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0461 PARKER ROAD
UPC 12543 No. 53LOR M Af:tN... yN Town of Barnstable Building Department - 200 Main Street BA STABLE, MASS. H0 (508),62 40261 1639• Argo�s Certificate of Occupancy Application Number: 201405606 CO Number: 20150196 Parcel ID: 176025002 CO Issue Date: 09/21115 Location: 461 PARKER ROAD Zoning Classification: Proposed Use: Village: WEST BARNSTABLE Gen Contractor: PACHECO, SHANE Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: ` 2 r Building Department Signature Date Signed 0 —' ,� -y � TOWN OF :I j - �1� � BuJ-,*b,,1.n.g .201405006, BARNSTABILE, Issue Date: 10/02/14 y MASS. 039. 3���� Applicant: PACHECO,SHANE Permit Number: B 20142676 Proposed Use: Expiration Date: 04/01/15 Location, 461 PARKER ROAD Zoning District Permit Type: NEW SINGLE FAMILY HOME Map Parcel 176025002 Permit Fee$ 892.50 Contractor PACHECO, SHANE Village WEST BARNSTABLE App Fee$ .100.00 License Num 164440 Est Construction Cost$ 175,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD 4 BEDROOM HOME THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: JENKINS,RUTH E&KATHERINE E&JILL E BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 147 LAKESIDE DRIVE INSPECTION HAS BEEN MADE. MARSTONS MILLS,MA 02648 Application Entered by: RM Building Permit Issued By: i�Lti w Li THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. e MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: ✓ 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION K 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. { 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL_MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. 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: � PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTYTUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS //4y 2 j31 N N a 2 �', rt >✓� 2 FIA/A L o/ 0 � / 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health e ry_ 308' PROJECT NAME: Q ADDRESS: PERMIT# PERMIT DATE: d h M/P: OZ- LARGE ROLLED PLANS ARE .IN: BOX L SLOT Data entered in MAPS program on: BY: q/wpfiles/forms/archive 461 Parker Road, WB Specs. Page 1 of 1 Mckechnie, Robert From: MICHELE CUDILO [mcudilo@comcast.net] Sent: Wednesday, May 27, 2015 12:30 PM To: Mckechnie, Robert Subject: Re: 461 Parker Road, WB Specs. that is correct; the input of 3.5" was what failed, not the member size; next time i'll change the defaults so the report won't read "failed" thanks, Michele Cudilo, P.E. 123 Cottonwood Lane Centerville, MA 02632-1979 mcudilo _ comcast.net VOICE: 508-771-7601 CELL: 508-737-8521 FAX: 508-771-7163 On May 27, 2015, at 11:50 AM, Mckechnie, Robert wrote: Hi Michele, Thanks for getting back to me. The confusion was generated by the first line in the Forte reports for both the 3 member and the 4 member 18" LVLs. That line states that both failed. The 4 member Forte report had your handwritten calcs for steel (specifically W10x39) and referenced the post detail on SK-1. I guess I can presume that by increasing the support/bearing size the LVL beams pass as installed? Thanks, Bob Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 5/27/2015 Mckechnie, Robert To: mcudilo@comcast.net Subject: 461 Parker Road, WB Specs. Hi Michele, Thanks for getting back to me. The confusion was generated by the first line in the Forte reports for both the 3 member and the 4 member 18" LVLs. That line states that both failed. The 4 member Foprte report had your handwritten calcs for steel (specifically W10x39) and referenced the post detail on SK-1. I guess I can presume that by increasing the support /bearing size the LVL beams pass as installed? Thanks, Bob Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 1 Message Page 1 of 1 Mckechnie, Robert From: Roma, Paul Sent: Tuesday, May 26, 2015 3:29 PM To: Mckechnie, Robert Subject: FW: 441 PARKER RD. LOT 3 for your reading pleasure -----Original Message----- From: MICHELE CUDILO [mailto:mcudilo@comcast.net] Sent: Tuesday, May 26, 2015 12:08 PM To: Roma, Paul Cc: Shane Pacheco Subject: 441 PARKER RD. LOT 3 PAUL: PLS. FORWARD THIS TO BOB MCKECKNIE (SP?) PLEASE NOTE: the stamped beam calculations provided state minimum bearing lengths required for ea. as follows: . DINING SIDE: 4.5" ea. end . GUEST ROOM: 5" ea. end T Y, Michele Cudilo, P.E. 123 Cottonwood Lane Centerville, MA 02632-1979 mcudiloC@.comcast.net VOICE: 508-771-7601 CELL: 508-737-8521 FAX: 508-771-7163 5/27/2015 -Commonwealth of Massachusetts et Metal Permit �,7 69 Parcel U Map Date: 3 Permit# � �' " ��� � �s Estimated Job Cost: $ A.000 W,r �,�C������ � ��lj�'rmit.Fee: $ Plans Submitted: YES NO a,,�r Plans Reviewed: YES NO Business Lic ense# 0 w� O 20� Applicant License# SrAoI TOWN OF BARNSTABLE Business Information: Properly Owner/Job Location Information: CA R ACrAO l Name: Name:wsz�g : 69�6r A,;y�2�C?t1 Street: Re Street: City/Town: /►+a.IV"I City/Town: Oil. 69 Trgf�L�f /►'i9. Telephone: Telephone:5o8' ayS6 �SIARM0 Photo I.D. required/Copy of Photo I.D. attached: YES vloe NO • StafTIni al J-1/M-1-unrestricted.license I J-2/M-2-restricted to dwellings 37storie8 or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 family AZ_ Multi-family Condo/Townhouses Other. Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. Z over 10,000 sq.$. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: � �� D, _r'' le/ABM ATlt1,aGlc Ui7-rN C#��- A/�,��rd� zo�IF s,r . ,r� i3y �L��.��c 2i�►� I i INSURANCE COVERAGE: i I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L Ch.112 Yes eNo ❑ If you have checked)'IZ indicate the type of coverage by checking the appropriate box below: A liability Insurance policy ( Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement: Check One Only -Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this bo4<1 hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of'my knowledge and that all sheet metal work and installations,performed under the permit issued for this.application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General laws. Duct inspection required prior to insulation installation: YES "NO F Progress Inspections Date Comments FinalInsnection ` Date Comments I I Type of License: 00, 3y Master Fide ❑Master-Restricted r_ :;ityfrown ❑Joumeyperson . Signature of Licensee permit# ❑Joumeyperson-Restricted License Number.. �<aoa. :ee$ Check-at.www,mass.aov/dal I nspector Signature of Permit Approval I I 27w Commonip mh*ofMassachusr D pr hnenf ofI'au&s&id Accidents - (�`ue o��rx�r�gr�ions 600 Washington Street $osfoq,,MA 02111 -�' nm=w.�nrrssgota/dir� ' 'workers' ti` GmperlsationlummuceAffidavit Bmlders/C.antra:ctoYs/ElectncmnsMumbers pglkant Information Please Prof Legibly Name CBz lO�gar zailon�individnal)= lt'r J� it AA5;u2 zdgg� AzAaMl:. Z. L city/Stabe-Jzip f RLane 47?�y a63 Are yl� employer?Check dw appropriatae bay: Type of ect r. I atria confractor and I <w �� - 4 1. I am a employer with � � 6_ evw oonsfruction employees tfull andlorpart-ts net.* have hired the sub-contacibrs. 2.❑ I am a sole proprietor or partner- listed on the attached sheet; 7- ❑Remodeling ship and hate no employees These sub-confractors have g- ❑Demolition employees and have worirers' woidring forme in any capacitic 9- ❑Building addition L"oworkers' comp_inVza=e comp-msurancer1 Wired] 5_❑ We area corporation and its 10_C]Electrical repairs or additions 3.❑ I am a homeommer doing all wort offic s baN--+e exercised their 1I_❑Plumbing repairs or additions myself [No workers'comp- right of exemp.tionper MGL 12-0 Roof repairs. ins7xAnre require&]t c-1.52,§1(4',aadwe haute no e-playeec_[No woikers• 13_❑Other comp_insurance required, °day saptiranf that checks boa WI most also fal oia the section below shoari ig their wo3tea;commessatioa pp�F ir� m nnxtic 1 Homeowners olio saomit this affias immrstieg they are doing sH ttcxc amol then/rum offside coousetam mast sob�rrt s new affidavit so[Iz dontcacmrs that check this box MTMt suacbkd Ira additionaI sheet shooing tbLe name of 6Le sab--o=ft3ctas and state whether ocmmt thane entities have empIuyees_ If the solrcoatmctam bare mmpioyees,they must pruw6e their workers°comp policy uumb!r .Tarn are employer that is prm ijng tvorl;• 'co.rrgxnuyrfiaa inmirarica for my emp7ayecu Heloty is the po&cy'and}ob site infor matLmL Insurance Company Name: i&{LM rSn&= Y cissua= `r►IL Go Policy 4 ar Self-ins-Lit_ .��- (� Expiration Date_ 41 Job Site_address: /6/ ft u�& Ry CiVStatty2ap: P nAJ D_eye"- 2668 Attach ae copy of the workers'compensation policy declaration page(showing the policy number a-ad+xpsation date). Failure to secure cm-;erage as reju red under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50G-Oa and/or one-year imgtisonument as well as civil pemdfies in the f- m.of a STOP WORK ORDER and a fine ofup to$250-00 a.day against the:violator_ Be advised that a copy of this stdem ut maybe forwarded to the Office of Immu6gadons of the DIA for insurance coverage verif ication- I dv hereby ceritfy under th g pains agdpenaUies ofpe ury that the inforratifian protadeZ agave i.b-ua and correct Sianatar /�� Date: Pfione I I—1- A6 3 -o 70 ©_f Ecfal rrse only. Dar not write in this area,tv be completed by city at town officiaL City,or Towa: Permit/License# Issu g Anthar4(circle oae}: L Board of Health Building Deepartmeut I Cit,Jra-vm Clerk 4.EIectrical Fnspector S.I'lumbing Inspector .fi.Other • Contact Pmsan: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Iegal 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 IocaI Licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth;or 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 compliaice 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 ceri=ficate(s)of insurance. Limited Liability Companies(-LLC)or Limited Liability Partnerships(L LP)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 roverage. Also be sure to sign and date the affida-,nt 11ie aft-davit sbould be returned to the city or town that the application for the permit or license is being requested,not the Department of j Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' j 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 addatom,an applicant that must submit multiple permit/license appli; ations 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 oa 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 aifida�-it I 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: 'fie Comm:Qu �ealiit of I�assachusctts Depaztmnt of Ilidustrlal Acckd wf s Office of kvle�stigations Goo Washmatton Size I aston,IAA 02111 TeL A 617 727-49-GO W 406 or 1-$7-r-I ASSAFE Revised 4-24-07 Fax#617 727-T 49 Fa�w_�as�gov�dia t Town of Barnstable Regulatory Services r }� Thomas F.Geiler,Director 1639.. • ► " Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property l P PAY hereby authorise to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature&Mwnet Signature of Applicant 6rey9 T�� 1A1&Sox1 Print Name Print Name 3 av is Date Q:FORMS:O W NERPERMS SI ONPOOLS OMMONWEAILTH OF MIbSJiUSE7TS> i.^. r g.. 11 • • • ' • • 61411111111111 B.DARQ':O.F SHEE?'': ?[ET L `WORKERSU.;% < ISSUES THE FOLLOW I€J'ts ::!%I` ENSE,.r..a. > AS9--k4'iASTER-UNRESTRICTED T!*,DR A CARLSONX. o 20 -WARE + '`f lff ... <lf>v< W <>Cti°L <BORo :::1A o2346-19:, `:' v. 2+0° % Wo 28 1,6::>. ; .. 187919 x.... COMMONWEALTH OF MASSACHUSETTS SHEET METAL WORKERS:`_ AS A BUSINESS - ISSUES THE ABOVE LICENSE TO:,.: :-.DAYID:; J-.CARREIRO III CARR:E I-R_0 & CARLSON ME -`CT11. 78` FR:E.ETOWN STREET LAKE_V,1: LE MA 02717-081.6._ O 1/11/15 3 a'6 24.6 LICENSE • EXPIRATION DATE SERIAL NO. t Commonwealth of Massachusetts Department of public Safety. Oil Burner Tcri}nirian Certificate ; License: BU409182 TEDD A CARLSON 124 HOWLAND ftD 'T° ASSONET MA 02702 Expiration: Commissioner 03/26/2015 i ACORD CERTI ICATE OF LIABILITY INSURANCE DAT810 712 01 4Y) 08/07/2014 PRODUCER j 508-998-0512 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CHERYL A.LORANGER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HLDER. THIS CERTIFICATE DOES NOT AMENDENOR CHERYL LORANGER INSURANCE AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 13 CROMPTON STREET i ACUSHNET,MA 02743 1 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: FARM FAMILY CASUALTY INS CO CARREIRO&CARL�ON MECHANICAL INSURER B: CONTRACTING,INC i INSURERC: P.O.BOX 816 INSURER D: E.FREETOWN,MA b2717 INSURER E: COVERAGES THE POLICIES OF INSURANCE LIS D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CO DI ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFF110RDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOYVMNMAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR WIL POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONTYPEOF INSURANCE LIMITS A OENERALLIABILRY EACH OCCURRENCE f 1,000.000 DAMAGE T X COMMERCIAL GENERAL LIABILITY PREMISESO f CLAIMS MADE lil OCCUR 2012XO277 05/24/2014 05/24/2015 MED EXP(Any one rwn) f 5,000 PERSONAL&ADV INJURY f 1.000,000 GENERAL AGGREGATE f 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG f 2,000,000 POLICY I JECT PRO LOC AUTOMOBILELIABILm COMBINED SINGLE LIMIT ANY AUTO (Ea accident) f ALL OWNED AUTOS BODILY INJURY f SCHEDULED AUTOS (Per Pew) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) f PROPERTYDAMAGE f (Per eedderd) WtAGEW1BUJITY AUTO ONLY-EA ACCIDENT f RANY AUTO OTHER THAN EAACC III AUTO ONLY: AGG f EXCESSIUMBRELLAUABRM EACH OCCURRENCE f OCCUR CLAIMS MADE AGGREGATE f f DEDUCTIBLE S RETENTION f f WORKERSCOMPBILfrY NAND WC STATU- OTH- A M0Y �LJABILRY ENT S 1 OO,000 ANY PROPRIETORIPARTNERIEXECUTFVE 2012W6419 01/28/2014 01/28/2011 E.L.DISEASE-EL.EACH ACCIDENT EMPLOYEE f 100000 OFFICERIMEMBER EXCLUDED? i If yes,desoibe under SPECIAL PROVISIONS balm EL.DISEASE-POLICY LIMIT I f 500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES l EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CARREIRO&CARLSON NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO So SHALL P.O.BOX 816 IMPOSE NO OBLIGATION OR LUABILRY OF ANY HIND UPON THE INSURER,RS AGENTS OR E.FREETOWN, MA 02717 REPRESENTATIVES. AUTHORQED REPRESENTATIVE ACORD.25(2001108) ©ACORD CORPORATION 1988 CORd - CERTIFICATE OF LIABILITY INSURANCE 2/5/2015 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AF OWATIVELY 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 INSURERIS), AUTHOROW REPRESENTATIVE OR PRODUCER,AND THE CatTIFTCATE MOLDER. IMPORTANT: M the ceMcas holler Is an ADDITIONAL INSURED,ft poHCy(Iss)must be sndasad. M SUBROGATION M WAIVED,stlbjod to the terms and eondtdons of the pulley,cartatn pok*w may r"UIM an sndorS*ffN) . A stRISM11t on Uds CarHeeate does not coder rW is to the Ceffif ats holder in Hsu of such endo PRODUCER CONTACT FARM FAMILY AMUCY PHONE (508)747-8181 205 Pest Grove St, Ste C Middleboro, MA 02346 Christine.Mercier@farm-famii Loom AFFOR000 COYOt sa woof INSURER A: Farm Family Insurance INSURED Carreiro a Carlson INSURER B: 18 Douglas Cor INsuRERC: Rochester, MA INSURER D: MURER 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.LW M SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'fm VTR TYPE of INSURANCE POLICY NUMBERam % L"TS ~"B''ONUL GENENAL LIAau.rrn EACH OCCURRENCE s 1 OOO 000 GAIMS*MDE a)OCCUR (FA r rroe $ x business 22llcy 2012XO277 05/24/2014 05/24/2015 MEDE P or* ) S 5 000 PERSONAL 8 ADV INJURY i OEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY❑jELPRPT ❑LOC PRODUCTS-CO.PIOP AGG $ 1,000,000 OTHER: i AUToMom u 14amy eai $ ANYAUTO BODILY HNAIRY(Per Wwn) $ ALLOSW"ED ACKEDULED BODILYINJURY(PweoddeM i TGS HIRED AUTO$ AUTOSi i i UMBRELLA LNB OCCUR EACH OCCURRENCE I EXCESS LIAR C AIMSAUOE AGGREGATE i DIED RETENTION i WORXERS COMPENSATION AND LIABILITY °f" 2012K6419 01/28/2013 1/28/2016 EL EACH ACCIDENT S 100,000 OFFKZRMAEMBER E70`l 060?ok"dom In ❑Nfa EL.DISEASE-EA EMKOYE1 i 100,000 MIf yye8as describe undor RIPTiON OF OPERATIONS below EL DISEASE-POLICY LIMIT i 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addliom!Rer wU Sdredule,may be a"adled if moo spew Is req Amd) CERTIFICATE HOLDER 26EELLATION Carreiro 6 Carlson SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEIIED BEFORE Rochester, MA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEHTATNE 0198&2014 ACORD CORPORATION. AA rights reserved. ACORD25(2014101) The ACORD name and logo are regishmxf marks of ACORD I 1 "vOMMONWE4LTH OF11$MCHUS `TTS:_:'_: > DIVISION OF PROFESSIONAL 90 a SHEET 1~kET'AL WQRKkR SSU $ SHE. FOLLOW1I 0 L LICENSE ..:. s..::, .AS A SU.S'I MESS ��5.. , cc . -q�M `r 2 .DA1/1.;�1 J CARRE I RO III CARRE IRS;= ,<' A`I SON ME CHGALk,CTRT 8 FRE'E>�OtJN`:' 0 1 —08 >1_A IEV1 L A 2 L.E �:::� 7 7 :. 364128 I `�aE Town of Barnstable BARNSTABLE Regulatory Services MASS ,Eo ;�,�• Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location KC--n, Wc--;V14 Permit Number 2 n L/ �� CD- Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: 8 ' OAJ I-L/C-- '5 /It / �S�1 T — /iL(y /-",#7z/ 15'*-'(A�'-.c 5 S'r 8 �Guz�r ��C To �E5/5 r d�3 kJ7 r/f .40GcC-,-rrav3 Please call: 508-862-4�$ it 01 Inspected by �v/� c Date r.A. 4r^ °F114E Town of Barnstable BARNSTABLE. ' Regulatory Services Y MASS. t639. Building Division p�ED MAC a. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice a Type of Inspection /41 Location �fa f � � 40':6, &)h. Permit Number 02 Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: LUGA� �P'rY&LC— �N,f� — s�vGcvl�—�- GG Xq " ' J Please call: 508-J8}62-4-03-84or-fg ' • on. Inspected by ✓' �'1// �/ G��, Date L"-- a6 //J- Message Page 1 of 1 Mckechnie, Robert From: Miorandi, Donna Sent: Monday, December 29, 2014 1:37 PM To: Building Dept Cc: HeathDeptMailbox; Parziale, Jim Subject: Certificate of Occupancy for 461 Parker Road, West Barnstable Hello: At this time we are requesting that building not issue a certificate of occupancy as one of our inspectors issued a septic permit in error. It should not have been issued due to the fact that we do not have competed well test results for this new lot/house and septic. The address is 461 Parker Road in West Barnstable-owned by Anderson and is known as Map 176-Parcel 025-002. Any questions please see me. Thank you. Donna Miorandi 12/29/2014 i I 0% w , o II I 3 k CONC. 0 k FNDN. CB FND LOT 3 7 Tp `5�6., 2.56 2.56 ACRESESt PARKER RD 61� C0M,ypN k qC41 tttC7' Co' fqS fM fNr 09- DH IN ROCK FOUN (DISTURBED) 130.66' .� FOUNDATION PLOT PLAN 14-017 PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE LOCATION 461 PARKER ROAD,WEST BARNSTABLE SCALE : 1" = 60' DATE : 11/20/14 PREPARED FOR: REFERENCE : MAP 176 PARCEL 025-002 GREGG ERSON PB 596 PG 70 �jH Of MgSS I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE �o� DANIEL m GROUND AS SHOWN HEREON. o A. off 508-362-4541 L) OJALA f.508-362-9880 ,� No.40980 downcape.com A own espe MMdinte rk4r,inc •�O'e s s 0 civil engineers ( /.t .1 l NC SUR y� land surveyors ------------ ----------------- ----- 939 Maln Street ( Rte 6A) YARMOUTHPORT MA 02675 DATE REG. LAND SURVEYOR i I A , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1`1ty Parcel 0615 - 00a Application #O I V� Health.Division Date Issued Z Y Conservation Division % Application Fee 0 Planning Dept. _ AP ,bqt, a 20A, °& Permit Fee -7 V Date Definitive Plan Approved by Planning Board old` Historic - OKH _ Preservation/ Hyannis, " Project Street Address q6 f �'�✓ Q � Village Wcs %avnSUhie . 1'►1Grs�� Owner A-naev-so Address Lakke-sl L �)r m,1ts &I �t�`{ 93ty �1�Sa oa6c�& Telephone '• Permit Request 1 I ne W ko Square feet: 1 st floor: existing D proposed i Ml 2nd floor: existing a proposed I Total new 07S09 Zoning District Flood Plain Groundwater Overlay Project Valuation -7 s,6 0 o Construction Type Waaa Lot Size nc M5 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure -0+1 d Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 12"Full ❑ Crawl [<Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) bq1 Number of Baths: Full: existing o new 0 Half: existing new Number of Bedrooms: a existing �new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric G�Other rn nl, 11// Central Air: l�Yes ❑ No Fireplaces: Existing New Existing wood/coal stove{VO YePA❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size = Barn: ❑ existing ❑ new Vie_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: c Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C-tmmercial ❑Yes ❑ No If yes, site plan review# G.urrent Use Proposed Use APPLICANT INFORMATION _ I, _ (BUILDER OR HOMEOWNER) Name -36,C V' CtCte_Go Telephone Number y d ys Address 8 75-49 1U License # CS 0 9a9Y 8 mGrS aviS I' 0S mG O;Ug 6 Home Improvement Contractor# 17(p5?3 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO j �174 G all e 6 Rrr S SIGNATURE DATE FOR OFFICIAL USE ONLY } :APPLICATION# ' DATE ISSUED ' -MAP/PARCEL NO. . ADDRESS ' VILLAGE OWNER DATE OF INSPECTION:,,_ Ra FRAME A-A= r oa v 3 a-9 ok. '/oh rj 7, r ;INSULATION, rGuS ''yys� FIREPLACE �Cr �/l, �� d`t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL C FINAL BUILDING,'-��f//t/ ie DATE-CLOSED OUT ASSOCIATION PLAN NO. ti� Dia amrrrcrnt of?�lfassaeT users Dequart ent of fudiatrial Accidents - OTwe-of 11M estigatons 600 Wayhiagton&reet Boston,.MA 02111 nTrl.-minass-gorldia W,orders' Compensation lasum-aceAffidavit:Builders/�antr-a:ctors/EfectxiciauMumbers Applicant lufarmation Please hint Lej�ibfy Dame(Bush s Organi2�on8aaviduaq: go►"L Vady-u -- qfty/S tate/Zip= �rS nS f IlS o 4t Phan --- so -Aa Lt S (0 - Areyau an employer?Check the appropriate T rofo ect z4_ I atnsgWMIlcontractorandI {exlnu eI_❑ I am a employes with. 6_ canstruouoa loyees{full andlorparf- me�* havehsreslthe sub-contraoto_s. I am a sole proprietor orpariner listed on the attached shr�et �- ❑Renrodeliag ship and have no employees These sub contractors have g_ ❑Demolition w far me in art c cr r_ employees and.have w rke:s' or�ng y � � $ 9_ ❑Building additicn Fo Workers, comp:in¢,trxnre camp_imn ante reguir-d� S_❑ We are a corporation and its 1f3_.❑Electrical repairs or additiors 3_❑ I am a homeaxmier doing all Work ofEcers have exercised their I i_❑Plumbing repot R cr ai tic ns myself [No workers'comp- right of eizemptioa per MGL IZ❑RDof repairs immnmace required]t c- 152, §1(4,and we fi.nm no employs_[No' s' 13_❑t?.ther comp-insurance required.Y *Asp Epptixant drat becks box fl nmst also 511 oirt tle sectioa below ing,haw theirwodces'comnenss moat uoiiry in£flt3aatia3 t Hnmevwne m crbo submit ibis afndzvff-Er sfmg they are damg zH scud,and dies bae catade coetimc mum mCn- C�t>BCit3r5 that cher�c this bcx mast stht[lt�d as addifinasl street 5hbumg the name Of&E sub-On-:C rf3=d 52M trhEthet tic not tmss.ndtks bsvil. amloyees_ If the sub-contimctom h-re empIoyees,dtey must pxavide ter workrss'comp.paLcg number_ Tam arm employer ihatis prmdrhrzg itvri e_m'comlmrrsahon irrsrtranc—e for r} Stpuc djobstires r op in,formaftort_ Insurance CompanyName: Policy fr.,or Self-ins-Lic_ Fxpi catio•a Date: Job Site Ad&ess: City,StatelT_tp: Adach a copy of the workers'compensation policy declaration page(showiag the policy n-amber and expiration duke). Failure to secure cm-erage as raquuednuder Section 25 A of MGL c. 152 ma lead to the imposition of criminal penalties of a f c up to$1,500.OU an or one-year-imprisonment as well as citril penalties in the,form of a STOP WORK ORDER asd a.die of up.to S250.00 a day against the violator_ Be advised that a cop.of this statement maybe forwarded to the Office of Irrregt gatiom of the DIET Ex inmmmce coverage vetcation- I da her e-bp certify uraler-tks pains alZaL enaWas ofperyury thatthe inforrrzatio:n praizdt?d ab.,wc is.b-uz and correct Siamtum: Aot�L Date: I Phone 9- So (6 offrczirt use alit . Do not twits in flits twee,,to be campleted by Gity or town afjicLat City or Towa: Pmmiff icease M fcsid-g c'luthar4{circle oae}: L Soard of Health ..Budding Department I CltV ra-v Fr Cleric 4.Electrical Inspector S.Plumbing Irisp--cto r 6.Other Contact Fersan.: Phone'_ - - 6 Information and Instructions Massachusetts Creneral Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an employee is defined as"__every person in the service of another under any contract of hire, express or implieA 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 auy applicantwho has not produced acceptable evidence of compliance with the insurance.coverage requircd." 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 ur_til acceptable evidence of compLapce with the insuramce requirements of this chapter have been presented to the contracting authority_" Applicants Please fill out the workers' compensation a$davit 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 ceribr5c..ic-(s) of insura.ace. Limited Liability Companies(LLC) or Limited Liability Partnerships(.LP)vrith no em'rloy�ees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLl'does have employees, a policy is required. Pe advised that this affidavit may be submitted to the Department of indusirial Accidents for confirmation of insurance coverage_ Also be sure to sign and date the affidavit 11e affidavit sboul_d be returned to the city or town that the application for the permit or license is being requested, not the Deparment of Industrial Accidents. Should you have any questions regarding�e law or if you are required to obtzin a vrorkers' compensation policy,please call the-Department at the number listed below_ Sell'-insured companies should enter their self-insurance license number on lee appropriate lime. City or Town.OiFacials Please be sure that the affidavit is complete and printed legibly_ The Department has provided a space at the bot±om Of the affidavit for you to fill out in the event the Office of Inves'dgstions 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 a fc avrt 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 mtLSt be;filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i_e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this afda it 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 Comiaan ealffi o.i Massachusetts Degatmuoa of Industrial Accidents MQe Of fxLvestigafFoxrs (500 Was]zl gtaa Sit Boston__MA 02111 Tc,d A 6I7 727-4 M(xt-406 or I-9 7-MAS AF-E devised 4-24-07 Fax tt 617-7?7-7749 ylrwrw mass;'go.v/di,a � y Town of Barnstable Regulatory Services g, Richard V.SmIi,Interim Director 1639 �e 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 I, Gre l!q A'njerswi ,as Ownet of the subject ptopetty heteby,authoriz e _ �5)�)U n Q, YaA LLo to act on tap b eh4 in aIl=ttets relative to work authorized by this building p ermit Nq1 PA40- RD 'Lo4- 3 (Address of Job) Pool fences and alarms ate the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are petformed and accepted. Sb a±=e 6WWner Signature of Applicant (SL /-4/vx, Ptint Name _ Print Name Date IUW1l UI "211-MLIUM - Regulatory Services: . Richard V.Scal4 Interim Director. .. °-� BuiIding.Division - } Tom Perry,$wilding Commissioner 16MASS 3 � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maaus Office: 508-962-4038 .:Fax: 508-790-623 0 HOMEOWNER LICENSE ENMITTON Please Print DATE: JOB I.00ATIQtiT'' member street village "HOMEOWNER": name home phone# work phone CURRENT MAaJNG ADDRESS: cityhown \ slate zip code The current exemption for"homeowners"was ndedto include owner-occuied dwellings of six units or Iess.and to allow homeowners to engage an individual for who does n•t possess a license,provided that the owner acts as supervisor. . DEBIITION OF HOMEOWNER Persons)who owns a parcel of I on which he/she resnd or mtends to reside,on which there is,or is'iniendeli to be,a one or two- family dwelling, attached or de shed structures accessory to such use and/or farm strtnctlues. A person who constructs more than one home in a two-year period shall not be considered a homeown r. •Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be resnonsn le for all such work performed under the buildingermit (Section 109.1.1) The undersigned"homeowner"asses responsibility for comp ' anh the Slate Building Code and other applicable codes, bylaws,rules and regulations. The uundersigned`Homeowner"certifies that he/she understands of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of I3nmeowncr Approval ofBuddiagOfcial 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 E10M0V ,UR'S EM26 ION 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,RnIes&Regulations for Licensing Construction Supervisors,Section Z: T., lack of awareness often resnits in serious problems,-particularly when the homeowner hires unlicensed persons.. In this ease;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 Supdrvisor. On the last page of this issue is a.form currently used by several towns. You may caret amend and adopt such a form/certificatiou for use in your community Q:1wPFILESIFORMSIbmldmg pErmit fa=sUDUTESS.doc i Affidavit of Substantial Financial Interest 1, CS�Ukt ady-0 of , on oath depose and state as follows: 1. 1 am an applicant for a building permit for the property local at Map , Parcel . The address.of the property is u(�I ?A✓tb✓ (�� 2. 1 have 0 % legal.or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above. 3. Within in the last twelve months from today's date, which is 561 )14 , the following individuals or entities have had a 1% or greater legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name - Address 4. Within the last twelve months, from today's date, which is b I , I have had a 1% or greater legal or equitable interest in the following properties which have been the subject of a building permit application: Map/Parcel Address 5. Within this calendar year, i have submitted 0 building permit applications-for property in which I have a 1% or greater legal or equitable interest. . 6. Within the last ten days, I have submitted "` 0 building permit applications for property in which I have a.1% or greater legal or equitable interest. 7. Within this month, I have submitted 0 building permit applications for property in which J have a 1% legal or equitable interest. 8. Within this month, I have received 6 building permits for property in which I have a 1% legal or equitable interest. Signed.under the pains and penalties of perjury,.this-L) day of At v5f , 2001. 2001-0050/aifin 1 Q/LOTTERY/AFFIDAVIT 1 .7xe Ctaa -man:ctmh%of-Uassachmsez& Deparftmwt nf,idrutr.id Accidents -- Owe Of Invest4wiens 60,0 MIIyk&- Von greet f'astari,JIM 02- -� rvn�r►r.rxasxgo�duc . 'workers' Compensaf aniInsurance tdav&BraQl&rJCantra.ctorsUei-friciaiaMimbers plicant Iufarmatiain 1' Please Priaf Lef�ibly Name(B F O zan�onFIndivittnal): a A-t- C� � -�c 0 nit -A — .Are you an employer?Check.the apjw Ovate bow: Tyre of project(required): L❑ I am a employer with 4. ❑ I ain s geeral contractor and I 6_ ❑New won er rloyees(full andforpart-f=e * have hi�the sub-contractors. 2. am a sore proprietor orpartner- listed on the atiarhed sheet ❑Rr�todeltng irfp and have no employees These sub-contractors have mp_ g_ ❑Demolition to . and have workers' wonting forme iu any capacitlr_ COMP- mvtrwn'�, 9_ ElBuildmg addition WO workers, G4IIlp_inrorranre CO �r�1 5_❑ We are a carporatimand its 10..❑Electrical repairs or additions 3_❑ I am a hnmeou ner doing all work officers have exercised their 1 L❑Plumbing repairs or additions right.ofesmmptionper MGL myself [No worl-M'camp_ 12 Roof saran re haired_]1 152, §1(4,and we liaL a no � repairs. employees_[No� , 13_❑Other comp_insurance required./ "Piny anpUcmt that cheers box W l uxrm also fill out the:sectian below shawhmg fl eir wo3keaT comgensadon policy inf nnx6tn_ Hmmemxvners vitro submit ibis 8ffidiviE in c rg they ate doing as wcxk and then bim offside ccnttacmrs Est snhmir a need zMdavR intfirWdn such.. !Cantmcmcs that check this box mast attached m additioosl sheet shoscing the name of the m*-caak3cba and state whether ornot thmse entities have mmplayees- If the svlr-contmctarshaveemployees,their nnutpwvuk&ewwwl-e&comp.polirfnumber_ I am an employer that ispm id&rg worke-rs'c-ompensah'on imrarartce for my PngW&yee,% Belau is thepaIicy and job axle ir,formaliarL . Insurance CompanyName: Policy 9 cr Self ins Uc.9`- F-xpirationDate: Jolt Site Address: Cityl'StatclT_"tp: E$iUCIt a copy of the Workers'compensation policy declaration page(showing the policy number and expnation date). Failure to secure cm-crage,as regruredunder Section,25A of MGL c. 152 can lead to the imposititm of criminal penalties of a fine up to$1,500.00 and/or one-yearin3prrsemme&,as weU as civil peaaltiEs in rite form of a STOP WORK ORDIIZ and a fine ofup.to $250.00 a day against the violator_ Be advised that a copy of this st dement maybe farwarded to the Office of Iurestigations of the DIA€or mi sman a coverage vet cation_ I do hgreby czrttfy ander s and/ a as ofpegary thetthe in ormtdion prmddsd�a7biwe is true and correct SiEnatm�e: Date: li e V ©ffEciat use out}. Da trot write in this areap to be campleted by Gity ar town afficiaL City or Town: Pu-rudtUceuse# Issuing A�atharitg{circle'one}: 1.Board of$eaIth 2.Binding Department I City-1Taxrr Clerk 4.EIectrical Inspector S.Pluirtbing T ctor 6.Other Contact Person: Phone#- 6 Information and .Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. - Pursuaatto 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 ot`on the grounds or building appurtenant thereto shall not because of such employment be deemed.to.bean'zniployer" MGL chapter 152, §25C(6)also stains 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 "Ne-iher 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 numbers)along with their ceri_ricate(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 af5d2vit the affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Departinent 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 cease number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense 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 oa file for future permits or licenses. A new affidavit must be tilled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidav t. 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. T'he Commo m,-alth of Massaahusat -, Depazdnent of Industdal Acc0e, Of Xavestiptio-ns 600 Washin ou Suet Boston=MA 02111 Tel,#617-727- 00 ext 4Q6 or I-&-I ASS FE 1Zevised?-24-07 Fax#f 617-727-7749 vjww_mas5�,govfdia i , l.. CERTIFICATE OF LIABILITY INSURANCE D/20/ATE /DDIY4 YM �� 8/20/2014 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 Select Department X66807 NAME: P Eastern Insurance Group LLC PHONE (508)651-7700 A/c No:781-586-8246 233 West Central Street E-MAIL ADDRESS:selectwork@easterninsurance.com INSURE S AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A:Peerless Indemnity Insurance 18333 INSURED INSURER B.-Excelsior Insurance Company 1045 Steven Belanger, DBA: No 1 Foundations, CC INSURERC-Peerless Ins Co 24198 559 Old Stage Road INSURERD: INSURER E: Centerville MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER-CL1461739604 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 ADDLSUTYPE OF INSURANCE BR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AGE To RENTED X COMMERCIAL GENERAL LIABILITY PREMISES t E. occurrence $ 300,000 A CLAIMS-MADE ❑X OCCUR BKS56000722 6/14/2014 6/14/2015 MED EXP(Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EOMaBBIINdED SINGLE LIMIT 1 000 000 nt) ANY AUTO BODILY INJURY(Per person) $ B ALLOWNED SCHEDULED aA8681992 6/14/2014 6/14/2015 AUTOS X AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Medical payments $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AREXCESS LIAB CLAIMS-MADE TED /17/2014 6/14/2015 AGGREGATE $ 2,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION X VJC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N LIMITS 'ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? a N I A (Mandatory in NH) C8746778 /4/2014 /4/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Foundation Contractor CERTIFICATE HOLDER CANCELLATION shane.smpl@gmail.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Shane Pachew ACCORDANCE WITH THE POLICY PROVISIONS. 81 Jasper Road Marston Mills, MA 02645 AUTHORIZED REPRESENTATIVE John Koegel/KABl -T'-� ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025nn1nn5t of 7'hn A(_npn n*mn nnA Innn nra mnicfnwrl mthrke of A(`npn Bk 28044 Po 183 .0611641 o 0:.�3-21-2014 & 12 m 2 ass 00"0004tsT$ :su03 08,9B4 :89 F�itN5TA�LRr COUNTYT REGISTRY OFX DEEDS IMI :;gad M :A7113 Date: 03-21-2014 1 12:25pm Ct1aw: 546 Docr: 11641 Wdsz:ZT e tT0z_TZ-£C1 :rsqu4 3U AUSI938 A1NM 318d1SHNIPa Fee: 526.6E Cons: 81549044.04 �t1330 XVI 3SIOx3 AtNM 319VISMSM QUITCLAIM DEED We, Ruth E. Jenkins, Katherine E. Jenkins and Jill E. Jenkins, all of West Barnstable, Massachusetts, for consideration of$154,000.00 paid, grant to Gregg D. Anderson and Rebecca Anderson, of 147 Lakeside Drive, Marstons Mills, Massachusetts 02648, as Husband and Wife, tenants by the entirety with Quitclaim Covenants, A parcel of land in West Barnstable, Barnstable County, Massachusetts, shown as Lot 3 on a plan entitled, "Plan of Land in West Barnstable, MA, 441 Parker Road, Prepared for Ruth E. Jenkins" dated August 11, 2003, by Down Cape Engineering, Inc., and recorded with the Barnstable Registry of Deeds in Plan Book 596 Page 70. Easement 1: Said land is conveyed together with an easement for the benefit of the grantors and grantees, their successors and assigns, appurtenant to Lot 2 and Lot 3 on the aforementioned Plan Book 596 Page 70, being a 15-foot wide access and utility easement running from Parker Road across Lot 2 over the existing Driveway Easement shown on said Plan Book 596 Page 70 for approximately 15 feet, then turning and running easterly and southeasterly through Lot 2 near and approximately parallel to the southerly and southwesterly boundary of Lot 2 to the beginning of the northeasterly boundary of Lot 3, as shown on the "Easement Sketch" attached hereto, for all purposes for which ways are commonly used in the Town of Barnstable, including without limitation, access on foot or by vehicle and installing, maintaining, replacing, removing and using utility lines therein and thereunder. By their acceptance hereof, the grantees, for themselves and their successors and assigns, hereby agree that said easement shall be used in common by the grantors and grantees, their successors and assigns, subject to the following: a) Grantees shall have the right to construct a driveway within said easement to access Lot 3 at their sole expense. Upon the sale of Lot 2 and at the time and date of delivery of the deed, the new owner("Buyer") of Lot 2 shall pay one-half the.expense of construction for that portion of the driveway to be used by Lot 2 for access to the remainder of Lot 2. PROPERTY ADDRESS: 441 PARKER ROAD, LOT#3, WEST BARNSTABLE, MA 02668 i • J a l' j b) In the event grantees do not construct a driveway within said easement and a driveway is constructed within said easement by the owner of Lot 2, grantees shall have the right to use said driveway to access Lot 3 provided grantees shall pay to the owner of Lot 2 one-half the expense of driveway construction for that portion of the driveway to be used by grantees to access Lot 3. c) The expense of constructing utility lines to benefit Lot 3 shall be bome solely by the i grantees. The owner of Lot 2 may choose to connect to any or all utility lines constructed by the owner of Lot 3 within said easement. In the event the owner of Lot 2 chooses to connect to any such utility'line to benefit Lot 2, the owner of Lot 2 shall pay to the owner of Lot 3 one-half the cost of construction for the portion of any such utility line(s) already constructed by the grantees to be used by the owner of Lot 2. d) Each will indemnify and save the other harmless from and against any loss, damage, or liability arising out of their respective use of said easement. e) The foregoing easement shall be exercisable only by the grantors and grantees and their respective successors and assigns and shall not be assignable by either except as appurtenant to the benefitted lot. . Easement 2: Said land is conveyed subject to an easement for the benefit of the grantors, their successors and assigns, appurtenant to Lot 1 and Lot 2 on the aforementioned Plan Book 596 Page 70, being an access easement running from Parker Road along the southerly boundary of said Lot 3, being an existing travelled way and in the approximate location as the "Travelled Way" shown on a plan entitled "Plan of Land in (West) Barnstable, Mass. Prepared for James A. Jenkins" dated September 16, 1986 by down cape engineering and recorded with, the Barnstable Registry of Deeds in Plan Book 424 Page 42. The Grantors, Ruth E. Jenkins, Katherine E. Jenkins and Jill E. Jenkins, hereby certify that they are unmarried and voluntarily release any and all rights of Homestead in the property as set forth in M.G.L. Chapter 188, if any, and there are no other persons entitled to any such rights. For title see the deed of Ruth E. Jenkins, dated May 3, 2007, and recorded with the Barnstable Registry of Deeds in Book 22006 Page 157. EXECUTED as a sealed instrument this �a day of March 2014. Z I _..... r Ruth E. Jenkins Kat i E. Jenkins , ' I E. Je kins I COMMONWEALTH OF MASSACHUSETTS Barnstable County On this owl%day of March 2014, before me, the undersigned notary public, personally appeared Ruth E. Jenkins, Katherine E. Jenkins and Jill E. Jenkins, proved to me through satisfactory evidence of identification which was personal knowledge, to be the persons whose names are signed on the preceding or attached document, and acknowledged to me that they signed it for its stated purpose. 4 ,,d 1 �E MITCHELL �> r- c �r " OTARY PUBLIC :!Q commonwealth of Massachusetts Notary Publi My:commission Expires Feb 13,2015 My Commission expire -A- S Massachusetts-Department of Public Safety f ^ .. Board-of Building Regulations and Standards Construction Sup.enisor License-CS-092958 SHAKE-PACHECO` - ---- . . 8I Jasper Road ! Marstons Mills IVrA_0264$M i ! Expiration Commissioner 10/17/2045 T W w d _ -- ---- -_ t� ---- - o m U U,.M License or registration valid for:mdivrdul use onlyv .� c ao A�< - ; w a I u ; �, - before the ei P iration date. If found return to: E rn/ `rr - ; �'�! 11! rt1 d�j�I%co. 7 [ Nr .�. E W C� + Office of Consumer Affairs and Business Re ulation rn c�'i `'��' +1 i t'+ o rn• ;;+ 10 Park Plaza;Suite 5170 N o a c Boston,MA 02116 c t� O`.\ ) u 2 «L° o O E o w O u) W „d fn E - 1 r u. W N. V w J LJJ Q _ s N Y N U o it7 U I i w d K _ L CO c J Od+P� A 1 I 0 QU Q 2 Z I Z Lu Z Q U) I Not valid without signature" I f6 0 + _ = Q F � gcm � co wao � 1 . Building Air-Tightness Test Form Customer Information: Buildine&Test Conditions: Name: s aigIJ6, Yf ok(_-C.b Address: Date: > /� City: State/Zip: Phone: SOe Time: j!JO d!'" Email: SA AN)C-6M 6Nt-*IL-GO#V% Building Address:(if different from a74p4z ) Street: �/ / Floor Area (ft2): 9-5-8 2- Al 2 City/State:f��A2NSTiIBLE. ���� Comments: /F,� �r 4 &AI Z47& — cf�A�/vf/•�D `�'rtt`< �c<v.�'�9Cy Test#1 Depress: Press: Test#2 Depress: Press: Pre-test Baseline Pressure: .y (Pa) Pre-test Baseline Pressure: f.S'� (Pa) Bldg Press. Flow Ring Fan Press Flow Bldg Press. Flow Ring Fan Press Flow (Pa) Installed (Q 7 J Pr'a) (dm) Q(�Pa) Installed (Pa) Cfm)) -S' A '"oY /J 7 6 / J1,qO JD. '7 2 1'lyO S ra - Yf,g Post-test Baseline Press re: . 2' (Pa) Post-test Baseline 'ressure: (Pa) Fan Model/SN:/Rivx,& 130227 Fan Model/SN:Ali&i Results: Results: ,� CFM50: AM 9' CFMSO: II�7, ACH50: 3rD ACH50: � HERS Rater Name and Cert.#: E i 7 HERS Rater Signature and.Date: /, / .._ Developed by Advanced Building Analysis,LLC I f r 1"l ` fez C'r'l. r i I Town of Barnstable BAR.WTARLE. • Regulatory Services MASS. 1679• Building Division g 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice I I Type of Inspection Location y�� /'q'q' c Permit Number 2 O/ �0�6 Owner Builder One notice to remain on job site,one notice on file in Building Department. , The following'items need correcting: - 1 9Q� c -7-6-10 A,,5 �� ,QS 7. f E 0� Please call: 508-862-40-3'8 for re-inspertion. �Ins ®r�ected b P Y �t5 Date � l/� /�S (e� / �p fa MEMBER REPORT Leve/1,Copy afFbor Qmp Beam 6' R W. " - _ FAILED` /F O R T E 3 piece(s) 13/4"x 1s"1.9E Mladlam®WL Support 1 failed the reaction check due to insufficient bearing capacity. Support 2 failed the reaction check due to insufficient bearing capacity. e Overall Length:IV + + U O All locations are meawred from the outside far-�of left support(or left cantilever end).All diahasion s are horizontal. Dedgn Rnsulb Mod 0 team Yowl IOOwR tOF toed!tJaet6lostloe(Plum) p system=Rocky Memoer Reaction(lbs) 10999 @ 2- 7809(3.50") Failed(141%) — LO D+1.0 L(All Spans) HeYrba Type:Diop Barn Shear(lbs) 8809 @ 1'9 Im 179SS Passed(49%) 1.00 1.0 D+LO L(All Spans) : &MO9 We:Residential Moment Ft-Ibs) 4709 @ 9 58130 Passed 82% 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC live toad Deft.(in) 0.434 @ 9 0.S89 Passed(1 M) — 1.0 D+LO L A8 ) i Design Y:ASD Total Load Defl-(in) _0.614 @ 9 1 0.883. — Passed(VMS) 1-0 D+1.0 L(All Spans) i oeae an site ia:LL(UM)and TL(UM). Bracing(Lu):Ad aomixession edges(top and bottom)must be braced at G 7 3i0•olc dlfa0ed othervAW.Props att lidunent and of lateral brdcuV is required to achieve member stability S illso e UNDO leeNbSrnYaeli(ie, y E L SUM0111s ,tow Avdbw V3214 FbwTook" Aoawota 1-Stied wall-$PF 3S0" 3.50' 493" 7M 10999 2-Stud wall-SPF 350" 3S0" 4.93" 7785 10�b*,* •Bbclung Panels are assumed to am no bads Y dheM and the M bald B applied toed. Dad FkwLve ---- Loom IoYIOw ■110h MAM (Lao) coomm ra 1-Undonn(PSF) 0 to 18' ITT 12.0 40.0 Residen1101-Living Areas 2-Uniform(PLF) 0 to IB• WA 40.0 - WALL 1ST TO 2RD TO t1G 3-Undorm(PSF) 0 to I8' law 12A 30.0 AA IIIIeEetltsatner Iil0t0ls -- ---- ftsl susTAbLAUE FORESTRY IMf NIVE Y P.� Weve hmiser Warants gig the stung of its prom,cts.rm be in acwnft ee with Weyerlraea w aoeuct design ateir)a and published design Weyerhaeuser expessh disclaim any other xanantla re, -to the sofbkae Refer to current Weyerhaeuser tiEnratue for it on delaft (W W W.wood M—M)Ass-oriel(Rim Bond,elodeng Pands and Squash Btodrs)are not I ig br this sdhvare.use of tie:sObrme is not in>h3ded to &amwent the need fora design profession!as ddennii by the aNtorib having)uafsdktlon•The designs of rem4 builder or banks is responsible to asun that duffs relnbatrm is compatible With the overall project Products menuParsoed at Wepshaeeas facilities are ttrro-paity catfled to sustainable, toresoY surds. The product apokabon,input design loafr dmeeaons and support trdonoatbn have[seen pov+ded of DOP-M ��iroF 2 MICHELE �dk CUDit . U STRUCTURAL y NO 34774 p ti0 Q �p 9FQ►STE� �It7NAL�G Pf T:— - 1—i51h:14 : 12 37 PN' Sanware Ope.ator --- r ;oa Mutes Y �..._ __ __._.._.. ._. .. Forte '4 1;t]e rcr•Engire:V� i 0245 r- :.VARFJSIAV•' rr_: 2014-anderson 4,1e. page,of. n gT- � � -" bjA1#4 Slob �)F O R T E MEMBER REPORT Leven,Fbor-Dmp Beamr FAILED 4 oe*s) 13/4'x U" 1.9E Mlcrollam®LVL ' Support 1 failed the reaction check due to insufficient bearing capacity. Support 2 failed the reaction check due to insufficient bearing capacity. ` Overall Length:W T U U 18! Ir All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. De sly Acond O UmnO s Alliwnd PANk LDF Lr!k CoM1111001 a(Ptr VAM) = SoM=Roe► Member Reaction(Ibs) 13084 C 2" 10413(3.50-) Failed(126%) -- 1.0 0+1.0 L(All Spans) Me to Type:Drop Beam Shear Ibs 10479 @ V 91/2" 23940 Paged(44%) 1.00 L0 O+1.0 L(A0 Spans) 841drg Use:Residential Moment(Ft-4bs) 56718 @ 9' 77506 Passed ) 1.00 1.0 D+1.0 L(Alt Spans) cede Live load Deft.(in) 0.369 @ w 0.589 Passed(L/574) - 1.0 D+1.0 L(A0 Spam) Design HeModology..Aso Total lead Deft.(m) 0-w @ T 0 883 Passed V3B7) - 1-0 D+1.0 L(A0 Spans) -- _ Dore[danoifaia:LL(u36o)and TL(t/240). — - -- •Bring(L+):As coopessw edges(Wp and bof , must be braced at u'13/8,'t o/ ur!less d���ap(�d�odre�"ae Props►attadvnei arid;�llonig of Wival µ r y0•. Q tracing is re¢ired to acideve member stabft. Nff --- --- DwYDLM 6 imAss.0lppmrI me) SUPPaHN Tort AnaYle Dr a Lha R00' iaw Amrroefr 1-Stud wam-SPF 3-W 3-W 4.40' 4NA 8820 Bioddrg• Z-Stud wan-SPF _ 3.50" 3.W 4A0' 4264 SM 0084' lilodsag "aWdng Pannds are assumed tD cany no loads apoW due My ab3k4w1fi and the fid load is app0ed bag designed. _ ------- lit Ord fRrrW&ku LOadtt LGCMJW wim (0.9" (140) Cawb i-Ltr ftm(PSF) 0 to IV IT 9" 12.0 40.0 Rmidenilal-Lift Ames � i j�j /� AL-1 2-Liniform(PLF) 0 fo IF WA 80.0 - WALL 1ST TO ZnD To QG [/•/'7l 3-Unftwi(PSF) 0 t)1B T LLD 30.0 4-Un ftcm(PSF) o to IF 11• 10.0 20.0 weverhaeusw I [�SUSTAROW raREsrw rN!Tnanvi wevenaanser wanrares that the slAnng of fts podn�will be In aomrdar ith!ee w Weyalaaner product it design a a and pntli9ed design valises YY F Weyelaeum e*resafy dhdalms any Wtwr wanar!b s rekled to the softmare.Refs m Giment Weyelaasc nteraLnre for knollailm chalk. (www.woodbywy oom)Accemm(Rim Boa i,Modx g Panels and Spuash BlodLs)are not designed by dt sdhvae Use of dds sabowe is not u!telded to dicumvent the need for a design professional as deEarr tr!md by de The deslgna W rem4 ttllder or fame k neMonsWle tG assure that di s caloiadw is mrtipabW with the overall pro)wL PrOdud4 wrwdacbred at Weverhaerae fad0les are ftdvarly aetltied Lo srarahalk fifes"swidards. The"bid apoicabonn,input dese9n Wds6 dtmens)aLs and support udornad-have been PWAded by oEvi.nl L. �� j q to 3 ort- OF p M(Ct4ELE G Cl1DILO SrRUr_TURAL No 347744774 Asp 9FGISTEQ'��Q AL r.:,2 sM:Are rain» .iob Nines ! 0:2„-A 1 Yi F Owe Porle v= t Dear.n Enwse:�icl; gr of (�t LAP Am . 1 . FLOM SST I asr'rn.os xjx mL6 . 1 - 1 1 , 1 - _ I I 1 - 1 1 � b / !Lf&IN>LQ! 1 I L�vr 0'ULTS iTAGGEIEW GIP PL i� Ir�iw I I S� ftXf L ITT" I , 1 •sTm cm-um A sot 3t�w DAD. CAP PLATE 9ETAIL a n+c,�nor vaL rms�� OR. k OF 44 z� MICHELE m /dam rXo z GUpILO g STRUCTURAL y G No 3477o Q A'9�9F131SStiPF. 1�.ALL WORKMANSHIP TO CONFORM WITH AMERICAN INSTITUTE OF STEEL CONSTRUCTION AND MASSACHUSETTS STATE BUILDING CODE LATEST EDITION REQUIREMENTS. 2. STRUCTURAL STEEL- ASTM 572 (FY=50 KSI); Optional: SHOP PAINT WITH RUST INHIBITIVE PAINT. 3- EXPANSION BOLTS: ASTM A510 3/4' MAx6:-EMBEDMENT IN CONCRETE; THRU-BOLTS:ASTM A307 1/2' DIA. 4. PUNCHED HOLES IN PLATES = 9/16' DIAMETER. 5. ALL WELDS E70XX ELETRODES_ SHOP WELD CAP AND BASE PLATES TO COLUMNS. 6. COORDINATE ALL DIMENSIONS W/ ARCHITECTURAL DRAWINGS. AND FIELD VERIFY WHERE REQUIRED. STEEL BEAM CONNECTIONS TO WOOD FRAMING MICHELE CUDILO, P.E. Consulting Structural Engineer � A . 123 CaftOn*oad tam Cmdi Allm Mmodwaft 02032 441t p - ��� �-� n ar.IC lm s Drawing cats AS NOTED Rev- 0 S K— l Mame Project No.: 1 be required. i°1 Quarts N/A. M �. his sample may vary slightly in r L Moore'"products and sizes. 0 y re`retailer. ;U 3 4T-6 -o Z Mj 11119I111111l�1�811 m° I. . ' M _.� country redwood 5 t - i `• . II i i f' ' hwa Historic District Committee - Barnstable OLd I�ingS �1g Y 20o Nia�n Street,Ilyannis,MA 02601,TEL. 508-862-4�8� Fax 508-862-4784 ATION, CERTMCATE OF APPROP Certificate of Appropriateness 7 RIATE riateness and ectio APPLIC of G�pter Application is hereby made,with five(5)complete sets,for the issuance of a hoto 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings, -n accompanying this application for. ,�.. Check all categories that aPPly;. 1. Building construction: L" New ❑ Addition ❑ Alteration 2. Tvne of Building: L�1 House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ _„ er ca roof ❑ new roof ❑ color/material change,of trim,siding,window,doL M 3. Exterior Painting.__ 4. Si ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ElWall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ ' er 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ c r • l �i:���+ NUS ��� 4��. Type or Print Legibly: Date l30/�`j U'A Rt,-,5TA')Lc T 01,!t':i CIERK NOTE AH applications nwst be signed by the current owner Owner(print): f-a c�!1 Telephone#: �/�0��' Address of Proposed Work: L a- �"3 Village�d 51- C NS-AOL i Map Lot# Mailing Address(if different) -/7 f Sl Q U Owner's Signature ` Description of Proposed Work: Give particulars of work to be done: I I II p hone G Telephone Agent or Contractor(print): ��4� k p Address: 8t JGS Contractor/Agent'signature: For committee use only This Certificate is hereby APPROVED/TENIED 1 Date Membe s' natures l APPROVE JUL 2 32014 own o arnstable Old King's Highway Committee TI Q.W.oar,&and Co—d-,o-I0Id Kings HighwayI0KHAppliaationsl0Kff 2011 Cert Appropriateness.doc � I CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 5 copies Type: 12"exposed) material-bricklcement,other Foundation yp (Max. xp )( ) w , 3 Siding Type: Clapboard/shingle a/ other Material: red cedar white cedar :/ other Color a Chimney Material: bri c Color. Roof Material: (make&style) Q t � A rah;4c c Color. g 4L i)1 Roof Pitch(s): (7/12 minimum) I�l° (specify on plans for new buildings, major additio Window and door trim material: wood other material,specify A Z F K . j Size of cornerboards pt 5 i X size of casings(I X 4 min.) j x'y color i Rakes Ist member I X V tad member J)t _ Depth of overhang Window: (make/model) A n C�2.rS material i,J;, �! Q^i �+^Y f color �,!�,s e (Provide window schedule on plan for new buildings, major additions) Window grills (please check all that apply_: / t true divided lights_ exterior glued grills_ grills between glass_/ removable interior None Door style and make: Th er in v :Rv material •ri be--A)k. s Color: Garage Door,Style Size of opening Material Color I Shutter Type/Style/Material: UvUn.A- Color: i E Gutter Type/Material: A I UM I n v+a►• Color. Wit Deck material: wood other material,specify i� Color. PAL iI ( ac/ t n Lr !�'et K Skylight,type/make/model: material Color. SiCE ze: Sign size: Type/Materials: Color.RID Fence.Type.(max 6')Style material: Color. JUL 01 t014 i i Retaining wall: Material: Q= NAr'*YMW ! t Lighting,freestanding on building illuminating sign I OTHER INFORMATION: THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED f Please provide samples of paint colors,manufacturers brochure of windows,doors,garage door,fences,lalm�p posts etc Signed: (plan preparer) f7�es� { Print Name �oYlGvu a C/ APPROVED i � (Boards and Commissions101d Kin Hi 10KHA lrcations10KH2O11 Cert A ro riateness.doc fi 2 Q. � ghway np � pp p JUL.2 3 2014 � Town of Barnstable Old Kin g's Highway Committee ' 1 Plans shall include the following: _Name of applicant,street location,map and parcel. _Name of Builder Designer,or architect;original signature of plan preparer and stamp;plan date,and iall revision dates. ALL NEW HOUSE OR COMMERCIAL BUILDING PLANS MUST HAVE AN ORIGINAL`I SIGNATURE AND STAMP,IF ANY,BY A REGISTERED ARCHITECT,MEMBER OF AIBD,OR A LICENSED MASSACHUSETTS HOME IMPROVEMENT CONTRACTOR,UNLESS THIS REQ� T IS WAIVED BY THE OKH DISTRICT COMIVIITTEE. _ A written and bar drawn scale. _ Elevations of all(affected)sides of the building,with dimensions including height from the natural erade adjacent to the building to the ton of the ridge;location and elevation of finished grade roof vitch(s)dormer setbacks-,trim le window and door gyles. Changes to existing buildings must be clouded on dravvm s. Window schedule on plans. Landscaping plan,5 copies drawn on a certified perimeter plan containing the following information: Name of applicant,street address,assessor's map and parcel number. Name,address and telephone number of the plan preparer,plan date and dates of revisions. The location of existing and proposed buildings and structures,and lot.lines. Natural features of site(e.g.rock outcroppings,streams,wetlands,etc.). Existing buffer areas to remain. _Location and species of trees outside of buffer areas greater than 12"caliper to be retained or removed. _The location,number,size and name of proposed new trees and.plants. Driveway,parking areas,walkways,and'patios indicating materials to be used. _Existing stonewalls,and proposed walls including retaining walls for slope retention or septic systems (for removal of stone walls,file Demolition Form). I l All proposed exterior lighting and signs. Sketch or photos of adjacent properties,(1 copy only) here present,along both sides of thl eet A sketch(s)to scale or photographs of nearby adjacent buildings,w p t, g frontage,showing the proposed new house or commercial building in scale and in relationship to the e ' ting buildings. Please discuss with staff if you do not think this is relevant to your application. Photographs of all sides of existing buildings to remain,or being added to. Fees according to schedule. APPROVE ®V Please complete the following: ¢�r JUL 2 32014 Existing building,foot print: Building 1 '-f** t sq. ft. Building 2 Town of Barnstable aid �y" a Existing Building,gross floor area,including area of finished basement: comm i ttee Building 1 sq. ft. Building 2 New building or addition,foot print: Building.1 sq.ft. Building 2 New Building or addition,gross floor area,including area of finished basement: s. Building 1 sq.ft. Building 2 S 4 Q:Woards and Commtsstonsl0/d Kings HighwaylOKHApplicattons10KH2011 Cert Approprmteness.doc pgB e / e! �a a / / s R REScheck Software Version 4.5 0� Compliance CertifitD rARNSTABLt 201g SCP 16 AN 10: 0 6 Project New Custom House Energy Code: 2012 IECC 1 V! II,�� Location: West Barnstable, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 2,445 ft2 Glazing Area 14% Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Owner/Agent: Designer/Contractor: Construction Site: Shane Pacheco 461 Parker Rd. 81 jasper Rd. W.Barnstable,MA 02668 Marstons Mills,MA 02648 . - Compliance: 0.3%Better Than Code Maximum UA: 342 Your UA: 341 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 Glazing Gross Area Cavity Cont. or Door UA Perimeter i 1.547 38.0 0.0 0.030 46 Ceiling 1: Flat Ceiling or Scissor Truss 210 30.0 0.0 0.034 7 Ceiling 2: Cathedral Ceiling 2,480 21.0 0.0 0.057 120 i Wall 1:Wood Frame, 16"o.c. 258 0.290 75 Window 1:Vinyl Frame:Double Pane with Low-E 20 0.300 6 Door 1:Solid 100 0.310 31 Door 2: Glass 56 1,697 30.0 0.0 0.033 Floor 1: All-Wood joist/Truss:Over Unconditioned Space d here is consistent with the ing ifications ,and other Compliance submitted w th the permt appl building icationsThe p oposed build ng has been designed todm et the 2012cIECC equi ements in calculations REScheck Version 4.5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Date Signature Name-Title Report date: 09/12/14 Project Title: New Custom House cane of 1 trial,ar4m1sa.flWl :.��iw-w1t.73�r\ '-IILL^�11i!_+1,ftt•CQNry•t7ln-t:n,•,r,•rt�s\`u��V,rICi•R"Sl`R��.Si:ii������,#iv^9.iS3�.S,ll �le ••y•. _ ••• Pacheco.rck l�` 2012 IECC Energy �... Efficiency Certificate Insulation . Wall 21.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.29 Door ' 0.31 CoolingHeating& Heating System: Cooling System: Water Heater: Name: Date• Comments C3 � tea, � rn. RECEIVED AND RECORDED ' ZOOS JAN 12 P 3 00 REGISTRY OF DEEDS JOHNF.YIEA.OE omr v s[ Locus PwC sr. 50' OH IN ROCK WALL/ I 1 FOUND POND �g4.38.38•E B4.7B' sao Nu x S82 18'E OH IN ROCK WALL NlIF POND � — �• J` 10.79' 169./7- FOUND PETER P. JENKINS A. :�S3Ji\ � PROBATE 0578—A1 ,�\\/�?'• 4 �! �, 114.61 SB \ FOR REGISTRY / USE ONLY LOCUS MAP SCALE 1 2000' 10.yc� S825i'18-E TO HERE 8`>r8 DRIVEWA EASEMENTS �.` ASSESSORS MAP 176 PARCEL 25 Q/ F• � •� ZONING: RF. RESOURCE PROTECTION ov"LAY.DISTRICT MIN. LOT FRONTAGE - 150 FT YIN. AREA - 87.120 SF y �•` t,`'1 i�r',p' ��3p F SETBACKS: FROM - 30' *3 SIDE - 15' 00, REM — 15' i FLOOOZONE C BARNSTABLE.COMMUNITY PANEL /250001 0015 C AUGUST 19. 1995 OWNER OF RECORD:- 4O�gt' i/o t j�s 3 rE urN E. JENKINS a I v, T �1• /p \ 441 PARKER ROAD -Q,Y�p4, ••2�, �q, x r�SA I / WEST BARNSTABLE. MA 02688 i; Q � i i •� � 4.05' / REF: DEED BOOK 9251 PACE 86 i EXIST. DH IN ROCK PLAN BOOK 284 PACE 1B \ DWELLx i I 'a FOUND 99.612 SFt 2.29 ACRES± SHAPE— 16.8 a LOT 1 110,846 St 2.54 ACRES* .. SHAPE— 14.6 RX \ POOL `Q .....:.... = .. 5 J? °FauNR°°at - BARIKSI.ABL 80ARD _. .y L under t e StfBD/VISIOM[ —._. CONTROL LAW NOT REQUIRED 111.597 ± \ Z56 ACRES± N DATE: A40]j . SHAPE— 16.2 JAMES A.1174^,542 S748g.p4• :.CB FND nS 0� JENKINS OMINEES TRUST 'u'[. G/^. " 43D '$`4?)•E �S,p$, \ t `SB310f 6J DEED BOOK 9994 PACE 100 \ \ SHAPE TO HERE \ ,^A ry NOTE: NO DETERMINATION AS TO COMPLIANCE WITH THE ` ZONING ORDINANCE REQUIREMENTS HAS BEEN MADE \ 0 OR INTENDED BY THE ABOVE ENDORSEMENT N/F \ JAMES A.JENKINS, TRS. \�q JENKINS NOMINEE TRUST N \ DEED BOOK 9994 PAGE 100 PLAN BOOK 424 PAGE 42 PLAN OF LAND IN �• \ WEST BARNSTABLE, MA _ °FOUN°C=� \ \ j 441 PARKER ROAD \ A \ \ sBB'as'oYW m \ \ PREPARED FOR 130.66' cok\ \ R UTH E. JENKINS \ \ M� "�' lk6 CO.' \ \ \ I CERnFY THAT THIS PLAN WAS MADE IN SCALE: t' = 40' ACCORDANCE WITH REGISTRY OF DEEDSREG \ DATE: AUGUST 11. 2003 ANDULATIONS AS AMENDED JANUARY 7. 1 88.1976. \ lm soe aexwaeo 40 0 40 BO 120 Feet •// ? A // f�' M. x 3 ,k� � \ down cape engineering, inc. D ARNE H. OJALA, P.LS. '�.:4, a��� \ CIVIL ENGINEERS \ LAND SURVEYORS i \ i \ 939 main St. yormouth, m0 02675 rvi� 03-170 JENKINS THC W \