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0110 INDIAN HILL ROAD
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T - , _�, I .I ��i, � -_W . , ,��,, ,- a_�, I I... ��," � �1,wr_2L,,. �n lt4, � 1�1 I �� ,-_�,: — — , ' '770 1, , WTV 1 g 1 . ...��0 2 W" `14 - -- Aim 1 1111 I I I w -3 W- 017� . <Dn Lf Town of Barnstable *Permit# tME r Expires 6 months from issue date Regulatory Services Fee "1 snxxsrA1314 t y MASS. $ Thomas F.Geiler,Director TEp MP't A Building Division 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 �� C!'l� Q,r Y\SAIA �. Property.Address /ld .7�i��1/�✓) �►�� 4660� Residential Value of Work IS Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address FA e o e I CK /10 rnnrAY) Atll 4046 , Cvanfr. 4QoIQ, Mfi 61637 I Contractor's Name I OQ A S II S-e Telephone Number—SL .3��"Syt'b Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 41 jq.q64rota ^, A ❑Workman's Compensation Insurance Ch ck one: MAY 9I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance N OF Insurance Company Name ti i7 t- P Y 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) [A,Re-side #of doors-. ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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 exemp,,�omp a ce 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: fine. a—( a of�Toy, y • BnaxsraBM MASS, i Town of Barnstable 639. ��� iDl fD�,l A Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry,CBO 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 1 as Owner of the subject property hereby authorize �p /M G S. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 2,01 Signature of Owner Date Print Name If Property Owner is applying for permit,please.complete the Homeowners License Exemption Form on;the reverse side. i i Q:IWPFILESTORWbuilding permit formslEXPRESS.doc „o4T"�TOw Town of Barnstable Regulatory Services BARNSTABLE, ” Thomas F. Geiler, Director MASS. 9`b 16g9. ��� Bui g ldin Division Tom .erry,Building Commissioner 200 in Street, Hyannis, MA 02601 town.ba rnstable.ma.us Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWN R LICENSE EXEMPTION ease Print DATE: JOB LOCATION: number street village "-HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: ' city/town state zip code The current exemption for"homeowners"was extended to include owner-occu dwellin s of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, ro ided that the owner acts as supervisor. DEFINITION OF HOMEOW Person(s)who owns a parcel of land on which he/she resides or intends to resi e,o which there is, or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or arm st ctures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"ho eowner" all submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all ch work e rmed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance ith the State Buildin Code and other applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that he/she understands t Town of Barnstable Buildin Department minimum inspection procedures and.requirements and that he/she will comply with s 'd procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15, 0 cubic feet or larger will be required to comply wit 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.L I -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/certification for use in your community. I 0-kUMIZTT AR\Rr1RMR\haildinwnermitformsTXPRESS.doC _ I E TOWN OF BARNSTABLE PARNSTIBLE, 1639. BUILDING INSPECTOR APPLICATION FOR PERMIT TO watte.e.5.........S1................................................... TYPE OF CONSTRUCTION ........... ......................................................................... ......................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location d..................... . .. ...................... ................................................. Proposed Use .... -...e ... .......................................................................................................................................... Zoning District ...... .........................................Fire District ...X4.e-:..,41 .................................................... Name of Owner tiP,.SAAA....waltf).........T.e..............Address 1.M.4.1.,x...Y�Jl..J?J........ Name of Builder irp.afth...V4,.5tA .—A!!S..F..............Address ff�. AA . .. q.j w,4..... .W......... ............... Name of Architect -J*A?!.... kr.,m.a Ir. .............Address ..................................................... Number of Rooms ............/......................................................Foundation ... .......... Exierior .............................................................Roofing .... A...................................................................... Floors .........C.2.............. .7............Interior .......... ............................................... Heating ... .................................................Plumbing ........ ..................................................... Fireplace .........4.....................................................................Approximat(- Cost ...�t).OPpl............................................. Difinitive Plan Approved by Planning Board --------------19 4.,4 / ? / - .0 -�4 J Diagram of Lot and Building with Dimensions 3 -J7 > > M C) > -0 > > 0 ;E, M 0> * M G) > 0 FA ;jr > r-j C-- rn zMo 0 Tj M > C z V,r M 0 0 -ri Z -T1 ;TJ > 0 rm C C < --j M M z CA C.r) G) rT1 36 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................................. Walters, Joseph Jr. OEC 31 1 ... Permit for .....two stor.V ......... No ..... 7..... ...... single farm -y dwelling„ tt0 Location .....Indian Hill Road ........................................................... w...._. ........ Owner ......... ................ ' Type of Construction frame................... I ................................................................................ Plot Lot .......#.18................... Permit Granted .... rch j ..................l q 71 s Date of Inspection .. v./�1...1 1.......19 Date Completed ...... ....4.�.....19 PERMIT REFUSED ............................................................................... ................................................... ........................ ............................................................................... ............................................................................... � 4 Approved ................................................ 19 ............................................................................... ...............................................................................