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0343 SANDY NECK ROAD
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P:; Rae'.'..;.: ..a. .. sue,........ ... � _.s-. ,.:.•.,. .. .. ti •._ .. ,. ,_.. .i ...-. ,.. .. .. .. -._ .,. .. .. .....is _,..., ....... ..,.r .. ♦.._ .., .. „v. .,. � �.. r:.. ..... �. x y. ✓. y s : x -,, ,.t.. ,. ,..,. -.. .: ,{..., ,. ,.. ,. ..,.i :,;. .,. .��. ....,.. +.... .-. ...,. ..,. 'Fri"•"�� .1 d. �r y( .r 1 Y li E L' tnl_ 3 } 1 r ! P Y: x.n 1 .sr � k t a A A S k •L 4 x 3 1' 1 �'an.siC.M�4 oFIHE r� Town of Barnstable *Permit Expires 6 months from issue date Regulatory Services Fee snxxsrABM 9� 1639. ,0� Thomas F. Geiler,Director ArFO MA'I� 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 Not Valid without Red X-Press Imprint ` Map/parcel Number Property Address _ 7 A, [Residential Value of Work moo Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address iFp 6�• �jyc� AA r-) AAA Contractor's Name / 6�� Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ® ❑Workman's Compensation Insurance - ESS PERMIT Check one: ❑ I am a sole proprietor J {) 21'am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF 6ARNSTA6LE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must,accompany each permit. Permit Request(check box) w �e-roof(stripping old shingles) All construction debris will be taken ❑ Re-roof(not stripping. Going over exiqW layers of roof) ��+V ode \J� e' #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other towr 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: QAWPFILESTORMS\building permit forms\EXPRESS.doc Revised 070110 or . �oF1HEr Town of Barnstable Regulatory Services • BMWSTA13LE. y MASS. Thomas F.Geiler,Director 16,39.lFn Nw.A Building Division Tom Perry,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 as Owner of the subjectproperty / J hereby authorize i- G to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address df Job) !��c (7,a l Signa e of Owner ate 2 Uc Print Mame If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION I THE Town of Barnstable p t 0 �P o Regulatory g Y Services BARNSTABLE, Thomas F.Geiler,Director v MASS. 4,,, �b39• ,� Building Division lED �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/ EXEMPTIOZ / Please Print DATE: -7/9 ( (/ JOB LOCATION: L/— �C number / street S village "HOMEOWNER": nameV home phone## A work phone# CURRENT MAILING ADDRESS: /6 © ®G''` Go city/town state zip code The current exemption for"homeowners"was xtended to incl}4de owner-occupied dwellings of six units or less and to allow homeowners to engage an individual fo hire who does not possess a license,provided that the owner acts as supervisor. ' DEFINI ON OF/EION,1EOWNER Person(s)who owns a parcel of land on which he/sh residies or intends to reside, on which there is, or is intended to be, a one or two=family dwelling, attached or detache strt ctures accessory to such use and/or farm structures. A person who constructs more than one home in a two-ye period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on acceptable to the Building Official,that he/she shall be res onsible for all such work performed under the buildin emit. (Section 109.1.1) The undersigned"homeowner"assumes responsibil' for co liance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/s e understands Town of Barnstable Building Department minimum inspection procedures and requiremen and that.he/she '11 comply with said procedures and req ments. .. 4v Q Signatur f Homeowner Approval of Building Official r , Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construe ction 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 f5nstruction 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 fomr/ce-tification for use in your community. t Q:forms:homeexempt