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HomeMy WebLinkAbout0060 STONEWALL DRIVE _OxfordNO. 152 1/3 ORA ESSELTE 10% x i I o i Fla Y�BKRS� �G 03 2017 08:21 AM Tupper Construction Co. 15087785010 page 1 TUPPER CONSTRUCTION CO.PLC 546A Higgins Crowell Rd.WEST YARMOUTH,MA 02673 PHONE: 508-77"111 FAX: 508-778-5010 WVWV.TUPPERCO COM Date: , 3UILDING DEPT Town of Barnstable Thomas Perry CBO Nov 0 3 2017 200 Main Street Hyannis, Ma 02601 OWN OF SARNSTABLE (508) 790-6230 fax I Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application Issued on J�I I has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Address: I Richard Tupper License # CS-69058 Town of Barnstable Building Post This Card So That it isVisible,From the,Street=Approved Plans Mue R st betained on Job and th Ca is rd Must be Kept x. a l Posted UntiLFinal Inspection HasBee' Made.,, � + ? • - �pdr' Where a Certificate`of Occupancy is Required;such Building shall Not�be Occupied„u'til a Final Inspection has been made ����1� Permit No. B-17-2267 Applicant Name: TUPPER CONSTRUCTION CO, LLC. Approvals Date Issued: 07/31/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/31/2018 Foundation: Location: 60 STONEWALL DRIVE,WEST BARNSTABLE Map/Lot: 217-050-003 Zoning District: RF Sheathing: Owner on Record: LAY, MARCIA A TR Contras N e,: TUPPER CONSTRUCTION CO, Framing: 1 Address: 60 STONEWALL DRIVE "N 2 WEST BARNSTABLE,MA 02668 ` "`"`Contfactor License: 178434 Chimney: Description: weatherization Est..Project Cost: $980.15 Insulation: Permit Fee: $85.00 Project Review Req: weatherization Fee Paid: $85.00 Final: Date:" 7/31/2017 Plumbing/Gas Rough Plumbing: - � Final Plumbing: F Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work a6cirized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Jam_ Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in GL c.142A). Fire Department M Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` Map Parcel (9S0 . Application # Health Division Date Issued 7 ��-- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis AEG Project Street Addr ss Village 9-aild Ownerkavi� Address &,0 6Z)n/� Telephone S , ' — Permit Requestl Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay r Project Valuation S Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other —'+ W Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) r ` Number of Baths: Full: existing new Half: existing ne _ � 0 Number of Bedrooms: existing _new o Z � Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: O 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: _ Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ . JUL 2oL.: ; Commercial ❑Yes ❑ No If yes, site plan review# DWN OF ft iim,. Current Use ti Proposed Use APPLICANT INFORMATION _.(BUILDER OR HOMEOWNER) Name Telephone Number rL,U 0 J77f —0 Address J/60 ' IV 6r 01 I"( eGL-License #�"6 r U&i_JA) m / ��&Aome Improvement Contractor# / 7f f c Email 1� r CO Worker's Compensation #�CI� AL ONSTRUCTIO EBRIS RESULTING F OM j S PROJECT WILL BE TAKEN TO d-Q-� _lJ SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' MAP/PARCEL N0. ; ADDRESS VILLAGE f OWNER r DATE OF INSPECTION: FOUNDATION n FRAME Y INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL xf PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT; 9 ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services ' Richard V.Scali,Director ° ►`�� Building Division Tom Perry,Building Commissioner 200 Main street,Hymns,.MA 02601 -A vw.town.barnstable-ma.us Office: 508-8624038 Fax: 508-790-6230 Property_ e Owner Must P Complete and Sign This Section If Usina _A Builder as Owner of the subject propnny ltc mby aurhorv�� }LAJ�11 � ( to act on my behalf, in all batters relative to work authorized by hm building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be fillets or utilised before fence is i stalled and all final inspections are performed and accepted_ Signature of Owner Signature of Applican cL Print Name Print Name 5' Dat Q:FORMS:O%bA'F.RPF-VAI SSIONPOOLS ZWe CO"oaivesltJl a Manae- I 1 t ofln/alatrWA=M.,, 1 Cottrm S Vgw,Subs 100 Btyston,MA 02II4-2017 wwrraM&Ugov/db orken Coaupea:atyp Insurance AM'&'t;B'fl'nWC dractorwElect icIam/Mwbem TO U PtL I)VVrM TUR PIRMTM AU M01M Name(Bwine"0MWUdm&&v dn: Tupper CCM4UC ion Co 11C Address: U6A HIMin Crowe Rd City/SWwZip: Well Yarmouth,MA 02673 Phone#: aw""111 An yys as CWWI,z dale ttte a/PnvrWe bow- l.(4 t sm a mooy"WM I employ=(iaU.n"vw$-fM).• Type of project(required): 2.Q t an a rote paprktorarpuh>aabipand hm 7• ❑New conduction &y capseiW-1W wathaa'�R(amaoe megw*&J fat ale<4 S. BRAmodding 3.Q i am a bmoawaer d6heail_*MWILDlowwam,cw4Lioaeasosmo i a j, 9• Demolition 4.❑1 am a bmwwnw gad wiU bg bbtrts coot utm to coWm ati,rock ao my,,,petty. 1 wt7l 10❑Building addition ,sure tint d cobvatatr s&-t haw Mohan compmaeyoa ware oa orom rob i 1. Electrical propricton wills so uvbyxs ❑ repaint or additiow sCI t am a grtatal wMadar sad r tiro hired the rnM.00atreatora Wotd os tbeatt cbw,heat. 12.QPlumbing repairs or additions,Tlsae orb coaaaalosa barns cospbem y sad w"wsdtar'Mv.k%oamat 13.QRoof repairs 6.13 we are a carporwas and Ica oraons love aasirrd Sir fish of asetr*das par Mm c. 14.1 Ogw WaattnllzeWn IS2,11(4).and we have w m picy"L[tic wa*w.aaesp.lnraeroec mq".] 'Any aS S 31 that ehocim soot#1 ZMA at"fill out efts seadonbalow dwnloa thairwaAteae'oo4aswdan prey t xwommss&who k two tlrls aQWavlt bidsoatt they cute 4ofsa au wait and tarn him agadaa oodaaetota neat adroit a new at &%*, indite Mach. MHpmbywwa * tCastr ws. i t cheek this M amrt aaar]ted w addidasal&w tits arms ofthe nib-e0WWtow sed atate wbodw or am chore waWN have. umo ab oomaelws hgw ampbyeer,they MW ptovido tbair.rods'=W mwabw. 1 e0 ,rA elgployer that 1't piot+t t nvtftat'cow#fiaatriauses jot MY MAIN,% lsiow Is Oe and oaks ttrjorraatt.,r. ��v !� insurance Cortlperty Name:AMC Policy#or SelWw.Lie.ll: WCC5005583012016A 1C/3f17 Expiration Data: Job Sit+eAddren: 60 Stonewall Dr a W Barnstable MA 02668 Attxclt a copy of the workers' City/SdtdyZip: mP��a Polley declaration pass(sbowlrtj tie policy atmtber and expiration daft). Faihn to avow coverage as required tinder MOIL c.132.§25A is a criminal violation pu nisbable by a five up to$1,500.00 "or one year imprison W14 as yell sa civil pcoaltia m the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the viobaw.A cagy of thin sate i t may be forovarded to the Office of bw aftmdona of the D1A for fi=rmwe coverage verification. !do fusuteij 7 alls►f r►rl fist die fitfaraitadur p+n abmrs is tuns Are/sour ue Si ze. 6/20/17 Phone 50&77"111 t?�ieitri teas a De pat w►iro itt thin arw,to be compie W by db'or 1bt/N trJWd City or Town: PaatitlLe 0 Invb g Authority(c&eb one): I-Board Of Enith 2.Btilidlag Depaetaaest 3.Cltyfrown Clam 4.Electrical Inapecbr S.pbnrnbfrep Iaapeebr 6.Otbor Contact Person• phans 0: ` '4`oRo® CERTIFICATE OF LIABILITY INSURANCE DATE 11/28/2016(MWDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER E; Ashley Paiva Southeastern Insurance Agency, Inc. vHONE (508)997-6061 IFAX 439 State Rd. .(SOB)990-2731 P.O. Box 79398 DR-M:apa:Lva@southeasterni.no.com North Dartmouth INSURER AFFORDING COVERAGE NAIC 0 t9L 02747 INSURED INS1RERAArbella Protection Insurance 41360 Tupper Construction Co LLC INSURER a Moston Insurance Brokerage Inc 546A Higgins Crowell Road INSURER C: INSURER D: West Yarmouth MA 02673 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER2o16-17 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LT. TYPE OFINSURANCE DIZ POLICY NUMBER Mt L-ICYEFF PO ym C LIMITS XCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g 1,000,000 A CLAIMS-MADE 1 OCCUR P S(Ea o=rrenceiS 100,000 9520045208 11/1/2016 11/1/2017 MED EXP(Any one pwaon) g 51000 PER SONAL&ADVINJURY $ 1,000,000 �GEIWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY - LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: g AUTOMOBILE LIABILITY i (Ea a RM I L LIMIT-— A g 1,000,000 ANY AUTO A A BODILY INJURY(Per person) 3 AUTos U'rOS D X AUTOS SCHEDULED 1020009389 12/1/2016 12/1/2017 BODILY INJURY(Per accident) g IX HIRED AUTOS R NON-OWNED PROPER MACE Pet den S UMBRELLA UAB X Uninsured mctw it el s tit urrdt S 250,000 OCCUR A EXCESS LIAR CLAWS-MADE EACH OCCURRENCE $ 1,000,000 � ED RETENTIONS 14600058368 11/1/2016 11/1/2017 AGGREGATE gS WORKERS COMPENSATION P O - AND EMPLOYERS'UABIUTY Y l N ATUTE ER ANY PROPRIETOR/EXCLUDED? E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MFJNBEREXCLUDED? �NIA (Mandatory In NH) WCC5005593012016A 10/3/2016 10/3/2017 E.L.DISEASE-EA EMPLOYE $ 11000,000 If yes,tlesCribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 16 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Addttlonal Remarks Schedul e,may be attached H mono specs Is requited) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Display Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i AUTHOFL2ED REPRESENTATIVE Ashley Paiva/AMP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 rpnlmn I ' v Office of Consumer ' Affairs and Business Regulation 10 Park Plan- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Reaistration: 1784M f 71+pe: LLC TUPPER CONSTRUCTION CO, LLC. Expiration: 4/16no1s Trf 419M RICHARD TUPPER �r 546 A HIGGINS CROWALL RD W. YARMOUTH, MA 02673 - Update Address and return card.Durk reason for ebange. a+ o zoµa6n� f`,Address L—] Renews, Employment pp l,oat c.rd OMlee ofCoesomerAm rs de B=uenAesaloor License or reostntion valid for individuid an only HOME IMPROVEMENT CONTRACTOR before dbe expiration date. If tband rataro to: Registration: 178434 Type: OHlce of Comer Affda and Bashes:Regulation Explmllon: 4/1812018 LLC 10 _S�5170 UPPER CONSTRUCTION CO,U.C. ort0n' t JCHARD TUPPER 46 A HIGGINS CROWELL RD ✓,YARMOUTH.AAA 02M Not boat signature at�.lye �uunoH cue snsr�ols PW"ORYAIM VWjj UM Me f�f��aft ado VM asr-W4 walep�4p � BUILDING PER FORMANCE IN57nV E, INC aEser tessa w�mMNp(8lA�0� Ur1riggirl9w. f MassachUft is Department or Public Safety Gromf&m�� Board of Building Regulations and Standards �oloMd apBoa COW"0910 of "y License:C94ege 3a Construction Supervisor RICHARD 8 TUPPeR ' f 8.A NHi01N,,,O.,L.,,RQAD WEST YAWgOm MA 026n no �eo pOw�•own>tIt�n dtdM�IIm I°r� ��awtlot+Ngts d'✓,{{!rl�.c, ':: Q.._. Expiration: +� Colnmlaaloner 12/31/2016 Sri Town of Barnstable Permit:Z—alI 0(0(O Regulatory Services ate: °FVEr Thomas F.-Geiler, Director Fee: Building Division BARNSTABLE, Tom Perry, Building Commissioner MASS. 039.� �m 200 Main Street, Hyannis, MA 02601 o www.town.barnstable.m2ms Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: a r C-1 Phone: 1-7 S ! (O Install at: G O S'To vL e--�,j ad ( L)r I"v R Village: Map/Parcel: f ( n; 2 j Date: 7 13 -/D Stove - A. ew/ Used B. Type: adia /Circulating C. Manufacturer: ec rtL1 st",911 1.— Lab. No. D. Model No.: ?6 Chimney A: New xisti (If existing, please note date of last cleaning J -.? O/ o B. Flue Size I :? X 13 " C. Are other appliances attached to Flue? A/O D. Pre-fab Type and Manufacturer �T�,",�1 esr S -( H e.U vti W a e( 3 41 E. Masonry: Line nlined r Hearth A. Materials: B. Sub Floor Construction: ] ;C-L Installer Name: �Grc�`c, L.0� f Address: 60 StuL4ewa, rf� . Phone: A ddGG e Location of Installation: G H.I.0 Registration # Construction Supervisor CD CD OR check t/Homeowner Installing, no license required 1 ri_- `Q �1- APPLICANTS SIGNATURE -� APPROVED BY: e> N N Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection, photographed, and approved by the Building Inspector Q:forms:stove Rev 103107 The Commonwealth of Massachusetts t Department of Industrial Accidents Office of Investigations 600 Washington Street Boston MA 02111 c www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L. Address: C.D City/State/Zip: t cJ � � cla��-Qz .�t/l a a 66 P Phone #: Sy V 7 3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. t ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. '❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 1.52, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: I Policy #or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine t of up to$250.00 a day against the violator. -Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Signature: C(4 o Date: ( i F I{ Phone#: _ Zj A Z--l'o I Official use only. Do not write in this area, to be completed by city or town official je 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 t 6.Other Contact Person: Phone#: Information and Instructions a Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual, partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not.more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such.dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have.been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia Town of Barnstable o Regulatory Services Thomas F. Geiler,Director awxtasrasr.e, mass. 039. Building Division ATED MAI A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA.02601 www.iown.barnstable.ma.us Office: 508=862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print c DATE: //- [ d ti/0, I �� 10B LOCATION: 6 to D yi a �✓� 1 � �,�v�— C/lJ ��r�Sf�` t Ua 6 6- number street village "HOMEOWNER": S. 0 3 S — 2)6 I 1V ,4 name Ahome phone# workphone# CURRENT MAILING ADDRESS: © 5-re"A C�{h--/ta l� k�/ I%/e- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor: The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns: You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC �1HEr Town of Barnstable Regulatory Services BARNSTABLE, ' Thomas F. Geiler,Director MA & f16.39. � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-.790-6230 Property Owner Must , Complete and Sign This Section If Using A Builder j i I , as Owner of the subject property hereby authorize to act on my behalf, j in all matters relative to work authorized by this building permit application for. (Address of Job) i Signature of Owner Date i Print Name i If Property Owner is applying for permit please complete the Homeowners "License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION i I PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 11/09/10 TIME: 12:23 -----------------TOTALS-------------- --- PERMIT $ PAID 35.00 AMT TENDERED: 35.00 CHANGEPLIED: 35.00 APPLICATION NUMBER: 201006101 PAYMENT .METH: CHECK PAYMENT REF: 366 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a �1 Parcel 0 50 — Permit# 4 9 Health Division `�' �r°� 4*7 Date Issued Conservation Division 2 G2'I � '��Cfor��/3/� Fee Tax Collector lr `- 0 SEPTIC•SYSTEM MUST SE INSTALLED IN COMPLIANCE Treasurer WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND '' ®WN.REGULATIONc' Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address e< J V Village Owner'-TO{Y�dlY1d lvor callIFS o/J Address - 5-0-3 pA r7-Yyoy Ay& S lL(Iu—S k4s Telephone 1ln4*Y&VIv.a oyio Permit Request Square feet: lst floor: existing proposed l��;Sb 2nd floor: existing proposed 105�0 Total new 9,)30O e Valuation A7tQ ?7S_ Zoning District Flood Plain Groundwater Overlay Construction Type s 1 1 3 e — Lot Size 48q sg�f Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: Q/Yes ❑ No Basement Type: 8 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) q— Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing TT new�_ First Floor Room Count E Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes t(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:Cl existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use I ,, BUILDER INFORMATION Name 6 W �QU��� Telephone Number 5,6A—yoir Address -SD��� � License# ?,�CQ-' Home Improvement Contractor# j Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY 8 PERMIT N'O. 96- ,. -_ DATE ISSUED' ` MAP/PARCEL NO., << ADDRESS- VILLAGE s o OWNER DATE OF INSPECTION: FOUNDATION. FRAME /,�Lo o INSULATION^ !� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH; FINAL GAS: ROUG FINAL FINAL BUILDING ` ' k DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents 01IJce oJ/ooestigat/oos - � 600 Washington Street ' i Boston,Mass. 02111 Workers Com ensation Insurance davit name J, / c location VJ J� ��'1�/�� 'D^E�f� - city 4dj ,4-R-0J�L�(Tv /y A�'s�� phone# 3,10 ❑ I am a homeowner performing all work myself.. . �]"am a sole r rietor and have no one workin in allycapacity ❑ I am an employer providing workers' compensation for my employees worlang on this job. .. . ........... camanvname:. ,..............,.:::.::.:.::.:::. ::.�.:.......:::..-...:.. .:.. .. .:.....;............. aa r•:e'ss:: a insurance co. ❑ I am a sole proprietor, general contractor, or homeowner"(circle-one)-and-liave hired the contractors listed below who have the following workers' compensation polices: com anv name: ;::<;::; ad�dre Ss:' ....... 'one :>:h City' - .ms n 4:::::+ :'isi::ti::i::i::4:�i::;:;::ism::'vi•}:':iii::•:`i}':•i:?i:i•:is�i::i:':'iii::'' :J:::>'::i::`:i?Xi[{ ?isvi}}::?:isSS:ti:S:::?::•:•isi:}}ii v}SS:•iiiT:+.....•..,StiffisS ': ii+;i:;:j::jtij :;:•:;'....•::•:::i.....::::!:':•i::•i�i:ti;iii:{Cii:::iii i:•:::::i•::iii:•:;i'v':':.,:::�i;::ii:':iiiii :': vi::•::'iii:i::'.::i::..:'.::.. cam anv name:. .: :::.::>::::::::;:.;:;::.:::::;:::;:;;.. :.:.... .. ........ address: . city= irunranctY co:: �. .....:..:......... ' . .. olt iv Falture to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crtminai penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the Corm of a STOP WORK ORDER and a dne of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the VIA for coverage verification. I do hereby cerh the airs and penalties of perjury that the information provided above is true and correct Signature Date Print name S U Phone# MENEM COcheck se only do not write in this area to be completed by city or town official • wn: permit/license i! :OHealth g Department ng Board itimmediate resporue is required en's OfficeDepartmenterson: phone d; (maned 9195 P1A) Information and Instructions rovide workers' compensation for their al,employers to pMassachusetts General Laws chapter�152 section 2 i requires defined awry pets°in the service of another under any cow' employees. As quoted from the"law",an employ of hire, express or implied, oral or or any two or more of partnership, association, corporation or,other legal entity, y w the receiver� An employer is defined as an individual,p the 1 eves of a deceased employer, the foregoing engaged in a joint enterprise,and including rep to employees. However the owner of a trustee of an individual,partnership, association a other legal entity, * of the dwelling house of apartments and who resides therein,or the occupant dwelling house having not more than three ap air work on such dwelling house or on the gads c another who employs persons to do maintenance , construction or rep to be as employer. building appurtenant thereto.shall not because of such employment be deemed 'on 25 also states that every state or local licensing agency shall withhold the issuance or renep MGL chapter 152 sects the commonwealth for any applicant who h: of a license or permit to operate a business or to construct buildings a required. Additionally,neither the not produced acceptable evidence of compliance with the insurance coverage the performance of public work until commonwealth nor any of its political subdivisions cshall��Ythis chapter have been presented to the contracting acceptable evidence of compliance with the insuran authority. i Applicants and the box that applies to your siiou compensation affidavit completely,by checlang ce as all affidavits may be j Please fill in the workers' comp hone numbers along with a certificate of insurance address and p Also be sure to sign and supplying company names, Accidents for caufninatiou of insurance coverage. submitted to the Department of Industrial or town that the application for the permit or license is date the affidavit. -The affidavit should be returned to the crt3' regarding the claw"or if yr requested, not the Department of!t:=iccideots. Should you 1 bet listed below. beingatthr I compensation cy,please call the Dep are required to obtain a workers comp City or Towns legibly. The Department has provided a space at the bottom of Please be sure that the affidavit is complete and printed legs Y• the applicant. Please Office of has to com�tact you regarding affidavit for you to fill out in the event the er. The affidavits may be returned is be sure to fill in the Permit Cense number which will tie usements e been made.-rcfnumb the Department by mail or FAX unless other arraag The Office of Investigations would like to thank you in advance for you coop station and should you have any question'` please do not hesitate.to give us a call. NO The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents K Office of 113ues18e9085 600 Washington street Boston;Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 eat 4069 409 or 375 nO atilt Appmdkg Tabk.tSZ.lb(condaae� prneriptire Packag,far One aedTwo-Faml11►R=W=' l RuadhW gated wild FOW Farb MA=um 14@IRIi[1M cooling �g ci C4UWS Watt Floor Satem� Slab Mc Ate'05) Uwaine Rwalu2 R-vela R"We eau E�ideacY' ttrvdaa�' R- OF Package Sf01 to 690 Rndng Dowse Dave Normal Q 1ZY� OA 13 19 10 6 R 12% am 30 19 19 10 6 Normal S IrA 0.50 3i U 19 10. 6 85 AFUE T IS'�fi 0.36 38 13 25 WA WA Normal U 15% 0." 33 19 19 10 6 Normal V 15'�fi 0.44 31 13. 25 WA WA iS AM W 15% 0.52 30 19 19 10 6 iS AFVE X 19% 032 32 13 25 WA WA Normal Y 19% 0.42 33 19 25 WA WA Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA Ii'/. 030 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 40 4. %GLAZING AREA(93 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: 440=4980303a 780 CMR Appendix J Footnotes to Table JSZlb: doors, skylights, and { area is the ratio of the area of the glazing assemblies (including sliding-glass Glazing but occluding opaque doors)to the gross wall basement windows if looted in walls that enclose conditioned�y�occluded from the Uvalue requirement. area, expressed as a percentage.Up to 1/o of the total glazing design with 300 fl of glazing area• For example,3 fl of decorative glass may be excluded from a building l m accordance with glazing U-values must be fated and documented by the manufacturer 2 After January 1, 1999, tat adore. or taken from Table J1S.3a. U-values are for the National Fenestration Rating Council (NFRC) Pro whole units:center-of-glass U-values cannot be used. The ceiling R-values do not assume a raised or ovasized.truss coon- the insulation substituted fotr R-38 insulation thickness over the exterior walls without.compression, R 30 insulation may insulation and R-38 insulation may be substituted for R-49 insulation Ceiling R values represent the sum of cavity For ventilated ceilings► insulatmg sheathing must be placed between insulation plus insulating sheathing (if us r4. F of the r+oo£ the conditioned space and the ventilated portion insulation plus insulating sheathing (f used). Do not include •Wall R-values represent the sum of the wall cavity i an R 19 ent could be met EITHER exterior siding,structural sheathing.and interior drywall'For�P C6 - ants apply to Insulation OR R-13 cavity insulation Plus R-6 sheathing. Wall PP Y by R.19 cavity log)wall constructions,but do not apply to metal-frame construction. wood-frame or mass(concrete,masonry, such as unconditioned crawlspaces,basements, 'The floor requirements apply to floors over unconditioned spaces or garages).Floors over outside air must meet the ceiling requirements* less than 50%below grade must Tt a entire opaque portion of any individual basement Wall with an average depth doors of conditioned meet the same R-value requirement as above-grade walls. Windows and shdmg glass with the other glazing. B�� doom must meet the door U-value requirement b.semenu must be included described in Note b. 'The R-value requirements are for unheated slabs Add an additional R 2 for 3eated�slabs you plan to install more ' If the building.utilizes electric resistance heating Use compliance appr Piece of cooling equipment,the equipment with the lowest than one piece of heating equipment or more than one pi . . the selected package. efficiency must meet or exceed the efficiency required by ents of the closest city town see Table J521a j 'For Heating Degree Day requirem NOTES: le levels.Insulation R -vahus are minimum acceptable levels. a) Glazing armand U-values are maximum acceptable R-value requirements are for insulation only and do not include Structural components. must be tested b) Opaque doors in the building envelope must have a U-the NFRRCe no g test�reater than� �rce �uthe door U value and documented by the manufacturer in accordance with thU-value rating for t>�door is not available, Include the in Table J1.5.3b. If a door contains glass and an ag�l'� e door with your windows and use the opaque door U-value to determine compliance of the door. glass area of th ant i.e.,may have a U-value greater than 035). One door may be excluded from this requirem (� crawl spy wall component includes two or more areas with c) If a ceiling,wall,floor,basement wall,slab-edge than or equal to different insulation levels,the component complies if the weighted average R-if due is average U- the R-value requirement for that component. Glazing or door components comply value of all windows or doors is less than or equal to the U-value requirement(035 for doors). A Application to Old Kings Highway Regional Historic District Committee ' in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application Is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Constructio New Building ❑ Addition Q Alteration Indicate type of building: (House ❑ Garage ❑ Commercial- ❑ Other 2 Exterior Painting: ❑ I Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK � � �n 1>ALL ASSESSORS MAP NO. OWNER �� jN1AQG y.ST SDI�1 ASSESSORS LOT NO. C) HOME ADDRESS 503 PARtNtO" A}VC 91"Ek SP-PA6 IM.D. TEL NO. .s301 aOTlD FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners acfoszs aniiLuhlic ��r street or way. (Attach additional sheet if necessary). I ll eb cAT Z i f'''t Yam_ N � O� OR CONTRACTOR 'J a�A) Sc�Ul TEL NO. 362219C ass SCv DDEI ! �A Sri WAR - 6 a630 LED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.8,other side),including ils to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). c��- A a s�-y A 33 'x ' w �ax��� Rrnn n , UJ to Signed . -Contractor-Agent Space below line for Committee use. 0 he Cer i ate is hereby & -� V�� Date OLrZ �m`9 Ti Approved" ❑ IMPORTANT: If Certificate is approved,approval is ject o the 10 day appeal pe r Alk- . _. _.... ..__ . �( ..._G 6S0 oo 9.47 !-fol-amp pR.. . V j.�PD j G.Sa 00 A .. S700L V/A-u-.. 04-7. Rn -I- CLA" Pox Did Wiz- �` � r Town of Barnstable ` Old King's Highway Historic District Committee SPEC SHEET FOUMATION SIDING TYPE ,��� COLOR /JA LEAL_ CHIMNEY TYPE COLOR F ROOF MATERIAL Fi&jW C,0&<7 COLOR t540y PITCH 7�iZ WINDOWS D COLOR GJM7E- SIZE_ UA TRIM COLOR DOORS COLORS ✓_ tfO � SHUTTERS COLORS BU GUTTERS A1JP,W41 fiV)4 COLORS DECKS VTOEYD MATERIALS '- {Z CVC42- P T,L GARAGE DOORS COLORS SKYLIGHTS SIZE. . A- COLORS SIGNS - COLORS U FENCE O�U COLOR NOTES: Pill out completely,. including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along.rith Four copies of the plot plan, landscape plan and elevation plane, when applicable. SPECSHT Revised 11/98 JOHN B. SQUIBB 9 SCUDDER LA.. BARNSTABLE, MA. 02630 CONSTRUCTION AND RENOVATION MASS LICENSE # 03406.4 HOME IMPROVEMENT CONTRACTOR # 108662 508 362 9125 Landscaping; Although no formal landscaping`plan is being submitted the intentions are as follows. Some clearing of the land was done prior to the sale to the present owners.The clearing seems to have been done thoughtfully,preserving the mature trees and removing the underbrush in accordance with Conservation guidelines. The owners intend to remove only the trees which would interfere with the house or driveway contruction,(the garage is not being built at the presnt time) After constuction shrubs or low bushes will be planted around the building as well as grass in the areas disturbeb by construction. The finished driveway will be gravel or . stone, John Squibb Builder o ode MA AW { TOWN OF BARNSTABL$ QLQ IN - H GE{1AAY }oI. �1�' Ilk �/r/fir/ � \ ` `\\ � �• � \\�•� �� � •�,� �-��• .l: ' , '- , •!� •;' Ir lo- lz Ir • \ \ \\� -•�'� \ �\ .,yap p `` \\\\\ ♦ \ � .. � / !� /•' �. � 1 J •� \ 1. " � � � ,� '-'�..' `f„ �� .�' 2 . ( '�.. �__ .. ' y.:.. �ice• -^y�--;��1-�.�"� j p o l.� N \- � .. . . _ Value LIVING SPACE S (high end construction) ,J 0 square feet X$115/sq. foot (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57Aq. foot= GARAGE (UNFINISHED) . square feet X$25/sq. foot= PORCH o square feet X$20/sq. foot= S� O"Zi"Z1 DECK a square feet X$15/sq. foot= �� > OTHER square feet X$??/sq. foot= X ,003t Total Estimated Project Cost S>7�' For Office Use Only /nc/usionarY Afforda/i/e Housing Fee ET Residential Commercial" Property Owner's Name 7- Project Location :2 /L 1-,r-��7 /;o .7 `, S Permit Number 7 G� Project Value "Existing Sq. Ft. "Proposed New Sq. Ft. i-:Tiro'd.�,:+,:..LafCma:.+.:..•i.;:..:':,:,, ."•.'.�«J.,.a... .._._ _�_-. ' - -- ✓R6 V/O'IfYlltINIIIJCfll(/L O�✓l�laG66GtUdP, BOARD OF BUILDING REGULATION! Ucense:CONSTRUCTION SUPERVISOR Number:_CS 034064 EzpIAA:_0W21/2001 Tr.no: 5236 ReshTcted'To:.- 00 JbHN B SQUIBB.' 2 9.SCUDDERLANE BARNSTABLE, MA 02630. Administrator if:i5•n�...�.+.wy.n,p,..`'ww;�. r..T.v. -,;w..w;u...quw.....-- `. .r,...� .--• 186.90' N ' CONCRETE d FOUNDATION T-7 co T.O.F.= 44.1 -� 1oa•2' LOT 3 55,489 sq.ft. N w N � O O � O N O i O i 3 W O L=146 99 90 9>. R=65. 00 STONEWALL DRIVE , o �o• JOB #00-038 CERTIFIED PL 0 T. PLAN LOCATION : 60 STONEWALL DRIVE PREPARED FOR: BARNSTABLE, MASS. SCALE : 1" = 50' DATE : SEPTEMBER 21, 2000 THOMA S G US TAFS ON REFERENCE : PLAN BK. 382 PG. 36 ASSESS. MAP 217 PCL 50-3 CERTIFY THAT THE STR SHOWN ON THIS PLAN IS LOCATEDU ON THE ����lH OF MgJJgc ARNE ti GROUND AS SHOWN HEREON. H. c OJALA off. 508-362-4541 o No. 26-q i Q fax 508-362-9880 9p yc y _ � down cape aaginewdn& Inc.CrM ENGn;EER9 LAND SURVEYORS OU mob sL 7armcuth. ma 02M DATE REG. LAND SURVEYOR f MAScheck COMPLIANCE REPORT I o I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I I I I I Checked by/Date I I TITLE: Gustafson Residence CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 9-12-2000 DATE OF PLANS: 9/12./2000 PROJECT INFORMATION: 60 Stonewall Drive W. Barnstable, MA COMPANY INFORMATION: John Squibb 9 Scudder Lane Barnstable, MA 02630 NOTES: Prepared by: Summit Insulation Co., Inc. P.O. Box 1337 Harwich, MA 02645 (508)430-8144 COMPLIANCE: Passes Maximum UA = 547 Your Home = 543 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 228 30.0 0.0 8 CEILINGS 1376 30.0 0.0 48 WALLS: Wood Frame, 16" O.C. 2082 19.0 0.0 125 GLAZING: Windows or Doors 552 0.500 276 DOORS 110 0.233 26 - FLOORS: Over Unconditioned Space 1281 19.0 0.0 60 HVAC EQUIPMENT: Furnace, 94.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR .1310 and J4.4. D1de /Designer /v_ Date 5& 6� Jy I I TITLE: Gustafson Residence MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 9-12-2000 Bldg. l Dept. l Use I I I CEILINGS: [ ] I 1. R-30 Comments/Location [ l I 2. R-30 Comments/Location I WALLS: [ ] I 1. Wood Frame, 16" O.C. , R-19 Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.5 For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I I DOORS: [ ] I 1. U-value: 0.233 Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 Comments/Location I HVAC EQUIPMENT: [ ] I 1. Furnace, 94.0 AFUE or higher Make and Model Number I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in-the building envelope, recessed lighting fixtures shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I DUCT INSULATION: ( j I Ducts shall be insulated per Table J4.4.7.1. i I I DT_JrT CON4TRTTr TTo N- [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I I SWIMMING POOLS: [ l I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I I HVAC PIPING INSULATION: [ l I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in. ) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-l" 1 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- TOWN OF BARNSTABLE CERTIFICATE OF: OCCUPANCY PARCEL ID 217 050 003 GEOBASE ID 31997 ADDRESS 60 STONEWALL DRIVE PHONE W BARNSTABLE ZIP — LOT 3 BLOCK . LOT SIZE. DBA DEVELOPMENT DISTRICT WB PERMIT .53756 DESCRIPTION CERTIFICATE OF OCCUPANCY--BLDG.PMT.048495 PERMIT TYPE BC00 TITLE . . CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: - and Environmental Services TOTAL FEES: BOND $.00 per CONSTRUCTION COSTS $.00 . 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P' ( I� T' + 1ARN3I 814 s' a: MASS. 03 FD MO►I BUILDING DIVI- N BY �� —� DATE ISSUED 06/06/2001 EXPIRATION DATE ' �"� ' TOWN OF BARNSI _, t" BUILDING R RM� PARCEL ID 217 050 003 GEOBASE ID 31997 ADDRESS 60 STONEWALL DRIVE PHONE r W BARNSTABLE ZIP - LOT 3 BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT WB PERMIT 48495 DESCRIPTION. 4BR/2.BA12ST CONTEMP/HIP. ROOF (SEW# „2 00-4�4) PERMIT TYPE BUILD TITLE NEW RESIIDENTIAL BLDG PMT F, d(YNTRACTORS: S%TIBB, JOHN " ..Department of Health, Safety ARCHITECTS: and Environmental Services l�rOTAL FEES: '= f $845.91 OND $.00 t OxIm ONSTRUCTIgN COSTS $27j2,'8 5'.00 .." 1.01. SINGli �FAM HOME DETACHED 1 PRIVATE PI: t E'"' * RARNSI'ABLF, s _ 039. 1p, 4 BUILDINOWDIVISION ..a DATE ISSUED 09/07/2000 EXPIRATION DATE BY N VI TOWN OF BARNSIABLE: V ;^ BUILD�-FJt, 'P.RRMIT PARCEL rD 217 050 003 GROB�ASL ID 31997 ADDRESS (30 ST014EWALL DRIVE PHONE W BA'RNSTABLE ZIP LOT 3 BWCK LUT SIZE DEVELOPMENT DISTRICT WB PI.RMIT 48495 DESCRIPTION 4BR/213A,/2ST CONTRMP/-HIP ROOF (SEW# 20Gu- 452 ) Fz'FMIT '.TYPE BUILD TITLE NEM RESIDENTIAL BLDG PMT CONTRACTORS: SQUIBS, JOHN � _ Department of Health, Safety ARCHITE(M: and Environmental Services TOTAL FEES: $845.91 �Im fit' w $.00 CONSTRUCTION COSTS $272,875.00 :!Ol SINGLE FAM HOME DETACHED ] PRIVATE Pi * ? ►RN3TABI.E, •' MAS& 039. BUILDIN.GfDIVISION BY PATE ISSUED 09/07/2000 EXPIRATI0k DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT 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 MAY BE 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 FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION: , OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION.BEFORE OCCUPANCY. A • BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 7/01 2 (3 2 2 f;V tape 3 , 1 AT G INSPEC 10 APPROVALS ENGINEERING DEPARTMENT 2 BOARD MOF -,_Ubb liar 5 OTHER:Wa Ca5&kf ELL SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED,ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED-.FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PER --IT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. V 5-3 Z J j r i ' i T.O.F, AT EL.44.0' :. LEGEND 2" DOUBLE WASHED PEASTONE �Oo WATER SHUT OFF VALVE ACCESS COVER WITHIN 6" TO FIN. GRADE ACCESS COVER (WATERTIGHT) PROPOSED .LOCATION / WITHIN 6" TO FIN, GRADE ELOF MIN / EXISTING WATER LINE LOCUS MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM Y,�L.36 MAX ____�,_� PROPOSED LOCATION 7ACCESS COVER PROPOSED 1,500 RUN PIPE LEVEL WITHIN 6" �So -4 � FOR FIRST 2' F FIN. GRADE GAS SHUT OFF VALVE z r L.34.7 GALLON SEPTICILI- TYPICAL OF 2) TO BE LOCATED ( ) EL.34.50 ��H2 EXISTING GAS LINE TANK H- 10 GAS EL.33.0 `� @- 6A EL.37.3' o EL.32.31 - TO BE LOCATED ROUSE BAFFLE EL.32.48lag 0 O d _ �` EXISTING PHONE LINE BASEMENT FL. TO EXISTING LOCATED o PROP. AT EL, S C' EL.:32.17i � 0 0 � 0 � d CI jE0::lr3 34" G� EXISTING RI I 36.3' t 6" CRUSHED STONE OR MECHANICAL - --v--. 4' 0 SIDES L� 0 4' SIDES G ELECT C L NEDEPTH OF FLOW 4' COMPACTION; (15.221 [2�) 3.5' (� ENDS 2 C] [D C] (� 0 Q O O .5' ® END TO BE LOCATED O o EL.30.17t REQUIRED TEE slzEs: H-20 EXISTING CABLE T.V. LINE E BARN ABLE, MA INLET DEPTH 10" MIN. BELOW FLOW LINE # 3�4" TO 1 1 �2" "DOUBLE WASHED STONE TO BE LOCATED OUTLET DEPTH = 14" MIN. BELOW THE FLOW LINE E ( . MIN. SLOPE) (- SLOPE) (SLOPS MIN. SLOPE) +35.8 EXISTING CONTOUR /� EXISTING SPOT GRADE LOCUS MAP SCALE 1" = 1000' j FOUNDATION 31' SEPTIC TANK g2' b' BOX - 2' 14' .LEACHING FACILITY 6.37 PROPOSED CONTOUR LONGEST LENGTH 16' S'REMOVAL REOU/RED 72'j- TO B4"t D££P TO BOTTOM Cl LAY£R 6.67' SYSTEM PROFILE SEE TEST HOLE LOGS ENciN£ER ro INSPEcr� cERrIFY REMo�AI PROPOSED SPOT GRADE ASSESSORS MAP 217, PAF.CEI, s'S0--003 TH1 SOIL TEST HOLE FLOODZONE: C, BARNSTABLE (NOT TO SCALE) SEE TEST HOLE LOG(S) PANEL # 250001 0003D *ZONING DISTRICT: RF FRONT: 30' SIDE: 15' BOTTOM OF TH2 .EL:23. REAR: 15' SEE SOIL LOGS *TO BE CONFIRMED BY BUILDING COMMISSIONER ' ' BOTTOM OF 7H1 L,23.5 SEE SOIL LOGS i r 1A r I r V 4A � EXISTING WELL `._ems_ 3A_ _ 2�/ APPROXIMATE LOCATION NOTES: 1. THE LOCATION OF EXISTING UNDERGROUND UTILITIES SHOWN ON THIS PLAN IS OD APPROXIMATE. PRIOR TO ANY EXCAVATION ON THIS SITE, THE EXCAVATING CONTRACTOR SHALL MAKE THE REQUIRED 72 HOUR NOTIFICATION TO DIG SAFE (1-888-344-7233) AND ANY OTHER UTILITIES WHICH MAY HAVE CABLE, PIPE OR EQUIPMENT IN THE CONSTRUCTION AREA FOR VERIFICATION OF LOCATIONS. �q� 0 2. ALL SEPTIC WORK AND MATERIALS TO CONFORM TO 310 CMR 15.00 TITLE 5 \ / AND BARNSTABLE HEALTH REGULATIONS. \ 3. VERTICAL DATUM IS NGVD, ELEVATION ASSUMED FROM QUAD. \ ,55 N �0 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHTO-H10 SEPTIC TANK, H-20 D-BOX & CHAMBERS. \ ��'�" 5. THIS PLAN IS FOR A PROPOSED SEWAGE DISPOSAL SYSTEM ONLY AND IS NOT TO STAKEO BE USED FOR ANY OTHER PURPOSE. S✓L T FENCE 6. ALL SEPTIC PIPING SCH-40-4" PVC UNLESS NOTED, 0 v, 7. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT HEALTH AND PERMISSION OBTAINED p� o INSPECTION BY BOARD OF A ION 4 i ' FROM BOARD OF HEALTH I 8. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT, R0�• " 9. PIPE JOINTS TO BE, MADE WATERTIGHT. s, - it ✓ - Z�` 1:1:,WATER SERVICE D-'BO FOR LEVELNESS. - �_� ES� � 10. WATER T VICES',APPROXIMATE AS SHOWN, GAS, ELECTRIC, TELEPHONE & CAf31L.E UTILITIES - - 2,. �6• .a •taC. � rry In3:T4i _!`n Tur n •nncr ..., - _ - -- PE- - s T^ ._ -.,.��C �.,,i�,'.:; wi-rc`i'cv b'r' UiriEKJ. ALL SUBJECT TO FINAL DESIGN AN LOCATION 1 ( D LOCA 10 AS REQUIRED BY UTILITIES VENDORS). - j A 4 B ROOM C� / / _ E. C"� '_;i�1G 38 \ EL.4.4.0' /TOP iNON. N \ ry / a �R oAZ O \ ^ J..�3 PROPO.S£D 1,600 CAL, SEPTIC TANK EXISTING WELL v,� 39 �~~ APPROXIMATE LOCATION IA, 38 s 150' ( ' / 1a�1 v� ��/ NUMBERED WETLAND FLAGS SHOWN REPRESENT A Rf--FLAGGING OF THE IT "Q r � / WETLAND LINE AS PREVIOUSLY DELINEATED BY DONALO SCHALL, WETLAND DEPTH (in.) TH1 ELEVATION P#9711 6 0 E 1 Z , SCIENTIST, IN 1994 p 36 S �� y5 z �98/ 0 SANDY LOAM 35.5 PEPRESOAK: 0:0 00-0(:10 15 II (10 MPI DESIGN)) 0 / ya �6 / 10 YR-3/3 12 0:10:15 14' 34.3 9": 0:10:3$ Cl 6": 0:11:02 SEPTIC DESIGN,_ (GARBAGE DISPOSER IS NOT ALLOWED) / /FED � �y/ SILT LOAM TOP OF PERC: AT 72" EL.29.5 NUMBER OF BEDROOMS: 4 / 1 ` ! i �� / 2k/ 1N YR 6 4 DESIGN FLOW: 4 BR x 1110 G/D/BR = 440 G/D / 0 ��' 12►I (10. 9 / TH t�\� �p / #7 72 C2 29.5 USE A 440 G/P REQUIRED DESIGN FLOW L O { Mlk �� - LOAMY SAND NO WATER OBSERVED 5ERTIC TANK: / / •;:;i 2.5 Y 6/4 440 G/D (2) _ 880 G/D I / / 1 144" 23.5 USE PROPOSED 1,500 GALLON SEPTIC TANK / / / Lro LEACHING: o / . ., PROPOSED I / y / 5�° " `�� r� 2�2b DEPTH (in,) TH2 ELEVATION SANDY LOAM PRESOAK:SIDE AREA: 2 x 2' x (12.83'+41') = 215 SF O-BOX OB-6 y6 / / "> M`� � �o N°j �7 2� 6 0' A 35•$ PERC SO RATE: 0:O MPI ((CLASS II (10 MPI DESIGN)) BOTTOM AREA: 12.83' x 41' = 526 SF �' / � �- � 22, 05 0.20 s / ry / 10 YR 3 4 12": 0:10:20 SIDES: 215 SF PROPOSED I 12, H2 `�' ti ^� / � � 12" U UITA L 34.$ 9": 0:10:42 + BOTTOM: 526 SF SOIL ABSORPPON SYSTEM g3' / 100 `dry, '#5 B 6": 0:11:07 LOAMY SAND 4 - 500 GALLON PRECAST CONCRE I w [ MIN. 10 YR 5 8 TOP OF PERC: AT 72" EL.29.5 TOTAL: 741 SF LEACHING CHAMBERS ''0 ti� 36 UNSUITABLE 32.8 PROPOSED CAPACITY: 741 SF x 0.60 G/D/SF 444 G/D O.K. WITH 4' OF STONE ALONC THE SIDES ANO J.5' OF STONE A T TH££NOS. '4 Cl # SILT LOAM NO WATER OBSERVED SEPTIC SYSTEM DESIGN DATA 10YR6 3 5 REMOVAL REQUIREO 72'a TO 94"t DEEP, TO BOTTOM Cl GAYER \ M oo r N N rc-, "c'\�•� 84" N C2A 2$.8 V SEE TEST HOLE LOGS w M� M �, N N N LOAMY SAND ENGINEER TO INSPECT& CERTIFY REMOVAL 2.5 Y 7/4 #3 144" 23.8 �z L T 3 DATE:\ P � �' 6.Vyy E 3/14/00 !g \ F� -.__ ENGINEER: MICHIAEL S. FARIA, SE 54 9 f (DOWN CAPE ENGINEERING) ARRY EXCAVATOR: BORTO OTTI BCONSTRUCTION A \ � TEST HOLE LOG NOT TO SCALE RO W OF PROPOSED 9 S �� l Sz 1 AY CONTI?ACrOR TIE INTO TOWN WATER _ COORD/NA rE WITH WATER DEPARTMENT y-' pq V <Z �� , of EOF SAgN, B� MANHAOLGEO COVER I\ off. 508-362-4541 ATER �� /� TITLE 5 SITE PLAN SITE PLAN �� fax 508-362-9880 S uTOFF � � OF LAND IN WEST B down cape engln e ering, Inc. BENCHMARK 405 SCALE: 1 "=30' \� s� HYDRANT - - BARNSTABLE MA TAG BOLT #40 �� ���" Of M PREPARED FOR THOMAS A. GUSTAFSON CIVIL ENGINEERS EL,39.28 TEL �,�9 Of o�� ARNE H. cyG LOCATED AT LOT 3 STONEWALL DRIVE y NGVD --� RISi=R o�� ARNE Jq�ti oJALa �. WEST BARNSTABLE, LAND SURVEYORS n. :.� �.: . . � H. � CIVIL �O LE MA -02668 _. U U OJALA NO,30792 • - 1, ^' . y - y BOARD OF HEALTH r� SCALE: 1 =30 DATE: 4--�5-00 939 main St. armouth, ma 02675 sTE REVISED: _sL31oa � � L5/MA r-- 5 30 0 30 60 90 Feet .. APPROVED DATE DATE ARNE 11, OJALA, P.E,, RL. i i, v r ,f ..,„.w t'✓,rr?,r" .:'� ,,�'' `` ;'-..�...� �zt ,� ,s' s�,ax2�' +s t ^s'x s t� �}', ' .,P, r�, „�-� r � q r r �M t g_ ,,*��t ems:, \ , ,s•E �. � � §_� P ' ,W� � ; �� x, ss% +�,.� s / - � .r Y l d r J. y_ ,✓ f '` ak�' sN#: a; § r%ya' a ; r qq foil :"''�1 � �/ ;� � yt."" -e�? � 'i 'ddot �✓ � !' �! � i � 1 e k an aio€, r �s �,y� �'', ��'� �Z "�'� E y tt i i xf � ✓ -n w/J'�"�•".i. ,�i ;{y 'i�4 -! 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