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S­V0 f"o Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address < 2;*,%' � f�✓ Oifi J'�i �y-- Contractor's Name— ►` Telephone Number Home Improvement Contractor License#(if applica Email: Z#_ Construction Supervisor's License# if applicable) ( ❑Workman's Compensation Insurance X-PRESSPERMIT IT Check one: 99�� KI a sole proprietor the Homeowner OCT 2 3 2013 ve Worker's Compensation Insurance Insurance Company Name i roWN OF NSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Reque check box) , A ,may e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �✓S �yc� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A co of the Home Improvement Contractors License&Construction copy p Supervisors License is re uired. SIGNATURE: C9 _ C:\Users\decollik\AppDat ocal\Micr so t\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 VE Town of Barnstable : BARNSTABIZ Regulatory Services MAM Thomas F.Geiler,Director ��ED MA'I A Building Division Tom Perry,Building Commissioner 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:_'`"r JOB LOCATION: numbe ��r / street village A) ..HOMEOWNER"_ �y+ 1 >1iO�� l II(© �`�C! name home phone# work one# CURRENT MAILING ADDRESS: 31 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 pr=uranirements and that he/she will comply with said procedures and requirements. /Siiture of Ho eowner 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Out]ook\8R76BDVA\EXPRESS.doc Revised 061313 a -Ingineering Dtft. (3fd-floor) Map Parcel = t!5�71 9 Permit# House# Date Issued -�'Bo rd of ealth(3rd floor)(8:15 -9:30/,1:00-4:30) Fee D� Cons atio Office(4th floor)(8:30-9:30/1:00-2:00) G� � Plannin ept. 1st floor/School Admin. Bldg.) Definitive an A roved by Planning Board 19 BARNSTABLE. 019. OWYOF BARNSTABLE, ` Building Permit Application roject Street Address �( JZ 3 IT .` Village Ste,:ths` r Owner �,r�+ ' S JS �� Address ' Telephone 36:7,0 • 10 Permit Re nest I nn E g S� q `l�— l _X • i First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 1000 , 0 0 Zoning District Flood Plain Water Protection s d)Ci Lot Size r J�, Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes LU On Old King's Highway Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Al Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: �s ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 0 lv `j e OeK Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FO HE FOLLOWING REASON(S) - _ FOR OFFICIAL USE ONLY PERMIT NO. U� , ATE ISSUED > .a 1k AP/PARCEL NO. ADDRESS VILLAGE, OWNER DATE OF•INSPECTION: FOUNDATION- g FRAME � - � � ,� _ � � . � . � • INSULATION FIREPLACE -, ELECTRICAL: ROUGH 'FINAL PLUMBING: ROUGH FINAL _ GAS: ROUGH FINAL FINAL BUILDING (y -7Y f DATE CLOSED OUT. i e ASSOCIATION PLAN NO. ri • �.� TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Number Street address Section of town "HOMEOWNER" US. �/•-rS f� J G � ' D 7' � ....'. . ._ Name Home phone Work phone - PRESENT MAILING ADDRESS 67 re Ali R 0 19PAl A4a 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, -on which there is, or is intended to be a one or two 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 Officia. on a form acceptable to the Building Official, that he/she shall be res onsiblF for all such work performed under the building permit. p (Section 109. 1. 1j The undersigned "homeowner" assumes . responsibility for compliance with the Sta+ Building Code and other applicable codes, by-laws, 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 rocedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that such Home Owne: shall act as supervisor. " Many Home Owners who use this exemption are' unaware that' they are assuming the responsibilities of a supervisor (see Appendix 01 Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarene; often results in serious problems, particularly when �the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home " wner actir. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Fier responsibilities, mar. communities require, as p 'q part of the permit application, that the Home Owner 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. r