Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0020 HARBOR ROAD
��� .� .J Commonwealth of Massachusetts ShX4Pftd&V&M1T Map 304 Pamei12—L— JAN 2 3 2013 Permit Date: 1 Uab--3- p it Fee: 0®. e/ Estimated Job Cost: $ 0TOWN OF BARNSTA LE Puna Renewed: S_ —. NO Plans Submitted: S.--_— N®----- IY Applicant License# Business License m Property Owner 1 Job Location Information: Business information: ` �'' ,n �f Street: � Street: i� '"' CitylTown: City/Town: -- d Telephoner Telephone: NO / COPY of Photo I.D. attached: YES Photo I.D. required f p} �-11� -�-unrestricted Incense well' 3-stories or less and commercial up to 10,000 sq. ft. 12-stories or less d-2 I M-2-restricted to 0 Residential: I-2 family Multi-family Condo 1 Townhouse. Other commercial.. Officc Retail industrial Educational Fire Dept. App ro",at�____ institutional_ Other Square Footage: under 10,000 sq. ft. over 10,000 sq. Number of Stories: ft. Sheet metal work to be completed: New Work: Renovation: RvaC Metal Watershed Roofing Kitchen Exhaust System Me Chimney!vents JUr Mancin Provide detailed description of work to be done: i�Tv 77 Tn--eal ------------- INSURANCE COVERAGE: 1 have a current dE insurance 1t icy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No ❑ i� If you have checked YX&indicate th type of coverage by checking the appropriate box below: insurance oti Other type of indemnity ❑ Bond ❑ A Ilabf9lty lns P cy OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application t this requirement. Check One Only 1 owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this bo ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and Installations performed under the permit issued for this application will be in compliance with a pe all rdnent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO E rogrem Iatstsectifsias Date Comments Ewa,WRISti >n Date Comments Type of Li nse: 3y aster 11We ❑Master-Restricted ^.ityrrown QJoumeyperson Signature of Licensee �errnit# []Joumeyperson-Restricted f p°�p'Z 1.51 License Number. :ee$ ❑ Check at 90dw ---ar-mr Cinnaftira of Perm It Acoroval I Page 1 Residential Heat Loss and Heat Gain Calculation 1/17/2013 In accordance with ACCA Manual J Report Prepared By: Balanced HVAC Inc For: Lokshin Residence 20 Harbor rd Hyannis, MA Design Conditions: Boston Indoor: Outdoor: Summer temperature: 70 Summer temperature: 90 Winter temperature: 75 Winter temperature: 0 Relative humidity: 50 Summer grains of moisture: 88 Daily temperature range:Medium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 2,183.3 sq.ft. 36,268 4,815 41,083 68,639 ( 3.5 tons ) First Floor 27,183 4,083 31,266 53,943 Bedroom Master 220 sq.ft. 5,279 573 5,852 9,266 Master bath 64 sq.ft. 874 80__ 954_ 1,350 Den 144 sq.ft. 2,438 287 2,725 4,277 Entry 42 sq.ft. 1,016 207 _J1,223 _2,684 Laundry 35 sq.ft. 683 64 747 994 Kitchen .224 sq.ft. 5,372 414 5,786 6,361 Dining Room _ 168 sq.ft. _ 1,200 920 2,120 344 Powder/Mud room 156 sq.ft. 3,613 566 4,179 8,569 Family Room 456 sq.ft_ v 6,708 _ 972 7,680 20,098 Second Floor 9,083 734 9,817 14,697 Bedroom 2 • 286 sq.ft. 4,231 319 4,550 6,361 bath 2 _ 88 sq.ft. 1,342 96 _1,438 2,130 Bedroom 3 240 sq.ft. 21571 239 _ 2,810 4,969 Hall 60 sq.ft. 939 80 1,019 1,237 Whole House 2,183.3 sq.ft. 36,268 4,815 41,083 68,639 (3.5 tons) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. Rightfax N3-1 1/17/2013 9:00:00 AM PAGE 2/002 Fax Server A DATE WDDYfM CERTIFICATE OF LIABILITY INSURANCE 0/17/�20 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S).AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION Is WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER PAYCHEX INSURANCE AGENCY INC E1d: 877 362-6788 No: 877)677-0447 150 SAWGRASS DR avelerscan ROCHESTER,NY 14620 (877)362-6785 PRODUCER p 8472F1146 S V996 70A INSURER(S)AFFDR=COVERAGE NAIC# INSURED I NSU RER AIME TRAVELERS INDEMNITY COMPANY OF CONNECI1CUi BALANCED HVAC INC INSURER B: 15 JAN SEBASTIAN DR STE E1 INSURER C: SANDWICH,MA 02563 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 824903439580710 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 M AY 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. NSR ADDI SUBR POLICY EFF POLICY EXP TR TYPE OF INSURANCE INSR POUCYNUMBER IIMTS GENERAL LIABIRY EACH OCCURRENCE OO MERCIAL GENERAL LIABILITY NTEI CLAINEMADE OCCUR PREaISFS(Ea ce $ VIED EXP me arson $ PERSONAL&ADVINJURY $ GENERAL AGGREGATE $ HGNL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/Op per,E POLICY P LOC $ AUTOMOSILELIABILITY CCMSINED SINGLE LIMIT $ (Ea accident) ANYAUTO BODILY INJURY Per ( Pam) $ ALL OWNED AUTOS SCHEDULEDAUTOS paaad BODILY RI7fWyURY(Per acdcf3nt) $ HIREDAUTCI6 (P E $ NON-OVJNNED AUTOS $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIN&MADE AGGREGATE $ DEDUCTIBLE $ RETENTION WORKERSOOLVENSATION WA UB-7348P140-12 03/01/2012 03/01/2013 X A AND EnrpLOYERSr UABI ITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE❑ E.L EACH ACCIDENT I$100,000 FFFICER./MW EXCLUDED? ry m E.L.DISEASE-EA EMPLOYEE $100,000 desmbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD I M,Additional Rsmarks Schedule,U more space Is regWreco CERTIFICATE HOLDER CANCELLATION THE TOWN OF BARNSTABLE SHOULD AN Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 200 MAIN STREET EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE HYANNIS,'MA 02601 WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEN TATTVE C 1988-2009 ACORD CORPORATION.All rights reserved. ACORD-25(2009/09) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndusMd Accidents Office of Investigations, 600 Washington Street Bostoi✓y MA 02111 .. www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AvRlicant Information i Please Print Le ibl Name(Business/Orgmftfion/ladividual): C�.'0. •Address:_ l Dv , City/State(Zip: VIY,J--) � �a hon.#: Are you an employer?Check the appropriate bog: .,•Type of project(required):. 1 V I am a employer with . Q I am:t general contractor and I s have hired the sub-contractors 6. . New construction . employees(full and/or part-time). 7. Remode' ng 2.❑ I am a'sole proprietor or partner- These on the'attached sheet ❑ ship and have no employees These sub-contractors have 8. ❑Demolition worldng for me is any capacity. employes and have workers' 9 ❑Budding addition [No workers'comp.insurance comp.instrnance 3. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3 ❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL myself: [No workers comp. 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13 Other —t �tC. 1S comp.insurance required.] •Any applicant that chxks box#1 must also fig out the section below showing Suit workers'compensation policy information. t Hon=waas who submit this affidavit indicating they am doing all work and thm hire outside contractors must submit anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have emoployees,they must provide their worlosrs'comp.policy number. I arm an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance CompanyName--FV—GLVe—V-r5 ►'u / Policy#or Self ins. Lic.# 3 4� 4�'� a Expiration Date: �� L I Job Site Address•� ��-' � City/State/Zip: H)1 Q V) "s 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 imprisonmm ,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy-of this statement may be forwarded to the Office of _ Investigations of the DIA for insurance coverage verification. I do hereby certify under the parins arndpenaltles ofperjury that the information provided above is true and correct Date Phone# lU r Z�� 191 Lt Official use only. Do rwt,wrrte in this,area,to be completed by city or-town o wkL City or Town: Permit/License# .,Issuing Authority(circle one): : i Board of Health 2.Building-Department 3.SCity/Town Clerk 4.Electrical Inspector S.•Plumbing Inspector 6.Other w Contact Persom. Phone#: coIM T —OF=S > ` a �. a •o s :a•'sa SHEET METAL WORKERS AS.'A BUSINESS ISSUES THE:ABOUE LICENSE TO s , LINGtILN T ST'UBBS. : + BALANCED; HVAC, INCH; 15 J.`AN: SEBASTIAN: DR.. �'. `SANDWICH MA; 02563 12/07/14 307263 C®M(4 N�fVEALTIi x ASSACM-USET. S :a• •ea + :s A $b4�t5•.� t t_1NY' E,ST�9OED ISSUES THE,ABOVE LIC€NSE LA 44C0L# T. iSTUAtS n ALANC'E;? AV,At:= INC p 1: JRNi I- BASTION D SA PtDott I'CH M l?26 01/28/13 - � Town ®f Barnstable . Regulatpr`Services a Thomas as F.Ge➢'@er,Director Building Division Tom Ferry,Building Commissioner 200 Main Street,11yawds,MA 02601 WWW.towti.ba rnstabla.rma.us Office: 508-862-4038 Pax: 508-790-6230 J Proper Owner Must Complete and Sign TIxis Section ` If Using A Builder as Owner of the subject property hereby authorize 1�Von CO-6 1--A V A k,fir to act on my behalf, in all matters relative to work authorized by this building permit. t t (Address of jobs #*Pool fences and alarms are the responsibility of the applicant. Fools are not to be filed before fence is installed and pools are not to be utilized until all final inspections are performed and accepted.,' . r Signature of Owner Signature of.Applicant �= Print Name Print Name gate F Q:FORMS:OWNERPt-L141SSloi4POO[S TOWN OF BARNSTABLE Building Department - Foundation Permit Date Permit # Name C 4 Location kL i)T-) Y Insp. of Bldgs. � . X . W- P ._�- �a � ` `.- �.� ;,_ :r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map SO GO Parcel �'l A ca #( � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address 20 ActAy� cA, 4- Village VA,L!N J IM A t Owner `S `,of� �� Address ?6 WtM Q .✓ Telephone Permit Request AA q X IL1 &Ja:�,wS ovv - leys ,in�j M.J. .Square feet: 1 st floor: existing proposed _2nd floor: existing 0 proposed 6 li Total new 12Q� Zoning District , Flood Plain r Groundwater Overlay Project Valuation a u Construction Type V-4- .d Lot Size 10( 000 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. i / Dwelling Type: Single Family, C Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Ll IVo On Old King's Highway: ❑Yes A44 Basement Type: ull �wl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) ifILA= Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing 0 new 0 Total Room Count (not incl ding baths): existing new �- First Floor Room Count (P Heat Type and Fu ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Existing Fireplaces: wood/coal stove: Yes �No p 9�New � Existing ❑ Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size._ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Others i r.a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes U46 If yes, site plan review# Current Use Proposed Use u, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number 570S Address .P�C7Y �� License # cuv✓1,y✓l. ck,a obi Home Improvement Contractor# Worker's Compensation # L)b —!I 1 I 06M—f 2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO1.rr_ ���, SIGNATURE DATE t FOR OFFICIAL USE ONLY APFUCATION# DATA ISSUED , MAP/PARCEL NO. ' r if ADDRESS VILLAGE ` 4 OWNER DATE OF INSPECTION: FOUNDATION k FRAME INSULATION " FIREPLACE �L r , r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL `r GAS: = ROUGH FINAL 7 F FINAL BUILDING t DATE CLOSED OUT 4 ASSOCIATION PLAN NO. 4 1 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/Oro nization/Individual): / Address: . b,X �� �'vv►1 vvC_r q�U '/� /-� C Z City/State/Zip: Phone#: Are ou an employer?Check the appropriate box Type of project(required); 1. I am a employer with 4. [] I am a general contractor and I employees(full and/or part-time).*. have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have 8• []Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comP•'insurance. 9. 0 Building addition required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL I 2.0 Roof repairs insurance required.]t C. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showingtheir 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.. Below is the policy and job site information r Insurance Company Name: �,, �;\ -Pi Policy#or Self-ins. Lic.#:_ y L-2—t4'A-[�p S g Expiration Date: !610 2 t 20 1 Job Site Address:_ �Zo tAcI-,r '6 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of up.to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce nder the pains and p alties of perjury that the information provided above is true and correct~ Si afore:. Date: 7i Phone.#: Official use.only. Do not write in this area,to be completed by city or town official or Town: Permit/License# Issuing Authority;(circle one): 1.Board of Health:!..Building Department 3. City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspector 6.Other ContAct Person: Phone#: . I - f RX MOT!= 1012212012 05:12 31 P.002 ghtfax C3-1 10/22/2012. 5:09:58 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE galmiYYrr) IFICATE 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. t IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policAies)must be endorsed. If SUBROGATION IS WAIVED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAUL PETERS AGENCY INC PHONE FAX 680 FALMOUTH ROAD INC,No,Ext): (A/C,No).- E-MAIL MASHPEE,MA 02649 ADDRESS: 28LBR INSURERIS)AFFORDING COVERAGE NAIL#' . INSURED INSURER A ACE AMERICAN INSURANCE COMPANY STRUCTURES BUH-DING INC - INSURER B: INSURER C INSURER 0: P'O BOX 398 INSURER Ei I CUMMAQUID,MA 02637 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER HIS IS TO CERTIFY THAT THE POLICIESOF INSURANCE OW 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 POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADD SUB POLICY EFF DATE POUCY EXP DATE LTR TYPE OF INSURANCE L R• POLICY NUMBER (MID0IYYVY) (MMMIYYYY) LINTS GENERAL LIABILITY :ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY. AMAGE TO RENTED $ CLAIMS MADE OCCUR. a PREMISES(Ea ocaurence) ED EXP(Any one person) $ ` DERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: NERAL AGGREGATE $ POLICY PROJECT❑LOC 3RODUCTS-COMPIOP AGG $ ti.. AUTOMOBILE LIABILITY OMBiNED SINGLE $ ANY AUTO - [FP"er IT(Ea accident) ALL OWNED AUTOS DILY INJURY $' SCHEDULE AUTOS person) HIRED AUTOS DILY INJURY $ r accident) NON OWNED AUTOS OPERTY DAMAGE $ Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGRfGATE $ DEDUCTIBLE $ RETENTION$ ; $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-4718P881-12 08/07/2012 0810712013 LIMITS ANY PROPERITORIPARTNEtIEXECUTIVE ...�NIA E L.EACH ACCIDENT - $ 100,000 OFFICERIMEMScR EXCLUDES E (Mandatory in NH) L DISEASE-EA EMPLOYEE $ -100,000 If yes,describe under SDESCRIPTION OF OPERATIONS helbw E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSINEMCLES!RESTRICTIONS/SPECIAL ITEMS ` THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE » CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL DEL 367 MAIN ST IN ACCORDANCE WITH THE POLICY PROd�I AUTHORIZED REPRESENTATIVE am / �I'ANMS,MA 02601 ' ACORD 25(2DIOMS) The ACORD name and logo are registered marks of ACORD 19SS-2010 ACORD CORPO r gh ' reserves. A FYC Grride to Wood Construction hi Higlr mind f[ -aasr 110 Mph Wiud Zone' Massachusetts Checklist fo> Compliance(78o cll,[Rs3or 2,i.i)` Check Compliance. 1.1 .SCOPE Wind Speed(3-sec. gust)................ 110 mph Wind,Exposure Category......:.:....... .........................._. ...................: ........: ....................:.B Wind,Exposure Category.................Engineering Required For Entire Project 12 APPLICABILITY ` Number of Stories(a roof which exceeds 6 in 12 slope shall be'considered a story) stories 5.2 stories Roof Pitch............... (Fig 2) ..........................................�6 51212 V Mean Roof Height... (Fig 2)... eft g'33• Building Width,W............. .......... ....__(Fig 3)... ..... a.0' Binding Length, L .................,...................... ........:.(Flg 3) ..... ...._:........ ft s 80' V Building Aspect Ratio( :......:.:........ ..........:........(Fig 4).,.: :.... <3:1 t/ Nominal Height of Tallest Opening .......:.....................:__(Fig 4)....................-••.........................- 1.3 FRAMING CONNECTIQNS General compliance Wrrth framing connections........... ....:.(Table 2).....................................:......:....:...:. 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CUR 5404.1 Concrete............................................. Concrete Masonry..: ................._..... .. ........ _LG _' ..... .......... .•. jC 22 ANCHORAGE TO FOUNDATION1,3 5/8`Anchor Boh4mbedded or 5/8".Proprietary Mechanical Anchors as an alternative in concrete onl Bolt Spacing-gereraf ;.(Table 4)..-*.....•..........................• .(T )..----.................................................... 2 in. Bolt Spacing from endroint of plate ........(Fig 5)...:.: ......_e in.-6"-12". Bolt Embedment-concrete..........................................(Fig 5)...... ...::.... > -i_L in._7" i__` Bolt Embedment-masonry.................:... (Fig 5)............:...._. .. n.>15" • PlateWasher........ .....................................................` (Fig 5).......................... 3'.x 3'x/. 3.1 FLOORS Floor framing member spans checked.................................(per 780 CMR Chapter 55)..................:. ....._. Maximum F1oorOpening Dimension..._ ..................(Fig 6)....... ._.......:.._..:_.......:.............. ft<_12' Full Height Wall Studs at Floor Openings less than 2'fram Exterior Wall(Fig 6):.:........... .. Maximum.Floor Joist Setbacks Supporting Loadbearing Waifs or Shea naall ..............(Fig 7).................................. {{ <d - -••••-•.......... Maximum Cantilevered Floor'Joists Supporting Loadbeanng Walls•or Sheanrall.................(Fig 8) :...:.: .. ............. ft s d FloorBracing of F:ndwans ` ...................(Fig 9 :..._:....................... _.. ................................ / Floor Sheathing Type _.._....._.(per780 CMR Chapter 55)............ FloorSheathing Thickness ...:..: .......:. (per 780 CMR Chapter 55)• .......... in. Floor Sheathing Fastedrng :...... ......:: ......._ CQ :......:.:.(Table 2).:�d nails at�in edge/�in field 4.1 WALLS Wall Height. Loadbearing walls.. ................................. .......(Fig 10 and Table 5) ....... .... <10' Non-Loadbeadn walls... ft's20' 9 ....(Fig 10 and Table 5) ....._... Wall Stud Spacing ...............................................(Fig 10 and Table 5) Ain:524'o.c. Wall Story Offsets• (Figs 7&8)._.:............... < _.... ft d _ 4-2 EXTERI OR-WALLS' Wood Studs, Loadbearing walls::.: ... ale 5) Q in Cr ft Nort-Loadbearing. ................................................ /(fable 5)....... 2x - ft in.. JG Gable End Wall Bracing' — Full HelghtEndwall Studs.:.. ..................................(Fig iD).......................... WSP-Atfic Floor Length ............Fig 11 - Gypsum Ceiling Length(rf WSP not used) ....................(Flg 11).........: _ ft>_0 9W / and.2.x 4 Continuous Lateral Brace@ 6 ft o.c ..(Fig i t).................... ......... ........:.........._. -� or.1 x 3 belting furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays DDuble Top Plate Splice Length ..:_. ...::............ ....... (Fig13 and Table 6) ... ........ Splice Connection (no of 1.6d Common nails) (fable 6) ATVC Guide to Wood Construction trt High [Vind,4reas: 110 trlph kindZorie Alasochusetts Checklist for Compliance (790 CLIR5301.2.1.1}i y : ,Y Loadbearing Wall Connections . Lateral(no.of 1 ad common nails) (T T) _ ................. .. abler .....---............---..._...........---......._ Non=L.-aadbearing Wall Connections Lateral(no-of 16d common nails)....... ............_...._._.(fable 8)..........._......................................_.... _ Load Bearing Wall-Openings(record largest opening but check all openings for compliance to Tabi 9) HeaderSpans ` .......................................................(Table 9)..---........................... Sill Plate Spans . ........................................._.._..........(fable 9)..........4........ .........Z ft in.<11' U Full Height Studs (no.of studs).....................................(Table 9)..................................................... Non-Load Bearing Wall Openings (record largest opening but check all openings for compllapce to Table 9) Header Spans........:...................:...................._..........(Table 9).................................... ft&n.512' l/ SIII Plate Spans.......:::.............. --------...........(Table.9)................................._jgL ft b in.5 12' Full Height Studs(nb.-pf studs)....................................(Table 9)....................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneousiy4 'Minimum Bullding•Dimension, W Nominal Height of Tallest Opening2 SheathingType..............................................(note 4)...................................................... -Edge Nail Spacing...............:..........................(Table 10 or note 4 if less)................ .... Feld Nail Spacing .. able 1 D Shear Connection(no. of 16d common nails)(fable 10)....................................................... Percent Full-Height Sheathing...................:...(fable 10)......_.........__.._..................._.....:_...1#0,% 5%Additional Sheathing for Wall with Opening> S'B'(Design Concepts).................... . Maximum Building Dimension, L Nominal Height of Ta[iest Opening2.................................................................... Sheathing Type;............................................(note 4).. -_._ ........ ......._...... iL.L Dim Edge Nail Spacing able 11 or note 4 if less ` in. Feld Nail Spacing...........................................(T'able 11).........._.....,._.. ........_.........._...._._ in. ✓� Shear Gonnection(no. of 16d common nails)(Table I) .. ✓� Percent Full-Height Sheathing.....................(Table 11)................................................�®� o 5%Additional Sheathing for Wall wfth'Opening>6V(Design Concepts)..................... Wall Cladding , r- Ratedfor Wind Speed?.............................................................. ..............................._.............................. 5.1 ROOFS . . Roof.framing member spans checked?........................(For Rafters use AWC Span Tool,see B.BRS Website) ✓ Roof Overhang , :.:........................................(Figure 19) ............. ft s smaller of 2'or L13 ✓� Truss or Rafter Connections at Loadbearing Wails 'g Proprietary Connectors Uplift................................ able 12 U= .0 if Lateral ..(Table 12)..................... ..........._L= Hooswplf _� I Shear................._........:..................(Table 12)................I......................---•_.S= pff. Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T= if GabII;Rake;Oudooker.........................:................(Figure 20)............ ft_<smaller of 2'or L12 Truss or,Rafter Connections at Non-Loadbearing Walls Proprietary Connectors , Uplift...............................................(Table 14).........................................--.U-_alb. !% Lateral(no.of 16d common nails)...(Table 14)........ .................:.........._L_yt,"Ib. Roof Sheathing Type................:................................:.(per 780 CMR Chapters 58 and 59) Roof Sheathing Thickness. ._._....._.__.__...._......... .° in >7f16'WSP Roof Sheathing Fastening..."; ..:._..(fable 2) Notes: - - .......................................... _ � - 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR•53D1.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are-not required per tha WFCM.'110 mph Guide: a. Steel Straps per Figure 5 IS. 2b Gage Straps per Figure11 c- Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 1 Ba and Figure lab Exception:Opening heights of up to aJL shall be permitted when 5%isadded to the percent fuikheight sheathing requirements shown in Tables 10 and 11. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal.thickness pressure treated#2-giada. oFZHE ram, Town of Barnstable Regulatory Services BARNSrABLE. MASS, �* Thomas F. Geiler,Director 9Q 019 �0 °rFo rr+p�" Building Division Tom.Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and. Sign Tbis-1 Section If Using A Builder - /0 I A) , 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. 6(76 r U an f) I S M A— (Address of Jo ) �. Signature of Owner ate Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on thereverse side. QYORMS:O WNERPERMISSION OWtVU,l��H VL 1 1 V M1 Received: _ APPLICATION FOR RENEWAL OF REGISTRATION , v ` HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR ti '�• .,�;.--may MGL Chapter 142A,780 CMR R6 (PLEASE READ INSTRUCTIONS CAREFULLY) 1. Name of Applicant as on Current Registration- ! 2. D/B/A used by Applicant(if different from that used with current registration): 3. Address of Applicant(if different from address on current registration): -7— ,W vvto-c o4A, n i ' L)vy) M P. 4. No.of Employees: ® 3 5. If Applicant is a Partnership,Corporation or Trust,state the name of the individual responsible for Applicant's work: First Middle last Telephone No. C�� l� 6. Does the Applicant hold any other construction-related,state.city or town licenses or registrations? _'Yes _No Construction i Expires: i 2t3 I 17_ Supervisor License: Motor Vehicle Repair Expires: Shop: 7. is the Applicant claims exemption from the registration fee".(Please see instructions) (]Yes No & Registration Renewal Fee endured:S ,( ; Make all certified cheeks or money orders payable to Commonwealth of Massachusetts." ONLY CERTIFIED CHECKS OR MONEY ORDERS WILL BE ACCEPTED Pursuant to Massach eral Laws Chapter 62C§49A.I certify under the penalties of perjury that,to the best of my knowledge and belief,I ve led an state tax returns and paid all state taxes required under law. Sign re of at Title held with applicant Date' e_ A FALSE ANSWER TO ANY QUESTION IN THIS APPLICATION CONSTITUTES GROUNDS FOR SUSPENSION OR REVOCATION OF THE APPLICANT'S REGISTRATION. I License: cs a Po 00x70 =� . E SANDWICK MA 02537 Expiration: 12rmM2 .�"��auni*vii+srr Tr#: gm t?�aefCe ABa m& g ITtOUTRAC7DRRegkuggo .0441- -. 3 h�dfiddual a i-w1G7' AMIA Ail , r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map pp Parcel Application # OZ O/Q 66 Health Division Date Issued Z- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board n Historic - OKH _ Preservation/ Hyannis e �r Project Street Address fL0 CA&4 Village� : Owner _ I n��..t Address 20 Telephone 11v Permit Request `�-�v�nn �'�S v��-c,f ?� �,(' i►ug p �- P Square feet: 1 st floor: existing "O roposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type bC w-D Lot Size 91 wo r Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family UX Two Family ❑ Multi-Fam ily s) Age of Existing Structu 1,- Historic House: ❑Yes Old King's Highway: ❑Yes ❑ No Basement Type: M411 ❑ Crawl ❑// Walkout ❑ Other Basement Finished Area(sq.ft.)—iV/& Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new ?L Half: existing new D Number of Bedrooms: existing 0 new Total Room Count (not including bat " xisting new t> First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other E -'7 r, C Central Air: ❑Yes No Fireplaces: Existing . New Existing wood/coal stove: 0 Yes ) No C'7>� r1l) � Detached garage: ❑ xi g ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ exi"sting ❑ 6ebv se_ Attached garage: xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: 1 U13 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w F Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name�. ;Se Telephone Number 10'r6 Address Q,d It/ `��1:9� License# ? fo V LL)vv%e% i 4 , &M ( (TL(o Home Improvement Contractor# u ) Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO G SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE OWNER 3 DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE R ELECTRICAL: ROUGH FINAL •f PLUMBING: ROUGH FINAL Y i - - GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. T'he Commonwealth.of Afassach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 - www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricia 's/Plumbers Applicant Information Please Print Legibly Name(Business/Ora niTation/IndividnaI): CYV`o-b l-11 ill Address: City/State/Zip: Phone#: coo 5 Are y an employer? Check tht appropriate box: Type of project(required); 1. I am a employer with. 4. ❑ I am a general contractor and.I employees(full and/or part-time).*' have hired the sub-contractors 6• ❑New construction . 2.❑ I am a sole ro rietor or partner- listed on the attached sheet. 7. Remodelin P P F C�, g shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'.comp.insurance comp.insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'. comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp.insurance required] *Any applicant that checks box#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. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that isproviding workers'compensation insurance for my employees.. Below is the policy andjob site information n Insurance Company Name: Policy#or Self-ins.Lic,M. L��.'� � �w � Expiration Date: Job Site Address: C) ' CA City/State/Zip: J Attach a copy of the workers' compensation policy declaration page-(showing the,poficy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up.to$250.00 a day against the violator.:Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification.. I do hereby certi der the pains and pen hies of perjury that the information provided above is true and correct' Si tore: Dater Phone#: — 'T Official use only. Do not write,in this area, to be completed by city or.townofficiaC City or Town: Permit/License# Issuing Authority(circle.ane); 1.Board of Health 2.Building Department 3. City/Town Clerk .4.Electrical Inspector. 5.Plumbing Inspector 6. Other Cont#ct Person: Phone#: 1UI1Z41ZU M)5I1S47/649tl r.UU17UUl pe IU/YL/ZU1Z Ub:l'Z J 1 P.002 K C3-1 10/22/2012 5:09:58 .AM PAGE . . 2/002 Fax Serv6r CERTIFICATE OF LIABILITY INSURANCE DATE(mwoo YYYY) TbUSAIENTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVECERTIFICATE.HOLDER. IMPORTANT:It the certificate holder Is an ADDITIONAL INSURED,the pollcy(1e6)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen s. PRODUCER CONTACT NAME: PAUL PETERS AGENCY INC PHONE FAX 680 FALMOUTH ROAD (A/C.No,Ext); (Alt:,No); EMAIL MASHPEB,MA 02649 ADDRESS; 28LHR INSURER($)AFFORDING COVERAGE NAIC N INSURED INSURER A; ACE AME=AN DNSURANM COMPANY STRUCTURES StRLMNU INC N$URi R e; INSURER C: P O BOX 398INSURER E; INSURER 0; CUMMAQMD,MA 02637 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY BTeo ISFL13W HAVE BEEN ISSUED TO THE 101MMUMMEOVE,010 THP ~ NOTWITHSTANONO ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMONT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BEIBBUEO OR WAY PERTAIN, THE INSURANCE AFFORDED BY THLPOUCIES DESCRIBED HEREIN le SUBJECT TO ALL THE TERMS,EICLUSIONe AND CONDITIONS OF eUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAMS. INBR - ADD SUB POLICY an DATE POLICY EXP DATE - - LTR TYPE OF INSURANCE L R POLICY NUMBER (AMSDDIYYYV) (MNMDIYYYYI. LIMITO GENERAL LIABILITY ZACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY. AMAOETORENTED $ CLAIMS MADE a OCCUR,- EMISFS(Es ocourrence) ED EXP(Anyone person) $ RSONAL&ADV INJURY 8 GEN'L AGGREGATE LIMIT APPLIES PER: ENE AGGREGATE 9 POLICY Q PROJECT lOC DUCTS-COMPIOP AGO S AUTOMOBILE LIABILITY OMBINED SINGLE $ ANY AUTO IMIT(Ea accident) ALL OWNED AUTOS ILY INJURY $ SCHEDULE AUTOS - Per penson) HIRED AUTOS ILY INJURY, 6 Per aocident) NON-OWNED AUTOS OPERTY DAMAGE $ Per accident) UMBRELLALIAB OCCUR EACH OCCURRENCE 6 EXCESS LIAB CLAIMS-MADE AGGREGATE. $ DEDUCTIBLE $ RETENTION B $ A WORKER'S COMPENSATION AND WC srATVToRY OTHER EMPLOYER'S LIABILITY YM UB•4718P881.12 08/07/20112 08/07/2013 UMITB ANY PROPERITORiPARTNERIExECUTIVE WA E.L EACH ACCIDENT $ 100,000 OFFICERIMEMWA EXCLUDED? : (MnndntorylnNH) E,L.DISEASE-EA EMPLOYEE. $ :100,000 - Ityer,darorloe under E.L.DISEASE•POLICY LIMIT S 500,000 DESCRIPTION OF OPERATION$below _ OESCRIP11ON OF OPERATIONSILOCATIONSNEHICLESIRE$TRICTIONSlSPECIAL ITEMS THIS LSPL: (Ms ANY.PRIORCIRTMOAT8ISSUDD TO THE C13RTIFICATE HOLDER AFFECTING WORMSRS Conies COVERAOR CERTIEICATE`HOLDER CANCELLATION TOWN OF BARNSTABLB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 367 MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL DELIV IN ACCORDANCE WITH THE POLICY PRO AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 CID RD 25(2010l05) he name an logo are raps ere mars 1 6• 10 A O e . E, �tHE rati Town of Barnstable ` Regulatory Services awaxsTesu, y MAS& �+ Thomas F. Geiler,Director �'plfn u►�",� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder i I, BOM C 0�_Sk 1 dU , as Owner of the subject property J P P rtY hereby authorize to act on,my behalf, in all matters relative to work authorized by this building permit application for ohoa��Oor h iS (Address of job) �0/ Signature of.Owner ate /AJ Print Name If Property Owner-is applying for permit please complete the . .Homeowners License Exemption Form on-the reverse side. , Q:FORMS:O WNERPERMISSION Town of Barnstable ` F'THE Regulatory Services * Thomas F. Geiler,Director "`" 2619. Building Division �� ArEp 1"��A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax;_508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: village number street g "HOMEOWNER": work hone# name home phone# p CURRENT MAILING ADDRESS: 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 Persons)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 cutrendy used by several towns, You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeex empt,DOC A, , Lkm= CS - E SANDVAM MA 02 3T ExphaWw 120=2 TtT-- 9205plea Schaft i.. Now ITWI '- FA-ULS LANE License or registration Vaud for i re the expiration d ndiv►dul,use only befoate. E3ftice ofC IFfound turn ;< 10 park I'1 onsumer Affairs and Business R'egulatinn aza-Suite 5170 Boston, 16 t valid-withoat Signature atptou,nee% vat Au ! Received: I APPLICATION FOR RENEWAL OF REGISTRATION HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR MGL'Chapter 142A,790 CMR R6 - (PLEASE READ INSTRUCTIONS CAREFULLY) 1. Name of Applicant as on Current Registration: 2. D/B/A used by Applicant(if different from that used with current registration):'1CAv � 3. Address of Applicant(if different from address on current registration): -----� 4. Na of Emplovees: ® 3 a., ! S. it Applicant is a Partnership,Corporation or Trust,state the name of the individual responsible for Applicant's work: First Middle Last Telephone Na 6. Does the Applicant hold any other construction-related,state,city or town licenses or registrations? ✓Yes _No Construction Expires: Supervisor License: Motor Vehicle Repair Expires: Shop: 7. Is th;Appricani claiming exemption from the registration fee?(Please see instructions) ❑Yes No S.-Registration Renewal Fee'enciosed:S j C Make all certified checks or money orders payable to "Commonwealth of Massachusetts." ONLY CERTIFIED CHECKS OR MONEY ORDERS WILL BE ACCEPTED Pursuant to Massach neral Laws Chapter 62C§49A,I certify under the penalties of perjury that,to the best of my knowledge and belief,) a led all state tax returns and paid all state taxes required under law. &�fleAc 5 'C V+GSi of ntheld witb applicant t, Date A FALSE ANSWER TO ANY QUESTION IN THIS APPLICATION CONSTITUTES GROUNDS FOR SUSPENSION OR REVOCATION OF THE APPLICANT'S REGISTRATION. I 8 E E (gam 01 p dEAPORTANT-UPGRADE REQUIRED F-:4 A-, s STATE BUILDING.CODE 4 REQUIRES THE UPGRADING OF ~V SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN O aU �.: A NOT OR MORE SLEEP NG AREA E ADDED 0 CRE i - 0 R AED U� I S R E: A SEPARATE PERMIT IS RE 04 V s INSTALLATION OF SMOKE DETECTORS REQUIRED FOR THE Q i� THE ELECTRICAL 'PERMIT COFs A 6 _,NOT SATISFY THIS REQUIREMENT. . SMOKE q EX. DETECT X.GRP.WL uy -- �_ ORS........... .r% IIr --- REVIIEmWED Nsa-MEX: --SEMEN' ._ BWRAL APNST `f e f —-- u _a — ABLE BUILDING DEPT. DATE. TO g�EF� ! o s>e FIRE DEPARTMENT --- -- 607HSIGNAL RES REREO UIR'E D FOR PERMl1T lNG.' oQtz e�rUz 00 C-9•N=BOo`�L a€ °E z o12 CRBDNMD N� NDXIDEA(A r- a4ASSACHUSE m iTTSBUILDINGCODE yNl Jg INSTAttED .. - '- .'_ = FOUNDATION. PLAN - - A-1 ISSUED FOR PERMIT am I of Is • .. 4 - o new . . A Q A m - - 6 _ r dlO yygy 22 da B aY© fa{� S •-- § IDv y$-• ��f �". i ty i .4Y. . s .. - q 7 � ... .VA", ��... §� ... in y F, aA -- ---J 3 t '. c a5 a yu S k _ e� x"s� t� •g$. �. g� 98 d A • � a a a Additions&Alterations to the w N Lokshln Residence tiMa r®. "a $ A R C H I-TECH 5 e�„�,street S 50a.420.5775 t5W.d2a.5a0/ 20 Harbor Road Hy annis,'Massachusetts ^ IFA S S O C IATE S I cotuit.ma nea 41ine(O�ad@echassocales.com First Floor Plan` ,"" a r c h i t e c t u r a I d es i g n architech associates.com s N .- > m z 0 A d O. r' 4 A a . a Y ...--- ' ..._... a ............................................................ .: i d sa g a o Additions 8 Alterations to the Lokshin Residence 20 Harbor Road emw j A R C H I—TECHI 6 school street t 5a6.,2o.5af5 t 5R420.539 ° ¢ Hyannis,Massachusetts f"� •.M m„* ASS 0 C IAT E S cotuit,ca oats �info(�a ch echassoc ates.com Second Floor Plan architect u r a I design architech associates.com r -- T m ' - r I L Z I I z I I oq I I I I � t• I .e. ` . ,T _ I Q-M I Fills L - i I I I 011 Paj. C k 10 . s gH IMF Additions&Alterations to the s F Lokshin Residence 20HarborRoad. t °� ARCHI—TECH L p+ 6 school¢treat t 50a.420.5335 f S03./20.M 1 ' Hyannis,Massachusetts p,. ;.;�; �� ASSOCIATES AI a inlo@amhRechassouafes.00m tt e Exterior Elevations � "� �^� architect u r a l design architechassociates.wm _ - o n x m a I r y ' R or I m - I S• Q r . ......... o Z I c d I j I lit 2 I I : UP , law I I. � 1 , 23 *CIE 11101 011 [ANI S =ggp Ill e e g e Additions&Alterations to the E Lokshin,Residence r p • a u o 20 Harbor Road P W' A R C H I-T B C H I 6 school street }5ca.4Z0.5735 }W6.41a.5304 P 1 § y Hyannis,Massachusetts + A S S.0 C I AT E S G cm it:me ores a info@achftechassodates.mm " g Exterior Elevations ardhitectural design .architechassoaates.com ' ,, „ oq �tA m mF re I ul m m N 0 �. Z to A D a N 1 m - z -L a� t i -- 8 a z ------------ - x pq m ;3 r A Additions&Alterations to the s ° Lokshln Residence Q• 20 Harbor Road "'; �- - A R C H I-T E;C H L y �m"'a � sschool street tsoe.em.sans fsoa ago.xwa _ 1 Hyannis,Massachusetts t � �� ASS 0 C I A T E S A I' �Pwn,oa o v a nNga¢hdechassavales.com r Building Sections „a p 1 ,,,, architectural.design architechassociales.com U, m - ----- a - rt t F m -� t- 3 20 o � , �22 t- - I Is ag a` g aoy 5 @ RR - .y M D F i — — - Additions&Alterations to the w r k s Lokshin Residence : .i 2Q Harbor Road aai a i A R C H I-T E C H L L w+ 6 school street t508.420.m IF508.420.5004 1 Y Hyannis,Massachusetts ;w �� ASSOC I A T E S S I cotuit,ma mes a into@amhdechassodataam c Building Sections �M,; = architect u r a l design architechassociates.com rrA t D S P m s LD bi iP a fin.. n}p I I ' s � ° ---- m IW 77 rn _ '-0 ", • - � O 1 rn sD dm - 4mrn - .. :tl DEQgyt (A p 1§g -3 # Dpi - 1 m ® g g Additions&Alterations to the s Lokshih Residence z + �a ARCHI-TECH 20 Harbor Road s nam street t508.420.5005 15W.4205804 o '1 Hyannis,Massachusetts t M „p Ron ASS 0 C I A T ES A I eatuit. a inoa�a h echassadatea.cbm` CO' ' g w Details architect u r a I d e s i g n, architechassociates.com i { • a o. GENERAL - FOUNDATIONS - - MASONRY - 3.CONNECTORS 5HOYIN ARE AS _ 10.ALL PLYWOOD SHALL BE APA MANUFACTURED BY SIMPSON. PERFORMANCE RATED PANELS CONFORMING _ B - I.STRUCTURAL DRAWING5 ARE 1.THE ALLOWABLE PRESUMED SOIL I.MASONRY CONSTRUCTION SHALL MUTT BE TIE CO. ED.IN MI MIONS - - 70 THE FOLLOWING MINIMUM REQUIREMENTS: 57 _ TO BE USED WITH THE ENTIRE BEARING CAPCITY 15 3000 P5F, CONFORM TO THE REQUIREMENT5 MUST BE APPROVED IN WRITING 'f BY THE ENGINEER. INSTALLATION A.FLOOR-5TURD-I-FLOOR id G,EXPOSURE 1 SET OF DRAWINGS - - WHICH 15 TO BE VERIFIED IN THE FIELD OF SPECIFICATIONS FOR MA50NRY OF ALL CONNECTORS SHALL BE 3/4',SPAN RATING 16". - BEFORE CONSTRUCTION.- '- STRUCTURES(ACI 530.1/A5GE 6-B6). _."IN STRICT ACCORDANCE WITH THE , 2.ALL SAFETY REGULATIONS STRENGTH OF MASONRY F'M=1500 P51. THE MANUFACTURERS INSTRUCTIONS - B.YVA.LL SHEATHING-EXPOSURE I,1/2'. s _ ARE TO BE STRICTLY FOLLOWED. 2:' /MUST EMPLOY ALL REQUIRED SPAN RATING lb*. RFOOTINGS SHALL BE CARRIED - FASTENERS. - s METHODS OF CONSTRUCTION a TO LOWER ELEVATION THAN SHOWN 2.VERTICAL REINFORCING OF MASONRY - C.ROOF SHEATHING-EXPOSURE-I,5/8', - "m ERECTION OF STRUCTURAL MATERIALS ON THE DRAWINGS IF REQUIRED TO WALLS SHALL BE AS INDICATED ON - SPAN RATING W. 15 THE CONTRACTOR5 RE5PON51BILItt. REACH PROPER BEARING CAPCITY. - THE DRAWINGS. ALL CORE5 OF 4.ALL CONNECTORS SHALL BE. MASONRY UNITS SHALL BE FILLEDHOT DIP GALVANIZED. WITH GROUT. REINFORCING BAR - - - m 3.THE CONTRACTOR 15 RESPONSIBLE 3.WALLS ACTING AS RETAINING WALL5- LAPS SHALL BE 2'-b'MIN. -. DESIGN CRITERIA -FOR 0155EMINATION OF ALL - SHALL NOT BE BACKFILLED WITHOUT 5 INSTALL ALL CANNEGTOR FASTENERS REVISIONS a REQUIREMENTS 70 - BRACING UNTIL ALL SUPPORTING SOIL - - BEFORE LOADING THE JOINT. THE SUBC,ONTRAGTOR5. _ J SLABS ARE IN PLACE a AT 3.HORIZONTAL JOINT REINFORCING - I.APPLICABLE BUILDING CODE ADEQUATE STRENGTH. FOR MASONRY SHALL BE EQUAL - MA55AGHU5ETT5 HTH.EDITION TO DUR-O-WALL TRUSS MANUFACTERED - �:6.SPLIT WOOD IS NOT ACCEPTABLE - - - 4.RESONIN THE PARE HAS BEEN WITH WIRE CONFORMING TO A5TM A 152FOR - - - - -�!ANY . TAKEN IN d W rn'THE PREPARATION OF 4.COMPACT ALL FILL UNDER FOOTINGS COATED FOR GORRO5 TM A 1153EGTION 2.EDESIGNXP05 WIND SPEED: IIO MPH y ALL DRAWINGS AND SPECIFICATIONS. a. � IN ACCORDANCE WITH A5TM A i - � _ _SLABS TO THE FI S 53 P SPECI ED DENSITY EX .OSURE C I LO G -0.18 GHONEVERUARANTEE THE ENGINEER DOES NOT - d VERIFY. CLASS B-2. ALL WIRE SHALL BE -l.ALL EXPOSED FRAMING MEMBERS - W GUARANTEE AGAINST HUMAN ERROR L GAGE 6*4 LJM. PROVIDE MINIMUM SHALL BE TREATED PER AWPA - [� a FOR THAT REASON IT IS IMPERATIVE - LAP OF 6'a USE PREFABRIATED 75 -G2/Cq CCA 0.25 t MEMBERS IN _ • THAT THE CONTRACTOR SHALL CHECK - OR CORNER SECTIONS AT ALL - CONTACT WITH SOIL SHALL BE STRUCTURAL OE51CN CRITERIA F Q m " ALL DIMENSIONS/-DETAILS t MUST - - WALL INTERSECTIONS. " - - TREATED PER AWPA C23/624 I--I VERIFY ALL CS AT CONDITIONS DIMENSIONS, -- STRUCTURAL STEEL -. `; e ELEVATIONS AT THE SITE.ALL � � - GPA 0.60.JOB SITE FABRICATIONS -'FIRST FLOOR � 40 PSF LL 4.CONNRETE MASONRY UNITS SHALL CUTS 1 BORES SHALL BE TREATED IN 15 P5F DL DISCREPANCIES SHALL BE BROUGHT I.DESIGN,FABRICATION d ERECTION ..ACCORDANCE WITH AWPA STD.M4. TO THE ATTENTION OF THE ENGINEER - _ SHALL.BE IN ACCORDANCE WITH CONFORM TO A5TM C q0. - -SECOND FLOOR - -30 P5F LL U THE AI51-SPECIFICATION FOR - - -_ -- 15 P5F DL STRUCTURAL STEEL FOR BUILDINGS, - - 6.ALL MANUFACTURED LVL WOOD FRAMING �- - 5.THE CONTRACTOR SHALL SUBMIT LATEST EDITION: 5.CONCRETE BRICK SHALL CONFORM MEMBERS SHALL HAVE THE FOLLOWING -ATTIG/5TO. 20 P5F LL COMPLETE SHOP DRAWINGS FOR TO A5TM C55. - - PHYSICAL PROPERTIES'AS A MINIMUM: - . 10 P5F DL - Qlj Q� m ALL,GONCRETE REINFORCNG ALL -. - -ROOF G5L 3O P5F SL STRUCTURAL STEEL 1 BOTH _ _ 2.STRUCTURAL SHAPES SHALL CONFORM E=LgXlO P51 - - CALCULATIONS J SHOP DRAWINGS 6.GROUT SHALL CONFORM TO THE b .,FB-2800,FV-240. � �" � IS P5F DL TO THE FOLLOWING: • J FOR ALL MANUFACTURERED LUMBER REQUIREMENTS OF ASTM C 146/ - EXT.WALL5/STOR. 75 PLF DL PRODUCTS d THEIR CONNECTORS - A.WIDE FLANGE MEMBERS A5TM SHALL HAVE A GOMFRE551VE q"ALL FLOOR JOISTS SHALL BE AS FOR REVIEW PRIOR TO FABRICATION. Agg2 GRADE 50. _ STRENGTH OF 3000 P51. - MANUFACTURERED BY BOISE CASCADE -INT.WALL5/5TOR. - 50 PLF OL '� e AS SIZED ON THE DRAWINGS. ALL -OECK5/PORCHES 40 P5F B.CHANNELS e ANGLES A5TM A36. " - FASTENING,BEARING,BRACING d - 10 P5F 7.VERTICAL a BOND BEAM STIFFENING SHALL BE IN STRICT ACCORDANCE - REINFORCEMENT SHALL CONFORM L G.O ROUND d RECTANGULAR TUBES WITH THE MANUFACTURERS REQUIREMENTS CONCRETE TO A5TM A 500,GRADE B FY=46 K51. TO THE REQUIREMENTS OF A5TM A615.. - - - CL C) v 1.ALL CONCRETE WORK AND MATERIALS - - - x G.`t SHALL COMPLY WITH THE SPECIFICATIONS b.MORTAR SHALL N -4 - O 5 L CONFORM-3.ALL GALVANIZING SHALL CONFORM T1 THE - m REQUIREMENTS OF A5TM G 270 FOR STRUCTURAL CONCRETE.FOR BUILDINGS TO ASTM A 123. - - w (ACI 301-8q). - AND SHALL BE TYPE M OR 5.. o m a 4.BOLTED CONNECTIONS SHALL BE WITH - eT 2.ALL CONCRETE SHALL HAVE A 25-DAY HIGH STRENGTH BOLTS IN ACCORDANCE 9.OUALITY ASSURANCE TESTING 1 ¢ ao COMPRESSIVE STRENGTH OF 3000 P51, WITH THE SPECIFICATION FOR iN5PEGTION SHALL BE PERFORMED WITH MAXIMUM I INCH AGGREGATE/ - - STRUCTURAL JOINTS USING A5TM A 325 IN ACCORDANCE WITH THE MAXIMUM 6%AIR ENTRAINMENT FOR OR A 4q0 BOLT5. REQUIREMENTS OF AGI 530.1/A56E(WB6. EXTERIOR CONCRETE EXP05ED 70 - - MOISTURE. 5.ANCHOR BOLTS SHALL BE A5TM A 307, 3.ALL REINFORCING STEEL SHALL BE FRAMING LUMBER d CANNEPTORS DEFORMED BARS OF NEW BILLET STEEL 6.WELD5 SHALL BE MADE BY OPERATORS' - _ V . CONFORMING TO A5TM A 615 GRADE 60. CERTIFIED BY THE STANDARD I.ALL FRAMING LUMBER SHALL BE - - o C'O O O OUALIFICATION PROCEDURE OF THE - KILN DRIED Iq%MAXIMUM M015TURE - - AMER'AN YIELDING SOCIETY. CONTENT. LUMBER SHALL MEET 4.CONCRETE COVER OF REINFORCING BARS AS A MINIMUM THE FOLLOWING "6 - V SHALL BE AS FOLLOWS: DESIGN VALUES FOR SPRUCE-PINE-FIR: - •p _ « 7.WELDING SHALL BE IN ACCORDANCE A.2X STUDS CONSTRUCTION GRADE u`> O N 15A.3'AT CONCRETE PEALED DIRECTLY WITH AGAINST EARTH. IN THE AW5 01.1 CODE FOR WELDING _Q ` ' - BUILDING GON5TRUCTION. FB=800,FV=65,FG-150 - B.2'A7 ALL OTHER LOCATIONS. B.2X JOISTS/RAFTERS NO.I GRADE cf) _ 6.CONNECTIONS NOT DETAILED SHALL FB=1150,FV=70 _� BE DESIGNED FOR THE LOADS 5HOYiN - p N O 5.NO HORIZONTAL GONSTRUCTION.JOIN75 ON THE DRAWINGS OR FOR LOADS C.POST NO.I GRADE FB=600, - «Y N 1. ARE ALLOYED,UNLESS SPECIFICALLY - GIVEN IN THE STANDARD LOAD FV=65,FC=6l5 '- 'v = 5HOYP4 ON THE DRAWINGS OR ALLOWED TABLES OF AISC FOR THE SPAN, - v O IN WRITING BY THE ENGINEER. - ¢ CD SECTION d STRENGTH SPECIFIED. J 2.ALL FASTENING OF FRAMING, PLATES,51LL5,SHEATHING e 6. „• .•.dM '1.ELEVATIONS NOTED AS'TOP OF STEEL' OTHER WOOD MEMBERS SHALL - 101'- �• REFER TO THE TO BE N ACCORDANCE WITH THE P FLANGE OF ROLLED SECTIONS. DETAILS SHOWN t MINIMUM, a•m REQUIREMENTS OF THE •�• MA55AGHUSETTS STATE BUILDING - a CODE 8TH EDITION. a _ IS 1 `ISSUED FDR PERMIT .m q of' Is - s N gg ---- Ft g T # •" • ., ---------------- D - 3 i - ' , ------ ---- ------- .. �- :m - .. Z1 -------------------- s .P w•n x............... -------------------------- ---------------------- , •. •4 - -�. -W� -.. AL 1—': F -.- ....- ----.-- 5. _ ........ --'.. d rn . a s u - , . � , t .. a .. i�2r• rill. Additions&Alterations to the s 3 s Cokshin Residence ®• 20 Harbor Road- 'WILLIAM 0. BISHOP A R C H I T B C H 6 school street t 506.4l05315•}5pg,420 57W w� a s Hyannis,Massachusetts Structural Engineer ASS 0 C IAT E S. I cotm t,ma mms 0 Inrc®arch4.hnwWe—. „'. .508.328.5544 " ' v First Floor Framing Plan z architectural design architech associates.com z y .. Z z m I- -. .. .. .. .. .. .. .. .: .. .. .. .. .. .. . ; ; a05NiIII g § 9 a R g g Additions&Alterations to the v Lokshin Residence m V ' 20 Harbor Road WILLIAM O. BISHOP A R C H I-T E C H b "y �•--� 6 as I street t..m.m.f.,2o.W- Hyannis,Massachusetts Structural Engineer I ASS 0 C IATE SA I wW ca mm aink(aja dried asses ales.wm m ... 508.328.5544 u - Second Floor Framing Plan architectural design architech as—iates.com - ---- Z _ c z -.- - � r y i< Z � � .o� i r O. . O ....... ...... t F .......... t . >o r 1za€ �� 11i , Additions&Alterations to the C/^) Loksh in.Residence EGO 20 Harbor Road WILLIAM U. dlSHOP V A R C H I—T E C H I 6 6�001 SS(BeT t soe:amaus tsoe.aso.saw $, w- y Hyannis,Massachusetts Structural Engineer jMr A S S O C I AT E S A cotui t,ma mm,a inf4arrhtechamciates.com T., 508.328.5544Ui _ Ceiling Framing Plan architectural design architechmociates.com T .. D SgR� D ..Z �T,m 5 4. s g 8 Additions&Alterations to the Lokshin Residence e� V 20 Harbor Road. WIUTAM 0. BISHOP ARC HI—T E CHI 6 s wl street It 508420.5335'�52.420.5304 0, 5 Hyannis,MassaCh USette Structural Engineer Mr] A S S O CT AT E S.� cotuit,ma mnrs a inkQanilechassodales.0om m e r n - 508.328.5544 - . .. V• Ii Roof Framing Plan architectural design architech associates.00m pa N iN E-19 A O P O. mA a. o� / \ / m� ggRq 1E tal 3 €$ a 8 Dr �m i o Nu, Z . �� ra rwa.w rnma acnmwr�se.ra - Cpp t p z Z Nt T D - i z - d N €g P s 4G N m g a a o Additions&Alterations 'to the A Co a s Lokshin Residence • 20 Harbor Road WILLIAM 0. BISHOP A R C H I-TECH 6 school street t 50&420.5735 t5094ta.57a Hyannis-Massachusetts structural Engineer - ASSOCIATE S.�I catuit.sre m .info@amh1techassoialm.mm - 508 328.5544 Structural Details a r c h I t'e c t u r a I'design architechassociates.com g m O €. z rn 9 m a €' ox z - S€i - -to - - rn JAM FF �� u x sad Zi O I c0 A z y z - -- _ 0 . m m D .. F 4£ 0 e-n . m 13 A A. - F. ,g & Additions&Alterations to the e� w Lokshin Residence .rn.� L 20 Harbor Road WILLIAM 0. BISHOP V A R C H I—T E C H I 6,cnooi street a soe azo.s�s isoe.am,eaa s Hyannis,Massachuse$S Structural Engineer 506.328.5544 tructural Detail ASS 0 C IATE SA cotult.ma maa ainfn®amhftechasaociatmTm --4 - Ss a r c h it e c t u r a I des[g n architechassociates.com Engineering Dept.(3rd floor) Map f Parcel /.7 Permit# a J"PI House# Date Issued - �0) Fee :: } 1:00-2:00) in. Bldg-)_D , T ��Me iniz Board 19 BARNSTABLE. TOWN OF BARNSTABLE Building Permit Application Project Street/Address /q Village/ Owner Address Telephone -7 7 S " Permit Request 7 :P YZ_ Z 47 First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ !!y oc, Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) 4 ❑Attached(size) ❑Barn(size) \ ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name /Y1, 7 , 4-ek Telephone Number 7) 7,;�- " -7- 3 Address v. m k" Z l License# �irJ• �,c2/ys TA '745 Home Improvement Contractor# 91 Worker's Compensation# 7 e;?141 Fbl`7 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �s SIGNATURE �/� 7r� �,Z-,- DATE �tK !7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 4 i FOR OFFICIAL USE ONLY ; ` PERMIT NO., 41 E = 4 DATE ISSUED MAP_/PARCEL NO. ' E ADDRESS a 1 VILLAGE OWNER DATE OF INSPECTION: µ FOUNDATION FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s FINAL BUILDING s DATE CLOSED OUT ASSOCIATION PLAN NO. 1 Suggested Affidavit for Home Improvement Contractor Permit Application For OMce Use Only NAME OF CITY/TOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c.142A requires that the"reconstruction.alteration.renovation,repair,modernization,conversion,inpmvement,removal,demolition, or construction of an addition to.any are-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building"be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: C 77 De'26— /Z 4007 Est. Cost �/ � �• Address of Work ® �y/r�'�/,7v/Z �� Owner Name: II DP Iy/J Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law —Job under S1,000 _Building not owner-occupied _Owner pulling own permit _Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: . Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: 7 - Z1 0 Denote fib/ Date Owner Name The Com ��µ `` 9= ,� �, • ,_� � 1I1O/1WQalth Of Department of I ndastria/.Acctdents} 600 Wd ashSIX trtgton.Street �• :�� � � �4 � �f�x � BO,SIOIt,1KaStw .. O2IlI f. `ce Anni CaWorkers' Compensation lnsu�ance Affidavit MOSL Roe tl� §Y �_ Q ant a homeowner performing all work myself, R t am sole proprietor and have no one aorkmg in anp capacity�: . {` , _` • _ [] I arn,an employer pro%iding workers' compensation for my em .lo�ees w �2 p orkin$on this job �.• _ _ x1 , � r z, ti shone to! tEE hC r' insurance co, l CD f�O�-�e:, no icy# Kd I am a sole proprietor. general contractor, or homeowner(circle one)and have hired the contractors`listed below who have the fo.liow inn wor�zr' compensation polices ( A' S f^„wSsiF H -;`� address• � ,' �'�� �f insurance co. nnlwc) N company name: � ��.�> addres n city j phone No s, , insurance co. • t+>taasY ' n Failure to secure coverage as required under Section 25A of MCL IS2 can lead to the impositica of criminal penalties of a Oise up to SI,SN.W aad/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Rae of 5100.00 a day against me. 1 tmderstais�;that a copy of this statement may be forwarded to the Once of Investitatiow of the DU for coverage vetiAtatioa. t do;bereby certify under the pains and penalties of per ury that the injor►notion provided above is.we oad..cott►act' T' 'Signature .,_._ J ds.: ;'Printnahte PhoneN .x ofGnal.use only do not w rite in this arts to be completed by city or town o111eW ctry or town: _ _ permitticease N n,Buildio�'tDepartmeat_.* ouce siae!Board ;,' ®check if immediate response is required OSeleetmea',a.Oftice: ", (]Health Depprtment contact person: phone M;_ ,_'� _ `_ -• nOtber ; Irevised 3AS NAI a � x K THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA e y to ner Ni zr x x14 '•'\r� _ �t4 ��T eT�� r T .G t s. t� ; ., p E`�..N: .. kf �+ r r� Ft s, n..4rt`1j't}�sp d'j F Sti'fitVY t 1 Y" aim - x� Xi- 04 � s.'�t .�. �x � � G��r�� �n��`�"''''ef §!�-� k d d•�p y,P'x� a���;:?�r x �y '�"��-�,ac�c�'i^"-p4y�,F:''$v''+�`!+r7'.Y=�•�''�, fi�r��'* a �;�� ��y���, t r f ve �+i vv4' n��+ x - '�, "� JtT���''e; `t'�k• J �,�".x�.5t sk��-iYt Y5 l:i�4�� �`r,�Ss��.} J! ,,.. s �'a to x .J+�'x fc � i ,.sAMM b`G. w:,}A t-?" 7Tk`t�°'�i-c' t , .. 'JS'iN e.4 C�!Ct1 r1�. l Y'; - s �'�. f�`^L��r.rry-�.� 3`�` z .s.,,. c ?< 7 "y/,�` -b,� 1� .��x��B, 3f }' 7 �„� `�'+�r�'��'t't �'1prt"« s G �'''`-• � ry �cq, 2 s z �` r , r[ } t � �—.f�3 r es� -4�' � i. ,� �t'a�' •szt 'm,d,;.�+�o 2� �• .d{ a �.� � 3� "4J _P+ �s; &r €y r "^.t ��f»"�'�' sr �`r �d rd+ i t ^�yy„s.,;ae;u.r w r it cOR, '! e.Sk W '� sr'�,�r 'A � t � 'i� -s ! y Af �i• yy{�`y F ,' y,�ry Nk 4, tf: i �F b ♦s. BSS D . E° S I G N y LOT .4 LOT ENGINEERING LOT 8 & SURVEYING S 09'34'47 E x 22.28 E IP .FND 8"CEDAR i) IP FND www.bssdesign.com 8-CEDAR` CEDA S & U `� x1 1 00-00'00 22,30* $12"CEDAR 22.58 BSS Design, Incorporated N 22.02 10"CEDA S n 12"CEDAR CE 23,07 g P 8-CEDAR,,, et T� to 12"CEDAR � 6"CEDAR 164•Katharine Lee Bates Rd EXISTING 21. SHED � 0 0 0 &0Vh� 22.73 Falmouth Massachusetts 02540 STRUCTURES 21.91 18"CEDAR 508.540.BB05 FAX 508.548.8313 t\\ l ' z;L � W DEAD '^ 8"CEDARS DECK L 22.69 0"PINE V I x 22.08ii\ t W PROPOSED HOUSE �� CHAINLINK x 22.04 C I D"CEDAR 0 STRUCTURES ��3; FENCE HOT, s"CEDAR _x 22.13 ` 0 L TUB.` � 6"CEDAR ' A "CEDAR 4 ' \ ` 1\`�' 2L74 O 10"CEDAR : N_ Z SHOWER t A22.29 a, �` t I 0"CEDAR z 13 8 :lti '` } 2.72 _ 22 �C �R • W 22.37 ` 10.1' PROP. ` : �;� ', 8 CEDAR z, 2 � V/ LEGEND - Q q .Z \ BIN z_ LOT 7 4� EXISTING HOUSE 20 `�';�� O �`\\ Z # \ CYPRESS Q„w FLOOR ELEVATION `� (e C • L0 S Of Ib49 Q = PROPERTY LINE o z \ i titiY \ s"cE a N. z3s9" ' W Q J 24.9 �� ���\ o O U `ti ': 28.9' 00 T � a • • • FENCE :`� t� ``; V) UNKEs En 0 N � Q ! �. ,\\` �,8"CEDAR U� L 0 T 3 . °� x 22,95 ��� ti � ,1 s �, NO.�� o Q o ? EDGE OF LAWN w 1�\0 .z 23.13 8"CEDAR �t O F O cc w y z w 22.69 22.98 !i '� ! 23,60 HOUSE Q m G cr IZ z 23.1 09 "'�+AL LA , " p oHw OVERHEAD WIRES _ ^ LOT cJ Q W w t a = J a " S SEWER o m O � t 23 74 .O to - f 24.00 x 23 51 I '' " ,-EXISTING UTILITY POLE O _ � � 0 �LirHT y . . 23,47 3 tp PAVED 23.5 Z V " GRAVEL CIN x 23,53 DRIVEWAY 24.01 J _ GRAVEL ' DRIVE 23,16 0 100.00 IP FND DRIVE m NOTES: SPRUCE » = 24'MAPLE s N 09'34,47 W [] 24"MAPLE 23,93 23.80 0- 1. HOUSE No. 20 HARBOR ROAD O O J r ASSESSORS No. MAP 306 BLOCK 176 23.06 STONES 2388 LOT 5 PLAN BOOK 110 PAGE 19 EDGE OF PAVEMENT x 23.71 _J _ 2. LOCUS IS WITHIN: . CURB S OP CL ZONING DISTRICT: RB S S WHEEL ST P S S S scale FLOOD ZONE: C HARBOR ROAD 1 = 20' WIND-BORNE DEBRIS REGION o= date BUILDING CODE WIND EXPOSURE CATEGORY B EDGE of PAVEMENT °NOV .1, 2 AP (AQUIFER PROTECTION) 23,07 z3.7s drawn 012 3. LOT COVERAG BY STRUCTURES: DRIVEWAY DRIVEWAY EXISTING: 2,315 SF 23.15% EJed TJB PROPOSED: 2,392 SF 23.92% oHw oHw oHw oHw oHw o checked 4. ELEVATIONS ARE BASED ON GIS MAP, BENCH MARK: NAIL SET IN UTILITY POLE , ELEVATION job number 24.80' 12204 5. RESIDENCE CONNECTED TO TOWN SEWER. BM NAIL IN title UTILITY POLE ELEV = 24.80 r Q' 20' 40, 60' drawing number P20-112 L i 1 I' BSN ' D E S I G N LOT T 6 ENGINEERING LOT 4 LOT 8 . &SURVEYING IP FND S 09'34'47" E IP FND 100.00' www.bssdesign.com E BSS Design, Incorporated N uj 164 Katharine Lee Bates Rd SHED - _ Falmouth Massachusetts 02540 508.540.8805 FAX 508.548.8313 EXISTING o. �..F. FOUNDATION / Z CERTIFY THAT THE STRUCTURES ARE LqqTED ON T SHOWN. THOk4AS JACKSON — 10.1' CD i3 I-- a � � - W CD V)/ z � rao.32��� o �i CONc ''' LOT 7 o P OFESSIONAL ND SURVEYOR ®�o�E �� .� LJ EXISTINGBEINGSE #20 PAD J LO Q s o N J /01 t�AN�S � o RECONSTRUCTED 28.9' 000 0 'Q � DATE: / N o V) O LOT 3Li- ° O i- o < 0 z J < M M LOT 5 Q w W M ' 0 ® = J d 10,000 SF o W p C;d LEGEND c� M G V) PROPERTY LINE P7— z C/) w a p 100.00' IP FND V m m k EXISTING N 09'34'47" W STRUCTURES scale HARBOR ROAD e = 20' NOTES: date DEC 18, 2012 1. HOUSE No. 20 HARBOR ROAD drawn ASSESSORS No. MAP 306 BLOCK 176g _ EJP, TJB LOT 5 PLAN BOOK 110 PAGE 19 checked 2. LOCUS IS WITHIN: ZONING DISTRICT: RB FLOOD ZONE: C job number I Q :01 w 114W 12204 WIND—.BORNE DEBRIS REGION BUILDING CODE WIND EXPOSURE CATEGORY B title AP (AQUIFER PROTECTION) (4 .0 Pit'01 0' 20' 40' 60' 3. LOT COVERAGE BY STRUCTURES: EXISTING: 1,833 SF 18.33% drawing number P20-112CPP