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HomeMy WebLinkAbout0075 MAUREEN ROAD s... .. o � �, T,. ,. ,, .. .. . ,�_ .. ., ,. ,. �.. �. ,. ,, �, ,.. n � #. x, ,. o � r ;, _ �. ., . . - ,. �. . ., , ,. ew' � .: �. 9 y . _ � .. .,; .: w ; � � ., o ;. ,. ., .. ;; .,. �: F .� �. .. .. �„ . .. . ,, ,o .� . � r, . . . . p .. .. _. a'. ' '' L ' '� -.. :. ., „ Y i„ �. . 'r:. i. �'• r'� 1� ,. � - .. i .,. .. .' _ .. .. '., � .. 4 �+ . .. ' �. -, � � .- �.. - , 4 ;� � "-� ��. - � � .. ' :';_ .. -.r y n .. :� '- � ..: ', � .. a � i b .... C.. � � ✓ "... � .. d'y" y .:.e. ,. �. .. x �... �, .. .. ,. .. x � . .' ....� � .. � n. a .V,.:. - .. .' .. �:. E y. n � � � �_. i r: �,.... .. _. ,. .._ m. ,. w .. ,, <. ,. - -, �.. _ -. r r. v. �� a. ., ,. .:x - ,; >,.�° �.. :� �� � . a„ 'R .. .. _ .. a + .. � �. ,�. .v �. .. - .. a. - � - � �. .' :. -. .� ., - � .. _ .. .. S � d ,� S ��'� _ _ - �. 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'Phone Number _•�'. 7 y -236 c.)-zeG Email Address:h61%r,.to D/A*- & 6;5.��.,1 cam... Cell Phone Number /•i 7'V -• 3 -o L E'6 Project cost$ oGo. r, c> Checkohe Residential Commercial 'OWNER'S AUTHORIZATION As owner of the above property I.her authorize- ' �` .0 Iv ems' , to make application for a building permi accordance with 780 CM.R Owner Signature: -�,., Date." �= 2c - "; s TYPE OF WORK , Siding Windows (no header change)# insulation/Weatherization Doors (no header change)# a Commercial'.00rs require an inspector's review Roof(not applying more than l Mayer of shingles) Construction Debris will be going to : G h: S:fie, CONTRACTOR'S INFORMATION S Contractor's name Home Improvement Contractors Registration if a licable # CGS a attach co p_ ( PP ) ( P5) , Construction Supervisor's License# /G S� rc1.��' (ahtaeh"copy) E Email of Contractor. D Phone number,,. ALL PROPERTIES THAT HAVE STRUC�TU iE—S.01 ER 75 YEARS OLD OR IF THE SUBJECT PROPERTY,IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN,BE ISSUED. APPLICATION NUMBER :.......................................................... *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach.floor plan with exits marked) :Dimensions of each Tent X X'� X Additional tent dimensions can be attached on a separate piece of paper: Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No - Flame Spread Sheet of each tent must be attached.Provide a site plan with the location.(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am.or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. i Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION ' Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Dates ! 45? All permit applications are subject to a building official's approval prior to issuance.' Construction Supefvisor 1&217an ily Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1000 Washington Street -Suite 710 Boston,MA 02118 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl Not valid without signature Commonwealth of Massachusetts Division of Professional Licensure Office of Consumer Affairs&Business Regulation Board of Building Regulations and Standards HOME IMPROVEMENT CON TRACTOR Con struction,$'n�er Aiior,1 & 2 Family TYPE Individual Rears— t__ ration Expiration CSFA-105994 EApires: 10/23/2019 168722 05/14/2021 ` ✓_ DANIEL O'NEI14 LL r D/B/A DAN L O NEILL CARPENTRY DANIEL O'NEILL 361 MEGAN ROAD DANIEL O'NEILL •.HYANNIS MA 02601 k*` i 351 MEGAN RD T 0I HYANNIS,MA 02601 ,rt Undersecretary Commissioner ��1R-� _............. - - Commonwealth of Massachusetts ictlo�,��, Division of Professional Licensure Constr�rctio 'u ur �1 i f� office of Consumer rrs usi anon Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR TYPE:Individual Construction,S4A� �� i;1 & 2 Family Reais_____ration Exuiration } 168722; 05/14/2021 CSFA-105994 E pire5: 1012312019 Registration ivand for rndivrr dual nl y DANIEL 0 NEILL before the exprra rn o:fion date.. D/B/A DAN L.O'NEILL GARPENTRY DANIEL O'Wg6ce of Consurnek Affairs ari s` t ashrr s R gulation 361 MEGAN �� gton Street Sui 71 ? /) HYANNIS M,&*$dr1MA'.OZ1T8 DANIEL O'NEILL $'. 351 MEGAN RD j )/4~":i t� . FaiOW O"ks Hurrent edition of the W 949WOR& State Building Code is cause for revocation of this license. For information about this license Commissi Call(617)727-3200 or visit www.mass.gov/dpi Not valid without signature � i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 600 Washington Street - - Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ..•� L !� NQ� / C q Lr cs Address: City/State/Zip: G,h/C ' 4 1 Phone #: �' 3 3 ;7 /,Q Are you an employer? Check the appropriate box: Type of project(required): I am a employer with '1 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.t required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. Other comp.insurance required.] F. *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such: #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ✓ sso C-/Z f7a tl.�� •-.,!�...cr CAA-- Policy#or Self-ins. Lic.#: WC s�5_yl c-?o /1�0 4,+ Expiration Date: Job Site,Address: IS, Allel-c✓C c &d City/State/Zip: cep�ti,!/e .�/�.�Q.Zc 3 Z Attach a copy of the workers'compensation policy declaration page(showing the policy number 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$1,500.00 and/or one-year imprisonment,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 verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: -- - 1 �� Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DANILON-01 CLEDDUKE '4�ORo CERTIFICATE OF LIABILITY INSURANCE DATE / 09/2828/2018Y) 018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 (A/C,No,Ext): (A/C,No):(877)816-2156 South Dennis,MA 02660 ED REss:mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Associated Employers Insurance Company 11104 INSURED INSURER B: Daniel L.O'Neill DBA Daniel L.O'Neill Carpentry INSURERC: 351 Megan Road INSURER D: Hyannis,MA 02601 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LT I S D MM D MM D LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED PREMISES Ea ocartence $ MED EXP(Any oneperson) $ PERSONAL$ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PEC LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB H•OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED F RETENTION$ $ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE WCC50050162012018A 07/12/2018 07/12/2019 1,000,000 OFFICER/MEMBER EXCLUDED? ® 141 A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TION DATE THEREOF, For informational purposes only ACCORDANCE WITH THE POLICY PROVISIONSCE WILL BE DELIVERED IN AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUI&ING PERMIT APPLICATION Map Parcel sic Application #k Health Division " Or- *,I T14as Date Issued:; Conservation,Division Application F Planning Dept. O P ermi t Fee Date Definitive Plan Approved by Planning Board Q41 A . Historic - OKH _ Preservation / Hyannis Project Street Address V Village C-0_n+-e r�`�, Owner Ce_e� tAA n r"AAn Address '_76 •01&U f"-C_ Telephoned Permit Request fWevi d- ck—e- 5Lvx 12 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation J10, 0 a ja 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'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: 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 ' (BUILDER OR HOMEOWNER) Name Se-4.ri V f 4t A M Telephone Number Address -75 Mv reen Xc License # 4.-ne 0 w Vn Pam' Home Improvement Contractor# Email Worker's Compensation # f_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ems'— DATE - �-�I� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ` the Uarsuawrtweaan afmassacnuseuy =u.. Deparhnent of Industrial Accidents ; Office of lnpesfigadons 600 Washington,street Boston,lfA 02111 k, wwmmass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/EIectricians/Pimnbers Applicant Information Please Print Legibly Name(lit ness/Organirafim&divi&4: n r Address: _7 S /n A L4.,r ee� C t Mate/Zi CP.�v`�'e.c'�/ �A c9'21( 32, Phorie#: ?q e{`-2 3�-0 2 P- Are you an employer?Check the appropriate bow - _ d I Type of project ui 1.El I am a employer with 4. ,I ama general ca&actor an - 1 employees(fall and/or part-time).* have hired the sub-conirac Drs 6. ElNew constm&fion listed on the attached sheet 7. Rhode" 2.❑ I am a sole proprietor or parts=- Q ship and have no employees'. These sub-sous tors have 8. ❑Demolition + working for me m ally capacity employees'and have workers' [No workers'comp.incnrance comp.ins�uance 9. El Building addition ' Z.required] 5• ❑ 'We area corporation and ifs 10.❑Electrical repairs or additions officers have exercised their I am a homeowner doing all work LEJ Plumbmg repairs or additions myself: [No woriceis'"comp. right of exemption per MGL 12.❑Roof repairs ' iamn-ance required_]t ,,c:152,§1(4),and we have no eutploYees.[No'workers' 13.❑Other' _ comp-msorance requited] *Anyapplicant that checks box#1 must also B1 out the section below showing their workers'compensation policy information. t Hnmeowners'who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such_ $Contractors that chick-this box must attached an additional sheet showing the name of the sub contrzctors andstd-_whether or not these entities have cmployeis.If the sub-contractors have employees,they mustprovidc their work='comp.policy number. I am art employer that is provitg workers'•compensation insurance far my employees Below is the poLL7 and job site ixformitfzon ., _ f+ Insurance Company Name: " Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: City/State/Zi Attach a copy of the workers",compensation.policy declaration page,(showing the policy number and expiration date). Failure to'smire coverage as required under Section 25A of MGL c: 152 can lead to the imposition of ci�inal penalties of a tine up to$1,500.00 and/or one year imprisonment;as well as civil penalties in the form of a STOP WORK-ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be farwarded to the Office of Investigations of the DIA for insurance coverage verification., I do hereby certify,under the' acid pena7l es of pedwy that the information provided above is true and correct S• g' t Date: 7_ Z€�/6 Phone#` 77q�.' 23 Official use only. Do not write in this area,to be completed by city or town ofjY ,j City or Town: PertnztlLicense#. Issuing Authority(circle one): 1.Board of$ealth 2.BuildingDeparlment 3. City/Town Clerk 4.Mectricallnspector S.Plumbing Inspector 6.Other Contact':Person: Phone#l: ` 4 structions Information and In ' Mhs=uisefts Ceaeral Laws chapter 152 requires aII employers to provide workers'compensation for then employees. Pursuant to ibis stare,an employee is defined as"_every person in the service of another under any contract of hire, express or implied,oral or written." employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiv or trustee of an individual,partnership,�assodation or other legal entity,employing employees. However the owner o dwelling house having not more bran`three apartments and who resides therein;or the occupant of the dwelling h use of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the pro ds or building appurtenant thereto I not because of such employment be deemed to be an employer." MGL chapter'15 ~§25C(�also states that"everyror or local licensing agency shall withhold the issuance or renewal of a likens or penmit to operate a busin to construct buildings in the commonwealth for any applicant who has no roduced.acceptable evidof compliance with the insurance coverage required." t Additionally,MCI;chap 152, §25C(7)states"Ne ier the commonwealth nor any of its political subdivisions shall enter into any confracf for perfaunance ofpublic ork until acceptable evidence of compliance with the insurance rupirements of this chapter e been presenfsd to the contracting authority." �Y Applicants PIe c fill out the woiicers' compensation davit com etely,by checking the boxes that apply to your situation and,if neces� a y,supply sub-contractors)name(s), ess(es) ` d phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC) ``Limited Liability Partnerships(LLP)with no employees other than the members\or partners,are not required to carry worlds' cc' ensation insurnce. If as LLC or LLP does have. mployees\a policy is required Be advised that this aft vt may be submitted to the Department of Industrial ccidenis fo canfirnation of in.� nce coverage. Also b i �sure to sign and date the affidavit. The affidavit should be fumed to e city or town that the application for the pi�nuit or license is being requested,not the Department of In Acci ts.. Should you have any questions mga Ant the law or if you are required to obtain a workers' comp anon poh, ,please call the Department attthe number listed below.Self-insured companies should enter their . self-' ce likens number on the appropriate City or wn Offici Please be e that the affi is complete and anted legibly. Zhe Department has provided a space at the bottom of the affida for you to Ell. in the event th Office of Investi. ions has to contact you regarding the applicant_ Please be sure Ell in the p sense numb which will be us as a reference number. In addition,an applicant that must sub multiple permit/h e apply ons in any given y ,need only submit one affidavit indicating current m policy inforation.(i=necessary)and der"Jo Site Address"the ap licaut should write"all locations in (city or town)_"A copy of the affidavit that has b n o cially stamped or m d by the city or town may be provided to the applicant as proof th�t a valid affidavit is on for future permits or li es. A new affidavit must be filldd out each year.Where a home 8er or citizen is ob license or permit not rated to any business or commercial venture (Lc. a dog license or pe it to bum leaves etc.) aid on is NOT require 'complete this affidavit The Office of Investigations would hike to thank ou in advan for your coop on and should you have any questions, please do not hesitate to gige us a call ` The Department's address,telephone and fax er `~ Tho Co onwialth of Massachusetts Deparfm t of Industrial Aecld is `t 0--M of luvestigatians. Goo asuugun fit. Bo =MA02111 TeL#f 17-727-490 ext 406 or 1-377-MASSAFE Bax#6 17-727-7749. Revised 4-24-07. `�. s i " fr �THE row Town of Barnstable RegulatoryServices 9s x SS,, Richard•V:Scali,Director o;�.���0 Building DMsion Tom Perry,BuildingCommissioner. 200 Main Street,H f 's,MA 02601. t, www.town.ba nstable.ma.ns 7 Office: 508- 62-403 8 Fax 508-790-6230 Property er Must Complete and Sign This Section If Usin A Builder 4 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize bythi\'ding ermit application for: • (Ad ss of Job) Pool fences and alarms.are e responsibility of th applicant.Pools are not to be filled or utilized before fence is installe and all final inspections are performed ind.accepted. . r b Signature of Owner Signature of Applicant Print Name �+ Print Name Date. Q:FORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services ��oFTHE rotyy Richard V.ScaIi,Director Building]Division rxs�Asrr~ Tom Perry,Building Commissioner v$ 16. �a� 200 Main Street, Hyannis,MA 02601 ''Teo htAt a www.town.barnstable ma us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �s I r 4 �/'1C 1 number street village "HOMEOWNER': sea.-n Ovn name home phone# work phone# CURRENT MAILING ADDRESS: s�`M' U 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. _ 1 . Therundersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and req ments and that he/she will comply with said procedures and requirements. {S/i/gn a of llorneiovmer 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 2.16) 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 tomeowner 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:\WPFILES\FORMS\building permit fonnslEXPRESS.doc Revised 061313 ' Town of Barnstable Geographic Information System July 25, 2016 ' 228082 �� .�1122 44 #285 #47 228074 228062 `' �(l #79 ��,• #57 � �° IN 228161 , #278' w w 228089 - 228150 W #355 # ' 22B093y #273 'a 228151 228061 #91 #67 0169 �. :. .. 228101 228193 ' 228152 #261 r t #151 . 9 a 228060 \\�%#75 228254 4. # 54 -V 228192 ..» #251 228194 41 #164 � #154 228165 w ' #238 »., 229191 228056 m 228059 #190 22B139002 228190 #37 #231 228171 P4 #40 � F 2281 0 aet - r s DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:228 Parcel:060 Selected Parcel 17-11LA boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:PUCCIATTI,DOR-ANN& Total Assessed Value:$395000 1"=100'may not meet established map accuracy standards. The parcel lines on this map - are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.10 acres - - Abutters . boundaries and do not represent accurate'relationships to physical features on the map Location:75 MAUREEN ROAD such as building locations. - BufterY� ,�'', � tt OW - �o � Ves zY col C)C] 1 . . _ V