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'- ' �'. � !� { ! .N Ir d �• + :r!},.! � � f -r'i�ty� 1,r�',� �y .�,I!�i,�.^�. ,.�� +. rSr'.yl�� � ���q'fA �� k -7 j !: y # �" yr�,r `�• `N' ,� .�� � �y �a -i, t-: p � ,�� t fix,.0*1 �! �I �7 1• ,.>, �Its ► °f� ! . !(� nn SJh:�r ! #! ti !4J1'Nrx 4 'y r.� � Fill I,' d,e� ��' 'f r 1! 'Y:{(�- l:•,U. d 9rr '.4 .� :�, c j' F,' t y ! � #: # v • 1 i :� � x'�;��,_�r��m�_r- � R� �"': .� 5 TOWN OF BARNSTABL UILDING PERMIT APPLICATION Map 9q-7 Parcel_071 Permit# Health Division 7-0l- Zq2 Date Iss Conservation 4ivision f 7 a 6 D I Fee f46 q(z( Tax Collector &a the �,� — Treasurer'f SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis - Project Street Address !�'1 Village 14 c.f Pe ,k Owner ^�uyO oelk,4 Address cSh q9 Telephone qkk— 35-0.S Permit Request An 8�)( 2!��f (Jg) 7`� ��Cf"{td2 S �-�� G� Square feet: 1 st floor: existing proposed_� 2nd floor: existing 0 proposed _3 Total new 2 Valuation ?✓ 6 Zoning District Flood Plain _V,1,1�' Groundwater Overlay Construction Type//tt SS 5 Lot Size Q<0Q0 Grandfathered: ❑Yes 9 No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family(#units) Age of Existing Structure _ Historic House: ❑Yes L$4o On Old King's Highway: ❑Yes ❑No Basement Type: KFull JW Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Y 1 _ Half:existing new Number of Bedrooms: existing� new 0 Total Room Count(not including baths): existing 5 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:;ff existing ❑new size& ol: ❑existing ❑new size'o_ Barn:❑existing ❑new siz&44 ne Attached garage:0 existing ❑new size li�ll Shed:❑existing ❑new size Other: //7- Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Cl Yes Zo • If yes, site plan review# Current Use �4_. l�' .. ,_ Proposed Use BUILDER INFORMATION �y Name Telephone Number Address es— t0l! License# Home Improvement Contractor# Worker's Compensation# LALLONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO TURE DATE 7`z�- 7SUtl) FOR OFFICIAL USE ONLY NO. MAP/PARCEL NO: r ADDRESS VILLAGE t' OWNER — � t { ' DATE OF INSPECTION: FOUNDATION FRAME . INSULATION FIREPLACE !' ELECTRICAL: ROUGH FINAL a PLUMBING: ROUGH - FINAL _ GAS: ROUGH FINAL J FINAL BUILDING 1 DATE,CLOSED OUT 7i _ a ASSOCIATION PLAN NO. ' 3 aFtHE►o,,ti The Town of Barnstable RARNSTARM Department of Health Safety and Environmental Services MASS. a 9Qp i639. `00 00�F0 MPS Building Division 367 Main Street,Hyannis, MA 02601, Office: 508-8624038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location f5l �--t �✓ Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: iz P L Please call: 508-(86622-4038 for re-inspection. Inspected by Date ; . M CMR Appajft 1 Table JS.Llb(continued) praeriptive Packages for One and Two-Family Residential Buildings Heated with Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling, A ea'(%) U.valttet R-value' R-value'. R vaitteJ Wail perimeter Egttipmem Efficiency' pie R value' R valtte' 5701 to 6500 Heating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal 12% 0.52 19 10 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 25 N/A N/A Normal U I S% 0.46 38 19 19 10 6 Normal V 1S% 0.44 38 13 25 WA WA 83 AFUE W lS% 0.52 30 19 19 10 6 SS AFUE X Is% 0.32 38 13 25 WA_ N/A Normal Y 18% 0.42 38 19 2S WA WA Nomtal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: �b 4. %GLAZING AREA(#3 DIVIDED BY#2): I 5. 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-f980303a ,a 780 CMR Appendix J Footnotes to Table J8.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing-area may be excluded from the U-value requirement. For example,3 ft2 of decorative glass may be excluded from a building design with 300 ft2 of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table'J1.5.3a. U=values are for whole units:center-of- lass U-values cannot be used." A o S ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full ` insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,-structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned cmwlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must mz=i the same R-value :requirement.�as above-grade. walls.--Windows and sliding glass doors of conditioned basements must be included with'the'other"glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. " If the building utilizes electric resistance heating use compliance approach 3,4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: `- a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 I r�4 The Commonwealth of Massachusetts • fl� _ _—_ , Department of Industrial Accidents clog,, ions 600 Washington Street -_ Boston Mass. 02111 r J Workers' Compensation Insurance Affidavit naMe UA,10IV A location cityhone# �,. �� �, - I am a homeowner perfo g all work myse . I am a sole proprietor and have no one workin in any capacity % /%%% %%%/////m/%///m/%%%O%O%% %%%%�%%%%% am an employer rovidin workers' compensation for my employees working on this job.. ❑ I p g re anv name:: address , ci hone#' 0Lcv#: :insurance co. ❑ I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers'. compensationpensationpolices: : X. coin an name; address ::.. i:.' i::'.:.i'::�i:...;. ne >X. ::.. oLcv#:: >'.;::. . /l//// Xx­ . . address. ;: hone#t .... 3va <: lit v #. 2%;:i% :;.:.i<i?i>�iii ';i`i::i;i%:�ii:::::::::i:,:,:::2_;::.;;:'.:ia:`?:::SiiB;::::.:i�<i2 :iy.?.••.::Si' i.. nmranc Failure to aecare covers;e a,required raider Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one yeah'imprisonment as well as dvfl penalties in the form of a STOP WORK ORDER and a fine of$100.00 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 veriflcatlon 1 do hereby certify the pains and en •es of perjury that the information provided above is true and correct/7 Signature Date �—��y — - Print name Phone# SEERS 151: official use only do not write in this area to be completed by city or town official permit/license# ❑Bunftg Department city or town: ❑Licensing Board . ❑Selectmen's Office ❑checkif immediate response is required ❑Health Department contact per,on• phone#; ❑Other /93 PJA (tNlaed 9 ) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their quoted from the 'law" an employee is defined as every person in the service of another under any contract employees. As qu of hire, express or implied, oral or written. t An employer is defined as an individual, partnership, association, corporation or other legal'entity; of any two or more of •the.foregoing engaged in a joint enterprise, and including the legal representatives of a�deceased'einployer, 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 mor e than three apartments and who resides therein, or the occup ant of the dwelling house of another who Pers ons to do maintenance construction or repair work on such dwelling house or on the grounds or employs s P Y thereto shall not because of such employment be deemed to be an employer. building appurtenant P MGL chapter 152 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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 pi number which will be used as a reference number. The affidavits may be retuned tlo the Department by mail or FAX unless other arrangements have been made. 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. FBI The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Imlesugadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 . . The Town of Barnstable &►xrrsTes�.e, - M g Regulatory Services `b 1639. �`0 Thomas F. Geiler, Director, QED MA'S Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. p' yI , Type of Work: l S� ����I ��� _Estimated Cost Address of Work: . Owner's Name: .�1 .*)AQ Date of Application:- zin� I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law []Job Under$1,000 4Building not owner-occupied owner 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. O Date O s Nam q:fonns:Af idav:rev-070601 - °� The Town of Barnstable _ g Regulatory Services �Eo;p.�►`` Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 7/ Please Print DATE: JOB LOCATION: jai Vill e number street.. "HOMEOWNER : rk ho e# name home phone# [3(/- . ES w CURRENT MAILING ADDRESS: J` ci. town yam zip code The current exemption for"homeowners"wasextended to include owner-occupied dwellings of six trolls or less and to allow homeowners to engage an individual for hire who does not possess a license, rop yided 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 ps and eats. im=mHo o er 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/certifrcation for use in your community. Q:FOAMS:EXEMPTN �r i t - f a j . I � LOT 22 LOT 24 plp•k, ' 00 �p�p0• . , -SHED HSE= J LOT 25 LOT 21 cY g �� p I - ' _ '. - ,�. .. rF S ../ `"si• tom' a a� � .. e� f � �°* f � r� ,�, LOT 2F , z �r r,,' NOTE. PRE—EXISTING NONCONFORMING s� r M RES. ZONE:• "RD-1" Thi MORTGAGE INSPECTION ga°,fk Use Only FLOOD ZONE "C" RMANCIESS AND ON THE PW SHOULD-BY-VERMED BY AN INSMUMENT SURVEY. TOWN: GISTRY OWNER: IZEUX A._B4EYN9LW_ DEED REF: tA9vAVW- _------ YER• �l�dl Cdf�BQDf 'B,�--- ------------ DATE: �LRTIFY TO ------ LAN REF: J1 10- _SCAI -fT _30 _FT I HEREBY CERTIFY TO YANKEE SURVEY THA„ THE BUILDING ► SHOWN ON THIS PLAN IS [ACATED ON TIC GROUND AS $ PAUL CONSULTANTS SHOWN AND THAT ITS POSITION DOES CONFORM o MEI AL AITH)?1M 40B (SUITE 1} TO THE ZONING LAW SETBACK REQUIREM_i ITS OF THE TOWN OF 8B8d�L'T,9.8,L AND THAT No. 3l W INDUSTRY ROAD IT DOES_.1V0�_ LIE WITHIN THE SPECIA�1� FLOOD HAZARD ,� °E'GJSTEa ARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DA�D_z/1?/� p� uw0 TEL 428-0055 C nit -Panel 250001-DO - ! FAX 420-5553 • __ THLS PLAN NOT MADE FROM AN INSTRUMENT SURVEY pFLS NO T0'BE USED FOR FENCES BUILDING PERMITS ETC. 30419 DAfF i . . z 4 ; �'1 - - E- M s — fl)�.- ; i,S _ I ) f � I � � i �� .,� �.:: _:� fIII .�.r.v �; � I._ � � i » � _.._ � i I .. .w.,... rw 4 I 1 1 ., d (' t'... � �• 4. .�...M �' d � ; { � f . 1P 1 1 I � I F , � r , , J _ _ oo 6-_o - - -- -- - _ 3�ZX zFr '� r ge- Talp N �W9A I_ - D - y. , -- rs - -- �� IN t > In _ 6 f Q CNN 4 tiut. F 04 As _ 1 7 it a fro T:U � ��+.a � fir.)' •nli.r •.r ,S. �� µ . , r' ion n fit .fi �\.{:;i ��`ry•S �.�. t f t } i TC =-, \Z : -A7rLI Ll � � DR 44 � t - 17 --4-H I. r r\� t 1 r t f � r 1 I 1 t j - / nth _ n I� r =Pat _ P T� �xi{ -�.- - -- ------ - - - � _ r^1 x _- -- -'1Ksl PARricle t3oa2D ol FhR 1 { rt �. Sal i •�' ! 1 _. .. _._ .._._ `�� � I � !_._=.-�. _ �• � _ �� - -- - 1 i 1 I tt ji- { 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o Parcel , Permit# 571CO2,77 Health Division � 4 W #0/0 /.� Date Issued 11goot Conservation Division S �//_/660/ Fee Tax Collector j®P SEPTIC SYSTEM MUST BE Treasurer INSTALLED IN COMPLIANCE Planning Dept. .✓hiss ,�� WITH TITLE 11 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOViN REGULATIONS Historic-OKH �0 Preservation/Hyannis Project Street Address Village _ I Owner. T040 IT(Y"ad-C t tZ 4 ddress j `O CY i 5 2-- 01 Telephone So 6 7 6� °l Permit Request u tii (c7� — c7 j _ _ � S uare feet: 1 st floor: existing (2-0 proposed--L)(A C 2nd floor: existing — proposed Total new q „ 9 p P g p p ValuatiohdCOO•6-0 Zoning District Flood Plain — Groundwater Overlay -- Construction Type UJ-10:9 Lot Size 9000 5 GrandfatKered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family UL Two Family ❑ Multi-Family(#units) Age of Existing Structure i '?65 Historic House: ❑Yes D-qNo On Old King's Highway: ❑Yes WNo Basement Type: ❑Full l-Crawl Cl 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_ 3 new Total Room Count(not including baths): existing S new First Floor Room Count S11M�' Heat Type and Fuel: aGas ❑Oil ❑ Electric ❑Other CentralAir: ❑Yes ZI 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:Ch existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION [ALL F1�c�,��c� �CZ o r\ Telephone Number : 2 (e ss License# Home Improvement Contractor# Worker's Compensation# ONSTRUCTION IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ATURE DATE ti FOR OFFICIAL USE ONLY :r A k PERMIT NO. �� �� '`•� , DATE ISSUED 4 MAP/PARCEL NO., 1 ADDRESS VILLAGE 1 a , OWNER ' 1 ' DATE OF INSPECTION: oe FOUNDATION " FRAME INSULATION f FIREPLACE w ELECTRICAL: ROUGH r FINAL , `> PLUMBING: ROUGH FINAL GAS: ROUGH` —t _ FINAL FINAL BUILDING �; ••• •— .' DATE CLOSED OUT =? � << ' ' �• � 4 Cat - ; ASSOCIATION PLAN NO. 9 �_S f C e t . '1ne -town of Darr • L►itrvsrwstt: • >�. Regulatory Services Eo;w �� Thomas F. Geller,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-62:0 HOMEOWNER LICENSE EXEbIPTION r Please Print DATE: I i 8 1 d 0 JOB LOCATION: TZ t��U-' number street village "HOMEOWNER": `s-o nt6 aui oys: c izrc ' 6 ` ,9,k Ok name home phone# work phone# CURRENT MAILING ADDRESS: i dry/town state rip 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 proce es and requirements. ,F1gnature of6dmeowner 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 EXEMP71ON 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 personts)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 formicertification for use in your community. Q:FORMS:EXEMM r . _ The Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. Type of Work: Estimated Cost 900'o 92 Address of Work: Z 1.4 u, a Owner's Name: 'So.A�o T`*j &6-1 CA Date of Application: ��^ 1 O o I hereby certify that: Registration is not required for the following reason(s): E]Work excluded bylaw QJob Under$1.000 []Building not owner-occupied ❑Owner 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. 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