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1301 SERVICE ROAD
i N SMEADQ No.53LOR UPC 125433 smead.eom • Made in USA ICY ti lBEtMNDE1R00 OU E wMa scup i Eouamm IOFI WWWSRPQDGRAMJM Town of Barnstable _ . .._ _ _ a Building w�xsres;e Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept 6' `�B Posted Until Final Inspect ion'Has Been Made:- r.I Where a Certificate of.Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-18-742 Applicant Name: INSULATE 2 SAVE, INC. Approvals Date Issued: 03/20/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 09/20/2018 Foundation: Location: 1301 SERVICE ROAD,WEST BARNSTABLE r— Map/Lot: 152-003-009 - Zoning District: RF Sheathing: Owner on Record: CUNNINGHAM-ALLBERT,WAYNE KEITH& Contractor Name: INSULATE 2 SAVE, INC. Framing: 1 Address: 1301 SERVICE ROAD Contractor License: 180�747 2 WEST BARNSTABLE, MA 02668 ( "' '°.� Est. Project Cost: $2,083.00 Chimney: Description: Weatherization i4 i Permit Fee: $85.00 I Insulation: Project Review Req: Fee Paid:: $85.00 Date: 3/20/2018 Final: Af'• r Plumbing/Gas Rough Plumbing: -- -- ',Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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. F- - —-—----- -� f� 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. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: \ All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r IKE t Application Number ........ .......By........................... . * BAMSTABLE, * S O Permit Fee........................0............Other Fee........................ >�►sa �,* BUILDING DBPT zb;q. �� Total Fee Paid TOWN OF BAIL' MARLE ,Qrh�/ 3 zD 1 TOWN n !Z Permit Approval by...............^..............On.....X../......... BUILDING PLfRJYAeLE l APPLICATION ` Map...........✓.....yh.....................Parcel... l.�l.�.�.....��............... \ l Section 1 — Owners Information and Project Location Project Address /�?o/-Pe-vice /?ol L/3a.fnclv-6le- Ain io-)G,�millage Owners Name_ k Q a e u h h i A 1 a,w -lib e-n-f Owners Legal Address 13 o / Se r!0 c-e R City 1221 "13a State 'hiA i Zip Owners Cell # ���' y�7 ��� � E-mail O �l A /La e .9 , W 4 i .Section 27- Structural Use Single/Two Family Dwelling ❑ Commercial;Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet t Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Pool I ❑ Fire Alarm Rebuild ❑ Deck ❑ Solar ❑ Sprinkler System ❑ Addition ❑ Retaining wall �nsula>ion ❑ Renovation Other- Specify Section 4—Detail 1 Cost of Proposed Construction Q,0Y3,QJ _Square Footage ofiProject Age of Structure Dig Safe Number # Of Bedrooms Existing Total # Of Bedrooms if(proposed) 110 MPH Wind Zone Compliance Method .❑ MA Checklist ❑ 7CM Checklist ❑ Design Last updated: 10/31/2017 I I Section 5 - Work Descriplon 2—l7 C(o s s I C e au/o.r f V-d Q "/'c s/a a C e414 FOP r e Sao rV 4,d-r on ycI z 6 a Kai, .I Section 6— Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility-�,Fe��9.;y.ee a.9< 2�. o Lf �.6`y�� I am using a crane C Yes El No a d7 U Section 7- Flood Zone f Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes!❑ No ❑ Section 8—Zoning Inforr ation Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage i #of Dwelling Units (on site) i Setbacks Front Yard Required Propo§ed Rear Yard Required Propo` d Side Yard Required Propo d Has this property had relief from the Zoning Board in the past? E,I Yes ❑ No Last updated: 10/31/2017 i Section 9— Construction Su `ervisor Name_ Z C c. TC j ;�/, Telephone Numbej tea)F 5 6--7 6 7 a 6 Address ly 6a O Ue iv, City L zz 41 e"ie Stat' '211 ,4 —Zip O d 1 d-4 License Number 6 / License Type Expiration Date Contractors Email _d1S' 0'0,111%15414O�Asa U e, n If Celi# 6���6 — .P4 Fea I understand my responsibilities under the rules and regulations for Licensed Co struction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction ins ection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your license. Signature / / Date Section 10-HomeYl=mprovemen Contractor Name f P�/C�ijz �Cq P y yJ Telephone Number 5^��— 6 7 Address :"7 X r 0 ile .S' City 74,C/ "e'�U 6.111 Stat,. Zip o d Ld Registration Number/P'D 7 Expiration Date d- j I I understand my responsibilities under the rules and regulations for Home Impro iement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction insl ection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your H.I.C... Signature Date 31111/r Section 11—Home Owners Licens D Exemption Home Owners Name• , ,i�ti. e Telephone Number q 9 Y/- �ZF�2 Cell or Work Numb r I understand my responsibilities under the rules and regulations for Licensed Co struction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction insi ection procedures,specific inspections and "documentation required by 780 CMR and the Town of Barnstable. Signature Date 3& i APPLICANT SIGN ' TUBE Signature.. --- Date 3t1111i i Print Name i26 f G a4A_5 n Teleph e Number j 0 ,P -J`^� 7- 6 '7 0.G E-mail permit to: /` o h b/ %, Sir �2 a S a v P. c Last updated: 10/31/2017 Section 12 —Department SiF'offs Health Department ❑ Zoning Board(if required) El Historic District ❑ Site Plait Review(if required) ❑ I ,Fire Department ❑ Conservation ❑ For commercial work,please take yoi ir plans directly to the fire&nartmentfor approvak Secti n 13 — Owner's Autho f ization I I, �C��r1 i✓t �G1� - a-n/� , as Owner of the subject property hereby authorize ZAA .gz Z-avu e to act on my behalf, in all matters relative to work authoriz d by this building perm t application for: 4r vi':e 1a6le Dd/ G (Address of job) Signature of Owner date Pri t Name Last updated: 10/31/2017 RISE Engineering +/ 5 Dupont Ave,South Yarmouth,NIA 02"A 'G'N 'N67 508-%8-1926 FAX 508-568-1933 CONTRACT Page 1 PROGRAM THIS CONTRACT B ENTERED INTO BETWEEN RISE CLC-AL'S ENGINEERING AND THE CUSTOMER FOR WORK'AS DESCRIBED BELOW . CUSTOMER PHONE DATE CUENTS WORK ORDER WAYNE CUNNINGHAM-ALL13ERT (931}494-4843 02/08/2018 250527 26002 . SERVICE STREET SLUNG STREET 1301 Service Road 1301 Service Road SERVICE CnY,STATE,MP SLUNG CITY,STATE,ZIP West Barnstable,MA 02668 West Bamstable,MA 02668 JOB DESCRIPTION HEALTH&SAFETY:Currently,the amount of natural ventilation(fresh air movement)in your home is sufficient enough to withstand the additional tightening up from this planned weathcrization work.However,future _._ lniae)s) remodeling projects of your home,a change in performance from your home's existing appliances or,a dramatic increase in occupants could create an indoor air quality concern that might require the addition of a mechanical ventilation system. We recommend you consider installing a controlled ventilation source able to provide a continuous exhaust of(35)cfm(cubic feet per minute)to help remove any household pollutants and increase the amount of fresh air in your home. Your signature is both your acknowledgement of these conditions and your agreement to proceed ATTIC FLAT:Provide labor and materials to install a 5"layer of R-17 Class 1 Cellulose added to(936)square feet of open attic space. $1,179.36 VENTILATION:Provide labor and materials to install ventilation chutes in(82)rafter bays to maintain air flow. $286.18 VENTTLATION:Provide labor and materials to install(0insulated exhaust hose with gable wall mounted tlapper vent to exhaust $118:75. existing bathroom fan(s). AIR SEALING:Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed $160.00 in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstrippina and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) (2)working hours. A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cf n is not.guarantecd. COMMON WALLS:Provide labor and materials to install 2"rigid board with the required fire rating to(88)square foot ofcommon $338.80 wall area. RISE Engineering RISE" 5 Dupont Ave,South Yarmouth,MA 02"41 EIUGINEERiNG CONTRACT 50& 08- 568-1926 FAX 5568-1933 Page 2 PROGRAMTHIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-HES ENGINEERING AND THE CUSTOMER.FOR WORK AS DESCRIBED BELOW . CUSTOMER PHONE DATE CLIENT S WORK ORDER WAYNE CUNNINGHAM-ALLBERT (931)194-4843 02/08/2018 250527 26002 SERVICE STREET BILLING STREET 1301 Service Road 1301 Service Road SERVICE CRY,STATE,I3P BILLING CITY,STATE,ZIP West Barnstable,MA 02668 West Bamstable,MA 02668 JOB DESCRIPTION YOUR INCENTIVE EXPLAINED: R1SE.Engineering will apply all applicable,eligible incentives and you will be billed only the net amount. Currently,for eligible measures,the Cape Light Compact offers a 75%insulation incentive,with no limit on the amount,and an incentive of 100%for the Air Sealing measures. Total: $2,083.09 Program Incentive: $1,602.32 Customer Total: .$480.77 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUN OF ***Four Hundred Eighty&77/100 Dollars $480.77 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMR AMOUNT DUE IN FYLL INTEREq 0 BE jC-NO�ANY UNPAID BALANCE AFTER 30 DAY&SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF SION,SC RISE REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EvECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS ANDCONDITWWARE SATISFACTORY TO US AND ARE HERESY ACCEPTED.YOU ARE AUTHORIZED:TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE - Town of Barnstable Regulatory Services Richard V. Scali,Director Building Division `r _a Paul Roma 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 I, WAYNE CUNNINGHAM-ALLBERT 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: 1301 Service Road West Barnstable, MA 02668 (Address of Job) Sign a of Owner Date Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:\Users\decollik\AppData\Local\Microsoft\Windows\lNetCache\Content.0utlook\L7U69LF2\EXPRESS(2).doc 01/25/17 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 ul www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant information Please Print Leeibly Name(Business/organization/tndividual): Insulate2Saye Inc. Address:410 Grove Street City/State/Zip: Fall River MA 02720 Phone#: 508-567-6706 Are you an employer?Check the appropriate box: Type of project(required): I.M I am a employer with 20 employees(full and/or pert-time).' 7. New Construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. [1 Demolition 10 Q Building addition 4.0 l am a homeowner and will be hiring contractors to conduct all work on my property. l will ensure that all contractors either have workers'compensation insurance or are sole I Lrl Electrical repairs or additions proprietors with no employees. 12.o Plumbing repairs or additions S.❑1 am a general contractor and l have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These subcontractors have employees and have workers'comp.insurance.t 6.a We are a corporation and its officers have exercised their right of exemption perMGL c. 14,❑X Other Insulation 152,§t(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workcrs'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. *,Contractors that check this box must attached an additional sheet showing the name of the subcontractors 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: Liberty Mutual Insurance Policy#or Self-ins.Lic.#: XWS 56418741 Expiration.Date, 12/10/2018 r Job Site Address:Z�Q/ J c'N,..'/tce Oec'ooe, City/State/Zipk),� Igo a/P, 4 4 e) Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 th ry that the information provided above is true and correct Signature: / / /J'G Date: Phone#: 508-567-6706 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#: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MaM-1u, setts 02116 Home tmprovemractor Registration Type: Corporation Registration: 180747 INSULATE 2 SAVE , INC. Z W Expiration: 12/28/2018 410 Grove St M 1 Fallriver, MA 02720 w a�M 5�o Update Address and return card. Mark reason for change. SCA 1 0 2OM-05MI .._....._....._..____.._______ _ .�.(ZAddrefss C7 Renewal 0 Employment O Lost Card :-Jlie`�pla�»mraixureal�o�C-3/��traaaa�zuaelTd office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Corporation before the expiration date. if found return to:-3 Expiration . Office of Consumer Affairs and Business Regulation ow 12/28/2018 10 Park Plaza-Suite 5170 Boston,MA 02116 INSULATE 2 S. t� Roland LangeYR, w /J 410 Grove St <' /L Fallriver,MA 0272 Undersecretary Not valid without signature ............. ..... Commonwealth•of Massachusetts Division of Professional ticensure i Board of Building Regulations and Standards Cons r. '4rvisor CS-103861lpises:08/24/2019 ♦ R" y .'R ROLAND LAI. 66 HIGHCRE41 OAD i FALL RIVER Commissioner x ' ® DATE(MM/DD/YYY`I) A v CERTIFICATE OF LIABILITY INSURANCE o3/on18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE°HOLDER:THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terns 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 NAME: ' Anthony F.Cordeirc Insurance AICNN • 508-677-0407 ac No: 508-1 n-0409 171 Pleasant Street LADDRE -6AIL sr- hsouza@cordeircinsurance.com Fall River,MA 02721 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A: Liberty Mutual Insurance INSURED INSURER B: Insulate 2 Save,Inc. INSURER C: 410 Grove St. INSURER D: Fall River,MA 02720 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 013R DO POUEY-0-1?— POLICY TYPE OF INSURANCE INSD= POLICY NUMBER MIOD MM/DD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,0001000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ $00,000. MED EXP(Any one person) $ 5,000 A Y Y BKS 56418741 12/10/17 12/10/18 PERSONAL SADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PEP, GENERAL AGGREGATE $ 2,000,000 X POLICY JEa LOC PRODUCTS-COMP/OP AGG $ .2,000,000- $ OTHER: CO AUTOMOBILE LIABILITY aunt SINGLE $ 1,000,000 AIANY AUTO BODILY INJURY(Per-person).' $ OWNED SCHEDULED B/l�56418741 12/1 O117 12/10/18 BODILY INJURY(Per accident) $ x AUTOS ONLY X AUTOS y y PROPER .D AG HIRED X NON-OWNED (Per acddent $ AUTOS ONLY AUTOS ONLY X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,000,000. A EXCESS LMS CLAIMS-MADE Y Y USO 56418741 12/10117 12/10/18 AGGREGATE $ 10,000' DED I I RETENTION$ 1 $ WORKERS COMPENSATION X1 STATUTE I I ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500 0,00' A OFFlCER/MEMBEREXCLLIDED? NIA XWS56418741 12110/17 12/1OI18 E.LDISEASE-EAEMPLOYE $ 500,000 (Mandatory in NFq If yes.desaiba under E L DISEASE-POLICY LIMIT $ 500,000'. DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE'VVILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Proof of Insurance ' AUTHORIZED REPRESEN /' • . O 19 2015 ACORD CORPORATION.Ali_riohts,reseived. ACORD•25'(2016/03) The ACORD name and logo are registered marks of ACORD I aRar�'4� Town of Barnstable 9Buildin, P ost FIRM ThIssCard So That;it�is Visible>sFcom the Street" ppco,vednPlan Must be-Retamed on,lob andYthis,Card Must�be Kept :s •.aattseweaE „ �;� my Posted UntihFinalQlnspeet on"Has'Been<IVlade. ° ' � � y e , ice €, : t� :" .. . .- :rNc+° Where"a Certificate:of Occupancy4is�Regwred;such Buddmg5liall�Not bye Ocupieduntil a final Inspect�on;has�been made p®,gyp®/� .�SPL�i�'E � T �Oi� �i�/�l 'PermitfNoa B-17-4394 -. ° Applicant Name: Ryan Lane Approvals Date Issued:" 01/12/2018 Current Use: Structure Permit.Type: Building-.Solar Panel-Residential Expiration Date: 07/12/2018 Foundation: Location: 1301 SERVICE ROAD,WEST-BARNSTABLE Map/Lot 152003 009 Zoning District: RF Sheathing: Cona SKYLINE SOLAR iLC. Framing: 1 Owner on Record: SEGOLINI :ADILSON&INES �rrne k—nz tractor rN ` ��� 4s, r Address: 1301"SERVICE=ROAD �s � k� w ContractoGLicense�172284 2 i f t c WEST BARNSTABLE,MA"02668 ' Cost: 46,000.00re Chimney: Description: Installation of a safe and code compliant,.grid�tiedPV solar system Permit¢Fee: $284.60 e fix. 'Insulation: on an existing residential roof. 47 Panels/12 925kWW � �eePa $284.60 F Project Review Req: Final: S ate .. 1/12/2018 O -01 M Plumbing/Gas � w Rough Plumbing: Official 4 Final Plumbing: This,permit-shall be deemed abandoned and invalid unless.the work authonzedRby this permit is commenced within six months after;=issuance. All,work authorized by this permit shall conform to the approved-application and thexapproved construction documents=for which th s permit has been granted. Rough Gas: All:construction,alterations and changes of use of any building and strictureshall bem compliance with thelocal zong byaa =codes. This permit shall be displayed in a location clearly visible from access str e entire duration of the - Final Gas: work until the completion of the same. r Electrical The Certificate of Occupancy will not be issued until all applicable sign atu sjby thelBuildin&andiFi��e Offc@ s are prov ��e rmit. a Service: Minimum of Five Call Inspections Required for All Construction Work: f 1.Foundation or Footing x�� - , .. Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue-lining is installed ; Final: 4.Wiring&Plumbing Inspections to be completed prior to frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.final Inspection before Occupancy Low Voltage final: .Where applicable;separate permits are required for Electrical,Plumbing,and MechanicaFinstallations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: Tersons:contracting with unregistered.contractors do-nothave-access10 the guaranty fund" (as set:forth in IVIGL c.142A). Department-Fire epa ment Building plans are to be available on site Final: All Permit Cards are the property.of the APPLICANT-ISSUED RECIPIENT Town of Barnstable e- RECEIPT BAWWnnt.�. 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-4394 Date Recieved: 12/21/2017 Job Location: 1301 SERVICE ROAD,WEST BARNSTABLE Permit For: Building-Solar Panel-Residential Contractor's Name: SKYLINE SOLAR, LLC. State Lic. No: 172284 Address: 4 CROSSROADS DRIVE SUITE 116, Applicant Phone: (732) 354-3111 HAMILTON, NJ 08691 (Home)Owner's Name: SEGOLINI,ADILSON& INES Phone: (732)354-3111 (Home)Owner's Address: 1301 SERVICE ROAD, WEST BARNSTABLE,MA 02668 Work Description: Installation of a safe and code compliant,grid-tied PV solar system on an existing residential roof. 47 Panels/ 12.925 kW O O t Z %-n Z Total Value Of Work To Be Performed: $46,000.00 tV Structure Size: 0.00 0.00 0.00,-+ c .o Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accuiate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Ryan Lane 12/21/2017 (732)354-3111 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $46,000.00 Date Paid Amount Paid I Check N or CC# 1 Pay Type Total Permit Fee: $284.60 12/21/2017 $234.60 XXXX-XXXx-XXXX- Credit Card 3253 _ Total Permit Fee Paid: $284.60 ^12/21n017 $50.00 XXXX-XXXX-)DM- Credit Card 3253 I �--- { THIS ISINOT °A` PERMITk `�FtHEtp,, Town of Barnstable .► ��0; Building Department-200 Main Street r �`e "foM Hyannis, MA 02601 Tel. (508) 862-4038 1` y Certificate Of Occupancy Permit Number: B-2015-01594-1 CO Issue Date: 2/28/2017 Parcel ID: 152-003-009 Zoning Classification: RF Location: 1301 SERVICE ROAD, WEST Proposed Use: 1300 BARNSTABLE Gen Contractor: SEGOLINI,ADILSON Permit Type: Residential - Comments: / Building Official Date: TOWN OF BARNSTABLE Buildinu z U 150 1590"4 Permit BARNSTABLE, » Issue Date: 06/29/15 9 MASS. i639•, �� Applicant: SEGOLINI,ADILSON Permit Number: B 20151682 Proposed Use: DEVELOPABLE LAND Expiration Date: 12/27/15 FLocation 1301 SERVICE ROAD Zoning District RF Permit Type: NEW SINGLE FAMILY HOME Map Parcel 152003009 Permit Fee$ 867.00 Contractor SEGOLINI,ADILSON Village WEST BARNSTABLE App Fee$ 100.00 License Num 159597 Est Construction Cost$ 170,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND NEW HOME CONSTRUCTION 3 BEDROOM WITH ATTACHED 2 CAR AUWARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH j Owner on Record: WEST BARNSTABLE DEER CLUB INC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL q Address: 1800 OLD STAGE RD INSPECTION HAS BEEN MADE. It WEST BARNSTABLE,MA 02668 n� " Application Entered by: RM Building Permit Issued By: 0'?Ae"4- d�ccJ' 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. MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2:SHEATHING INSPECTION 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 GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1/3 1 1 S�iel/IL/� D/< 5-»-1�-TF- KOJ pie I�or La�sf rts� §2"-1 4;O 2 2 7 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health v 4 : PROJECT t : : NAME: . -ADDRESS• '. f 't PERMIT DATE: LARGE ROLLED P 'Alm IN: a ent ed in MAPS ro am on: '. Dal � q/wpfi�es/ omss/archive..: INSTALL RISERS 4 COVERS TO PIPES TO BE LAID LEVEL FOR ' u N WITHIN 0 OF FIN15H GRADE Z OUT OF D15TPIBUTION BOXlu f (SEE PLAN VIEW FOR LOCATIONS) } w� rfi, � S y'xt i 7 WATER TEST D-BOX FOR t „'.�: b* '•'% Q °J LFVELNE55 4 FLOW I EQUALIZATION +t N Q (tIL : EL.72.0�A Ell WRW17 O — T.O.F.C — u�� O EL.73.0 a scn ao PVC ao rvc r . �64 6.sbc3n aoc ¢ ID• Pv 4, ST- INF A9 BAFFLE 7 w D ouTtPr Tee 725 —+ w (H-20) 1500 GALLON PRECASTw u srnTANK i D-BOX J Q SEPTIC TANK ON G'LAYER OF CRU5HED STONE TBM = EL. 68.2 ^` MAG NAIL IN PAVEMENT 1. •may � 65.1 70 / \ It It It \ \\ \\ '\ TH 1 90 09 r i r-- / \ \ \ I00 70 / \ < \ \ 1 mg XTh / \ 72.z. I {aye + I rH i- Y ' I +73.6 -- I) / 4-11 OE \ O 1 \ 69.2 Ar 80� \ Tri 0#4 Of NI +)I 1 IDE LOT q \\ \ \\ \\ 1 I It Qi \ \ +84.G \ \ ot /\v z3.27• It \) \\ \\ +84.9 PROPOSED`•- \ \\ \ 111 WCLL 1 / / / 99•D6• ^ \\ \ \ I EXISTING / \ \ WELL c / 1 80 L N s ' TOWN OF BARNS441E BUILDING PERMIT APPLICATION 3 Map Parcel v()_� V 0 Application # V S Health Division Date Issued (O Conservation Division �S 1 ��� Application FJ� 60 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address eillage- -CAJ Owner - l h/G Address-=-1-2//co Telephone' 77�e Permit Request A/a✓ 4/4 16 Otis->�.t�o:.� ���'r�-�c�h L•/.�i%�'.:.%/�J Z Goat ���C� Square feet: 1st floor: existing proposed 12oc-3 2nd floor: existing proposed Too Total new /16 Zoning District Flood Plain Groundwater Overlay Project Valuation R 0 Construction Type wo C51 Lot Size �"ooa s� �� Grandfathered: ❑Yes ❑ No If yes, attach supporting_doc-mentation. Dwelling Type: Single Family JY Two Family ❑ Multi-Family (# units) , - Age of Existing Structure Historic House: ❑Yes ❑ No On Old Ki g's Highway ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) D Basement Unfinished Area (sqft) 031 �n Number of Baths: Full: existing new Z Half: existing new r^ Number of Bedrooms: 3 existing *ew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ,4rGas ❑ 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 ❑ new size_ Attached garage: ❑ existing )<�new size _Shed: ❑ existing ❑ new size — Other: 2 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use ey `2 M1&-0rwA/tl-n A/0 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � ��/'�� , v�� ��✓�`��� Telephone Number ?Z P.6 44c? P y Address oi`' License # d Z S0 7 7 � �- r , //1/. Home Improvement Contractor# Z Email ��IOGi�/,��� gWorkerAs Compensation.-#--Awc -W-7,0ZdOz,$= 20 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �o a cZ ftcn- 0ul M SIGNATURE TE 3-Z�, ff f% 7 F' FOR OFFICIAL USE ONLY "APPLICATION# P .DATE ISSUED f MAP/PARCEL NO. ADDRESS VILLAGE OWNER `DATE OF INSPECTION: ®� fz( llrFOUNDATION oq*%�&_ &,v, CTL r. ,r FRAME d S i6��`�w► �c�l��rn� INSULATION 13/,0 S—AfX/g —k b — FIREPLACE .f; ELECTRICAL: ROUGH FINAL r� PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDING d DATErCLOSED OUT ASSOCIATION PLAN NO. Massachusetts -Department of Public Safety ' Board of Building Regulations and Standards Construction Supervisor License:-CS-025077 , PETER C N1110MOTMOlm- 29 BOARDLEY R� ? Sandwich MA 02363 . Expiratign,::i Commissioner 0 41-1 2/2 0 1 6:-A Massachusetts -Department of Public Safety Board of Building.Regulations and Standards ConstructionSupenisorSpecialty ' License: CSSG099907 ADILSON SEG01,*G 117 NMTON LANE IMQt WEST BARNSTA$ 68 Expiration ' Commissioner 10114/2015 ean��r�xaratuerr�/�.o�C�/lifaearrc� aeLtd 'fi: Office of Consumer Affairs&Busi ess Regplatiouu '•License or registi ation.valid,;fdr individul use only -_ ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: i . _ egistration: ,.159597 Type: Office of Consumer Affairs.and Business Regulation � x iration: =„5/15Y2016, DBA 10 Park Plaza-Suite 5.170 P ®' ; ,.= a Boston,MA 02116 SEGOLIM CONSTRUCTION i ADILSON SEGOLINI'-,, 117 MINTON LANE WEST BARNSTABLE,'MA'02668 �. Undersecretary 7. l N slid without signature i Massachusetts -Department of Public Safety Board of Buildin g Regulations and Standards Construction Suj)cnrisor License: CS-025077 _ y `i PETER C MEO11T •� t 29 BOARDLEY LAk Sandwich MA 02363 Commissioner Expiration .: 04112/Z016 :Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3)of enclosed."space: ' :Failure to possess a current edition of the Massachusetts 'State Building Code is cause for revocation of this license.' ;--.For DPS Licensing information visit: www.Mass.Gov/DPS Restricted To: CSSL-WS-Windows and Siding CSSL-DM-Demolition CSSL-RF-Roofing , I Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS eor��n�aooacuea/C/o�C�/�crgacrc/cr�eGl� Lice se or re istration.valid f6r in Office use.only Office of Consumer Affairs&Busidess Regulation g before the,ezpiration date. IIf.found return to: i i - ME IMPROVEMENT CONTRACTOR I i egistratiori: 159597 Type: Office of Consumer Affairs and Business'Regulation 1 z iration: -:5/.. 1.6 DBA' 10 Park Plaza-Suite 5170 P ' 15/20�`„ Boston,MA 02116 SEGOLINI CONSTRW TION ADILSON SEGOLINI :01,.,, 117 MINTON LANE F � _ WEST BARNSTABLE, MA 02668 Uu'dersecretary • :...:: ;' N slid without signature cos so 7vz-,ffa um,21 jv,�p d'q ppwpin=sq m"a m sg5 Ut7Iwm JON 4a -luo u5n 7szmffv C • �aria�purr arcq sr�,u3gn pap�,�Td u�aw.ta�up az�anig drnliarl,�rT sax�ua aru sumda�}I 1�rtga���.ap d- -UG?#OU3MA adz-.aaoO-�= .X3'#ZQ--;tD 30=0ll)d--q3-XI -To auugo abg.o;pgpje cg aq LEw v=qRp srg gn LIao 7P;BXD pasuLps a!g -MPgOra agT 4sal&Y LEP P 00 OSc' a}Iffn.T° �a P"TE,-�E(mo xaom dalS a-o uuai ar t u stead gin se III sa ut Jzzk-zao-mA=,p0-005 I$al do asg g�o sag�rad Iemmv��o avgrsod� aq��}pzal�o ZSI Z3°VE S mFun agaaa Sno amoas o4 aml_red �D rp uoi �m p q-na gDdz-c p�31f}iEs)a.Yxl uol}sixpap Siand uugesuadmm,sT ls�.,� In SdnJw xpz:n-v ' 1 1Sf�?o usi 97/r LOF l :ss � z#TjSgcj - Z :a;RCma4mjdxR {��j�OZ ' ?092Ov oP,4 7 �?"i- Hasis�LaT3oi ap g qO Of P,2W{JgadVW S!Mi�ag •ssa XOj&ua fzu.rofss=LIT n u UVaos<srasj rant ffg.q73,uxTd S.Z -qZ Jadaidwa un W V f �'Li asEF 1ua74Ta�aga F�1� 0S}RS 3a Aac{1a�QL[5 _ -gsTq1T--Pwg4 ru^r IIa m� ,Lai R� ^_='Fgsar-=miqasD%U-VRvraVqa°g L . ��S�nd uogssaad�m asraa�wnz�`au�ugsasala4 novas�}7an jg os[a�s�t t��s=P�P]�F�4��$f xzrzvznc�-dg7O7 mmv0 0"f1 ,�a�or�ox] saa�°tea m 2 a, Puu< )I§7SI m ±j'pana i gouan�so3 ssrerlai�ocr�� "IJ3�Tad�ot}dmara jo Tq2a -cl= s=pppa Ta—dw.9urga-Ta[]-II wag}pasroraBa GAzq a=-IPo Tzld&Re 4a!GP Tana a=q-R=I El T suo e w�adai RT pug mnlwudlm z are a� -g I pP. I t4' ❑OI - -demon . amemsas dma�,dam oI gotFsppa du ng❑ -� I dsua �mdm Lm m army _ a ?Ia I El $ aasq sscx}a�m-q-QsaqZ s=L-old=au aieq pua dR. g El °Sr PatF $ uo Pg?I S upvd-zo T� dozd alas E u�IEj g9?aI {Q-,zq *�atu zzd�ojpue Ilrg}saasola= CAI 9 I e im I ❑ --k .� TaSold�a a mu I �� }oa o rd o ac€{Z =oq a3F'rsd des��agn L.za fojdura azVa7 ncn/.s-uv, y� �za�zur'�dlsB�' z}�� IsieFEId � 1'�d rjyzv w 5of h assaaLmcbs General Laws chapter 152 requires a]I enuplopers to 1>1-ovide workers'compms'�`ion for the employees puc min this statrdn,ann employee is defined as a--may prison in the sm-vice of another msdea any coufract ofIA, ' express ffr>oaplied, oral or writmD-" . An emp[aye7-is defined as ,m individual,pat aersb p,associafion,corporadion or other legal entity, or any two or more ofthe fDregning engaged m a job mtxpr ise,and mck ding the Iegal representative$of a deceased emmployer,-or the receiver or true it of an individual,partnership,associafion or other legal entity,employing employe. However the owner of a dcveLtiag house having not more than three apartments and who resides therein or the oatipant of the dwelling g house of another who employs persons to do ma�ance,construction or re Rorie on such dweliing house or on the grounds or bmlding appurtenant thereto shaIl not because of such employment be deemed to be-an employer." MGL chapter 152, §25C(6)also stains th;it revery state or local licensing agency shall withhold the issuance or renewal of a Rceuse or,permit to aperate a business or to contract buildings in the common r-alth 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 ray contract for the performance of public work until acceptable evidence of compliance with the in�ce requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit courpletely,by checking the boxes that apply to your sibladon and,if necessary, supply mb-contractors)name(s), address(es) and phone number(s)along with their cerbSicatc{s) of insurranCe. Limited.Liability Companies(LLC)or L= tedLi.ab>l*Partnerships(LLP)withno employees other man the members or partners,are not required to carry workers' compensation incirrznce_ If an.LLC or LLP does have employees;a policy is requaed_ Be advised that this affidavit maybe submitted Lin the Department of Industii l Accidents for confirmation of insm- nce eoverage. Also be sure to sign and date the affidavit The affida)at should be retuned to the city or town that the application for the peaait or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding t�e Iavr or if you Win;required to obi yin a v*orkers' compensation policy,please call the Department at the number Listed below. Self-insured companies should enter their self-m�ce 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 iu the event the Office ofInvt-_g ons has to contact you regarding the applicant Please be sure tD III in the permit/licr-me number which will be used as a reference number. In addition-an applicant that must submit multiple peimiHIicense applications in any given year,need only submit one affidavit indicating currant policy infounation(if necessary)and under``lob Sim 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 fume permits or licenses A new affidavit must be tilled out each year Where a home owner or citizen is obtmiag a license or permit not related*to any business or commercial veAture (ire. a dog license or permsto bunleaves etc.)said person is NOTrequired to complete this afldavZt The Office of Iuvestigations would like to thank you in advance for your cooperation and should you have any questions, please do iiot hesitate to give us a caII_ The Depatmmfs address,telephone and fax number ` Thy eozrM�anv� ItT_ of Massachusr� D tme�at cuff 7ri&izsJzia1 AQaidmta of � o-n 6M_Washin9tan. &amens MA 02111 TeL.9 617727-490 (�xt 4-D6 ar 1477 I\L4,'�SAFE • . F 617-727-7745 Revised 4-24-07 I CERTIFICATE OF LIABILITY INSURANCE rDATE(MWONYYYY) 05/27/2015 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 poUcy(les) must be endorsed. It SUBROGATION IS WANED, subject to -the torms 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 ondomement(s). PRODUCER PAUL SCHLEGEL NAME: _ __ _____ _ SCHLEGEL INSURANCE BROILERS INC a"ol'E 508-771-8381 �� FAX SOB-771-0663 (AIL.No.Ecll: (AIL.NoL 34 MAIN STREET e•wlni�'.-____.____ _... AoeREss: SCHLEGELINSURANCQGMAIL.COM WEST YARMOUTH MA 02673 ..__ INSURERIS)AFFORDING COVERAGE NAIC a INSURENp NGM INSURANCE COMPANY 14788 INSURED INSURERS AIM MUTUAL Adilson Segolini Dba Segolini Construction — _ INSURER C:. 117 Minton Lane INSURER D INSURER E West Barnstable, MA 02668 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1111S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PF.I,'01) INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 1'0 VAIICII I WS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE Hilrl,)S. VXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, iNSN, ___._.—.,W .ADM ISUBR VOLICYE�-" LTR I TYPE OF INSURANCE ISR YYyO POLICY NUMBER (MMA)DHYYYI UMMIDONYYYI LIMITS A GENERAL LIABILITY MPT8486U 05/07/2015D5/07/2016 EACHOCCURRENcEED•- ,s 2,000,000 1 DAMAGETORENT _._ . IX i COMMERCIAL GENERAL LIABILITY ( _PREMISES(Ea mc-ence)_ I S 500,000 OCCUR CLAWS-MADE RY � � � NEDe%P 1AmJone Parban!_ 3 10,000 PERSONAL&ADV INJURY ..3. 1,000,000 GFRERAL AGGREGATE. I S 2,000,000 .GE NL AGGREGATE LIMIT APPLIES PER PRODUCTS•CONP:OP AGG $ 2,000,000 1 POLICY ( PRC 2,OOO,OOO R,LOC AUTOMOBILE LIABILITY CU?ft(EaeJVftDw I!LIMIT l At4YAUTO BODILY INJURY(per Person) 3_--•—••.,__..._... ALI-0*17E0 SCHEDULED AUTOS '-_ AUTOS ( GOUILY INJURY IPOI XcIdard) S --_- =I-OWNED H(REO AUTOS AUTOS I I I(Pei accl�rO) 3 UMBRELLA LIAR OCCUR EACI10(:CURRENCE S I I EXCESS LIAO CIAIMSMADE I AGGREGATE 5.. -. �DF.D.�. RETGNt10N S I $ B 'WORKERS COMPENSATION AWL-400-7026025-2014A 05/23/201505/23/2016 I TORYLl. ER': ANDEMPLOYEAW GILITY YIN - .. '.. . ANY✓ROPRIETORlPARTNERIEAECUTIVE E L.EACH ACC $ 100,000 C.FFICERMEMOER EXCLUDED' ❑ NIA _ IDENT _ IMandatory in NH) EL DISEASE EA EMPLOYEE $ 100,000 r:ESC1IIPitONOFOPFRATI(NlSoebM F.I.DISEASE-POLICY I.RAIT 3 500,000 I 1 1 I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(AMch ACORD tdl,AddmonolRelnarss Schedule,d rmro space to re4unad) ADILSON SEGOLINI HAS ELECTED TO BE COVERED UNDER HIS CURRENT WORKERS COMPENSATION POLICY THIS CERTIFICATE MAY OR MAY NOT BE IN EFFECT AT TIME OF PRESENTATION OF THIS CERTIFICATE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE MTTNN THE POLICY PROVISIONS. AUTHORIZED REPRE ENTA �E.. 01988-2010 ACORD CORPORATION. All rights reservoo. ACORD 26(2010105) The ACORD name and logo are registered mart, of CORD I ,ri Aitidavrt of 5uosranual rmancial Inieresi i; �i;�tON ��-/i'� of 1WIly D11/ on oath pose and state as follows: 1. 1 am an applicant for a building permit for the property located at Map 152 , Parcel 3.. The address.of the property is ,Z,_5!g&Lricz� so 2. 1 have O % 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 , the following individuals or entities have had a 1% or greater legal or ElWdable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address �6-s/odr^T lgop 04,0 S 3i9GS' /ev/g0 U/Esr ORAwsT0�LE oa 6 6g 4. Within the last twelve months, from todays date, which is , 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: MaplParcel Address 5. Within this calendar year, I have submitted © building permit applications-for property in which 1 have a 1% or greater legal or equitable interest. . 6. Within the last ten days, 1, have submitted ..`C� 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 .1 have a 1%legal or equitable interest. 8. Within this month, I have received 0 building permits for property in which I have a 1% legal or equitable interest. Si ned.under the pains and penalties of perjury, thi y of , 20�� 9 2001-0050/al in 1 O/LOTTERY/AFFIDAVIT i LICENSE OR PERMIT BOND BOND NO. S-839763 KNOW ALL MEN BY THESE PRESENTS THAT WE, ADILSON SEGOLINI of 1301 SERVICE RD West Barnstable MA 02668 as Principal, and 4 NGM Insurance Company a Florida corporation with its principal office at 4601 Touchton Rd East Ste 3400 Jacksonville, FL 32245-6000 as Surety, are held and firmly bound unto Town of Barnstable Building Division in the sum of Five Thousand and 00/100 Dollars ($ 5,000.00 ), for the payment of which sum, well and truly to be made, we bind ourselves, our personal representatives, successors and assigns,jointly and severally, firmly by these presents. The condition of this obligation is such, that whereas the Principal has obtained, or shall obtain, a license or permit from the Obligee for ROAD BOND FOR BUILDING PERMIT at 1301 SERVICE ROAD WEST BARNSTABLE MA 02668 for the term commencing on the 26th day of May 2015 and ending on the 26th day of May 2016 NOW, THEREFORE, if Principal shall faithfully observe and comply with all terms of the underlying license or permit, and all Ordinances, Rules and Regulations, and any Amendments thereto, applicable to the obligation of this bond, then this obligation shall become void and of no effect, otherwise to be and remain in full force and virtue. The Surety may, if it shall so elect, cancel this bond by giving thirty (30) days written notice to the Obligee and the bond shall be deemed canceled at the expiration of said period; the Surety remaining liable, however subject to all the terms, conditions and provisions of this bond, for any act or acts covered which may have been committed by the Principal up to the date of such cancellation. PROVIDED, HOWEVER, that this bond may be continued from year to year by certificate executed by the Surety hereon. Regardless of the number of years or terms this bond remains in effect, and regardless of the number and amount of claims that may be made, the maximum aggregate liability of the Surety is limited to the penal sum of the bond. SIGNED, SEALED AND DATED on this 26th day of May 2015 ADILSON SEG LINI '000c� By DILSONAEGOLINI NG nsuran p y By ., Attorney-in-Fact PAUL F SCHLEGEL r 4 J 1 i 68-QQ-0002a-05 f ' ®NGM INSURANCE COMPANY POWER OF ATTORNEY A member of The Main Street America Group z} . S-839763 KNOW ALL MEN BY THESE PRESENTS: That the NGM Insurance Company,a Florida corporation having its principal office in the City of Jacksonville,State of Florida,pursuant to Article IV,Section 2 of the By-Laws of said Company,to wit: "SECTION 2.The board of directors,the president,any vice president,secretary,or the treasurer shall have the power and authority to appoint attorneys-in-fact and to authorize them to execute on behalf of the company and affix the seal of the company thereto,bonds,recognizances,contracts of indemnity or writings obligatory in the nature of a bond, recognizance or conditional undertaking and to remove any such attorneys-in-fact at any time and revoke the power and authority given to them." does hereby make,constitute and appoint PAUL F SCHLEGEL its true and lawful Attorney-in-fact,to make, execute,seal and deliver for and on its behalf,and as its act and deed bond number S-839763 dated May 26, 2015 on behalf of ****ADILSON SEGOLINI**** in favor of Town of Barnstable Building Division for Five Thousand and 00/100 Dollars($5,000.00 ) and to bind NGM Insurance Company thereby as fully and to the same extent as if such instrument was signed by the duly authorized officers of the NGM Insurance Company;this act of said Attorney is hereby ratified and confirmed. This power of attorney is signed and sealed by facsimile under and by the authority of the following resolution adopted by the Directors of NGM Insurance Company at a meeting duly called and held on the 2nd day of December 1977. Voted:That the signature of any officer authorized by the By-Laws and the company seal may be affixed by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of any bond,undertaking, recognizance or other written obligation in the nature thereof, such signature and seal,when so used being hereby adopted by the company as the original signature of such officer and the original seal of the company,to be valid and binding upon the company with the same force and effect as though manually affixed. IN WITNESS WHEREOF,NGM Insurance Company has caused these presents to be signed by its Assistant Vice President, General Counsel and Secretary and its corporate seal to be hereto affixed this 20th day of March,2013 Vce unoFoo1-6 si NGM INSURANCE COMPANY By: Bruce R Fox State of Florida, Vice President, General Counsel and Secretary County of Duval On this 20th day of March, 2013 before the subscriber a Notary Public of State of Florida in and for the County of Duval duly commissioned and qualified,came Bruce Fox of the NGM Insurance Company,to me personally known to be the officer described herein,and who executed the preceding instrument,and he acknowledged the execution of same,and being by me fully sworn,deposed and said that he is an officer of said Company,aforesaid:that the seal affixed to the preceding instrument is the corporate seal of said Company,and the said corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Company;that Article IV,Section 2 of the By-Laws of said Company is now in force. IN WITNESS WHEREOF, I have hereunto set my hand and affixed by official seal at Jacksonville, Florida this 20th day of March,2013 TASkA p11U.P0T NUTAFV_STATE OF FL0F= rgmmAEEIW3E1'a5d37 Ealm 1M2015 I,Brian J Beggs, Vice President of the NGM Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by said Company which is still in force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company at Jacksonville,Florida this 26 day of May 2015 ,`pPt+,nllOft»»ryq,,, UN WARNING: Any unauthorized reproduction or alteration of this document is prohibited. TO CONFIRM VALIDITY of the attached bond please call 1-603-358-1343. TO SUBMIT A CLAIM: Send all correspondence to 55 West Street, Keene,NH 03431 Attn: Bond Claim Dept. or call our Bond Claim Dept. at 1-603-358-1229. i STEVEN J. PIZZUTI Attorney at Law 336 South Street Hyannis, Massachusetts 02601 Telephone(508)771-1911 Facsimile(508)790-0800 Email steven(apizzutilaw.com May 7, 2015 Town of Barnstable 200 Main Street Hyannis, MA 02601 ATTN: Thomas Perry,Building Inspector RE: 1301 Service Road, West Barnstable Map 1.52 Parcel 3-9 Lot 9 on Registry Plan 412, Page 96 Dear Mr. Perry: I have been asked by my client Adilson Segolini to provide a letter supporting the buildability of the above-referenced vacant parcel of land ('`Parcel"). Located in the RF Zoning District and a Resource Protection Overlay District. the Parcel contains 43,56.1 square feet and is shown on plan endorsed by the Planning Board on February" 24, 1986 as approval not required. Up until November 26, 2000, the effective date of the RPOD, the Parcel conformed to the bulk. requirements within the RF zone as it contained in excess of one acre. Pursuant to 5240-91.G. the Parcel is grandfathered from the increase in area requirement imposed .for those properties located within RPOD since it conformed prior to November 26, 2000. Please issue the building permit to my client accordingly. Thank you. Very truly yours, Sieve -u SJP/dd cc: Adiison Segoli.ni. I �Lhe COMMORWealth of MagoatbUoetto Filing Fee:$15.00 William Francis Galvin M.G.L.Ch.180 Secretary of the Commonwealth Corporation One Ashburton Place,Room 1717,Boston,Massachusetts 02108-1512 Annual Report Telephone: (617)727-9640 j ANNUAL REPORT IDENTIFICATI61 0 1 35 FLUng for November 1,20 In compliance with the requirements of Section 26A of Chapter one hundred and eighty(180)of the General Laws: 1.NAME: (,-) �AT— Ki9✓tN07~i9�� �' GL"JrS �`�C. 2.ADDRESS: � `� O G4 f A'sa P--o T— �T%4s k (street 0 z 6 6 (city or town) __(( / (state) (zip) 3.DATE OF THE LAST ANNUAL MEETING: C-T'o b-�-- r'y 2 0 1 4.If the corporation is a cemetery corporation,it must hold perpetual care funds in trust and attach a copy of the written agreement estab- lishing the crust. (check appropriate box) ❑The cemetery corporation certifies that perpetual care funds are held in crust and a copy of the written agreement establishing the trust is attached. OR ❑The cemetery corporation hereby certifies that it does not hold perpetual care funds in trust. 5.State the names and.addresses of the president,treasurer,clerk,at least one director of the corporation,and the date on which the term of office of each expires:(PLEASE TYPE OR PRINT). NAME OF OFFICE NAME ADDRESSES EXPIRATION Number,Street,City or Town, OF TERM OF State and Zap Code OFFICE President: �1 1 �3 l�/'1eCoi•vt(�r kv 1WIt C/ � Treasurer. Clerk: f��¢.�e, Q�Q M?/L S oe-D JrrlO G�.e�l•� J►Kd? (or Secretary) " UL6b� {� p (.��+ (.s.e M441w1 ftru 1 �N9- QQ Soy Directors: �l r—L G".10'j 6 3 r pL6 JLC¢.1 11 (or Officers / �� �oo ii471 ATa' t) having the /�� / J f� OL-6 powers of j Directors) 1¢iac�a,-WiJ-j/ /,� ,6� t7L I,the undersigned �`O^•/ being the of the above-named corporation,in compliance with General Laws,Chapter 180,hereby certify that the information above is true and correct as of the dares shown. IN WITN WHERE (AND UNDER PENA[1 IES OF PERJURY,I hereto sign my name on this day of ,20--4. Signatu Title: Contact Person: -r 1Gr � Contact Person Telephone#: redomr rrnsn� . r DEBRIS FORM In accordance with the provisions of MGL c.40,s.54,a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c. 111,s. 150A. This Debris will be disposed of in: 130*6 (LOCATION OF FACILITY) N Signature of Permit Applicant Date IF DUMPSTER IS USED IN EXCESS OF SIX (6) CUBIC YARDS A PERMIT FROM THE FIRE DEPARTMENT IS REQUIRED FOR COMMERCIAL, INDUSTRIAL, INSTITUTIONAL AND MULTI-FAMILY RESIDENTIAL OVER 20 UNITS DEMO, RENOVATIONS OR ALTERATIONS OF THE EXISTING BUILDING: CIRCLE ONE ** HAVE YOU SUBMITTED THE AQ06 NOTIFICATION TO THE MASSACHUSETTS DEP? YES NO r � r` . Town of)3arnstable -• services �- r Richard V..S,��t.Director 1NliNlYAff7d•p K �.� Btail'dxig.Division .e3,r �. - . rio'�''.. . ... .. µ"per I3uiIdio Com�ssinner — Tom ry► g 200 Main SU=t,tiy3nW5,.:MA 02601 www.toErn,barnstable.nsa.us t pax: 50&790-Q30 ol.fia. 508462=4039 Prbperty owner.M St Complete.and Sign This Sectxoa if Using A Builder. J wa t &ryas fJL 1, 7 rtu✓ v 4 ��j' ,as Owner of the subject property hereby authorize '�66 Q4%6,VJ M(/CZhV_Al . to act on aq beW, in 4 rptters relative to vDrk authorized bythis buiM4 perralt-appUm ion fors � �1 .SC—gV CE Klksr Z5AgtSLA,9V. ,Andress of Job) .r�vt .•. Pool•[===d.al =are the responsibility of the appkum Pools ater not ro be•filled or utilized before fence installed and all#final ipspections are performed and accepted. o . Signgu;r.of OW110 : -: V=t=of•Applicant I l 4 + Pnq . .:tint Name Dane Q:F0AW.'0WNSPIERM7SSIpNMLS •Demilee approved applicators L CAPCOD E -Construction Supervisor Speciality Propozat License INSULATION •OHSA 10 Certified �� ®®® DATE ESTIMATE N0. -Lead Paint Certified FIBERGLASS SEAM1.E55 SPRAT FOAM SUSPENDED 1/16/2015 11318 OATTS GUTTERS INSULATION CEILINGS BPI `a Certified 1-800-696-6611 18 Reardon Circle Home Improvement Contractor South Yarmouth, MA Registration#153567 02664 SUl3Ml`I"I'ED`I'0 ' \v\vNv.capecodI11SUIation.corn Chandler Bosworth P.O. Box 685 Unit C 2nd Floor Centerville, Ma. 02632 JOB LOCATION 1301 Service Rd. JOB SPECIFICATIONS CONTRACT PRICE Flat Ceilings with 12", R-38 Kraft faced batts with proper vents installed at eaves. 5,590.00 Exterior walls with 5 1/2", R-21 unfaced batts with polyethelene vapor barrior. Stairwell with 3", R-15 & 5 1/2" R-21 Kraft faced batts.. Basement Ceiling with 10", R-30 Kraft faced batts with support rods. Slopes with 8", R-30 High density Kraft faced batts with proper vents. Slopes behind kneewalls covered with 1" Thermax 1 st Floor& Basement Plates and runners with 5" R-22 Open cel spray foam insulation Above Quote Includes Airsealing Seamless aluminum gutters with downspouts installed on house. 1,100.00 $6,690.00 CONTRACT PRICE 1 chrislegere@capecod insu lation.com Proposal is good for 60 days unless otherwise noted. Work will be performed in a professional workmanlike manner. Jobsites are to be kept clean and free of any work hazards. Any alteration or deviation from the above specifications involving extra costs will be executed upon written or verbal orders,and will become an extra charge over and above the estimate, All agreements contingent upon strikes,accidents or delays beyond our control. Our workers are fully covered by workmens compensation insurance and we will furnish you a copy upon your request and your signing of this proposal. Owner to carry to carry any other necessary insurances. One third of payment is due upon acceptance of this proposal with the remaining balance due upon completion. All invoices unpaid after 30 days will be subject to a 1 1/2%monthly interest charge. Thank you for the opportunity to bid on your project. Acceptance Signature T ti REScheck Software Version 4.6.0 Compliance Certificate Project New Construction Energy Code: 2012 IECC Location:' Centerville (Barnstable), Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 1,814 ft2 Glazing Area 13% Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: o r� AJ004/1,100 Designer/Contractor: 1301 Service Rd. Bosworth Associates W. Barnstable,MA 02668 P.O.Box 685 1645 Falmouth Rd. Unit C 2nd Floor Centerville,MA 02632 Compliance: 0.40/6 Better Than Code Maximum UA: 229 Your UA: 228 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 or V. . . er meter 728 38.0 0.0 0,030 22 Ceiling 1: Flat Ceiling or Scissor Truss 372 30.0 0.0 0.034 13 Ceiling 2:Cathedral Ceiling 1,680 21.0 0.0 0.057 81 Wall 1:Wood Frame, 16"D.C. 180 0.300 54 Window 1:Vinyl Frame:Double Pane with Low-E 40 0.270 11 Door 1: Solid 40 0.310 12 Door 2:Glass 1,046 30.0 0.0 0.033 35 Floor 1: All-Wood joist/Truss:Over Unconditioned Space here is ifications,and other Compliance Statement: The proposed building design described proposed building has consistent een designed todmeetthe 2012cIECC requirements In calculations submitted with the permit PP REScheck Version 4.6.0 and to comply with the mandatory requirements listed in the REScheck In Checklist. Of'. I& Signature Date r Name-Title Report date: 01/16/15 Project Title: New Construction Page 1 of 8 Data filename: Untitled.rck t y 2012 IECC Energy Efficiency Certificate Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling /Roof 38.00 Ductwork (unconditioned spaces): Door Rating U-Factor SH.GC Window 0.30 Door 0.27 Meating&,Cooling Equipment Efficiency Heating System: Cooling System: Water Heater: Name: Date: Comments Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 404.1.1 ;Fuel as lighting systems have �'.?f* d--.- 9 9 9 Y � � ;? ..s❑Complies (FI23]3 :no continuous pilot light. e <, �•" ry �� ]❑Does Not - •]❑Not Observable ), :. ... iONot Applicable 401.3 :Compliance certificate posted. < " { '' ' '❑Complies [FI7]2 j ; § 1 1ODoes Not 4❑Not Observable t ; ,.� '; ❑Not Applicable 303.3 'Manufacturer manuals for ",❑Complies ;- [F[18]3 mechanical and water heating ,.y Yu ❑Does.Not systems have been provided. ❑Not Observable ` „: f• i❑Not Applicable P. Additional Comments/Assumptions: 1 111igh Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 8 of 8 r Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Ceiling insulation R-value. R- ; R- ;❑Complies See the Envelope Assemblies 402.2.1, ❑ Wood ;❑ Wood ;❑Does Not :table for values. 402.2.2. 0 Steel ;❑ Steel :CNot Observable 402.2.6 [f1111 '❑Not Applicable 303.1.1.1, ;Ceiling insulation installed per r❑Complies Requirement will be met. 303.2 manufacturer's instructions. ' ;❑Does Not [FI2]1 :Blown insulation marked every i❑Not Observable 300 ft2. Y ;❑Not Applicable 402.2.3 °Vented attics with air permeable ,❑Complies Exception: Requirement is [FI22]2 -insulation include baffle adjacent ;❑Does Not :not applicable. ;to soffit and eave vents that I❑Not Observable -extends over insulation. ❑Not Applicable 402.2.4 ;Attic access hatch and door R- R- :❑Complies [FI311 iinsulation zR-value of the i❑Does Not ;adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.1.2 'Blower door test @ 50 Pa.<=5 ACH 50 = : ACH 50 = ❑Complies [FI17]1 ;ach in Climate Zones 1-2, and ❑Does Not M, <=3 ach in Climate Zones 3-8. ❑Not Observable ' UNot Applicable 403.2.2 ':Duct tightness test result of<=4 cfm/100 cfm/100 ❑Complies [FI4]1 cfm/100 ft2 across the system or : ft2 f=t ;❑Does Not <=3 cfm/100 ft2 without air ; handler @ 25 Pa.For rough-in :❑Not Observable tests,verification may need to i ❑Not Applicable occur during Framing Inspection. ; 403.2.2.1 :Air handler leakage designated ❑Complies . [FI24]1 by manufacturer at<=2%of ` ❑Does Not design air flow. t❑Not Observable ] . J❑Not Applicable 403.1.1 ;Programmable thermostats f '' ❑Complies [Fl9]2 installed on forced air furnaces. i❑Does Not ❑Not Observable },• I❑Not Applicable 403.1.2 :Heat pump thermostat installed fi ❑Complies [Fl10]2 ;on heat pumps. ;❑Does Not ❑Not Observable FONot Applicable 403.4.1 ,Circulating service hot water ''. ;❑Complies [Fl1112 ;systems have automatic or , ; ':❑Does Not ;accessible manual controls. r t ;❑Not Observable i ;❑Not Applicable 403.5.1 :All mechanical ventilation system ❑Complies [FI25]2 'fans not part of tested and listed I❑Does Not HVAC equipment meet efficacy L . ;❑Not Observable and air flow limits. r ❑Not Applicable 404.1 ;75%of lamps in permanent ❑Complies [FI611 fixtures or 75%of permanent " :❑Does Not ;fixtures have high efficacy lamps.' Does not apply to low-voltage ❑Not Observable Righting. ! f• ;❑Not Applicable 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 7 of 8 Section Plans Verified FIe1d Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & RegJD 303.1 All installed insulation is labeled ❑Complies .Requirement will be met. [IN13]2 iorthe installed R-values ' t.r `❑Does Not provided. + , ❑Not Observable ,❑Not Applicable 402.1.1, Floor insulation R-value. : R- R- ;❑Complies ;See the Envelope Assemblies 402.2.6 Wood ;❑ Wood :❑Does Not ;table for values. (IN1]1 ❑ Steel ;❑ Steel f]Not Observable V ❑Not Applicable ' 303.2, :Floor insulation installed per ° e 3�',;'. }❑Complies Requirement will be met. 402.2.7 manufacturer's instructions, and ;❑Does Not [IN211 ;in substantial contact with the µ ;underside of the subfloor. ❑Not Observable ❑Not Applicable 402.1.1, ;Wall insulation R-value.If this is a; R- R- ;❑Complies !See the Envelope Assemblies 402.2.5, 'mass wall with at least'/2 of the ;❑ Wood ;❑ Wood ❑Does Not table for values. 402.2.E wall insulation on the wall Mass ❑ Mass []Not Observable [IN311 ;exterior,the exterior insulation Steel ❑ Steel '❑Not Applicable requirement applies(FR10). 303.2 ;Wall insulation is installed per f "�R °❑Complies ;Requirement will be met. [IN4]1 :manufacturer's instructions. ' �' Y`z �' i❑Does Not ❑Not Observable �❑Not Applicable Additional Comments/Assumptions: 1 High impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 6 of 8 Section Plans Verified- Field Verified # Framing/Rough-in Inspection.. Value Value Complies? Comments/Assumptions ' 403.5 ;Automatic or gravity dampers are 'Complies (FR19)2 installed on all outdoor air 'Does Not �. ;intakes and exhausts. -•�'9E]Not Observable , Not Applicable Additional Comments/Assumptions: 1 IHigh Impact(Tier 1) -2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 5 of 8 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies2 Comments/Assumptions & Req.ID 402.1.1, :Door U-factor. U- U- ;❑Complies ;See the Envelope Assemblies 402.3.4 ;❑Does Not 'table for values. [FR1]1 ❑Not Observable ❑Not Applicable 402.1.1, :Glazing U-factor(area-weighted U- U- :❑Complies -See the Envelope assemblies 402.3.1, 'average). ;❑Does Not table for values. 402.3.3, ;❑Not Observable 402.3.6, 402.5 ;❑Not Applicable (FR211 303.1.3 U-factors of fenestration products: 1 ;❑Complies [FR4]1 :are determined in accordance # . '❑Does Not with the NFRC test procedure or ❑Not Observable ;taken from the default table. ,❑Not Applicable 402.4.1.1 ;Air barrier and thermal barrier ! '❑Complies [FR2311 installed per manufacturer's , ;❑Does Not 'instructions. �❑Not Observable ❑Not Applicable 402.4.3 Fenestration that is not site built ' e❑Complies (FR2011 :is listed and labeled as meeting j❑Does Not s. AAMA/wDMA/CSA 101/I.S.2/A440( i❑Not Observable :or has infiltration rates per NFRC f '- :400 that do not exceed code ;, ❑Not Applicable ; limits. 402.4.4 :IC-rated recessed lighting fixtures i❑Complies [FR1612 sealed at housing/interior finish ;❑Does Not and labeled to indicate <_2.0 cfm Ice leakage at 75 Pa. ;❑Not Observable J❑Not Applicable 403.2.1 :Supply ducts in attics are R- R- :❑Complies (FR1211 insulated to zR-8.All other ducts R_ R_ 'ODoes Not in unconditioned spaces or ;❑Not Observable ;outside the building envelope are; insulated to 2!R-6. ; ;❑Not Applicable 403.2.2 ;All joints and seams of air duds, :❑Complies [FR1311 air handlers,and filter boxes are ;❑Does Not 40 sealed. �" � ;❑Not Observable p s❑Not Applicable 403.2.3 Building cavities are not used as i " 10Complies [FR15]3 :ducts or plenums. , t❑Does Not �s. S c❑Not Observable ! - :❑Not Applicable 403.3 ;HVAC piping conveying fluids R. ; R- :❑Complies (FR17]2 ;above 105 QF or chilled fluids 10Does Not below 55 QF are insulated to>_R- ;❑' 3 Not Observable i ❑Not Applicable 403.3.1 'Protection of insulation on HVAC ' ;`^ f❑Complies [FR2411 :piping. + ,❑Does Not 1 ' ;❑Not Observable I ❑Not Applicable 403.4.2 Hot water pipes are insulated to R- R- ❑Complies . [FR18]2 ;aR-3. ❑Does Not ^ ;❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 4 of 8 l [20121ECCI :Foundation Inspection- Complies? _ Comments/Assumptions 303.2.1 :A protective covering is installed to ;❑Complies [FO11]2 ',protect exposed exterior insulation ❑Does Not :and extends a minimum of 6 in.below ;❑Not Observable; ;grade. ❑Not Applicable 403.8 :Snow-and ice-melting system controls;❑Complies [f012]2 :installed. ;❑Does Not ; t ❑Not Observable; ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 3 of 8 I/ t REScheck Software Version 4.6.0 Inspection Checklist Energy Code: 2012 IECC Requirements: 33.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.1, !Construction drawings and ;_`' -' ;OComplies 103.2 :documentation demonstrate ;❑Does Not [PR1)1 ;energy code compliance for the building envelope. ❑Not Observable ❑Not Applicable 103.1, ;Construction drawings.and s •. ;❑Complies 103.2, documentation demonstrate ;❑Does Not 403.7 :energy code compliance for [PR3)1 'lighting and mechanical systems "" i❑Not Observable ;Systems serving multiple ❑Not Applicable . dwelling units must demonstrate ;compliance with the IECC Commercial Provisions. ` •��r:;.'- t 302.1, 'Heating and cooling equipment is; Heating: Heating: ❑Complies 403.6 :sized per ACCA Manual S based Btu/hr Btu/hr ;❑Does Not [PR2J2 on loads calculated per ACCA Cooling: Cooling: ![--]Not Observable bf, ;Manual J or other methods Btu/hr Btu/hr 'approved by the code official. ;[]Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low impact(Tier 3) Project Title: New Construction Report date: 01/16/15 Data filename: Untitled.rck Page 2 of 8 March 14, 1955 904'' STATE TAX COMMISSIO By Barnstable, ss., Received April 1, 1955, and is recorded. I, Fred S. Jenkins, Sr., of the. 'Nest Barnstable uistrict of Barnstaple, B'arnstab6Anty,Massachusetts, keiU9.2uawrried,for consideration paid,grant o West Barnstable Deer Club, Inc. a Massachusetts corporation, and aving an usut:l p ace of business ii7 of said WestB arnstable ' with quiltlatm taaeuanta the land in said `Nest Barnstable, bounded and described as follows: On the North by the Access Road; on the East by land of O'ohn P. mil~ Manning; on the South b��ies u rin own; on the West by the Old arston's Mill Road; comprising twelve (12) acres, more or less. ------- wife of said grantor. lease to said grantee all right of tenancy the curtest'and other interests therein. 8�'adower and homestead ' �ftrrss_.—.._>Y.hand and seal this--.— 2nd y day of M+--ah 1955 r vls�.b MR (8M=0mucat* of faemt4mas BarnatAjUe_....... ss March 2, 19 55 Then personally appeared the above named_--Fred_..S.._.._Jenkins,_Sr. ra "krowledeed the foregoing instrument to be..__K l ._free act and deed,before me, Notar y Public ►0 my Commission expires__:..Q,C..� :. BARNSTABLE COUNTY `i)': a^CCC61JJJ REGISTRY OF DEEDS �� •:?`Q:'� ' A TRUE COPY,ATTEST n ; s JOHN F.MEADE,REGISTER Barnstable, ss., Received April 1, 1955, and is recorded. i I :JOHN P. SYLVIA JR.6MIPUBLICN RATOR of the ESTATE•of -894: MARTIN HAKALA, also known as FRANK MARTIN HAKALA, late of Barnstable, Barnstable Ccpunty Massachusetts, deceased. 3 4 7; by power ooaferred by Lieease. of the Barnstable County Probate Court dated June 23, 1954 and every other power, or Three Hundred ($300.00)----------------------------------------Dollars .. Paid,grant to The West iBarnstable Deer Club, Inc. a corporation duly o"razed a existt , dnavjnerithe.l ws of tYi Comm$t ea th of Ma s hu g pr ncipal pace o us ness in a part of the Town of Barnstable called :Nest Barnstable# the following described parcel of land, viz:- '':". A certain parcel of Woodland, together with a small building ' thereon situated in the west, part of said Town of Barnstable, b oun9.ed, and described as follows:- Northeasterly by land now or formerly of one Dr. .Phelps there measuring one hur..ared twenty-five (125) feet more or. less; Southeasterly ti by land now or.formerly of Barney Wikin there measuring sixty (60) feet more or less; Southwesterly by land now or formerly of Peter Pins. GG there measuring one hundred twenty-five (125) feet more or less; and GI' Northwesterly by land now or formerly of Peter Barboza there measuring- sixty (60) feet together with a right of way across the land now or tlformerly'of said. Peter Pins. to the Highway. Being the same premises conveyed to Martin Hakala by Deed. from Peter Pina dated August 16, 1938 and recorded with Barnstable County Deeds, Book 588, Page 563. l" 9Qaess._.Wy--hand and seal this__.___._.._.._..___._._........_._ .. . day of_.__._.... et........__._ _._19-54: -- 74 cZi!pe Qinmmntunraltl� of �gsastl�us¢2is ' Barnstable. .. ss. August 17, 19 54. Then personally appeared the above named ' John P. Sylvia Jr., public Administrator of the estate.: of Martin Hakala. and admowledged the foregoing instrument to be his free act and deed,before me fy�,•� Nutars .e_.__ Or MliilOy•'� . Myeommisdonexpires -74,4J'• 9 19.6�il4 '.;n 939 83arnstable, ss.; Reaeived.DecembOr. lk.,,,;1954, and is recorded. REGISTRY OF DEEDS A TRUE COPY,ATTEST JOHN F.MEADE,REGISTER 7 -Commonwealth of Massachusetts Ilsl�4 Sheet Metal Permit Map Parcel ' Date: Permit: - :1 V Estimated Job Cost:S Permit:Fee:3 Plans Submitted: YES .NO Plans Reviewed: YES NO Business License# Applicant License# Business Information: Property Owner/job.,Location.Infon ation: Name: 1=a n G 1301 Street: 73 r-) Pm 13pkq J9_Ue- Street'. v o e nx) E Q alp City/Town:' RD �j���-1.n/ 19 City/Town: rob Telephone: SRO ,��� � Telephone: Photo I.D.required/Copy of Photo.I.D. attached: YES . N si tioiugr a S 1/MI-=estricted.licens eIliM s.3-stories or less and commercial u to 10;000 sq..f� /.2-stories or less .J-2/M-2-restncted�to dw g P i Residential: 1-2 famil3 Multi-family Condo/Townhouses Other � Commercial: Office Retail Industrial Educational Fire Dept. Approval Iastiftitional_ Other Square Footage:'under 10,000.-sq, ft,� over 10,000 sq.ft. Number of Stories: Sheet metalworkto be completed: New Work: notv CCConr�'a\U il��� HVAC� Metal Watershed Roofing. Kitchen Exhaust System :. UN-28 2016 � Metal-Chimney/Vents .Air'Balanc' g_:a ,� 1V1� O� BAHNSTABLE I Provide detailed description of work-to be done: Sn ,S14 If ���a D3U 96 d1'S 0 e,0 o o� i i .INSURANCE COVERAGE: I have a current liabilitv,Insurance policy or its.equivalent which meets-the requirements of KG:L Ch.112 Yi$:N,No ❑ If you have checked.y.0,1ridicate the type-of coverage:by checking the appropriate box.below: I A'iiability Insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:`I am aware that the licensee does.not have the insurance coverage required by Chapter 112 of the Massachusetts General laws,and that my.algrnature on'this-permh application: -this requirement Check One Only l --PC . G am►-a�� •Owner• Agent El 1 Signature of Owner or•Own'erl-s Agent 4 By ohecking thls.boic❑,�I hereby cerFlfy that all of the details and Information-i have submitted(or entered)regarding this appllcation are true.and accurate to the best of:my knowledge and'.thaf all sheet metal work acid Installations,performed under the permit issued'forthis application will be ` in compliance with all pertinent provisibri of the Massachusetts Building Code and Chapter 112 of the General laws. Duct inspection required prior to-insulatiori installafton:YES NO Progrress•.IaMections Date Comments Final Inavectian Date Comments Type of License: 3Y ❑ Master rye ❑Master-Restricted .'ity/Town ❑Joumeypeto'n : e Signature of Licensee Detmit.# . .[3Joumeyperson-Restricteti Ucense.Nurtitier =ee$ Gheck,at www.rrsass.govJdnl nspector Signature of Permit Approval 2Tw CommroaxapmMi gfHcasc chmseWs De=tmwt of I;rrdm- &idAcdd fits ' - tce o� t.�gr,F3Yoass' 660 Wmkington Mreet wn w. massga pldia Workers' CampensafionInsmrance Affidavit Eiiilders/Conttactors(Ftec ncia n&Mum'bers ApWk2n�I�afar ma6cu PleaseFrnaf I ihTY City/Stafa 2 p: lqYno M A Phone i�: Q 8- a Are yan an employer?Check the appropriate bow: •ram 6 f po1ert - k❑ I am a employer with. 4. ❑I anta gmmal mnfractor and Z emplogePs(full aodlorgact-time). * have h fired the sub�adxs. 6 Nevi camstn ou 12("I am a sole pmp:ddor or partner- listed on the attached sheet 7- ❑R o'er shift and home no employees lheg.e sub-contractors have g- ❑Demolifioc. -working #,r me in.-y capacity: =rn pinyees and have workers' g- 0 Building addition [No urorltam, comp:insu wxe comp.insu.aum 1 =�I 5-❑ We am a cotporafiou and its 10-0 Eect,ica repaim oradditions 3.❑ I am a homeowner doing all work officers have exercised their 1LD Plumbiag repairs or additions . zuytsel€ [No Worl m,comp- right of e:=.fion pe MM 12-0 Roof repass. a�171'8n�81 II71E{�.1 c-152. §1(4,and we hum no 13 0 Ogler employees.[Na won0ess' LJ comp.mR.*rarxp requ re-d-] *fay wyUcwd flat chedcs box-*I amct also fill oat the sectiom b9aw shavrnnc 61aVodc¢s'roaspeasatina Parmy i 1 Hnmeawnets vita sabnut this af6&vif nwrcxtiag they ace thing Eff Vn&and tbea hire Data&coat=mrs amdn*mfrirutm MCT FCC babmcmrs thst check this box worst stlsrhed as additiansl sheet shtra�g tlse name of$fie amd state trhethec rani ff�se 5 eaptvpees_ Ifthe nffi cmktrmctmsbare onpIoyees,dzyamst pr=&their warps"comff.policy mrmbez Iam an employes thatisprm*&W workers'congtattan6ma irruurartee for rtt}"a ye�aa Belatp is fhepa�ic}"rcr�d job aitg ircforrrralia+c. . Insmaace C;,ompmyName: Polity#or SelfLiar,Lim Fxp'iratiunDate: Job Si6a i9ddrrss CityfStafelZtp: ARach a copy of the workers comp en-atima policy dec AMbLaa P2rge(shag the pofiLT=mher•xnal exprr-adian date). Failure to secare•coverage as reguiredund x Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a ne fi up to S 1,50D da and/or onL--year impds as well as civil.penalties in the f-mm of a STOP WORK ORDER-and a fins of.up tcy V50.00 aE day against the violator. Be advised that a copy of this statemeat maybe forwarded to the Office of Investigations of tie DIA for morns m coverage 4exiScation- I dd hereby certify under&epa ns andpmaIties u.f pedwy thatthe atjbrmcG tan prm�idid above a hua Intl correct J / - Phone I#- �6� 3 � �.1� Q 7c irl u-se aril,}. Eta rrat write in this area,'fa be compleW by city ar town officiaL City or Town. Pern iduce=# EsudnZ Authority(drele one)c L Board of$eal`th 2.BaUd3ug Department I CibpTl awn Clerk 4.Electrical Inspector S.P$¢mbirtg Taspector 6.Gther Contact Person: Pho-ne#- 6 e i ' Information an.d Instruet-ions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an anplayee 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 as 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 budding appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 ofpublic work until acceptable evidence of compli;Epoce with the msurance requirements of this chapter have been presented to the contracting authority." &Pplicnnts Please fill out the workers'compensation affidavit completely,by checlamg 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 cerincate(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 retuned to the city or town that the application for the permit or license is being requested,not the Departl•_rreat of Industrial Accidents. Should you have any questions regarding the Iaw 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 pemzit/licease applii;ations.ai any given year,need only submif 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 bum leaves etc.)said person is NOT required to complete this aifidavZt The Office.of Investigations would like to thank you in advance for your cooperation and shouldyou have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: T`he Connaoriw-earth of Massachusetl�-. Depaztmn utoflndustdalAceidemts 4 oe of Zuvest gatjGn.S GQQ Washingtou Street $aston,IAA 02111 Tel.A 617727-4M QXt 4-06 ar 14 MA&SAFE Revised 4-24--07 Fax#617-727-7-749 F wwzaas�;,govldia I Town of Barnstable Regulatory Services Z '*1�,3uar�wr� i Thomas F.Getler,Director Building Division Tom Perry,Building:Commissioner 0 . 200 M4jn Street,Hyannis,NIA 02.601. www.town.barnstable:ma.us- Office: 508-862-4038 Fax: 5.08-7VO-6230 Property Owner Must Complete and.Sign This Section If Using A Builder f,5 04V as Owner of the subjectproperty hereby authorize QP�l,L.. to act.on my behalf, in all.matters..relative.to w.ork.authotized by this building,permit: -(Addiess of job) "Pool fences and alarms are the responsibility of the applicant. Pools ate not to be filled before fence is installed-and pools are not to be utilized,until all final inspections are performed and accepted. ��4Z Signature of Owner Signature.of Applicant Pig L)tQrrt Print Name Print Name Date Q:F0RMS:0WNERPMXMS70NP00C9 i c COMMONWEALTH OF MASS"U`SETTS • • • • • s BOQRQ QF SHEET-.-'...METAL WORKERS ISSUES THE FOLLOWING LICENSE AS A >' Ul'ASTER-UNREST.R TED •» PAUL A CARRIGAN;:_:-.';':.-'-'*: Lu cn 4 TEATICFfET,MA 02536-208 z <c "3288 `0412812018 :;' 3388 f Town of Barnstable BABNSMBLE. • Regulatory Services MASS 'b t°3� �• Building Division prFO MPS� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location /30/ SF v/ E /raAb 4-d Permit Number a 0/Sy/5?�4 Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: Y�r r u c ?S i �`—y i' •�t s eo G C19 T6A, E �i Gc(AIL Ns.: I � p Please call: 508-862- Inspected by Date W w S (V �/ InIn �A O � Ogg S9Oo 1 \O�Q z lO g o Lu 1 N ,3 I---I AIG T/off Sq CD o LOT 5 c O 435G2 . 2 5. F. 99 06, C.B. MD. BUILDING LOCATION PLAN FOR ' �SH OF 1301 SERVICE RD., WE5T BARN5TABLE, MA � PREPARED FOR GSTEVEN-.` G 1 0 *- A55 0 C I ATE5 o: RUMBA 5CAI,E: DATE: DRAWN BY: NO.3579 y I " = 50' 03-1 7-2016 TMW a JOB NUMBER: REV15ION: SHEET NUMBER: Fc� 1 5-003 CPP- I LAND WELLER * A550CIATE5 3-` P.O.BOX 417 CENTERVILLE,MA 02632 TELEPHONE:(508)328-4692 EMAIL: tn5wellerQgmail.com REGISTERED LAND 5URVEYOR5 E ENVIRONMENTAL CONSULTANTS Traverse PC Cs Beam 4.16.0.5 NILTON 3-24-16 krnBeamF i,;ine 4.13.7.1 SERVICE ROAD 9:54Bm Materials Database 1527 HYANNIS,MA I of I Member Data Description: Member Type:Beam Application:Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: U360 live,L240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight: 45.0 PLF Filename:Beam1 Other Loads Type Trib. Other Dead. (Description) Side Begin End Width Start End Start End Category Replacement Uniform(PSF) Top 0' 0.00" 24' 0.00" 12' 0.00" 40 12 Live Additional Uniform(PLF) Top 0' 0.00" 24' 0.00' 0 40 Live Additional Uniform PS Top 0' 0.W1 24' 0.00" 12' 0.00" 20 10 Live 2400 2400 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 a 0.000" Wag Steel 3.500" NIA 12594# - 2 24' 0.000" Wall Steel 3.500" NIA 12594# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to ca ying member. r Live Dead 1 8483# 4112# 2 8483# 4112# Design spans 23' 8.7W' Product: W 10 x 45 (50ksi) PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable' Capacity Location Loading Positive Moment 74.19'k# 135.02'k# 54% 12' Total Load D+L Shear 12.59k# 70.70k# 17% 0' Total Load D+L LL Deflection 0.6943" 0.7854" U407 12' Total Load L TL Deflection 1.0309" 1.1781" U274 12' Total Load D+L Control: LL Deflection ►►AAA4✓�N OF Mqs 9 . DOMENICW. Guy DeANGEL0 Id .� r�l CD STRUCTURAL N op. No.3506 .090�FO 97 :J7 Wd 61 bdl 910' All product names ar ga0�jl.'t@tfc4'Cf 1 yr't�e'sdp Iv wars thus Copyright(C)2015 by Simpson Strong-Tie Company Inc ALL RIGHTS RESERVED. -'Passing is defined as when the member,goorJoist,beam or glrdec shown on this crowing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet.The design must be revlewed bya qualified designerordeslgn professional as required for approval.This design assumes product Installation according to the manufacturers specifications. 9 T ( - 0 �:. Y 0 KEY MAP *CAL6 /M.m 2000 A r m � �9 \ \ ♦ ra \ f � 6 6 o0 3 6 � D ♦. R. 9 ♦ (1 1 ♦ vN �ry vA i ♦ W zCAz— ej V, ♦ m � `N ` \ 44 Aui � s 986 ACRES `��♦ 0� 3ti ' 14 ; V ASA Jl 2 � 4 B Oh'N �PNOS rymGs )>.�.vsT•ae r'o S e �.9 p r V♦ � ~Q M• 9` n s6.2 .o �TF G M EDS PLAN OF 4A V D /N BARNS BLE BARNSTABLE /aAss. w,nr..•:h w�n. [,..r.....,.,w a... r r�y.r,.,» u^rcr^R.»wu[w^oc FOR avr uo•..^.,:L.[a....a.r,..a...•»....»,• "`',,a,1lu.wn»u»n w°^r[r.^nuiw w WEST BARNSTABLE DEER CLUB INC. .[.:.'.»a.»+aw«o...»....»«..,...«h.•,. .ao;.:,iw'::n..cc o».»wr. . wn 0"...1.:ti[ou.Jy. o^ro G—9 T7/ ORA�NlAN�Y SCALE: //N. a 60 GT. M 0/y4 CNECKEO 0Y &Ana s'^ DATE : ✓UNE 9,/97/ W OY[ CNARLE.S N. 3A✓ERY/NC. 4 c.srEa oo- REG/ST.EREG SUMS ENG/NBERS 3UR✓EYORS /YA' NYANN/9 SOVTN YAgMOUTN O 7/ 1 BOOK PAGE EETINONOUSE rc.aN� WAY y�b 9igEEi m A . i s S' •� W 0 p0• SAND`• m � O 4i0 Pu c ' t SF CgpF Y.N.B.FND. .. - z m RO `LOCUS '.M.M.B. LOCUS MAP SCALE: 1"= 2,000' f 30 9 � I CERTIFY THAT THIS PLAN ZONE: R- �G ,I CONFORMITY WITHHAS BEEN RED IN THE RULES ASSESSOR'SS MAP: 152 PCL. 3 p n/J AND REGULATIONS OF THE REGISTERS OF DEEDS. W To`Li 2 s9 p /9Sr9 0. 16 �— c e 2 01 (// F V) 43.620S.F. SS T� ST.9 0 i.0 cy MN f qy\ /// BARNSTABLE_PLANNING BOARD APPROVAL UNDER THE SUBDIVISION Q allo i ry0�A0 3 - 'R , CONTROL LAW NOT REQUIRED.43.560 S.F. '\�/ DATE _ /_ Ffibau, 14a 6 v'N Rtiryyey�� sY0 °sv 300'sjq°'�� y 11. �cO�JI?baCl� 4 Z SSq 15.24E / 43.560 S.F. q�. / s e/ a e� Q l 0' - O ? yA e. Q N Y FND. W f J Oo 43.560 S.F. °O /j/•� C.B. N \ FND. 43,560 S.F. 3 h ° FN°. �o PLAN OF LAND ' 0 0 0ryo oy a ao N o. by i� ` •.ij � � 9ss y 6 IN 43,5651 S.F. DSO°O BARNSTABLE (WEST BARNSTABLE) MASS. CD �' 159.95 i0 : 0�1 9O� FOR --s67-55-11w sus ,ti�i °99s WEST BARNSTABLE DEER CLUB, INC. 11 � ' e �i 0. o f R9 s 9 1 yy a10 I , .qo 0 O 9 I 'c ry 7 /S Oq4 43,561 S.F. �O° !q� SCALE: 1" =60' FEBRUARY 10, 1986 W ? GRAPHIC SCALE /0 '49 / 1 A. - eQ 3� 60 0 60 120 `O C.B.FN0.HITOFE -�JQ 2.99 Ac. -.ia-yq tFFoar r:� 1 2093 ! N �sqp a` BAXTER d NYE, INC. - _`j ♦`, �� S 9 row• REGISTERED LAND SURVEYORS Bq,F'P po ��\ i 4i 43.561 S.F. O.H. a I l C. CIVIL ENGINEERS ysrOe�F /N>>.!g 29g.24 1 , 13 O.N.FND. A 0 OSTERVILLE, MASS. N NF -__-• N h o� � a! g2.!9w !l�q N 2 43,561 S.F. y Opp °,g4 l j'mcvam O.X. �e 37 0. CU��FN BAXTER SM. SB.gB. POINT oE-4AFr�v 6�36 i3>3.2> DA%o ti0 , o S> W . OH'P/orppyF.p 32 D.H.�N> 9.08 Y.H.& C.B.NIT o. B ,o` G•34.36 •. � Qv 0 A IV C.B. NIT OFF q I tl BSIQ4 SMOKE ®ETECTO S REVIEWED I • BARNSTABLE BUILDING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING i i I - i � • -i—�F'r—a�v�1- f s -�-� (Z) f37 C 4 air C71 4-4-4 t7l FTF �G��v�-rrorl_ r 1 } I • - � i I'4 tl . � f 1, I I� I II �\ ^yy1 L- G rjo i �I 1 I I II ,��NNII + S�� I l .I• i I PIP] Hr el Ot I IT 11 IV i' ' 11 1 ; i N iP, e . 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'':5:-' 1`f1 't; '•.I:•:..,.. ::I. .•'.I :i - I- .I r � � w -�:,qy, .._. . � �•' _:. .:�. : I� �::� . �<:: , i.,,.� d.h..:s '�.' L I 1 �{�L�N+3I!:A, ,,� ! � � , _ a i ..: � - 1 IN 4.1 - - '•i4: Y. x _ , _ I I kII1 �. >pyp r3np�r _ I y � - I O O-O O m �. �' I L I= m 74. ZOo 0 T. _—I o_ b- 0 0. . Ja j , IGN- I: p = N rONN I J. f :A filI I � I � - Imo' �- - -� \'- — ,i � • . t �� o o I. '7-Ib z ydz . Ji— I - -Nti �, �N 7: I �4Z. t . 0. : ' 22 GIs N � �.�lo'12f�4� 1� Gl7 :nP r v J . I r I I ...... ,. EEG 4.... :. _ >;v._.. '.,.. .:.-.......... ... ._._..... :.. • .i_ I N.. . :. ✓ NOISIA10 SMOKE DETECTORS REVIEWED -' n G :6 y;'y L A r BARNSTABLE BUILDING DEPT. DATE 111VISM9 -jG ►`&.01 FIRE DEPARTMENT DATE 'l BOTH SIGNATURES ARE REQUIRED FOR PERMITTING .. •. � �,-- nit-. � X d. �2 x ' Q 8 : h •6 . t V: • c �u' t - — fl . J i Kq ' . U rr r I. d. ...:..:.... . eet Suile D Ostervi{{e:MA� '02GS'S • : 50Q:�2t3=�1:1:9: D .� Pd01SIA10 C G J, 379VISNd'va j0 r .. .. f: 9 N> 11 It it — it ''I' •lji.iil -,:I f i. i t1 ;c ' TIT — �1'' ► i !'I �. I-I-I , = , ,:! . :.,.:•i �`_�1 cif` I< I - ' i''' <l:i. '; �!• I is it kit ( � ' -L ' 1 • I f I i TERRY. - LUFF ARCHITECT 832 Main Street • Su:te D • Osterville, MA 02655 • (503)-42.8-9119. N OISIA 919'V1SM9 A N10,0i -- , •i !: , II(I I III Mil II , _ 'I . . _ • 01 1 � { ! X 1 • j i:1 E i P �,] I I i` I � • i I I TERRY. tUFF -ARCH ITCT , 62 Main Street • Suite D • Oster�ille,MA 0265.5.• .(508).428-9119 a vj..*.Ex/TFPOF-- F-I-�✓,� i I )H l� . 4 . 1 I COVER PES TO BE LAID LEVEL FOR N INSTALL F RISERS F t ISH GRADE O 21 OUT OF DISTRIBUTION BOX ti OVE Y/R O'DOUBLE DOUBLE WASHED STONE GENERAL NOTES m (SEA PLAN VIEW FOR LOCAL IONS) ALL AROUND Lu Lt� WATER TEST D-BOX FOR Q U LEVELNE55 4� FLOW 7 Q s N EQUALIZATION I . 5EPTIC SYSTEM 15 TO BE INSTALLED IN ACCORDANCE WITH _ 3 10 CM R 1 5.00: TITLE V �*' N 2. THIS SEPTIC 5Y5TEM 15 NOT DESIGNED FOR THE USE OF A In EL. 72`O EL..�O.0 EL. 70,Q GAf�_. _ - - - - --- - -- - - - - - - - GAGE DISPOSAL. -- � p T.O.F.L a°SCH 40 PVC �oSCH TOP @ EL. G7.2 3. THIS PLAN 15 NOT TO BE USED FOR PROPERTY LINE DETERMINATION: r 'may Q 10• PVC 4"5CH 40 LOCUS :. Z g 14" (2) 500 GAL. PRECAST DRYWELLS 4 ENGINEER FOR ANY REQUIRED INSPECTIONS.OTICE TO DESIGN �G8.0 G7.50� � �GG-53 _;._ BOTTOM @ EL. G4.5 FOP,THE LOCATION OF ANY 7 INSTALL GAS BAFFLE �G7.00 5. CONTRACTOR TO BE RESPONSIBLER IN OUTLET TEE 7.25 G`-- G•50 1 B OR UNDERGROUND PRIOR TO ANY EXCAVATION I p UTILITY, A OVE , D5-6 t40TE:'- REMOVE ANY IMPERVIOUS MATERIAL FOR CAR CONSTRUCTION. uj (H-20) A 5' RADIUS AROUND THE 501L ABSORPTION 5.5' O 1 500 GALLON PRECAST SYSTEM AND REPLACE WITH CLEAN MEDIUM SEPTIC TANK INSTALL TANK E D-BOX ON G" LAYER OF CRLl5NfD 5AND. STONE BOTTOM OF TH #5 @ EL. 50.0 TBM = EL. G5.2 MAG NAIL IN PAVEMENT DESIGN DATA DAILY FLOW: (3) BDRM5 x 110 GPD = 330 GPD SEPTIC TANK: 330 GPD x 200% = GGO GPD I G5. I \ / • \ USE: 1500 GAL. PRECAST SEPTIC TANK \ I J�� ��� 70 ' 1 ;.� DISTRIBUTION BOX: DB-G (H-20) SOIL ABSORPTION 5Y5TEM: U5E: (2) 500 GAL. PRECAST DKYWELL5 LINED W/4' OF DOUBLE WASHED STONE ALL AROUND CAPACITY: \ \ TH 51DEWALL: 7G x 2 x 0.74 = 112.5 GPD t, \\ #2 °�S cgs ; r"" BOTTOM: 13 x 25 x 0.74 = 240.5 GPD `\ \`\ �' '0OO ! ` OBSERVATION HOLE LOGS TOTAL' 353.0 GPD \ , DEEP - �� DATE: 10-17-2014 N \ \ 7O TEST BY: R. BUKOE KI, CSE #270 WITNE55: D. MIORAN 71, HEALTH AGENT PERC RATE: < 2 MIN./ INCH TH 72.2 I ®#t • 055ERVAT ION r'_:LE#I EL. 70.0 + TH ! % / OTHER #5 ! e , -Df l"t1 SOIL SOIL 50i1-%OLC SOIL ' r ! 'M HORIZON TEXTURE (MUN5ELL) MOTTLING 1 :.1_ ! / � (� / --C' 12° .A 5ANDYLOAM IOYR2/i / Ti. '7(},,7 / _ I� .74" f3 4ANDY LOAM I OYR:/o PERC G as"-6G" ' , I - �! !! ! #far ..� •/ �' i - .;'O^ i. - LOr`.M1 CANc - 1 2 i`."oio 1 Ulnull•; \ I /y 17 ! ! G9.3 DEFr OB5ERVAT:GN HOLE#2 EL. GG.0 off'TH 501L 501L 501L COLOR 501L OTHER _ _ HCKIZON . TEXTURE (MUN5ELL) MOTTLING i S0 ,�O \ \\ 5UR.f ACE - \\ \• \ ~�� ;I O"- 12• A SANDY LOAM I OYR2/1 \ \ '��� + J I 12'-28' B SANDY LOAM 2.5Y5/6 72.6 ` - \` ' �8'-i q C 1 GRAVELLY SANDY LOAM 1 OYP5 3 I � s.2•_ 1 g C2 GRAVELLY SANDY LOAM I OYRS/6 'C TH' \ ` \ \ \ ®#4 1 \ DFEP 0135ERVATION HOLE#3 EL. G9.0 - \ DFIT H 5011. 501L SOIL COLOR 501E OTHER SUROM HCRiZON TEXTURE (MUN5ELL) MOTTLING 0"- 12' A SANDY LOAM I OYR211 12'-32' B SANDY LOAM I OYR5/8 PERC Q MIN/72'IN ' SN OF Mq�cl1 32'-84" C l LOAMY SAND 2.5Y616 1 MIN/IN OF 84'- 132' C2 GRAVELLY SAND 2.5Y6/6 ,lN .SigCb D I RC { LOTG� ` `\` \ `\�/ ` I N 1 tR 1 1 \ `� \ \ \ 1 g R�M5 g1 o. 1140 0 No.3 i \ \ \ � � I CEF_P 055ERVATION HOLE#4 EL.70.0 / \ `\s0 \ \ \ I DEFTI' SOIL SOIL 501E COLOR SOIL Ci �C sel T� I / \ _ _ FROM OTHER gNITAR�P �� �Ur;FACE HORIZON TEXTURE (MUN5ELL) MOTTLING /ONAL '0'- 12' A SANDY LOAM I OYR2/1 12-32' 13 5ANDY LOAM__A--' - 3'e'- 132' C LOAMY SAND I O5Y6 6 SITE - SEWAGE PLAN CLE7 OBSERVATION HOLE#5 EL. 70.0 FOR DEPTH FROM 501L 501L SOIL COLOR SOIL OTHER \ \ \\ 1 5URFACE HORIZON TEXTURE (MUN5ELL) MOTTLING 1301 SERVICE RD., WEST DARNSTABLE, MA \ \ \ \ 1 0'- 12' A SANDY LOAM I OYR2/I 12•-32. B 5ANDY LOAM I OYR5/8 PREPARED FOR . \ ` 1 32,• BO" C I LOAMY SAND 2.5YG/6 \ \ +84.9 PROPOSED`y ` ; 8D•_ 132" C2 GRAVELLY 5AND 2.5YG/6 S EG O LI N I CO N ST RU CT I O N / I / WELL/ /S'� ` 5CALE: DATE: DRAWN BY: \\ I = 30' 03-04-201 5 TMW ` EXISTING JOB NUMBER: 1 5-003 REV15ION: 5hEET NUMBER: \ WELL SP- DF-EP OB5ERVATION HOLE#G EL. 70.0 80 DEPTH SOIL SOIL SOIL COLOR SOIL OTHER WE LLE R ASSOCIATES HORIZON TEXTURE (MUN5ELL) MOTTLING SURFACE 0•. 12' A 5ANDYLOAM IOYR2/I 1645 FALMOUTH RD., SUITE F9 12.-34' B SANDY LOAM I OYR5/8 P.O. BOX 417 CENTERVILLE. MA 02G32 34"- 120' c LOAMY 5AND 2.5Y6/6 TELEPHONE: (508) 328-4G92 EMAIL: tri5weller@gmall.COM NOl'E: NO GROUNDWATER ENCOUNTERED IN ANY OBSERVATION HOLE REGISTERED LAND SURVEYORS ENVIRONMENTAL CONSULTANTS i . I I I I I 30 - i El ; I IF, a 11 I . : `r — • _- - - — — - ......�......•.—._�— •y'=_ -- _ _--=_— t III �I I f i ----- - —r i I PI rl I e - — _, �- .�, ,, ! „ I� is EU� • i I _ • _ V _ LVA - LL I SCALE- __...._.. APPROVED Bv: DRAWN By DATE: - REVISED • _ '�''�� DRAWING NUU-jhF�-8ER } I ' l f I N lSs:3C:� 00 oo Y — 1177An 1 9tC.� I r t'r Al — t i y7-'• -I At .. let{-�++r �-• —;! � l _ -� •- 'i vi+t 67 JL 1412 Aa f' I llr.. • it � �I � .:� u � 1 .a 1 • i, I I • . . .ca .. v t I • fl♦ jy}�/y/\ y`I I 1 - 1 � �at•+.�•��'__dry�',,�'�'�7G'11T•\ `r f I , / - ! I �+ '.LI -_ TI f - r t .'^F�a_.•ti.T '_"'•'� C / ry t � / I 1 �j Q t i 4YC± I . ziz dl- 4 1 f + 1 - I � ! _�73CH' .'gig ..�... -�..�:_- ,-_:_ . ___.--____ ;- _,---.- - -_. F..�'� � � • . : �� I � ' �� OA 414- I x— o I • 1 � �ti sl I 1 � _ � 1 I j I _ i ;i ---------- . 1 1!.► x I I AWE "o, ' e — Noe r 10 SCALE. APPROVED BY: DRAWN BY DATE: REVISED vx--=r - RA WING NIII///MBER D I I f ! i i ! 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