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HomeMy WebLinkAbout0044 PILGRIM LANE / I� r r i � ,. Town of Barnstable crtmtttt Regulatory Services Fee t Thomas F.Geiler,Director VY Building Division Tom Perry,CBO, Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.bamstable.ma.us Office— 508.862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not VnGd wUhout Red X-Press Imprint Map/parcel Number_ F> 6 6 Property Address. W� Residential Value of Work.� � Minimum fee of S25.00 for work under$6000.00 oisner's Name&Address 5 / A' 5/1 e o Contractor's Name 119mkv Telephone Numbe-r-51?,�—y77 �j J I Inme Improvement Contractor ticense#(if applicable) Maw Construction Supervisor's License#(if applicable) PRESS PERMIT ❑Workman's Compensation insurance APR 2 8 2009 Check one: ❑ I-am a sole proprietor TOWN OF BARNSTABLE ❑ I am the Homeowner gI have Worker's Compensation Insurance insurance Company Name Workman's Comp.Policy M _7 AI P&)1 D©L 4/J�50 Copy of Insurance Complia nee Certificate must be on tile. Permit 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) ❑ Re-side ❑ Replacement Windows/doorstsiiders.U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation,ate. w`+Note: Property Owner st s' Property Owner Letter of Permission. y f the me mp oveme Contractors License is required. SIGNATURE: r i.'>i Pt t1.I:Sv t)12M51huitding pemit tbnmtEXPRESS.doc Revised 100608 I 'd 816Z 'ON WE I i 60OZ tz a dy . WES 40 fr C-4 rk- f rR � S A O I Ibi �p W gg xx .Y a ® � �* Ch 45 so IA tlt3 [3 [j-n ;q Az INC cc � . 'A. .2 L ACORD „ CERTIFICATE OF LUMUTY INSURANCE �o09 o2ns/ A nomxm O if NiD 00 t69ait3 UP= im 1E 8L' . i011gM IM CENINWANE OOES Ili AO E A NA1Cd na n= emmmw;EMU=HMML Rioh 6azdftuc wompa 2as9BIABB aba 6azdmec comas aocum oesaewC _ 92 Part Plane ■u*N* ,ma , 1L 02649 varimE cowspium 1HE Foucles OF R us" 8i3WM an 6iBa� TO ilE R� A FOR ME POUCH P� � AW Jf, Is= OR C0 OF mw Oa OR63! oacuum ern Rat 10 lam Im o St an MAY PERTAK M "Wom H I*MM w in POLIM 0isr r"2D loom t5 WT 7o A L um wm P'01�8.AptEUIO199F�111911Yt1iWEl2$3BrPNIDd/�. _ rots YAE ._- aea9S tsR sooaas 01,000.000 a auaeam CPP0709Q41 09/20/2009 09/20/2009 E naLaa�Wttivatll�r � aeoaem aso,000 4 ia�� Qa�R ,i0O9PPiym.sasb�l- f9,000_ Pe+sa un+rrwmr _ 32,000,008 aA6tlE�dR6 s8.000.000 � � � :FRooucre.aoawAtae s 2.000.000 FcWW „ae SWAM : 9-5-" a �,eaa¢oarnae I '�. s a+. o s • �� aAiac s nee a . O�aeraar�ca s a�a+auaean+ s ocun aueveewoe " - a s o�c�s aO� s s 8 / A9J 07/06/2008 0T/06/2009 E m M"W" I es �. SL•�,uaaesat s i00.000 ELUMM-EPLEWUMM 0100.000 sroaaaere►.�r YES aa.tzmm-MMIA • -s S00,000 ome. ®eoFEblmo taFeme.Feaema+a► CERI MAW11CLO t CA im a a a m n ar I sc dynalmarm sowo AW ow"m Aaolm saewom.a,00 an aamaND 9axam ow�"►�'• 916 ORE TAMM tM mesa CMUM VUL 6sssO66 to WL 21 oars WMTUN ng, 7,0 IK CMWMM BOLM VWW m VW Leer.an FA»7o Oo 30 OiM" Hamm. Wk 02669 meemnms as.rrsuai►a am me @M sae as Ace�ic � un� 718�906-6037 �°0°4� J I co it ° t tn c� ? �5 t 9 ice» ........✓ t•.;��� ».. ...1 i�A�f,y.ry„1w,r �.a 0.q,,!'� 4 i �5 N � 1 N O O t0 r p„ N • r IL A r aoi O Ji o x o a' a g L L r. In r �3 N O y 'SJ O r o N 'D N v p N O N L IL Q Engineering Dept.(3rd floor) Map r0 `Parcel . G� Permit#' - - House# --�/� / L Date Issued 3 ' itBoard of Health(3rd floor)(8:15 9:30/,1:00-4:30)��!` i,h -9f/ Fee -eonservatien Office(4th floor)(8:30-9:30/1:00 L-2:00) Pa ring wept.(1st floor/School Adman.Bldg.) ° OZ Rolla Not NMI axi Wol�t I x03 Definitive Plan pproved by Planning Board '19 lamas v Ntv MY BARNSTABLE. MASS. EO 39. TOWN OY BARNSTABLE. r Building Pe 't Application , Pr c S Address Village e ' Owner �4-010 Address I JY;) 6,gLj; Z.,,J 5 s°l i//(L! Telephone !f`2� 9 917- 2 � l t•�1'( .-Permit Request 6V4-=-R Ex)!;�'J -►•r if �-�l L.9 +t - � FLke Q--%4k6 , lam+si- c W O l►7z�, 1N sue . R�� Jq-nP�i..� r . ffA-►& N15LJ )Doa 2S . i Ns�A-LL N)-r-W 4 iNSv�t.ti-,i3N 14 1i 11!Z4i7' ftC-A-'• ^/ 'First Floor LE-- square feet Second Floor / '� square feet Construction Type Wtv d FYtq-lvlro, Estimated Project Cost $ 6®O-a, u� Zoning District _-: s Flood Plain Water Protection Lot Size . 'lh Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes )KNo On Old King's Highway ❑Yes XNo 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 No.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 XNo Fireplaces: Existing New Existing wood/coal stove ❑Yes AU No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ►,None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4No If yes, site plan review# Current Use Proposed Use Builder Information Name • Wt,5— OwN t✓R Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURE ON THE LOT. ALL CONSTRUCTIONA E RIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE kk/` DATE l BUILDING PERMIT ENIED FOR THE FOLLOWING REASON(S) �0 r ' c— o FOR OFFICIAL USE ONLY _ PERMIT NO. ��� 9 n { DATE ISSUED MAP/PARCEL NO. ADDRESS UILLAGb OWNER DATE OF INSPECTION:1 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: . ROUGH R x FINAL r t i 1 r PLUMBING: ROUGH FINAL -� GAS: OUGH FINAL s `, FINAL BUILDING DATE CLOSED 601T ai !-ASSOCIATION PLAN`NO. , 1 Y • TOWN OF BARNSTABLE _ . BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE JOB. LOCATION Number Street address Section of town "HOMEOWNER" R, 6cites c'J� O 2 � - , C Name Home phone Work phone PRESENT MAILING ADDRESS City/town State Zip c.-d The current exemption for "homeowners" was extended to include owner-occ::= dwe llinas of six units or less and to allow such homeowners to engage an i dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to side, on which there is , or is intended to be, a one or two family dwellii:: attached or detached structures accessory to such use and/or farm structur= A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner" shall submit to the Building Off- on a form acceptable to the Building Official, that he/she shall be res.o::L for all such work performed under the building permit. (Section 109 . 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Building Code and other applicable codes , by-laws , rules and regulations. The unde_Si ,^nod "homeflwner ertifies that he/she understands the Town of arnstable Building Depar e t minimum inspection procedures and require--ennd that he/she will comply ith s id ocedures and requirements. OMEOWNER'S SIGNATURE PROVAL OF BUILDING OF ICIAL cte: Three family dwellings_ 35 , 000 cubic feet, or larger, will be require 0 comply with State Building Code Section 127. 0 , Construction Control.. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner performing work for which :,a': buildin c ' permit is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that is Home Owner engages a person (s) for hire to do such work, that such Home shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuminc the responsibilities of a supervisor (see Appendix Q, Rules and Regulat=cn= for . licensing Construction ' Supervisors, Section 2. 15) . This lack of aware:: often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner acm as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, m: Zommunities require, as part of the permit application, that the Home Owner >ertify that he/she understands the responsibilities of a supervisor. On Last page of this issue is a form currently used by several towns. You ma:: ,are to amend and adopt such a form/certification for use in your eommunit . PROPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD -L 112F KEY 1140. 0021 OTIS ROAD 07 R8 400 07MY 07/09/95 1011 00 638C R31U 106. 226767 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS ,. UNIT ADJ'D.UNIT Lantl Sy/oale S,zc D,men�,on ACRES/UNITS VALUE Description M URR A Y. E V E L Y N M MAP— / —D LOC./VR.SPE0.CLASs ADJ. COND. P PRICE PRICE #LAND 1 17i7OO CAR�SINACCOUNT — C . FF Dc Ift/Acres E L 10 16LDG.SiT, 1 x .1 =10 328 29999.9 98399.9 .111 1770U #8LDGIS)—CARD-1 1 26.700 01 OF 01 A #PL 50 OTIS RD HYIC ___4w4 — N BATHS 1 .0 U K D= 100 2700.0 2700.0 1.00 2700 B #CL418 ARKET 52900 D FIREPLACE U K D= 100 2400.0 2400.0 1.00 2400 9 #RR 1189 00$1 INCOME A - USE D APPRAISED VALUE D i A 44040C A U PARCEL SUMMARY T S AND 17700 A T SLDGS 26700 0—IMPS E TOTAL 4440C F E CNST E N DEED REFERENCE Tye DATE Reco Os1 P R I O R YEAR VALUE A T Book Peg' Insi. MO. Yr.DI Sales Pr ce AND 17700 T S C19715 100/00 BLDGS 26700 TOTAL 4440C R E REFUSAL — SHED BUILDING PERMIT $ Numbe, Dete Type Amoum N O VALUE........ LAND LAND—A DJ INC ME SE SP—BEDS FEATURES SLD—ADDS UNITS 17700 5100 Co w. Total B 'It Norm. DbsV. Class U.IIs L'nils Base Rale Atll.Rate Ac u 1 A9C Oepr. DOnA. CND Loc 4b Fl.G Repl Gos,New Atll Repl Velue Stories Meigm Rooms Rms B.tns I Fis. I P.rtyw.IJ F.c 01D+ 000 100 100 53.45 53.45 55 70 24 74 90 64 41660 26700 . 1.0 4 2 1.0 4.0 Description R.I. Square Feel Rept.Cosl MITT.INDEX: 1•GU IMP.BY/DATE: MR 8/8 7 SCALE: 1/01•G G ELEMENTS CODE CONSTRICTION DETAIL S SAS 100 53.45 684 36560 NS cl *----------------34---------------* STYLE 03RANCH 0.0 T 0LS_ ulN ADJMT00 ------------------- - R ! ! cXT'F_R:WALLS _ _TIWO60 SNTNGLES 6.0 U I HEAT/AC--TYPE- -7T AS=WAfd14 AIR----0 0 C ! 14 T-ER -Jb RYWAL1/PLASrt-- U."0 T ! I INTER:LAY0UT- -T2 VER:%N6RMA_ ----U=O U 22 BASE INT—cR:QVAACTY_ -02 AKE AS ERTE9 _.0 R ! ! FLDITR-STfWCT- -32 D -JOIST/8�AlIf --U.O A W ! *---8---X c F CO7TR-COVER- -J5 AITPET--9-RD-va---- .O L E TOIalA,..s Aux= Base a 684 ! ! ROOF-TYPF---- -01 ABLE=A PR-SH----'J.-0 BUILDING DIMENSIONS ! 8 ELETTRISKL JT VER A_GY -U 0 T SAS W 3 So W26 N22 E34 S14 .. ! ! OWN0AT_IUN- - -02 �ICRETE-SL7TCK-9V=9 A -- ------ --- ---------------------- *------------ .26-----------* -----NE17aKSOR OD 538C-l{YARNTS------- L LAND TOTAL MARKET PARCEL 17700 44400 AREA 2325 VARIANCE +0 +1810 STANDARD 20 II PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 310 106- - Account No: 226767 Parent : Location: 50 OTIS RD HY Neighborhood: 63BC Fire Dist : HY Devel Lot : - Lot Size : . 18 Acres Current Own: MURRAY, EVELYN M State Class : 101 BELL, LETITIA JOAN No. Bldgs : 1 Area: 684 13806 SENCA PARK DR Year Added: HOUSTON TX 77077 Deed Date : Reference : C19715 January 1st : MURRAY, EVELYN M Deed MMDD: 0000 Deed Ref : C19715 Comments : Values : Land: 17700 Buildings : 26700 Extra Features : Road System: 44 Index: 1246 (PILGRIM LANE ) Frntg: 81 Index: ( ) Frntg: Control Info : Last Auto Upd: 053197 Status : C Last TACS Update : 052897 Land Reviewed By: Date : 0000 Bldgs Reviewed By: MR Date : 0887 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [310] [107] [ ] [ ] [ ] 7=CUR AppwwuxJ Table JS=b(condoned) pracriptive Pscle"a for Dae and Tiro-Family Residential Buildings Hatcd with Ford Fads MAXIMUM MINIMUM Glaring Glazing Ceiling Wall I Floor I 8asemuat Slab FIeamng/Cooling �'('A) U-valuer R-value' R-value' R value' Wan ptuimaa Eqmpm� E1Hcie L? pie R-value` R-value' $701 to 6500 Hating Degree Days' Q 12% 0.40 38 13 1 19 1 10 6 Normal It 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 1 10 6 85 AME T 15% 0.36 38 13 23 1 WA N/A Normal U JE13% 0.46 38 19 19 10 6 Normal V 0.44 38 13 25 WA N/A 95 AFUE W 0.52 30 19 19 10 6 85 AFUE X 12% 0.32 38 13 25 WA WA Normal Y 18•/. 0.42 38 19 25 WA N/A Normal Z 12% 0.42 38 13 19 10 6 90 AFUE AA 18•/. 0.50 30 19 19 1 10 6 90 AFUE 1. ADDRESS OF PROPERTY: -o ori f,> Y�N�IS� 44it 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY 92): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-i980303a 780 CMR Appendix 1 Footnotes to Table J5.2.1b: ` Glazing area is the ratio of the area of the glazing..assemblies=(including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing'area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded`from a building design with 300 ft'of glazing area. Z After January 1, 1999, glazing U-values must:be4ested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used: ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R=38 insulation may be substitutedfor R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. •Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 r . �{. The Town of Barnstable . M&MABM . 9� &619. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. / Type of Work: ad Est. Cost g Q00 -aja Address of Work: Is aD 4MI-vyWt S , Owner's Name 9, H'0L. — Date of Permit Application: )12/ 2 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied )C Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR 3 w� Date ner's Name ' The Cunrnronll'ea111t of Afassachuscrts •�t_'t�} Dcparnyrrtrt of brdusrrial AcdWic trs OIIfCEOfIA79SVgal1011S' r 6011 11 aslungtua Strcrt :A BlJl,11H.AM= 03111 �-- Workers' Compensation Insurance Afriida♦•it liczm ntorm-*tion Plc�sr pR[N'T'1 my incarinn O Q T S a-0 ett♦ I am a homeowner performing all work myself• I am a sole proprietor and have no one♦vorl:ing in any capacity CI I am an employer providing workers' compensation for tm employees working on this job. emm�•rn♦ nnmr +rlflrrff �♦ nirnnr fh • infnnner en nnlfrr a -- — I am a sole proprietor.general contractor,or homeowner(circle oite)and have hired the contactors listed below who hr. the following workers' compensation polices m sn♦• narnr• - fluff! Rlrnnr�' - inevr•rner cn - nnlie♦•� _� _ __ mn!fnr nnfnr! (tlrrff- .r♦ nhnnr/r• Attaehadditional Sheet if necessary . .�. +•� �_ :, "'�i^:��•••f+ +� r•«_.�._�•�+..u.+�+�+�+ �]'�.��''„r� =ti Failure to secure euyeraee as required under:iectton 3A of AIGL 152 caa lead to the rmposruOn of ertmttutl petnluo of a tin rip to 51300.U0 aadlur one rears•imprison as••ell as ci♦•il penalties in the form of a STOP WOnX ORDER and a tine o(S1o0.00 a day apinst nit. I understand that a coin*of this atatem nt in ♦ forwarded forarded to the Olnce of Investigations of the UTA for coyerat:e verification. /rlo lureht•crrrif tut r Me.p its p alti of perjury that the informarion provfded above is taste and correct Sim mu Date 4 c� Lq V Print name v�._... Phone# �� ( � )� a ciai use univ do not♦Trite in this JIM to be completed br city or town ofncial permitilicense of r"7tInUdiaq Deparrmeat r.*i,.or roan: 13Lkeasma Board check if immediate response is required QSdeetmeds MMIce Qltnith Ueparnneat phone 1r• C30ther�.� i• contact person• i Information and Instructions MaSsaChU3etiS General 1.3%vs chapter 15_' section 25 requires all employers to provide workers'ct�m;pcnsation for em�dlovecs. As quoted loom the "law-.an emplt ree is dcfincd as every person in the service 01-:11 'W icr under art%- contract of hire. express or implied. oral or%vrinen. An cnrplt rer is dcfincd as an individual. partnership. association. corporation or other icLnl entity. or an}•two or m: the foregoingenuaged in a joint enterprise.mid including the legal representatives of deceased employer. or the receiver or trustee of an individual . partnership. association or other legal entity, employing employees. Howe%e- owner of dwelling_ house haying 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 wort: on such dwelling_ or on the_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empiov: MGL clta{tter 15? sectiart =5 also states that eti•erp state or local licensing agency shall withhold the issuance or- rencival ofa license or permit to operate a business or to construct buildings in the c:ommonivealth for any applicant who has not produced acceptable evidence of compliance i%ith the insurance coverage required. Additionally, neither tite 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 chaste- been :presented to the contracting authority. Applicants :ts Please fill in the %vrkers' compensation affidavit completely, by checking the box that applies to your situatiout and supplying compally names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance Coverage. Also be sure to sign and date tine affidavit. The s a it should be returned to the sity or town that the application for the permit or license is being requested. roc :'c Depanment of Industrial Accidents. Should you have any questions regarding the "law"or if you are -ecuire to eL'airt a workers' compensation polls}. please cell the Department at the number listed below. City or,ron•ns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottorr, the affidavit for you to 1-111 out in the event the Office of Investigations has to contact you regarding :lie applicant. P' be sure to fi in the permit/license number which wilt be used as a reference number. The affidavits may be returnee tite Department by mail or FAX unless other arrangements have been made. The Offce of Investigations would like to thank you in advance for you cooperation and should you have any questic ease do not hesitate to _live us a =11. The Department's address. telephone and fax number. - TIte Commonwealth Of Massachusetts Department of Industrial Accidents ' Office of Investigations ' 600 Washington Street Boston,Ma. 02111 fax rt: (617) 727-o 749 020AC.... 7 1 J 0.14 AC \ \ <' 173 O cJ 20 t Q v r, `" ... f _ #1 7 t o \\ # `C� _ ell 1 1 o: AC O r #170 \ / r f «: >.t` oc:_-- _ -,1_ 2CA , r,Q f / 00 AC #44 i0.48 ACJ. \\ t #176 j ar 0. 0 AC b2 t _.5 "1� 1 ;b 1 10 C, #182 1 , / 0.2 C _. ' 014A 7 # d 0 41�AC ac' -0;14 0: i _ \ #2 0.13AC f r : � J w 0.20 O t .. .. '''... #94 f 0.60 AC fr �0 5 AC J r f:' r �4 044A', r; ,. zbAC 'f 5 0.20 r i 1 - #-15 , j t 213 L12 , f (^ 0.20 AC �k 5 5: O I 0.20AC f'IAC 0. 4AC r; r j, t #97 _ , J A 78 rJ, 9 6 ' ` —� .r r map 310 scale 1"=100' �+�>• The Town of Barnstable 47i 3-A,� • ' °�' Department of Health, Safety and Environmental Services 1 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Cmssen Fax: 508 790-6230 Building Commissioner Home Occupation Regis= ion Date: Name: � Phone!#• � T J - Address: ��'//i✓i lei Vr7lage: • � — IUD i� Type of Business• , IN'MT. It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single fammly dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordmamr,provided that the activity shall not be discernible fium outside the dwelling: therm shall be no berme in noise or odor;no visual alteration to the premises which would suggest anything other thaw a residential sire;no mcrease in traffic above normal residential volumes;and no increase in air or pmndwater pabdorm. After xeglstradon with the Building inspector,a customary home occupation shall be permitted as of ngbt.subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwellmgunit. • Such use occupies no more than 400 square feet of space. • There are no extemal alterations to the dwellingwhich 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 noose,vibration.smoke,dust or other particular matter,odors,electrical disturbance,heat,&r,Imundity 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 an the same lot containing the Customary Home Occupation,and not within the required fismt yard. • There is no exterior storage or display of materials or equipment. • There n no eommerdal vehicles related to the CW miry Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to axooee 120 feet in length and not to exceed 4 tires,parked an the same lot eontainingthe Customary Home Occupation. • No sign shall be displayed indicating the Customary Hatne Oaupation. • 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 I,the undersigned,have read and agree with the ab restrictions for my home occupation i am registering. Appda=- Homeocdoc TO ALL NEW BUSINESS OWNERS Fill in please: YOUR NAME: �O 5 APPLICANT'S ® ® ® �® YOUR HOME ADDRESS: BUSINESS Telephone Number (Home) D� TELEPHONE Z *` E OF NEW BUSINESS G TYPE OF BUSINESS A HOME OCCUPATION? MAP/PARCEL NUMBESS OF BUSINESS ' 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.° 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) 'S 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This individual has beenJalermed of �Irmit requirements that pertain to this type of business. Authorized Signature e COMM NTS: - - 2. GO TO BOARD OF HEALTH (31113 FLOOR TOWN HALL) This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMI ISTRATION BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: After obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 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.