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HomeMy WebLinkAbout0355 SANDY NECK ROAD ,..t ','.67-A-.4::-.., , ''''.„ ' ''.''':, .s.;.,.: '' e,-., '',01:- ii., ' ,. . ,:: :,,-, 1,.', , " : 7 r .F,. r • .t•. 0 tL ', �yj /i'^ a r o II o • • • • • • • • • .... ,...... _max o • Town of Barnstable *Permit 1c2cSk sS Ring Fx Tres 6 nths from issue date ►�uift Pai � � ' iD l.�'•lnb Department �ee f sniwsrnsLe, Brian Florence,CBO • STA JUN 2 8 2018 Building Commissioner 1639•iOrE �� 200 Main Street,Hyannis,MA 02601 V\ciC �> Wf?NS v .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 3 73 Da Property Address 3 Sndif Neck [ajar n Stc3Zjlr� :/ Residential Value of Work$ ,3cc( Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C isocoe it Fats,I„ Tv 91 21D Z— C6q 1 SQt\-k,,;v Cot„ mak O 2-( S Contractor's Name Telephone Number 5O 3<,-)O 5 71(p • • Home Improvement Contractor License#(if applicable) n7ck. Email: CSC_ i.:,\f 0 r• c�cz�\ CyY) Construction Supervisor's License#(if applicable) ®Workman's Compensation Insurance Check one: ❑ I am a sole proprietor M. I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name 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 ® Replacement Windows/doors/sliders.U-Value 3 (maximum.32)#of windows LI #of doors: *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 Ho e I ovement Contractors License&Construction Supervisors License is required. SIGNATURE: v C:\Users\decollik\AppData\Local\Microsoft\W indows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 • Town of Barnstable Building Department come Brian Florence,CBO 4'91 Building Commissioner 200 Main Street, Hyannis,MA 02601 • BARNSTABLE. • iKnss www.town.barnstable.ma.us iti;q. �� '-rFD poi h Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: _A o r\42 aO 1 is. C JOB LOCATION: 356 s r,t-Iq N CCU- ,UAc -P number street village Croc-oral,1 "HOMEOWNER": 1itc' r oC) •S'liCo Rc7vty-0 name home phone# work phone# CURRENT MAILING ADDRESS: CU \U r-v,-. R (no, r �� O S 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"h•. :owner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce.-.:. 'nd r:'uirements,and that he/she will comply with said procedures and requirements. L • • Signa . eofid'om owner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. C:\Users\decoll ik\AppData\Local\Microsoft\W indows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 r r oFtl1, Town of Barnstable *Permit# -i__ ✓' Z, 7 ,,Tit+ _Expires 6 the from issue date • Regulatory Services Fee w t; xrrsrni.e, * �G l/ vim' r Richard V.Scali,Director [ (j �i639dae � '_ k` 5ritt `Y '�fo�. Building Division ._ ... » <�r *"0 Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 JAN 2 7 2011 www.town.barnstable.ma.us Office: 508-862-4038 TOWN F 508'�79-0 6 3 LI EXPRESS PERMIT APPLICATION - .RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 'S $' 0 IQ 1 Property Address r�Gj'j �X t1�.t{ 1 V LG� ( l3c. ins .a b`S� Residential Value of Work$ pn C ) 1 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address CroL0Q.A.1 Far,-, , Iv>1 `D,C))'D T..,s-t... Ailucta FFyr„er T4 (c-��l I) C�ctir, c1 Co-�',-c (Y) 5s D I�3 5 wee Contractor's Name 1-lorneCao6- c Telephone Number F5 3(.1 5-7)Co Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) El Workman's Compensation Insurance Check one: ❑ I am a sole proprietor R I am the Homeowner O I have Worker's Compensation Insurance Insurance Company Name (T"c. \l-"cA(` P ci -\ Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Ell Re-roof(hurricane nailed)(not stripping. Going over '), existing layers of roof) G- CvvQi Q. Co- �h,r\c\le J 11 Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: • El Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt c nce with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the .o Im t 'vein' t Contractors License&Construction Supervisors License is required. `•. - SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Window. emporary In:u,"Files\Content.Outloo \2PIO1DHR\EXPRESS.doc Revised 040215 - ail 1, 7/' 7 GOKH (e f t � it 11,e r Town of Barnstable Regulatory Services THEross, Richard V.Scali,Director /�' ji 49. Building Division BABNSTABLE ' Tom Perry,Building Commissioner [MASS 94rF�A 16,9• ♦�1 200 Main Street, Hyannis,MA 02601 ,. .1 s www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: �..20\a71 L`•l Please Print JOB LOCATION: 355 Sa.a... 1\1Q41e_ .ept,ir,nSib?Q number t street village "HOMEOWNER": P(1,11 dI Co.. Ft.)r'r.QY' 50$•3490. 511 CO n/q name home phone# work phone# CURRENT MAILING ADDRESS: ( Q L Sa►." ,., - Rd Ccty•c 0'l11L s g 02.co 35 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 undersigne. "homeowne ce i that he/she understands the Town of Barnstable Building Department minimum inspection procedur' equirements an. i at he/she will comply with said procedures and requirements. Alma Signature of 1r7 r r WW1" 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 caret amend and adopt such a form/certification for use in your community. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 TRUSTEE CERTIFICATE PURSUANT TO M.G.L. c. 184 § 35 Name of Trust: "Crowell Family 2012 Trust" Dated: March 3 , 2012 We, Aliicia Crowell-Furrer, Jeanne Crowell Willis and Laura Anne Swartz, Trustees of the "Crowell Family 2012 Trust", under declaration of trust dated March , 2012 (the "Trust") as the current trustees, certify as follows: (a) We are the current Trustees of the"Crowell Family 2012 Trust"; (b) The trustees of the Trust have authority to act with respect to real estate owned by the Trust, and have full and absolute power under said Trust to convey any interest in real estate and improvements thereon held in said Trust and no purchaser or third party shall be bound to inquire whether the trustees have said power or are properly exercising said power or to see to the application of any Trust asset paid to the trustees for a conveyance thereof; and (c) There are no facts which constitute conditions precedent to acts by the trustees or which are in any other manner germane to affairs of the Trust. EXECUTED, as a sealed instrument under the pains and penalties of perjury on March 3 , 2012. , Al>icia`Cro''1ell-F r` is - Jea me Sewell Willis, ` rustee Lira Anne Swartz, Trustee COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. On this; day of March, 2012, before me, the undersigned notary public, personally appeared Aliicia Crowell-Furrer , Jeanne Crowell Willis and Laura Anne Swartz, Trustees as afor -aid proved to me through satisfactory evidence of identification, which was P ` ." ,to be the individuals whose names are signed on the 144 precea:ing or attar,ed document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of their knowledge and belief. [official signature and seal of notary] No a y Public M Cornmi• ion Expires: 4 MAT1HEW J:©RESETTE. 2088245 1; (a WW1; W } (omE \ Town of Barnstable *Permit# Expires 6 months frosue date Regulatory Services Fee * BARNSTABLE, * Y; MAA9r ihNob Richard V.Scali,Interim Director /tg"tES [� �1►i;'VT Building Division 015 Tom Perry,CBO,Building Commissioner APR 0 2 200 Main Street,Hyannis,MA 02601 OF BARNSTABLE www.town.barnstable.ma.us -VOW Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 33$ 0 1 Property Address 355 Sandy Neck baftn, ®Residential Value of Work$ 500.00Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Crowell Family 2012 Trust 694 Santuit Road, Cotuit MA 02635 • Contractor's Name Homeowner Telephone Number 508-360-5716 na Home Improvement Contractor License#(if applicable) Email: �'° ire r`-' m I'Go m / 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 Mass Fair Plan Workman's Comp.Policy# na 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) • 2 Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #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 sig 'rope Owner Letter of Permission. A copy of the Home Imp ovement kontractors License& Construction Supervisors License is required. SIGNATURE: T:\KEVIN D\Building Changes\EXPRESS P ' IT\E 'RESS.• Revised 061313 . Town of Barnstable Regulatory Services OFtME r�,yti Richard V.Scali,Interim Director O� � 5..,,,., Building Division BARNSfABLE• * Tom Perry,Building Commissioner �� 1639.MASS. / .40 i639%0� 200 Main Street, Hyannis,MA 02601 o www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 --------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: r� JOB LOCATION: 355 Sandy Neck, Barnstable number street village "HOMEOWNER": Aliicia Crowell Furrer 508-360-5716 name home phone# work phone# CURRENT MAILING ADDRESS: 694 Santult Road Cotuit MA 02635 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"home er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures d squire en s an /she will comply with said procedures and requirements. Signature of Ho " r 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. T:\KEVIN D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 { EXECUTED, as a sealed instrument under the pains and penalties of perjury on March 3 , 2012. 46„.. Nemo- Aliicia Cro;''ell-Ft i° �s :e Jer5, Dwell Willis, ` rustee 1 S7/(441 L a-Anne Swartz, Trustee COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. On this. . day of March, 2012, before me, the undersigned notary public, personally appeared Aliicia Crowell-Furrer , Jeanne Crowell Willis and Laura Anne Swartz, Trustees as afor aid proved to me through satisfactory evidence of identification, which was ,to be the individuals whose names are signed on the prece ing or attac.'ed document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of their knowledge and belief. [official signature and seal of notary] No u y Public M Comm ion Expires: ppp rr ff ��1AT1 HEW J;BRESETTE '20 >;.ar'" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map f�� S �c. Parcel 01 ^ Application P2O 14007,5- o� pp Health Division Date Issued 2—Z?1(c( Conservation Division Ok- Seri (V sO 'ZSZ� Application Fee ip5D Planning Dept. Permit Fee DateDefinitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 3SS_ 5CAi}au) N Q clz Village ' >C\r rl S�oLb 1G �C� Owner (_mow P ) �c�m)1 a0) ��••►% Address (v-14 cxn t-v rt- Rd Telephone T01S (DD <)71 C/J Permit Request caQc c- / tX 1-)0Qc`6 cl Q G -yQca sc c ci 1 7 cr Croce s' os`rlm a cA m art Square feet: 1st floor: existing 4$I proposed 53. 2nd floor: existing n/o- proposed /a_ Total new °/0- Zoning District F - 1. Flood Plain Z'\- A Groundwater Overlay Project Valuation 1 V67 a° Construction Type W oo8 Lot Size IC) re_ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family 0 Multi-Family(# units) Age of Existing Structure I01-1 utearg Historic House: aYes ❑ No On Old King's Highway: i7 Yes ANo Basement Type: ❑ Full ❑ Crawl ❑Walkout AliOther pd�� Basement Finished Area (sq.ft.) not•2 Basement Unfinished Area (sq.ft) non€ Number of Baths: Full: existing 0 new 0 Half: existing O new 0 1/2 Number of Bedrooms: g‘ existing 0 new Total Room Count (not including baths): existing 3 new O First Floor�F,-oom Cou t Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric 'Other norms J, Central Air: ❑Yes c9.No Fireplaces: Existing I New O Existing wood/coal stove: O 10es ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing:: ne size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: W •- w Zoning Board of Appeals Authorization ❑ Appeal # S4g?) Recordedlg ;; Commercial ❑Yes 'No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Pt\\\ c. Cx-ocoe l,l Fvc c- Telephone Number 5O$ aoO (o r-o\\roc\'. A , Address Co°11--\ Src *- : Rc\ 35 Sa„a,i License # C.5 CMG'cl t1eac.Cc *-owt O7°S_S ba ,st-.�e1v,Home Improvement Contractor# 1 5Co% 2 Cp CD 5 Slob 0-7 3 Email nmoo.\1. • Cow Worker's Compensation # 14.3 -3 -A - 1� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO d(xfi c-1labl p 6J�cr to SIGNATURE 1 \/' DATE A cQAD aoVIA FOR OFFICIAL USE ONLY • APPLICATION# • DATE ISSUED MAP/PARCEL NO. a , ADDRESS VILLAGE F i OWNER . • • 1 F' DATE OF INSPECTION: ' FOUNDATION FRAME "t } INSULATION • FIREPLACE , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING • f DATE CLOSED OUT ASSOCIATION PLAN NO. . / E Town of Barnstable �3 Regulatory Services r rY uxrsreurs. 41 Thomas F.Geiler,Director �P Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannic,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE ETION �r n F� Please Print DATE 41 Q' _01 _ JOB LOCATION: 3 rJ 5 So,nd• N�c�. �jdr r,s-tab lQ number s village "HOMEOWNER":�l‘itc.\a C..ro 11 Co(ro( SC*, 3(1,3 Si l(.0 £$ Si It 7S name home phone# work phone# CURREt1T MAILING ADDRESS: CWCk'l JO•y V t't (I.0*.1.)rt_ ro 0. D 214 S city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFIN]TION 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 •dersi Lai.s "hp 1 i eown- ' certifies that he/she understands the Town of Barnstable Building Department minimum inspection prt--(4,•es .,• re. '...•-... :.• that he/she will comply with said procedures and requirements.' • Si, 3'omeo .' 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. L 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. �p require, part of the To ensure that the homeowner is fully aware of his/her responsibilities,manycommunities as 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. CAUsersldeeoIIildAppDataocal\tvfiierosoftlwmdows\Temporary Internet Files lContentOudoolc\QRE6ZUBN EXPRESS.doc Revised 053012 , Town of Barnstable it ``'"'" ct Regulatory Services f f • Thomas F.Geiler,Director - • ib 39- � 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 • • - C mplete and Sign This Section • If Using A Builder • • Tru ,, ge o.c Crowe.11. F0.rn 1 aO 1a I, t= • o r r,. , . Owner of the subject property Tr0 st hereby authorize cam.. . .•. • to act on my behal;� in all matters relative to work authorized bb,, building permit. k (Ad ss of Job) **Pool fences and s are the responsi ility of the applicant. Pools are not to be filled or ,tilized before fence is stalled and all filial inspections are perfo'hned and accepted. i • AArgi lave S . e pfvillrlir Signature of A 'can. • t . �h\cka �/cowQQ11 ---ur( C' : ‘ w. ( er Print Name , Print Name - • Date • Q:FORMS;OWNERPERMISSIONPoorS 62012 A • • TRUSTEE CERTIFICATE PURSUANT TO M.G.L. c. 184 § 35 Name of Trust: "Crowell Family 2012 Trust" Dated: March 3 , 2012 We, Aliicia Crowell-Furrer, Jeanne Crowell Willis and Laura Anne Swartz, Trustees of the "Crowell Family 2012 Trust", under declaration of trust dated March , 2012 (the "Trust") as the current trustees, certify as follows: (a) We are the current Trustees of the "Crowell Family 2012 Trust"; (b) The trustees of the Trust have authority to act with respect to real estate owned by the Trust, and have full and absolute power under said Trust to convey any interest in real estate and improvements thereon held in said Trust and no purchaser or third party shall be bound to inquire whether the trustees have said power or are properly exercising said power or to see to the application of any Trust asset paid to the trustees for a conveyance thereof; and (c) There are no facts which constitute conditions precedent to acts by the trustees or which are in any other manner germane to affairs of the Trust. EXECUTED, as a sealed instrument under the pains and penalties of perjury on March 3 , 2012. Aliicia Cro !ell-Ft is.`° lea 1.e rowel"Willis, Trustee SI/UO/Lt Z— za Anne Swartz, Trustee COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. On this day of March, 2012, before me, the undersigned notary public, personally appeared Aliicia Crowell-Furrer , Jeanne Crowell Willis and Laura Anne Swartz, Trustees as afor�� aid proved to me through satisfactory evidence of identification, which was ;, = to be the individuals whose names are signed on the prece 'ing or attac red.document, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of their knowledge and belief. 9 [official signature and seal of notary] No a y Public M •Comini ion Expires: AATI HEW J,BRESETTE 208820.1 i- }Uhr