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Town of Barn stable *Permit
` Expires 6 months from issue dale
- Regulatory Services Fee
Thomas F. Geller,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyarnis,MA 02601
www.town.barnstable,ma.us
'Office: 508-862-403 8 Fax: 508-790-6230. .
EXPRESS PERNTIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
[ap/parcel Number
�Z Obi?
roperty Address �~
Residential Value of Work �f�Cy v c`
Minimum fee of$25.00 for work under$.6000.00
iwner's Name&Address
Telephone Number
bntractor's Name
[ome Improvement Contractor License#(if applicable)
.� T'-s-LicErrse-#-{�-appiieable-)
,. ERMTI
ensation Insurance
]Workmen's Comp =
Check one: MAY 24 2QQ�
[] I am a sole proprietor
[� I am the Homeowner BARNSTABLE
❑ I have Worker's Compensation Insurance i-
lsurance Company-Name
Vorlanan's Comp.Policy#
;opy of Insurance Compliance Certificate must be on file.
ermitRequest(check box)
WYN
Re-roof(stripping old shingles) All construction debris will be taken to-
❑Re-roof(not stripping, Going over existing layers of roof)
XRe-side
Re lacement Windows/doors/sliders. U-Value (maximum.44)
❑" P
"7 ere required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
TSI.AM
***Note,. Property Owner must sign Property.Owner Letter of Permission,
A copy of the Home Improvement Contractors License is required.
SIGNATURE: ` Lo'
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Town of Barnstable
a Y PINE Pp��
Regulatory Services
BARNSTAXX z Thomas F. Geiler,Director
MASS.
1639• ��� Buildinu Division
TAD ' 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: b p
JOB LOCATION: GC 1
number treet village
"HOMEOWNER'
name ho phone 4 work phone
CUT-RENT MAILING ADDRESS:
tnl
city/town state zip code
The current exemption for"homeovmers"was extended to include owner-occupied dvrellines 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-.gear period shall not be considered a homeo-,aner. Such
"homeowner" shall submit to the Building Official on a form acceptable to the Building Off cial, that he/she shall be
responsible for all such work performed under the buildinepermit (Section 109.1.1)
The undersigned"homeowner" assumes responsibility for compliance to ith 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 NNrith said procedures and
requirements.
Signature of Homeov�t4r
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 EXENBTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the proNrisions
of this section(Section 109.M -Licensing of construction Supervisors);prodded that if the homeowner engages a person(s)for hire to do such
work,that such Homeov,, er.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-Supenrisors,Section 2.15) This lack of awareness often results in serious problems;particu',z-1y
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would ,�rith 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 Supenrisor. 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:fo;lns:homeexempt