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0076 CAMP OPECHEE ROAD
%G GAmP 0�� �� 4 � a 015 Town of Barnstable Tow h ^ Regulatory Serdees STABLE Fe m aac' 94p a6�p ,ao ABLE Thames F Caex,Dixector '°tEDas0.ti► C� '/ 3.ftg Drnsion TomPe=Tj�CEO,B alft;Comttussioner �1�+ • 20aIV1s�n.Street HvarmsM90?501 R�saw�ba�b]e_v�ns - Of�xce=.508-862-4038 T APPT TCAnON - R£SID +I MAL ONLY Mapfozrcd,Number lvvz va7u*svx&maRedX�rzsslmprtris Properly s (� (� O k c L ie d. �Rar;r?anr;a9 Vale otWork S Z� ,S(D y rifimitimux¢fee of 5�oa forcrox�:rmdzr56QG0.©Q - �O.lTle1'17gtOV'`c�DeY�CQ,t�gCLdYI.7C�UCs{�2�'171C2b�}�1a�3�(/ �'�t, �('�"G. r Q 1.{��iLr �(1' r l� y!'1 c�toraoaSt�roysor's�iu�r(zfappF�able} ����^ ' �',+''o�sCorrne�ation�ce rCbeck o u rs: 1 ama Sol rn+opri�tar Q�Yemthe$azoeowne- � ��""I have'�7ose�'s xmensatiou�re , � i r===ec=v=Yx&= Copy ofImumm CompiTisace Cexiificaz mus=accaxnpanc eachpezmiL ' PamukZegum(cbih-kbox) ' �[12e-xooz(�ira^na�edf(�PP�old s�3�)A]1ce�5nvcboade'bas Abe t�,e:o . Croft—cr layers o£ioof cep �°P '��iaws/door</s'.�de�1F Va7s�e r 2� ( .3y��o�•wa�ows � . ot'&-os= ['t Sxz�]ce/Casi�or,Mono4dedeterrors4iloorplaasmaxledwithredsaxulinspectionsxegnixed. . . SeparsLe Elecaies3&F.ue Perms xegroxe� '*�4�sesequxcl-Is.�am er£s'�"snzaz¢doesarcereagceom�xr}.ho�soaud��gs����az. ***wore: PropeayOwaer —StmPs R"zYOvmzi I*rterofFexmisstoa. 4.copvaf eHomeinrpravemam�CanuarzoisLirensefiComCrcctiomS�anexsiwxsS.icense5s xeTdre& , T ATIIR e C�iisasldx V....AT�.r �- 1SAD� osofdul � Isx _Ta�slCo&�S�tSSAD�T81FJSp�1S5.dcc Revised.061313 The Commonwealth of Massachusetts — -+-- Departtlaent ofbzdustrfalAccidents " ' = Office ofDivest/aations 600 Washing on Street . = Boston,MA 02111 www rnass govtdia Workers'Compensation Insurance Affidavit.BuRders/Contractors/Electricians/PIumbers ARpRcant Information Please Print LeaibIt= Name(BusiaessloTgani "onadividaai):_ Address: r!• � �$�`J City/State/Zip: t ! f ' Phone 9: Are y tt an employer?Checkthe appropriate boa: Type ofj project re 1. 1 am a employer with 0 4-L]I are a general contractor and I p ( e�- employees(fu11 and/or part-time).* have hired the sub-contractors 6. ❑New constriction 1❑ 1 am a sole proprietor or p artier- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8_ ❑Demolition wozleng for me k.any capacity. employees and have workers' INo vrarkers'comp.insurance comp.insurance+ 9- [1 blu'lding addition requited.] 5. [] We are a corporation sad its ME]Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself [No workers'comp right of exemption per MGL 12.[]Roof repairs insurance,recpliTr t c.152,§1(4),and we have no employees.[No workers' aEl Other comp.msm-n ce required.] *Any applicant dia.checks box 41 m1w a?so till our the section below showing theirwmkea'-oropettsatioapolky information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside conttactozs most submit anew affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contzetors and state whether or not those entities have employees_Ifthe sub-contractors bave employees,they ztust provide thew workers'romp.policy= r .(am an employer that is providing workers'wngensation btsarmwe for my employees. Below is the policy and job site infonzzadon. (,p Insurance Company Name: �(�l f I t. C� V Ill t. f-aO CC CO f Policy#or Self-ins.Lic.#: Oq cl,-zD on ( Expiration Da e:���{1 Sob Site Address: 7C (,w, V kC�t'r City/Stateat S65 /�I'�( S /pl4 ()Z 6 Attach a copy of the workexs'compensation policy declaration page(showing the policy number and expiration date). Failuze to secure coverage as required tnxder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fore up to S 1500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a e of up to$250.00 a day against the violator_ Be advised that a copy oftbis statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepahw andpertaltzes ofpedury that the znfornurtionprorUed shove is true and corn ept S' e: Date: Phone n�L—�4jA Official use only. Do not wrfte bz this area,to be completed by city or town official City or Tow= Pe mit/Liceuse# Issuiag.A.nthority(circle one): I.Board OfHealth 2.Building Department 3.CSty/Torn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9- Office of Consumer fairs and Business 1?eguha1-on 10 Park Plaza.-Surte 5 170 Boston,Massachusetts 02116 Home TImprovement Contractor Peaist?ation . Registmfon: 1125a6 Type: DBA Expireton: 3l23/201 i Tra 263SC-7 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1846 CO T UiT, MA 02635 Update Address and r et a card_.INfa k rason for shap e_ . Sam, Address Renewal []Employmaat _ast Card �s�re�;o�xr�va�aatGEarP�/laa:7e✓avaeQ2 - Office a.Co==cr Affairs S:BaSbmSS Ree.uat3oa lAcense or re�aton valid for in&vidul use only r ONIE WROVEMEWICONTRACTOR before the expimdoadam Ifkomfireturnto; 'on. 112S36 Type: Mce of ConsamerAffaits and BusimessRegulation Ex. _LmSor• -W32017 DBA 10 ParkPlaza-Suite 5170 Boston,NA 02116 ERASER CONSTRUCTION CO. / DEAN FRASER 104 TASINN VMW LANE E FALMOITTK MA 02536 'Undersea mty Yat v3Iid wi#hoat sio�aatsre Construction Supen icur _ic_=ns�: CS-097668 =:? DEAN C FRASER 104 TW1NN VIEW LANE.. _ EAST FALMOUTH-MA:0 536 06/07/2017 ' I� f GRANITE STATE INSURANCE COMPANY 0103090-00 WC 009-93-0601 13102 013-82-0915-50 • PENN YLVAN 1. FRASER CONSTRUCTION, LLC A I G P.O. BOX 1845 COTUIT, MA 02635-2443 An AIG company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 175 Water Street LD# 0001 0646 MA UI#: New York, NY 10038••.. . . - KEATING GROUP INC THE WORKERS COMPENSATION AND EMPLOYERS 144 TURNPIKE ROAD LIABILITY POLICY INFORMATION PAGE SUITE 150 SOUTHBOROUGH, MA 0 2-0000 INSURED IS PREVIOUS POLICY NUMBER LIMITED LIABILITY COMPANY RENEWAL 002930601 OTHER WORKPLACES NOT SHOWN ABOVE. SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE- WC990610 ITEM 2 POLICY PERIOOtr1291 A.M.standard lime atthe Insured's mailing address FROM 09/26/15 To 09/26/16 ITEM 3 A. Workers Compensation Insurance:.Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $_ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AK AL AR AZ CA CO CT DC DE FL GA HI ]A ID -IL IN KS KY LA MD ME MI MN NO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI WV D. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE- WC990612 I7EM4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Estimated Classifications Code Number Total Remuneration $10o OF Re- Fremlum QAnnual❑3Year muneratlon ❑X Annual ❑3Year SEE EXTENSION OF ITEM 4.OF THE INFORMATION PAGE- WC7754 TAXES/ASSESSMENTS/SURCHARGES EXPENSE CONSTANT(EXCEPT WHERE APPLICA13LE BY STATE) MINIMUM PREMIUM -$500 MA TOTAL ESTIM ATED ANNUAL PREMIUM If indicated below,interim adjustments of premium shall be made: Semi-Annually cluartedy Monthly DEPOSITPREMIUM 08/25/1 PARSIPPANY �fJ � 82 5 Issue Date -39967(ReWd 04106) Issuing Office 9 Authorized Representative WC 00 00 01A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION _. t Map Parcel; " Application #�� p pp Health Division - Date Issued 0, �-� Conservation Division ^`; Application Fee Planning Dept. ' ' Permit Fee Date Definitive Plan.Approved by Planning Board �f 2q�it. Historic OKH _Preservation / Hyannis Project Street Address Village A,,a�2AAof i/Lk— Owner Address a Y Telephone Permit Request Ski /'��_ciL Ti_� �r � 4=2 h yV_h I- oz►'l .d,_11i64-9-1 e Square feet: 1.st floor: existing ✓proposed 2nd floor: existing proposed Total new Zoning District _ Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq,,Il J ZE Number of Baths: Full: existing / new Half: existing . " new '65 Number of Bedrooms: existing _new r Total Room Count (not including baths): existing new First Floor Roor`i i Count-o `Zl� Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other .F a— Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stover❑1 s ❑ 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) Name ,l�a.�;i � y��i,. Telephone Number Address Ef .J`d e-,, - S License # Ia q z gy S"4L!2 c L miiA Home Improvement Contractor# 5 3 4 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _„� DATE r x LS s e FOR OFFICIAL USE ONLY APPLICATION# ; ` DATE ISSUED -}<. MAP/PARCEL NO. ADDRESS VILLAGE OWNER b DATE OF INSPECTION: .._FOUNDATION FRAME , INSULATION: FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL >GAS:�— ROUGH FINAL ,'fINAL.B_-ILDING< 1 1. DATE CLOSED OUT ASSOCIATION PLAN NO. A i s The Commonwealth of Massachusetts 16 Department of Industr ial Accideizts ..,t Office of Investigations 600 Washington Street tl t 1 v i- Boston,MA 02111 c www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): J�p i/�r. W�.�_��r. Address: x/3 f�✓,a1�R�. Ci /State/Zi tS' P: hhK/"-Lfi1 h'1 1�,j�Z Phone #: 3S5g Are you an employer? Check the appropriate box: FM ject(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I construction � �em loyees(full and/or part-time).* have hired the sub-contractors 12.Lei am a sole proprietor or partner- listed on the attached sheet.$ deling ship and have no employees These sub-contractors have litionworking for me in any capacity.. workers' comp. insurance. ing addition[No workers' comp, insurance 5: ❑ We are a corporation and itsrequired.] officers have exercised their cal repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL . ing repairs or additions myself. [No workers' comp_ c. 152, §1(4), and we have no 12.[] Roof repairs insurance required.] t. employees. [No workers' comp. insurance required.] 13•0 Other *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 their workers'comp,policy information. 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. Lie. #: 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: X� �2 Z Phone#: 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 bean 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 inio 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/Iicense 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 proofthat 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 (Le. a dog Iicense or permit to burn 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. # 617-727-490.0 ext 406 or 1-877,MASSAFE Revised 5-26-0S Fax # 617-727-7749 www.m:ass..gov/dia 4 Boaud ofBuildill Re-ulations and Standards Construction Supervisor License License: CS 104134 KEVIN HAMLIN 43 WATER ST SANDWICH, MA.02563 Expiration, 2/T/2014 Tr#: 104134 '. ✓!ze Ponmwnuea a�./aaaac�u4elta k1 . .. '.'. Office of Consumer Affairs&Business Regulation ! HOME IMPROVEMENT CONTRACTOR h,l Registratiot , 1;64936 t aw Expiration �12f2/2011 Tr# 291252 l i ` ' Type. y�Inaiavidual r !. KEVIN M. HAMLLN _ A KEVIN HAMLIN 43 WATER ST § 1; SANDWICH,MA 02563t ,-' Undersecretary w i I., License or registration valid individul use.only • �: before the ezpira ion date. If found return M:. i Office of Consumer Affairs and Business Iiegulat�on ` 10 Park Plaza=Suite 5170 I. N Boston,MA 021-16 ti , � - - Fal Not valid withoutsignaturie -1 TIME Town of.Barnstable • Regulatory Services 1 `r �ARN6TABI.£ ~ s .Thomas F.Geiler,Director 'Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 _.. Pr II operty Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject.property hereby authorizeP,V to act on= behalf, in all matters relative to work authorized by this building permit application for: 6 Car bcm,�IVN[ei (Address Of Job) c92-6 3 - S%nature of Owner Date DabrIV Print Name If P rop—ea Owner is applying for perm t please complete the Hom eo. wners License Exemption Form on reverse side. Q:FD RM3:0 WNERP ERMI581DN ��oFTHErowy Town of Barnstable yam. o Regulatory Services stirtxsuat> Thomas F. Geiler,Director } KAss. Building Division Tom Perry,Building Commissioner 200 Main-Street,_Hyannis,MA.02601 wwmtown.barnstable ma us Office: 508-862-403 8 Fax: 508-790-6230 HOlNIEWNERLICENSE EXEKPnoN, Please Print DATE: JOB L OCATTON: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOVrXF_R Persons)who owns a parcel of land an which he/she resides or intends to reside, an which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the'Burlding Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department minimutn inspection procedures and requirements and that he/she will comply with'said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any bomeownerr performing work for which a building permit is required shaD be ex crrrpt from the provisions of this scction.(Scction ID9.1.1 -Licensing of construction Supcvsors);provided that if the homeowner engages a person(s)for bin to do such worms that such Homeowner shall act as supervisor. 4any homeowners who use this exemption are unaware that they an assuming the responsibilities of a supervisor(see Appendix Q. Ru)cs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bftcn results in serious problerns,particularly when the homeowner hires unlicensed persons. In.this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. Tbc homeowner acting as Supervisor is ultimately responsible. To ensure that the bomcowner is fully¢wart of his/her responnbilitics,many communities require,as part of the permit application, that the bomcowncr certify that he/she understands the msponnbilitiea of a Supervisor. On the last page of this issue is a form currently used by scveraI towns. You may care t amend and adopt such a form/certification for use in your community, _ I Q:forms:homccxcmpt 4 a. "';.',R � "4r ,�.; "rf+tr�..+�. •c: i" #�,« f ,a,ry, r - ad ,,; tt. � � 7 . ♦ 4 TZ 2,i "7• •y„_ L yr. i ry,� � +., - ,€�i`� 'a�fr -5 _ �+ IL a xn 10, CD 31 C M} ol o� q ti N ►�' '„^^' - - ift 1 d a ..cy � �� � �� 1t,o-�°F" '�} ��� G�t`'4'� a�. •.� �.�''�3 ski � � � � �' � y b rwl 3.44' x �^ y� �; Vb SM6 �� „ ,ay.. ,� 0 p i k " 'r s� t _ _ � � a 3' � �s s� * `i �" .k' Fes.lJ�" {�;• Qf�J��CX [�faJ - � F4nAl 74 W Y y 7, 1 a ca 3 s ` +°oi C ` 4 le 'a #% i a , I ` �z n r ij 9}, - n: � ,h Ilktv : o My `;r �� '�"` _ ��n`t&u � ,r=„;`> >r •„�?'i. ,� � .h �< �^, � � �y � I � D x a -..fiw, .:;.5 BRACING FOR3x2 AND 4x2 Ifi- pARA16Et CHORD TRUSSES ` `a .BRACING.,FOR THREE:PLANES•OF,ROOF i EL ARRIOSTRE PARR TRUSSES.DE tUERDAS:PARALELAS 3x2 Y 4xT a EL'ARRIOSTRE Eft TREE PLANOS DE TEC'.NO �War toeCSi B7 Maximum lateral brace sparing t tmman�Reet 1010 C Par 3x2 chords 15'o .for 4x2 chords Diagonal biacces # f-7(This bracing medtod Is for aU trusses except 3x2 and ax2 parallel CRora trusses. Tgmoorary and B ery 15 truss #-A lJ 1 a 13F _R1 - 10 # Este miwdo de arrlostre es Para tOdo trusses excepto trusses de cuerdas paralelas 3z2 y 4x2. PIIr Parall t Chord spaces(30'max.) T4iS5Es for more �'�' = t 1)TOP CHORD—CUERpA SUPERIOR °Infoimadon. •'� ��''� a t . Truss Span ' Top Chord Tampora,ry UteraI'E eace.(TCTLBj Spacing Vea el[FSumeIL / Lon Itud de ado Es aefatnlento'det Arrtostre Tem Tat da•Pa Oerda Su'a or acd BP Arri6ztre Y�y� 10 o.c.'max. lYfmnofalY � *B UD.Co30. �;rmanenkede The'end diagonai t Nasty 30' 10 les m3xlm0 s rp•c4erdas (brace for cantli v@red ' + , c max: 30`m 45 palC�eloS,Para mayor trusses must be placed Laterai,pra°ces 30a 45 pfe5 8 mximo informaci6n.. on veNcal webs`.tn.i(rte 2x4z12 length tapped ? 45 to.60! 6 o c.max: = With•he suppgrt,' overtwa mosses + k 45'a fib tes 6 tes m3ximo E[ 6o'. :�o 44 esrtut ma INS7ALUN INSTA�.ACIO.N ,. Q-,Tolerances for Out-of�Plar • Ttiterarclas.Para FUera•de Plano._ t Consult a Professlonal-Engln@er.fartrttsses longer than 60'r Max. ` russ I { tax.sow. 00_" Bow.'Lan Consiitte a:un Ingente�4 pars trusses de mas de:s0(less. Urgtr -+ �ck3la' 125� east omrt [Wreath�► �/s• t a s E( See 8CS7.82 For TCTLB .dons: lble Vea et SCSk%82 Para!as oVIongs, �(Oui o-plu far _ }t:-_r Qut of DWmb 3 ' de 7CTl6. � i il4 20 8 t Toteranctaspara ° 112' I 2 ' ' Fu@ a d@•Pfamada: t•3s' 220 " Plumb `3l4 I fir, t-112''- 250' ( Reran to93al�fi mmerV Sh@Et . ', Vas ef, IlCd trN. Repeat diagonal brads. 4 1 3!a i 3, —grrl `rr -� RePft31g5 arf(o5tY�.5' dtagonal@s d t�ltisslCta �CO'NSxRUC1ION LOADING CIYRGA DE COt�STR�tCCION din[echo a riot 3 g y " hfaxlmum Stack Height`,. Do not or with conitructlon until aU prJctn its secures c, agues` r ff��ff Set.flrst fir e ollss�with slecer pieces,then add dragottats Repeat Li l an or In Pta� z " {t # .tor,Mawriais�on.Truxses sa LJ process on groups or(60 trusses unut all trusses are'set z, No,proceda.corl la xnsvuCcibn hasty gU@.todos.lbs arrlros At+tortat. tcotyht In1_ t'ns eie-lot ctnm't><frlreros Vuss@s epftsespecradores;iuego IosaMostrof men miocados 6i Fprrna apropla6 y segula.' r s. 0ypsum;. o � draQonales.RePita Este procgdhniento en gnapos de cuptro tru%fe _ F $ ar a,�, 'PrywrooQ;a OSa 'x* to- hasty qua tddd5 105 tN55d5 OBf¢�in5talados _ Dan exce@d m%ID1lirR s Ck'ReC M., er AsphAPt:- las .z ixmdas +y .. _ -::. '. ,; :, - $1;mrrturv'She>`t Cons"tfsrtlon i0adino{ar mor@:)nCotma`�oP.. & Coneiate'BIocR. 6" -'9 ,,..r c h ,• P 'V" F Cie Imo 14 l$li9 `�No oxcedarlas rhAxtmas�altura's recomendadas�Yta ei(tea 2j 80TTOM CNORq=CUERDA INFERIOR- - - x # ' Rr S1 Gm t any s ridn par mayor taPorfnadbn•r' i t E� ,Laterdtbracer' - r "� f' 2z4k12 le f9tfvlSpped s r {'c xr ov@r.tw0ttttsses - � „ ._ � .. -v47 f�r 5a zn Do rwt oveftoad srhalt groups or sfrtgie tNusses 5 x# w, 1 Al * s¢ ` � " No 5abr@Cargt�e p@queRas grupa5 o tnrss@s inIrl4duat� , ' ' ' -3. s �, n •�* axty : x ... t#*H =S, k•s t a.m. "-, 3 F es'•"..,r b r" 4„+,.�". -PICCC ICbd6 aYCr Pa many w9coeS aE pastlbty .}.r, ''e a k :. .Y*<- es4 a�.-" ^a`r Lal9gV@ Ia5 CarC��S.abrntas 4ttd550S CQflSa'Sf!a D051b� #. s'ttaChagonai braces >" I-3f PosrHon toads over toad beaflttg watts +' ,s a''.Dk "r j k KS- Na, '.•k}'+1'r .-, i @Ve'tyi10 brUK ": .' tp- �.�,. LJ a.. =� -x n s s t `i spates(20 mpx)- n CoIbgUe lall camas sobre as pared@s sopamantes t. �:� - .�'� 'r-a.�,ig, � }.. •:,a � 'i a: .. .,.. x • ,1s°:. � .. c3 a, � sYm � .. zy ,-x i .� ,r �,� 3pLTERATI0N5s a 34 max , " Some m4r4 and web pie nbers fwt'shown for deril� ®R@ter to a e '' Y �-,� :.}-.2iw.. r a `.�` t -;�t• V'Ea el - BR9S�E NO BIOS 3s'" Pq not cyt alter 4r dr U dnY strupitral Memtrer of a truss ess a�- � 3}WEB^ptEPtBEtt PLANE DLANO D LOS MIEM. 4U A speeincalty permhted tyy tit@ Tivss;Qesign 6rawfng E - r t Ott s y NO Corte;at e 0 perfore ningiSn rmem=a tuaural ge tqs z t r f )trusses a metos gUe`Estk aspec Cram@7te'pz{nllbdo en el d(lxrjp .#'"" �• _ �. � �� ., ... }mow,�.., 7 "� - dP�F dlSerso del tN55 '� `. Webtrte0lt>QrSta� }TnkSSeSthathaYe,bApttoY@ftabd@gdtffit+g.ConSttUtxP4nM8(ter@dwtE7wu[dte.TrLrss.Manufactul@+ pAe approval rpay render theihiss ManUfar Direr s Upnred warranty nutf'andvdid a t#"� „ v Trusses que se hari bretargadO.i�Urante to cc3ngtrvtd P o hen srdo att dos sin only autmtzac# xt * spa *�' ';; > '` preina del Fabr}pntd@ lruss@si;Dueden radudr o ei ml sad'lo garattda del Fabtfcartta•tk Trirsscs :; 0 ,A- ` ,� 'fit 5� 4 zr, •'.*NOTE7 TTra Trios MenuroEoum ejttl irnes aessgrd+rtas:. roe itur raec+ttat the 4iu+v mt air gwogm,tort7F � "pauamtmdaote the moat fpvesOrefA[otlFat+Forar°P'irole�.'nm ctWooly-slt�lsar7+arrrta6Waeass(suulcttNaz+tN- e `^ ,� A£' a�`` °1cpaatratury,prexihesh ift}rrlb4car$wrtY:rhalhabpta sMaceafrnesoured„�re4matoed,ta'e!+sur4.tlm9da�o amiftn+�vua � Tlre3r nth �k + aaamiwtNr: �u =su? L •s Diagonal braces s nJssarira triad ueonthac�artve ezua4 rs`. D Z. �,rolm-'a des GiWNaJt De 4resentrfialgar a{iillaEfa;rrwMa4w'�°YW�!4?�srlaror fCrnCaFmraltn r Q m spa tea as F ia:Marrt&59in s t d"and '"`,. t'•:= � 4:.4� s v� r c r ,ceYQry,1Q�n!5§.r" ' 1 •� `rntkridaG:,i�+re5amina�ta^ �n urged and A'_.. s� "' "-5 aces(20 max),�. Una HWaWW1° Eracd'aytncWlM a'cthetrdsC tar r�1n>t6t9�C and txadn¢ uamtuma4asgw(6s4aa . 15,t>lBx. 'fir'-s ,.: :,p - u�o tiwss E+eciroNrmmuatlai c�nLnnw• }rti�i wnrrati�r t �xaad uK'rruarekW insvtuW r,��rlwrvx9a.r .. same s 1 "'.g _• rusl atY . _ ..- ., tq aanWeesaraj mum Iho uso,'nppkatiC„ry,¢r.�?Ke bkOflaaapl�Sa!Na+^`'C E i as bOtmrn C ar • Some chord'and web memt,@rs'not shown for'dattry. F lateral bracing. ; -� s* on Na r COUNCIL OF AMEfiICA TRU55 Pt�1TE INSTITUTE�� h DIAGONAL BftACING,IS VERY,INPORTANT /��, orewrraeenta s)oo�tamnsa.te t tnadion;;Ytis7)ts „,' r sSTp�ricdr pma nadison wrsa�fs. 'U fEL,ARRIO5TRE DIAGONAL ES MUYIMP.OfTANtE!- soa/l�a+s�s """""ovO u�`°" sos/e3rssao waw.rtorp r = rtiwau+st tzo9; & i a oFtHME T Town of Barnstable *Permit# S S Expires 6 months from issue date Regulatory Services Fees` * snxrts ABLE, � 1�9 ,�� - Thomas F. Geiler,Director p _/ prEt)MA't /II L/l Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number c7QA0 / 5 Property Address C/.l.� Residential Value of Work 207, Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address 22u2 0 Contractor's Name AIA nJ%l Telephone Number S1P_ �7:2 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) AlJrL ❑Workman's Compensation Insurance A-PRESS Check one: 2-'ram a sole proprietor JF P - z Q1•a. ❑ I am the Homeowner ❑ I have Worker's Compensation.Insurance T�JUVhI OF EiARNST/ 1 Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit 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 #of doors / ®' Replacement Windows/doors/sliders.U-Value 0� (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: Q:IWPFILESTORMSIbuilding permit forms\EXPRESS.doc Revised 070110 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations s 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): flu�ill. iI/x�r L Address: City/State/Zip: M i)k .,Ci 1 Phone #: �F- . Are you an employer? Check the appropriate box: s 1.❑ I am a employer with 4• ❑ I am a general contractor and I Type of project(required): 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 have workers" [No workers' comp.insurance comp,insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature ��.r Date Phone#: 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#: r 1 THE Town of Barnstable Regulatory Services 1ARNSTASLE, MAa9 g. Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Pro perty Owner Must Complete and Sign This Section If Using A Builder -bKp4 , as Owner of the property subject l hereby authorize �,vtn Ranh V\ to act on my behalf, in all matters relative to work authorized by this building permit. (Address of job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until,all final inspections are performed and accepted. Si ature of Owner Signature of Applicant Br�D��rL� Print Name Print Name V1 13( 1 ) Date Q:FORMS:O W NERPERNES S IONP 00LS l *THE r Town of Barnstable Regulatory Services BARNSTABLE, = Thomas F.Geiler,Director MASS. 1639. •�� Building Division lfD MA'I a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellines,of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. i ' —I ' DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the,,Building Official;that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official , Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for.which a building permit is required shall be exempt.from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:fonns:homeexempt ✓lie C�oryro7na�u�e¢lC/ o�/Glaaoarizuaeka Office of Consumer Affairs&Business Regulation " HOME IMPRQVEMENT CONTRACTOR Registrations: 1,64936 Expiration i 1 1 Tr# 291252 Type =1�uRi�f- KEVIN M. HAMLINE_ KEVIN HAMLIN ' I 43 WATER ST - SANDWICH MA 02563 Undersecretary f. ri License or registration valid for in"dividul'use only before the expiration date. If found return to I t�fBce of Consumer Affairs and Business Regulation ,k #Park Plaza Su"ite 5170 . Boston,.MA 0211E Not valid wttlrout sigpature i Br�.11 rrhutiEtt�'; p Co of Buil�i�.r il).lrin.. i nstructio R�.ulatin oi'plfNli� s r 'tense, Cg . 1 0 4134SUPervisornl i Qnse`In[llr q`: . (: . 43 NAMLI WATER s N N4kviC T H' MA-02563 Ezpirati on: 2/1-1201 4. Try. 104134 j 7V� Q # Tt MIF To t� ( t.l_ �4T?� —ro �oG r17s 71) TO, O + I 3 coLn s n Z8i u 0 ° cx c- m v o o { 1 w o C 9 O weOD 7 t� GOM4f0 ,4 Lo_ � NAY o .� N . J (D N p 343o; C . CCU p r �A0M _V`K ' �ta TOWN OF BARNSTABLE l ` SP = 5 DIVIS- it N ` ' _� M N M �= All - N MASS 0CUDILO 2� ►AICNELE yGs� w I o Ko.34774 >� v U STRUCTURAL pFG151�P� SIQdIL�. 1 �r ,, , MICHELE CUDTLO`, P.E. P4CF pt,4f 4U r p t-yt4 Consulting Structural Engineer Centerville, Massachusetts 02632 508 771-7601 Drawn By: MC Date: �p �(( Drawing 7( CAMr Scale: AS NOTED Rev. p 2 nr 1M� File Name,"0-}MLJA_ Project S K— No.: �� STP TOWN OF OLE s r -6 F DIVISO i a d f v s I ® � � gip; .. •� � �. ,.� I ; I BRACING FOR 3x2 AND 4x2 PARALLEL CHORD TRUSSES BRACING FOR THREE PLANES OF ROOF EL ARRIOSTRE PARATRUSSES.DE CUERDAS PARALELAS 3x2 Y 4x2 Maximum lateral brace spacing EL ARRIOSTRE EN TRES PLANOS DE TECHO Refer to BCSI--B7 10'D.C.for 3%2 chords mina Sheep • 15'o.c.for 4x2 chords Diagonal braces t r7(This bracing method is for all trusses except 3x2 and 4x2 parallel chord trusses. Temor orary and ,0 of�5 every 15 truss lJ Pemanent Bracing_ Este mefodo de arnostre es para todo trusses excepto trusses de cuerdas paralelas 3x2 y 4x2. for Parallel Chord- spaces(30'max.) Trusses for more 1)TOP CHORD—CUERDA SUPERIOR information Truss Span Top Chord Temporary Lateral Brace(TCTLB)Spacing Vea el r Longitud de Tramo Espacianiiento del Arriostre Temporal de la Cue Su ardor B`S�po al vArriostre I) N Up to 30' 10'D.C.max. fi The 10 pies maximo permanents dg end diagonal Hasta 30 pies trusses de cuerdas_ brace for cantilevered __ V. i 30'to 45' 8'D.C.max. paralelas para mayor trusses must be placed Lateral braces E 30 a 45 ies 8 pies maximo information. on vertical webs in line 2x4x12'length lapped 45'to 60' 6'o.c.max. with the support. over two trusses, 45 a 60 pies 6 pies maximo 60'to80'* 4'�� max. INSTALLING -m INS'TALACION 60 a 60 pies* 4 pies maximo _ / para Fuera-de-Plano. R1� 20 :Consult a Professional Engineer for trusses longer than 60'. U Max.Bow Max Bo" Consulte a un ingeniero para trusses de mas de 60 pies. — Tolerances for but-of-Plane..�o erancias ' c Length---Y" ' i Max.Bow. rl( See BCSL62 for TCTLB options. � T Tolerances for � � D/50 D(ft.) Vea el BCSI-B2 para las opciones „ Out-of-Plumb. 8' de TCTLB. Z'31 8' Tolerancias para Fuera-de-Plomadif. d 'I Plumb22.9'1.1/2' 25.0' Refer to Cf3�L-66 wy:.;� 1-3/4' 29.2' 2" >_33.3' Cable End Frame D/50 max 1>11 ' ,'Its3SJII9• a 7�. �.� Repeat diagonal graces., .� � ;�'»,{�1 1.3/4" T ! Vea el res6nl ;�..<`- Repi[a IDS arriostres 2" BCSI-B6-Arriostre diagonales. del truss t rminal CONSTRUCTION LOADING—CARGA DE CONSTRUCCION de tin rs r Do not proceed with construction until all bracing is securely Maximum Stack Height aouas• (-7{ Set first five trusses with spacer pieces,then add diagonals.Repeat and properly in place. for Materials on Trusses lJ process on groups of four trusses until all trusses are set. Materiel Height(h) No proceda con la construction haste que todos Ios arriostres Gypsum 12 Instaie Ios cinco primeros trusses con•espaciadores,luego los arriostres esten colocados an forma apropiada y Segura. diagonales.Repita aste procedimlento en grupos de cuatro trusses. plywood or OSB J hasta qua todos!os trusses esten instaiados. Do exceed maximum stack heights.Refer c$551 L Asphalt Shinglas�� z nundles� i 5�mnotmary Sheet-Constructior:L,oadi 9 for nyore information. concrete Bi:xat— a" Clay Tile 3-4 dies higt: 2)BOTTOM CHORD—CUERDA INFERIOR I, No exceda las maximas altuias recornend €@ adas. Vea el fS�rte0. \ BC l-B4 Carga Oe.CnrstrucCi6o para mayor informacion. Lateral braces G`' •^ -., _ _— � il, 2x4xl2'length lapped 1 U t over two trusses. - 4,r 1 ® Do not overload small groups or single trusses. I No sobrecargue pequenos grupos:o trusses individuales. Place loads over as many trusses as possible. o Cloque las cargas score lentos trusses Como sea posibte. 7 - 1 i Diagonal braces I n( Position loads over load bearing walls. { every 10 truss LI Coloque las cargas sobre ias parades soportantes. / spaces(20 max.) 10'-15'max. ALTERATIONS—ALTERACIONES a5 Sh r_T «Da i_ne lY obs re�d La Qn zLd]ILitallatlon Error. Some chord and woo rnembars no,shown for c:a',.r � Re:c;to BS�l��L1rTa,2 f-."s:•- ` I Vea el( £LL@BSI:t:.Pah .CU.SSf: .4ad zii'L',:eLionr,»�:en!a Ob;�y rror s nsIe.C1Q0. iDo not cut,alter,or drill any structural member of a truss unless 3)WEB MEMBER PLANE—PLANO DE LOS MIEMBROS SECUNDARIOS I specifically permitted by the Truss Design Drawing. I ` No torte,altere o perfore ningi:n miembro estructural de IDS trusses,a menos que este especificamente permitido an el dibujo del diseno del truss. ° i j Web members Trusses that have been overloaded during construction or altered without the Truss Manufacturer .. T ® prior approval may render the Truss Manufacturer's limited warranty null and void. Sri, Trusses que se han sobrecargado durante la onstruccion o han sido alterados sin and autonzacr prevla del Fabncante de Trusses,pueden reducir D eiiminar la garantia del Fabncante de Trusses NOTE:'he Truss Manufacturer and Truss:,es grie must rely on the fact that the Contractor and cra.9e operator('.(apDl inDie)are c. 1�'\�..•� t» I gable to undertake the work they hive agreed to do on a particular project.The Contractor should seek requiredany assutaiue regards s' ~,•Y-1 �� � tl CAnstru,,io,practices from a corpetenl party,The methods and procedures outlined are intended to ensure that the overall wnstrucur �',v,^ '•�.'"�-� d; techniques employed will put Door and roof trusses Ictu pi3ce SAFELY.These recommen'dAws`or handling,Install ng and orac n9,va ``"�• ' r - I trusses are based upon dte collective expr:nence of leading technical personpei in the wood truss industry,but must due to the nature Diagonal M ti" l braces BVC' lO truss, - responsibilities involved,he presented only as a GUIDE for use by a qualified Building Designer(r avided y erno t r contractor It inr ry ,, intended that these recommendations W interpreted as superior w ary des ig specification(Dlovided by ei!ner a trusses a Engine S v SpdCeS(20'and%.) - the duiiding Designer,the Erecbongnstal ition Contractor,or otn9rwi5e)for handing installing and bracing wood:ruses a•x1 rt de 10'-15'max. not preclude the use of other equivalent methods for bracing and prcvldiof stab I a u the walls and columns a may be determined 4' Ne truss Erection/Installaodn Con[2ctoc Thus,the woad Truss Counol of America arw'the Truss Place Institute asp essly disdain a same spacing responsibility for damages arising from the use,app abort,or reliance on the re ommendations and information contained cnn as bottom chord Some chord and web members not shown for clarity. AIR- r, � !,lateral bracing ' s ■WOOD TRUSS COUNCIL OF AMERICA TRUSS PLATE INSTITUTE DIAGONAL BRACING IS VERY IMPORTANT 6 One VJTCA Center•6300 Enterprise Lane•Madison,WI 53719 583 D'Onofrio Drive•Madison,WI 53719 608/274-4849•www.woodt ww russ.com 608/833-5900•w .tpinst.org iEL ARRIOSTRE DIAGONAL ES MUY IMPORTANTE! g1WARN11x1703: t 1. r, Tone OF BARMSSTABLE 6 Ri !: 0 5 ITST 0_' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # �6 t 61 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address -7(o C.AvA P O PE C N Eg- Rd Village GL SIT-` v It 15 (Vl►� . Owner lv i- � ti EA— Address _7 6 C•A-W1+P b PEC 4� CZA Telephone Permit Request Fovz_ Iyt'cYL.(aot— LL'C L oN at= SF(� �+z-o�lt. � ta.s� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 00 Project Valuation l 00 Construction Type Lot Size I (o Grandfathered: ❑Yes • ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure gS'x YLc, 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: as _ existing _new Total Room Count (not including baths): existing S, new First Floor Room Count Heat Type and Fuel: ZAGas ❑ 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) Name 1 c�vv� 1►..) -f j I Telephone Number �9 IN �=d�v1 Address as I-�w�vL�C..k�N � S. .�icense # 7qa a 'R � 2esTazA'Zw" 56AL/I MiC, Home Improvement Contractor# / oo)9 c) t;l Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �wti ot` YA✓UAA-DQI_J4 ��S ASS SIGNATURE �� `L/� DATE 31�& k� r s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION t FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r' FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. f The Commonwealth ofMassachusetts-, Department of Industrial Accidents • � OcOf ce of Investigations ' 0 600'Washington Street g Boston, MA 02111 ' www mass.gov/din •`_ Workers' Compensation Insurance Affidavit:Builders/Contractors/Elect.ricians/Plumbers Applicant Information Please Print Leeibly Name(Business/Organization/Individual): .Whalen -Restoration Services Address: 22 American Way City/State/Zip: South Dennis, MA 02660 Phone#: 508 760 1911 Are you an employer?Check the appropriate box: Type of project(required): 4. ,Q I am a general contractor and I 6 ° 1.(�I am a employer with .. []-New 4 construction employees(full and/or part-time).' have hired the sub-contractors 7 Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub-contractors have 8. ❑ Demolition workers' comp. insurance. Building addition working for mein any capacity. �, ,., 9• ❑ g [No workers' comp. insurance 5•.El We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.El I am a homeowner doing all work right of exemption'per MGL 11. Plumbing repairs or additions myself. [No workers comp. c. 152,§1(4),and we have no 12.�Roof repairs insurance required.]t 41' employees. [No workers' 13.❑ Other conlp.insurance required.] •Any applicant that checks box#I 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 aonttactoi s must submit a new affidavit indicating such comp•policy xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers' fic informration. I am an em't 'er that is �rovidin workers'compensation'insurance or m em to ees. Below Is the l "Job site p oy p g .r y p 3' pa�' Information. Insurance Company Name: Arbella Protection Co. Policy#or Self--ins.Lic. #: 9091320408 Expiration Date: 4/1/11 Job Site Address:-7 b 4AVV\P t PFC 1A LE d2 City/State/Zip: CENT-z-YW c 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 ofMGL c. 1.52 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and,penalties of perjury that the information provided'abosw" true and correct. r_ Si-gnature: Date:`' Phone# Sbcs -7(00 lcl l of)`wal use only. Do not write in this area,to be c®napiet ra'by city or town official City or Town Permit/!.icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clem. 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact.Person: Phone$: I - Date:,3/,18./2011 Time: 8:56 AM To: 9,1508-760-9995 Rogers E Gray Ins. Page: 001 Client#:32193 WHALRES ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 3/18/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Ins.-So.Dennis PHONE 508 398-7980 FAX 434 Route 134 E•MILo,Ext: (AlC,No): ADDRESS: P.O.Box 1601 PRODUCER cus7oMERIDR South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC R INSURED Whalen Restoration Services Inc INSURER A:Arbella Protection CO 17000 22 American Way INSURER B: South Dennis, MA 02660 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR kDDPOLICY EFF POLICY EXP TYPE OF INSURANCE al UBR POLICY NUMBER MMIDD/YYYY MM/DDIYYYY LIMITS A GENERAL LIABILITY 8500040398 4/01/2010 04/01/2011 EACH OCCURRENCE $1 000 000 DAMAGE To RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $100,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $5,000 PERSONAL It ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIM17 APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ A AUTOMOBILE LIABILITY 74917400001 9/25/2010 09/25/2011 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 BODILY INJURY(Per person) $ ALL OWNED AU70S BODILY INJURY(Per accident) $ JX SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AU70S $ A UMBRELLA LIAB X OCCUR 4600021586 4/01/2010 04/01/2011 EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000000 DEDUCTIBLE $ X RETENTION 10000 A WORKERS COMPENSATION 9091320410 4/01/2010 04/01/2011 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED' a NIA - - (MandatorylnNH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,00 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Project location: 76 Camp Opechee Road,Centerville,MA 02632 CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Brett Dubner ACCORDANCE WITH THE POLICY PROVISIONS. 76 Camp Opechee Road Centerville,MA 02632 AUTHORIZED REPRESENTATIVE 0 198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S647181M61439 AMP Restoration Services Inc. , Fire, Smoke, Soot,Water Damage&Mold Remediation Services /X/A*4Cleaning • Deodorization • Reconstruction Specializing in Fire Restoration - All Work Guaranteed Access, Authorization and Direct Payment Request Form I (we) authorize WHALEN RESTORATION SERVICES to perform work as per estimate at property located at 76 Camp Opeechee Road, Centerville, MA 02632 to repair damage caused by fire on3/16/11 As owner(s) of this property, I (we) understand that I (we) must authorize this work. I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept responsibility for payment upon completion. (we) authorize and direct my Insurance Company Barnstable County Policy No. HOM00354197 , to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists, for doing this work and to that extent I (we) assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. I (we) acknowledge receipt of a copy hereof: OWNER DATED SIGNED . i 1 OWNER WH EN ESTO ION REP. SIGNED 22 American Way, South Dennis,MA 02660 Phone: (508) 760-1911 Fax: (508) 760-9995 • 1-800-244-2598 • E-Mail: restore@whalenrestorations.com Web Page: http://www.whalenrestorations.com OFFICE COPY GTE P� � ✓li Office of Consumer Affairs& usiness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business`Regulation Registration: 129244 ' Expiration:' 7/30/2011 Tr# 287004 ' 10 Park Plaza-Suite 5.170 Type: Private Corporation Boston,MA 02116 Whalen Restoration-:Services Inc. f William Whalen _ 22 American Way South Dennis,MA 02660" Undersecretary Not valid without signature t. V - Zlassachusett. - Department of Public Safet'A Board of Buildin'. Re�_ulutions and Standards Construction Supervisor License License: CS 74928 WILLIAM WHALEN a 122 POND STREET I BREWSTER, MA 02631 6, Expiration: 8/10/2012 ► * ('ununi �i mer Tr#: 70 Assessor's map and lot number ...c2./P..r../ .v " ' ' S TIC r T � —�� 7 • SYS M MUST IRE. INSTALLED IN COMP LIANO ; � • WITH ARTICLE II STAT E Permit number . ..G .... SANITARY CODE AND TOWtq - FTHET� IREGI TI)RIC �o TOWN. OF BARNSA�`LE BABHSTODLE. • .'" MAa.re iG39 - RUI DING INSPECTOR GD � ..,� , to- .otE O MpY a � a' �= APPLICATION FOR PERMIT,TO ... J..: TYPE OF CONSTRUCTION ............... .................................... {., ... ... .... : .. .19.7 TO THE INSPECTOR OF BUILDINGS: The undersigned j/hereby applies for a permit according the following information:. Location ..<.�P....�JL��. .1...�? .�...& �f... .!.l�Xtu.4J ......................... ................................:.. q. Proposed Use .............d4ly-l ................................................. ....................... ......................... ..............................Fire District . . � ui�. ........ Zoning 'District Name of Owner. X!yJ'1 ..k... � ....Address ..... .....i. 0 Name of Builder .....-/ L Aga. ................ U..Ip ............................................------------------- Nameof Architect .............:.....................................................Address .................................................................................... • Number of Rooms !�......... ..Foundation ............................:........................................... A Exterior �......... ...... ... . . .............................................Roofing ... ........ ... .. ..... .. Floors .�.......... la ..602.�r .......................................Interior .�.:. . t�� ..... ......... ....�.�5,!u!�!�....... Heating .J... . . .. .. L��: t1t...1 .. ........Plumbing .....:......... ............. ... .. . .. C .............................. Fireplace ..............................Approximate Cost �p d '.. 1�.... .................. ... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ......... ..... Diagram of Lot and Building with Dimensions Fee /!.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name °� ..................J..l.:...� ,�" ".< %S :` .......... Mathews, Gemma H. t r 18776 v tir remodel frame No .,, .Permif4for.............................. *, dwel 1 ing `s Location .........76 Crocker Street _ t ' ....................................................., Centerville • r��,*����` �'�' • .., ................................................... ................... • �- f• r Owner .............Gemma H.: Mathews Type of Construction ........frame ................................. . *.....`.......... ..... Plot ... Lot ................................ T Permit Grant@d'......O..ctober..28. .....19 76 '` Date of lns action M. ..� ` ... 19 Date ECompleted .... / �7.. ..............19 'PERMIT-REFUSED - . ........................................................... 19 , !'........................................ d t 4 L ............................................................................... ................................................................................. ;. ........................ ............................................... CA i 'Approved ............... 19 ................................. .............................................................................. t .................... ......................................................... ^+--E . . ,�C .., -.:,: � �;,,,,4a..�r>w! r..+ yFy'.. '-. ...+e�.'.a..z .:.�;..+ -•. .r.'+�-,wt'-. ...�Ca ^.. ...,..a�..n�xa.-:-�..'.w�wr,'...:-...��.h....,-',„^..-..:..^g. Assessor's map and lot- number ........x ......... ......... r.....SJ U!�' j . Sewage Permit number ...............� 7HE.r°�°, - TOWN OF BARNSTABLE i MAE33TADLE, • e. o YAr. BUILDING INSPECTOR !/APPLICATION FOR PERMIT TO /1,/ llsn...................... rf....'1'1 TYPE OF CONSTRUCTION ............ r9 rxf -+ i19?i f' d t.l off ........................................r� ... _TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies forr'Ia permit accc�ording� to the ,following information: Location ``�...�'(,t f' fl(t tr't: a , _1W)l6................` ;�/, t ? ................................................................. ProposedUse ........ .. Id. �.'.... .v/;e ....... ................ .. ................. Zoning District .... Fire District ..., ,tfr ...f........... Name of Owner 4! .A ;1YW)t,,1....X!:...1*1J;7,C� ( /....Address .....X .. Name of Builder v......-ii,lAdi� .�. �?F!����...Address ....................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...........��;•/.v......................................Foundation .............................................................................. Exierior k'`..... ..................Roofing Floors ........... .. .. ..:. ......... ......... ..................................Interior ......... ......... .:.. Heating .. �... ....� c_ \,....� `_ ....`...��.. ..............Plumbing•....... ....�... ........'r...................... Fireplace .............t....................................................................Approximate Cost Definitive Plan Approved by Planning Board ________________________________19________. Area ;:...-...::...._..... _:...__............ Diagram of Lot and Building with Dimensions Fee C............ .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH { f � _ t I y J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ,,�f �y / Name . ........... D Mathews, Gemma H. A=210-150 ` No J1 776 Permit for ....remodel frame dwelling,, Location 76 Cen erville Gemm Mathews Owner .................. ................................. Type of Construction frame ............................................... Plot .................... Lot ... Permit Granted ...... ......28...........19 76 .Date of Inspection .....................................19 Date Completed '..... ...............................19 PERMIT REF SED ...... .... ....... ....:./ .. .. r' ........i. ...... ........................................ ................. ......... .................. ............................................................................... 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