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0044 CEDARWOOD ROAD
_ l _ I b - - } q S !' i e .. J,.«�--.-.. �� - _ _ _ r Q Town of Barnstable *Permit# Qo iS O - Expires 6 months from issue date Regulatory Services ®P seaetarnstA NAM Richard V.Scali,Director 039� NOV 0 3 2015 Building Division TOW Tom Perry,CBO,Building Commissioner OF p/�D n' 200 Main Street,Hyannis,MA 0260.1 BARNSTAB�E www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 7-v 0 Prope Address �"� C m ayt-W UU n n" Residential Value of Work$ U II/n� Minimum fee of�$n35.00 for work under$6000.00 Owner's Name&Address v� / V' US UVL l�� II trg ti ti Lei wt- w�,M l�y, G O�i t oz_M Contractor's Name v Telephone Number 13(� ` l Home Improvement Contractor License#(if applicable) Email: C.�I�b� C d6'C`�C?laJ j0� t►t�4at I . LO�''t• Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I sole proprietor ❑ the Homeowner ' I have Worker's Compensation Insurance Insurance Company Name 11 G(6 tr ^I Workman's Comp.Policy# (�l1 LG 'BOG 1;�o 0 cL! (1� h� Copy of Insurance Compliance Certificate must accompany each permit. Permit Re ue c eck box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to j�f V)i 0(Oc1 S� S MR. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ��,'I Get ❑ 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&lire 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 requir SIGNATURE: C:\Users\DecollikWppData\Loca[\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 r G10A&.yjaclulj�' Office of Consumer Affairs and Business Regulation =` 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 131841 Type: Private Corporation Expiration: 9/2612016 Tr# 256305 CENTRAL CAPE CONSTRUCTIONCO. INC. STEPHEN DEVLIN 820 MAIN ST. COTUIT, MA 02635 Update Address and return card.Mark reason for change. A � „ Address - Renewal Employment =! Lost Card ' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 3ti>OME IMPROVEd►IEWT CONTRACTOR before the expiration date. If found return to: F T Office of Consumer Affairs and Business Regulation _ +Registration: 131841 Type: Expiration: W612016 Private Corporation 10 Park Plaza-Suite 5170 {= p Boston,MA 02116 CENTRAL CAPE CONSTRUCTIONCO.INC. STEPHEN DEVLIN 820 MAIN ST COTUIT,MA 02635 a Undersecretary No valid without signature Massachusetts11 -Department of Public Safety Board of Building Regulations and Standards Construction SuperVisor License;CS-047993 STEPHEN J DEVON � 820 MAIN ST Cotuit MA 0260 r M n 0`' Expiration Commissioner t)Z104/Z016 e ' The Contmoitivealth of fassachuselts Department of Industrial Accidents Office of Investigations 600 Washington Street z. Boston,M4 02111 tnrpt nias&gov/dia Workers' Compensation Insurance Affida-tit: Builders/Contractors/Electtzcians/Plumbers Applicant Information Please Print Legibly Name(Businens orgm&.ationtin&vidual): P//�/!�,cy{ c l�afi' (-d u-5 J jw(,r( d y Address: UZV Ay m-th1 S r• Ciwstate/Zip: U T e^' p ss UZ - Phone#: 5 6 g' 07 6— Gif d Are yoo an employer?Check the appropriate box: Type of project(required): 1. I am a employer with G 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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_ ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance connp.insurance.I 9. ❑Building addition required.] 5. ❑ We.are a corporation and its 10.❑Electric repairs or additions 3.❑ I am a homeouamer doing all work officers have exercised their 11.❑PI ag repairs or additions myself.[No workers'comp. right of exemption per viGL 12.DKoof repairs insurance required.]r c. 152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] •Any applicanr that checks box#1 must also fill out the section below showing their workers'compensation policy information- Homeowners who submit this affida%it 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 subcontractors and state whether or not those entities have employees. U the sub-contractors have employees,they must pronde their workers'camp.policy number. I ani an employer tleat is prodding it orkers'conipeusatiori uisurmice for rue'eiiiployees. Below is the policy mid job site informatioit. c Insurance Company Name: �"T1 C( \c' iLI-1l1 o Policy#or Self-ins.Lic. wcc-w u SOD "l i C! A Expiration Date: N Job Site Address: L f�[ �C�I i�u+".�Wt10 City/State/Zip: ®,� (t 3S 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 criminAI penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP IX70RK 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 render the p is and penalties etynry that the information prodded above is true and correct Si Mature.: ! Date: �Z Phone#: �Q `E M 6— (�CU o Official use only. Do not write in this area,to be,completed by city or town official. City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityllown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone M 6 ClienW:38438 2CENTRALCA DATE(r;�uDomYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 0710712015 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 pollcy(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 endorsement(s). PRODUCER Dowling 8r O'Neil WL .508 775-1620 1 c Noy 5087781218 Insurance Agency E46AIL 973 lyannough Rd., PO Box 1990 DREss. Hyannis,MA OZ601 IN8UR S AFF ORDING COVERAGE NAIC S INSURER A:National Grange Mutual Insuranc 0=RE0 Central Cape Construction Company,Inc. INsuRER B:Associated Employers Insurance 820 Main Street INSURER C: Cotult,MA 02635 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. ,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE SSU a POLICY NUMBER 020vMn ACM13 LWTS A GENERAL LIABILITY MPI9764Q 111141201411/141201 EACH OCCURRENCE $1000000 PREMISE X COMMERCIAL GENERAL LIABILITY &EM erroe $50O 000 cLAIMsA ADE 0 OCCUR MED EXP(Arty one person) $1 O 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GE N L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2,000 000 POLICY PRO- JECT LOC $ AUTOMOBILE LIABUM OOMBNWD SINGLE IT accidera ANY AUTO BODILY NARY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS S UMBREIJA LIARHCLAM.-MAE OCCUR EACH OCCURRENCE f EXCESS LIAB AGGREGATE S DED I I RETENTION g B A"EMPs COMPENSATION JN WCC50050091992015A 5/14/2015 05114/201 X WC STATU OTH- ANY AND EIILPLOYERS'UA811)rY CUTIVE Y/N IJ, OFFICER/MEMBERA EXCLUDED? a NIA EL EACH ACCIDENT iSIIO OOO (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 000 DE under SCRIbe PTION OF OPERATIONS betow E.L.DISEASE-POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES O twA ACORD 101,Additional Remarks Sdredule,if more apace Is required) Steven Devlin Is excluded from coverage under the workers compensation policy. Certificate holder is named additional Insured for general liability when required by written contract Insurance coverage Is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Mashpee Commons LP- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 1530 ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee,MA 02649 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S154066/M154065 LS1 Town of Barnstable Regulatory Services g rY 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 Ile VK mi ,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) l a Z.1, 15 Si ature of r /Dat D FirJILS Print Name f If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. •,�� - C:\Users\Decollik\AppData\Local\MicrosWWindows\Temporary Intemet Files\Content.Outlook\2PIOI DHR\EXPP ESS.doc Revised 040215 ? TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Farce 'Application Application # )I a .6' 65 i Health.Division Date Issued rZ Conservation Division Z/lam �J O e)�a�v�bo.,c� �'eyv�� I�7 1 �e. Application Fee eeo3)bro ,QC� Planning Dept. cu.� o(_ Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 4(-( C,CQ ZlK_ W Village 01-u lT Owner R- 6 yl L In t J 6t3 Address qY CeA C4► 4/600 O C, e'aryrr Telephone 6It) Permit Request CON Sr&V(J- N el,✓ l �Z l/hU✓�' Ii a rim /�'Vaf SOU Loom 6-L e S myl l A-10✓J I f U w Square feet: 1st floor: existing proposed 2nd floor: existing CY d proposed G Total new Zoning District R.F Flood Plain Groundwater Overlay Project Valuation D Construction Type Lot Size S0 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. Two Family ❑ Multi-Family (# units) L1 Age of Existing Structure Historic House: ❑Yes 'No On Old King's Highway: ❑Yes LK Basement Type: ❑ Full Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 0 nn11 Basement Unfinished Area (sq.ft) 3�2— Cam„J Number of Baths: Full: existing 2 new y Half: existing new Q Number of Bedrooms: existing _new l Total Room Count (not including baths): existing e'1new l First Floor Room Count 3 Heat Type and Fuel: ®'Gas ❑Oil ❑ Electric ❑ Other Central Air: &"Yes ❑ No Fireplaces: Existing New O Existing wood/coal stove: ❑Yes ®'No Detached garage: ❑ exiof/Aa new size_Pool: ❑ existing ❑ new size _J-hvu�a existing ❑ new size_ Attached garage: ❑ ex hg/PLnew size _Shed: ❑ existing ❑ new size _ e El Zoning Board of Appeals Aut rization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# �iO " Current Use 1h WTI(k( Proposed Use Llil/1 {Al* tk APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name &VI U Telephone Number :(A Address Q V/ x 6L 1 License # 9 f) gel � Co ru or J V)l A-S S Home Improvement Contractor# Worker's Compensation # UJ r(, S6(2G 1C,90 1ZO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO iUGJQ,J �dw►� SIGNATURE DATE a , j FOR OFFICIAL USE ONLY s APPLICATION# a� " -, DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER , , DATE OF INSPECTION: FOUNDATION 4elll-'!1 FRAMES aac y so��/e�r.yc-- IQ o sy �.1Z INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL fs PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED dUT ASSOCIATION PLAN NO`'• = i T6w.n. of Bari-stable .' . .-Zegulatory S6rvzces Thomas GeGer,Director Building Di'FaEion Thomas Perry,•CB O,•BruIding Commissioner 260?Main S`t�ut, Hyannis,2tfA 012601' w.town.barnsta blataa.us 'Offices 508-8624038 Fax. 508-790-623D' PLA'RE W 2- 0 t op 'S--c:) S- Owner /ll�`y�ri S - Map/pmc l: O 'ZD . © 0 Project Addressyl�Cfec+�arwoo�Q kb - Builder -?�'��r� vfh' The faIIowzng items Were noted.on r-eviewing: RepieWed by: ;,'� �— I The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ma)� q eh.1 Address: V-2/U !61 /r,N City/State/Zip: C O T t/IT 0 Z C 3 5 Phone#: V 6 Are yob an employer?Check the appropriate box: Type of project(required): 1. I am a employer with_gir' 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑�e 'gon working for me in any capacity. employees and have workers' 9. addition [No workers' comp.insurance comp.insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l l.❑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' 13.0 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: �S t� c4 'r, F�A L_a n-) Policy#or Self-ins.Lie.#: lJc c 4�U 0--i Expiration Date: Y2 Job Site Address: &)1) City/State/Zip: (6,-IVi T A-0 ,f J 6r e_6V S 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 unde th pains and penalties o that the information provided above is true and correct. Si ature: Date: � 1 ZJ Z Phone#: M— / Y U — p �b U 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#: f Client#:38438 2CENTRALCA DATE(MWDD/YYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 08/29/2011 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(ies)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 endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil [PHONE 508 7751620 FAX 5087781218 JC No E:t: - A/C No Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURERS)AFFORDING COVERAGE NAICIf Hyannis,MA 02601 INSURER A:National Grange Mutual Insuranc INSURED INSURER B;Associated Employers Insurance Central Cape Construction,Inc. INSURER C 820 Main Street INSURER D: Cotuit,MA 02635 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TXE T ERivtS, EXCLUSIONS AND CONDITiONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iY.SR TYPE OF INSURANCE 1 ADDL SUE, PO!irY EFF POLICY EXP LIi,S: 3 LTR INS WVD POLICY NUMBER MM/DDIYI'YY MM/DDIYYYY A GENERAL LIABILITY MP19764Q 11/14/2010 11/14/2011 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY P REM ISES EaEoNccTuED nca $500 000 CLAIMS-MADE a OCCUR MED EXP An one person) $1 O 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS _ Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEL I I RETENT:GN$ y B WORKERS COMPENSATION WCC5009199012011 5/14/2011 05/14/2012 X WC STATU- FORTH - AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $5OO OOO OFFICER/MEMBER EXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L:DISEASE-POLICY LIMIT $500 OOO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Steve Devlin is excluded from the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Jess&Lisa Devlin SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 127 Percival Road ACCORDANCE WITH THE POLICY PROVISIONS. East Falmouth,MA 02536 AUTHORIZED REPRESENTATIVE G C� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S85212/M85211 LS1 ' r i _ _ _., _ � ' i Lam,Forte? MEMBER REPORT Level, Walla Header // ASSED software 3 piece(s) 2 x 10 Spruce-Pine-Fir No. 1 / No. 2 (T 4 6L& W1 0 Overall Length:8' 10" °f 0 e� t - ' + + (@ 0 0 8'7" 0 All Dimensions Are Horizontal;Drawing is Conceptual Design Results Actual @ Location Allowed Result LDF Load:Combination(Pattern) System:Wall Member Reaction(Ibs) 1389 @ 0 2869 Passed(48%) 1.0 D+1.0 S(All Spans) Member Type:Header Shear(Ibs) 1340 @ 10 3/4" 4308 Passed(31%) 1.15 1.0 D+1.0 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 5451 @ 4'3 1/2" 5919 Passed(92%) 1.15 1.0 D+1.0 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.098 @ 4'4 3/4" 0.294 Passed(L/999+) 1.0 D+1.0 S(All Spans) Design Methodology:ASO Total Load Defl.(in) 0.151 @ 4'4 3/4" 0.442 1 Passed(1-1702) 1.0 D+1.0 S(All Spans) Deflection criteria:LL(L/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 8'4 3/4"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Applicable calculations are based on NDS 2005 methodology. Bearing Length Loads to Supports(Ibs) Supports Total Available Required Dead Snow Total Accessories 1-Trimmer-SPF 1.50" 1.50" 1.50" 501 888 1389 None 2-Trimmer-SPF 1.50" 1.50" 1.50" 480 847 1327 None Tributary Dead Snow Loads Location Width (0.90) ,(1.15) Comments 1-Unifonn(PSF) 0 to 8'10" 1' 15.0 30.0 Residenbal-Living Areas 2-Point(lb) 4'3 1/2" N/A 755 1470 iLEVEL Notes 1ej SUSTAINABLE FORESTRY INITIATIVE iLevel warrants that the sizing of its products will be in accordance with iLevel product design criteria and published design values.iLevel expressly disclaims any other warranties related to the software.Refer to current iLevel literature for installation details.(www.iLevel.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compabble with the overall project.iLevel products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator Job Notes 1/13/2012 11:41:17 AM Davd McLean MEYERS iLevel Forte v3.0:Design Engine:V5.4.3.2 Falmouih Lumber 44 CEDAR WOOD ROAD (508)5486868 COTUIT,FAA davem(afaimoufhlumber.com __ _ I Page 1 of 1 r Forte' MEMBER REPORT Level,Floor.-Drop Beam PASSED software 2 piece(s) 1 3/4" x 9 1/2" 1.9E Microllam® LVL ti Overall Length: 14' 3 + + d 14' a a All Dimensions Are Horizontal;Drawing is Conceptual Design Results Actual @ Location Allowed Result LDF Load:Combination(Pattern) System:Floor. Member Reaction(Ibs) 2243 @ 13'8" 8181 Passed(27%) -- 1.0 D+0.75 L+0.75 S(All Spans) Member Type:Drop Beam Shear(Ibs) 2013 @ 1'3" 7265 Passed(28%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 10451 @ 7' 13541 Passed(77%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.383 @ 7' 0.444 Passed(L/418) 1.0 D+0.75 L+0.75 S(All Spans) Design Methodology:ASD Total Load Defl.(in) 0.656 @ 7' 1 0.667 1 Passed(L/244) 1.0 D+0.75 L+0.75 S(All Spans) Deflection criteria:U.(L/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 10'8 5/8"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing Length Loads to Supports(Ibs) Supports Total Available Required Dead Flower Snow Total Accessories 1-Stud wall-SPF 5.50" 5.50" 1.51" 942 1000 735 2677 Blocking 2-Stud wall-SPF 5.50" 5.50" 1.51" 942 1000 735 2677 Blocking •Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Tributary Dead Floor Live Snow Loads Location Width (0.90) (1.00) (1.15) Comments 1-Point(lb) 7' N/A 775 40 1470 Residential-Uving Areas 2-Unifonn(PSF) 0 to 14' 7' 10.0 20.0 iLEVEL Notes _ - l SUSTAINABLE FORESTRY INITIATIVE !Level warrants that the sizing of its products will be in accordance with iLevel product design criteria and published design values.iLevel expressly disclaims any other warranties related to the software.Refer to current iLevel literature for installation details.(www.iLevel.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.(Level products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator Job Notes 1/13i2012 11:35:34 AM iDawd McLean MEYERS iLevel Forte 0.0,Design Engine:V5.4.3.2 Falmoulh Lumber 44 CEDAR WOOD ROAD j (508)548.6868 COTJIT,MA idavem@faimouihlumber.com Page 1 of 1 ■ Forte MEMBER REPORT Level,Roof.Ridge Beam PASSED software 1 piece(s) 1 3/4" x 11 7/8" 1.9E Microllam® LVL Overall Length: 14' S iV W I + + i _ O 0 �1 1� !1 1 1� 'I 14' All Dimensions Are Horizontal;Drawing is Conceptual Design Results Actual @ Location Allowed Result LDF Load:Combination(Pattern) System:Roof Member Reaction(Ibs) 2394 @ 4" 4091 Passed(59%) 1.0 D+1.0 5(All Spans) Member Type:Flush Beam Shear(Ibs) 1898 @ 1'5 3/8" 4541 Passed(42%) 1.15 1.0 D+1.0 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 7599 @ 7' 10263 Passed(74%) 1.15 1.0 D+1.0 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.349 @ 7' 0.667 Passed(L/458) 1.0 D+1.0 S(All Spans) Design Methodology:ASD Total Load Defl.(in) 0.568 @ 7' 0.889 Passed(L/281) 1.0 D+1.0 S(All Spans) Member Pitch:0/12 Deflection criteria:LL(1./240)and TL(L/180). Bracing(Lu):All compression edges(top and bottom)must be braced at 4'11 1/8"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing Length Loads to Supports(Ibs) Supports Total Available Required Dead Snow Total Accessories 1-Stud wall-SPF 5.50" 5.50" 3.22" 924 1470 2394 Blocking 2-Stud wall-SPF 5.50" 5.50" 3.22" 924 1470 2394 Blocking •Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Tributary Dead Snow Loads Location Width (0.90) (1.15) Comments 1-Unifonn(PSF) 0 to 14' 7' 18.0 30.0 Snow nnn iLEVEL Notes (zj)SUSTAINABLE FORESTRY INITIATIVE iLevel warrants that the sizing of its products will be in accordance with iLevel product design criteria and published design values.iLevel expressly disclaims any l other warranties related to the software.Refer to current iLevel literature for installation details.(www.iLevel.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.iLevel products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator .lob Notes 1/13/2012 11:35:46 AM I Oavtd Mclean MEYERS iLevel Forte v3.0,Design Engine:V5.4.3.2 IFa€mouth Lumber 44 CEDAR WOOD ROAD (508)548-6868 COTUIT,WIA davemrcfalmoufhlumber.com Page 1 of 1 `r AWC Guide to Wood Construction in High Wind Areas:110 mph end Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' Check 1.1 SCOPE Compliances Wind Speed(3-sec.gust).......................... .......... 110 mph Wind Exposure Category................................ B .................................. ............................................ .1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) stories 5 2 stories V RoofPitch...........................:...............................................(Fig 2) <_12:12 Mean Roof Height ............................ i ........�ft s 33' (Fig 2)......................................... Building Width,W ...............................................................(Fig 3)................................................—�ft 5 80, BuildingLength, L.....(�...................................:.............(Fig 3).............................:...................—ft <80' Building Aspect Ratio. ........... ................................... (Fig .).................................................��5 3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4)................................................��s 6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2) 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.......... ............. Concrete Masonry..........:................................: 2.2 ANCHORAGE TO FOUNDATION" 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete onI Bolt Spacing—general........:.................................(Table 4)............................................... in. Bolt Spacing from endfjoint of plate.............................(Fig 5).................................... in.:5 6"—12" Bolt Embedment—concrete........................................ (Fig 5)..................................................�in. a r Bolt Embedment—masonry.........................................(Figa PlateWasher................................................................(Fig 5).........---........................... 2:3"x 3"x'/<" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 85).........r0.... e. . . ..... Maximum Floor Opening Dimension..................................(Fig 6).....:............................................�ft:5 12' / Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)...................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)......................................................� t <d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... 6' ft 5 d FloorBracing at Endwalls....................................................(Fig 9)......:.......---............................. Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................A.Q.✓. reGH Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)....................... 3/, in. r/ Floor Sheathing Fastening...........................:.................... .(fable 2)..1_Qd nails at �in edge/�Z field 4.1 WALLS Wall Height V Loadbearing walls........................................................(Fig.10 and Table 5).........................:: ft 510' 7 Non-Loadbearing walls.......:...............:........................(Fig 10 and Table 5)........................ r ft `29 Wall.Stud Spacing . ........................................................(Fig 10 and Table 5)................... in.<_24°o.c. WallStory Offsets ........................................................(Figs 7&8).............................................C)ft <_d 1G 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(fable 5)..............................2x -- din. Non-Loadbearing walls................................................(Table 5)..............................2xa- ftft__Q in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10)................................................................. WSP Attic Floor Length.................................................(Fig.11)............................. ................ I ft>_W/3 Gypsum.Ceiling Length(f WSP.not used)....................(Fig 11)............................................Jyft a 0.9W and 2 x 4.Continuous Lateral Brace @ 6 ft.o.c... (Fig 11).............................................................. or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays V Double Top Plate Splice Length .................................:......................(Fig 13 and Table 6)....:............................... , Splice Connection(no:of 16d common nails)..............(Table 6)......................................................... ��' .� -, t �-, � , �� AWC Guide to Wood Construction in Him ah WmdAreas:li0 mph end Zone Massachusetts CheckYist for Coca fiance Aso -- Loadbearin ( CMR 5301.2.1-I)1 g Wall Connections Lateral(no.of 16d common nails ........................(Tables Non-Loadbearin Wan nnections ) Lateral(no-of 16d common --- Load Bearing Wall Openings rco d largest opening but check a� ......(Table 8) .................. Header Spans openings for compliance to Table 9 Sin Plate Spans .. . .............................................(Table 9).................................. 9) 11' Full Height Stu ............................(Table 9 ft < 9 Studs (no_of Studs)._... ............................... )._...............................� in.S 11, Non-Load Bearing Wan openings ••••............. able 9)..............;•••........:......_...:.__ft .... 2— Header S P ��(reed largest Opening but check all Openings for compliance to Table 9 ...:..... ....................................................(Table 9 / Sill Plate Spans. )._............................... ft G in.s 1) !/ Full Height ......................................................(fable 9). — 9 Studs(no-of studs)--- .. ..................... ._ 12" Exterior Wall Sheath' ---- --"�_----------------(Table 9)._.:........................ ..tom mg to Resist Uplrtt and Shear SimuttaneOuslya m < Minimum Building Dimension,W Z Nominal Height of Tallest SheathingT Opening2 ............... Edge Nail ....................................... < 8 (note 4)— -. - .......'�,��r • Sin. 'g...---.... ........Feld Nan S ap able 10 or note 4 if less).•.•-•-.,P ng....... ... (fable 10 ............ in.Shear Conn ) --•--••..........................action(no.of16d common nails (Table 10 '"'Percent 5 W(eight Sh ).................................53. °n.Bathing.................... (Table 10 j�--_._._Addrtional Sheathing ) °/ Maximum Buildin Di - for Wall with Openmg 6'8' rConcepts) Z ° 9 mention,L >. (Design Concepts).......... • _ Nominal Height of Tallest Opening2 Sheathing .................:.........0.............. 9 Type:... (note 4 rr Edge N 71. .E....... 9 ail Spacing )•.............. � '��......_....._..._ Field Nail Spacing ..._.... -•.............._.--(-able 11 or note 4 if less)----........... _� acing.................. in Shear Conn "'•" (Table l l Connection(no.of 16d common nails ) �in. / Percent Futl-Height Sheathing )(Table 11).......................................................3 L e_ l/ 5%Add- •..................with able 11)............................. ifional Sheathing for with p e-pis .......•.•. /° Wall Cladding 9 Wall Opening>6gn(Design Concepts)..............•... N9-- i� Rated for Wind Speed? ................................... 5.1 ROOFS - Roof framing member spans checked?............ g . Roof Overhang (For Rafters use AWC Span Tool,see BBRS Website) Z .... .............................. (Figure 19 Truss or Rafter Connections at Loadbearing Walls •. ft<� smaller of 2'or L/3 Proprietary Connectors uplift_......................... '..(Table 12 Lateral..._ )- ...................••......-••.._...u�? plf / ••.............................. (Table 12 IL Shear. _.. ......................................... _ IN plf Ridge Stra able 12).................... .... _ 9 p Connections,if collar ties not used era "' Gable Rake Outlooker...... P P: 9e26r (Table .... ..... rt-Q cLA;Ls..T= '� plf .................. _ F ure 20 pIf - Truss or Rafter Connections at Non-Loadbearing Walls ""--� smaller of 2'or L!2 Proprietary Connectors Uplift.................:. (Table 14)... IV Lateral(no.of 16d common = able 14 RoofSheathmg Type nails)_ ).................. _ I b T ....................L Roof Sheathing Thiclmess .......................... ................ Chapters 58 arld 59) Roof Sheathing Fastening... �L in.z 7/16".WSP --� Notes: ............................................(Table 2)_ 1. This cheddrst shall be met in its entitety,excluding the specific exception noted in 2,to comply with the requirements of 7 CM 80 R 53012.1.1 Item 1.If the checklist is met in its entirety then the required per the WFCM 110 mph Guide: fonowtng metal straps and hold downs are not a. .Steel Straps per Figure 5 b. ,20 Gage Straps per Figure 11 G UPfift Straps per Figure 14 d. .All Straps.per Figure 17 e. .Comer Stud Hold Downs per Figure 18a and.Fgure 18b 2. Exception:Opening heights of up to 8 fL shall be permitted when 5%is added to the percent full-heiht sheathing requirements shown in Tables 10 and 11. g 3. .The bottom sill plate in,exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. REScheck Software Version 4.4.2 Compliance Certificate Project Title: New Custom Addition Energy Code: 2009 IECC Location: Cotuit,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 44 Cedarwood Road Thomas&Deborah Meyers Steven Devlin Cotuit,MA 02635 Date of Plans Central Construction Company 01-12-2012 820 Main Street Cotuit,MA 02635 Compliance: Compliance:5.0%Better Than Code Maximum ILIA:100 Your UA:95 The%Better or Worse Than Code index reflects how close to compliance the house is based on code tradeoff rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. AssemblyGross Cavity Cont. Glazing ILIA or or D•• Perimeter U-Factor Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 392 30.0 0.0 13 Wall 1:Wood Frame,16"o.c. 598 21.0 0.0 26 Window 1:Vinyl Frame:Double Pane with Low-E 79 0.300 24 Door 1:Glass 61 0.310 19 Ceiling 1:Cathedral Ceiling 168 30.0 0.0 6 Ceiling 2:Flat Ceiling or Scissor Truss 236 38.0 0.0 7 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Notes: REScheck by Cape Cod Insulation,Inc. 455 Yarmouth Road Hyannis,Ma. 02601 ' 1-800-696-6611 #9928 Project Title: New Custom Addition Report date: 01/16/12 Data filename: C:\Documents and Settings\Keith\My Documents\REScheck\#9928.rck Page 1 of 4 r i- l , REScheck Software Version 4.4.2 Inspection Checklist Ceilings: ❑ Ceiling 1:Cathedral Ceiling,R-30.0 cavity insulation Comments: ❑ Ceiling 2:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.310 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. ❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 50 pascals OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. Project Title: New Custom Addition Report date: 01/16/12 Data filename: C:\Documents and Settings\Keith\My Documents\REScheck\#9928.rck Page 2 of 4 7 (9 Comers;headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. o Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Cl Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: O Building framing cavities are not used as supply ducts. ❑ All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Temperature Controls: Where the primary heating system is a forced air-furnace,at least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the coolirig cycle. Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. ❑ For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. n Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. o Timer switches on pool heaters and pumps are present. Project Title: New Custom Addition Report date: 01/16/12 Data filename:C:\Documents and Settings\Keith\My Documents\REScheck\#9928.rck Page 3 of 4 Exceptions:' Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. i Lighting Requirements: ❑ A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and—40 (a)60 lumens per watt for lamp wattage>40 Other Requirements: ❑ Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement's'). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: New Custom Addition Report date: 01/16/12 Data filename:C:\Documents and Settings\Keith\My Documents\REScheck\#9928.rck Page 4 of 4 2009 IECC Energy Efficiency Certificate Insulation Rating R-Value Ceiling/Roof 38.00 Wall 21.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.30 Door 0.31 NA Cooling'Heating& Heating System: Cooling System: Water Heater: Name: Date: Comments: 6 oFtKE To Town -of Barnstable Regulatory Services ' $"tNsT"B Thomas F. Geiler,Director y MAss. n ;, Building Division Tom Perry,Building Commissioner 260 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 ; I, (};(1..�9 I-t L, e!J eyt_ ,as Owner of the subject property hereby authorize V�C4j 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 Pr_ open Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERM ISSION r w Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 47993 Restricted to: 00 STEPHEN J DEVLIN 820 MAIN ST -* COTUIT, MIA 02M5 o— Expiration: 2/4/2012 ' ('ei�uitiviuoer Tr#: 451W Office of Consumer Affairs and VUSness Regulation 10 Park Plaza- Suite 5170 Boston, Massacl,u�setts 02116 Dome Improvement C t' or Registration Registration: 131841 n Type: Private Corporation Expiration: 9/26/2012 Tr# 202911 CENTRAL CAPE CONSTRUCTIO``P u STEPHEN DEVLIN ;t 820 MAIN ST. 11W of COTUIT, MA 02635 rrG •° Update Address and return card.Mark reason for change. '1,1g S`0 Ej Address Renewal ❑ Em,..ploywRt Lost Card CA1 0 50M-04/04-610121..66 Office� License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 131841 Type: Office of Consumer Affairs and Business Regulation Expiration: jKfi/�012 Private Corporation 10 ParkPLiaa-Suite 5170 Boston,MA 02116 EL CAPE q _QNQ0. INC. ,- ;TEPHEN DEVLIN�--'_ ��; ;20 MAIN ST `•' � ;pTuIT,MA 02635�'•.\ Undersecretary Not vie ridwithout signature i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 020 Parcel 68 0 Application I I Health Division Date Issued Z Conservation Division Application F . Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 44- Cr-nA:I2t,J0o 6 Village eo TV )T Owner e�N T141 A PARR Et�(A Address i3oX 493 f349�5;M8c.F 62630 Telephone 5-0e-24-b Permit Request Rg-l" 12E44f, PAP77AI. IerTr-F4 6A1 Isr�=1_001Z L3 � Myoyhel R i►n/lz L //VSy��3"i�i✓ A/412774L lei7z/fe/fl ram+ l Square feet: 1 st floor: existing gj proposed 2nd floor: existing proposed Total new ZoNrig District Flood Plain Groundwater Overlay , Project Valuation 3 0 0D Construction Type Lot-Size C 0 S0 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ar Two Family ❑ Multi-Family (# units) Age of Existing Structure 41 Historic House: ❑ Yes O<o On Old King's Highway: ❑Yes .2mo Basement Type: �2<11 ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) 6 Number of Baths: Full: existin 2' new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 413as ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes frNo 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: I Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes J(No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A jo Telephone Number Address ?0 pDX 4b3 License # 6-2 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO M fmym SIGNATURE S rN , �G� �- DATE &411 FOR OFFICIAL USE ONLY `-i APPLICATION# DATE ISSUED S F' MAP/PARCEL NO. ADDRESS VILLAGE:-. Y !µ OWNER i F 1; DATE OF INSPECTION: FOUNDATION 4' FRAME INSULATION /!�S ®� D("0 FIREPLACE .� ELECTRICAL: ROUGH FINAL hPLUMBING: ROUGH FINAL r GAS: ROUGH FINAC' FINAL BUILDING DATE CLOSED'OUTel ASSOCIATION PLAN'NO 1 The Commonwealth ofAfassachusetts. 16 Department of Industrial Accidents .j Lj I y ; . Office of Investigations Irk!> >I 600 Washington Street Boston, MA 02111 wfv>v.mass,gov/dig Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): .Cyll/-7-r-II A PbYtttll Address: boy 4(e3 City/State/Zip:" 22egd57Mc-k__ NA Phone #: Lo&-Z V6 -&/89- Are you an employer? Check the appropriate box: 'Type of project(required): 1.❑ I am a em to er with 4. ❑ I am a general contractor and I ' p y * have hired the sub-contractors 6. ❑.New construction employees (full and/or part-time). 2. ❑ I am a sole.proprietor or partner- listed on the attached sheet. # �• Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp, insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.� am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions Myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.}t employees. [No workers' comp. insurance required.] ' 13•❑Other *Any applicant that checks boxy I 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. tConiractors that check this boz must attached an additional sheet showing the name of the sub-contrinclors and their workers'comp.policy information. I am an employer that is providing workers'compensation insirance for my employees. Below Is the policy and job site information. Insurance Company Name: Policy#or Self-ins, Liic... #: Expiration Date: Job Site Address: 44 Cfoyw�&J&-o O City/State/Zip: eO7V t 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$1,500.06 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 the pains and penalties of perjury that the information provided above is true and correct. Signature: w Date: Phone Ofjlcial 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 Hadith 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector ti. Other 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 die 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 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 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 Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 0 Town of Barnstable �otitrte ray Ll Q Regulatory Services Thomas R Geiler, Director Bk r, � ' Building Division PrFO MAt" Tom Perry, Building Commissioner 200 Maid.Street, Hyannis, MA 02601 R-wv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HO EEOWNER LICENSE EXEMTTION Please Print DATE: I ' JOB LOCATION: "► ����� s'""v � �1J number street / village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 1(�6 a 14-3 3 . 'A-P—IJS7MS L 6 2 630 ' city/towo Eta to 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 superyisoI. DEMMON OR BOMEO`WER Persons)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 constrycts 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.L 1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, toles and regulations. The undersigned "homeowner"certifies that.he/she understands the Town of Barnstable Building Department Minimum inspection procedures and requirements and that be/she will comply with said procedures and requirements. GG�� 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 pm-nit is required shall be exempt from the provisions of this section.(Secticn 109.1.) -Licensing of construction Supen isors);provided that if the homeowner engages a person(s)for hire to do such wofk, that such Homeowner shall act as supervisor." lvlany homeowners who use this exemption arc unaware that they art assuming the responsibilities of a supervisor(see Appendix Q, Ru)cs&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 honccowner acting as Supervisor is ultimately responsible. r 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 hdshe understands the responnbilitics 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 fomr/certifrcation for use in your community. i1A oFT Teti Town of B arnstable ` Regulatory Services sAxNsrAs[..� q ' rs�ss Thomas F. Ceiler,Director t6 9- O µel 1.�� Building bivision Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabfe.ma.us Office: 509-862-4039 Fax: 508-790-6230 Property Owiier Must Complete and Sign This Section If Using A Builder r , as Owner of the subject.property hereby authorize to act on my behalf, m all matters relative to work authorized bytLis.bWJcU0.g permit application for. (Address of job) Signature of Owner nab Print Name If Property Owner is applying for permit please complete the Home owners'License Exemption. Form on 'the reverse side. 1 Town of Barnstable 'Permmod/�� 7�5� �oFrw rowit# ti Regulatory Services LFeees6monrhi•rrolnisraedare v loss. $ Thomas F. Geiler, Director Building Division {_,�- � . ; � L: �i� Tom Perry, CBO, Building Commissioner X ,F Kt"-w,J F : (11'VHj 200 Plain Street, Hyannis, MA 02601 i)f_C 2010 www.town,barnstable.ma.us Office: 508-862-4038 !" ';�. 16�1 OFFafxS"0'837g230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nol Vaiid willtoul Red X-Press Imprint Map/parcel Number CD an— 05C) Property Address 44 -CFoAA4,4jOyQ 607v 1� ® Residential Value of Work 4166bQ. oo Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address C / -- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Constructiqn 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 Request (check box) "Re-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers ofr000 ( Re-side #ofdoors Z Replacement Window /doors/ liders. U-Valtte (maximum .35)#of windows *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. SNATUIZE: px 44t ti / i! The Commonwealth of Massachusetts t f Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibl Name (Business/Organization/Individual): el VA,1141 A 10A0.,, u 4- Address: P bo X 4-93 I_ 0 City/State/Zip: 6NA1sT�16 ,{£ / A ��Phone #: 50 8' 246-Of�J� Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and 1 6. El 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. t . y• ❑ 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 required.] officers have exercised their 10.0 Electrical repairs or additions 3. I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.®Roof repairs insurance required.] t employees. [No workers' 13Q Other 5/b/N4 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-contraclors and their workers'comp.policy information. I am.an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob 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 the pains andpenalties ofperjury that the information provided above is true and correct. Silznature• ��Vln. A �� " Date: Phone Official use only. Do not write in this area, to be completed by city or town official Lte n: Permit/License#. hority(circle one): Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: Phone#: A 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 e`mploys'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." MGC<chapter 15,2,§25C(6)also states that"every,state or local licensing agency shall withhold the issuance or renewal ota license or permit to operate a business or to construcCbiiildings 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 cant'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 bum 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 Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727=7749 Revised 5-26-05 www.mass.gov/dia w � DARNSTADLE, Town of Barnstable PlFp Mp'l A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 0260) www.town.ba rnsta ble.ma.us i Office: 508-862-4038 '` 4 Fax: 508-790-6230 Property ®wne r M-ust . Complete and Sig .This. SegiDn If Using A Builder - ... _ ...-...._ _ ......_... ........... .._ I, � [ 1_J��. CL ff �- , as Owner of the subject property hereby authorize D A)) D PARAEUA (Ads""i`T— to act on my behalf, in all matters relative to.work authorized by this building permit application for: 44- CFDRI%wo o-b. CUN)i (Address of Job) Signatutt of Owner Date i J Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. i 0(KE y Town of Barnstable ' Regulatory Services iELAI;(VABLE. Thomas F. Ceiler, Director tass. $ , Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 518-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1 j s) /0 JOB LOCA•riON: 44 cemewoo 6 Co j U i T number street village "HOMEOWNER" fl Ar2/2e,('.4 5'O 8 -24.6-6 US' name home phone N work phone N CURRENT MAILNG'ADDRF_SS: 10 03 a )t 4-53 G AIZP l S'T7°19)t,lL Im 14 city/town state zip code The current exemption for"homeowners" was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OPHOMEOWNER - 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 "homeowne'?'shall submit to the Building Offi,cial'on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the buildingpermif (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. ; C. Signature of Home wner Approval of 8 uilding Official Note: Three-family dwellings containing 3 5,000,c�lc feet or larger will be required to comply with,the State Be ilding Code Section.1.27.0 Construction Control. ` •� - HOMEOWNER'S EXEMPTION ' The Code stales 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 ofconstruction 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 sup'crZ&(sde-Appendixs;Q,'Rules&•Regulat'ioris 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/certitication for use in your community. Assessor's map and lot 'number ............ .............................. oFTNETo Sewage Permit number ��✓:... tt+...,�..i r ...,.,.�+..•. ... Z 33AUSTSDLE, i House number ................... IL ............................................. 90o MA69 16 QED MA-4 6� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... �� - .. '.... .`. . .....:............................................................................: TYPE OF CONSTRUCTION ...........fir : ........ ..... ............................................................................... .................19.to , 1 TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location ......................:............................................................................... ............................................................................... Proposed Use c�..Ufa• �/s 7"s....�..r...�y................:......................................................................... Zoning District ................................�:..................................Fire District ......l.,/ ...1.......................... Name of Owner cq)c!�................Address 4/ 66rT d Name of ct � 11 S..............................Address ...� r....... ........d....... .-..a Name of Architect ............'""...-----.-................................Address ...... -......................................................... Number of Rooms .......... .................................................Foundation---:" { � ..'.}.. ......l....................................................... ?— Exterior .. � .......... ...................Roofng .............. .......................................... Floors .......... ..................................I.. .. ...... ._..............Interior �l✓?;' r.`..........:......................................................... Heating ...... :..�'f:... ..'........... ....................................Plumbing ........... ... '..................................................... Fireplace ........Approximate Cost ............. //ff ,Q Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area h4".,EC- .� ✓ � Diagram of Lot and Building with Dimensions Fee �. SUBJECT TO APPROVAL OF, BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above ' construction. :Name ...L::-��..... COXE, JOHN & JUDY A=20-80j 2 ADDITION No .... ... Permit for ....................... ............. Single Family Dwelling ............................................................................... rN -o Location ....44 Cedar Wood Road ............................................................ Cotuit ............................................................................... Owner ...John & Judy Coxe ......................................... ..................... Frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted June 24. .......1982 .....- ........................ Date Of Inspection ............................ .......19 Date Completed .......................................19 Assessors map and lot number ............................................ uF THE ro Sewage Permit number SEPTIC SYSTEM �fltJ� Q/�G�../h,n.�,� ��..r.^.�.. INSTALLED IN COI!!IP a R„ i - BABHST/1DLE, • House number TITLE 5...................rt1 .............................................. WITH900 M 9 ENVIRONMEAOT'dACCOD ' o AY a. TOWN OF BARN'STAft9RULATIONS BUILDING ' INSPECTOR APPLICATIONFOR PERMIT TO ....... ................. .......................................................................................... TYPE OF CONSTRUCTION ........... .5:7.e �f/TZ.!%..'""............................................................................... ` ..RkR................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ...�/, ......... � u��v�..........2®�D Location ............................................................................................................. l�2 ./� 7 Proposed Use ... .... ............ � �..................................................................................................................... Zoning District ..............................J. ..J.................................Fire District ....... ............................................. i-- Cd /�ec�ask ►c� C�ry� Nameof Owner .. �.�'f....v...I............... ................Address ... .........4-......................................(n............................ Name of Builder �.. .1.!E^C't�}.'►'1 ..............................Address ...1CQ iName of Architect ............:.....................................................Address .................................................................................... Number of Rooms ..........................Foundatio ............................................................................. ............ .......................... r Exlerior .... .......... P.((.................:.............Roofing ..............ftp.4 f.-;: -�............................................... Floors ...........k............................................................................Interior fct�............................................................................... Heating ....... "A°. A. ' O ...1....................................Plumbing. .. .. .................. ... ...................................... Fireplace ............../ ...........................................................Approximate Cost .......% ............................................ Definitive Plan Approved by Planning Board -----------_------_-----------19_______. AreaALr Diagram of Lot and Building with Dimensions Fee �. i SUBJECT TO APPROVAL OF BOARD OF HEALTH, D ' rme-r4 e L OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 41 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above r construction. ���' Name ...1..�4 -. �Jl ............. _ r I COX , JOHN & JUDY 2 4 1`5 7 ADDITION No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location ....44 44 Cedar Wood Rd. ........................................................ Cotuit .............................................................:................. Owner ...John....&....Judy...C.oxe..................... .. ....... . ......... .. ....... Type of Construction ......F....rame................................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .....El.une...2.4.................19 82 cl:z Date of Inspection, . ................19 ................... Date Completed .............. ...19 2 N6 0 ! �i6 PROJECT' TITLE' • -ru�r I. is I4' j S d ,.. e � � , �\• yi l .r 1 ,� .I q`+6 n nr IMPORTANT Vw, e e i Ji , 6 ANY CONSTRUCTION THAT INCREASES LIVING SPACE ( BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE(THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS,I �•� .� 1 I � � TORS. — w�_ —'I NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE I 4L•e—c"v G rfit G I L, c ! ERMI DOES NO T SA OF OTISFY THIS REQUI[REMENT.KE-DETECTORS—THE CTRICAL I iy ! j N PREPARED FOR I � `I 7-6 J �! c. 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Tt •I PREPARED FOR en J } •l Centr®I Construcfi®n Company,.In` Steve Devlin•President Ys • The Excitement Is Building- 4 820 Main Street•Cotuit,MA•508-420-1340 e-mail:centralconstructio Website:www.centralcapeconssttrr ctlon com i SCALE 4 = 1 DATE , IZ i Z DWG NO. A DESIGN S UI Lt.t ru , CHECK ' DRA WN v _ JOB.,NO. SHEEI OF o� a 0 s� o a a a Cb Schoo/ St. •Q ocus COtu t Bay err Shew B/off o gsse Or Pf c_ 160.00 CON;. BND. FOUND e LOCUS MAP EXIST. 3 BEDROOM FLO DIFFUSOR SYSTEM + SCALE 1"=2000't PERMIT # 90-563 LOT 202B MAP 80 PARCEL 20 21,800f S.F. i LOCUS IS WITHIN FEMA FLOOD ZONE C rn N EXIST. 1500 GAL. ST ZONING SUMMARY 2 641 cr o 0 0 o ZONING DISTRICT: RF DISTRICT N .�144 MIN. LOT SIZE 43560 S.F. MIN. LOT FRONTAGE 150' 2.2 A MIN. FRONT SETBACK 30' X 19.45 �x 25.97 MIN. SIDE SETBACK 15' " MIN. REAR SETBACK 15' PROP. RE—LOCATED RETAINING 16 WALL. DIRECT ALL RUN—OFF -?g 0 0A..,S AWAY FROM FOUNDATION. x 18:88 �s SITE IS LOCATED WITHIN RESOURCE o g' ■ 1 � 18.90 \ PROTECTION OVERLAY DISTRICT, AP EXIST. DWELL. N PROP. DISTRICT, ESTUARINE PROTECTION DISTRICT TOP FNDN. = ADD'N. X 24.98 EL. 19.6' 18 45 — ---� '4 3 OWNER OF RECORD PROP. FUTURE GARAGE 18.00 THO A S C.C EY ERS & DEBORAH L. MEYERS 9 } NATICK 1 4 3 1 17.91 1 .29 � REFERENCES ■ '� � � 1 DEED BOOK 25385 PAGE 269 00 86.0 IS' a 6.68� PLAN BOOK 184 PAGE 33 3, 14.16 CCO� IQ 14. 1� C 1 .47 CONC. BND. FOUND "w OQ� p 0 12. 3 ,�9.0 1�3 AY, cal o A ,3k 0.57 � 13.94 SITE PLAN OF ° 44 CEDARWOOD ROAD COTUIT PREPARED FOR off 508-362-4541 fax 508-362-9880 A • 6 e downcape.com © / #3 91O\F�'� • \tiG �� OFMgs �NpFMA3s THOMAS & DEBORAH MEYERS- d*w!1 cope eng/aeet/ng, h7C. 2ti � ®ANIE �� oDAIVIEL 9°yam civil engineers # `�'�,�, dog A. L C�� A. land surveyors �o 1 CO-) 0i OJALA 0 JANUARY 11 , 2012 939 Main Street ( Rte 6A) �No.40980P �No.40980� YARMOUTHPORT MA 02675 #1 9ti� '/-F6'ss\o O 1t ° � °� , � UFN Scale:1 20 11-301 DATE DANIEL A. OJALA, P.L.S. 0 10 20 30 40 50 FEET