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0121 DUNN'S POND ROAD
��/ �cam m��--- �r��. ��.-. TOWN QF BARNSTABLE BUILDING PERMIT APPLICATION Map-. Parcel ApplicationQbi sIR33 Health Division Date Issued Conservation Division Application,Fee Planning Dept Permit Fee �- y �HIS, Date Definitive Plan Approved by Planning Board Historic- OKH _ Preservation/ Hyannis Owner— 3 k'o l .Address Tele�e`> Permit-Request Rc A / Fla A+ �-fosse_1 310 F Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project- ivation �/UO'• 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'!`""H ghway: 0 Yes: No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ OtherTri "r I Basement Finished Area(sq.ft.) Basement Unfinished Area (sq:M N ' 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: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ 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 Y (BUILDER OR HOMEOWNER) c Tele hone NumberCJ�®� p Address �U ram 7�/S License# C S -ox�v 9/ 2. 5h&A"ae_- /Y4- d 2-S(& Home Improvement Contractor# Email Worker's Compensation # " ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE`" t FOR OFFICIAL USE ONLY , s ,x APPLICATION # DATE ISSUED � r MAP/ PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ;r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 'I o* Town of Barnstable r Regulatory Services BAMSTAWA KAM Richard V.Scali,Director A 'tiFo ' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us i Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder G'K, w e ` ,as Owner of the subject property hereby authorize (J to act on my behalf, in all matters relative to work authorized by this building permit application for: z (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before f�nce is installed and all final inspections are performed and accepted. Signature Owner Signature of Applicant Print Name r Print Name Date ! Q:FORMS:OWNERPERMISSIONPOOLS t Town of Barnstable Regulatory Services Richard V.Scali,Director z Building Division $AMiffrABi_,F ' Tom Perry,Building Commissioner NEAM 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# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling 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 to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 i Tire Commorrivealth of-Massachusetts Deparam rut of IrndrrstrialAccidents - Of w-e of Investigations , 600 Washington Street M. , Boston, M4112111 n-vin r mass grivfdin Workers' Campensatinn Insurance Affidavit:Builders/Con tractnrsMectricians/Piumhers Applicant Infarmatiou Please Print Legibly �Name�'BvsmessX0 ganizafim&diddna1 7 D�A� r'1'Y�� ,J Awe. s: 'PO. GQ>e -7yS Phone r; ✓�'Cy •e an employer?Check the appropriate bow ' Type of project(required}: I am a employer frith 4. ❑I am a general contractor and I 6. ❑New construction loye:es(full and/or part-time).* have hired.the sub-contractors 2.LVJ I am a sole lxnptietor or partner- listed on the attached sheet. � 7- ❑modeling These sub-contractors have slop and have no employees. $_-❑Demolition wodring for me in any capacity. employees and have workers' INo umikers'comp.insm-ance comp-insurancf--1 9. ❑Building additio>g required-] 5_ ❑ We are a corporation and its 10_❑Electrical repairs or additions officers have exercised their 3.❑ I am a h,ome�v�er doing all work11.❑Plumbing repairs or additions ix) f [No washers'comp- fight of exemption per MGL 12-❑Roof repairs insurance required,]s c.152, §1(41 and we have no employees.[No workers' 13.0Other camp.insurance required.]' •Any spp&c=ewt cheft box#1 mush also Me=the secdoa below showing their waakere compmsationporky MfbrMZda3- #Mine urners who submit this af5d wA im catmg dray am doing all wow and thm him outside cantorctors must submit a new affidavit indicating such_ ' FCantcactprs that diech This bwE mast attadied sn additional sheet slowing the name of the sub-cautrartna and state whether or oat tbose entities ham employees. If the zub-contotctors have employees,theytmrstpmvidetheir workers'camp.palicynumber- lam an Below is the policy and job sue information Insurance Company Name: Me lk G �►-5 S. Policy lit'or Self-ins.Lice tk 510 9 212 0 Expiration Date: 7 /S !� Job Site Add,,- 121 )_1>v Nn/s A&C- Oed - I� Gity/statelzap:-�� �^�S /l�I�• Attach a copy of the workers'compensatioapolicy dectaratioa page(showing the policy num`laer 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$1,506A0 and'or one-yearimprisoumenk 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 tierification- I do hereby radii&miner t e is rtaI es ofFevuty,that the iaiformafion prm &d abm a is.brag avid correct 15 a Sr---isture-_ IiI7�ate: �� i / Phone Official use.mail Do not write in airs are .(j"a y a,to be cainpletned by taffy artown od4ciat " City or Town: PermitMicense if Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.'Other Contact Person: Phone#: Information and Instructions ; Massachusetts General Laws chapter 152 regaires all empIoyers to provide workers'compensation for their empIoyees. Pnrs�this stye,an elnplvyee is defined as."_.every Person in the service of another under any contract:of hare, express or implied,oral or writltn." An enTIoye1-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 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 t3ian three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do mamtmance,contraction or repair work on such dwelling house or on the grounds or building appurfenau:t thcretn shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)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 hnsnrauce.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor ray of ifS political subdivisions shall enter into any contract for the performance ofpublic work unfit acceptable evidence of compliance with the ius rrance.. requirements of this chapter have been presented to the contracting aufhodtyf = Applicants Please fill out the workers'compensation affidavit completely,by checkiag the boxes that apply to your situation and,if necessary,supply sob-contractors)name(s), address(es)and phone number(s) along with their certfi-cate(s)of in ance. Limittd Liability Companies(LLC)or Limited LiabfiityPartnm hips(LLP)with no employees other than the members or partners,are not required to cany workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this a.ffidayit maybe submitted to the Department of Industrial Accidents for confirmation of iIISZ rance coverage. Also be sure to sign and date the affidavit. The affidavit should be mtnmed to tile city or town that the application for the permit or license is being requested,not the Department of InAnstial Accidents. Should you have any gnestims regarding the law or ifyou are required to obtain a workers' compensafion policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sine that the affidavit is complete and pried legibly. The Department has provided a space at the botfom 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 permL t ceme number which will be used as a reference number. In addition, an applicant that must submt multiple p=ifillicense applications in any given year,need only submit one affidavit indicating currant policy iaformation Cif necessary)and under"Job Site Address"the applicant shoT?ld write"all locations in (city or town)-"A copy of the-affidavit that has beta officially stamped or masked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permit or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial vezlture (Le. a dog license or perni t to bum.leaves etc.)said person is NOT req�d to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number_ The CommmWealtlt of Massachu&F--tts . Departraent of lrid sal Accidents f ffice Of lvegtigafiaa!i 1500 wasbinzan Stzz Boston,MA 02111 Te,-L 4 617'27-49QO�t 4-06 or 1-977=IASS.AFE Fax#617-727-7M Revised 4-24-07 .ma-Z-90-9/dia Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Cbutractor Registration Registration: 181648 a _ Type: DBA Expiration: 4/21/2017 Tr# 264982 •��i DOUGLAS MANGANILLO F `e `eg- ------ -- DOUGLAS MANGANIELLO P.O. BOX 745 SAGAMORE MA 02561 c ✓ f _— Update Address and return card.Mark reason for change. -- y ❑ Address n Renewal 0 Employment Lost Card SCA 1 Co 20M-05/11 CJfae` a-nLrzoraauecrltf a�'G��nsamc�u.�erC� License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration: 181.648 Type: DBA 10 Park Plaza-Suite 5170 _ Expiration; 4i2-Ft�0.17 Boston,MA 02116 DOUGLAS MANGAN�LLOyt F ti DOUGLAS MANGAN�EI LQ " `' 1 152 CRANBERRY HVI/Y#7 — SAGAMORE,MA 02561 Undersecretary Not val► without signature .. R Massachusetts —Department of-Public Safet Board of Building Regulations and.Standaff boo ;ructcn S nervISM, License: CS-M91'2 Douglas R Mangan klo PO Bog 745 Sagamore MA 02361 t.. Expiration a Commissioner 03/05/2017 i j r / ►J J W RL 'Tv V5E- 'Ey j�rf` C, _ Tom&. Z J ( @ 2 I,rJT ��iGS Z� FouN�l�r�ow 6ALL - t�u��k P P�S�iJ ( Ac4z- eouair-b w� Z c-ou.rzs Now �LAux ell ell Zx'� Lto b,c wf 'n-PAtJb QOTIraK 16) o UO eft- lW wisIA1 M ..�..um.... ¢sCa�xM:u:FaW.t. Md`..rn. ..�........._... alp Dt,NN S AND ems' Ea`d y 1 (A-t\JNTS n ,ice j s ,�� G�jy��i�6r (gtA)6W'fi`P Poo l4`f d-IJNY5 � m r I-If s,06 C 717*111 ulI v� FOuOA u-ow WAS -- �us�k — P�P�S�:� (WA642- eourir-D Z Lourz s Now tam Lb d�G� w( ql -PA Jb QcYToK it's- wgfoa) Su P phi— 5Z'Ru�Tv( cu ic. o(. UPJD rs p- 14,?w 4 Al 0 t7lSNN S AND (z4)ol 1 �Y6 Pr' SILL - t odtr.- sr- iuF Al y �t3 Po, TIE 906 6XIEV L r.00'a 16 �+= K-�'(S7oN� 20 OAIS.;7�G i * DQQ zH Town of Barnstable Permit# SSI� Expires 6 mouths from issue date Regulatory Services F:{ Fee 9 MA� t 312014 1639. Richard V.Scali,Director F BARNSTABLE , Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 2-7 C) 0 Not Valid without Red X-Press Imprint C �.Map/parcel-Number 1 PropertyAddress-. QJ DU YV AI S PQN -ROAD ❑ Residential Val.`ue of Vork$ S O�O0 Minimum fee of$35.00 for work under$ 00 .00 Owner's Name&Address 1 J uuNr j �mb k mlwm S gn c � Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: Vamm a sole proprietor am the Homeowner:_-- ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) [ Re-side ' "TKI WL ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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&Construction Supervisors License is re ed. �. SIGNATURE: aza=ezzz QAWPFILESTORMS building permit forms\EXPRESS.doc Revised 061313 y ' The Commorriveal h of Massachusetts Ilepartrrrent ofbidustria1 Acddc x' (office oflirlaesgatotas y r � i 600 Washington Street Boston,JVA 02111 f rvtvmm g&v1dia '"corkers' Cumpensation Insurance Aida-Tit: Builders/ nti-actorsllt I ricians/Piumbe s Applicant Informatian Please Print Legibly .--121 �uny-�►S �a Yy7 �`� rGity/State p l Mtj 0 Q/Phone 47 S 2 9 2. �I � Are you an employer?itheck the appropizate box: Type of project(reqnued): 1.❑ I am a employer with 4.TD`I am a general contractor and I �.�.�� 6_ �New construction (full andior part-time)_* have hired the sub-contractors 2_❑ I am a sole proprietor or partner- listed on the attached sheet. y- ❑Remodeling ship and ba-ve no employees These sub-contractors have S_ ❑Demolition. working for the in any capacity- employees and have workers' 9_ ❑Building addition o worTo-ers'comp_i►r©r-Mce. comp_insurance l ecluiresi_] 5. ❑ We are a corporation and its 10-❑Electrical repairs,or additions ,-3NU,am a homeowner doing all world officers have exercised their 11_.Q Plumbing repairs or additions 'c of exemption per MGL myself.�o workers'comp- 1?_❑..Roof repairs insurance required.]^ c_152,§1(4),and we have no employees-[No workers' a El Other comp_insurance required] Any applicant&at checks box#1 r'm also fill out the section belowshossing theirworken'compensation policy info€mation_ 1 omemmers who submit this affidnit'iadicstmg they are doing all.wok and d Len hire outsi&contractors nmst submit anew ew a13Fd2rit m&cami.-me =C•ostracmrs th.^t check ibis box must attache3M an addmonal sheet showing the name of the sob-contractors and state whether or not those endues have employees. Ifthe subcontractors have employees,tlaeyxmistpmv de their workers'comp.policy number- lain art employer tizat is prosidurb a vorkers'congwnsaliort insurance for rrry etriployees. Beloiv is the poEcy acid job site iP3fOrrit(!llort. Insurance Company'-Nanw: Police A or Self--ins_I..icr 44: Expiration Date: 1166E Site Ad DVNNS ?o vV b itt�r teJzip_.--W/& tA/19 Attach a copy of the corkers'compensation policy declaration page(showing the policy mber and espn-ation date). Failure to secure coverage.as required under Section 25A of NMI,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 foam 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 fiotw-arded to the Office of Im-estigations of the DIA for insurance coverage verification_ I do hereby cent f r er the pains an vjah es o it.iy.tltattlte ircforruatioit pratided aboi a is trrae and correct " Phone;k: Official use only. Do not write in this area,to be completed by city or town ofcia£ � City or Toviu: P'ermidUcense 9 Issuing Authority(curle one): 1.Board of Health ?.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone# ----- - --- - - _ -. 6 a Town of Barnstable Regulatory Services �oFZHe roty,� Richard V.Scali,Director Building Division M NSTABLE, Tom Perry,Building Commissioner y MASS. 16;9•� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION /77 ! Please Print, DATE: I2// J L JjOB,LOCATION: �/ Du ry^1.5 Po r\j ZN &I-N N t S number street village 21q s)- I M name home phone# work phone# (CURRENT MAILING_ADDRESS: A)N N `®N)1 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 procedur s and requirements and that he/she will'comply with said procedures and requirements. `Si n ture of Homeown ` - 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:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 061313 t{1 y�FTNE 1p� * BARNSUBLE, '"`ASS. Town of Barnstable ArED MA'I A Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnsiable.ma.us Office:i �508-862-4038,, „ t, - j 4 ' Fax: 508-790-6230 a r , r Property Owner MustR Complete and Sign This Section If Using A Builder I, Owner of the sfibject property', herebyauthorize /to act on m behalf, Y in all matters relative to work authorized by this buildin ermit plication for: (Address of Jo Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\E)PRESS.doc Revised 061313 7' WI TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE Please print_ DATE _ JOB LOCATION • Number Street Address Section Of Town "HOMEOWNER" -------------- Name Home Phone Work Phone PRESENT MAILING ADDRESS .�SG�ntiP i y Town Zip Code The current exemption for "homeowners" was extended to include owner- occupied dwellincs of six units or less and to allow such homeowners to the owner acts as supervisor.engage an individual for hire who does not possess a license, provided that 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 to six 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 wort- performed under ti:c building permit. (Section 1C9.1.1 j The undersigned "homeowner" assures responsibility for compliance with the State Buildinc Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Departr„ent r inimum inspection procedu requirements res and i Fi03;EOF, ZEP,'S SIG'.;A1UrE . 7.PPROV�Z OP EUILDING OFFICI7-T, / Note: Three familydwellings ncs 35,000 `cubic feet, or larger, will be 4 - recuired to ccaply with State Building Code Section 127.0, Constructicn HOME OWNER'S EXEMpKON The code states that: "An Home Y Owner performing work for which a building permit is required shall be exempt from the (Section 109.1.1 - Licensing of Construction pSu Supervisors);of this section Home Owner engages a person(s) for hire to do such works provided that If- Owner shall act as supervisor.« . that such Home Many Home Owners who use this exemption are unaware that the the responsibilities of a supervisor (see A ' , for Licensing Construction Supervisors Section 2. 4 Y are assuming awareness often. results in serious ' Section 2 l5' Rules and Regulations ack of Owner hires unlicensed - Problems, particulailywhen the Home against the unlicensed person as it would with ons. In this case ur B Owner acting as supervisor i- ultimate Board cannot proceed Home licensed supervisor. . The To' ensure that the Home ultimately responsible. many communities require,Owner is fully aware of his/her responsibilities, Owner certify that of she understands permit application, that the On the last a r responsibilities of a supervisor.ome You ma page of this issue is a form currently used by several ows Y care to amend and adopt such a form/certi fieatien for use in community. your y ����- � } �1�- , �� ._�: � �i� i 1 � �� ., _� � . �.�. Assessor's office(1st Floor):. / Assessor's map and lot num � TIC SP�S�'• of'THEto` Conservation(4th Floor): . � ��ALLED IM CO P Board of Health(3rd f oo WITH 7I LE 6 t I'mu DLL Sewage Permit numbs Tit awRRONMENT 1L Cols" ^'a;q Engineering Department( rd floor): � I�/��, Tf�y��j � �� �L�j . House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO . TYPE OF CONSTRUCTION _ �-9 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit acco ing to the folio ng information: t Location 4v2d Proposed Use P[V OIL Z n Zoning District Fire District Name of Owne Address Name of Builder l'�--(o -7 Address t Name of Architect r Address �D Number of Rooms Foundation Exterior Roofing Floors rllq,. Interior Heating p Plumbing Fireplace IF!V Approximate Cost /'4 Area Diagram of Lot and Building with Dimensions Fee V 00 o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. °t Name s Construction Supervisor's License h WOOD, LOUIS r No 3Z-6 � Permit For ADDITION Single Family Dwelling Location "121 Dunn' s Pond ,Road Hyannis Louis , Wood Owner' Wood Frame. t Type of Construction -• r ` - Plot Lot t Permit Granted April 29 19 94 Date of Inspection: _ t Frame 19 Insulation 19 r �., Fireplace 19 Date Completed 19 t . 1 Assessor's office 1st Floor): ° 0 r � Assessor's map and lot number pi TME7p Board of Health(3rd floor): �M°' � �j �i �r r a' ' dQ �♦ Sewage Permit number ZSCc�d C7K �-'`2 CAD ENVIR'OMWE TA. . Engineering Department(3rd floor): TOWN REQU VAgdPLZ House number °o 039• Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only r TOWN. OF BAMNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 'Wo a6 19 21 t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location m,1 `� �nS �m�i C�• Proposed Use Zoning,District 9�- d-� ^ Fire District Name of Owner �C'� Address Name of Builder4N/A Address �/ �y �� �� `aw4 Name of Architect Address Number of Rooms ��Ca`� 0� '— '1V IL' Foundation C,nC ezL Exterior C✓h'TL �� � ���1fS Roofing As c�l) Floors Liao CIS Interior S�f e ! l,,o c Heating tn6o r Plumbing Fireplace Wane_ Approximate Cost 3Od i Area Diagram of Lot and Building with Dimensions Fee .7 � r �n7S aR - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re,ard' g the above c struction. Name i Construction Supervisor's License a,), 2o( WOOD, LOUIS P. ` .4 N 34-178 uild Addition Permit For r Single Family Dwelling vt Location. 121 • Dunn' s Pond Road - Hyannis R _ Owner Louis P. Wood k Type of Construction Frame , 4. + + Plot Lot Permit Granted February 20 , 19 911 45 ` ! Date of Inspection ssC11ia 19 ? �+ Date Completed �� � '19 av J , ,f ; ✓•. . .o..'" ., _ . .. v. -r-,V - .. r.,.-r.. �..i.w�r..j't.�, ti-v'ti"v� ..�.�.,r.��^•..C'�'..y.,...r�',-^-*--. .. < li.. . 11.E-• . '- -.}.�.'n..—fi F` -.Yti. Assessor's office(1st Floor): Assessors map and lot number —Qy/ I i c of THE To Board of Health(3rd floor): � )y�� r'C a L C Sewage,Permit number "^� t DA$39T►DLL i Engineering Department(3rd floor): ,, MAN& i House number �o 1639' Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only _ 4� TOWN OFF, kill BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION A Nz!�,-71 'Wo -Ad 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District Fire District 4r Name of Owner Address 1 \ -D "\In Name of Builder 1 v Address Name of Architect � Address v i Number of Rooms A `l On — G")C— Foundation C Onc e7e Exterior Roofing � \\ � ��t°P HOC Floors C_j000s Interior _ 1 Heating Plumbing iQ— 00 Fireplace Approximate Cost 35Od � I � Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regard4g the above construction. ' Name .�� Gnstructian Supervisor's License WOOD, LOUIS P. A=270-001 No 34178 Permit For Build Addition Single Family Dwelling Location 121 Dunn' s Pond Road Hyannis Owner Louis P. Wood Type of Construction Frame Plot Lot ` ' r Permit dranted February 20 , 19 1 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED i i i i I �O 17- } P .. r _ o � 6 E R � � i �} _.__. ._..�...- pC .. I r i i __ ` P�� __ �, � � 1 i i i i i ' V i I ', i I i 1 i t I `�: � '� I ./ /� �'� � �\ !p , !J � ,\�. 1 ' i �j �,ate b®��,�,��