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N it TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 3 I le Parcel D 0 3 Application # 3015D 7774p
Health Division Date Issued /(" /7-( '�
Conservation Division e Application lication Fee 1 Sa e C� tfr
Planning Dept. Permit Fee <CDD-00
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
t�Project Street Address 3 Sa_rT RG('_C< kd
Village PyA r n 51 cb 1 M t 6 2-63(�
Owner c3-ogflhe obi GhO U j Address Marble 12& . osnc7 bl�
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Telephone S bT - ip 2 - 5 16 5
Permit Request tah1, I lcl c e,C k ! 2 x l co
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Square feet: 1st floor: existingt (2Z0proposed 2nd floor: existing proposed Total new
Zoning District R I Flood Plain Groundwater Overlay
Project Valuatior; -1 2606 , Construction Type
Lot Size . 75 6.C-'(tee Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family '1,1 Two Family ❑ Multi-Family (# units)
• Age of Existing Structure `1 O yes - Historic House: ❑Yes krNo ?On Old King's Highway: Yes ❑ No
Basement Type: 1%Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 14OO
Number of Baths: Full: existing c9N new Half: existing new
Number of Bedrooms: .3 existing _new
Total Room Count (not including baths): existing cc) new First Floor Room Count
Heat Type and Fuel: ' Gas ❑ Oil ❑ Electric ❑ Other 1
Central Air: "E,Yes ❑ No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes\ANo
OP
Detached garage:I$ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: CI existing ❑ new size _ Other: )
/ �'
----
Zoning Board of Appeals Authorization ❑ Appeal # Recorded U - :.iP
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Commercial CIYes CINo If yes, site plan review #
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Current Use Proposed Use N;
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
aNme joq�ne- R 66 i cho�A Telephone Number S 0? ' �lp �"5 � � �f
a� M�.r b 1�
Address k J License
arnsfik bl\e MO b210 3 b Home Improvement Contractor#
E4 �
mail e a r O b 1 LO'►N1 ck,s4-- net Worker's Compensation #
AllJ 11
CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO d U ryl p
SIGNATUREavoyvyvi_ DATE 1 ( f 13 ) 15
"%
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER '
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
r
Town of Barnstable
Regulatory Services
�oFsrE tos, Richard V.Scali,Director ,
,517 s,, 90 Building Division .
j
* j S`rABL^1* Tom Perry,Building Commissioner
o4I'1 200 Main Street, Hyannis,MA 02601
MO
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
V� HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: I III` ID
JOB LOCATION://) t 3 7 C.t. I+ R U C-L( R A P)L{ 1 A 6 t u1 k
//` number '^ street'' /( p ) village] �( --7 /� 19
.HOMEOWNER : QJ O Ck V\ 11 g 6161 at O Vomit 6 0 O - oa—5 fl 5 s% ^ - ( v
name home phone# work phone# .
CURRENT MAILING ADDRESS: �� t-C,Y\k) 1 e, /2�
I bGI( ns bl-e Akit. o2iO3
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
procedures and requirements and that he/she will comply with said procedures and requirements.
r,
ature`of Homeowner
if
Approval of Building Official
/7 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 040215
i
•0
Ai.N. ,
+ )ARNSTABI.F,
Town of Barnstable
�A t63y. ��m
T
�EbMA't�
Regulatory Services
g rY
Richard V. Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner . .
200 Main Street, Hyannis,MA 02601
wwvw.town.barnstable.ma.us " " " '
Office: 508-862-4038 '- . ' : . ; - Fax: 508-790-6230
•
` Property 0 ' ►er Must
Complete and S'!n This Section
If Us' A Builder
I, , as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work autho. ed by this building permit application for:
I ddress of Job)
.. 1
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\EXPRESS.doc
Revised 040215
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