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°Fz►,E 7 Town of Barnstable *Permit#
'- Expires 6 months fro issue¢ate
s, °- RegulatoryServices Fee S (�
• BARNSTABLE, : Thomas F.Geiler,Director -
94) .•� 'Building Division
rEo— .� g 05 0
Tom Perry,CBO, Building Commissioner 3/
200 Main Street, Hyannis,MA 02601
•
www.town.barnstable.tha.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 3 , o(5
i
Property Address '3Ct✓� ���5� `.? N�C� -1/�'A l%1
�(�� �—t�C%tC�� - ek-0cL�
❑ Residential Value of Work 1 �v0.(rt./ Minimum fee of$25.00 for work under$6000.00
J60c1'-I- C.L
Owner's Name&Address ( �j L) J Siv) i_?W
, SCR t )01 PAR N s OP L► •
Contractor's Name N ! Telephone Number 5C3 36)--94 �f
Home Improvement Contractor License#(if applicable)
❑Workman's Compensation Insurance -PRESS PERMIT
Check one:
❑ I am a sole proprietor JAN - 8 2008
[Dram the Homeowner
❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name
P Y
Workman's Comp. Policy#
- Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going'over existing layers of roof)
e-side
❑ Replacement Windows/doors/sliders. U-Value (maximum .44)
*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 Lic a is requ
SIGNATURE: e bi—
°'df1,
dfi
Of
Q:Forms:buildingpermits/express
Revise 112807
ot 1HE ro s.Per
H . -
Town of Barnstable
Regulatory Services
BARNSfABLE • Thomas F.Geiler,Director
9
MASS. tg
$ 1639. stb Building Division
prEDMA�p
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
JOB LOCATION:__ 3( j Sv)i4 0 l�j t�C.K {}Y�(3�l'51 A�1<.
nuumber stralet village
HOMEOWNER":'PtilYH S S 4(1 4 ,51? 36)-%d 31)57 .5"/e&S.-
home phone# work phone#
CURRENT-MAILING ADDRESS: PO. 1�0� 10,14
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
require ents.
Signature om-:
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.
Q:forms:homeexempt
OFTHE T Town of Barnstable
y, 94 Regulatory Services
*�� BL E • r Thomas F.Geiler,Director
'P ED mg' ; Building Division
i Tom Perry,Building Commissioner
' 200 Main Street,Hyannis,MA 02601
/
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
y
t J
1 Property Owner Must
Complete and Sign This S7 ction
i
\ If Using A Builde ,
\ , . ,
I, as Owner of the subject property
hereby authorize \ l y/ to act on my behalf,
in all matters relative to w• k authorized by x building permit application for.
3C'3 SAS- 0- / i?cv,
Address of Job)
J
Psi 1 7 fl o
Signa e of f Date
4i/ deyPrint lme /
s
I
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the everke side:
Q:FORMS:OWNERPERMISSION
„. F. Town of Barnstable *Permit# Fr/li- 2
, ..e- • s5 , 9• • Expires 6 months from Issue date
I;' „ , i Regulatory Services : Feed
Thomas F.Gefler,Director
p51,
��E°r+�+k Building Division R�
n
IT
Tom Perry, Building Commissioner JUN
200 Main Street,.Hyannis,MA 02601 8 2CQ
Office: 508-862-4038 TOWN '
Fax; 508-790-6230 ®F BAN A
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY •
• Not Valid without Red X Press Imprint
fap/parcel Number 33- 01 S
?ropertyAddres 3:/3 t 3 next- att ns fe
Residential Value of Work 4c_ •00 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address /91/ '' j S
•
PCB. BOA /24• r d O
Contractor_s_Name . Telephone Number
•
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
•
❑Workman's Compensation Insurance •
Check one: 1 •
❑�a sole proprietor •
Lr I am the Homeowner
•
❑ I have Worker's Compensation Insurance •
Insurance Company Name • . .
Workman's Comp.Policy# .
Copy of Insurance Compliance Certificate must be on file. • .
Permit Request(check box) •
[ ' e-roof(stripping old shingles) All construction debris will be taken to -�.vr) Ojny,.-
❑Re-roof(not stripping. Going over existing layers of roof) •
[ Re-side . D - O8
❑ Replacement Windows. U-Value (maximum.44)• 9-'d'/a
• *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.
Home ov t Contract rs License is required.
i . •
Signature //
Q:Forms:expmtrg
Revise063004