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0082 CRAWFORD ROAD
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / Parcel Permit# i v- Health Division" la d��� Date Issued o!�Z� 0� ,Conservation Division Application Fee "v t Tax Collector J Permit Fee t f"72,2-D hA- Treasurer Planning Dept. pCISTiNG EPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address w j" 1) 7,pA: Village (p(2�6rJ I-t Owner J®h a sk�7_v eC Z 4q k Address C;rU S 4 iQ0 d% 6(1Yt,1h,;rn , Telephone ;z%� / Permit Requestt C14 d NO S�T12u�Tu��� Cf�A�G Square feet: 1st floor: existing proposed N 2nd floor: existing��proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type jc�� �8 't..'ekv ERt Lot Size Grandfathered: ❑Yes ❑No If yes, attach supportingRa umentalfon. -v Dwelling Type: Single Family ZTwo Family ❑ Multi-Family(#units) -- y � c� Age of Existing Structure Historic House: ❑Yes WK10 On Old King's High ay: ❑eves � to Basement Type: "Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) �(2'7,8 s� Basement Unfinished Area(sq.ft) �76 y Number of Baths: Full: existing new N Half:existing new Number of Bedrooms: existing new Al Total Room Count(not including baths): existing ZZ new First Floor Room Count Heat Type and Fuel: ❑Gas /Oil ❑ Electric ❑Other Central Air: dYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes dNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Zexisting ❑new size�� Shed:❑existing O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes VNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name e,ttwy LP_.a>Alo-Z C-He v uOep Telephone Number 54'g35 C�Sc)© Address}70_fox_qV-Z ?vazNr®s ftl- 0,253 2 License# C S- 6,557yr7-5 Home Improvement Contractor# = � A7. j J�A C leY'S _-no J Worker's Compensation# //CUFF• ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6,14 do0< Lt.44 S-tia_ /-71,9asr SIGNATURE DATE c3 + , FOR OFFICIAL USE ONLY PERMIT NO. . f DATE ISSUED ' MAP/PARCEL NO. } ADDRESS i VILLAGE OWNER ' .i r DATE OF INSPECTION: " FOUNDATION FRAME OS INSULATION FIREPLACE .- ELECTRICAL: ROUGH zi FINAL f � PLUMBING: ROUGH © FINAL . O GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT, n ASSOCIATION PLAN NO. w r " f t 03/17/2005 15:53 9782495617 ATHOL HOSP ER PAGE 03 • 6 Town of Barnstsble Regulatory Services t Tbomos P.emer.Die.ei� BalldiM AiVWQn ' Tompam,311aftS Comadestoner 200 Main Steeet, Hie.MA 02601 n �I Fez: 508-790-6290 0&=: 508-862-40H 'I F000s><itno. Date f AP=AVIT BVMWLMW 11+3hOpn=llR'WCATt41�1�� tb0 the w1m mt�uatsoa eltmsLiame,reo4vatia4 tep�I damizstian,couvsreio9. Via„ 1emm MMY4 demo daa,at oaaabcuotkm of an addition to my pre`w 3stine awmMmVied tuadbaMtsiniq at braes cm but not Mwe tUn fm dwelft uni%or to st ct m wbi4t ace adj&Gent to d Coatxaotoie,wig cmt ,•1"a wAh oths auob.naidramce ortTn7ditt;be doaaeby3epsteco I . Eg ted Coet Type of Wosk: W" A07-W" - Ad&w of Wo&. , is K 3 . . 'paiaet'a Name- II 0.1 Dom of Applloat[m' C. . f 11,neby oettify tact RorAjaon is not ceq imd for the fnlia�v3ng nseoa(s): i Owork aoak"by law Job Vndet310 OwwpuftB ownpemnt Notice le busby 0TVU that: OR S, G OlF'N pgS=OR DEALMr WITS` MGISTM'D ApP C_ASS�L w OL¢COINT"CTODSAaa MY .147A* TIP' RA O �ACCISbTO SIGNMUND$RPEKALTMS Of P M+Y I hereby apply!ot'a permit u the agent of flee C"W- 3 y s N, 44-", � i2•:1 u�i�aj3' • ntcaoroot Name !, Registeatioa No. , Data 3ji-7ior Not • it pxotms:ham�ffldav � • Ih h l 03/17/2005 iS:53 9782495617 ATHOL HOSP ER PAGE 04 Mar t? 05 11 : itTA p•3 Repixtory Selvlcm Ofao - 308462AMI Fm S08.790-6230 propetty Oovner Must I complete and sip This Section'I If Using ABuilder owner of j mbiaes yw?ely _ta vat�a a>rbsrft� Wart:wLiwd for. Se ;net:t jLr :a]etiveto b'Y*6 Pew°'4 WPM e job C j • . j a The Commonwealth of Massachusetts Department of Industrial Accidents* • — i�IsssfJ�rms�d0�s 'i 60 ftshington Street Boston,Mass. .02111 Workers'; Coin ensation.•Insurance Affidavit-General Businesses •� �.''p•+�..�9-�}r .. 'n'3'. i4i°sm..• • :•t*,�a+��,/"rt�N"'ev.a•`• , �.x. -• ..�y �. name: c3'ri1 Servo .e� v C� SS:_. city �l?1�,Z2 I�rJS state: Yyl� zip: 2 phone# 6 �'3 —0,30 0 work site loeatiori(full address): ('1�L✓i ✓ l >L°" V�r � ❑ I am.a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bai/Eating Establishmeat long in any capacity. ' ❑Office❑ Sales(including Real Estate,Autos etc.)' an em toyer with '- 'en••1 ees(full&• art time: '❑Other an-employer providingNorkers, compensation for my employees working on this job.. comysniy •l «tilt' .s 'd•. ..� > : '• :t:rv: ,•r,yb.�. - i. '.i.:.ti :1^ v i s.Yf. ''l.:. .t•:.p+., r<.• stl�r'e5k '.�• K�J�• a Imo'•''•:�� •.1'; e' .:a. •,Y�. 't 'A•.•. ,�` ;� y,ate «. ••a`+ •.. #rJ :' ,'IS/y�j. .'risui•atice.cur''• ...sry ���:.'4•�'•i�,,_:..�.-.r.•/W�: ,s:�.:<:;.. 'oh'•.#': I am a sole proprietor and'have hired the independent contractors listed below who have file following workers' ; ,compensation polices: cOIDpeIIV'n'ame '�<. x 7Ct.. i v.:t'r•. .1. ��rh.t:":i�D .iv}�J,r;•p'r..> 'r`}.;':::� „r '••' :Z rr'�,::'•'•' _ •:A. :4.•• .4.'• �'a3 rSFi'•r•'•.t ti r•f i'$'r:.:•:?;'• .'4.: insurance'co. :: r::e��• ra rr ,•w. ,'::.• i ri •�r:r •. :•'S. i1:•'t' :••�.l'�'•� t.�'+' '.•?« _. .$:'a .•ty y`•'� '+.Ni..r '�•' •, ebmpaytiaa a r' ...... c eddresS:. •'4.1 t: CiTY'• .. .. ''. :p11011E:#{ �' �'{„ •��•:•«'t . . i.t -ter,: ,.t- t'..•, .,.: .:r;.:_ t: r.Si �.. ... ydy, `t•c: ";T•. .may c. .i,�4+ '.4. insurance sb: !+`::' ;, olicV:V :. %i swom Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of aline up to$17500.00 and/or one years,imprisonment as well as civilpenalties in the foim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that tk copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify,under the pains d penalties of perjury that the information provided above is true and correct Signature D$te L)rS Print name ]'7r��✓ ' �/lt/U Phone'# 1 0 .✓ " �. official use only . do not write in this area to be completed by city or town official city or town: permit/license# ElBuilding Department ❑Licensing Board ❑-check if immediate response is required ❑selectmen's Office ❑Health Department , contact person: phone#; ❑Other (seviaed Sept 2003) RED— f Information and Instructions. ; Massachusetts Ceveral Laws;chf pter�152 section 25.Tequires all employers.to provide workers'compensation for their.. employees:- As quoted from the law',an employee is.defined as every person m the service of another under any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or mare of the foregoing engaged-in ajoint enterprise, and including the legal.representatives of a deceased employer, or the receiver or trustee of an individual,partnership,. association or other legal entity, employing employees. 'However the owner of a dwelling house having-not'more than three apartments and-who resides therein, or the.occupant of the.dwelling house of another who.employs-persovs to do.maintenance, contraction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such eanployment.be deemed to be.an employer. :.. : . :. MGL chapter 152 section25 also'states thative'ry. state or local licensing-agency.shaIl withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the ' commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work-un. til acceptable evidence of compliance with t�e insurance requirements of this chapter have been presented to the contracting . authority. ` R///f/%%%%��%%///%%%///O%///////% %%%//%%///%///��%//////////%%%% ////%////////%%///////%//�i,,%%%//////%%/O�%%%//////// Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation..-Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the DeP a.rtment•of Industrial Accidents..for confirmation of insurance coverage. Also:be sure to sign and dato the affidavit. The affidavit should.be returned'to the city or town that the application for the permit or.license is being requested, not the Department of Industrial Accidents. Should you have any questions regardin `the"law"or if you are required to obtain a.workersr-cornpensationpolicy,please call the-Department at the number listed:ljelow- ,.. ///% City or Towns . Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Of!iiee of Investigations has to contact you regarding the applicant. Please be sure to fill.in the permit/license number.which wdl be used as a reference number, The.affidavits may.be.returned to the Department b* mail or FAX unless othei'arrangements have been made. F .The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call.: The Department's:address,telephone and fax number: : The Commonwealth Of Massachusetts. Department.of Industrial Accidents emee of Wvesdpwns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727=4900 ext:406 _................................................<.........:..........----....... ..... _.. ...... ....... ... ., ... .... r .... a.... .... ....:.... ........ ....... !.... : ! , ......................................:. ...'.............. ..- ..... ... /gym .... ...s....... ..4............... ...i.... ...b. N4 j o.... ....o.... ....y.... ...:,..: n,..,,...,..,` w i i 1 ....�.... ..o.... ........ . _.: : : : : : /.V:: : :. e.... : ........,..., �. 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Ai" : ....b... .....�. ...... ._... ...... n ..... 1(1D Me a. M • f ME Li e'mse O STR . T N - P, a a,as"o, N' r ' 0 ,54715 jj{{� Tr na: 2183.0 HEENi2YaR+LE=NG_a C•" mi sione� �'� I ~ ...., ram„may-�.,. ... .. �.��,�,.s„.„.•._. s i OF PLYMOUTH &BARNSTABLE P.O.BOX 342•BUZZARDS BAY,MA 02532•UPPER CAPE(508)888-5985•PLYMOUTH(508)746.5885•FAX(508)833-0974 Richard Lennox is a principle officer in this corporation, Servpro, and has authorized the use of his home improvement license (number 108642) for this project. II Results Page 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name,or License number Select Search type: • AND • ORck1N Search Results ...............................................................................................,................. ..........., ........ ... ...................... ... ................ Reg.No. Applicant Street City :State Zip Name Title :Expiration ................ ;.:... :...:.... ----• 108642 BENABBY INC/DISASTER 9 Jan-Sebastian:Sandwich MA 02563 LENNOX, Owner/ 8/20/2006 ...................................... ` SPECIALIST Way RICHARD President Total of 1 Records matched. ..........................................................................................•---....................................-----------------------•--............................................--.---........------------.....----------------------------....----..............: Back to Home Page MRS Privacy Statement http://db.state.ma.us/bbrs/hic.pl://db.state.ma.us/bbrs/hic. 1 04/19/2005 12:17:05 PM I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map✓ do,5 arcel 0 V6 I Permit# 4(t 2 3 Health Division Date Issued 2 Conservation Division Fee �� l " Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address C caw fo a R d Village AU Owner ::SD \ K A2_V PC 2 4 K Address c?.;l 4 R - Telephone 41P R Permit Request ® /00 Ic QKI Rem 5�;I.!Eje W, I� Exl(CL- , Replace LOV'A � � l��e� �'�� A�drrSo�i �/�f1lce5�6�r/i'�af! �Wa 23 U o3 Square feet: 1st floor: existing D W proposed 2nd floor: existing / VO proposed Total new Estimated Project Cost ' Odd Zoning District Flood Plain Groundwater Overlay 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: Gull C3 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) eS Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 1 I new Half: existing I new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count _5' Heat Type and Fuel: ❑Gas 'Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:Yexisting ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Brcc?_i*dA.� Zoning Board of Appeals Authorization ❑ Appeal# Recorded Cl Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 4ea OG��✓ r" Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY r + •PERMIT•NO. ( Z3t, DATE ISSUED .' s r Y e- •. MAP/PARCEL NO. r 1 •:,,em�s,, _ :r - , ADDRESS . ° ` VILLAGE r OWNER - •1 DATE OF INSPECTION: e • 4 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING F DATE CLOSED OUT ASSOCIATION PLAN NO. 1 •d 1 ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X$100/sq. foot= GARAGE (UNFINISHED) square feet X$50/sq. foot= PORCH square feet X$25/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= • Total Estimated Project Cost { K g990915b `�"\ The Commonwealth of Massachusetts __— - Department of Industrial Accidents ::= .. ,� -=: - , _._ Olfice of/mestigatioos _ 600 Washington Street - `, Boston,Mass. 02111 _� Workers' Compensation Insurance Affidavit name•QQ k h .S K A 2.1V PC 2-#4 1� location: 9,4 C FCL uJ-r f 11 RA - --I - . c' cot `- . ' hone# t3? 3 P, Ig I am a homeowner performing all work myself. . ❑ I am a sole rietor and have no one work'n in anv ac�ty - %/��%%/G�%��%% %%%%%%%%/// ///%//%%/ %%%/%//%%%%%%//////%%%%/%%%/////%%//%/%/%/%/%%%%�%/%/G%%%%%//G%�%%%//G%��%%%/ I am an employer providing workers' compensation for my employees working on this job. .... ..... .........:.:. ..:::::. :...:.::::.::::::.}:. -:::::.:::.::....:::-::::::::::.:..:.....:..:.. i. address:. -:.::...:::::..:.:.}.:....::...: . .. ..... . ...:...,:...::: ahnne#:,..: .. : olcv# ansusance<co, ,.:: -. }<::::::: _:. ....... .. %/ ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who. have . . the following workers' compensation polices: }`'name com anv 0 .......... .. ::%yi:i;'<;;:i:.` :::E;::: ':: :i:::` :a}:i`::isYi:ii?i+is7i::ii:i :(::;.':4isisi:::`5::}`i`.:.'a'i'>;:.::''::.i;ii::;:i:::i:<i': <i:::i i{ .............. iii: ::;i:i ific[:iiE? i ` .:::.:..... :::.:. - :: .............................. f :::. ....... .............................. ............................................. ..... .............. .. ....................................................... ... .. ,............................... ............... ............. .................:.............::......................................... ......::. ............ .......v-.w:::nt.:.:..w.::v:.v::::...... ..................'-' ....... ................................................:..:.......------.......}.............. :v:::::+�::•:::::::•:::::•::::•:::•:::.�:::•::i•i:•i:.}}:i::i.::....:•::.i:ii•}}}:::vv'i•:::.�::.�::::::::.�:::.�:::::•..:�:}::�. .::::" ::::::}::::::j;:;isi:ii::::i:::ii:iii:_isiti:::: iiii:isJ:i!h:::ii:+iiiiii}ii'T;{i:ii:}:'4iii}}iii.+:.+i'::i: city i,"*><:: <8>» :z; .::::.::::::::•:.:::::::::::........ :::.::::.:::::::::::.:.:..:.................................,....................................................... ::::. ............. ...................................................... ...................................... ..:.,.:::.:::::.::.........::.:.:::.:::::: :............ ..................r........................ .......................::.::::.:._::: r.-....::>.•...:::::::.: :In3ucsnce''c0�': :!::,<::i:::.zii:;:;c;::;::::>:;};};:;:,:,....:..... ::>:<: :,::: ..-:.:,:.;:.»:;}>}•,:.}::::.;:.,;::.:.}:::: :;:, :::::::.::::::•:.::•:..:::.........::...:..:..........:..........:......... acne:}:::;<:>::<:><::::::::;:><:<:::};}::,:.:..:.,;..:.<:;<.::.;}::::...:..:::... ...... c anvr -. address: I. jjtt ::>:y?e'f1`2?: ?? < "..via>�� �' ::i:: < `:22>�?:i:: f:Y::S ' cl::.. b han :;:7:;:3 ::s >`::::: �:i:':::z:: : ::::�_Y::: ::::::::: <': olicv r:ic.:t:`:::i:: ::::::::::i::ii;��:::::;:i;`::.....:..:.�:::.�:::::.... innran �/ Fanu a to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as dvll penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is trw.and correct Signature00, Date , 2_ �2 _ - Print name . Phone it Check do not write in this area to be completed by city or town official permit/license# QBuilding Department ❑Licensing Board diate response is required ❑Selectmen's Office []Health Department phone#; ❑OtherOr4ted 9/95 PIA) �JFTFIE Tp� . . � The Town of Barnstable ,nxivsrneie, � . Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. 1 Type of Work: Red�+ S rAeLtG ft .L iJ i A -.0 s Estimated Cost Address of Work:CV C�� waG �_ 1�e�. 40 i' Owner's Name: 12a Date of Application: �'-.22- 9' 9 I hereby certify that: Registration is not required for the following reason(s): [Work excluded by law OJob Under$1,000 Building not owner-occupied 26wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date , Contractor Name Registration No. OR Date Owner's Name a .K q:fonns:Affidav 10CMA"modimi . . tablm.lS2.ib(ooatmaed) pruaip&e Padn;e for 06e mad TwD-Fsn*Rnfdmdd 11291111W Heated with Foarit FaeL lYUM1111V1 mDmum Walt Floor BAMMM Slab 1°B �) u rains R. gbmJ R value` &Vail wan Fb Effia� lie R.traitta' R.VRW 5701 to 650011ndoS Dew Daw Q 129E Q40 39 13 19 10 6 Nommi R 12X QM 30 19 19 10 6 Natmd S 12% QJO 33 13 19 10 6 1s AFVE T 13% I36 33 13 2S WA WA N� U 15% OA6 3f 19 19 10 6 Naemai `v 159A, 0.44 �e 1.•0. 25 WAWA i5 A� W 15% 0 S2 30 19 19 10 . 6 iS AFVE x IV/. am 35 13 2S WA WA Normal Y IVA 0.42 31t 19 25 WA WA Nmami Z IVA OA2 311 13 19 10 6 90AF1JE AA IVA 030 30 19 19 10 6 90AFUE 1. ADDRESS OF PROPERTY: 92 2- SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA 03 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a Ftt+e=rq � Deparirrles � 3,> 1T< fety and Envlronlln tal , �„ e Building Division • tLAWm'ABIA • 367 Main Street,Hyannis MA 02601 t+AS& �os9• �m�' Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Q Please Print DATE: 9a JOB LOCATION: (:;k- C t6L W O number street n �7 G2 90 "HOMEOWNER": je)11.E name hom6 phone# work phone# CURRENT MAILING ADDRESS: ® C' 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said pros dunes and requirements. S' store 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 who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules 8t 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN