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Town of Barnstable *Permit#
ILI � F_xpires 6 montles frwn issue da!
3 Regulatory Services Fee �- c�
anata ARM t Thomas F.Geiler,Director
039. .•� Building Division Q� y/6
Fn 4�
Og
�+
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.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
Property Address G 0 1-31-11V t✓4,tS 6-9 V,6,
Residential Value of Work ��Z-U0 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address
/0/ / OGu n ( v✓�i rip2_so574- L,! /'7.n. 0-U 3 Ll
Contractor's Name Telephone Number S l/ 36�
Home Improvement Contractor License#(if applicable)
❑Workman's Compensation Insurance IT
Check one: X-PRESS PERM
❑ I am a sole proprietor
I am the Homeowner MAR 2 7 2008
❑ I have Worker's Compensation Insurance
TOWN OF BARNSTABL
Insurance Company Name ��✓��`?
Workman's Comp.Policy# NV-9
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
Replacement Windows/doors/sliders.U-Value " 33 (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.
•�f1 fir•;
SIGNATURE:
Q:Forms:buildingpermits/express ,.
Revised 123107 _. ;
Town of Barnstable
THE Tp��
Regulatory Services
M Thomas F.Geiler,Director
+ BARNSTABLE, +
MASS. Building Division
DIED a 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: '.G✓r1-'o
JOB LOCATION: %� D�✓J �101�a �3 GA'o �aT��u �
number street village
"HOMEOWNER": cl,b J;�Z- ��
name home phone# work phone#
CURRENT MAILING ADDRESS:
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' pection procedures and requirements and that he/she will comply with said procedures and
requirem ts.
Signature of Home wn
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/certification for use in your community.
i
r"
oFYHE rqy Town of Barnstable
Regulatory Services
9BMASS.ARNSTABM ` Thomas F.Geiler,Director
�p 163q. �m .
rFnMa+" Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
wwwltown.barnstable.ma.us
r
Office: 508-862-4038 Tax- 508-790-6230
Pro pLertY Owner Must
�
Complete and Sign This Sec on
If Using A Builder
as Owner of the.subject property
hereby authorize to act on my behalf,
in all matters relative to work orize by this building permit application for:
(Addres of Job)
Si tore of Owner Date
Print Name
If Property Owner is applying for permi please complete the Homeowners License
Exemption Form on the reverse side.
(lFl1R TTC•f1WT�fRR PFRMi.CCIf1N
-,; Town of Barnstable *Permit#,:;;'1P0 7 6 a
«� Expires 6 months from issue date
i
X®PRESS PIT Regulatory Services Fee dam"
Thomas F.Geiler,Director
0 C T — 2 2007 Building Division
Tom Perry,CBO, Building Commissioner
TOWN OF BARNSTABL E 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-
Property Address �f C/�-C� lowl'o�y16-'s Z-4:y /�✓ �!. J C � '
[,Residential Value of Work 00 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address �c/�� --'�1✓t�i Sl��i
o A/�,I Telephone Number
Home Improvement Contractor License#(if applicable) ��a4
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
® I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof)
® Re-side >V �VIV 4&r l,
❑ Replacement Windows/doors/sliders. U-Value (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.
SIGNATURE:
Q:Forms:expmtrg
Revise061306
d
Town of Barnstable
f. �DFTHE TpN'1,
Regulatory Services
* BARNSfABLE, Thomas F.Geiler,Director
9 MASS.
1639• .• Building Division
rFn �s 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
j Please Print
DATE: d(o7,
JOB LOCATION: 7 SJ G ZO
number street village
"HOMEOWNER": GI/✓L. �✓�'L �SL.�I/1�� �S�l/� .�7SZ' S
name home phone# work phone#
CURRENT MAILING ADDRESS:
✓�iOrL�STiG'3 Ld'� 14to GZ6 y
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
su ep rvisor.
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 procedures and.
requirem ts.
Sign ture of Homeown
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/certification for use in your community.
Q:forms:homeexempt