HomeMy WebLinkAbout0042 CROCKER ROAD No. 4210 1/3 ORA
100
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATIONJi..
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Map �� (` Parcel �} 7 ` Permit# 7L0
Heat Division al .h� 7� 913 3 Rr.,n C,.A Date Issued
Conservation Division I),/X-k 03 � Application Fee
Permit F Tax Collector ee _ �� �s3
SE T IEPdf1vIUS
Treasurer �C �-. sQ P
C Q j tAN-STALLED IN COMPLIANCE
Planning Dept. WITH TITLE 5
ENVIRONMENTAL CODE ANC
Date Definitive Plan Approved by Planning Board TOWN REGULA''IONS
Historic-OKH Preservation/Hyannis
Project Street Address T,2� y RLC>
Village 6065 45
Owner v O "� �Y� 2&6x< Address
Telephone cJ c� c;24r 970p0 7
Permit Request W
Square feet: 1 st floor: existing (Q25 proposed 2nd floor: existing 12.6 proposed 760 Total new
Zoning District Flood Plain Groundwater Overlay
/;Project Valuation Construction Type
Lot Size Grandfathered: O Yes O No If yes, attach supporting documentation.
Dwelling Type: Single Family O' Two Family O Multi-Family(#units)
r _
Age of Existing Structure .3v Historic House: ❑Yes o Cr Old King's Highway: O Yes o
Basement Type: Full ❑Crawl ❑Walkout ❑Other /rN
,
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing_ new `
Total Room Count(not including baths): existing new�_ First Floor Room Count
Heat Type and Fuel: Gas O Oil O Electric O Other 64)
Central Air: ❑Yes No Fireplaces: Existing ( New Existing wood/coal stove: ❑Yes ❑ No
Detached garage:O existing O new size Pool:O existing O new size Barn:O existing ❑new size
Attached garage:O existing new size W24 Shed:O existing ❑new size Other:
Zoning Board of Appeals Authorization O Appeal# Recorded❑
Commercial O Yes O No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION p
Name 4 W 5 Telephone Number
Address U_ License# 0/0"3�2(,!--P
J31 &1&0 Oq/L &A) Home Improvement Contractor# 13&
Worker's Compensation# UX r,-3MI =3
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 7 2,*V S/q,5z S147704J
43 /00// 0/-7
!SIGNATURE DATE1'eqC710
i
9
FOR OFFICIAL USE ONLY f
' . PERMIT NO.
DATE ISSUED
MAP/PARCEL NO. a
ADDRESS VILLAGE _
OWNER
DATE OF INSPECTION:
` FOUNDATION 410Lj10 ,V
FRAME 6 f/'c/» k'�a y a '.� /217
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH - : FINAL
FINAL BUILDING = `y
DATE CLOSED OUT 6: -
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts,
u^ zi Department of Industrial Accidentswee 611MAMWM
'
F � 600 Washington Street
Boston,Mass. 02111
Workers'Comensation Insurance Affidavit-General Businesses
.. -. .-._.: ram.;, .. ..,. •, _ .. ... ." .... .: _ -.... , .
name: "
address:
city state: zip: phone#
work site location(full address):
❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment
working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.)
❑I am an em I with employees(full&part time). ❑Other
g%%%/%%%/%%//O�%/'�i./. /%/%/ %/%%%%��///%%/%%%�%%/%%%/%%�%�%%%// %%%%%%%%
I am an employer providing workers' compensation for my employees working on this job.
company name:
address:
city: phone#:
insurance.cb:•:'.:::: .;
I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices:
company name:
address:.:. ..
city:. p}ioiie
insurance co. ROlic'':#
company name::e::
address
citY:
insurance so.::: .:. olicv# .:
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct.
Signature Date
Print name Phone#
official use only do not write in this area to be completed by city or town official
city or town: permittbcense# ❑Building Department
ElLicensing
oard
❑check if immed' es nse S req ❑Selectmen'Bs Office
i
contact person: phone#; ��Q�'/ ,� Health Department
❑Other
. (mvaed Sept 2003)
1
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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.
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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal a
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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please
isupply company name,address and phone numbers along with a certificate of insurance as all affidavits 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.
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 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 perrrit/license number which will be used as a reference number. The.affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would Ile to thank you in advance for you 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
BMW of Inlre9wan8
600 Washington Street
Boston,IMa. 02111
fax#: (617)727-7749
phone#: (617) 727-4900 ext.406
oFTME,a�. Town of Barnstable
Regulatory Services
ssrear.E, t Thomas F. Geller,Director
ss
9q,A 1639• k,� Building Division
TfD MAy
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
-improvement,removal,demolition,or construction of an addition to any pre-existing owmer-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 Estimated Cost
Address of Work:
Owner's Name:
Date of Application:-
-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 EYIPROVEMMNT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UN) R.PENALTIES OF PERJURY
I hereby ap ly for a ermit as the agent w4er:
Date Co ac a Registration No.
OR
Date Owner's Name
Town of Barnstable
Regulatory Services
3 warm ' Thomas F.Geiler,Director
Bull&n Division
g
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
office: 508-8624038 Fax: 508 790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
the.subject Property-
hereby authorize ��l�S.to"act on my..behalf,.
in,all matters relative to work authorized-by this building•pe=ait•application for:
(Address of Job)
/ a6
Suture of Owner D to
Print Name
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
00
New Buildings,Additions $50.00 ®,
Alterations/Renovations $25.00
Building Permit Amendment. $25.00
7 FEE VALUE WORKSIiEET �� 77r
NEW LIVING SPACE
square feet x$96/sq.foot= aor x.0031= 171
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE ,
square feet x$64/sq.foot= x.0031
plus from below(if applicable)
GARAGE�(attached&detached)
square feet x$32/sq.ft. 3,kL x.0031= _
ACCESSORY STRUCTURE>12,0 sq.ft.
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf- 1500 sf 100.00
>1500 sf-Same as new building permit:
square feet x$96/sq.foot= x.0031=
STAND ALONE PERMITS
Open Porch I x$30.00= 34P
(number)
Deck I x$30.00= �®
(number)
'FireplacelChimney x$25.00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable) 1 q4 60
Permit Fee
`y\ ,./lie "tJominzaruural(� a�✓'vGttOJaC�utve�d
�_ — Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Re do � One Ashburton Place Rm 1301
Expiration: g/26/2026/2004 Boston,Ma.02108
Ty e SBA
FOELIE +WRIGHT
WRIGHT WRIGHT
57 CROCOR RD.
W. BARN9TABLE, MA 02668 Administrator t valid thout signature
/ie vanvnza�uuea� a�✓�/�aacaclauaP,ll �
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
i :t
! Number: CS 010366
` :
� Expires: 08/26/2005 Tr.no: 5580
esthete&-O
WHITNEY P WRIGHT
POB 1045/331 OIL JAIL LN ( �
BARNSTABLE, MA 02630 Administrator
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE
Associated Employers Insurance Company
Burlington, Massachusetts NCCI NO 40959
(800) 876-2765
POLICY NO. I WCC 5003983012003
ITEM PRIOR NO. rNEW BUSINESS
1. The Insured Fogel &Wright,Inc.
Mailing Address: 57 Crocker Road West Barnstable MA 02668
(No. Street Town or City .County State Zip Code
I
❑ Individual ❑ Partnership ❑ Corporation ❑ Other FEIN 30-0134908
Other workplaces not shown above:
2. The policy period is from 0002/2003 to 01/02/2004 12:01 a.m.standard time at the insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here;
MA
i
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.
The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 100,000 each employee
C. Other States Insurance: See Endorsement WC 20 03 06 A
D. This policy includes these endorsements and schedules: SEE SCHEDULE
4. The premium for.this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating plans.
All information required below is subject to verification and change by audit.
Classifications Premium Basis Rates
Code Estimated Per$100 Estimated
Toil Annual of Annual
Remuneration Remuneration Premium
INTRA - Ol I I I I
SEE EXTI 7NSION OF INFORD LATION PAGE
Minimum premium$ 500.00 Total Estimated Annual Premium $ 10,057.00
As indicated;interim adjustments of premium shall be made: Deposit Premium $ 2,625.00
❑ Annually ❑ Semi Annually ®.Quarterly ❑ Monthly
MA Assessment Chg.
$9,813.00 x 4.5000% $442.00
This policy,including all endorsements,is hereby countersigned by 01/07/2003
Auftfted Signature Date
GOV GOV KIND PLACING CLAIM NAME SAFETY
STATE CLASS AUDIT OFFICE OFFICE CHECK GROUP Dowling&O'Neil Insurance
MA 15645 14 15M Agency Inc
WC 00 00 01 te(11-88) P O Box 1990Hyannis,MA 02601-1990
Includes copyrighted material of the National Council
on Compensation In ,
used with its permission.
Application to-
g,{ng'.o �igTj�Oap �eginn�I �t�toric �totrftt Committee
S
In the Town of Barnstable.
CERTIFICATE OF APPROPRIATENESS
)lication is hereby made,with four complete sets, for the s 1973 for of a proposed ed work aste described eness belowander Section c)
on plaice
f Chapter 470, Acts and Resolves of Massachusett , p p o
wings, or photographs accompanying this application for. � tom-,
I'
iECK CATEGORIES THAT APPLY: ,
❑ New Addition ❑ Alteration
Exterior building construction: ❑ Commercial ❑ Other
Indicate type of building: ❑ House Garage W
Exterior Painting: °O
Signs or Billboards: ❑ New Sigh
❑ Existing Sign ❑ Repainting Existing Sign
Structure: aFence ❑ Wall ❑ Flagpole ❑Other
DATE 0111 k
YPE oR PRINT LEGIBLY: q
ESS OF PROPOSED WORK �t r� � C� ASSESSOR'S MAP NO. -
DDR off
- ASSESSOR'S LOT NO.
►WNER
IOM
E ADDRESS TELEPHONE NO. N a
'ULL NAMES AND ADDRESS S OF ABUTTING OWNERS, Including those of adjacent property owners acro z ny
)ublic street or way. (Attach add onal sheet If necessary.)
7 cao
20 _.
OR CONTRACTOR B2C"n l,� z�C1 �jUI�ELEPHONE NO.
AGENT ADDRESS C`0 f?20)( 04 L UtIJ &i2J�` L6 1'AA 0��
DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please
include locations of proposed signs.
V t A (��2v� b x T1�rz '3 f2� Ls
�{ 6--el577A1
_/O A Signed - 1�
Own - ntr r- nt
For Committee Use Only
Certificate is hereby Date
Approved/Denied .
v 1.
mittee Members' Sig ture
O C T. 2 2 2003 -*-
TOWN OF BARNS BLE I'I
i
-- _
a V-A
�7,),
1
JAl
• oa Rbt3t:RY �,�
too.aQt� • j
CERTIFIED: PLOT PLAN.
I'd /3 L�
W CONSTRUCTION ONLY :
G"�� s 7- j��1��NS 7.1
'PP..GF FOUNDATION 19 f S FEET VA
ADOVE LOW POINT OF ADJACENTm�W _8 LJAS Se
ROAD.
SCALE: / "=40 ' ®ATE: 7//e/7�
(rFUNi�F.OGE ENGINEERING CO.INC) Fo E1nr y 4- 7-= o
CLBE B�T �/L L I CERTIFY THAT THE
-----� SHOWN ON THIS FLAW 10 LOCATED
��QIS�'ERE1� RE®1STERE® JOB P.IO. "�8G` 7.. b ON THE GROUND AS INDICATED IND
CIVIL I LAND , CONFORMS ORMS TO THE Z00100LAWNS- .
P LAWS- .
E�301C�EGR SURVEYOR DR. BY: fi . fl. i �
33 NO. MAIN ST 712 MAIN ST. 7/Y 79
SO.- YARMOUTH, MASS. HYAINNIS, MASS. SHEEP L OF / ®ATE RES. LAND SURVt `UiR
A complete TJ-Xpert framing plan requires the Trus Joist Framer's Pocket Guide
. •
fTi to
T -
24' ,
JOIST AND BEAM LIST
Plot ID Length Product Plies Qty
` Al 24, 14" TJI/Pro-350 joist 1 20
P1 22' 3 1/2" x 14" 2.0E Parallam PSL 1 1
Rml
i
ACCESSORIES LIST
Plot ID Length Product Plies Qty
Rml 16, 1 1/4" x 14" 1.3E TimberStrand LSL 1 5
Shl 4' x 8' 23/32", 3/4" Panels (24" Span Rating) 1 21
Rm, Rim Board
Ok
_ LEVEL NOTES
A3
File Name: FOGLE-CARR.JOB
Level Name: 2ND FLOOR
Plotted: 4/29/03 11:33
Design Status:
2ND FLOOR....4/29/03 08:41
= NOTE: Level design times indicated above provide CREATED BY
assurance for proper level stacking.
Design Methodology: ASD Mid-Cape Home Centers
Route 134
Floor Area Loading Is: PO Box 1418
40psf Live Load and 12 psf Dead Load South Dennis, MA 02660
Maximum Joist Deflection: 508-398-6071
L/360 Live Load FAX: 508-398-4559
f L/240 Total Load -
TJ-Pro Rating Information:
Weighted Average: 33
Lowest Rating: 33
Highest Rating: 33
Glued 6 Nailed Decking is Required SYMBOL LEGEND
j Direct Applied Ceiling of 1/2" Gypsum is Required
11 Floor Decking: 23/32", 3/4" Panels (24" Span O Point Load
pi Rating)
f Line Load
Normal O.C. Spacing = 16"•
1 f Area Load
'Unless noted otherwise
O
O (See FramerIstail Call tPolabel
cket Guide)
# Layout Scale: 1/4" = 1'
4
1 JOB COMMENTS Page 1 of 1
2,1' — .
FOGLE d WRIGHT
NOTE FROM OPERATOR CA" JOBFOR THE TJ-XPERT WARRANTY
REVISED 4-29-03 W. BARNSTABLE MA
SEE FRAMER'S POCKET GUIDE
( TJ-Xpert 6.30(#686)C6.30 D6.30 56.30 P6.30
i
FRIEDLINE& CARTER ADJUSTMENT, INC.
436 Maui Street, P. O. Box 338
Hyamiis, Massachusetts 02601
Tel. (.508) 771-3232
FAX (508) 790-2344
TO: ----Building Commissioner or Inspector of Buildings
( ) Board of Health or Board of Selectmen
( ) Fire Department
TOWN OF Barnstable
TOWN HALL
Hyannis, MA
RE: Insured: CARR, William & Linda
Property Address: 42 Crocker Road
W. Barnstable, MA
Policy,Number: H0326690
Type of Loss: Lightning
Date of Loss: 7/2/2004
File#: 100096
Claim has been made involving loss, damage or destruction of the above captioned
property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143,
Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate,
please direct it to the attention of this writer and include a reference to the captioned
insured, location, policy number, date of loss and file number.
On this date, I caused copies of this notice to be sent to the persons named above at the
addresses indicated above by First Class Mail.
J. F. MCNAMARA
Adjuster
7/28/2004
Application to O O O . 005
Old Kings Highway Regional Historic District Committee
in the Town of Barnstable for a
CERTI FICAT9 OF APPROPRIATENESS
Application Is hereby made, id triplicate, 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 fora
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: ® New Building ❑ Addition ❑ •Alteration
Indicate type of building: ❑ House ❑ Garage ❑ Commercial. Other -5Wb
2 Exterior Painting: ❑
3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
(Please read other side for explanation and requirements).
TYPE OR PRINT LEGIBLY DATE )a I ro
ADDRESS OF PROPOSED WORK 2 C' ,c,YER l�o A 11 ASSESSORS MAP NO. /C7
OWNER W I 1,__L i A M F <2,21Z ASSESSORS LOT NO. . G E7
HOME ADDRESS �d C's CK�C1Z �0A h • 2vSFOkA-4 TEL. NO. 14,1-9777
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
-Ws reet or way. (Attach.additional sheet if necess ry). �1.!BigRf�sTi)�
Q5N SP�4LE — Wi p9"ISpk COM/n,4sSN- C�O +`Lc CN C.f�Pi�l1 SK/ BS' L-'r�t.ev�S
L.'r 74, VEQ�r4 )%C&ADD 46 CA'OeXA-R.;?p 14/.AAAws7-A8 4Z
LO+ 13ENrJ67'r 60 C_gea a RD. tN. l3/1aNsr�eLr
LoT q1 /cx InA tusge _r -
Lor 40 cw FoGU S7 CR6b<�Q. RV. W �4 ssrr�Cic�
AGENT OR NTRACTOR �. Ja� An"- 4t19zioP"72, --XS T E L NO. 5��- 77�-sT�Oc�7
ADDRESS 3VV YA02-IMOU.-U-1�r, NgA� an, is . MA - 4sal0/
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No. B,other side),including
materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed
locations of new signs. (Attach additional sheet,if necessary). �(
ell
A D P
Can` &A AJ- �
v Signed
&4d-d14
Owner-Contractor-Agar
Space below line for Committee use.
Y
D a e h ertificate is hereby Date
Tiff" Ile 09 �GV
r
nF
HSTABLE
1
1 Approved ❑ IMPORT If Ce-Ificat s approved,approval Is subject to the 10 day appeal period
provided In the Act.
Town of Barnstable
Old King's Highway Historic District Committee
SPEC SHEET
FOUNDATION
SIDING TYPE �p�,2;1 hv.);� �t�"T-Te j COLOR
CHIMNEY TYPE /Vo,U COLOR A
ROOF MATERIAL ,5 0 ,AA 1,m COLOR O
PITCH
`l /I PFox
WINDOWS FI �(�(� f ,[ _COLOR SIZE X 16
TRIM COLOR
DOORS'. 3 / f / COLORS h 42V fZ0
SHUTTERS o ZZ' X 7// COLORS
GUTTERS Ale,.N COLORS
DECKS N/1 MATERIALS
GARAGE DOORS /I/ A COLORS /y
SKYLIGHTS /V A SIZE COLORS
SIGNS /V I COLORS N /
s
�• FENCE— A COLOR
NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this
form are required for submittal of an application, along with Four copies of the plot plan, landscape
plan and elevation plans, when applicable.
SPECSHT
Revised 11198
All plans submitted for approval shall be prepared to accurate scale without reduction, and clearly
drawn so as to indicate the nature and extent of the proposed project Should a conflict exist, the
Committee will make their decision based on application form.
I .
THE FOLLOWING INFORMATION,DOCUMENTS,AND PLANS MUST BE PROVIDED WITH
YOUR APPLICATION TO THE OLD KING'S HIGHWAY COMMITTEE
ONE
Application Cover Page
FOUR(4)EACH OF
Spec Sheet, Each Elevation, Plot Plan, Landscaping Plan
APPLICATION: All sections must be completed
SPEC SHEET: Complete applicable information
PLOT PLAN: Show all structures on the lot and
any proposed additions/changes to scale
Certified site/engineered plans for new homes
DRAWINGS: All Elevations and please include
Landscaping plans for changes in existing footprint:
stipulate the principal trees on the site, the approx. number
of trees on the site for new homes and additions only.
ADDITIONALLY THE FOLLOWING MAY BE SUBMITTED:
PICTURES: Of area (s)affected; Street view for additions/changes.
SAMPLES: Of materials/colors(i.e. color chart)
AN APPLICATION MAY BE DENIED IF ANY OF THE ABOVE INFORMATION IS NOT PROVIDED WITH THE
APPLICATION.
THE FOLLOWING FEE(S) MUST BE SUBMITTED WITH THE APPLICATION UPON FILING MADE PAYABLE TO
TOWN OF BARNSTABLE
************New rates will go into effect April 5, 1999*************
rr+►aa+r+a++r►wa++rrrawa+rw++++wrwwrarwwr++aaw++aa-ewww+++r+waww*w+►ar++►++awwaww++arw+aft+++r++►awr+ww++++w+rawwwwa+++r+++*awa+++
As of January 1, 1996, the applicant will be responsible for their legal advertisement. Please anticipate an invoice from
the Barnstable Patriot that will be your responsibility to pay. The actual cost of the advertising fee will reflect the length of
each ad.
++++a+ww++aaraarww►+►aww++++wwwwwww+++wrwwwwwww++w+wr+awwrwww►++++rr►rwaaarwww+w+rsaw+w+r+r►ra+wa+a►wwr++wrraarawwra++rr+aaaa+a++
Approved Plans
Please be advised that plans approved by the Old King's Highway Regional Historic District Committee may now be
picked up at the Building Department. You no longer have to stop at the Planning Department before going to the Building
Department. Remember, "There is still a fourteen (14) day app6al period on approved plans". This is necessary for each
Certificate of Appropriateness and/or Demolition issued by the Old King Highway.
If the 14th day falls on a Saturday, your plans will be available on most Mondays unless there is a holiday, then the plans
have to be picked up on Tuesdays. Thank You.
APPINPO
Revised 2/99
WE SHALL BE PLEASED TO ANSWER ANY QUESTIONS REGARDING THESE APPLICATIONS:
PLEASE CALL GWEN BROWN AT8624684
PLOT PLAN
FOR LOT #
Indicate location of, garage or. accessory building
Additions with dashed lines --------------------
Sewerage disposal (cesspool)
Well
I I
/�-----I—UPg, SQAc� (lot.. . . . . . .7�� . . .ft. rear)
Abuttor's Abuttor'
Name Name
Lot # I Lot #
REAR YARD
If this is a {� If this
corner lot, . . . . .:EC, . . . .ft. corner 1
write in name write ii
of street. name of
other
v street.
SIDE YARD HOUSE SIDE YARD
L1 .;�,
SO— FT_ — �� — — FT� Z
V)
4l
SET BACK r
I
(lot. . ..�� �. . .�9..ft. frontage)
\ / 'q 0, C P-C S-V-"6 �D A it
\ / (NAME OF STREET)
Information
Supplied by ��► l�.1, ✓iM �', �1���-
MARK NORTH POINT
gl _ 174R '
• �'` DEPARTMENT OF PUBLIC SAFETY 1.74662
ONE ASHBURTON PLACE;, RM 1301
BOSTON, MA 02108-161.2
CONSTRUCTION RVISOR LICENSE
Number: Expires:
Re,'trict.ed To: 1G
DAMES 0 MCGRATH
PO BOX 708 DD
S DEN N.T.S, M A 02660
Kee,- top for recei n..;
o trio �� of ;address not . ::'C-
01
HOME IMPROVEMEN..T CONTRACTORS REGISTRATION.:
;Boar.d of Buid�rg Regulations and 'Standards.:
One` Ashburton Place Room-',1,30.1:
BOston, Massachusetts 02108
HOME IMP OVEMENT4CON CTOR `
Reglst :ati'on 10937�t Expiration 09/11/00_
aType PRIVATE CORP TI0 '
PINE HARBOR BUILDING CO . ,INC
JAMES ..D McGRATH ,
259 9UEENANNE RD
-° HARWICH MA °02645
OWNER: Map Lot
DATE:
.The Commonwealth ofiMlassachusevs
_•tom -•..
Department of Industrial Accidents
• � •"- — 0/llce of/n;�sllAal/oos
600 Washington'Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
name,
location-
city nhonc#
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
CD I am an employer providing workers' compensation for my employees working on this jobD8/i
caml2anv name-,
ad d rest
y 11 ►'Y1 a U C/
irv- nhoncft
s 0. c�
1 am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who hav
the following workers' compensation polices:
company name
nddr ts-
city- phone a:
insumnce rn_ policy to
company name-
•tddress:
city. phone M:
insurance rn_ DOlicy I$
Failure to secure coverage as required under Secrion 25A of NtCL 152 can Ind to the imposition of criminal penalries of r,,.up1oSL-U0M4&d/or
one years'imprisonment as well as civil penalties in the form of a STOP 1VORK ORDER and a fine ofsloom a day against me. I uoderstaad that a
copy of this statement be forwarded to the Orrice of lnvcadgations of the DIA for coverage vcrifteadon.
!do hereby certify u de r p a d lies orperjury that the information provided above is true and correct
Signature / Date /�
Print name VicArnes D. "l L V�� Phone a 1/13U �UV
ofricial use only do not write in this ary to be completed by city or town official
city or town: - permiVlicensc 0 MBuilding Department
C]Lieensing Board
check if immediate rapnnsc is required C]Seleetmen's Orrice.
SO8 QHealth Department
Suggested Affidavit for Home Improvement Contractor Permit Application
For omce use only NAME OF CITYITOWN
Permit No.
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGLc.142Arequires that the"reconstruction.alteration.renovation,repair,modcrniration,conversion,inprovcment,removal,demolition
or construction of an addition to any precdsting owneroccupicd building con tainin¢at least one but not more(han tour dwelling units....or
to structures which are adjacent to such residence or building"be done by registered contractors,with certain mceptions,along with other
requircmcnts.
Type of Work: ccn 5trychon o� Pa3j" t 13i'� � Est. Cost
Address of Work v
Owner Name'✓
Date of Permit Application:
I hereby certify that:
Registration is not required for the following rcason(s):
_Work excluded by law
_Job.under S1,000
Building not owner-occupied
_Owner pulling own permit
_Other (specify)
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 aa/71
l S 7�
DateCQntractor Na a Registration No.
OR:
Notwithstanding the above notice, I_hereby�apply for a permit as the owner of the above property:
Date O%vner Name
n J
J COtiS'��iLC:IOii SUPERVISOR FGRM
PLEASE PRINT DATE
JOB LOCATION
PROPERTY OWNER.
CONSTRUCTION SUPERVISOR e_<1 u m C bylcwh
LICE.iSE ,N.U?USER ( �� PE02iE 760-y
ADDFcEss.J!�y YGrry)nij h �d Nyr�u1LE. Ue erg nn� Na(�
�ICENSED DESIGNEE ( IF MY)
2 . 15 Resnonsib.ility of eec:, license holce
2 . S . 1 Tice 11cense holder c:icl 1 to ful1v am come e=e_v
re=3ons_bl e %Or all wor:= w i ca he is sunervis_nc . He shall he
resoons_ble for see_rC t all wor.. is cone pursuant to the Sts_e
.Bu_lC_nc Code an"' l.ne Cra`d_nCz cs a::_rr)ved. by t ie BL' ui ld_'C
Ozz
f_i ci a1 . r
2 . 15 . 2 The license holder s .al1 be reE^cns_b1e to su-er-,r_se t e
construction, recor.s zruc _on , al_er- _o ' , re jai_ , r e=vai cr
Ce'Ol'!L_O: _ ;G1':_-C_ t_� s = C e ::le.n-zs o= C_s c-C
S-Zruczures Ci:1 ' Ci rye `-�' .. . ..e `^ c ` � _-__G_ZC Cc(---- a-... c_! Oz..e•-
azol_cable Laws c-f z C ..= C 1':IE e'.'�' t:iOL'C ? hA , Z 1 i r me
h0_Cer, IS nct t..e Der-_r cue on v c O
c-_::trac cr t0 t.e ce_:u_.. he 1 def .
2 . 15 . 3 The 1=cense holder not_=_7 the bu_lc_-c
0==_c_a1 in wr_ti.:c o= t _ c-scover_i c: any viola.._ons w*:_c'n ere
covered by the bui?c_:lc oe=;t .
2 . 15 . 4 Anv licensee who shall will-fully vi o1ate Subsect_ons
2 . 15 . 1 , 2 . 15 . 2 or 2 . 15 . 3 cr any other sect_ons off t ieses rules a-d
reculations end an-i orccec-res as a:zencec, shall be subject to
revocat_On Or susoerS_on o= t:e 1_cense by the Boara' .
2 . 16 All bu?ld_nc Der-:_- a ol_cations Shall corte_.^. .the name,
S_C:iazure and l_cense nu::'.re 0= —e coInszruc-z_oi. Sil er-i_Sv= wn•o _S
tO ShoerJ_Se o CSe ? e^ ccnszr'�ct_.on, reconstru•c7_o:.,
a..?rct_en, re^a__ , r e ^C 'c_ or Ge^ O_-:_cn as r----- =eC bV Sec�_cn
109 . 1 . 1 Or t:'.eVCode an i-Gce rules and re.,Tu!cZ_JriS . in t:ie eve_
t.:a: Suc.''. licensee _S .0 .cer SUOe'- •__ _::C sa_C Dt'_ Sons , tn'e. wcr.-
sL:all i-Lmec_ate_• ce:Lse L: :�_l a saccecsor 1_ce se holder is
su St_tuted on z...e recc_z_: Of ..^_e bu_lC__.Q cedar-.:.e_n-_ .
I have read and underst.a-d may responsibilities under t_:e rules and
reculzL_ons for l; censi-c co::=tr•sct_on sucer-ii sor= 2.n accor'ance
wi_.i Sec-: on 109 . 1 . 1 Of t :e Sta%e Bu'ld_-c Code . I un6erszanC tie
coP.S_ruC_lon insn_ eC.,_'_OP. DioCecures cnQ D 'y Eec _C ins-oeC__Oi.S as
ca I lea for by t e bu I; C_.:C 'J_ -_C_al . - _
LICENSED CONSTRUCT-ION
QUERY PERMITS: QUERY END
QUERY PERMITS
PENTAMATION----------------------------------------------------------- 06/08/01
PERMIT NUMBER 11957 PARCEL _ID-10-9---0.87 42 CROCKER ROAD
PERMIT TYPE BPLUM PLUMBING PERMIT
DESCRIPTION 1WH
CONTRACTOR
PERMIT FEE 10 .00 VARIANCE
STATUS C COMPLETED
CONSTRUCTION TYPE 753 GROUP TYPE -
APPLICATION 11/30/1995 EXPIRATION
VALUATION 0 .00 DATE ISSUED 11/30/1995 COMPLETED 12/18/1995�
DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS-- DATE----
(N)EXT/ (P)REVIOUS/ (C)ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/
(F)EES/ (A)RCHITECTS/ (V) IOLATION/ (E)XIT
This value is not among the valid possibilities
Y" I
IA-
G1�
i
G
c 5
101 T
�
mv- P-e le)9 0$7
o• TOWN OF BARNSTABLE Permit No. _----21475-
t Building Inspector cash -----____--
OCCUPANCY PERMIT Bond ----_X - �
Issued to Vil liam F. Gar Address
Lot 091, 42 Crocker Road, `-!est Barnstable
Wiring Inspector ,. _ Inspection date
r
i
Plumbing Inspector '! . Inspection date
Gas Inspector �' Inspection date
X Engineering Department I� �� �. •,�i Inspection date
Board of Health �� Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
.. ...:.. .............................:................
/ i Building Inspector
TOWN OF BARNSTABLE Permit No. -------')
---- --------------
Building Inspector
Cash
9"16
1619.
OCCUPANCY PERMIT Bond
Issued to Address
42
Wiring Inspector Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department_ Inspection date
Board of Health
Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITII SECTION 119.0-OF THE MASSACHUSETTS STATE
BUILDING CODE.
.. ..................... �Z---7-,
................. .L ..................
Building Inspector
�,N �cr�t G-a y-79
Assessors map and lot"number ......... ......... ..........
?NE
Sewage Permit number .../....�,1�...............���......,............ .
Z 33AW STABLE,
House number ..........:............:.................: :............:.,
NAM
0 039.
`e00
i
TOWN OF . BARNSTABLE
BUILDING INSPECTOR
VIP
APPLICATIONFOR-PERMIT TO ..............................................................................................................................
TYPEOF CONSTRUCTION .....................................................................................................................................
................................................19........
TO THE INSPECTOR OF BUILDINGS:
t
The undersigned hereby applies.for nna permit according to the following information:
Location .... ....!......!'?... ................. ..................................:.......................................................................
Proposed' Use ... �CO.! '� ................................................................................................................................................
ZoningDistrict .............................-.....•..n....................................Fire District ..............................................................................
Name of Owner ....................Address ..,S71 ............
Name of Builder �O /)2✓�� ..•.. r!.c......
Address .................. ............... ...
Name of Architect s LJ�. t�n ✓ .! .......................Address Z%!o� .•.............................
Number of Rooms ...............................................Foundation , Q..f .,...? �D....�.... ........................
Exierior ....................................................................................Roofing .....fit .lPa/ ... ?!.(.. .??. !...................................... ?'
Interior r l Y!�)/ C "Floors ...........................................................
Plumbing 3.. 1 �C'TGN�.--)
Heating ............. .....c.................................. g .... ...,... ............... ........................
Fireplace ...... .. ................Approximate Cost T 0 6
....
........................................................ ........-......................
Definitive Plan Approved by Planning Board -----------_--_--__-_ f � •:t.....
- -------19--------. Area ................................
d
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH U
AJ
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
e4 . � ................
I Name r.<r. �. �.
Carr,
No ....... Permit for aIrLg-le..family.......
................... ..........................................
Location .... ....42...Crocjcqr...Rd...........
..............'Rest-BarnatablAz!..............................
Owner ........Wz,11iam..F-..Ar2;.-:......................
Type of Construction ...Z.-f-r-ame.....................
...............................................................................
Plot ......... Lot ................................
Permit Granted ...............Ju1Y.....I. .....19 79
Date of Inspection ........................ ...........19
Date Completed ...................... .........19
PERMIT RE/USED
................................ ................................. 19
.......... ... ...... . . .......... ....................
........... . . .. . .. ........ ... ......... .... ...................
.... .... .............. ... ....................
................ ........ ........
Approved.........................f................... 19
...............................................................................
...............................................................................
o >o
�`�y ••'. TOWN OF BARNSTABLE
BUILDING DEPARTMENT
sesa%T ! TOWN OFFICE BUILDING
� rua
.639. `� HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
i
DATE: L/ '17 -
An Occupancy Permit has been issued for !the,building authorized by:
Building Permit � � �...................................._.......»...._».
issued to »„,�:»�.. ....................................».............»....»............
»»»»»..»..»».»......»....»..»»».».. ,. .
Please release the performance bond.
Nq6 � h
�Io '
l7 I 0 — F.
1 3 NAl
0,A
1 N, r __-
N z8 60
. J _ - w ,0
91 M
a t •!
3 S; 7 3 SF-. I ,,
• G�-7 _ ^^ or• ItODERT
No.
CERTIFIED PLOT PLAN
l 07
NEW CONSTRUCTION ONLY : PVF-:•S7 ;R44'NS7A/3 LE
TOP OF FOUNDATION IS L S FEET IN
ABOVE. LOW POINT OF ADJACENT .0AJ1kl SIASJ ASS16
ROAD.
SCALE: ="4 6 ' DATE
SLDREDGE ENG/NEFR/NG CO.IN CLIENT 31 t L I CERTIFY THAT THE '"u '04-r'o
IrGISTERED RE(31STERED SHOWN ON THIS PLAN IS LOCATED
CIVIL I LAND JOB N0. lea 2.8 ON THE GROUND AS INDICATED AND
�,,� CONFORMS TO THE ZONING LAWS
ENGINEER SURVEYOR DR. BY: OF BARNS B E , A S. x
CH. BY: /� �� � �Gati
33 NO. MAIN ST 712 MAIN ST. //�'/�1'
SO. YARMOUTH, MASS. HYANNIS, MASS. SHEET OF / DATE REG- -LAND -SURVEYOR 4
Assessors map and lot number ... ... ............... .. ... ,
i
.. , THE T0�
t
Sewage Permit mber .. .... ...........:. .. 3................... lr d`" ��
M '
House number .......... �... ...c�ld 9T9 LE, S
11114" TITLE 5 � Y aye
TOWN OF BARNS -41%U T°`=;;�;r -
?�. _
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ...........:...........................................
4
TYPEOF CONSTRUCTION .................................:......................................................:......................................... ..
................................................19........
-TO THE INSPECTOR ,OF BUILDINGS:
The undersigned hereby applies for a permit according to the fol lowi41 information:
Location -�- ��2fi►S! �L f�Ss
.:. . . ............................... ....
ProposedUse ...,1,l 'I.�r.....................................................................................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of .........................Address 119
Name of Builder C!t%C�,!1.,P........� 1.L.�...................Address (a G !��'✓!f .Q....�5'T................. .... ......... ............ .
Name of Architect ..��i)L..... .......................Address •.............................
Number of Room� ................7..................................................Foundation ..1�...�'A..�f.� ....G.�il�l'f9/.�......................
.,.ra
Exterior U..........................Roofing ..... :......................................
Floors .................8............. ......................................................Interior .....................10&...................................................
"�
_ Heating ,...................... ,.............................................._..........Plumbing ....... .. !"L................: . GI�' ........................
Fireplace ....... ........................................................................Approximate Cost .. ./ .0...
,r
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .....
.....................................
/ S'
Diagram of Lot and Building with Dimensions Fee
.............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH --Wa AJ N
0 �
1. o�
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .... ................
Ls�1.
�l
II/Ce.'rr, William F
�P
' n
i No ..21..4.75.... Permit for ..s-ingle•-fami-iy.....
.....................dwelling........................................
Location ........lot..#91.....42.-Gr-eeker.-Rd;......
s � a
West.-Barns-table..............................
a t ,
Owner ....... ......................... j
r
Type of Construction ............frame...................
F. ..........................................................................
Plot ............................ Lot ................................
' � Y
July 18 79
Permit Granted ........................................19
Date,of Inspection . .
. ... . ..... . .......
Date Complet d ... ....... .:�`.�:..P9
PERMIT REFUSED ,
°� ................. 19 1
....... G. ................................................
.. ...... .................................................. o
......... ..a.�. ........................................... F =
........ AO. .........................................................
Approve,, .......................................... 19
.............:.................................................................
...................................�.......................................... ..
41 c`
IKE IO The Town of Barnstable
BABVBTABM
'--CM- u Department of Health Safety and Environmental Services
'`�' ' •'� Building Division
�f0 Mpy
367 Main Street,Hyannis,MA 02601 "
ce: 508.862-4038
508-790-6230
PLAN REVIEW
Owner: A4.11 C A121 60RA . Map/Parcel:_ ®r7 -
Project Address: -_!-1 Builder: BC L 4 A/, Z�"6ZOT
The following items were noted on reviewing:
)P, d/&,p'OR .,k e®R I gl o f14,*, g���SS S 6�d•�
� yc eve To
11
%a I & J-
�l�.�o�G:rJ 1��2
0f16yRA-Tie Al /9e %el Co�I_ - Y
3) 1 %2 V a v Ts d&e Fee $O IW,.m9tf
Reviewed by:
Date: /`LZZAA1 /�D® q
rr
Mi
39 30
`l IZ E F, \\
00
1 � C
N o u
n I
b I
M .
V"IN$ I
u
T J 1
o -
e
cr
n �, r
rip
.> � III :��• ,- I c�� '��� f �
I
I � III
II VI•
A r A 03 % 1: 41a MID CHPE S. DENHIS 5083984559 P. 1
1
• V
Material List Report
PERM
STORE# Mid-Cape Home Centers
ACCT.# Route 134 NAME Cn Wt >w
SALESMAN PO Box 1418 JOB L CATION S��
t!-� �`����= South Dennis,MA 02660 C `ti
W.509-398-6071 "� i4 L .
r
508 398-4559
Level Name:2ND FLUOR Report Date: 4/29/0311:36:35 AM
Joist Products
Plot Product Net Unit
Net
ID Length Label Ply Qty. Price
- Price
Al 24' 14"TJI/Pro-350 joist 1 20 $2.07/ft
- $993.60
Sub-total $993.60
' Rectan lar Products
Plot Product Net Unit
ID Length Label Ply Qty. Price Net
Price
P 1 22' 3 112"x 14"2.0E Parallam PSL t I $10.29/ft
5226.38
Sub-total $226.38
Accessories
Plot Product Net Unit
ID Length Label Qty. Price NetPrice
Rml 16' 11/4"x 14" 1.3E TimberStrand LSL 5 S2.38/#t
$190.40
Sh 1 4'x 8' 23/32",3/4"Panels(24"Span Rating) 21 $0.00/sht
$0.00
Sub-total $190.40
TJ-Xpett 6.30 (#686)A Page 1
FOGLE-CARR.JOB Design pate:4/29/03 8:41:45 AM
41 a---- fn CAPE -513LNrr13 �[rxi�a�-ra�� N•�
vel Name:2ND FLOOR Report Date:4/2910311:36:35 AM
Sub-total $1,41038
/ SALES TAX(5%): $70.52
Tax Sub-Total: S70.52
REPORT TOTAL: $1,490.90
Tl-Xpen 630 (0696)A Page 2 FOQE-CARR.JOB Design Dace:4129103 8:41:45 AM
v
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SEE FRAMER'S POCKET GUIDE
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.
VU
CERTIFIED. PLOT PLAN.
NEW CONSTRUCTION ' ONLY : JAI� s7- ;?Af-n/.s
TOP OF FOUNDATION 13 S FEET IN
ABOVE LOW POINT OF ADJACENT
ROAD.
SCALE: / „_4 D ' DATE:
W.40 EDGE ENGINEERING CO.IN CLIENT �! L I CERTIFY THAT THE FovN y 4 7-f o,
I�CQBJT�RED REGISTERED SHOIE N ON THIS PLAN IS LOCATED' .E 11€@L I LAND JOB NO. �8a z 8 OPT! THE GROUND AS INDICATED AWD
cl0lca��R� SURVEYOR ®R. @Y: /S . fl.i�l CONFORMS TO THE Y®��IP�f LA .
_ OF ®ARNS ® E s A S.
CH. 0Y: .lam.
33* NO. MAIN ST 712 MAIN ST. -71�.�/ cr �•�, �._:
A 1 � MASS. / � �`. . -�SO.-YARPAOUTH,, MASS. HY NN S, SHEET DATE RES. LAND SURVIVOR .
All Cape Insulation anti 'Supply, Inc.
P O Box 645
(508) 385-71381-800-626-9276
E Dennis, MA 02641 Estimate
NAME/ADDRESS
DATE 5/2/2003
Fogle&Wright
57 Crocker Rd CITY/TOWN STREET
West Barnstable,MA 02668
508-362-7669 White/760-4467 Fogle Crocker Rd W Barnstable,MA
TERMS Less 10%COD
OUR INS ULA TIONIS FORMALDEHYDE-FREE
Ceil ROG&connector(2nd fl): R 30: Kraft Batts
Ext Walls ROG&Connector(2nd fl): R 13:Fric Fit/Poly
Crawl: R 19: Kraft Batts
Gar Ceil: R-19: Kraft Batts
ROG Slopes to plate(2nd fl): R-30:Kraft Batts/Vents
G.H.Wall: R-13: Kraft Batts
Rear Overhang:R-30: Kraft Batts
Gar'Walls: R 13: Kraft Batts..
Sun Rm Ceiling: R 30:Kraft Batts
Vent Chutes
NOTE: Price from plans,when framed we will measure for final price. Also,price includes unheated sun room
insulation,however footages for this area are not relected on MasChek as it is.unheated space.
SUBJECT TO 10% DISCOUNT IF PAID ON DAY OF COMPLETION
Price guaranteed for 30 Days TOTAL
$29150.00
:WE PROPOSE to f ni ish.material and labor,complete in accordance with above specifications,for the sum of:
($ ),Payments to be made as follows:
Contractor/Salesman
Acceptance by Purchaser and Title Any alteration from
above specifications involving extra costs,will be executed only upon written orders and become an extra'charge.
over/above. All agreements contigent upon strikes,accidents or delays beyond our control. Owner to carry fire,
:.tornado and other necessary insurance.
I I
KAScheck COMPLIANCE REPORT I I
Kassachusetts Energy Code I Permit # I
1AScheck Software Version 2.01 I I
I I
I Checked by/Date I
I I
:ITY: Barnstable
STATE: Massachusetts
IDD: 6137
"ONSTRUCTION TYPE: 1 or 2 Family, Detached
iEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 5-2-2003
TITLE: Fogle & Wright Blders
PROJECT INFORMATION:
�arr Residence
rocker Rd.
N Barnstable, MA
COMPLIANCE: PASSES
Required UA = 172
Your. Home = 165
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
::EILINGS 855 30.0 0.0 30
igALLS:. Wood Frame, 16" O.C. 800 13.0 0.0 66
3LAZING: Windows or Doors - 105 0.330 35
FLOORS: Over Unconditioned Space 625 19.0 0.0 30
FLOORS: Over Unconditioned Space 140 30.0 0.0 5
-------------------------------------------------------------------------------
OMPLIANCE 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 requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate,
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
Sections 780CMR 1310 and J4.4.
Builder/Designer Date
S
SNSPECTION CHECKLIST
usetts Energy Code
check Software Version 2.01
Fogle & Wright Blclers
DATE: 5-2-2003
Bldg. 1
Dept. 1
Use
I CEILINGS:
[ 1 I 1. R-30
I Comments/Location
I
I WALLS:
[ J 1 1. Wood Frame, 16" O.C., R-13
I Comments/Location
I
I WINDOWS AND GLASS DOORS:
[ l I 1. U-value: 0.33
I For windows without labeled U-values, describe features:
I # Panes Frame Type Thermal Break? [ ] Yes [ ) No
I Comments/Location
I
I FLOORS:
1. Over Unconditioned Space, R-19
I Comments/Location
[ ] I 2. Over Unconditioned Space, R-30
'I Comments/Location
I
I AIR LEAKAGE:
[ ] I Joints, penetrations, and all other such openings in the building
I envelope that are sources of air leakage must be sealed. When
I installed in the building envelope, recessed lighting fixtures
I shall meet one of the following requirements:
I 1. Type IC rated, manufactured with no penetrations between the
I inside of the recessed fixture and ceiling cavity and sealed or
I gasketed to prevent air leakage into the unconditioned space.
I 2. Type IC rated, in accordance with Standard ASTM E 283, .with no
I more than 2.0 cfm (0.944 L/s) air movement from the the
I conditioned space to the ceiling cavity. The lighting fixture
I shall have been tested at 75 PA or 1.57 1bs/ft2 pressure
I difference and shall be labeled.
I -
I VAPOR RETARDER:
[ ] I Required on the warm-in-winter side of all non-vented framed
I ceilings, walls, and floors.
i
I MATERIALS IDENTIFICATION:
( ] I Materials and equipment must be identified so that compliance can
I be determined. Manufacturer manuals for all installed heating
I and cooling equipment and service water heating equipment must be
I provided. Insulation R-values and glazing U-values must be clearly
I marked on the building plans or specifications.
I
I DUCT INSULATION:
ucts shall be insulated per Table J9.9.7.1. "
I DUCT CONSTRUCTION:
[ l i All accessible joints, seams, and connections of supply and return .
I ductwork located outside conditioned space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
I using mastic and fibrous.,backing tape installed according to the
I manufacturer's installation instructions. Mesh tape may be
I omitted where gaps are less than 1/8 inch. Duct tape is not
I permitted. The HVAC system must provide a means for balancing
I air and water systems.
I TEMPERATURE CONTROLS:
[ ) I Thermostats are required for each separate HVAC system. A manual
I or automatic means to partially restrict or shut off the heating
I and/or cooling input to each zone or floor shall be provided.
1 .
I HVAC EQUIPMENT SIZING:
[ l I Rated output capacity of the heating/cooling system is
I not greater than 125% of the design load as specified
I in Sections 780CMR 1310 and J4.4.
I
! SWIMMING POOLS:
-11 heated swimming pools must have an on/off heater switch and
I require a cover unless over 20% of the heating energy is from
I non-depletable sources. Pool pumps require a time clock.
I
[ ] I HVAC PIPING INSULATION:
I HVAC piping conveying fluids above 120 F or chilled fluids
I below 55 F must be insulated to the following levels (in.) :
PIPE SIZES (in.)
I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
I Low pressure/temp. 201-250 1.0 1.5. 1.5 2.0
i Low temperature 120-200 0.5 1.0 1.0 1.5
I Steam condensate any 1.0 1.0 1.5 2.0
i COOLING SYSTEMS:
I Chilled water or 40-55 0.5 0.5 -0.75 1.0
I refrigerant below 40 1.0 1.0 1.5 1.5
I
[ I CIRCULATING HOT WATER SYSTEMS:
I Insulate circulating hot water pipes to the following levels (in.) :
I
i PIPE SIZES ('in.)
NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS
I HEATED "WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0". 2.0+"
I 170-180 0.5 1 1.0 1.5 2.0
1 140-160 0.5 1 0.5 i.0 1.5
1 100-130 0.5 1 0.5 0.5 1.0
I
----NOTES TO FIELD (Building Department Use Only)-------------------------
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