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Home My WebLink About0312 ARROWHEAD DRIVE ��} Vim/ �'� _. I i� PERMIT PAYMENT RECEIPT T011N OF B A R N S T A B L E BUILDING DEPARTMENT 200 MAIN STREET HYANNIS , MA 02601 DATE : 12115 / 06 TIME 13 : 50 - - - - - - - - - - - - - - 10TALS - - - - - - PERMIT $ PAID 25 . 00 A M T TENDERED : 25 . 00 AMT APPLIED 25 , 00 CHANGE : 00 APPLICA110N NUMBER ; 20065292 PAYMENT METH : CHECK PAYMLPII RE. F : 971 t Town of Barnstable ennit:a60s _ 3 �ppTME A Regulatory Services ate: 5 aqa P , F. Thomas F.Geiler,Director _ * BARN STABLE, Building Division ee.a�'QD 9 MASS. 1639• �m � �DEC 1.5C Pm ,:Tm.Perry, Building Commissioner- 4 ArEo �a 20R Main Street, Hyannis,MA 02601 www.town-barnstable.ma.us Office: 508-862-4038 NVISION Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: Is��-� Phone: 0�f— /� "�67 Install at: Y/.z /�1�ew Pa Village: M /5I,/mil Map/Parcel: l �� Date: 1.211 v Stov 1 A' New/ se B. Type: iant culatin • C. Manufacturer: Lab, No. C� 0 D. Model No.: Chimney A. New/ xistin (If existing,please note date of last cleaning) j�� f, �s C�J) I�I� B. Flue Size 10, C. Are other appliances at66hed to Flue? D. Pre-fab Type and Manufacturer Masonry: Lined/Unlined Hearth (� A. Materials: B. Sub Floor Construction: Pi / G InstallerE' �� Name: Address: Phone: Location of Installation: vP APPROVED BY: r d` I �o Please make checks payable to the Town' of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector i Q:forms:stove Rev 122801w ., p w & t i 4i, � ti t 1 ! a � kTI ��,.... , _ °'-e«a.y �, "a""a, wi a ,r� .2 �- "n°h "' s'rti4.. =}+- $,. �,�,° ��" � � e` `� ?" •_ � :'� _ :, h� ,�• r- - Y +-, "e r m mm "nr,,.�-•• ` � r wr�r a v, :,wa,a�, - ,`., ';r a�:• :+ R. ^ •w" r ` ,w,a;r. w - y� qya m. M ry, ,.uy ,mum�\� �... ^ -,.� ....�." ;_. ax„„ •. .. r., .:,. r. n ay* :'. a w ^+• s :p +rt' 's +s ,. 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'+,y'',y�'f� ,�, m* w '. �,.. :a� v� ,+.�, -m-�., � T "., r+$, _'�t'r , � - .psi,.,,�.. �. � - • � � es,4 ,.,E *k s ar «, -04 i� '�,r ;�'kt a <a.•'�'Y .� x�` x x �� ' �,. �t u": cYs`. � � .,,� x .,f'�° ®,z x� {.� :..o W.evi= s.�.`: � � m� � "' �w .., e 'i�`h _ '��' m�@,.,' e,ppe r •. �ti 'a 312 Arrowhead Dr. , Hyannis 12/19/06 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I Map 0 Parcel - Application# O� Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee 4_-_.>U 4 Planning Dept. Permit Fee ' C Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address VillageAIIA-1 I f Owner Address Telephone �/,�Q Permit Request /�42e_W /?'h.e /'2o�NCd. fi✓ �5 �ti�� '��o eon Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwellingljype: Tpgle Far^ily ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basemerrt Type(1"❑Full S21 Crawl ❑Walkout ❑Other CC o u) Basement Finished Area(sift.) Basement Unfinished Area(sq.ft) r CD Number of=Bath= Full existing new Half:existing new Number o7- ca Bed ms: a fisting new Y 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 ❑`Yeas ❑No If yes,site plan review# Current Use Proposed Use BUILDER-INFORMATION— ' Name� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,tSIGNATURE_-\ ` DATE, l%-�7�.- m� } FOR OFFICIAL USE ONLY PERMIT NO. DATOISSUED ` MAP/PARCEL NO. s s. ADDRESS VILLAGE OWNER r 3 DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r , GAS: ROUGH FINAL i FINAL BUILDING 4 i DATE CLOSED OUT I r ASSOCIATION PLAN NO. f k i (7 I S e ommonwea t of Massachusetts Department of Industrial Accidents' 4 Office of Investigations i� r v^ 600 Washington Street Boston, MA 02II1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 4.q Please Print Legibly Name(Business/Organization/Individual): 3 Iva ) Q Address: City/State/Zip A.r S d7/'. Phone#: ��`.�/'iG -0 kre you an employer? Check the appropriate bog: Type of project(required) ❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time),*, have hiredthe'sub-contractors- 6• ❑New construction ❑ I am a sole proprietor or partner listed on the attached sheet.t 7. [ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any-capacity, workers' comp;insurance, 9 ❑Building addition [No workers' comp,insurance 5. ❑ We are a corporation and its _ /i'equiied] officers have exercised their 10.❑Electrical repairs or additions / I am a homeowner doing all work right of exemption per MGL I I-❑Plumbing repairs or additions . myself;[No workerstGomp� e. 152, §1(4), and we have no 12.❑Roof repairs insurance-requir`ed:]': employees. [No workers' comp.insurance required.] 13.❑Other my applicant that checks box#f must also fill out the section below showing their workers'compensation policy information. lomeown,is who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. rm an employer that isproviding workers'compensation insurance for my employees- Below is thepolicy andjob site formation. surance Company Name: Jicy#or Self-ins.Lic.#: Expiration Date: 6 Site Address: City/State/Zip: tach 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 and/or one-year imprisonment, as well as civil penalties in the 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 may be forwarded to the Office of vestigations of the DIA for insurance coverage verification. !o hereby certify under the pains and penalties of p ' that the information provided above 1s true and correct ,_.. t>nature „" Date> 7 — one#: Of 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.BuiIding Department 3. City/Town Clerk 4.Electrical Inspector 5.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 udder 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 Qf 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 ?lease 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 certI ficate(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 permittlicense applications in any given year,need only submit one affidavit indicating current policy.informatim(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 maybe 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 Depaxtment o€lnddustial Accidents Office of Investigations 600'Washington Strut Bostob,MA 0.21 11 Tel, 617-727-4900 W. 406 or 1-&77-MASSAFE Fax.# 617-727-7749 Revised 5-26-05 . xww.igass.gov/dia . 1vTr11 vi Nail 13L"LJFA%, Regulatory Services s,►xxsrae . " Thomas F.Geiler,Director �ATFo 5 ► Building Division Tom-Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us fice: 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 tban four dwelling units.or to structures which are adj agent to such residence or building be done by registered contractors,with certain e%ceptia s,along wdth other requirements. Type of Work: A /hn we.0 > �� Estimated Cost, Address of Work: H��OW�� Owner's Name: () �if Ili Date of Application I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑ rlding not owner-occupied , weer pulling wno perm t� . Notice is hereby given that: OWNERS FULLING 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 PERMY I hereby apply for a permit as the agent of the owner: Date Contractor Signature Registration No. OR , Date J Owner�sSgna e..--� Q;wpMes Jo=:homeaffiday Rev: 060606 r Tint!JS:Z1D�eOnttnned� ' Prescriptive Packages for One and Two-Family Residential Bolldings Heated with Foasr7'Fuels i � ,• MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Bascneat : Slab HeatiaglCooling Area'CIa) U-value= R e R v-valw; ' R-valualue° Nall pesimeier £quipmert EMcieacy' p tek ge • • R-value R-valuer 5701 to 6500 Heating Degree Days' Qf 12% 0.40 38 13 19 10 6 Normal R I2°l. 0.52 30 19 19 10 6 Normal 5 12% 0.50 31 13 19 10 6 15-AF-JE T 15% 036 38 13 25 NIA NIA Normal U I5% 0.46 38 19 19 10 6 Normal y 15% 0.44 38 13 25 NIA N/A 15 AFUE W 13% 032 30 19 19 10 6 15 AFUE X I S% 032 38 . 13 23 NIA NIA Normal y 13%. 0.42 38 19 23 NIA NIA Normal Z 12% 6.42 31 13 19 10 6 90 AFUE Rom. 10•/. 030 30 19 19 10 6 90 AFUE 1, ADDRESS OF PROPERTY: --7 C- 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: d ✓ �y "'�� / 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY 42): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DEG ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FORTIES INFORMATION. BUILDING INSPECTOR APPROVAL: YES:. NO: Q-for=49803 03 a Town of Barnstable Regulatory Services swxrtsznsi E Thomas F.Geiler,Director y MA33. �A i639 ,�� Building Division rFDMA�s 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: _Ze,;Z oeua /4f 49'a 4i 2,!V_ Y �� number street village «HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 3/. /Z 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 requirements Signature - omeowner 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