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0263 CHURCH STREET
�,. - ---� s . �3 �� 7"" a e o _-.- �:_� �� ems." � ".^..��+"'."""*!"�"'-' ,"_'. ..�,.`.;`M� .-``�-+,,�+.��.e+a= ^^: `.',.,,... » ) \ . � ) ) . \ % � \ IVI ] ® n� F _�� \ Mk ) \ } \ j ( � < � (. � ) , � ) � � ) � ) � ! � | . : j � ) Application number pA �► Fee .............................. g��, ,,. Building Inspec?&,,, Initials.... . ...... �� ............. sMA't 24 ��q� Date Issued..........LalZ�l./..�.... `�.:'�: '°� OCT �� dl ............... FDA]N tk I�F�l M I AW Map/Parcel...... ryl"� TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: . Cell Phone Number 6" �VY Project cost$ 0 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize Qi4Ulb �w�✓��� to make application fora ilding pe t 'n accordance with 780 CUR Owner Signature: Date: T OF WORK Siding a Windows (no header change)# ED Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review I1 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name ��CJ/ �L✓�✓��� Home Improvement Contractors Registration(if applicable)# /02 d (attach copy) Construction Supervisor's License# 9/5-0 7 (attach copy) Email of Contractor/��NAV���,�/(✓Z' C�tnAi l Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. G�/�c rnoin�nn�tucal!/t.n`"•lt�autc�r��el/J office of'Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Recndividual Registration valid for Individual-use only I qn before the eXPIratlon date. If found return to: j'2059 02/18/2020 Office of Consumer Affairs and Business Regulation DAVID LINNELL _ One Ashburton Place.Suite 1301 Boston,MA 02108 DAVID J.LINNELL� 2 CHEQUAQUET CENTERVILLE,MA 02632 Undersecretary- Not valid without signature i Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructio�SCYwi �1 &2 Family t CSFA-071507 Y I Ekpires:08/11/2021 DAVID J LINNELL, 2 CHEQUAQf1ET WAY> CENTERVILLEfjMA 026 1 <? Commissioner / P APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm4.30pm.Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's 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 APPLICANT'S SIGNATURE Signature Date 9a� ! All permit applications are subject to a building official's approval prior to issuance. '11� 0 CERTIFICATE OF LIABILITY INSURANCE Ac"REP DATE(MM/DD/YYYY) ,% — 1 08/08/2019 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Blackstone Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.C . Box 3144 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester, MA 01613 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: A.E.I.C. Linnell Enterprises INSURER B: 59 Freeboard Lane INSURER C: Yarmouth, MA 02675 INSURER D INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE.MAY BE ISSUED OR MAY IIERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH I'rOLICIES AGGREGATE OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUULTP. INSR TYPE OF INSURANCE POLICY NUMBER DA M /D n ) A E MMID / Y LIMITS GENERAL LIABILITY EACH OCCURRENCE S 71 COMMERCIAL GENERAL LIABILITY DAMAGE � S CLAIMS MADE OCCUR PREMISES Ea occurence)_ MED EXP(Any one person) S - PERSONAL&ADV INJURY S GENERALAGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER" PRODUCTS-COMP/OP AGG $ POLICY n PROJECT R LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY g SCHI:DULEO AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON,OVJNED AUTOS (Per accident) PROPERTY DAMAGE a (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT S ANY AUTO EAACC S OTHER THAN AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ✓ TORN LIMIT$ ER A ANY PROPRiETORIPARTNERJEXECUTiVE WCC50050074472019A 8/1/2019 8/1/2020 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? If Yes.describe under E.L.DISEASE-EA EMPLOYE $ 100.000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER David Linnell is covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 367 Main Street DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN Hyannis, MA 02601 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHOR 60REPRESENTATIVE ACORD 25(2001108) ©ACORD CORPORATION 1988 J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I �� Application # 1 DL 6 Health.Division Date Issued L , Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/Hyannis Project Street Address a26_r z� Villages /Slv� Owner Address Telephone 5 d9-- 27b a 1' 9 Permit Request Square feet: 1 st floor: existing da proposed 2nd floor: existing '© proposed - Total new J�S� Zoning District Flood Plain Groundwater Overlay Project Valuationj2ff00Q 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 YO Historic House: • ❑-Yes ❑ No On Old King's Highw4;i es ❑ No Basement Type: ❑ Full 62trawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: .3 existing o new �= Total Room Count (not including baths): existing S new First Floor Room Count Heat Type and FueL, ' as ❑ Oil ❑ Electric `:❑ Other Central Air: ❑Yes _,1i 'No Fireplaces: Existing , New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garag�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 Si<' APPLICANT INFORMATION t. (BUILDER OR HOMEOWNER) NJ N Name ��Ull�? �i�✓N 'r� Telephone Number Address License# Home Improvement Contractor# l02 6)a Worker's Compensation # 6" (' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY I i APPLICATION# DATE ISSUED MAP/PARCEL NO;:�. ADDRESS. VILLAGE F OWNER y DATE OF INSPECTION: :. =FOUNDATION4 '�c9t .olc' R �)L 1 FRAME ! YK4r / L/Zrtic ,e�liG 9 0 /ii GQa� rsu�s.r,� r INSULATION,d�iUS/�3�s' IN � ,3g1.r,(irr F FIREPLACE ELECTRICAL: ROUGH FINAL t� o 4 PLUMBING: ROUGH FINAL ROUGW#e,,r, FINAL FINALBUIL••DINGr tt�//J((�C� 7 /-T��-3 letL�e a �. ..� _ DATE CLOSED OUT• ASSOCIATION PLAN NO. -38/07/2011 04:52 5087527172 �co,�v� CERTIFICATE OF LIABILITY INSURANCE DATEI►AMINVrYY) 08/08/2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Blackstone.Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 37 Harvard Street Suite 213 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ✓vorcester, MA 01609 INSURERS AFFORDING COVERAGE NAIL a INSURED INSURERAA A.EI.C. Linnell Enterprises INSURER B; 59 Freeboard Lane INSURER Q Yarmouth, MA 02675 INSURER a INAUMR E.- OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .TR WOAD TYPE OF INSURANCE POLICY NUMBER D LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERA4 LIAQIUTY V REM lSES OtEe S CLAIMS MADE r 1 OCCUR MEO EXP(Any one PW'^an) S PERSONAL&AOV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S POLICY Fj PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANYAUTO (Ea aaidant) ALL OWNED AUTOS BODILY INJURY g SCHEDULED AUTOS (Pet person) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per eocldanl) PROPERTY DAMAGE S (Par accldRM) .z' --4 GARAGE LIABILITY AUTO ONLY,.-EA ACCIDENT` S r ANY AUTO OTN R.TkAN EA AU S AUT�ONLY AGG S -rl EXCESSIUMBRE1IA L.IABIL)rY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE' G $ %n DEDUCTIBLE S �" RETENTION S u • 9 � WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'UAWUTY ANY PROPRIETOWPARINER/EXECUTIVE WCC5007447012011 8/1/2011 8N12012 E.L.EACHAccIDENT S 100D00 OFFICERIMEMBEREXCLUDED? E.L DISEASE•EAEWLOY5 $ 100,000 n yr oeevloe under 5=ODo 6 ; JAL PROVISIONS below E.L.DISEASE.POLICY LIMIT S OTHER )avid Linnell Is covered by the workers compensation policy. ;ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE T„Omop,THE IBSUINO INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRTTIEN Building Department 367 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED To THE LEFT.BUT FAILURE TO DO�SHALL IMPOSE NO ODUGATION OR LIAM ITY OF ANY KIND UPON THE INSURER.M AGENTS OR Hyannis, MA 02601 REPRESENTATIVES. AUTHORCM REPRESENTATIVE i „ter 'o xz. of B ar'nstable . Regulatory Services Thomas �. Geiler, Director :6s9L, Building Division rra Thomas Perry,.CB O,Building Coro u�issioner 200 Maim Strbet, Hyannis,MA.02601- W-WW.town.barnst2 b le-ma.us Fax: 509-790-6230 'Office( 508-862-4038 PLAIN RF� 7 2-60 Owner "l9NS��l _ Map/Parcel: Project Address 26 3 4Cwm Leyf Sr., k* Builder: !� The f6III0•wing Reins were noted:on reviewing: 4 � p �tv Regiewed by: .Date: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 t z� www.mass.gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeZibly Name(Business/Organization/Individual):�i/QU/,ice Address: $+rj' /a4 City/State/Zip: y-�2,C?4t;, Phone #: S"O 9- l.Q9/ Are ou an employer?Check the appropriate box: Type-of project(required): y =1%�I am a employer with f 4: ❑ I am a general contractor and I 6. ❑New construction 11 employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees ' These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL I LE] Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑other *Any applicant that checks 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. pp,,��. Insurance Company Name: �✓`/.Z eo t.2 Policy#or Self-ins.Lic.#:waC Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . I do hereby certify under the pains an penalti s of perjury that the information provided above is true and correct. Sianafar Date: 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#: :�Lrssachusctts- Dcp;u tment ()f Public S;ri'ch 4 Board of Buildin Regulations and Stan(I:u-ils Construction Supervisor License One-and Two-Family Dwellings License: CS 71507 DAVID J LINNELL JR 59 FREEBOARD LN YARMOUTHPORT, MA 02675 Expiration: 8/11/2013 ('unmiisiuner Tr#: 2398 71; tom...toozeueacua n�✓` LUGer a License or registration valid for individul use only _ Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registratiori _:120659 10 Park Plaza-Suite 5170 - Tr# 294382 Boston,MA 02116 Expiration:`°y19f2Q:42 Ty pe:'.':;;:Indiyidual :' LINNELL ENTERPRISES DAVID LINNELL JR _f_______ 59 FREE Undersecretary BOARD LANE_. Not valid without signatdre YARMOUTHPORT,1111A U2675 f Town of Barnstable Regulatory Services rMASS Thomas F. Geiler,Director r 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 p , as Owner of the subject property hereby authorizes--��" to act on my behalf in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. SiAture of Owner yclig-nature of Applican Print Name Print Name i Date QYORM&OWNERPERMISSIONPOOLS r THE Town of Barnstable s Regaratoty Services Thomas F. Gerler,Director �F 16 Building Division Tom Perry, Btu7ding Commissioner 200 Main-Strmc _Hyannis,SSA 02601 _ Www.to Wa-b arastab l e-ma_us office: 508-862-4038 Fax: 5Og-790-6230 Hon�oRh�r.Icl�s-�x�r�rrorr . • Pleeee Ptiat DATE- JOB LDC.UMN• �a///2 C�,/ T �A2NS Ti9�L� numbs _ slhmt village "xoh�owxi:xR": S yuw) name bane phone# q%ork phone$ CURR-=JN L MAlIM40 ADDRESS: P�A2/(/�STi4,CSL-r up code TlSc m==t excxoption for"homeownta-s"was exfmded to includt owner-oecuoicd dwellin of six units or Ims and to allow homcownmrs to cngagc an individual for hire who does not possess a license,providrd that the owner acts as I DEFDanOx OF HM=VrIxTa Pmrson(s) who owns a parccI of land on which he/she resides or intends to'reside, on which there is, or is intendad tn- be, a one or tvro-fa�ly dwelling, attached or dateched siructosrs accessory to such use and/or farm struct=. A person who constrgcts more than trine home is a two-year period shall not be considered a homeowner. Such "homeowner"shall suhInit to the Building-Official on a fomn amrptable to tf c Building Official, that be/she shall be responsible rk for all such wo Performed umdcr the btnlding pmtnit (Section Io9.1.1) Tb,c undersigned"homcownet'•assttmcs responsibility for compliance with the Stater Building Coda and other applicable codes, bylaws,roles and regulations. The undersigned"homeowner"certifies flat,.hc/shc understands the Town of Ba=nstablc Building Depu.t=t rniniTmTm inspection pro=dmcs and re-q+Tr•�nts and the he/she wm comply with said procedures and rcgEnXr-mcnts. Cigna' f Hommavmer i pproyal ofButldmg O5cia1 Notr: Three-f niil s co y dwelli% ntinmg 35,ODO cubic feet or larger w.tll be regtxirzd is comply with the torte Building Code Section 127.0 Constriction Control. HonMowxERIS EXQU-nbx .The Code states that: "Aay bottuowncr pm*am-ling work for which i bmIduig p=Tnit is mquu•ed shaD be exraipt fnan the provisions 'this=ction(Section 1D9.1.1 -Liiaiszng of construction Supervisors);provided that if dim homootivmr engages a pamon(s)fur hiTz to do such n1r, that such Homeowner 4ME act as supervisor." klany homcowncas who use this cxrmptim mt unawart that they an assuming the trsponsibhlitics of a supervisor(sec Appendix Q. )es&R.egulations for Lirms*ng Construction Supervisoa,S=tioa 2.15) This lack of awaraiess oftma T1 hints in serious problems,particularly an the homeowner hires unlir'n=d persons. In.this ease,our Board camhot proceed agahut Ihr imliemased person as it would with t lieaw.scd �,crviur. The homeowo,er acting as Supervisor is uhimatrly responnb)r- To auure that the homevwncr is MY rw c,Df his/her itsp=mbhlities,many communities mquh-r,as part of the p=nit apphration, the bDm=D,Ymc7 citify that he/she imdershmds the mrp=bilities of a Supervisor. On the last page of this issue is a form=rrmtly used by rat towns. You may care t a==d and adopt mmb a fmTrilmervfieation for use in your cmMmI city, rms:hommc mmpt I �,t►E r o� Barnstable Old Kings Highway HE orce District Committee 200 Main Street, Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 (1V APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four(4)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 all categories that apply; 1. Building construction: ❑ New InAddition ❑ Alteration 2. Type of Buildin;: House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Others o 3. Exterior Painting roof ❑ new roof'❑ color/material change, of trim, siding, window, door c::, rs') --� 4. Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall . ❑ Flagpole ❑ Retaining wall ❑ Tennis court E�Other7;:z rn 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ dther Type or Print Legibly: Date NOTE All applications must be signed by the current owner Owner(print): ' Telephone#: Address of Proposed Work: Village I Map Lot Mailing Address(if 4ift ent) Owner's Signature Description of Proposed Work: Give particulars of work to be done: - l/_�) Agent or Contractor(print): G' Telephone#:' �; , qD •��� Address: 1 Contractor/Agent' signature: For commi ee use o This Certificate is hereby APP VED/DENIED Date .71 - Members signatures ��T202011 : : ; TOWN OF `' vJ APPROVE® NOV 0 9 2011 Town of Barnstable Old Kings Highway 1 Committee Q:\Boards and Commissions\Old Kings Highway\OKH Apphcations\OKH DRAFT 2011 Cert Appropriateness DRAFT:doc CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 5 copies Foundation Type: (Max.1�12"exposed)(material-brick/cement,other)�P61JFCEJ) 42Z r-R Siding Type: ClapboardN sgleq other ` Material: red cedar white cedar other 4( ' Color. Chimney Material: Color: t Roof Material: (make&style) N1 J9RfA Color: 6�J Roof Pitch(s): (7/12 minimum) Z 11 (sp�fy�p�aor new buildings, major additions) Window and door trim material: wood other material, specify J1 4zd '1,&;, Size of cornerboards 1,Q size of casings(1 X 4 min.) f X 4 color�d Rakes Ist member 2°d member Depth of overhang r Window: (make/model) material �b JZ 1'�4 color � (Provide window schedule on plan for new buildings, major additions) 1 Window grills(please check all that apply: �� k ? b true divided lights_ exterior glued& s_ grills between glass_removable interior None Door style and make: �f-� � � material , ^Color: Garage Door,Style 'Size of opening Material Color 1-�Zr1 dtL Shutter Type/Style/Material: ,C _�� Color: Gutter Type/Material: !2 L Color.1 1 k��,l ' ./', r Deck material: wood l� other material,specify Color: . 161 Skylight, type/make/model: material Color: Size: akin of Barnstable Old King's MY, "" Committee Sign size: Type/Materials: _Color: x r-rN Fence Type(max 6' )Style material: Color: Retaining wall: Material: so, Lighting, freestanding on building illuminating�sign^ OTHER INFORMATION: THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED Please provide samples of paint colors,manufacturers brochure of windows,doors,garage door,fences,lamp posts etc Signed: (plan preparer) Print Nam _ /__ L 2 Q:\Boards and Commrssions\04d Kings HighwaDAOKHApplications\OKF1 DRAFT 2011 Cert Appropriateness DRAFT doc i t A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)t j Q Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust).................................................................. .................................................110 mph WindExposure Category...............................................................................................................................B a, 1.2 APPLICABILITY Number of Stories ..............................................................(Fig 2)............................ stories <_2 stories RoofPitch ..........................................................................(Fig 2) ........................................... <_ 12:12 MeanRoof Height ..............................................................(Fig 2)................................................ ft <-33' BuildingWidth,W ...............................................................(Fig 3)................................................ -ft 58 BuildingLength,L (Fig 3)........................................... _8 '.............................................................. Building Aspect Ratio(UW) ...............................................(Fig 4)........................................ ... ... :1 Nominal Height of Tallest Opening2 ...................................(Fig 4)........................... .... .... ...... 5 6'8" 1.3 FRAMING CONNECTIONS • General compliance with framing connections....................(Table 2).................... ......................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry.................................................................................................................................... 2.2 ANCHORAGE TO FOUNDATION''3 5/8' Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concr&k only 3 Bolt Spacing-general ..........................................(Table 4)..................................... in. Bolt Spacing from end/joint of plate ............................(Fig 5)..................................... in.<_6"-12" Bolt Embedment-concrete.........................................(Fig 5).................................................$in.>7„ Bolt Embedment-mason (Fig 5 ............................................ in.>_15" PlateWasher...............................................................(Fig 5)...............................................a 3"x 3"x,/4" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)............................_ft 5 12'or U2 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 <_d •— Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)....................................................—ft <-d �-— Floor Bracing at Type ..l.....................................................(Fig 9)...................p.........).....................�. ......:... Floor SheathingType (per 780 CMR Chapter 55 ..................... Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55).......................14 in. Floor Sheathing Fastening..................................................(Table 2).-ad nails at jC0 in edge/12 in field 4.1 WALLS Wall Height \ Loadbearing walls........................................................(Fig 10 and Table 5)................... 'k....... ft Non-Loadbearing walls................................................(Fig 10 and Table 5).......................... ft <_20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)..................Jj(0 in.<_24"o.c. WallStory Offsets ........................................................(Figs 7&8)............................................—ft <_d 4.2 EXTERIOR WALLS3 ; Wood Studs Loadbearing walls........................................................(Table 5)..............................2x-- ft_in. Non-Loadbearing walls................................................(Table 5)..............................2xco - ft_in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10).................................................................. .— WSP Attic Floor Length................................................(Fig 11).............................................1 ft>_W/3 `Ny Gypsum Ceiling Length(if WSP not used)...................(Fig 11)............................................+">_0.9W 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ..(Fig 11)............................................................ Double Top Plate Splice Length ........................................................(Fig 13 and Table 6 ft �l Splice Connection(no.of 16d common nails)..............(Table 6)....................................................... AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CNm 5301.2.1.1)' Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)..............(Table 7)........................................................ Non-Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)...............(Table 8).......................................................� Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................ Table 9 aft in.<_ 11Sill Plate Spans ........................................................(Table 9).................................. ft_in.5 11' Full Height Studs (no.of studs)...................................(Table 9)........................................................ � Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) \ - HeaderSpans.............................................................(Table 9).................................. ft_in.<_ 12' V Sill Plate Spans...........................................................(Table 9).................................. ft in.512" Full Height Studs(no.of studs)....................................(Table 9).............................................. ....... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously° Minimum Building Dimension,W r Nominal Height of Tallest Opening2 ...........................................................................6 6,8" . SheathingType..............................................(note 4)..................................................... Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ in. Field Nail Spacing..........................................(Table 10)................................................. in. Shear Connection(no.of 16d common nails)(Table 10)..................................................... Percent Full-Height Sheathing.......................(Table 10)................................................. .. /o 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... -- Maximum Building Dimension,L Nominal Height of Tallest Opening2.....................................................................' 6'8" SheathingType..............................................(note 4)..................................................... ` \ Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................ in. Field Nail Spacing..........................................(Table 11).................................................J _ in. Shear Connection(no.of 16d common nails)(Table 11)...................................................... Percent Full-Height Sheathing.................... ..(Table 11)................................................... % 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... — Wall Cladding Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19)..........'7ii ft<_smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................Uplf Lateral.............................................(Table 12).............................................L= If Shear...............................................(Table 12)............................................S= plf Ridge Strap Connections,if collar ties not used per page 21.....(Table 13)..............................T f Gable Rake Outlooker......................................... (Figure 20).............. ft<_smaller of 2'or U2 .-- Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift............................... ...... ......... Table 14 U �#8b. p ( )....... ........... ....................... Lateral(no.of 16d common nails)...(Table 14).......................................L Ib. Roof Sheathing Type...................................................(per 780 CMR Chapters 581 59).................. Roof Sheathing Thickness........................................... .............................................. in.>_7/16"WSP Roof Sheathing Fastening...........................................(Table 2).................................. .................& _ \_� Notes: 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a 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 be a minimum 2 in.nominal thickness.pressure treated#2-grade. AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 4. a. From Table 10 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per the Figure, Vertical and Horizontal Nailing for Panel Attachment A'WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Check fist for Compliance(7so CMR 5301.2.1.1)1 -MEN THIS EDGE RESTS ON FRAMING LMESd NAt$ A'f fibs. ' 11 11 11 1� 11 1 71 n 1/ 1 u 1.1 71 11 11 1 11 �1 11 11 I r 11 11 11 11 f M 1•I �( 71 11 11 6 1 I I `C 11 l i K 1 11 1{•� 1 O 11 1{ 1- II 11 I Q { I r 48 j� m I{ to 71 11 1 Z 60 to II {� II ►1 1 �1 11 11 fl Ir 1 1•I II W ii 11 1 060 ME EDGE II Q If it W 1 I I I I J I 7 IJ 1 II 11 t NAIL SPACNG i { PANEL _ See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment I f AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)' a 1 ' r 1 1 1 r ' 1 r 1 ' 1 1 Ir I� ti 1 k{ m z 1 1 a �a kl I1 1 FRAdAING MEMBERS i 1 EDGE ffaFRMEDIAT£ � 1 1 1 1 N 1 1 _ 8"FAIN. 1 STAGGERED 3"MMd AU1fL PATTERN � PANEL r PAWL EDGE DOUBLE NAIL EDGE SPA(MG DETAL Detail Vertical and Horizontal Nailing for Panel Attachment vi. Ems. Generated by REScheck-Web Software Compliance Certificate Energy Code: 2009 IECC Location: Barnstable,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 263 Church Street John and Sue Tansey Kenneth Sadler West Barnstable,Massachusetts 263 Church Street KSAdesign West Barnstable,Massachusetts P.O.Box 1149 Hyannis,Massachusetts 02601 508.790.3922 •Iwo Compliance:1.4%Better Than Code Maximum UA:71 Your UA:70 The%Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. AssemblyGross Cavity Cont. Glazing UA or or D•• Perimeter U-Factor Ceiling:Flat or Scissor Truss 352 38.0 0.0 11 Wall:Wood Frame,16in.o.c. 128 21.0 0.0 6 Window:Wood Frame,2 Pane w/Low-E 17 0.270 '5- Wall:Wood Frame,16in.o.c. 175 21.0 0.0 8 Window:Wood Frame,2.Pane w/Low-E 26 0.270 7 Wall:Wood Frame,16in.o.c. 128 21.0 0.0 5 Door:Glass 41 0.320 13 Floor:All-Wood Joist/Truss Over Uncond.Space 352 21.0 0.0 15 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in R�ES/check-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title tignature Oat Project Notes: Calculations are for Addition only.CS#39020 Project Title: Report date: 11/14/11 Data filename: Page 1 of 4 Generated by REScheck-Web Software Inspection Checklist Ceilings: ❑ Ceiling:Flat or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall:Wood Frame,16in.o.c.,R-21.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-21.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window:Wood Frame,2 Pane w/Low-E,U-factor:0.270 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?_Yes-No Comments: ❑ Window:Wood Frame,2 Pane w/Low-E,U-factor:0.270 For windows without labeled U-factors,describe features: #Panes-Frame Type Thermal Break?-Yes-No Comments: Doors: ❑ Door:Glass,U-factor:0.320 Comments: Floors: ❑ Floor:All-Wood Joist/Truss Over Uncond.Space,R-21.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. ❑ Automatic or gravity dampers are installed-on all outdoor air intakes and exhausts. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 50 pascals OR 2)the following items have been satisfied: Project Title: Report date: 11/14/11 Data filename: Page 2 of 4 I (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayediblown insulation extends behind piping and wiring. (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: (] Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and equipment are identified so that compliance can be determined. Cl Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: (] Building framing cavities are not used as supply ducts. ❑ All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181 A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 U. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Temperature Controls: Where the primary heating system is a forced air-furnace,at least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: ❑ Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Project Title: Report date: 11/14/11 Data filename: Page 3 of 4 Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an onloff heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage<=15 (d)50 lumens per watt for lamp wattage>15 and<=40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) i Project Title: Report date: 11/14/11 Data filename: Page 4 of 4 2009 iECC Energy Efficiency Certificate Insulation Rating R-Value Ceiling/Root 38.00 Wall 21.00 Floor/Foundation 21.00 Ductwork(unconditioned spaces): Door Rating U-Factor SHGC Window 0.27 Door 0.32 NA Cooling;Heating& Heating System: Cooling System: Water Heater: Name: Date: Comments: ItIfR1=UPGRADE s�g �s . SMOKE DETECTO 5 REVIEWED aI! �. �til-6 'b� PIEDUIRES THE UPGRADING Af; T�_t6��g, kOFi THE ENTIRE DWELLINGSg �� BF:@�RFE§LpEf''IkBA�iEASAREADDEDORCREF 3t9 .'333� BARNSTABLE BUILDING DEPT. / pQTEfA-5E"p�Ai_ E�21�! 1t REQUIRED FOR %vn_. Wit Raoff,.THE CTRtCF �RM'�fRPL0.9 FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING i5 d a L e co) W +a c�oc•oon., i_ ..__._ ._....__._-__ _.__.-_. d S+ 6 c 4 4 o u z s+ B 7 W 0 � CARBON MONOXIDE ALARMS — • MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE s e ep u It 3k $Q r�i i o i ie v e.i �oF•o� ' uwl�P-oA'1 ' .ero n.....w......souv- $ Vm! e . - Q• �s s" a Mimi wu..w..°o.wa..,.n. ow.rawsrrre Iswear Huneew ' ft200 � i .,,.w»..„..,w....:�...e, �dl••1 algr}swdr,J}saM °e°, i ireri i..w..d 7NN,bO O .,.r..,..,..°„....r }aa.j-Foi y7jnq,2 eo maNaaKaa•m,aa,o+m rir.,ror-"•u+-.0 r.-w'wi..d �a ^'•^'°"`^" �NOIlV70-I N916309NIOlNB IVN01663dOLd m 3.5 Rubtsdp-vs l �.m II 'r rcal:;IN`d1.any pun NHot �o�ava N1�r6ryd :ao3 suO!}mnoua-J Pur uo!}!PP`d:17aro*ajd I L9I a 4Wr6JJ ww a . 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O �NOI1V'J'Ol N915a49NIO�f191vN0166adOYd �sNaenaa � ,ca iMd1 any Puv NHor, ��7lOVQ N.L.Fi1'Io. IJO 4U01 tlnOU9 Utl UOI 1 PwAowt�s`9Md. 4 CAB NMVtIO ! t P �PPV U.)ar-OLId I LQI {:),.?r II o �. �" 07. •. �� g 'Li130 -3-I. 4 � a Ail � e 0 a 3 a Eli OI TA66f� Ail .. F�a o t t b of Yla al9b}su�v�}sa/� dnu•�n 1......Yv—H— II/al/OI w•Id✓•b•N,IWY.4 NOIlH70-I N9163p 9NIplN9lVN0155ddONd '6N0161A2L d O 6 T"UMSOP vs w F /C��iN`d1 any,pun NHor ••._ '° d•I• _ � :�a;suo!}+�noua�puv uo!}lppy :173! 21d0 I [e »����bJd .•a•'w �:� 'a..w 'AB NMVYp 111 ^°yaw v.y'm•�c.•w.mo p �i I. �1 9 I u• ' .. •� 4 .. d: ii is i . I ; I I I i iI 1 i i I r a i PROJECT NAME: ADDRESS: ��Q3 G1�luVzJ, � PERMIT#_ 6 I I 6--7 Z) to PERMIT DATE: ► L MAP: LARGE ROLLED PLANS ACE IN: BOX SLOT . Data entered rn MAPS program on: C 7 B Y: 'n Y. 7: .pr �c t N1 `6, oia k ....... 7 t: g `.`o, 5 LA29 's L 2,,t _0 & 'riA -.11: 7 c s.A N. BARNSTAEJLf-'ASSESSORS:.MAP CL'P 21 'NOT JO_SCALE-�, CUISP.Q.- -A "'FNEY 7 -(GOO6) ,t ZONING DISTRICT Rf MINIMUM LOT:SIZE:`.-43,560.' N 1'14iMUM LOT i (DISPL)' Ira - MINIMUM:YARD'SETBACK$:' FR*bN'F,:,7 0, -T, :ft. sr ARE ABR HAM P. LIES I& TOTAL' -A:'336 -P.K.:SET.,..-.: Y i6o OT ALF:.,� CERT'#127435 L 70� FLOOD!ZqNE*. "0:!L ff- -.1J.. .FYI) t /DH F�D /dH tt,. 06 w*.*mo j '(HELD)' fo, t 5:,*�,,Pit. ;1_ .j `7 7 0 N SET'-t.-.i,:�4':".'%-: t al 10.- .......... ,,��:-;R CORMICK Z" L , GERI.- Iluoul, l , X t IV _ C121 (6000) SLN: 177 7 r 6, t y ;? t tt. w NTi:WE Al NANCY'-JENNIE JOHNSONET. R..'-PROEIATE. 8 SET 3i 7,. ;AR*�R'DOLGOFF 0 'o DETAIL ''NOT-TO'.SCALi:; C. _FN p v w 7 00 El m '(OISPL)' 14H B tIOT,TOr ta col. r -7 k ET OoA',(OISPL) ` 'A -V..- M ICHAEL.J 4. DEED.8K.-3157 PG 7 4.: Z. 4.cc t. N JOT.TD w Y.:. C_9, r �AIK r ssJ .I-10 tq /V a D.H NOT FOUND C.U. H.FN t::"-: (STONEWAII REMOVED'FOR. ACCESS-AT THIS ARFA)- % '0 F..*ANDERSON et'ux. xb s: c?. SE a CERT. 75 L.C.P. 36078P#5 32.98 p 6) KENNETH,t S et uxl w D. DEED 8 K. 13.67'PG. 66.8 6j* 'o. J.: DETAIL NOT TO SCALE SCALE I CERTIFY;.THAT:THIS ACTUAL SU IRV& 'WAS-MADE ON THE. z 'GROUND IN�AccbRDANCE VA*TH'THELAND--' tT:lNsTkucnows . ..COU.� r OF 1889 ON'OR R Y�-2;..Ig S.ANO-JANQA t BARNSTABLE PLANNING i BOARD.�:`- AN 'APPROVAQiUN( _-itts�6kk�f0_N':7. CONTROL REQUIRED LAND IN ,6ATE , 6 v a DATE%--O�_W. EST) BA'. STABLE'' .-MASS TO BE FILED IN THE-LAND COURT PRECISION: I:149;697 BEING A SUBDIVISION OF;LOT'I-AS SHOWN ON LAND COURT PLAN' 3667 SA -' LINEA'/DIREC110NAL ERROR.OF-CLOSURE 'T SCALE,-1 l3v.-32.4a...E 010S. APRIL.21'.1995 :�s q E.D.M.:ACCUAR*ACY-' 5 rnm + ppT 0' 66 .120 '180 F-.t %t NO A�10 COMPUANC WITH :'O%VNER...OF'RECO.RD ORDINANCE;"REdUiREMiNTt:..HA§'*BEEN.:MAbE'-bk.IS INTENDED r r 'ORldlNAL'-CERTlFl.CA CURRENT.LAND COURT DEED: BY THE!4ABOVE-..EWDdASEMEN't.,�'-'t eeriz?' ind. -.8ARI3MA:E. & HARRY W..BRADY, -'�kLEN;C:-SXMIJEL. : -dowh cape, g, kNK-Rb.- EET -dS'CHbRCH- 77 MYRTLE 8� 2' HILTON.HEAD.-S.d. 2 926:' VVEST BARNSTABLE,,'.MASS,02668 CIVIL- ENGINEERS 'CERT.'.*#50892 - . LANb'.-§URVEY0RS - DOCUMENT. 612713 (CER TIFICATE-NOVISSUED) 936'main st. ..4 yarmbuth, ma ta PERMIT Town of Barnstable *Permit# d a� � 6m°nguf'- ra ddte"2`1'-$ Regulatory Services . t 7 2008 Thomas F.Geiler,Director i6g6 ,�• Building Division F_gARNSTA��om Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 . www.town.bamstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number. 6 fib Property,Address 963 � 0 ,ye,11 Residential Value of Work"1 �a��, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name i 1.2p- eyle, Tel hone Number Home Improvement Contractor License#(if applicable) 5 ❑Workman's Compensation Insurance Chec one: [► I am a sole proprietor ❑ lam the Homeowner ❑ I have Worker's'Compensation.Insurance Insurance Company Name - Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) I ❑ Re-roof(stripping.old shingles) All constriction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof)- ❑ Re-side Replacement Windows/doors/sliders.U-Value (ma immin - *Where required:•Issuance of this permit does not exempt coWhance with other town department regulations,i.e.Historic,Conservation,etc. i.*.**Note: Property Owner mustsign Property Owner Leftei of Permission. A copy of the Home Improvement Contractors License is required. + Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Public Safety Mass.Gov Home DPS Home EOPSS Home Mass.Gov Home State Agencies State Online Services Department of Public Safety Licensee Complaints I I License Type Home Improvement Contractor License# 128257 Restriction Company All Cape Energy Name Daniel White Address 155 Underpass Rd/po Box 1492 City, State, Zip Brewster, MA, 02631 Expiration Date 3/17/2009 Status Current No complaints found for this Licensee. Back To Search w i http://db.state.ma.us/dps/Iicdetails.asp?txtSearchLN=HIC128257 5/7/2008 f oFZHETo Town of Barnstable Regulatory Services IE Thomas F. Geiler,Director rEnt�►�0. 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 r u i as Owner of the subject property hereby authorize /� (�1_44e � to act on my behalf, in all matters relative to work authorized by this building permit application for: C (Address of Job) L Si ature of Owner Date I Print Name f r permit lease complete the Homeowners License If Property.Owner is applyingo p t p p Exemption.Form on the reverse side. Town of Barnstable Epp THE Tp�� • Regulatory Services Thomas F.Geiler,Director BAMSTABt.e, v Mass. $ .esq. Building Division ,�lfOtA Tom Perry,.Building Commissioner . 200 Main Street, Hyannis, MA 02601 ww•tv.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 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 10§.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 1om.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)forhire 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 fomJcertification for use in your community. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia UT. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers .Applicant Information ^ Please Print Legibly Name(Business/Organization/Individua): Address l RS— .( A S s City/State/Zip: 6(`r°L0,5kA.. . 0163 l Phone.#: M27 qQZ1 CIE Are you an employer? Check the appropriate box: Type of project(required): 1.El I am a employer with 4.. I am a general contractor and I 6. ❑New construction loyees(full and/or part-time).* have hired the stab-contractors 2. am a'sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g• 0Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.•insurance cow' # required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers' comp. right 6f exemption per MGL 12 ❑Roof repairs �insurance Iegtnled.]t c. 152, 1(4),and we have no 13.❑Other employees. [No workers' comp.insurance required.] *Any applicant that checks box iil must also fin out the section below showing their workers'compensation policy infannation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must pruvidt their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: Policy#or Self-ins.Lie.#: 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 crimifial 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 may be forwarded to the Office of Investigations of the DIA for ine,rrance coverage verification. I do hereby cerli the pa' -and pe alties of perjury that the information provided above fs true and correct r Sig-nature: Date: o Phone#- �r6)�_ 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 S.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 hue, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant 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 conuract for.the performance of public work until acceptable evidence of compliance with the insurance requirement's 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 certificates)of insurance. Limited Liability Companies•(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towp 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 permitibcense number which will be used as a reference number. In addition,an applicant that must submit multiple pemiit/license applications in any given year,need only submit one affidavit indicating cuirent 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 homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to born 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 TO. #617-727-4440 ext 4-06 or I477-MASSAFE Fax# 617-727-7749 Revised 11-22.06 www.mass.gov(dia ,4 a r Town of Barnstable �t do Regulatory Services Thomas F.Geiler,Director • BMWSTABM MASS. Building Division 163 AtFD MA'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERAIHT# k 5�0 / FEE: $ `5 SHED REGISTRATION 120 square feet or less f� Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/Parcel# is ignature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? . 00 Conservation Commission(signature required) a� PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 � :. •00 - n t - s LOB' Z Vtom. 9 S.M. St EASIN& OWELLING lam ' is 22 rt aa. 29 . :f. C.A. XH 4.1 Pc: FNI .: ( (G.01 s:N. .7.7. . . d.� SET Oa" , JENNIE : 0 •o� N ANCY J4HNS01� �. PRQBATE 01 _ t` ow Orr o DUAIL S NOT TO. SCALE C-B./D.H. FNt ' 4 (QISPL) S cd. �3�, oo F �c�h • � MICHAEL �J. ORISC LL ', STK. DEE. B.K. 41 7, P. 7 Application to Old Kings Highiny Regional Historic Dimiet Committee Ei in the Town of Barnstable for a CERTIFICATION OF EXEMPTION Application is hereby made,in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470. Acts and Rasohn-o1 Massadfusetta,,1973,as amended for proposed work as desvibed below and on plans,drawings,or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED rVYORK ASSESSORS MAP NO. OWNER �,,,�,O0G,I ` &k LsSrU ASSESSORS LOT NO. (� HOME ADDRESS ') C.'(�U'ya) 'S l' l��' .hnn TEL.NO.n%_ / dos AGENT OR(OONIAACTOR ADDRESS TEL NO. ThYpplication is for exemption of proposed exterior construction on the ground that: (1)It will not be visible from any way or public plow. Q (2)h it within a category declared entitled to exemption by Old King's Highway Regime]Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot,and,if an addition is Involved,shoe& ing location of existing building. - �� 5P/4&-T Rai o v Lg' /�6 lUk2i A"66-4M' 04P6VY LIVE SIGN r A SpaeeblloYv Iles fox Committee use Agent Received by H.O.C. The certificate is hereby Data- rim BY Data; Approved : The categoric of work entitled to exemption are listed an Disapproved the i>adk of this form. 36 n.