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Home My WebLink About0025 SECOND AVENUE (HYANNIS) a5 Sec.�nd Aye -- - f \\ -�----- i i s + rZ. // WHI. \10 ITown of Barnstable �;�► Community Services Department Marine and Environmental Affairs Division 1189 Phinneys Lane,Centerville MA 02632 Natural Resources 508-790-6272 Daniel J.Horn,Director Harbormaster 508-790-6273 Office: 508-790-6273 Animal Control 508-790-6274 FAX: 508-790-6275 REPORT OF ANIMAL BITE Reported By: Mid Cape Medical Center Sept. 11,2015 name date Investigated By: Cynthia Sherman Sept. 12 2015 Officer's name date Bite Victim: Leslie Prouty Sept.08,2015 name date bite occurred 25 Second Street,West HyannisPort,Ma 02672 ij `--`local address mailing address—permanent address (if different) 508-790-2463 parent's name(if minor) Left hand part of body bitten/location of wound Mid Cape Medical Center Sept.08,2015 bite treated by doctor(name). date Animal Owner: Norman LaMarre 508-479-1555 name telephone 4 Prestwick Road,Bourne MA 02532 local address mailing address—permanent address (if different) Animal Dog Terrier 15 years old dog-cat-other breed-name-description Dog License: town-year - number Rabies Tag: WARNING: This is an interdepartmental report. It is a summary and does not necessarily contain all the facts or information known to the officer. Description of Incident Leslie Prouty was caring for Norman Lamarre's Terrier when the dog slipped the off the leash,it was about 2 a.m and very dark out. She picked the dog up and it bit her left hand. ACO CYNTHIA SHERMAN �l3r-tiC,, C.T supplemental/continuation statement report attached Message :.' Page 1 of 1 Lewis, Charlie { From: Sherman, Cynthia Sent: Monday, September 14, 2015 12:45 PM To: Lewis, Charlie Subject: Dog boarding Charlie, On Sept. 12 2015 Saturday morning I received notification of a dog bite to Leslie Prouty of 25 Second'Street Hyannis MA 02672.The owner of the dog was listed as Norman Lamarre of Bourne MA.I spoke to Mr..LAmarre via telephone at approximately 8:15 a.m. 9/12/15 regarding the incident.At that time Mr.Lamarre divulged to me that he had been boarding his dog at 25 Second Street for the week when the incident took place.Mr.Lamarre also stated that his dog stays there once Oil twice a year. `.Cindy t 9/15/2015 TOWN OF BARNSTABLE Marine and Environmental Affairs DEPARTMENT/DIVISION VIOLATION REPORT Marine/Environmental Affairs Division NAME (LAST, FIRST, MIDDLE) RACE SEX Prouty Leslie if ADDRESS (permanent) ,. City/Town _ ° STATE ZIP 25 Second Ave W. Hyannisport West Hyannisport Ma 02672 OPERATOR. LIC. # OR S. S . # STATE Ma TELEPHONE # S 56463777 508-846-6545 EMPLOYER ADDRESS LOCATION OF VIOLATION TIME - DATE . 25 Second Ave 9: 05 am §=11-2015 WARNING: This is an interdepartmental PHOTOGRAPHS ,TAKEN OFFICER NAME report. It is a summary and does not Lewis necessarily contain all the facts or information 'known to the officer. VEHICLE/BOAT INVOLVED- (YEAR, MAKE, MODEL, .V. I .N. ,, REG. #, STATE) EQUIPMENT, I . D. #S (FISH & GAME ETC. ). HELD : ' EVIDENCE TAG, # .' MAKE, MODEL' SERIAL # OFFENSES: Failure to .license_ & tag 4 CH/SECf'�T.M. Dog R'eg Sec 403-2 dog' s License and"Tags DETAILS & OBSERVATIONS : Senior �ACO Charles Lewis states the following: On- 8- 21-2015 this officer received a barking dog complaint from Mr Tobin #33 Second Ave about several dogs housed at #25 .Second. On arrival to #25 no one was home and no dogs were heard.' A 'card requesting' a call back was taped to The door. Dog owner Leslie Prouty is known by animal control -due to previous unlicensed dogs, other issues and complaints. Prouty has a dog sitting - walking business . No - return call being received this officer made several attempts by` phone House stops to follow- up. On 9-11-15 contact was made with Prouty. Prouty _ acknowledged receiving my request for a call back. Prouty stated a retired cop told her• she- didn' t" have to -return any calls . A verbal- warning was ` issued and education for the barking complaint. A verbal warning was issued That without a kennel license no dogs were' allowed to ..be boarding for fee' s . Citation 78564 was issued in the amount of. $200 for 4 unlicensed` dogs . `°. - SUPPLEMENTARY REPORT DONE? CITATION #S, 78584 $200 . WITNESS: TELEPHONE # SUBMITTED BY Senior ACO Lewis TDATE: 9-11-15 CAPE COD INSULATION Fq N F9 MIR GLASS SEAMLESS SRATMAAI SUSPENDED \AWS "11.5 INW'A"O" pttIN05 1-888-696-6611 Town of Regulatory Services Building Division Address - Address 2 - - --Date: — 3 ( � - ---- - - Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Pro ert Owner Property Address Villa e V L2 Insulation Installed: Fiberglass Cellulose R-Value Restricted Unr s ricted } Ceilings -` g Slopes Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Sincerely Henry E Cassidy Jr, President Cape Cod Insulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map P Parcel V lic tioh pp Health Division Date Issued Conservation Division : Application Fee Planning Dept. Permit Fee k7 Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation/ Hyannis Project Street dress Village W4WAM 06V� I VU Owner I Address Telephone Permit Request vow Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain I �1� Groundwater Overlay Project Valuation V v Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family a/ 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 Number 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 woo`cFloal stove; ❑` S ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: LYE-Aaisting Qnewugasize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: —a Zoning Board of � site plan Appeals Au horization ❑ Appeal # Recorded ❑ J rn Commercial ❑Yes 20 If Y Ian review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C '� Telephone Number Q �� 4_� Address G � � �' �' License# ' 0G 1 IS v�/vim Home Improvement Contractor# l�✓ 5 6 Email Worker's Compensation # wc"" ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WI BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAR/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION t FRAME INSULATION FIREPLACE t EL-•ECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING- DATECLOSED OUT iy AS>SOCIATION PLAN NO. f_ r =. r ' Massachusetts - Department of public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-100988.. HENRY E CASSTV 8 SHED ROW WEST YARMOUrH �. 6 .r \ Expiration Commissioner 11/11/2015 �JG-�y (2s-llQ Office of Consumer. Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE ---- SO, YARMOUTH, MA 02664 _— Update Address and return card. Mark reason for change. >cA 1 :i 20M•05/11 Address ❑ Renewal Employment Lost Card V/ze tpamr��ao�ruueu.�C�c`'C�/T/I�CUJJCLC�ctJBG�ii \ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon; 1.53567 Type; Office of Consumer Affairs and Business Regulation xpiratlon;;;_:1.2f15/20:}.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULA'tIO:N';;;INC` HENRY CASSIDY 18 REARDON CIRCLE" SO.YARMOUTH, MA 02664 Undersecretary N. valid wi tit sign e The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations W a d 1 Congress Street, Suite 100 Wa Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/ElectricianslPlumbers Applicant Information Please Print.Le ibl Name (Business/Or 'zation/Individual); , Address; 0 �V V City/State/Zi Phone #; Are you an employer? Check Jhe 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 ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and h$ve workers' 9. 0 Building addition [No workers' comp, insurance comp, insurance. required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.El officers have exercised their I am a homeowner doing all work - 11,❑ Plumbing repairs or additions 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#t must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this`d'ffidavit 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 r Information. Insurance Company Name: l Qw. � Policy#or Self-ins. Lic. #: M000 Expiration Date: , �✓� 1 r Job Site Address: 2 ")W( City/State/Zip: K.) ,K6 Attach a copy of the workers' compensation policy declaration page(showing.the policy number an expirati n 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 certify n r pains and penalties of perjury that the information provided bov ise and correct. Signature: Date, �1 Phone#: b Official use only. Do not write in this area,to be completed by city or town official., City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6,Other Contact Person: Phone#: CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/13/2014 'HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS :ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES IELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED. :EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, APORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to ie terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the ertificate holder in lieu of such endorsements), DUCER + - CONTACT NAME; Barbara De Lawrence IR�e&3 ray Insurance Agency,Inc. PHONE FAx AIc No: (877) 816.2156 th Dennis,MA 02660 A oRILss: bdelawrence ro ers ra .com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company RED INSURERB:COMMERCE INSURANCE COMPANY s Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle South Yarmouth,MA 02664 INSURERD:ATLANTIC CHARTER INSURANCE GROUP ' INSURER E INSURER F ERAGES CERTIFICATE NUMBER; REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD °ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, {CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE f POLICY NUMBER MM/LDD�FF MM DD E YY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063' - 04I011 y 2014 04101/201$ " • PREMISES Ea occurrence) $ 100i000 - MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY E PRO- ❑ JECT LOC OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000$- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accldenn $ 11000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS r BODILY INJURY(Per accident) $ rx HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ X. UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE _ XONJ453514 0410112014 04/01/2015 DED X RETENTION 10,000 AGGREGATE $ ORKERSCOMPENSATION Aggregate $ 1,000,000 PR •ND EMPLOYERS'LIABILITY � STATUTE ERH. FFICERIMEMBERNY JEXCLUDED?ECUTIVE YIN NIAWCAOO525904 O6/3OI2014 06130/2015 E.L.EACH ACCIDENT $ 1,000,000 ' Mandatory In NH) I yes describe under E.L.DISEASE-EA EMPLOYEE'$ '1,000,000 ES�RIPTION OF OPERATIONS below E.L.DISEASE.POLICY,LIMIT ,$ 1,000,000 ' 4 RIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) era Compensation Includes Officers or Proprietors, Jonal-insured status is provided under the General Liability and Auto Liability when required by written,contract.or agreement with the Certificate WO'Ider. 1. ti "' . IFICATE HOLDER- -. CANCELLATION HOME OWNER WEATHERIZATION WORT( PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. lt � hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: " � �'7c ( ! The.weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic & basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(signature) ` HomeOwneremail:--C� � i 'x Dater/ Agent-.(Signature) Pi aA r. Date: • Weatherization Contractors: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement fence Constr. ction Resolution Energy Cape Cod Insulation Tupper Construction s , CAPE COD P . I,NSULAT,ION $ R' _ 1 IT. 5 9 ;.. � FIBER GLASS SEAMLESS SPRAY FOAM SUSPINDED BAT GUTTERS INSULATION CEILIN05 1-800-696-6611 ' is Town of Barnstable Regulatory Services Building Division ' 200 Main St - j Hyannis, MA 02601 Date: e Dear Building Inspector- Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed& completed the insulation and-weatherization work at the property listed below.Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements." Property. Owner Property Address 1Villa2e ?roj y �S. secoo Q` 'A re. . t-t Aij*.j1'$; Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings. X g ( ) • (X) (3$ ) CSlopes/�e;I+ Floors Walls " ( ) Oy ( 13) (^ ) r (+ )w E inc r y H y E assi y Jr, P esident " Cape C Ins lation, Inc: ` S TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel �` " l -Application lication # 06LG�� HealthyDivision `-•Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan.Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address d�L 5 Se C rZticQ w� Village LA)snt3- Pr-..>)jii5 PQ�f Owner �P�1►'�- �� '�( Address Telephone SOT' $L4 5 Lf J Permit Request u.&4A4 rsNc" cloorS - Wr:,r Scab 4W%( - AJoQ a-3-0CC' OW-c -�b Aiti c Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation &) SOD Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s pporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) c"-�) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's"H.ighway:-U 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 rn Number 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 Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) f Name Cete-e- CO Telephone Number 50---77—-1 a 1 14 F Address Ll SS Yy -Pr,,,D AtN License # I oc) Q T 6 MA_„ Home Improvement Contractor# Worker's Compensation # W c 6 DOS�2-S<to ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z i =w;c F FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP/PARCEL N0. ADDRESS VILLAGE } OWNER t _ i DATE OF INSPECTION: 1 FO.UNDATION .. T FRAME INSULATION FIREPLACE41 " '.1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r r E GAS 3= : " -4 ROUGH ,4 .<. ;, FINAL ' '� �;;tFINAL BUILDiNG�.-�:`•>t�y -� -.�. ` DATE CLOSED OUT ASSOCIATION PLAN NO. - i t Y The Corrunonwealth of Massachusetts Y Depar(rnent ofIndustrialAccidents �1 Office of Xn))estigations I' 600 Washington Street t - Boston MA 02111 s rv7-v14):rnass.gou/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electl-icians/Plunlbers Applicant Information Please Print Legibly d' 'dual . i Name (Dustn.ess/Orgamzahon/In iv, ) �A �_�('��,$_(1 �,C.11 I Ch'L- .r'il9 l' Address: ✓' City/State/Zip: Phone #:_ roe Are you an employer? Cliecic th appropriate box: Type of project(required): 1.(X I am a employer with _ 4. ❑ 1 am a general contractor and I Q— 6. []New construction, einployces(full and/or part-time).* have hired the sub-contractors.. . 2.❑ 1 ain a sole proprietor or partner-' listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, Demolition workingfor mein av capacity. employees and have workers' Y P h 9. Building addition [No workers' comp. insurance comp, insurance. required.] 5. We are a corporation and its- 10.[� Electrical repairs or additions officers have exercised their 1 1. Plumbing repairs or additions 3.❑ 1 arYt a homeowner,doing all work. ❑ g p myself. (No workers' comp. right of exemption per MGL 12.[❑ Roof repairs insurance required] t c. 152, §1(4), and we have no employees. [No workers' 13.[❑ Other(V�� 1 .i A{,1 comp. insurance required.] "Any applicant that checks box M must also fill out[hc section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors,and state whether or not those entities have employees. tf the sub-contractors have employees,they must provide their workers'comp.policy number, f am an employer that is providing workers'compensation insurance for m)r emploj)ees. 'Below is the policy and job site information. Insurance Company Name;_ C(A BA)3 U 1 Ce Policy 9 or Self-ins. Lic, 11: (,w,��Q��Z,79 01 Expiration Date: Job Site Address:�_� �Ped�-t9- �kte_ City/State/Zip:U./ 40 pjy 1- Attach a coP), 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 Cmc 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. Ldo hereby certify ur e prx• and penalties of perjury that the information provided above is trice and correct. Signature: Date: Phone#: D 7 ?S'' Officiat use only. Do not write in this area, to be completed by city or town offieiaLk .City or Town; Permit/License# Issuing Authority (circle one): 1. Board of health 2. Building Deportment.3, Cite/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: I 1 Nlassachusett. -.Depaiiment (it'Public >afe(N Board of Building Regulations and Stund.trds Construction.Supervisor,License License' CS-- 100988 Rest,r:icted to:, 00 :: R HENRY CASSIDY N,,h q" 8'SHED ROW , WEST YARMOUTH, MA 02673s � .:1 Expiration: 11/111/2011 . ( niiuis.i ner Tr#: 100988 - - - AM�Ie �ars la`�'on�an ! One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2010 Tr# 278247 CAPE COD INSULATION, INC HENRY CASSIDY - 455 YARMOUTH RD. HYANNIS, MA 02601 ......... Update Address and return card.Mark reason for change. ❑ Address Renewal [] Cmployment Lost Card -CAI 0 5OM-07/07•PC8490 Z [3oaf•w8f�B6?i'ttf4V� ttiaifotts aEf�'�ti�4 License or registration valid for individul use.only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: g g Board of Building Regulations and Standards _ Registration: 153567 = Expiration: One Ashburton Place Rm 1301 �`_. ,• p 12/15/2010 Tr# 278247 Boston,Ma.02108 Type: Private Corporation CAPE COD INSULATION;INC HENRY CASSIDY 455,YARMOUTH RD. HYANNIS,MA 02601 Administrator ` iit id witi utrignature i tlavk t,-- 9,1b087785735. Client#: 4597 CCINSUL �, CORD,, ECER"TIFI TE OF LIABILITY INSURANCE t)ATE(MMlDD1YYYYI 07127120 T 0 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:It the cart'tic ale holder-is an ADDITIONAL INSURED,the policy(ies)must t bee-] the lea sed.If SUBRQGATIQN IS WAIVED,subject to leans and conditions of he policy, certain : may require an endorsement.A statement on this certificate does'not collier rights to_the' cerlJrrc,le`holder in hell of such eodorsement(s). PRODUCER - ... CONTACT` Rogers 8 Gray Ins. -So. Dennis -NAME, Margaret g-ret Young PHONE 508.760-4602 434 Route 134. �A C.,NOO E xr) EMAIL '--- A/C,No- P.O:Box 1601 - ...ADDRESS: - ---. - RODUCER-- — ---- ---- SouthDennis, MA 02660-1601 CUSTCIERIDii:- ��_-- - ` INSURER 5 -—DING COVERAGE ttJtitIREO ---_"-- - I I - NAIC Jt Cape Cad Insulation Inc wSURERA Peerless Insurance 455 Yarmouth Road INSURERH•Ohio Casualty Insurance Conlpahy Ii ,nriis, MA 02601 wsuRERc:Atlantic Charter Insurance ----" wsuREaD:Commerce Insurance Con IY 34754 INSURER E:. - _ .. - 1 INSURER F.. -- r- COVERAGES CERTIFICATE NUMBER REVISION NUMBER THI h 10 Itv[:)IC; C ER I I�I l HA I 1 HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TFIE POLICY PERIOD ATED NOTWI I HS'1 ANDING ANY REQUIREMENT,TERM OR CONDITION.OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH 1'I-11S CEF HACAIE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.. EXC L LJ}IONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MIT 7g i'i FL OF INSURANCE NJCyExp SI2 Vn - POLICY NUMBER .. iwlwnwYYVY P M/OD/YYYY LIMITS q cENtRA`uA°wrY CBP8263063 p 0410112010 0410112011 EACH OCCUR' $1 QOQr000 X i:(1tv161t 1(,li\I (SL.NI-kV\L LIALULIT.•( - DAMAGE FO RE-N'1 0 "- --' . PREMISES IF.a ]C1.n015 0\10F OCGUH MED EXP(Any ono noc:on) $5,000 -- '------ PERSONAL x ADV INJURY-. $1,000,000 GENERAL ACGRI_C A rE $2i000,000 (I NI;\C;GRI.(,AI I-I Ibll l AI PI.II.S 1 t_K PRODLIC L S-COMP/OP AGG $2,000,000._'--- ('t II ICY I .i... L(.)C p AurorloeaE LwearrY 10MMBCKVMK 04/0112010 04/01/2011 COMBINED SINGLE uparr :\ivvrtnd - (Eaaccowii).' $1000U00 i BODILY INJURY(Per per son), $ . MI (PA'rJrU A[II(IS _ , ' ,( BODII Y INJURY(Par accidei_U) SCI II-0UI l-I)AIIIU:i - s X JIIKI PROPERTY DAMAGE `.0/\U l Cl:i (Per aCClnenl) X B waBRELLA LTA° X OccUh MEYAPP397725 0611712010 04/01/201.1 EACH OCCURRENCE — $1 000 000 Lxc Es5 LIAu CI.HINIti-NIADI: r• AGGRLCAI E- $1 000 000 --. .._ X.KI'II-NIION 10000 - C w D ENIPL COMPENSATION LI ATION WCA00525901 •613012010 06/30/2011 X WC STAI_U: O l t AND Eh'IPLOYEIlS'LIAHINJ Y I N - Tl'Y 'LI L - 6I=.-. ----- It .__. :... AIVrI h�)I'KIL IOhir ARrNI FU XECUI IVE� L=.L.:EACII ACCIOLNT - '. $500,000� OF 1 It I[1P:ILI IUI.K I.XCLUDI-D7 nl N/A - (Mrnnatcuy in NIT) EL,DISEASE-FA L MPI OYCE $500,000 11/�iq,tlb>ll llJtl to 111 al ., UL75CH11'I ION(II'011E RATIONS Below - E.L.DIS FASF-ROT.ICY LIMIT $500,000 DESCRIPTION OF OPERATIONS F LOCATIONS I VEHICLES(Attach ACORD 101,Addilional Romallis 5chodulu;it more spa co da wquirud), .* - "Workers Cornp Information.""" Included Officers or Proprietors (See Attached Des-scriptions) ' CERTIFICATE.HOLDER CANCELLATION . '10 Da s.for Non-Pa nient e- ' SHOULD ANY.OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.r AUTHORIZED REPRESENTATIVE .019818.2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 2 TITe ACORN name and.logo are registered marks otACORD i1S54814/M53353 MEY t r;C? hest ivia r1 St.- ENE'RGY & HOME REPAIR CORPO ON HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: —PL6kSE FrL OUfiAN-D LtrS-FO-RM-1-F-Y0t-J-ARi=---- THE APPLICANT HOMEOWNER. � vv I� hereby consent to and reethat wmtherizatian work may be [ tl t✓ f_w y a9 Y done by the Weatherization ogram of Housing Assistance Corporation (herein after referred as "Agency") on the property located at: The weatherization work done will-be based on programmatic priorities and availability of funding and it may includeall or someof thefollowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sidewalls& basements, attic and other ventilation measuresand possibly replacement of badly deteriorated windows. In consideration of theweatherization work to bedoneat my homel agree to the following: 1. 1 givepermission to the"Agency" itsagentsand employeesto travel onto or acrosssaid property with such equipment and materials as may be necessary to perform weatherization work on said property. 2- The H ousing Assistance Corporation reservesthe right to inspect thefuel or utility bill for the weatherized unit on an ongoing basis for no more than five(5) yea�s after theweatherization work iscompleted. have read the provisions of this agreement as listed and freely give my consent. Home Owner: (Signature) Date: i Agent: (signature) Date: (t r U. HAC approved Weatherization Company : Caliber Building&Remodelin Cape'Cod Insulation Cape Save Creswell Construction Frontier Energy Solutions Lohr ons Peter Smith Resolution Energy Rock Solid Construction Sprinkle Home Improvement [ 6�" .-The-Commonwealth of Massachusetts -- - ,Department of Industrial Accidents a Office ollnyestig8tians•. 600.Washington Street 3 Boston, Mass- 102111. Workers' Com ensation Insurance Affidavit / i location' � �+ ' cityall work myself. 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'Qli' ff::ti:`• {r. t• }!$}r•Y•;t•:.C;6:;::}v:::.,r.•n{;?:•{•}i.'v:/;:r.}'r:'tS i?:•:::F:}r:v`:.t L..n:.. x::w.v...... vr...v.:.... • • ...:............,..:.....: ��/. ' i�i[t±JRTADr ?CO::'•r<:$:<z>.:::<:•.;: ?i.i$:s::>,L.3x•i:;. :%::..:::!:;^:::::{ s{•}:•:}:<•}}.?z:3>::i:R:..::........;t::::.. enalties ota�tenp to 51,50U.D0 and/or FafJnre to secure coverage i1 requirednnder Secdon Z .0 MGL 152 carileadto theimpoaition of etiminalp one years'imprisonment as well as dvII penalties in the form of a ti O'F WO DIALER d �iiflcaHon00 a dap againstme. Itmderstsmdthat a' copy of this statementmay be forwarded to the Oface of Investigcoverage ;J - ' . . •.� •.• thad-the-in ormatian-pravoided.abnue_islur�.au�correc5t - Ida hereby c'etti he�ains-and-penoSiies-of-perjury •f -' Date / , Signature � ,. .,:- • ..�. , ;'�.,..• r S , ��C/�/t- _ :Phone# '�✓d print Dame official use only do not write in this area to b e completed by city or town oMcial _ „ permit/license# OBuildingDepaxtment city or town: ❑Licensing Board contact p ers on: � . I ' .Information and Instructions comp ens ation Massachusetts General Laws chapter�152 section 25 red ires all fried everyers to provide erson**thee serviceeof another under anoy ontract Ployees._As quoted from the_`law , an employee ryP .. - .. .... ..... .... of jge -express or imp lie or or association, corporation or other legal entity, or any two or mare of An employer is defined as an individual, Partnership, _ fie foregoing engaged in ajo�enterprise,'and including the Legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner.of a ..•. dwelling house having not more than three apartments and who resides therein;•or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on-the grourids or building appurtenant thereto-shall not because of such employment be deemed to be an employer: c MGL chapter�lSZ section 25 also states that every state or local licensing agency shall �withhold fortane1au�cant who has of a license or permit.to operate a business or to construct buildings to the cam y PP 6r the not produced acceptable evidence'of complli 5h all enter into any contract for the the insurance coverage iperfouAdditionally, aa performance o public work u� commonwealth•nor any of its political subdivisions acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ,':. _ .' .. • • _�. •. .. .. . . ,. .. . .' ". . ' . .;.: .. .. . . Applicants ; your situation ancf Please fill in the workers' compensation affidavit completely,by checking�te of insurane box that ce as lies all affidavits_may be suPP1Y�g°0�'az"y names, address and phone numbers along with r . ,._,.. . . supplying c 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 anapplir dons re regarding the`lar t�e permit or. w'.of u of Industrial Accidents. Should you have y qu g �. -YQ being requested,not the Departmentber-listed below:.-' t6 obtain.a workers' clompensatioirpolicy,please callttie Depaituieiit atthe mum are required , . . . . . :, City or Towns at thebc�ttom'_Y e Please be sure that the affidavit is complete and printed legibly. The Department has provided a space , to fill out inthe event the 0$'ice of Investigations has to contact you regarding the applicant. Please,, affidavit for you - �_._ bei�v}ucliwillbe use3 as a reference rum tr..1'he affidavits maybe r t� . be sure.to e ,email�o`FAX unluessss other arrangements have been iaade the Departm , Y., _ •. .. .. �. ^ a ' • ._ .• • .. . . . ations would like to thank you in advance for you cooperation and should you have anyyuestions. . The 0$ice of Investrg. ,.a, � _, please do not hesitate to give.us'a calf. The Department! address,telephone and faxnumber. , ThCCommonwealth Of Massachusetts ._Department of Industrial Accidents Office of inirestlgatIons 600 Washington Street =t Boston,Ma. 02111 fax 0: (617) 727-7749 ;;i;.,'„p • «171 727-4960 e" 406, 409 or 375 i a FINE T � Town of Barnstable Regulatory Services BARNSTASLE, * Thomas F.Geiler,Director 9 MASS. g g 1639. �� Building Division prEp��a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. / ,A t Estimated Cos Type of Work: !6 `.X �� 4� �f��—/o vl Z Address of Work: Z ��` 'W x4iele'k-1410 �U Owner's Name: 6: SGC < e2✓(00ry Date of Application: I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by law ❑Job Under$1,000 OBuilding 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 PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: /o ; z f 141o'(w s �T� r/�«� 1a S� 5Y ' Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav � w rT ��yyiyancuecu l BOARD OF BUtUDING REGULATIONS License. CONSTRUCTION SUPEtfiVISOR ram, NumberCSa� 002283 tF' Expired 07,13t/2 4'3 Tr:no: 610 i �` __ Restticted ;® THOMAS F FITZpATf�IC pp BOX 646 MA,_.pM563 Administrator 1 MONUMENT BEACH Board of Burld►pg Regulations an(Stauda d's HOME III,(F O"VEMEN CONTRACTOR- Reyi�stration 05038 � Txpe=ljrxtllvidual J THOMAS F.FITZ�RAT#�9� !� Thomas Fitzpatr 1 l_YNNE.IA. MONUMENTBEACH,MA 02553 Adminktra6.r Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By/Date TITLE:Fitzpatrick Construction CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATIN YSTEM TYPE:Other(Non-Electric Resistance) DAT- 10/30/02 DATED ,PL ': 10/30/02 PROJECT CUTION: 25 Secon a<ftyannisport,MA COMPANYZIN'FORMATION: Colony Insulaattiobn,Inc-1 I Jonathan Bourne Drive—Unit#4 Pocasset,MA`.02559 NOTES: PO BOX 646—Njonument B ach,MA 02553 COMPLIANCE:Passes Maximum UA=80 Your Home=79 1.2%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value -Factor UA Ceiling 1: Cathedral Ceiling(no attic) 440 30.0 0.0 15 Wall 1:Wood Frame, 16"o.c. 380 13.0 0.0 26 Window 1:Wood Frame,Double Pane 30 0.350 11 Door 1: Glass 36 0.350 13 Floor 1: All-Wood Joist/Truss,Over Unconditioned Space 300 19.0 0.0 14 Furnace 1:Forced Hot Air,85 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications;and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release 1 a. The heating load for s building,and the cooling load if appropriate,has been determined using the applicable Standard Design onditi found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 25%oft esi load as specified in Sectio 80CMR 1310 and J4.4. Builder/Design Date M'-30, �- MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release Ia DATE: 10/30/02 TITLE:Fitzpatrick Construction Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: [ J 1. Window 1:Wood Frame,Double Pane,U-factor: 0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: Doors: [ ] 1. Door 1: Glass,U-factor: 0.350 #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: Floors: [ J 1. Floor 1: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1:Forced Hot Air,85 AFUE or higher Make and Model Number Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] ( When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: ( J Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R values,glazing U-values,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ) I All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed I using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ) I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and 14.4. Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. a i Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(f) Up to 1" Up to 1.25" 1.5"to 2.011 Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Ran e F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) y �I ' ^ ] C `1Y//v\I 1 RIDGE BEAM TJ-Beam(TM)6.05 serial Numl5er�70�dD bt535� 2 PCS of 1 3/4" x 11 71$" 1.9E Microliam�LVL ueer:2 1012510212:23:11 PM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS Pagel EngmsVersion:1.5.12 FOR THE APPLICATION AND LOADS LISTED Member Slope:0A2 Roof Slope5A2 1❑ All dimensions are horizontal. Product DiaBraflt is ConCAlrtual. LOADS: Analysi4 Is for a Headef(Flush Beam)Member. Tributary Load Width:10' Primary Load Group-Snow(pat):30.0 Live at 115%duration,15,0 Dead SUPPORTS: Input Bearing Vertical Reactions(lbs) Detail Other Width Length Llve/DeadlUpllft/Total 1 Stud wall 3.50' 3,50' 24001 1302 10/3792 L1:Blocking 1 Ply 1 3/4"1.9E Mlcrollam®LVL 2 Stud wall 3.50" 3.50" 2400 1 1392/013792 L1:Blocking 1 Ply 1 3/4"1.9E MicrollamS LVL -See TJ SPECIFIER'S I BUILDERS GUIDE for detall(a):Li:Blocking DESIGN CONTROLS: Maximum Design Control Control Location Shear(lbs) 3713 -3185 9081 Passed(35%) Rt.and Span 1 under Snow loading Moment(Ft-Lbw) 14542 14542 20525 Passed(71%) MID Span 1 under Snow loading Live Load Defl(In) 0.456 0.783 Passed(IJ404) MID Span 1 under Snow loading Total Load Deft(in) 0.735 1,044 Passed(1-1258) MID Spon 1 under Snow loading -Deflection Criteria:STANDARD(LL:L1240,TL:U190), -Bracing(Lu):A i compression edges(top and boNam)must be braced qt V 8"o!o unless detalled otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -Design assumes adequate continuous lateral support of the compression edge. ADDITIONAL NOTES: -IMPORTANT[ The analysis presented Is output from software developed by Trus Joist(TJ)• 7J warrants the sizing of Its products by this software will be accomplished In accordance with TJ product design criteria And code accepted design values. The specific product application,input design Iosde,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available, Check with your supplier or TJ technical representative for product avallabtiity. , .THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLYI PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Sues&Design methodology was used for Building Code 130CA analyzing the TJ Distribution product listed above. .Note:See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: ' FITZPATRICK JOB Michael Miller Wayerhoeueer 11 Campanalll Or Aesonet,MA 02702 miehael.mlller@weyerhaeuser,com copyright P9 2002 by True 70.3t, a WvYtxbam'sar. 9uaineay Hicroliamo is a ragistered trademark of. Trus 'To ict•. - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel'• /Z Permit# Health Division 00-5-)b I( r o) Date Issued (C Conservation Division �� j //b2 Application Fee 1 00 Tax Collector a 00a '--C7 k- — k)-L 0 Permit Fee �1 '30 Treasurer t� �( da°"'�t� �� i �. � SEPTIC SYSTEM MUST GE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board W611Th;TITLE 5 ENVIRONMENTAL CODE AND Historic-OKH Prservatiin/Hyanhis TOWN REGULATIONS Project Streets 'e sS UT qg e)U ME . aTS g R 3 � _ 1 Villa e Gl/ 9IGGER AN Owner 2 KE DETECT®RS r `� aw Telephone �ND HAVE YOUR l �Ec c T � ®uT �P oP � ~� Permit Request G/`( I f F-Fl A l t, 4 44 Square feet: 1st floor: existing C7�i proposedYG 2nd floor: existing proposed l-1 Total new Zoning District Flood Plain Groundwater Overlay Project Valuation W,�QCV Construction Type Vva P T/lvf Lot Size /Ua X /&d Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U Two Family ❑ Multi-Family(#units) Age of Existing Structure IS- i'� Historic House: ❑Yes a No On Old King's Highway: ❑Yes 8VNo Basement Type: ❑Full 21 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) c-4" Basement Unfinished Area(sq.ft) /C/v Number of Baths: Full: existing new C7 Half:existing new Number of Bedrooms: existing_Z new f ` Total Room Count(not including baths): existing new l First Floor Room Count �" Heat Type and Fuel: 0 Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes 1a No Fireplaces: Existing _� New D Existing wood/coal stove: ❑Yes eiNo Detached garage: ❑existing ❑new size WO Pool: ❑existing ❑new size /`ly Barn:❑existing ❑new size y L Attached garage:❑existing ❑new size /Yy Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 91 No If yes, site plan review# Current Use /2E S, Proposed Use r2 C S BUILDER INFORMATION --� Name——a lkto S rz-e r lZ,(ca Telephone Number 5� 75-S �vrl S Address l/-/ 4-t A 73o x License# C,o Z,?-8 3 6`l6 I 6244,A" T 3 Home Improvement Contractor# !y Ge�r// erZ�5� --1 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATURE ,. DATE 147 e,,, z- . 3 a FOR OFFICIAL USE ONLY PERMIT NO. ,DATE ISSUED MAP/PARCEL NO. �. is _ ... ADDRESS "' ' '` __ VILLAGE l � f OWNER DATE OF INSPECTION 14 r t is�t L:i 2'V ;f FOUNDATION FRAME !�/�1 / Y: INSULATION b 1AIS tU FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH `_% . FINAL' . - Iv. GAS: ROUGH. FINAL t ' - FINAL BUILDING x " DATE CLOSED`OUT• i ' ` .: • - � 0 � I ASSOCIATION PLAN NO. i Sh?p#r DE!SC%f?rs 4u �1 17PoAK642LL- CI ±H H+ I �w 1 u-r si 72 70Sr'/� i ! 7 i l3FD RODM 1 - - -- -- r �14; _ 1 Q. 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S�CDx -- i I s i --- ix3 f31t,v r-l� yx� ad�Sr (D TOWN OF BARNSTABLE, MASS. � a ' a d - -- ----- _. 19 0 M L1bo 4) THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO o .. 0 _..............................................................._..........._........................_...._..........__ ...._...._............. ............_................................................................................_..... __ O J~ (PROPERTY OWNER) (ADDRESS) It bo •" ob ti 3 TO ..........................................................................................._................_......__ __....................................................................................................................... (BUILD) (ALTER) (REPAIR) 4) a 02 ....._..._..__............................... ..................... .......................... .... ....... ................. ..-.._... d (TYPE OF BUILDING) (APPROXIMATE SIZE) O O w op LOCATION ......................................................_........................_.._..._....----._ ..._......................................................................................._........... _...-- - V 4)g STREET AND NUMBER) (VILLAGE) t c NAME O F BUILDER O R C O N T R�CTO R _____._._._..__......_..._........_._.._......._._....-......_............_........_._...__...._.____....._.._...._._......... A APPROXIMATE COST d d boas I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN OF BARNSTABLE REGARDING THE ABOVE CONSTRUCTION. oM >.o O aa "cs ---...._........._......-.-........_..._........................................................................ .......-..............._.........._.................................._.............................................................................. h a) Coh (OWNER) (CONTRACTOR) cs 0 00 _._.._..__._....._......-.....____....-..._...............__.................................................................................. BUILDING INSPECTOR A Subject to Approval of Board of Health. /� �� r -� TOA4N OF BARNSTABLE BULK RATE COUNCIL ON AGING U.S. POSTAGE PAID 198 SOUTH STREET NON-PROFIT ORG. HYANNIS, MA. 02601 PERMIT NO. 2 _ 'f 4 �I 1 ,SDlL-S TEST A'ES4/L-T5 /=/N. FLOOR EL. 3 7 Z 3 S�W,96 E SYSTEM PRoFiL.E E4. 32•8 A LaAM 75Y,f"/2 SL.O P E OF 2 ' �"MAX• 9"MIN. —�- 36"MAx• OIS7: .5OX W16"SUMP G„MAX- 9" M/N, SANDY /OYR �g ° I2"M/N, INA16:,f Sc/RE /'vv, -- 36" MAX, 2" CO yER OF �4' - YZ S" TONE "L3W L-o'4Aj scy. 90 PvC �„ scH. 4o Pvc 2H.8o II_ _ _ y 4">� 56H. 4o P VC t 48 E� . z S.8 IIVV. ° 32. $4 L9.90 �. GASH 2 9. L5 29. 27 29I3/9'-1%z" 3/t' _ WASNE/� b+l A sMEo MEDlc/NJ AFF G"DEp of r. SToivE 2 E 5 .STONE 2' EFF. 1�EPTN C 2 uS y Ep ) SOO GAL. G HAMS R o TO S TO NE s� o c� » ° o ° . •. , . a --: - — - V O O O C,0 _ -•.---•. . . . z z� 8o CDAi4sE USE /Soo G. PRECA5T SEPT/G Ti4Nk 4'I a -__ ____-., 4" C .5.�)MD — -- ----- i 2' /p" --Wl7Jl INLET/OUT[ET 1��5 CON,5-MLJCTE/J P M EN/�L 3 • /�/ P /O� 3 S PER 3/O C-Mg 5, 227 �SoTTo� or TE s T � IZ3.. Ems. 7-2. 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