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Home My WebLink About0050 LAKE STREET ,. Town of Barnstable Building ` F Tha 'F�=is Visible from he'Street-A rove Planss,Must be Retained on,Job-•andl his �ard,Mu`st be Ke , Post This Card 5r t t !, :;:..L► xSrA6L6,. a � �d ,�„ � «v✓,�a ppu,c � �� :a py f M"�` p Posted Unt►I Final Inspection;as,Been Made x'" � � � � �� ► a�Cert�ficateof.Occu ant s Re aired�suchw6 ;ild� shall Not be�Occw ied until a•�Final lns ectlon�has.been,made � Permit Permit No. B-17-2342 Applicant Name: ASSMUS,CARL F&CLAUDIA A MULLALY TRS Approvals Date Issued: 07/26/2017 Current Use: Structure •n -Siding/Windows/Roof/Doors Expiration;Date: 01/26/2018 Foundation: Permit Type: Building i .Location: 50 LAKE STREET,COT IT 3 Map/Lot: 020 026 z Zoning.District: Rf Sheathing:. , Framing: 1 Owner on Record: ASSMUS,CARL F&CLAUDIA A MULLALY TRS Contractor Name: ng. Address: 104 CREST ROAD Contractor License` 2 FAIRFAX,CA 94930` Est P oJectCost: $ 1,000.00 Chimney : in over 1 existing layer of roofr Permit fee: Description: reroof(going O g y .Insulation: detached garage) ( g g ) Fee ak $35.00 reroof(going over 1 existing layer of roofs 4 x Date 7/26/2017 final. Project Review Req. (g g O. g y ,, . . (detached garage), e Plumbing/Gas ram. z t Rough Plumbing: I rl �. Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within siX m`nths�after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applica#ion and Lhe Wl�approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonmgrby lawsand codes. final Gas: This permit shall be displayed in a location clearly visible from access st eet or r an ad d shall be maintained open for pub[ nspectinn for the entire duration of the work until the completion of the same. w� y 110 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by theeBuil and ire®fficials are prouide`d on th s'permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing , - Rough: 2.Sheathing Inspection ... .,., .., a. .... .. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage'Rough: 6.Insulation 7.Final Inspection before Occupancy tow Voltage-final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGLc.142A^). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 427 P f�n4 Town of Barnstable *Permit tE�fires 6 months from issue date Regulatory Services Fee BAWMASIX MASS Richard V.Scali,Director16.19. 35, V Building Division � � ,� . Paul Roma,Building Commissioner ° 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us. JUL 25 2017 Office: 508-8624038 TO1,41AI 0 1 ,Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTI Y6W1.&, Ofi Not Valid without Red X Press Imprint Map/parcel Number�`3— U � ^� ` rIs o e Addre ® (�A__-',�— cc) I Residential Value of Work S (, Q00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �j�A " _ 'rtrw S:I C-CM 06-�-6 's!�E Contractor's Name QAi 4 Telephone Number �� 9 12j�2,j Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Che 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) ❑ 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 ❑ 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 required. SIGNATURE: . Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 01/25/17 T7z�C'dlrnrnmmeakh ofli&ysadiusetts Departmait q f1rd-ust Zd Acdde7zhv Office 0AMW ligaf ins r 600 Was iiugtozz,�krs t � Bostoul CIA 02111 tVFvtu niamgoFldia Warlters' Cu mpensaianInsll mna a Affidavit-BEdldexm/CunfracfarsMectricians/Phomhers AppEcant hfw m,atean Please Print Ike Address: S� Cityfttel �Llo Ph,�ae �{�g 12_( Are you an employer?.Cheekthe appropriate ban ' Type of project(required}: L❑ I am a employer with 4 ❑Tama general confractor and I 6. ❑New oonstmctiota employees(full andfor part-time)-* lie luredtie sub-comtmCtozs 2.0I am a sale proprietor or,partuer- listed on the.attached sheet.. �- ❑Remodediug slip and have no employees These sob-contractors hake 8. Q Demolifion w ryTTq for is any capacity.L.` employees andhave wo&ere 9. Building addition Ij o UP&Mrg' comp.imsu anre comp-iM: car l 5. El We are a cmPoration and its . 1 ❑F1P�-k: 1 repairs ar adc oas 3- Iama homeor mer doing 211.Wwk officers have exercised fhear 1L0 Phnnbing repairs oradditiow self o wozlcers' u of csempfiou per MGL y.,❑Roafr era „ceereSuiredji c.152,§1(4k and we have no L 'employees-[Nowodm& 1.311 other comp.insurance required-1 ;Airy WffcmtCatcbedcshaa9lmasfalsoMomitthesectionbelmAxatdngtie¢wuAexecvmpeasat; npeTcginfaamaua _ ffomeovraetswbosnbmff3tT�saffidacai gtLeyRmdaiz6-zUvrcalm4thmbaeautsidecont3cMmwmst.mAonitanmxMd21&bMru!Kr soffh =Cautn�ctnis tbst chxYthis box must sttadsed M sddifinnal shed showing tbe=ne of the snb-eamd:necda=s xod statewhether araatthose enddeshsee employees.Ifthesah-ca*,.txct b=e,employees,9heymQstgimide their wadmn'camp.parm7 auombw- I era art slxp�r t7errl;is pruuidit; workers't:otrrlrensatian insrirarrce�vr rrc}*e�IQ}�es $etonv is 7Ytepo�i��anri jaFr sde, Ftl�t7t7TrffI7DtL Insurance Company 21fame: Policy�or Self inq_I.1.C_4 FkpiniffoaDate: Job Site Ai ddses CifyfS#ateE sg; Attach a.copy of the workers'campmsadonpalrcydeclaration page(showing the policy number and expiration date). Fare to secure coverage as required under Section 25A of MGL c�1577 can lead to the imposition of criminal penalises of a flue up to$L;Saa OU muVGr one yearimpdsoaateut:as w611 as civil penalties in the form of a STOP WORK ORDERand a foie of up to$250_O0 a day against the violatar. Be adtised that a copy of this statement.nmy.tam fxwarded fta t e Of5,ce of Inesfigaffons of the DIA f r Mi si uYance-coverage-umdficafi Yn. 'Ida fterAy c ruder tkapahn andpenah&safF&fitryth&&s in orma€rmrprmitfa_d abore is bars and correct Siffiature C�- J 'Bate -Phase ik 02ki'd wa ffl9y. Da itet write in tits area,tit be cmnpfetdd by city arto►rra nJ07ciK City or Town- Permit Ucease# Issuing Authority(drde one): L Board of Htalih Building Department 3.C.ty rown Clerk 4.Electrical Fnspector S.Pharth g Inspector fi.Other Contact Person Phone 9: --- 6 ormation and fustructions M,s� Gem Laws ffiapte:r M req=m all=ployers'In provide W011CCES'=EPETESSfion frs f Mir emplayees- � p {n fhiS ,as enplope=is defaled as_".eveaYpersonin.fbe scrdce of another undo any conixact ofhn- empress or finPHDd,.oral or writ� An�srplayer is d efined as-ait individual,pn ers associatiCM coiporahon or ether legal�Y, mY fwo or more . of fig foregoing=gagedis aJoint Vie,andincbfmgthe legal=Fsem±ativw of a deceased employex,or fhe receivEa or trustee of an nodMdA p ,associa:6=or of�erIegal wf dL empl°Ping Ploy - Ho�eYer fire owner of a dweIImgl�onsebavmgnotmoref3=tbree apsrUne23ts and"who residesfhe ,arfi�e occupant of the- dw•elIiag I1oase of enter who employs pMscros to do mahftmm.ce,cansh-rc-F;on car repair vD3k on such dwelling house fheaeto ffionotbmanse of emplaymeatEbe det medto be an employer-" or on the grotmds or butldmg appm-�nanf • MGL chapter 152,§25C(17 also states that aevay sfafe or local licensing agency shall wrthfiold the issuance or renewal of a license or perMitto operate a bMness or to construct buildings is the comxuon TealtTi for nay applic=t Who lies not produced acceptable evidence of cdmfa pnce with the insurance cnv�i Additionally,MGI,chapter 152,§25CM state$=N6 fher flee carom. nor 21y of its political subdivisions shall enter into any cot trod for the perfmmaneo ofpublio vmk unfl acceptable evidence of campliancewifh the ft=mce.. re a e of•this cbapfPrhavebempresentEdtotheOmff ting.arriiioziiy:' Applies Please f01 oiot file woj=1 compensation affidavit compleinly,by Cher the boxes that applY to Your si tnatl on and,if neCessary,SIOPPIY snb-cantactm(s).name(s), address(es)andphonenr= MCs)along W3Pubheir cMtIEcate(s)of insui ca. LnnftrdLiabffity Companies(LLC)or LinritedLiabMttyParft�s(LIP)'Td&no =:EPIoyees othertbanthe members or partners,are not rbqaired to carry w06=e =mpmsafion fil= nce. If an LW or LLP does have �pIoyees,mpolicyisrequned, Be adsisedtbattbisaffdayi#maybesnbmffedtothr, padmentoflndr�sSrial Accidents for conErmalion of insurance coverage Also be sure to signs and daft ice affidavit The affidavit should b e•retomed to the city or town that the application fW the permit or license is being rega�not the D epmtnenf of Inaa t i al A ; M:LI Shouldyan hav0 any 4nestons regarding foie law or ifyon are required to obtain a Workers' compensation policy,please call the Dep artmexit at the numbea listed below: Self-msled companies should enter their self-insmaacelicense,=mberCEMthe, aD City or Town Officials t Please be sate that the afdavit is complete and pi[ fe legffily. The:Depaxtnenthas provided a space at tht:bottom in the event the Office oflnvestiD o s has in com actyoa zegM7dmg file applicant. of the affia3vlt fOr yoII tD fll out Please be sine to$I]in tine peamiHIiee�se nts�nber Wilk iw>II be used as a reface rammber. In audition,an applicant indicati that must sobmit multiple P=MWHcense appli:tafions m.any gtPea year,need.only submit one affidavit ng eosent Policy inforn atian Cif n=msary)and under"Job SI-Addrese the applicar t should vie"all locations in (Cy or town):'A copy of the-affidavitt3�has been offiGiallp stamped orm edbyf�e city or town maybe provided to the applicant as proof that a valid affidavit is on fle for fotore•peM-S or fieense$_ A new affidavit must be:fMed out`a a year.-Wh=a homeowner or citizen is obtaining a license or permit not relate d:D any business or cmm=ial vie e_ clog lic orpmmitto bumleaves of-.)saidpmson is XOTMF6F dto c�PICt this affidavit a d ense: The Office of Inve stigaiions would lbe to thank yon.in.advance for your cooperation aad shouldym have any qua-fions, please do nothesifafe to give us a call The Depadm e f s address,tE;Iephone and fax number: Y7 ago /�__--,�R�., (ff ace.dTIve&tiniio= MA OiIII xevise:d4--2¢-07 Town of Barnstable Regulatory Services cl of Richard V.Scali,Director Building Division t Paul Roma,Building Commissioner NAM �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:— JOB LOCATION: number street village "HOMEOWNER": C A 1(4 � � name 7—�—� home phone# work phone# CURRENT MAILING ADDRESS: 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 hermit. (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 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 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 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\building permit fom]s\EXPRESS.doc 06/20/16 Town of Barnstable Regulatory Services KAM ' Richard V.Sca14 Director. Building Division. Paul Roma,Balding Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862-403 8 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 may bebalfy 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 inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QYORMS:OWNERPERMISSIONPOOIS f 63Y t �/ 0*1 Town of Barnstable * ermit# {. Expires 6 niont roni issue dal BA ,s,AgLY Regulatory Set-vices Fee s6 q 1� Thomas F. Geiler, Director 3 �plfoMa�r< Building Division G 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 � ___ Property Addresses [Residential Value of Work �� —'- Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address i C) ce �� c 2 CAft Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESS PERMIT Check one: am a sole proprietor JUL 2 8 2009 I am the Homeowner ❑ I have Worker's Compensation Insurance TOWS! OF BARNSTABL E Insurance Company Name Workman's Comp.,Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ' `❑ Re-roof(stripping old shingles) All construction debris will be to ' Re=roof(not stripping. Going over existing layers of roof) [ Re-side - Replacement indows. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter.of Permission. - ^ Ho e Improvement Contractors License& Construct Supervisors License is required. SIGNATURE: 0J Q:\W PF ILES\FORMS\Express\EXPR ESSPE RM IT.DOC Revise060409 .y v The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 i�•y� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print]Leaffily Name(Business/Organization/Individual):�J�.1(L�. tom}—<��ryyu V" Address: _ City/State/Zip:_ U (( a tlrb Phone.#: `)"�C LtlL$' S'',5 eL Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6: ❑New construction employees(full and/or part-titn.el.* have hired the sub-contractors 2.[] I am a sole proprietor or partrler- listed on the attached sheet. T. Q Remodeling ship and have no employees These sub-contractors have g, []Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp. insurance.$ equired.] _ 5. We are a corporation and its 10.0 Electrical repairs or additions 3.R I Zu a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no . employees. [No workers' 13.❑ Other comp.insurance required.] *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: Policy#or Self-ins.Lic. M Expiration Date: Job Site Address: City/State/Zip: 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 tip 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 ofperjury that the information provided above is true and correct Signature Date: ,7 Phone# Ar5- _c7f V(Z_ 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 Information aiid Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in.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 more of the foregoing engaged in a joint 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 persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall 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,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-con6actor(s)narrie(s),-address(es)and.phone number(s) along with their certificates)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or part e-rs, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance.coverage. Also be sure to sign and date 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 regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter then self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernnittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permitAicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in__(city or town),".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. ue Office of Investigations would like to thank you in advance for your 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 Office of favestigatians 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 4.06 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 . www.mass.gov/dia ,J Town of Barnstable �TItE ' Regulatory Services. Thomas F. Geiler,Director • stixris•rAsre. . P .1 Building Division rFD `� Tom Perry,Building Commissioner 200 Main=Street—Hyannis;NIA 02601 www.town.barnstable.ma.us Office: SOS-962-4038 Fax: S08-790-6230 iOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: O I_{i4 Lr C�-sl'v number street village 2 r� ..HOMEOWNER name home phone# work phone# CURRENT MAILING ADDRESS: 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. DEEMMON OF HOMEOWNER Persons)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.OfEcial 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 procedures and requirements. Signatzrm of Homcbwncr A roval of Building Official ]7P _ 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 hamcowner engages aperson(s)for hire to do such work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption are unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q, Rulcs&Regulations for Licensing Construction Supervisors,Scction 2.15) This lack of awarcncss often results in serious problcnu,particularly when the homcowncr hires unlicensed P-sons. ]n 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/hcr rrsponsrbilitics,many communities require,as part of the permitapplication, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form con-no used by several towns. You may care t amend and adopt such a fam>Iccrtifi cation.for use in your community. ` z IKEr, Town of Barnstable Regulatory Services v B&AANqRM . Thomas F. Geiler,Director Efl Building Division 0 Tom Perry,Building Commissioner .200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 509-790-62 Property Owner Must Complete and Sigri 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. (Md-ress of job), Signature of Owner Date Print Name If Pro-pejU Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side.