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HomeMy WebLinkAbout0423 LINCOLN ROAD EXTENSION L If r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # A4? Health Division Q��i Date Issued 111 14h i. Conservation Division TOE *a;, 0®� Application Fee ' Planning Dept. Dire ®' ��'P ermit-Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis l'k� S EST Project Street ddress �'j 2 ba �G T Village 414 Owner elf Address Telephone Permit Request L �io�'l 3g PB Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain //Groundwater Overlay Project Valuation Construction Type�WY7A � Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes `)dNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ` Telephone Number Address ar License #fn Ma, C� Home Improvement Contractor# l✓3 b Email Worker's Compensation # woz©o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL E T ZENTO SIGNATURE DATE I FOR OFFICIAL USE ONLY ,i APPLICATION # t 4 DATE ISSUED MAP/PARCEL NO. y . t ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION r FRAME INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. S �i a HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. Vl t 74 hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: i The weatherization work done will be based on programmatic priorities and availability of funding and it.may include all or some of the following measures: Weather stripping; air sealing; attic & basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. j� Home Owner(signature} Home Owner email (Fjart Date: l0 Agent:(Signature) Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Build' uction Tupper Construction Cape Cod Insulation i. Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS•100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROWI �` y WEST YARMOU;fH Expiration; Commissioner 11/11/2017 C���� (251-1pt�2�2o�vcr�ec���� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co. t.ractor Registration :q Registration; 153567 ' Type; Private Corporation Expiration; 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC '. HENRY CASSIDY --- 18 REARDON CIRCLE -- 80. YARMOUTH, MA 02064 Update Address and return card, Mark reason for chnoge. $CA i <'+ zoMosm Q Address Renewal 0 Employment U Lost C"11.0 �ie anu�+aooaruerr/G/Z 01QAKajdack"16 d •Ofnce of.ConsumcrAffnirs I3usincss Reg ulntIon License or registration valid for Indlvldul use only OME IMPROVEMENT°CONTRACTOR before the expiration date, If found return to; egistratlon; '153507 Type; office of Consumer Affairs and Business Regulation ,j xpiratl.on; ,:.1.2G45l20:1.6 Private Corporation 10 Park Plaza •Suite 5170 ,,.., Boston, MA 02116 CAPE COD INSUTAT:fQN INC:.­. HENRY CASSIDY I REARDON CIRCLE` 50. YARMOUTH.MA02609 Undcrsecretnr Y N• valid wl ut sign .e ,r •w The Commotaweralt/a of Mrtssrachusetts Del�artm.ent oflntlaastnralAccitients 1 Congress Street, Suite 100 Boston, MA 02111.2017 rv'vw,=8,90011 a 1.Yurkers' Compensation Insurance Affidavit; Builders/Contractors/Electrielans/Plumbers, licant Information TO BE FILED WITH THE PERMITTING AUTHORITY, Name(Business/OrgenizatiorUlndividual)' la Please Print Le i _ _Q__ rJ y Address: City/State/Zip; �0,kl�he Phone M -7Arc you nn employer? C appropriate box: / ^� I.�am a employer with .�.✓ employees — employees(full and/orpart.time).' Type of project (required) 2Q I am a sole proprietor or partnership and have no employees working for me in any capacity,fNo workers'comp, insurance required.) 7' ® New construction l.�I am a homeo+utter doing all work myself. $'••(� Remodeling Y [No workers'comp. insurance required•)1 9. Q Demolition a I am a homeowner and will be hiring contractors to conduct all work on my property I will ensure that all contractors either have workers'compensation insurance or are sole 10 Building addition proprietors with no employees. I 1 Q Electrical repairs or addittc,r•.. S.Q I am a general contractor and I have hired the sub,conlrectors listed on the attached sheet. These sub•contractrprs have employees and have workers'comp, insurance.! 12,[Plumbing repairs or additirsr, 6 p we are a corporation and its officers have exercised(heir right of exemption per MGL o, l 3'Q Roof repairs 152,§1(4),and we have no employees (No workers'comp, insurance required.) 14.[r ,Other chqck 'Any applicant theo submi box NI must also fill out the section below showing their workers'compensation policy inforrnali :Any who submir2his affidavit indicating they are doing all work and then hire outside contractors must submit IConuactors Thal check this box must attached an additional sheet showing the name of the sub-oontraetors and slate w or _ ernployees. If the srib-contractors have employees,they must provide their workers'com P. a new affidavit indicating such. /nm rrn employer that is provirliirg workers'eoirrpertsRtc'on insurance o policy number• whether or not those amities have insura nt C f my employees, Below Is the policy and Job sice Insurance Company Names :—� Policy b or Self ins. Lic. k: ,, / ,���� Expiration Date: Job Site•Address: (� �` Attach a copy of the workers' compensation policy declaration page sbow City/state/Zip; �� � Failure to secure coverage as required under MGL c. I S2, §25A is a criminal violatng ion policy nu and/or one-year imprisonment, as Well as civil penalties in the form p y er and expiration (late) y g iolator. A copy o'f,ti;is statement may be forwarded to the Office ton punishable by a fine up to$I,500 00 day a atrist the v of a STOP WORK ORDER and a fine of up to$7.SCi Uii coverage verification• of Investigations of the DIA for insurarn;:e 0v rlo hereby certify unrler the pales alert penalties ofPeClury that lire lt(/ormata'on provlrle SI nature. /' a a ov lr true and correct. - Phone Date; ( Z E!rb Official use only, Do-riot write In !Ills area, to be completed by city or town o - City or Totvn; fflcla4 Permit/License ���, �) Issuing Authority (circle one); i I. Boarc! of Health 2, Building Department 3, City/To,yn Clerk 4, Electrical Ins e 6, Other ; p ctor S- Plumbing Inspector• j Contact Person; Phone#; CAPECOD•27 CLEDDUKE ACORO° CERTIFICATE OF LIABILITY INSURANCE DAT 7/1/2 DnrrY) 11l2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements, PRODUCER CONTACT NAME: Barbara DeLawrence Rogers&Gray Insurance Agency,Inc. PHONE t aIc No 434 Rte 134 South Dennis,MA 02880 aADDRESS:bdelawrence@rogersgray.com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company INSURED INSURER B:Safety Insurance Company 39454 Cape Cod Insulation,Inc,. INSURER C:Endurance American Specialty Insurance Company 41718 18 Reardon.:Qircle INSURERD:Atlantic Charter Insurance Company 44326 South Yaim'outh,MA42664..' INSURER E: INSURER F: COVERAGES CaRTIFICAf.1'NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF;INSURANCE-;U§TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY'REQUIREMENT,•1 EFtIA;%Oft,CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY:J?�IZIAIN, THL::(NSlJ1�ANC� AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SIIC:HP.OLICIES.LIMI75'SHOWN,MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE OLICS!Y'NU BER MMIDDIYYYY MMIDD/YYYY LIMITS A. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CBP8263;063 04/01/2016 04/01/2017 PDAMAQE TO REMISES RENT occurrence) $ 100,000 MED EXP(Any one person) $ 51000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT:APP,.(l PER: P GENERAL AGGREGATE $ 2,000,000 x POLICY �I Rpp• CJ'JECT IOC PRODUCTS•COMP/OP AGO $ 2,000,000 OTHER: AUTOMOBILE LIABILITY MBINE I Ee so, eDt M $ 1,000,000 B ANY AUTO 6232707COM Id 1 4/,0 Y INJURY(Per person) $ OSNEOXU.TSULEDAUT AO 80OILY INJURY(Per accident) $ DWN X HIREDAUTOS X.•'AUiNOS ED . FIT Per a ident $ $ X UMBRELLA LIAB X OCCUR.: a;AONiO.000RRENCE $ 2,000,000 C• EXCESS LIAR CLAIMS.MADE EXd1.0006635001 04/0f1 1,6 04/01/201`7• AGG t!C�'AmE $ DED X RETENTION$ 1'0.,000 :: • •;Ag gregt9 :... WORKERS COMPENSATION $ 2,000,000 PER AND EMPLOYERS'LIABILITY Y!'N STA7UT ` ER D ANY PROPRIETORIPARTNERIEXECUTIVE WOE 0,0431902 06130/2016 0.6l30/2017 "ff;':.''cHAccIDENT:;.; $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E•L.DISEASE•EP•EMpL4lE $ 1,000,000 It Yes,describe untler DESCRIPTION OF OPERATIONS below E.L.DISEA.&,: L'ICY LIMI;F.::$: 1,000,000 •:is • DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLErA (ACORD 101,Additional Remarks Schedute,'may;bo;At a.d.li8d:l('tgore space 18 required) Workers Compensation Includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto LI$billtyiWfien required by written contract or ag(66MORfswith the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE h.6i H{g$.. Ug d S THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 94A Co 1werce Park SOLI h ACCORDANCE WITH THE POLICY PROVISIONS. Sou,wham,MA 0265�`°, t AUTHORIZED REPRESENTATIVE 01988.2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD �t►+E r Town of Barnstable .*Permit# Expires 6 months from issue date Regulatory Services Fee s � + SARNSTABLE • MAW Richard V.Scali,Director ® s6gq. p�0 _ Building Division Rim Tom Perry,CBO,Building Commissioner F 200 Main Street,Hyannis,MA 02601 f J www.town.barnstable.ma.us Office: 508-862-4038 'roWn,I 0P jZfjaxalef SQ8-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number Not Valid without Red X-Press Imprint �{ Property Addressl Z 3' ,1 l A C o\a CX% �110 CI HgaY1 n�,s /-I o'�(o(�CJ I ❑Residential � Value of Work'$` �/i Y00, U 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address dD U 7 412-S lyl co> n 011 'i\o 34A 02.CoD I Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: 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 Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re- est(check box) ''i- 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 (maximum.32)#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 sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: m i -2 . Q:\WPFILESTORMS\buil ing p rm� forms\EkRESS.doc Revised 040215 17te Comu:onwealth o;—Vassachusetts Deparament of 1ndTistrial Acciderds Offwe of f7Z1w3firuions 600 Washington Street Roston,MA 02111 witiv.mass_gvvldia '"tarkers' Compensation Insurance Affidavit:Bt ilders/ContractorslEIectricians/Plumbers Applicant InfGnnatian Please Print I*MbIy 'Name e(BusiuewJ0rganizatie�a& ' � ly: � , C� �-_. _ .. o Q 'Address:` q1,3 L\ W\n C X7 �\Occ\ cityfstal/Zlip._ I A nyl'k 5 A A oupu i Pllcne iw,-_ 150k 3l - 3► Are you an employer?Clierl the appropriate box: .l Type of project(required) 1.❑ I am a employer with 4 ❑I am a general contractor and I employees(full and/or part-time)-* have]tired_the sub-contractors 6 ❑New c:ons�ucton 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I ❑Remodeling ship and have no employees These smb-contrac#ors have 8. Demolition wo z ng far me in any capacity- employees aadhave workers'[No workers' camp.irnsurance comp-m g- �Building addition surancel required] 5. ❑ We are a corporation and its 10..❑Electrical repairs or additions 3. I am a homeoramer doing all work officers have exercised their 11.❑Plumbing repairs or'additions Nmystalf- [No workers_camp- right of exemption per MGL 12' afr insurance required-]t c.152, §1(4h and we have no employees-[No workers' 13.❑Other camp.insurance required-) *Any ap ksa that chec3mbox ifl must also filloutthe section below shavdug theirworkers'compeusatioupolicyinfbrmatioa T Enmemners who submit this affidant indicating they are doing zU wed and then bire Gum&contractors mast submit a new affidavit indicating,satch- ZCant wmrs iffut check ibis boa must attached as additional sheet shoarmg the Warne of the sub-contractors and state whether or nut those entities bane employees. if the subtaattactuomhave employees,they rmtstprovide their workers'comp.policy number- I am art ernplo1w that is prmziiirrg tuarkers'contpertsativrt irisairartce foe•arty*enrpiny es ,S¢Ioly is tuts policy an jab site infor mathm Insurance Company flame: Policy or Self-ins.Lic.;9: Expiration Date: Job Site Address- City/Stawzl p: Attach a.copy of the corkers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andror one-year imprisonment as well as ci-.ail penalties in the farm of a STOP WORK ORDER and a fine of up to$250-0!0 a day against the ivzolator. Be adiised that a copy of this statement maybe fat:warded to the Office of Investigatiow of the DIA.for insurance coverage verification. Ido hereby certify axnider•the pains and penalt6es of•pei;Fwy thattJte informatiol>pr of ided abmw is true and correct: n S enature:�7' uo ICZ Date: 'k -l l d Ul v Z. Offleiai use only. Do not writs in th&area,to be completed by city ortown ofjrciaL City or Tom•m: PerrnitMicense if Issuing Antharity(circle one): 1.Board of Iffealth 2.Building Department I C ty1rown Clerk 4 Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#s 6 Information and Instructions ` M�ccaehusetts Geheral Laws chapter 152 requites an employers m provide workers'compensation for their employees. pursTar,t-to this sfaftte,an.ernplayzff is deed as."_.cvery person in the service of another under any contract of hire, express or implied,oral or " An Moyer is defined as"an ndividaA partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling horse having not more than three apartments and who resides therein,or the owapant of the - dweIling house of another who employs persons to do maintenance,construction or repair work on such dweling house or on the grounds or building app rhmz rtthemtb shaIl not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(t7 also stars that"every sfzte or local Ticensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has notproduced acceptable evidence of compliance with the b1surance.coverage required." Additionally,MGL chaptrr 152, §25C(7)states"Neither the commonwealth nor a-ay of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the;nrr crance._ requirements of this chapter have been presented In the contracting author" Applicants Please fiIl out the workers'compensation affidavit completely,by chtr—+ the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone nuzmber(s)along with their certificate(s) of has„—an ce. Limited Liability Companies(LLC)or Limited Liabi—Part amships(LLP)with no employees other than the members or partners,are not regim ed to carry workers' compensation insarance. If an I LC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of in.s Trance coverage. Also he sure to sign and date--he affidavit The affidavit should be retrmed to the city or town that the application for the permit or license is being requested,not the Department of Indusiial A ccidents. Should you have any questions regarding the law or if you are regnaed to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insuz e l companies should enter their self-;T,er�mce license number an the appropriate line. City ar Town Officials t - Please be sure that the affidavit is complete and primed.legibly. Thy Department has provided a space art the bottom of the affidavit for you to fM out in the event the Office of Investigations has to contact you regarding the applicant Ple-w a be sure to fill in the pemut(license number which will be used as a reference number- In addition,an applicant that must submit multiple pennWHCen se applit ations in any given year,need only submit one affidavit indicating mirrent p olicy haf6=ation(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of theaffidavit that has been officially stamped or marked by Ahe city or tows may be provided to the appLcant as proof that a valid affidavit is on file for f tora permits or licenses_ Anew affidavit must be El(--d out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i_e_ a dog license or permit to bum leaves eta.)said person is NOT ret� to complete this affidavit The Office of Investigations would at to thank you n advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. Chet C-ammr2an th of Massaahuszf--tts Ileparimmt of llidu&tzal AocZen:4 Gff ce of lvestigatio= ��Q-�asbingtQn��i • . 02111 Tf,-L 4 617 727-4900 e�- 4€)6 or 1-a` -MAS&AFF Fax#617-` 27-?7� Kevrs�4-24-07 I • oF�roy, ti • r a t • BARNSTABLE. + - ,�� Town of Barnstable ArEp�� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO 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 subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services °FSHE turf, Richard V. Scali,Director ti Building Division RAMsrnsr.E Tom Perry,Building Commissioner �u►ss �' 200 Main Street, Hyannis,MA 02601 pTED www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: t'JOB LOCATION: 41�Z 3 J wx co\A C K 7 20� P j o y I t number street village G. d0Q7/ -1ZY ..Ct qy. d L)t -z name 1 home phone# 1 work phone# . CURRENT MAILING ADDRESS:-, y� J�nr.y1Yl C X 7 - >ly Iyjr, 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 procedums and requirements and that he/she will comply with said procedures and requirements. f,1 D t _ Sign m of er . 7 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215