HomeMy WebLinkAbout0050 QUAIL LANE �o ��� �
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map ` 0 0 Parcel :Application #
Health Division Date Issued �l mow-
Conservation Division Application Fee S V
Planning Dept. 'Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation / Hyannis
Project Street Address QU� 4 1 L pv�-.
Village
Owner Address ��a��` ! t A k''e
Telephone
Permi Request ��C� ��r4 e � Ct•eeti-c. ®/c f� U a 10a
17�_
Square feet: 1 st floor: existin ro osed 2nd floor: existing ro osed 0�?- Total new
q 9��� p 9—proposed
Zoning District Flood Plain Groundwater Overlay
Project Valuation C1tJ�600 Construction Type
Lot Size y3 A-r-r,i 5 Grandfathered: ❑Yes ❑No If yes,`attach supporting documentation.
DwellingType: Single Family Two Family ❑ Multi-Family # units .
Yp 9 Y � Y Y ( )
f f
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway:']Yes- ❑ No
Basement Type: XFull ❑ Crawl LA Walkout ❑ Other
Basement Finished Area(sq.ft.) I Basement Unfinished Area (sq.ft) LSO
Number of Baths: Full: existing new Half: existing new
tb I I- -i
Number of Bedrooms: TOO
existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: Qd Gas ❑ Oil ❑ Electric ❑Other
Central Air: ❑Yes No . Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: b existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name _s�� Telephone Number sow 2 _oka S'
Address � �� 7�-� License # 8
62W0?-' 1V 7 Home Improvement Contractor#
Worker's Compensation # nn
ALL CONSTRUCTIOrBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO
SIGNATURE DATE
>., FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED i'l r.:a
1 .MAP/PARCEL NO. ..
t
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION:.
FRAME •j
INSULATION.>
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
-GAS: ROUGHi" <'..,t : FINAL
;•_FINAL BUILDING L'-
t r
1- DATE CLOSED OUT ;. .
. .t ASSOCIATION PLAN NO.
1 _
' s
>� r The Commonwealth of Massachusetts
Y Department of Industrial Accidents
Office of Investigations
.600 Washington Street
t F Boston, MA 02111
yy w ww.m ass.go v/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le—plibly
19�aLName (Business/Organization/Individual): 7 A 4 ]3 .A
Address:
City/State/Zip: �� 1�1,/��f dlv1— Phone
Algwyou an employer?-Check the appropriate box: Type of project (required):
4. I am a general contractor and I.
1. I am a employer with � 6. ❑ New cons ctioii
have'hired the sub--contractors.,
employees (full and/or pait-time), -- -- --- - -
2.ElI am a sole propnetor.or partner- listed on the attached sheet. 7.I
. modeling
ship and have no employees These sub-contractors have g, ❑ Demolition
workingfor me in an capacity. employees and have workers'
Y P h 9. ❑ Building addition
o workers' comp. insurance comp.insurance.1
p a e airs or additions
required.] S. ❑ We are a corporation and its 10.[] Electric 1 r p
officers have exercised their 11.[] Plumbing repairs or additions
3.❑ I am a homeowner doing all work
myself [No workers' comp. right of exemption per MGL 12.0 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#) must also fill out the section below showing their workcrs'compensation policy in formation.
t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside con tractors"must submit a new affidavit indicating such,
tContractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and state'Nhethcr or not those entities have
employees. If the sub-contractors have employees,they must provide their workcrs'comp.policy number.
I am an employer that is providing workers'compensation insurance fo'r my employees. Below is the policy and job site
information_
Insurance Company Name: ,1 / �"'�'
-3 6
Policy# or Self-ins. Lie. #: �� �� 1 — S3 Expiration Date: f
Job.Site Address:
(D QvA< City/State/Zip: xnr
Attach a copy of the workers' c ensation poticy'declaration page (showing th.e policy number acid expiration date).
Failure to secure coverage as r quirt under Section 25A of MCL c, 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or e ar imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up"to $250.00 a day aga' violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the D o ranee coverage Yen)cation.
1 do hereby cert� t e pains and penalties ofperjury that the information provided a ove is tr4e and correct.
Si ature: -te.
Phone#: a�� -V G
Offic -I use only. Do not write in this area, to be completed by city or town official
"City or Town': Permit/License#
Issuing Authority(circle one);
1. Board of Health 2. Building Department 3, City/Town Clerk 4. Electrical Inspector 5. Plumbing inspector
6:Other
Contact Person: Phone#:
e
Massachusetts Gencral Laws chapter 152 rcquiies'a)) employers to provide workers' compennsalion for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is dc5ncd as "an individual, partnership, association, corporation or other legal entity nT any two or of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, °f Lbe
receiver or trustee of ao individual, partnership, associalion or other legal entity, employing employees. Ho"Yever the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of
line house
dwelling house of another who employs
ys persons to do mainlcnancc, constrriclion yr repair work on such dw So er."
ig appurtenant. thereto shall not because of such emp to merit be deemed to be an ern
or on the grounds or build y
NIGL chapter 152, §25C(6) also slates that "every state or local licensing agency shall withhold the issuance or
any
renewa) of a license or permit to operate a business or to construct buildings in the commonwealth for
as not produced acceptable evidence of compliance with the insurance coverage req:uired."shall
Additionally, MGL chapter 152, §25C(7) stales "Neither the conunonwealth nor any ofits political subdivisions applicant who h
enter into any contract for theperformance ofpublic-i ork until acCeplable evidence ofcompliancc with the insurance
requirements of this ehapterhave been presented to the contracting authority."
App
licants
at a 1 to our situation and, if
the box es th y
ere] b checkin PP Y
Please fill out.the workers compensation affidavit compl y, y g
necessary,supply sub contractors) narne(s), address(es)and phone numbers)along with their cerlificate(s) Of
insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the
members or partners, are not required to carry Workers' compensation insurance. if an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage, Also be sure to sign and date th-e affidavit, The affidavit should
be returned to the city or lows thai•1-t application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a,workers'
compensation policy,please call the Department at the number lisicd below. Self-insured companies should enter their
self-insurance license number on the appropriate line,
City or Town Officials
Please be surd that the affidavit is complete and printed legibly The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of)nYestigations has to coniact you regarding the applicant.
in addition an applicant
Please be.sure to fill in the permitJhccnsc number which will be used as a•reference number. G t
ent
that must submit multiple pcnnit/license applications in any given year, need only subinil one afLdavit indicating (c)ty or
Policy information (if necessary)abd under"Job Site Address the applicant should write"aJ1 locations in__
tovrn).`A copy of the affidavit that has been officially stamped or marked by the city or town nay be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A.new affidaYi be filled oL�t each
year. Where a home owner or citizen is obtaining a license or permit not related to any businesS°f commercial venture
(i,e, a dog license or permit to burn leaves etc.) said person is NOT required to complete this ajFfidavit.
questions,
The Office of InYesligahons woo 1 e o �k—Tm-i ra-dya�f-Gr�'°ur rati� nn and shoo➢d youhave any
please do not hesitate to give us a call.
The Department's address, telephone and fax number: '
The Commonwealth of Massachusetts
Department of Indusb7 al Accidents
Office of Investigatjons
600 Washington Street
Boston, MA 02111
Te). #I617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-1749
Revised 4-24-07 www.mass.gov/dia
' Ef18I LLkbVal
r. - .!W ... �•Ud�CCEtS t~Jittpehs8hptt BTt�- .
r ON PAGE
0 A ACCI No. IImu Ir--e Group/Boston
Iayers I.iabalit) Policy
ODD4 LI$F,RTY MUTUA).,tNSURANCE f.0
'ICY NO. TD1CD SALES OFFICE J�zs
5-365323-010 i %%XIWESTC:OP.E I SALES CODE N/R
ON 102 REPRESENTATi\rE I tQOp l2.
! YEAR ,
:ASSIGNED I �_ 2t1 10g
em 1 tame of T D I REALTY GROUPING
Address PO BOX 796 I'EIIN 04-3529499
HYA\'1�TSPORT,MA 42647 RISK iD 7,M819
Status 03-CORPORATION
at Other Workplaces not shown above: SI F-ITFM 4
. Ago.Day;ear ASe.�zy Year• — .. .
item 2 Policy Period:From 03-05.241U to- U3-US-2411
12.01 AM standard.time at the address of the insured as stated herein.
Item 3.Coverage —
A'. Workers Co P.' _
mPznsation Insurance: Part One Of the applies to the Workers Compensauan I aNv of the states listed
here.. Policy
MA
B. Employers Liability 7nsurance:.Part Two of the policy applies to work in each state listed in item 3.A. The limit•of our
liability under Part Two are
Bodily Injury by Accident 100,4tI0 each accident
Bodily Injury by Disease W'000
Bodily Injury by Disease 100 Policy limit
each employee
C. Other States Insurance:Part Three of the policy applies to the states,if any listed here: '
SEE END WC 20 43 08A .
D. This policy includes these.endorsements and schedules: SF;E EX7.EN510N.ol L'�FORNIATION PAGE
item 4.P emits— m_The premium for tills policy will be determined by our Manuals of EZules Cla aficaticros Rates and Rating Plans,.
11i information required below is sabject to verification and cllanwe by audit,
. - P[8[-IIU.T.B311S tt dl� �IN
Por Si*. "
rmupag
Cl9SSlfh^^8llans `-de Fs--.t d o:RE- Es:intaleo - .
SEE EX'CENSION OF'LNTORNUTI0 PAGE Nam.. Trla!Annual Pr niumd ^uae ratino �rnua!
Inint-- 'm— um—Premium Soo (MA j 'Total Estimated Annual Prenlium •„ i —Interim adjetmen[of premium shall be made: ANN UAL
This policy,including all endorsements issued therewuh,is.hereby countersigned by .
U rxd.Rewmt
- I
latl. n ur,02-24-3.0
Loy_CoJe rerun• Dom,;, Ardis i3adr Ptriedic?z}mert TTJN
g Basi< ?oi.H.G Hose sta4 Dividenu O2-24-10 R RENFw'ALtrlA i 14�'CI-31S-Sa323 419
c �!r+• 2t ccpyri&A 1987 Naliona[Car wll on Comoonsation lriaurance
. - 'AT 00 00 01 A
I
Town of Barnstable
Regulatory Services
II.LR7t6'tAB[..� t -
vp $ Thomas F. Geiler,Director
i7 ibSp. tie ,
Building Division
Tom Perry, Building Commiggioner -
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property OwYier Must
Complete and Sign.Th�s Section
If Using A Builder
I' �3 v , as Owner of the subject rn e
® P P rL7
hereby authorize to act'on my behalf,
in all matters relative to work authorized by this building permit application for.-
0 A,C �AK
i"-
(Address of job)
Sig a
Print Na=
If Property Owner is applying for permit please complete:the
Homeowners License Exemption Form .on the reverse side.
Q:FORMS:O WNERPERMISSl0N
Town of Barnstable
o
Regulatory Services
I Thomas F. Geiler,Director
s.ttursr.�s[:s.
Building Division
Tom Perry, Building Commissioner
200 Mairi.Street, Hyannis, MA_02601
Rv.to wn-b arnstab le-ma.us
Office: 508-862-4038 Fax: 508-790-6230
FIONE0•WNSER LICENSE EXEMPTION
Please Print.
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town State Zip code
Tbc ct cnt 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-
superyisor_
DEFAMON OR BOMFOWNER
Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended Lo-
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
rz nimum inspection procedures and requirements and that he/she will comply with said procedures and
requixements.
Signatiirc of Homtowncr
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger wil.l be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
.The Code states that: "Any bomcowncr performing work far which a building pcmvt is required shall be cxempi from the provisions
of this scction,(Scetion 109.1.1 -Licensing of construction Supervisors);prov;ded that if the homcotp err cngagcs a parson(s)feu hire to do such
work, that such Homcowna shall act as supa-visar."
Many homeowners who use this cxcrtrption arc unaware that they an assuming the responsibilities of a supervisor(sec Appendix Q,
Ru)cs&Rcgularions for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious prvblcma,particularly
when the homeowner hires unlicrnscd persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed,
Supervisor. The horricowncr acting as Supervisor is uitin-atcly responsible.
To cnsvrc that the homeowner is fully aware of his/her responsibilities, many communities require,as part of the permit application.,
that the homeowner certify that hc/Ae undersLands the responnbilitics of a Superyisor. On the last page of this issue is a form currently used by
several iDwns. You may cart t amend and adopt such a forr✓ccrti6c2tion for use in your co=unity.
Q:fornu:homcczcrrrpt
A
a Board �i?"rn°'zurea/�
ofBu►Idinaa�x f
Constru gRel;uiadonsand
' ctionSuP ry orLicen et►ndards
License: CS
P
98149
EXp►rat
4z ►.; / L 3724/2011 I
! Restrict►o Iq/ T1W 98149 f
n �00 ;
'ATE SE MDT
�r
PO BOX 796
HYANNI
SPORTS" -� I
I .MA 02fi47
Com
m►ss►one
r -
- ✓lie -Vo rwnrzo�uue2�2 a���acfurie�.a I� - .. .. - . . .
Board of Building Regulatiods and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR I 1 before the expiration date. If found return to:
hs Registration: 155997 I Board of Building Regulations and Standards
Expiration .5/29/2011 Tr# 283568
One Ashburton Plac m 1301
�' ;Type Private Corporation Boston,Ma.02
r '
T D I REALTY GROUPKING
TATE. ISENSTADT, f -,"�:Fl✓
55 LAKE AVE.
HYANIdIS PORT,MA 02647 '`" Administrator No valid without signature
i
REScheck Software Version 4.3.0
Compliance Certificate
C�J(
Project Title: Renovations and Additions for:
Energy Code: 2009 IECC
Location: Hyannis,Massachusetts
Construction Type: Single Family
Project Type: Addition/Afteration
Heating Degree Days: 6137
Climate Zone: 5
Construction Site:, Owner/Agent: Designer/Contractor:
50 Quail Lane Sam Baxter Kenneth Sadler
Hyannisport,MA 50 Quail Lane KSA design
Hyannisport,MA P.O.Box 1149
Hyannis,MA 02601
508.790.3922
Compliance: Maximum UA:119 Your UA:119
OEM
Ceiling 1:Flat Ceiling or Scissor Truss 470 38.0 0.0 14
Ceiling 2:Cathedral Ceiling(no attic) 150 30.0. 0.0 5
Wall 1:Wood Frame,16"o.c. 312 19.0 0.0 18
Door 1:Solid 20 0.350 7
Wall 2:Wood Frame,16"o.c. 220 19.0 0.0 11
Window 1:Wood Frame:Double Pane with Low-E 12 0.310 4
Door 2:Solid 20 0.350 7
Wall 3:Wood Frame,16"o.c. 312 19.0 0.0 16
Window 2:Wood Frame:Double Pane with Low-E 14 0.310 4
Door 3:Glass 26 0.330 9
Wall 4:Wood Frame,16"o.c. 80 19.0 0.0 5
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 589 30.0 0.0 19
Compliance Statement. The proposed building design described here is isle with the building plans,specifications,and other
calculations submitted with the permit application.The proposed building has be el esi ned to meet the 2009 IECC requirements in
REScheck Version 4.3.0 and to comply with the mandatory requirements lis in a pection Checklist.
D
Name-Title 1��i^`. ignature Date
Project Notes:
Calculations are for Family Room addition only.Area over Garage is to be Unfinished Storage.
CS#39020
Project Title: Renovations and Additions for: Report date: 11/04/10
Data filename: Baxter.rck Page 1 of 4
REScheck Software Version 4.3.0
Inspection Checklist
Ceilings:
❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation
Comments:
❑ Ceiling 2:Cathedral Ceiling(no attic),R-30.0 cavity insulation
Comments-
Above-Grade Walls:
❑ Wall 1:Wood Frame,16"o.c.,R-19.0 cavity insulation
Comments:
❑ Wall 2:Wood Frame,16"o.c.,R-19.0 cavity insulation
Comments:
❑ Wall 3:Wood Frame,16"o.c.,R-19.0 cavity insulation
Comments:
❑ Wall 4:Wood Frame,16"o.c.,R-19.0 cavity insulation
Comments:
Windows:
❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.310
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
❑ Window 2:Wood Frame:Double Pane with Low-E,U-factor:0.310
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Doors:
❑ Door 1:Solid,U-factor:0.350
Comments:
❑ Door 2:Solid,U-factor:0.350
Comments:
❑ Door 3:Glass,U-factor:0.330
Comments:
Floors:
❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation
Comments:
Floor insulation is installed in permanent contact with the underside of the subfloor decking.
Air leakage:
❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are
sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or
solid material.
❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between
window/door jambs and framing.
❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk
between the housing and the interior wall or ceiling covering.
Project Title: Renovations and Additions for: Report date: 11/04/10
Data filename: Baxter.rck Page 2 of 4
ii
Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or
�J damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed
to maintain insulation application.
Wood-buming fireplaces have gasketed doors and outdoor combustion air.
Air Sealing and Insulation:
Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7
ACH at 33.5 psf OR 2)the following items have been satisfied:
(a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or
repaired.
(b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed.
(c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier.
(d)Floors:Air barrier is installed at any exposed edge of insulation.
(e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or
sprayed/blown insulation extends behind piping and wiring.
(0 Comers,headers,narrow framing cavities,and rim joists are insulated.
(9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall.
Sunrooms:
Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum
skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope
requirements.
Vapor Retarder:
Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that
moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided.
Comments:
Materials Identification and Installation:
Materials and equipment are installed in accordance with the manufacturer's installation instructions.
Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value.
Materials and equipment are identified so that compliance can be determined.
Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided.
Insulation R-values and glazing U-factors are dearly marked on the building plans or specifications.
Duct Insulation:
Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are
insulated to at least R-8.
Duct Construction and Testing:
Building framing cavities are not used as supply ducts.
All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means
of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181 A or
UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically
fastened.Crimp joints for round metal ducts have a contact lap of at least 1 112 inches and are fastened with a minimum of three
equally spaced sheet-metal screws.
Exceptions:
Joint and seams covered with spray polyurethane foam.
Where a partially inaccessible duct connection exists;mechanical fasteners can be equally spaced on the exposed portion of the
joint so as to prevent a hinge effect.
Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa).
All ducts and air handlers are located within conditioned space.
Heating and Cooling Equipment Sizing:
Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and/or Service Water Heating(Sections 503 and 504).
Circulating Service Hot Water Systems:
Cj Circulating service hot water pipes are insulated to R-2.
Project Title: Renovations and Additions for: Report date: 11/04/10
Data filename: Baxter.rck Page 3 of 4
Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the
system is not in use.
Heating and Cooling Piping Insulation:
t] HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3.
Swimming Pools:
Heated swimming pools have an on/off heater switch.
Pool heaters operating on natural gas or LPG have an electronic pilot light.
Timer switches on pool heaters and pumps are present.
Exceptions:
Where public health standards require continuous pump operation.
Where pumps operate within solar-and/or waste-heat-recovery systems.
Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a
minimum insulation value of R-12.
Exceptions:
Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source.
Lighting Requirements:
A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following:
(a)Compact fluorescent
(b)T-8 or smaller diameter linear fluorescent
(c)40 lumens per watt for lamp wattage 415
(d)50 lumens per watt for lamp wattage>15 and<--40
(e)60 lumens per watt for lamp wattage>40
Other Requirements:
Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting
off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is
above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement'c').
Certificate:
Cj A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window
U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility
of the circuit directory label,service disconnect label or other required labels.
NOTES TO FIELD:(Building Department Use Only)
Project Title: Renovations and Additions for: Report date: 11/04/10
Data filename: Baxter.rck Page 4 of 4
2009 IECC Energy
Efficiency Certificate
mMm
Ceiling/Roof 38.00
Wall 19.00
Floor/Foundation 30.00
Ductwork(unconditioned spaces):
Omamwaft avow
Window 0.31
Door 0.33 NA
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments:
i
i
'9
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P Lo7- z 6
r X
' �3700 O
v
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SCALE / So. U.9 T1 �f 7i!C H 211977
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Tt1E Zo v i�vC, 44-w.s a F' 7 N6- 7-O W-(l/
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y,- SEPTIC SYS,Em MUST BE
Assessor's map and lot'nufmber ...�n.y< .......:., ... aq I�`:SrTI,!}�ii�'��+I COMPLIANCE
rx{ { /O�ig( . L' i • �'''_i I H /l.`RTICLE .11 STATE
.
t v,
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Sew ge"Permit number � ..." i"
.. .........a.............. tG€J�q A0Wh6
s QpFTHET��ys. y, TOWN OF BARNSTABLE
�l t 2 STAIILE. i CCi oy t
9�p '.M6 9. '0� �. � . :� �.��� - 76 BUILDING INSPECTOR
AigQ --
1' •
APPLICATION:FOR PERMIT TO 1 .I� G� _ ................................` ................
Zi
c TYPE OF CONSTRUCTION ........ w� �C.. ........ .............................................................
.- :........... 3/ /...........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the'following information:
i Location .....4L Cy*-z C. �i` �� y 1/NJr p�!Q ./�1% .. ...`....L�� .....9 .............
Proposed Use . . L�.1�,, .. � 1 .... /. lu�r .................................................... .........
ZoningDistrict ..............................................!.....................:...Fire District ................................................................................
Name of Owner �i�t ...�fi. IFGLr�. ..Address7.49..61 , l::s'-•
��
Name of Builder R ...Address t'.. ..
Name.of Architect 0Q.!�. .C,.M�646:. ..... .....Addr.ess�7i���G���li���i..AP.. ...................
ZA
Number of Rooms 4).............................................:.........Foundation .�.. �GYAi.04A1 Tyr A-11 '!dd
ExleriL. .K. .......................................................
n J/ �j
Floors ......:......................................'.....................Interior 4,�../9Z_d7—P 5.....�� ��..........
Heating ...V�r�r,.f0�..fAetim- D..PIumbing ..-I—X ��....................................................
Fireplace ...A......t i�r�J�. �...................Approximate Cost ....�?,.00lo.�.o............
. ...... .. ...
/� QQ
Definitive Plan Approved by Planning Board ________________________________19________. , " Area .......I.....�/�. ..
C d
Diagram of Lot and Building with Dimensions Fee ......... 0 `~
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. I
• Name :. ... ........1.............................. ........ 3
Pllicy° Francis X.
' 19063 l 1/3 story
---. ParmU�for ..................:................. ^ '
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..........................._______.`___.
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Type of Construction .... ._.�------.
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Plot ------.�--. �Lot ----------..
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PermitGronto6 --.. �]1----lq 77
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Date Completed -----�
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PROJECT NAME: Did re-ly-m,l -�S -f
ADDRESS:
Lk- vi .5
PERMIT# V Gt'rt C1 t.LS
PERMIT DATE: I
M/P: ?� {J c f
LARGE PLANS ARE FILED IN:
BANKERS BOX 0
FILED ALPHABETICALY BY STREET
INFORMATION SHEET FILED IN STREET FILE
q/wpfiles/forms/archive/BANKERSBOX
PROJECT 6 t c
NAME:
ADDRESS: })
PERMIT# I C)0 ca R 3
PERMIT DATE: lo
M/P: l 1
LARGE PLANS ARE FILED IN:
BANKERS BOX 4.s
FILED ALPHABETICALY BY STREET
INFORMATION SHEET FILED IN STREET FILE
q/wpfiles/forms/archive/BANKERSBOX
Map z 8 Parcel Z Permit# ,50 7 R 7
House# �� 4. Date Issued O 9
Board of Health(3rd floor)(8:15 -9:30/1:00 Fee �d 3U
Conservation Office(4th floor)(8:30-9:30/1:00=2:00) /V°
Planning Dept.(\t floor/School Admin. Bldg.) ME ��,��
SE11" is S
Definitive an p oved by Planning Board 1�9 INSTALLE a B E. 6ANCE
T
TOWN OF'BARNSTABLR� IROW". DE AND
Building Permit Application
Projec eet Address QLkA I L. L-A4
Village H16QNhs PORT i
_Owner CJ44fLUE$ S4MPLE Address qO VJ&)QUir.JQ RD,
Telephone _ �a`f D (ol 5 -7-73 z L1KE ffieeSTI l-U DiS �aoyyS
Permit Request "PRDK -7 Z S 5 F jWe9y2 DW( WI-TH Te:05 To<&Joe.
ElY1(N� A "T2AE Ddou;L kuj4. \M Jobw fltjD rRArne i,,i A V! 6LOeK W/FiYeo
P 11N f-2S i►J 17`S DO-cE To PRtWE Lcmi fiejn k0u-ce Ta I�L'k3 d�cJC.
I
First Floor square feet Second Floor square feet
`Construction Type P2&S5LkU 'Tk&&Tap 'V JMO
Estimated Project Cost $ _13 ,"0-6 0
Zoning District ____ R 1. Flood Plain Water Protection
Lot Size S J 3 S'f S F Grandfathered ❑Yes ❑No
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Iq I1 - ,Zly2s, Historic House ❑Yes Q,No On Old King's Highway ❑Yes kfNo
Basement Type: '2Kull ❑Crawl 91.Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing G7 New Half: Existing �_ New
No.of Bedrooms: Existing New _
i tl)
Total Room Count(not includin baths): Existing New First Floor Room Count
W
Heat Type and Fuel: ❑Gas ZOil ❑Electric ❑Other
Central Air ❑Yes 46-No Fireplaces: Existing New 0 Existing wood/coal stove ❑Yes llo
Garage: ❑Detached(size) Other Detached Structu es: ❑Pool(size).
OAttached(size) j`f� L(p � ❑Barn(size)
` ❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes �"o If es, site plan review#
Current Use 51',J u��b X-( �)`DePIAL� Proposed Use &r-)qLQ ,c1 c�S rx, (q1—
Builder Information
Name R08�-T e? ttC)Gey Telephone Number % -0001
Address ?.O• -&,< 133 License# O Lt 8 8 s q
8 tL S�40 C ST. Home Improvement Contractor# 10013 t
C-AYTUI f A 021(0 Worker's Compensation# (o R10LcF,5 - 155K9i7-7-9 8
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTI DEBRIS RESU TWG FROM THIS PROJECT WILL BE TAKEN TO 13 F I.
SIGNATURE ti DATE
BUILDING PER IT DENIED FOR TH L OWIN REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO. _ -- -
• - . ,1 a ,i. —F ` r , t -_ t + - ) :1 ' F{ ! 'r�
ADDRESS _„VILLAGE ,-
OWNER - _~ •..•_ •--• ° , Y x � _ �, . - ", . _
DATE OF INSPECTION:
FOUND_AT_ION
FRAME
-INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL":
PLUMBING: ROUGH " FINAL z r.
GAS: ROUGH FINAL.
FINAL BUILDING �" • j, Y ~; p
DATE CLOSED OUT ' ```
ASSOCIATION PLAN NO.
The Town table
. WE
T of Barns
r M �,��' Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-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.
.J
Type of Work: 1 EW Est. Cost /,3 dvt
Address of Work: 50 Qcd-A1� Lry.1£ _ WYAtwisibRI, NA ,
Owner's Name QH A 91,FS A)-1D c1 l lj S,(M(ALE ,
Date of Permit Application: MAC
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Building not owner-occupied
Owner pulling own permit
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 PENALTI F PER Y
i
I hereby apply for a permit the g
S 9 6 6- �0 100131
Date Contractor Name Registration No.
OR
Date Owner's Name
n
The Commonwealth f!0fassachusctts �.
;; :-•-. 1 t_ Dcparn»enr ojlndusrrial Accidents
Ofliceollayest/gat/ons
'•� i1 -:_ 600 11 ushi igre)n Srrccr
,��. ��_,:'� Bustoa.A1ass 112111 .
Workers' Compensation Insurance AtTdavit
dEllrtnt information': _ Ple;tse PRINT Ie�' "'""""'^'-• -'"" —�
Warne f'219:1 T T(�DC�� Ib2 '?N0raEM SI tic
1�restinn o�P 1 S '. J- o 6�c i� )L Lit
pit"• �[ l'\ -j"5t R M n nhtme 0
I am a homeowner performin_all work myself.
I am a sole proprietor and have no one workin__ in any capacity
a an empiover providi—n-:-workers' compensation for my employees wori:ing on this job.
cmm�an� name: T � eG�s .
ttlrlrc�s X l� J I J���� OT.
cit%-: CoTuI-f nhnne#. ( �) Li C)C.b
incurancc cn. riV-.a C-E Pniicv# 6 R-I OU a - 15 50 ri--i-1 b
M I am a sole proprietor. general contractor, or homeowner(circle one)and have hired the contractors listed below who have
tp
the following workers' compensation polices:
comnam nnnne*
r
elt�" nhnne#•
incurancc rn. nniiev#
I_-..-_._.... .._ ._—_-«..._. -I.��aa..�."'" ... - �_.Y...:...-.; - -_- _f.�.q�:.��1t1T•'!!•�wwy�� _ �T.r,'t:_- -ti. .��-r-�
comnanv name,
a d d r"-v
rin•� nhnne#•
insurnnee co. nelicv it
Attach additional sheet if necessary
Failure to secure ctr%•crat:c:ts quired under Section 35A of t11GL 152 can Icati to the imposition of criminal penalties of a line up to S1500.UU andiur
unc cars'imprisonment:ts c as silk ii penalties in the form of a STOP«'ORK ORDER and a fine of S100.00 a day against me. I understand that a
Copy of this st:ucmcnt mad c ur»ardcd to the tee of restirations of the DIA for coverage verification.
1 do herehr terrify tin d the ills m pen es o try r i ormarion prodded above is true and correct.
Si^nature �l Date �(8
Print name r2
" �GeT7 Phone# C5an "UUC)
'official use unl%- do not write in this arcs to be completed by tiny or town official `
cih or tnlvn: permitAicense# nBuilding Department
Licensing Guard C
check if immediate response is required. Oseieetmen's Office i
C311e2tth Department
contact person: phone#:nOther
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide worker.-,' compensation for the
employecs. As quoted from the "la\%`. an e►►►phi ree is dcfincd as every person in the service of another under anv
contract of hire, express or implied. oral or written.
An en►plurer is defined as an individual. partnership. association, corporation or other legal entity, or anv two or trio:
the foregoing, enuaged in a.joint enterprise, and including the legal representatives of a deceased emplover, or the
receiver or trustee of an individual . partnership. association or other legal entity, employing employees. However tl-.
owner of a dwelling 110USC having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance , construction or repair work on such dwellinu lic
or on the :rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commomrcalth foram
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter
been presented to the contracting authority.
r �..-.�-.ram.._._-.......w� _._�..�..+-.-.���.... .�T.. - ..... ..-. • w.w'T. - _ter.._
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying; company names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that tite application for the permit or license is being requested.
not the Department of Industrial Accidents. Should you have any questions regarding the "law'or if you are require:
to obtain a workers' compensation policy. please call the Department at the number listed below. .
City or 'I owns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questio:
please do not hesitate to give us a call.
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 'Washington Street ' `
Boston,Ma. 02111 �
fax #: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
4xe CONTNUOUS wDDD POST
2U HAUM BEYOND
2 X 2 BAWSTEM r CLXAR SPACE BETWEEN OJAX)
NV I
' S T/T O.C. czm (VAX.)
RAIL PLAN
S�
m
1 l l 1l�V1S1l/ I 5(qQj Y ,X] T BOARO 1,R_ {
S 1 TM 2 - zxe N•a
l
2 x 2 BALUSTERS
WAY. MXM SPACE BETWEEN
US WOOG POST AT S-J' O.C. wx
4� CCNTIN JS TO FOUNDATION
S�D+o 2Xe NAIlER
20 Oz.ALUM. nASHM
4X4 A,IAM" PLYM OLM SPACER
9
Al r-d o c. T- 2 - va BEAM
SLW= I THROUGH BOLT TO EACH POST
T• AM SPACE DEM JOTSTS AT T� O C.7 1�- W H TWO ]/4' OVUETER BO'.Ts
swA, mNa txa HEADOI ^l�
U . JQST FW+GER AT 9O�Ti um or
UNC or IX8 LEDGER BM= TO SOIL BLOW EAC,/MAZM JotsT
M/ ]14' VO BC3rTI r-t or- STAGGi]! CMfrlNUNy 4XX WMO POST
. �/�L eou HEAc
20 oZ ANAL. FL43HM
O uRAL POST ANOM
. ALi ooac TAAM{N0 TO BE_'�I ANOCj%�ty '� 14
C r.OMMETER CONCRETE BASE
M!L 4'-d BN JOW GRADE
ALE,HAROMAN[ Nt NNAt<.s TO e< CALYAHIZID
�5�n��{iIJI�`.Sp S STl✓ I JA uNc a wDE
RECOMMENDED DECK CONSTRUCTION.
t_In
— —_—
72.
DEPARTMEWOF PUBLIC'4SAFET,Y
155732
CONSTRGTION SUPERVISOR LICENSE I
Restricted To: iG Nu r Expires: ' '
ki
- — PR ted4o 16
f IA - Masonry only ±1; ;x.. ..::_•_ = s .
16 - 1 & 2 Family Homes s 1 ) RO)38 DGETT+
k�- J,3. ry, , �,.;,
Failure to possess a current edition of the ! Y a....w7i ,�r 184"S6N00�"ST,,POB 133 5:
# Massachusetts State Building Code Est; COTUIT, MA 02635
is cause for revocation of this license. �+
at -HOME,IMPROVEMENT CONTRACTOR!,
Registration ' 100131 . .
Type r ,`PRIVATE,CORPORATION
�t !Expiration x i 06%09/00 E
•' e�
{ ♦ dcr rq v r"I i S j.-4� .♦ -.� s :4 t "�
F PADGETTa BUILDERS; INC.,
Robert R:, Padgett
ox 133hWSchool St J
ADMINISTRATOR��,�. tCotuit MA.02635
• _s -;
r!
O TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -
n
Map Parcel 2, 19 , Permit# 32
r .
Health Division ��D�JG i" �/` 99 Date Issued
Conservation Division = -- r Fee
Tax Collector
S ZE
Treasur IING MILLED PNI '
Planning Dept. DE AND
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
'Project Street Address �0 Qi t.1'3 IL- LA-r-9 -
Village H�If1v. i��OR`I , rAA o?-LPLf1
a
Owner 0—H kR-E 5 OL,G Address 5&E
Telephone, -IJ (a3 'f I j
Permit Request ADD (faO ;SF TO "NLA�1� -To CaNy&fir
r rJ Rx3?)z Surd -�To h mW»� ALSOJ?, At-'r0J AiWT ra ssliwcg
f
A,,rD `t',� Rt(LFt�� ��-C, R{JAce- 4 TO e6W\etrr fi2m 6�L- TO S.
Square feet: 1 st floor: existin O proposed 0 2nd floor:existing proposed Total new 4 0
Estimated,Project Cost Zoning District Ar= 2 `Flood Plain Groundwater Overlay
Construction Type WozM FRArnE.
Lot Size �se�3�tc AJ5� 3 b4 sr Grandfathered: O Yes ❑No If yes,,attach supporting documentation.
Dwelling Type: Single Family Two Family Cl Multi-Family(#units) -
_ s .
Age of Existing Structure '57iRs Historic House: ❑Yes Flo On Old King's Highway: ❑Yes 4EI-No
Basement Type: -Full ❑Crawl t4Walkout ❑Other
Basement Finished Area(sq.ft.) "Basement Unfinished Area(sq.ft) 1180
Number of Baths: Full: existing z new Half:existing new - -��
wJ ---
Number of Bedrooms: existing_ new
Total Room Count(not including baths): existing ew _ First Floor Room Count �
Heat Type and Fuel: )(Gas Cl Oil ❑Electric •'❑Other 5wi-[CRit-Yej-''Tv CAS 17AP4-c9
Central Air: ❑Yes *No Fireplaces: Existing O►4e New ' Existing wood/coal stove: -❑Yes Ft5JVo
Detached garage:❑existing 0 new size • Pool:❑existing, ❑new size Barn:❑existing ❑new size
Attached garage',existing' Elnew size Shed:❑existing ❑new size' Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes p6_No If yes, site plan review# r
Current Use - Proposed Use J1�ZLE l- tsow�CJ
BUILDER INFORMATION
Name��' l I�,-:P� C-�.�T/ •'J1 2 . Telephone Number ���a� �2� �cxx)
Address rp. tzoy- 133 License#
Home Improvement Contractor# 100131
Worker's Com ensation# k `�1`7-7q 8
p 1 e)ut�9551�n
ALL CONSTRUCTIO EBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - �PS"Ct ,
SIGNATURE T/M DATE I2'1 ��
FOR OFFICIAL USE ONLY ,
* PERMIT,NO. � ��_ • .
DATE ISSUED-
MAP/PARCECNO.
ADDRESS -'VILLAGE
OWNER
DATE OF INSPECTION: yy -
, s �
FOUNDATION
FRAME . 7J�///\Q��►' ., , , ~, �e 1. ? j' • ` ' • '' ~. r ° "
INSULATION l' Y
T o
' ,,. __ rr' _ - * - - Al 0 . i r ...r f• J
FIREPLACE
ELECTRICAL: ~.ROUGH FINAL
^ ,.. - .-- �, ` _ .mil ! � •f
PLUMBING: ROUGH - FINAL - -
GAS: F ROUGH r ' r ' FINAL ` '' _• T
FINAL BUILDING
DATE CLOSED OUT
•
f ASSOCIATION PLAN NO. .' `.r, ' p r r
The Commonwealth of Massachusetts
�•a _— -- Department of Industrial Accidents
...... . Office ollnsestigatiolls -
l3`' -�� ' 600 WashingtonStreet
<
Boston Mass. 02111PX
R
Workers' CoTyensation Insurance Affidavit
Vj
name:
location:
city phone#
❑ I am a homeowner performing all work myself.
❑ I am a sole proDrictor and have no one working in any capacity +
am an employer providing workers'Zompensauon for my employees working on this job.
comnnnv name: aDC3
address: R 0 133 Z 8
city: CUTLA.i 7 T71 4 (3 phone.# CW
insurance cn. policy# /0�� 0�•(�Q SS K91 ' 1
❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who
have
the folloning workers' compensation polices:
comnanv name:
... .:.::.:.:...:.:.....
address:
dtv: phone#:
insurnnce cn. poliiv#
comnanv name:
address.
tiff: ... phone M
insurance co. :>.:>:; z;s.;.. olicv#
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or
one years'imprisonment as w penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this statement may b fo ed to the Ounce of tigations of the DIA for coverage verification.
I do herebv certify'unde a airs d allies o to rmation provided above is tru,-and correct.
Siamnire Date
Print name ogt:2 _I�� Phone#
fc�hretck
nly do not write in this area to be completed by city or town official
permit/license# ❑Building Department
❑Licensing Board
mmediate response is required ❑Selectmen's Office
❑Health Department
on: phone#; ❑Other
Ur!1n 9195 P1A1
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the "law", an employee is defined as every person in the service of another under any contr-=
of hire, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: c:
trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa:
of a Icense or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither.the .
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
ME
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Me o11We:tlpad011s
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone #: (617) 7274900 ext. 406, 409 or 375
o, ...
NF
The Town of Barnstable '
�m�' Department of Health Safety and Environmental Services
Eo►+a't' Building Division . .
367 Main Street,Hyannis MA.0260.1 r` ' Yp
='.x .
Office: 508-862-4038 JR" Ralph Crossen
Fax: 508-790-6230 y fi' Building'Commissioner
Permit no. A -
Date _ R'
AFFIDAVIT ,
HOME IMPROVEMENT CONTRACTOR LAW
` SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,' R.;
improvement,removal,demolition,or construction of an addition to any pre-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 withother
requirements.
Type of Work: AD I Vb 47 Estimated Cost
Address of Work: J`(n 7 W'
Owner's Name: (ZI.CS
Date of Application:
PP � x, ` ` M n .. . , •
I hereby certify that; "' u
Registration is not required for the following reason(s): .
Work excluded by law ";a
Job Under$1,000 w
Building not owner-'occupied ,
0Owner"pulling own permit
Notice is hereby given that: i,'
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
IGNED UN ER PENALTIES OF PERJURY'
r =1 hereby apply for a p it a ag of caner. }
ogr7�2• �4e T(
Date! ontra Name > r
F
- ^° 'Registration No:� y
6R n
Date t •" s' Owner's Name
q:forms:Afridav
«
✓/2�
+: OEPAA6MMENf OF PUBLIC SAFETY : S # 15573 2
} Restricted To: 1G
F ' CONSTRUS
TI0�1 SUPERVISOR LICENSE
Hq er Expires:
SAL)
1A -.Masonry only
16 16 - 1 & 2 Family Homes.
` Failure to 'possess a current edition of the
ROBER� �� DGETT` , Massachusetts State Building Code
p4..w tK w 184 $CM04V' PO8 133 r`
is cause for revocation of this license.
COTUIT, MA 82635
-Y t �-yv.4� ...,.r v, '� js
✓/ea�oywrno�uaea o��/uaeaaa/uuelA .x � �} n �w i
MOMS IMPROVEMENT CONTRACTOR ;
Registration 100131.
i "y+
Type -. PRIVATE CORPORATION F L'ic hse'�or registration:,va I `for individual
Expiration,, 06/09/00 use onl y ibefore'expiration date If found
t return to
One•Ashburton P�ylace Rm`1301„'
i' t �osto 02108 ^'�' r C�•.c'_ eh''>:
PADGETT BUILDERS, INC: �y
Robert R Padgett
ox 133/18.4 SchoolB-Sty r
i
ADMINISTRATOR Cotult MA 02635 "'I v ar} ria
' '} .# tS ,3 _ x93 ✓� 'yam � 't' e �.
,I a
. t
M CUR AppwW&J
Table JS=b(condoned) -
Prescriptive Packages for One and Two4an*Residential Buildings Heated with Fossil Fuels
MAXIMUM MINIMUM
Glazing Glazing Ceiling Wail Floor Batemeat Slab HcuftWCoolimg
Am'('/o) U-value= R value' R value` R vaiuea Wall p=eta Equipment EfEacncY'
Package R value` R valud
5101 to 6500 Hating Degree Days`
Q 12% 1 0.40 38 13 19 10 6 Normal
R 12% 0.52 30 19 19 10 6 Normal
S 12% 0.50 38 13 19 10 6 83 AFUE
T 15% 036 38 13 25 WA WA Normal
U 13% 0.46 38 19 19 10 6 Normal
V 15% 0.44 38 13 25 WA WA 85 AFUE
W IS% 0.52 30 19 19 10 6 85 AFUE
X 19% 032 38 13 25 N/A WA Normal
Y 19% 0.42 38 19 25 WA WA Normal
Z 18% 0.42 38 13 19 10 6 90 AFUE
AA i s% 0.50 30 19 19 10 6 90 AFUE
1. ADDRESS OF PROPERTY: 5c) Q-kA,L- �
NE V,I AL)bi-T k A 02 oqj
6(Qosr- T-
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 1 5 3 �F
3. SQUARE FOOTAGE OF ALL GLAZING: / S F
4. %GLAZING AREA(#3 DIVIDED BY#2): T 3 /O
5. SELECT PACKAGE(Q--AA,-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: _� t NO:
q-forms-080303a
780 CMR Appendix J
Footnotes to Table J5.2.1b:
' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall
area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area.
2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used.
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding, structural sheathing, and interior drywall. For example,an R49 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or.mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements,
or garages).Floors over outside air must meet the ceiling requirements.
The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
basements must be included with the other glazing. Basement doors must meet the door U-value requirement
described in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J5.2.la
NOTES:
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
43
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�t .1- ? 7 c
Sewa a Permit number .
TNET� ` TOWN OF BARNSTABEE
ttt
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^ Z B8HH3TADLE, i s � �
t4639
BUILDING ' INSPECTOR
A�,O AIPy h
��- APPLICATION FOR PERMIT"TO ..L.` ............................................... .........:..:`:............................................ ......
-6 . TYPE OF CONSTRUCTION .......F.......................................'...................................................................................
' ............................. ................19........R'!
TO. THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
or Location .................. ...�...L............-/.................... !llft!,�.. �.'. .ti:! 1/1..�c............ ft......... .... ...............
Proposed Use .. �'� `..-)..r.'.......... r �f J !�....::�- ,--... .�.�'.)..'"....t..,'. °a..................................................................
ZoningDistrict ...............................................:........................Fire District ..............................................................................
Name of Owner ...�/1,... .f .-1 y- l�r t... ..!`� ..Address �+ !'...?2! ..........................................r..................... �
. � .. ....fit !✓ a 0/ f'! +�-� . �,
Name of Builder ..! �./.-.* .. x'" Address -t I° ' �'',� r/d("Lf-r
Name of Architect -/ t,/�U ( ,11-/. /—'7...........Address /1" "'�', 1Gt t�/i����i;re 1.:.../1.'.'.:°'� 4. ".........
...............................................
•�..Number of Rooms ..................................................................Foundation ...................:..........................................................
Exterior ......zl , / r- 1r"eJa -xr 1+1,1/7 *r Roofing ....l��!f , �Ji_.j ..................................................... ........................ ......... ....... ............ ....
!
Floors .. t`. .�..................................................................Interior '.�" ! .1
..... .. ..............................................................
Heating '...lf:`.!......`...: f'a/ .'� ` .!..t!:%4 al.. Plumbing ....7......��-7W....................................................
.......... .... .. .
Fireplace �. ...sP:............1�r'e :;.......................Approximate Cost ref�1:. ...............................
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ..........................................
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. . —)
Name ................. .....................................
c '
ilicy, Francis X. A=288-219
19063 1 1/2 story
No ................. Permit for ....................................
sicns single family dwelling
.................................. ....
d Qail Lane
Locatio ............................................ ....
Hyannisport
Owner Francis X. Pilicy
..................................................................
Type of Construction ........frame
#�26
Plot ....................:....... Lot ................. ...........
77
Permit Granted ....March 31
...........................19
Date of Inspection . ..................................19
Date Completed ......................................19
PERMIT REFUS D
...... ..... 19
.......... ...... .,/. ...
...............................
. ......................................
.................................................... ........................
Approved ................................................ 19
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A KSA desiOCATION:
O3 REVISIONS: PROFESSIONAL BUILDIN6DE516N - -
0 Preliminary Floor Plana 0/10/1 0- COMMERCIAL-RE51DENTIAL
FL-1-4 Plane f 0/IH/10 50 G�'Uail Lane
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DRANN BY:
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Professional BuOding Designer
d y Mydi nd in epzes dlmena onsana.o
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ca - drehallb bro ineght on the attention ft.
`� - the Designer prior to the commencement
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construction constitute.the acceptance
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dlscrepardes,errors and/or oml.&ons
become theresponNUIlty of the
truilding contractor.
Gop�lgbY 92010 by KSA deelgn ENGINEERED BY:
m TheseplensareprotectedunderPederal # PROJECT: —enovakions and Addii'ions for:
f D copyright taws.The original purchaser of this
M t plan is authorized to conscr-1,one and ony
T Z one home using this plan.Modlfldation cr
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O Au m LOCATION:
O REVISIONS: PROFESSIONAL BUILDINS DESI&N
Praliminnry Ploa Plane 9/90/1 O COMMERCIAL-RESIDENTIAL 50 e?Uail Lane
R.¢oieed Plane f O/1 B/1 O Cape Cod•Massachusetts
Pr¢limina-y Cons+ruc+ion Plane 1 1/I/1 o Guarlaceate•costa Rica HyanniSPor•I'1 IIA
Engin¢ved Gone+ruc+;o„Plane 1 1 B/I O capecodoksadeslgn.com•www.ksedesigrtwm
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Professional Building Deslgner
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Any dlecrepandea errors and/or omissions
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shall be brought to the attmaon of
the Designer prior to the commencement
of construction.Roeeedng with
construction eonatltute5 the acceptance
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dlscrepancles,errors and/or omissions
become the responsibluty of the
bullring contractor.
In S d Gopyrlglrto2010by KeAdaelgn - ENGINEERED BY:
m p These plans are protected under Federal Pjgp9# j 8��' PROJECT: penova4-ions anti fJA4-ions for:
m y Copyright Laws The original purchaser of this
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REVISIONS:. PROFE5510NALBUILDIN6DEBI6N _
3 PrelimiawryFloorRwn.,9/'oo/I o COMMERCIAL•RESIDENTIAL 50 cgUail Lane
�avised Plwns I O/1 9/1 O Cphe Cod
Preliminwry Gone#ruction Plwnz I I/1/1 O &,swan•c Costa
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become the g wont elblllty of the
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m A iheseplansare pr Mooted underFederal PIU11# PROJECT: F.enov,44-ions anal fl.JA4—ions for: -
A Copyright Laws The original purchaser of this
plan is authorized to construct pro and only
one.h � 1—
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h, M t KSA design_
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REVISION5: ROFE9910NAL BUILDING DE516N LOCATION: _
OA Pr.f.ninnryFloarRans9/90/l o GOMMERGIAL•RE5IDENTIAL Cl0 c?Unil Lane -
�e�iyed Pinny I O/I O/1 O Cape GOd•Ma55achu5ett5
Preliminary GonytNGtion Plans I 1/i/1 0 6uanaca5te•C—ta Rica Nyan n isPor-",rJA
Engin.er.d Gonstruchion Plant' I I B/I O cape-1.1,saaesign.com•unUw.ksadesigrtcom
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rn Professional Building Designer
n,yolacrepanaes.errors anon lops
11 In the notes,amemslona,and/or 5 _ drawngs contalned on these documents
• shall be brought to the attention of
the Designer prior to the commencement
of conBtruotlon.Foceeding Wth
construction constlwtes the acceptance
of these docunents and any
dlecrepancles,errors aW or omiselons
beGom..a reaponsiWlity of the
bulang contractor.
COPIPlaft_ A then a.pro ee.-n�Federal P�afj # g,� PRO.�EGT: �+P.nOVA'�'IOnS AnC�,�'acicll4'IOns for:
ENGINEERED BY:
M y copyright Laws.The original purchase of this
ID 1:1-5' plan is auchor'iud co Construct one and only
z y' one home using this plan.Moaflcatlon or
teasels prohibited withouteVress written
permission of the Designer,
M } KSA design
Q A o M LOCATION:
REVISIONS: F'ROFE5510NAL BUILVIN&VESISN _
.�-. Proliminxy l'loar Rana 9/%o/lo COMMERCIAL•RESIDENTIAL 50 e?ualil Lane
' R—i—I Plana I O/1 B/1 o Gape God•Massachusetts ��et
PrchminAry 6—'-auction PIA—I 1/1/lo Guanacaate•Costa Rlca HyAnnISPori-,IJA
Engineered GanatrucFion Plana I I b/1 O cepecodoksadeslgn.com•www.ksadeslgnoom
P.O.Box 1 149•Hyannis,MA o360 1•505,190.39 32
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Any mscrepandee,errors anaor omnslonn
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dr_11 eeon ghtdon[nottimv,menro
•(r) 1 npeo g brought[o[he nttenenoem
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j of conn[rucclon.Proceemn
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of[hpe docunenro and nny
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become there ablll[y off the
he
bNlding eontntrDGtor.
N j� tl eopyrighto2oloby KBAdealgn... p�m ENGINEERED BY:
m a e p These 10"'reprotcotedunderFederal PIUII# 8� PROJECT: �enov t4-1ons anJ AJA4—lons for:
M. s D copyright Laws.The orfgina purchaser of this
plan is authorized to construct one and only -
�S Z one home using this plan.Modlfloatlon or
Creuse is prohibited without expre%written
S permission of the Designer /
a 'r KSA design
=
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� m PROFESSIONAL LOCATION: _
1, REVI510N5: _
N 3 prellmineryPlanpleua9/9O/10 COMMERCIAL•RESIDENTIAL 50 G'Ugl�LanQ�
,y �aoi.,ed plans 1 0/1 a/1 O Gape cod•Massachusetts
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Engineered con•,}rur.V'ipn glen', I f B/I O capecodeksadesign.com•unaW.ksadeslgrtcom
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dw CIS ProfessionalBuilding Designer
Mydlscrepandasarr. a,Nor.....
ip' VV In the notes,dimensions.and/or
draWngs contained on these d—ments
shall be or
to the attention of
Me Designer prlor to the commencement
S113 of cohetracvon.f•roceadhgu M
construction eoneututes the acceptance
of these docunents end any
dlscrepanUee,error.and/or o N.h.
become the responslWilty of me
b0ding wntrecCOr.
N ll tl cofq�Ighte]o10by fcaAdealgn..< ENGINEERED BY:
_ 9 A These plans ereprocectedunderPed—I Flab# 1.831 PROJECT: P—enovai'ions anal Aeld ions for: -
mAt j D Copyright Laws.The original purchaser of this
•f- plan is authorized to construct one and only
Z Z one home using thwptan.Modification or
to %AM �A^rlrF-
W 0 reuse is prohibited without express written r,�J �(
< permission of the Designer.
KSA design
REVISIONS: PROFE5510NAL BUILDINb D@516N LOCATION:
OPreliminaryNo—Plane's/90/10 COMMERCIAL•RE5IDENTIAL 5O equ Ail Lane
R-eJ✓,ed Plans 10/f B/1 O Cape COC•Maseachueatt5
Preliminary Gope}rul}i—Plane I I/I/I O Guanacaste•CostaRIca HyannisPor°Fr MA
Engineered Gorre#ruc}ion Plane I I b/I O capecodoksadeslgn.com•www.ksadesigncom
P.O.Box 1149•Hyannis.MA o2 B01•508.'l90.3922
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wENNETH 2Af7LE�.1�.
Professional Building Designer
Anymscrepandeserrors and/or omisslons
m the notes,dimensions,and/or
'� drawings coneamed on these edcumentz
sha0 be brought to the attention of
the r prior to the commencement
of_9
of construction.
co .dlrtg pth
ce nstruction tvn5tltutestan
' of these docun,mt Ne acceprn[s and any
elscrecome th,errors and/or omissions
become the g wnt slblllty of[he
' buliGing contractor.
N (p CI Gopyy1ghl12,110 IcSAdeelgn.0 ENGINEERED BY:
m A These plans ereproceccedunderFederal P��j9# ' g�9" PROJECT: F_enovAkions An A�.eleJi4i ,for:
M < y ropyrlght Laws The original purchaser of this
i y plan Is authorized to construct one and only
t ne home using this plan.ModlFfcatlon or ^
p reuose is prohibited without express written S Ir{�
AXT
permission of the Designer.
f 'Q KSA design=
Q AM LOCATION:
REVISIONS: PROFE55I0NAL BUILDING DE516N
Preltmin,ryPloarPlanee/oC/10 COMMERCIAL RESIDENTIAL �7�t!�UAI�LAne
R-ev'wed Plane 10/Id/10 Gape God•Massachusetts f �t
Prel�m�nxy Ganetruetion Planet I/1/l0 Guanacsate•Costa Rica HyAnnisPorl'r YJA
Engineered Gorr,fruyF7on Plane I I ea/I o capecodoksadesign.cam•www.ksadesfg,wno -
P.O.Box 1 14 q•Hyannis,MA 02601.505.1 q 0.3 q 22 „�
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BARNSTABLE PLANNING BOARD APPROVAL UNDER'
THE SUBDIVISION CO 01. L.A W IS NOT REQUIRED
SMITH ST. 4W - -
p� S HOOLHOUSE i
, A.E: p
Jp POND �
�� O�� LOCUS / NOTE: PARCEL A AND LOT 36 ARE CONDITIONED AS A NON-BUILDABLE LOTS
Oc&% P�. AND ARE CREATED FOR CONVEYANCING PURPOSES ONLY.
a a CID I c NO DETERMINATION AS TO COMPLIANCE WITH THE ZONING ORDINANCE
.� REQUIREMENTS WAS BEEN MADE OR INTENDED BY THE ABOVE Z
HYANNISPORT �I / L 0 T 2 2 ENDORSEMENT.
HARBOR - $ 3 L. C. PI. No. 19844 1
v, / (sheet 2 of 2) /
L 0 T 2 1
L. c.(sheet"z of 2)844 I GENERAL NOTES
p,ry 1•) ZONING INFORMATION
N.LOCUS MAP \ �6' �'�/�o ZONING DISTRICTS: RF-1
S. ` � .t ti
LOCUS IS COMPRISED OF: „b 2 OVERLAY DISTRICTS. AP AQUIFER PROTECTION
MINIMUM CURRENT ZONING REQUIREMENTS
ASSESSOR'S MAP 287 PARCEL 109/001 ti `�\�`,. ( �o •: / 8E� .
PLAN BOOK 533 PAGE 98 - LOT 3A \ �'?O, ° ( '`� / L 0 T 2 3 .� MINIMUM AREA: 43,560 S.F.
DEED BOOK 21,618 PAGE 255 L. C. Pl. No. 19844 1 MINIMUM FRONTAGE: 20'
OWNER/APPLICANTS: DAVID BRUNICARDI 4` w (sheet 2 of 2) M� ^ ,
CARYN MAROONEY CB FD %•° L 0 T 3 5 '
1309 GLENDALE AVENUE MINIMUM WI 1
BROKEN FRONT YARD = 30 SIDE do REAR YARD = 15
BERKELEY, CA., 94708 \ 0.24' 01 CONSISTS OF:
LOCUS ADDRESS: 40 QUAIL LANE 16 �, n f/ ELIHU STONE )2. A TITLE SEARCH WAS NOT PERFORMED BY THIS FRIM FOR THIS SITE,
G ?, PARCEL A (UNREGISTERED) SHOULD ONE BE REQUIRED IT SHALL BE PERFORMED BY OTHERS.
HYANNIS PORT, MA., 02647 �' � Is,S�'o LOT 38A 131 S. F. t 3, THE PROPERTY LINE INFORMATION SHOWN IS BASED ON
ASSESSOR'S MAP 288 PARCEL 219 CB/DH 3 \���?s�� n 0.00+ Acres t
\ s• 653• PLANLOTSO45A1 dt PAGE
93 ) CURRENT AVAILABLE RECORD INFORMATION CONSISTING OF
LAND COURT PLAN 19844-1 (sh 2) - LOT 26 HOLD LINE \ $ 723, BALANCE OF LOT 26 PLANS AND DEEDS.
CERTIFICATE OF TITLE: 148323 CB LOCATION L=o.n' SOUTH \ /I o^_ \ o �IECD> PLAN BOOK 84 PAGE 69 LC.PI. 19844-1
OF LOT CORNER PER LCPI r p \ C8 FD 653 784, (REGISTERED) PLAN REFERENCES.
OWNER/APPLICANTS: CHARLES F. SAMPLE 19844-L ton o \o.a1 BROKEN �f 43.538 S. F. t
JULIA SAMPLE v ^"' c�O> 0.99+ Acres
_ n f JOHN P. TAYLOR
/ PLAN BOOK 84 PAGE 69
P. 0. BOX 3 �' do JUDITH R. TAYLOR TRS.
HYANNIS PORT, MA., 02647 CB/DH / �S?. _ _ _ ._. __ __�._ TOTAL •. PLAN BOOK I II PAGE 93
NON-RECORD MAG S AS. 11�� REALTY TRUST PLAN BOOK 130 PAGE 67
LOCUS ADDRESS: 50 QUAIL LANE s9 ��s\o8� 8s 68• � 43,669 S. F. f TAYLOR NOB HILL
o• ,� CB/oH 1.00 Acres t PLAN BOOK 203 PAGE 43 FRAME 1
HYANNIS PORT, MA., 02647 5 g1•03'41 W NON-RECORD / shape factor = 17.89 LOTS 42-A & 44-A
I b \ • PLAN BOOK 247 PAGE 96
20.a�. v, \ N PLAN BOOK 111 PAGE 93
,�,�'/ PLAN BOOK 285 PAGE 3
L 0 T 3 2 ONB FD f o.�0. �; PLAN BOOK 338 PAGE 31
L. C. PI. No. 19844 L NO DETAIL /rn \ ti� /DH FD j �yh/� PLAN BOOK 492 PAGE 45
o N i \ .h`' �. o z PLAN BOOK 533 PAGE 98
/3 PLAN BOOK 555 PAGE 61
S LAND COURT PLANS 19844-A, F, I (sh 1 do 2), J. K, L do M
o . 1
� /N \ ' \s�• 's3e.1p. E
0 It("ah
ce,4r ^ �+ snc SET-A(, / S MARBLE SB FD 4.) COMMUNITY PANEL NUMBERS 250001 0006 D
O g '� t• NON-RECORD 3Z4 • • rD
LC THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C,
Z o -� �+ `° ^ v� L 0 T 2 4 �86-2 " w \ 1 ,?e AN AREA OF MINIMAL FLOODING.
J �,• �`a c / z L. C. PI. No. 19844 I 220.44' \ �O,Z4• �� 5.) LOCUS IS WITHIN HYANNIS FIRE DISTRICT
o_ �'�°� �_ �` S `� v Al (sheet 2 of 2) W / P FD
�� moo, \� ry \ , \ 6.) BUILDING LOCATION AT TRIM BOARDS 5-FEET ABOVE GRADE
/ - l- OT 35
\ STK SET
U Q
CB N^ ^ ^O J tta REGISTERED AND f HOLLD CO-ORD
a CB/DH FD N Z / Q _ \ UNREGISTERED THE PURPOSE OF THIS PLAN IS TO CREATE DRIVEWAY ACCESS FOR NEW
_ n/f JOHN J. 0 ROURKE � \ W CONSTRUCTION AT 40 QUAIL LANE, HYANNIS PORT, MA.
NON-RE o0R / - -- 43 669 S. F. t
w / - _- - _ & KATHLEEN VIVONA \ 1 00 Acres t
CB/DH IP FD LOT 2 5 _ •�" --_ 5 \ss•3 shape factor 17.89 ;� ,�� / THIS PLAN CREATES PARCEL A (UNREGISTERED) AND LOT 36 (REGISTERED)
5
. BOTH OF WHICH ARE CREATED FOR CONVEYANCING PURPOSES ONLY AND ARE
N 7T
3g 39" w L C. PI. >No. 19844 I q 'sq�so' o •h^ �ti n/f TAN GLEY.L. f3ELANEY NOT TO BE CONSIDERED BUILDABLE LOTS.
s .•3` .� s ti
s 4 �.._ _...e � f
/ 8 \ shoe 2 0 2 ,.,::•. 2,. \ _ /.�
N\�' ti �� LOT 1 `
4 PLAN BOOK 203 PAGE 43 PARCEL A (UNREGISTERED) IS TO BE COMBINED WITH`THE REMAINDER OF LOT 1
CB/DH FD G�sy�\ C4 �. s� \ l 26 (LAND COURT PLAN 19844-1 sheet 2 of 2 - REGISTERED) TO CREATE LOT
NON-RECORD • • •
/ t! o � 00 1"5e1.21 7
3. 5/ • �' �.0.3• 7.82 p• ^� \ QI• �- \ � 35 AS SHOWN ON THIS PLAN.
17
s�� F N 78.1 STK SET LOT 36 IS TO BE COMBINED WITH THE REMAINDER OF LOT 3A (PLAN BOOK
5 6 m .. � �MAC S \ er� W � do�j, -
/ 160•�• + + �� ,��, _ 533 PAGE 98 UNREGISTERED) TO CREATE LOT 3B AS SHOWN ON THIS PLAN.
h�•��6, / • R,.2B0.000b-31'50'21• \1.s1• \ \ S �O• r��'� �' N•�Av
/ CB/DH FD S 6 1�55. RaW.00• b�30'28'20• P FD \ ��28" �. •3l3' '► / STK
sET tic •c`/ s'•is,
RECORD / •s1�•92 e: : 3\98� Q U dl14, 11 1 / �� /� •� C9 `
LOCATION PER �. S 7 • / \ a
30
(LATEST PLAN) p
>• - 'ATE / / MARBLE SS FID ��/ \A "CS 05 SITE LOCATION. „
\ y� q DN REG ^, ,°��. �/ #40 & #50 Quad Lane
PRECISION: 1:72,343 0 o i ' te,�• 4*1 �,'�� % \ n/f J. BRIAN O'NEILL Hyannis Port, MA., 02647
LINEAR/DIRECTIONAL E/C. /�W l Cam• 4 13 dj • L,� .....JD \ NON-RECORD/ CB/SEAL FD
210. 46' 54- (AZ) ''o e0• •?0• ` •� •, 1� 2'B ON BOUND
0.028 d� h STK SET NO DETAIL PREPARED FOR (OWNERS/APPLICANTS)
-Pop
S 87'48.35" E
ALL DISTANCES TAKEN WITH TOPCON \ `� ��TM ti PARCEL A 1� 0'w 43.59' David Brunkardi & Caryn Marooney (#40 Quail Lane)
GTS-702 TOTAL ELECTRONIC STATION .�
EDM ACCURACY: t(2mm + 2ppmm) m.s.e. � 131 S. F. t \ 3 `.�
•�MAG `� $ o d �,•' 1309 Glendale Avenue Berkeley, CA. 94708
l $ 0 hA ^�11 NOT A BlaCREA10 FO LOT -/DHRE FD � `` ! !
ALL NAILS ARE MAGNETIC CONNEYAAMCM ON-RECORD •
I � � � � 3 s � � , Charles F. Sample, et ux. (#50 Quad Lane)
EDM BASELINE CALIBRATION ATTACHED p +' ' ry `�8•
n/f JOHN W. CAMPO, JR. g .� �'�� \ J°•F o y art, MA., 02647
CV - TRUSTEE OF THE DOROTHY W. CAMPO '� s P. O. Box 3, Hyannis P
cu " QUALIFIED PERSONAL RESIDENCE TRUST c� \
g'M g y 1.846 S. F.,f �e%? 4�s,• �?' •'� TITLE
l L o T 3 4 0.04 Acres t y y2o , o, , d LAND COURT SUBDIVSION PLAN
"` NOT AAB LOT 2pv� .9 F N n/f MARSHALL FARLEY
`M Of L. C. PI. No. 19844 M �3 CONVEYMICMIG PUIRPOSEs �� °\��,� \ tie'f H & MARY ANNE PARLEY „
�`` and Court AR LE SB/DH FD Bung a Division of Lot 26
i+ 2 plan copy obtained from L '� �J2 HELD
qy ELUS � , Ca NF L 0 T 3 e \ Shown on L. C. Pi. 19844m1 (sheet 2 of 2)
'`�b� No. 2aM Io P REGISTERED AND \ \ s ?e, Creating 4 Lots
.3�... pfGtSTEa�� S �' gym\ cqy► UNREGISTERED `'o. 7� S8• „
�. ,�.••--------� L,� l F 2 Registered & 2 Unregistered
n I _ 6 l 9 3 4g" 'A7• �.434 S.06 Acres
' AUG 2 �' ZOOS L•C�o ' / I � ��1 . shape
° w °,�• \\� ,6 gB EM IM HE
SIB Gf FD HELD BAXTER NYE ENGINEERING & SURVEYING
50 ✓_
_ PK FD 5 C� �ry. !�. 7`���a 86.43'
_.. . iL ��e. __S 8r23•30. ,, �+ " N a�'02'11 E Registered Professional Engineers and Land Surveyors
$ \. 171.63 �� N 8 4535 Ems- 'STK FD
s / _ �_ _ 14 ;`Ns 4 MARBLE � 78 North Street - 3rd Floor, Hyannis, Massachusetts 02601
s?• s �6 S,� T ; S9 s,\SB/D►+ FD Phone (508) 771-7502 Fax - (508) 771-7622
9.
40' 0 40' 80'
I CERTIFY THAT AS OF THE DATE OF THIS SURVEY THE MONUMENTS CONTROLLING PRIOR PLANS ARE IN THE GROUND AS SHOWN AND DESCRIBED HEREON. I r� CURVE RADIUS ARC LENGTH DELTA ANGLE �^
_ .
FURTHER CERTIFY THAT ANY ADDITIONAL MONUMENTS SHOWN HEREON HAVE BEEN SET IN ACCORDANCE WITH THE LAND COURT INSTRUCTIONS OF 2006 AS OF 10. FD o Ct 280.00 27.5 01 22 01 � SCALE IN FEET
� •"� °'�• /•: � C2 320.00 27.53 04'S5 48 � � ,•� n/f ERIC K. BACON ,
THE DATE OF THIS SURVEY.
C3 320.00 124.35 22.15 55 L 0 T 3 B o`\ h� SCALE: 1 = 40
I CERTIFY THAT THIS PLAN WAS DRAWN FROM AN ACTUAL SURVEY MADE ON THE GROUND IN ACCORDANCE WITH THE LAND COURT INSTRUCTIONS OF 2006 ON C4 320.00 25.94 043838 CONSISTS OF: "' q►
C5 50.00 81.1 93'00 54 y DATE: 03-21-08
OR BETWEEN FEBRUARY 28 AND MARCH 6, ZOOS. Ces 50.00 60.lf4 69'29 22 LOT 36 (REGISTERED) b
C7 100.00 9.83 05'3749 1.846 S.� F. t MARBLE SB/DH FD �\ 0 3. 're 07-15-08 REV PER LC PFR REVIEW
C8 100.00 60.74 34'48 00 0.04 Acres t �'
C9 30.00 30.75 5543 49
JOHN R. ELLIS, R/PLS ^• No. 29874 BALANCE OF LOT 3A CB/DH FD HELD 2. 're 07-01-08 REV PER LC PFR REVIEW
LINE BEARING DISTANCE C10 30.00 25.04 W28 56 PLAN BOOK 533 PAGE 98
n L1 N 25'S8 50 E 10.51 C11 52.50 50.83 55.28 3 1. 're 06-13-08 REV PER LC PFR REVIEW
•=-t - 'L-1 .Lea 15 L2 N 8557 40 W 25.00 C12 52.50 50.8 5530 51 /
(UNREGISTERED) n f HIGH G. O'NEILL, ET UX. LC
-- L3 N 8a'4e 1 w as7 c13 .50 45.0 49.50 21 441.02 S. F. t N0. BY DATE REMARKS
L4 N 86'461 W 27.10 C14 52.50 37.28 40'39 38 1.02 Acres L 0 T 1 B DRAWN DESIGNE BY: CHE KE BY: MWE DRAWING NUMBER
HEREBY CERTIFY THAT THE LOTS SHOWN ON THIS PLAN HAVE FRONTAGE ON A PRIVATE WAY THAT WAS SHOWN ON PREVIOUS PLAN WITHIN LAND COURT C15 52.50 76.52 83'30 36 TOTAL: PLAN BOOK 555 PAGE 61
CASE No. 19844 APPROVED IN ACCORDANCE WITH THE SUBDIVISION CONTROL LAW, OF AT LEAST SUCH DISTANCE, IF ANY, AS IS THEN REQUIRED BY C16 I 370.00 15.01 02'19 29 46.434 S. F. t
ORDINANCE OR BY-LAW OF SAID CITY OR TOWN FOR ERECTION OF A BUILDING ON SUCH LOT, AND IF NO DISTANCE IS SO REQUIRED, HAS SUCH FRONTAGE C17 370.00 10.00 01'32 55 1.06 Acres t 0: 2008 2008-010 SURVEY worksht 2008-010-LC.dw
OF AT LEAST TWENTY FEET.
Shope factor = 21.87
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