HomeMy WebLinkAbout0140 MEGAN ROAD (2)
01301-7
Town of Barnstable *Permit# '1 ( I
p Expires 6 mo the from issue date
Building Department Services fee
sntixs AMA : Brian Florence,CB ;® - n
116Jq. ��' Building Commissio n
'OrFnr�� 200 Main Street,Hyannis,MA 02601 OCT 19 2U,1 t
www.town.barnstable.ma.us
Office: 508-8624038 TO � �- �NtiIVS 5b8-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
q _Map/parcel Number 'C 0 Not Valid without Red X-Press Imprint
Property Address �� /�1/ ��J
p
❑Residential Value of Work$ 3� t �6 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Addre s �E1� -� 1
Leo
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
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)
[L�/Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to t4.15,e
Roe-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,'
•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:
QAWPFILESTORMS\building permit forms\EXPRESS.doc
08/16/17
The Comwo7tweakh c,f Massadiusetts
Depaaknerrt cr,f rudl strid Acc idews
office O,f�tigadG=
�. . 600 Washington,street
Barstvn,AM 02111
iviviuma-,s govAdia
Wiarlmre Caffipensaffcm Imn-mce Adavit Suitders/CuntractarsMecfricians(Phombers
APPHcantWmm=fiun Please Prim lmffi
Na=0amnessfOrgan&an/fn&dual NEDRA*
CifgfSfiatel ip /�/v N f s o��p o / " Piwao.4.
Are you an employer?Checkthe appropriate bam ' Type of ro'ect r
I am a metal contractor and I YPe p ] � e4��=
I_❑ I am a employer with ❑ g 6. ❑New emmftucticn
employees;(fal andfor part-;time,* have l*edthe sub-contmetom
2.❑I am a sale proprietor or partnw- fisted oil the.attached sheet. 7. ❑RemodeHng
ship and have no employees These sub-conhracfors ha7e $.,❑Demolitioa
-wading forme in any capacity. employees anrlhave wo6mrs' 9. ❑Building addition
[NOwpdm& comp,insurance conv-roan Mr
6. ❑ We are a corporafioa and its 10.❑EleFftical repairs or add i ions
3. amabameowner doing adwork ofFcmhave exErdsedtheir 1L❑Flumbingrepaimoradditions
Myself o W09Mrs' _ tight of exemption per M(M
finw=e require ]i c.152,j1(4k and we have no 1 . ofrepairs
employees.(Nowo&ers' 13-❑Other
conq_msurmce required.)
;+fir�Pp�e�st cbed�vasl spa fin a�tfie seo¢ueTozv�a�ag ieaworke rnmpa�poTcginBe�
#Snmevava.�swhu sabngt dais�Sda«i�aiiag tiny a�t3ci�aIF Wade and tfiffihaz a4tSid�CbatIIlC�rSnnRti.5Vb]IIIr a aewaffidae>�t Win`SnrF. I
fCaa�actoiszbstcheX*ftboxmustattarh Itaddiba"dsiezishowingffienmeof1]be m sad stilevrrhedmarnat4hosesiddeshme
empivyen.If thesnh-cantactu shave employees,dtey=mtpm dd&tbeh wwke&camp.policy z=beL
I out are etrtp�r Seat irgrauidtiy workers'cotrgseresrriiart insrirarrca,jar rrc}*eQrpTQl�e¢s $etoty is fhepaficy artd jab site
informatiau.
Insmarlcer Conipany.Narae=
Po-ficy or Self-iws.7ic., FxpirationD-ke:
Job Site Address= City/StafefrV
Aftach 2 copy of the Workers'compensationpolr'eydectarathm page(showing the poficy member and respiration 4ate).
Failiue to secure coverage as nequiredvade r Section 25A of MGL c.157-can lead to the imposition of criminal peoaftaes of a
hue up to$1,54U OU awYor one-year inq)dsonmeA as well as civil penalties in the form of a STOP W}RF ORDERand a fine
of up to$2QDa a day against the violator. Be adtdsed tlrat a copy of this statexnent"nag be forwarded to the Office of
Ir esagataons o€the DIA far insurance coverage verifrcation.
"Ida heraby audar tha pains psr a, er try'ffW As&cf orma&npmidcd a5m a ish=and correct
Siffiature c Date:
:-0
O,Ucitd uss mity. Do not wrka in Srs area,tie be ramptetad by cxfy arton-ij officiQt
City or Towu• PermitEkense:9
Tgsaing A.n6writy(cable one):
L Board of Health 1 Buffding Department 3.fhtylFowa Clerk 4.Electrical Inspwtar rr.Plumbing Inspector
6.Other
Confact Person: Phone 9:
— -- - - 6
ormatxon and lastruefions
M�ccarlmce s =,L,salLaws chaptra M reganes all employers'to grov&W=keas'�e�on for their employees.
Par=Snt-b this sue,an wgrkyee is defned as¢:�eayPrasoni a the service of anoi3m ffides any contract ofliae,
express or implied,'cod or wa tom"
Ao_employer is defined as-an inc�iffiA p��,asso�on,torpor do or other legal eaxtliy,c r any two or iamm .
of the foregoing=gaged M a Joint ,and inclndnog 1he legal sepa =f a&w of a deceased employer,or the
receiVr or tzosEee of an btvidnal,per,associaftnn or other legal entity,eroPloymg emploY(--es- However the
owner of a dwelling house having not more'ffim tlnee artments andv�ho resides ih err the octet ofihe-
dwellMg house of anoihm who employs perms to do ,cam*uction or repair wow on such dweIIing house
or on the grounds or bmldmg appmnardthereto ffiOnntbecanse of such employmentbe deemedto be an eanploymf
MGL chapt=152,§25C(6)also states that¢every state or local£u-�agency shall withhold the issuance or
renewal of a Ecen r-or permit to operate a bBsmess or to constmct bwa iags in the commonwealth for my
a-PFhcant Who has notprodnc ed acceptable evidence of compliance vPUii tJxr bIs-arance.coverage required."
Addi iDnaIly,M('f,chsptrr 152,§25CM states al�Teitberihe nor�y ofitspoIrtical jhh the
shall
ems into any contr�t for the perfomiauc6 ofpnblio wm:k unbI acceptable evidence of comPliancevr h Me mstn`� ._
req�enf�ofiliis r�teshavebeenprese�.$dtn{he co„i�t��.a�.ozity."
AgplicarrEs '
Please f0l.Out the VD]i r''aomPeosafion affidavit complei-ly,by clog the boxes ihst apply to your situation and,if
nay,amply sub-contracEar(s)name(s), addresses)and phone mimber(s)along withtheir c tffica±e(s)of
,��_ Laaited Liability Companies(LLC)or Lanited Lbbility Par�shrps(LI P)'vrtthno�Ioyee s other than.th e
filsurmembers or pmta=s,are not rimed to=Y wmix&comp®sation in=z oe~ If an T LC or LLP do es have
employe�s,a.policyisregoired- Beadvisedthaftbisaffdayitmaybesnbmz�dtothDDeparfmmtoflndvsixial
Accideuis for conf=aatim of insm,a=coves Also be sm a to sign and date ice a�davif The affidavit should
b eretr=med to 1he city or town that the agpficafion for the permit or license is being recjaesf not the D eparEmenf of
Ir astrial A_ccid®i nouldyan h��'4�'0� g the law or if Se sie rued c d in obtain a should.
e t
compe,nsationpofiey,please call the Depar[me�atthm= bes listed beloW Self-ins�aedrnagsaniessbnnlden�riiieir
self-msur�ce licaose number on the appinpmtm.Ima.
city err Town O$cials _
f
Ple use be sure that the affidavit is complete andpricted Iegfly_ The Deparhnenthas provided a space at the bottom
of the affidavit for you to fill out i a the event the Office oflnvestigafons has to comet yonregardmg the applicant_
Please be sTn a to fffi m the peamitJIi ce use nzanber whir-h wM be used as a refer mce n omber In ad&don,an applicant
at must submit=Ubt ple pem>itfficcense applications M any givenyear
th ,neej only submit ane affidavit indicating=mt
p oHcy information lifnecessmy)and under"Job Situ-Addre the applicant should v rite-an locations in (may or
•town)»A copy of t1e affidavitthat has been officially sbonped or•maned by the city,or town maybe provided to the -
applicant as pmoff oat a valid affidavit is on file for f1dMI *permits or licenses- A new affidaPit naMt•be Eled oilt each
year. Wlie ere a home owner or citizen is obtaining a license or permit not related tD any busin s or comm ecial vie
to bum.ICZVM etc-)said person is NOT to rxrmplete this affidavit
Cie.a dog license or peunit
Ilse Office of InVCgdg aft=W UJ&hIce to ti mk yonin advance for yoUr cooPmadon and should you have my gvestims,
please do nothesihafbto givens a call-
`Ihe Deparfmmfs aridness,telephone and fax mmnber: -
C=10awmSth of act.
Depadmmt of al AmUenta
• �4`(fan S
�as�zn�I�E1�11�
T61 4 617- -4 *xt 4.06 err 14 M MAIM
Fax#6.17 727 7M
1Zevised4-24-07 ww .masq gpT��
! Town of Barnstable
Building Department Services
AAA : Brian Florence,CBO
1635. k�� Building Commissioner
AN
°lam
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 /�/l.����-0 �� U /lQA" to act on my behalf;
in all matters relative to work authorized by this building permit application for.
I� IVF&41\1 1JAIIS Ins-
(Address o Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Mao , mid
Print Name Print Name
10-t q-1
Date
Q:FORMS:OWNERPERMISSIONPOOLS
Rev:09/16/17
Town of Barnstable
Building Department Services
Brian Florence,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
MASJL snaarsress. : .
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
q� q Please Print
DATE: (�/
JOB LOCATION: /��_[%V
rap_#
&t-o\j
Q" �/(J �] village
"HOMEOWNER": �v _AAA_AC70d
name home phone
e# work phone#
CURRENT MAILING ADDRESS:
cityhown —� 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 buildingpermit. (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
cedures andlquirenignts and that he/she will comply with said procedures and requirements.
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
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.
Q:\WPFMES\FORMS\building permit forms\EXPRESS.doc
08/16/17
.TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
`Map V Parcel Application# T
Health Division
Conservation Division Permit#
Tax Collector Date Issued lb O�
Treasurer Application Fe a s ®D
Planning Dept. Permit Fee
d �
Date Definitive Plan Approved by Planning Board ®�4 �--
Historic*-OKH Preservation/Hyannis
Project Street Address A4 Ca
Village 0 7 4-IJ AJ 15
Owner Una /D I &t Address 1'TU
Telephone /�'
Permit Request reD? IrIl/►a d&� I.;?—
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
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 o On Old King's Highway: ❑Yes
Basement Type: gull ❑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: `Qas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes �Slo Fireplaces: Existing ' New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage �Axisting ❑new size Shed:❑existing ❑new size Other:
C..?
Zoning-Board-of Appeals Authorization -O=Appeal# Recorded❑ --�
Commercial ❑Yes If yes, site plan review#
Current Use Proposed Use
-00
BUILDER INFORMATION .:>`
Name M-CPKA k0i
Telephone Number �7
Address #k IV EC—� kffl License#
HWAiis t Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE �' —
FOR OFFICIAL USE ONLY
? PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
4 OWNER
t a
DATE OF INSPECTION:
FOUNDATION
i
7
FRAME
E _
INSULATION
t t
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
� b s
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Department of Industrial Accidents
Office.of Investigations.
' a 600 Washington Street
s
Boston,MA 02111'.
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
applicant Information Please Print Legibly
1Tame (Business/orpnizationam&vidual): ® L�
Address:_...A_ IUC�
."ity/State/Zip: N15 D q w Phone#:
.re you an employer? Check the-appropriate box:: Type of project(required):
❑ I am a employer with 4, 111 am a general contractor and I
6. ❑New construction
employees(full"and/or part time).* have hired the sub-contractors ElI am a sole proprietor or parnrer- listed on the attached sheet$ ? Remodelin❑ g
ship and have no employees These sub-contractors have S. ❑ Demolition
working for me in any•capacity. :workers' comp. insurance: g ❑ Building addition
[No workers' comp. insurance 5• ❑ We area corporation and its � 10.❑ Electrical repairs or.additions
aired.] officers have exercised their
am a homeowner doing all work right of exemption per MGL 1*1.❑ Plumbing repairs or additions
myself.-[No workers' comp.- c. 152,§1(4), and we have no 12. Roof r
insurance required.] t employees. [No workers' ❑ ��
] 13. Other %gt(r {/1C 1S�-irn/,,
comp.Msurance required.
ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomration `.
iomeowners who submit this affidavit indicating they are doing all work end then hire outside contractors must submit anew aff davit indicating such
mtractors that check this box must attached an additional sheet showing the name of the sub contraftn and their workers'comp.policy information. .
!m an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
Formation.
,urance.Company Name:
licy#or Self-ins.Lic..#: Expiration Date:
b Site Address: City/State/Zip-
tack a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
ilure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
e up to$1,500,.00 an one-year imprisonment, as well as civil penalties in i ie form of a STOP WORK ORDER and a fine
up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
restigations of the DIA for insurance coverage verification.
'o hereby i y under the pa' s and pe aloes of perjury that the,information provided above is true and correct:
afore:. Date:
one#:.
Official use only. Do not write in this area,to be completed by city.or town official
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#:
Information and. Instructions
fassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
arsuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
dress or implied,oral or written."
m employer is defined as_"an?�dividual,.partnership,:association,corporation or other legal entity,or any two or more
f the foregoing-engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
meiver or trustee of an individual,partnership,association or other legal entity,employing employees. However The
,caner of a dwelling house having not more than three apartments and who resides therein, or.the occupant of the
welling house of another who employs persons to do maintenance, construction or repair woik•on such dwelling house
)r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
4GL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
•enewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
►pplicant who has not produced acceptable evidence-of compliance with the insurance coverage required."
.kdditionally,MGL chapteT 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
,ntterr into any contract for the performance of public work until acceptable evidence.of compliance with the insurance
-equuements 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-contractor(s)name(s),address(es) and phone number(s)along with their certificates) 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
for the permit or license is being requested, not the Department of
be returned to the city or town that the application
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 to give us a call.
The Department's address,telephone and,fax number:
The Commonwealth of Massachusetts .
Department of Industrial.Accidents ..
Office of Investigations
,. 600 Washington Sxreet4
Boston,MA 02111.
Tel. #617-727-4900 ext 406 or-1-877-MASSAFE
Fax#617-727-7749
evised 5-26-05 www.mass.gov/dia
°FtMETp�, Town of Barnstable
Regulatory Services
snxivszast>r. ' Thomas F.Geiler,Director
y 'MASS. $
1639.
c i '`0 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
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion,
improvement;removal, demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along
requirements. p�p,
Type of W ork:�a 'b s `tip
Estimated Cost 0(
G 1 V y V ED
Address of Work:
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
Building not owner-occupied
weer pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Signature Registration No.
jOR
Date Owner's Signature,
Q:wpfiles.fomu:homeaffidav
Rev: 060606
Town of Barnstable
o� Regulatory Services
BARNSTABLE,
Thomas F.Geiler,Director
9 MASS. g
q, 039. Building Division
ArfD ,ts 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:
JOB LOCATION: /"/ti 'I v`' �J�/ !1�/!/ /V
number street Q village
"HOMEOWNER":
name (home phone# work phone#
CURRENT MAILING ADDRESS:
TULS /yI _
city/town state zip code
The current ekemption 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
AQuirements.
h,
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 fomm/certification for use in your community.
Q:formr s:homeexempt
LOCI OF PRO' P E-R 1 N M Y) OOJF BE ACC U RATE STANDARD LEGEND
NOTE:not all symbols will appear on a map
GOLF COURSE FAIRWAY
EDGE OF DECIDUOUS TREES
132
EDGE OF BRUSH
ORCHARD OR NURSERY
EDGE OF CONIFEROUS TREES
MARSH AREA .
-- EDGE OF WATER
DIRT ROAD
DRIVEWAY
�—PARKING LOT
�—PAVED ROAD
---—--— DRAINAGE DITCH
————— PATH/TRAIL
PARCEL LINE
MAP 326 -< MAP#
021 F PARCEL NUMBER
#367 ; HOUSE NUMBER
2 FOOT CONTOUR LINE
l
—i.®— 10 FOOT CONTOUR LINE
Elevation based on NGVD29
4.9 SPOT ELEVATION
STONE WALL
40
-X--X— FENCE
A- Ift IN RETAIN G WALL
RAIL ROAD TRACK
— --
,.=-'�'•, ......_. -•.,,,--,,, `, — STONE JETTY
I
POOL SWIMMING POOL
.....-...-
PORCH/DECK
' 0 BUILDING/STRUCTURE
DO PIER
1
................_-. `• .Q HYDRANT
e VALVE OO MANHOLE
K)AA A M f7I 1 0 POST p FLAG POLE
T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T .a SIGN ® STORM DRAIN
M PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James
1"=100'scale ma and may NOT meet of roe boundaries.The are not true locations,and W.Sewall Company.Topographyand ve vegetation were interpreted from 1989 aerialphotographs b GEOD 0 UTILITY POLE TOWER
w •- e � P V property hV V P Y• 0 P V
0 10 20 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation.'Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards ¢ LIGHT POLE O ELECTRIC BOX
1 INCH=20 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from FY2004 Town of Barnstable Assessor's tax maps.
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