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` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
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Map � Parcel Application
Health Division Date Issued
k Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board—
Historic - OKH _ Preservation / Hyannis .
Project Street Address a�' += �1 f\Cw b NO
Village. Cl; l�` 1 \Al (V1 Q b7-/G 0 k
Owner ��•C � ` � i���� Address l e�� V UNMOO to DRI"Ty K
Telephone
Permit Request MY) Yy Iti MOD �Inv% ap" f VX Q.-,
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Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
_Zoning District Flood Plain Groundwater Overlay
Project Valuation*43% 00 Construction Type
Lot Size Grandfathered: ❑Yes , ❑ No If yes, attaches portingr�ocur ntation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) ?-- -�
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Age of Existing Structure Historic House: ❑Yes ❑No On Old Kin"'," Highwayi ❑Ye'� ❑ No
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Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. t)
Number of Baths: Full: existing new Half: existing r.QW w
Number of Bedrooms: existing _new
Total Room Count (not including bath>): 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-User- - -
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name � � � Telephone Number M ,
Address o ' � License#
c-w �Y) ���J Home Improvement Contractor#
Worker's Compensation #
:ALL CONSTRUCTION DEBRIS RES LTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE FV'
FOR OFFICIAL USE ONLY
j YAPPLICATION#
DATE ISSUED
MAP/PARCEL NO.
s ADDRESS VILLAGE ;
OWNER '
ti DATE OF INSPECTION:
FOUNDATION
FRAME s UK 4 lo117 AQ ;
INSULATION C V- )42-1 IS
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
s
FINAL BUILDING
- F
` DATE CLOSED OUT-
.
F
ASSOCIATION PLAN NO.
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owm'6 Barnstable
Regulatory Semees
• R• w Thomas F.Geiler,Director
6��,��' Building Division ..
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601 .
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION'
� ����1 �� Please Print "
DATE:
JOB LOCATION: 1 1 C C N kz),R 1 LE,(;
number - sheet
village
""HOMEOWNER": �� l�f �
name home phone# work P hone#
CURRENT MAILING ADDRESS:
cityltown 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.
DEFINMON 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 Iog.1.1)
The undersi ed"homeowner"assumes responsibility for compliance with the State Building Code and other.
applicable des,bylaws,rules and regulations.
The undersi o o, ej res that he/she understands the Town of Barnstable Building Department
minirrnim ' c c s requirements and that he/she will comply with said procedures and
requiremen .
i
Signature of —
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
.1,i'ij, r 4.. tj 1 �-i'4
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`} - TovPn'of Barnstable
Regulaaoxy Services
. Thomas F.Geiler,Director
6;�c►'� Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,,MA 02601
www:town.barnstable.ma.ns_
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This .Section
If Using A Builder
I, , as Owner of the subject property
hereby authorize to act on my beh4
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'
QFORMS:OWNERPERMISSIONPOOLS 620I2
TOWN OF ARNSTABLE-
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TOWN OF BARN TABLE
2013 MA -8 M ?: 44
DIVISION
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Town of Barnstable *Permit#
C Expires 6 months from issue date
Regulatory Services Fee ? . S-d
BARNSPABtiF�s
MAC $ Thomas F.Geiler,Director PERMIT
1659. �0
ACED Mpt�' .
Building Division
Tom Perry,CBO, Building Commissioner DEC 11. 2012
200 Main Street,Hyannis,MA 0260J
www.town.barnstable.ma.us TOWN OF B
Office: 508-862-4038 ja?l;'§WNW230
EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property.Address �� �A qNc \
®Residential Value of WorAS`DQO L Minimum fee of$35.00 for work under$6000.66
Owner's Name&Address C`.. Jo k1 ;�GQ
Contractor's Name Telephone Number"Co7cl
Home Improvement Contractor.License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
1' 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
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. .
Separate Electrical&Fire Permits required. `
'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Prope Owner must sign Property Owner Letter of Permission.
A cop f the Home Improvement Contractors License&Construction Supervisors License is
e
SIGNATURE:
QAWPFILESTORMS\build i onns\EX�RESS.doc
Revised 053012.