HomeMy WebLinkAbout0108 MEGAN ROAD / o � �
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Town of Barnstable Building
.Post,Th�s"Card So That it is,_U�sible From the Street,,,-,Approved Plans Must be Reta�ned�on J,ob and this CardMust'be Kept
+ rA8HI8T'ABL6. • ��s.��{`i '> �r„%. �,,���_ s,�. y_ r`. P �" � f '°��. �: ;,yam ,l�' ,.Wz '} � ', �'
6� Posted�Unti,I Final Inspection Has-Been Made � _ �" �� � � ' � Permit
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�R �.W,here a Certificate�of OccupancsRequred,siich�Buldmg'shall Not;be Occupied,unt�l a�Final:Inspection has�been m,'aFde� ,x,
Permit No. B-19-1062 Applicant Name: GENTILE, MARK C Approvals
Date Issued: 04/17/2019 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 10/17/2019 Foundation:
Residential Map/Lot 292 246 Zoning District: RB Sheathing:
Location: 108 MEGAN ROAD, HYANNIS m
Contractor Name Framing: 1
Owner on Record: GENTILE, MARK C Contractor License:, „
{ 2
Address: 108 MEGAN ROAD �y Est Project Cost: $6,000.00 Chimney:
Perrn�it Flee: 85.00
HYANNIS, MA 02601 , $
Description: Construct Bathroom in the Basement.Change existing windows in Fee Paid $85.00
Insulation:
basement to egress windows. '
Date 4/17/2019 Final:
z �. '
Project Review Req: No bedrooms allowed in basement per"�Health x
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%K4 Plumbing/Gas
P
Mft
�x Y Rough Plumbing:
:. Building Official
-�
� � Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by mo this permit is commenced withinsix nths after issuance.
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
Rough Gas:
All construction,alterations and changes of use of any building and structuresshallfbe in compliance with the local zoning by laws and codes.
This permit shall be displayed in a location clearly visible from access street or ad and shall be maintained open for pubUc mspectio for the entire duration of the Final Gas:
work until the completion of the same. z
The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials are provided on thispermit. Electrical
Minimum of Five Call Inspections Required for All Construction Work A � � Service:
1.Foundation or Footing
2.Sheathing Inspection r Rough:
Iiiii;3.All Fireplaces must be inspected at the throat level before firest flue'(i6ing innstalled' '
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persa�s-c racting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
�P p Application Number.............................................................
�Y.
f �
OF PAR TABLE
•
* i�ABsPg P t Fee. .. Other Fee........................
Total Fee Paid............................................................... ......
TOWN OF B DE° a 'Pi ►ppmal by....... .on..... ...1,
Aar{ t
BUILDING PERMIT a 4� (,
Map........................................P 60arcel..............�.......................
APPLICATION
Section 1 - Owner's Information and Project Location
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Project Address Village !Z kCA�J N
Owners Name
Owners Legal Address ,
� n
City1) State Zip
Owners Cell# �D o! 63F E-mail er "�Et0// V C t (fC)
Section 2 —Use of Structure
Use Group ❑ Commercial Structure over 35,000 cubic feet
❑ ommercial Structure under 35,000 cubic feet
Single/Two Family Dwelling
Section 3 — 'hype of Permit
❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use
❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm
ebuild ❑ Deck Apartment ❑ Sprinkler System
`Addition ❑ Retaining wall ❑ . Solar
❑ Renovation ❑ Pool ❑ Insulation
Other—Specify.
Section 4 - Work Description
a
A64rd�f- N
Y
A:
Last undated: 1 MR/2018
' r
' Application Number..............::.
Section 5—Detail
< Cost of Proposed Construction'> Square Footage of Project
Age of Structure Dig Safe Number
# Of Bedrooms Existing Total#Of Bedrooms (proposed)
110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design
1
Section 6—Project Specifics
,j
❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors
[Plumbing ❑ Gas ❑ Fire Suppression
❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom
Water Supply ❑ Public ❑ Private
Sewage Disposal ❑ Municipal ❑ On Site
Historic District ❑ Hyannis Historic District ❑ Old Kings Highway
Debris Disposal Facility: I am using a crane ❑ Yes ❑ No
Section 7—Flood Zone
Flood Zone Designation
Within or adjacent to a wetland, coastal bank? Yes ❑ No
Section 8—Zoning Information
Zoning District Proposed Use Lot Area Sq.Ft.
Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site)
Setbacks Front Yard Required Proposed
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Last updated 11/15/2018 I
Application Number............................................
Section 9- Construction Supervisor
Name Telephone Number
Address City State Zip
License Number License Type Expiration Date
Contractors Email Cell #
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license.
Signature Date
Section 10—Home Improvement Contractor
Name Telephone Number
Address City State Zip
Registration Number Expiration Date
I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.LC...
Signature Date
Section 11 —Home Owners License Exemption
a , Home Owners Name: rk
Telephone Number �(� o�� '0� Cell or Work Number
U
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.
L Signature C Date 3 3/-
1
APPLICANT SIGNATURE
Signature��� Date `9
Print Name Mar`� C G&— -1�T'�Telephone Numbers
E-mail permit to: '°r /'ve , C®
Last updated. 11/15/2018
Section 12 —Department Sign-Offs
Health Department ❑ Zoning Board(if required) ❑
Historic District ❑ Site Plan Review(if required) ❑
Fire Department ❑
Conservation ❑
For commercial work,please take your plans directly to the fire department for approval
i
Section 13— Owner's Authorization
I, , 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: {
a
(Address of job)
Signature of Owner date - N,
1
Print Name
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- i
Last updated: 11/15/2018
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,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 house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing 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 not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confu mation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant
that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled 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 burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would bike to thank you in 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.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of fnvestiptlo s
600 Washington Street
Boston,MA 02111 -
Tel.#617 727-49M ext 406 or 1-877-MASSAFB
Revised 4-24-07 Fax#617-727-7749
www.rn gov/dia
' r
AVL
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Bwlders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leuibly
Name(Business/Organizatimlbdividual):
MackcG&ijf; l(t�-
Address• IM MG,l al RCI-
City/State/Zip: 6 M4 a2kL Phone#: 03 5�
Are you an employer?Check the appropriate box: Typeproject(required):
of 'ect
L❑ lam a employer with- 4. 0 I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g• ElDemolition
working for me in any capacity.acitY• employees and have workers'
# 9. ❑Building addition
comp.incnranCe.
[N workers comp.insurance p 10.❑Electrical
yeqdred.] 5. We are a corporation and its repairs or additions
3.91 am a homeowner doing all work officers have exercised their 11.[RfPlumbing repairs or additions
myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employees.[No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box A must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'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 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office.of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under a pains d penalties of perjury that the information provided above is true and correct
Si store: Date: 3—3/'—I q
Phone#:
Of,j7cial use only. Do not write in this area,to be completed by city or town grcial
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ,
6.Other
Contact Person: Phone#:
TOWN OF BAR STABLE
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N:EREBY CERTIFY THAT THE BULL. NG REG.: LAND. 5U-RVE,Y
_5I4OWN ON THIS PLAN _. IS LOCATED ON '
_f.ftE .GROUND AS SHOWN .,HEREON AND
M AT IT - C>O N F O R M r 0 T W E OF IW
� QMING BY=- L.AWS OF THE.- TOWN OF
W H E N C -O N S T R U C T E D. EYERE T
R; NST'ABeLE S_ VAVEY : C0NSULTANTS, INS
�? W E'S T Y. R M O U:TH,. Etix =�
= MASS:
SY TEM MUST BE-
SEPTIC
INSTALLED IN COMPLIANCE
WITH ARTICLE II STATE
SANITARY CODE AND TOWN
REGULATIC`"
} tNEro�y'� TOWN OF BARNSTABLE
t MARNSTABLS, i
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0 M pr. BUILDING INSPECTOR
�FF'�
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APPLICATION FOR PERMIT TO(1.49
TYPE OF CONSTRUCTION ss
..... .... ..... 5...........19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby appl' s for a permit according to the following information: y
Location ................ ........ ............................ +�....� ...............
ProposedUse .... `�.... ...... .. .:. ............. .......... �. . .......... .........................................................
Zoning District . . Fire District 1i2 ...........................................L
Name of Owner ....&.4zzts� ......./ :. ......Address ....`r�..(J.l.....�1 ... .. !..'. ��.E
Name of Builder ...........1..................................Pr.................Address q
Nameof Architect ...........l.J....................................................Address ..........."........................................................................
Numberof Rooms .................'t... .......................................Foundation ..... ..............., ......... .........................
Exterior ......................... ... .. �`:" .. ..........Roofing
..............................................
Floors ....... ................................................................Interior .... . ......... .. ... .. . ...............
� ..................................
Heating ....... ..........................................................Plumbing ............./.................................................................
Fireplace ..................................................................................Approximate Cost ....... .....................................
Definitive Plan Approved by Planning Board e19
Diagram of Lot and Building with Dimensions
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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r
I hereby agree to conform to all the Rules and Regulations of the Town of Barnsyble regardip4.the above
construction.
Name .... G.... . .... ..................
J/�
Dacey, Alliam E. Jr.
'No ....16246Permit for ......•one
...story.........
......................
...... .....
Location 0 --Nemn..Aq�ad.................................
....................... .......................................
Owner .........WilliM.
Type of Construction .............f rame.................
................................................................................
Plot ............................ Lot ............... ........
y
Permit Granted ...........Ma.........2....5
.................19 73
Date of Inspection ..... .........19
Date Completed .... ......19
P ce as
PERMIT REFUSED
................................................................ 19
................................................................................
- f.
.............................................................................
. ................................................................................
o........................................................................... �
Approved ................................................ 19
...............................................................................
................................................................................
30 o
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AI regdy
�� C6IhQ�el io✓I � n SPr'�ny Z00 �
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Town of Barnstable *Permit#
Lb a3
Expires 6 months from issue date
Regulatory Services Fee too
Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,Mk 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number o? 7
Property Address /,O 0 / 19121' lq v c� vl o/
Residential Value of Work�p�� 00o Minimum fee of$25.00 for work under$6000.00
I • Let'
C� R
Owner's Name &Addiess / �e t ,4��/1 � gdeff 6(n tl l e
/09 Rc6i gn 14oi d 11wgr),ol's r / W O ,5?6d f
Contractor's Name t v IA Telephone Numbers 7 /I I S—YO
Home Improvement Contractor License#(if applicable) N
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one: X-PRESS PERMIT
I am a sole proprietor
I am the Homeowner JUN — 5 2007
❑ I have Worker's Compensation Insurance
Insurance Company Name TOWN OF BARNSTABLE
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)X Re-roof(stripping old shingles) All construction debris will be taken to 4gq't/F/R///
❑Re-roof(not stripping. Going over existing layers of roof)
Re-side �� /
[Replacement Windows/doors/sliders. U-Value �aximum.44)
*Where required: Issuance of this permit does not exempt compliance with other totem department regulat ons're2-` s1-4_lr Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Per ion.
A copy of the Home Improvement Contractors License is re�
i.; r'�SIGNATURE QAx ea-&
� - j�t�;,'; �;s. :7 L
t.
Q:Forms:expmtrg
Revise061306
f
a The Commonwealth of Massachusetts
Department of Industrial Accidents
m
Office of Investigations
600 Washington Street
a` Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance, davit: Builders/Contractors/Electricians/Plumbers
Applicant Information n p Please Print Legibly
Name(Business/Organization/Individual): . K!} ff e /OR/` e
Address: 0 @�4 IQ�Ad
City/State/Zip: ! 0� Phone.#: F ' 7/ /S�0
Are you an employe Check the appropriate box: Type of project(required):,
1.❑ I am a employer with 4. I am a general contractor and I
6. New construction
employees (full and/or parttime).* have hired the sub-contractors
-
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
These sub-contractors have Demolition
ship and have no employees 8. ❑
workingfor me in an capacity. employees and have workers'
Y P tY $. 9. Building addition
[No workers' comp:insurance comp.insurance.
required.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3;9,I am a homeowner doing all work officers have exercised their . 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.] .
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins,Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' 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 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investieations of the DIA for insurance coverage verification.
do hereby certify under the ins-a penalties of perjury that the information provided above is true and correct
Si ature: ` Date: .S O®
Phone#: W 0 -7 7/ 15 Y d
Official use only. Do not write in this area,to be completed by city or town of 1ciaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,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 house having not more than three apartments and who resides therein,or the occupant of the'
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing 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 not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for.the performance of public work until,acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-conti•actor(s)name(s), address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers'compensation insurance. If an LLC 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 insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled 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 burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate t6 give us a call.
The Department's address,telephone-and fax number:.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations '
600 Washingto:r Street
Boston,MA 02111 l
Tel. 4 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 11-22-06 Fax 4 617-727-7749
www.mass.gov(dia
Town of Barnstable
-" pF THE Tp�
Regulatory Services
snartsTAsi.E Thomas F.Geiler,Director
MASS.
94, s639• ,�� 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
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: lJ
JOB LOCATION: (0 e G x17 r3k2
number Q� street village
"HOMEOWNER': 1T ll /1 efi�� l� l/QO Z /-7/ ! ,5�V0
name home phone# work phone#
CURRENT MAILING ADDRESS: /O UQ e("do &dd
'-5
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
re ements.
Signature of Homeowner
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
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The Town of Barnstable
9 6 Department of Health Safety and Environmental Services
►19 P Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
SHED REGISTRATION
670 #KRAZ leis
Location of shed(address) Village
ME K Celli
Property owner's name T lephone number
Size of Shed Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?.
Conservation Commission(signature required)
PLEASE NOTE: IF YOU ARE WITIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,TBERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
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