HomeMy WebLinkAbout0082 DAYBREAK LANE
Town of Barnstable }
Regulatory Services ?,� ` g F �_
Thomas F.Geiler,Director
' anarrsTnsi.E.
9 �0$ Building Division 6
1639.
Tom Perry,Building Commissioner _
200 Main Street, Hyannis,MA 02601 ''' %0 r
Office: 508-862-4038 Fax: 508-790-6230
PERNHT# �I FEE: $
SHED REGISTRATION
120 square feet or less
2 -V41 L5gzeRIC z-4ff f//wVAIlS
Location of shed(address) Village
J
s er t•_ ` 3 1790 -13�
Property owner's name Telephone nuinber
G X /o z'73 z�l
Size of Shed Map/Parcel#
SignatteJ Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required) U "
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
REV:121901
. . .. . .. :...... . ... . .:.... ..:......:..... .:.
—zr-P. 7.1999 9:321c'M BAYSIDE BUILDING C0.5087750155 NO.8-37 P.3/5
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CERTH IED PLOT PLAN saoO=m r�'RAT "Ou"ATION
LOCA7T.D ON
FOR THE GROUND AS SHOWN HEREON AND
LOT 42 DAYBREAK LANE- HYANNYS,MA. THAT IT CMC ORM TO TEM MMMMM
BUMDING, 9ZT3ACS REQUMUMM TB OF
TBE TOWN OF NAMWARM
PUMARED FOR
BAYSIDE BUILDING INC. ��„a
SCALE: 1"-30' APRM 5119" ��
Wdler&ASSOC1ateS
1"S Bal@0wth AL -Salts 4C CCaSaTIIIe,Ms.02632
77SM
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,
Map Parcel Application #
Health Division n Date Issued
Conservation Division -Application Fe'
Planning Dept, Permit Fee
Date Definitive Plan;Approved by Planning Board
0
Historic - OKH Preservation /Hyannis
Project Street Address
Village 1�5
Owner \'�K8'iC>d2 Addres
Telephone
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Permit Request iv
' 11 S it
Square feet: 1 st floor: existing ' proposed ,2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction TypeQ _
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 �q No On Old King's Highway: ❑Yes No
Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing ,. new Half: existing 0 new
Number of Bedrooms: existing new
Total Room Count (not including baths): existing ( new First Floor Room Count
Heat Type and Fuel: XGas ❑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 garag9)4existing ❑1 new size _Shed: ❑ existing ❑ new size _ Other:
N
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Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ � :!:_�
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Commercial ❑Yes No , If yes, site plan review# t
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER) co m
Nam _7:;� lilt Telephone Number `���-`1-Z t
Addressl- 5 =Swu License #
Home Improvement Contractor#
Worker's Compensation # � �Q
ALL CONSTRUCTION DEBRIS RE LTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
" I
� s
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
x
".INSULATION -
,FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
Department of Industrial Accidents_
T Office of Investigations
600'Washington Street
Boston,MA 02111.
www.mass.gov/dia
Workers'Compensation`Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name.(Business/Organization/Individual)
Address:�l �
City/State/Zip. Phone.#��-� �S
Are you an employer?Check the.appropriate bog: Type of project(required):
I am a employer.with(3� 4. ❑'I am a general contractor and I
`" ime 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ;
shipand have no employees These sub-contractors have
8. ❑Demolition
working for me in any capacity. employees and have workers' c
9. F Buildin addition"
[No workers' comp.insurance comp. insurance.$ ❑ g
required.] 5• ❑ We are a corporation and its' 10.❑Electrical repairs or additions
officers have exercised their
3.❑ I am a homeowner doing all work 11:❑Plumbing repairs airs or additions
myself. [No workers' comp. right.of exemption per MGL 12•❑Roof repairs
insurance required.] t c. 152 §1(4) and we have no
employees.[No workers':::._ . - 13.:..❑ Other
comp. insurance required.] ! -_
*Any applicant.that.cheeks.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 anew affidavit indicating:such
$Contractors that check this box must attached an additional sheet showin;the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have em to ees the `p y y 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 Namet
Policy#or Self--ins.Lic.#: Expiration Date:
Job Site Address: 0�. City/State/Zip. > 1` d j
Attach a copy of the workers' com ensation policy.declaration page(showing the policy number and expiration date):,
Failure to secure coverage.as.required under Section 25A of MGL c.452 can lead to the-imposition of criminal penalties-.of a " -
fine up to$1,500.00 and/or one-year.imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine.
of up to$250.00 a.dXIA
against the wi lator. Be advised that a copy of this statement may forwarded to the Office of
Investi ations of the for insur covera e verification.
-I-do hereby eerti- rider thew penalties-of-perjury-that-the-infor-mation-pr-ovided above-is true-a�cor-r-ee-t.
Si ature: Date: 1
Phone#: .
Official use only. Do not write in this area to be coin feted b city or town o
P. Y ty 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#:
e
ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY1Y)
PRODWCER 12/30/08
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rogers&Gray Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
434 Route 134 HOLDER:THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O• Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
South Dennis; MA 02660-1601
INSURED INSURERS AFFORDING COVERAGE NAIC#
Capizzi Home Improvement,Inc. INSURER A- NGM Insurance Company
Capizzi Enterprises,Inc. INSURER B: American Home Assurance
1645 Newtown Road INSURER C:
COtuit, MA 02635 INSURER D:
INSURER E:
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
s
LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE MM/DD DATE MMIDD LIMITS
A GENERAL LIABILITY DATE
O6/O8/OS O6/OS/O9 EACH OCCURRENCE $
X COMMERCIAL GENERAL LIABILITY 1 000 OOO
DAMAGE TORENTEDn E50 OOO
CLAIMS MADE �OCCUR EMI E TT
MED EXP(Any one person) $5 000
PERSONAL&ADV INJURY $1 000 000
GEN'L AGGREGATE LIMB APPLIES PER: GENERAL AGGREGATE $2 000000
POLICY JE 0. LOC - PRODUCTS-COMP/OP AGG '$2 O00 OOO
A AUTOMOBILE LIABILITY MIM28044 06/08/08 06/08/09
ANYAUTO COMBINED SINGLE LIMIT
(Ea accident) $500,000
ALL OWNED AUTOS - - -
X SCHEDULED AUTOS BODILY INJURY $
(Per person)
X HIRED AUTOS
X NON-OWNED AUTOS BODILY INJURY $
(Per accident)
X Drive Other Car
i PROPERTY DAMAGE $
(Per accident)
.GARAGE LIABILITY ANY AUTO -
AUTO ONLY-EA ACCIDENT $
� - -
OTHER THAN - EA ACC $
'. AUTO ONLY: AGG $
A EXCESS/UMBRELLA LIABILITY CUB1076H O6/08/08 O6IO8/O9 EACH OCCURRENCE E5 OOO OOO
X OCCUR ❑CLAIMS MADE ,
AGGREGATE $5 000 000
DEDUCTIBLE $
X RETENTION $10000 $
B WORKERS COMPENSATION AND -
WC6957000 -
. $
EMPLOYERS•uAelLm 12125/08. 12/25/09 XrAT _
ANY PROPRIETOR/ R/EXECUTNE RY
OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT $5 00 000
K yes,describe under. E.L.DISEASE-EA EMPLOYEE ESOO,OOO
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Carpentry
CERTIFICATE HOLDER CANCELLATION
" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL �_ DAYS WRITTEN
2OO Main Street - - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE - -
ACORD 25(2001/08)1 of 2 #S40650/M40647
KW O ACORD CORPORATION 1988
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Board of Building Regulations and Standards License or registration valid for individul use only
- :HOME IMP'ROVEMENT:CONTRA:CTOR,-.;; ..,. ,.. ._.,before,.thp..exp.iration data._.If:foun,d return,to
Re91stwaQb;; 100740 Board of Building Regulations and Standards
)n u
plea 171I f 23/2010 < e Ashb rton Pl ce I2m 1301
-7) Boston,Ma.02108
-r!' `element Card
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CAPIZZI HOME ,.1�_FITl�
p�r `4 ��;
bARY GUSTAFSOty;�.:
1645 Newton Rd.
Cotuit, MA 02635 Administrator )`7ov itho t nature
Nl issachu set 6- of Public Saletti -- -
• Boar'cl. Regvlation.s and Standards
Construction-Supervisor License
L)csnse'. CS 74640
Restricted to: 00Xz
GARY GUSTAFSON 8 SHORT WAY 4 �'�y
SANDWICH, MA 02563 c
11/29/2010 -
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Page 7 of 7
CAPIZZI HOME IMPROVEMENT INC.
SPECIFICATIONS AND ESTIMATES
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
I,JOHN BREDICE, OWN THE PROPERTY LOCATED AT 82 DAYBREAK LANE IN HYANNIS,
MASSACHUSETTS.
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR
A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING
CODE.
ll/,/- - ai
I GIVE MY PERMISSION TO LESSEE
TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS
STATE BUILDING CODE.
SIGNATURE OF OWNER:
OWNER'S ADDRESS: 82 DA REAK LANE, HYANNIS, MA 02601
OWNER'S TELEPHONE: 508-775-3833
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS:
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE:
APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635
APPLICANT'S TELEPHONE: 508-428-9518
RESPONSIBLE OFFICER:
RESPONSIBLE OFFICER ADDRESS:
RESPONSIBLE OFFICER TELEPHONE:
` TOWN�OF BARNSTABLE BUILDING PERMIT APPLICATION
Map c27 3 Parcel o2S9 Permit
Health Division 'm .NT MUST OBTAIN A SEWER �, Date Issued
.CTION PERMIT FROM THE ',r
Conservation Division d 'iS1TRUCTIONDIViSION PRIOR TAtHmFee 1 7�) ,
Tax C611ect'
AMICANT MUST OBTAIN A SEWER
Treasurer 7 CONNECTION PERMIT FROM THE
` ENGINEERING DIVISION PRIOR TO
G�I,.TRUCTiON "
Planning Dept. Q
�. / 19
Date Definitive Plan Approved by Planning Board � � � � S 10 '
L Q f /Ze/�cS�
Historic-OKH Preservation/Hyannis q
Project Street Address DIJ'IMF 14C 1,AAJ4 (1—bZU L07 q-),)
Village YAtiN IS
.Owner 66 Y5 /be 6 n/ 5 lylnOi Address CEav?Y)e- V lL L
Telephone -17/— /U q0
Permit Request 70 e0N57�NC7- f} �5/NBZC F.,Qt�14Y /Y671U 49
Square feet: 1 st floor: existing proposed /10Q 2nd floor:.existing proposed Total new f7�
Estimated Project Cost -0 Zoning District, �G_ / Flood Plain C. Groundwater Overlay (o?
Construction Type WOO P FRS W
Lot Size 9 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family 3 Two Family ❑ Multi-Family(#units)
Age of Existing Structure NE� Historic House: ❑Yes - M o On Old King's Highway: El Yes,
Yes U
Basement Type: 3'Eull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new of Half:existing new
Number of Bedrooms: existing new 3
TO Room Count(not including baths):existing new - First Floor Room Count -7
Heat Type and Fuel: GYGas ❑Oil ❑Electric ❑Other
Central Air: dYes ❑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 sizeZxc9 Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 3*' o If yes,site plan review# '
Current Use VAC-PtAvT LOT• Proposed Use
BUILDER INFORMATION
Name_ f3 y5 /l 6LAC /illC Telephone Number 77/— /Q'Yb
Address 6DX q License# 60 S i
CFAJTe2 V I L. E 0a 6 3;z Home Improvement Contractor#
Worker's Compensation# IG9 00 1 l Q 16 1//
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &d eAJF L19A/0 F l LL
SIGNATURE DATE _—/1-9
" FOR OFFICIAL USE ONLY " a• `
PERMIT NO. l
DATE ISSUED
MAP/PARCEL NO.'-
7 t
wls
ADDRESS VILLAGE -
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATIONu��� � ,. - : •' � _ - -• y
FIREPLACE
ELECTRICAL: ` ROUGHS FINAL
PLUMBING: ROUGH'- FINAL - =
GAS: ROUGH " FINAL
FINAL BUILDING
r-�t
DATE CLOSED•OUT '
ASSOCIATION PLAN NO.
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TOWN OF BARNSTABLE
CERTIFICATE OF OCCUPANCY `'
fi'
PARCEL ID 273 259 GEOBASE ID 37684 R
ADDRESS 82 DAYBREAK LANE PHON \',
HYANNIS ZIP -
LOT 42 BLodK LOT SIZE
DBA DEVELOPMENT DISTRICT HY
PERMIT 40894 DESCRIPTION SINGLE FAMILY DWELLING (BLD PMT 036338)
PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY
CONTRACTORS: Department of Health, Safety
`ARCHITECTS: and Environmental Services
TOTAI, FEES: THE
BOND $.00
CONSTRUCTION COSTS $.00 lfa,
753 MISC. NOT CODED ELSEWHERE 1 PRIVATE Pl fI
STABLE, •
- MA83.
• � i639 ��
FD MA'S
BUILD I
BY
` DATE ISSUED 09/07/1999 EXPIRATION DATE
BUILDING PERMIT
J :ESO 82 DAYBREAK LAIC PHONE �
i HYANR I S u'.s P - I
1
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AT 42 BLOCK LOT SJ".*ZE R ..
wFr
(3'(}},�('T�} ��/�??q T, f y�y i'(�. �b7• �7,�,yTff��++rr FAIL
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�RMIT 4lL 338 DESCi; IPTIf.N, S.L1.`G.1, .>aAl�S.L VS:.�A7,;#.f.NG
IRMIT TYPF BUILD TITLE NEW R, .81DEN`I`I'A , ELF EMT ,
Department of Health, Safety,
IN'iRACTORS;. BA''�SIDE '.BU!ADTN , TNT
�C�.�ITECTS and Environmental Services
AL FEES:
ND
$,00
N4PL�L'TI:f N. COSTS ��58 g 1.t.C),4C�`�'
101 SINGLE FAIL I OME DWACHED IL PRIVATF 1,
;Y°PARN, BI.E,
ib
39.
BUILDING DIVISION I
i t •
BY
1 �
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' LATE :ISSUED C?' /009)069-9 FvRiAAT1e'bA - ..
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 FAOM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANC APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON--JOB AND
I. THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE
1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR
2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE bi;,.00C 1- ELECTRICAL,PLUMBING AND MECH-
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE gNICAL INSTALLATIONS.
j 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN.MADE.
4.FINAL INSPECTION BEFORE OCCUPANCY. .
BUILDING INSPECTION APPROVALS PLUMBING ISPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
� / �) Alf,
2 r BOARD OF HEALTHa 3i
f' OTHER: SITE PLAN REVS W"I,PPROVAL 4.
UPWU" 0/19 N
ORK SHALL NOT ROCEED U TIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVED HE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
j VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
r TION. NOTED ABOVE. TION.
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CERTIFIED PLOT PLAN I CERTIFY THAT THE ON
SHOWN ON T A IS LOCATED
ED ON
FOR THE GROUND AS SHOWN HEREON AND
LOT 42 DAYBREAK LANE HYANNIS, MA. THAT IT CONFORMS TO THE MINIMUM
BUILDING SETBACK REQUIREMENTS OF
THE TOWN OF BARNSTABLE.
PREPARED FOR
BAYSIDE BUILDING INC.
o��t�45 N Or qiq�9c
SCALE: V=30' APRIL 5 1999 STEVENW. .4
RUMBA `
Weller & Associates
1645 Falmouth Rd.—Suite 4C Centerville, Ma. 02632
(508) 775-0735
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M 62
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LOT 4Z
96 1j
PROPOSED PLOT PLAN
FOR
LOT 42 DAYBREAK LANE HYANNIS, MA. ,a ov or M J
PREPARED FOR SMEN
RUMB H
9
BAYSIDE BUILDING INC.
2 �- yq
SCALE: 1" =30' JANUARY 26, 1999
Weller & Associates
1645 Falmouth Rd. — Suite 4C Centerville, Ma. 02632
(508) 775-0735
: lie orrunnxrnen�/�
DEPARTMENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Number: Expires:
Restricted To: 11
BRIAN T DACEY
62 FERNBROOK LN
CENTERVILLE, MA 02632
:17:10,)0
i
Restricted To: 11
10 - 35,601 cf enclosed space
I (M6l C.112 S.661)
1A - Masonry only
16 - 1 6 2 Family Homes
Failure to possess a current edition of the
Massachusetts State Building Code
is cause for revocation of this license.
,I
` - = COMMONWEALTH OF MASSACHUSETTS
DEFARrMEN 7 OF LNDUSTRIALACCIDEN'TS
600 WASHINGTON STREET
amen s Cam:oei, BOSTON, MASSACHUSETTS 02111
zornm:ss+cne• WORKERS' COMPENSATION INSURANCE AFFIDAVIT
(licensee/permincc)
with a principal place of business/residence ar.
/1764 . U.� 6 3 2
(Gry/S t3teMp)
do hereby certify, under the pains and penalties of perjury, that.
Ivy I am an emplovcr providing the following workers' compens:rion coverage for my employe:s working on this
job.
AWl"(Ak1b Clq S5 u4t TY Tc/ oa l q f 16 V I
Insurance Company Policy Number
[ ) 1 am a sole proprietor and have no one working for me_
[ ) 1 am a sole proprietor, general contractor or homeowner (cirt is one) and have}Tired the contracrors listed b-eK•
who have the following workers' eompensarion insurancc polio
8 /1 Y 15 i -/) T C. 0 0 l 1� 1-0
Name of Contnctor Insur:nee Company/Policy Number
Name of Conrraaor Insumnee Company/Policy Number
Name of Cont+actor lnsurne: Company/Policy Number
0 I am a homcowncr performing all the work myself.
NOM Pleuc be aware that while homeowners who employ persoes to do maintenance,eonstruaion or repair wont on ;
dwelling of not more than three units in which the homeowner also resider or on the grounds appurtrnanc thereto are not general v
considered to be employers under the Workers' Compensation Ar.(GL C 152,sect_ 1(5)), application by a homeowner for a lice:sc
or permit msv evidence the Icgal status of an employer under the Workers'Compensation Act_
1 underst:.id that a copy of this statement will be forwarded to the Depar-- e::of Industrial Aeade:tu'Ofnce of Insurance for envc.a::
vc:::ic;-ion and that failure to secure coverage as required under Section 25A ol-MGL 152 can lead to the imposition of criminal pc.z:.; s
consisong of a Fine of up to S1500.00 and/or imprisonment of up to one ye::ad avtq penalues in the form of a Sto:Work Order
firs of S100.00 a d:v a€ains: me.
Sic:ncd this day of 19
Licc�sce'i'crmirtcc Licc-isor/Pcrmitror
SUBCONTRACTOR'S INSURANCE
ENGINEEER:
BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866
(W) LIBERTY MUTUAL - WC13125955630'23
WELLER & ASSOC: (L) NAT'L GRANGE MUT.- MSP45246
EXCAVATION & SEPTIC:
ROBERT J. OUR (L) U S F & G - 1MP30109550901
(W) U S F & G - 771521695
DECO CONSTRUCTTON (L) TRAVELERS - 660364IC8342
(W) LIBERTY MUTUAL - 312446298044
FOUNDATION:
BAYSTDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267
(W) LIBERTY MUTUAL - WC1312201785044
WELLS:
DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92
(W) WAUSAU - 151300062926
CELLAR/GARAGE FLOORS:
MICHAEL BROWN: (L) AETNA - MP0023672849
FRAMERS:
ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9
(W) AETNA - 006C0023972416C
MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356
(W) LIBERTY MUTUAL - WC1312492127024
MASON:
SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689
(W) WAUSAU INS - TO BE ASSIGNED
ELECTRICIAN:
CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649
(W) MISCELLANEOUS INS CO. - 0708878 91 1
PLUMB & HEAT:
WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9
(W) EASTERN CASUALTY - POLICY IN MAIL
ALARM SYSTEM:
BALTTC SEC.URTTY: (L) FIRST FINANCIAL - FF0131 G400831
(W) COMMERCIAL UNION - CB0743379
CENTRAL VAC:
VACUUM IIOUSE: MERRTMACK _MUTUAL - SBP1608045
rt ,
INSULATION:
MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3
(W) U S F & G - 7711099932
SHEETROCK:
MEL REED: (L) WORCESTER INS - CB817530
(W) COMMERCIAL UNION - CBH557387
INTERIOR TRIM:
DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442
M & R CARPENTRY (L) MARYL,AND INS. GRP- SCP30235965
(W) CIGNA PROP & CAS.- C80049997
OAK INSTALLER:
ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652
PAINTING:
CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF
(W) AMERICAN POLICY - WCC 186604
GARAGE DOORS:
ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301_
(W) COMMERCIAL UNION - CBH573757
STORMS & GUTTERS:
ALUMINUM PRODUCTS: (L) AETNA - MP0021-01414 6
(W) AETNA - JC89258880
OAK FINISHER:
AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0
CARPET, VINYL & TILE:
CARPET BARN: (L) VERMONT MUTUAL - SBP6507393
(W) PHOENIX INS. - 6NUB476J652794
TILE INSTALLER:
TONY AVERTNOS : (L) ASSURRANCE CO. - CFP26528977
(W) HARTFORD FIRE - 77WZCY2409
WIRE SHELVING:
CAPE COD CLOSETS: (L) U S F & •G - BSC146983441
APPLIANCES:
KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098
(W) HARTFORD INS CO - 77WZNB1603
MIRRORS & SHOWER DOORS:
L & M GLASS : (L) COMMERCIAL UNION - CBR409003
(W) U S F & G - 0071439933
LANDSCAPE & SPRINKLER:
COY'S BROOK: (T) COMMERCIAL UNION - ABR345850
(W) CIGNA COMPANIES - C41138178
DRIVEWAYS:
NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945
(W) THE PHOENIX - UB387K530
A
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit #
MAScheck Software Version 2 . 0
Checked by/Date
CITY: Hyannis
STATE: Massachusetts
HDD: 5973
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 2-5-1999
DATE OF PLANS: 8/28/98
TITLE: LOT 42 DAYBREAK LANE
PROJECT INFORMATION:
COBBLESTONE LANDING II
COMPANY INFORMATION:
BAYSIDE BUILDING
F
COMPLIANCE: PASSES
Required UA = 367
Your Home = 293
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
--------------
CEILINGS' 1608 38 . 0 0 . 0 48
WALLS: Wood Frame, 24" O.C. 1728 21. 8 3 . 0 85
GLAZING: Windows or Doors 192 0 . 350 67
GLAZING: Skylights 16 0 . 600 10
DOORS 21 0 . 350 7
FLOORS: Over Unconditioned Space 1608 19 . 0 '76
COMPLIANCE STATEMENT: The proposed building design represented in these
documents 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 .
Builder/Designer , Date
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2 . 0
LOT 42 DAYBREAK LANE
DATE: 2-5-1999
Bldg.
Dept .
Use
CEILINGS:
[ ] 1. R-38
Comments/Location
WALLS:
[ ] 1. Wood Frame, 24" O.C. , R-21 + R-3
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] 1. U-value: 0 . 35
For windows without labeled U-values, describe features :
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
SKYLIGHTS :
[ l 1 . U-value: 0 . 60
For skylights without labeled U-values, describe features:
# Panes Frame Type Thermal Break? . [ ] Yes [ ] No
Comments/Location
DOORS :
[ ] 1. U-value: 0 . 35
Comments/Location
FLOORS:
[ ] 1. Over Unconditioned Space, R-19
Comments/Location
AIR LEAKAGE:
[ ] Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. Recessed
lights must be type IC rated and installed with no penetrations
or installed inside an appropriate air-tight assembly with a 0 . 5"
clearance from combustible materials and 3" clearance from insulation.
VAPOR RETARDER:
[ ] Required on the warm-in-winter side of all non-vented framed
ceilings, walls, and floors.
MATERIALS IDENTIFICATION:
[ ] Materials and equipment must be identified so that compliance can
be .determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
provided. Insulation R-values and glazing U-values must be clearly
marked .on the building plans or specifications.
DUCT INSULATION:
C l Ducts in unconditioned spaces must be insulated to R-5 .
Ducts. outside the building must be insulated to R-8 . 0 .
i
DUCT CONSTRUCTION:
[ ] All ducts must be sealed with mastic and fibrous backing tape.
Pressure-sensitive tape may be used for fibrous ducts . The HVAC
system must provide a means for balancing air and water systems .
TEMPERATURE CONTROLS:
[ ] Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
[ ] Rated output capacity, of the heating/cooling system is
not greater than 125% of the design load as specified
in sections 780CMR 1310 and J4 .4 .
MISC REQUIREMENTS: #
[ ] Refer to 780 CMR, Appendix J for requirements relating to swimming
pools, HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F, and circulating hot water systems .
----NOTES TO FIELD (Building Department Use Only) -------------------------
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