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Town of Barnstable *Permit#
Erpir 6 months from issue date
X-PRESS PERMIT Regulatory Services Fee
DEC 3 1 2007 Thomas F.Geiler,Director IV
Building Division SIC — 0 g
TOWN OF BARNSTABLETom Perry,CBO, Building Commissioner J
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office:- 508-862-4038 Fax: 508-790-6230
EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number ,r
Property Address / � �� F/ P_ �u,tS` qb/e- j'r) / 7
❑Residential Value of Work ow Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address j7,:g C_ (- ,j X.(�,
Contractor's Name iaac dlk7c?ti 601 Telephone Number1,5 O t? j eo Z.
Home Improvement Contractor License#(if applicable) 1 --(�1
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
0 I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name A;
Workman's Comp.Policy,#co�'5 Lj LO G t 4(30 1
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box) A f
2-"Re-roof(stripping old?shingles) All construction debris will betaken to
❑Re-roof(not stripping. Going over existing layers of roof)
ED Re-side rj,C�; s
replacement Windows/doors/sliders. U-Value _ J (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.
A copy of the Home Improvement Contractors License is required.
IN 3IGNATURE: L`J/
f`
�Tonns:expmtrg
teviseOMD6
Town of Barnstable
Regulatory Services
• a
MABs Thomas F.Geiler,Director
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
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, J eG rtt �etg�; epemecfe-s ,as Owner of the subject property
hereby authorize -I-'Y�- to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Address of Job)
Can / /7 /0-7
Si° ture of Owner Da
3WL \�. �
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORM&O WNERPERMISSION
Town of Barnstable
oFt�ram,
Regulatory Services
Thomas F.Geiler,Director +�
BARNSfABLE, 1
MASS.
9q, 1639. �•� Building Division
Arfpa Tom rry,Building Commissioner 1
200 MaStreet, Hyannis,MA 02601
R �toR n.barnstable.ma.us
Office: 508-862-4038,• Fax: 508-790-6230
` HOMEOWNE LICENSE EXEMPTION,
ease Print f
DATE:
t
JOB LOCATION:
number stree village
"HOMEOWNER":
name home p one# f• work phone#
CURRENT MAILING ADDRESS: f
city/town / state zip code
The current exemption for"homeowners"was eNtended to incltid owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does no possess a license,provided that the owner acts as
supervisor.
-^
.x< _ DEFINITION OFH JEO-'4T:E1i�
Person(s)who owns a parcel of land on which he/she resides�r inte s to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or detached struc es acc `ssory to such use and/or farm structures. A
person who constructs more than one home in a two-year p riod shall of be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a fo acceptab to the Building Official,that he/she shall be
res onsible for all such work performed under the build*, erniit. (Se�ion 109.1.1)
The undersigned"homeowner"assumes responsibility or compliance the State Building Code and other
applicable codes,bylaws,rules and regulations.
'f
The undersigned"homeowner"certifies that he/sh understands the Town of Barnstable Building Department
minimum inspection proceduresi andrequiremen and that he/she will comI ly with said procedures and
requirements.
Signature of Homeowner
.t .
Approval of Building Official
Note: Three-family dwelli/gascontaining 35,000 cubic feet or larger will e,required to comply with the
State Building Code Section 127.,dConstruction Control.
HOMEOWNER'S EXEMPTION
The Code states that: " y homeowner performing work for which a building permit is required hall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner enga es 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 supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction.Supervisors,Section 2.15) This lack of awareness often results inl\enous problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person 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 o e 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 fomn/certification for use in your community.
Q:forms:homeexempt