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0101 ANSEL HOWLAND ROAD
� rr. • ru Lrl Car `,tified Mail Fee ,J3 s 1"i 181Q _lea - Extra Services&Fees(check box, d appropriate) �2 -1❑,Return Receipt(hardcopy) ��� U Q u Return Receipt(electronic) �$ ark 0 ❑Certified Mail Restricted De $ ( r3e a r ❑Adult Signature Required N $ U Q ❑Adult Signature Restricted DClivery$ p Postage e— o 3 � 0 T Z O ? w"r W ti otal Postage and Fees r� T asent To 4—,.Ie r- S O Sliest and Apt No.,or Pr3 Box IVo. L nIr Y.'r rr- city sraieiP — Gi!_ o �C Gv2 :rr r r• Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(no, First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is not available for requires the signee to be at least 21 yearp of age international mail. and provides delivery to the addressees ecified ■Insurance coverage Is notavallable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the' ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should beara certain Priority Mail items. fW' USPS postmark If you would like a postmark on ■For an additional fee,and with a proper t this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.if you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion.. of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece., electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTAfii:Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000.9047 COMPLETE THIS SECTION ON DELIVEI4Y C ' '" a items 1,2,and 3. 'd A. Sign tore o x A"- - X � Agent le 'rH ,name and address on the reverse so That we can return the card to you. Addressee ■ Attach this card to the back of the mailpiece, B• eceived by(Printed C. ate of Delivpry or on the front if space permits. s i 1..Article dressed to: D. cielive address differe m item 1? ❑Yes f� e-le i' J R�o`o/�-/aP7 If YES,enter delivery ad below: ❑No 3. II I IIIIII I'll III I III I III I II I I I I II I I I I I II I II III Service11 Signature 0 e Priority Mail lri❑Adult Signature ❑Registered Mail 9590 9402 3630 7305 3403 61 O Certified Mail Restricted Delivery >4etum Receipt for 0 Collect on Delivery Merchandise 2. Article Number_(Transfer_from-(Transfer _Collect on Delivery Restricted Delivery 11 Signature Confirmation*' red Mail El Signature Confirmation ?01? 1000 0000 6?5? 2 4 4? red Mail Restricted Delivery Restricted Delivery —„-. r$500) Ps Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt LISPS TRACKING# First-Class Mail' Postage&Fees Paid 111 lilt N I:N]AI I I.- USPS Permit No.G-10 I 9590 9402 3630 7305 3403 61 United States •Sender:Please print your name,address,and ZIP+40 in this box Postai,Service TOWN OF BARNSTABLE N BUILDING DIVISION 200 MAIN ST. Y-AINNY1S, -1A 02 6 0 i �o✓ ,�K se/ffd��� J L (i,„1111,1,11111►Ili,11,111 Hilt 1111,.1111111111,,,1,.1111111111 � oFt�E ,, Town of Barnstable ti Building Department Services v MRMASTAB s& Brian Florence, CBO qjo 1639. �0 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.maxs Office: 508-862-4038 Fax: 508-790-6230 December 10, 2019 Peter J. Appleton 37 Baird Way Centerville, Ma. 02632 Dear Mr. Appleton: On December 6, 2019 the Building Department conducted final inspection per your request for permit B-19-2743 and a violation of 780 CMR c. 3 § R314.3 was noted. Specifically, interconnected smoke detectors required to be installed in each bedroom were not installed. In order to abate this violation and to avoid enforcement action by this office, smoke detectors must be installed as required and all required inspections completed. And, if aggrieved by this decision; you may file a Notice of Appeal (specifying the grounds thereof) with the Building Code Appeals Board within forty-five (45) days in accordance with M.G.L. c. 143 § 100. Respectfully, r r L. Lauzon Chief Local Inspector jeffrey.lauzon@town.bamstable.ma.us (508) 862- 4034 I Town of BarnstableBuilding Post This Card So That it is Visible.From'the Street-Approved=°Plans Must be Retained on Job and this Card Must be Kept MAIM � Posted Until Final:Inspection Has Been Made.,,,; .6s Permit ,,uct Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a'Final Inspection has been made Permit NO. B-19-2743 Applicant Name: PETER J APPLETON Approvals Date Issued: 09/13/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 03/13/2020 Foundation: Location: 101 ANSEL HOWLAND ROAD,CENTERVILLE Map/Lot. 172-224 Zoning District: RC Sheathing: Owner on Record: AUSTIN,SAMANTHA R&DRISCOLL,JEFFREY Contractor Name`PETER APPLETON Framing: 1 r 30 ly Address: 101 ANSEL HOWLAND ROAD Contractor License: 103218 2 CENTERVILLE, MA 02632 Est. Project Cost: $40,000.00 Chimney: Description: NEW SIDING, 2 WINDOWS AND FRONT DOOR-INTERIOR WALLS Permit Fee: $254.00 Insulation: REMOVE STAIRS TO ENLARGE SITTING ROOM!-INSTALL NEW K Io I I14 kf i Fee Paid: $254.00 STAIRWELL ANY WALLS TO ANOTHER SECTION=ADD CLOSET AND Final: Q NEW INT DOOR TO CREATE ANOTHER BEDROOM Date:i 9J13/2019 Project Review Req: NEW BEDROOM REQUIRES SMOKE DETECTOR UPGRADE FOR - � � Plumbing/Gas ENTIRE HOUSE. ENGINEERED LVL BEAM TO BE SIZED:FOR Rough Plumbing: THIRTY POUNDS PER SJF LIVE LOAD. Building Official- _ Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afteEr,',issuance. All work authorized by this permit shall conform to the approved application.and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall"be in compliance with the local zoning by-laws ai5d codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public.inspection for the entire duration of the Final Gas: work until the 1 completion of the same. p Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided:on this permit. Minimum of five Call Inspections Required for All Construction Work: ,f' Service: 1.Foundation or Footing 2.Sheathing Inspection : Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site �_ Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT (' S Final: Sr �tHE Application Number. '.l d .' �.. ......... 00 MASS. Permit Fee.......................................Other Fee........................ EO�cl s TotalFee Paid................................................................ ...... TOWN OF BARNSTABLE Pemi t Approval by.................................On............................ BUILDING PERMIT Map.......... ... . .............Parcel..... .13.4.................... APPLICATION Section 1 — Owner's Information and Project Location Project Address j01ti_54e 110t., A,o t� Village e,�c Owners Name SL,f=(= O t SC 0 LL— ' Owners Legal Address lO i & Sa L � �� C�h• V'�c// city. State Zip Owners Cell# — Z E-mail ._.9 ® � ti d 0. C 0 Section 2 —Use of Structure LSUI Use Group LDINGDEPr ❑ Commercial Structure over 35,000 cubic feet AUG 24 2019 ❑ Commercial Structure under 35,000 cubic feet TOWN OF L 13ARNSTAB Singl e/Two Family Dwelling _ Section 3 —Type of Permit �ew Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment El Sprinkler System ,❑ Addition ❑ Retaining wall ❑ . Solar L 'Renovation ❑ Pool ❑ Insulation Other-Specify it ew S�n i W ?w No �� -Y�wk��a� �� (k v-s�e3 r Section 4 - Work Description l Dam & . w - via S/4` 0-v F4 09-4— - ki'w Afat-f"2e t ��IG�Y vty wi�.� O�uBI.�'c, �UwQL{e Gu.yOoc� C��. G' 4e&V' ' c/f;rt��d'� ►� w4b 5,ecfiog.. - di>G/ox,-� tiew �Jo� 49 gc�r�I�,11'k Last undated: 11/15/2018 f. 1 Application Number.................................................... 1 F— Section 5—Detail 3 a Cost of Proposed ConstructioA Square Footage of Project Age of Structure D °{(� Dig Safe Number # Of Bedrooms Existing a Total#Of Bedrooms (proposed) � 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics L y �`u'ng ❑ Oil Tank Storage E-- moke Detectors ' ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney -A- /relocate bedroom Water Supply a Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway ' Debris Disposal Facility: flit.-w &F I am using a crane ❑ Yes 0 o Section 7—Flood Zone Flood Zone Designation ram-, Within or adjacent to a wetland, coastal bank. Yes ❑ No a Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed I Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 Please Print Legibly Name(Business/Organizationdndividual): Address: .7.7 . 61 (J�o Lk City/State/Zip: rjt vA Dry bF,31-Phone#: Sy Are yo employer?Check the appropriate box: Type of project(required): 1. I am a emplo r with� 4. ❑ I am a general contractor and I 6 ,construction employ (fu and/or part-time).* _have hired true sub-contractors 2.❑ I am a soI r 'etor or partner- listed on the attached sheet 7: odeling ship and have no employees These sub-contractors have g• olition workingfor me in an capacity. employees and have workers' Y � t3'• 9. El Building addition [No workers'comp.insurance comp•insurance.: required.] 5. ❑ We are a corporation and its 10. 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.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors mast submit a new affidavit indicating such., :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees;they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. I - Insurance Company Name: ,/!906-r TtAo U(/�;✓1 S• GlJ, Policy#or Self-ins.Lie.#: La GL —,5-00—,S—O HI 0// piration Date: .3 h IAV o Job Site Address: /01 /7"for'o I* City/StaWzip:� {cv�.�� Y�'I/� G��sa Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section,25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the o ' ce coverage verification. I do hereby c fy under e p ' d penalties of perjury that the information provided above is true and correct: Si 01 Date: /� e Phon #: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the,legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commmwwlth of Massachusetts Department of Industrial Aeaidents Office of Investigates 600 Washington Street Boston,MA 02111 Tel.#617-727-4400 ext 446 or 1-877-MASSAM Fax#617-727-7749 Revised 42407 www.nim.gov/dia NOTICE _ NOTICE TO m TO W a EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017 617-727-4900 As required by Massachusetts General Law,Chapter 152, Sections 21, 22, &30, this will give you notice that I(we)have provided payment to our injured employees under the above mentioned chapter by insuring with: Associated Employers Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 . ADDRESS OF INSURANCE COMPANY WCC-500-5013114-2019A 03/24/2019-03/24/2020 POL1iCY NUMBER EFFECTIVE DATES 411 Route 28 Chagnon Insurance Agency Inc West Yarmouth, MA 02673 NA OF INSURANCE AGENT ADDRESS PHONE Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 02/22/2019 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury mgst be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be aid b the insurer, if the treatment P y e t >� necessary and reasonably connected to the work related injury. In cases requiring hospital attention,•employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER 'Boise cascade Triple 1-3/4" x 14" VERSA-LAM® 2.0 3100 SP PASSE® FB01 (Floor Beam) BC CALC®Member Report Dry 11 span I No cant. August 14, 2019 14:35:24 Build 7192 Job name: Driscoll File name: Address: 101 Hansel Howland Rd Description: City, State,Zip: Centerville, MA Specifier: Builder: Peter Appleton Designer: Joe Madera Code reports: ESR-1040 Company: Shepley Wood Products . . 1 1 0 1 1 1 1 20-00-00 B1 B2 Total Horizontal Product Length=20-00-00 Reaction Summary (Down / Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B 1, 3-1/2" 2800/0 1613/0 B2, 3-1/2" 2800/0 1613/0 Load Summary Live Dead Snow Wind Roof Tributary Live Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 160% 125% 0 Self-Weight Unf. Lin. (lb/ft) L 00-00-00 20-00-00 Top 21 00-00-00 1 Standard Load Unf.Area(lb/ftz) L 00-00-00 20-00-00 Top 20 10 14-00-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 21065 ft-Ibs 48.4% 100% 1 10-00-00 End Shear 3769 Ibs 27.0% 100% 1 01-05-08 Total Load Deflection L/389(0.603") 61.7% n\a 1 10-00-00 Live Load Deflection L/613(0.383") 58.7% n\a 2 10-00-00 Max Defl. 0.603" 60.3% n\a 1 10-00-00 Span/Depth 16.8 %Allow %Allow Bearing Supports Dim.(LxW) Value Support Member Material B1 Wall/Plate 3-1/2"x 5-1/4" 4413 Ibs n\a 32.0% Unspecified B2 Wall/Plate 3-1/2"x 5-1/4" 4413 Ibs n\a 32.0% Unspecified Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum (U360)Live load deflection criteria. Design meets arbitrary(1")Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALC®analysis is based on IBC 2015. Design based on Dry Service Condition. All FastenMaster screws may be installed from one side of multiply Versa-Lam beams. Member has no side loads. Connection Diagram: Full Length of Member a c e Page 1 of 2 '. Boise Cascade Triple 1-3/4" x 14" VERSA-LAM® 2.0 3100 SP PASSE® FB01 (Floor Beam) BC CALCO Member Report Dry 1 span No cant. August 14,2019 14:35:24 Build 7192 Job name: Driscoll File name: Address: 101 Hansel Howland Rd Description: City, State,Zip: Centerville, MA Specifier: Builder: Peter Appleton Designer: Joe Madera Code reports: ESR-1040 Company: Shepley Wood Products Connection Diagram: Full Length of Member a minimum=2" c= 10" b minimum=4" d =24" e minimum= 1" All FastenMaster screws may be installed from one side of multiply Versa-Lam beams. Member has no side loads. Connectors are: FMFL005 Disclosure Use of the Boise Cascade Software is subject to the terms of the End User License Agreement(EULA). Completeness and accuracy of input must be reviewed and verified by a qualified engineer or other appropriate expert to assure its adequacy,prior to anyone relying on such output as evidence of suitability for a particular application.The output here is based on building code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call(800)232-0788 before installation. BC CALCO,BC FRAMER@,AJSTM, ALLJOISTO,BC RIM BOARDTM',BCIO, BOISE GLULAMTO,BC FloorValue(D, VERSA-LAM@,VERSA-RIM PLUS@), Page 2 of 2 �fze�v�m�noruuea/,t�a�C�ac�ruaeG7a . Office of Consumer Affairs,&Business Regulation HOME IMPROVEMENT-CONTRACTOR Registration valid fors Individual use only TYPE:Individual before the expiration date. If found return to: geaistration. Exolration Office of Consumer Affairs and Business Regulation 103214l 07/05/2020 1000 Washington Street-Suite 710 PETER APPLETON! Boston,MA 02118 PETER J.APPLETON; �2 CCP� - 37 BAIRD WAY C. CENTERVILLE,MA 02632 Undersecretary --;-Not Vail, lhgynat"ure unie less thap 3. .gU5a °nstr, OpOd ee gc4b'f ( �tt r o9 or space.ctlbic 4p pk'ter Bch co )of epc os eq Commonwealth of Massachusetts Fai/fir '® Division of Professional Licensure StateeU�d�ssess � Board of Building Regul tions and Standards p9 C a c Constrtl6tl1-r b rvisor C Po,,,,,ode is p'rapt v � a//`7j 1141on forre y oft a CS-005414j. �. ` ires: 06/08/202 200 or abo4t oIrkcat o Maser s/ic�se this h�its PETER J APPLETONI ss90 pe. 37 BAIRD WA* I- v�rtp/ CENTERVILLE MA, lYlB S� 1 �- ' 8/1/2019 RoomSketcher®Home pesigner Lz Tt 7,41 . .� ryes.` ". Via►- !'^+. .4.^aP.uuw. .�s�.,..„. +��*x'!� �x Now. " *"Pa. arti+w '.�y °•^ewe�- +S,xrx - .� Aft OVUM Sketches f https://planner.roomsketcheccom/print/?imageURL=https%3Al/media.roomsketcher.com/levelimage/%3Fpid%3D5642631%26id%3D8089531%26ts%... 1/1. 6` Application Number........................................... Section 9- Construction Supervisor Name ��,l Awle,�' Telephone Number —Oct 9�b Address 7? (3vt City ajld'-c State Zip 6�9 License Number �S�f i Ticense Type C S' Expiration Date 0 Contractors Email 7 Z QC,-,. 4.Cciw Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re 8 CMR a Town of Barnstable.Attach a copy of your license. Signature Date / �)9 Section 10—Home Improvement Contractor Name/`. G -- Telephone Number Addre s 7 #4 [,(,+j City 0'<L v,j I e State 1,n,2AL Zip Registration Number Expiration Date C> I understand my responsibilities under the rules and regulations for home in Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required 0 MR an4Ahj Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date LICANT SIGNATURE Signature Date V/S� Print Nan Telephone Number 5) ��� � E-mail permit to: P Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) 1 Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I J, �rt`sc as Owner of the subject property hereby authorize Te�e Awls-A�,1) to act on my behalf, in all matters relative to work authorized by this building permit application for: 161 AN l hoa) id &. /den�&rvl/fe, M4 07-4 39- (Address of job) S a of CWner date Print Name Last updated: 11/15/2018 ,-7r , Barnstable Bldg.Dept. 3 Approved by: ✓) Permit plc ,,,w..,....--...�.mw.,.,. � ! �......._._........._..-. ._ .�_ L—r.--_ .._ ....�Y -...� r-J� 4« ,/ �"�_✓ter ._ .-- l ,.-_. .�..,_. .. ~.- _, 9 � .� .-._......... •----.......__.. ,. I ?'�I �°�4Ci W?�-'_k�f vas gsSMOK 'MA CTORS REVIEWED 1 r— Ica �J RN LDING DEPT. DATE FIRE DEPA^ENT DATE C9 us ! BOTH SIGNATURES ARE REQUIRED FOR PERMITTING ve ua- yo p(j c1 .f o o k (AN GA.8-eiok t3oisew� Triple 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PASSED FB01 (Floor Beam) BC CALL®Member Report Dry 11 span I No cant. September 16,2019 07:56:05 Build 7295 Job name: 101 Ansel Howland Rd File name: P Appleton_101 Ansel Howland Rd Address: Description: City,State,Zip: Centerville, MA Specifier: Builder: Peter Appleton Designer: Joe Madera Code reports: ESR-1040 Company: Shepley Wood Products 0 I L 20-00-M B1 B2 Total Horizontal Product Length=20-00-00 Reaction Summary (Down/ Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B 1,3-1/2" 4200/0 1613/0 B2,3-1/2" 4200/0 1613/0 Load Summary Live Dead Snow Wind Roof Tributary Live Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 160% 125% 0 Self-Weight Unf. Lin.(lb/ft) L 00-00-00 20-00-00 Top 21 00-00-00 1 Standard Load Unf.Area(lb/ftz) L 00-00-00 20-00-00 Back 30 10 14-00-00 Controls Summary Value %Allowable Duration case Location Pos.Moment 27747 ft-Ibs 63.7% 100% 1 10-00-00 End Shear 4965 Ibs 35.6% 100% 1 01-05-08 Total Load Deflection U295(0.794") 81.3% n\a 1 10-00-00 Live Load Deflection U409(0.574") 88.1% n\a 2 10-00-00 Max Defl. 0.794" 79.4% n\a 1 10-00-00 Span/Depth 16.8 %Allow %Allow Bearing Supports Dim.(LAN) Value Support Member Material B1 Wall/Plate 3-1/2"x 5-1/4" 5813 Ibs n\a 42.2% Unspecified B2 WaIUPlate 3-1/2"x 5-1/4" 5813 Ibs n\a 42.2% Unspecified Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(U360)Live load deflection criteria. Design meets arbitrary(1")Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALL®analysis is based on IBC 2015. Design based on Dry Service Condition. Connection Diagram: Full Length of Member owl b _ d �. e� e2 Dane 4 -0•2 t Triple 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PSSE FB01 (Floor Beam) BC CALL®Member Report Dry 11 span I No cant. September 16,2019 07:56:05 Build 7295 Job name: 101 Ansel Howland Rd File name: P Appleton_101 Ansel Howland Rd Address: Description: City,State,Zip: Centerville, MA Specifier: Builder: Peter Appleton Designer: Joe Madera Code reports: ESR-1040 Company: Shepley Wood Products Connection Diagram: Full Length of Member a minimum=2" c=10" b minimum=4" d= 12" e minimum= 1" Calculated Side Load=560.0 Ib/ft All FastenMaster screws may be installed from one side of multiply Versa-Lam beams. Connectors are: FMFL005 Disclosure Use of the Boise Cascade Software is subject to the terms of the End User License Agreement(EULA). Completeness and accurapy of input must be reviewed and verified by a qualified engineer or other appropriate expert to assure its adequacy,prior to anyone relying on such output as evidence of suitability for a particular application.The output here is based on building code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call(800)232-0788 before installation. BC CALCO,BC FRAMERS,AJSTm, ALLJOIST®,BC RIM BOARD-,BCI®, BOISE GLULAM-,BC FloorValue®, VERSA-LAW,VERSA-RIM PLUS®, f Town of Barnstable *Permit# 306-V( � " •' Expires 6 months from W a date Regulatory Services Fee �� Thomas F.Geller,Director � �� as=RMIBuilding Division 6k _J�3°b7e Tom Perry,CBO, Building Commissioner 2007 200 Main Street,Hyannis,MA 02601 B-fV�fi www.town.barnstable.ma.us Office: 508-80-23 8EIARNSTASLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint [ap/parcel Number/ 7 a1-Z 19 roperty Address 201 )c VL 6e-j-- How' AW 9L RD C_e_4 `G, Residential Value of Work DQ Minimum fee of$25.00 for work under$6000.00 1wner's Name.&Address .ontractor's Name_— 1N 4 d�� Telephone Number_ [ome Improvement Contractor License#(if applicable) -0:' Z'9 lj,:51 7 Lzcens�liFapplim llej ]Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance asurance Company Name Vorkman's Comp.Policy# ,opy of Insurance Compliance Certificate must be on file. emit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value e (maximum.44) *Where-required: Issuance of this permit does not exempt compliance with other town depamnentregulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Pr perty Owner Letter of Permission. A copy of the Home rov ment Contractors License is required. JGNATURE: I:Fo=:expmtrg 411AL xvise061306 r ' 2, 0 co 10 VONA t r.. i c ' The Commonwealth of Massachusetts 1 Department of Industrial Accidents Office of Investigations _ + d 600 Washington Street Boston,MA 02111 t . wrvw.mass.gov/dia Workers Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information .Please Print Legibly Name(Business/Organization/Individual): Address• h �—� p2 r 'Z City/State/Zip: Oe.KA,ej .A1 Phone.#: ��2gO- `i Are you an employer?Check the appropriate box: .Type of project(required):. 1.❑ I am a employer 4. ❑ � I am a general contractor and I with 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 2. I am a'sole proprietor or partner- listed on the-attached sheet. 7.�Remodeling 'ship and have no employees These sub-contractors have g, ❑Demolition working for me in an capacity. employees and have workers' g y p ty. t. 9. ❑Building addition [No workers' comp.insurance comp. insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its .3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs . insurance required.]t c. 152, §1(4),and we have no 13.0 Other employees. [No workers' comp.insurance required.] ' *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains penal 'es of perjury that the information provided above is true and correct. Si tore: © Date: _ Phone#: ` b �� O 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced;acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter.152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance withthe insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a.policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"allIocations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,-MA 02111 Tel. #617-727-4900 ext 406 or 1.877-MASSAFE Revised 11-22-06 Fax 4 617-727-7749 www.mass.gov/dia "f Town'of Barnstable Regulatory Services STAIBIX, ` Thomas F. Geiler,Director XASS 9q,A sbgq' Building Division �fD►A� Tom Perry, Building Commissioner . 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using .A.Builder as Owner of the subject property hereby authorize 1Je7`�' 0/�//P�1� to act on my behalf, in all matters relative to work authorized by this building permit application for: tewl Ile (Address of Job) r V Signature of Owner ate /1l1 A Punt Name Q:F0RMS:0WNEP FERMIS SIGN . F ! ' . TOWN OF BARNSTABLE -__--- -__- � � Permit No. __._______-.__ Building Inspector ' • wa Cash _ --------------- - a Val OCCUPANCY PERMIT Bond Issued to Aj Sma.L Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering DeparLment Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUIIMING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THP: BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ` r ......................................................1 19 _._ ........................:................:...:..: ...................... Building Inspector SINGuG- FAMILY - :5 BEOROoM ; { WO GARBAGE 0'T ' 13 4 pA%L. FL .OW 'a 110 X 3 = a3oG.P.L? 6F-PT G -rAwK =` 330x15a% :-4956.P o ►G, I z9 �,lr. �' use loco o15Po5A1- P1T U's 100 GAL. 4%pr,WALL AV-SA, 150 5.F x �.•5 F 3?5 G.RD. exv. PST SOTTOA AREA= l�o �F• Zg 'ToTA1.. vs5161,4 * .¢2� G.PQ• n` 1Z 1 4' -TOTAL. DA 1%-Y FI-OVA! � 33o G.Po, y o �' ►,000���. m , S TANK PE2Go�ATIoN RATEa 1''IN 2MIN1 Of • ¢ � FouKD AT 1 o N , ; IFVICHARD. "v; �O� ALAN BA TER y JONES H 41 NU.2K04$O• p N 25100 4�o su SS R�•�`�� � . - • t A�s��° .t�ow� Df . . •_� F�•53 TOP FM =S TEST 8�i2�8� . ' , • .w,y �. • s of �r►.M loco INq. , GAL• 6Vb Scl►. p14T. INJ. £,g;TIC. 50,O - BvX �'7 e►11K i LEAG11. F% •.�. KI► %om PIT INV. INV., S . I tGnNA WITLI' '; .So. r WASNGD , GE2TIFlGD p1.oT PI A-W PROFILE 1-04Alf I C e.►kT EwI p No 5GA.l-E $GALE �`"_ q.o' .. V!°�1z/I O WkTloz- Ev-r--NGE 1 CE QT1FY THAT TNfa Fau NO^�IoN 5NOV1N 1{6.RFao►J GoMPI.`(5 1rJITH-TN6 �,Io�L.INE LOT I3 AuD Sf�T�.GK R.6QV12>✓?�t6.N'f� u T • C E NTE PLY I L.t. N IG N LAN 05 SEC. L0C, .TE D W ITH IJ 1a•6 F �D PLAT N DA?E.�2-1-M .---- BAxTE v-a W`f E INC. . iZEG I ST 6.Q6.D'LAU D 5 u r-v EYoZ j "�Idlcj PL.�.N t�i NOT gAD OId AN 03T�6ZVILLE• • lil�•SS. i IN5j-R•uMENT Su2VG--Y 'THE oFFSB?5 SucuL� c Td G G.L- l►-I C t_n�' L I N �� /1►P P L-I r A►`1'f A L11 n1 A, N . - � Assessor's map and lot number ... ... : ....::. ...... ... .;.f.'1,.:: I -!swage Permit number .....�Z`....r�..�... ............... ....... . .....:., House1 '• .l.Y t.�.. ..................................... number ............ ............. ........ r�ss IC SYSTEM MUD;' °YAY d� L 1OKIPLIANC - TOWN 'OF kB`A`R '- LE EN UUILDI . INSPECTORT APPLICATION. FOR, PERMIT TO . ,�r �ft� !°{rs� '............. ......................................................................... : / TYPE OF COIdSTRUCTIOF! ........ ......................................................... ..................................................... ..... . ....`:.:':............... ..:.......19..Ry TO. THE INSPECTOR OF BUILDINGS: The undersigned h reby applies for Aa'rpeerr/mit according to pthe following,information: �+ Location'...............................i ......1 /t'id G .. +:l 4.1". . .:J&...........5�... "�ti:.................. .......... Proposed Use ..............,...................,...K/ . . ................. ................................................................................................ ........ ............ Zoning District ..... ............ .............:............... ..`.....: :........Fire District .............. Name of Owner �'" /� ...,J�4'�—. ..Address ..... ..�..je/7 � �..................................... ....................... Name of Builder" ........... .'...........................Address ................... 1............................. .... .......... Name of Architect ....Address ................ Number of Rooms .. ...........................::.:... Foundation . :.....4�.. .! Gb' o�. ........::............... Exterior ... �' / 'i''r.��.. � :.Roofng :.. ............................................... Floors , .........................:....................... ......Interior ..4.044..4�r�L ........................... Heating " / .... ....................... ................. ....... ..Plumbing ....:�......CAT ................................... ., Fireplace ............................................Approxi.mate Cast .... .... .. �.. . , ............ .. Definitive Plan Approved by Planning Board ----------- ----__-_-----------19------- Area Area .... . .................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED'FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-regarding,the abo/e construction. ( J Name .... ..... .... ....... .............. .. . . ..................... - �� SMALL, ALAN E. �►.. 24617 One Story Flo .......:......... Permit for .................................... :...Sin_qle• Familx..Dwelling.�............. r Location Lot 13 101 Ansel Howland Road ? Centerville ............................................................... Owner ..Flan E Small............................. Type of Construction, Frame .......................................... .............................rP .......................... �Y Plot ........................... Lot . .....:...... December 7,; 82 Permit Granted .......................................19 Date of Inspection .. ...... ......... 19 a Date Completed ( L !T ..............19�It-3 � • . � it y`'4•; 7