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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
- �
Map Parcel (� 13 IlJl, ',Application #
Health-Division Date Issued l
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board 9�lll10:
Historic - OKH _Preservation / Hyannis
Project Street Address .-PI-) Ct
Village 1 tt Vawv� s In r I "
Owner C�ilSy� ��'c�T► ��i�•.�. Address
Telephone 'S66 N_-)-
Permit Request rp,_AA_<t_ wi'/`.A ,Js
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Typek
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: Z 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 ❑ U JCT
Commercial ❑Yes ❑ No If yes, site plan review# SEP 1 `4 R
_= "Current Use - _ Proposed Use
F ey
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name_76� Telephone Number ��
Address.k!z $ _,�.,. -, License # C-S S z-o
� Home Improvement Contractor# Stu L
Worker's Compensation #
I RE FROM THIS PROJECT WILL BETAKEN TO ALL CONSTRUCTION DEBRIS RESULTING SU
SIGNATURE DATE ! (
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FOR OFFICIAL USE ONLY
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(APPLICATION#
-DATE ISSUED
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L."MAP/PARCEL-NO.,. _
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t-ADDRESS VILLAGE _
OWNER
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DATE OF,INSPECTION:
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T_,`FOUNDATION
FRAME
"INSULATIONA' fs s' '► '-'L
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FIREPLACE
ELECTRICAL: ROUGH FINAL
4 PLUMBING: ROUGH FINAL
:GAS:; GM � ROUGH : F FINAL
i)R-FJNAL BUILD.ING'.�t:
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ASSOCIATION PLAN NO.
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AL
OF THE 1p�
+ STABLE, i
9� 36g9." Towri' of Barnstable
♦�
ArfD WW'1 A
Regulatory Services
Thomas F. Geiler, Director
eti Building Division
Thomas Perry, CBO
y Building Commissioner
200 Main Street, Hyannis, MA 02601
t wwwrtown.barnstable.ma.us
Office: 508-862-4038 � Fax: 5.08-790-6230
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Property Owner Must
Complete and Sign This Section
If Using A Builder
f
as Owner of the subject property
hereby authorize KP to act on my behalf,
s
in all matters relative to work authorized by this buildir permit application for:
�i 0 I
(Address of Job)
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9 .
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Signature of Owe �, Date
OAi
Print Name fL
If Property Owner is applying for permit, please complete the Homeowners License Exemption For'rrI on the
reverse side.
Q1WPFILESTORMSIbuilding permit formsFEXPRESS.doc ,
Revised 072110
��ol► To,,ti Town of Barnstable u
Regulatory Services
� k
* ^lyA BLE. Thomas F. Geiler, Director
.� tAss. �,, ,
cbprQ 9. N. Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnsta ble.ma.us
Office: N8-862-40 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTI N
Please Print,
DATE:
JOB LOCATION:
number street - village
"HOMEOWNER"
name home phone# work phone#
CURRENT MAILNG ADDRESS:
city/town state. zip code
The current exemption for"homeowners"was extended include owner- cupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does no ossess a licen e, provided that the owner acts as supervisor.
DEFINI ON OF HOM OWNER
Person(s) who owns a parcel of land on which he/she resides intends t reside,on which there is, or is intended to be,a one or two-
family dwelling,attached or detached structures accessory to su use a d/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner, ch `homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be res onsible all such work performed under the building permit. (Section
109,1.1)
The undersigned"homeowner"assumes responsibility for complia e with e State Building Code and other applicable codes,
bylaws, rules and regulations.
The undersigned"homeowner"certifies that he/she understands e Town of Barn ble Building Department minimum inspection
procedures and requirements and that he/she will comply with id procedures and re irements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35 00 cubic feet or larger will be required to co ly with the State Building Code
Section 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performin work for which a building permit is required shall be exempt from th provisions of this section(Section
109.1.1 -Licensing of construction Supervisors);.provided tat if the homeowner engages a person(s)for hire to do such work,that su Homeowner shall act as
supervisor."
Many homeowners who use this exemption a unaware that they are assuming the responsibilities of a supervisor(see Appen ix Q,Rules&Regulations for
Licensing Construction Supervisors,Section 2.15) Thi lack of awareness often results in serious problems,particularly when the homeo er hires unlicensed persons.
In this case,our Board cannot proceed against the un 'censed person as it would with a licensed Supervisor. The homeowner acting as Sup isor 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
adop,such a form/certification for use in your community.
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 072110
A,
�„�•""'• TOWN OF BARNSTABLE permit No. _______-_21117-
1 11A""YL a Building Inspector Cash ___--
� rua
OCCUPANCY PERMIT Bond
No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."'
Issued to Lebel—ShJLelft Const.- Address '
Bui l ding 11, T Tn-i_t A Rt 9 nI d Ai 3 T Rnnfi
Wiring Inspector ��2x, Inspection date
Plumbing Inspector 0, { � _ Inspection date
Gas Inspector v Inspection date
Engineering Department f Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
19
y�/ Building Inspector