��/d�S•P`�3 ---- ` X Permit equest �� v�1� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure 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) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑& sing ❑ to'w Vie_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I zz -4 NO -n Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# w Current Use Proposed Use w APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Name Aisitv-6 Telephone Number 6 Address License# �Uz �- ��5 ��4 , �`^°• DZ-S - Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ��Z IZi�a FOR OFFICIAL USE ONLY E c APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME 4 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. fi �sHE, Town of Barnstable Regulatory Services 9 EMWFrABLA Thomas F. Geiler,Director �''�en �►�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 • . Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I,.IVI)/h V�rS SS�C�o�jive/ Cas Owner of the subject property hereby authorize 1171er/2�1Z to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) /G I ature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION j Town of Barnstable a' o Regulatory Services • Thomas F.Geiler,Director i3wxrvsrwsi:E. MAS& 9q, 0.19. ,�� Building Division pTEnl'�{a 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: number street village "HOMEOWNER": name home phone# work phone 4 CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\bomeexempLDOC The Commonwealth of Massach usetts .. Department of Industrial Accidents Office of Investigations � . 600 Washington Street t _ Boston, MA 02111 may' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print l,e2ibly Name (Business/Organization/Individual): �wb� ( � _ Address: )5 GUt. ., City/State/Zip: 63�1� �� `' P'� 67, 3 Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2XIam 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' Y9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required..] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13Other�G n �-� 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 a new affidavit indicating such. tContractors that c'neck 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: 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 up to$1,5'00.00 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 insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided.above is true and correct. Signature: 014, Date: )O.Z� /U 1 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#: