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Home My WebLink About0031 HOLWAY DRIVE I i 1 i I I i o s UPC 12543 'z ' No. 53LOR MOCT�Y90 4w i �t�h PROJECT NAME: Z ADDRESS: /► 1 way f� PERMIT# PERMIT DATE: 1 ► I U M/P: LARGE ROLLED PLANS ARE IN: Box 'Ovx 3 SLOT Data entered in MAPS program on: 41'� i BY: � •�✓y� vl q/wpfiles/forms/archive I " EVALUATION ICC 1 Widely AcceptI and I reportSERVICE Innovation ICC-ES Evaluation Report ESR-3824 This . • renewal 16 1 DIVISION:07 00 00.:THERMAL AND MOISTURE PROTECTION SECTION:0T-21'00=THERMAL;INSULATION 0 1 REPORT HOLDER:. DEMILEC (USA) INC. 3315 EAST DIVISION:STREET . ARLINGTON,TEXAS 7ib011 EVALUATION SUBJECT: HEATLOK® XT4 SPRAY-APPLIED INSULATION icc . icc icc C� ( 91 Look for the trusted marks of Conformityl "2014 Recipient of Prestigious Western States Seismic Policy Council an INCMal (WSSPC)Award in Excellence" A Subsidiary of CHEccouu6ci`r ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not 'ate specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a 1 {J recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as to any finding or other matter in this report, or as to any product covered by the report. �W�0= fi 8MeWy A=606CM Copyright m 2017 ICC Evaluation Service, LLC. All rights reserved. I 1 ES Widely . ICC-ES Evaluation Report ESR-3824 Reissued June 2017 Revised August 2017 This report is subject to renewal June 2018. www.icc-es.org 1 (800)423-6587 1 (562)699-0543 A Subsidiary of the International Code Council® DIVISION:07 00 OD—THERMAL AND MOISTURE 2.0 USES PROSection:07 21 00—Thermal Insulation CTION Demilec Heatlok®XT-s closed cell spray foam product is used as a nonstructural thermal insulating material in Type REPORT HOLDER: VB construction (IBC) and dwellings under the IRC. The insulation is for use in wall cavities, floor assemblies, DEMILEC(USA)INC, ceiling assemblies or attics and crawl spaces when 3315 EAST DIVISION STREET installed in accordance with Section 4.4. ARLINGTON,TEXAS 76011 Under the IRC and the 2015 IBC, the insulation may be (817)640-4900 used as air-impermeable insulation when installed in www.demilec.com accordance with Section 3.5. EVALUATION SUBJECT: The insulation also may be used in exterior walls of Type I, 11, 111 or IV construction that do not exceed 40 feet HEATLOK®XT-s SPRAY-APPLIED INSULATION (12 192 mm) in height above grade plane when used as described in Section 4.5. 1.0 EVALUATION SCOPE 3.0 DESCRIPTION 1.1 Compliance with the following codes: 3.1 General: ■ 2015,2012 and 2009 International Building Code®(IBC) Demilec Heatlok®XT-s product is a rigid, medium-density, ■ 2015, 2012 and 2009 Intemat/onal Residential Code® spray-applied cellular polyurethane foam plastic insulation (IRC) 11 installed as a component of wall assemblies, ceilings, floors, crawlspaces and cavities of roofs. The foam plastic ■ 2015,2012 and 2009 International Energy Conservation insulation is a two-component, closed-tell, one-to-one by Code®(IECC) volume spray foam system with a nominal density of ■ 2013 Abu Dhabi International Building Code(ADIBC)t 2.0 pcf (32 kg/Ms). The insulation is produced in the field by combining a polymeric isocyanate(A component)with a rThe ADIBC is based on the 2009 IBC. 2009 IBC code sections polymeric resin blend (B component). The insulation referenced in this report are the same sections in the ADIBC. components have a shelf life of six months when stored in ■ Other Codes(See Section 8.0) factory-sealed containers at temperatures between 50°F (10°C)and 80°F(26°C). Properties evaluated: , The attributes of the insulation have been verified as ■ Surface-burning characteristics conforming to the provisions of ICC 700-2008 Section ■ Physical properties 703.2.1.1.1(c) as an air impermeable insulation. Note that decisions on compliance for those areas rest with the user ■ Thermal resistance of this report. The user is advised of the project-specific ■ Attic and crawl space installation provisions that may be contingent upon meeting specific conditions, and the verification of those conditions is ■ Air permeability outside the scope of this report.These codes or standards ■ Water vapor transmission often provide supplemental information as.guidance. 3.2 Surface=burning Charac' erlstl s ■ Exterior walls in Types I through IV construction a 1.2 Evaluation to the following green standard: Demilec Heatlok®XT-s product,at a maximum thickness of 4 inches (102 mm) and a nominal density of 2.0 pcf ■ 2008 ICC 700 National Green Building StandardTm (ICC (32 kg/m ), has a flame spread index of 25 or less and a 700-2008) smoke-developed index of 450 or less when tested in Attributes verified: accordance with ASTM E84 (UL 723).ZThere are not any thickness limitations when insulation-is covered by a code- ■ See Section 3.1 prescribed thermal barrier. ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use.There is no warranty by ICC Evaluation Service,LLC,express or implied,as t to any finding or other matter in this report,or at to any product covered by the report. Copyright©2017 ICC Evaluation Service,LLC. All rights reserved. Page 1 of 5 ESR-3824 I Most Widely Accepted and Trusted Page 2 of 5 3.3 Thermal Resistance(R-values): ''equivalent 15-minute thermal barrier complying with and Demilec Heatlok ® XT-s product has thermal resistance installed in accordance with the applicable code except (R-value), at a mean temperature of 75°F (24°C), as where the installation complies with the requirements set shown in Table 1. forth in Section 4.3.2.When installation is within an attic or crawl space as described in Section 4.4, a thermal barrier 3.4 Vapor Permeance: is not required between the foam plastic and the attic or HEATLOK° XT-s has a vapor permeance of less than crawl space,but is required between the insulation and the 1.0 perms (5.7xl0-12 kg/Pa-s-mz) when applied at a interior of the building. minimum of 1 inch (25.4 mm)thickness and may be used There is no thickness limit when installed behind a code- where a Class II vapor retarder is required by the prescribed thermal barrier except as noted in Section applicable code. 4.4.2.1. 3.5 Air Permeability: 4.3.2 Application without a Prescriptive Thermal HEATLOK® XT-s foam plastic insulation, at a minimum Barrier:The prescriptive 15-minute thermal barrier may be omitted when installation is in accordance with this section. insulation (25 mm) thickness, 2015 and 2012 IRC Section considered air-impermeable The insulation and coating may be spray-applied to the nsulation in accordance with interior facing of walls and the underside of roof sheathing R806.5 (2009 IRC Section R806.4)and 2015 IBC Section or roof rafters, and in crawl spaces, and may be left 1203.3 based on testing in accordance with ASTM E283. exposed as an interior finish without a p prescribed 3.6 DC 315 Coating: 15-minute thermal barrier or ignition barrier. The thickness DC 315 Coating (ESR-3702), manufactured by of the foam plastic applied to the underside of the roof International Fireproof Technology, Inc. / Paint to Protect sheathing must not exceed 11 /z inches (292 mm). The Inc.,is a one-component water-based coating.The coating thickness of the foam plastic applied to the vertical wall is supplied in 5-gallon (19 L) pails and 55-gallon (208 L) surfaces must not exceed 7/z inches (191mm). The foam drums and has a shelf life of 12 months when stored in plastic must be covered on all surfaces with DC 315 factory-sealed containers at temperatures between 50°F coating at a minimum wet film thickness of 18 wet mils (10°C)and 80°F(27°C). (0.46 mm) (12 dry mils z [0.31 mm)), at a rate of 1.12 gal/100 ftz (0.457 Um ) or with BlazelokTm TBX at a 3.7 Blazelok TBX Intumescent Coating: minimum wet film thickness of 18 wet mils (0.46 mm) (12 dry mils [0.31 mm]), at a rate of 1.12 gal/100 BlazelokTm TBX intumescent coating (ESR-3997), z manufactured by TPR Corporation, is cone-component z (0.457 Um ). The coating must be applied over the water-based liquid-applied coating. The coating is supplied Demilec Heatlok XT-s insulation in accordance with the in 5-gallon (19 L) pails and 55-gallon (208 L) drums and coating manufacturer's instructions and this report. The has a shelf life of 12 months when stored in factory-sealed DC 315 coating must be applied in accordance with the containers at temperatures between 45°F (7°C) and 95°F manufacturer's instructions and ESR-3702. The Blazelok (35°C). TBX coating must be applied in accordance with the manufacturer's instructions and ESR-3997. Surfaces to be 4.0 INSTALLATION coated must be dry,dean and free of dirt,loose debris and 4.1 General: other substances that could interfere with the adhesion of the coating. The coating is applied in one coat by airless Demilec Heatlok° XT-s product must be installed in spray equipment at ambient temperatures above 50 F accordance with the manufacturer's published installation (10 C)and relative humidity of less than 70 percent. instructions and this report. A copy of the manufacturer's 4.4 Ignition Barrier-Attics and Crawl Spaces: published installation instructions must be available at all times on the jobsite during installation. 4.4.1 Application with a Prescriptive Ignition Barrier: 4.2 Application: When Demilec Heatlok®XT-s insulation is installed within attics or crawl spaces where entry is made only for service The insulation is spray-applied on the jobsite using of utilities, an ignition barrier must be installed in equipment identified in the manufacturer's published accordance with IBC Section 2603.4.1.6 and IRC Sections installation instructions. The Demilec Heatlok® XT-s R316.5.3 and R316.5.4, as applicable. The ignition barrier product must be applied when the ambient and substrate must be consistent with the requirements for the type of temperature is between 50°F (10°C) and 120°F (491C). construction required by the applicable code, and must be The insulation must not be used in areas that have a installed in a manner so that the foam plastic insulation is maximum service temperature greater than 180°F (821C). not exposed. The attic or crawl space area must be The foam plastic insulation must not be used in electrical separated from the interior of the building by an approved outlet or junction boxes or in continuous contact with rain 15-minute thermal barrier as described in Section 4.3.1. or water. The substrate must be free of moisture, frost or Demilec Heatlok XT-s insulation, as described in this ice,loose scales, rust,oil and grease,or contaminates that section, may be installed in unvented attics in accordance will interfere with adhesion of the spray foam insulation. The Demilec Heatlok® XT-s product is applied in passes with 20 and 2012 IRC Section 03. .5 l`(20Q9_IRC R having a maximum thickness of 2 inches (51 mm) per Section 806.4)or 2015 IBC Section 123.3. pass. When multiple passes are required, subsequent 4.4.2 Application without a Prescriptive Ignition passes can be sprayed once the core temperature drops Barrier: Where the spray-applied insulation is installed in below 100°F. accordance with Section 4.4.2.1, the following conditions 4.3 Thermal Barrier: apply' 4.3.1 Application with a Prescriptive Thermal Barrier: a) Entry to the attic or crawl space is to only service Demilec Heatlok®XT-s insulation must be separated from utilities,and no storage is permitted. the interior of the building by an approved thermal barrier b) There are no interconnected attic or crawl space of 1/2-inch-thick (12.7 mm) gypsum wallboard or an areas. ESR-3824 I Most Widely Accepted and Trusted Page 3 of 5 c) Air in the attic or crawl space is not circulated to other e 31/2 inches long (89 mm), must be installed at a nominal parts of the building. 24 inches on center to each vertical steel stud, using d) Attic ventilation is provided when required by IBC two No. 14 by 5-inch-long (127 mm) hex head screws. Section 1203.2 or IRC Section R806, except when Exterior veneer must be 4-inch-thick (102 mm) standard air-impermeable insulation is permitted in unvented brick with a nominally 2-inch air gap between brick and the attics in accordance with the 2015 IBC Section 1203.3 foam plastic insulation. or 2015 and 2012 IRC Section R806.5 (2009 IRC 5.0 CONDITIONS OF USE Section R806.4). Under-floor(crawl space)ventilation The Demilec Heatlok® XT-s insulation described in this is provided when required by 2015 IBC Section report comply with, or are suitable alternatives to what is 1203.4 (2012 and 2009 IBC Section 1203.3) or IRC specified in,those codes listed in Section 1.0 of this report, Section R408.1,as applicable. subject to the following conditions: e) Combustion air is provided in accordance with International Mechanical Code®Section 701. 5.1 This evaluation report and the manufacturer's published installation instructions, when required by 4.4.2.1 Application without a Prescriptive Ignition the code official, must be submitted at the time of Barrier:In attics and crawl spaces, Demilec Heatlok®XT-s permit application. insulation may be spray-applied to the underside of roof 5.2 Demilec Heatlok® XT-s insulation and applicable sheathing and/or rafters, and to vertical surfaces and the coating must be installed in accordance with the underside of floors as described in this section. The manufacturer's published installation instructions, this thickness of the foam plastic applied to the underside of report and the applicable code.The instructions within the overhead surfaces (roof sheathing, rafters and the this report govern if there are any conflicts between underside of floors) must not exceed 11 /2 inches the manufacturer's published installation instructions (292 mm). The thickness of the foam plastic applied to and this report. vertical surfaces must not exceed 7 /2 inches (191 mm). The insulation may be left exposed without a prescriptive 5.3 Demilec Heatlok®XT-s insulation must be separated ignition barrier or fire-protective coating. The attic or crawl from the interior of the building by an approved space must be separated from the interior of the building 15-minute thermal barrier, as described in Section by an approved 15-minute thermal barrier as described in 4.3.1, except when installation is as described in Section 4.3.1. Section 4.3.2 and 4.4. 4.4.2.2 Use on Attic Floors: Demilec Heatlok® XT-s 5.4 Demilec Heatlok® XT-s insulation must be protected insulation may be installed at a maximum thickness of from the weather during application. 111/2 inches (292 mm) between and over joists in attic 5.5 Demilec Heatlok®XT-s insulation must be applied by floors. The Demilec Heatlok XT-s insulation must be installers approved by Demilec. separated from the interior of the building by an approved thermal barrier. The coating specked in Section 4.3.2 and 5.6 Use of Demilec Heatlok® XT-s insulations in areas the ignition barrier in accordance with IBC Section where the probability of termite infestation is "very 2603.4.1.6 and IRC Section R316.5.3 may be omitted. heavy" must be in accordance with 2015 and 2009 4.5 Exterior Walls of Type I,II,III and IV Construction: IBC Section 2603.8(2012 IBC Section 2603.9)or IRC Section R318.4,as applicable. 4.5.1 General:When used on exterior walls of Type I, 11, 5.7 Jobsite certification and labeling of the insulation must III,and IV construction that are 40 feet(12 192 mm)or less comply with 2015 IRC Sections N1101.10.1 and above grade plane, the Heatlok XT-s insulation must N1101.10.1.1 (2012 IRC Sections N1101.12.1 and comply with Section 2603.5 of the IBC and this section N1101.12.1.1 or 2009 IRC Sections N1101.4 and (Section 4.5). The insulation must not exceed a maximum N1101.4.1) and 2015 and 2012 IECC Sections thickness of 3.2 inches (81 mm). The potential heat of o C303.1.1, C303.1.1.1, R303.1.1 and R303.1.1.1 Demilec Heatlok XT-s insulation is 1953 Btu/fiz (22.0 Myrn ) per inch of thickness when tested in (2009 IECC Sections 303.1.1 and 303.1.1.1), as accordance with NFPA 259. applicable. 4.5.2 Specific Wall Assemblies: One layer of 5/8-inch- 5.8 When use is on exterior walls of buildings of Types I, thick(15.9 mm),Type X gypsum wallboard complying with II, 111, and IV, construction must be as described in ASTM C36 or ASTM C1396 is installed with the long Section 4.5 and must not exceed 40 feet(12 192 mm) i dimension perpendicular to 35/e-inch-deep(92 mm),No.20 above grade plane. gage steel studs spaced a maximum of 24 inches 5.9 Demilec Heatlok® XT-s insulation is produced in (610 mm) on center. The wallboard is attached with Arlington, Texas and Boisbriand, Quebec, Canada No. 6, 11/4-inch-long (32 mm), self-tapping screws located under a quality-control program with inspections by 8 inches (203 mm) on center along the perimeter and in [CC-ES. the field of the wallboard. Wallboard joints must be taped 6.0 EVIDENCE SUBMITTED and treated with joint compound in accordance with ASTM C840 or.GA-216. Fastener heads must also be treated 6.1 Data in accordance with the [CC-ES Acceptance with joint compound in accordance with ASTM C840 or Criteria for Spray-applied Foam Plastic Insulation GA-216. (AC377), dated April 2016, including reports of tests 4.5.3 Exterior Face: One layer of 5/8-inch-thick in accordance with Appendix X of AC377. (15.9 mm) sheathing complying with ASTM C1177 is 6.2 Reports on room corner tests in accordance with attached to steel studs using 1 1/4-inch-long (32 mm), NFPA 286. self-tapping screws spaced 8 inches (203 mm) on center field of the sheathing. 6.3 Report on air leakage testing in accordance with along the perimeter and in the Heatlok®XT-s spray-applied polyurethane foam insulation, ASTM E283. at a maximum thickness of 3.2 inches (81 mm), is spray- 6.4 Reports on water vapor transmission tests in applied onto the exterior of sheathing. Brick ties, accordance with ASTM E96(desiccant method). ESR-3824 I Most Widely AcceptBd and Trusted r"�, Page 4 of 5 6.5 Reports of fire propagation characteristics tests in '8.2 Uses: accordance with NFPA 285. The products comply with the above-mentioned codes as 6.6 Reports of potential heat of foam plastic tests in described in Sections 2.0 through 7.0 of this report, except accordance with NFPA 259. as noted below: 6.7 Supplementary fire engineering analysis. ■ Application with a Prescriptive Thermal Barrier:See Section 4.3.1, except the approved thermal barrier must 7.0 IDENTIFICATION be installed in accordance with Section R314.4 of the Components for Demilec Heatlok® XT-s insulation are 2006 IRC. identified with the manufacturer's name(Demilec),address ■ Application without a Prescriptive Thermal Barrier: and telejhone number; the product trade name (Demilec See Section 4.3.2. Heatlok XT-s); product-type (A or B component); use instructions; the density; the flame-spread and smoke- ■ Application with a Prescriptive Ignition Barrier: See developed indices; the evaluation report number Section 4.4.1, except attics must be vented in (ESR-3824). accordance with Section 1203.2 of the 2006 IBC or Section R806 of the 2006 IRC, and crawl space The TPR2 Corporation BlazelokTm TBX coating is labeled ventilation must be in accordance with 2006 IBC Section with the manufacturer's name, the product trade name, 1203.3 or 2006 IRC Section R408,as applicable. date of manufacture, shelf life or expiration date, manufacturer's instructions for application and ESR-3997. ■ Application without a Prescriptive Ignition Barrier: See Section 4.4.2, except attics must be vented in The International Fireproof Technology / Paint To accordance with Section 1203.2 of the 2006 IBC or Protect, Inc. DC 315 coating is identified with the Section R806 of the 2006 IRC, crawl space ventilation manufacturer's name, the product trade name, date of must be in accordance with 2006 IBC Section 1203.3 or manufacture, shelf life or expiration date, manufacturer's 2006 IRC Section R408, as applicable, and combustion instructions for application and ICC-ES evaluation report air is provided in accordance with 2006 International number ESR-3702. Mechanical Code®Sections 701 and 703. 8.0 OTHER CODES ■ Protection Against Termites: See Section 5.6, except 8.1 Scope: use of the insulation in areas where the probability of termite infestation is "very heavy" must be in In addition to the codes referenced in Section 1.0, the accordance with Section R320.5 of the 2006 IRC. products recognized in this report have also been ■ dobsite Certification and Labeling: See Section 5.7, evaluated for compliance with the following codes: except jobsite certification and labeling must comply ■ 2006IBC with Sections 102.1.1 and 102.1.1.1, as applicable, of ■ 2006 IRC the 2006 IECC. ■ 20061ECC TABLE 1—THERMAL RESISTANCE(FILVALUES)' THICKNESS(inches) DEMILEC HEATLOKO XT-s FLVALUE(°F.fe.h/Btu) 1 6.7 2 13 3 19 3.5 23 4 26 5 32 5.5 35 6 39 7 45 7.75 50 8 51 g 58 10 64 11 71 12 77 13 84 14 90 15 97 16 103 For SI: 1 inch=25.4 mm;1°F.fe.hr/Btu=0.176 110 k.m" 'Calculated R-values are based on tested K-values at 1-and 3.5-inch thicknesses 'R-values greater than 10 are rounded to the nearest whole number Agribalanc6 Spray Foam Insulation Installed Insulation Statement Location of Insulation Thickness Total R-value Approximate Sq.Ft. Walls 5 x 4.45= 22 Attic-Floor or Roof Deck(circle one) x 4.45= Cathedral Ceiling 8.5 x 4.45= 38 x 4.45= x 4.45= R-value= 4.45 per inch Tensile Strength= 3.87 psi Density= 0.6-0.8 Ib/ft3 Compressive Strength= 1.86 psi DEMiLEc Batch# Andek Batch# (if applicable) American Building Systems 508-484-4931 Company Name Phone Number NATHAN RICHARDSON 4/10/19 Applicator Name Applicator Signature Date Agri balance" Spray Foam Insulation Installed Insulation Statement Location of Insulation Thickness Total R-value Approximate Sq.Ft. Walls x 4.45= Attic-Floor or Roof Deck(circle one) x 4.45= Cathedral Ceiling x 4.45= I x 4.45= x 4.45= R-value= 4.45 per inch Tensile Strength= 3.87 psi Density= 0.6-0.8 Ib/ft3 Compressive Strength= 1.86 psi DEMiLEc Batch# Andek Batch# (if applicable) Company Name Phone Number Applicator Name Applicator Signature Dale -� //_70 AGRI BALANCED 08 DEMILEC Agribalancem is a two component,open cell,spray applied,semi-rigid polyurethane foam system that contains more than 20%renewable agricultural based materials(refinecfv�g`e'fable oils).This product is a fully water blown foam system having a low in-place density with excellent adhesion to various substrates and to itself.Agribalance incorporates the single phase solution technology developed by Demilec for excellent shelf life and consistent processing.Agribalance complies with the intent of the International Code Council's residential and commercial building codes for spray polyurethane foam plastic insulation.Agribalance meets the USDA guidelines for incidental food contact. ASTM D 1622 Density 0.6-0.8 Ib/ft3 9.6-12.8 kg/m3 ASTM C 518 Aged Thermal Resistance(R-value @ 1 inch) 4.45 ftzh°F/BTU 0.78 Kmz/W Air Permeance @ 75 Pa @ 3.5"(75 Pa=25 mph wind) <0.02 L/smz Air Permeance @ 500 Pa @ 3.5" 0.003 L/smz ASTM E 283 Air Permeance @ 1000 Pa @ 3.5" 0.006 L/smz Air Permeance @ 1500 Pa @ 3.5" 0.011 L/smz Air Permeance @ 2000 Pa @ 3.5" 0.018 L/smz ASTM E 96 Water Vapor Permeance @ 5" 4.95 perms 283 ng/Pa•s•m2 ASTM D 2126 Dimensional Stability @ 158OF(70°C)97%R.H.(28 days) 3.16(%volume change) ASTM D 1621 Compressive Strength 1.86 psi 12.82 kPa ASTM D 1623 Tensile Strength 3.87 psi 26.68 kPa Surface Burning Characteristics,5.5"thick Class I , ASTM E 84 Flame Spread Index 15-20 Smoke Developed 400 Ignition Barrier-Compliant with 2006,2009&2012 IBC and IRC,and ICC-ES AC-377 Appendix X,for use in attics and crawl spaces with: NFPA 286 Blazelok'"I134 at 5 mils dry film thickness,9 mils wet film thickness,or Pass No Burn Plus XD at 6 mils dry film thickness,10 mils wet film thickness,or Heatlok Soy at 2"thick NFPA 286 Thermal Barrier-Compliant with the 2006,2009&2012 IBC and IRC,as an interior finish Pass without a 15 minute thermal barrier with Blazelokl"TBX at 15 mils dry film thickness. ASTM D 1929 Ignition Properties(spontaneous ignition temperature) 968°F(520°C) PROPERTY A-PMDI ISOCYANATE AGRIBALANCE RESIN Color Brown Amber Viscosity @ 77°F(25°C) 180-220 cps 250-450 cps Specific Gravity 1.24 1.08-1.12 Shelf Life of unopened drum properly stored 12 months 12 months Storage Temperature 50-100°F(10-38°C) 50-100°F(10-38°C) Mixing Ratio(volume) 1:1 1:1 'See SDS for more information. Cream Time Gel Time Tack Free Time End of Rise 1-2 seconds 3-4 seconds 6-7 seconds 6-7 seconds 3315 E.Division Street,Arlington,TX 76011 Agribalance Technical Data Sheet Phone(817)640-4900,Fax(817)633-2000 Last Revision 2-25-19 Info@Demllec.com,www.Demilec.com Page 1 of 2 AC R 1-BALANCEMW � o® r Initial Recirculating Setpoint Temperature 80-85OF 27-30°C Initial Primary Heater Setpoint Temperature 120OF 490C Initial Hose Heat Setpoint Temperature 120OF 490C Initial Processing Setpoint Pressure 1300 psi 8963 kPa Substrate&Ambient Temperature Summer>50OF Summer: >10°C Winter:30°F-60°F Winter:-1°C-160C Moisture Content of Substrate 519% s 19% Moisture Content of Concrete Concrete must be cured,dry and free of dust and form release agents. 'Foam application temperatures and pressures can vary widely depending on temperature,humidity,elevation,substrate,equipment and other factors.While processing,the applicator must continuously observe the characteristics of the sprayed foam and adjust processing temperatures and pressures to maintain proper cell structure,adhesion,cohesion and general foam quality.It is the sole responsibility of the applicator to process and apply Agribalance within specification. General Requirements:Equipment must be capable of delivering the proper ratio(1:1 by volume)of polymeric isocyanate(PMDI)and polyol blend at adequate temperatures and spray pressures.Substrate must be at least 5 degrees above dew point,with best processing results when ambient humidity is below 80%.Substrate must also be free of moisture(dew or frost),grease,oil,solvents and other materials that would adversely affect adhesion of the polyurethane foam. Agribalance must be separated from the interior of the building by an approved thermal barrier or an approved finish material equivalent to a thermal barrier in accordance with applicable codes.Agribalance must be sprayed at a minimum thickness of 3"per pass.This product must not be used when the continuous service temperature of the substrate or foam is below-60OF(-51°C)or above 180OF(820C).Agribalance should not be used in contact with bulk water, below grade or to cover flexible ductwork. Disclaimer:The information herein is to assist customers in determining whether our products are suitable for their applications.We request that customers inspect and test our products before use and satisfy themselves as to contents and suitability.Nothing herein shall constitute a warranty,expressed or implied,including any warranty of merchantability or fitness,nor is protection from any law or patent inferred.All patent rights are reserved.The foam product is combustible and must be protected in accordance with applicable codes.Protect from direct flame and spark contact,around hot work for example.The exclusive remedy for all proven claims is replacement of our materials. NNSERTp ��+`�r�r SCENTER C E �i APPRi 10 C. V$ GREEN — -12,11"wnoernoe APPROVED � n le�a.,�� 3315 E.Division Street,Arlington,TX 76011 Agribalance Technical Data Sheet Phone(817)640-4900,Fax(817)633-2000 Last Revision 2-25-19 Info@Demilec.com,www.Demilec.com Page 2 of 2 I HEATLOK5 XT DEMILEC TECHNICAL DATA SHEET Heatlol,XT is a two component,closed ce 1,spray applied,rigid polyurethane foam system.This product uses recycled plastic materials,rapidly renewable soy oils,and the blowing iigenthas zero ozone depleting potential.Heatlok XT complies with the intent of the International Code Council's residential and commercial building codes and is commonly used as a thermal insulation,air barrier,vapor retarder and water resistive barrier in above grade,below grade,interior and exterior applications. PROPERTIESPHYSICAL ASTM D 1622 Core Density Summer-2.23 Ib/ft' Summer-35.7 kg/m' Winter-2.17 Ib/ft' Winter-34.8 kg/m' Aged Thermal Resistance(R-value @ 1 inch) Summer-6.7 ft'h°F/BTU Summer-1.18 Km1/W ASTM C 518 See CCRR for Heatlok XT-s(summer)and Heatlok XT- Winter-6.9 ft'h°F/BTU Winter-1.22 KmZ/W w(winter)Table 1,for additional R-value information. ASTM E 283 Air Leakage @ 75 Pa @ 1" <0.02 L/sm' ASTM E 2178 Air Permeance @ 75 Pa @ 1" <0,02 L/sm' Water Vapor Permeance ASTM E 96 (Summer @ 1.625",Winter @ 1.1") <1 perm <57.2 ng/Pa•s•m' Qualifies as a Class II vapor barrier per IBC Section 202 ASTM D 2842 Water Absorption(volume) Summer-0.87% Winter-0.81% ASTM D 1621 Compressive Strength at 10%Deformation Summer-18.0 psi Summer-124 kPa Winter-23.1 psi Winter-159 kPa ASTM D 1623 Tensile Strength Summer-37.9 psi Summer-261 kPa Winter-53.7 psi Winter-370 kPa ASTM D 2126 Dimensional Stability @ 158OF(70°C)97%R.H.. Summer-5.45%(%volume change) (168 hours) Winter-4.14%(%volume change) VOC Emissions UL Environment(Greenguard Gold) Meets Criteria ASTM C 1338 Fungi Resistance No fungal growth ASTM D 2856 Closed Cell Content Summer-93.1% Winter-93.8% FIRE TEST RESULTS Surface Burning Characteristics,4"thick Class I Summer-Flame Spread Index 0-5 ASTM E 84 Summer-Smoke Developed 350-400 Winter-Flame Spread Index 5 Winter-Smoke Developed 250-300 Ignition Barrier-Compliant with 2009,2012&2015 IBC and IRC,and ICC-ES NFPA 286 AC-377 Appendix X,for use in attics and crawl spaces without a prescriptive Pass ignition barrier,thermal barrier or intumescent coating. Thermal Barrier-Compliant with the 2009,2012&2015 IBC and IRC,as an interior NFPA 286 finish without a 15 minute thermal barrier with DC-315 at 18 m(Is wet film thickness, Pass 12 mils dry film thickness. ASTM D 1929 Ignition Properties(spontaneous Ignition temperature) Summer-1010°F(543°C) Winter-932°F(500°C) RECYCLED&RENEWABLE CONTENTOF • Finished Foam Renewable and Recycled Content Summer-Winter-21.0%.0% Polyol Renewable Content Summer-8 Winter-8% Polyol Recycled Content Summer-30.4% Winter-34% 3315 E.Division Street,Arlington,TX 76011 Heatlok XT Technical Data Sheet Phone(817)64D-4900•Toll Free(877)336-4532 Last Revision 10-8-15 Fax(817)633-2000:Info@a,Demilec.com,www.Demilec.com Page 1 of 2 r HEATLOK° •T REACTIVITY PROFILE Cream Time Gel Time Tack Free Time End of Rise 0-1 seconds 2 seconds 3-4 seconds 3-4 seconds LIOUID COMPONENT PROPERTIES' PROPERTY A-PMDI ISOCYANATE HEATLOK XT RESIN Color Brown Blue Viscosity @ 770F(25°C) 180-220 cps Summer-250-350 cps Winter-200-300 cps Specific Gravity 1.24 Summer-1.17-1.21 Winter-1.20-1.22 Shelf Life of unopened drum properly stored 12 months 6 months Storage Temperature 50-100°F(10-38°C) 59-77°F(15-25°C) Mixing Ratio(volume) 1:1 1:1 'See SDS for more information. RECOMMENDED •• • . • Initial Primary Heater Setpoint Temperature Summer 100-10S°F Summer 38-41'CWinter 95-100°F Winter 35-38°C Initial Hose Heat Setpoint Temperature Summer 100-105°F Summer 38-410CWinter 95-100'F Winter 35-38°C Initial Processing Setpoint Pressure 1200-1400 psi 8274-9653 kPa Substrate&Ambient Temperature Summer>50OF Summer>100CWinter>10°F Winter>-12°C Moisture Content of Substrate <_19% <_19% Moisture Content of Concrete Concrete must be cured,dry and free of dust and form release agents. Foam application temperatures and pressures can vary widely depending on temperature,humidity,elevation,substrate,equipment and other factors.While processing,the applicator must continuously observe the characteristics of the sprayed foam and adjust processing temperatures and pressures to maintain proper cell structure,adhesion,cohesion and general foam quality.It is the sole responsibility of the applicator to process and apply Heatlok XT within specification. General Requirements:Equipment must be capable of delivering the proper ratio(1:1 by volume)of polymeric isocyanate(PMDI)and polyol blend at adequate temperatures and spray pressures.Substrate must be at least 5 degrees above dew point,with best processing results when ambient humidity is below 8096.Substrate must also be free of moisture(dew or frost),grease,oil,solvents and other materials that would adversely affect adhesion of the polyurethane foam.Applicators should limit the application of this product to no more than a thickness of 2" (50mm)per pass(after expansion)to avoid fire hazards(including spontaneous combustion)resulting from excessive heat generation.A second 2"(50mm)layer may be applied immediately after the first one has fully risen.If subsequent passes are needed,applicators should wait until the core temperature of the foam has dropped below 100°F to allow any reaction heat to dissipate from the prior applications before attempting to reapply the product. Heatlok XT must be separated from the interior of the building by an approved thermal barrier or an approved finish material equivalent to a thermal barrier in accordance with applicable codes.Heatlok XT must be sprayed at a minimum thickness of 1"per pass.This product must not be used when the continuous service temperature of the substrate or foam is below-60°F(-51°C)or above 1809F(820C).Heatlok XT should not be used to cover flexible ductwork. Disclaimer:The information herein is to assist customers in determining whether our products are suitable for their applications.We request that customers inspect and test our products before use and satisfy themselves as to contents and suitability.Nothing herein shall constitute a warranty,expressed or implied,including any warranty of merchantability or fitness,nor is protection from any law or patent inferred.All patent rights are reserved.The foam product is combustible and must be protected in accordance with applicable codes.Protect from direct flame and spark contact,around hot work for example.The exclusive remedy for all proven claims is replacement of our materials. RINOW ro � s 3315 E.Division Street,Arlington,TX"76011 Heatlok XT Technical Data Sheet Phone(817)640-4900,Toll Free(877)336-4532 Last Revision 10-8-15 Fax(817)633-2000.Info@Demilec.com,www.Demilec.com Page 2 of 2 ■ FACT SHEET THIS IS GREENFIBER° ALL BORATE LOOSE FILL FORMULA INSULATION Application Coverage Chart 30 lbs (13.6 kg) INS765LD Minimum Thickness Net Coverage Net Coverage(adjusted for 2"x 6" R-Value at (inches) (no adjustment for framing) framing on 16"centers) 75°F Mean Expesor minimo Cubertum note(sin compensaci6n Cobertura neta(con compensoci6n pare una estructum Temp. (en pulgadas) pain el estructum) de 2'x 6`an centms de 16') valor de Initial Settled Maximum Mimimum Minimum Maximum Mimimum resistencia termira Installed Thickness Sq.Ft.per Bag . Bags per Weight per Sq.R.per Bag Bags per (valor R)a Thickness Espesor Metros 1,000 Sq.Ft. Sq.R. PieS 1,000 Sq.R. 75 Fde tempemWra Espesor asentado cuadmdos Camidad minima Peso minima cuadmdos Cantidad minima media inicial mdximos bolsas por1,000 pot pie cuadrado maxlmos de bolsas par 1,000 de instalado pot balsa pies cuadmdos pot balsa pins cuadmdos 11 3.36 3.02 100.8 9.9 0.298 111.3 9.0 13 3.99 3.59 83.5 12.0 0.359 92.2 10.8 19 5.86 5.27 54.3 18.4 0.552 59.6 16.8 22 6.77 6.10 45.9 21.8 0.653 49.7 20.1 26 7.99 7.19 37.8 26.4 0.793 40.5 24.7 30 9.19 8.27 32.0 31.2 0.937 33.9 29.5 32 9.79 8.81 29.6 33.7 1.01 31.3 32.0 38 11.57 10.41 24.1 41.4 1.24 25.3 39.6 40 12.16 10.94 22.7 44.1 1.32 23.7 42.2 44 13.33 11.99 20.2 49.6 1.49 21.0 47.6 48 14.49 13.04 18.1 55.2 1.66 18.8 53.2 49 14.78 13.30 17.7 56.6 1.70 18.3 54.6 50 15.07 13.57 17.2 58.1 1.74 17.8 56.1 60 17.96 16.16 13.7 73.1 2.19 14.1 71.0 THE ABOVE COVERAGE CHART IS BASED ON A NOMINAL BAG WEIGHT OF 30 LBS USING A VOLUMATIC III,3rd GEAR AND 8"GATE. THE CHART IS BASED ON SETTLED THICKNESS AND IS FOR ESTIMATING PURPOSES ONLY.DO NOT EXCEED MAXIMUM SQUARE FEET COVERAGE PER BAG. THE APPLICATOR MUST INSTALL BOTH THE MINIMUM NUMBER OF BAGS PER 1000 SQ,FT.AND THE MINIMUM INSTALLED THICKNESS TO INSURE THE STATED R-VALUE HAS BEEN REACHED.FAILURE TO MEET BOTH THESE REQUIREMENTS MAY PREVENT THE APPLICATION OF SPECIFIED R-VALUE.THIS PRODUCT IS INTENDED FOR DRY APPLICATION ONLY.JOB CONDITIONS,APPLICATION TECHNIQUES,EQUIPMENT, AND SETTING CAN INFLUENCE ACTUAL COVERAGE.DO NOT ADD WATER TO THIS PRODUCT.MINIMUM NET WEIGHT IS 28.5 LBS. THIS COVERAGE CHART IS FOR DRY Dry Dense Pa k Sidewall ApplicationsAPPLICATIONS ONLY AND IS BASED Thermal Resistance Framing Installed Thickness Minimum Wt. Maximum Coverage Per Bag Maximum Coverage Per Bag ON THE KRENDL KS200,WITH MATERIAL (R value) (inches) Per Square Foot (No Adjustment for Framing) (Adjusted for Framing)ft2lBag APPLIED DRY.FOR MAXIMUM Estructum •'Bag Resistencia t6rmica Espesor instalado IbNt 2 ft2, pot balsa (R) (pulgadas) Peso minima pot Coberturamt�ma pot bolsa ( Coberelramimna concompmsaci6nParamestmctura) COVERAGE PER BAG(ADJUSTED FOR piecuadmdo (sin mmpemaci6nwaiaesaucana) ft2,'Bag FRAMING),THE FRAMING FACTOR FOR roat2 d2reag 16'oc 24'oc o ( ) ( 16'OC STUD SPACING IS 9.375 io;FOR 13 20 3.5 1.02 29.39 32.4 1 31.3 24'OC STUD SPACING THE FRAMING 21 2x6 5.5 1.60 18,70 20.6 19.9 FACTOR IS 6.25%. READ THIS BEFORE YOU BUY What you should know about R-values This chart shows the R-value of this insulation. R means resistance to heat flow. The higher the R-value,the greater the insulating power. Compare insulation R-values before you buy. There are other factors to consider. The amount of the insulation you needdepends on the climate you live in. Also, your fuel savings from insulation will depend upon the climate, the type and size of your house, the amount of insulation already in your house, and your fuel use patters and family size. If you buy too much insulation, it will cost you more than what you'll save on fuel. To get the marked R-value, it is essential that this insulation be installed properly. FOR MORE INFORMATION CONTACT GREENFIBER: MANUFACTURING LOCATIONS: GreenFiber Corporate Office Albany,NY 2500 Distribution Street,Suite 200 Charlotte,NC Seal and Charlotte,NC 28203 Delphos,OH Win,late Norfolk,NE EMENERGYSTAR MGOE IN THE (p)800.228.0024(f)704,379,0685 Phoenix,AZ U S A (e)greenfiber.info@greenfiber.com Salt Lake City, UT www.greenfiber.com Tampa,FL Waco,TX PM-6.3-328 Rev A 08/11 TM-6.4-12 Rev C 05/10 J `t 1� Y Professionally Installed . With a knowledgeable representative,you can a� ti evaluate your current insulation levels and x determine how much additional insulation you u may need to meet the Department of Energy's h. recommendations.Consider adding insulation not only to your attic,but to exterior and interior walls.Also,by installing it around media rooms, ' bathrooms and between floors,your home will be noticeably quieter. Do You Need More nsuIation In Your Home? 1)Accordfng to Ridge National labort,"Study(199I)comparig Ober giaaa loaw fl11 Irtwladen to bl win collate"Insulation.Se•Anga vary.The higher the R-valuo,the greater the Inatriabn9 power.Auk your ao9a rot the fxt he.on R..k o. 9 Compzin an based on an R30 ntuo a1 ono square foot-go arse, Maybe.The U.S.Department of Energy has issued Thb canporcron mdudea the production and onargy trod In the lrmulatbn m 10"udng procasn.geood an SuuainabWry Unp=Ind.-Prepared by Principal Parfrtcra new R-value recommendations to help you make 3)eased on a UnNordLy of Cdaado study 0990)w Padtg canulOw and Oba,&_bunt Ina d can in dandwl saucturaa during fha wNror 000aon &Mngs vary.find out why In your raolhr'a loot ahem an RNOfum fthar better decisions about how much insulation your R,wlvoa moan grwter maulndng power, home needs based on where you live.Go to For A Quiet, And www.greenflber.com,"Homeowners"section and input information in to the"Insulation Calculator". Comfortable Home. This handy tool will help you determine how much insulation you need based on your current R-value and the region of the country that you live in. �ibe4 blouwin insulation US Greenflber,LLC 5500 77 Center Drive.Suite 100 Charlotte,NC 28217 • Toll Free:800-228-0024 fiber,. Fax 704-522-3748 blow4n insulations PM-6.3.23 Rev 2 2118 ' Warmer in Winter' G—ft—M*.0 mOfa R-M.am tbsa i1 tetllper.u belch hmxhB 2520 g Y Y Cellulose m 10 �� u 0 55• 5M SS nM V Ia• Ia' ID• 15• IT 5• M -5• 4M -15' 4M Attic Temperature(Degrees Fahrenheit) High R-Value Better Sound Control Added Fire Resistance Greenfiber provides a high R-value per inch:meaning Where air flows,sound follows.But because With a Class 1 fire rating,Greenfiber is 57% you can realize more insulating performance with Greenfiber is so much denser than other insulation better than fiberglass at resisting fire?Fiberglass less material.Our insulation fills in gaps and voids products and it is blown in to fill each space,it does not contain active fire-retardant additives, to reduce air infiltration where energy can escape. provides superior noise transfer reduction through but Greenfiber is treated to slow the spreading Plus,it's two to three ties denser than other insulation floors and walls.This creates a quieter and more of flames.In addition,its density gives it more products.As a result,you can count on Greenfiber to comfortable home. fire-blocking capability. keep homes warmer in the winter and cooler in the In open attics,Greenfiber Insulation easily forms Greenfiber Insulation has earned a Class 1 summer while reducing energy bills. around irregular construction and stays in place, fire rating as determined by ASTM E84. fitting snugly against framing members and even Our insulation is treated with safe fire retardants Made Responsibly moderate slopes. that exceed test requirements set by the Consumer Because our insulation absorbs noise so well,it Product Safety Commission(CPSC)standard 16 Greenfiber cellulose fiber insulation is made with up has been chosen to mitigate noise problems in CFR parts 1209 and 1404. to 85%recycled material that's free from unhealthy homes next to airports. Our insulation meets all test requirements of ASTM substances like formaldehyde and asbestos.Plus we use •Special effort should be taken during construction C739(US),CAN/ULC-S703 in Canada,and all 1/5 of the energy to manufacture Greenfiber as that used to make all walls,ceilings and floors airtight in FHA,VA,HUD and building code requirements. to make competing insulation products? order to eliminate any potential leaks for sound They include: transmission.The staggering of outlets and Corrosiveness plumbing is also recommended. Density (/5E" Flame Spread Permanency Fungi.Resistance Moisture Vapor Sorption Odor Emission 0 f� C Separation of Chemicals blotn�in insulation Surface Burning Characteristics } ® Thermal Resistance 22%Lass F•iaray Lp 4e 85% i American Building Systems Lakeville Insulation Certificate 415 Millenium Circle, Unit 3 Lakeville, MA 02347 Job Number: F 2292 Date: 4/17/19 Bill To: Project Information: JIM HAGERTY Job Desc. Combination 31 HALWAY DRIVE Lot # 31 WEST BARNSTABLE, MA 02668 Street 31 HALWAY DRIVE - PROPOSAL 1 City,State,Zip WEST BARNSTABLE, MA Area installed Product Installed Footage AIR SEAL CAULKING 1.00 WINDOW& DOOR FOAM WINDOW AND DOOR FOAM 1.00 FIRESTOPPING FIRESTOPPING 2.00 ROXUL TUB TRAPS "ROCK WOOL 3"", 16 0/C" 2.00 1 ST FL OLD SLOPE AREA 16" BAFFLES 35.00 PORCH CEILING R-19 UNFACED BATT 15 X 93 200.00 BASEMENT CEILING W./RODS R-30 KRAFT FACED Batt- 16X48 Batt- 16X48 230.00 SLOPES GARAGE R-21 KRAFT FACED BATT 15 X 93 240.00 I GARAGE CEILING W/RODS R-38 KRAFT FACED Batt- 16X48 Batt- 16X48 800.00 EXTERIOR WALLS 2X6 R-1 1 UNFACED Batt- 15X93 Batt- 15X93 720.00 'GARAGE EXTERIOR WALLS R-19 KRAFT Batt- 15X48 660.00 j STAIRWELL UNDER R-30 R30 KRAFT 12 OC Batt- 12X48 50.00 I STAIRWELL LANDING R-21 KRAFT FACED BATT 15 X 93 30.00 ROG ALL INTERIOR WALLS R-1 1 UNFACED Batt- 15X93 Batt- 15X93 700.00 I 1 ST FLOOR BED WALL R-1 1 UNFACED Batt- 15X93 Batt- 15X93 120.00 I 1 ST FLOOR BATH R-11 UNFACED Batt- 15X93 Batt- 15X93 100.00 BETWEEN FLOORS (OLD) R-19 UNFACED BATT 15 X 93 580.00 BETWEEN FLOORS (NEW) R-1 1 UNFACED Batt- 15X93 Batt- 1 SX93 220.00 EXTERIOR WALLS 2X4 (OLD& NEW) CLSD CELL FOAM R21 320.00 j EXTERIOR WALLS 2X6 CLSD CELL FOAM R14 720.00 CUT 2" AROUND CHIMNEY IN MAIN CEILING LABOR 30.00 1 ST FL COLD TO KNEEWALL OLD DEMILEC OPEN CELL R35.5 310.00 j BAND JOIST GARAGE DEMILEC OPEN CELL R24.75 100.00 j 2ND FL SLOPES OLD DRILL AND FILL DENSE PACK CELLULOSE 260.00 Date Completed Company Representative Phone: 508-484-4931 Fax: 508-484-4934 r American Building Systems Lakeville Insulation Certificate 415 Millenium Circle, Unit 3 Lakeville, MA 02347 Job Number: 2294 Date: 4/17/19 Bill To: Project Information: JIM HAGERTY Job Desc. Combination 31 HALWAY DRIVE Lot # 31 Street 31 HALWAY DRIVE - PROPOSAL 3 WEST BARNSTABLE, MA 02668 City,State,Zip WEST BARNSTABLE, MA Area installed Product Installed Footage 1 MAIN CEILING PEAK TO PLATE DEMILEC OPEN CELL R38 1440.00 GABLE WALLS 2X6 DEMILEC OPEN CELL R22 150.00 I RUNNER NEXT TO SLIDER DEMILEC OPEN CELL R22 10.00 j Date Completed Company Representative i Phone: 508-484-4931 Fax: 508-484-4934 BUILDING DEPT. - APR 72 - HEATLOK01w. 019 . TOWN OF BARNSTABLE Density b Company Name American Building Systems Phone Number 508-484-4931 Applicator Name NATHAN RICHARDSON Installation Date 4/10/19 Jobsite Address 31 Halfway Drive Barnstable MA A-Side Lot #'s Permit Number B-Side Lot #'s Location of Insulation Thickness Total R-Value Approximate Sq. Ft. Walls 2 & 3 inches 2=R14 3 r21 1040 Attic Intumescent Coating Used Location Thickness Coverage Rate t www.Demilec.com QSDEMILEC Town of Barnstable _ Building VSrASM ; !Post This Card So That it'_is Visible From the Street-Approved Plans.Must be Retained on Job and d this Card Must,be Kept 1 `�$ -Posted Until Final Inspection.-Has Been Made. 4 Permit mac639.' 'Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made,, Permit No. B-18-3092 Applicant Name: HAGERTY,JAMES P& LYNDA J Approvals Current Use: Structure Date Issued: 12/11/2018 ( r Permit Type: Building-Addition/Alteration-Residential Expiration Date: 06/11/2019 Foundation: Location: 31 HOLWAY DRIVE,WEST BARNSTABLE Map/Lot: 136-039 Zoning District: RF Sheathing: Owner on Record: HAGERTY,JAMES P&LYNDA J Contractor Name: Framing: 1 Address: 31 HOLWAY DRIVE Contractor License: 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $300,000.00 Chimney: Description: CONSTRUCT A MUDROOM ADDITION. RENOVATE KITCHEN,ADD Permit Fee: $ 1,580.00 NEW SCREEN PORCH WITH ROOF DECK. CONSTRUCT THREE CAR Fee Paid: $ 1,580.00 Insulation: GARAGE WITH MASTER SUITE ABOVE Date: ,p 12/11/2018 Final: Project Review Req: Office not to be used for Sleeping � — Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and thetapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local Toning by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Service: J The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: �V4E � Town of Barnstable Building Post This Card So That it is Visible From the Street_ -Approved Plans Must be Retained on Job and this Card Must be Kept SAILNsrABLE M"S Posted Until Final Inspection Has Been Made. i639' `0 Permit Fob' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final,lnspection has been made: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r i d s f t I (,0- .................. • ...........Ot�ca Fee.................:. MABELPermit Fee..........................:. .... %63¢ '`� 0 0 9 2018 Total Fee:Paid WN ng FARNSTABL� � a. .....v....c.0.TOWN OF BIOSTABLE Pe , l9.. o ............. BUILDING PERMIT Map............�.'3(0............Parc&............ ............... APPLICATION Section 1 —Owner's Information and Project Location Project Address L W p Village Owners Name -, —AM ES &4 0 LeU",A 1:51 =9 Owners Legal Address ( L City V IC v �7 - - State0 Zip DZEc(o8 owners Cell# 56 3�ybily Frmail Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑-,/Commercial Structure under 35,000 cubic feet Ir Single/Two Family Dwelling Section 3-Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm build El Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ Solar aienovation ❑ Pool 0 Insulation Other-Specify Section 4-Work Description A 012DV-404A ADPrt7A) T Ad nndsxtmi-2/9r201 S I ApplicationNumber.................................................... Section 5—Detail Cost of Proposed Construction' ODD Square Footage of Project CDs ZE5 Age of Structure ��. 'r �'" ` Dig Safe Numberl2?j�D 7 ?j # Of Bedrooms Existing Total# Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method MA Checklist [/WFCM Checklist ❑ Design Section 6—Project Specifics EfWiring ❑ Oil Tank Storage (Smoke Detectors [7�Plumbing [ Gas ❑ Fire Suppression ZHeating System ❑ Masonry Chimney 12'Add/relocate bedroom Waxer Supply ❑ Public Private Sewage Disposal ❑ Municipal "19 On Site Historic District ❑ Hyannis Historic District [g/Old Kings Highway Debris Disposal Facility: �UJ?Wafb I an using a crane Yes l No . Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No 19/ Section 8—Zoning Information Zoning District Proposed Use 2L& Lot Area Sq.Ft. -35-1 Total Frontage Percentage of Lot Coverage Z, o 7of Dwelling Units (on site) DL)� Setbacks Front Yard Required 10 Proposed i Rear Yard Required � Proposed �3 Side Yard Required l_Proposed__ /-/4/ 7— Has this property had relief from the Zoning Board in the past? ❑ Yes P/ No Last=fint-4 2/ ON .. ......... Application Number........................................... Section 9— Construction Supervisor Name Telephone Number Address City State Tip ' License Number License Type Expiration Date Contractors Email Cell# 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.Attach a copy of your license. Signature . Date Section-10—Home Improvement Contractor Name Telephone Number Address City State zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your HSC... Signature Date Section 11—Home Owners License Exemption Home Owners Name: 14A45T Telephone Number-3(o�•�� Cell or Work Number - (o • ��a� I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Co I understand the construction inspection procedures,specific inspections and documentation by and th Town of Barnstable. Si Date 91117110 AP LI ANT SIGNATURE Si gna Date 1117116 Print r• Telephone Number E-mail permit to: �G7 iL . Gam 11 mini o Section 12—Department Sign-Offs Health Department ❑ Zoning Board Of required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization L , as Owner of the-subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) ' Signature of Owner date i Print Name i Last undated:2/92018 DWD ENGINEERING, INC. I Structural Engineer SHEET NO. 5 Michael Road By IN DATE I �� East Bridgewater, MA 02333 Phone:(508)378-9602 Fax(508)378-2922 e-mail:domdean@aol.com JOB J.�L��r I Ams J; r�'a � � Cs �v s[ �� ) �� { fins 41 i% 1 J' PL.--(won mljlµm 5wm 0100s. �a � � ��0c V!� "bA 1112��'( //4 1• `�� ',l�J ' 3'�%�G� InW \AOF MAss DOMENIC � DeANGELO L �IM1�Sn(� 14 5 SI?S�i�j l�'0�901�J�5 A-r &-N4� L' 9 0 STRUCTURAL y 9No,35062 0Q FGIST '-?i ReorOer from NESS CUSTOW°'printing serviCe 1.80O-M-11327 PlEOS,Inr,.Poeertmroupn,NH O3d58 wAwnebe.emn Rei.No:O 195058828 DWD ENGINEERING, INC. SHEET NO. Structural Engineer 5 Michael Road ev �� DATE (1� East Bridgewater, MA 02333 �111tY P6511on/1 " Phone:(508)378-9602 Fax(508)378.2922 e-mail:domdean@aol.com JOB24 I p „� i I Ltowi �G v'�� N1 ctirly�t o fA ijA 11 SPA'-&` H v ? �o� �� K-�LA-Ioop Ci�J� tvr1) �1�� 2� ��,�qs I� oc wf Itio� 1 09� r vau iwmetJ t i I o sjfzuc .o /rr'Cii 0 3 i �1.4v I 12�rtJ� Reortlor From NEBS CUSTOyM`printlng scrvi<e 1.8004188-CW;' NEQS,Ina.VmerborouglC NH 03458 Wmi,ebs.omn Rof.No:G 1050568N Shear Wall "A" Construction (see plan for dimensions) Foundation to the underside of the roof plywood -2x6 studs spaced at 16"on center with 2-2x6 studs at each end. -1/2" exterior grade plywood (minimum) nailed w/8d common nails spaced at 6" on center around the perimeter of the shear wall dimensions and all interior joints. Note: Plywood to span vertically between floors or provide solid blocking at all horizontal plywood joints nailed at 6" on center(staggered). Provide 8d common nails spaced at 12" on center elsewhere. -Connect the 2-2x6 studs at either end of the shear wall to the foundation with a Simpson HDU4-SDS2.5 holdown. The holdown shall be located on top of the foundation shoe, connected to the 2-2x6 studs with (10) Simpson SIDS W x 2-1/2" screws, and connected to the concrete with a 5/8"diameter anchor bolt epoxied into the concrete a minimum of 8". Shear Wall "B" Construction (see plan for dimensions) Foundation to the underside of the roof plywood -2x6 studs spaced at 16" on center with 2-2x6 studs at each end. -1/2" exterior grade plywood (minimum) nailed w/8d common nails spaced at 4" on center around the perimeter of the shear wall dimensions and all interior joints. Note: Plywood to span vertically between floors or provide solid blocking at all horizontal plywood joints nailed at 4" on center (staggered). Provide 8d common nails spaced at 12" on center elsewhere. -Connect the 2-2x6 studs at either end of the shear wall to the foundation with a Simpson HDU5-SDS2.5 holdown. The holdown shall be located on top of the foundation shoe, connected to the 2-2x6 studs with (14) Simpson SIDS W x 2-1/2" screws, and connected to the concrete with a 5/8" diameter anchor bolt epoxied into the concrete a minimum of 8". Shear Wall "C" Construction (see plan for dimensions) Foundation to the underside of the roof plywood -2x6 studs spaced at 16"on center with 2-2x6 studs at each end. -1/2" exterior grade plywood (minimum) nailed w/8d common nails spaced at 6" on center around the perimeter of the shear wall dimensions and all interior joints. Note: Plywood to span vertically between floors or provide solid blocking at all horizontal plywood joints nailed at 6" on center (staggered). Provide 8d common nails spaced at 12" on center elsewhere. -Connect the 2-2x6 studs at either end of the shear wall to the foundation with a Simpson HDU4-SDS2.5 holdown. The holdown shall be located on top of the foundation shoe, connected to the 2-2x6 studs with (10) Simpson SIDS W x 2-1/2" screws, and connected to the concrete with a 5/8"diameter anchor bolt epoxied into the concrete a minimum of 8". i I i i R®ELL1 r—I �v• _— �1 esv o.....0 I � i wb• � I 1 , r-r Y- �* ) �- �•_'may aettn eu:. _ —_ ; i{<• •s:r;Y lx ?tar, Al I reanxm I't.-t . 1 b , v m� - HQ41 Hrd7L1 ��N _-_ - C W �r tee.°u a �, tiyp nj TGJ fV 1 _ _ .`�>.•+�C_�..,,.I I _�... 'j.1:. !' ,y.�M..�:oa7lae,"'t:.�.'ik ,� r ;. AJ rmu I r6.: "lJ ; r-e• „<• � ram• >,+`� ry•Yr..��__..__..:.__._ r•OVERED Eris LIVING cn•OFFICE , —---- I is I .......—.�_R_--... .__— � ___..._•.. ,... — .. _ FIRST F'00R, .ADDITION W 1 N D 0 W S C N E D U L E DOOR S C E D O L E g $ b§ - ...__.......-----_._.__...........-..... ..Ru -- --'----'-----'- 6 - v °v r-•fT•.Y•>fR' . • lL)ai.WC P/r8M>C wY°m tJ,l>° •>•-•TT' • ° n°p1°we.:kBln�im.•L1c"! °d> e.e'euRll[A R4M C•rt.•e>LqR ----------- ------._ ' ..... ....... e�..>a,P�a.oe�u.P�.Iaa��, .�w � . °°u,e•�. A2.1 F F® R A E s MEMBER REPORT Roof,Ridge Beam PASSED 2 piece(s) 1 3/4" x 11 7/8" 2.0E Miceollam® LVL Overall Length:26' IAN i S ,L i r w xnx Y 4 s r y .k ; ft r a o o • All locations are measured from the outside face of left support(or left cantilever end).AII dimensions are horizontal. Design Results:,,;;, . ;%lctral Location y-. 1v 'Ailowed3 , Result; a•Sc i L'DF Loath Combinadori(Pattiern) i;'; System:Roof Member Reaction(Ibs) 9454 @ 13' 9450(3.60) Passed(100%) 1.0 D+1.0 S(All Spans) Member Type:Flush Beam Shear(Ibs) 4047 @ 14'1 11/16" 9081 Passed(45%) 1.15 1.0 D+1.0 S(All Spans) Building Use;Residential Moment(Ft-Ibs) -11976 @ 13' 20525 Passed(58%) 1.15 1.0 D+1.0 S(All Spans) Building Code:IBC 2015 Uve Load Defl.(in) 0.150 @ 19'11 3/16" 0.422 Passed U999+) -- 1.0 D+1.0 S Alt.Spans Design Methodology:ASD Total Load Defl.(in) 0.213 @ V 11 3/8" 0.633 'Passed U715) 1.0 D+1.0 S(Alt Spans) Member Pitch:0/12 Deflection criteria:U.(U360)and TL(L/240). Top Edge Bracing(Lu):Top compression edge must be braced at 20'2"o/c unless detailed otherwise. Bottom Edge Bracing(Lu):Bottom compression edge must be braced at 11'10"o/c unless detailed otherwise. FC..a• st i.,uT`a Q r. :. Bearing Loads tp$u?pOr♦S(ha) Supports ?;� .ri, ..i �r t`,.:'-,Total,;; ..Available,•; =,;Regwred,_ .. Dead.,' h�5now ,. ;, Total.:' Accessories 4.r d;t ' 1-Column-SPF 5.50' 5.50' 1.50" 1053 1 2137 1 3190 None 2 Column-OF 3.60' 3.60' 3.60" 3279 6175 9454 None- 3-Column.-SPF 5.50" 5.50, 1.50' 1053 2137 3190 None Sti.L'; Loads},.; ocatlon(Side) Width r(0.90) . ., .,(1 15]_•, t7omments:, rn�. 0-Self Weight(PLF) 0 to 26' N/A 12.1 1-Uniform(PSF) 0 to 26'(Front) 13' 15.0 30.0 Roof Weyefiaeuse t r Notes fk � ,, SUSTAINAMFORESTRrINI'RATI E Weyerhaeuser warrants that the sizing of Its products will be in accordance with Weyerhaeuser product design criteria and published design values l Weyerhaeuser e�ressly disclaims any other warranties related to the software.Use of this software Is not Intended to circumvent the need for a design professional as determined by the authority having Jurisdiction.The designer of record,builder or framer Is responsible to assure that this calculation is compatible with the overall project Accessories(Rim Board,Bloddng Panels and Squash Blocks)are not•designed by this software.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evzluated by ICC ES under technical reports ESR-1153 and ESR-1387 and/or tested In accordance with applicable ASTM standards.For current code evaluation reports, Weyerhaeuser product literature and Installation details refer to www,weyerhaeuser.com/woodproducts/document-library. The product application,Input design loads,dimensions and support Information have been provided by Forte Software Operator k � &AA .��P�• \A OF MAS SC DOMENIC W. yG rn DeANGELO o STRUCTURAL c. N0.35062 A�p�,9Fcr Forte software Operator .lob Notes 10/14/2018 6:44:12 PM Domenic DeAngelo Hagerty Residence Forte v5.4,Design Engine:V7.1.1.3 DWO Engineering,Inc. 31 Holway Drive 1 S�t71.4fe (508)378.9602 West Barnstable,MA domdean@aol.com 18-425 Page 1 of 1 I,F Q R 1 G MEMBER REPORT Roof, Window Header � PASSED v� It.. 3 piece(s) 13/4" x 7 1/4" 2.0E Microllam® LVL Overall Length:8'6" 1 + 0 0 a o All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. Deslgrt.Results ;: 1 ., ;,..Achnal�.Locatlon; Allowed,tr°!Result t- .LDP, Load:eombinatlori(Vattiem) ,,,s y r System:Roof Member Reaction(lbs) 1642 @ 1 1/2" 11419(3.00') Passed(14%) 1.0 D+1.0 S(All Spans) Member Type:Drop Beam Shear(lbs) 1633 @ 10 1/4". 8317 Passed(20%) 1.15 1.0 D+1.0 S(All Spans) Building Use:Residential Moment(R-lbs 6674 @ 4'3" 12273 Passed.(54% 1.15 1.0 D+1.0 S(All Spans) Building Code:IBC 2015 Live Load Defl.(In 0.143 @ 4'3" 0.275 Passed(L/693) — 1.0 D+1.0 S(All Spans) Design Methodology:ASD Total Load Defl.(in) 0.217 @ 4'3" 0.412 Passed 1J456 1.0 D+1.0 S(All Spans). Member Pitch:0/12 Deflection criteria:LL(L/360)and TL(1.1240). Top Edge Bracing(Lu):Top compression edge must be braced at 8'6"o/c unless detailed otherwise. Bottom Edge Bracing(Lu):Bottom compression edge must be braced at 8'6'o/c unless detailed otherwise. c I v 8ea ing Length`: ' Loads fn5upports(Ibs), y. § ;.• v' Supports', Total' 'Avallabte Required , Dead ~.Snow :_ ;Total '.•. Accessories 1-Column-SPF 3.00. 3.00' 1.50, 574 I069 1643 None 2-Column-SPF 3.00" 3.00" 1.50" 574 1069 1643' None r r Trlbutary' Dead snow 7 Loads Locaiion(siee) :'widen .' (0.90j, '(i.15). comments 0-Self Weight(PLF) 0 to 8'6" N/A 11.1 1-Point(lb) 4'3"(Top) N/A 1053 2137- ridge beam reaction Weyerhaeuser Notes.` _ t 1 //�� '` - •. .:•.- . - .._.r- •_q:.;:.j.r r _:,.•: +. (2�SUSTAINA8IE FORESTRY INRWTNE Weyerhaeuser warrants that the siring of its products will be in accordance with Weyerhaeuser product design criteria and published design values, �} Weyerhaeuser expressly disdaims any other warranties related to the software.Use of this software Is not intended to circumvent the need for a design professional as determined by the authority having Jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation Is compatible with the overall project.Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR-1153 and ESR-1387 and/or tested In accordance with applicable ASTM standards.For current code evaluation reports, Weyerhaeuser product literature and installation details refer to www.weyerhaeuser.com/woodproducts/document-library. The product application,Input design loads,dimensions and support Information have been provided by Forte Software Operator � N ♦�►�,��N OF MAS, 1 0=� DOiIENIC W. ZZ D ANGELO STRUCTURAL cn No.35062 • �A9p��FGr S � • _ of� Forte Software Operator Job Notes 10/14/2018 6:46:12 PM Domenic DeAngelo Hagerty Residence Forte v5.4,Design Engine:V7.1.1.3 DWD Engineering,Inc. 31 HoAvay Drive 1`r001.4te (50a)378-9602 West Barnstable,MA domdean@aol.com 18425 Page 1 of 1 0 T MEMBER REPORT Second Floor,Beam over Garage-Short Sian PASSED F R 4 piece(s) 13/4"x 18" 2.0E Microllam@ LVL Overall Length:24' 2, 7 % + + 0 0 3�t 24' q All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. Result 6P:1&aa:ltointili;iiiWnt System Moor (Platbarn)�Vl Member Reaction(Ibs) 9985 @ 23'8" 27913(5.50") Passed(36%) 1.0 D+0.75 L+0.75 S(All Spans) f Member Type Drop Beam Shear(Ibs) 7718 @ 22'1/2" 23940 Passed(32%) 1.00 1.0 D+1.0 L(All Spans) Building Use.:Residential Moment(Ft-Ibs) 63473 @ 13' 89132 Passed(71%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Code:IBC 2015 Live Load Defl.(in) 0.594 @ IT 3/4' 0.778 Passed(V471) 1.0 D+0.75 L+0.75 S(All Spans) Design Methodology:Aso Total Load Defl.(in) 0.932 @ 12'3/4" 1.167 Passed(V300) 1.0 D+0.75 L+0.75 S(Ail Spans) Deflection criteria:U.(V360)and TL Top Edge Bracing(Lu):Top compression edge must be braced at 8'10"o/c unless detailed otherwise. Bottom Edge Bracing(Lu):Bottom compression edge must be braced at 24'o/c unless detailed otherwise. Member should be side-loaded from both sides of the member to prevent rotation, Searing Length':1..-_.; Loads;to Supports(Ibs) . . , !'�FUloor!:1VL I"PP Tot3l Available equ!�e� Dead iTotal Accessories Ve 1-Column-SPF 5.50, 5.50" 1.92* 3501 5520 2822 21843 None 2-Column-SPF 5.50, 5.50, 1.97' 3591 5520 3005 12116 None Fl Snow. , Lct �q.isyj..-. co, 0-Self Weight(PUF) 0 to 24' N/A 36.8 1-Uniform(PSF) 0 to 24'(Top) 111 6" 12.0 40.0 second floor 2-Point(lb) 0'(Top) N/A 1053 - 2137 ridge beam reaction 3-Uniform(PSF) 0 to 24'(Top) 5'11/2' 1 15.0 30.0 roof V; SUSTAINABLE FORESTRY IN mATrvE Weyerhaeuser warrants that the sizing of Its products will be In accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software.Use of this software Is not Intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer Is responsible to assure that this calculation Is compatible with the overall project.Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry.standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR-1153 and ESR-1387+and/or.tested In accordance with applicable ASTM standards.For current code evaluation reports, Weyerhaeuser product literature and Installation details refer to www.weyerhaeuser.com/woodproductsldocumentAibrary. IThe product application,input design loads,dimensions and support Information have been provided by Forte Software Operator 11 K .4 .r deekWL W41 W /40. MWV 16b000 w b_AA OF Mgss DOMENIC W. *DeANGELO o STRUCTUR L N , 50 Forte Software Operator Job Notes MAIL 4/2018 6:49:46 PM Domenic DoAngolo 1129'orty Raridanco esign Engine'V7.1.1.3 DWD Engineering,Inc. 31 Holway Drive 15-001.4te (506)378-9602 West Bam3table,MA domdean—aol.com18-425 Page 1 of 1 'a--7 ° MEMBER REPORT Second Floor,Beam over Garage-Long Span PASSED O E 3 piece(s) 1 3/4" x 24" 2.0E Microllam® LVL Overall Length:26' l o o a All locations are measured from the outside face of left support(or left cantilever end).AII dimensions are horizontal. Desi n.ResWts ,i,actual0Locatiori wauowed::'.' Result`,; 'LDF,:' Load:Combination(Patterrt) System:Floor Member Reaction(Ibs) 11531 @ 4" 21656(5.50") Passed(53%) -- 1.0 D+0.75 L+0.75 S(All Spans) Member Type:Drop Beam Shear(Ibs) 9153 @ 2'5 1/2" 23940 Passed(38%) 1.00 1.0 D+1.0 L(All Spans) Building Use:Residential Moment(Ft-Ibs) 96848 @ 13' 114283 Passed(85%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Code:IBC 2015 Uve Load"Deft. In 0.578 @ 13' 0.844 Passed(1./526) -- 1.0 D+0.75 L+0.75 S(All Spans) Design Methodology:ASO Total Load Defl.(in) 0.918 @ 13' 1 1.267 Passed 1./331 -- 1.0 D+0.75 L+0.75 S(All Spans) Deflection criteria:LL(L/360)and TL(L/240). •Top Edge Bracing(Lu):Top compression edge must be braced at 4'V o/c unless detailed otherwise. Bottom.Edge Bracing(Lu):Bottom compression edge must be braced at 26'o/c unless detailed otherwise. Bearing Length,•' Loads to 5uppotis(Ibs) sU OTts to Floor `, 1 PP Total Available Required Dead Snow' "Total Atxessortes Live 1-Column-OF 5.50, 5.50" 2.93' 4145 6760 3088 13993 No 2-Column-OF 5.50" 5.50' 2.93" 4145 6760 3088 13993 None Tributary Dead Floor Live Snow Loads,1r , Lotation(Sinej Width ;(0.90) ,..(I OOj. . (i.19) comments 0-Self Weight(PLF) 0 to 26' N/A 36.8 1-Uniform(PSF) 0 to 26'(Top) 13' 12.0 40.0 - second floor 2-Point(lb) 13'(Top) N/A 3279 - 6175 ridge beam reaction Weyerhaeuser.NotesfsusTAINABLEFOResrltytramAmrla Weyerhaeuser warrants that the siring of Its products will be In accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software.Use of this software Is not Intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer Is responsible to assure that this calculation Is compatible with the overall project Accessories(RIm Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at Weyerhaeuser facilities are thlyd-party certifled to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR-1153 and ESR-1387 and/or tested in accordance with applicable ASTM standards.For current code evaluation reports, Weyerhaeuser product literature and installation details refer to www.weyerhaeuser.corNwoodproducts/document-library. The product application,Input design bads,dimensions and support Information have been provided by Forte Software Operator , . OF MASSgCyG _� DOEIEN�CW• tn,`► 1 QeANGE RAl v � STRIICSU v tyo.35D6 A9p 9FG1 1 Forte Software Operator .cob Notes 10/14/2018 6: :55 PM Domenic DeAngelo Hagerty Residence Forte v5.4,Design Engine:V7.1.1.3 DWD Engineering,Inc. 31 Holway Drive 15-001.4te (508)378.9602 West Barnstable,MA ` domdean@aol.com 18425 Page 1 of 1 Generated by REScheck-Web Software Compliance Certificate I Project Hagerty Residence Energy Code: 2015 IECC Location: Barnstable, Massachusetts Construction Type: Single-family Project Type: Addition Orientation: Bldg. faces 0 deg. from North Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 31 Holway Dr James Hagerty West Barnstable, MA 02668 31 Holway'Dr West Barnstable, MA 02668 508-364-8844 Compliance: trade-off Compliance: 4.2%Better Than Code Maximum UA: 229 Your UA: 220 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. Envelope Assemblies Gross Area Assembly or Cavity Cont. U-Factor UA Ceiling: Cathedral Ceiling (no attic) 1,316 40.0 0.0 0.026 34 Front Wall:Wood Frame, 16"D.C. 415 27.0 0.0 0.051 17 Orientation: Front Front Door: Glass Door(over 50%glazing) 20 0.350 7 Orientation: Front Front Window:Wood Frame 30 0.300 9 Orientation: Front Window 2:Wood Frame 30 0.300 9 Orientation: Front Right Wall:Wood Frame, 16"D.C. 308 20.0 0.0 0.059 17 Orientation: Right side Garage/House Door: Solid Door(under 50%glazing) 20 0.200 4 Orientation: Right side Rear Wall: Wood Frame, 16" D.C. 415 20.0 0.0 0.059 17 Orientation: Back Door to Porch: Glass Door(over 50%glazing) 40 0.320 13 Orientation: Back Rear Window:Wood Frame 90 0.300 27 Orientation: Back Left Wall:Wood Frame, 16"D.C. 190 20.0 0.0 0.059 8 Orientation: Left side Door: Glass Door(over 50%glazing) 40 0.320 13 Orientation: Left side Window:Wood Frame 18 0.300 5 Orientation: Left side Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 1 of10 Gross Area Cavity Cont. Perimeter Floor: All-Wood Joistlrruss 900 30.0 0.0. 0.033 30 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 2015 IECC requirements in REScheck Version : REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 2 of10 REScheck Software Version : REScheck-Web Inspection Checklist Energy Code: 2015 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.1, ;Construction drawings and ❑Complies 103.2 ,documentation demonstrate ❑Does Not [PR1]1 ;energy code compliance for the building envelope.Thermal ❑Not Observable , .envelope represented on [Not Applicable ; ,construction documents. 103.1. ;Construction drawings and ❑Complies 103.2, :documentation demonstrate []Does Not 403.7 ;energy code compliance for [PR3]1 ;lighting and mechanical systems. ❑Not Observable U iSystems serving multiple ❑Not Applicable ; ;dwelling units must demonstrate ,compliance with the IECC ; (Commercial Provisions. 302.1, Heating and cooling equipment is. Heating: Heating: ;❑Complies 403.7 sized per ACCA Manual 5 based Btu/hr Btu/hr ;❑Does Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: Manual J or other methods Btu/hr Btu/hr ❑Not Observable approved by the code official. ;❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 3 of10 i Section , .M = u :- .. # :Foundation Inspection Complies' * Comments/Assumptions, & Req.ID r �- x h q, •. .. .. •F. f... — .:*:2 i c..:i'. j. Kitt ..a•. z-tz«+ +sib'^" :wr ., . 303.2.1 A protective covering is installed to ;❑Complies [FO11]2 protect exposed exterior insulation :❑Does Not sand extends a minimum of 6 in. below grade. :❑Not Observable; :[]Not Applicable 403.9 2 Snow-and ice-melting system controls;❑Complies ; [FO12] installed. ;❑Does Not V . ;❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 4 of10 section Plans Verified Field Verified # Framing/ Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, '.Door U-factor. U- U- ;❑Complies ;See the Envelope Assemblies 402.3.4 ❑Does Not ;table for values. [FR1]1 Q ; ;❑Not Observable ❑Not Applicable 402.1.1, ;Glazing U-factor(area-weighted U- U- ;❑Complies ;See the Envelope assemblies 402.3.1, average). ;❑Does Not ;table for values. 402.3.3, 402.5 ;❑Not Observable j [FR2]1 ; ;❑Not Applicable ; ; 303.1.3 ;U-factors of fenestration products ; ❑Complies [FR4]1 :are determined in accordance ❑Does Not ;with the NFRC test procedure or ;taken from the default table. ❑Not Observable ❑Not Applicable ; 402.4.1.1 ;Air barrier and thermal barrier ❑Complies [FR23]1 :installed per manufacturer's ❑Does Not instructions. ; ❑Not Observable ; ❑Not Applicable 402.4.3 Fenestration that is not site built ; ❑Complies ; [FR20]1 :is listed and labeled as meeting ❑Does Not :AAMA/WDMA/CSA 101/I.S.2/A440 []Not Observable ;or has infiltration rates per NFRC ; i400 that do not exceed code ; []Not Applicable ; limits. 402.4.5 t1C-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate <_2.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.3.1 ',Supply and return ducts in attics ❑Complies [FR12]1 :insulated >= R-8 where duct is ❑Does Not U >= 3 inches in diameter and >_ ; 1[]Not Observable ' ;R-6 where < 3 inches.Supply and return ducts in other portions of ❑Not Applicable ;the building insulated >= R-6 for ;diameter>= 3 inches and R-4.2 ; 'for< 3 inches in diameter. 403.3.5 }Building cavities are not used as []Complies ; [FR15]3 'ducts or plenums. ❑Does Not [-]Not Observable ❑Not Applicable 403.4 °HVAC piping conveying fluids ; R- ; R- ;❑Complies ; [FR17]2 above 105 9F or chilled fluids ;❑Does Not ibelow 55°F are insulated to >_R- ; 3 i i ;❑Not Observable ❑Not Applicable 403.4.1 ;Protection of insulation on HVAC ❑Complies ; [FR24]1 'piping. []Does Not [-]Not Observable ❑Not Applicable 403.5.3 Hot water pipes are insulated to ; R- R- ;❑Complies [FR18]2 >_R-3. ;❑Does Not �J ;❑Not Observable ;❑Not Applicable , 403.E Automatic or gravity dampers are ❑Complies [FR19]2 I installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 5 of10 Additional Comments/Assumptions: 1 High Impact(Tier 1) 1. 2:1 Medium Impact(Tier 2) F,3:- Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 6 of10 i Section Plans Verified Field Verified! ` # Insulation Inspection Value Value Complies? Comments/Assnr`riptions & Req.ID 303.1 All installed insulation is labeled ❑Complies [IN13]2 or the installed R-values []Does Not J provided. ❑Not Observable ❑Not Applicable 402.1.1, ;Floor insulation R-value. R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.6 ;❑ Wood ;❑ Wood :[]Does Not table for values. [IN1]1 ❑ Steel ❑ Steel UNot Observable ❑Not Applicable 1 ; 303.2, '.Floor insulation installed per ❑Complies 402.2.7 ,manufacturer's instructions and ❑Does Not [IN211 in substantial contact with the ; i underside of the subfloor,or floor ❑Not Observable , Warning cavity insulation is in ❑Not Applicable ;contact with the top side of ;sheathing,or continuous i insulation is installed on the underside of floor framing and extends from the bottom to the top of all perimeter floor framing members. 402.1.1, ;Wall insulation R-value. If this is a, R- R ;❑Complies ;See the Envelope Assemblies 402.2.5, :mass wall with at least 1/2 of the ❑ Wood ;❑ Wood ;❑Does Not table for values. 402.2.E ;wall insulation on the wall ;❑ Mass ❑ Mass ❑Not Observable [IN3I1 ;exterior,the exterior insulation ; ; ; requirement applies(FR10). ;❑ Steel ❑ Steel ❑Not Applicable , , , 303.2 ;Wall insulation is installed per ❑Complies ; [IN4]1 ;manufacturer's instructions. ❑Does Not I ; []Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 1,3'1 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 7 of10 I section Plans Verified Field Verified. # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Ceiling insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ;❑ Wood ;❑ Wood ;❑Does Not table for values. 402.2.2, ❑ Steel ❑ Steel QNot Observable 402.2.6 ; [FI1]1 ;❑Not Applicable I , I ; , I I I I 303.1.1.1,;Ceiling insulation installed per ❑Complies 303.2 :manufacturer's instructions. ❑Does Not [F12]1 ;Blown insulation marked every ❑ ;300 ft2. Not Observable ❑Not Applicable 402.2.3 Vented attics with air permeable ; ❑Complies ; [FI22]2 insulation include baffle adjacent ❑Does Not ito soffit and eave vents that extends over insulation. ❑Not Observable ❑Not Applicable 402.2.4 (Attic access hatch and door R- R- ;❑Complies [FI3]1 :insulation >_R-value of the :❑Does Not ;adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ; ACH 50 = ; ACH 50 = ;❑Complies [F117]1 :ach in Climate Zones 1-2,and ;❑Does Not <=3 ach in Climate Zones 3-8. ;❑Not Observable ;❑Not Applicable 403.3.4 Duct tightness test result of<=4 ; cfm/100 cfm/100 I❑Complies [F14]1 :cfm/100 ft2 across the system or , ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in :❑Not Observable itests,verification may need to I ;❑Not Applicable I I I I I ;occur during Framing Inspection. 403.3.3 i Ducts are pressure tested to ; cfm/100 cfm/100 ;❑Complies [FI27]1 :determine air leakage with ft2 ft2 ❑Does Not either: Rough-in test:Total ; leakage measured with a :[-]Not Observable pressure differential of 0.1 inch ;❑Not Applicable ;w.g.across the system including ;the manufacturer's air handler enclosure if installed at time of ; ,test. Postconstruction test:Total j leakage measured with a ; pressure differential of 0.1 inch ; w.g.across the entire system ;including the manufacturer's air handler enclosure. ; 403.3.2.1 'Air handler leakage designated ❑Complies [F124]1 !by manufacturer at<=2%of ❑Does Not ;design airflow. []Not Observable , ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies [Fl9]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to ❑Not Observable , code specifications. ; ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [Fl10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable ; 403.5.1 Circulating service hot water ❑Complies ; [FI11]2 isystems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ' ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 8 of10 Section Plans Verified Field Verified. # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 403.6.1 All mechanical ventilation system ❑Complies ; [F125]2 fans not part of tested and listed []Does Not HVAC equipment meet efficacy and air flow limits. []Not Observable ; ❑Not Applicable 403.2 Hot water boilers supplying heat ❑Complies ; [F126]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback control to lower boiler water []Not Observable temperature based on outdoor ❑Not Applicable ; temperature. 403.5.1.1 Heated water circulation systems ; ❑Complies ; [FI28]2 have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable pipe. Gravity and thermos- ❑Not Applicable ; syphon circulation systems are not present.Controls for circulating hot water system pumps start the pump with signal for hot water demand within the ; occupancy. Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ; ❑Complies [F129]2 comply with IEEE 515.1 or UL ❑Does Not 515.Controls automatically adjust the energy input to the [-]Not Observable ; heat tracing to maintain the ❑Not Applicable ; desired water temperature in the piping. 403.5.2 Water distribution systems that ❑Complies ; [F130]2 have recirculation pumps that ❑Does Not pump water from a heated water supply pipe back to the heated ❑Not Observable water source through a cold ; ❑Not Applicable water supply pipe have a demand recirculation water ' system. Pumps have controls that manage operation of the ; pump and limit the temperature ; of the water entering the cold water piping to 104°F. 403.5.4 Drain water heat recovery units ❑Complies [FI31]2 tested in accordance with CSA ❑Does Not B55.1. Potable water-side pressure loss of drain water heat ; ❑Not Observable , recovery units < 3 psi for ❑Not Applicable ; individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units< 2 psi for individual units connected to three or more showers. 404.1 ;75%of lamps in permanent ❑Complies ; [FI611 :fixtures or 75%of permanent ❑Does Not fixtures have high efficacy lamps. Does not apply to low-voltage []Not Observable alighting. ❑Not Applicable 404.1.1 Fuel gas lighting systems have ❑Complies [F123]3 no continuous pilot light. ❑Does Not V ❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 12 IMedium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 9 of10 i Section Plans Verifieda Field Verified' # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 401.3Compliance certificate posted. ❑Complies ; [FI7]2 []Does Not ❑Not Observable g ❑Not Applicable 303.3 "Manufacturer manuals for ❑Complies ; (FI18]3 mechanical and water heating 1, []Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) ;3 1 Low Impact(Tier 3) Project Title: Hagerty Residence Report date: 11/08/18 Data filename: Page 10 of10 2015 IECC Energy Efficiency Certificate Insulation . Above-Grade Wall 27.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 40.00 Ductwork (unconditioned spaces): Glass&Door Rating LI-Factor SHGC Window 0.30 Door 0.32 CoolingHeating& Heating System: Cooling System: Water Heater: Name: Date: Comments i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations tv 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information -- Please Print Legibly Name (Business/Organization/Individual): d.11� gkt�rRe Address: t�L City/State/Zip: `L}e � G-F—i Phone#: �7� 00171 Are you an employer?Check the appropriate bo : Type of project(required): 1.0 I am a employer with 4. I am a general contractor and 1 6. ❑N w construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9 Fg�uilding addition [No workers'comp.insurance comp.insurance.: required.] 5. We are a corporation and its 10.�lecfrical repairs or additions ❑ 3.El am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.[1 Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ains and penalties of perjury that the information provided above ' true and correct Si ature: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,.§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mm.gov/dia DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/19/2018 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAYCHEX INSURANCE AGENCY INC (A/CNo,Ert): (aC,No): (888) 443-6112 AIL 210705 P: F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURERA: Twin City Fire Ins Co 29459 INSURED INSURER B: I INSURER C A AND E FORMS, INC. INSURER D: 32 GENERAL HOLWAY RD INSURER E: SOUTH YARMOUTH MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SURR POLICYNUMBER POm0 EFF POLICYEXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED S PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL 8 ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO LOC PRODUCTS-COMP/OP AGG JECT $ OTHER: $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA UAB d OCCUR EACH OCCURRENCE LlEXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION E $ WORKERS COMPENSA TION X PER OTH- ANDEMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $5 0 0, 000 OFFICER/MEMBER EXCLUDED? A (Mandatory in NH) ❑ N/A 76 WEG KZ1964 04/04/2018 04/04/2019 E.L.DISEASE-EA EMPLOYEE $500, 000 If yes,describe under $5 0 0, 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured' s Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REEF REALTY, LTD AUTHORIZED REPRESENTATIVE PO Box 186 U .CaDG�N WEST DENNIS, MA 02670 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD MARKSTI OP 1p� CERTIFICATE OF LIAMLITY WSURANCE DATE(MMIDDIYYYY) 04/30/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL'INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER 508-771-1632 APF.CT Kathy Geddis SG&D Insurance Agencies, LLC PHONE 508-771-1632 FAX 540 Main Street,Suite 9 (AIC,No,Ext): (AIC,No): Hyannis,MA 02601 E-MAILADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 - INSURERA:Norfolk&r Dedham Mutual Ins. 23965 INSURED TImothyMarks INSURER B:Liberty Mutual Ins.Company . P.0.Box 1197 Mashpee,MA 02649 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS L R INSD WVD MMIDD MMIDDIYYYY A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR R1224696A 10/15/2017 10/1512018 DAMAGETORENTum $ X Business Owners MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ M'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jE8T LOC PRODUC S-COMP/OP GG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS yy Ep BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY (Moor pTlyht AMAGE $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ STATUTEB WORKERS COMPENSATION PER R AND EMPLOYERS'LIABILITY ANY PROPRIIETOER/PARTNER/EXECUTIVE YIN N CERT WILL FOLLOW FROM CO 04120/2018 04I2012019 E.L.EACH ACCIDENT $ 5OO,000 Mandatory In NH)ELUDED? NIA WITHIN 5 DAYS 500,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION REEFCAP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Reef/Cape Cods Home Builders ACCORDANCE WITH THE POLICY PROVISIONS. P0 Box 186 West Dennis, MA 02670 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) L� ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i (�® yr� y� p(� INSURANCE ,p�p�a DATE(h1M10D1YYYY) CERTIFICATE OF LIABILITY 6:YC71�6�RU�lV^Cf� 01/23/2018 THIS.EERTIFICATE 1S ISSUED A5 A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS CERTIFICATE DOES'NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND. OR.ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS .CERTIFICATE OF INSURANCE GOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESEN fAT1VE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If t4 certificate holder is an ADDITIONAL INSURED,the policy(}es)must be endorsed. if SUBROGATION I'S WAiVED;subject to the terms and conditions of the.policy,certain policies may require an•dridorsement. .A statement on this certificate does not confer rights to the• certificate.holder In lieu of such•endorsement(s), . PRODUCER CA T: T Ain Kelly HANNON'MUR*PHY"INSIJRANCE.ASSOCIATES INC PHONE . . 78'1'293-5500 AIC n EMAIL DDRESS• 'amy@hannon=ryah.com .PO:BOX 457' INSURER S A&MWWO COVERAGE NAIC N PEMBROKE MA 02359 INSURER A: :ACADIA INS CO 31326 -INSURED INSURER B: JBS RQ.0I`11VG'U.0 INSURERC: INSURER D: 50 GROVE ST INSURER E: 1.PLYMPTON' .. MA 02367 INSURER F f COVERAGES.. . . CERTIFICATE NUMBER: 232474 REVISION NUMBER: THIS IS'TO CERTIFY THAT THE.05LICIES OF INSURANCE LISTED BELOW HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER106 INDICATED, .NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY.CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE.MAY.BE ISSIJED.OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO.ALL THE TERMS, EXCLUSIONS AND BE OF SUCH POLICIES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR �TYPEOf IN51}RANCE lumJ 6R pOL10YNUMBER MMILDDY YYF MM/DD YYY LIMITS, COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE ^� CLAIMS MADE OCCUR D ORE ED PREMISES Ea occurtence 4 .MEDEXP(Any one person) $ NSA PERSONAL&ADV INJURY $ GEN'LAGG ❑REGATEUMIT APPLIES,PER GENERAL AGGREGATE $ POLICY PRO--ElJEC7 LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMB RED SINGLE LIMIT $ Ea ccident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED (Pe—PROPERTY $ AUTO$ $ UMBRELLALIAB ..H OCCUR EACHCURRENCE b EXCESS LIAR CLAIMS-MADE NIA OC AGGREGATE $' OEO I I RETENTIONS $ v WORKERS COMPENSATION SEATUTE H AND BMPLO%RS`LIABILITY YIN ER ANYPROPRICTORUPARTNERIEXECUTNE U.EACH ACCIDENT $ 100.000 A OFFICER/MEMBEREXCLUDE1)9 NIA -NIA NIA. :MAARR�00752 01/09/2018 01/09/2019 (Mandatory In and E.L.DISEASE-EA EMPLOYE $ 100.000 If yyea,describe under � — — DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT Is 500 000 N/A DESCRIPTION OFOPERATIONSI LOCATIONS IVEHICLES(ACORD'161,Additional Remark Sthedule,may be iftechod I.I more space Is required) Workers'Compensation bertefts.W11 be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 08 B;no authorization Is given to Pay claims for benefits to employees in states other than Massachusetts If the insured.hires,or has hired those employees outside of Massachusetts. This certificate of instirance shows the policy in force on the date that this t:ertifitate Was issued(unless the expiration date on the above policy precedes the Issue date OHMS certificate 6f irisurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage r•Coverage Verification Search tool-at www.Mass.govAWd/workers-compensailonfinv6sUgitlohs/: CERTIFICATE'H.OLDER_ CANCELLATION SHbULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANC( LLED-BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 'ESE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Reef Cap.e..Cod Home.Buildel-s 24 School St AUTHORIZED REPRESENTATIVE West Dennis MR 02670 Daniel M,Croy,CPCU;Vice President-Residual Market-WCRIBMA ©1988.2614 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I AC®® DATE(MMIDD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE 06/07/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: W Scott berry KERRY INSURANCE AGENCY PHONE (508)255 8000 Nc No, E-MAIL ADDRESS: SCOtt@kerrylnsurance.COm P 0 Box 1945 INSURERS AFFORDING COVERAGE NAIC# N.EASTHAM MA 02651 INSURERA: LIBERTY MUTUAL FIRE INS CO 23035 INSURED INSURER B: S CRIES INC INSURERC: INSURER D: 195 PINE STREET INSURER E: CENTERVILLE MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER: 277953 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DDIIYCY YYY MMIDD/YYYY LIMITS POLICY EXP LTR COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE DOCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ M'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY❑jRa LOC PRODUCTS-COMP/OPAGG $ Is AU70MOBILELUIBILITY COMBINED SINGLE LIMIT $ Ea..(dent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per..(dent) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per act dent UMIIRELLALIA13 HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ �/ $ WORKERS COMPENSATION /� STATUTE EORH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED9 NIA N/A NIA WC231S610224018 04/19/2018 04/19/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this Certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Reef Realty LTD ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 186 AUTHORIZED REPRESENTATIVE W Dennis MA 02670 � Daniel M.Crq y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i Client#:36625 2RCAEL ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE 011(MMIDD(MM/DD/YYYY) 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING_.INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to' the terms and conditions of the policy,certain policies may require an endorsement.A stateinent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).. PRODUCER CONTACT Dowling 8r O'NeilNAME ' Dowling&O'Neil Insurance Agy PHONE. 508 775-1620 FAX No): 5087781218 AIC No Ext 973 lyannough Road E-MAIL ADDRESS: coi@doins.com P.O. Box 1990 INSURERS AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER ANGM1—ranceCompany 14788 INSURED INSURER B.Foremost Signature Insurance Company RCA Electrical Contractors,Inc. INSURER C 381 Old Falmouth Road,#13 INSURER D: Marstons Mills, MA 02648 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMB ER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY MPT0467D 1/04/2018 0110412019 EACCH�EOCCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY PREM ISES Ea occu ence $50O 000. CLAIMS-MADE FR OCCUR MED EXP(Any one person) $10,06d - PERSONAL&ADV INJURY $1-OOO OOO GENERAL AGGREGATE..,... . $2,00.0000., GEN'LAGGREGATE'LIMITAPPLIES PER: PRODUCTS.-COMP/OPAGG s2,000,000 POLICY '. PRO-. X LOC A' AUTOMOBILE LIABILITY' ::, M1T0467D 1/04/2018 01/04/201 EaaccideDSINGLELIMIT 1,000;000 ANY AUTO BODILY INJURY(Per person) $- ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PerracEcidenDAMAGE $ AUTOS $ A X UMBRELLA LIAR X OCCUR CUT0467D 1/04/2018 01/0412019 EACH OCCURRENCE $4 OOO OOO EXCESS LIAB CLAIMS-MADE AGGREGATE s4,000,000 DED X RETENTION$10000 $ B. WORKERS COMPENSATION W .00505001006 - 110412.018 01/04/201 X 'STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? ® N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 O0O If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Reef,Cape Cod's Home Builder SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 186 ACCORDANCE WITH THE POLICY PROVISIONS. West Dennis,MA 02670 AUTHORIZED REPRESENTATIVE tag 1twl— ©1988 2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S204304/M204294 RPJZ1 Page 1 of 1 DATE(MM/DDfYYYY) AC410R D). CERTIFICATE OF LIABILITY INSURANCE 09/20/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Willis of Tennessee, Inc. PHONE FAX C t• 1-877-945-7378 AIC No: 1-888-467-2378 C/o 26 Century Blvd E-MAIL P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAICfI INSURER A: Old Republic Insurance Company 24147 INSURED INSURERS: American Guarantee and Liability Insurance 26247 j MAP Installed Building Products of Sagamore,LLC 165 State Rd (02562-2415) INSURERC: P. 0. Box 1309 INSURERD: Sagamore Beach, MA 02562-1309 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:W7596343 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDY� MM/DDIIYYICY rr LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 F___1 DAMAGE TO RENTEU CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 1,000,000 A MED EXP(Any one person) $ 10,000 y y MWZY 314253 10/01/2018 10/01/2019 PERSONAL 8ADVINJURY $ 2,000,000 GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY�X PRO JECT a LOC PRODUCTS-COMP/OP AGG $ 9,000,000 PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y MWTB 314252 10/01/2018 10/01/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY $ B X UMBRELLA LIAB X_ OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE y y AUC 9314206-07 10/01/2018 10/01/2019 AGGREGATE $ 10,000,000 DED I X I RETENTION$0 OTH- WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY AND ER A ANYPROPRIETOR/PARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED9 No NIA y MWC 314250 00 10/Ol/2018 10/Ol/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REEF CAPE COD'S BONE BUILDER AUTHORIZEDREPRESENTATIVE P.O. BOX 186 WEST DENNIS, MA 02670 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR IW 16754573 BATCH: 874197 f LSD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE R054 2/23/2018 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: EASTERN INSURANCE GROUP LLC/PHS (A//CC.14,11A): (866) 467-8730 ONE (AIC (888) 443-6112 087059 P: (866) 467-8730 F: (888) 443-6112 AORESS: 301 WOODS PARK DRIVE INSURFR(S)AFFORDING COVERAGE NAlC9 CLINTON NY 13323 INSURER A: Hartford Fire Ins Co 19682 INSURED INSURER B: INSURER C: BRIAN KIRK DBA BRIAN KIRK ELECTRIC INSURER D: PO BOX 290654 INSURER E: CHARLESTOWN MA 02129 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rYP£OF INSURANCE ADDL SUBR POLICYNUMBER aI�D EFF PULICYEXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Es occurrence) MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JEC 1-1LOC PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSA 77ON X PER OTI+ AND EM➢I.OYERV LIABILITY STATUTE Ell ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1 0 0, 0 0 0 OFFICERIMEMBER EXCLUDED? A (Mandatory in NH) ❑ wA 08 WEC CU3817 10/15/2017 10/15/2018 E.L.DISEASE-EA EMPLOYEE 1100, 000 If yes,describe under $5 0 0, 0 0 0 DESCRIPTION OF OPERATIONS belmv E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERA TIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Those usual to the Insured' s Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cape Cod Builder AUTHORIZED REPRESENTATIVE 24 SCHOOL ST WEST DENNIS, MA 02670 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD � ® ��aa22��pp4 pp 2 p p p� o mpg �p p� /,��p (� I�ER Y 8��CATE O I��WLdJU 0 ll �11�7SURANCE DATE/16/2 DIYYYY) 10/16/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Judy Salkovitz 211. Bearce Insurance Agency, PHONE FAX 670 Pleasant Street (508)586-3400 .(508)586-3700 E-MAIL Brockton MA 02301 jsalkovitZ@bearce.com INSURERS AFFORDING COVERAGE NAIC H INSURERA:ACadia Insurance CO. INSURED INSURER 13:Commerce Ins Co. Coastal Heating&Air Conditioning,Inc. INSURER C:Liberty Mutual _24198 1039 Ash Street INSURER D: Brockton MA 02301 INSURERE, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR Mtn minpOLIC MBE POLICY EFF POLICY EXPJJR_ LIMITS C X COMMERCIAL GENERAL LIABILITY X X BKS55722745 12/05/2017 12/05/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR DAMAGE TO RENTED. occurrence) $ 100,000 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY❑PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER $ B AUTOMOBILE LIABILITY X X ZT5262 97/17/2018 07/17/2019 COMBINED SINGLE LIMIT $ 1,000,000 �Ea_accrdent) _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNEDPROPERTYDAMAGE $ included X HIRED AUTOS X AUTOS (Per accident) Is C X UMBRELLA LIAB X OCCUR US055722745 12/05/2017 12/05/2018 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 $ 10,000 $ A WORKERS COMPENSATION MAARP300047 09/14/2018 09/14/2019 X I PER IITF OTH- AND EMPLOYERS'LIABILITYYIN 'TAT ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N 1 A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required( CERTIFICATE HOLDER CANCELLATION AI 033992 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Reef Realty LTD THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Attn:Lord Alexander ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 186 W.Dennis MA 02670- AUTHORIZED REPRESENTATIVE Fax:(508)258-7068 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 24. 3112hi Commonwealth of Massachusetts, U Sleet Metal Permit Map `� Parcel _ Date:a . ako S':z h0folHi 1 Permit.# - q Estimated Job Cost: $ 2/;?-O Pern�it'Fee:.$ Plans Submitted: YES. V NO , �,► 1' Reviewed:: YES U. kSf� 01'0'0�� Business License'# -9 3 e Applicant;License �- Business Information: Property Owner/Job Location Information- Name: Name: ;54M ECOASTAL S _cp?a G L i y Street: HEATING & AIR CON®., INC. -Street: � ( �`-�C3L-Ce>�y b(2 � 1039 ASH ST _ City/Town PUROCKTO e1 MA 0-23-01 City/Town: L00 ST. �o4�/US�aG� ' Telephone:_-5C9-'?6_�=, 4cl--7- Telephone: og—3 qq— 3c)�r o Photo I.D.required/Copy of Photo I.D. attached: YES I/ NO �— smart t�iaai J-1 M -unrestricted licen -J:2/M-2-restricted to dwellings:3-stories or less and eommercial:up:to.10;Qa0 sq. ft./2-stories or less Residential: 1-2 family ✓ Multi-family, Condo/Townhouses Other Commercial: Office Retail Industrial Educational Fire:Dept.Approval Institutional_ :Other Square Footage: under 1.0,000 sq. ft. V over.10;000.sq. ft. Number of Stories: .Sheet metal work to be completed: New Work:. Renovation: HVAC. i/ Metal Watershed Roofing Kitchen Exhaust System Metal Chimney:/.Vents Air$alancing Provide detailed description of work to be done: .tiv57,1 L- AI-Q CoD(J10 S-1S7� �ri�G f TcS 7z�li� ��AZ I-'4 �� r• J I E INSURANCE COVERAGE: I. " I have a current liability insurance policy or its equivalent which meets the:requirements of K.G.L.Ch..112 Yes;t/No ❑ If you have:checked Y M indicate the type of coverage by.checking the appropriate:box below: i { ? A liability insurance policy Other type.of indemnity ❑ Bond ❑ I OWNER'S INSURANCE WAIVER:I am aware.that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws;and that my signature on this permit appl'rcatioTl walwa this requirement. Check One Only Owner El Agent Signature of Owner or Owner's Agent 3 By checking this box[],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are.true:arid accurate to the best of.my knowledge.and that all sheet metal work and installations performed under the permit:issued for this application.will be: in-compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General haws. Duct inspection required prior to.insulation installation:YES NO ProgLe_ss IysRections Date Comments Feral Inspection Date Comments Type License` 3y Master filie. Master-Restricted !` �ity/Town ❑Journeyperson Signature of Licensee ?em'it ❑Joumeyperson-Restricted License Nurriber. Lf =ee O Check at www.tnass.aav/dol i nspector Signature of Permit Approval Town of Barnstable Regulatory Services $ � Thomas F.Q.eUer,Director ;,"'°' Building Division Tom Perry,Building Commisalouer 200 Main Sfreet,,F0an ,MA.42601 www.town.barnstable;ma.ns 0ffica: 508-8624438 Fars 508.1004230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize ,�Ii �� to act on my behA in all matters relative to work authorized by this building permit c.w , (Addres 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. S' 46e of 1 V Y T Signature of Applicant 1�k7ek AWXV/0 Print Natae Print Natne qte . Q:FORMS:OWNERPERM=ONPOOLS COMMONWE�—. TH OF COMMONWEALTH OF MASSACHUSETTS M �� SHEET METAL WORKERS BOARUOF SHEET METAL V1 ORKERSV..,`' ISSUES THE FOLLOWING LICENSE ISSUES THE FOLLOWING:LICENSE t, ;- ' BUSINESS MM� MASTER-UNRESTRICTED PETER ►nERIANOS PETER MERIANOS z ''=5 ASH ST COASTAL HEATING AND AIR CONDITIONING INC." �KCCr(TOIl, MA 02301.6238 1039 ASH STREET � i z l BROCKTON,MA 02301 j 47 07/28/2019• 232 02/08/2020 408279 298431 CONTROL a 1865581 -E"•SE •5 csl, oamMPORTANT CONTROL # t �•4 '� y V ;'- ��ected, visit destroyed. ,s inaccurate;or IMPORTANT web site at mass.gov/dpl for 'a= E^nI`e the proper mailing Of your Renewal -- --^ If your license is lost,damaged or destroyed;is inaccurate;or a i otnEr corresponoence. needs to be corrected,visit our web site at mass.gov/dpl for ` "s� •s s instructions to ensure the proper mailing of your Renewal elect to t+lassachusens General Laws and Application and any other correspondence. • `i-•a�•�'S YO;;r license is a privife e.and cannot be lent or a'; Gerson o r e 9 This license is subject to Massachusetts General Laws and ntity under penalty of law.Keep this Gerson or.posted as required by law and/or regulations.Your license is a privilege,and cannot be lent or assigned to any person or entity under penalty of l license on your person or posted as required by la aw.Keep this w and/or regulations. E � ASSA��H6UrSYE�TT�S� R,, .4a'19 9a END'�IERfff k. P-dl . 026, SOFAS RE .ib1S '�MER AI�O ' Y f[s PETERS i t� i s�BROCKTON yMA 02301 623�8„ _; ,�>/ / f/ � �• S�ppW 142015 Rev0 1 7009}/ _ �. /: The Commonwealth.ofMassachusetts Department of Industrid Acciden& Office of Investigations 600 Washington Street Boston,l►1A 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apyiicaut Inforffiaft A cTAI Please Print Legibly Name($t , INC Address: ST City/State/Zip: Phone* 5C0 Are you an employer?Check the appropriate.box: -Type of project(required): •4. I am a general contractorand I p J � 1.❑ I am a employer with�_ ❑ employees(full and/or part-time).« have hired the sub-contractors 6. ❑New construction . 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. modeling ship and have no employees These sub-contractors have 8. ❑Demolition woddng forma in any capacity. employes and have workers' 9. ❑Building addition [No workers'comp.insurance comp,insurance.t required.] 5. ❑ We area corporation and its 10:❑Electrical repairs or additions officers have.exercised their•3.❑ I am a homeowner dog.all work 11.(]Plumbing repairs or additions . myself [No workers'comp, right of exemption per MGL I2,❑Roofrepairs insurance required.]t c. 152,§I(4),and we have no ees e to c workers' 13.❑ Other . employees.[N• comp.insurance regdired.] *Any applicant thatehecks box#1 must also fin out the section below showing fheir.woTkers'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. ZContractors that check this box mist attached an additional sheet showing the name of the sub-carometors'and state whether or not those entities have employees. If the subcontractors have employees,they mustprovidt:their work='comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: l_ 8 C �T—/ A QTCJ4 L- Policy#or Self-ins.Lic.#:X 41 l�-/ n 3(-)C2 U 4--7- Expiration Date: O Yob Site Address: &/ 7q4 ZR City/State/Zip: 9fiQ/US 74p4t�7_7.' 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 cr minal,penalties of a fine up to.S 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 ad'vised:that a copy"of this.statemetst maybe forwarded to the Office of Investigations of the)DIh2 for insurance,covers Fe verification. I do hereby ce _the pains pens of perjury that the information provided ab a is tr e and correct; Si tore• Date: �5 Phone# Official use only. Do not write.in this area,tb be completed by city or town official. City or Town: Permit/License# •IssaingAuthority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: - Phone#: j ACO® DATE MM/DD/YYYY CERTIFICATE OF LIABILITY INSURANCE 1ti2 MIDDIY ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Judy Salkovitz Bearce Insurance Agency, PHONE (508)586-3400 508 5 670 Pleasant Street FAX ( ) 86-3700 E-MAIL Brockton MA 02301 jsalkovitz@bearce.com INSURERSAFFORDING COVERAGE NAIC -INSURER A.Acadia Insurance Co. INSURED .Commerce Ins CO. Coastal Heating&Air Conditioning,Inc. INsugEg c.Liberty Mutual 24198 1039 Ash Street Brockton MA 02301 INSURER D, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB. POLICY EFF POLICY EXP LIMITS C X COMMERCIAL GENERAL LIABILITY X X BKS55722745 12/05/2018 12/05/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX I OCCUR DAMAGE TO RENTED $ 100,000 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY a JEC LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER, $ B AUTOMOBILE LIABILITY X X ZT5262 07/17/2018 7/17/2019 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS X NON-OWNED AMAGE U $ Included PROPERTY D $ C X UMBRELLA LIAB X OCCUR US055722745 12/05/2018 12/05/2019 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 10,000 $ A WORKERS COMPENSATION MAARP300047 09/14/201$ 9/14/2019 X PER oTH- AND EMPLOYERS'LIABILITY YYY///NNNTTF ANY PROPRIErORIPARTNER/EXECUTIVE , N/A E.L.EACH ACCIDENT 1,000,000 OFFICERIMEMBER EXCLUDED? U (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 UII es,describe under P I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached it more space Is roqulred) CERTIFICATE HOLDER CANCELLATION AI 038971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f Fax:( ) - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD �,a..W.n•.•[dr„mald,„„a.n m.amm„bm, .�mea,adm.,„..mfmwa.nil,eoeexm..anm.nmm.,e�.ae•mamddd.me��.naamN.xmd 1 S/ mN.m,+l arxeeXw plmmX W.t e'conPcremca lu.ow^e4 Pcrclwla m commm l«,.m wc.aat,i•on cdlnc« V��/v_ Coxma Ne 2.9t mE.tl tlNd dl0 a Ne Ymd w.a a Ne muaelbn Mel a Smfp.on NDW SD$2.l,IGeL.X.Tm m lne d Ne ld.tlmbn./ae,eolnemm ro 1M 25.8 Mtl.v.W lal SMne.en SDS%'.2.,? � , ,a .aWn,en.oamva.o m Ne a.vsm NN a SIB'ebmtld aMrordY ap.As.Oro Ne oalvaro s mHman a B'. DD..I rall'B'Comhvalon f...vlan fa dmm,lvm, • .hBmW.pdeem,d on aantl Mm bLBmW tl.dN mtl. �-� .?.mmmrdme areeulmeedmq moaamea conllmenmu.,.detivon raXd w.a ero wanwaue.nem D om m.,muloe.tl m wdlorleao,.xa.:dy.oeaeo w•n mnxtlh ea.wn nod.d detlaa.aa aae.me tl m Mr1.veY,e,Yxeee Iex..m.m.,.•on coma Itl.ppx.X1 PrarW m cdnmm m W.gce0 tl,2'on cams © O�MUMud. M1J Lm.ma Ne 2.2ae.el.d tlm.r da a M abd.m m Ne ml.lmlbn WN a Smle.dl NWS5052!ImW.n.TM lvamo.nm,wma,mmmp�a aoNe,o-.ww�,Nma.a..mewalm zm me.lw„o smlum sos r.•.2n¢ .-_______ --- 3Ai .de..,daa.memoe mem wN.lre•emmm,dwe......me Xe.Ne ama.,e.mm.ndl,ae.. I ._.___. >Ne.r W.X•[-[em,rxnXon/...elan/er mmnmbm, y �� I Pa.mmmn.e Xm.etlermn. . .?tl.mm wewed,c• �r�2.9a tlue.tlemlenE. � �� z a 8� SPeN.2mmvpeee ay.<oe(mmM inmeXMm oemmenmu.wemeae•ma.ederow N.wmmea.aumemd Beonarx! xmi mnan.mn.enomea.m�n.xae:ayxooamw•n.wmym,w..n nod.dpo.,a..ala ad.mytl tli 4 Q I'4 i� ' X.na,awe..wd.m ., en m d f.,.ewd.4 Pm a.m.dnm.n mu.w.ad.,,:•en e.md ! 3 c° �(-JQ2c�sif r tluMvn. BDOP DOCK Y 4 H ----------------------------------------------------- cd.ma Ne xam wtl.m tlmd da a Ne amu.aa w um/m.mmun wN a s.ngon NDwsosz.!nem..n.iM T lmtle.nNmbM mmlopaNsfa.Mabn.M1ve.codroaoeaNOS2.Bu,e.MN(,elSmq.mSDSx•.2.,1Y � i m I �V?sG �ANVLG� � a, eaon.dmmdxaw mna a.ca.wNa x•aemad ercm epo.,.e mm um a.vdeem:lme.nme•. O; Y ° �I - � � oar. .. d Cm 0 ix = l l� __ A✓ m �i�/ m —__m _ctc fr SECOND FLOOR 644Z0 SECOND FLOOR ADDITION RCTve$� r F, a 91 W I N D O W S C H E D U L E D O O R S C H E D U L E neaa...ea.n a.m eoo. .�rw t{6 fl SECOND FLOOR PLAN A2.1 c� YOU WISH TO OPEN A BUSINESS? >K r. For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) `r'ou must first obtain the necessary,signatures on this form at 200 Main St., Hyannis. Take the completed form to the 1"o\A,n Clerk's Office, 1st FI., 367 Main St., Hyannis, N,V4 02601 (To•:Ain Hall) and get the Business Certificate that is required by law. man at N DATE: Fill in please: �00 lln'gm 9a ko,.,;-,r'R APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDR SS: VII OL !mot sa nra �F TELEPHONE # .kl e�I hone Number 2.0 NAME OF CORPORATION: U V1 NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME Orr-1 1PATIa? vftS 0 NO •J ADDRESS OF BUSINESS F& P/PARCEL NUMBER I Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO MI 10 ER' FI MUST COMPLY WITH HOME OCCUPATION This individ al a in r f6\Arimlire uirements that pertain to this type of business-RULES AND REGULATIONS. FAILURE TO COMPLY MAY RESULT IN FINES. Au riz i ture * MMENTS n i 2. BOARD OF HEALT S This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: - 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: i uwlu ui DarnstiaDle Building Department Services � pYTHE Tp� ' Brian Florence,CBO o* Building Commissioner s STABLE. 200 Main Street,Hyannis,MA 02601. Mass. v 1639• �� www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Q , Name: Phone#: 174. 2,3 6. 92 0� Address: Village:_ Name of Business: _ J/14' 4 n a Ih fil, Type of Business: A— MiCill Map/Lot' 1.614 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • -The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • ' Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • 'There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: Homeoc.doc Rev.06&0116 I l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 40 Parcel 039 Permit# Health Division I Jo 2SL)_do I 13d77 Date Issued d 0 Conservation Division Fee Tax Collector Treasurer f S E PTl SYG T R," ;z d' y'+ :. , (31�cPr�) INSTALLED 1M Planning Dept. \ V SI eTH TITLE- 3 Date Definitive Plan Approved by Planning Board / A- 1'" . ' 'E�iVIR N, Historic-OKH Preservation/Hyannis Project Street Address Village ,\ --- Owner r'ta►n Linn k Cel 4e i C)vJe Address Some Telephone 50-S 3!0 2 — d 9(0�4 i�l y O 1 — 6 21 14 2 3 S Permit Request De_AaCbed Gov-naP — 7t8 s f'. Around level 5011 s f• s�nrc�P I�-1- 121 2' +o4a l s•�. Square feet: 1st floor: existing 1-0164 proposed.1.,0614 2nd floor: existing ',&Sto proposed S56 Total newD C>C>o Valuation '` "" • Zoning District RI` Flood Plain Wo Groundwater Overlay Construction Type 'VJQQa frame / Lot Size Q•'S ACT e Grandfathbred: ❑Yes f2 No If yes, attach supporting documentation. Dwelling Type: Single Family Q Two Family ❑ Multi-Family(#units) Age of Existing Structure 2J1 4r-5. Historic House:- ❑Yes O(No , On Old King's Highway: ❑Yes 9'No Basement Type: ❑ Full ❑Crawl Walkout '❑Other Basement Finished Area(sq.ft.) O Basement Unfinished Area(sq.ft) 1 O!oy Number of Baths: Full: existing 2. new 0 Half: existing O new 0 Number of Bedrooms: existing 3 new D - Total Room Count(not including baths): existing (o new 0 First Floor Room Count I ' Heat Type and Fuel: ❑Gas YOil ❑ Electric ❑Other Central Air: ❑Yes C(No Fireplaces: Existing I New D Existing wood/coal stove: ❑Yes M No Detached garage:❑existing Znew size321(2I} Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: � C It r I Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes OCT2 5 2001 �I 4No If yes, site plan review# Current Use Proposed Use -- BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ZJ . 41 ATE I®�ZS�� FOR OFFICIAL USE ONLY �• •PERMIT NO. �' e DATE ISSUED MAP/PARCEL NO. ° ADDRESS VILLAGE • a OWNER DATE OF INSPECTION: FOUNDATION ` /L FRAME INSULATION \ FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL a a FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. • z r' S _� The Commonwealth of Massachusetts Department of Industrial Accidents ,; ---,-.: ; '=� . 011Iceo1/aaest/aaUoos • 600 Washington Street s Boston,Mass. 02111 . 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Fsdhue to seems covers;e as required order Section 2SA of MQ.1S2 tam lord to the impoaiMaat of esfadnal pmaitiea of a @ae up to S1.S00.00 smd/or rile yam,}mp�o,�mt ss weII os etva penaifln in t11e form of a STOP WO1tK ORDER and a doe of 5100.00 a day agabnt me. I mderstand fhat a espy of this stattment may be forwarded to the Offitx of Iavestieatiom of the DIA for eovera�e von. I do hacby certify / tht pain,* perlrrry that'thcntfornta�n provided above is trw and concct Signatlre print name Phone 0 oIIicial use only do not write in this area to be completed by city or town otli" • ❑Building pepat�neat city or town: P ❑Licensing Board - use nusd ❑selscdnen's Office ❑che&uimm response p° is required ❑HealthDeparaaent contact person: Phone�, — ❑Other Oevum 9/95 P1A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employee is defined as every Person in the service of another under any contract employees. As quoted from the"law", an 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 recerver or trustee of an individual, partnership, association or other legal.eatity,.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, consttuction 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. issuance or renewal _ MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issua who has of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant acceptable evidence of compliance not produced with the insurance coverage required. Additionally,neither 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 and supplying company names,address and phone numbers along with a ce:tific ate'of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for c of insaraacx owe• Also be sere to sign and date the affidavit. The affidavit should be rearmed to the city or twn that the application for the permit or license is being requested,not the Department of Industzial Accidents. Should you��,q�� the-law- are or if you required to obtain a workers' compensatian policy,Please call the Department at the number listed �� City or Towns _. bl The Department has P provided a space at the bottom of�the Please be sure that the affidavit is complete and printed legr y. lica�. Please affiirjavit to fill out in the event the Office of Investigations-has to contact you regarding the aPP a sure t. 'or you fill is the pe.... iceas .munbcr which will be used as a r munber, The affidavits may be retained is the Department by marl or FAX unless other arrangements have bees The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• . please do not hesitate to give us a call. OOK/ The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investigations 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 THE 1, The Town of Barnstable RAIRNSTee[E � g Regulatory Services ` `bprEo 59. ° Thomas F. Geiler, Director, Building Division Peter F. DiMatteo, Building Commissioner 367 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 owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: �P�O►Cr1�d C�1QIrQo e�1 12`�1 Can C stimated Cost�5D,_Q Address of Work: 3 Owner's Name: 1�Y1a►Yl Linn � e`er— Date of Application: ID I?��d► - I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑ uilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED _ CONTRACTORS FOR APPLICABLE HOME IM ROVEM. ENT WORK DO NOT R GUARANTY FUND UNDER MGL cE. 142A. ACCESS TO THE ARBITRATION PROGRAM O SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Registration No. Date Contractor Name OR -6 . 1 Date Owner's Name q:forms:Affidav:rev-070601 I � °F ZHE r The Town of Barnstable „ Regulatory Services 94� i639- �•� Thomas F. Geiler, Director ArE0 .Building Division Peter F. DiMatteo, Building.Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-:.1038 HOMEOWNER LICENSE F.EMFTION Please Print DATE: i 31 r1o1•�nJ �iriN& r village JOB LOCATION:, street number 6 vJ p�- Zl-LA23$ -$9y�— -HOMEOWNER": phone 1f ►7� IQl'l t rnr'� � �._. ._ work phone# name home CURRENT MAILING ADDRESS: 3 1 state zip code city/town The current exemption for"home_ ners"was extended to include owner-occupied dwellings of six tutus or less and to allow homeowners to engage an individual for hire who does not possess a license,arovi_ d the owner acts as supervisor. Dg1�1ITTON OF HOMEOWNER ide, or is Person(s)who owns a parcel of land on which he/she resides or intends to res accessory w�o such use�and/or intended to be,a one or two-family dwelling,attached or detached structures period shall not be considered farm structures. A person who constructs more than one home in a ear a homeowner. Such"homeowner"shall submit to the Building on a form acceptable to the Building Official,that he/she shall be res onsible for all such work joerformed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. le The undersigned"homeowner'certifre:that he/ m�sents and tha hefshe of Bwill comply ulwlidi said Department minimum inspection procedures and require pros dur s and requirements Signature of meowner Approval of Building Official Note: Three-family dwellings containing 35.000 cubic et or larger will be required to comply with the State Building Code Section 127.0 Construction HOMEOWNER'S FXDWnON permit is required shall be exempt from the The Code states that: "Any homeowner performing work for which a building provisions of this section(Section 109.1.1-Licensing of construction supervisors);provided that if the homeowner engages a person(s)for hire to do such work that such Homeowner shall act as supe are assuming the responsibilities of a supervisor(see Many homeowners who use this exemption are unaware that they ot the Appendix Q,Rules&Regulations for Licensing Construction unlicensed Persons- In thu tion 2.15) c�sc.our Board cannot proceed againsresults to problems.particularly when the homeowneronsible. serious p art of the peraut communities require.as p unlicensed penon�i�o�e homeownelicensed is fully aware of his/her responsibilities.many communities is ultimately r�pace of this issue is a To ens unity• last application.that the homeowner certify that he/she understands the rip Suchta farmlcertifpcau n for usein ourcomm form currently used by several towns. You may Q:FORMS:EXEMM'N RESIDENTIAL: SHEDS - POOLS-DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ " >750 sf- 1000 sf.. 75.00 $ >1000 sf- 1500 sf 100.00 $ 100 - C>0 >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ 1 DO DO Q:forms:dkcost eff:082301 . i I t Application to/ 2 0 0 1 3 ,94 ®Yb Ring'o jLgigbbiapi3.egionat jOfotoric ;Diotrtct Committee !N GLE ?X In the Town of Barnstable BARN,, E, I'.`iASS. CERTIFICATE OF AP PROPRIATEN'ESS 10 M", 8: q-0 Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: E{ New El Addition Alteration Indicate type of building: House d Garage ❑ Commercial •❑ Other _ 2. Exterior Painting LJ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: El Fence ❑ Wall ❑ Flagpole ❑ Other _ TYPE OR PRINT LEGIBLY: DATE Serkember 5, 2oDl_ ADDRESS OF PROPOSED WORK 31 Igo lwa�j 'Dr i J c- ASSESSOR'S MAP NO. 1510 _ OWNER S lan f , Linn and ele��e M. OovJe ASSESSOR'S LOT NO. 039 _ HOME ADDRESS 31 11o�waA Dr. \A1 • F)mns+able F HA TELEPHONE NO. 50'6-3to2-��n�} FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) M►l-on LarSon l 2$ hlolwmn j i7r. i yJ . �rirn�kn►ble, 1�1 A C3 2��8 P-0-hax 1414 R►cha,rcl and Reyerkl lao -VP'nj ion �lehoi Qn Rd.; 1�1ev�lon� MA o2yre8 Sohn and elPandr -FFrenna►n� SI Nol�.lay Dry VJ P�c+rn� cab P HA (�2&[,28 'Fred 6c carnd 5uf�an Lena-le, 17 olvjay' Dr., vJ . aCAM-4cable A o2&I's 3-ca,r1-jce Brock te. 100 Ocean Rd_� A�2j. 1®(0 . \/ero Se.a►eh FL 3291n3 AGENT OR CONTRACTOR tJon TELEPHONE NO. _ r� ADDRESS — DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. i ew d el-ach ed +W o bay garage vJ i-4h I CA. Second 5kor� ren0\1cJ%0n `,�t4k rear -Facing Shed dormer. 'Replace. e- is+ing deck Signed 1 �;i ;�r? ner-Contractor-Agent �x der nor a'►n+i n mittee-U.sD.Dn U I9 is L I J p \t9 L=; , 16 1. T is Certificate is hereby Date - -i ApprovedID need SEP 0 6 2001 m itte Members' Signatures: ?,+'N OF BARNST !31- JE Ind`4S H I G H V VAY OTown of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION �nU1'eC� ('nnri-e4e . to�� mcu kmom ex?o5u1re Whlle Ce8crrr 5hingles Ie0-Ch n9 p'k � SIDING TYPE C—loy oorCI (from-) COLOR yel Gov//C-�c�lc� I CHIMNEY TYPE one- COLOR 1 �3`C`iia ROOF MATERIAL 'J�ea (1,e30kr Sh►ngjeS COLOR �J XTOr(3 1 Geroge. - PITCH NOL)Se- rear Shed dormer Trouble hvny �, �WINDOWS I?- J Oev, 12 COLOR Cream SIZE x TRIM COLOR Cream DOORS 9 14+ 5keel Or -FibeNIA55 COLORS `� B r,,n T SHUTTERS None COLORS GUTTERS y- SM GD2d VJ OO c r n COLORS C_re-o n DECKS I(e, )( IZ rear 6eC'K MATERIALS ?re55y*fe +reaped W©ad ,Aeel clad or -V'1ber91a55 ogerheM GARAGE DOORS C.o1on*,Q1 5+41e COLORS Creom l005e �1) rear SKYLIGHTS Cara e_ (Z) 51de SIZE 36"X y 2" COLORS Grown ff" -R SIGNS N one n COLO CEP 0 0 20 LLD N OF BARNST°`gLE FENCE I�p(1� COLOR TO. , ING'S HIGHWAY L 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 11/98 i °F'T�r Town of Barnstable *Permit a 36 f Expires 6 months from issue date Regulatory Services Pee . > MAS&LEI Thomas F. Geiler,Director ,IL` v mass. � �'� 4, t639. Building Division prEp MAI A Tom Perry, CBO, Building Commissioner /0 200 Main Street,Hyannis,MA 02601 www:town.barnstab le.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address �, ci��Gtf) .� �Ue F., FJ� /Residential Value of Work �`( y �� Minimum fee of$25.00 for work under$6000.00 1 Owner's Name&Address 'f'' I�+ " r Contractor's Name 1`Q� �T �((oteu J Telephone Number U � 3 G0 09 Home Improvement Contractor License#(if applicable) A " d Xorkman's Compensation Insurance Check one:. SEP 2008 ❑ I am a sole proprietor ❑ am the Homeowner TOWN OF BARNSTABLE have Worker-'s Compensation Insurance Insurance Company Name Workman's Comp. Policy# j f ! `J O Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) e-roof(stripping old shingles) All construction debris will betaken to ❑ Re-roof(not stripping. Going over existing layers of roof) .❑'-Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the a Irnprovemerit Contractors License is required. SIGNA`t'URE: l 1 1 Q:\WPPILES\FORMS\building permit forms\EXPRESS.doc Revise020108 NN The Commonwealth of Massachusetts 137. Department of Industrial Accidents Office of fnyestigations 600 Washington Street Boston, MA 02111 • www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information i p Please Print Le 'bl Name(Businessiorganization/Individual): �Q��`� C1/ eo J Address ko�c,,,q rot City/StatdZip: C-Ac�L, lAc:- Phone.#: Are you an employer? Check the appropriate boic Type of project(required): 4• I am a general contractor and I 6. ❑New construction 1 I am a employer with � ❑ . employees(full and/or part.timz).* have hired the st&-contractors 2•❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition and have workers' working for me in any capacity. employees9. ❑Building addition [No workers' comp.-msrrranre comtp.incrrrance,t 10• Electrical repairs or additions rtquued] S. ❑ We arc a corporation and its ❑ p 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 f repairs insurance,required_]t jr. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp,insurance required.] *Any applicant that cheeks box#1 rmst also M out the section below showing their workcn'cmnp=Lwlinn policy infmTmtinIL t Homcownen who submit this af5davit indicating tirey are doing all work and than hirr-outside contractors nest submit anew affidavit indicating such rCont mctnrs that check this box nmst attached an additional sh=t showing the nama of the sub-cmfractors and stafz whether or not those entitiex have employes. If the sub-cantractors have employers,they must provi&their wmi=-S'camp.policy number. I ant are employer that is providing workers'compensation insurance for my employees. Below is the polity and job site information. i Insurance Company Name: i �-`� ✓� f�S V 't(P (' (-� — Policy#or Self-ins.Lic.#: n ` 0-7(�o 3 01 '20 0 O Expiration Date: � liq D lob Site Address: ;i7 LAJt:e.i1 ' rl e!P City/State/zip: Ap le 104-L�^ ' 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 ofup to$250.00 a day against the vio a advised that a copy of this statement may be forwarded to the Office of Investi lions of the DIA for insuraner,rovd=e verification.. I do hereby cerlrfy under the enalties of perjury that the information provided above is true and correct Si e: Date: C) — Phone i- O ' O - ® '7 Official use only. Do not write in this area tb be completed by city or town offtclaL City or Town: Permit/License# Isodug 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#• i �oFZKET . Town of Barnstable Regulatory Services 9B" "BHASS. �E�,` Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize / to act on my behalf, in all.matters relative to work authorized by this building permit application for: ( dress of Job) a Ze-- f Owner D e �74 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �pc THE T ti Regulatory Services .. Thomas F.Geiler,Director BARNsrAsr s. 9q, MA-la Building Division PTFD 1 u'�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vsww.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: 1 ` city/town state zip code The current.exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less.and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on'which he/she resides or intends to reside; on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1..1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that be/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in.scrious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. 8/25/2008 4 : 09 : 33 PM 6764 3 02/02 ISSEL DATE 0"312008 WODUCER TRIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY.AND Jnited Ir+eTTlanee Agency Inc CONFERS NO RJ(3HrS UPON'1•HE CERTIFICATE HOLDER TRIS CERTIFTCATE DOES NOT AMEND,F)crrsND OR ALTER THE CovERAGE AFFORDED BY THE Box 1013 POUC1ES BFI.QW. Tlratlds Bay,MA 02532 COWANTMS AFrOnING COVERAGE suam obl:Tt Robichl:nu C.oMPANY A A.I.M Mutual InswNTlce Co a M ConatNcdon L£TTER 1 P9nkbam Rond endvheh,MA 02563 THIS IS TO CERTIFY THAT POLJCJES OF INSURANCE UST•ED BELOW HAVE BEEN 1S,9UBD TO THE INSURED NAMET)ABOVE FOR THE POLICY PF.•RIOD INDICATED,NoTw.rrHSTANDINO ANY MUIREME'NT.TERM oR CONorrION OF ANv CONTRACT OR OTTER DOCUMEb r atTH Rr,SPEC7 TO WHICH TITM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED IERBIN TS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDMON3 OF SUCH Pol ICIES.LIMB SHOWN MAY HAVE BEN REDUCED BY PAID CLAU4. CO TWEOTINjIIRARCT. DOt.Tcv RDMBCR POLICY tTFECTIVE PM.tCV L7tPIRATtOfl T.IMR6 LiA DATE(MtUDDtY� Dn7S(MMIDD/vT) a6z+IiRnL ncc•R.RDAr6 1 M"RAL LIADIMITY PRCIDUM-1coMWOP AGG. r=GOMM►.RCIALOSNSRALI.IARILTT► PSREONALRAIW W"RY 1 ©=CLATMR NADS=OCCVR EAVI CICCUILRENCE [�DnmRres s cOlrnlncT00.t cRor. RR6 DAVA06 Cwv*om) MED.rxvRxxr.N�fe+R T,1►Nil AUTOMOOME LTAUll TTY COMM PR UT uIAR HAIITAVfO RODILY INJURY ALL OWNED AUTOS my►rm0 g"601 11VA AUTUR MW AV70% BODTLY INA7RY N4N•OWNBD AVTM Tvr Rsib"o OARAOR LIABILITY PROnRIT DANACE MEN LTAMITY SACN OCT,URRIXCE UMBRWAFORM AOORWAY& Ol S M TITAN UMBR6LM/OR9 WORXERS COMMSATIOR AMfl AT KY LIMITS t(x,) EhWLon"LIAI1111MY x t6m,R� ELEACA.AI:t'WNT A, ARNuIL�ruzunvL MCIE HAR9 6010768012008 01/14/2008 01/14/2009 ELDTSEAGB--P0I.TCYLIMTTINCL ®ML nUISEAM-EACH EPOLOYEE COMME S/nrACRIPTION OF MERATION.4 OR LOCATIONS: oBFRT ROB.T.t;t•rFAU IS NOT COVERED BY THE.WOTtMS'COM'PENSATION POLICY. Omm ANY OP TV ABOVE DE SUM?0T,ICM9 BE GANG, ARPORE=-MUUAMM GATE OWN OF BARNSTABL1par •TI>P>Aatnaroco�A ' E^vanroblAR tZ`I'ItmlSNxoTlt�tot> ryRrt�cn LOER RAMRTI TO TM LEFT.BM FAILURE TO WJL SUM NO'=MIALL DOSE NO OMIGATION LLMMZrY Op ANY TRII�D UPON Tn. COWAIOY,TT9 AGENTS OR XWRnlWTATty pS- On MAIN STREET. C�a-) ANNTS,MA 02601 UTTmRIxf,DRRrT nExrATM 4810 r DATE(MWOOIT " AC CERTIFICATE OF LIABILITY INSURANCE a 25/oe RtoouCER THIS CEtI'IFiCATE IS ISSN AS A MATTES OF INFORMATION United Insurance Agency, Inc. h�ppL T S AND OCEWIIFICWEFtS NATE DOES NOT AMOP EXT13'IDAOR 199 Main Street ALTER THE COVERAGE AFFORDS SY THE POLICIES BELOW 8.O. Sox 1013 M Buzzards Bay, MA 02532 INSUMMAFFORDWGCOVL�RAGE INSURED INSURERA: SCOLL9dal6 Robert J Robicheau INSURER S: DBA RJR Construction INSURERC: 91 Pinkbam Rd INSURER 01 Sandwich, MA 02563-253 INSURERE: COVERAGE'S THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT. 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, ELUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR D' Y NUMBER PO CY EFF E POLICY TKltl LIINIT 61►CN ocDURraENCE I 300,000 OEJFERALUABILITY DAMACETO TED S 100 000 A X CoMMERCIALGENERALLIABILITY CLS1476508 1/14/08 1/14/09 . 6RstPecsum ClAar13MADE OCCUR MEDEXPIA are m I 5.00a FERSONALAADVNJUtY S 300�OOO GEW!nLAG(VkWIRE S 600,000 PR IDUCTS-COMP0PA03 S 60D IA00 GEN'LAGGREGATE LMR APPLIES PFR: X POL ICYE-7 PRO LOC AU OBILE LIABILITY TO M COMBINEDSNQEUMn I I8,eclitlem) ANY AUTO ALLOMEDAVTOS EO OILY NJURY I Ow poem) SCHEDULED AUTOS RY MIRED AUTOS BDDLY N(Farecddml) NON•OWNED AUTOS __: PR(PERTY OHMAGE I (AV eco drn) I AUTO ONLY,EAAOCDFNT i GARAGELIAMLITr EAACC 3 ANY AUTO AU TOR THAN AUToONLY: AGG S FC OO CUR RENCE "CESSNMBRELLA VABILITY OCCUR CIAIMs MADE AGGREGATE ISIS DEDUCTIBLE A I RETENTION f WC STALL OT WORKERS COM PENBATION AMC TO.ftx i&l_$ EMPLOYERS'LIAEILITY ELEACHACCIQENT i ANY FROPRIETORIPARTHERMXFCUTNE EL,01 SEASE•FAEIv9LDI EE I OFFICER(MEMBER EYCLUDED? W4�ypp EL()40FA9-POLL UNIT I SONS below OTHER DEVAPTION OF OPERATIONS F LOCATIONS F VEHICLES I EXCLUSIONS ADDED BY EAOO"ffMENT I SPECIAL PROVISIONS carpentry CERrIFICATEHOLDER CANCELLATION SHOULD ANYOF THE ABOVEDESCRIBEO POUCCOSE CANCTA.LED SWORETHB E70MRATION Town Of Barnstable DATE THEREOF,TNEN43UIN0 INSURM WILL ENDEAVOR TO MAIL 10- DAYS WRITTEN 200 Mail] St. NOTICE TO THE CER IFFCATE HOLDER NAMED TO THE'"T'BUT FALURE TO CO SO BN AU Hywmis, MA 02601 IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTAfIVEB. AUTMORIiEO R TATTV ACORD 25(2001108) 0 ACORD CORPORATION 1900 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / �C(�'J IL DATA f 4 Licensee Details x. V Department of Public Safety Licensee Complaints l� License Type Home Improvement Contractor License # 124401 - .2008 http://db.state.ma.us/dps/licdetails.aspAxtSearchLN=141CI24 401 Page 2 of 4 Licensee Details r , Restriction Company Rjr Construction Name Robert Robicheau J' Address 91 Pinkham Rd City, State, Zip Sandwich, MA, 02563 Expiration Date 6/18/2009 i 2 9/2/2008 http://db.state.ma.us%dps/licdetails.asp'ht-tSearchLN=HIC124401 Page 3 of 4 Licensee Details Status (u:r r:e n t No complaints found for this Licensee. Back To Search 9/2/2008 http://db.state.ma.us/dps/licdetalls.asp?txtSearchL.N=HIC124401 �p10HE A Town of Barnstable *Permit# ( 2 6e ~per Expires 6 months from issue date •AxxsrABt.s, : Regulatory Services Fee$ Thomas F.Geiler,Director �A�FD MA't a` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not Val'il itty bout Red X-Press Imprint Map/parcel Number 19 C CFi �,DG� Property Address V _ o� eff-Residential Value of Work ©QD Owner's Name&Address �` /�-®,s/e- 43 be Contractor's Name �� `T' V�pb'C�i ea c' Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) © CO ©.� P = '"•;. ❑Workman's Compensation Insurance '4.0 Check one: ❑ I am a sole proprietor ❑ L=the Homeowner I have Worker's Compensation Insurance N QF B Insurance Company Name Workman's Comp.Policy Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side d ��✓Y' 'j� l� ❑ Replacement Windows. U-Value (ma imum.44) ` ❑ Other(specify) , J� 'Where required: Issuan of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 Town of Barnstable . PP Regulatory Approved `� Re ulator. Services Fees. Thomas F.Geiler,Director Building Division Peter F.DiMatteo,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 Home Occupation Registration Date:_ 1)t 0-2— Name: T l A\J,. /A C,-,,� Phone#: S 0$- 'S Z I (n t Address: 1' 0. &A, -32-0 31 LW vv % Village: W � Name of Business: 1�;"V\O-e�.I i +Irv- S J Q. Type of Business: - I c A Map/Lot: -'G INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no Iincrease in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restri ns for my home occupation I am registering. Applicant: Date: 3/is Z OoZ G Homeoc.doc Phoenix Fun and fitness Conch Michelle Aceto P. O. Box 320 West Barnstable, MA-02668 (508) 362 - 7619 phoenix719 @ yahoo.com phoenix-fun-and-fitness.com I Assessor's map and lot number ... �/jJ y" C — l- 7- 7 7. 7� SEPTIC SYSTEM MUST B-E Z INSTALLED IN COMPLIANCE Sewage Permit number ......................... 17 --................. WITH ARTICLE If STATE SANITARY CO D TOWN Q�ofT"E TOWN OF B A R N' L�IOL-E--- BASa9TAALE, i o AYjk.% BUILDING INSPECTOR J �'p APPLICATION FOR PERMIT TO .........� .�.!L.... .h,,<............................................................................................ TYPE OF CONSTRUCTION °V. 04?0. 1. ; 1. ......................................................................... ........................ TO THE INSPECTOR OF BUILDINGS: 41 ,JC 'y/ The undersigned hereby applies for a permit according to the followin information• a Z i Location ...1L-....! ..... ...................�. 1". ........! ..� -............ /.....4,5 T.. 17WS..7-l7i ...:........... ProposedUse ......<,.l ............................................................................................................................................... ZoningDistrict ................. ........................ .............................Fire District .............................................................................. n ,/ Nameof Owner � l� �Y....................Address .......................................... Name of Builder '1 ' !....r �4�:. 7................Address �11....7. ..1..(::.. 51).(- D.. Ci............ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation OO'�eZ F Exterior ....... ®�O...sJ.l'�lh�f ..............................Roofing Floors .Interior ....... Heating ��T �i T, 'G..........................................Plumbing �!-?!A .................... . ................ .............................................. �`fdpOa Fireplace ..... 5 ................................................................Approximate Cost ........................... ...................//.........c....... .. Definitive Plan Approved by Planning Board ________________________________19________ . Area ......../.�. !P.. �?.. .....• Diagram of Lot and Building with Dimensions Fee .......13 '" ............ a SUBJECT TO OPROVAL OF BOARD OF HEALTH lie 36 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .;J ...................................... Rudy, Dr. David E 9 i VZ No 18920 permit for ....two story, ................. ..................... single family dwelling ............................................................................... Location ...31 Holway...Drive....... ........ ............................. West Barnstable ........................................................ Owner ......Dr... .. David. ..Rudy .... ......... . ....................................... Type of Construction frame .......................................... ................................................................................ ..........#24 Plot ............................ Lot ................ Permit Granted January 27 77 Date of Inspection . ...7..� .........19 Date Completed .1.. ... .... ...............19 PERMIT REFUSED z............................................................... 19 ................................................................................ ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... .............................................................................. Aoxexno/, map and lot number -------------- ' 3evvoge Permit number .......................................................... ' ��7�J �� J�� K �� TOWN�� |� �� BARN STABLE �� ! -IL �� 0 ��m N �� N0 N N-N� 0 �� INSPECTOR �� m � 0N �� APPLICATION FOR PERMIT TO .................. .. —/1---------------.--------------- , / 7�� F ----...!—l!.-�.z—''�— ... .-------------------------- —.--�..—.! ------.lV.......... | TO THE INSPECTOR OF BUILDINGS: ^ / The undersigned hereby applies for o permit according to the following information: Location ......................................................�--c . ../ '------_--^----------------^------. .�---� � . PrupouedUse --.---..�' ..................................................................................................................................................... ,o Zoning District ----_------------------'Fine District -------------------------- ^ Nome of Owner ''''-----�.��—'.--.-!--------A66res ---------------------------- '�/4� �� Nome of Builder -..--.-!��L'—.--��.��.`-----A66nss ��—.--�.�..�_�._��'��.�.��&��`----- Nome of Architect ----------------------A66,eo ---------------------------- Number of Rooms ----------------------..Foundohon —...~`.�...-'��.....'��^-------------- Ex/e,io, --.�..._.�� n Roo�ng __...............^� !� __________� Floors ----..--'.�--------------------|ntehur ......... ......................................... -� . — Heating --'.----./��./��---------------�F1um6ing ---_��...........i�---------------- Fireplace ----_----------------------'App,oximote Cost --...—.�-------.---.,_____._ Definitive Plan Approved by Planning Board lg----' Area --'/.....--------. ' Diagram of Lot and Building with Dimensions Fee ........... | SUBJECT TO APPROVAL OF BOARD OF HEALTH , ° - ' ' ^ , | � | � | . ^ | | hereby o' ee to conform to all the, Rules and Regulations of the Town of Barnstable regarding the above construction. Nome ��' - ./��. �� ......................................... ,. --.—.— . -� U ~ | U | " ' Rudy, Dz. David A=136~39 No . lG92� Permit tvna atmry, ' .-----. . ~. -----..------. ' , single family dwelling --------------------------. , . . . 3l'' Drive ' ' ' Locohon -----.��-------_---'' ' West Barnstable, ' ' --------------------------. . OwnerDr. David Rudy . .�---------------------. �rama Type cf [ono�ucUon -------------_ _ --------.------- —' . . . . ' . :��D Plot . . ' . . Permit' Granted ' ^ Date of | Date Completed ' ' ^ ERMI REFUSED . , ' . � �] f. ..m . _ . . ` . ^ . . . � - | � ' Approved lg ' . -------------- --"-----.. . -------`-------. ----.--.—. . . . � . *THE t0� TOWN OF BARNSTABLE OFFICE OF 13AH34TABL MAM BOARD OF HEALTH 1639. 397 MAIN STREET HYANNIS, MASS. 02601 To : Building Inspector From: Health Department Subject: Test hole and Percolation Test A examination of the soil at A)c 11&141 y zole/Vc w• f3/� •-sr.��4 (Lot) (Address) ( Village) was made on ?� o c t ��/ 7� and found to be (date) suitable for sub-surface sewage,! at Site of test hole. Building Permit will not be approved or sei-aage permit issued until Health Department receives two copies of plan showing building, . sewage systems and all other details listed in Board of Health instructions to sewage applicants. This approval does not constitute a final decision concerning the installation of a •sewage system. All State and local Health regulations apply to final approval. 7 (. gnatur rEw /=car. T 6c- j �f/CUUlc r AlLIJ7- If Ile, 4- l4CLa1'e. L 'Z- 6/20/75 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A �.- I m / �C(L� L DATA f C� 15 P' ''•5 ./, • t,` �� p r,.eta '� .�..`" '-�. ... r jr � .. ;. k' `�T'�,�j" �).••�;� ,_•. � ,. ,ti. 7i.r�4rF j r --rVi .-., y.� 'f.''.� 1"7�"�� ---- _ PROJECT--� .NAME: ADDRESS: PERMIT# PERMIT DATE: b b M/P: 136 1d�9 LARGE PLANS ARE FILED IN: BANKERS BOX FILED ALPHABETICALY BY STREET INFORMATION SHEET FILED IN STREET FILE q/wpfiles/forms/archiveBANKERSBOX Barnstable Bldg. Dept. CUSTOM A • ved by:` CUPOLA•. REEF GABLE VENT 24 School Sheol NN PO Box ISE Perm t #:—B- _� " Q.Q�, We$I DM 3994•MA 02870 t 508.760.1408 ' 1:60B.7HO.i40B ®'------1------� CLEAR GRADE ' EXISTING 1 PROPOSED WHITE CEDAR IxB.b'BOX RAKE ' 1 SHINGLES S. T.W. WITH IXB TRIM 1 x 0 SUB RAKE 1 30 YEAR A..RCHITECTURAL 12 ' • , A5F'HALT 6NINGLEB;Tyr. FAUX OR .TRACK 1 1 .•��Q 1 g 1L TOP P 1I�J u.Te ; � . • , FAUX S '14 1 x 5/6 CO 1 LOFT DOOR .B 111111 OARDS TOP SUBFLR ' o ® FA DOOROOR 14 LITRANSO GHT TOP PLATE 1 ' . o0 1 4x4 PT WRAPPED INT m 4• y. PINE WITH BOOT ® 1--t A f0 \ r' ,3S* REVIEWED I I%B RED CEDAR FAU%SLIDINGTODO5 P5 v-GRmve BARNODDRS _____________ ____________________ j N 1 BARN STABLE B1'IL0!`'4G DEPT. DATE 3 NORTH ELEVATION r�------------------------------ --1 EXISTING I PROPOSED FIRE DEr 41TMENT ..DATE ' �"—EXISTING �—PROPOSED 1 -� BOTH SIGN�TU;ES ARf FEt'UIRED FOR PERMITTING W 1 N D O N S C.H E D U L E I I TAG SIZE ROUGH OPENING NOTES aTY• , I I A AXBI 2'-7 1/2'x 2'-7 1/2' 4 1 I I B 2442 2'-G I/e'z 4'-4 7W 4 • C 2646 2'-S 1/5'x 4'-0 7/5' 4 ' 1 I 80 YEAR ARCHITECTURAL I D CWISB 2'-4 3/0'x W-4 7/8' ASPHALT SHINGLES,TYP. I I E CN155 2'-7 I/2'x 9'-4 7/e' 4 . o 1 � 1AND SOFFIT Ico 1 I I WINDOW SIZES BASED ON ANDERSEN 1 OWNER TO SELECT MANUFACTURER,COLORS AND ACCESSORIES. N a O AT LEAST ONE BEDROOM 5HALL HAVE 3.3 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING SHALL BE 20'IN WIDTH 4 24'IN HEIGHT AND SHALL NAVE'A SILL'HEIGNT.NOT GREATER THAN 5 I x e FRIEZE!BOARD w/ Co 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER cY -I/4'BED MOULDING 12 PROVIDE EXTENSION JAMES FOR WINDOWS IN 2 x 6 WALL'CONSTRUCTION h 44 c • 1 O DOOR 5CI-IEDU LE 1 0 1 TAG TYPE SIZE ROUGH OPENING NOTES o0 00 1 1 FIBERGLASS, INSULATED, 12 PANEL 90G0 SEE SUPPLIER PROM PORCH DOOR 1 O O I 2 FRENCHWOOD GLIDING PATIO DOOR FWG6060 6'-0'x 6'-B' ONTO ROOF DECK 1 _ ' 9 PRENCHWOOD GLIDING PATIO DOOR 64GI2066 12'-0°x b'-B° IN DINING ROOM' 1 4 FRENCNWOOD HINGED PATIO DOOR FWHGOGB 6'-0'x G'-B' INTO SCREEN PDRCH 1 ELEVATIONS OUTDOOR • 1 I I I I I SHOWER __—_I ____________� 1 LJ ----------------------------------- 1____________J EXISTING' I PROPOSED -------1------'► NEST ELEVATION Al . 1 SCALE,;'.I'-0' I REEF CAPE COD'S HMM BUDDER ------1------� 2PO "ol Street PO Box SIr PROPOSED I EXISTING WeSf DenNe,MA 02670 l'608.394.3090 .. I F.508.7E0.1408 • 12 '' IZ '!2 D CLEAR GRADE • WHITE CEDAR . . SHINGLES B'T.W. I .. . . ❑ ❑ ■ 50 YEAR E , V. TOP PLATE ASPHALT SHINGL SHINGLESS, I Do SS*CABLE RAILS � ' TOP 6UBFLR ' BO YEAR ARCHITECTURAL 0 ' TOP PLATE ASPHALT SHINGLES,TYP. El !1 �� 1� �l 0 (D . 7- PROPOSED 55 EXIST. m CABLE RAILS ALUMINUM FRAMED V SCREENS TOP FND IXISIN.6 DECK •r-x RS i I B'x 4' I I I II 1 3 ai O ER SROWER VTDOOR I O p I L--?-----.--------------------------- ——----- ------y i ) ------------------------=---------1 ��-----ll— SOUTN ELEVATION I I I y ---------------------------- ----� x SCALES i'.I'-0' I'I------------ LJ -r+-------1J--------C1I PROPOSED I EXISTING LJ I' I L J PROPOSED i IXISTING— 1 J W I N D O W S C H E D U L E TAG SIZE ROUGH OPENING NOTES ?fY. A AXBI 2'-7 1/2'x 2'-7 I/Z' 4 / I 90 YEAR Al1TICTIIRALJ B 2442 2'-6 VB'x W-4 7/B° 4 ' ASPHALT St INGLES, TYP. � C 2646 2'-0 VB'x 4'-B 7/B° 4 I D CWIB5 2'-4 B/B'x 61-4 7/B' I E CXISB 2'-7 1/2'x 5'-4 7/8' 4 O O 6 • 65 CABLE RAILS .. WINDOW SIZES BASED ON ANDERSEN tV z OWNER TO SELECT MANUFACTURER,COLORS AND ACCESSORIES. 0 ' AT LEAST ONE BEDROOM SHALL HAVE 5.3 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING SHALL BE 20'IN WIDTH 4 24'IN HEIGHT AND SHALL HAVE A SILL HEIGHT NOT GREATER THAN Q ' 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER PROVIDE EXTENSION JAMBS'FOR WINDOWS IN 2 x fi WALL CONSTRUCTIONro m y 1 IXIST. D O O R, S C I-I E D U L E ALUMINUM FRAMED • SCREENS TAG TYPE SIZE• ROUGH OPENING .NOTES 41 III 1 FIBERGLASS, INSULATED, 12 PANEL SoGe 9EE SUPPLIER PRONV PORCH DOOR 2 FRENC60y060 GLIDING PATIO DOOR FWG6068 6'-0'x W-S° ONTO ROOF DECK91 ' S FRENCHWOOD GLIDING PATIO DOOR FNG12065 12'-0°x 6'-B' IN DINING ROOM ' I I I 4 FRENWWOOD HINGED PATIO DOOR FWH606B 6'-0°.x 6'-5° INTO SCREER'PORCH ELEVATIONS I� 1 EAST ELEVATION • SCALE.i"_I'-0' I TL------------------------------ ---- /'ems /A/ PROPOSED I EXISTING ' Shear Wall"A"Construction(see Plan for dimensions) 24'-0' Foundation to the underside of the roof Plywood B�-0' la'-o• 5'-0• -2x6 studs spaced at 16'on center with 2-2x8 studs at each end. �' -1/2'exterior grade plywood(minimum)nailed wl8d common nails spaced at 6'on center around the perimeter of the sheal D wall dimensions and all Interior Joints.Note:Plywood to span vertically between floors or provide solid blocking at all ASA CAPE OWS HOM BUUX horizontal plywood Joints nailed at 6"on center(staggered).Provide 8d common nails spaced at 12"on center �x'4'elsewhere. 10'-6• 24 school shoal -Connect the 2-2x8 studs at either end of the shear wall to the foundation with a Simpson HDU4-SDS2.5 holdown.The eHa+eR Po cox lee holdown shall be located on to of the foundation shoe,connected to the 2-2x6 studs with 10 Simpson SDS A'x 2-12' westDonnls,IMozerl P ( ) P A 0 1:608.0s4aoeo screws,and connected to the concrete with a 5/8'diameter anchor bolt epoxied Into the concrete a minimum of 8". c 50e.760.1409 Shear Wall"B"Construction fsee plan for dimensions) _ lI� UNDER BLAB Foundation to the underside of the roof Plywood I WATER LINES IXISTING PROPOSED ' -2x6 studs spaced at 18°on center with 2-2x8 studs at each end. I A/2°exterlor grade plywood(minimum)nailed w/8d common nails spaced at 4'on center around the perimeter of the sheet well dimensions and all Interiorjoints.Note:Plywood to span vertically between floors or provide solid blocking at all I 1 _ g HEAT c a horizontal plywood Joints nailed at 4"on center(staggered).Provide 8d common nails spaced at 12"on center DeT. - - 2'-0• elsewhere. 14'-w 1 SEE SECTION I -Connect the 2-2x6 studs at either end of the sheer well to the foundation with a Simpson HDU5-SOS2.5 holdown.The I Has e;•x5;'B• holdown shall be located on top of the foundation shoe,connected to the 2-2x6 studs with(14)Simpson SDS A'x 2-12' - 5'-2' 4' 5'-2• 4' 2'-10' 4• a'-• 4 STEEL CO MN screws,and connected to the concrete with a 5/8°diameter anchor bolt epoxied Into the concrete a minimum of 8°. . �1 WI2x40 STEEL BEAM ABOVE(0•FLANGE) v ____ ____ - _ ___ _ _ _ _ J__ _____________ _____________ _ 0:'m 79/4' Shear Wall"C"Construction(see plan for dimensions) I , ( r- 16- n ( WES!4'x-4'xa' _ Foundation to the underside of the roof Plywood m I STEEL COLUMN POINT LOAD -2x6 studs spaced at 16'on center with 2-2x6 studs at each end. FROM RIDGE SEE SEC ON 2 1'-2 • Y I 2 In' In' q' 2 In' -1/Y exterior grade plywood(minimum)nailed w/Bd common nails spaced at 6'on center around the perimeter of the shear r 1 I �°n✓ wall dimensions and all interior Joints.Note:Plywood to span vertically between floors or provide solid blocking at all 14SS m I I m STEEL •coLunN horizontal plywood.Joints nailed at 6"on center(staggered).Provide 8d common nails spaced at 12"on center L I PROPOSED Q I I�i w 4• elsewhere. c 1 gGREEN § D� (2) 1'-2• q• e• -Conned the 2.2x8 studs at either end of the shear wail to the foundation with a Simpson HDU4-SDS2.5 holdown.The a ' I O C - t'a HEAT ` 6 holdown shall be located on top of the foundation shoe,connected to the 2-2x6 studs with(10)Simpson SDS A'x 2-12' DET. Bj'.5coL01LU nN • screws,and connected to the concrete with a 5/8'diameter anchor bolt epoxied Into the concrete a minimum of 8° m�I R I I s7eeL o PROPOSED 2 I r-2• t _ GARAGE V -� 4'CONC.SLAB WITH 6x6 C 4'-0' 7'-0' ® B -1IIX\ I W. OVER 6 MIL.POLY BIc O EXIST.WIN. O O O II A9.1 I IT A9.1 4 0' -V] (�� f 068_ SW N I- O O O J I TR I I DW II' I I ——— _-_I W12x90 STEEL BEAM ABOVE_i6'FLANGE) _ __ I�°m v 0 a +- o 00 ———— -- ----- -- _-- ----- I � SECTION 1 SECTION 2 �0y - Q II -- _ W m 3 ttt��•--MII a 96'RANGE / ; — 6.6 P9 POINT LOAD 6 P5L 6 PROPOSED 8 1 .9 POST FROM RIDGE POST EXISTING EXISTING KITCHEN _ m a1 11 h Cd M a r =__ tT� DINING EAR ROOM iF---�i---_ II i'� \\I UP ROOM m'-0• W a BOTTOM I 'I CO TC-U4. L_______yl II A per_ 2 it A TOP 4FLANGES J'CAP PLATE 11 1 A9.1 6'•'q- HEAT A9.1 ENa TRY 't4 DET. PLATE LONG W/(9)9'0 A325N;,BOLTS BARN PIZ I I -_WOOD I L -(9) EAX.POSTS � ° m • __,r_______________ — TILE m a TO HEADER Q ❑ wine REP PRZ PANTRY ulI - O ABOVE O ' •RAT HOLE' a I m III Gil $ � — 14 DIUS LIGHT — (TYPICAL) Has 6J'x5�j°xg' ml 16g EMPERED SHEAR WALL'C' TRANSON SHEAR WALL'G• STEEL COLUMN 1 TEMPERE - BACK GOUGE ROOT I PASS 4 REWELD -10• 7'-B• V-B° 8'-4' AFTER BACKER BAR II ex15T. EQUAL EQUAL11 IS REMOVED REMOVE AND INFILL OPENING II'-0' II'-01 25'-6' EXISTING WINDOW EXISTING BEDROOM PROPOSED I DETAIL A EXISTINGm COVERED ENTRY LIVING PROPOSED ROOM SMOKE CO I OFFICE —m ■ — ■————— ■ DET. — — _ GRANITE STEP I I I 6'-q EXIST.WIN. EXIST.WIN. — I IST.WIN. EXIST.WIN. I C AS.I IXISTING 1 PRO=OSED� I y PROM99 N FIRST FLOOR ADDITION } SCALE,J' 1'-0' _ 9 W 1 N D O W S C J-I E D U L E D O O R S C 14 E D U L E o a TAG SIZE ROUGH OPENING NOTES OTY. TAG TYPE SIZE ROUGH OPENING NOTES i A AXBI 2'-7 1/2".2'-7 In' 4 1 FIBERGLASS, INSULATED, 12 PANEL 906E SEE SUPPLIER FRONT PORCH DOOR B ADH2644 2'-6'x 4'-4' TWO IR 4 2 FRENCHWOOD GLIDING PATIO DOOR FWG6068 6'-0'x 6'-B° ONTO ROOF DECK (IR) C ATF28110 2'-B•x I'-8' IR 4 9 FRENCNWOOD GLIDING PATIO DOOR PWG12068 12'-0'x 6'-B' IN DINING ROOM ACW2690 2'-B'x 5'-0- 4 FRENCHWOOD OUTSWING HINGED PATIO DOOR FWW6068 6'-0'x 6'-0' INTO SCREEN PORCH D AC-12650-1 2'-6'x 9'-0' IR/TEMPERED 1 B FIBERGLASS, INSULATED,9 LIGHT 906E SEE SUPPLIER REAR GARAGE DOOR FIRST E qU-t21094 2'-10'x 9-4• IR 4 6 FIBERGLASS, INSULATED, 4 PANEL 9069 SEE SUPPLIER GARAGE/HOUSE FIRE DOO FLOOR PLAI "OF otxz�xc W. WINDOW SIZES BASED ON ANDERSEN o DcV+GU0 OWNER TO SELECT MANUFACTURER, COLORS AND ACCESSORIES, u 61RUC URAL Z, g, hn 3505z AT LEAST ONE BEDROOM SHALL HAVE 9.9 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING 0•,Fc; SHALL BE 20'IN WIDTH 4 24'IN HEIGHT AND SHALL HAVE A SILL HEIGHT NOT GREATER THAN 1 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER. ■ ■PROVIDE EXTENSION JAMBS FOR WINDOWS IN 2 x 6 WALL CONSTRUCTION Shear Well"A"Construction(see plan for dimensional Foundation to the underside the roof plywood-2x6REEF -2x8 studs spaced at 16'on center nter with 2-2x6 studs at each end. ' -1/7 exterior grade plywood(minimum)nailed w/8d common nails spaced at Won center around the perimeter of the shear wall dimensions and all Interior Joints.Note:Plywood to span vertically between floors or provide solid blocking at all GIPS CDD•sN mBUDDER horizonfat plywood Joints nailed at 6"an center(staggered).Provide 8d common nails spaced at 12"on center 24 school strwt elsewhere. PO Box 169 -Conned x6 the 2-2 studs at either end of the shear wall to the foundation with a Simpson HDU4-SDS2.5 holdown.The wmtDe.%nwoze70 holdown shall be located on to of the foundation shoe,connected to the 2-2x6 studs with 10 Simpson SDS 11W x 2-12' 1.s08'3e4'3090 P ( ) P /:shrews,and connected to the concrete with a 5/8°diameter anchor bolt epoxied Into the concrete a minimum of 8'. 508.760.1408 Shear Well"B"Construction(see plan for dimensions) y'-6' 7'-0° a'-6• Foundation to the underside of the roof plywood -2x6 studs spaced at 16'on center with 2-2x6 studs at each end. G 4x6 SL POST FROM -12'exterior grade plywood(minimum)nailed w/8d common nails spaced at 4"on center around the perimeter of the sheaf A9.I BI E EA BELTO OW horizontaleEL wall dimensions and all Interior Joints.Note:Plywood to span vertically between floors or provide solid blocking at all 14'-0' horizontal plywood Joints nailed at 4"on center(staggered).Provide 8d common nails spaced at 12"on center elsewhere. Q C c -Conned the 2-2x6 studs at either end of the shear wall to the foundation with a Simpson HDU5-SDS2.5 hotdown.The ■ holdown shall be located on top of the foundation shoe,connected to the 2-2x6 studs with(14)Simpson SDS'/.'x 2-1/2' - -------- ---- NP screws,and connected to the concrete with a 5/8'diameter anchor bolt epoxied Into the concrete a minimum of 8'. ---- -- ---- m I < Shear Walt"C"Construction Isse plan for dimensions) ? 2W I a Foundation to the underside of the roof Plywood PROPOSED mI I a -2x6 studs spaced at 16'on center with 2-2x6 studs at each end. V BEDROOM a -12'exterior grade plywood(minimum)nailed w/8d common nails spaced at Won center around the perimeterof the sheaf wall dimensions and all interiorjoints.Note:Plywood to span vertically between floors or provide solid blocking at all v horizontal plywood Joints nailed at 6"on center(staggered).Provide 8d common nails spaced at 12"on center ROOF PROPOSEDDECK KQ 1 o iz I �S -Conned S the 2-2x6 studs at either end of the shear wall to the foundation with a Simpson HDU4DS2.5 holdown.The - M holdown shall be located on top of the foundation shoe,connected to the 2-2x6 studs with(10)Simpson SIDS W x 2.1/2' �' SMOKE 9'-10' y screws,and connected to the concrete with a 5/8°diameter anchor bolt epoxied Into the concrete a minimum of 8'. O DST. I U n g D m I �1eq I I0M 6 PSL POST I E A9.1 TEMP OD '1- W-0° LRBEAM TO I I O '� 1-1 rft1A _____________________________________________________ ___________ _ __ r r_________-I____________ __ RN 1 COFFEE rf. �m Im•1 ,,y I.._I I II I INEN 3 Jx 0) I� I GLST b'y 6 , LH BATH EXISTING _ ' BATH II _ A3.1 4 � _ B 0° 7-I' __ aka l l 2 s' JH BATH --- if e' I 54'WAN i, • I I B 78 42 � B II I K m T ID 2 / I - SMOKE 0 SMOKE I EMPERED TEMPERED J Q DET. M1� / DET. I SHEAR WALL'G' (9))I-9/4'x7 I/4'LVL SHEAR WALL'C' I I nEADER IN LOOR EXISTING `x� EXISTING ---------�----------------- BEDROOM BEDROOM 4.6 PSL P 7ST FROM RIDC E TO LVL IN P SMOKE/CO C DET. A3.1 EXISTING 0 6'-10° PROPOSED rEXISTING , SECOND FLOOR ADDITION SECOND FLOOR SCALE,;' 1'-0' m N � m1 N Z O r� 0 W I N D O W S C H E D U L E D O O R S C H E D U L E TAG size ROUGH OPENING' NOTES OTY. TAG TYPE SIZE ROUGH OPENING NOTES A AX81 2'-7 1/2'x 2'-7 1/2' 4 I FIBERGLASS, INSULATED, 12 PANEL 9069 SEE SUPPLIER FRONT PORCH DOOR T B ADH2644 2'-6'x 4'-4' TWO IR 4 2 FRENCHWOOD GLIDING PATIO DOOR FWG6068 V-0'x 6'-B' ONTO ROOF DECK (IR) C ATF25110 2'-9'x I'-e° IR 4 9 FRENCHWOOD GLIDING PATIO DOOR FWG12068 12'-0'x V-S' IN DINING ROOM AGW2B90 2'-9'x 5'-0' 4 FRENCHWOOD OUTSWING HINGED PATIO DOOR FWH6069 V-0'x 6'-e' INTO SCREEN PORCH D ACW2650-1 2'-6'x 9'-0' IR/TEf9PERED I 9 FIBERGLASS, INSULATED, 9 LIGHT 906E SEE SUPPLIER j REAR GARAGE DOOR E AC421034 2'-10'x 9-4' IR 4 6 FIBERGLASS, INSULATED, 4 PANEL 906E SEE SUPPLIER GARAGE/HOVBe PIRE DOOR SECOND FLOOR PLAN WINDOW SIZES BASED ON ANDERSEN OWNER TO SELECT MANUFACTURER,COLORS AND ACCESSORIES. 0F AT LEAST 011E BEDROOM SHALL HAVE 9.9 SO.FT.NET.CLEAR OPENING.NET CLEAR OPENING '6� W. SHALL BE 20'IN WIDTH 6 24'IN HEIGHT AND SHALL HAVE A SILL HEIGHT NOT GREATER THAN o`er DOAIFNILO 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER. OeAx0El0 SiNU35%2 PROVIDE EXTENSION JAMBS FOR WINDOWS IN 2 x 6 WALL CONSTRUCTION No.35061 A2.1 I 9FOf REEF iDAP600D•6 RDlO;BUDDER 24 SChWI Strobl PD Box 166 Wo Dmnb,MA 02870 1:508.394-M 1:608.760.1406 D AS.I 24'-0' �IX19TING TPROPOSED� m - — ———————— I ,I UNDER SLAB Ie WATER LINES I A8.1 pJI I I I la m o ZZQZZQ I I I IIQ0.p 14'-0' I • 9'-10' - �I I �8)2x10 BEAL•I I I 2 PORMED10- IA.CAN�CN�ER9 I `I II•• � �+ r�/1 W/24'DI A.BELL FTG. 48'MIN.BELOW GRD. I I IT. I I I I •.-I A Cd Ilm ICI 3 PROPOSED Ln GARAGE 4' OVER SLAB WITH 6.6 13'-6• •:�: '-B' WWM OVER 6 MIL.POLY l o w i I B 3 -------- AS.1 i?: A Lmm .49.1 0 I I IQ m UP 9'-10' •ti I I to m IXISTING PROPOSED A - I I A o- BASEMENT CRAWL SPACE —I •-. — AS.1 AS.I ;'8 WALL B LLI Q• 13 B-6• q I 4 I - L— ------------ .8' n UP -- —.— -- _ -------------------- SMOKE/CA ---------- DET. O ——— ——\ 7-— N O 6'-S' .r 10'DIA.SONOTUBE W FORMED CONC.PIERS C W/24'DIA.BELL FTG. Q <Ay i 48'MIN.BELOW GIRD. m PROPOS 36.-0° I �E%IB=ING�PR=OSED� FOUNDATION PLAN SCALE:i' 1'-0• n FOUNDATION PLAN ..`x Of yam, . sa V601JfNX W. . s'+ 0w+0B0 N g S7S6CTURAI It.35067 Q A2.2 $o,F'a 1 i REEF STRUCTURAL RIDGE (2)I-9/4'xll-7/B'LVL STRUCTURAL RIDGE CAPE 000S BOALL'BU0DE0 (2)1-9/4'x11-7/8'LVL 24 School SIre6t UNVENTED HOT ROOF 12 LNVENTED HOT ROOFS PO Box 186 6'CLOSED CELL FOAM(R21) 12 9'CLOSED CELL FOAM(R21) Waxt Cle001e MA 020f0 6'GATT INSULATION(RI9) / 6•BATT INSULATION(RI9) L ITTO% A00 5118.760.1408 12 2 X 1 N TRUC-*I ROOF CONSTRUCTION 12 2 x 10 RAFTERS-*16'O.C.W/ 12 / 12 2 x 10 RAFTERS O 16'O.G.W/ I/2'COX PLYWOOD BH FAT14 NG / I/2'CDX PLYWOOD SHEATHING EC ICE+WATER SHIELD IST 96' 7.70 �12 ICE+WATER SHIELD IST%' 2 x 10 O 16'O.G. 150 FELT PAPER / M C CEILING JOISTS ARE 50 YR,ARCHITECTURAL So10' PELT PAPER ROOF SHINGLES /�f�'°/ AREA 90 YR.ARCHITECTURAL ROOF SHINGLES 2XIO CEILING JST AT 16'OC IE40H RAFTCLIPSER / FAC1W2.5 CLIPS 0 ® ® EACH RAFTER m 3 TOP PLATE 2'-E" C c 6'-9' a TOP PLATE v - 1'-10' - EE EE m o ROOF = ,^,II DECLC 5EDROOM CLOSET n TOP SUBFLR TOP SUBFLR m J STAIR DETAIL, a' TOP PLATE 14R O 7 1/2' STEEL BEAM BEYOND -I 12T 0 q• TOP PLATE gyp p� +LANDING Z S AO /2 3/4 T G A' d DVA � Z PLQ R CONSTRUCTION 01 1 O 9' GLUED 4 NAILED (3)2x10 MDR N 9/4 T4G ADVANTECH y + O GLUED ENGINEERED m GLUE•ENGINEERED FLOOR JOISTS PER GARAGE FLOOR JOISTS PER ry V SUPPLIERS SPECS/DWGS. m SUPPLIERS SPECS/DWGS. GARAGE R-90 INSUL. 1.. 12'BATT R-513 INSUL. ^ qy LQ •� 1--i cO 4'CONC.SLAB OVER •4'CONC.SLAB OVER .y' •O 11 - 6 MIL.POLY BARRIER 4 6x6 WWM TOP OF FND O 6 MIL.POLY BARRIER 4 TOP OF FND IF'+✓1 O � IST FLOOR CONSTRUCTION 3/4'T4G ADVANTECH r-- ?' q'_p' PORCH FLOOR CONSTRUCTION _ "•� y3 GLUED 4 NAILED - in o 2'RIGID INSUL. B/4x6 AZEK DECKING i-1 rr 2.10 FLOOR JOISTS r- (_ v SCREWED AND PLUGGED M R-90 INSUL. .......... .. ON PT 2XIO FLOOR JOISTS ;• dA 'p AT 12'ON CENTER 4'CONC.SLAB OVER 16'xq'CONTINUOUS ,x 6 MIL.POLY BARRIER 4 CONC.FOOTING 16'xq'CONTINUOUS CONE.FOOTING y CCTIPACTED 801E (SEE FND.PLAN) 3 (SEE FND.PLAN) BUILDING SECTION 'A' BUILDING SECTION 'B' SCALE,1/4'•1'-0' SCALES 1/4'•1'-0' STRUCTURAL RIDGE (2)1-3/4'x11-7/8'LVL 12 12 / / FINISH DECKING SECURED / WITH SHORT SCREWS TO 12 / COUNTER-TAPERED PT 2x4 0 12'- 7.75 / OVER A 10•STRIP OF O COLD ASPHALT MASTIC EPDM MEMBRANE 2x10 CEILING JST AT 16'OC OVER TAPERED RIGID FOAM AND UNVENTeD HOT a0op, UP WALL 10-24'. 9'CLOSED CELL FOAM(R21) / INSTALL MEMBRANE 6'BATT INSULATION(RI9) 4f- PER MFGR 5 SPECS (�� 12 ROOF CONSTRUCTION TAPERED RIGID FOAM rygTCM� 2 TO RAFTERS 0 I6'O.C.W/ 1/2'COX PLYWOOD SHEATHING O y AS REQUIRED FOR EXIST ICE+WATER SHIELD IST 56' i/B'PER 12 PITCH CUPT'NUE ROOFRUBBER SLOPE Igo FELT PAPR Q� Q AWAY FROM MOUSE 90 7R.ARCHITECTURAL _ _ LAP WITH SHINGLES ROOF SHINGLES 10i_p. ? O O O O m ATTIC ROOF �B 2xe RAFTERS 016 OC RAF Na �_ o� Nul C j pE K 9/4•SLl UBFLOOR 2x6 JOISTS 016'OC 2 4 DECK 3 BEDROOM 2xB FTERS 016 OC (9)2x10 BEAM 2x10 JOISTS 016'OC 2xi0 CEILING JOISTS 016'OC POSTS ATTACHED WITH O ON AC POST CAPS(ACE ALIGN TOP OF BEAM STEEL BEAM O ^ ^ CAPS AT CORNERS)TO (2)2x10 MDR (5) x10 MDR WITH TOP OF WALL TOP PLATE HEADER ABOVE O N ' (9)2XIO KD BEAM (9)2x6 HDR SCR EEN C N 9/4 T ADVANTECM s GLUED 4 NAILED IIMPSON LSTA-15 STRAP 6 o SCREEN FRONT II-7/8'ENGINEERED FLOOR J018T8 PER AT POSTS _ IO'-4' S l BATT B SUPPLIERS S E S/DWGS. a PORCH O RC N PORCH O RC H I� 2xS PT JOISTS 016'OC 2xi JOISTS 16'OC _ (9)2x10 PT BEAM n L'• 11 (5)axe PT BEAM GARAGE BUILDING SECTION 'El FIN.GRADE 2x10 PT JOISTS 012•OC TOP D SCALE,1/4' 1'-0' CRAWL SPACE SECTIONS i 15'-q• 16-y B-6 ' _ 10'DIA.SONOTUBE ''- FORMED CONC.PIERS 24'DIA.BELL G. I I FORMED CONC.PIERS 40 MIN.BELOW GRD. BUILDING SECTION D W/24'DIA.BELL FTG. `1N 0f 48'MIN.BELOW GIRD. SCALE,1/4' 1'-O' V- o�pp41ENICW. a peANCfLO ,. BUILDING SECTION 'G' sy dSTR al "` p A ^.� SCALE,1/4' I'-0' HL CUSTOM F V CUPOLA 44� CAFE ODD'9 How 11UBIImt GABLE VENT 24 School Simt PO Box 4B8 . We3t Dennl6,MA 02670 1:508.394.3080 CLEAR-GRADE 1:608.780.7406 IXISTING 1 ,PROPOSED WHITE CEDAR • SHINGLES S'T.W. 1I 6'BOX RAKE ' 1 WITH 1X9 TRIM .- 1 I x S SUB RAKE 1 / , A AL 12 YEAR ARCHITECTURAL 1 ASPHALT SHINGLES;RAL / FAV% 1 / .TRACK 12 . 1 1 1 TOP]PLATE,FAUX9LIDI I x 6/6 CLOFT DOORS .BOARDS PA DOOR 14 LIGHT RACK TOP PLATE ' - ® NSOH 4.4 PT POST ....�� Cd PINEH PWIT IN ® h TOP FND �— N P.T.WOODD'I I 11 I I I I IXB RED CEDAR I x N FRAMED S7 P9 FAUX SLIDING MMM 1 11 I I I 11 I II V-GRo6✓e I I 11 1 I I I II BARN �RO II Il ---------+-I------+-14------=--------------------------ti , ' M u ---------- —————— I U---------------------------------J ----------------------'-------------------------1r---------�, NORTH ELEVATION ' i------------------------------------------------- ---------L SCALE- 1'-0' EXISTING 1 PROPOSED EXISTING 1 PROPOSED 1 1 W I N D O W S C H E D U L E 1 I I TAG SIZE ROUGH OPENING NOTES QTY. 1 I I 1 j A AXEI 2'-7 1/2'x 2'-7 1/2' 4 1 1 I B 24,12 2'-6 1/B'x 4'-4 7/6' 4 C 2646 2'-B 1/8'x 4'-B 7/B' 4 1 I 50 YEAR ARCHITECTURAL I 1 I ASPHALT SHINGLES, TYP. I D CW18B 2'-4 9/6'x 6'-4 7/8' I 1 I I I E CXIS6 2'-7 1/2'x 5'-4 7/8' 4 1I I I 0 IxS FASCIA 1 ,pI AND SOFFIT I ff I I 1 WINDOW SIZES BASED ON ANDERSE4 m OWNER TO SELECT MANUFACTURER,COLORS AND ACCESSORIES. N O J AT LEAST ONE BEDROOM SHALL HAVE 3.3 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING 1 SHALL BE 20'IN WIDTH 6 24'IN HEIGHT AND SHALL HAVE A BILL HEIGHT.NO7 GREATER THAN 1 x B FRIEZE BOARD w/ 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER. j I-1/4'BED MOULDING Co ul 5 2 PROVIDE EXTENSION JAMBS FOR WINDOWS IN 2 x 6 WALL'CONSTRUCTION Q y r - o i D O O R 5 C N E D U L E 1 TAG TYPE SIZE ROUGH OPENING' NOTES 1 1 i FIBERGLASS, INSULATED, 12 PANEL 90uB SEE SUPPLIER FROM PORCH DOOR , 2 FRENCHWOOD GLIDING PATIO DOOR FWG6060 6'-0'x 6'-B' ONTO ROOF DECK 1 B FRENCHWOOD GLIDING PATIO DOOR FWG12068 12'-O'x W-B IN DINING ROOM 1 4 FRENCHWOOD HINGED PATIO DOOR FWHGO66- 6'=O'x 6'-B' INTO SCREEN PORCH ELEVATIONS I I I I I I I OUT . 1 I I �.-1L-------------- --------IT SHOWER ------------ ------------ 1 LJ L—J-----------------------------------1'------------J IXISTING 1 PROPOSED • NEST ELEVATION f'�1 . 1 SCALE,i' I'-O' . ' REEF - CAPE COD'S HONE BUDDER ' PO Box 188 PROPOSED 1 EXI9TIN6 Weer Oennls,MA 02M L•SOU 4.3090 . I - t 508.760.1408 1 , 12 12 . 12 D .CLEAR GRADE� 8 WHITE CEDAR 1 . SHINGLES B'T.W. 1 / 90 YEAR ARGHITETURp1ILJ - TOP PLATE �-PHALT SHINGLES,Tl�. O O O O SS CABLE RAILS m TOP BUBPLR 90 YEAR ARCHITECTURAL TOP PLATE ASPHALT SHINGLES,TYP. 0 . OO O O O O (Di PROPOSED SS EXIST. m m CABLE RAILS F .] ALUMINUM SCREED ENS TOP FWD EXISTING DECK ~ . I I B'x 4' I I SHOWWERR rl--rL---------------- --------------1r--_------- --- L— L---------------- —— _ ——— SOUTH ELEVATION T�---------------------------- --rt-- . --- x SCALE.;'.1'-0' v------------ -- Ft-------�-J----_---ram LJ . ----------------- -------II . PROPOSED 1 EXISTING _ L J ------1------ P, • LJ PROPOSED i EXIBTIN6— J W I N D O W S C N E `D U L E i j TAG SIZE ROUGH OPENING NOTES OTY. A AX01 2'-7 1/2'x 2'-7 I/2' 4 / I 90 YEAR A ITECTURALJ B 2442 2'-6 1/8'x 4'-4 7/6' 4 ASP14ALT IN- G 2646 2'-B 1/8'x 4'-B 7/B° 4 J.� D C 4155 2'-4 5/8'x W-4 7/11' 1 E CX185 2'-7 1/2'x W-4 7/8' 4 D m ' 99 CABLE RAILS O O , ♦ .E 1 1 .. O 0 . WINDOW SIZES BASED ON ANDERSEN N Z OWNER TO SELECT MANUFACTURER, COLORS AND ACCESSORIES. A 6. - AT LEAST ONE BEDROOM SHALL HAVE 3.3 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING V• SHALL BE 20'IN WIDTH 4 24'IN EIGHT AND SHALL HAVE A SILL HEIGHT NOT GREATER THAN OU Q 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER. PROVIDE EXTEN910N JAMBS'POR WINDOWS IN 2 x fi WALL CONSTRUCTION H m p 'M NUM 1 EXIST. D 0.0 R S C N E 'D U L E .. FRAMED ' ' SCREENS TAG TYPE SIZE. ROUGH OPENING .NOTES de , I FIBERGLASS, INSULATED, 12 PANEL 9066 SEE SUPPLIER FRONT PORCH DOOR ' 2 FRENCHWOOD GLIDING PATIO DOOR FWG6065 6'-0°x 6'-B° ONTO ROOF DECK TLI - 9 FRENCHWOOD GLIDING PATIO DOOR FWGI2065 12'-0°x 6'-B' IN DINING ROOM 4 FRENCHWOOD HINGED PATIO DOOR I FWH606B' 6'-0°.x 6'-B° INTO SCREEN'PORGH ELEVATIONS . I1—=.----- — -- --------'--'f— I ' EAST ELEVATION ; A 1 /A/ SCALE,;".1'-0• 1 '--------------------------------=—� _ / ■ ■ i1 L---------------------------- --- —J ' i PROPOSED 1 EXISTING J 24'-0' W-0' D A3.1 E e'x 4' OUTDOOR 6HOWER CAPE CODS xmm BUBD®l O 24 School StroaI A A PO Box ISO Wort D4nnlo,MA 02870 t:BOB.J84.3080 _DE I t:SOB.780.1908 � _ T uNOIER SLAB IXISTING 1 PROPOSED— WATER LINES A3.1 a b HEAT c 9'-2' 4' 3'-2' 4' 2'-10' 4' 9'-' 4 M W12x40 STEEL BEAM ABOVE(B'F 4E) IrI � r ml I I...P.L. — - - --- L I P05T TYP. I POINT LOAD FROM RIDGE v IQ,W I Z PROPOSED y K Q m SCREEN Q z°a PORCH _ 103 HEAT e I I DET. I m PROPOSED GARAGE -1 4'CONC.SLAB WITH 6x6 4'-0' 7'-0' iv i O B 1 I\ WWM OVER 6 MIL.POLY B �"',., U co O EXIST.WIN. O O O I 0.— SWI�J AB.1 IDN i— A3.1 `O Q J 1 I I DW — \ I WI2x30 STEEL BEAM ABOVE(6'FLANGE) co 000 TRI _ T I I 1! I M cd 6- 0 K II _ COATS 3 G N 96°RANGE POINT PSL LOAD 6x6 6 PSL PROPOSED w ,� POST FROM RIDGE POST xi Yd EXISTING EXXISTTI H INGGM KITCFIEN �_____ DINING EARTH Ir ,I II / / \\ UP ROOM ROOM I IL--- m'-e' cd m I II___ 4 1L ______J 1 I II SMOKFJCO - I II L_______- \ / 11 DET. II i I I AS.1 6 HEAT II I PROPOSED — DIET. I I I ENTRY ' Fi1 7 = II ° ______________________ II _ __WAD (3)2X6 POSTS ___ _ wne III 1 TIL m TO HEADER ABOVE i REF FRZ PANTRYBARND 2 14 LIGHT ER Oi OB TRANSOM O TEMPE LIFE .. rit � A A 4'-10• 7'-B' 7--El' 1'-4' IXIST. EQUAL EQUAL i OPENING 25,_6' 3 0 _ I PROPOSED EXISTING EXISTING BEDROOM m COVERED ENTRY LLYI JLCI PROPOSED O ROOM SMOKE/CO OFFICE —— ® _—— —_ ® ———— ■ DIET. i GRANITE STEP ' ILIST IXIST.WIN. IXIST.WIN. N. EXIST.WIN. I C, q3.1 �IXI5=1NG 1 PRO=ED� —LP O y PROPOSED Ef FIRST FLOOR ADDITION �� z SCALE.i' I'-0' N sD O ¢ W I N D O W S C I-I E D U L E D O O R S C N E D U L E m o $ TAG SIZE ROUGH OPENING NOTES OTT. TAG TYPE SIZE ROUGH OPENING NOTES 0 A AXSI 2'-7 1/2'x V-7 1/2' 4 1 FIBERGLASS, INSULATED, 12 PANEL 906E SEE SUPPLIER FRONT PORCH DOOR m B 2442 2'-6 I/B'x 4'-4 7/8' 4 2 FRENCHWOOD GLIDING PATIO DOOR FW06068 6'-0-x 6'-B' ONTO ROOF DECK C 26" 2'-S 1/0'x 4'-B 7/8' 4 3 FRENCHWOOD GLIDING PATIO DOOR FWG12068 12'-0•x 6'-5' IN DINING ROOM D CW16 2'-4 B/B'x 6'-O 3/8' TEMPERED 1 4 FRENCNWOOD OUT5WING HINGED PATIO DOOR FWH6065 6'-0'x 6'-B' INTO SCREEN PORCH E CXI3B 2'-7 1/2'x W-4 7/6' 4 B FIBERGLASS, INSULATED, 9 LIGHT 5068 SEE SUPPLIER REAR GARAGE DOOR 6 FIBERGLASS, INSULATED, 4 PANEL 30" SEE SUPPLIER GARAGE/HOUSE FIRE POO FIRST FLOOR PLAN WINDOW SIZES BASED ON ANDERSEN OWNER TO SELECT MANUFACTURER, COLORS AND ACCESSORIES. AT LEAST ONE BEDROOM SHALL HAVE 3.5 SO.FT.NET CLEAR OPENING.NET CLEAR OPENING SHALL BE 20'IN WIDTH'.2 IN HEIGHT AND SHALL SILL HEIGHT NOT GREATER THAN t A /1■ 44'.VERIFT ALL ROUGH OPENINGSGS WITH SUPPLIER. HL PROVIDE EXTENSION JAMBS FOR WINDOWS IN 2 x 6 WALL CONSTRUCTION REEF ' 24 School Seeel PO Box 166 W441 Do9019,fM 02670 1:SM.304.3090 1:506.760.1406 C 4,6 6L POST FROM A9.1 RI E TO STEEL 14i-pe BEA O BELOW C OC C v m I� mW 13 �I, PROPOSED VI I o 0 1 = BEDROOM P PROPOSED W. 2 ROO DECK ''I m 8 b CLST y I m I _ `` SMOKE 9'-10' 6) g O m I I 4 6 PSL POST F ON RIDGE TO A3.1 TEMPE I1' 4'-0' SS BEA EL ESL M __________ _ __ p I. _ 1�__ -� __ _ DN I COFFEE H .� �] 'Cco 11 I f I I 1 _ —119fr1trEmm En cd G !Al INEN 3 0) Z C S 6 1 � 7 i SHLF W/D I LH BATH I I bDLED— M _ 1 I m b m r - - I. -III -- 1 I 4 _ A PU -Dh�! I I A. 1 1L I �+ EXISTING - --♦•---- U7 s HATH q 4-3• B'0' —r �1-6. 1 A3.1 g9 i I 2'-2' Vj J n 1 H BATH I 64•WAN �' I 76 42 ^ SMOKE SMOKE I EMPERED TEMPERED J (9))5 1-9/4'x7-1/4'L 11 I B HEADER IN FLOORq x6 PSL P TO II'_6• J----- ------------ O ABOVE WIN.TRANSOM FROM RI E TO -•.I EXISTING �¢� EXISTING ---------1----------------- LVL IN P R BEDROOM BEDROOM 6'-10• 12'-4' 26'-0' SMOKE/CO J �I DET. PRO SECOND FLOOR ADDITION HALNLG � • SCALE.�• 1'-0' r- EXISTING SECOND FLOOR SCALE,i' I'-0• EEr t m p • O o N Z W I N D O W S C H E D U L E D O O R S C H E D U L E I c TAG SIZE ROUGH OPENING NOTES OTT. TAG TYPE SIZE ROUGH OPENING NOTES m o m 0 A A%61 2'-7 V2'x 2'-7 1/2' 4 1 FIBERGLASS, INSULATED, 12 PANEL 9066 SEE SUPPLIER FRONT PORCH DOOR m B 2442 2'-6 I/6•x 4'-4 7/6' 4 _ 2 FRENCNWWD GLIDING PATIO DOOR FWG6066 6'-0'x 6'-6' ONTO ROOF DECK C 2646 V-6 I/6'x 4-6 7/6' 4 9 FRENCHWOOD GLIDING PATIO DOOR FWG12065 IV-0'x W-6• IN DINING ROOM D CW16 2'-4 3/6'x 6'-0 9/6' TEMPERED 1 4 FRENCHWOOD OUTSWING HINGED PATIO DOOR FHH6060 W-0'x W-6' INTO SCREEN PORCH E C%199 2'-7 1/2'x 9'-4 7/6' 4 6 FIBERGLASS, INSULATED, 9 LIGHT 3065 SEE SUPPLIER REAR GARAGE DOOR 6 FIBERGLASS, INSULATED, 4 PANEL B068 SEE SUPPLIER GARAGE/HOUSE FIRE DOOR SECOND FLOOR PLAN WINDOW SIZES BASED ON ANDERSEN ' OWNER TO SELECT MANUFACTURER, COLORS AND ACCESSORIES. AT LEAST ONE BEDROOM SHALL NAVE 9.3 SO.PT.NET CLEAR OPENING.NET CLEAR OPENING SHALL BE 20'IN WIDTH 6 24'IN HEIGHT AND SHALL HAVE A BILL HEIGHT NOT GREATER THAN 44'.VERIFY ALL ROUGH OPENINGS WITH SUPPLIER. _ A /� PROVIDE EXTENSION JAMBS FOR WINDOWS IN 2 x 6 WALL CONSTRUCTION ' /` J. AkL REEF CAPE COD'S HOHB BDODDI 24 School Swot PO Boa 186 We,Da—b.MA 02870 1:508.394.3080 t 508.760.1406 D 43.1 24'-0' ———————— ——————————— 9 -1- �EXISTIN4 TFR---ED� ap I I WATER LINES • I A3.1 P ojl I I I la m o 3 —_--- 10•DIA.SON LEE FORMED CONC.PIERS I I I I L y W4B'4MIN.BELOW 4RD. I I I I I W I I Q co PROPOSED GARAGE I la 2 x co m 4'CONC.SLAB WITH 6x6 13'-6' '-B' WWM OVER 6 MIL.POLY I I , I I/ID x °a I I •'i a $;5 I DNN � mFm :•DROP 16• ————————— — ' I I F-1 I I IQ m UP I I a I 1[[y3 8'-10• EXISTING PROPOSED A — EASEMENT CRAWL SPACE �I ——J I 31 B WALL: B' ALLI Q,r O C /,L———— C ——————————————J P N j I I.WALL.'.'.. ... ...•. '.. ' , .....' � I (r J' -------------------- m. N l. UP 5MOKE/CO —— ————————— DET. 25'-6' O B'6• 6-B' �• s IO'DIA.5011011112 C I FORMED CONC.PIERS Q j W/24'DIA.BELL FTG. 1 4B'MIN.BELOW GRD. 0 p m PROPOSED O I MI5=1NG PROPOSED 56'-0' P FOUNDATION PLAN m r SCALE. I'-0' h FOUNDATION PLAN A2.2 L AkL STRUCTURAL RIDGE (2)1-9/4'zil-7/0'LVL ()STRUCTURAL 9 4'�L RIDGE 8'LVL GPO COD'8lUMe BVBDBt UNVENTED HOT ROOF 12 UNVENTED HOT ROOF, 24 Scho0l Stroot 3'CLOSED CELL FOAM(R21) 3'CLOSED CELL FOAM R21) PO Box 18B 6'BATT INSULATION(RI9) i2 / 6'BATT INSULATION(Rlq) west Dennla.MA 02670 t:50B.3B4.3000 508.760.1408 12 ROOF CONSTRUCTION ROOF CONSTRUCTION 12 2 10 RAFTERS o 16'O.C.W/ 12 / 12 2 0 RAFTERS 06'O.C.W/ 1/2'CDX PLYWOOD SHEATHING / 1/2'COX PLYWOOD SHEATHING 2 x 10 O 16'O.G. iga PELT PAPER TeR SHIELD IST 96° 7.75 ,,..aa4Q / MECH, 12 19a PELT PAPER TER IELD IST 96' CEILING JOISTS AREA 90 7R.ARCHITECTURAL ROOF SHINGLES i AREA ROOF SHINGLES 2M0 CEILING JET AT 16'OC H2.8 CLIPS O / 142.5 CLIPS 0 EACH RAFTER // ® EACH RAFTER m 6'-q' TOP PLATE - o TOP PLATE - EE v - 1'-10' b m o m ROOF J 4 DECK BEDROOM CLOSET TOP SUBFLR TOP SUBFLR M STAIR DETAIL, J TOP PLATE 14R O 7 1/2' STEEL BEAM BEYOND = 12T 0 q' TOP PLATE -_ Z 9 t D1//=i�- 2ND FLOOR CONSTRUCTION = +I1J1DIN4 pyry1R CONSTRUCTION Y 3/4-TAG ADVANTECN (3)2xI0 MDR 1- 9" TiG 4DVANTECH y N 0 q' r� GLUED 6 NAILED N GLUED 4 NAILED h m II-7/8'ENGINEERED it-7/B'ENGINEERED V FLOOR JOISTS PER GARAGE FLOOR JOISTS PER , U SUPPLIERS SPECS/DWGS. m SUPPLIERS SPECS/DWGS. m Q GARAGE R-30 INSUL. f 12'GATT R-36 INSUL. s- _ _ G] vi 4'CONC.SLOB OVER b I 6 MIL.POLY BARRIER 4 4' L. SLAB OVER ry 6x6 WWM TOP OF FIND c 6 MIL.POLY BARRIER t - - -- � - - 6x6 WWM - - TOP OF FND IST FLOOR CON5TRUCTION -- 5/47 TAG ADVANTECN f--- ? 4._p. PORCH FLOOR CONSTRUCTION r' i GLUED 4 NAILED 0 2'RIGID INSUL. 0/4x6 4ZEK DECKING D�10 FLOOR JOISTS r-- - SCREWED AND PLUGGED M I_ R-30 INSUL. ON PT 2.10 FLOOR JOISTS a' AT 12'ON CENTER 4°CONC.SLAB OVER I6'xq'CONTINUOUS 16'xq'CONTINUOUS 1T4 6 MIL.POLY BARRIER 4 CONC.FOOTING CONC,FOOTING y COMPACTED SOIL (SEE FIND.PLAN) (SEE FND.PLAN) 26'-0' BUILDING SECTION 'A' BUILDING SECTION 'B' SCALE.1/4'-1'-0' SCALE.1/4' -I'-O' STRUCTURAL RIDGE (2)1-9/4'x11-7/0'LVL 12 12� / FINISH DECKING SECURED 12 / WITH SHORT SCREWS TO 77S GAUNTER-TAPERED PT 2x4 O 12'- OVER A 10'STRIP OF COLD ASPHALT MASTIC EPDM MEMBRANE 2x10 CEILING JST AT 16'OC OVER TAPERED RIGID FOAM AND UNVENTED HOT ROOF, UP WALL I6-24'. 9'CLOSED CELL FOAM(R21) INSTALL MEMBRANE 6'BATT IN5ULATION(Rlg) PER MFGR'S SPECS 12 ROOF CONSTRUCTION 2 x 10 RAFTERS 0 16'O.C.W/ HATCH O TAPERED RIGID FOAM 1/2'COX PLYWOOD SHEATHING ra A5 REQUIRED FOR EXIST ICE WATER SHIELD IST 36' t9 CONTINUE RUBBER o I/BAWAY PER M PITCH UP ROOF SLOPE IBtt FELT PAPER �L - u tb AWAY FROM HOUSE 90 7R.ARCHITECTURAL KK LAP WITH SHINGLES IC ROOF SHINGLES 10'-0'ATT v O8 N Z. O ROOF 5 2xe RAFTERS 016 OC ROOFDECK m mQ N 3/4'SUBFLOOR 2.6 JOISTS 016'OC -BtB i2 PECK m BEDROOM rn wm44 2xB FTERS 016 OC O ul 2xIO JOISTS 016'OC fiy 2xIO CEILING JOISTS 016 OC - - - a (3)2.10 BEAM ALIGN TOP OF BEAM STEEL BEAM C (2)2x10 MDR— i (3) dO HDR WITH TOP OF WALL TOP PLATE - ,~ I I ELQp (9)2x10 KD BEAM CONSTRUCTION o (3)2x6 MDR SC 9/4 T4G 4DVANTECH m PORCH GLUED 4 NAILED v a - FLOOR JOISTSEPER (9)2z10 PT BEAM RED SC V FRONT I I 10'-4' SUPPLIERS SPECS/DWGS, h P.T-b 6 PORCH Q PORCH I I 2xB PT JOISTS 016'OC �` 12'BATT R-98 INSUL. POSTS W/SIMPSON = Zrl I5T5 16'OC - POST BASES o .L APPROX. (9)2x0 PT BEAM GARAGE BUILDING SECTION 'El FIN.GRADE 2.10 PT JOISTS 012'OC � O ND SCALE.1/4' -1'-0' CRAWL SPACE SECTIONS = III'DIA.90NOTU.E v FORMED CONC.PIERS 10'DIA.SONOTUBE W/24'DIA.BELL FTG. FORMED CONC.PIERS 48'MIN.BELOW GRID. BUILDING SECTION 'D' W/24'PIA.BELL FTC. 1 48'MIN.BELOW GRIP. SCALE.1/4'-1'-0' BUILDING SECTION 'C' A/\J SCALE.14'.I'-o' / 2.3 I t -010 •' ., .r .. ..:�<1': `a` .nr. .rr' .r7":^::,o<:h' :Yi ^�`- '•cc '• .b,r �. ., r :...... :.. .ti�r..:..:T. - �.�•+�•. ._��. y�r�'.5.:-� _ - lam'.:.: t. .. .:... ,\ PROPOSED , N ty c� HOUSE 'Ploy' Nib . D . . � �! tom; �'� N�-Zi�'`.� r �,,,4i �-?�- �� --�'J``►,{-*� �--� -�� --' - " L 71(a7- l 2 0 01 , 19 4 47.4 I I West Barnstable, ZONING TABLE Vegetated Wetland - Storm Runoff � k I _ BENCHMARK: M Top of PK Nail in Pavement LQCUJc AP-AQUIFER PROTECTION OVERLAY all, � _ ' EL=50.0± (1988 NAVD) vats 47.3 RF- RESIDENTIAL DISTRICTS /,L REQUIREMENTS: x-46 6 �x 7.5 I ��N��a�Or LOT SIZE 43,5G0 SF - - FRONT SETBACK 30 FEET Edge of Wetland SIDE SETBACK 15 FEET REAR SETBACK 15 FEET / BUILDING HEIGHT 30 FEET Holway Drive FROWIDTH AGE 150 FEN (40, Wide -Private Ro Way) m Existing Driveway - 6q 6�, TO BE MODIFIED 50.9 O PROPOSED COVERAGE 50 . � NOT TO SCALE LOT AREA 35,200 SF �' 50.1 _..�� , 51.1 48.9 1 G0.00'/ BLD. COVERAGE: 0 PLAN BOOK 249 PAGE 107 HOUSE 1,081 sF N DEED BOOK 31275 PAGE 149 SHED IIG SF �; _ ---- ---- --- %� ASSESSORS' MAP 1 3G PARCEL 39 NEW GARAGE =Buffer 0.4 Post an Rail Fence ENTRY WAY ` 52.6ED PORCH 1,417 SF \ rn TOTAL 2,G 14 SF \ �0_ --" 31: LEGEND 9�x / x 52.8 0 - BLD. COVERAGE=(2,G 14/35,200)X 100%=7.4%± 4 �/ I x 5 ,6 x 53.0 _173-21 EXISTING CONTOUR c� A ndscaped / I v 32 PROPOSED CONTOUR ea 53.5 I /O � xi2.34 _- EXISTING SPOT GRADE c� / I 1 3.0 24x5 PROPOSED SPOT GRADE 52. x 53.0 53•1 -w- WATER SERVICE LINE s� rn -o- OVERHEAD UTILITY SERVICE s2,6 Cb 526 I I �' I+ -U- UNDERGROUND UTILITY SERVICE 2.7 -G- GAS SERVICE LINE 52.9 I I TEST HOLE/ BORING LOCATION ST SEPTIC TANK 100' Buffer o ru DB DISTRIBUTION BOX �� n Zone: BVw _,_ _ .- ' fax 53.0 `s I x 53.3 52 7 SAS SOIL ABSORPTION SYSTEM 52 7 x s Ot�� I c\E 53.1 Reserve RESERVED FOR FUTURE '46 X s2,8 `� UTILITY POLE Cca 1 f53. ® CATCH BASIN NO I c \ 31 .2'± 52a4 � FIRE HYDRANT N I 53.0 ° f 53.2 _ WELL N 52.5 ' 0 DRAINAGE MANHOLE O I � FARMERS PORCH x sz.7 ■ CONCRETE BOUND, FOUND O 44.7�± Existing 3 Bedroom _ Dwelling, TOF EL=54.2± � TOP OF BANK -x-=- LIMIT OF WORK x 52.3 N 521 No FENCE PROPOSED 51.7 `�`�^^ EDGE Of CLEARING GARAGE *ENTRY 49, 00 • WAY ADDITION 1 g2 Exis ng UG Electric -J Well E�-E�i E'er-.5 15 TOF EL= 54.2-± r -'�.;- \. 2.9 X 47.0\� X 0.5 T05 EL=53.2± x 50.2 SOb 0 49.2 �O c4 ,5 Septic Taink L� _j \ i x 46.7 x 49.4 51.1 IBox p 1.1 r------1 �d 47.9 49.2 Existing Well ,SAS - O7 TO BE PLACED I �� IN H2O RISER 52 COVER TO GRADE I i 0 x 46,5 Basketball x 50,6 // � 19'5 - I Q co Court I w �----�--� .7 46.2 x 44.4 �P�ZN OF 3 Concrete Slab Shed 131 TO BE REMOVED M. � yc x 45.0 JOHN M. in Edge of Glearin j O'REILLY 51,0 51.5 4 x 47.3 CfVIL t i 0.5 38200 PLAN x 50. � 50 �ALg SCALE I��=20' X 47.0 Existing Septic Per Health Records m � 48.4 lt6 I+ I+ �� Hagerty Residence �� x 45.2 31 Holway Drive, West Barnstable, MA 02G3 I CONSERVATION AREAS LOT 24 Area=35,200 5f PROP05ED SITE PLAN 0-50' BUFFER VEGETATED WETLAND 3 I holway Drive, West Barnstable, MA PROPOSED ALTERATIONS 0 SF ••..... 160.00' J.M. O'REILLY & ASSOCIATES, INC. 0 20 40 60 Professional Engineering & Land Surveying Services 50-100' BUFFER VEGETATED WETLAND PROPOSED DRIVEWAY 193 SF SCALE 1 "=20' 1573 Main Street - Route 6A P.O. Box 1773 (508)896-6601 Office Brewster, MA 02631 (508)896-6602 Fax DATE: SCALE: BY: CHECK: JOB NUMBER: GAAAjobs\Ha6jerty3 I Holway859 1 Propo5ed51tePlan.dwj 9/1 2/18 As Noted MTF JMO JMO-859