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THE Town of Barnstable *Permit# 03 }�,_ Building Department �o a 6monthsjromissuedate HjA ST„j3j,E : Brian Florence,CB0 MASS. 9�A i639, ��' Building Commissioner ` V D QED 200 Main Street,Hyannis,MA 0260 NAR www.town.barnstable.ma.us too,1/i` �e Office: 508-862-4038 rC�01Chjj Fax- 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLN t j 1 � _D(0� Not Valid without Red X-Press Imprint Map/parcel Number ,, Property Address l/G�� )&eL %U%T�/y ❑Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �2�72x,,L) Contractor's Name %� / �J,y Telephone Number ��U 9('?I Home Improvement Contractor License#(if applicable) Email: ,;P,p,G 1 6 Fz�vkwyee,, 4o7l Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner Y,have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# �/,t /(�,✓✓' ,�Z, Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ st(check box) VRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to J A6117?dz/d;_1l/ ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (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. A copy of the Home Improvement Contractors License&Construction Supervisors License is re uired. SIGNATURE: Q:MWPFILESTORMSTY PRES S2017 OFIMHE r Town of.Barnstable ti Building Department BARNRML Brian Florence,CBO Ar 1639.39. � Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.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 application for: IV (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. e of Owner _ �. Signature of Applicant Print Name Print Natne Z ate QTORMS:OWNERPERMISSIONPOOLS Rev:10/17 JLVvvu V1 "a1u3i.aU1V �pFTHE Tqk� Building Department Brian Florence CBO • Building Commissioner BMWSCABLE, « v MASS. $ 200 Main Street, Hyannis,MA 02601 ATEC µp'I A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEpVPNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village ' "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: y/tp state s zip code The current exemption for"homeowners" extended to include o er-occ ied dwellin s of six units or less and to allow homeowners to engage an individ or hire who does not ossess a license,provided that the owner acts as supervisor. D ON OF HOMED Person(s)who owns a parcel of land on which he he resides or in rids to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or de ed structures cessory to such use and/or farm structures. A person who constructs more than one home in a two ear period all not be considered a homeowner. Such "homeowner"shall submit to the Building Official on form ac ptable to the Building Official,that he/she shall be res onsible for all such work performed under the buil t (Section 109.1.1) The undersigned"homeowner"assumes responsibility for pliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she under ds a Town of Barnstable Building Department minimum inspection.procedures and requirements and th he/she ill comply with said procedures and requirements. ; Signature of Homeowner Approval of Building Official Note: Three-family dwellings con ' ' g 35,000 cubic feet or larg will be required to comply with the State Building Code Section 127.0 Constructio Control. H OWNEWS EXEMPTION The Code states that: "Any home wner performing work for whi a building permit is required shall be exempt from the provisions of th' section(Section 109.1.1-Licensin�of construction Supervisors); provided that if the homeowner engages person(s)for hire to do such work, at such Homeowner shall act L as supervisor." Many homeowners who use t is exemption are unaware that they are as uming the responsibilities of a supervisor(see Appendix Q,Rules Regulations for Licensing Construction S ervisors,Section 2.15) This lack of awareness often results n serious problems,particularly when the ho eowner hires unlicensed persons. In this case,our Board c not proceed against the unlicensed person as it ould with a licensed Supervisor. The homeowner act' g as Supervisor is ultimately responsible.%,\ To ensure that the ho owner is fully aware of his/her responsibilities;man• communities require, as part of the permit applicat' n,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last pa of this issue is a form currently used by several towns. You may care to amend and adopt such a farm/ce cation for use in your community. DIME Town of Barnstable *Permit# r IT Regulatory Services Fp 6,,,o„rhsf m,sue�rate AU szA-aLE,�A Thomas F.Geiler,Director31),O kAl— TOWN OF B. TABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us . Office: 508-862-4038 Fax_: 508-790-6230 EXPRESS PERMIT'APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /1 a 0 6 5— Property Address /0,5 0 1 6 n. 4t-W�_- FO Residential Value of Work 31 `� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address i �5C—LL, ea aar( el lcfo1 r� Contractor's Name A9LC(ente l4 Oms-reucxw Co . Telephone Numbed 03 l 14r71-- (os Home Improvement Contractor License#(if applicable)_ //U0.3- Construction Supervisor's License#(if applicable) t D'KO-rkman's Compensation Insurance Check one: ❑ I am a sole proprietor 1 5❑��m the Homeowner I have Worker's Compensation Insurance Insurance Company Name d-1 9L`-nTo a(UIV A L Workman's Comp.Policy# 4)C_ 13i s-:�) qq 61 q oao 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. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) V/Re-side . . - � txl ✓I L.UQ C_ #of doors' dReplacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance ofthis 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. AFo of the Home ove ant Contrac ors License&Construction Supervisors License is SIGNATURE: C:\Users\decollik\AppDat ocalWicrosoft\Windows\Temp ry Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doca Revised 072110 ansxgrABL MAM a'� Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry;CBO Building Commissioner .200 Main Street, Hyannis,MA 02601 Www.town:ba rnstable.m a.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section P g If:Using-A Builder as Owner of the subject property hereby authorize Aae-1ULA C'Wdsvuc_*04 Q: to act on my behalf, in all matters relative to work authorized by this building permit application_for: 165- ZO (40& K1104 eo/46 (Address of Job) Sign ture of Owner Date k«AJ w(, c✓C,2 Print Name If Property OWner is applying for permit,please complete the Homeowners License Exemption Form on the _ reverse side. C:\Users\decollik\AppData\LocaiNicrosoft\Windows\Temporary Intemet Files\Content.OUtlook\DDV87AAZ\EXPRESS.doc'. Revised 072110