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1671 OST.-W.BARN. RD
D �rF'Vl i OxfordNO. 152 1/3 ORA ESSELTE 10% e_ ® o O 7- =- - M ;� C f S f n �, _ .. � a {� vim. �l t 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' SAANSTA M" Posted Until Final Inspection Has Been Made. 39. .1 Y.- y.~ Permit i6 � Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. -_ I Permit No. B-19-296 Applicant Name: Mark Mordini Approvals Date issued: 01/28/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/28/2019 Foundation: Location: 1671 OST.-W.BARN.RD,WEST BARNSTABLE Map/Lot: 128-038-W00 WM Zoning District: RF Sheathing: Owner on Record: MCGUINNESS, PATRICK L&SUNNY K F Contractor Name ,MARK E MORDINI Framing: 1 Address: 1671 OST.-W.BARN. RD Contractor License: CS-057645 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $7,840.00 Chimney: f Description: replace all fascia (250'), replace all soffit(130'),gutters and ��'� Permit F e: $39.98 Insulation: downspouts(250') 5 Fee Paid: $39.98 Project Review Req: Date: %E 1/28/2019 Final: Plumbing/Gas .z Rough Plumbing: kBuilding Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sic months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. 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. �`- ff Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:; Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: ' Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT PROJECT NAME: ADDRESS: PERMIT# O cl PERMIT DATE: 1 �L)O O . M/P: LARGE ROLLED PLANS ARE IN: BOX ( � SLOT SI� � Data entered in M ro p g ram on. /ILIAPS BY: q/wpfiles/forms/archive i f01°eo a: ooSolarCity December 18, 2015 Town of Barnstable e ATTENTION: BOLDING DEPARTMENT ���Q�N 200 Main Street c QQ�p Hyannis, MA 02601 40CC3 T ? #S,RE: 1671 Osterville-West Barnstable Road, Marstons Mills OF B Permit No.: 201309516 �RNST Our lob No.: JB-026182 �e�F NOTICE OF CANCELLATION This letter is to certify our proposal to install Solar(PV)at the above-referenced property has been moved into a cancellation status. SolarCity Corporation and Patrick McGuinness will not be moving forward with the proposed installation at this time. We would greatly appreciate reimbursement for the permitting fees paid, but understand that the town,will not refund any fees. If you have any questions or concerns, please don't hesitate to contact me. Thank you for your attention to this matter. Sincerely, CheryCGruenstern Cheryl Gruenstern Permit Coordinator SolarCity Corporation cgruenstern@solarcity.com Telephone: (508)640-5397 t .r t1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d DD Parcel lic ion # r Health Division Date Issued 1^2, �� 0 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 101 � Gl Skill l2 J�D-1 �i eyX t e- 1�t not Village 1 1 laf ADn mI is /.tJ Owner rl6L Address j(o-11 05-6111e k)e,4 6V1 &6k, [, Telephone 506-9151-Q 80 Permit Request hAaAll Solar eLe�G PagOP ©n non E O-`i Pxl s-h rya h � b2 1 n rcz)n ned�d ek& nA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ?:000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes X No On Old King's Highway: ❑Yes No Basement Type: ❑ Full ElCrawl ElWalkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count rvl* Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing �i nevA size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other cn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w Commercial ❑Yes l No If yes, site plan review# �^w ` Current Use ( Proposed Use f ' SOlox M APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Mrv, Telephone Number Address a45+- M-fl gl� a ( )n i+ 1 License # OqS SN b0QD(L\k,)M8 O175 A Home Improvement Contractor# )(_0�57a (a lrl'it°�-1 @ Solof Gom Worker's Compensation # QA IPQ DO&Wb 56Z3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO FOB 501 Of ft4q dQ MaC41 6 1 A c;L Onif I Madbcfo yA k, MIA 6 57�_ SIGNATURE DATE 4aJ 1cy1I- FOR OFFICIAL USE ONLY APPL*tCATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER G DATE OF INSPECTION: PFOUNDATIONICAFUkh. he lWDIRK, N FRAME - k JNSULATION:,_-; FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i _ , 10 �-- SolarCity. OWNER AUTHORIZATION Job ID: Location: Z. r 1 a"�`���� • W C �n'��S S G as Owner of the subject property hereby authorize SolarCity Cori)—HIC 168572 to act on my behalf, in all matters relative to work authorized by this building permit application and signed contract. Signature of Owner: Date: 24 St Martin Drive,Building 2 Unit 11 Marlborough,MA 01752 T (888) SOL-CITY IF (508)460-0318 SOL ARC ITY.COM AZ ROC 243771,CA CSLB 888104.00 EC 8041,CT HIC 0632778,DC HIC 71101486,DC HIS 71101488,HI CT•29770. MA HIC 168572,MD MHIC 128948,NJ 13YH06160600,NY WG24624H11,OR CC8 180498,PA 077343,TX TDLR 27006,WA SOLARC•91901 _ f t �1,...: .... � t f 3 T J�f yuaa-.1.I_I I I �r it y� �\ f11 �rain�. � r. i �Q Z 4> ft 3 17 hm ����� t}•gat, 04 IQ' r ll{}}{ lP i 5 y ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ~Map VZ v Parcel w�w pp A lication Health Division Date Issued b a O Conservation Division Application Fee J� Planning Dept. Permit Fee 51 o•a Date Definitive Plan Approved by Planning Board voe/Z� Historic -' OKH Preservation / Hyannis © �g Project Street Address 0 f 8d C/LfJ �le, xz::2 Village �-- Owner Address /O9��I�n a�S'L— �/V• Telephone ° Permit Request ;fiG A-It i"`1�2i®� /� i .Nei.0 e. t2s/�-- o ! L-J r dt e'Lo S ,/ L e Square feet: 1 st floor: existing proposed 2nd floor: existing 24. proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 660 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. s"Y Dwelling Type: Single Family Two Family ❑ Multi-Family( units) Age of Existing Structure Historic House: ❑Yes VNo On Old Kin 's Highway: ❑Y 9 9 ges (0<0 Basement Type: trfull ❑ Crawl UPIGlkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existin new Half: existingC7 ® n(8 Number of Bedrooms: existing —new -ro O t Total Room Count (not including baths): existing new First FIR r Room Qount Heat Type and Fuel: YGas ❑ Oil ❑ Electric ❑ Other ' =' can Central Air: ❑Yes ®'No Fireplaces: Existing New Existing ood/coato W ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ exi&g CPnew size_ Attached garage:'existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use, - Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number �5"$- -744 -7 1-3 Address �`� ClJ4c:a!1P License # astr+s�io�ble_. A Z&3 o Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO *_SIGNATURE <� SZ DATE Xti �� o� U ti l FOR OFFICIAL USE ONLY ° e . � APPLICATION# DATE ISSUED MAP/PARCEL NO. 3 ADDRESS VILLAGE OWNER a f Fes. DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL v FINAL BUILDING DATE.CLOSED OUT, ASSOCIATION.PLAN NO. e o�TM�r Town- of Barnstable Regulatory Services HAF11t3TA�L.'� Thomas F. Geiler, Director Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barn-ta ble.ma.us Office( 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: /J;:,q .41 Map/Parcel: /A 8 D AJ C9 Project Address /6'7/ Off AP Builder: E0 G y The following items were noted-on reviewing: -2�etl< . I MS7, /a it /GT 7-o Pir o V c.s l are)s . of 1t}�� /dos is �Uc omma �O CoNC to r S0A)c '- Wa -5 c is G IT S T S 12 GC(�E-a L L • �N A S O� �?o /S tS. y L6/ S `T E/ES /UAX i ff /ZliN/`i� k�t�t /dosfs �x �� w A#fo,U ,-_ c1416. Reviewed by: Date: 16 O 9 d F Q:Forms:F1arvw Town of Barnstable of THE ro��T Regulatory Services Thomas F. Geiler, Director � BAWJSTAH[.E, MASS. Building Division aTEo �r♦ Tom Perry,.Building Commissioner 200 Main Street, Hyannis., MA 02601 -Awly,town.bariistable.ma.us Fax: 508-790-6230- Office: 508-862-4038 _-- HOAJEOWNER LICENSE EXEMPTION Plense Print DATE: G( 0-1,ot 100 1 b1 i O 10S L.00ATJON: street village number "xoMr owNER �e s'c�o+� � i�-• ��)1(*4--1 name home phone# work phone# CURRENT MAiL1NG ADDRESS: 0d63 0 city/town state zip code The current exemption for"homeowners"was extended to include , ts or less s not possess a p license,d dwellings P ovided that the owner and owner act as to allow homeowners to engage an individual for hire who doe p supervisor. bEIrINITION OF HOA4EOlTJNER 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 Offcial, that he/she shall be responsible for all such work.,)crforme.d 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. r"certifies that he/she understands the Town of Barnstable Building Department The undersigned "homeowne minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements• Sigrnaturc 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. HOMI OWNER'S EXEMP ION at: "Any h that: r Wes omeowner performing work for which a building permit is required shall be exempt from the provisions Supervisors);provided that if the ho cowncr engages a person(s)for-hire to do suc The Code s h of this section(Section es th 1-Licensing of construction work, that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities oCa supervisor(see Appendix Q, Rules &Regulations for Licensing Construction Supervisors;Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would H�[h 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 fication for use in your community. several towns. You may care t amend and adopt such a form/c I a �OF'VHEroh Town of Barnstable Regulatory Services a^ SS gam buss. Thomas F. Geiler, Director v . � r�o,r,H�b Building Division Tom Perry, building Commissioner 200 Main Street, 14yannis, MA 02601 www.to)Yn.barnstable.mn.us Office: S08-862-4038 Fax: S08-790-6230 Property Owner Must Complete and Sign This Section If Usirig A Builder 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 Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners "License Exemption Form on th'e reverse side. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):��SVt1At.Cd� v . Address: \Oq Cal6%-k!N Lv',-je. City/State/Zip: c-)-L63OPhone #: SOT- 7t.1 — -L Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 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. ❑ Building addition [No workers' comp. insurance comp. insurance.# quired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.eI m a homeowner doing all work officers have exercised their I LE] 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' 13.0 Other comp. insurance required.] *Any applicant that checks box ttl 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signatur : \!,� Date: !-.20- Z 00-9 Phone#: S o8" 'I Le!A Q Z;Z- 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 1 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-contractor(s)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.mass.gov/dia i MORTGAGE INSPECTION PLAN STRCCT ADDRESS:1671 OSTERVILLE W BARNSTABLE RD DEED BK&PG: CITY & STATE:BARNSTABLE, MA L.C. CERT #:C187149 DATE PREPARED: PLAN REFERENCE:LC 37157—C field:9/24/09 ASSESSORS MAP/LOT: dwy: 9/24/09 SCALE.1"=50' APPLICANT: DESMOND KEOGH CERTIFIED TO: DESMOND KEOGH PLAN#:080198 Oq� NOTE: DECK & o LOT 11 STEPS AT REAR N 18,300f SQ FT OF DWELLING UNDER CONSTRUCTION AT TIME OF SURVEY. DECK #1671 0 LOT 10 N �TH OF�y O� CRAIG rGn VANCURAmi c0 c' N-36127 y 4 q/zH/cq 150.00' OSTERVILLE W. BARNSTABLE ROAD GatewayThe rrrazionwai Rupnrmunenistructurelsl stet mherson are appmximate and for Oke pnrpnsb of determining Flood Zone,Zoning Conplance.and any possible Fneroachments. Survey Associates, LLC. The permammt sructurelal shorn: WWW.GATEWAYPLOTPLAN.COM Durx,l conform to Zoning llewrcrtrmm (horizontal dimensional setback only) P.O. BOX 54 WAREHAM, MA 02571 V Conform to 7nning HMpAremonfa or are exerMf ban each requirements under PH: 508.291.8991 F: 508.291.0534 M.G.L.Thlo Vll.Chapter 40A.Se lion 7 (horizontal dimensional setback Only) Any mannarefaong to Zoning ynn-rainow"or apµvenlencroachments shown hereon shoulll h: i V : - D .i -- kv CN, y -_ � v lu 19 _ 1 o! F � � `J' r'�C f • a Q V S 1 ' 't ' le ���C��D��a �f -] OpYHFT Town of Barnstable *Permit # Expires 6 nhonths fro1nr issue(late BARNSTABLE, Regulatory Services Fee 16 MAE& Thomas F. Geiler, Director �Alfoyr, Building Division Tom Perry, CBO, Building.Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint �. Map/parcel Number Property Address 6-1 1 OG7E LLE— dResidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address -_)eGMC r A 10 Cesc s:C\ C�'_ awe Contractor's Name Telephone Number S ng'14�1--7 Z Home Improvement Contractor License#(if applicable) N_ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor SEP. — 9 Z009 RI am the Homeowner ❑ I have Worker's Compensation Insurance TOWN QF BARNSTABOE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. 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 replacement Windows. U-Value (maximum .44) p *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. Home Improvement ontractors License &.Construct Supervisors License is required. SIGNATURE: CAW PFIL:EMFORMS\Exoress\EXPlkESS PERMIT.DOC l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street _ Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information pp Please Print Legibly Name (Business/Organization/Individual): ��5tr�o.Jd` tLeoc�� Address: 10°\ City/State/Zip: ,1 aQ4, o)b�Q_ rA 19 Q 63() Phone #: 508- 744 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees . These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition (No workers' comp. insurance comp. insurance. equired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.].t c. 152, §1(4),and we have no employees. (No workers' l3.❑ Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hirc 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is trite and correct. Signature:—, - Date: I 9 —a10�>9 Phone#• S03— 744 -1Z3-L Official itse only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: 1 i. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone 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 Fax # 617-727-7749 Revised 4-24-07 www.tnass.gov/dia , k° . Town of Barnstable o Regulatory Services snaxsTnat a Thomas F.Geiler,Director Mass. 16.19. �.� Building Division. rF0 MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: q^ 1�'eZ 00y\ JOB LOCATION: 6-7 aAVj4%W\J4L number street village "HOMEOWNER": al t_ v 11_`, 508'14 4-�Z3Z- name home phone# work phone# CURRENT MAn lNG ADDRESS: 1oc\ C &,c T\0.!�Q. �N� ca�t�5�cb� ,nn A city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeexempt.DOC THE To Town of Barnstable � f Regulatory Services 9� ��g` Thomas F. Geiler,Director ia?9. �0 �f039.�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Own of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized this b ' g permit application for. (Address.o ob) Signature of Owner Date Print?fte If Property,Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM S:O W N ERP E RM I S S I ON s M ;erase '�uperINICT, 127_F-I Rflofrepairs we have no workers' 13.❑Other . ers'cmnpeasationpoH4in�on.. outside coouscma must submit a new affidavit indicatmg such #the sub-cmarxbm and state whether at not-ffiose entities have p.policy mffibm cue for rriy employes.& Below is the poHcy and job site Fxpication Fate: City/S#afi6�_ ge(showing the policy mamber and espiratson date). 152 can lead to the imposition of criminal penalties of a _enalftes is*e foss of a STOP WORK ORDER and a fine this sit may be forwarded to the.Of&e of infvrm.atjon prvW&d above bus-and correct 1Date: raowrt oat .• r . . � ^• � `' .. • .. . .. "cease#, --ram• �- ¢�4 4. IRiiicalwII ector 5 TOWN OF BARNSTABLE L i 1 CERTIFICATE OF OCCUPANCY ' PARCEL ID 128 C38 WOO GEOBASE , ID 35912 ADDRESS 1671 OSTERVILLE-W/BARNSTA PHONE W BARNSTABLE ZIP - LOT PART 11 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB .PERMIT 57087 DESCRIPTION 'CERTIFICATE OF OCCUPANCY--BLDGPMT#48093 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY ..CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 pfr CONSTRUCTION COSTS $:00 756 CERTIFICATE OF OCCUPANCY �1 PRIVATE P`<Gr'F ' BARNSTABLE, 's I MASS. �ED Mlr►I BUILDING DIVI'AI,, BY Gam,✓��-^---. ISSUED 11/09/2001 EXPIRATION .DATE r Department of Health, Safety and Environmental Services * * BARNSTABM MAB& 1639. ♦0 BUILDING DIVISION BY 4 ill'. . S.LaLItll 41et` fI a• �UIOI 'tee- j 1�-+ 1�1 ,t �` Y, �I r , SCR Mi Lii f f DM,3 epartmen of H61th, Safety f '• • • 1, CX�/ 1 n �/1 Q .. , and Environmental'Services Ir , �i..' ;1.r �k-�v:�E ;�E:'AC�.�D � p � I: # �:^' I y, , • o t• ♦ t[(1 • BARNSTABLE, a' 9A l�l. QI, ,1f OpQ'.f •'�'� 1 BUILDING DIVISION' BYef THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- GIRIOACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GP^DES.AS WELL AS,DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANOE OF THIS PERMIT DOES NOT RELEASE THE'APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED' L FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE TE • 1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AIeD MEC1+� (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS VIM d � 1 J•�� 2 2_PW � ` 2 3 1 EATING INSPECTIONAPPROVALS ENGINEERING)Er...RT►lRENT I (( 0 2 BOARD OF HEALTH OTHER: Nyar&4U 5FAIE FXE fl;pT. SITE PLAN REVIEW APPROVAL i WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THI: THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC-' MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. �,_I TION. ` . y -.: , BUILDING PERMIT } n r \ s - 1 .rvAY:-0J-00 03 :30 PM SHELTER 5182370125 P. 02 enterprises �►' Inc. z �u•JcvCTuarc!O'tov(rc r ro%�w a,,GQunTr r�c�o�Crf i Ps IL r OY7 aPP,rnx ��iGv , �— ��tC, o`er I5E�S F�a�►�l AA R `�P��w� P p , :: --�=--- -- -- -- ----••-- • •—•=.*Prue •c0L�u�cs �►���,u�� .._ ; (ion may be Withdrawn if not accepted Within 30 days• �Lc�s�, do not hesitate to or this opnartunity, and if th:ire ore nny gcjest•iOn5, ! . •tter �nterpriscs, Inc. _ •%, I i I 9 'i i i • I Pa s ' .. tressaskin nel I Custom Made Panels Easy installation At 5helter Enterprises inc., we specialize Our one of a kind laminated spline systerr, E In the manufacturing of stress-skin panels eliminates air infiltration at every joint, for the past and beam industry, as well as while the beveled route system makes refrigeratiort, commercial and industrial assembly trouble free. applications. Ours vs. "R"'s At SEI, we go to great Iong$ths to insure Our EPS has a guaranteed "R" value which i that each panel we manufacture meets our remains stable throughout the life of the highest standards. Our panels are manufac- installation. This may or may not be the turgid in a controlled environment which case with other products on the market, } ensures supx•rior qualily. Typical Physical Properties of EPS ASIM 17rn/1 ( •� W.1,p 1"V UNITS Tat 1.0 1 tham V »uo.♦ NMLYI ].0: 1.92 4DO 4.17 � Nk valun}b 7S° farnpr Ilve IWnI 11"o% p°1 111671 17.17 In.70 21.77 ad 1n l FIMIJ9MI1101 of C201 76-19 41.00 'i.70 M-91 Y1111et Wppwo� tnromipi nn ywin60 C272 1.2.2.2 1.1.19 ¢9-1.1 0,v0.8 rr. ahwrption r/ lvolu111e1 7. 072 1.5.2 S 1 14 1 I.9.t.0 1.1.2.0 pun morn InrN(l t4M '� l t75• t75• I7S• I75• CAWK VIII Anour i xihmsiNu ihr of U696 1.5 r In I.i x 11) is It 10 1.12 10 1L 'Versatility SEI is capable of accommodating any of i your special needs or requests. k I Other available Substrates: "R"Value through Cavity Q 757 17 0000.air film) • OSB •62 osa • i lywoud 21.45 5•1/2•expanded oohsirIvIie { .62 osoy • Gypsum .45 gypsum boW1 0 Kraft Paper .62 insfre air 1rt • Fiberglass, reinforced plastic • CDX, Pressure treated CDX • Texture 1-11 • Foil $chrim Aluminum Coil ` All products also available with 150 or X11S j core material. Shelter EnWprimIm Cohoes, New York ' 10EFS 1=800-836-0719 • 5111/237-4101 www.sholicr-ent.com :;'i Crt�;:73. oAje t TOWN LE BUILDING PERMIT APPLICATION Map "' d Parcel Per # Health Division G� /, �� Date Issued 1 b Conservation Division , �� �� �vLL� N6�; (0/27/'06 SE,PTIr&YSTEM MUST SE Tax Collector - � INSTALLED IN COMPLIANCE WITH TITLE 5 Treasurer ENVIRONMENTAL CODE AND Planning Dept v C°(v' 4OWN REGULATIONS Date Definitive P;VY/ vvned�b/�j//P�lanning Board aM;•:- Historic-OKH Preservation/Hyannil Project Street Address Village 2 Owner �Z �l c ��2 f �0� ., Address .Telephone 75-9— 93g ( t Permit Request 64i4-A Square feet: 1st floor: existing// proposedaa 3s 2nd floor: existing proposed 1 S/ Total new _� �y Valuation 7890?, 4025, 00 Zoning District Flood Plain Groundwater Overlay Construction Type -Pcyf f&tfm Lot Size t 4 C(L Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Z Two Family ❑ Multi-Family(#units) Age of Existing Structure iV Historic House: ❑Yes O'fTo— On Old King's Highway: ❑Yes moo' Basement Type: ❑ Full ❑Crawl 0"Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 6d, Number of Baths: Full: existing new Y Half:existing new Number of Bedrooms: existing new q Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ld Gas ❑Oil ❑ Electric ❑Other .Central Air: ❑Yes ZrN o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing P/hew size 936 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes O'No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name (� Telephone Number Address 7 W License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - SIGNATURE DATE FOR OFFICIAL USE ONLY i PE MIT NO. 3 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE / OWNER r. DATE OF INSPECTION FOUNDATION FRAME Z(Zoo INSULATION FIREPLACE ....� ELECTRICAL: ROUGH '' ems FINAL PLUMBING: ROUGH 4=' Sil FINAL GAS: ROU _, ► FINAL X �j ,,: lil FINAL BUILDING -� ,, 7' `_ DATE CLOSED OUT n= ASSOCIATION PLAN NO. ` 1 i _ The Commonwealth of Massachusetts ,,;���_.-- --;� Department of Industrial Accidents "` --.... Office of/ayestigations 600 Washington Street Ich., Boston,Mass. 02111 workers' Com ensation Insurance Affidavit ON yil w DeAd c Cal`c location l d U e d r city Q .J• Y3 N phone# % 9 I aiii�a"hoii►eoivrier-performing all-work-myself. I am a sole pro rietor and have no one working in any capacity I for my employees working on this job. am an employer providing workers' compensation com nnv name:. ' dr es .ad hone#: city: ID ..:::>:: insurance co. / / %////// /// I am a sole proprietor, general contractor, r homeowner circle one)and have hired the contractors listed below who ha e the followingworkers' compensation polices: ::,.:::.:. ::>::::<;:::;<::; »<::>::»:<::«':::><'>:::..:::...... v name �1 a m an co a n /'1:6Ut9'� : ..... • � ess i� J f �> ad dr camp anv na me. address X. .. >� ............. p 0 1iV .::'i i:i.'<:':::' ii;;::`;<;;i;:':�:.�'.i;;i;:r�'"��i; >i;:.>:'2:::.:; r�::Gil 1::iS::<:i:�i.�C;:i:�>:.;:�::.::r.:�;:::<.»:o:.::::..:. �;:;y�:.::>•:.> - ... insurance co:. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the'DIA for coverage verification. I do hereby certify under the pains and penalties of per•ury that the information provided above is true and correct ' Signature Date Print name 2: /s� r-e r AJ ��/ay G-t Phone# c-0�� 7�/ "93%1 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑Selectmen's Office ❑check if immediate response is required ❑Health Department contact person phone#; � ❑Other (rcmed 9/95•P1A) Information and .Instructions ' Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law";an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver o: 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 employmect be deemed to be employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew£ of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your srtaatian and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for camfirmation 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. Por City or Please be sure that the affidavit is.complete and printed legibly. The Department has provides 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 peniAllicense number which will be used as a reference mimber. The affidavits may be retnched io the Department by mail or FAX unless other arrangements have:been made. The office of investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. i The Department's address,telephone and fax number. - _. ..The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Imlemoadons 600 Washington Street Boston;Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat. 406, 409.or 375 ' � TabN.LS2.Ib(off .• procnlyehe padcasa for Qae and Two Warmly Reddeadal BoiMM Saaed with Food Fads MAXIMUM MINIMUM ng O1 dug Glaring Caliag Wall moor 8a®ms Slab Coo0 a Arm''(%) U.vW=J R-value R-value` R:vaiue' wall Pld Esfac � Rrvaloa' I Rrvalod 5"1 to 6500 HeatfaS De6eee Dam Q 129A 0.40 38 13 19 10 6 Normal R 120A 032 30 19 19 AO 6 Naamal- S 12•b OJO 38 13 19 10 6 8S AFUE T 13% 036 38 13 2S WA WA Normal U 15% OA6 38 19 19 10 6 Normal aw 137i M4 2e ��'� iiiis :. tS AFZ11r W IVA 0.32 30 19 19 10 - 6 85 AFUE x IV/. 032 38 13 2S WA WA Normal Y 18% 0.42 38 19 2S WA WA Normal Z 18Y. 0.42 38 13 19 10 6 90 ARJE AA Ir/. 1 0.50 30 19 19 10 6 90AF1JE 1. ADDRESS OF PROPERTY: `� / Vt.cr.0 .�UcS -/` /';'f 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: X 3. SQUARE FOOTAGE OF ALL GLAZING: S ,2% d- R v� ,�7 4. %GLAZING AREA(#3 DIVIDED BY#2): ''. •� 5. SELECT PACKAGE(Q--AA-see chart above): ' NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a INE Tp Department of Health Safety and Environmental Services Building Division anttrvsraat.>;. = 367 Main Street,Hyannis)CIA 02601 t►�ss. 9 i63 9. `0$ Ralph Crossen Office: 508-862-4038 Building Commissioner Fax: 508-790-6230 HOMEOWNER LICENSE E KEMPTION /� please Print DATE: V O Oct U JOB LOCATION: strsec village number �/�' / �� ,t� .� /,� & 9j,/ / "HOMEOWNER": EI ram_ t- t " �( phone# work phone# name CURRENT MAILING ADDRESS: ^ � Eo G zip code city/town state The current exemption for"homeowners"was extended to include owner-occupied dwellingts of six units or less and to allow homeowners to engage an individual for hue who does not possess a license,provided that the owner acts as supervisor. DEFMMON OFHOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intendsto reside,on which there is,or is attached or detached structures accessory to such use and/or intended to be,a one or two-family dwelling, eriod shall not be considered farm structures. A person who constructs more than ane home in a two-year p a homeowner. Such"homeowner"shall submit to the Budding Official on a form acceptable to the be responsi Building Official,that he/she shall ble for all such work performed lender the bud dine yermit (Section 109.1.1) The undersigned"homeowner"assumes respo nsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building and that he/she win.comply with said Department minimum inspection procedures and requirements procedures and requirements. Signature of Homeowner Approval of Building Official containing 35,066 cubic feet or larger will be required Note: Three-family dwellings. to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION rming work for which a building permit is required shall be exempt from the The Code states that "Any homeowner perfo .this section(Section lo9.i.1-Licensing of consauetion Supervisors):provided that if the homeowner engages a provisions of person(s)for hire to do such work.that such Homeowner shall act as supervisor'Lssurning the respotmbilities of a supervisor(see Many homeowners who use this exemption are unawsm that they won This lack of awareness often results in Appendix Q,Rules&Regulations for Licensing Construction Supervisors ns. In this case,our Board cannot proceed against the serious problems,particularly when the homeowner hires unlicensed pens as Supervisor is ultimately responsible. unlicensed person as it would with a licensed Supervisor. The homeown big tin,runny communities require,as part of the permit To ensure that the homeowner is fully aware of his/her resPons .bilities of a Supervisor. On the.last page of this issue is a application.that the homeowner certify that hdshe understands the response form currently used by several towns. You may care to amend and adopt such a fomtleertification for use in your community. Q:F0RA1S:EXE.\4PTN . F.G.100.0 F.G.98.0 •• I Qz 97.0 95.0 =500 Top EI.96.0 �96.3Bot.E1.93.0 95.5 Bedding as Bottom of Test Hole Per Title 5 Elev.86.0 No Ground Water -DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM Not to Scale NOTES raao O.aa 4 Water Supply ForThis Lot is a Private Well. n CW90C1W nu ' 2 Location of Utilities Shown on This Plan Are Approx. 4iAll ve At Least 72 Hours Prior to Any Excavation ForThis M i Proiect The Contractor Shall Make The Required Notification to Dig Safe(1-800-322-4844) e Cho.b p 3 The Contractor is Required to Secure Appropriate « c"° �1001101 , . Permits From Town Agencies For Construction Defined byThis Plan. L •"'' t p r 4 Install Risers as Requiredto Within 12!'of Finished Grade. CROSS SECTION OF CHAMBER 5.All Structures Buried Four Feet or More or Subject 'MOT to sine to Vehicular Traffic lobe H-20 Loading. 6 Septic System to be Installedin Accordance With DESIGN DATA 310 CMR 15.00 Latest Revision And The Townof Single Family-4 Bedroom Barnstable Board of Health Regulations With no Garbage Grinder 7. AI I Piping to be Sch.40 PVC. Daily Flow=110 x4=440 GPD Septic Tank:440 GPD x 200%=880GPD Use 1500 Gallon Septic Tank LEACHING AREA 440 GPD/0.74=595'SF Required Sidewall=2(12'+36)2=188 S.F. TEST PIT No. I ELEV. q6.0 BottomAreo=12'x35'= 420 SF. 608 S.F.Total Provided O LEACHING CHAMBERDESI6N 3" MED. SAND W/COSOLES All Pipes to be Schedule 40. Use 30 C, to Y R 6/6 4 500 Gal.Leaching Chambers Ina 12'z35�Washed Stone Field as Shown GZ M6D. STRATIP►EO 12d' Y SAND IOR 7/3 PERCOL-ATION TEST CLA86 %MATERIAL 05PT14 - 60 INCHES 2MIN-/INCH NO GROUND WATER DATE: 02/22�to00 No; P-q 1084 ENG. BAXTER,NYC JHOLMGREN, ING WITNCSS: D. MORANDI T.O.p.R.O.H. O TEST PIT No.?- q2.o OF SANDY LOAM SULLIVAN f' IoYR 14/4 NO.29733 18 1j SI LT'Y LOAM CIVIL r' � 1 OY R• 3/& , �A 60 514-TY TILL 910� CI 10'YR L/Z A V SILTY SANDY lyy'� C2 `TILL 2.5 YR G/,3 SHEET 2 of 2 DELOUCHE MARSTONS MILLS,MASS. SULLIVAN ENGINEERING INC. OSTERVILLE,MASS. JUNE 27, 2000 D O�' GU�E/ 1�•87• � �'. '� // K AY 'A �vE)�� 0 - Roc,Y � c LOT 11 �f3. AREA=43,561f SF ZoT .10 ~Nw A.,y I?8/37 IF- A.Af 32. o- \• 0 Qs- \ A.M. 1A8/38- 00 h, cB/Dy i O s', 4 9 CB/DISC . `S' 0 A.Af 2B/3B_TOO a Izy/33 •00Q'� ` � o o��V�cj q1 a o FLOOD ZONE "c"_ FO UNDA TION CERTIFICA TION RES ZONE. "RF ToWN.MARSTONS MILLS SCALE*1"=40' PL.REF. 37157C ELEV.•NIA I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FO UNDA TION IS LOCATED ON P. 0. BOX 265 THE GROUND AS SHOWN, AND P y UNIT 1, 40B INDUSTRY ROAD ITS POSITION DOES ----- � A. CONFORM TO THE ZONING LAW MARSTONS MILLS, MASS 02648 U 1'O{G�i SI�e-7Gtl0 y I TEL• 428—0055 SETBACK REQUIREMENTS OFF a,���n FAX 420-5553 BARNSTAB E � ,� ls� �� JOB PAUL A. MERITHEW DATE PZ—?Z—O NUMBER52403FND !1 Maloney Kathy From: Schlegel Frank To: Maloney Kathy Subject: E-911 Report Date: Thursday, June 28, 2001 10:14AM Hi Kathy. A modification was made to the report for Osterville-W.Barnstable Road. The high number for M.Mills was changed from#1671 down to#1670 AND in West Barnstable#1672 down to#167`l,. This facilitates the listing of#1671 from M.Mills to West Barnstable, which is where the building is actually located. Contact me if you have any questions.THANX PJ I C� rn , YY1 , �� 5 Page 1 r SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse C I X &LUVIIe, ❑Addressee so that we can return the card to you. B. ce' d b Prfnt ed.Na�Ie) C. Date o Delivery ■ Attach this card to the back of the mailpiece, � G �/ � or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes fl,09&a j _ If YES,enter delivery address below: ❑ No i -1I 0Srkvi1 t1 A)-terns (7't beet r >qft`woje, lu t G�tr?tee I 3. Service Type ❑Certified Mail ❑Express Mail - ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ; :: (Transfer from service label) E S f E 5 s�0 0'2 1.0 0 0 A_O;O 5 0 2 81 _i7 6 48 PS Form 3811:August 2001 ` ` Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 *.,Sender: Please print your name, address, and ZIP+4 in this box • vi f6c a i iii:��,,ICI,II,�Ii�,,:�,If,i,�°i°I�:��il��„�tl,fli���li„►,I�i�! � ' Maloney Kathy From: Schlegel Frank To: Maloney Kathy Subject: E-911 Report. Date: Thursday, June 28, 2001 10:14AM Hi Kathy. A modification was made to the report for Osterville-W.Barnstable Road.The high number-for M.Mills was changed from#1671 down to#1670 AND in West Barnstable#1672 down to#1671.This facilitates.the listing of#1671 from M.Mills to West Barnstable, which is where the building is actually located. Contact me if you have any questions. THANX rn , YYA Page 1 Maloney Kathy From: Schlegel Frank To: Maloney Kathy Subject: E-911 Report Date: Thursday, June 28, 2001 10:14AM Hi Kathy. A modification was made to the report for Osterville-W.Barnstable Road. The high number for M.Mills was changed from #1671 down to#1670 AND in West Barnstable#1672 down to#1672. This facilitates the listing of#1671 from M.Mills to West Barnstable, which is where the building is actually located. Contact me if you have _ any questions. THANX i Maloney Kathy From: Schlegel Frank To: Maloney Kathy - Subject: oops! Date: Thursday, June 28, 2001 10:17AM West Barnstable was chaned from#1672 down to#1671. Sorry!!!!!!!!!!!,,'— _ I . i I The Commonwealth of Massachusetts 7 �-_:r' =• Department of Industrial Accidents 600 Washington Street ' -= Boston,Mass. 02111 Workers' Compensation Insurance Affidavit ►�. name: ��,� location: l9 v''rl hone# � d�✓ city f r� ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one workii in any capacity PMENA I am an em 1 roviding workers' compensation for my employees working on_this job.::: ::::::;;:;:::;:>;:::; X. address::'• - �,.,�* hone#.. .. insurance-co.-'::.):>:.-: .;';: :>: '. >;::::.; .,::>. >z;; >.:::::: :;.;<:;:<::..:::.:::...:..::: oiicv#.: .�.::1..< .::::-:-:.: !....... ................. /%/ ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have theollowin workers' compensation polices: f :.>v n e m a n m w :._.. ...:.:...::. . : >< :>::`;?: >:::;:::;::>:>:::::::<:::::::«:::::; »::X.;:;:>::::<::z:: >::>::>z......:::z .....::z:<:z::zzzzz:z:z::::zzz: zz>z:>.:.:<.;;:.;:.;;:;r;;:.;: M. a sure S ........... ..............................................,: .:..-., .............. ... .....::,.:.::.._:::::.::::..:................:.::::::::...::...;<:::�:zz:>.:z:<::>:::>�::; ::.L....•:^:: ...::::•:::::::.:......::::.�::............,........�:•::::::::......-----..............M1... ;;:.>:?>;;:.:;»:.<:.>:.;v;<.::::.:::.::::.:.�.:::::::.:::::::.:..:�.::.:.;::::.. . . ............. cv 3•r.'•: 5:;2:::::: :::::: :��i:'•;:<:5%;:isr::?::ri:`:::::$;::i :%;':> :':` ;:: i:f:::r: ::;:%:::::'::<;:;`:%;:r'::::2�i;;':;:::;::`;::;:,;.»:.:::::::r.:;•:;<•;:-:::•::-> ..............: .......................:.�........... ..... ... ... .......... .. c anv name:">:::>:<:>::zz:>;::::•:'<:::;:z;:•;:;;:;;;:.;:;:;;:.:.:::.......::::.::.::.:::::•. ::-::::.:;::::.;:;:.;:.... :.....<......,,.<:z:::;:::z;::;:<•;:;;: essr ad dr ........... ::...........::::..::... ci ty" '< j�. '~•':N>+Si!i:!Y':vi:Siiii:^::jji::: ..............::::::::::.v:::::r:.v::.::x:.v::n,•.v::.v::.�..:::r:.v.v.:v::::::::.v:•.v::::::::.v.w.:v:::::.:::v.:::::.:.::::':::::::;,::::;v:'::::;::?i'r`??':ivi is ii r iii:^ii::?f!'vi:'::i:•i:•i}i::v::i}`iii}Y.y:•iiiiii .....:....................................:.. ................................................t..:::.v:.v:v:::::nv.::w::::.v.v::.�:............... .. ...................... ....:::::::.....r.•.v::::::x•iiii:«<-:�:::::::::::v.v::::::w::::v:.v:::•.n...•:.+i:::::::�<•:<�Y:i•ii:v':::::::::::.........:... :.,F'risii:��'�t>.C{:•:ii{rj:i.::::)::'::�::�i}:..:...:v.:...�.....:.::::::::w:::::•:::::•._:::+�:•...... Fafiure to secure coverage as required under section 25A of MGL 152 can lead to the imposition of criminal penalties of a fiae sip to$1,500.00 and/or one yam,itnprisomaent as well as civfi penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I undetstmd that a copy of this statement may be rwarded to the Office of Investigations of the DU for coverage verincatlon. I do hereby a pains and p ojperjury that the information provided above is&w.and correct �� Date Sigaeture Print name ' Phome# 5 official use only do not write in this area to be completed by city or town official permit/license t! ❑Bufiding Department city or town: ❑Licensing Board ❑checkif immediate response is required ❑selechaews Office ❑Health Department contact person: phone#' (�svued 9195 PJA) l BOND NO. 24311188 WESTERN SURETY COMPANY STREET PERMIT KNOW ALL MEN BY THESE PRESENTS,.that we, Ethel Fern Delouche; 1671 Osterville West Barnstable Rd, West Barnstable, MA 02668, as Principal and Western Surety Company, as Surety, are holden and stand firmly bound and obliged unto the Town of Barnstable, Massachusetts, in the full and just sum of Six Hundred Dollars and 00 cents ($600 Dollars,) to be paid unto the said Town of Barnstable, its successors or assigns, to which payment, well and truly to be,made we bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, whereas, an application for a license for use of Streets has been made to the Superintendent of Streets of said Town by the said Barnstable, MA for 1671 Osterville West Barnstable Rd, West Barnstable, MA 02668. NOW, THEREFORE, if the said Ethel Fern Delouche, 1671 Osterville West Barnstable Rd, West Barnstable MA 02668 shall indemnify and save harmless the Town of Barnstable from all costs, actions, suits and claims whatsoever arising from any and all costs, actions, suits and claims whatsoever, arising from any and all work, occupation, or obstruction authorized by said license, and shall restore said street or other public place so occupied or obstructed to its original condition within the time specified in said license and to the satisfaction of the Superintendent of Streets, then this obligation shall be null and void; otherwise, it shall be and remain in full force and effect. IN WITNESS WHEREOF, we hereunto set our hands and seals this day of August 8, .2000 . Witness: Ethel Fern AD�ello�uche BY: WESTERN SURETY COMPANY BY: Charles N. Robinson Attorney-in-Fact • 1 �wOF yICi1�E a �. TUDOR No.34774 �FcrSTER�°��`�``� ass/ONAI .I CONTINIM S NAILERS FLOOR JOIST I ATTACHED V/UDI/e' DIA THRU-BOLTS B e4' aC. I STAGGERED (1)��ZN \ p q e x t(�2 NAILER FA.SIbe e'IM N. VOID EDGE DISTANCE CAP PL�1/x_a_xL1 I I SIMPSON JOIST HANGERS -... . - Al.',C1aN. (TYP) I I I I OF 5�yr 0 BOLT I I STEEL COLUMN-----3-�J.21 � I rZl GAG �oLTS CAP PLATE DETAIL 1 TO Fob=5�2t0-(� }� •I -Tl{ •-•------------ 1 13R CONTIAwouS vAIL�L,FOU ITING BASE PL. ?_x��X_t_-J It I fZ 8o�-rs 'GENERAL NOTES AND MATERIAL SPECIFICATIONSI l41S� -:t;v_ �( Y�{) 1. Structural Steep ASTM A36, shop painted w/ rust Inhibitive paint 2, Anchor Bolts --- I 3. All workmanship to conform with American Institute of Steel Construction and Massachusetts State Building Code Latest Edition requirements. 4. All welds to be E70xx electrodes, Shop weld cap and base plates to columns. 5. Coordinate all dimensions with Architectural Drawings, and field verify where required. e;a&tiV-1 A?r D UIY� ALTAIur fC� �� ��! Fo��t�o►.6 PLC �n b�-�1u�.1� o� �rtb�ma--1 i - STEEL BEAM CONNECTIONS MICHELE . C. TUDOR, P.E. TO TIMBER FRAMING Consulting Structural Engineer (FLUSH FRAMED 123 Cottonwood Lane Centerville, MAssachusetts 02632 PROPOSED DELOUCHE RESIDENCE Drawn By: MCT Date: Figure POST AND BEAM RE—CONSTRUCTION Checked By: — Scale: none b 1671 Osterville—W. Barnstable Rd. S K— W. Barnstable, MA File Nanne:>,_-1 LYE Project No.: 2 I FIRST FLOOR GIRT iTJ-Beam^' v5.45 Serial Number:7000W2293 3 PCs of 1.75" x 11.875" 1.9E Microllam® LVL BEAMUSA 1111 8121/00 11:25:49 AM Page 1 of 1 Build Code:124 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED Overall Dimension=31' 1.2" III Iil 10' 2❑ '❑3 15'6.6" 15'6.6" Product Diagram is Conceptual. LOADS: Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 13' Loads(psf):40 Live at 100%duration, 12 Dead,0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER 1 Pocket, Conc./Block 3" 3" Left Face 3574/1024/4598 Detail A3 2 Column 3.50" 3.5" Centered 10026/3340/13366 Detail B3 3 Pocket, Conc./Block 3" 3" Right Face 3574/1024/4598 Detail A3 -See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3, B3. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 6683 5896 11845 Passed(50%) Rt.end Span 1 under Floor loading Moment(ft-lb) 20617 20617 26772 Passed(77%) Rt. end Span 1 under Floor loading Live Defl.(in) 0.357 0.514 Passed(U518) MID Span 1 under Floor ALTERNATE span loading Total Defl.(in) 0.428 0.771 Passed(U433) MID Span 1 under Floor ALTERNATE span loading -Deflection Criteria: STANDARD(LL: U360,TL:U240). . -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -The load conditions considered in this design include Alternate member loading. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist. Trus Joist warrants the sizing of its products by this software will be accomplished in accordance with Trus Joist product design criteria and code accepted design values. The specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not been reviewed by a Trus Joist Associate. -Not all products are readily available. Check with your supplier or Trus Joist technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing.the Trus Joist Residential product listed above. -Note: See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. OF o2a MI GELE PROJECT INFORMATION OPERATOR INFORMATION: T a H DELOUCHE-FRAME RE-CONSTRUCTION Michele C.Tudor, P.E. Consulting'Engineers Me.34T/4 W. BARNSTABLE, MA Michele C.Tudor STRrvCfURAL 123 Cottonwood Ln., IS1E� Centerville, MA 02632-1979 �ESSIOfVAI E�6 508-771-7601 508-771-7163 Copyright 02000 by Trus Joist,A Weyerhaeuser Business. TJ-ProTM and TJ-BeamTM are trademarks of Trus Joist. ^ ✓//�/ J Microllam is a registered trademark of Trus Joist. SLY f fIRST FLOOR GIRT2 �y x 11.875" 1.9E Microllam® LVL em^ v5.45 Serial Nu mber:7000002293 3 PCs of 1.75 " ;iMUSA 1111 8/21100 11:27:34 AM + .:fie 1 of 1 Build Code:124 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED Overall Dimension=31' 1.2" n ul �a 15'6.6" 15'6.6" — Product Diagram is Conceptual. LOADS: Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 16' Loads(psf):40 Live at 100%duration, 12 Dead,0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER 1 Pocket,Conc./Block - 3" 3" Left Face 4399/1236/5635 Detail A3 2 Column 3.50" 4.158" Centered 12340/4034/16374 Detail B3 3 Pocket, Conc./Block Y Y Right Face 4399/1236/5635 Detail A3 -See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3, B3. -Bearing length requirement exceeds input at support(s)2. Supplemental hardware is required to satisfy bearing requirements. i DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 8187 7223 11845 Passed(61%) Rt.end Span 1 under Floor loading Moment(ft-lb) 25257 25257 26772 Passed(94%) Rt.end Span 1 under Floor loading Live Defl.(in) 0.440 0.514 Passed(U421) MID Span 1 under Floor ALTERNATE span loading Total Defl.(in) 0.525 0.771 Passed(U353) MID Span 1 under Floor ALTERNATE span loading -Deflection Criteria: STANDARD(LL: U360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -The load conditions considered in this design include Alternate member loading. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist. Trus Joist warrants the sizing of its products by this software will be accomplished in accordance with Trus Joist product design criteria and code accepted design values. The specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not been reviewed by-a Trus Joist Associate. -Not all products are readily available. Check with your supplier or Trus Joist technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the Trus Joist Residential product listed above. -Note: See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. �ytM OF IUICGEIE G PROJECT INFORMATION OPERATOR INFORMATION: TUDGA DELOUCHE-FRAME RE-CONSTRUCTION Michele C.Tudor, P.E.Consulting Engineers Me.34T74 Michele C.Tudor STRUCTURAL W. BARNSTABLE, MA � 123 Cottonwood Ln., 'SISTER O� Centerville,MA 02632-1979 ESSIOMAL 508-771-7601 508 771-7163 C/� Copyright®2000 by Trus Joist,A Weyerhaeuser Business. TJ-ProTM and TJ-BeamTM are trademarks of Trus Joist. � -" ` Microllam®is a registered trademark of Trus Joist. �f 00- 2r-tad S I� y fIRST FLOOR GIRT3 eam�h45 Serial Number:7000002293 2 PCs of 1.75" x 11.875" 1.9E Microllam® LVL r�AMUSA 1111 8121100 11:31:14 AM Page 1 of 1 Build Code:124 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED Overall Dimension=38' 10.2" • ,4 13'3" 13'4.8" 12' 2.4" Product Diagram is Conceptual. LOADS: Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 13'7.2" Loads(psf):40 Live at 100%duration, 12 Dead,0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER 1 Pocket, Conc./Block . 3" 3" Left Face 3262/928/4190 Detail A3 2 Column 3.50" 4.271" Centered 8624/2587/11211 Detail B3 3 Column 3.50" 4.07" Centered 8263/2422/10685 Detail B3 4 Pocket, Conc./Block 3" 3" Right Face 3071 /849/3920 Detail A3 -See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3, B3. -Bearing length requirement exceeds input at support(s)2,3. Supplemental hardware is required to satisfy bearing.requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 5800 4984 7897 Passed(63%) Rt.end Span 1 under Floor ADJACENT span loading Moment(ft-lb) 14227 14227 17848 Passed(80%) Rt.end Span 1 under Floor ADJACENT span loading Live Defl.(in) 0.320 0.438 Passed(U492) MID Span 1 under Floor ALTERNATE span loading Total Defl.(in) 0.390 0.656 Passed(U403) MID Span 1 under Floor ALTERNATE span loading -Deflection Criteria: STANDARD(LL: U360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -The load conditions considered in this design include alternate and adjacent member skip loading. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist. Trus Joist warrants the sizing of its products by this software will be accomplished in accordance With Trus Joist product design criteria and code accepted design values. The specific product application, input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by'a Trus Joist Associate. Not all products are readily available. Check With your supplier or Trus Joist technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the Trus Joist Residential product listed above. -Note: See Trus Joist SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. o G PROJECT INFORMATION OPERATOR INFORMATION: STRUCfU�L DELOUCHE-FRAME RE-CONSTRUCTION Michele C.Tudor, P.E.Consulting Engineers '09� RfGI$ZER`����a`�� W. BARNSTABLE, MA Michele C.Tudor `FssIONAL 123 Cottonwood Ln., ,. Centerville, MA 02632-1979 508-771-7601 -C)t"A 508-771-7163 Copyright®2000 by Trus Joist,A Weyerhaeuser Business. TJ-ProTM and TJ-Beam-are trademarks of Trus Joist. MicrollarrO is a registered trademark of Trus Joist. EST/MATED PROJECT COST WO.RKSHEET Value LIVING SPACE (high end construction) �� square feet X$115/sq. foot= 7 (above average construction) square feet X$96/sq. foot= Z-% 7 (average construction) square feet X $57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= 3 y PORCH L o square feet X $20/sq. foot= / ?0 d DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost O` ? �� � �y: � For Office Use Only - /ng,& s nary AMordab/e Housing Fee Residential Commercial" Property Owner's Name C—14C L TCZ°N �c LOIN Project Location v,e - �f+e-f.S t i�P P,�J Project Value Permit NumberZS(O / "Existing Sq. Ft. "Proposed New Sq. Ft. ETHEL FERN DELOUCHE 53-7107/2113 DANIEL DELOUCHE B51009472 11 ENTERPRISE RD. PH. 508-759-9391 POCASSET, MA 02559 DATE �i PAY TO THEOR71 ER c P.O. Box 10 ORLEANS. 7A 02tl' d 1 AV MEMO i 1: 2 L L37 107131: 85 L0094 II' 0376 - - --_ iJ � a,.vemvvea I A i �I k 1 ' _ / ' �/ PAD — \ \ \ � ` 'gym 4 9 � °d •�� • �l Roca/ LoCug / \ 0>, LOT 10 end �� c / � \ \ �' A.M. 128137 ' ID, 11 � �� \ ® � \ O yMCD A.M. . �o 127/3— 02 �g6 LOCUS PLAN p. Scale•I -2000 Assessors Map 128 I ``l Parcel 38 T00 8 A PROP �e .�v►c�:• �1- j Zoning: RF 38W00 y3 \ Tp`I ' Setbacks: Front 30' 9EP�1G e = Side 15' . \ � � I ZI. \ TANK -t • BENCHMARK Rear 15 Gro ct TOP OF C3 ion A.M. 128/3.'?— WO I I CB/Dtt 100 (ASSUMED) Q I� / Tom'"'ti 127/3—XOI ?gyp � I /� p VACANT OSC� 1� l \ ,0�1� O"OF PETER SULLIVAN 733 A. 38-RJO `sl' SHEET I of ,� N VIEW 0 PLAN 0 S_� ITE PLAN � 0 v �' Scale • I PROPOSE- 30 1 �; � � Q � D SEPTIC SYSTEMAT , � s ° 1671 OSTERVILLE- W. BARNSTABLE ROAD A.M. _ 127/33 • � . MARSTONS MILLS. MASS. �o FOR EX\s-r.wEl-L / DANNY DELOUCHE SCALE AS SHOWN DATE: JUNE 27,2000 ` ` - SULLIVAN ENGINEERING INC. OSTERVILLE, MASS.