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0039 APOLLO DRIVE
,�9 . ., Town, of Barnstable Buildin d Until Final in This Card So That it is Visible'From the Street.-.A roved Plans Must be Retained onrJob�and thir•Cakd Must be Ke t - � M" Postespection Has Been Made. ,6,�• « Permit .Nude° :- Wherea Certificate of Oceupancy�is Required,such Building shall Not be Bccupied=until a Final"Inspection has been made. . " Permit NO 1348-1234 Applicant Name: ROLAND LANGEVIN Approvals Date Issued'.'_ 04/26/2018 Current Use: Structure Permit'Type: Building-Insulation-:Residential Expiration Date: 10/26/2018 Foundation: Location: 39 APOLLO DRIVE,WEST BARNSTABLE Map/Lot. 131 047 Zoning Distract: RF Sheathing: Owner on Record: KAPP,KRISTIE NELSON ontr-i—Name ;. INSULATE 2 SAVE, INC. Framing: 1 Address: 307 WILLOW STREET "' " ' Contractor License: 180747 2 WEST BARNSTABLE, MA 02668 . T iEstaProject Cost: $0.00 : Chimney: 4 Description: insulation/weatherization: Permit Fee: $85.00 ¢. Insulation: Fee�ai8 $85.00 Project.Review Req: Final Date 4/26/2018 T 3 Plumbing/Gas .t, hid' ^:. � "��G.. ,- s" k,� ..✓A Rough.Plumbing: N10 MA - -- Buildin Official 3�. � g Final Plumbing: f fl Rough Gas: This permit shall be deemed abandoned and invalid unless the work author M,,by,this permit is commenced within six" dnths after issuance: g All work authorized by this permit shall conform tothe-approved app�canon andithee`approved construction document`s for wh�icFi<this permit has been granted. 14 Final Gas: All construction,alterations and changes of use of any building and structures-shall be in with the local zonmg;by laws and codes. 2 � r" yt2 This permit shall be displayed in a location clearly visible from access streetoKroad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. " ��e Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldmg=and Fire Officials are°provided,on this permit. Minimum of Five Call Inspections Required for All Construction Work: '�� d � - Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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 constructions -- - Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: - Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ` Application Number...2........................By l/��..........'.... ' C���' Permit Fee......... ...... ...............Otirer Fee........................ FOP Total Fee Paid.....` .............................. �. TOWN OF BA:NISTA:BLE ` Permit Approval by.................................On........................... ' BUILDING PERMIT Map.......G......................Parcel.............:........:...................... APPLICATION Section 1 —Owners Information and Project Location Project Address Village_ GU. ��rh fV�6l Owners Owners Legal Address3�,,veLld ,."1_ City:,-Goo' a.,- _rila 6LAP State. Zip _ Od Owners,Cell# :Old P—�'6/ — �03S E-mail L/i v-ile�� ,yam C'v n'► .Section 2-; Structural Use (Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic:feet .Commercial Structure under 35,000 cubic feet Section 3—Type of Per> it New Construction ❑ Move/Relocate ❑ Accessary.Structure. ❑ Change of use" ❑ Demo/(entire.structure) ❑ Finish Basement ❑ Pool ❑ . Fire Alarm Rebuild ❑ Deck. ❑ Solar S .' er.$. stem i 1 y Addition ❑ Retaining wall ❑crnsu4on ❑ 'Renovation Oilier—Specify Section 4—Detail Cost of.:Proposed Construction 12,457, 207 Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 110:MPH Wind Zone Compliance Method .❑ MA Checklist ❑ TNFCM Checklist. ❑ Deslgn 4 Last 4p4ated:.,1N3 ino)7. j - Section'! -Work Description �d1,e lit to 1�C % Q 9/'c Q 4c 14a-i4 ih_4r-�'��, U���6 9 ti �t(yri I Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing M/Gas i ❑ Fire Suppression ❑. Heating System ❑ Masonry Chimney ❑Add/relocate bedroom A Water Supply ❑ Public 'I ❑ Private 'j Sewage Disposal ❑ Municipal ❑ On Site Historic.District n ❑ Hyannis Historic District ; ❑ Old Kings Highway " K•etx�6f�cServic.Ps' Debris Disposal Facility p0A2 wvr L Zc% I am using a crane ❑ Yes .❑ No v ao Section 7—Flood Zon Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes:❑ No ❑ ;I Section 8—Zoning Infor tion Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage ; #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Real Yard Required Propo Side Yard Required Propo Has this property had relief from the Zoning.Board in the past? Yes ❑ No Last updated: 10/31/201-7 I f - Section 9—Construction Suiervisor E Name id�L o Telephone.Numbe4 J�0 7--!5-6 ?- 6 to 4""" Address Vle lH o ve.f-. City eo Sta ` Zip 9d -License-Number License Type __ 1 iration.Date Contractors EmaileZ1-ems,Viirti ela.*a.r"e,�e e- ell# I understand my responsibilities under the rules and regulations for Licensed Co istuction Supervisor.in accordance,with 780 CMR the Massachusetts State Building Code. I understand the construction insi ectioh procedures,specific imspections,�and documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your license. Signature AP17 Date �lld Section 10—'Home Im P.rovemen Contractor Name � c�. a,,, e did. Telephone N. er Address'/a K'Po v� �City Fa f l2�yer S Zip Oa 9 Registration Number 4? cK7 Expiration Date F I-understand my responsibilities under the rules and regulations for Home went Contractors.in accordance,with,780 CMR the Massachusetts State Building Code. I understand the construction' on procedures,specific-inspections.and documentation required by 780/CMR and the Town of Barnstable.Attach a cop .of your H.LC... Signature l Date �3 -Section 11 Home.Owners LicensP Ezeihptio Home Owners Name: e e/-r e Telephone Number J d'-56 G - 4-1355- Cell or Work N r I understand my responsibilities under the rules and regulations.for Licensed. lion Supervisor:ia accordance with 78U CMR the Massachusetts State Building Code. I understand the construction' on procedures,specific.inspections and' documentation required by 780 CMR and the Town of Barnstable. Signature 5 ,e e o 4 _a_ Date .l� APPLICANT SIG TI; E Signature Date od � Print Dame /arc cK L a-n P e ellit_ Telephc ne Number f'�l 7-'6 .7y E=mail permit to: o Su l4 s a tale, e Last.upda#ed::I O%3_IlZOI7 i aecuoa TZ—vepartment sf, -Offs " Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site PI Review(if required) ❑ Fire Department ❑ Conservation ❑ i For.commercial work,please take yo r plans directly to tke fire apartinentfor approval Section 13— Owner's Authoi lzation 19 B//f V'e L� as Owner o the subject property hereby authorize %� to act on my behalf, in all matters relative to work autho ' d by this building pe application for: (Address of job) Signature of Owner date Print Name 149 updated: 10/31/2017 ..... . ... ... ... ;BISE:Xngifleeri.>ng: RISE5 Quporrt Avenue;.5ouih'Yermouth,l3AA 02664 : :ENGINEERING' �' *y.:,+ J0 N T-I CT 508 6&192VA4197 FAX 50&5684933'. ...... Page �. PROGRAM.. TO �s: ro wso:et�*M*si CLG-MES: oac oAbMTHEcusTOaERFORVXMxns: -.... CUBTOM'P,jt .. - wsaHE DATE p.BENTa t907IKORDfa .. :MAWnN:WP _ a (508)5fi6-433 03/29lZt? 8. 252195; 07542 Al � GlA seavrcE sT> a 1a sTAEMT 39 Apofi€i Drive 39.Apol(o Drive West Saftlata to NtA.0266.8 west Samstaatel."o2660, DE$CRFPTtON . QTY.. ... ...;:;CQST .IICEi�tTtllE... . -TOTAL ftTt'IC.FLAT ..8°.OPEN.R.30.CELLULOSE 7.00: $7008Ot1. $1,00"Q $0.0tY: Provide labor ihd,:.ritaterials to.install`r8"10er of R-30:Glass I Cetlrilose:to open attic:space. /CTTIC HATEht SEAL&!NSULATE ......... ..1........ 360.00: $W 00..... Provide::falter aR f`mateiiats Winsitlate.:die:back.of:aii attic hatch with: ..: 2'-rigid:insulation~t oard:'UUeatherstrig`the:perimeter. _ .._ FilvlSHl=f3 CEILING AdGES'S ........ 35 00 :. .. Pr.Wde::labor.and mgter s to:install:� iew,.:finished ith:Rn* plyvtoocl:hatel;insutated-witfi'2"rigid Insulation board;and; we therstripped. Fiirste coat and/or qj$h paint is no ... `tlt4hL --nFN EPUTFS :40: ...... $134 60: V. 00` Pravicie latioi and materials to iristall;ventitatiah chuties in:tale°iafte bajrs to m-aintain:ait Clow: Ili=i�#T BATH FAIV HRtI.:GA$LE 2 $237 50: :8237.54 ...... $0'40: Pray+de:iatiorand,motenals:toiinstall an insulated 4xhausttiosewith gable wall.9 UA d�tiapperVent to exhaust.ewst+ng tiafhtoom Fars{s}: _ .. ._ 4"x 16°'SOFI=t 1!l=l�l $: $ $23 l:28 :$231 c28 $0:t30: ' Provide'laborand::materiais..to nstali 4"X.16";redangularalunMuni soffit vertts to lncrease:verrtilatron+n attic>a(eas Speafy color White Provide'Gabor and.materials..to seal:areas.of your-home.against stetiil,,.:ezc+rss:air isaiiage:.litlateirais to be.iised to:seak your ttorne, .,. :can include,.:caulks;:toams:and:other.products. Primary.areas for sealing include:gr teak8ge to attics,basertseists,::attached:garages and other'ilnheatec+'sif6 s:(windows.are..nof:gerierallyaddressed.).'A .twuddn M bubic feet per'ipin€ite.{cfrn)of airirifiitrafron:v+iill oecui;bw :. . . .. ttie a ctual.riitmber of cfm:is:not.guaranteed. At f9 e.compl.Qtlon of-their "-the' tiot work,.and:it no additional.cost to:the:homeowner;a::final:blo.Werdoor.andlorcombustion safety: :analysis.virilt.:be coiiftled:b-the:...b�cantractor:: l✓OMMaN WALL :2°RlGtD BG R€),.. . :.... .. Provide lam and<rnatenais`tainstalt:2":FSK faced'sern%rigid: fftiergiass:;boarit;insulatiFsii;tp a;comnan'wali:area; COMAIION.INALC:'R13:FG<BATT OPEN: 20 $31.60 $3160 $0:00 Pfo.-hide:latecir and aterals to iistaN'R-1'3 faced fiber g lass to a:. . . cornmonwaN:. Insuiatiort;will,lae fastesFeii`lriplace;; RISE.Engineering SDupontllverwe„$nulh,YarmauElt,.&IA:U2664: ENG VEERING CONTRACT` 508=5fiB-392S:X=679T. FAX fi08=568,1:933 .... Page:. Z 00,63RA: M . EAC-0iIJTO BESY/ J.'fUB4 C ;TWOONTRaCT,ISE4T kC:-FIBS. :ENGi No!4WD,ti 'CUSTOMER FORWOR i:AW ..:. .. ZDESCRWEO'eEuw LUS DMER PHONE DATE; 'CLaiT,s WORK ORDER. MARTIN KAPP (508)566 4335 03QW20118 25219.5 07502 �'SFJiVICE.6'7REfiT'. BttlJIt6�:STREET. 39:Appllo:Drive: 39.Apio ,Drive; SFR1lIC£'Cr1Y,STRi$YtP a11tD10;CTTY;87ATECDP� tiJVe5f B&M. Wble;.l.02668 1 Iest'BaMtWble:ARA:02668 ... �I;SCRtPTION QTY ` COSH INC NT YE N..: 01fERNANG 11"fJE 1SE Ft-35 CELLIIL©SE 52 $110.24: $:11:0:24 $U b6: pro+ride let of aiid'iY►ateraals.to ins all 11 R-40 d:enselyp;K.. +✓lass J.kCeiiufose insulation toian exteiior'o.v.erhang located below:a`heated: floor::area;;k y::dq ng. de sift:ina'overh qn"'friim'below, tioles.dri�ed; wait;-be plugged. 'Plugs will tie sealed wttt,eiftenor,;grade spackle:and' lekin a relatively srrfooth corrdrtlon<Ffrash.sandmg`and#ovEh up. pruning ai iting. ill be the:eustonaer`s responsibility. _.... .. __ . . . ............. ...... . YQLJR tNCEOVE`EXPLAWEb RfSE Esiguteenrtg:has appfred atl applicable,effgitile,recent es asiiS (lam sj.. :.you will be billed only the:net amount.. Cufrently,'under.the Landlord . .:....:. '::. Incentive,the Ca{e::Light fram:pact;offers:100%inrehtive.for etigibW insulifion:.measures,with:no limlF:on'the.amount;and:an'incentive:Of .. 1*00°l for the Ait:Sealing measures:To participiA in the Landlord ncanUve,please:returna':copy of'this:contract signed by tioth`ttre fencilorii:aiid:tfie tenant;it:weli as a.cof.y q:,: a;year-round vontaf :agreement:: .. ... ..... .. 3. TE3QAIdT•$GNA � /° :.... DA:,E.. TofiaE< $3;253:72: .rogram.lecentiv.0i $3T253 72i Gust ier TO i:. :i1GREEiHEREBYTO:FURN151tSERYlCE3-;CAMPCETE:IAIACCOR411NEE;YAT4i'ABOVE'S?, lCJ1itOM5 FORFHESU61' *�.00IDibhars $a:t}0. V(?QN FO"QWPECTM AND AP '.$K RISE:EN6i ...Cll3'TOME&A6REES;TO REb5T A0.SQUNT iHIEAfl Ft7CL'Ih�TERE3T.. ',t WILL'. CNARtIED..4t)p1INLY ON ANY Ut}PAR]BAtAftCE`AFTEA SO DAYB.. FOR TANT UHWMATM O?I.OUARANTEEB.RgNTB OF RECiSICK rORRECiI$TRA?76fi1. .. ..,. S3OkATE1RE:' CONTRACT,iN1YEiE . ... BY.'US'IF.NOT EJ(ECFJTEQ Y57Ti1R1.' TEOF°ACCEPT siON QATE .DAYS;` � 'ACGE?TAHf.E OF CONTRACT.;[NE ABONE'PR4^_ES,SPEC67Ck7ipN$AND.-0037DPftON$'AAE..... 'SA{'gFACTORY Xf;IlS;IWDAREiHHtE811f1CCEPTEO,Y.OIi'ARE YItI.THOBtL IO.cpT wM A3'BPECIF7ED.PAYgb'w L8EVADE-7l$.'CUTLOORnSWE: . r ':.. Town of Barasable Regul.Gory'Services: . A its-Aat , Richa:i�[3:V.::Scal�,Director. ���, Bitfldin :Division °'` .: .. .... .. :::.' au oma Builaiug C mnrission& 04'Ma ..Scree ;.;kiya�rnis,.I1 A 02 �1 vvivw tow.n'.barnsfable uia ns i 0 ce .>5,0&S62-4M Fax:<5084194=6230: Property Owner=:Must: a :pl to and!Sign This.Sectioi : I; ICRISTI APP s IN- t o erty aQwnerofhesT . r h..""'by autYior ze. , . .act:ori.my''�ehalf' �n all matters.relative to work:atthd sbudgn. p n for.:: :39 Apolha:l3r ve fi?STe$t Ba nsta�le,.:IVIA.:021 ;(Address af:Job} . ........:: ::Of, ate Print.Name: .. if PropeFty Q►v�iier:is apply�ng:Io€;peFii t,:p[ease comptete;the:Hoineawners License��xempt�oti Ford, I C!,xusersldecalliklAppData'J ocaN;-rMftiWt�dowsllNetCachetContent.0utlooklL:7'llb9LF21�XL S.(2)doe 0a12511:7 I The Commonwealth of Massachusetts Department of Industrial Accidents > 1 Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia Yorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/individual): Insulate2Save Inc. i Address: 410 Grove Street City/State/Zip: Fall River MA 02720 Phone#: 508-567-6706 Are you an employer?Check the appropriate box: Type of project(required): L[D I am a employer with 20 employees(full and/or part-time).' 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 1 ❑Demolition 10 Q Building addition 4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.o t am a general contractor and t have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.0 We are a corporation and its officers have exercised their right of exemption per MOL c. 14,oX Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. "Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. ham an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Liberty Mutual Insurance Policy#or Self-ins.Lic.#: XWS 56418741 Expiration.Date: 12//10/2018 A ? Job Site Address: 7 g h;o ooIle xt .( /e— City/State/Zip:0 6Z...'/t,J' &V/`.Pzt f Od Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. h do hereby certify under d, ry that the information provided above is true and correct. Signature: / Date: Phone#: 508-567-6706 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#: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite.5170 Boston, Ma; husetts -021.16 Home ImprovemeU' tractor:Registrat'ton Type: Corporation {� Registration: 180747 INSULATE 2 SAVE , INC. ^} J' Expiration: 12/28/2018 410 Grove St ` Fallriver, MA 02720 'H V F G w ' Orr. 4� Update Address and return card. Manic reason br•dtang@;. ,CAI G 2OM-05111 �i,__y_....,_ __..._ _�_ _._..__ ___ ❑ Addr��s',_ Renewal ❑ Employmerrt ❑losfCard CJ/ce Loc�nvnzmrurea�o�'C�/l�ua:ruc�use%(� Office of Consumer Affairs&Buslness:Regulation H HOME IMPROVEMENT.CONTRACTOR Registration valid forindividual use only -`, TYPE:corporation before the expiration date. if found return to: ~_4 Office of Consumer Affairs and Business Regulation ration Expiration 10 Park Plaza;.Suite 617*0 .- ' 12J28/2018 Boston,MA 02116 INSULATE 2 S�AV—-211 � t ; i Roland-Langevih' 410'Grove`St Failrivwr,'MA.0272tiw � Undersecretary Not Valid withoutsignature COn mo!tw.eaitt;01�tassach.usetts t• Davison of Professional Ucensure j Board of Suiidingfteguiations and,Staadards i ,� ��isOr , CORSyr �, • } L-'.S-t03.8.61 ;}' i=�piresx;��'12�112013 t h t ROIAND IANCyE 66-tHl.o dlktS AD " FALL RIVER NIA02 7 y� 3 Commissionei i A�R�® CERTIFICATE OF LIABILITY INSURANCE DATE 0=7/18 TtllS CERTIFICATE IS ISSUED AS A MATTER OF INFOItMgTION-ONLYAND-CONI W NO:RIGKrS tip(aN,E}#E CER#iF�ATE}i(?LpER.THfs:CERTIRCATE DOES NOT`AEFIRriAATNELY•OR NEGATIVELY AMEND;EXTEND OR ALTEWINE tCO1rEl2AGEAfFORDED BY T POLICIES BE{AW THIS CERTIFICATE OF'INSURANCE DOES NOT CONSTITUTE A CONTRACT BETYYEEN THE'iSSUING 1NStIRfR{S);AiPTH iryZED REI'RESENTATfVE;OR.PRODUGER,AND THE CERTIRCATE HOLDER. INIPpRTgNi:. •the holder is an ADDITIONAL RISURED,the policy(les)must Have ADDfT10NAL INSWE visions or tie endorsed. If SUBROGATION IS-WANEp,subject to the terns and conditions of the policy,certain-policies may require an endorsement. A static:Rdo_on this certificate does not confer rights to the certificate holder in Ileu of-suchendorsement(s). PRODUCER Anthony F Cordelro Insurance wtoNe 171 Pleasant Street a , 50"77-M7 FAXRol: 'S(18-.577-0409'. Fall River,;MA.02721 ADDRESS: hsouza@eordeirolnsurance,Com' INSUREWAFFORDINGCOVERAGE NA1C S INSURED INSURERA: Liberty Mutuallnsurance INSURER B: Insulate 2 Save,Inc. C 410 Grove St INSURER Fall River,MA 02720 INSURER D: INSURER-E: INSIJRERF: COVERAGES< CERTIFICATE NUMBER: REViStOM.''NUlI/t3ER, THIS tS TO CERTIFYIfEiAT THE PaUC1ES OF,sINsURA►NCE LISTED'BELOW HAVE'BEEN tSSUED TO'THE INSURED NAMED ABOVE'FOR•}NE.PO[JCY PERIOD INDlC%1TED'IJOTINITHSTANDING A NYREDUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT:TO ICY P I THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO-ALL THE TERMS, EXCLUSIONSAND•CONDM.ONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'LTRT TYPE OF.INSURANCE I 1NVD POLICY NUNHER X c OMMERcuu.:GENERAL LUSLI Y LINM FJ1QH OCCURRENCE $ 1fl00,00p CLAIMS-MADE �OCCUR PREM6ES: otammtes $ i�r�l A MED.EXP ny ...: S , Y Y BKS 56418741 12/1017 12/10/18 pabDUVY ;DVINJURy $ GENP AGGREGATE LAIRAPPUESPER GREGAg 200B000 POLICY dC-C LOc OTHER: COI�IQtOPAC,GI $AUTOMOBILE LIABI ITYANY AUTO/A. SCHEDULED Y(Per person) $ AwosONLY X y. y BAA 56418741 12/10/17 12/10/18 BODILY INJURY(Peracdder g X'AIJfOS'ONLY x AUTOS ONLY eradddenr S ;X UMBRELLA LIAB X OCCUR A EXCEss.LIAB p A1M OE Y Y USO 56418741 EACH OCCURRENCE $ 2 OOD,000t. 12/10/17 12/10/18 AGGREGATE 5. 10�pap, DED, RETENTION S WORKERS.COYPENSATION $ AN6EA9L4MWIJA0LITY YIN X S PE ER ANY PROPRW DR/P, AM,E�.ABER EXCLUDED? NIAXWS 5418741 12/10/17 EL EACH ACCIDENT QQ 12/10118 _ E L EA DLSEASE'' K'yyeess;;desatbe"under: DES?RIPTION OF OP8tATIONS,bebw .�, `DISEASE--.P017CYL7MTr S:_ DESCRIP710N OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarb Schedule,may be albched J more Is required) CERTMCATE'HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES:BE:CAN6l3:LED.:BEFORE THE EXPIRATION DATE TF EREOF#?ONCE WILL S'E F flYlrttgj',IN Proof WI of Insurance ACCORDANCE-WITH THE.POLICY FROV jg. AUTHORIZED 1'�` 01 °2015 ACORD CORf'QRATION. AB r+g#►ts'resei verk ACORD25.(�16103) The ACORD name and logo are registered marks of ACORD c? 6 °F, row 'own of Barnstable *Permit# �. I—P''"s 6 r artlrs from issue date Regulatory Services Fee i 1 BARNSTABLE, 9� 1 . �0$ Thomas F.Geiler,Director ATED MAy A Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY n�-} Not Valid without Red X-Press Imprint Map/parcel Number ' v l� Property Address uAsUboat-or Q Residential Value of Work OC) Minimum fee of$25.00 for work under.$6000.00 Owner's Name&Address IQ l Me Contractor's Name Z/✓j l/ l &ss e 11 Telephone Number Home Improvement Contractor License# if applicable) 7o -PRESS RESS PERMIT Construction Supervisor's License#(if applicable) Q 7 q0 b NOV — X IUiU ❑Workman's Compensation Insurance Check one: TOWN OF BARISTA3LE [&<am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance p c Insurance Company Name /� ko ( V 1 40q L Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) / VRe-roof(stripping old shingles) All construction debris will be taken to rQlC�f ST/4�J� &17d M ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows i "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILES\FORMS\building permit forms EXPRESS.doc The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations z 600 Washington Street 1 Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: ]Builders/Contractors/Electricians/Plumbers Applicant Information �}� Please Print Legibly Name (Business/Organization/Individual): KI m // l � 'C 1 1 Address: , �1��J�r414 ST . City/State/Zip: A 14 S 6 & //l Phone M a 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. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.VI 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' Y9. ❑ Building addition [No workers' comp. insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself..[No workers'_eomp:...-.__,__._._.......:.._right of exemption per MGL T 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 hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name or the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is(true and correct. Signature: Date: Phone#: S 3�,2-- 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, 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-contractor(s)name(s),address(es)and phone numbers) 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`iLC or'lTl'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-frll in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permiUlicense 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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia COKE Tp Town of Barnstable Regulatory Services BMMTABLE. " Thomas F. Geiler,Director 9 MASS. g 1639.., 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 L , as Owner of the subject property to act on my behalf, hereby authorize in all matters relative to work authorized by this building permit application for: 3 (Address of job) Sign e of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. i Q:FORMS:OWNERPERMISSION �oFYwe tqy� Town of Barnstable o� Regulatory Services BARNsrABLE Thomas F. Geiler,Director tKASS. 1639. ,m� ]Building Division ATfD MA'1 t. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ----------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied 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 3 Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. ' The undersigned"Homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for•hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) 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:\WPFILES\FORMS\homeexempt.DOC chuseft - Departnicnt of f tiblit 'ABO,'lr l of Ruildin4i Regulations a6d.St fidards I . Corlstruetiori Sppervisor•Specialt License:. nse:e .CS SE.Lt� 99406 f: •:, f t Resir;cted tc .RFW.S,DM KIM BASSETT ~ 3775 MAIN STREET GUMMAQUI,D, MA 02637 s • •' �='�- �`�"�—`' � Expiration:-'12J1Q/201.1.• i? b ('nnniisiaecr Ti-,: 99406' o ��o Jy w° J tC '�;; Ja wJ Ica`aim`c�yy poi�o;Aqp;y wq, qj y •.tom~, ����h oD 4F• f Q O� �� r 41 O � Cba, 4 VJ i TOWN OF BARNSTABLE BUILDING PERM ftARVCATION Map j3j Parcel 0yZ h/qY f e�mit# �D 5:s roQ' 1 Lsue ////Health Division 1,fr, Date � 000Conservation Division r * �. Tax Collector " off ;,/-01 _10a awi —0 k— SEPTIC SYSTEM MUST BE Treasurer l INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address gil paU Village 9d t,Y_V /L ,AA p 4n -s 4 ol L 4 rI ec �1 Owner �04/=gnn (Cth At&st ,�'� Address CSC?n1 e-- Telephone � ' 320,6 Permit Request M41D 17.a4i a-c.._ re,4) z rIct-ee"_ 4&? Ir A46 s� Square feet: 1st floor: existing dd proposed 2nd floor: existing lJ� proposed N,�. Total new Valuation dAa Zoning District Flood Plain Groundwater Overlay Construction Type LvZkW Fy"..Q Lot Size / &g.r- +' Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family )4 Two Family ❑ Multi-Family(#units)�O Age of Existing Structure 3o S I- Historic House: ❑Yes XNo On Old King's Highway: XYes ❑No Basement Type: )6 Full Cl Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) © Basement Unfinished Area(sq.ft) �- Number of Baths: Full: existing new Half: existing new a T-0"c� Number of Bedrooms: existing new T)'L- Total Room Count(not including baths): existing 6 new�_ First Floor Room Count Heat Type and Fuel: ❑Gas 4 Oil ❑ Electric ❑Other Central Air: ❑Yes )d No Fireplaces: Existing — New Existing wood/coal stove: Cl Yes )4 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:9 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes gNo If yes, site plan review# Current Use e�i V)\, S • Proposed Use -Clq BUILDER INFORMATION Name Telephone Number Address Z License Home Improvement Contractor# ©ZrS3 orker's Compensation# ALL CONSTRUCTION DEBRIS RESUL ING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �5 , Z 0 . D1 7 FOR OFFICIAL USE ONLY b PERMIT NO. DATE ISSUED. . MAP/PARCEL'NO. 0� ADDRESS VILLAGE 'd OWNER .�' r DATE OF INSPECTION: FOUNDATION ."y FRAME Cp /a77 L,7n/ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH-' FINAL GAS: ROUGH - FINAL FINAL BUILDING V. f-41 DATE CLOSED OUT su ASSOCIATION PLAN NO. o sssNsr�tE. e Town of 13arnstame 19. ,e$ Regulatory Services Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 i Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation.repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: e1440 hw -Finwe d>3stimated Co Address of Work: �� 4 .D/ L�'C' 7 Owner's Name: - 47 Date of Application:_�/Z a z 4 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 03®z---70� Date Contractor Name Registration No. OR Date Owner's Name q:f6mis:Affidav Nil VVY VAPMA i ,ice ,I 11 1 \ 11�• • 1 a •a. • 11 1 ■ 11 1 • \• • 1/ 1 1• 1 1 •'\ ..t / 1 .11 • \K 1• M •. IIU=11 1 \ 1 1 11 :11111 . - • •.. 1 . 1 1 \. 1 n 1 q�gag6 4 f 1 1 1 1 1 Y I \ 1 1 II �1 1 MI I 1 1 1 1 �• 1 ►• 1 1 1 . 1 1 1 • 1 ' '\ I. �1 •• 111•' 1 111 •1 •.. i I 11 K t. 1 1 1 1 1 jjE/11j11111, .I. - • I- • 11 :A• I I �I 1 1 _ .1:1 � 11 • 1 .11 I r I I •11: 111 i 1 I /' � � •1 111 ' ' ' •111 1 11 � _ 1 11 do not write in this area to be completed bY cilY Or to" liuse only �.E3Buading Departlagnt city or tawmOSdectu• 1 11 ce ■ Departulcut ::...::........................... ............ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. partnership, association, corporation or other legal entity, or any two or more of An employer is defined as an individual, p p, the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an mdividual,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 an the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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,"ad 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 contacting authority. VIA FENNN� _ Applicants the box that lies to your and ensation affidavit completely,by checidng applies`z Please fill is the workers comp Sapp company names,address and phone numbers along with a certificate of insurance as all affidavits maybe for coon of insurance coverage. Also be sure to sign afd ''1 submitted to the Department of Industrial Accidents ' :� date the affidavit. The affidavit should be returned to the city or town that the application for the permit or lic®se is being requested,not the Department of Industrial Accidents. Should yun have any questions regarding the"law"or if you are required to obtain a Pwilm, compensation policy,please call the Department at the munber listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit fur you to fill out in the event the Office of Dons has to contact you regarding the applicant. Please be sure to fill in the p ienmitllicense nsmber-which will,be used as a reference member. The affidavits may be ret®ed ie the Department by mail or FAX unless other anangemeats have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a*call. �7 The Department's address,telephone and fax member. The Commonwealth Of Massachusetts Department of Industrial Accidents office of Investfoadons 600 Washington street Boston,Ma. 62111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 Y i F ESTIMA TED PROJECT COST 14 RKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= ` PORCH square feet X$20/sq. foot= square feet X$15/sq. foot= DECK �� , . l�oo square feet X$?/sq. foot= Dc OTHER / ' Total Estimated Project Value 1 h c �a a fc %\ MAP 13141 #123 63 log 131 m,U3 28 MAP 131 \ 39 i/ #93 4.9 MAP 131 #11 O�j MAP 131 y: � 7 #40 a MAP 13 \� #23 MAP 131 / MAP 131 - --- 46 P 131 ai #59 - / #680 MAP 131 #SO / x 47 f — / #39 \�. N :i" MAP 2131 MAP 131 '1 =h� ' 02 295 MAP 131— #3077MAP Dl MAP 131 52 \ O % \ / MAP 131 ! \ 19 / #325 MAP 131 #30 .F MAP 131 t \• *' .` MAP 131 32 +.#2 \ #353 298 N SCALE: 1"=150' MAP 131 PARCEL 47 W .E S *NOTE: Planimetrics,topography,and **NOTE: The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aeriol photographs by The lames vegetation were mapped to meet Notional of property boundaries. They are not true locations,and W.Sewall Company. Topography and vegetation were interpreted from 1989 aerial photographs by GEOD Map Accuracy Standards at a scale of do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mopped to meet National Map Accuracy Standards 1"=100'. on the map. at a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps. M CMR Appeeda/ Table JSZ2b(continued) Prescriptive Packages for One sod Two-Family Residential Buildings Heated witb Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Area'(Yo) U-value R-valttc' R-value' R-values Wall penmeW EgWpmem Effiidency' Package R-value° R value' 5701 to 6500 Heating Degree Ds"P Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 036 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A WA 85 AFUE W 15% 0.52 30 19 19 10 6 95 AFUE X 19% 0.32 38 13 25 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 l0 6 90 AFUE AA 19% 0.50 30 1 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: ,��2 4. %GLAZING AREA(#3 DIVIDED BY#2): / P__Z2 5. SELECT-PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-t980303a 780 CMR Appendix J - Footnotes to Table J8.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from.the U-value requirement. For example,3 ftZ of decorative glass may be excluded from a building design with 300 ft of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. `Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. "Me floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `T):e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meat the same R-value,,requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. " If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. s For Heating Degree Day requirements-of the closest city or town see Table J5.2.1 a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component•includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). d 43 r _______- --- ---------------------------------- ------------------------------------------------ -------------------- ------------------------------- ------------ -------------------------------- ------------- -------------- --------------- ---------------- --------------- 0111 . . . . . . . . . . . . . . . . . . 00 711 0 0 00 T-111 Brick Existing Front Elevation --------------------------------- i 00 0 0 00 New White Cedar Shingles Brick Proposed Front Elevation NEAL A. PRATT ro osed Nelson Residence DATE: 4-2D-01 PACE 1 OF 6 B /DB West Barnstable SCALE: None 4Z CH ROAD 42 CHASE ROAD E. SANDWICH MA. 02537 BY: NAP PHONE: (608) 888-3206 Home renovations i O Existing Rear Elevation O Proposed Rear Elevation NEAL A. PRATT roposed Nelson Residence DATE: 4-20-01 PAGE 2 OF 6 BUILDER/DESIGNER SCALE: None A Q CHASE ROADWest Barnstable E. SANDMCH MA. 02537 BY: NAP PHONE: (608) wa-ww Home renovations Existing Right Elevation Proposed Right Elevation 0 0 0 0 Proposed Left Elevation Existing Left Elevation NEAL A. PRATT Proposed Nelson Residence DATE: 4-20-01 PAGE 3 OF 6 BUILDER/DESIGNER West Barnstable SEE: None 42 CHASE ROAD E. SANDWICH VA. 02639 BY; NAP PHONE: (608) BM-3200 Home renovations Family Roan B!q See SK-2 14 6' Rom eoM Single S Tub Bed Room 6tT o. Car Geroge Cotherol cell no 22'-5' 4x4 post connector past LQ�dDun •to L-xSimpson , Irlig plain to 2'x2'x]See�SK 4 ® sho.v 2 • __ ________C_ 2• 20' cPon ________ �tm •• S 2'x2'xl• �p 3 1I Inlly 9 V2'xlV LV Concrete „p�m, to L I FootN concrete Foundptlon 1 I S Rev Q !� stoma I» C—G/b rz I I I I DINng I I I I Room I Bed Room Study I I I I I I L__J Kitchen L__J L__J 1 12'x16' Deck Proposed Floor Plan NEAL A. PRATT ro osed Nelson Residence DATE: 4-20-Dl PACE 4 of 6 B /DC� West Barnstable S� None 42 CH ROAD 42 CHASE ROAD B. SANDWICH KA. 02537 BY: NAP PHONE: (608) WO-3206 Home renovations Cedar Tree Existing Floor Plan NEAL A. PRATT Proposed Nelson Residence DATE: 4-20-01 PACE 5 of 6 942 CHASE ROAD SCALE: None a2 CHASE ROAD West BarnstableAA J5 E. SANDAIcH AU. 02637 BY: NAP PHONE: (606) BBB-3206 Home renovations R-34 Roof Insul -9' fiberglass=R30 1.5'air=R2 -Asphalt shingles=R.l -1/2' ply=R.62 -1/2' dryrnll=R.45 Deck System Balustrated Rail R-13 Insul 5/4x6 decking R-19 Insul 2xg PT joist 16'OG ID, span 2-1.14'6* 5 n ( joist band Double 2x1D girt 14joi span (max) 6' span 2xID joists 16'Cmax) 4x4 PT post t span mexi •/sinpson Post up From existing foundations 31/2' tally ABU44 New 2'x2'xl' footing for 12-x4'dp concrete center column DECK SYSTEM NEW FAMILY ROOM FLOOR SYSTEM 12 15 Existing 2x6 rafters 16' DC Existing ridge bean Sister 2x10 raters 16' OC Now Ridge 2-1.75x14' LVL 20' span (max) 26' 4x4 post to 2'x2'xl' footing (typ> Simpson post cop connector Joist hung rafters to LVL ridge bean EXISTING CROSS SECTION CATHEDRAL CEILING CROSS SECTION NEAL A. PRATT roposed Nelson Residence DATE: 5-16-01 PAGE 6 of 6 BUILDER/DESIGNER SCALE: None 42 CHASE ROAD West Barnstable E. SANDIIICH A(A. 02637 E. NAP PHONE: (508) 888-3208 CROSS SECTIONS FIRST F1,00R GIRT , f AT REMODELED PORTION OF GARAGE TyBeam"- Y5.55 Serial Number 700708586 BEAMUSA 1111 5121101 12-.01.23PM 2 Pcs of 1.75" x 9.25" 1.9F- Microllam® LVL Page 1 of 1 Build Code-.146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED Overall Dimension=22'6" Product Diagram Is Conceptual, LOADS: Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width:6' Loads(psf):40 Live at 1000/o duration; 12 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(pit) Floor(1.00) 0 80 0 to 22'6" Adds to Watt SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LNE/DF.AD/TOT. PLY DEPTH DETAIL OTHER 1 Column 3.50" 3.5" 1482196312445 1 9.2" Detail A3 2 Column 3.50" 3.5" 3575/2398/5973 1 9.2" Detail 83 3 Column 3.50" 3.5" 897/260/1157 1 9.2" Detail A3 -See TJ SPECIFIER`S/BUILDER'S GUIDES for detail(s):A3,83. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 3414 3046 6151 Passed(50%) Rt.end Span 1 under Floor loading Moment(ft-lb) 7745 7745 11204 Passed(699/9) Rt.end Span 1 under Floor loading Live Deg.(in) 0.337 0.478 Passed(U511) MID Span 1 under Floor ALTERNATE span loading Total Oefl.(in) 0.541 0.717 Passed(U318) MID Span 1 under Floor ALTERNATE span loading -Deflection Criteria:STANDARD(LL U360,TL:U240). -Bracutg(Lu):Alt compression edges(top and bottom)must be braced at 2'W o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -The load conditions considered in this design include Alternate member loading. ADDITIONAL NOTES: -IMPORTANT!'The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordanoe with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by.the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY1 PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the TJ Residential product fisted above. -Note: See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. OF PROJECT INFORMATION OPERATOR INFORMATION: MI FOR: NEAL PRATT BUILDER Michele C.Tudor PE,Xtreme Engineering o�� M MICHELE C.TUDOR,PE C'L 123 Cottonwood Ln. �� H Centerville,MA 02632-1979 8'AtUCfURAL 503-771-7601 gUST R SW771-7163 F' �MAL E ►'t` CoWgM O 20M by T(vs Jdst.a Weyerhaeuser ausimss. TJ•Pro'r end TJ-8wm'w are trademarks d Trus Joist MicroHertYA is a registered trademark d Trus Joist. C:1Progrom Files\True Joiat1T19ewnm%001-WpRATTQRT.brn � A!beam TJaeam' r5.55 serial aambw.7wj0&6.5 2 Pcs of 1.75" x 14" 1.9E Microllam® LVL BEAMt1SA 1111 5w16J01 2:20:50 P MI Poo 1 or 1 Budd code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOAD$ LISTED Member Slope:0 Roof Slope:5112 Overall Dimension=30' 2 3 All dimensions are honttontaL Product Diagram is Conceptual. OL ADS: Analysis for Beam Member Supporting SNOW Application. Tributary Load Width: 14'6" Loads(psf):25 Live at 115%duration, 15 Dead SUPPORTS: INPUT SEARING REACTIONS(Ibs.) 000 ;-r MI/ -St wso CH WIDTH LENGTH LIVE/DEAD/TOT PLY DEPTH D TAIL OTHER 1 2x4 Plate 3.50" 3. 3018 12049 1 14.0" De ( �j j 2 2x4 Plate 3.5a' 7411 /5094 Detail R7 (��� 3 rJ 7.5- C 3 Column 3.50 3.5 108913 1 1 4q-,-F Detail R1 SB Shear Blocking it -See TJ SPECIFIER'S/BUILDER'S GUIDES for Beta ).R1, 1. u � A Rot ?- Bearing length requirement exceeds input at support(s)2.Supplemental hardware is required to satisfy bearing r��nts. 7 DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 7203 6400 10706 Passed(60%) Rt.end Span 1 under Snow Roof loading Moment(ft-lb) 22557 22557 27897 Passed(81%) Rt.end Span 1 under Snow Roof loading Live Defi.(in) 0.512 0.992 Passed(U465) MID Span 1 under Snow Roof ALTERNATE span loading Total Defl.(in) 0.849 1.322 Passed(U28p) MID Span 1 under Snow Roof ALTERNATE span loading -Deflection Criteria: STANDARD(LL: U240,TL:U180). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -Design assumes adequate continuous lateral support of the compression edge. -The bad conditions considered in this design include Alternate member loading. ADDITIONALNOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application, input design loads•and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the TJ Residential product listed above. -Note:See TJ SPECIRER'S/BUILDER'S GUIDES for multiple ply connection. OF PROJECT INFORMATION OPERATOR INFORMATION: ��' M�ICHELE FOR: NEAL PRATT BUILDER Michele C.Tudor PE.Xtreme Engineering Ga� R MICHELE C.TUDOR.PE $ Na D074 O �' 123 Cottonwood Ln. 8"RUCTURAI Centerville.MA02632-1979 'PECISTE�6�� 508-771-7601 •�' 508-771-7163 /4NAL E� Misr pM tD 2000 r gi True Joist.a W of True user Business. TJ aeam"'is a trademark of Tres Joist MiCrOflamt9 is a registered trademark or Trus Joist 9 Application to 2 001 , 097 ®rb Ringo Jftb nap Regional jLqiotoric 3N.5trict Committee In the Town of Barnstable BAP-NS APLL'_E, MASS. CERTIFICATE OF APPROPRIATEN;ES;Sf hyp' ,�� �► f 2 Ali 10: 55 Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ❑ New ❑ Addition Rr Alteration Indicate type of building: House Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign 4. Structure: ❑ Fence El Wall El Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE Y, 2-(vo 0t ADDRESS OF PROPOSED WORK- /" �-LU ASSESSOR'S MAP NO. /3j OWNER 6'a4 — i 'A, elh ASSESSOR'S LOT NO. C)Z—Z HOME ADDRESS ,4,��[,� z� %1 Z A�,ojOS y/47ELEPHONE NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attac7ditional sheet if necessary.) �.. AGENT OR CONTRACTOR 1— ,/Y TELEPHONE NO. ADDRESS ?2 DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. ..��s r�zt, � s��/i��s ice. ✓e�.�'� /n��s-.� ell Signed - � � // Owner-Contractor-Agent For Committee Use Only D his Certificate is hereb D 1 o D S -0) '71 y L Date C I 3 Approved/Denied I mmittee Members' signatures: :4U AY 6 HONE INPROUENENT CONTRACTOR Registration: 103690 Expiration: 1/9/02 Type: OBA NEAL A. PRATT, CUSTOM BUP. Neal Pratt 42 Chase Rd ADMINISTRATOR E Sandwich MA 02537 —ss...�.i'....._�........v.!.t.^�_.i....l.�:.......ice..>c.�...i....•.�... a�._...._ . ✓fie V�omvnwouuea� o�✓�aaoac�euaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR j Number. CS 030908 Bi rthdate: 11/24/1941 Expires: 11/24/2001 Tr.no: 10347 ° Restricted To: 00 NEAL A PRATT _ 42 CHASE RD E SANDWICH, MA 02537 Administrator b�P�OfIMET��`� TOWN OF BARNSTABLE BARNSTABLE, i MAM 9 BUILDING INSPECTOR �D MAI{r• APPLICATION FOR PERMIT TO J .Y*.I ......5..!.!!t?. e' (� rv1t TYPE OF CONSTRUCTION ..... oc� ....... ! A.Yee......................... ....I„G6b..... ........:.................... ......... ...."..-..... ................19...; TO THE INSPECTOR OF BUILDINGS: 9 The undersigned hereby applies for a permit according to the following information: Location o. ....�.13 4 � ...... .4./ ......Aoz:............. 'f�...J�� ti � :... �i�S. ...................... ProposedUse .......................................................................................................... ............ eS Beb ►�� Zoning .District .....D.\......�........................................................Fire District .............................................................................. Name of Owner ..YV��.��1. ...�.N.S}:....Q....a�............Address .z1�....VV.......(.t7...........:....W... ax�u.!�.�..V:I�Sg Name of Builder �!...��11�(.... STe.... -.......Address ,4d..... t,��0 ......tJ ........ ....Rpxk�..i"Um, Name of Architect gf'! .................Address ..'Qe�M 6��r�� gS Number of Rooms Foundation Lao�r4e. r`. �11Q,� ...... .......................................................... . ................................................................. Exterior ..........V" v�............................................................Roofing o`ivwt St�ovg�eS cy- -j - tq............... Floors ...............w®a:Gt........................................................Interior .....�.�� E —rC e-A�.J ................ f�j �-- Heating ............(AP." ::.... ..................................Plumbing ....COA C...... .. .�. ,� ... �r z ............... i _ Q E] Z� Fireplace ...........V. .l .....................................................Approximate C O � ..... .. .....0.............../A©S O m.Z................. V � 4 � � / 9 Definitive Plan Approved by Planning Board -----------_______-----------19 . p.., � a U- O 1� Diagram of Lot and Building with Dimensions 0 � Q O Q =w Z g..E" .. SUBJECT TO APPROVAL OF BOARD OF HEALTH p . m C�, ; HA c'• W OO ux± n = y � Xcn \j zz W � _. -- —. o Q a � ¢ N z w Pz, J = ZCa � \ � Qa: -3 d•�B Z V 7 43a q• 3 a_ �� �'e 1 d° I Ft.' 6E L► 0 — 12� /DOGjj ; SA' a � 0 �'" vz=o 3 /° '7 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �jrr�✓�(1 Name ........................... ......... ..................................... I�Fel}n, Construction Co. , Inc. ` ' - - ' NoO m- - ore story it for .................................... � single family dwelling -`----^--^^-'--------'-'-'----' Apollo Drive ~ ' Location_ .--.--,-..--.-~.--..----- / West IarootaliLa ' '-^'--------~--'-----`-'-----'' Welby Construction Co., ]nc.> ' Owner ......................... � �zz�u� , .� �����-----. ' ^ -------,. , ' \ . _ ............................ .. «13 � � . . � ' Permit-- Granted—"".= of Inspection -.���x.��,.-��x,n,�np°^ Dote Completed ------------..l9 � � � PERMIT REFUSED � , S ---------..--..------- 19 . , ` . X ' ~--.--~...~---..------...-----. ^.._~~-...-.-.-..----..'--.---.-.- , . . -`-'-~^--^-`^--^^^^'-'~--`'-^-'^^--' l �� ^ . .. ..-~---..----..,---..-..-..-.----. Approved ,---------.--..--.. lA ` ' ` --------.-----.-...----.--.-... ^ . ` . ` ----.-------------.---.-,...-. . . '~ ` ^ `