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O901 o C�)qS �
pFt rp�, Town of Barnstable *Permit#
, gyp Expires 6 mon rs from issue date
Regulatory Services Fee
* swtuvsTABM
9� 1639. 108i Richard V.Scali, Director
Building Division
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
C Not Valid without Red X-Press Imprint
Map/parcel Number,
Property Address O&/ /?00( JZR J?1jZ 1S71q gt_ m*4.
R Residential Value of Work$ 7_ 600 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address &OU 6/,41y1VET7_/
97 51&T (20cf( Q0. WAST/let c 1A0,
Contractor's Name f(.4QL Telephone Number _�0�t
Home Improvement Contractor License#(if applicable) 7 7 b 7 Email: k E TIC 9 @ Com w7,,N C`%
Construction Supervisor's License#(if applicable) C s - I o Z 1 ,: Q Ulf'
❑Workman's Compensation Insurance
Check one: APR 18 2014
❑ I am a sole proprietor
❑ I am the Homeowner
t. I have Worker's Compensation Insurance
TOWN OF BRtFINSTABLE
Insurance Company Name A.—T.M. M U-1U,4(_ 1 NS- Cd
Workman's Comp.Policy# V W C - f oo -6of7 T9 6 - zol y A
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 to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
91 Re-side
® Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows Z.
#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 copy of the Home Improvement Contractors License&Construction Supervisors License is
IT
ed.
SIGNATURE:
Q:\WPFILES\FORMS\building permit form,4 XPRESS.doc
Revised 061313
E
EARMABIX
,r M. Town of Barnstable
Regulatory Services
Richard Scali,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
7 �
as Owner of the subject property
hereby authorize '� l� to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
Q:\WPFILES\FORMS\building permit forms\smokecarbondetectors.doc.
Revised 050412
C
Town of Barnstable
Regulatory Services ow�'
�tH¢ Richard V.Scali, Director
Building Division
MRNNBTAM ' Tom Perry,Building Commissioner
MASS,
039. &�e� 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 f Fax: 508-790-6230
i
r
r.
H MEOWNER LICENSE EXEMPTION
Please 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 extend to includ owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire o does of possess a license,provided that the owner acts
as supervisor.
DEFINITION O H MEOWNER
Person(s)who owns a parcel of land on which he/she resid or intends to reside,on which there is,or is intended to
be,a one or two-family dwelling,attached or detached stru es accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year eri d shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a rm a eptable to the Building Official,that he/she shall be
responsible for all such work j2erformed under the buil erm (Section 109.1.1)
The undersigned"homeowner"assumes responsibil' for compli ce with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/ a understands the T of Barnstable Building Department
minimum inspection procedures and requirem is and that he/she will c mply with said procedures and
requirements.
Signature of Homeowner
Approval of Building Official
t
Note: Three-family dw lings containing 35,000 cubic feet or larger l be required to comply with the
State Building Code Section 1 .0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states t at: "Any homeowner performing work for which a building permit is required
shall be exempt from the/ 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. 4
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 understand;4he 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.
Y
AWE Town of Barnstable
*Permit m►t#
Expires 6 months from is a date
Regulatory Services Fee
snnivsTasl>
MAS& Thomas F.Geiler,Director
1639.
Building Division
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
�p No Valid without Red X-Press Imprint
'
Map/parcel Number
Property Address l Qi
Residential Value of Work Minimum fee of$35.00 for work nder$6000.00
Owner's Name&Address `
Co
ntractor's Name L' Telephone Number �o ( (�
l � / rcr
Home Improvement Contractor License#(if applicable) .>
Construction Supervisor's License#(if applicable)
0 orkman's Compensation Insurance -PRESS PERMN8T
Check one:
❑ I am a sole proprietor MAY
❑ I am the Homeowner
I have Worker's Compensation Insu ance
Insurance Company Named. -� T1 OWN OF BARNSTABLE
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 to
❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
[ Re-side #of doors
❑ Replaces I ws/doors/sliders.U-Value (maximum.35)#of windows
'Wherd requ : Issuance of thi permit does not exempt compliance with other town departmen[regulations,i.e.Historic,Conservation,etc.
�i
* *Note: Property wner must sign Property Owner Letter of Permission.
A copy f the Home Improvement Contractors License&Construction Supervisors License is
requir .
SIGNATURE:
C:\Users\decollik\AppData\Lo ott\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
i
J
TU PPE R
CONSTRUCTION CO.uc
79B Mid-Tech Drive West Yarmouth,MA 02673
Phone 508-778-0111 Fax 508-778-5010
Registration#121845 License#069058
Date: 4/12/2012
Attn:Building Department
I hereby authorize Tupper Construction Co.,LLC to pull the permits necessary to complete the project described
on the attached permit application form.
Thank you,
Owners' Signatures
/ ����� .
Print Owners Names: �G7Gf�/wG
Street Address:
/ y
,*THE. ♦o� TOWN OF BARNSTABLE
i 3B) STADLL i
"6 9
o M a. BUILDING INSPECTOR
a�
APPLICATIONFOR PERMIT TO C....". .............................. .......................................................................................
TYPEOF CONSTRUCTION .....................................................................................................................................
................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ......... z. .................^..� . . ..1............... : eT ����. ...........................
ProposedUse ......................................................................................................................................
ZoningDistrict .......dzb.....3.............................................Fire District .......................................................................:.
Name of Owner . . 2x 2....f. .f :...........................Address
Name of Builder 4c?.0r..-A64.?' :.........................Address
Nameof Architect ..................... ............................................Address ....................................................................................
Number of Rooms ...................(;..........................................Foundation .......[ " l'Y ".!°.. ." .................................
Exterior .4�1�.P.Z................................................................Roofing ... 5�2�'���.f....�.t..�7�.�t�.�C..�'....................
Floors .!Y...... ................................................Interior Svl. .{..T`. 4.. 9.............................................
Heating /..�1 r. ...�`!.�! .Gvd?R lr..v'..... ..P.P.4.........Plumbing .... .. o7x ja ,j»
Fireplace ..../
..................................................................Approximate Cost ..... ... ... ......................................
Difinitive Plan Approved by Planning Board ---------------_---------------19 . —:?/�_7 , s,
Diagram of Lot and Building with Dimensions rf' U) / 7S
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Nam p® Q��
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ........
i
Lanza Corp.
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^~. «�ma otozv .
---.�~^_... Permit for .-----�..''��---.. '
v�
single family d=e^-^i°*g �
----.—.--..—~.,---.---.,---..—.. �
0p� SuItf&`mk I�i
Location ��.�..----'..���--.^.--------'
Barnstable
� --'--..—.--.cc.....-.........---_._.----. .
a���o��
Owner Corp.-----''�.......--''s...-------'-- �
frame �
Type of Construction -------------...
----'—^—'''---'--`'-------''~--'—'
Plot ............................ Lot —.—#1-------.
�aneo��� �I �I
Permit Granted ---.-- ---]V '—
�
Date of Inspection .. ��� ---]V �
Dote Completed ------------..lQ !
PERMIT REFUSED `
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-----_—.-------------' lV
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'--~—^^--'^—'—^^—'-----^—'~--'^--
'--~^^^^—'-^'----'--------^'—'—'^'''
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'-`'---^'--^—'--`-~'``---~^^'—'^'~^`^—'
—'--`'—^'`~^'^``^^^--^^^^^^^--^^'—'--^'
Approved ................................................. 19
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'----~—'------'—^^^^^---~'`^—^`~'
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Of THE TO
�& 4� TOWN OF BAR.NSTABLE
Y
I BAHBSTOHLL
°moo p9- i� �� y BUILDING INSPECTOR
APPLI ATION FOR PERMIT TO ..�.o!.!...?.......
TYPE OF CONSTRUCTION ..... ...................................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
� f
Location .L®f......./....... ...... f�f...�-..:...............................:...................................................................
ProposedUse .... "t !Lip— . .... ............................................................................................
Zoning District ......�`��'...,<�..-..3..................................................Fire District ...r�'�9 !✓, ..e..........................................
Name of Owner /d4..Address ..a&. --,. V.$..... ! ......................................
r
Name of Builder e� .....Co.Q�p�.............................. ��°... �v,v .s
Address ...�...... ��,,.......�Y.�9.......0..................................
Nameof Architect ............ei4? t/ ....................................Address ....................................................................................
Number of Rooms .......—'`..'✓. x......Cl2y�....................................Foundation .1� / ....-.... �r�1ec°.G ... ®yF.• 4�>`e.....
Exterior ...4�X- .......5 .�l�l�10,5....................................Roofing ...f'`� �. ...........................................................
Floors ....�'!?,q�,.?:.71...........................................................Interior %e f/ ! ll... ... o% ! '..............................
Heating ...................................:....................Plumbing ... f :..................................................
Fireplace ......P ................................................................Approximate Cost ....................................... �I
Difinitive Plan Approved by Planning Board ________________________________19________. L
Diagram of Lot and Building with Dimensions
O
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�� � try °T '
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o� v
s
47 63
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name �`
Childs, Mr. & Mrs. Ernest r
2
No ........14..9..2.. Permit for .......one sto.ry
............
single family dUrelling
9 ... ...................
� � ..
Location ........................................................... l
Barnstable
............................................................................... i
Mr. & Mrs. Ernest Childs
Owner .................................................................. I
frame
Type of Construction ..........................................
................................................................................
Plot ............................ Lot ............#�............... i
.. I
:x
r
Permit Granted epte' raber.. 0 19 71
...... ..........
� r
Date of Inspection� '�.....:.......19 y
Date Completed ......................................19
PERMIT REFUSED s
...................................... ...................... 19 €
................................................................. .......... i
t -
................................................... ........................
.......................:.......................................................
............................................................... ........... - t
Approved ................................................. 19
............................................................................... .
.................... ......................................................... ' �,