HomeMy WebLinkAbout0034 NIGHTINGALE LANE '/ _ `_
f�"
��� �,
-- '�
.�- - - - _ �
.� ,. Town of Barnstable Building
t % Post This Card So That rt is Visible From t
;x. -�- ..,
he Street Approved Plans Must be Retained on Job and this Card Must be Kept
s , Posted'Until Final Inspection Has"Been Made
�axt" Where dCertificate'of Occupancy is Required,such Buis Idmng shall Not;be Occupiedunt�l a Final Inspection has been made
Permit
Permit No. B-20-331 Applicant Name: Paul Eaton
Approvals
Date issued: 02/19/2020 Current Use: Structure
Permit Type: Building-Solar Panel-Residential Expiration Date: 08/19/2020 Foundation:
Location: 34 NIGHTINGALE LANE,HYANNIS Map/Lot 311 047 Zoning District: HB Sheathing:
771
Owner on Record: HOWARD,CHARLES F Contractor.Name ,PAUL A EATON framing: 1
Address: 34 NIGHTINGALE LANE Contractor License: CS-088720 2
HYANNIS, MA 02601 AEst Project Cost: $27,000.00 Chimney
.Description: Install 8.19kw solar panels on roof.Will not exceed_roof panel,but Permit Fee: $ 187.70
will add 6"to roof height. 26 total panels. ` . Insulation:
q Fee Paid: $ 187.70
` Final:
Project-Review Req: 'Date." 2/19/2020
Plumbing/Gas
K
G Rough Plumbing:
s This permit shall be deemed abandoned and invalid unless the work a' l o "°' `` u rn icia
uthorized by this permit.is "com'�menc"' "e"d"within six months after iss an Final Plumbing:
All work authorized by this permit shall conform to the approved application and,the approved construction documents forwhich tlis.permit has been granted.
All construction,alterations and changes of use of any building and structures shalfbe in compliance with the local zoning by-laws and codes. Rough Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the,
work.until the completion of the same. al Gas.
Fin
The Certificate of Occupancy will not be issued until all applicable signat
ures bythe Building and._Fire Officials are"provided on this permit. Electrical
Minimum of Five Call Inspections Required for All Construction Work:
1.Foundation or Footing Service:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue linm is installed`
Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) - Final:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Rough:
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty.fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
Town of Barnstable Permit: dia f7/
Regulatory Services _
ate;(�
of THE T°� Thomas F. Geiler, ))hector
ti�P� do ee: '
Building Division ✓
} MA� Tom Perry, Building Commissioner"-
Q� 16391 200 Main Street, Hyannis, MA 02601
www.town.ba rnsta ble.ma.us
Office: 508-862-4038
TOWS OF BARNSTABLE Fax: 508-790-6230.
SOLID FULL STOVE PERMIT
Owner: lay-1dbu
� Phone:_ 6 �7I�
Install at: . SYN444�&
Village:
Map/Parcel: qj
Date:
Stove
'A. New
B. Type: Radiant irculatin�
C. Manufacturer: _5So Lab. No. Q
D. Model No.:
Chimney a
A. New/Existing (If existing, please note date of last cleaning)
Ca
B. Flue Size -1 F
C. Are other appliances-attached to Flue? `'
O cry
D. Pre-fab Type and Manufacturer #1 ?
Co
E. Masonry.; Line relined ; cr .
Hearth
A. Materials:
B. Sub Floor Construction: �..
Installer
Name; Address:
Phone:
Location of Installation:
H.I.0 Registration#
Construction S rvisor#
OR check VHoffieowneT Installing, no license required...
APPLICANTS SIGNATURE
APPROVED BY:
Please make checks payable to the Town o Barnstable
*This constitutes an.official stove permit after inspection,photographed, and approved the
Building Inspector y
1%ie Comrrianwealth.OfMassachusetts u
Depa�tntent of Industrial�ccidenfs
Office of lmestia-ations
600 Washington street.
Boston,MA 02111,
www.mass.gov/diu
Workers" Compensation InsurAnce Aff.Idavit: Builders/Contractors[Electricians/Plnmbers
A Ucant Information .Please Print Le ' l
Name(Business/Orgauizadon/Individual): , &
Address: 14 A) 6� � 721�L ���A� '
City/State/Zip: (ALA _ 114 A Phone.#: � "�y`'�✓ _ �
Are you an employer? Cbeckthe appropriataboa: :Type of project(required):
1.[] I am a employer with 4. [] I am a general contractor and I 6 Q New construction. .
employees (full and/or part tine);* • have hired the stib-contractors
2.7 I am a'sole proprietor or partaer- listed•on the:attached sheet 7. Q Remodeling
ship and have no-employees These sub-contractors have 8. ❑Demolition
working for me in any capacity, employees and have workers'
[No workers' comp.insurance cGMp..insurance,$ 9. Binding additi
rkers on
5. [] We are a corporation and its 10.❑-Electrical repaas;or additions
3. am a homeowner doing a7.l-work officers have exercised tbeir I1.0 Plumbing repairs or additions
myself [No workers'comp right of exemption per MGL IZE]Roof repairs
insZrrance required.]t c. 152, §10), and we have no 13.❑ Other. '
employees. [No workers'
cozap, insurance required]
*Any applicant that checks box#1 must also M out the section below showing their workers'compeosation poficyinformation. -
t Homeowners,wbo submit this affidavit indicating they are doing'ali work and then hire ou tside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additiaaal shoat showing the name of the$ub-contractors and state whether arnotthose entities have
ernployces. If the sub-contractors have employees,they must provide their workers'comp.policy number.
ram an e7nplayer that is providing workers'compensafivn in for my employees Belaw is.ihe policy cUsd job site'
information.
Instn ance Company Name:
Policy#or Self-ins.Lic.#: Expiration Data:
Job Site Address: city/State/Zip:
Affach a cnpy of the workers'compensation policy declaration:page'(showing the policy number and expiration date).
Failure•to sec -e coverage m required tmder 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 imprlsonment, 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 DIA for cnr ince coverage verifi
i-n cation.
Ida hereby certi fy under fhepains andpenaltFe of
perfury that the informatfaxprgvided above is true and c07ec4
Si tore: Date: 6
Phone 4; 7 7�&0`&Z26-97`f
orcial-use only. Do not write in.this area, to be completed by city ar tarn official
city or Town: Y ermit/License#
Issuing Authority(citde one):
A,Board of Health 2.BuildingDenartment -1. OfvPTnwn.f ia,-lr d Tta.,+,; ,r, a r b,__L._- r �
Q. jWho is responsible_for making application for the
;permit? - -
Application for a permit is required to be made by the owner or lessee or
their agent of the building (e.g.; the HIC-registrant ). if application is made
other than by th•e owner, written authorization of the owner must
accompany the application. Such written authorization shall be signed by
-the owner and shall include 'a statement of ownership and shall identify the
owner's authorized agent, or shall grant permission to the lessee to apply
for the permit. The full names and addresses of the owner, lessee,
applicant and the.responsible officers, if.the owner or lessee is a corporate
body, shall be stated in the-application.Please note: It is the responsibility of the registered HlC to obtain all .
ermits necessary for work covered by the Home Improvement
Contractor Registration Law, M.G.L. c 142A. An owner who secures
his or her own permits for such shall be excluded from the guaranty fund
provisions as defined in M.G.L. c. 142A.
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Q. �My contractor told me I need to obtain the permits for.'
my construction. May I obtain the relevant permits froml
my local building department or is the contractor,'
Ireq wired to do that?I — --- _-----While you may certainly obtain your own, permits, be aware that if you do,
you will fall into a homeowner exemption that will disqualify You from being.
eligible to receive recourse through M.G.L c. 142A, the HIC Law, or the
statutorily authorized GuarantyFund, should a roblem 'p arise. it is the
responsibility of the registered HIC to obtain all permits necessary for work
covered by the Home Improvement Contractor Registration Law, M_c
142A. If the HIC you are contracting with refuses, you may wish to
reconsider using that contractor's services
DIME T � Town of Barnstable
Regulatory Services
BARN9STABjE Thomas F.Geiler,Director
.19.
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www4own.barnstable.ma.us
Office: 508-862-4038 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.
(Address of Job)
**Pool fences and alarms are the responsibility of the-applicant. Pools
are not to be filled or utilized before fence is installed.and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
Q:FORMS:OWNERPEPMSSIONPOOLS 6/2012
��t T Town of Barnstable
Regulatory Services
B Mtsznsr,E, : Thomas F.Geiler,Director
9 MASS.
i639• 6..�� Building Division
rFD MA't i
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
Q l Please Print
DATE:
JOB LOCATION: 13Y a�number' �yVI��PLt�Q �-� (�!
nu' str village
HOMEOWNER": &Wa 77y 36 IF .
name ' ( home phone# work phone#
�jt l d
CURRENT MAILING ADDRESS: ` V '10�T(Vl f f/-i [aR xc
\Ij V
!f 44 ® d`
ity/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:forms:homeexempt
Towla of BarnstaIe erm;t:
Regulatory Services ate;
woe rye T°►s� „Thomas F Geiler, Director
yw� ° BuYlding Division
y
AARNMass.BLF Tom Perry,. Building Commissioner
x679 200 Main Street, Hyannis, MA 02601
w ww.town.ba rustable.jna.us
Office: 508-862-4038, :
Fax: 508-790-623 0
TOWN OF BARNSTABLE :.
SOLID FULL STOVE. PE '
i
Owner: Cl�"� - V
7 .
Phone:
Install at: 14 tte Village;
y
MaplParcel• f) Date;
Stove
A. New-/ sed -
B. Type: Radiant irculatina
C: Manufacturer:SSC�
Lab.
No. ��, N 6-
D. Model No.: U✓ .
Chimney
A New/Existing.,(If existing, please note date of Iasi cleaning ' ; ;fl
B. F1ue:Size 1 F 2 ,
C. Are other appliances attached to Flue?
h G7
D. Pre'-fab Type and Manufacturer
E. Masonrx: Line " .
mined M
Dearth
A. Materials:, . ur Y44c. : I 'l ,
B. Sub Floor Construction:
Installer
Name: -
Phone:. .
Address:
Location.of Installation:
H.T.0 Registration.#..
Construction S ` rvisor# t
OR check-_Homeowner Installing, no license required
APPLICANTS SIGNATURE
APPROVED BY:
Please make checkspayable to the Town o Barnstable
*This constitutes an.official stove permit after inspection,photographed, and approved by the
Building Inspector.
The Town of Barnstable
Department of Health, Safety and Environmental Services
= Building Division
MAM
639. �.� 367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Home Occupation Registration
Date: // 7,
Name: vo
Address: Village: _
Type of Business: 400l 6-MOWI�Map/Lot: 3
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: -
C"n Date:
FEB-13-97 THU 12 :21 AM SOUTH'S. SUPREME-. COFFEE 508 862 0674 P. 01
_oAk.4A- . _'� ..coo c C w a.""At
)Itc f 5
r_ .. .._ .... _..._ .._ ...
�VEri The Town of Barnstable
Department of Health, Safety and Environmental rvices
1 •WrABLL Building Division
MABI
367 Main Street,Hyannis MA 02601
Office: 508- 90-6227 Ralph M.Crossen
Fax: 508-7 0-6230 Building Commissioner
Home Occupation Regis on
Date: (0
Name: M1 1 EA Phone#• b 'd IS
Address: '3"f Iv G- -t )N G'N Le-- L Village:
Type of Business•'/L ZASt'"`Map/Lot• .3/ —D y
INTENT: It is the intent of this se 'on to allow the r idents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject the provisio of Section 4.1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from o ide the dw g: there shall be no increase in noise or odor,no visual
alteration to the premises which would s st an g other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air dwater pollution.
After registration with the Building Inspector, customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by pe anent resident of a single family residential dwelling unit,located
within that dwelling unit.
• Such use occupies no mor than 400 sq a feet of space.
• Tliere are no external alt ..ons to the d llingwhich are not customary in residential buildings,and
there is no outside evide ce of such use.
• No traffic will be gene ed in excess of norm residential volumes.
• The use does not inv ve the production of offe ve noise,vibration,smoke,dust or other particular
matter,odors,ele disturbance,heat,glare,h 'dity or other objectionable effects.
• There is no stotabe r use of toxic or hazardous rials,or flammable or explosive materials,in excess
of normal househ d quantities.
• Any need for p ' g generated by such use shall be me on the same lot containing the Customary Home
Occupation,an not within the required front yard.
• There is no erior storage or display of materials or equip ent.
• There is no mmercial vehicles related to the Customary Ho a Occupation,other than one van or one
pick-up not to exceed one ton capacity,and one trailer no to exceed 20 feet in length and not to
exceed 4 ' s,parked on the same lot containing the Customary ome Occupation.
• No signs be displayed indicating the Customary Home Occup 'on.
• If the tomary Home Occupation is listed or advertised as a busine s,the street address shall not be
includ
• No p on shall be employed in the Customary Home Occupation who not a permanent resident of the
dwe unit.
I,the undersi ed,have read and agree.with the above restrictions for my home occupation am registering.
Applicant Date:
Homcoc
oc d
06/19/2007 09:12 15087906230 BUILDING PAGE 02
Town of Ba rnsta.ble "permit#��-j6--3gfjD
E*&M 6 moAft from twee date
Regulatory Services Fee
Thomas F.Geller,Director
Building Division
Tom perry,CSO, Building Commissioner
200 Main Street,Hyammis,MA 02601
wtww.town.barnstablo,ma,us
Of oe: 508.8624038 Fax: 508-790-6230
EXPRESS EERb•TI'I'APPLICA' lON - �LESIDENTI"ONLY
,Not Valid withow Red X-freso fmprW
Map/parcel Number cm I 041
Property Address .3 ,N i a h-konacLL t-tv ja n t,,- MA 0 2-&D i
#
YResideutial Value of Work 3800- LTD Mulmum fee of$25.00 for work under S6000.00
Owner's Name&Address W OLI+er ,-- G l o waG1C.1
^P.o. fox a8 Naniilckf _ M.A. oa51-
Cowactor's NamaNNa +R r .T 61 a Wa CSC-' &,-qxS Telephone N=ber5SB o lB 11` 9(p
Home Improvememt Contractor License#(if applicable)
Construction Supervisor's Liceme#(if applicable) 0)
IT
❑Workmaals ConTensation lnsurauce
Cheoko e. JUN 2 6 2007
a sole proprietor
atn `e Homeowner TOWN OF BARNSTABLE
0'l have Worker's Compensation Insumuce
tnstiranee Company Narme Z U r It C�l 1 V OY`�l L?.1'l C.L�.�f�L
Workmen's Core.Policy* CD ZZ U13 J' 13 y 5 0-il a(e
Copy of rnsurance Compliance Certificate[must be on file.
Permit Regt:est(check box)
Re'sMf(stripping old shingles) All eonstruatiao debris troll be taken to 1Bae ll s I
'❑pwroof(Dot stripping, Goimg over exiating layers of roof)
❑ Re-side
�] Replacement'9+rindowstdoors/sliders. U.Value_d (1nWdnn m•41)
''V, Mt required: Issuance of this punt does not exempt camplianee with other tovm dcparuwt regulations,i.e.Historic,Conservation,etc,
t— Note: Property Owner must sign property Owner Letter of Pe i"'Sion.
A copy of the Home Improvement Conftet9ee 0 =k a A�uGd
SIGNATURE:
';Forms:expmtrg
rtaviaei3613D6
06/19/2007 09:12 15087906230 &ALDIN6 PACE 03
} ?'he Comm itweakh ofMdmAwhasetts
- DepartQze'nt of Lmd'ast�'iaT Acchtents
tpjae oflvvW*adoxs
' 6t0 washingfon MM d
Bonwi,4 MA 02111
www massgouldia
Wori ears*Compensation Ynsurance.Mdavlt:Buflders/Contractors..Tlectricins/Plumbers
Ats»llmt Information Meese print Leeibiv
Name(B„iA0W g=bWAiQAft(cvi&dY /►! I ,r ) (�I o a[,b nt. d so A S C,
Address• t7 -k 14L0 Q
City/StatelZip•_Na of-uOCCr YY1/ 02 b�)Phone.#: G-19,f3-• I,39(o
Are you an oyw?Chat the appropriate box: Type of project(required):.
1. I ..._—T 4. (�I cal a general contractor and I
a eraplcyer w&es 13t11 ant tme • have hired the bra 6. ❑New construction. .
( P )• lismd oa ttaa attarbed e3zeet. 7. [I Remodeling
2. 1 em a kole proprictor or psrb=- 'These sab•coat<acmrs have
ship and helve no ertsployees $. ❑Dcmelitiaa •
form in eml►loP�and have vvadrns'
working anl'�eapwitty. Camp. t. 9. []Bufldiuu�ad8i#ien
a ���• We ame a caaparsAm and its 10.0 Elachiml repairs or additions
-]'3- lam ahot�aavveer dtun3 tul vvorl€ officare have�dM it l l.[]P mg repairs or additions
:a❑ )Uz[No wort a ,camp- sight of exemption pea MGL 12. of repair$
Wince rogtraed.j t e-152,¢1(4),and we have no 13.[.[Other
MplOYM•yo arorkece'
camp.i wmw rbgtt m&
-Any wph mt that shaft box 01 mutt tau M out des smtioa below showing thoi WOWM'aompmadon policy intmtnation.
t Homeowners who Dub*this affidavit bdiming okay M doing au work and then hire outside conbradan roust submits:new aiSdrdt indicatbag'such.
t dntmatm ibet check tlds box=d atuhrA en addidund sbeet abaftg Uw none ofthe sub.eontractms and Me wbediv or not those entitles have
emptoyeu, Hthe nUb-oo uumtxbere employee.tsayttt pwWdatheir w*rkm'coup.poticyaumbw
ram an s�ttpioyer Beat is providing workers'cotnpeeYsatton tdsurance far my aneplayees Batew ts.tke policy and Joh site
tqforma*'%hjsu =CompauyName: Z Ur I < d r++-) A-M CX I.C Ol.a_
Policy#or self-ins.Uc.* 4-2 Z - U lb 63 L4 3 C 4 a(o ravisation Date:
Job Site Address:_�� !•O hf 1 1-CLi't.2 CitylStateJZip:-- i11.� 0?1'O1
n policy deer anon page showin the policy aua* r and expiration date),
Attach a copy of the workers etsmpeosatio p cY ar p g ( g p �' ;p )
Feilwo.ty sewaa cevezage as req*ed=der Sectim 25A of MCM c. 152 can lead to the i, Wosiiion of tzdaainal pWald0a Of a
fine dp to$1,500.00 and/or one-year hqaaumment,as wad as civil panakies m tlm form of a STOP WORK ORDER,surd a fine
ofnp to$250.00 a day against*vk1dar. Be advised.that a cagy of this=k merit maybe forwarded to the Offim of
)�vtsti- �f t3re DIA for iaaureast coycraaaveztfication.
l do him*ceno:/Lariat the paba-and penarld M Of palwy that this lnfammfOts pra►AW abOW I t ilm and dvrrmt
Sipattzce �// �GC , ��`TJ� Date: �"o�� ` Q— —
139 G
rrse o o sot� tJtit;sues&td be Comp cKy ar towA a,�9Ctat
City or Town: PermiMicmae k
?sit Anthorfly(circle one):
1.Board of Beaiklr 2.awldU g Departivent 3.C•ttyll'own Clerk 4.Mectrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
06/19/2007 09:12 15087906230 BUILDING PAGE 05
<r . Town'of Barnstable
Regaalatory Services
'Thomas F.Geilwr,Director
' Builtffng Division
Tam Perry,Suiiding CommL4siioner
200 Main Street, Hyannis,MA 02601
www.town.barnstablema.us
Office: 509-962-4038 Fax: 508-790-6230
1 0bWOWI`PRItLIMNSR LMMMON
// Please Print
DA:B: n l0 I C1-orl
JOBLWATION: / U 1 5��`��P
awnber atreec 41age
,1xol,SOWNEW': r�l 6o s-alas- 39
nam lto=ph=# workpbone*
CURRENT PdAI-WOADDRESS' Y'c -6D K 903 -- --- -
N axIiI&Ck Lk MA
aityltovss t state sip code
The current cxomption for I%= "was extended to include gw„%,w-occ}M�eA LVje U of&ix units or less and
to&now homeowners to angage an individual for hire who does not possess a license,aQ Id that the.owner acts a&
— DzPr4n=QN or HOMOWNW
Persons)who owls 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-famUy dwelling,attached or detached structures accessory to such use and/or.farm-structures. A
person who consttucts more than one home in a two-year period shall not be considered a horzoo-omer. Such
"homeowner"shall submit to the Building Ofaciel on a fo►ua acceptable to the Building'06rW,that he/she shall bg
resoMIlo fox all such weak porPo=d ttndetc the buildinn Run iUSeotion 109.1.1)
The undersigned"homeowner"assumes rosponstbility for compliance with the State Building Code and other
applicable codes,bylaws,rules and reguladol.u.
minimum inspection procedures atsd requiremelate and that he/she vqM comply With said procedures and
signature of Hamaownly
Approval Of auOding Ohtctal
Note: Throo-fam4ly dwollinga containing 35,000 cubic feet o:larger will be required to comply with the
State Building Coda Sectiom 127,0 Cmtracttion Control. .
SOMEOR'M'315RFtvMON
The Code states that "Any ba=owncs perfinmie;wort:fbrvWch a btitidtng ptstrdt is required sball be exempt from do provisions
of this etmtion(Section 109.1.1-Licensing of conabuctloa SupeMaam);provided that if the hameow.=eagasu a person(f)for hire to do sueb
work that stub Hoineowmer shall act as supervisor."
mxW homeowners who use this exetnpdon am unaware that they as assumlrtg the rerponsibiliaes of a supervisor(see Appendix Q,
Rules&Regnlatitms for Ltesadng Construction Superr`.sm,Sedan 2.1S) This laekof awarenss ohan mutts in serious probinns,particularly
when th htmteowoer hires unlimsed persona. In this case,our Board catutotp w-A against Lhe%9Hccu3cd pemo'z as it would with a licensed
Supervisor. Tho bmaeowner acting as Supervisor is ulthmulyresponsible.
To ensare that Ste 11MMem rter is My aware of his/her respoasi .Was.nmy co[mmaides require.as part of the perrrdt appliesdon,
that ibehorneawmer certify that be/abe ur)dcratasds the resparsiMTJcv of a Supervisor. On the lutpage of this issue is a?arm ewmtly used by
several vom. You may care t amend and adapt such a foraoloati5cation for use in your cournunity.
Q:fOrnts:botncexrmpi