HomeMy WebLinkAbout0033 BREZNER LANE s .
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Town of Barnstable *Permit# �- �-
'b Tres 6 months fr Issue date
Regulatory Services ee
yKAM � Richard V.,Sca%Director039.
® ,
o +" , Building Division
Paul Roma,Building Commissioner JUN O 2 2031
200 Main Street,Hyannis,MA 0269°
www.town bamstable ma us � � f �� �u`�I A B L F
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press I*rint
Map/parcel Numbet222J�6 6/6 c
Property Address. 33 , L c', /?
o Z673 Z
14 Residential Value of Work$ `� �� Minimum fee of$35.00 for work under$6000.'00 '
Owner's Name&Address S an
.. r
Contractor's Name / V QY_A_ Telephone Number -2j y 9 5
Home Improvement Contractor License#(if applicable) Email: ;s r
Construction Supervisor's License#(if applicable)
❑Workmaa's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner '
j I have Worker's Compensation Insurance-
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate niust:accompanyeachpermit. ,
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) -All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over . _ existing layers of roof)
® Re-side ' 7- . �S55-^v— Z
[� Replacement Winddws/doors/sliders.U-Value Z I {maximum 32)#of windows .
#of doors:
*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'. f
A co y of the Home Improvement Contractors License&Construction Supervisors License is
eq d:
SIGNATURE:
Q:\WPHLEMFORMS,building permit formATMESS.doC {
01/25/17
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Are you an employer?:Checkthe,apprngriate box: Type of project{refired}:
L❑ I mn a employer Frith 4. ❑I am a geu`ezal coatmcta r and I 6. ❑Idea*oomsfractiot�
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2.❑ I am a sale P1Dpi'•etar orP listed odthe attached sheet 7.,R Remodeling.
ship and hwe no employees These sob-co�ac.#ars Ise 9. ❑Demoliiba
waiing for me in 1 easployees andbave warts'
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officers have c=dsed i�r
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Fai-lnre to secom coverage as requimdnuder Section 25A of MOIL m 152 can lead to tiie imposition of criminal peaa113es of a
fine up to$1„54a OQ in&or orii yearimpfiso=Mnf as weg asciO penalties ffi the fazm of a STOP WORK OMERand a fime
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�VE TOVPn of Barnstable
s
Regulatory.Services ;
r sn IffAM Richard V.Scab,Director<
Building Division.
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.maus
Office: 508-862-4038 f. Fax: 508;790_-6230
Property Owner Must
�• t
Complete, and Sign This Section -
If Using A Builder,
l"' f• - J ,as Owner of the subject property
hereby authorize ltA� S f to act on mp behalf s
in all matters relative to work authorized by this building permit application for:
(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
ections are performed and accepted.
L
i atUre-of Owner Signature of Applicant" .
Print Name x +Print Name _
Date
QTORMS:OWNERPERtMSIONPOOLS
Town of Barnstable
Regulatory Services
pt< Richard V.Scab,Director
Building Division
K Paul Roma,Building Commissioner
6,1 a,� 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 - Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
DATE: AA
Please Print
•.JOB LOCATION: �� �G'P ,n-p T L A y1R
number street village
"HOMEOWNER": V` �'� S/»� ) 1 TC-Z►
- name home phone# work phone#
CURRENT MAILING ADDRESS: O� er I� /e r'� lz�
cityhown 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 au 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 un ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
prose d re ments and that h 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 wbo use this exemption are unaware that they are assuming thesesponsibili.ties of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section2.15) 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,ihe last page
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\btdldingpemitformsEXPRESS.doo
0620/16