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0086 WOOD DUCK ROAD
Wood u(-kl �bQ � �� s� II � �y�.� Town of Barnstable_ Building eAwsrA Post This Card So That it is Visible From the Street-Approved Plans Must'be Retained on Job and this Card Must be Kept M' Posted Until Final Inspection Has Been Made. �^ Permit ��t• .Where a Certificate of Occupancy is Required,such Building shalt Not be Occupied until a Final'Inspection has been made. Permit No. B-20-371 Applicant Name: DAVID W RICHARDS Approvals Date Issued: 02/20/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 08/20/2020 Foundation 3o?7�6 Location: 86 WOOD DUCK ROAD, MARSTONS MILLS Map/Lot: 030-117 Zoning District: RF Sheathing: Owner on Record: VARLEY,PATRICK W& KRISTEN L Contractor Name: DAVID W RICHARDS Framing: 1 Address: 86 WOOD DUCK RD Contractor License: CS-101506 2 MARSTONS MILLS, MA 02648 Est.Project Cost: $ 110,000.00 Chimney: Description: Addition. Add new sf to garage and over garage extend both Permit Fee: $611.00 Insulation: bedrooms. Total addition 336 sq ft to first floor Fee Paid:` $611.00 Project Review Req: Date: F 2/20/2020 Final: Plumbing/Gas Rough Plumbing: ui in iva This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ] j Final Gas: i r The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and Fire Officials are'provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:' Service: 1.Foundation or Footing 2.Sheathing Inspection ` 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department ie All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Application Number......... ....t7a V.-. .�..................... s * 1ARNSPABL4 • MASS. ,� '� ��� Permit Fee......... ....................Other Fee:....................... 039. ` '°ram��� ..• ,> ,� ���P JJ �<b Q� Total Fee Paid............................................................... ...... TOWN OF BARN�LE Permit Approval by......����.... .. �..,.....On.,a � BUILDING PETU'NIIT 03 /� lam] Map...... Q....................Parcel..........1.�....1.......................... APPLICATION Section 1 — Owner's Information and Project Location - Project Address �N6;5 t-x- S• -co Village i" Owners Name ��. iL\� �G•/�� SCANNED FEB 212010 Owners Legal Address b �N vs; ll�a City �him-5 State M�� Zip d,6Y g Owners Cell At 7 7 L J—3 C5 3—b q Z), E-mail \l .r k IS( Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ti ❑ Commercial Structure under 35,000 cubic feet i Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ . Solar Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description AAA rN, of 01(S f vL a ra a IY\ did0( ,ivs 5° C.z i�o S r lvor_ I !!!!I T.ACt nnrlptP.A• 11/1 Snnl R Application Number.................................................... Section 5—Detail Cost of Proposed Construction C p op _oa Square Footage of Project, Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms (proposed) S G.�E �S 110 MPH Wind Zone Compliance Method N MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics t �twiring ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing ❑ Gas Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate'bedroom I Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: ;�?�,n, �/a r m v�,�� I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yazd Required Proposed Rear Yard Required Proposed Side Yard Required Proposed ' Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 ' }i EXISTING WINDOW To BE f EXISTING TOILET TO BE DEMOLISHED AND INFILLED DEMOLISHm DEMOLISH PORTION OF WALL FOR EXISTING - _ EXISTG SINK AND VANITY VAN-SEE FLOOR PLAN TORE LOCATION FOR - - DEMOLISHED I I EXISTNG YANDOW TO BE EIE TO B DEMOLISHED TUaISHOWER DEMOLISHED AND INFILLED .ENCLOSURE TO BE DEMOLISHED ® ,}�. EXISTING DOOR&FRAME •' y� TO BE DEMOLISHED SH EXISTING AND III III Er : PORTIONOF WALL FOR VANITY TO NEW WNOSEE FLOOR PLAN BATHROOM DEMOLISHED FOR LOCATION SMOKE DK E DETECTORS REVIEWED KITCHENAOIKNO ROOM 6ai' TO BGo.T/L M D BEDROOM / C_ �j r �� EXSTNosHowER I OB NWEFUEDE mW"` i GARI'STABLE LDING PT. DATE ` ED II�II a EASTNG DODR6FRAME 'I _ZZ TO BE DEMOLISHED EXISTINGDOORANDFRAME TO BE I� E%ISRNO wOmow TO BE TIRE DE RTMENT DATE DEMOLISHED DEMOLISHED AND NRLIID +.GCTN SIGNATURES APE REQUIRED FOR PERMITTING LL LIVNO ROOM EXISfINO WALL TO BE I I DEMOLISHED BEDROOM Barnstable Bldg. Dept. TO I EXISTBE°EING MO DOOR 6 FRAME USNED / BEDROOM 6/� DUSTING DOOR!FRAME G TO BE DEMOLISHED I r Approved by: , I I I I Permit #:�� EXISTING DOOR S FRAME TO BE DEMOLMKm SCALE:1/4' 1'-0• FIRST FLOOR DEMO PLAN — — — — — — — — — — — — — — — — — — — — — LAUNDRY I III IROOY I I I I I II I III SCANNED ' I FAMILY II I I R°°" GARAGE FEB 2 12020 I II I _ I ' III C ADOWALTERNATE 01A I AD°MLTERNATE NIA Addition to the Varley III Residence II( 86 Wood Duck Road III Marstons Mills,MA 02648 IMECHANICAL III Drawn By. I RDDLL A°aALTERNATESIe—�I ADD/ALTERNATE Daniel Johnson 124 Pike Ave. . I III NOTE#1A:GC TO PRICE DEMOLITION Attleboro MA,02703 OF EXISTING FOUNDATION&III INSTALLATION OF 320-3432 NEW LALLY COLUMN TO PROVIDE ONE dnl.jjhnsoon@icloud.com III DOUBLE CAR GARAGE. L— — — — — — — — — — — — — — — , NOTE#1B:GC TO PRICE DEMOLITION OF EXISTING FOUNDATION&INSTALLATION OF NEW BEAM TO SPAN BOTH TO PROVIDE ONE DOUBLE CAR GGARAGE.STALLS SueTR C1�ON LEGEND FORGO tAs SCALE:1,4•=V-0• BASEMENT DEMO PLAN ISSUE OATS: INDICATES ITEMS TO BE PRELIMINARY NNE 72.]D19 Demolition Plans DEMOLISHED CONSTRUCTION SEPT.17.2019 Scale:As Shown REaSSUE 9 INDICATES EXISTING A1 .0 t92W 1 )14 r GENERAL FOUNDATION NOTES: " -ALL CONCRETE FOOTINGS TO BE MIN. f NEW I•DOW f "a$oow f �, 3.000 PSI IN 28 DAYS B 12. -ALL FOOTINGS SHALL REST ON UNDISTURBED SOIL EXCEPT WHERE NOTED ® 25WS � -10'CONC.FOUNDATION WALL POURED BY G.C. � ae trt 4•s94• t4•-1 trr -ENGINEER TO VERIFY FOOTING DEPTH, SIZING S REINFORCEMENT MASTER r, 3 -WALLS SHALL BE MIN.4'-0'BELOW GRADE ro SATHROO 1/2'DIA.ANCHOR BOLTS MAX 6'-0'NO MORE �D"�DW1NO Roots THAN 12"FROM CORNERS tr � . DATHROOM S-M MASTER . zexeeCLOSET � BEDROOM GENERAL FLOOR PLAN NOTES: O CLOSET _ -T-7't ROUGH CEILING HEIGHT,SECOND f" TS ! NEW Wnmow FLOOR,CEILING HEIGHT TO MATCH EXISTING. i -(2)200's OVER ALL EXT.R.O. ea 1u• -WINDOW SILL HEIGHTS TO MATCH EXISTING -CLOSET SHELVES&POLES BY G.C. zm -ALL INTERIOR FINISHES TO BE SELECTED BY OWNER AND INSTALLED/APPLIED BY GC. -INTERIOR PAINT TO BE SHERWIN WILLIAMS OR N EQUAL,(2)PRIMER COATS AND(2)FINISH p.OSET H °ym4ro 2TAB9 COATS ON ALL WALUCEILING SURFACES -2x6 EXTERIOR CONSTRUCTION EXCEPT W t WHERE OTHERWISE NOTED ROOM as 1/! S j ea,u• -2X4 WITH}'GYP.BD.AT ALL NEW INTERIOR WALLS UNLESS OTHERWISE NOTED. e DR ' '? -NATURAL OCCUPIED ROOMS FOR ALL HABITABLE BEDROOM -ALL HABITABLE&OCCUPIED ROOMS SHALL CLOSET NEW WAMMOW HAVE AN EXT.GLAZING OF NOT LESS THAN 8% d N TOTAL FLOOR AREA -HALF OF REQ'D GLAZING SHALL BE OPERABLE -NEW EXTERIOR GLAZING SHALL NOT EXCEED a Mrtea 1rr 40%OF COMBINED GROSS WALL/GROSS CLG. NEW WINDOW AREA -ALL ATTIC ACCESS PANELS SHALL BE MIN. e�tu• 22'x 30'W/A CLEAR HEIGHT OF 30- -EACH BATH&TOILET ROOM SHALL BE 1z.o• EQUIPPED W/MECHANICAL EXHAUST FAN S CORRESPONDING DUCTWORK @ 80 CFM MIN. -NEW TUB/SHOWER ENCLOSURE,TOILET AND SCALE:1/4'=V-0' FIRST FLOOR PLAN SINKNANITY TO BE SELECTED BY OWNER AND INSTALLED BY GC. -ALL NEW PLUMBING FIXTURES TO BE SELECTED BY OWNER AND INSTALLED BY GC. -ALL NEW INTERIOR AND EXTERIOR DOORS TO BE SELECTED BY OWNER AND INSTALLED BY �� .. GC SOIL COMPACTION 1 Y;C E F. -NEW WINDOWS;MANUFACTURE AND SAGE CI)REO'D.(PINS OPTIONAL) Ail Nc:a4r4 TO BE SELECTED BY OWNER-SPEC TO BE ,w,ANULtURµ EQUAL TO (HARVEY-VINYL DOUBLE HUNG, ,za `\�;,c.,4�'% DUAL PANE ARGON FILLED LOW E wALLIN NEW FOUNDATION .a 1 NNED TO '. -MINIMUM REQUIRED INSULATION: • Ewsra F PIa DUNDATx1N — — — — — — — f'�'••�'�`/";;6w�rS�,�,s (PER 780 CMR TABLE 6107.1- - — — — — -- — — — — — — — — — — — — — — — — — — - -- — — ...:.:;.:,,- .. .: : PIW20 S7RUC7.ONLY PRESCRIPTIVE APPROACH) `CON,RACTORTO I S EXPOSED aaDEr�moFFOO FLOORS: R38 — — — r — — —I I I ���PLT H OF�lgss WALLS R19(Dc6 G. (MAX)r EXTERIOR WALLS) 'WICHEIE q`z ' Sr UCT(j n SHEET SPECIFIC NOTE: ND �RAL y ALL EXTERIOR DIMENSIONS ARE TO F.O.S; 4 ALL INTERIOR DIMENSIONS ARE TO C/L OF NEW Ta �Q WALL AND FACE OF EXISTING WALLS E I I �'l I I I I I o L GARAGE GARAGE UNLESS OTHERWISE SPECIFIED. EXISTING :,'• I. T 2 I I I I I A21 x Addition to the Varle I I I I I i Residence y It I I I I I I I /G Q� • 86 Wood Duck Road Marstons Mills,MA 02648 I I Drawn By. I ADD/ALTERNATE Daniel Johnson 124 Pike Ave. UP NOTE q2:GC TO PRICE REPLACEMENT OF Attleboro MA,02703 EXISTING WINDOWS WITH NEW TO MATCH 508-320-3432 I I I I a EXISTING IN SIZE.SPEC TO MATCH NEW dnl.johrmn@icIoud.com WINDOWS 41 L — — — — — — — — — — — — — = OOR J u I GARAGE De \O otSS.�RUCIN LEGEND FOR C Az.1 Issue DATE: SCALE:1/4•=r-o- FOUNDATION PLAN �� INDICATES NEW Floor Plans PRELIMINARY NNE 22.2019 CONSTRUCTION SEPT.11.2019 Scale:As Shown RE4SSUE Alml NOTE:FOUNDATION DIMENSIONS INDIGTESDUSTINOITEMS �. ARE TO FACE OF CONCRETE,TYP. 2X10b 0Ir O.C.FULLY WSULATE BETWEEN FLOOR JOIST W R29 A VAPOR BARRIER ' I 72%45 SEE SK-3 f i I —BRIDGING®MID SPAN AS REQUIRED CUDILO I I I ..3477A 1 T FtuCfuHn ENGINEER er ENOINEE ''^r+•Y, cq*I rt-• -1.75X9.25"LVL 12'FLUSH i a rr. dt: II ,zmoouaLEvrsu BELOW /3/20 STRUCT.ONLY ir FLUSH JOIST W/ { IMPSON LU210 N OF 414`SSy MICHELE AS REQUIRED { BRDG PAN O CUDILO -4 � STRUCTURAL y No 34774 °90 9FQ/STE PLO �Q AL ENG ,zY It -7.75"X11.875" 2XFL J O.c.FULLY INSULATE BETWEEN e qt —q FtooRmLSTWR2aavAPONBANRIEA PER APA PORTAL ` L/A-/J DET.SK•2,SEE �"[ SCALE:1/4•=1•-0- FIRST FLOOR FRAMING PLAN ODECK'LIST. �� �'� ., 1 1 E20STINO CEILING FRAMING TO REMAIN ,z GENERAL FLOOR FRAMING NOTES: MIN.C Ir O.C.FULLY INSULATE BETWEEN CEILING JOIST W ROB a VAPOR BARRIER -2X10 FLOOR JOIST FRAMING&LVL SIZES TO BE VERIFIED BY SUPPLIER&G.C. SOLID BLOCKING OVER ALL BEARING ® P.O.FASCIA ABOVE PARTITIONS S GIRTS -DOUBLES&HANGERS AS SHOWN 8 REQUIRE NG WALL BELOW -BRIDGING AT ALL MID SPANS,TYP. SEE FLOOR a FOUND.PLANS FOR ALL DIMS. SECOND FLOOR LIVE LOAD=401b/ft DEAD LOAD=10 Ib/ft O —REFER TO CONTRACTOR PROVIDED JOIST SPEC.FOR INSTALLATION REQ'S NEW LVL.FLUSH BRIDGING a MD SPA! AND DETAILS. MOUNTED INTO CEILING O AS REOUW® . EARNING,BY ENGINEER —BEARING WALL BELOW Addition to the Varley NEW 4X4 POSTS Residence 86 Wood Duck Road Marstons Mills,MA 02648 ' Drawn By. Daniel Johnson 124 Pike Ave. Attleboro MA,02703 508-3203432 BRIDGING®MID SPAN dni.johnson@idOud.com AS REQUIRED BEARINO WALL BELOW I F.D.FASCwAeOVE O SURuc1�ON L EXISTING CEILING FRAMING TO REMAIN I , O�C NS 7%8t Y tlt®1B•O.Q FULLY BVSUTATE BETWEEN CEIuNo mLsT W R]B a VAPOR BARRIER ISSUE. DAM Floor Plans PRELIMINARYSCALE:1/4•=V-0• CEILING FRAMING PLAN coNsTRucn DUNE22.20/B coruTRucT,oN sEVT.n,m,e Scale:As Shown . RE-ISSUE A1 .2 f f 4 Td FACE OF FACIA 2W.MIN.®1W O.G UNE OFF LINE INDICATES LWE O EXTERIOR WALL eELOW 2X RIDGE BEAM NOTE:FRONT AND REAR ROOF PLANE TO , MATCH EXISTING PITCH;G.C.TO V.I.F.& CONFIRM W/OWNER PRIOR TO • CONSTRUCTION.SEE ELEVATIONS ON A2A. 4-- tI`--1'_1Ijjtfl SCALE:1/4•=r-0- ROOF FRAMING PLAN ADDIALTERNATE NOTE 113 NEW GUTTERAND DOWNSPOUT GENERAL ROOF FRAMING NOTES: -ROOF PITCH TO MATCH EXISTING -ROOFING SHINGLES TO BE 3 TAB 30 YR.MIN;STYLE&COLOR TO BE SELECTED —� — — — — — — — — — — — — — — — — — — — — — BY OWNER -ROOF VENTS AS SHOWN Lu -RIDGE VENTS AS SHOWN —o O -WATER 8 ICE BARRIER TO COVER ALL HIPS, w VALLEYS,AND 1 COURSE UP FROM EAVE — -ZONE 3 LIVE LOAD=30LB/FT z w DEAD LOAD=10 LB/FT y -CEILING LIVE LOAD:20 LB/FT ' N -CEILING DEAD LOAD:10 LB/FT SEE FLOOR PLANS FOR DIMS. �- 0U3 FUDGE VENT vErrr®Roof PEAK Tvf+. Addition to the Varley Residence 86 Wood Duck Road Marstons Mills,MA 02648 Q. - a DASNm LINE.A. Q O EXTENT OF WATER&ICE Drawn By. y N aARFUEFk TW. � Daniel Johnson z 124 Pike Ave. ai Attleboro MA,02703 508-3203432 dnl.johnson@icioud.com NDGWNSPWTA `NST� 0N T za FOR CO ' ADD/ALTERNATE ROOF PLAN ISSUE DATE Framing/Roof Plan SCALE:1/4`=1'-0' � NOTE#3:GC TO PRICE REPLACEMENT NNE2zm,e EXISTING ROOF SHINGLES WITH NEW PREVMl7aAm, ROOFING SHINGLES TO BE 3 TAB 30 YR. CONSTRUCTION SEPT.17.2019 Scale:As Shown r MIN;STYLE&COLOR TO BE SELECTED REaSSUE BY OWNER Al ■3 1 NEW ROOF SHINGLES STYLE •MANUFACTURER TO BE SELECTED BY OWNER - ADO/ALTERNATE NOTE 03 �• EL�r 6f TOP PLATS Y NEW WINDOW.MILE& SEE ADD/ALTFNATE NOTE•2 ❑ \ ■ MANUFACTURE TO BE SELECTED \ BY OWNER NEW SIDING TO MATCH EDDSTING. SEE ADDHLLTENATE NOTE w CONFIRM LIMITS OF NEW SIDING W / OWNER SEE ADD/ALTERMATE NOTES / EL D•P � FIRST FLOOR Q ADD/ALTERNATE NOTE w \ SEE ADD/ALTENATE NOTE, /_ NEW DOOR TO MATCH / E)GSTW G;OWNER TO PICK SME•COLOR EL.6-V ADD/ALTERNATE BASEMENT NOTE#2:GC TO PRICE REPLACEMENT OF SCALE:,/4•_,•-o• FRONT ELEVATION EXISTING WINDOWS WITH NEW TO MATCH EXISTING IN SIZE.SPEC TO MATCH NEW ^� WINDOWS NOTE#3:GC TO PRICE REPLACEMENT EXISTING ROOF SHINGLES WITH NEW ROOFING SHINGLES TO BE 3 TAB 30 YR. MIN;STYLE&COLOR TO BE SELECTED A3.1 BY OWNER ADO/ALTERNATE NOTE$3-. NOTE#4:GC TO PRICE NEW VINYL CLAPBOARD SIDING AT FRONT ELEVATION AND TREATED CEDAR SHINGLES FOR BOTH LEFT AND RIGHT SIDES AND REAR OF HOUSE GENERAL EXTERIOR NOTES: roPPUTE Q -ALL NEW VINYL SHAKE SIDING;CONFIRM NEW WINDOW,STYLE A O STYLE S COLOR w/OWNER MANUFACTURE TO BE SELECTED -ROOFING SHINGLES TO BE ARCHITECTURAL 3 BYOWNER TAB 30 YR.MIN;OWNER TO SELECT ADD/ALTLANATE NorE w sEE � ���w MANUFACTURER&COLOR -FLASH TO ALL ROOF TO SIDING CONNECTIONS NEW SIDING TO MATCH - INCLUDING NEW EXTERIOR WALLS TO 1 E.STWG.CONFIRM LIMITS OF EXISTING ROOF BELOW NEW SIDING W OWNER SEE -CONTINUOUS RIDGE VENTS AS SHOWN Aoo/uTEaNAhNo s '- FIrsrFLDGR Ax COMPOSITE FASCIAS TO MATCH EXISTING _ ADJACENT ADDIALTERNATE NOTE P2 -CONT.PERFORATED.SOFFIT VENTS,TYP. -ALUM GUTTERS @ 4x5 W/CORNER scALE:va•=r o• REAR ELEVATION Z DOWNSPOUTS,TYP. -WATER&ICE BARRIER TO ALL HIPS, VALLEYS&EAVES;2 COURSES APPLIED ABOVE EAVE LINE&ALL LOW SLOPING ROOFS -CONFIRM SIZE&STYLE OF NEW WINDOWS W/ OWNER(MATCH AS SHOWN ON NEW WORK ELEVATIONS). ELra: 11, Addition to the Varley TOP RATEilli Residence NEW WINDOW,STYLE A NEW SIDING TO MATCH E%ISTING. 86 Wood DUCK Road MANUFACTURE TO BE SELECTED ❑❑ CONFIRM LIMITS OF NEW SIDING d. BY OWNER OWNER SEE ADD/ALTERNATE NOTES Marstons Mills,MA 02648 ULI itADD/ALTERNATE NOTE IM EL raS TOPRATE Drawn By. SEE ADD/ALTENATE NOTE w Daniel Johnson h ELOd SEEADD/ALTI!}TE NOTE W 124 Pike Ave. FBiST BOOR ' Attleboro MA,027 ADOIKTERWITE NOTE°° 500-3203432 SEE ADDIALTENATE NOTE w dnl.johnson@idoud.com 42 II` I +FIRSTI. I ASS�RN UC�\p II �ORCONS i ------------------ I' R SCALE:va•=,-0• LEFT ELEVATION 4 I 1 , I-— —————- yy A2. ISSUE DATE' Elevations PRELIMINARY AINE 22,2DIB SCALE:1/4•=V-0• RIGHT ELEVATION /�.3 y �, CONSTRUCTION SEPT.17.2019 Scale:As Shown REJSSVE A2 . 1 � 2 . 1 ,f—�` s I-EXT.GRADE PLYJOSa WI I FELT AS READ WATER&10E BARRIER WATERPROOF MEMBRANE 2C UP FROM EXTENT OF EAVE: SEE ELEVATIONS FOR ADOTL INFO. ROOF TRUSS: SEE FRAMNO RAN CONTINUOUS ALUM.DRIP EDGE A.FASCIA W/ALUM, GUTTER CONTNUOUS RIDGE VENT®PEAK 2)W MN.ROOF RAFTERS X6@ 16"TIES A +A SOFFIT wi r CONT.MATCH vEmO �ExT GRADE PLY W/14 FELT ASPHALT ROOFING SHINGLES r r r r r TO BE SELECTED BY OWNER I ` ` SECURE RAFTERS TO 2XB TOP PLATE W 2 SIMPSON STRONG TIE'OR EQUAL H2.SA 1X FACIA TO MATCH UP WITH EXLSTNO FACA:ROOF PITCH TO MATCH EXISTING EL.T-0'! TOP PLATE CONTINUOUS SOFFIT VENT 2 TYP. EAVE DETAIL ,) (3)Zm MN HEADER OVER WINDOW M MN.CEILING JOISTS d BATT INSULATION A3.1 SCALE: 1 1/2" = 1'-0" .S.MIL.VAPOR BARRIER STRAPPING WITH I-GYP.BD.C NEW CEILING NEW WINDOW.STYLE AND MANUFACTURE TO BE SELECTED BY OWNER • • 2%BLOCKING AT MID SPAN TYP. R-19 BATT INSULATION d B MIL VAPOR NEW SIDING,SEE PLANS FOR MORE NFORMAnON BANTER }'GYP.W.TAPPED AND PRFyARED FOR PAPT FINISH.TYP.ALL NEW WALL LOCATIONS EL.0'-0" FIRST FLOOR (2) 2XSPTSILLPLATE FROMCflp -o•C•NO MORE THAN 12'CORNERS,TYP. /C W/3X3X1/4" _k4 TOP 2" GRADE VARIES PLATE WASHER i LEAR TYP. i (D)L16RLVL BEAM AT GARAGE DOOR OPENING Ui R]DO1TT NSuuSPA JOI ST ST®I�er L/NCOIa]Rpm NSPACE YI NELE STRAPPING ANDCIE r FIRE RATED GYP.BD. gf1 � 1 AT GARAGE W0 CU!RLO NEW INSULATED GARAGE DOOR TO MATCH EXISTING n)2X10BEAMBE AT LOADFLODRAPoNO POINT.BEAM rah No.]gJa ...... 51 RUCTUA.�L TO FLUSH WRIT FLOOR J01313 "ONIOMIL CONCRETE SLAB ITCONC.FOUNDATION MDAMPPROOFING APOR BARRIER BELOW GRADE INSULATE AS REIM g HAUNCH SLAB AT ALL DOOR OPENINGS ENGINEER TO VERIFY FOOTING DEPTH. lA ^'/,y�fwj�aC SUING A RENFORCEMEfT 320 STR UCT.ONLY EXISTING ASPHALT DRIVEWAY ENGINEER TO VERIFY FOOTING DEPTH. SmNG 6 REINFORCEMENT Addition to the Varley 4"x,o"THI<. Residence KEYED FTG. 86 Wood Duck Road Marstons Mills,MA 02648 HOFMAS Drawn By- SCALE:3/6'=1'-0' BUILDING SECTION 1 ��P`� sgcyG DanelJ Johnson A3.1 02 MICHELE 124 Pike Ave CUDILO Attleboro MA.02703 o STRUCTURAL rn 508 3203432 No 34774 dnl.johnson@icioud.com O cQ o�9FGISTEP �SSIONAL� r.- \NS R OF,CO tG2� r� F W�IZo ISSUE DATE: Sections/Details J V PRELIMINARY1MINY DUNE 22,2NB CONSTRUCTION SEPT.17.2010 Scale:As Shown H. RSSUE A3. 1 ' Qom• A ti �O i I 5T nnm JOIST CONTINUOUS NAD_ERS ATTACHED W/CM/2' DIA 1/4' THRU-BOLTS ! 24. Em I a STAGGERED C , @ i O� LJ�/ t a X �F2 NAILER : a' KIN. W®D EDGE DISTANCE CAP PL __X--X I I I SINPSO}1 JOIST HANGERS A/lQ55 -_--t CTYP) I I -.------ 1 Of��1/2' R BOLT i I I I 1 I ,A � 5�1 STEEL COLUMN , GAGE I I CAP PLATE DETAIL- TO FOOTING i OR CONTINUOUS WALL FOOTING BASE PL. LaX_D__ t I NOTE 1. ALL WORKMANSHIP TO CONFORM WITH AMERICAN INSTITUTE OF STEEL CONSTRUCTION AND MASSACHUSETTS STATE BUILDING CODE LATEST EDITION REQUIREMENTS. 2. STRUCTURAL STEEL: ASTM 572 (FY=50 KSI); Optional: SHOP PAINT WITH RUST INHIBITIVE PAINT. 3. EXPANSION BOLTS: ASTM A510 3/4"-D.IA.x6" EMBEDMENT IN CONCRETE; THRU—BOLTS:ASTM A307 1/2" DIA. 4. PUNCHED HOLES IN PLATES = 9/16" DIAMETER. 5. ALL WELDS E70XX ELETRODES. SHOP WELD CAP AND BASE PLATES TO COLUMNS. 6. COORDINATE ALL DIMENSIONS W/ ARCHITECTURAL DRAWINGS, AND FIELQ VERIFY WHER RE �• OF".f!4 ` _ o`'--.MICHELE aN STEEL BEAM CONNECTIONS TO WOOD FRAMING o STRUCTURAL N MICHELE CUDILO, � No 34774 Consulting Structural En in �FcisT E (I ' 123 Cottonwood lane, Centerville. Massachusetts 02 FSg�IZ:i " G VA 1:36 Drawn By: MC Date: /Ozn D r awing MP rboW 1q, / f n Scale: AS NOTED Rev. 0 2� C V I�� �/ file Name: ' ?j Project No.: . Registration valid for individual use only- before the expiration date. If found return to:. pffice of Cons r Affairs and Business Regulation 1000 washi Otto 1/8 treat -Suite 710 Boston, i alid with ut signature • I r ®� Commonwealth of Massachusetts.. + Division of Professional Licensure Board of Building Regulations and Standards _ Const`;t�N�r iSp�rvisor ' . j. CS-101506 I Fires: 11/29/2020. , ff , DAVID W RICIIAR 65 TREASUR AN MASHPEE MA 1 too Commissioner r' gm ('l//)?/%ZO/I.CIICP.(.//d d�✓!/!'JCLJ�I/.C/LL/•OP.�.�1' . office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TY0Ea Individual Registration, Exairation f62Q81 07/28/2021 DAVID WILLIAMG}IARDS3111 RI DAVID RICHARDS � — �ar 65 TREASURE • i MASHPEE,MA 02649' Undersecretary The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Businesss//Organization/Individual): i ;J Address: [� S �f �•�� �!w� city/state./zip: o Phone#: Are ou an employer?Check t e appropriate boa: Type of project(required): 1.E&I am a employer with- 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for mein any capacity. employees and have workers' 9.4Building addition [No workers'comp.komi*+ce comp•insuranceJ required.] 5. ❑ We are a corporation and its 10.❑Electrical repass 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 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 hue outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the subcontractors 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 thepolicy and job site information. 1 Insurance Company Name: �U �1�Vv5 Policy#or Self-ins.Lic.#: \m AI- Sob a i y �0 3aa°C Expiration Date: Job Site Address: 0 D ll4-o o J\ t {�o City/State/Zip: U.f S4.^S t`�S A CQ 6`f X Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration ate). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un a pains penalties of perjury that the information provided above is true and correct Signature: - Date: Phone#: 1 7 l 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 M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,.§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public.work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants —Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if -necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www maw.gov/dia r ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Allison Petkiewich-Sousa NAME: RSC Insurance Brokerage,Inc. AHONN Ext: (781)986-4400 A/C No): (781)963-4420 15 Pacella Park Drive E-MAIL etkiewich-sousa ADDRESS: apetkiewich-sousa@dsk-strategies.com p @ g Suite 240 INSURER(S)AFFORDING COVERAGE NAIC p Randolph MA 02368 INSURERA: AIM Mutual Insurance Company INSURED INSURER B D3 Builders Inc,DBA:D3 Builders Inc INSURER C: 65 Treasure Lane INSURER D INSURER E: Mashpee MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: CL19101034584 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR UDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM1DD MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL SADVINJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION X/ PER OTH- AND EMPLOYERS'LIABILITY Y/N /� STATUTE ER A ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ NIA WCC50050193032019 OS/22/2019 OS/22/2020 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Robert S.Bacon,dba Wellfleet Custom Builders ACCORDANCE WITH THE POLICY PROVISIONS. 5 Abigail St. PO Box 316 AUTHORIZED REPRESENTATIVE Wellfleet MA 02667 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A;W- f GjilrC f; VY-voa d-i OF ciaedist for Corn.P-11liar-ce k Z Check Compliance 1.1 SCOPE WindSpeed(3-sec. gust).................................................................. .................................................110 mph WindExposure Category................................................................... .............................................................B 1.2 APPLICABILITY K#v L.-,-- vwc-nyple Number of Stories ...............................................................(Fig 2).........................T........L stories :5 2 stories RoofPitch ...................:......................................................(Fig 2) ......................................... 12:12 MeanRoof Height ...........................04................................(Fig•2)............................................ ft :5 33' Building Width,W.�....................* 2.. .--r.............................(Fig 3)................................................/2�-ft :5 80' Building Length,L ..................... ... ...............(Fig 3).................................................z6ft :5 80' Building Aspect Ratio(L/M ......................(Fig 4)...............................................7,::5 1:5 31 g .......... -A)................................................4- Nominal Height of Tallest Openin2 .........................(Fig A!5 6'8" 1.3 FRAMING CONNECTIONS General compliancewith framing connections....................(Table 2)............................ ................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry .................................................................... ................................................................ 2.2 ANCHORAGE TO FOUNDATION'.3 5/8"Anchor Bolts imbedded or 5/8"Propfietary Mechanical Anchors as an alt -ti e,in concrete only Bolt Spacing-general ................G..!!' ..................(Table 4).......... .. ..........f.... ""' -z"t in. Britt Spacing from end/joint of plate ............................(Fig 5)................................... in,:5 6" 12" Bolt Embedment-concrete.........................................(Fig 5)................................................._7 in,2t 7" Bolt Embedment-masonry.........................................(Fig 5)............................................ - in.2: 15" PlateWasher...............................................................(Fig 5)...............................................a Yx 3"x 1W 3.1 FLOORS Floor fratning member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)........................*jkft!5 12'or L12 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)........................................ Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)....................................................^ ft :5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... —ft :5d FloorBracing at'Endwalls...................................................(Fig 9).................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)..................... .... .....in. Floor Sheathing,Thickness .................................................(per 780 CMR Chapter 55)..... Floor Sheathing Fastening..................................................(Table 2)..Y d nails at_4_in edge in field 4.1 WALLS Wall Height 11�Lo :5 Loadbearing walls........................................................(Fig 10 and Table 5)........................ ft 10, Non-Loadbearing walls................................................(Fig 10-and Table 5)...................... ft 5 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)...................-.Up in.15 24"o.c. WallStory Offsets ........................................................(Figs 7&8)...........................................-- ft :sd 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls........................................................(Table 5)..............................2x-ha!=�ft --in. Non-Loadbearing walls................................................(Table 5)..............................2x-k6:X-ft-�in. Gable End Wall Bracing' FullHeight Endwall Studs............................................(Fig 10).................................................................. WSP Attic Floor Length................................................(Fig,11.)............................................. ft�W/3 Gypsum Ceiling Length(if WSP not used)...................(Fig 11)............................................ TiDi-4 0-9W 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11)..................;........... ..........T..................... T. 5 ........................................................ .............;W....`.. I�A OF 444 ......................................... ................. ............ 'D MICH L 7,D STRUCTURAL No 34774 CUD L 9 o e !/3 o`Zo FFSS'o N A L | .^- - ~-..- �oc' ec^ `^ + far .", omp��mnzce "79-01 C��;71 531�';".1i�)� ` Loadbearing Wall ConnectionsNon-Loidbearin ' - Wall Connectionsu~~ Lateral Vno.nfandnoUod1Gd common nails)...............(Table 0........................................................ ___ Load Bearing Wall Openings(record largest opening but check all:openings for compliance Table 9) SpansSill Plate . ---�' --- FuUHo�h¢Studs (no. -----------'(Fab�0)--------------' uhwmkoU for SpansHeader ( ) --- 44-Full Height . . . �_-- ---_ ExtoriorVVo!SheothingbuReshstUpUftandShesr Simultaneously 4 _-- Minimum Building Dimension,VV 'Dww~~~ Nominal Height ofTa|�w Openin"o �� ~�� SheathingType.............................................. 4) ---------------. Edge Nail Spacing-------------' 1Opr note 4if less)-------- i n. Field Nsi|Spocing--------------(Table 10)----------------. in. ' Shear Connection(mzof16d common naUm O�b� 1O>- r�. �vI -, ����� Pon�a� ----. -������-' �� 5&Additional Sheathing for Wall with Opening>6'8^ nConcapts}-------- Maximum Building Dimension, L Z= ��4�" Sheathing HeightNominal � - 4) ---- � Edge Nail Spacing (Table 11 or note 4 if less).....................�a�if [ 11) P�� mon --------------p�mo ---------------- Shear Connection 6d common noUo (Table 11) - �c P__--Full-Height__--- ----.-`T--- ,--__-' ---- ° -__ ' 5&Additional Sheathing for Wall with Dpnning* � �. vuax l�pmc x��vp - Ro�d�nVWndSpeed?--------------------' -------------'����mw-���^-�- 5.1 ROOFS Roof framing member spans checked? .......................(For Rafters use AVVC Span Too. ueo.BBRSVVebwite) Roof Overhang ................................................... (Figure 1S)............��3�'ft:5 smaller wf2' orU3 ' Truss or Rafter Connections atLoodbeohngWalls �&��. ��*m� =��\° . Proprietary Connectors " ~ Uplift................................................(Table 12)--------------. U Lmte�|---------------�ab� 12�----------. Shear- -- -.�ab� 12)----------' ' R�goS��pConn���ns. m�c�@��erpoge21-' �ab� 13)---------. Gable Rake Outloohar......................................... (Figure 2D)----�jA ft:5 smaller uf2'orU2 Truss mr Rafter Connections otNon'LoadbeahngWalls Proprietary Connectors ' Uplift................................................(Table 14).................... ------ U= - !b. Lateral (no.of1Gdcommon nails)...(Table 14)..... ............� = ~_b. Roof Sheathing Type...................................................(per 78OCMR Chapters 58 Roof Sheathing Thickness............................................ -----� . Roof Ghea�ingFaoh�ing --------------.�ab�2>.A��k��'��'�%���. ��. Notes: ~ 1. This checklist must be met inits entirety,excluding the specific exception noted in 2.0o comply with the requirementsof 780CIVIR5301.2.1 1 Item 1. |f the checklist ismetin its entirety then the following metal straps and hold downs are nc� required per the VVFCM11O mph Guide: a. Steel Straps per Figure 5 b. 20Go Straps per Figure 11 c Uplift Straps per Figure 1* d. All Straps per Figure 17 a. Corner Stud Hold Downs per Figure 18o 2. Exception: Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall baa minimum 2'in nomino�thiohnouo. p�sounutnaoted#2gnede ���� ~~ ' No 34774 Co)__~- R er tt�ffcRMTritlktti YRkN1t NG I } 41,%140 WON, W 6 d1IMhfA T(f• - I � RAC►�P�TER1� 3�8 � I � SP ACHMENT- 0 . A�0? TO 3GAt•E Top *AT. mil) Ao z. hrAC MBMT NOTES: Wood Structural Panels shall be minimum thickness of 7116"and be insmHed as follows: i. pawls"be wunned with%rength axis parallel to studs. 6. All horizontal joutta`shall occur over and be mailed to fmming iii. On singly story coassuucdon.pants shall be attached to bottom places and top=rnberpf rise double top plate. iv. On two story cotsstrucdM Upper panels shall be attached to the top rs,crnber of the upper double cup plate and to band joist at bOUOM of panel:Upper at=hmenl of lower partol sttaIl be matt to band joist and lower attachment made to lowest plate, fuu floor flaming. v. Horixmtal nail spacing at double top plates,band joixs,and gussets shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Naihng for Panel Attachment AMP m cz. i•i1 •► f• 'ri z � � jl , : � ( �{ I � l �f �i i �-l; ;'I '� �) i 4 .wit� � f ` f ` { 3o f � _� ai � l ; l � f N ( � � �. ej cl; JL �i lil f.i �. ,� i I � -W-7, • ta:i -E WSP ATTACHM., NT Utb 1 G L - QR IZOW TAL *TTA CH M bNT f GENERAL NOTES AND MATERIAL SPECIFICATIONS: SK"1 FOUNDATIONS 1.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2. For site location and grading information,see Site Plan,by others. 3. Assumed-net allowable soil bearing capacity,q=3000 psf,for a medium sand/gravel composition. Other soils encountered, contact the Engineer of Record. 4. Concrete: Minimum 28 day strength,f c=3000 psi,3/4"aggregate,designed per American Concrete Institute Code,latest issue,maximum slump=4". a.) Anchor bolts ASTM A307 galvanized,min.5/8"diameter, 12"long,w/2-1/2"hook spaced per Code Checklist,or in concrete piers w/Simpson ABU-series base;SPACED 2'o/c for slab-on-grade construction(i.e.Garage,Basement,etc.). b.) All walls to have min.2#4 top horizontal,2"clear,to prevent shrinkage c.) All walls longer than 25' shall have vertical control joint with waterstopping between wall joint. FRAMING 1.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2. Structural Design Loads: Dead Loads:Actual Weight of Building Components Live Loads: Snow Load =30 psf(plus drift)with applicable reduction ATTIC Storage=20 psf Living Floor=40 psf Sleeping Floor=30 psf Decks and Balconies=60 psf Wind Load: Criteria used for 110 MPH Exposure B or C as noted per plans 3. Structural Steel: (as required) a. ASTM A572 Grade 50;shop paint with rust inhibitive paint.Thru-Bolts: ASTM A307, 1/2"diameter;punched holes: 9/16"diameter. b. Welds: Shop weld cap and base plates to columns;shop weld bearing plates to beams;use E70xx electrodes. Alternatively,field weld by certified welders. c. Deflection Criteria: L/360 total load deflection. 4.Timber Framing: a.All new timber framing:Spruce-Pine-Fir No.2 with Fb=1000psi,E=1,300,000 psi,or better. b.Pressure treated timber(P.T.):Southern Pine with Fb=1300 psi,E=1,600,000 psi,or better. c. Laminated Veneer Lumber:All L.V.L.shall be 1.9E L.V.L.with Fb=2925 psi,E=1,900 ksi,Fv=285 psi,Fc_per=750 psi, Fc_par=3035 psi. Parallam(PSL):All PSL shall be min. 1.9E ES with Fb=2900 psi,E=1,900 ksi,Fv=285 psi,Fc_per-750 psi, Fc_pat=2900 psi. Note that Microllam and Parallam may be used interchangeably. 1. Deflection Criteria: L/480 Live Load,L/360 Total Load 2. Optional: Provide shop drawing submittal of engineered lumber systems for approval prior to materials purchasing. 5. Metal Connectors: As manufactured by Simpson Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail holes filled,with the size nail as specified by mfgr.or herein. a. Rafter to Ridge Beam: Simpson LSSU-series,or Simpson Straps over top of plywood,spaced 16"o/c; Rafter to Ridge Plate: Collar ties min. 1 x6 a 16"o/c at top or Simpson Straps over top of plywood spaced 16"o/c b. Rafter ends to top plate: Simpson H2.5A c. Band Joist: Simpson straps at 4'o/c: CS-14R-48"centered at band joist 6.Bolts: Bolts in wood framing shall be standard machine bolts unless noted otherwise.Bolt holes in wood shall be 1/32" larger than bolt diameter.Bolt heads and nuts shall bear on standard malleable iron washers,or square plate washers.All nuts shall be retightened at completion of job. 7. Blocking: a. Blocking shall be solid blocking,2x minimum,and full depth of member. b.Stud Walls:provide blocking at 8'-0"o/c,maximum height. Comers to be blocked at 48"o/c with plywood edge nailing to this blocking for the first 48"of these building corners. c.Nailing Schedule: Solid Blocking to Bearing 2-8d toenails ea.side Blocking Between Studs 2-I0d toenails ea.end,or 2-16d end-nails ea. End d. New Framing:Provide 2x blocking for 2 joist/rafter bays and spaced 48"o/c in joist and rafter plane at all edges;attach plywood edges to this blocking 8.Nailing Schedule: All nailing shall be in accordance with Appendix 120.Q,unless noted herein specifically. Multiple Studs 16d C 12"staggered a.All nails shall be common wire nails. b. Sub-bore where:nails tend to split wood. 9. Headers less than T-0",use 2-2x6;all others per MA State Building Code Table 5502.5(1)and(2). I Application Number........................................... Section 9- Construction Supervisor Name �o yr LV—J S Telephone Number Address S tis.�e _ ` _ City �061qrg, State IA—Zip License Number 6 License Type - U Expiration Date Contractors Email� ui kc�Q1S T J\�S ,�( ,��In Cell # 2Z� 3Z-�7� I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Buil ' g Code. I understand the construction inspection procedures,specific inspections and documentation required by 0 and the Town of Barnstable.Attach a copy of your license. Signature Date - Section 10-Home Improvement Contractor Name Telephone Number 3 Address 5'tr<.a s N J c City ?kA5 1= State A Zip Registration Number .a Expiration Date 7 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State B .ding Code. I understand the construction inspection procedures,specific inspections and documentation require CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town-of Barnstable. Signature Date AVLICANT SIGNATURE Signature Date - Print Name o �i W�-'-�1 Telephone Number r E-mail permit to: �3 y l��Q.�(' a Ok 6 Last updated: 11/15/2018 Section 12—Department Sign-Offs I Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department- Conservation --- For commercial work,please take your plans directly to the fire department for approval I Section 13 — Owner's Authorization i i as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: F (Address of job) Signat6ire of ON66'r da e Print Name r Last updated: 11/15/2018 w TOWN OF BARNSTABLE Permit No. Building Inspector I �.a,ar.ns Cash OCCUPANCY PERMIT Bond --------___ Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. �........... ............................................................................................................ Building Inspector w FROM �- TOWN OF�BARNSTA13W' =' . Clerk BUILDING DEPARTMENT W. Frances 367 MAIN STREET HYANNIS, 'MA 026M `Y�OVJil .....�r��.Q;•4•�!•4�N+u�F�H V A'I(II� . . "" $�.••»aa. ..•,",��»•��� Phone: 775-1120 SUBJECT: FOLD HERE DATE March 25, 1985 .LYA E S S A G E My Work h been�coni�ileted under P dt #27210 Arthur Belanger) . w.al t 1P N'aM1R'w lYrA 9MQ. aeN'aw-,irli:+a*+`sY f- -*+'•a+4+.t' {YCi r.A.a h Plead-release-Bond r-w 414Ml Nl gtN4MA'•MQ _[1111113 DATE - - REPLY SIGNED NEI7-RMI - - RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY - ' PRINTED IN'U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. f lzil o 0 O � �0 I U 1 zo b ! b p;;?1.'y �IMINMIfy • ' d Rp. I WILLI IV P7 1341 1977 O •ty O I' S4CHV� ` .�- Y lo e•c/ 7AS � TO THE BEST OF MY INF R AT J'�.TP ,�1' R ,0 M ON KNOW.LEQGE, AND .BELIEF THE Z-9 > 7 � . ����► ' SHOWN ON THIS R O HEARN, _ -PLAN HAS BEEN -LOCA EQ ON- THE � �' '� 134® ROUTE •ISa GROUND AS I.NQI TE EAST DENNIS, MASS.- lop ' DATE /O P f� SCALE:ec DATE- REGISTERED LAND SURVEYOR* JOB N0. CLIENT� erc�9.•.'r -• f DR. BY , SHE ET_. Of i DONALD F. HENDERSON, P. C. ATTORNEY AT LAW 776 MAIN STREET HYANNIS, MASSACHUSETTS 02501 617-775-1904 PLEASE REFER TO FILE NO. September 26, 1984 Mr. Joseph DaLuz Building Inspector Town of Barnstable Hyannis, Massachusetts 02601 Dear Joe: This is to certify that I have examined the title to Lot 7, Wood Duck Road, Marstons Mills, which lot is more particularly shown on a plan filed in the Barnstable County Registry of Deeds in Plan Book 254 Page . 29. That plan is dated February 5, 1972. This lot was conveyed into single ownership on July 10, 1972 and in my opinion, is a valid building lot under the Barnstable Zoning By-Law. Very truly yours, DONALD F. ERSO , P.C. By: Donald . Henderson DFH:djp I - . .»-i , •t#�?i,� .�s�: � ...; �yrir:er=....;.;•„�:-�; �.: Gl�.'�/'Q/,�° �'-2G./�fl 7Jj „` jo - A s or's m and lot/number ...........�....... ..........,...... ' �� L�s � EM MU F >o l�%. . ° deb Co �. Sewage Permit number WITH TITLIE 4 y.�� by!AL i� AM ABLE, i House number ........................................ l G..................:. �- �> wP) ! 900 �e}9 \0� ` TOWN OF ; BARNSTABLE BUILDING- - INSPECTOR APPLICATION FOR PERMIT TO .........65?f <.'...................................................... TYPE OF.CONSTRUCTION ............ ........ ,�:...........4I`f,... . .P.................................. ...........................K7......>I 9. Y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �r�.! ...... 'h` / /.✓vv� UG/.l /9/LSTdNS /y/.LL5 /079S S.. ... ...... r ...... ........................ ....................... �..........................�� .... Proposed Use ...... i'`'GLr .......�i9/h.cy........................................................................................................................ ............... ........ Zoning District .&...............................................................Fire District ..........��.:.��'......................s......s.............. :%a cs Name of Owner ... 2Th'�Z i�7tZr�.v6 c� Address ......5_. GvfJsrc..3:Y /� .................... Name of Builder .... e .! `! .................I.✓...GN9N6��......Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms E5 �'-'"....................................................Foundation ..ors ..............:............................................................... Exterior .................��$Lt................✓...... . .......S......'Gcc�a... :...Roofing :.......................................................... Floors .........................................Interior ............�G Heating ............................................ Plumbing .................................................................................. "�Z.. !..'c Fireplace � ......................................................Approximate Cost �./ / � Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ...... .. ........ .......... ire Diagram of Lot and Building with Dimensions Fee ............................ SUBJECT TO APPROVAL OF. BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ...... ....................... Construction Supervisor's License ../� �/&&Y.." ...... B e- ,langer, Arthur 272I0 one story .—',N�Ar............... Permit for .................................... or, single family dwelling e....................................................................... 86 Wood Duck Road Location ................................................................ Marstons Mills . ............................................................................... Arthur Belanger i, Owner .................................................................. frame Type of Construction .......................................... ................................................................................ #7 Plot ............................ Lot ................................ flt I Permit Granted .................................November 13 I....... 9 84 Date of lnsp&tioni4?i...... .. 19 IQ Date Completed Assessor's map and.lot number :�V�O 9- �6 � � �/ of Sewage Permit number .......... - WP Z BARNSTABLE, i pe, aHouse number ....... R ............... ............................ . ... 4639. TOWN OF BARNSTABLE BUILDING INSPECTOR �,�� APPLICATION 'FOR PERMIT TO ......... .......................,.................:......:.................................................................. TYPE OF CONSTRUCTION .:................ ........ '/G .. .............�..... .2.....'.................................. ' ............................... ............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. // aU � /1$TVNS �.LLS SASS' Proposed Use '�ti�L<— F!�!h��r .:..................................... ................................................................................................................................... c f ZoningDistrict X ...............................................................Fire District ..................................................2 ro,, s , , . /oO. /jdj� / .A..s..............��.....c� �i[�y�� IJtZIviV6 c ` s ./ Gv f/rc� Nameof Owner ......................................................................Address .....................................:....Y....................................... r � Name of Builder .. iCiiw2 �e�/�.�!G�«-......Address ...................................................... rr '• it /r Name of Architect ................................ ................Address Number of Rooms �...............................................Foundation .... Corc�Cc?a ................. .................................................................... Exierior ....................... `... ` (:...Roofing .......................... Floors', %��dc� ............�.................:....................................................Interior ........................................................:.. .......................... -Heating. ..........LG:C.........c.....................................................Plumbing ......°............`j..9...f/5............................................. Fireplace .........�..................................................................:.....Approximate. Cost Definitive Plan Approved by Planning Board -----------______-----------19_______. Area .......................................... Diagram of Lot and Building ,with Dimensions Fee ...,'-::: A....... .................. -� t SUBJECT TO APPROVAL OF BOARD OF HEALTH oµ... t 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. ~l Name .L%^ ....... Construction Supervisor's License 3. Evy Belanger, Arthur A=10-111 V No ... Permit for one story ...................... ............. ...........single...family., ..................... 86 Wood Duck Road Location ................................................................ Marstons Mills ......................................... ..................................... Arthur Belanger Owner .................................................................. frame Type of. Construction ............................................ ................................................................................ Plot ............................ Lot ......... .................. November 13 84 Permit Granted .......................................19 Date of Inspection ....................... ............19 Date Completed ......................................19 67 Z' i 1641 a- I.? Town of Barnstable RECE I PT HAWWAOLL200 Main Street, Hyannis MA 02601 508-862-4038' Application for Building Permit �, rn Application No: B-17-3482 Date Recieved: 10/6/2017 Job Location: 86 WOOD DUCK ROAD, MARSTONS MILLS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: OCEAN EDGE CUSTOM HOMES INC. State Lic. No: 184418 Address: 481 DEPOT ST., HARWICH, MA 02645 Applicant Phone: (774) 836-5799 (Home)Owner's Name: VARLEY,PATRICK W& KRISTEN L Phone: (774)353-6422 (Home)Owner's Address: 86 WOOD DUCK RD, MARSTONS MILLS,MA 02648 Work Description: Replace windows for like windows Total Value Of Work To Be Performed: $2,500.00 w � 03 Structure Size: 0.00 0.00 1 0.00%_j Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: David Crosbie 10/6/2017 (774)836-5799 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,500.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $35.00 10i6n017 $35.00 �xXxX-}000C?OQIX- Credit Card 4365 Total Permit Fee Paid: $35.00 THIS IS:NOT A,PERMIT �_ _._ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O`'J Parcel Application # � Health�Division ) " Date Issued Conservation'Division Application Fee (}� Planning Dept. ' Permit Fee oZS Date Definitive Plan Approved by Planning Board ®tiL Historic'- OKH Preservation/ Hyannis ` Project Street Address Village XV, Owner ' Address Telephone Permit Request -T-7' V • -o.�. ZnJ ; Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ; Project Valuation fI WN Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach si -pporting�&ocumentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) i Age of Existing Structure zy Historic House: ❑Yes ❑ No On Old King's Highway r❑Y.es ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other , ' Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.fti I-TI Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing b new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other I 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:1511�existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes �&No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name `�a.�<; �,J Telephone Number Address License # Home Improvement Contractor# Worker's Compensation # j ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Z,,4 � SIGNATURE DATE 5'1- �-a8 T t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. f ; ADDRESS VILLAGE 1 ; OWNER ' DATE OF INSPECTION:. FOUNDATION FRAME ' INSULATION ' FIREPLACE ELECTRICAL: ROUGH !FINAL t =PLUMBING: ROUGH FINAL - ..GAS: ROUGH J FINAL FINAL BUILDING DATE CLOSED OUT ' y ASSOCIATION PLAN NO. i Town of Barnstable - Regulatory Services V ' _"'�''i' i E Thomas F.Geiler,Director �'°rED ;►`0� Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnsta ble.maxs 'Office: 508-862-4038 Fax: 508-790-6230 PLAN RE'VEE W. Owner: Map/Parcel: Project Address � Builder: The following items were noted on reviewing: Z V©?(!:A g 124 Av lr o Iv CcIi Zt ni LA-0u- C JV ?o �'C , Reviewed by: — Date: Q:Forms:Plnrvw i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Ivww.mass.gov/dia --1 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLribly Name (Business/Organization/Individual): Address: p G Lz City/State/Zip: r\,kks . g, bz rodS Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6.SNew construction . employees (full and/or part-.time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition workingfor me in an capacity. employees and have workers' Y p n'• $ 9. ❑Building addition [No workers'comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its ME]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.❑Roof repairs insurance required.]t e. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavitindicating such. xContractors 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 subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. tic. M 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 Iead 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 against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and a pain -a penalties of perjury that the information provided above is true and correct Signature: Date: 'y— "o 19 _ Phone# 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, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliarice with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation.and, if necessary,supply sub-contractors)name(s),address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have '. employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for 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 Iisted 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 Eo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: The Commonwealth of Massachusetts Department of lndustdaI.Accidents Office of Investigations i 600 Washington Street Boston, MA 02111 TO; #617-727-49GO ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 1.1-22-06 www.mas.5.gov/dia i 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 Legibly Name(Business/Organizationgnd Uividual): f1 h 1()�V Address: 0 6C1L 7LcafSS ►11 S } n a(0 y City/State/Zip: Phone.#: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I . employees(full and/or part-time). # have hired the sub-contractors 6. P New construction 2.❑ I am a-sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' 9 0 Building addition [No workers' comp.-insurance comp.insurance, required.] 5. We are a corporation and its 10.0-Electrical repairs or additions 3.Q� I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself-[No workers' comp. right of exemption per MGL 12 0 goof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating They are doing all work and then hire outside contractors must submit a new affidavit indicating such. %Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-conlract=have employees,they must pravidb their workers'comp.policy number. ' lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M 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 against the violator. Be advised that a copy of this statement maybe forwarded to the Office of _ Investigations of the WA for insurance coverage verification. I do hereby certify under the1 pains-and penalties of perjury that the information provided above is true and correct Si afore Date: N 7 Q s _ �--�o Phone#•-ylq-1�'�:3 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, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for 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-insura=e license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The C6mmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TO. # 617-727-490.0 ext 4.06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia �oFTHt r Town of Barnstable Regulatory Services BARNSTABLE, Thomas F. Geiler,Director y MASS. i6.9 •�� Building Division TED MAC A Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-962-4038 Fax: 508-790-6230 ----------------------------=------= HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: e` C.- ]lumber street village "HOMEOWNER": �� _ _ name home phone# work phone# CURRENT MAr1_rNG ADDRESS: Ca sac Q� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or fame 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 be/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-tndersigned "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 requiremen .' / Signa re of Homeo er Approval of Building Official 1 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. 1 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']09.1.1 -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, i Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that-the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonn/certification for use in your community. Q:forms:homeexempt �OtIHEI° Town of]Barnstable ' Regulatory Services t B" MASS f Thomas F. Geiler,Director y nsaes. � � �ArF1639. 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 as Owner of the subject property hereby authorize to act on my behalf, in all;matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q.FO RM&O WNERPERMISS ION I � I I i r`f�l f I 1 i I I ................ RA ; YI I ;I. is I _it i -_............._........_.. . ....... ..__..._.......__.. ; ' 4 J� o 0 •o �0 o r V 'r '' S an a• NEARNIPj r 1 r' 1341 i� 1917 7 . _ ICY • CCVNN✓ �.S :UJ LT P40T P" TO THE BEST OF MY I NFORMAT ON ,MAS . KNO►ACL.EQ�E, AND BELIEF THE L-o > 7 P, SHOWN ON THIS -PLAN HAS BEEN LOCATED ON, THE 348 � 'r a GROUND AS INQI EAST DENNIS, MASS.. O ^ � DATE� : /O P r �` SCALE: .. o • DATE REGISTERED LAND SURVEYOR' JOB NO. CLIENTS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 Parcel l ( � : Application#_ 6� Health Division Date Issued Conservation Division Application'Fee Tax Collector Permit Fee , Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Villages Owner —�,c-r• cN,�- Address L4,=, Telephone - yl a- t 31. Permit Request iVXAC a� LJAA t-A\6 • 00<et)6f t)fo Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 9,�0 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 2q Historic House: ❑Yes 19 No On Old King's Highway: ❑Yes )'No Basement Type: ;)Tull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing Z new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing (4> new First Floor Room Count Heat Type and Fuel: ❑Gas XOil ❑ Electric ❑Other Central Air: ❑Yes ANo Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes MNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size i r•.a Attached garage:Xexisting ❑new size Shed:❑existing ❑new size Other: f ' r Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ , Commercial ❑Yes XNo If yes, site plan review# c7 i3.1 Current Use t - P ed Use i -rn -tr BUILDER INFORMATION 1 i Telephone Number -<!/1 /r33 77'Y--3S3-G6Y?Z Address Ito License# t\-- o7 a-yCB Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION � x , FRAME INSULATION FIREPLACE 15 �a ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i M DATE CLOSED OUT ' 7 ASSOCIATION PLAN NO. >y y J ,per The Commonwealth of Massachusetts �\ Department of Industrial Accidents Offzce of Investigations _ 600 Washington Street Boston,MA 02111' w>Ow.mass.gov/dia ' Workers'Compensation Insurance Affiddvit: Builders/Contractors/Electricians/Plumbers �kpplicant Information Please Print LeLY Y Name-(Business/Organizatioa/Individual): Address: "- �o - C S t/Zip: Phone.#: Y19— /)Sz Are you an employer?Check the appropnatehox:.- •.:Type of project(required):, �4. I am,a general contractor and I 1.❑ I am a employer with = 6. New construction . * have hired the sub-contcac otof rs ❑ employees(full and/or part time). ,__ .. ' ?.' Remodeling 2.❑ I am a'sole proprietor or partner- listed on the'a�ttached_sht ❑ g CThese subcontractors have 8. �]Demolition ' ship and have no employees :-•. employes and have workers' working for me in any capacity. - 9. ❑Building addition comp..insuranc0.t ,.4 [No workers comp.insurance 10.❑Blectrical repairs or 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 bf exemption per MGL 12.❑Roof repairs insurance.required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.wha submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating'such. =Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.potic'y number. I am an employer that is providing workers'compensation insurance for my employees. Below is-the policy and job site, information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: ' lob 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 against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of' Irrvesti ations of the t)IA for insinp a coverage verification. I do hereby certify and pains-andiLwalties of perjury that the information provided above is true and correct. i Phone#: Official use only. Do not write in this area, tb be completed by.city or town official City or Town: ' Permit/License# Issuing Authority(circle one): A.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Phone#: Contact Person: i °Fn+e)oy� Town of Barnstable Regulatory Services BABNSTABM Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, .impiovement,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. $Oo — eAddiess of-Wor-k� Ito tx�ocx� vc c_-Owner'sName::D ���-c-,• k �c,-c-�s -� CDate.of-Applieahon I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by law ❑Job Under$1,000 Building not owner-occupied G Owner puftg-own-pTpit- Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's-Name Q:fomu:homeaffidav ,per The Commonwealth of Massachusetts �\ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wtivw.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information .Please Print Legibly Nam(Business/Organization/Individual): . e �S�i✓ Address: P 6072wJ 7�C� City/State/Zip:� ,cJS�./� AW, Fhoneft:__' G_ Are you an employer?Check the appropriate bog: :Type of project(required):. 1.❑ I am a employer with 4• ❑ I am a general contractor and I 6. ❑New construction . `employees(full and/or part-time).* have hired the sub-contractors -listed on theattached sheet. 7. ❑Remodeling w 2:�:I am a'sole proprietor or partner- '. s These sub-contractors have hip and have no employees g• []Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ 5. ❑ We are a corporation and its 10.❑•Electrical repairs or additions requited.] officers have exercised their 11. Plumbin re airs or additions ' 3.❑ I am a homeowner doing till•work . . g p myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance.required.]t c. 152, §1(4),and we have no 13.❑Other_ employees.[No workers comp,insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homcowners.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 mutt attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ani an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site. information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: ' _Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORKARDER 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 bIA for insurance coverage verification I do hereby certify, et the pains and enalties of perjury that the information provided above is true and correct: Si ature••"" � Official use only. Do not write in this area, ib be completed by.city or town official City or Town: ' Fermit/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#: tHE Town of Barnstable Tp�� y�P Regulatory Services BARNSrABLE, Thomas F.Geiler,Director 9 MASS. g �A 1 39. .;0 Building Division �f0 MA't s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 WMb HOMEOWNER LICENSE:EXEMPT� ON I DATE: ff �Z+rI'07 10B LOCATION: a(o number \ ► street - -,�vlillaagee "HOMEOWNER': /-7 c��c y o�C'�-2�/ SZ�'��R ' `� / - a-53 name home phone# work phone# CURRENT MAILING ADDRESS: ': 1�cxStu�S IAI t`\,S A d city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to.reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirement . Signa a 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." I . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:formr s:homeexempt oFtHErq,,, Town of Barnstable Regulatory Services " B'' " Thomas F.Geiler,Director y Mass. MASS. � `bArF169..,6. 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name ,-I-Q-}r-qo e-- Owner-is-applying for perm-it--pleas.e complete the Homeowners License Exemption Form on the reverse side. QTORMS:O WNERPERMISSION