Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0272 WHISTLEBERRY DRIVE
r Q e n a R p o � � , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map (�Z Parcel OR Application # - I � �N Health Division Date Issued Conservation Division Application Fee 50 Planning Dept. Permit Fee 3� l Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis B Project Street Address 11Z_ "is �t ue✓�y ✓� Village Hhrs 4vsn 115 Owner Address ZZ DV Telephone 0 ZZ toil/ Permit Request J:,kilohok al PU Vs� CovlstA W ?,0 3��•� VQD,9 GDRAA J I /44 A y .L k a 6 (de.7 KO Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation2-:LOZ7 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑ Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other - Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing_.,❑ new, size_ Attached garage: ❑ existing ❑ new size _Shed: El existing ❑ new size _ Other" Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ;G eJ Commercial ❑Yes ❑ No If yes, site plan review# ' , -a Current Use Proposed Use _ w e r- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name j"" ec r� � ��' Telephone Number ° `�Z y V✓ Address `t Q�fc �He!r License # GS ` ( 0 94 M 01,7C q Home Improvement Contractor# l'"� �� 6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULT G FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �— ,( — 1 y FOR OFFICIAL USE'ONLY APPLICATION# DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE Y r OWNER. w DATE OF INSPECTION: [> FOUNDATION FRAME S INSULATION 1 FIREPLACE ELECTRICAL: ROUGH FINAL ' e PLUMBING: ROUGH FINAL` R GAS: ROUGH FINAL 4 FINAL BUILDING � F Y r' g'" DATE CLOSED OUT ASSOCIATION PLAN NO... dF� > rABU& ; KAM Town of Barnstable Regulatory Services Richard V.Scali,Interim 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 I, bo4las l as Owner of the subject property hereby authorize C-A A S©lar to act on my behalf, in all matters relative to work authorized by this building permit application for: 2-7z lJ is�l2bE'fr��r . mars�a�.s �',11s 11�tiq OZ(o�l� (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN D\Building Changes\MRESS PERM TEXPRESS.doc Revised 061313 i i Cotuit Solar LLC Project: System: 6.3 kW DC (STC) Site Plan 508-428-8442 Doug Stefano 20 Monocrystallyne 315w modules Revision: March 6, 2015 PO Box 89 272 Whistleberry Dr. 20 Enphase S-280 Microinverters COTUIT SOLAR., Cotuit MA 02635 Marstons Mills, MA 02648 1. Warning: Dual Power Source Second Source is PV System (10) LG 315w 2. Photovoltaic AC Disconnect Modules (SDervitcye� i Voc=40.6V, Isc=10.02A Nema 3R Revenue Grade 100 Amp 3 PV Meter Enclosed #12,#12gnd- 10 Enphase S280 3/4"c Circuit 280VA, 1.13A,2a0vac Breaker Line Side Tap— UL 1741/IEEE 1547 (2) (distance<10') I ®—® 3#10,#10gnd- 100A AC ®— 3#10,#10gnd- 3/4"c Main Panel (1) (10) LG 315w 3/4"c Modules Voc=40.6V, Isc=10.02A 3#12,#12gnd 100 amp 13/4-C 10 Enphase S280 MLO 280VA, 1.13A,240Vac UL 1741/IEEE 1547 2 Pole 20 2 Pole 20 J S A. CY 5 N James A. Clancy, PE 601 Asbury Avenue National Park, NJ 08063 Massachusetts PE Lic#46775 Cotuit Solar LLC Project: System: 6.3 kW DC (STC) Solar Riser PV Wiring detail 508-428-8442 Doug Stefano 20 Monocrystallyne 315w modules Revision: March 6, 2016 50 Box -8 272 Whlstleberry Dr. 20 Enphase S-280 Mlcrolnverters (OTUIT SOLAR«< Cotuit MA 02635 Marstons Mills, MA 02648 Eversource ISA#: 2130512 f JAMES Av CLANCY PROFESSIONAL ENGINEER 601 ASBURY AVENUE NATIONAL PARK, NJ 08063 (856) 358-U25 FAX: (856) 358-1511 Construction Code Office Date: March 6,2016 Re: Cotuit Solar LLC,3800 Falmouth Rd.,Marston Mills,MA 02648 Subj: Doug Stefano Residence, 272 Whistleberry Drive, Marstons Mills, MA 02648 We have provided an inspection and review of the residence roof construction of the above named property in regards to verifying the capacity of the existing roof for installation of a new Solar Panel Array. We have found the residence to be of wood frame construction bearing walls with a rafter framed roof system. The main roof is of 2x8 @ 16" o.c. and is sheathed with 1/2" ext-ply sheathing and a single layer of composite shingles. The existing roof structure bears directly upon the exterior stud framed wall system. The existing rafters as installed meet the required load/span ratings with sufficient capacity to carry the minor additional load of 4#/sf imposed by the proposed solar array per the details below. Installation of solar rack systems shall be as follows: Each panel row shall be supported upon 2 mounting rails. Rails shall be screw anchored through roof and directly to rafters below. Rail attachment points to rafters shall be staggered each row with exception to the first fastener row from the gable end which is attached to two adjacent rafters. Silicone caulk shall be applied between the angle foot of the mounting system and the existing roof shingles at each foot location. Typical mounting detail sketch attached. When installed per the above specifications the system shall exceed 110 MPH wind & 30 PSF snow loads as required by Massachusetts 780 CMR table 1604.11. Should you have any further question or comment please feel free to contact our office. Respectfully, OF c MES A. tiG NCY .46775 ,may J mes A. Clancy Professional Engineer AL MA License#46775 i bo!AR MopvtE�� p ot-Ow-AIL/rr e Los" SS !KX Bow a$�� lYT't I'A^� ' ftdC 9teen4Ytztlq g�y' GAIN- U4 --� a►va+e Ph�� TY Pt�/tLo Me�N4s�IG ' SA F�ao_r J S A. ti C5 00 James A. Clancy, PE 601 Asbury AvenueSi �oe� National Park, NJ 08063 Massachusetts PE Lic#46775 Cotuit Solar LLC Project: System: 6.3 kW DC (STC) Site Plan �N Revision: March 6, 2015 �� % 508-428-8442 Doug Stefano 20 Monocrystallyne 315w modules -_�w PO Box 89 272 Whistleberry Dr. 20 Enphase S-280 Microinverters COTUIT SOLAR«` Cotuit MA 02635 Marstons Mills, MA (a) LS o m o� Lifes Good r LG NeON z LG's new module,NeONTm 2,adopts Cello technology.Cello technology replaces 3 busbars with 12 thin wires to enhance Ce (pry APPROVED PRODUCT 60 ^ellpower output and reliability.NeCINT"'2 demonstrates LGs DVE I�osefforts to increase customer's values beyond efficiency.It Intertek features enhanced warranty,durability,performance under KMS64573 BSEN61215 real environment,and aesthetic design suitable for roofs. PhMt 1taic Modules Enhanced Performance Warranty 01L o High Power Output LG NeONTM 2 has an enhanced performance warranty. Compared with previous models,the LG NeONT"'2 The annual degradation has fallen from-0.7%/yr to has been designed to significantly enhance its output -0.6%/yr.Even after 25 years,the cell guarantees 2.4%p efficiency,thereby making it efficient even in limited space. more output than the previous NEONT"modules. Aesthetic Roof G Outstanding Durability LG NeONT^'2 has been designed with aesthetics in mind; With its newly reinforced frame design,LG has extended thinner wires that appear all black at a distance.The the warranty of the NeONT"'2 for an additional 2 years. product may increase the value of a property with its Additionally,LG NeONT"'2 can endure a front load up to modern design. 6000 Pa,and a rear load up to 5400 Pa. ,0, Better Performance on a Sunny Day Double-Sided Cell Structure • LG NeONT"'2 now performs better on sunny days thanks The rear of the cell used in LG NEON'2 will contribute to to its improved temperature coefficiency. generation,just like the front;the light beam reflected from L the rear of the module is reabsorbed to generate a great amount of additional power. About LG Electronics LG Electronics is a global player who has been committed to expanding its capacity,based on solar energy business as its future growth engine.We embarked on a solar energy source research program in 1985,supported by LG Group's rich experience in semi-conductor,LCD,chemistry,and materials industry.We successfully released the first Mono X°series to the market in 2010,which were exported to 32 countries in the following 2 years,thereafter.In 2013,NeOKl-(previously known as Mono X®NeON)won"Intersolar Award'which proved LG is the leader of innovation in the industry. LG NeON-2 Mechanical Properties Electrical Properties(STC*) Cells 6 x 10 315 W Cell Vendor LG MPP Voltage(Vmpp) 33.2 Cell Type Monocrystalline/N-type MPP Current(Impp) 9.50 Cell Dimensions 156.75 x 156.75 mm/6 x 6 inch Open Circuit Voltage(Voc) 40.6 0 of Busbar 12(Multi Wire Busbar)Q Short Circuit Current(Isc) 10.02 Dimensions(L x W x H) 1640 x 1000 x 40 mm Module Efficiency(%) 19.2 64.57 x 39.37 x 1.57 inch Operating Temperature(°C) -40-+90 Front Load 6000 Pa/125 psf Maximum System Voltage(V) 1000 Rear Load 5400 Pa/113 psf Maximum Series Fuse Rating(A) 20 Weight 17.0±0.5 kg/37.48±1.1 Ibs Power Tolerance(%) 0-+3 Connector Type MC4,MC4 Compatible,IP67 STC(Standard Test Condition):Irradiance 1000 W/m',Module Temperature 25°C,AM 1.5 Junction Box IP67 with 3 Bypass Diodes The nameplate power output is measured and determined by LG Electronics at its sole and absolute discretion. `The typical change in module efficiency at 200 W/m'in relation to 1000 W/m'is-2.09& Length of Cables 2 x 1000 mm/2 x 39.37 inch Glass High Transmission Tempered Glass Frame Anodized Aluminum p Electrical Properties(NOCT*) 315 W Certifications and Warranty Maximum Power(Pmpp) 230 MPP Voltage(Vmpp) 30.4 Certifications(In Progress) IEC 61215,IEC 61730-1/-2,UL 1703, MPP Current(Impp) 7.58 ISO 9001,IEC 62716(Ammonia Test), Open Circuit Voltage(Voc) 37.6 IEC 61701(Salt Mist Corrosion Test) Short Circuit Current(Isc) 8.08 Module Fire Performance Type 2(UL 1703) *NOCT(Nominal Operating Cell Temperature):Irradiance 800 W/m2,ambient temperature 20°C,wind speed 1 m/s Product Warranty 12 years 14�II Output warranty of Pmax Linear warranty*Q) Dimensions(mm/in) (measurement Tolerance±3%) la°1a� •1)1 st year 98%,2)After 2nd year 0.6%p annual degradation,3)83.6%for 25 years Temperature Coefficients F G NOCT 46±3°C Pmpp -0.38%/°C� Voc -0.28%/°C -Deoi% Deta4Y Deo4t lu°q C4e0m Slur a4e lrm Isc 0.03%/°C amrw...�,• Characteristic Curves ? 1000W 10.00 6.00 80ow _. .�.o°aalx.qA0) 6.00 60OW aa�l w°ic`ysl 4.00 40OW 2.00 20OW P B vouaOeM F 2 0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 4500 ? sa[ q q y, 140 EEEkloo ---------- .............. ...._ y� Vac P.. 60 ----------------_--------------------------........................................._........ `e 20 - a 0 r:aDaa.am tcI - -40 -u 0 25 5D 7s s0 •The distance between the center of the mounting/grounding holes. North America Solar Business Team Product specifications are subject to change without notice. � LG LG Electronics U.S.A.Inc DS-N2-60-C-G-F-EN-50427 a .-. U s Good 1000 Sylvan Ave,Englewood Cliffs,NJ 07632 Copyright©2015 LG Electronics.All rights reserved. Innovation for a Better life Contact Ig.solar@lge.com 01/04/2015 www.lgsolarusa.com ° �1J En phase Microinverters EnphaseS280 JV r rl Designed for high-powered, 60-cell modules,the advanced grid-ready Enphase S280 Microinverter" is built on the fifth-generation platform and achieves the highest efficiency for module-level power electronics along with cost per watt reduction. With its all-AC approach,the S280 simplifies design and installation for 280 VA installations, and delivers optimal energy harvest.The S280 is compatible with storage systems, including battery management systems. The Enphase S280 integrates seamlessly with the Enphase Envoy-S" communications gateway, and Enphase Enlighten" monitoring and analysis software. PRODUCTIVE SIMPLE AND RELIABLE ADVANCED GRID READY -Optimized for higher-power, -No GEC needed for microinverter -Complies with fixed power factor, 60-cell modules No DC design or string calculation voltage and frequency ride-through -Maximizes energy required requirements production -More than 1 million hours of testing -Remote updating to respond to -Minimizes impact of shading, -Industry-leading warranty, changing grid requirements dust,and debris up to 25 years -Configurable for variable grid profiles like Hawaiian Electric Company (HECO) Rule 14H,California Rule 21 ENPHA SO® S Ee c us Enphase S280 Microinverter H DATA INPUT DATA(DC) S280-60-LL-2-US,S280-60-LL-5-US t Commonly used module pairings' 235 W-365 W Maximum input DC voltage _ 48 V Peak power tracking voltage 27 V-37 V Operating range 16 V-48 V Min/Max start voltage 22 V/48 V Max DC short circuit current 15 A OUTPUT DATA(AC) 208 VAC 240 VAC Peak output power 280 VA 280 VA Maximum continuous power 270 VA 270 VA Nominal voltage/range2 208 V/183-229 V 240 V/211-264 V Nominal output current 1.30 A 1.13 A Nominal frequency/range 60/57-61 Hz 60/5761 Hz Extended frequency range 57-63 Hz 57-63 Hz Power factor at rated power 1.0 1.0 Maximum units per 20 A branch circuit 21 (three phase,balanced) 14(single phase) Maximum output fault current 663 mA rms,100 ms 663 mA,100 ms Power factor(adjustable) 1 /0.7 leading...0.7 lagging 1/0.7 leading...0.7 lagging EFFICIENCY 208 VAC 240 VAC { CEC weighted efficiency 96.5% 97.0% Peak inverter efficiency 96.8% 97.3% MECHANICAL DATA Ambient temperature range -400C to+65°C Connector type S280-60-LL-2-US:MC4 S280-60-LL-5-US:Amphenol H4 Dimensions(WxHxD) 172 mm x 175 mm x 35 mm(without bracket) Weight 1.8 kg(4 Ibs) _ Cooling Natural convection-No fans I Enclosure environmental rating Outdoor-NEMA 6 FEATURES Compatibility 60-cell PV modules Communication Power line Integrated ground The DC circuit meets the requirements for ungrounded PV arrays in NEC 690.35.Equipment ground is provided in the Engage Cable.No additional GEC or ground is required.Ground fault protection(GFP)is integrated into the microinverter. Monitoring Enlighten Manager and MyEnlighten monitoring options ff pliance UL1741/IEEE1547,FCC Part 15 Class B, CAN/CSA-C22.2 NO.0-M91,0.4-04,and 107.1-01 1.Suggestion only,inverter self limits DC inputs. 2.Nominal voltage range can be extended beyond nominal if required by the utility. To learn more about Enphase Microinverter technology, visit enphase.com v E N P H AS E. ©2016 Enphase Energy.All rights reserved.All trademarks or brands in this document are registered by their respective owner. January 2016 i professional SOLAR ProSolar® RoofTrac® productS'M Intertek Bonding and Grounding Guide 4arni7 UL2703 (Patent Pending) I� Applies to GroundTrac®and SolarWedge® R mounting systems which utilize the RoofTrac® �I rail/clamp design. For RoofTrac®Rail Bonding Splice No buss bar Drill 112"holes at bottom of rails with 112"110 Irwin f Unibit®using the rail support as a hole location guide. Insert 5/16"bolt through support holes and hand o thread into thread rail splice insert.Fasten to 15 ft-Ibs. I For Bonding Module Frame and Clamps to Support Rail Green lock washer indicates Fasten pre-assembled mid-clamp assembly to module electrical bond frame,to 15 ft-Ibs. Module Frame Design: double wall,aluminum,1.2"-2.0"tall,0.059"-0.250" thickness,UL1703 or equivalent tested module. UL467 standard tested bonding equipment for use with Professional Solar Products(ProSolar®)support rail. Bonding of module to RoofTrac®rail via ProSolar®rail channel nut using buss bar. Bonding of RoofTra&rail to RoofTra&rail via ProSolar® UL467 tested universal splice kit(splice insert and splice support). Assembled Self-bonding Self-bonding Mid Mid Clamp With SS Bus Bar Clamp Fastened on Rail Grounding of RoofTra&rail via Ilsco SGB-4 rail lug. (solar module not shown) System to be grounded per National Electrical Code(NEC). See NEC and/or Authority Having Jurisdiction(AHJ)for grounding requirements prior to installation.See final run(racking to ground electrode)grounding equipment installation instructions for specific installation information. COPYRIGHT PROFESSIONAL SOLAR PRODUCTS 2015:All information contained in this manual is property of Professional Solar Products(PSP). TileTra&is a registered trademark for PSP and is covered under U.S.patent#5,746,029.RoofTra0 and FastJace are registered trademarks for PSP and are covered under U.S.patent#6,360,491.RoofTrace bonding designs patent pending. ProSolar®UL2703 Bonding and Class A Fire Rating Page 1 of 4 professional SOLAR ProSolar® RoofTrac@ products Bonding and Grounding Guide (Patent Pending) i Can be placed .P i •� under module to hide connection I Q - if desired For Grounding Connection ILSCO SGB-4 rail ground connection I I Basic Wiring Diagram I Roofrra&Universal Rail Bonding Splice / Grounding Lug Grounding Lug COPYRIGHT PROFESSIONAL SOLAR PRODUCTS 2015:All information contained in this manual is property of Professional Solar Products(PSP). TileTrac®is a registered trademark for PSP and is covered under U.S.patent N5,746,029.Roorrrac'e and FastJacW are registered trademarks for PSP and are covered under U.S.patent k6,360,491.RoofTrac®bonding designs patent pending. ProSoIsrG UL2703 Bonding and Class A Fire Rating Page 2 of 4 Listing Constructional Data Report (CDR) 1.0 Reference and Address Re`ort-Number 100779407LAX-003 I Original Issued: 14-Se -2012 Revised: 28-A r-2015 Standard(s) UL Subject 2703-Outline of Investigation Rack Mounting Systems and Clamping Devices for Flat-Plate Photovoltaic Modules and Panels.Issue#2:2012/11/13 Applicant Professional Solar Products,Inc. Manufacturer Professional Solar Products,Inc. Address 1551 S.Rose Avenue Address 1551 S.Rose Avenue Oxnard,CA 93033 Oxnard,CA 93033 Country USA Country USA Contact Stan Ullman Contact Stan Ullman Phone (805)4864700 Phone (805)486-4700 FAX (805)486-4799 1 FAX (805)486-4799 Email sgprosolar.com 1, Email s@prosolar.com Page 1 of 63 This report is for the exclusive use of Intertek's Client and Is provided pursuant to the agreement between Intertek and its Client.Intertek's responsibility and liability are limited to the terms and conditions of the agreement Intertek.assumes no liability to any party,other than to the Client in accordance with the agreement,for any loss,expense.or damage occasioned by the use of this report.Only.the Client is authorized to permit copying or distribution of this report and then only in its entirety.Any use of the Intertek name or one of Its marks for the safe or advertisement of the tested material,,product or service must first be approved in writing by Intertek.The observations and test results in this report are relevant only to thesample tested.This report-by Itself does not imply that the material,product,or service or has ever been under an Intertek certification program. ProSolar®UL2703 Bonding and Class A Fire Rating Page 3 of 4 Report No.100779407LAX-003 Page 2 of 63 Issued: 14-Sep-2012 Professional Solar Products,Inc. Revised:28-Apr-2015 2.0 Product Description Product Photovoltaic Racking System Brand name ProSolar The product covered by this listing report is a rack mounting system.It is designed to be installed on a roof.It will be secured by means of Fast Jack or Tile Trac attachments, depending on the type of roof it is intended to be installed upon.The Rooftrac mounting system is comprised of support rails and top-down clamping hardware.This device can be used on most standard construction residential roof-tops. This system is in compliance with the mounting,bonding and grounding portions of UL Subject 2703.This system has the following fire class resistance ratings: Class A for Steep Slope Applications when using Type 1 or Type 2,Listed Photovoltaic Modules.Class A for Steep Slope Applications when using Type 2,Listed Photovoltaic Modules with or without the wind skirt.Class A for Low Slope Applications when using Type 1,Listed Photovoltaic Modules when a minimum of 12"gap between the roof surface and the bottom of the module is maintained.Class A for Low Slope Applications when using Type 2,Listed Photovoltaic Modules when a minimum of 14"gap between the roof surface and the bottom of the module is maintained. RoofTrac has different types of bonding and grounding,below is a list of them: Bonding of module-to-Roof Trac rail via Weeb PMC Description Bonding of module-to-RoofTrac rail via ProSolar rail channel nut using buss bar Bonding of module-to-Roof Trac rail via Ilsco SGB-4 lugs Bonding of Roof Trac rail-to-Roof Trac rail via Weeb Bonding Jumper-6.7 Bonding of Roof Trac rail-to-Roof Trac rail via Ilsco SGB-4 Lugs Bonding of RoofTrac rail-to-RoofTrac rail via ProSolar UL 467 tested universal splice kit(Splice Insert and Splice Support) Issuance of this report is based on testing to PV module frames with a height of 1 1/4 inch to 2 inches The grounding of the entire system is intended to be in accordance with the latest edition of the National Electrical Code,including NEC 250:Grounding and Bonding,and NEC 690:Solar Photovoltaic Systems.Any local electrical codes must be adhered in addition to the national electrical codes. This product investigation was performed only with respect to specific properties,a limited range of hazards,or suitability for use under limited or special conditions.The following risks and other properties of this product have not been evaluated:electric shock,Ultraviolet light exposure. Models RoofTrac Model Similarity N/A Fuse rating: 20 A Mechanical Load:30 PSF Fire Class Resistance Rating: Ratings. Class A for Steep Slope Applications when using Type 1 and Type 2,Listed Photovoltaic Modules. Class A for Low Slope Applications when using Type 1 and Type 2,Listed Photovoltaic Modules Mechanical load was tested using 60 Cell Canadian Solar Modules model CS6P with 40mm Other Ratings frame height and maximum span of 48 inches using 4 inch and 6 inch TileTrac or FastJack posts with 1-1/2 inch tall RoofTrac rail.And maximum span of 72 inches using 4 inch and 6 inch TileTrac or FastJack with 2-1/2 inch tall RoofTrac rail. I r ProSolarO UL2703 Bonding and Class A Fire Rating Page 4 of 4 ED 16.3.15(1-Jan-13)Mandatory The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cotuit Solar LLC Address: P.O. Box 89 City/State/Zip: Cotuit, MA 02635 Phone #: 508-428-8442 Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 12 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. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no Solar PV Installation employees. [No workers' 13.❑■ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Travellers Insurance Policy#or Self-ins. Lic. #: 6yKUBI-4�988P868-15 Expiration Date: 3-26-2016 Job Site Address: �W k. l�b�nr� it k'. City/State/Zip: 14 f 94 � �?5 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 in urance coverage verification. I do hereby certi ndert a ains an p nalties of perjury that the information provided above is true and correct. Si ature: Date: Phone#: 5084288442 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#: HightfaX C3-Z 3/31/'L015 4:88:18 AM PAGE .. 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDD/YYYY) TMjP..eRTlFICArE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEFM RCATE 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(tes)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may fequ ire and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endo s PRODUCER CONTACT NAME.- DON BUNKER INS AGCY PHONE FAX PO BOX 221 (AEC,No,Ezt): (A/C,Nor E-MAIL IL NOVER,MA 02339 ADDRESS: 73JCD INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELMWDfiItiNrM COMPANY OFAMMUCA COTUIT SOLAR LLC INSURER B: INSURER C INSURER D: 3800 FALMOUTH RD INSURER I MARSTON MILLS,MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS TO CERTIFY THAT THE POLICIES OFRISURANCE LISTEDBELOWHAVESEENL95UMTOTHEINSUREDNAUMABOVEFORTHEPOLICYPERMINDtCATED.NOTWITHSTANDING ANY REOUfHEIIIEM,TERH OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CSTTEICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES OESCFRBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (rBMIDDIYYYY) (MM DD\YYYY) LIMITS GENERAL LIABILITY [REMISES H OCCURRENCE S COMMERC(AL GENERAL LIABILITY AGETOR(JdTED $ CLAIMS MADE OCCUR. (Ea ) EXP(Arty one person) S SONAL&ADV INJURY S GEN'L AGGREGATE LIMB APPLIES PER: ERAL AGGREGATE S POLICY �PROJECT LCC DUCTS-COMP/OPAGG 'S AUTOMOBILE LIABILITY BNIEDSINGLE S ANY AUTO LIMIT(Ea acddere) ALL OWNED AUTOS BODILY NUURY S SCHEDULE AUTOS (Per person) !-TIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE S (Per aeddem) UMBRELLA LIAR OCCUR . EACH OCCURRENCE $ EXCESS LIA3 CLAIMS-MADE AGGREGATE S DEDUCTIBLE S RETENTION S S A WORKER'S COMPENSATION AND WC STAMNORY OTHER EMPLOYER'S LIABILITY YIN UB498OP868.15 032E-2015 03I26=6 g umrrs ANY E PROPERITOR?ARTNEAlEXECtIT1VE OF RC Q NIA RIMEMBER EXCUIDED? E.L EACH ACCIDENT $ 500,000 (Mandalory tn NH) E.L.DISEASE-EAEMPLOYEE $ 500,O0D If yes,desaele Under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS!LOCAIIONSMHICLESMESMCnONS/SPECIAL ITEEILS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTTICATE HOLDER AFFECTING WORIaM COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION ) CONR AD GEYSER SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED 44 OLD SHORE RD BEFORETHE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESETLT COTUIT.MA 02653 v ACORD 25(2010A)5) The ACORD name and logo are registered marks of ACORD 1988-2MO ACORD CORPORATION. All rights reserved. c 1 iassachctsetts-Depart M- ent of Public Safety `S^ �ard of 8uiiding Regulations and Stands;ds C'iin.truction Supemmir License:CS-107947 JOHN VREELAN17.:: . 'id . 48 QVASHIVET ROAD"17 Mashpee MA 02649 7 - .,.,� Commissioner 04125/2018.` Fold,Then pemchAlong AD PerroretlonsAs _ v.COMMONWEALTH-OF MASSACHUSETTSY: • • • • ZSNFA r , -80 ELECTRICIANS i.4SSUES ATNE tFOLLOWI NG LI LENS S�A" REGISTERED MASTER`EL:ECTRPCaAW, 14 c. COTUIT:SOL�AR'LLC v ' "j°I FRANC I S rJ 9RAOYl"JR e . PO MX 1366 'W, uPLYMOUTHA�,s> xMA o2362 1366 C/fZ•fi C�I?2=%ICf��/`l-tl1C'f,�.ill.• i 1�T' t� .:1I% Office of Consumer Affairs d Business Regulation 1..0`Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home.Improvement Contractor Registration c_ Registration: 146276. Type: Supplement Card Expiration: 4/8/2017 COTUIT-SOLAR JOHN VREELAND r•, _.____..._.._._._._ __.__�__ __ ___ P,O.. BOX 60 COTUIT. MA 02635 Update Address and return card:Mark,reason for change.,. s at G F:w-N r f t_�Addroks:'_I"Renewal Employment + (Cost�a'rd a "���E•�"°r.iirt.i.,:iii,:ri�/�i���lriiArr�ftu.%/: �- "- fiice of Consumer Affairs.@ 8usiuisi Reguladou License or registralion.vulid far individul use only �-tNrtlONE IMPROVEMENT CONTRACTOR•. before the expiration date:if fbund.return to. "f 4Registrati=,14527fi.:, Tom• Ofiice of Consumer Affairs and Business Regalation .. w 10 Park Plata-Suite 500 "N Expiration: 4/8/2017 'Supplement Card soston;NIA 02116 COTUIT SOLAR JOHN VREELAND 3800 FALMOUTH RD, MARSTONS AAILLS.im 02648 Qudercrcretary Nnt valid:withoui signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Q(D Parcel pOCN Permit# I q7 Health Division gam"7 9 � � /d� -o!� Date Issued O Conservation Diyision m leig Fee d 7- S� Tax Collector '� ti� vr, j SEPTIC SYSTEM MUST BE Treasurer rn F /C / 25/W INSTALLED IN COMPLIANCE WITH TITLE S Planning Dept.- ENVIRONMENTAL CODE AND Date Definitive'Plan Approved by Planning Board Q TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Z Vy i�T�� b��ru `�Jr i U�2, /Yla�.S�odc.C� i�'l !1 S , m4 oza r/S! i Village Owner e tj gS�e U Pv-i ce_ Address d- A Cc)h(d 10 eK ,l�Yi up /?- 0• box72,C Telephone(�09-) YID_ 0'YD!7 Permit Request 62-t --49 Square feet: 1st floor: existing proposed_Z 2nd floor: existing proposed lYi0l'a—�Total new Estimated Project Cost LS eAD Zoning District Flood Plain Groundwater Overlay Construction Type Wgo Lot Size 3, 01/7 Grandfathered: ❑Yes U"No If yes, attach supporting documentation. Dwelling Type: Single Family Clf' Two Family ❑ Multi-Family(#ununits)W Age of Existing Structure 4&- �.-- Historic House: ❑Yes On Old King's Highway: ❑Yes ®'No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ffNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name (3-\A-L_%0yW CoCkS~ QO�. eo Telephone Number &Og) Address 12-3 Pond e'����`e License# r� `S 1!52 6" 19�S11 '(yLkL X k-e-v 1M A 0�_&3 I Home Improvement Contractor# llt,0170 Worker's Compensation# I G, 7 �W,91 Y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE C.a( ��i/lz /�i6� DATE FOR OFFICIAL USE ONLY 'PERMIT NO. � _ U,,TE ISSUED ; MAP/PARCEL NW-11S 1 Y ADDRESS '� VILLAGE OWNER , , DATE OF INSPECTIO'N'. FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s J` GAS: ROUG Q F FINAL FINAL BUILDING DATE CLOSED OUT ,' sit ir go c ASSOCIATION PLAN NO ® 0 , �. .� � i/ tea/ '._ • 9 4 r The Commonwealth of Massachusetts —r.: - R -= — Department of Industrial Accidents _ 600 Washington Street ...... Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one kin in any capacity % % % % ❑ I am an employer providing workers' compensation for my employees working.on.this job. :'�`�..'��'::�:f.���:'�;c.•��'::;>5:::: phone#..: ....:...: :....... `t.......................,.::....::::.::,:::::. `' olic Insurance � j / ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following;workers' compensation polices: company name-. :cadre ass<` <>> ;>>><;><>»<':><«> >'> <>>;?> ':``:». >< :'<:»::>:::: v :::: c^:iu. ..a:,::•::: :c�;:;::is:::5:::6iix::::?::ti�iiiii:::::i::iiiii:i'�i�:;:?c::i:::'i:#�iiiii:�i:i:;::;:;:�;<:;+:>:;:>;:!;+:;}i:;<:iiii:v:y:i>.?�;::;:}•:: ::>.•';;: ::::#i T: ; F ii:i.{??{;?;i:: ii:;?:;i:;':;?'i$:i{;ii+:;:j;l`...ii:<:.. >'Itione�•'4'�: :�i�'�'�' s��Y%ix. {:�: f:�:}�:;:;::i?:;:!;?`?'i�iJ;:�;:::sf::i:::;:;'i:;:;::;:+::�:!�:•<:i?j?n;:j;:�•;:;i:; n v.h........r.. .}............�.iry:•: ;i?;::}}j ::':i'ii:4::i+ii$iiiiiii:{'ii:{;?T.:i>.:i}ii:j}i:ij:i+i sti:!i:;ii:;i iiiiiii:i iiijJr:;iii.............}+......i::iiiii$i::'::ti:ii-ijiiriii:}:v �................................................................:: }:......w:::::v: .................................... :v:.�:.�:::::::::•::::::::::.}i:.y:ry: ..:..........................:.�:::w:n...............................................................,�..:: ............ ... ..::...............:.�.::::::::::::::.�::.�.�::.�:::. ................ .. ..,..................::::::::.;:•:.�:::.�:::::..:: .:.... ...............................................................nv.f}$i•�S}'•}:::i{••. insurance.ca..... .........,.....:::.::,.:...:::..,.:....:......:...................:. camnanv<name- s dre ads. h d' X. - :.zy:; •:..::::::::::.:::.:::::::.::::::::::::::::::._::::•::.::::::. 11 ::::::::::::::::::::::::::::•::::::::...::::::._:::::.:: :.....:...::•::::.::::. .....:::::::::::.._.:::: ........................................................................ ................................................ >:«:»i:<::>::'::z:>:::« < : :>.:::._.:::::::..._:::::::::::,:::.:?.:::::::.:::;.:.};:.:.;:.?:..<.?:.?:.:: nsnranceco:«:., :.;:.:.:.;;:.:.»: :.:.::.::.:::;::.:.;:.?:::.;:.;:.}:.?}::«;>:.?..::.::.}::.:;.};;::::.::::,..:::::::::::::::::::. .::::: olice# ................................................................. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crbninal penalties of a fine up to$1,500.00 and/or one years'Imprisonment as weft as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains aannd peenalties of perjury that the information provided above is into and correct Signature Date /D Print name Ile, Phone#'.So8—U� official use only do not write in this area to be completed by city or town official city or town: permit/ficense 1t ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person phone#; ❑Other Ucy sed 9/95 P1A) The Town of Barnstable z Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissione. Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: IV P-LV 90-`r7 �d-i'a� � Estimated Cost Bov Address of Work: 7 ly1 �q f/�� �N✓� L a.1 P, .Mae sfeh Axl/, wa, Owner's Name: Ae Ss-e ,L LE �/'i G Date of Application: 49—•01 S--7 7 I hereby certify that: Registration is not required for the following reason(s): OJob 11 Work excluded by law 3 Under$1,000 Building not owner-occupied Owner pulling own permit Notice is.hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. i0— C 9 q '15,01 /X A # /6 u62 Date CT o N Registration No. OR Date Owner's Name gIbmis Affidav ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X$55/sq. foot= GARAGE (UNFINISHED) -7 0(J square feet X $25/sq. foot= �D D PORCH square feet X $20/sq. foot= DECK 'square feet X $15/sq. foot= OTHER square feet 4$? /q. foot Total Estimated Project Cost g990915b � r . _._;_.-...... .... ... -...- .,._.... ._ :.._ � - .. _ _• -- -. ` `. •fir 1y ''�•. J;N���. �,,j,4lI WKv r♦a�{•'" .... - .r O7 e - a Fi•�.iat "sctt�ys�t ... we.., � �r �++>>--,,�r..����.-..yth.'.� tt5��R`�}�'���1k��•`}a'F�t-y 4.�v... .. HOME IMPROVEMENT CONTRACTORS REGISTRATION' �� '� 4 : . .*Board of Building Regulations and ;Standards, One Ashburton Place - RoomnL 301 « 4y ,►� �, # s a y' i Boston , Massachusetts '02108 r, y a. HOME IMPROVEMENT CONTRACTOR Registration 116570 t `Expiration 06/28l.00 � ri T � X�`-iti a' ~- - Type PRIVATE CORPORATIONq `aa +Cy� �rw� ayi+r1��!•�X� � t K� �°P`v' y,,.�/Re'f06�xoxo�eu�aa�O�./��ad0aa�ettdef• ", ,HOME IMPROVEMENT CONTRACTOR t;�t & ;' ''`' + :Registration 116510 OLD WORLD CRAFTSMAN BLDG CO , - INC 4Type -''PRIVATE CORPORATION ED H . SCHULTE ;Expiration 06/28/00 123 SHEEP POND CIRCLEa r� [. .r• �i.4"ti � 4' tf�V A\J $:J. fA•-X`Y~t.ra 1...--� •n BREWSTER MA 02631 - � 3x 4 ' x r i : Ir �< OLD WORLD CRAFTSMAN BLDG CO, •.} _. .. 4l �lE•' 1eM t�� SSzt' V,'i � $ .+ 'S F y._ ED H. SCHULTE , SHEEP POND CIRCLE I I r ��. - fi sru 5 02631 7 _ gt TO k � ,�' INI R I '(� fir' ✓��e �mnvntar:cueall�c �aaJt�iude Al DEPARTMENT OF PUBLIC SAFETY CONSTRUC DKC SUPERVISN LICENSE — Nueher Expires: Restricted To: @@ ED H SCHULTE 123 SHEEP POND M BREWSTER, MA 0631 If located: . North of Route 6 - any work visible'from outside- needs approval from OKH In Hyannis -If work visible from outside-Check to see if it's included in the Hyannis Historic Waterfront District-if so it needs approval from them APPLICATION PACKAGE MUST INCLUDE: Map/parcel number Approval S' -offs from:' Health —]V_Conservation-(if exterior work) Tax Collector Treasurer If ZBA relief(Special Permit or Variance is required for project: Copy of ZBA Decision Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date. [� Street address Owner's name&address Permit request-full description of proposed project(u-value of replacement windows if applicable) Square footage -proposed project Estimated project cost. [� Complete Dwelling information for Assessor's Office Builder's information Signature L� Plot plan � sets of reduced(8.5"x 11: or'8.5"x 14'� plans with foundation, floor plan, cross section, framing schedule&smokes (SB or SH) Home Improvement Contractor's Affidavit orm must include: Insurance company's name & Worker's Comp policy Worker's Comp f number Energy Compliance Form --��_Copy of Construction Supemsor-s License & Home-Improvement-Specialist'-s"License "' OR Homeowner's License Exemption Form. -= Fee CHIlVINEYS Need Home Improvement License No plot plan required PIERS & DOCKS Need Construction Super license AND Home Improvement License Owner cannot pull own permit q-forms:permits 1. rev. 7127199 Y Town of Barnstable -.BARNSTARLE. Regulatory Services r— -- - MASS. t639.• ' Building Division .ergo UAP�p 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 i Inspection Correction Notice � Type of Inspection , Location Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: T Ii Q Jle40 'd.- �&r"1219-7 .r r"1 y 1 w PT1 Please call: 508-8�62_W- for re-inspection. Inspected by f Date i F K•y I � aR �9 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map ), Parcel, =; ,'Application # / I Health'Division _r Date Issued :•, Conservation Division ti `.:Application F Planning.Dept: '=Permit Fee Date Definitive Plan Approved by Planning Board ,,,nn, Historic - OKH Preservation/Hyannis R!rY Project Street Addrre_ss 971 - ��"►s ��•b�, ,' �ic�ili' Village Ic��"STOks R%��S Owner Address 9-7X L1)WTg4EL- i•-, eft . Telephone Permit Request MC nov we1 Ok. ����,� �(,coi�Aso �. �'t��`.•4 ��iw 0- �2 �rcy.�t�4�s. Square feet: 1 st floor: existing UNK proposed '39<7 2nd floor: existing proposed #�(4(9 l al new 1 Zoning District Flood Plain L- Ground water,Overlay Project Valuation Construction Type UU sV - Lot Size 43 G Grandfathered: &Ie's ❑ No If yes, attach s orting $cur entation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes No On Old King's Hi hway:wc: ]Yert' k'No r:. Basement Type: ❑ Full Crawl ❑Walkout ❑"OtherAe Basement Finished Area (sq.ft.) ""'�� Basement Unfinished Area sq. �? Number of Baths: Full: existing_ new 1 Half: existing new —� Number of Bedrooms: existing<—Ynew Total Room Count (noZap ding baths): existing new t First Floor Room Count Heat Type and Fuel: ❑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 Au rization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number • ���� ��� Address ® ° `S® � License#_ �� 7 Home Improvement Contractor# jo Worker's Compensation # ALL CONSTRUCTION DEB RESULTING FROM THIS PROJECT WILL BE TAKEN TO e SIGNATURE DATE C FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED . MAP/PARCEL NO. .ADDRESS VILLAGE - OWNER DATE OF INSPECTION: .FOUNDATION SroD t Cy .so o� Z "7 "/o9 _ s im— FRAME ��� w�',d`y 8 D arcs /3-Fit° SG q l� m`P,L�lit L��r 9 r INSULATION i(/S 0 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL y FINAL BUILDING r rZu►ii,�' DATE CLOSED`OUT. ASSOCIATION PLAN NO. - M '7 rt 6/24/2009 To: George W. Blakely, Builder Re: Kiele Residence 272 Whistleberry Drive Marstons Mills, MA Mr. Blakely, Page S-3, General Note#5 specifies TrusJoist Laminated Veneer Lumber structural members as noted. Shepley Wood Products supplies Boise Cascade Laminated Veneer Lumber whose sectional properties meets or exceeds those of the TrusJoist Brand and as such is an acceptable substitution for"LVL"material specified and designed by the Engineer of Record. See attached sheets for product comparison. Sincerely, Y Joe Madera Engineered Wood Products Shepley Wood Products Hyannis, MA i POWfr - - Closest Allowable Nail Spacing Nailing Parallel to Glue Lines _ `� ' •• (Narrow Face) n�•7 �i� 1�" rLs�: � •n.•. 1'a o ,+ri n ,.. r Nailing . � �tlNalhrig'Parallel to,Glue Lines(farrow Face)('I k , zbS 4 Perpendicular f-< ns4,r"s?.v to Glue Lines t r, zr,a .-'„5 .�rf'.:.'.b1r1L T�• 9 Y ?i� 'f;n $ 4$!,; _ Nail.Size 1 :f [,.<.; (Wide Face) ,? ' VERSA-RIM° � VERSA-LAM° � � s2 1.4,1800 Rimboard VERSA-LAM° ° s the" VERSA-LAM a Z+e O.C. End _3% &Wider_ All Products O .C. End. O.C. End O.C. End O.C. End �j K (inches] Finches], -,[inches) [inches]- [inches) Finches ] [inches) [inches] [inches] [inches) s -' t'•.-i' 8d Box 3 1'% 3 + 8d Common 4 3 3 12 2 1 2 1/22 %2 10d&12d Box 4 3 2 2 1 2 1 3 3 2 3 2 2 1 2 1 Nailing Perpendicular to 16d Box 4 3 3 2 3 10d&12d Common 6 4 4 3 2 2 1 2 1 Glue Lines (Wide Face) 16d Sinker 6 4 3 2 2 2 Nailing Notes 16d Common g 4 4 3 4 3 2 2 2 2 1) For 13/4"thickness and greater,2 rows 6 4 6 3 2 of nails(such as for a metal strap)are • Offset and stagger nail rows from floor sheathing and wall sole plate. 2 2 2 allowed(use'/:"minimum offset between • Simpson Strong-Tie A35 and LPT4 connectors may be attached to the side VERSA-LAM®I'VERSA-RIM'°.Use nails as specified by rows and stagger nails). Simpson Strong-Tie. ,► I, Allowable Allowable ,Moment Width Depth' Weightr Shear ; Moment` of Inertia Allowable Allowable Moment Grade [in] [in] [Ib/ft] [lb] [ft-Ib , Width Depth Weight Shear Moment of Inertia ] [in] I Grade [in] [in] [lb/ft [lb] [ft Ib] o 3%2 1.5 998 776 5.4 5'/4 [in] 0 8.0 5237 6830 63.3 n 1'/2 5'/2 2.4 1568 1821 5'/2 8•4 5486 7457 72.8 20.8 W 7'/• 11.0 7232 12566 166.7 > 7'/ 3.2 2066 3069 47.6 9% 14.1 9227 19908 346.3 3'% 1.8 1164 1058 6.3 9% 14.5 9476 20937 375.1 F� 5'/2 2.8 1829 2486 24.3 11'/4 17.1 11222 28814 622.9 7'� 3.7 2411 4189 55.6 5'/a 9'� 4.7 3076 6636 115.4 11% 18.1 11845 31913 732.6 9'/2 4.8 3159 69790 125.0 0 14 21.3 13965 43552 1200.5 13/4 1114 5.7 3741 9605 207.6 CO 16 24.4 15960 56046 1792.0 11% 6.0 3948 10638 244.2 CD c� 0011 14 7.1 4655 14517 400.2 18 27.4 17955 7 2551.5 CO 0 16 8.1 5320 18682 597.3 20 30.4 19950 85428 3500.0 0 18 9.1 5985 23337 850.5 < 24 36.5 23940 120549 6048.0 g 24 12.2 7980 40183 2016.0 W 91 16.6 w 12303 26544 461.7 r¢ 5/2 5.6 3658 4971 48.5 > 9Y2 17.1 12635 27916 500.1 Cr 7'� 7.4 4821 8377 111.1 > 9'/4 9.4 6151 13272 230.8 11'/" 20.2 14963 38419 830.6 9'/2 9.6 6318 13958 250.1 11 v° 21.4 15794 42550 976.8 3%z 11'/4 11.4 7481 19210 415.3 7 14 25.2 18620 58069 1600.7 11% 12.1 7897 21275 488.4 14 14.2 9310 29035 800.3 16 28.8 21280 74728 2389.3 16 16.2 10640 37364 1194.7 18 32.4 23940 93348 3402.0 18 18.3 11970 46674 1701.0 20 36.0 26600 .113904 4666.7 20 20.3 13300 56952 2333.3 24 43.2 31920 160732 8064.0 s Modulus of Horizontal Tension Parallel Compression Com rl;s ion qulva en Elasticity Bending Shear to Grain Parallel to Grain Perpe ilaIgtl��ar to Specific Gravity Des f or Design Property Grade E(z 106 psip') F t�N3l z VERSA-LAM®Beams 2.0 3100 2 0 °(Psi) F [psi]t lin F,(psi)Izxsl FC°(Psi)tzi FL(psi)niteJ (SG) 3100 285 2150 3000 750 VERSA-LAM®Columns&Studs 1.7 2650 0.5 t•7 2650 285 1650 3000 1. This value cannot be adjusted for load duration. Tension value 750 0.5 2. This value is based upon a load duration of 100%and may be adjusted for other load durations. 5 member length[ft)II Use Ll=4 for iedbmemberrs less than f/our feet long. 3. Fiber stress bending value shall be multiplied by the depth factor,(12/d)'"where d=member 6. Stress applied parallel to the gluelines. depth[in]. 4. Stress applied perpendicular to the gluelines. Design properties are limited to dry conditions of use where the ALLJOIST°Specifier Guide-UNITED STATES maximum moisture content of the material will not exceed 16%. May 2008 + wer v rb ry rcperp rcpan UTn t Microlam 2600 285 750 2510 7.35 1900000 Parallarn 2900 290 750 29-UU- 9 2000000 Timberstrand LSL 1700 400 680 1400 10.87 1300000 Timberstrand LSL 2250 400 750 1950 10.87 1500000 E Timberstrand LSL 2325 310 800 2050 10.87 1550000 Timberstrand LSL 2600 400 880 2380 10.87 1700000 Parallam Column 2500 230 600 2500 9 1800000 !I 1 Wolmanized Parallam 2117 241 533 2030 9 1660000 d 2 Wolmanized Parallam 1827 197 368 1508 9 1460000 d 3 Wolmanized Parallam 1624 171 263 1189 9 1340000 nanized Parallam Column 1512 171 263 1300 9 1314000 �,He,gyti Town of Barnstable Regulatory Services. BAMAy NA sB ' Thomas F.Geiler,Director 1639. D � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder /(�FA , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this b ding permit application for. (Address of job) Signa of er .Dafe Print Name If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:O W N E RP ERM IS S ION i Town of Barnstable o Regulatory Services ' Thomas F.Geiler,Director anrwsrear.e. 1 ��� Building Division TFo � 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: 10B LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellinQs_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. DEFINTTION 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 of Homeowner . Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.1.5) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeexempt.DOC The Commonwealth of Massachusetts 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 LeLribl Name(Business/Organization/Individual): G7� Address. CK City/State/Zi �f�• -�"� ® C9 Phone.#: 'OR Are you an employer? Check the appropriate box: Type of project(required): 1.01 a employer with 4. I am a general contractor and 1 6 � w construction l poyees(full and/or part-tim.e).* have hired the sub-contractors 2. I am a'sole proprietor or'parhder-' listed on the*attached sheet. 7.. U14modeling ship and have no employees These sub-contractors have 8. -Q D molition working for me in any capacity. employees and have workers' 9 ilding addition [No workers'-comp.•insurance comp. insurance. required.] 5. E] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] Any applicant.that checks box#1 must also fill out the section below showing their w6rkers'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. tContractors 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. Iam 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 tip 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 a ins the violator. Be advised that a copy-of this statement may be forwarded to the Office of investigations of the D- I insurance coverage verification. Ida hereby cerh in d nalties of perjury that the information provided above its true and correct Si ature: Date: Phone 4: Official use.only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions 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, eicpress 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 tiustee 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 of 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 v�zth 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-contiactor(s)name(s),-address(es)and.phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to 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 burn Ieaves 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. #617-727-490.0 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia i REScheck Software Version 4.2.2 Compliance Certificate Energy Code: 2006 IECC Location: Barnstable,Massachusetts Construction Type: Single Family Conditioned Floor Area: 371 ft2 Glazing Area Percentage: 16% Heating Degree Days: 6137 Climate Zone: 5 7 Construction Site: Owner/Agent: esigner/Contractor: Compliance:Passes on UA Compliance:29.7%Better Than Code Maximum UA:145 Your UA:102 Gross Cavity Cont. Glazing UA Assembly Area or R-Value R-Value or D.. Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss 496 30.0 32.0 8 Skylight 1:Wood Frame:Double Pane with Low-E 8 0.500 4 SHGC:0.50 Wall 1:Wood Frame, 16"o.c. 1055 19.0 21.0 29 Window 1:Vinyl Frame:Double Pane with Low-E 139 0.300 42 SHGC:0.30 Door 1:Glass 30 0.330 10 SHGC:0.33 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 371 19.0 22.0 9 Boiler 1:Other(Except Gas-Fired Steam)84 AFUE 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 2006 IECC requirements in REScheck Version 4.2.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: Report date: 06/26/09 Data filename: Untitled.rck Page 1 of 1 Boa� Eu f i ing eguliifioand an arils"" r HOME IMPROVEMENT CONTRACTOR.- Registration: 104514 E4piratiori7./_g4/2010 Try j Type lndroidual i GEORGE W.BLAKELX' ' George Blakelyy t,j 130 Redwing Ln/P.O=`Boz'206' 'I Barnstable,M 2630""rA Admiri§trator :- ..... ...............-... .. t p - '�`*"� y ✓fe�J��vr�taizca� a�./f�.aauicf F iuvellit x ; Board of Bmldmg Regulations and Standards Gonstructwn Supervisor License j Ucense CS :14344 ; •, `,F Expiration 3/20/201 U Tr# 20063 Restnctio•n 00 GEORGE W BLAKELY r;L 130 REDWING LN/PO BOX 206 - - �J PROJECT r NAME: ADDRESS: c PERMIT# C� C� PERMIT DATE: M/P• LARGE ROLLED PLANS ARE IN: BOX SLOT C - Data entered in MAPS program on: 'l o BY: q/wp fi I es/archive I Town of Barnstable * Permit# Expires h nt o�n issue date . Regulatory Services Fee .� � XmP E Thomas F. Geiler,Director PERMI T Building Division MAY — 9 2007 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.to"n-barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 2 Not Valid without Red X-Press Imprint p/parcel Number rperty Address gun, VCI. NES (( Residential Value of Work a 3, 9a D .. Minimum fee of 525.00 for work under 5.6000,00 mer's Name&Address ! IGiN 1$ ,_Tz— \ ntractor's Name___Sol_� P'�3J�b.�' Telephone NTum. l�yci� )me Improvement Contractor License#(if applicable) (0 11 LA . r''s-L�erise Tr(iEaPPii b§e) ]Workman's Compensation Insurance. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 0�2 have Worker's Compensation Insurance surance Company Name C°1 tm SmA'6yC'a-s d-'6,,,5 orkman' Val s Corm Policy# LL�U o U(6rPlj A't y)�� )py of Insurance Compliance Certificate must be on file. .rmit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to 1 J=VA'-*g— ❑Re-roof(not stripping. Going over existing layers of roof) DC�' Re-side Replacement Windows/doors/sliders. U-Value 3 (maximum.44) °Where required: lssuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservatio etc. ***Note: Property Owner must sign Property Owner Letter of Permission: A copy of the Home Improvement Contractors License is required. iGNATURE: J. Forms:expmtrg nr=061306 2CO lo r CERTIFICATE OF LIABILITY INSURANCE 10/10/o 6 PRODUCER (781)344-3200 FAX (781)344-1425 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Malcolm & Parsons Ins, Agcy.' Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6 Freeman St. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 527 Stoughton, MA 02072 INSURERS AFFORDING COVERAGE NWC# INSURED Jon Dunn INSURERA: Associated Employers Insurance DBA: John Dunn IINSURERB. P:O. Box 924 INSURER C: Centerville, MA 02632-0924 INSURER0: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY CUMBER POLICY EFFECTIVE POLICY EXPIRATION OMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCLAL GENERAL LIABILITY DAMAGE TO REtgED S PREMISES(Ea.,^,LR.IMS MAD=- U OCCUR MED EXP(Any one perwni S PERSONAL 8 A.OV INJUR" S GENERAL AGGREGATE S GEN'L AGGRECATF LIMIT APPLIES PER* PRODUCTS-COMPIOF AGG S POLICY PECOT LOC — AUTOMOBILE LIASLITY COMBINED SINGLE LINK ANY AUTO (F.v sc:ident) ALL OV.ED AU T IDS BODILY INJURY SCHEDULED AUTOS (Per person) S HIREJAUTOS --- ----------•-- BODILY INJURY S NON-0VJNED AJTOE (Per secitleM) PROPERTY DAMAGE S (Per saldentl GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHER THAN EA ACC S _-__- AUTO ONLY: AGG S E XCESSNMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE _ S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND WCC500465SD12006 09/29/2006 09/29/2007 1 WC 5'TATU• OTH. Y S _ EMPLOYERS'LIABLTY A I ANY PROPRIETORJFARTNERlEXECUTIVE E.L.EACF ACCIDENT S 500,000 OFFICEPJMEMBER EXCLUDED? E.L.DISEASE-FA.EMPLOYE S 500,000 'I- d—L*Und" . SPECIAL PROVISIONS below E.L.DISEASE-POLICY LItA:T S 500 00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES J EXCLUSIONS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT. Town of Barnstable BUT FAILURE TO MA L SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Attn: Building Department OF ANY K14D UPON-HE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE + [Irving Parsons - ACORD 25(2001-108) FAX: (508)790-6230 ©ACORD CORPORATION 1988 a. 3 Qs� F��,y Town of Barnstable. Regulatory Services 'CAM' Thomas F. Geiler,Director �'ATf26 91 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us - Office: 508-862-4038 Fax: 508-790-62-30 Property Owner Must Complete and Sign This Section If Using A Builder I, �ISPc ��Qi—•- , as Owner of the sub)ect property hereby authorize c to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address)of Job) igna er ate Print 14=6e OrORI?5:OWN VERMISSION The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wyOw.mass.gov/dia ' Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Le gib Name(Business/Orgenization/k(ividual): Address: Q ez M NX4 V— City/State/Zip: C ��Ti���i��. VAA- e.#: r2, e you an employer?Check the appropriate bog: :Type of pioject(required):. I am a employer with�_ 4. ❑ I am a general contractor and I 6 ❑New construction . employees (full and/or Part-time),* • have hired the sub-contractors listed on the'attached sheet 7. ❑Remodeling ❑ I am a'sole proprietor or partner- These sub-contractors have g, []Demolition ship and have no employees employees and have workers' -.Vorking for me in any capacity. 9. ❑Building addition [No workers' comp, co insurance, 10.[]Electrical repairs of additions required] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers comp. ` right 6f exemption per MGL 12,[�Roof repairs insurance.required]t c. 152, §1(4),and we have no 13.❑ Other (A1'bUvJ employees. [No workers' comp,insurance required.] Uxy *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tractors must submit anew affidavit indicating such. t Homeowners,who submit this affidavit indicating they are doing all work and tlien hire outside con #Contractors that check this box must attached an additional sheet showing the name of the yub-contractors and state whether or-not those entities have ; employees, If the sub-contractors have employees,they must provide their workers'comp.policy number. n insurance for my employees. Below is the policy and job site I am an employer that is providing workers'compensatio information. Insurance company Name: (� j S� Policy#or Self-ins,Lic.#: �j L`-�-�L7� ,�U Expiration Date:• Job Site Address: Dina City/State/Zip: M�w�M,((% 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 maybe forwarded to the.Office of' Investilizations of the'DIA for insurance coverage verification. Ido her certify under the pains-and penalties of perjury that the information provided above is true and correct, Si tore: Date: "1 — Phone ���1—� FT only. 7n �n to.be completed by.city or town official n: ,Permit/License# Is hority Healthnt 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector rson: Phone#: Information any. 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 hue, 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 offhe 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 j, 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." Addition0y,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 Gf•compli-iee v A-:lie insura*+ce- 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-contractor'(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the . members'or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign.and date the affidavit. The affidavit should be returned to the-city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers.' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom '.of the-affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information•(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant.as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo 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 Commonwmli&dMas Chu-setts Departaeut of ln.dusftiW Aeezdmts ; P.M,"of In;vesapums 600 Wasrii "ton Stmet BWmat,,.MA 02111 • . Tel.#617.727- 04Q ext 406 or 1-87 -MASSAFE Fax#617-727-7749 Revised 11-22:06 www.ma3s.gov'/dia S �s n ...Ckl......tor's map and lot 'umber ......... .54--Sewage Permit number ..............?..............-....7....(W..q.I............... SEPTIC SYSTEM MU INSTALLED IN COMP MILE, ......................... WITH TITLE 5 use number ....;0�. F17.1.•............. ENVIRONMENTAL CO 4 TOWN OF . BARNSTNUCE"111LATMNS BUILDING INSPECTOR ....................... APPLICATION FOR PERMIT TO ........................................ ....... ................... � %TYPE OF CONSTRUCTION ....................... .............................. 4000 ......... ... . ......1W.......... ....19. i TO THE INSPECTOR OF BUILDINGS: J,, The undeWrs.ii ned hereby applies for a permit according to the following information: �Xs Location .... ®p;.... ....... .................................................................................. 00 Proposed Use .................................................................................................................................... ............................. P-F 14 -Z� Ize,......A7�.�- Zoning District ...... ......................... ....................Fire District . ..... Name of Owne�x .....Address/0....6.... ...d... ....... Nameof Builder ....................................................................Address .............................................................::.............. Nameof Architect ...........................................................:......Address .......................................................................... ......... 6 Numberof Rooms ........0....................................................Foundation ... .................................................. Exierioree,444 - .5 to(( -�4....Roofing .......................................... Floors A .. .........................................Interior ..........6�.W49/ ......... .............................. . ..... .. ...........................Plumbing ............. ...Heating ................................... . ....—A Fireplace ....................................................Approximate Cost ..... Definitive Plan Approved by Planning Board --- ---------19 . ......00........ ap m of Lot and Building with Dimensions Fee ..........72- Diagra . ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town arristable arding the above construction. he T4own /ornsta 9 1 Name ... ... .....I........... ........................... ..................... Construction Supervisor's License ............................... YOUNG, CHRISTOPHER No ....2$.4.U.. Permit for ... S.t.O.0................ Single.;Family Dwelling...................... Location .......2.7.2...Whi.s.t.leb.e.rry...Drive .................MaXA t p n.s...Mills........... ................... ........Christopher..Young .................... Owner ....... ......... ... . ...Yo....Ala Type of Construction ....Frame ...................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........Oc.tp-mbex..............1931; Date of Inspection ....................19 Date ',Completed ,.'.� , ru - _ N ".. r•.i1` -. �.-{•: .�...w -,�.:_ --. „k*,,,=•-- �x'°�I;d_Iia.!'w. a. tx?r r�,:V.4..r r. --] o � TOWN OF BARNSTABLE Permit Mo. ..?.�488...... • BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash Nl HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Christopher Young Address Lot #27, 272 Whistleberry Drive Marstons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ......r'ebruary..8.►..... 19.....PP........ . ...41*'***'**....'...* Buil ing Inspector °•� TOWN OF BARNSTABLE BUILDING DEPARTMENT �saa�T TOWN OFFICE BUILDING � rua HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: �— An Occupancy Permit has been issued for the building authorized by BuildingPermit #...:....._........................._....».....................�....�..........................................................................................._..................»............».._. rissued to .......` ...fie.».... �L `?// .. ................_...................... ........._.._ . ». »_....._.»......».»»..»»»»» z: i Please release the performance bond. r BU-I.LDIN. TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT ' JOB WEATHER CARD_ - c: DATE �� ' �,+—•�c�- 19 � PERMIT NO. - APPLICANT ADDRESS - (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) • - ZONING AT (LOCATION) DISTRICT • - ... - (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) ' LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI r TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION ii (TYPE) ! REMARKS: l AREA OR VOLUME ESTIMATED COST $ PERMIT FEE s ♦ (CUBIC/SQUARE FEET) OWNER BUILDING DEPT. ADDRESS 'BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY i ® PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE f PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL-AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAIN, FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO l- OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM 'OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. I 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT 13E_OCCUPIED'UNTIL - MEMBERS(oREADY TO LATH).. - FINAL INSPECTION HAS BEEN MADE. '.3;.�INAL"IN§. ECTION BEFORE ' OCCUPANCY. POST. THIS . CAR® SO IT IS VISIBLE FROM STREET ' BUI ING INSPECTION APPROVALS PLUMBII`jG INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 � 1 No i / \\ �w� r/V 4i IN ROB N ��; 3 3 HEAT:NG INSPECTING APPROVALS REFRIC INSP CTION APPROVAL: OTHER '2 i A 7/? go. WCRK SnALL NCT PROCEED 'UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS Ct :NSPECTCF :iAs APPRCVEO T`+E VAPIC.US WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPH( STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. • -a Assessor's Office(1st floor) Map O(1�0 Parcel Permit Conservation Office(4th floor)(8:30-9:30/1:00-2:00) , 3 I to Issue �' 2-- 9 - r,. Board of Health _(3rd floor)(8:15 -9:30/1:00-4:45) s' q 9o-� �w ,r Engineering Dept.(3rd floor) House# BABNSTABLE. ASS. 19 M , I:9. .� rf0►APy� 6� TOWN OF BARNSTABLE Building Permit Application ( IC:! 31 Project Street Address 272 (1A fJe" tk, Village 11 ' . Owner �sse �—_ �t�f cep Address �ox 73S ��orC�far,���/JS Oat, � Telephone 4 0 -CAI 09 - w` +Permit Request _ e• a a r.,cl nrx 01 d First Floor square feet I Second Floor square feet Estimated Project Cost $ ppd Zoning District Flood Plain Water Protection Lot Size �tc�e_ Grandfathered ? , Zoning Board of Appeals Authorization %�' Recorded Current Use U`2Si�v���` Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family ✓/ Two Family Multi-Family Age of Existing Structure /d Years Basement Type: Finished Historic House f Unfinished Old King's Highway Wd Number of Baths No.of Bedrooms 3 Total Room Count(not including baths) -7 First Floor 4— Heat Type and Fuel GJ Central Air Air) Fireplaces Garage: Detached Other Detached Structures: Pool ND Attached Barn /JO None Sheds AJ0 Other \\ Builder Information Name �t �v►ec— i.c �wsJsvcn�. Telephone Number_ Address License# Home Improvement Contractor# - Worker's Compensation# NEW CONSTRUCTION O�DITION,&REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON-THE-LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE D BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY -72 PERMIT NO. .� 4 L5 t DATE ISSUED ' MAP/PARCEL NO. ' ADDRESS t { VILLAGE - OWNER DATE OF INSPECTION: FOUNDATION _ 12 � t t FRAME -' INSULATION. r FIREPLACE, » ELECTRICAL: ROUGH FINAL - T PLUMBING: ROUGH FINAL GAS: ROUGH FIN.j L ' FINAL BUILDING + DATE CLOSED OUT ASSOCIATION PLAN NO. ' + Q A W 02 6 ' Au u3G �' d> o + 0 w 7,�t W Lo ItA -, CERTI FI ED PLOT PLAN LOCATION SCALE :!.."=:` a DATE . 21..34,/8"I" PLAN REFERENCE d 7 00 of 'V4S EDWD G /, `T7•. .45 : . . . .. .. : . . :. . . . : . . . . . No. 26100 Ao rIST ,�� 1 CERTIFY THAT THE .-Y/.S.?= `^pvvvw" SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF T'91 ?,*HEN CONSTRUCTED. DATE C1,119;5 T 0,.+1e1e You V C REGISTERED LAND SURVEYOR o,c b .41 I d ti z7 `,7s9• 43 .�/ Q 4 0 0 10, N071&- ✓�no,�,s BAsev �• vp 00 M M.gTzsTv•us !`i/tom s LOCATION . . . . .. . .. SCALE . �. . . DATE .S&P f !y85 ' PLAN REFERENCE dooi t.' ,. . OF R�� . . . . . . . . . . . . . EDW CERTIFY THAT THE 9 .26100 c SHOWN ON THIS PLAN 19 LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE e's 9fC1STER�� SETBACK REQUIREMENTS OF THE TOWN OF l LANDS WHEN CONSTRUCTED. DATE . CH,6/SToP/q,r7z Yov.VG - 1040777/OAv4XZ REGISTERED LAND SURVEYOR TOP OF FOUNDATION e CONCRETE COVER •;° CONCRETE COVERS L.2 ' ,�a 4"CAST IRON 2"MAX. 4� 12"MAX. . OR SCHEDULE 4� SCHEDULE 40 PV.C.(ONLY) P.V.C.• PIPE PIPE- MIN. _T LEACH YL PITCH 1/4"PER. PITCH I/4"PER.FT. PIT PRECAST ?'e o' NVERT ! Q 4•0 LEACHING e EL...-f4.7. INVERT INVERT ? . `,' PIT OR SEPTIC TANK DIST. s do w �:'• EQUIV. ,•e INVERT BOX 3.5►=F- 4S .. .. GAL. INVERT ;: c-a 0• •.• �' e; INVERT .•. 3/4 TOII/2' EL.-—7 •. w w 0 � EL'3;do o WASHED w STONE • . .20'--►�~—W DIA. /4' DIA. PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM A/o7r- ¢'oF P&wv/ous NO SCALE M,+Tz7Z/,-fL B6Cow 94>7725-� of lcs/ P- 3�7.3 Pr r /,ter eE C�nGi� .B y n/E DES/GN C'a/6'/N�`t'7Z SOIL LOG WITNESSED BY : DATE T /� TIME.�o:3o Arlon/ �i«Rb .�-s. BOARD OF HEALTH /�/.sTi�Y1�4Tlo.v TEST HOLE I TEST HOLE 2I✓ip E: ENGINEER ELEV. . .O./0. . . ELEV. .. .. . . . . . . DESIGN DATA : �Z.sl.io NUMBER OF BEDROOMS . . . . . . . . TOTAL ESTIMATED FLOW . . o . GALLONS/DAY Cosrusr _ BOTTOM LEACHING AREA SQ.FT. /PIT1,C.f?D, s►-r/o /s3 9 SIDE LEACHING AREA . . : . . . • . SQ.FT./ P1�3B¢Bc,P.� G,2Av&Z GARBAGE DISPOSAL (50% AREA INCREASE) TOTAL LEACHING AREA SQ.FT 044 PERCOLATION RATE l SS 77/Au !4 . MIN/INCH LEACHING AREA PER PERCOLATION RATE SQ.FT. CAR I . .WATER ENCOUNTERED NUMBER OF LEACHING PITS . . . . APPROVED . . . . . . . . . . . BOARD OF HEALTH ' !�wlL `44_ o� S7aN� oi✓ .9'L!� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DATE . . . . . . . . . . AGENT OR INSPECTOR OF M e�P�Sy OF P�qs 1 Eg .Z7 . . . . . o y E. = w BEi 171L/✓E �ELLEY WX/45 4 r N o. 26100 •/`9�,Q.57an�S /41/ZsREC15T fR sa yNrt�Mp►� R 4L Lp�10 PETITIONER CisroPf�Lf7?,. yov.v.G 1 zs a: 7 a V 4``Y. - s - - - - Q Ares, ac ov ak is --6re'l C,:,afl� 10 .Pos�lTo _ Max SP " (o" Max Over ►Jai c, — �'6 - as o � i - i i y� On oona\�orrs „1 _ Irj x • a S�M� �JG4m I//n I ! i 0`K��8 1So 1 - ` \ , - r `� Pp6is x 4 PT y� , f) 1 aX�o Sois�S On hi0/�c�OR �i+ � - Mc,X Ge A cs. Hoist -- Z9 - — _ Oel AK a lel 3` ra4al rItG?Tft. * 5�y K P'f Oe ram__. __ 5�� .X 6 PT- bec-L s/vr A L �1 m V-7- -IxG sots 4x4 tour G(aun r .�� - - - _- �� __ ___ �.�._ •-- - - --- - -- . __ lt7 -. • �ecfw. cJo��l� �.xla � 4,c4 �s ao �x � � 1 '�4 X Pr- o 9 j 1 I s� x� Amc. _ �� 10 Pos�s d x`i P1 rem-� - 15 14♦ �� zr,�, S ;S s/w xb PT p,. Ax6 Qo,�IeL ax I�- on �515 6 y �y o b �X� 0.covn� PBt`imCTt� Q v V Jotsts b ' Q T� arcs o"Qea"'. Max EMS ' I �el I � ► aZ 1 me S o re j ,'n , coll/ll C.t N I i I CA -1 piw armr= set C.w Lzsa K. Price) locatfoyv '414ritOK Mills 9 I 2 Str�v � i N d t t + ec i i V� c4ea=43,617ts-� o 0 • Cad' , ref:43t4/q2 ffoodyeC 254oa1 QDtSc fCoodfmu=�, I QrvGy certify thtar tQ pCa v`i�us kem prep r oC f e or 'tit Y Pn t �:' sc CO� ��°' i ��rEcS�vovn.�ereori. aCOes 1�ot �ca. >rAt. � � �hazanc rvitirt,Ayi.cfec 'ave daze 8-l9.85 a •aoC Elie Coeattory eovea Ale alms rrn.i� CucaaC -Caws as e� C �. t=0"AC Cr tfu tlUW COWtVUC, "OM witft VOUCCirr W 1 gkCs C.a#v"6 "ot'rrdad"for " •es �~for,am in prga an�cJ feed oC5CYiytiOM venom IRAu '; .J y } . ?��aztorE _pr'�togper fiYw di�i mscoriS, f"Acts or � - CO tAy'AI�Y ol'sr fftQiJ Q aCeO"Wfi:S a&f fns ana ro-' 5CA�i trUMenrSuvey w", ref-act I tSian, wQC & Sko;rc, rereoru -%r F"W: two COLOt2l at, IaMb SURVfYIOE� COMPAnY,MC. 2" 12NWVM 8CREZC, bW?OVW,MASS. 02359.0)Ot X 617 826.1186 {X 617-826-4623 Dc partinc»t of ludustria/Accidents Office ofloivesV90ons :3 r7�I IOI 600 Washington Street Boston,A1ass. (12111 `- Workers' Compensation Insurance AMdavit ;w5tff^r.. :T.R �h�3�1e fist �t-• �ax 735� city Hfi v A� I I I IS, 1 'A phone# liar,I am a homeowner performing all work myself. p 11wa.m�aa sole proprietor and have no one working in any capacity L.Jaw...l�Li�4�=.r.��'.T.t:.q. -.- .: .. .. . • ____-• __-n..�.. �_..__.:.T _�. ._�.!✓►.',f.�'y`+!T^'.".r`.�a+•.e� ❑ 1 am an employer providing workers' compensation for my employees working on this job. enmpany name' add ress- may: nhnne N• insurance co 120licy N I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: compgm'name: address• cftv: phone N! insurnnee co nolicv N 1:..;'�•'• .-_ ..: ':R'- .•cm✓-•y"•'nw'°� •"i'+iY�fr"S :'4p^' '► i i-7L7++.•f7k�SS.F'a��,^-�4"+.•� -r:.a!roT.: -^-?�S ctimpanv name• address- --- citn•• phone N• insursince co policy a :Attach additional sheet if tiecess_�;._ - -_ _'-- - --- ..':•is '= ,rs r'..,':�Jl�;i': •;-•.; .,'. _ ._.�.Y�__ 'S .�ll.rfwfc'.tii�a: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of Se00.00 a day against me. 1 understand that a copy of this statemen fa ed to the Once of Investigations of the DIA for coverage verification. 1 do Iterebt c if rn �r a ins a» enalties of perjun•that the information provided above is true and correct. Sienature Date Print name �l���l __Phone 9 �.�..�. oll'icial use only do not pyrite in this area to be completed by city or town official � city or town: permit/license N r•tlluilding Department C3Licensing Board ❑check if immediate response is required OSelectmen's Office �lieatth Department contact person: phone N; nOther_ Irem,sed 3,95 PJA) : . The Town of Barnstable KAM�$ De artment of Health Safety and Environmental Services P Building Division 367 Main Street,Hyannis MA 02601 Ralph Cross= Office: 508 790-6n7 Building Commissioner Fax 508 775-3344 For office use only 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 mole than four dwelling units or to sanctums which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: Qp�k. �ec114rptnavti +l di i�ov, Est.Cost tom' a Address of Work: Owner.Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH T3NREC13'T'� FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contra a Registration No. OR 2-7 Date Date Owner's name . • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. •" DATE JOB. LOCATIO - Number Stre t address Section of town "HOMEOWNER" C-pri c� -.. . Name Home phone Work phone - - PRESENT MAILING ADDRESS x 7 3L .•?' ._ _ ity .town State Zip cod The current exemption for "homeowners" was extended to include owner-occur dwellings of six units or less and to allow such homeowners to engage an i dividual for hire who does not possess a license, provided that the owner acts as supervisor. -- DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one to six family dwellia ' attached or detached structures accessory to such use and/or farm structur A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner" shall submit to the Building Off on a form acceptable to the Building Official, that he/she shall be respon for all such. work performed under the building permit. (Section 109.1- 1) The undersigned "homeowner" assumes ..responsibility for compliance with the Building. Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Depar imum inspection procedures and requireme: and that he/she will c ith aid procedures and requirements. HOMEOWNER'S SIGNATURE (APPROVAL OF BUILDING OFFICIAL i Note: Three family dwellings 35 , 000 cubic feet, or larger, will be require to comply with State Building Code Section 127. 0, Construction Control. HOME- OWNER' S EXEMPTION The code state that: "Any Rome- Owner performing work for which a- wild: permit is required shall be exempt from the pr®visions of this section (Section 109. 1. 1 ® Licensing of Construction Supervisors) ; provided that Some Owner engages a persons) for hire to do such work, that such Rome shall act as supervisor. " Many Rome Owners who use this exemption are unaware that they are assumi the responsibilities of a supervisor (see Appendix Q, Rules and Regulati for .licensing Construction' Supervisors a Section 2. 15) . This lack of awa often results in serious problems, particularly when the Roue Owner hire unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed. Supervisor. The Rome "der• as supervisor is ultimately tesponsibleo To ensure that the Rome Owner is fully aware of leis/her responsibilities co=unities require, as part of the permit application, that the Home 'Ow- certify that he/she understands the responsibilities of a supervisor. 01 last page of this issue is a form currently used by several towns. You r. care to amend and adopt such a form/certification for use in your co=un: d d TOWN OF BARNSTABLE P � "B Permit No. .. .�..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ,eyo. of HYANNIS,MASS.02601 Bond ....X.......... CERTIFICATE OF USE AND OCCUPANCY Issued to Christopher Young Address Lot #27, 272 Whistleberry Drive Marstons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r February..$.:..., 19.....$.$....... . .................. Buil 'ng Inspector d(01- ° 3� Q 1 he Commonwealth of >tilassachlisetis PemiitNo. r Office Use Only p7$-7 f Department of P'ublie Soi�:rY ox�ya Cheked I j BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 120W j 3/90 (IeavebLnlc) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Work to be performed In accordance Wioh the Masaachusens Eleetriul Codc. 527 CMR 12:00 (?LT:*A.SF_ PRINT MR TWK OR �k; Ef.-T. Y)`FFO:�ZS�12� ) y�t'e. ato< <� r..T . > >. w. ._ y_ O 1v:<.1 V" u',' i•.).. 1J `w,w.�.d: ••gyp xhe undersigned appiics j*r a pettaiL to Ve►focm;,e -efcctriccl W_ck tc:::°-LY t' below. Location (Street & Number) 0.rer or Tenant Owner's Address ,.. Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters % 1 New Service Amps / Volts Overhead ❑ Undgrd❑ No. of lieters Number of Feeders and Ampacity Location and Harure of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners Batter mergency Lighting No. of Switch Outlets No. of Gas Burners Units FIRE ALARMS No. of Zones No. of Ranges Total No. of Detection and g No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heat Iotal Total Pumps Tons KW No. of Sounding Devices No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other Connection No. of Water Heaters KW No,nsf Ballasts LowWir Voltage SigNo. Hydro Massage Tubs No. of Motors Total HP -...ice OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES❑ NO I have submitted valid proof of same to this office. YES❑ NO ❑ If you have checked YES, please indicate the type of coverage by cnecking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration ate Estimated Value of Electrical Work S Vork to Start Inspection Date Requested: Rough Final&ire Signed under the penalties r ot perjury: FIRM NkIT Licensee 1 90 Signature LIC. NO. r Addres Bus_ Tel. No. S Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its 6d stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S _ Signature of Owner or Agent 1 f ) J Assessor's map and lot number .........6.vS.:..............�x� " � � - .7.g qqYNero�o Sewage Permit number ............................. L..... .�... Z 33ABd4TADLE, i House-number .... ..... ...7. ;.. ...:.................................... ' Yaea Apo,1639. \00 rF0 MAI p TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO }�/f L `� -...........:................................................................................................................ TYPEOF CONSTRUCTION ..................................................................... .... .......................................................... ......... ...................................19........ TO THE INSPECTOR OF BUILDINGS: The undersi nedd hereby applies for a permit according to the following information: Location ! ... .7'................... 0 r. f/. f� . .... ........................................................ ................................... ProposedUse ..� ...................?.....:::...:!........................................................................................................I......................... Zoning District ... !`. .................................. ...................Fire District ..... '{a: �.44�.�..�l:i:..... ................................ , Lra s Yt �•�,t / '� d . Nameof Owner .�`...........................................:;� ; .......Address ....................... ..................... .�..� a. . .... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ........l ...................................................................... � Number of Rooms ........4�......................................................Foundation .Ir......` !" ..J....................................... ............. Exterior<'C(i :. FW...........I............................................Roofing ................... ............'`:..1............................................ Floorsi / r ......................................Interior .......... :�!: :..... ................................................ r n I Heating ..................................................................................Plumbing ...................................:.....:........................................ . - .Approximate Cost Fireplace ........................................ ......... ...... .................................................. ............................ ........... Definitive Plan Approved by Planning Board 19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH `3 U� s 1� 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 .................................................................................. Construction Supervisor's License ...............r...........I......... YOUNG, CHRISTOPHER A=62-31 28488.... Permit for ...... ...S t o.roy..............No ............. . . ...... . . ........Single Family ...................... ..Dwelling.................... Location . L...o..t.. 27, ...W..h...is.t:.l..e..be.r..ry..Dri..ve Marstons Mills ......................................................................... Owner .........Christopher..Young.._.,...,., .. Type of Construction ......Frame......................... . ................................................................................ Plot ............................ Lot ................................ Permit*Granted ......Oct.....4.,..................:. 8519 Date of Inspection ....................................19 Date Completed ......................................19 C'o MPcEr� 111197 � v eiI[z p� MYSTIC o� LAKE N a URTL �g T � 0CIJ5 ' i�00 s� SET w b WATER 40 EDGE L� z LOT AS 30 LOCUS MAP 80 $ SET AS MAP- 62 RES. ZONE: "RF" SETBACKS. FR—30� ` :w � ' cD, w FLOOD ZONE.IQ COMMUNITY PANEL.• 250001 0015 C C$ 0� srx. PLAN REF 349156 OB ��V LOT 27 SET 43S LOT eft PLOT PLAN Off' LAND IN l R =4� 325.00'L = 8.98 '00"E MARS) TONS M/LLS MA. N78 35 , S88'00'00'E 175. 00' 127 50 PREPARED FOR DIRT WA y AS LOT M-45-17 RUSSELLPRICE N/F Cc lonial Cranberry Co. PAM JUL Y, 28 1999 nfa 32M L LOT 28 GRAPHIC SCALE YANKEE SURVEY CONSULTANTS :- UNIT 1, 40 INDUSTRY ROAD I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE 40 0 20 80 160 P O. BOX 265 IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL MARSTONS MILLS, MASS. 02648 STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN ; THE MMONWEALTH OF MASSACHUSETES TEL 428-0055 FAX 420-5553 ehA40,01— �kAA ?�Z 9 9 9 ( IN FEET ) PAUL A. MERITHEW, RLS DATE 1 inch = 40 ft. J# 52032 CB Race Lan, ��9 On a� �a Asti hrfiP6oc� Mystic Lake e6�rry 0 Locus a a _ fiddle Pon 00 LOCUS MAP ,� pp SCALE 1"=2000't 4, ASSESSORS MAP 62 PARCEL 31 LOT 27 LOCUS IS WITHIN FEMA FLOOD ZONE C 43,617E SF PAVED DRIVE DATUM.: APPROX. NGVD EXIST. GARAGE ZONING SUMMARY �i ZONING DISTRICT. RF DISTRICT EXIST. LEACH PIT MIN. LOT SIZE 43,560 S.F. O MIN. FRONT SETBACK 30' MIN. SIDE SETBACK 15' 3� PROP. PORCH MIN. REAR SETBACK 15' N � ' SITE IS LOCATED WITHIN RESOURCE PROTECTION OVERLAY DISTRICT, GP DISTRICT AND ESTUARINE PROTECTION — _ DISTRICT EXISTING DWELLING PROP. O ADD'N. 1 EXIST. SEPTIC TANK O ,��,` ,,../ REFERENCES EXIST. ,.�% 6 6a DEED BOOK 7587 PAGE 122 DECK EXIST. 6� PLAN BOOK 349 PAGE 53 BRICK 66 0 PA110 �5 :✓ �� SEPTIC SYSTEM SHOWN PER AS—BUILT op. w K �� ON FILE AT THE HEALTH DEPT. LI o 0 i co p 1 O c0�0 BENCH MARK — CORN. OF CO BULKHEAD (WOOD) EL. = 71.3 1 SITE PLAN oco OF 4 rnco , N 5 0 �i 12 EDGE DITCH AT CRANBERRY BOG 272 WHISTLEBERRY DRIVE 1 75.00 MARSTONS MILLS PREPARED FOR off 508-362-4541 LIS /� K' I fax 508-362-9880 /`1 G CLC G downcape.com © �jHOFMAss9c j"OFlygs9 s down Cope en eerin8 MC. moo DANIEL tiG o��DANIELA. cyG� �'hn , U A. OJALA APRIL 17, 2009 civil engineers OJALA CIVIL N No.40980 land surveyors � ss� �- c,46��2° Scale:l"= 20' - 939 Main Street ( Rte 6A) aN suRVE'ta sG NA e \ YARMOUTHPORT MA 02675 Li-1'7_ mac) 0 10 20 30 40 50 FEET 08-284 DATE DANIEL A. OJALA, P.E., P.L.S. w- C>o -r I 0 t-4 .L v r-o L A- r-.,r 0 i_rr_A.8 2 4 6 RA K E 00, III�X4, r1k�t�r-M�15O A�Rtl-s� ARCH CONTOUR-DETAIL OF 2-XC. 5TUD L 0 c WA L_ 14, s c A I-- fz,0;Lx4 mreAciNG AT 12-A S NOT,r-: 5)kf-H CN V rX !S H F_A-r t-t I N�t Iv I C) rk I C)C,I- t?,r.F-HALT CIM VV000 SF4I1`-4G.LF_Z L s IF-C q I , __ I I I - - A StA L F_ I 0 ----------- Ix M A+ f ffic:L A IJ- TO 11MA t-4, t IITop r1LArr, 14 C_ H I5'r L",C:) Iv A L_L_ r F-M'5 FAr t 2.x 6 2. 0 R A Frr F_M 1E I R Ise, 14 I,,D 1 1 + Ijt7 x 14(z r:7 S,H 00n I00-r, HE TO P 0 F r4T �,IA L L rL*Ll Tk; �,ALL �1 r T 7 IT 4- I1 17) I FAC_ Mt>Ia A. bPd:.:3 L E D 0(1,R 17 X E3 5 3/4 Iez.) 2 n r?k I-A Tit C,H I 0,-C',u- C4 'f 2/D.H, 5 A b H V2_ IF-LY C OM I-= SH EArH,I N a t e, IIIIr F V F 1�1_'AN K I L y 1(3 r. -r-TICAL T T Z-2 Y4"x 4' 1 '/4 ovt,-r-.:. V4F-r^c) I0 m#a L u's t4 I00 III�4 C_AT- IZ IIII00 M r,"N'rFi it(0 5 Iz F;_(z v IIIIL OC!Z Ij4 L I -r Fl! SLAM 4 I(�5) ;I C, 0 1=,rZ A I--3/4- X C 0 r'*- J_A LL PI-ATM 1/7 cor-A c proo r I r4 r,U-)C)0 r> IC) F,_ S-1-0 I- F'ok PR I!P CON C. F OL)"DA-T 1 0 X :5 E2.rr A C Vr_S I x 10 2X(o 5 I L L_ F_M -A I- M Z> 13/4 I:z z x N C., Ii5 H 'TH I NG I/Z ,F-I-YW OOD rr lk Ir U__v(3 C)m 7,p, t H C A L-I-H I I0'-C) IF) (o E" AA61 Y, f:---L A T"r-- (C v FLI T_U)ET I 7. 0 NO 5 C A L M Ir,-7 ICA I.- r--L );� I I�j C, Z X I E A D r-L ------- r,T_ I 1E F A L P, S A S 2-t,.14,SA_ 4 -I '/,f R I-T a V RA 1 14 A G It:- 0 N D I-1Z A:N`e 5 L A(3 13 L)I L 0 11 N G I 5 E 5 S M 1` T,1.,;,L R 195 M 0V I-J LOA" -LAClk W ITH MAN K (t L)N A Lli >7 0 rl K F-E-1 ASH rj AV E L A S N It C r- 5 S A Fz N r"A J:��J=0 017 r S t) r-4 1=� T M 00 LOCAT I 0 N 0 0 --A I t4� PI P-r-Z IT H r�Vi 0 M a C> D r 2 1 2. L 0 10-T':,Or 0 1 t5.-r 5 o,c (o\1 P_m-) -r 0 IE: I- ( L r- A,C) c,p p A,%kl fr.L L_ A PLYWOO 1:> 171-00M N LOW r-M LOC A'r I C)1` 0 M C>frV Z: :S U C L D B F A I_T F T,LL F fZAM IF- ? -74 1 C)N V) 7_r`?' E^T- .ALL SILL S F, f-0 S T_ C>0 L C M F-= A C'-F E M IIOb U L .Do C) sT I- P F A L V 7-W_6!;E H 0 r 0 i t IS tA A I-'-V,1,-J A In L L E-A r-0 S r-C> Ld C_A-r I N S A b I A L T H 0 V G.H r coH Pos IT 514 , N Q L_;:7 L 2 x 3 Do a e,r%, F_z T H I- M 0 F N IF R HAY BF-I'SUM w o c) D s v4 I N'r,L IS S rLA5H UNPE p- ,- S T m r> 1 F2 p F_5 1 M pr C_,�): o 5 t N u t-1 15t rz,_AN K MAOM L At D S FrIN,' FL �%, i Tci W I-At 4 iz T I-+ CO N C fZ r AL50 ALT f,4 OV G H W 00 D SHI N G L "Ay.> nAsw I N r II0 1-4 JIM L.A I 0 C)I M a r--r L,.e 0 N Pt C_s H L=A-r H j N r- A T H -5 Pt rc-H �s C't-4 E_LL r.rZ a pe F_rz_ -ci �_.u,t�k sy 7'i T Vr M I -A At-", F i R_Lu N> I C> A-r 'ITCH-ek A.T-r rss r4 -5 T7 lie IImF- L TH E r L A N I- r c)0 0 S ��`O M F=-RF-HOVABL.E WOOD CS) P P_I HE. I r-4 L 1`�Q, POO F E F-e-C N r I A L 0 LA L It 7 /T R I�,NG ILM L Ij, \d A r,--'r-A Q M_T7, __�j w I N D6W A' N L I . ___ I C'L-Iz A,c r C.L 0-_E_�> r AMr Fr I IDL BAr_f,4 WALLS I_r'-4 'A M AN t> a A r-A I- I N 1 4 S 90 IV7 s H P-,^T H P� I T P4 T-L,-/W 6(3 C)o N C,r?_M Z L 0 < A rq L >T I F r N IIS 1 N I CAr M P 0 V L WOCO TRIANGL-E . I I �,,� -LAC X + 14 0 rt 1 7-0 N-r^L_ I it re I N'r,, ST M I I-5-7 A I- E D I N T -LU\1 E_ A� -3/4-",,n rZ H I'N C 1,3 PA I- I1v E,)t-r I C,A L PL�A K,5 Ir-r-U�a M_5 A);w-rF- M 5 M A 45 0 1-4 C5 M: ,5 O�r f-L F--g Ca'S 5 I 4V 1z I �'S F-At OL L M A M F, PO L/A MAM 1`4 V�A TT _N r D W I v T T- 5A TT M N S-T'O C�_K.> D ON lt*r Y 0 U M Lt�U I t- i N 471.0-7 -1 I T Pr��m t IF' o i,ff% D t�T IFL 11 U.3 zl TL, S c A L_ E 0 F /4.Y 5 CA M A L_r-ID)E,�rPL I 1, IE,x C I-pIr A S N 0 T M j=)SCAL 0 r I O X -7 IF_ R 0 s V,D A T r-a a N