HomeMy WebLinkAbout0193 HORSESHOE LANE Iq� � � �� 1
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f
Sri J
,',,.Map 0_7 Parcel Z Permit# �
Health Division Nk;t- Ud.�=.a8� Date Issued li o
Conservation Division �. 7 a_ Application Fee
Tax Collector 6& Per O ��,IQT R
`�_ _ Qd2 SEPTIC S� ��PuA�ICE
Treasurer INSTA ED IN CO
Planning Dept. V'T=s
."RONMENTDF-
Date Definitive Plan Approved by Planning Board Yoh
Historic-OKH Preservation/Hyannis
Project Street Address
Village e,1_;44(f
Owner / i�� Z / /� oA/560*Address
Telephone 506 775--
Per it Requests
Square feet: 1st-floor: existing 0 proposed — 2nd floor: existing proposed IM6 Total new/ #
Zoning District e Flood Plain Groundwater Overlay
Project Valuation p1001)� Construction Type kno/
i
Lot Size Ot C 1'eS Grandfathered: ❑Yes 2, o If yes, attach supporting documentation.
Dwelling Type: Single Family Q/ Two Family ❑ Multi-Family(#units)- !al Age of Existing Structure . Historic House: ❑Yes d El On Old King's Highway: Yes .alo
/ Basement Type: 2 ull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) P 029,0
Number of Baths: Full: existing / new / Half: existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing S new First Floor Room Count S
Heat Type and Fuel: O"Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes 1lo Fireplaces: Existing New Existing wood/coal stove: ❑Yes CENo
Detached garage:Cl existing ❑new size Pool:❑existing ❑new size Barn:❑existin6 ❑newasize
7
Attached garage:❑existing Cl new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ a
� ts7
Commercial ❑Yes ❑ No If yes,site plan review# co X_
co
Current Use Proposed Use c M
BUILDER INFORMATION r�r�
Name��G� fl�� (���fi1�7 .<, Telephone Number 5-M ! l!3 70
Address/01 " 4,esg 8keg /;I, � License# 0�g
Home Improvement Contractor# �LZ
Worker's Compensation
##ti.�C 590/ W 6, 38/ 2 dV 2--
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO
•�wc�c:1`�.
SIGNATURE DATE __S_�a-t3 ld,4-
ti -
FOR OFFICIAL USE ONLY
k i ,
PERMIT NO.
e DATE ISSUED
MAP/PARCEL'NO.
ADDRESS VILLAGE
OWNER rr r
DATE OF'INSPECTION: :
FOUNDATION
FRAME
INSULATION D �
FIREPLACE
ELECTRICAL: ROUGH; FINAL
T.
PLUMBING: ROUGH. rM c FINAL
t'ri' '
'> GAS: ROUGH . - FINAL
FINAL BUILDING
! tq,> '
DATE CLOSED OUT ; ► « £`'
ASSOCIATION PLAN NO.
r
h E'
OpIME r Town of Barnstable
Regulatory Services
snzAnB�.e, Thomas F.Geiler,Director
9�A 1 MASS. ,0�'
Tpp�.�A Building Division
Tom Perry,Building Commissioner
200 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:/T//��
dd L /?e—IC Estimated Cost
Address of Work: I p A/ut,54 —/- 9£ 'A � � �2tr.1/�
Owner's Name:2>ft/f I NCoft- Vi 411C
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job 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:
Date Contractor Name Registration No.
OR
Date Owner's Name
Q:forms:homeaffidav
L
_`�` ` The Commonwealth of Massachusetts
n.�-- — Department of Industrial Accidents
-= - Office ofinrestigatians .
600 Washington Street
Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit
name:
location
city phone#
❑ I am a homeowner performing all work myself.
❑ I am a sole
ir eiioiri iinidi ihiaiivaea niioi iioiniiei wiioiirkiiniini any; i iaic
ii iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiaiiiaiiiiiiiiiii
I am an em to er. roviding workers' compensation for my employees working on this job.
•s��ildl� •'a
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❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who
have
the>.f
.ollowin workers pen satton o.lices:
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::.;�;:t�P''Cd ��ii''S? '}Y?{�`�>: '`??i >t' `'c';'•.�? :i ' > is �i�t�'1�<it'` �<"i�:±ii`[?�`: i< [i?i.
�iu�urn
Failure to secure coverage as req�red under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sne np to S1,500.00 and/or
one years'imprisonment as wen as dvIl penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a
copy of this statement may be fossvarded to the Office of Investlgations of the DIA for coverage veriflcatton. �
I do hereby nertify under the pains 1penalties of perjury that the information provided above is truo and correct
Date.
Signature T
Print name i OAV� Phone
official use only do not write in this area to be completed by city or town official
city or town. permit/license# (3Building Department
[]Licensing Board
❑check if immediate response is required ❑Selectmen's Offlee
OHealth Department
contact person: phone#; ❑Other
Onised 9/95 PIA)
Information and Instructions .a
r
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", 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.
.i
MGL chapter 152 section 25''also states,'that every state or local'licensing agency shall withlbld�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't'' insorance 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 ifie
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 permii license number which will be used as a reference number. The affidavits may be rebune 'Ind .
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.
The Department's address;telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of MUUMUU
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
RESIDENTIAL BUILDING PERNIIT FEES
APPLICATION FEE
New Buildings,Additions $50.00
Alterations/Renovations $25.00
Building Permit Amendment 525.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
square feet x$96/sq.foot= W101 -x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot= x.0031=
plus from below(if applicable)
ACCESSORY STRUCTURE>12.0 sq.ft
>120 sf-500 sf S 35.00
>500 sf-750 sf 50.00 '
>150 sf- 1000 sf 75.00
>1000 sf-.1500 sf 100.00
>1500 sf-Same as new building permit:
square feet x$961sq.foot= x.0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
I
Deck x$30.00=
(number)
Fireplace/Chimney x$25.00=
(number)
Inground Swimming Pool . $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable)
Permit Fee
proicost
7io CMR Appendi=!
Table J&Llb(eoudaued)
Prescriptive Packages for One and Two-Family Residential Buildings Heated with Fossil Fuels
i
MAXIMUM MINIMUM
Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling
Area'(%) U-value= R-value' R-value' R-value' Wall Perimeter Equipment Elflciency9
Package I It-value R value'
5701 to 6506 Hating Degree Days'
12% 0.40 38 13 19 10 6 Normal
rT
12% 0.52 30 19 19 10 6 Normal
12% 0.50 38 13 19 10 6 85 AFUE
+ 15% 0.36 38 13 25 N/A N/A Normal l
U 15% 0.46 38 19 19 10 6 Normal
V 15% 0.44 38 13 1 25 N/A N/A 85 AFUE
W 15% 0.52 30 19 19 10 6 85 AFUE
X 19% 0.32 38 13 25 N/A N/A Normal
Y 18% . 0.42 38 19 25 N/A N/A Normal
Z 19% 0.42 38 1 13 19 10 6 90 AFUE
AA I S% 0.50 30 19 19 10 6 90 AFUE
1. ADDRESS OF PROPERTY: l q3 6g$4®f M.
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 146
3. SQUARE FOOTAGE OF ALL GLAZING: 7< '5,�—
4. %GLAZING AREA(#3 DIVIDED BY#2): dr a-7 7 2Z 2-
5. SELECT PACKAGE(Q--AA-see chart above):
. r
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-f980303a
780 CMR Appendix J
• y
Footnotes to Table J5.2.Ib:
' 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 fF of decorative glass may be excluded from a building design with 300 ft of glazing area.
Z 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-glass U-values cannot be used.
' 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 crawlspaces,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
meet 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
described 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 5. 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(035 for doors).
43
�'fie 1�arrvrreaiwiea� o�✓��oac�ucaeka � �
BOARD OF BUILDING REGULATIONS
License: QpNSTRUCWO'N SUPERVISOR
I Numbe_� 048338 1
iF
r
Butl�at 1�2-�7�95� ;
1 r b 120,04 Tr.no: 13739
RereEed
MICHAEL J DA1dC� L2�= :%
105 HORSESHOE
CENTERVILLE, MA 02 Administrator
. ._
i
41
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
'Map oC C57 Parcel 1 Permit# 9
Date Is ,e Z —
Fee
Tax Collector
Treasurer
roved by Planning Board
tien/k�.yan►�is
Project Street'Address 3 - �0 rS�e Sti G
,Village -�
Owner l J6 U t 4SDY► Ile Address ��o e Sk a e '1
'Telephone
'Permit Request S7 1? 1 P -4. re ro o:e — f S S/"(1[ AX's
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Estimated Project Cosh 0 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 ;213 Historic House: ❑Yes QrNo On Old King's Highway: Cl Yes ❑No
Basement Type: 'Full ❑Crawl ❑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 e2— new
Total Room Count(not including baths):existing 5 new First Floor Room Count
'Heat Type and Fuel: dGas O Oil ❑ Electric 0 Other
Central Air: ❑Yes QNo
Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:O existing .❑new size Pool:❑existing ❑new size Barn:Cl existing ❑new size
Attached garage:❑existing* ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization 0 Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name DA V i /4 M&g rn Telephone Number 7 7
i Address I q-Yy l ',� � //,-(. License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TQJ,��PJYI�
r
SIGNATURE /(� `%�Ill�-'`` DATE _ /0 • a�/ /r'�
1
= r. FOR OFFICIAL USE ONLY
PERMIT NO. = z '
DATE ISSUED Li
MAP/PARCEL NO.
ADDRESS VILLAGE ,
OWNER_, - ..
DATE OF INSPECTIOi: -
FOUNDATION
FRAME -
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL '
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT ,
ASSOCIATION PLAN NO.
The Town of Barnstante
Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038
Ralph Crossen
Fax: 508-790-6230 Building'Commissi: oner
Permit no.
Date
AFFIDAVIT
s 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.
t
Type of Work: rf- f 01 ' — Estimated Cost
Address of Work: �hFD 1'�p /'1/L0. Pm .
Owner's Name: D 4 y 0 0 A M Arin Vf�.
Date of Application: y_
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job 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.
Date Contractor Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
— "'�,\ The Commonwealth of Massachusetts
I -=_�
-= -= De Department o Industrial Accidents .
Y--_,,_ . — P f
• _ _ 600 Washington Street
;. - �I . Boston,Mass. 02111
r=;`� Workers' Co m ensation Insurance davit
name � 1 12-4 m Ja 2a J 12 -
location: ! 3 f&r�ahae- Aa a te , -
city � hone# of
am a homeowner performing all work myself. j
❑ I am a sole rietor and have no one workm in any cap aci
/%/%%//%// %%%%/%%/%%/%/%%%%%%%%%%%%%O/% %/%/%//%%%//%/%%%/%%%%%%%//%%///%%%%%%//%��%%%////%%%%%%%%%%%/�%%%%%////////%/G�%%%/%%/
❑ I am an employer providing workers' compensation for m. employees working on this job. :: :::::: :: :::::::::..... :::: : : .
conibanv name•
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city .
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.
insurance co. ;:., o kv#..
❑ 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:
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comaanv name :<::;;:;::;;,.
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..::....
.
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or
one years'imprisonment as wen as civil 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 verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct .
. �J ` J/ ff
Signature / Date — -
Print name D&V 2 b 1 M PS 01 J - Phone# ' J�A�'• 7. - . <�, L �1
o e only do not write in this area to be completed by city or town official
city or town. permitNcense# a� g Department
ard
[—'
❑checkif immediate response is required ❑Selectmen's Office
__ ❑Health Department
contact person: phone#; ❑Othen_
ogmed 9/95 PIA) `
.
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their.
employees. As quoted from the "law", 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.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 permit/iicense number which will be used as a reference number. The affidavits may be rOmfi6d io
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.
,The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Me of toyesugadoas
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 eat. 406, 409 or 375
N Building Division �
367 Main Street,Hyannis MA 02601
.i t�esa ,eg
Eb��
Office: 508-862-4038 Ralph Crossen.
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: /d- a2 �• f / . ,,' I/.
JOB LOCATION: �P.�►��� -
number NN ees village
"HOMEOWNER ID"!d- 14 /Asia/ Je 775—' Y-14 V 7757' .S'SPy
ame home phone# `` work phone#
CURRENT MAILING ADDRESS: Q2 L1,6 iY S4 h e old h CZ
city/town state zip code
The current exemption for"homeowners"was extended to include QVvner-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 sum.
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 nerformed 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,tales 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.
Signamme 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
persons)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they ate 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 cage.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.
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--_.—._-.-- — ___--__—_.._.—_—_..—__—_ —_ _--_-_-- hereby reserves its common law copyrigN
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—-----
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...._.... reproduced or changes N any mannw, -
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MICHAEL JIMER50N AIA
ARCHITECTURE
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193 H0R5E5H0E LANE
CENTERViLLE MA
02632
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F05T BrWKET HOK5E5HOE LANE COTTAGE
193 HOR5E5HOE LANE
CENTERVILLE MA
02632
Ll
EXPAN510N AND ALTE2ATIQNS
FRONT ELEVATION
no. A.4
date 10 MAY 02
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•WW - : .._.._._...._......_......._.__._.._._.._._.._._. - hereby reserves Its common law w0Ytl9ht
and other Poparlyrights not plane,
m. '\� ,, —�------------- esa w antltleaigns which are not to he
p•,• , _' �:':y .._..._.___..._..—_..._.._...._.._.-... _- reproduced or charged in any manner.
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Party without the written permLsalon of the
architect.r: architect.
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W/3/4" PLY SHEATHING MICHAEL JIMER50N AIA
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ARCHITECTURE
INTEk10k OESIrnI
3/4" PLYWP SUB FLOOR 193 HQKSESHOE LANE
CENTERVILLE MA
02632
TELEPHEXISTING 2"X 8"$I$TERING 7 I/2' TRUSS JOIST$ OR LVL LUMBF_R 6172422.11a00
EXISTING FIRST FLOOR
HORSESHOE LANE GOTTAGE
193 HOk5E51-10E LANE
CENTEkVILLE MA
02632
EXPANSION AND ALTERATIONS
EXISTING BASEMENT
O
BUILDING 5ECTIDN
na. A'7
date 10 AAAY 02
Scale 114-_1•_0-
drywrl J.M.F.
.checked _ M.J.
- rovi5ipr15.
issue dates I
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2" x FKAME_D BALCONY
w/ 4"x4•• PO5T BKACKE_TE)
copyright
MtCHAICHAEL JIMER80N AW
hereby reserves its common lmv copyright
erM older propeAy rights In Weae plans,
IdeaM O U N TE_D B E L DW and and designs which am net to
be
3'0"
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F_X�rjT�N(� 2" X 8 515TE�ING �,2" T'U55 J015T5 0" LVL LUM VEh no a,e Way to 6easegned taa lldd
partY without the written permission of the
architect
N
MICHAEL JIME.RSON AIA .
A2CHlTECTURE
INTERIQR OESII;N
193 HORSE5HOE LANE - -
CENTERVILLE MA
02632
TELEPHONE
617.242.1400
d.
HOR5E5HOE LANE COTTArE
- 193 HOR5E5HOE LANE
CENTERVILLE MA -
02632
WFW RUA i
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EXPAN5I0N AND ALTE9ATION5'
FLOOR FRAMING
no. A.B
date - 10 MAY 02
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