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0108 HOLLY POINT ROAD
�D� 1�bYl � �o i n� `��, , ., :� __ .. . a � ��� i e d . . . � a i �' _ C . _ 1 ..� Town of Barnstable ildln : . i `. Post This Card SoTFtat rt�s Visible From the Street Approved.'Plans=Must be Retained on Job and'this Card'Must be Kept trrwes , T"" Posted Until Final�Ins ection Has+BeemMade 3 ,, Yx Where a Certificate of" O,ccu an c ,'is Re wired,such.Buildmg s.hal4 Not be Occupieduntil a Finahlnspection has been made �a �� Permit NO. B-17-3374 Applicant Name: BRIAN L DUBAY Approvals Date Issued: 10/12/2017 Current Use: Structure SonmS ' Permit Type: Building-Addition/Alteration-Residential Expiration Date: 04/12/2018 Foundation 3 9/,6)em Location: 108 HOLLY POINT ROAD,CENTERVILLE Map/Lot-„232-041 Zoning District: RD-1 Sheathing:' Owner on Record: MONTGOMERY, MALCOLM K&PAMELA B Contractor Name ; _BRIAN DUBAY Framing: 1 Address: 36 HADDEN ROAD Contractor'License �156162 2 SCARSDALE, NY 10583 x �' ..Est Project Cost: $4,000.00 Chimne y: t s Description: new trash shed attached to side of house 4'6"x6 Perrnit Fee: $85.00 r Insulation: Fee Paid:` $85.00 Project Review Req: Final: K /Sf x Date 10/12/2017 Plumbing/Gas lot f Rough Plumbing: Buildin Official 3r _ g Final Plumbing: vim" i Rough Gas: .This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months�after issuance. g All work authorized by this permit shall conform to the approved applicatron and the,approved construction documents"for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. Final Gas: ,, �r ��' fit' This permit shall be displayed in a location clearly visible from access street or`~road and shall be maintained open for public mspection for the entire duration of the work until the completion of the same: Electrical .Service: The.Certificate of Occupancy will not be issued until all applicable signatures by the BuiidM&and Fire Offiaals;are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:4 Rough: i.Foundation or Footing ,. 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed . 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection- Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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). Fire Department Building plans are to be available on site Final All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel Application # -/ T 3 3 7 Health Division Date Issued =- s7 ' ll� Conservation Division Application Fe Planning Dept., Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address sA Village l c,-Ac��C,c 1A V_c Owner Col1� ¢ri` ress 36 QJA,. ROO Telephone I " N T_ q0 o n Permit Request N env f+M&S Aj) L�° SIA)e Qd- �a ys� GAS l'h e��c� ®fin �"10� @�A4►'� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Types 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.ft) Number of Baths: Full: existing new Half: existingj � new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First FI'oor Rodin1Count Heat Type andFuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: a/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 diLNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION `: -(BUILDER OR HOMEOWNER) Name o Telephone Number 7? �7 �-� Address PO Qo-r-' lo_C License# C: S - (7 73SbJ Home Improvement Contractor# Email S CCJQ �� o �o c'h. Worker's Compensation # �,�®�lt9C; II !07 ALL CO __NSTRUCT'ION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� �oCco Lo SIGNATURE DATE �� FOR OFFICIAL USE ONLY .APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION K FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Si (o aces- I�� � � - - �- -- ��e �ioa��n�aoaacuealC��C�,ea�ccaeCifa . Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Remstration Expiration Office of Consumer Affairs and Business Regulation 1�56162 06/06/2019 10 Park Plaza-Suite 5170 BRIAN DUBAY �r r Boston,MA 02116 D/B/A B.LD RE(VOVATIO i BRIAN L.DUBAY 31 SEAMANS LANE^'' —""� Undersecretary BREWSTER,MA 0263� ;1thout Slgnatur@. y Massachusetts Department of Public Safety y Board of Building Regulations and Standards - License: CS-083505 Construction Supervisor BRIAN L DUBAY 31 SEAMANS LANE i a! 1 r BREWSTER MA 0263,1, AL �'�rt _ Expiration: Commissio er 09/25/2018 f _ ti Construction Supervisor Restricted to: Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIPS Licensing information visit: WWW.MASS.GOV/DPS t a Ali The Commarrilpea ofMaEgadmsetts. Departneut af -as-&W Accident Offwe-afro gatims 690•Washingtow rS treat _ Baston,MA 02111 ' tt�tv�u r��us�gaP�iiicx urrlmrs' Campens.3fimaIIIsmmnc fMavit`13atIdex-dCuntmciurMec€ricians(Phombers Applfc2mfI�c�rm3f zl P� ase rmi Address: O 1 CitgfS'ta-e ;--. �c �� Phan rlre you an employer?Checkthe apprapride.it ` Tylre of project(retlnired)_ L❑ I am a em 1 �. 4 I i am a geaeral confractor and.1 p b 6. ❑New constracfiog emgleyee�(full an�for gaz#-#ime:�* Ise lvred.tf�e sir-ca�.k�t-f�s . 2.❑I am a sale proprietor orpartnef Tisted onihe attached gf�ect. 7- ❑R�adeltzlg Ti�zse sib-caracars Have • slop and have no employees . � S.,❑Demolifiozr ` -wodQ forte in employees andhare wars* rin zry y c msurant $ �- �mldmgsddifiau. IN4 wa�� Ca-mp.Msa==5 comp- ' re�sired] 5- El We are a oorPm-ation and its ldl ElEleeiFical repairs or addshaus 3_El I am.a bomemm:er doing an work affcers irdve exercised� 1L❑Piuurb ngrepaiss or ad�iians � o dam.Czmp- uglbt,of exe npffon per}5!IGL �❑Raofregaizs c-�. �l(�and t�eTiavena employees.INa WAE& 13.❑Other camp.ins =nm regmred.j gay apg}i®t�at cfie�tsaz l am:t alsa fiIl ant a sectFaabeTaw sc�da5 die¢wo3cer �P �Pa FR mL SamEoamersu�o biaud-mondi � enrFi =b= das Ada«it thz try xmAai-afw3m16=hEP outage contr ck--d Sm � s fCa cs3utchec�ihisbox atesaaddiSanslsbeetalmwingfl+cn=eofthesub�m and sbihevrkehecarnotihnaemEtkashsre emp5oyeEs.Ifthesvh caatradnEsf a emPIofet�f�e�'amstFm4�de tlr r saar�'mmp.paIi a�sbes I arrt art ersgFul�r ffirrt i,grauidurg u�rkets'canrperisrdiart itrsrirat�ca j'or rrzy empl gee Reloty is f iTpalicy amd jab site irc,�arracrtiart hsa ce Company : 'PORGY 4 or self-his-Iic¢ gifafian]]afe: Job'Ete Addt Ciiy(S a: Aaarh a.copy of the ry orkere compwsxfiQnpolic-dedaratims page(shauiug the poRry,mamhher and expiration date). Faiinre to se=e coverage as requiredun&r Sa=kon 2.5A of MGL m U2 can lead ja the imiposid=of criminal penalises of a up to$I,1Q0 4a aadFor ana�earimgrisor as wel as civil peadges isle farm of a STOP WOK ORDER-md a fiae of up to$25100 a day aaaint the viola nr. $e adzdsed that a ctxpy of this staterned.may,be forvarded iu the Office of Investigadons of$ie DIA for insmmce Coverage ver on_ , Urfa kcriy cet �raarx tits ands pgrtas a.fFdxcrl'fiiattFte utfat- ort prmicl�d abw�is bra avid correct a1�►rE;: - Dater va . 1 4 Phone� �� _��-� '�0 � • t),okitdawanTy. Da not rrrkff in fftis=ea,fft be winpletad 5g city artown afai2t City or Towu.: PernAff- pease# Issuiatg Anffimrfty(circk one).: L Board of$eaIt€t 1 ceding DePm went 3.CitY,t£o n Clem 4 Flectrical hispector S.Plmbmg h2sperter 6.Othw Can4act Person: Fb:ane#- -- 6' a a� and f c oxes Information . G n,d Laws c 152 ryes.all=oY� 'P de ,.c°arpeasatzon or$sir employ - g in tilts statofn,an�Iaye=is dsfined a3-w_�yPesonin.$}-e srrvice of anti=md�aaY Cum t°� eagress or implied,_oral ar " as man ink pa ,asso�on;corporatron or other Iegal ey,or any or more AiL� � �� dives of a deceased�pIoyes,or the €the f ?ng in a Jomf crpnse,and inclndmgiiie legal rs aasoc;iE i or olhmr Iegal enfrCy,�Y�m3PIoY However fhe re,,jY or trash of an in. PEIA or the of the- ownerofad�elIm househavingnotmare�tb=agadM=fSandwhorDn&Sfbehm, o, a dwrMng house of anon Who=MPloys pesons to do maim m,caus mcdon or repair w�on sock dwell�g haose or cm flee grounds Or bm mg aggnr�az¢ thereto shallnotber:,anse of sorh�IoYmr�tbe de=edfn be an eozplayen" MCs`L chapter ISZ,§25C(�also sty that¢every sty or Iocal li=WlIIg agency shall�haId$ie issaan�ar r�ewal 'f a Ecease or perurit to operate a h®aess or to cnnsirurf bmZd�g�za the common�ealf for any RP, has notprodnced acceptable evidenm of campliian.cewith ixcsatatrce rnYeragaregnsed-�' AddffinnaIlY,MCA,chaptez-152,§25CM sfafrs-Ieifi=the nor any ofits poIifical subdivisions shall emtex iOtD 2M forthep�anCd ofpablio wcalcmtl accepf able evideo.ce of con�Iiance rite ins�ance• rerp>honie:f,-of f is have lieca P==d=d to rite c g.a�iioz y.,, easy n.affidavit completely,by = g ffi boxes that aPPIY to your Mfsaiion and,if Phase fiZt oil the wow'cp $tell cerfffis)of necessary, PIY�r(s)namme(s),ad�s(es)aad ph.one-'mmb¢(s) aTorg acmes or Limit IbbiTitp Prigs( )�rthno r�Ioyees other than the L= .ii>:d.Lial?il¢YCo� ��r ensaiioninsm�ce- Ifan7I.CvrlLPdoeshage members orparinexs,a -notremedtn emery r =Pioyess,a Policy isrtltl� Beadvise tTadthisa$dmyitmaybesn tothoDegafinentofrndusfrial Accide�s for conE=3 ion.of fi rr . ce coverage Also Ire sure in siga and date e affidavit The at aVit shovld heir ed to e city of town that the applka�nn far the peovif or license is being notthe D.rparfineat of Tnrhocfi-i�T A,MIden� Sbouldyonbavn any ciu s ms r6gar�g a lam orifyon areruedto obtain awogs' Compensation policy,Please call the Deparfraent at$ie=tuber lis�belovt Self-insrn�d cc anres sb anld ear ljieir self-insar�ce licr�se number on the appr�IiIIe. City ar Town Off irlaIs _ r Please be sore that fhc a�dav¢is cnmplete andpri ed Iegrl�ly_ The Depemmithas provided a space of the bow of the affidavk for you to:El out in the ev�ot the Office ofInv ct has to confayortrega�g the aFT ` t. pleasebesr�refofr7linthepe icenseao;nberwhichvMbeusedasareferen.cem=br�Inaddition,onaP Pant that Mrust submit maple pemzrdH= se gphcslions in any given Yam,neem.o�Y=butt one affidavit count and mzder"rob On li�_rc&'-Le applicant shoulder¢aU lcymE--ns in (i `o policy infor�f on(¢��y) ed or..i d.byALm city or town maybe provided fn the ' town)-'A copy ofthe-affidav Ahas bow officially stamp applicant as proofthat a valid affidavit is on file for fni�se'permlt;or licenses. Anew affidav �C be filled oot cant : yeas. where a home owner or cit" is obta ui g a fieeuse or p=it notrelated to any business or commercial v� dog liceose or pemut to bum leaves etc-)said person is NOT rid to cOMPIcte'this affidavit I Office of In�7e�figalinns wovldlike to tick yanm advance for your cooperation and sbould.yon have any qFh�> please do nothcsihdr to 1mms a C�z Ihe geparlme�s ate,fnlepb one and fax rmmbex: ftt).=Ehoa of MgssarhMsettg - ' Depa�mt af1i lAwir�t� , R }24 M&E1 11 Rax#R7-727-7749 g�gised¢24-0 T Ma�-g!aTIER- '00 Main Street.Hynnnis,MA 02601 w'rrK.to�r fl.N n me tv UT F m a.its ce: 508462-9038 Fnx: 508.790-6VI .Property, Owner Must Complete and Sign This Section I 115. i:n B 'Idcg I� �• �l ��`� �.�5��r�1'�^S�\t�,1 ns Owner of the subject property berebc nutltori�c m,LO' a ct on rnT beh-- £ in all matters rr_tatirc to nrork authorized by its building pednit application for. (Address`o ob) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are perfo, ed and accepted. SW a of er Signature of Applicant Print Name - �U print Name Date. - ----------- ------- • • h 2+-V d�tS�i C, i — I 3 i j _ v e. 'D Jlo 'F i i 69 _),OYv . �r�eC _Jn 0, ry\�' Ste ---- r -T- l l i f d j �S L ( 1 �� j Q.v —� v h e� �(t9 n e v O 4 i i ' ' r c, 00 Oc OVI S� ®n if 1y �-- W co ■u=u■ Town Boundary 'r 't .23-3so - a - • .. ; I' ::: ,' ri".""tl 12'-456 Parcels FY2017 41 C36n Address Street Numbers 1 + fi f a Buildings ' •, s yq� q• �Sn TW Y'. ,h ='. ' �Rm ''.. .ski fi '1 .. .. y P ,'' ,i. n'C ••fix *'• Decks/Patios '" ! P _.. O` ` ti r� QOAbove Ground Swimming Pools ,w 't,� i�"" ,'' ' i, ,A` r § -. In Ground Swimming Pools I „ -p Paved Walkways pI { I'..:;i; #94 Unpaved Walkways t "r .: '0 4 "t Paths ! � � O ® Stairways Paved Roads rF Unpaved Roads Paved Driveways 4 Unpaved Driveways ° •= r" n��9 f i • Painted Lines ,.ti - ' `°r' •. ," O Paved Parking Lots Unpaved Parking Lots ar_::, � M,. l `,L" .. •;' �• 3,z ° .�! ^, a§l,x' " --- .............. .9._, >ti " w Bridges Railroad �. ."I . : ny, i Ih ,iaN� � .' �.� �• � ', gt x a ;, h t —ice FencesP, r Guardrails �s ti ip - O— RetainingWalls 1 tib Stone Walls '_ VV § Other Walls Y g l:: Hedges b III Imr d I' w h. , x E Q dw Sports Areas '� - ``�-'� Golf Areas 1N 'G "?. ^•" ',ti {, nry Docks/Piers Boardwalks /A2 Jetties .. €- L Streams o Drainage Ditches. y Marsh Areas QWater Bodies X Spot Elevations(NAVD88) C= Topo to fr Contours(NAVD88) m9 "+ ' '�' i^ tiI hM K�... �I''yu •t: � rti= 'E* ,. 1a✓} r;. ..._ �„, a a:• w .i T0 o2frContours NAVD88 I Wooded Areas x .Street Trees , -,. �' . ,..• .. ..... ., .,. .•..... ........... * . 3 3r as ,: v , ..,: .,....{{.•: Catchbasins .,:',•�,.. .kr I. II,, ,», I..,qpe m - ..,wD+ t iulaln a. � .. i.x Monuments t .w!hti ": z' y 233-040.'.:::'::! :.•:..::. �p Lamp Posts .i ' _ }.• .,'-�', ,"... # 120 --- 7 Satellite Dish 9. •_�:.? M��',a•, . .: :.. »�, :� .. �, :•::_....•'•'.', `::: •- ....; ';..r �P R• .,. - 'F. M§1,N"9:4 F �a Im'I Manholes �da .�'c ,. ..... � � xri+ y F., ... .. � s.. .'.::..:.:.-r{..:`:','.'••:•':;.::}'..:� �®Fuel Tanks - OUtility Poles. I �M,�. ty' Water Tanks - y 6 r •:a... , '�' ,y :±I}',. ':e, Signs Y q pl.. 'M1...9b Y �7Ndna r. -l45'� •Y.ds•..':: n.�:¢&.; t #' ': .S �* • 4� �r - Flagpoles. :'a -• - ' $:y - - - - - - 'v.." 3i' .. .m• ;4 5 ram,.' ... -: ..yn#_`.a. ,r_ 7.. ai-: .. ..._ Town of Barnstable Data source Human-made features, Disclaimer This map is for planning purposes only. It is 1 inch=3o feet N hydrography,topography,and vegetation were Parcel lines on this map are only graphic not adequate for legal boundary determination --Feet \l%Y Conservation Division interpreted from 2014&2oo8 aerial photos representations of Assessor's tax parcels.They or regulatory interpretation.This map does no O $ LO 20 30 40 W E htto://www.town.bamstable.ma.us and may have been updated from more current are not true property boundaries and do not represent an on-the-ground survey. , e, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, "bVZ�o Map Parcel Application O Health-Division Date Issued Zi Conservation Division ale Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic.- OKH Preservation/ Hyannis Project Street Address �f l�c�(1�o n, 1R0®J Village .W n^� Owner /mac.\ Cc lyv, 1lhonA-gknmt1rsx Address r1-3o�S "ems i°CcJ , Telephone - &q(g_oq(o� 3� `�`� !Os' 3 � Permit Request New Cable rt- l Seg n h eoe �%w. <6 ta�, Cbancae kvcoer Mc}-R)Lme c S e (J, S�C,6 ,100 fc�%,,gN04 d A- knJce_ �ti.►S��1 h�.�A-1-6� hyo� will . ��� . polsa b l0d- 'CCX&k*.- SquardAbet: 11st floor: existing proposed 2nd floor: existing proposed Total new L $ ZoningbstridV Flood Plain Groundwater Overlay c cam, .r Projec /alua ion `�/s,��' Construction Type O Lot Si:p,.. n Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ur Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes C'No On Old King's Highway: ❑Yes C/No Basement Type: QJ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) —8 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ t new — Half: existing - new - Number of Bedrooms: 'L/ existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: &'Gas ❑ Oil ❑ Electric ❑Other Central Air: &Yes ❑ No ; Fireplaces: Existing J-New Existing wood/coal stove: ❑Yes 3/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 ErNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ('�-a. , Ir. "Talephone Number Address PO Ga c T License# K3� � P ' Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO fi ` SIGNATURE DATE C9)&G 4 i i FOR OFFICIAL USE ONLY 'APPLICATION# PATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: II FOUNDATION �Il�s010 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 971 z DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts -Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizati on/Indivi dual): '� Y�C'y1OVGt �Oy�s t ���C�✓\ �-� � Address: pc) City/State/Zip: e. j k�i"C jhk� Phone #: `��`a�S -(4'1 qJ Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4• MI am a general contractor and'I 6. ❑New construction employees(full 7. Remod and/or part-time).* have hired the sub-contractors. . _ __._ __.elin_g.._.... 2.El am a sole proprietor.or partner- listed on the attached sheet. ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' 9 Building addition No workers' comp. insurance comp.insurance. 5. � We are a corporation and its 10.0 Electrical repairs or additions required.] 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 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no q. 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. tContractors that cheek 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.M 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.$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded.to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa' enalties of perjury t t-.the information provided above is true and correct. Si nature. v Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official . City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: The Commonwealth of Massach usetts Department of Industrial Accidents ' Office of Investigations j 600 Washington Street Boston,MA 02111' a www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): oe e. k1l WIN 4- L�0)&I L4?r .Address: �0� Oe'r?nl Kor" 6 3 City/State/Zip: Phone #:` �� f �1.�7 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and 1. * have hired the sub-contractors 6. 0 New constructio. n mployees (full and/or part-time). ' 2. I am a sole proprietor or partner- listed on the attached sheet. ,7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. E] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. 0 We area corporation'and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work 4 officers have exercised their 11.0°Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.O..Other *Any applicant that checks box#1 must also fill out these ction 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. XContractors 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 thepolicy andjob site information. L Insurance Company Name: Policy#or Self-ins. Lic: s 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.Oo and/or one-year imprisonment, as well as civil penalties'in the form of a STOP WORK ORDER_ and a fine of up to$250.00 a day against the violator.''Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify Ec e e pa " and_ penalties of perjury that the information provided above is true and correct. Signature,,,. -�~ Date: /U / Phone f �J /L/ �- 77 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: -- '� The. Commonwealth of Massachusetts - Department of Industrial Accidents !�. 1 Office of Investigations 600,Washington Street t Boston, MA 02111 .yam www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers' Applicant Information 1 Please Print Legibly Name (Business/Organization/Indivi dual): Ko cry- PC,,,I V1-k-1 b1� � �I C� l�0 r-�<^r o Ld t C., Address: N CI S+o to Cc City/State/Zip: ZrV wsi ccr iM e4 O Z& 3 l, Phone #: ,5dZ g`f� ` .$y`� -7 Are you an employer? Check the appropriate box: Type of project(required): 1.❑-I am a employer with 4. I am a general contractor and I employees(full and/or part-time).*- have hired the sub-contractors 6. ❑ New construction 2.X1 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 workingfor me in an ca acit employees and,have workers' Y P Y 0. ❑Building addition [No workers' comp. insurance comp, insurance.$ required.] 5, 0-We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised.their 111:1 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 mustIsubmit 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 thepolicy andjob 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and Penalties ofperjctry that thejnformation provided above is true and correct. Si nature: �" Date: 1 " 1 � r r - Phone#: 50$ '996 - g`( V -1 Official itse only. Do not write,in this area, to.be completed by city or town.of-ciaL . 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#: — The Commonwealth of Massachusetts .� Department oflndusirial.Accidents' Office of Investigations 600 Washington Street _ 0 3 Boston, MA 02111 may' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LelZibly. Name (Business/Organization/Indivi dual): At!i1V �p- Address: -rAp,/ City/State/Zip: - izc__ 1 S i iZ'2_ MA- Phone #: �D� � ¢y C'V �16-t Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4:' ❑ I am a general contractor and I employees (full and/or part-time): have hired the sub-contractors 6. ❑New construction 2.0 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 any capacity, employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ 5. We are a corporation and its Io.❑ Electrical repairs or additions required.] ❑ rP 3.❑ I am a homeowner doing all work officers have exercised their 1 LQ'Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t _ c., 152; §1(4), and we have ino, employees. [No workers' 13.0 Other comp. insurance required.] ' 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob 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.ofa 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 a in/s�any pens ' of perjury that the information provided above is trice and correct. Signatur )ate' l ,f� / is e; / Phone#: �t7 '—�cl� �r /t Official use only. Do not ivrite 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 M. . . I' ,..cam . -----1 _, _... CJ - 91 - - . .- _ ; ,_ ::_ �.. Jo s !s r� E .-Irx'.0.... .�,._ IN r� kcR M1 w r } i. e COFli --- - __� r C �_r-. -- - -- - -- -- - - ----- - - - - C .. - ---- --- - -. --------._. ___ _.-- ---- __-�- ---------__-' -_-_---.---____-_ _--___ ___-_ ._ _ ___ -- _- --_-- __ _-__-__----- . f ----- - --- ------ -- -- _- ._ __-___ - --- - --- . - --- - - ------- a . i AI��DM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/ 9 23 2009. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ! McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE i HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 508-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Select Staffing INSURER A: National Union Fire Atkinson Staffing of Mass, Inc INSURERB: Associated Employers 114 State Road, A5 INSURER C: Sagamore, MA 02562 INSURER D: INSURER E r - - i COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING iANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR i MAY PERTAIN,THE INSURANCE AFFORDED BY.THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I I R IADD'L LT POLICY EFFECTIVE POLICY EXPIRATION LTR INSIPID TYPE OF INSU ANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 I COMMERCIAL GENERAL LIABILITY% a oc urence $ 5 PREMISES E c CLAIMSMADE._�IOCCUR MEDEXP(Any one person). '.,.$ 5 Q.00 .. A SSL19377671 3/17/09 3/17/10 PERSONAL&ADV INJURY $ 1 OOO 000 GENERAL AGGREGATE $ 2,000,000 I EGEG N'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OP AGG $ 2,000,000 I j POLICY JECT I LOC AUTOMOBILE LIABILITY ANYAUTO (Ea accident),COMBINED SINGLE LIMIT $ I ALL OWNED AUTOS - + BODILYINJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS HODILYINJURY $ NON-OWNED AUTOS (Peraccident) i I PROPERTY DAMAGE I$ i (Peraccident) - GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ F ANYAUTO , ' ' IOTHERTHAN EA ACC $ AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ �—I OCCUR CI CLAIMSMADE AGGREGATE $ r— ai $ - DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONAND T T TORYLIMITS ER ANY PROERS'LIIPARTNY E.C..EACH ACCIDENT $ 1 0OO OOO ANY PROPRIETORlPARTNER/EXECUTIVE - -OFFICERIIdEMHER--E%O'CUOEO? B under AWC7O23401012008 12/29/08 12/29/09 EL DISEASE-EA EMPLOYE $ 11 O00000 O0I ydescribe O000 SPECIAL PRVISIONSbelow E.L.DISEASE-POLICYUMIT $ OTHER i 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ' - CERTIFICATE HOLDER CANCELLATION "^ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION , DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYS WRITTEN I BLD Renovations NOTICE TO THE CERTIFICATE HOLDER NAMED TO"THE LEFT,BUT FAILURE TO DO SO SHALL, ATTN: Brian Dubay .: ; PO BOX 256 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Brewster, MA 02631 AUTHORIZED2EP ESENTATIVE iA J ACORD25(2001/08) 0AC DCORPORATION1988 Massachusetts.- Depai-taunt of Public Safety Board of Buildin- Re-ulations and Standards Construction Supervisor License License:. CS '83505 Restricted to: 00 ' BRIAN L DUBAY , 31 SEAMANSLN/P4-BOX 256 BREWSTER,'MA 02631 ; Expiration: 9/25/2010 ( �rnunissi„ncr Tr#: 2523 BoWfdIld) ifirkMWAn'atifAVd • HOME IMPROVEMENT CONTRACTOR Registration• 156162 Expiration:T617/2011 Tr# 284969 TYPe DBA � J B.L.D. RENOVATIONS ; BRIAN "DUBAY 31 SEAMANS LANE BREWSTER, MA"02631 Administrator . .. ki• , fix,'. MAR-21-2010 17:57 FROM:BLD RENOVATIONS 1-50B-258-0077 TO:16468487587 P.1 Town of Barnstable Regulatory Services NAM Thomas F.Geller,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder" I, as Owner of the subject property hereby authorize b(kA b ubOGVj to act on my behalf, in all matters relative to work authorized bydh s_building permit application for. \, P6 1 v-St C a6� �1 ( (Address of Job) Signature of Owner r Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNEUERM ISSION 0 window header MW�-Yllh�,e, 2 PCS Of 1 3/4" x 9 1/2" 1.9E MiCI011am® LVL TJ-Beam®6.35 Serial Number: User:1 1/18/20104:08:34PM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 1 Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED Member Slope:0t12 Roof Slo pe6l12 ' P 1 'Ell a All dimensions are horizontal Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width:14' Primary Load Group-Snow(pso:35.0 Live at 115%duration,20.0 Dead SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Wood column 3.50" 1.70" 2695/1772/0/4467 L1' Blocking 1 Ply 1 3/4"x 9 1/2 1.9E MicrollamO LVL 2 Wood column 3.50" 1.70" .2695/1772/0/4467 L1: Blocking 1,Ply 1 3/4":x 91/2"1.9E MicrollamO LVL -See iLevel®Specifier's/Builder's Guide for detail(s): L1: Blocking DESIGN CONTROLS: Maximum Design Control Result- Location Shear(Ibs) 4332 -3587 7265 Passed(49%) Rt.end Span 1 under Snow loading Moment(Ft-Lbs) 11552 11552 13541 Passed(85%) MID Span 1 under Snow loading Live Load Defl(in) 0.326 0.356 Passed(U393) MID Span 1 under Snow loading Total Load Defl(in) 0.540 0.533 Passed(U237) MID Span 1 under Snow loading -Deflection Criteria:STAN DARD(LL:U360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 8'4"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -Design assumes adequate continuous lateral support of the compression edge. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel®. iLevel®warrants the sizing of its products by this software will be accomplished in accordance with iLevel®product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not-been reviewed by an iLevel®Associate. -Not all products are readily available. Check with your supplier or iLevel®technical representative for product availability. -THIS ANALYSIS FOR iLevel®PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel®Distribution product listed above. -Note:See iLevel®Specifier's/Builder's Guide for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: 108 HOLLY POINT BILL RUBEL CENTERVILLE MA. MID-CAPE HOME CENTERS 465 RT 134 PO BOX 1418 SO. DENNIS, MA 02660-1418 Phone:508-398-6071 Fax :508-398-4559 brubel@midcape.net Copyright O 2009 by iLevel®,. Federal Way, WA. - Microllam® is a registered trademark of iLevel®. 0 window header TJ-BeanNID 6.35 Serial Number Py Weyerhaeuser 2 Pcs of 1 3/4" x 9 1/2" 1.9E Microllam@ LVL User:1 1/18/20104:08:34PM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 2 Engine Version:6.35.0 t CONTROLS FOR THE APPLICATION AND.LOADS LISTED. Load Group: Primary Load Group 10' 8.0011 Max. Vertical Reaction Total (lbs) 4467 4467 Max. Vertical Reaction Live (lbs) 2695 2695 Required Bearing Length in 1.70(S) 1.70(S) Max. Unbraced Length (in) 100 Loading on all spans, LDF = 0.90 , 1.0 Dead Shear at Support (lbs) 1423 -1423' Max Shear at Support (lbs) 1719 -1719 Member Reaction (lbs) 1719 1719 Support Reaction (lbs) 1772 1772 Moment (Ft-Lbs) 4583 Loading on all spans, LDF = 1.15 1.0 Dead + 1.0 Floor+ 1.0 Snow Shear at Support (lbs) 3587 -3587 Max Shear at Support (lbs) 4332 ' 4332 Member Reaction (lbs) 4332 4332 Support Reaction (lbs) 4467 4467 Moment (Ft-Lbs) 11552 Live Deflection (in) 0.326 Total Deflection (in) 0.540 PROJECT INFORMATION: OPERATOR INFORMATION: 108 HOLLY POINT BILL RUBEL - CENTERVILLE MA MID-CAPE HOME CENTERS 465 RT 134 PO BOX 1418 SO. DENNIS, MA 02660-1418 Phone:508-398-6071 Fax :508-398-4559 brubel@midcape.net Copyright © 2009 by iLevel% Federal Way, WA. _ - - Microllam® is a registered trademark of iLevel@. - 4 Oct � � a so yym 71 Etta `'` .; ' � .,p,« w w . M�i r u ?.., � .'` * � 6 ..� , �y - � -fit �••�. .--�.• �'� ,' \`ti, ,t,� a't •F ,`• ••,\1't `j�� a! R`: •�\ `� a-'.`• •'a �\ ♦ ��•• �` M � (J �i } rv�a ,�vv.vvv. S pav1 be wee h A-k S ,�y Cc �of�{ lla,r 3/1G� S�S c I •.: conned on ¢ten r Lr110L COhnec _ (� 0 PC ccJ 1 �cc ��® ram I 108 Holly Point Rd., Centerville 3116/10 �j 108 Holly Point Rd.. Centerville 3/16/10 h h 108 Holly Point Rd., Centerville 3/16/10 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7,3 2- Parcel 0` 1 Application #CX01T0 7 K Health Division Date Issued I0 Z Conservation Division Application Fee v r Planning Dept. .-'Permit Fee Date Definitive Plan Approved by Planning Board r, LO' ,16y Historic - OKH _ Preservation/ Hyannis Project St� re kAddressIn wrier-"c�,A Q_oNjnn _0y-x -QLnyv`c 'Lk Address C &arS'r1_1g,_ Telephone ' "C Pe mite Req C(`e+��� ��ac,�. C �c.�a f Glm iss1 O. yC1IcsoC 1n2,J �t.�Che r� Square feet: 1 st floor: existing proposed 2nd floor: existing — proposed — Total new — Zoning District Flood Plain Groundwater Overlay ProjectValuation�4rT o."' Construction Type Si m��- Prlr8.S�%XQ_ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .C' Two Family ❑ Multi-Family (# units) Age of Existing Structure c Historic House: ❑Yes YNo On Old King's Highway: ❑Yes L'klo Basement Type: dFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Areas ft. Basement Unfinished Areas ft V , � �� Number of Baths: Full: existing_ new Half: existing -- new Number of Bedrooms: existing Total Room Count (not including baths): existing new First Floor Room Count 1 C) Heat Type and Fuel: UrGas ❑ Oil ❑ Electric ❑ Other / (�N l Central Air: I Yes ❑ No Fireplaces: Existing 1 New — Existing wood%coal stover ❑1 dNo a W Detached garage: ❑ existing ❑ new size_Pool: ❑ existing 0 new size _ Barn: C`existing &new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ snew size _ Other: a C Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ No Commercial ❑Yes 2rNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) \ .Telephone~Number Narne .= t`� 7)j"ae—k -° A L ddr(:"ss Itpo Q)� aS License# � O . Home Improvement Contractor# Worker's Compensation # 62,?0 G 0.° 1 1 Ai 16 A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO'-1 %r\r -QA S SIGNATURE DATE O q t FOR OFFICIAL USE ONLY APPLICATION# D'ATEASSUED MAP/PARCEL NO. M' ADDRESS VILLAGE _ OWNER DATE OF INSPECTION: FOUNDATION FRAME L ( 6q INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - J GAS: ROUGH FINAL FINAL BUILDING 0 6l Q ! s DATE CLOSED OUT ASSOCIATION PLAN NO. i I • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):) i`"o,V-, t Address; .. - 10 City/State/Zip: J�- . Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.)9,,I am a general contractor and I employees(full-arid/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 _ These sub-contractors have ship and have no°employees' _ , „ 8. ❑ Demolition M. g� a ;. workingfor me°in an capacity.�` f employees and have workers' Y9. El Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 I.❑ 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. 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 i 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 t ' s and penalties of perjury that the information provided above is true and correct. Signature: Date: /o/1409 Phone#: �- il" — 079 S! 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-contractor(s)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 pen-nit 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 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. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia . The Commonwealth of Massach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl 540iA Name (Business/Organization/Individual): e ib .JIC � j z� F /� / 'g, . 02, 3 Address: �� JiIL���/����, Dewlis�f.��"/ /" �, City/State/Zip: Phone #: 2/ Z 77 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I mployees (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 g, ❑Demolition workingfor me in an capacity. employees and have workers' y9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of _ Investigations of the DIA for insurance coverage verification. I do hereby certify e e pa' and penalties of perjury that the information provided above is true and correct. Si nature: . - Date: / ZeY 2, Phone#: / Z 2 / 77 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector . 6. Other Contact Person: Phone M The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t _! Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ��ff Please Print Legibly Name (Business/Organization/Individual): kocAl pC�t►1'4 i ink IC0CH C^rX0 w t L-. Address: qc( S+oyticc City/State/Zip: i3s�ws'F v-r m 4 OZG 3 t Phone #: 50% Z 16, --VA g 7 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P Y� 9. ❑ Building addition [No workers' comp. insurance comp, insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ 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. 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and pen�a-ltt ieess of perjury that the information provided above is true and correct. Signature: �C ���~� �"„''""7/ - Date: 10 Phone#: 50% 8c1(0 - %14 9 7 Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: The Commonwealth of Massach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street. t _ Boston, MA 02111 41 y www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual)'. _.!�Abtli Address: 0 tZ t rAiV n 0 � City/State/Zip: tA4 Phone #: L Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New constructiori 2.tJ l am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We area corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] 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. XContractors 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.M 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 jeinsan�;pena of perjury that the information provided above is true and correct. Si nature: 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#: co ,,cam II I RZ IT - -- 5z o-Goy c e �A-4 3 0(g(gS t.r ry &-d &co 511 r W C- C d ' 8 I : ACORD- CERTIFICATE OF LIABILITY. INSURANCE DATE(MM/DD/YY"T9/23/2009 k PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 508-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Select Staffing 9 INSURER A National Union Fire Atkinson Staffing of Mass,- Inc INSURER B: Associated Emloyers 114 State Road, A5 INSURER C: Sagamore, MA 02562 INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. `TTR DAL POLICY EFFECTIVE POLICY EX PI RATION LTR NSRD E OF INSURANCE POLICY NUMBER DATE MMIDDM DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 ][ COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ 50,00 1_.... .___. CAMSMAD ECI OCCUR _ MEDEXP(An one person)___ _ . .0.0A SSL19377671 3/17/09 3/17/10 PERSONAL&ADV INJURY $ 1 00000 GENERAL AGGREGATE $ 2 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,0 OO POLICY JECT JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Eeaccidant) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY. (Per person) $ i HIRED AUTOS j I jNON-OWNEDAUTOS B eracci ent) $ _ (Per accident) !j t I PROPERTY DAMAGE $ (Peraccident) j GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTHAN EA ACC $ AUTOONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR I CLAIMSMADE AGGREGATE $Y j DEDUCTIBLE $ s,*; RETENTION $ $ WORKERS COMPENSATIONAND TORYLIMITS ER TH- EMPLOYERS'LIABILITY ID ANY PROPRIETOR(PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERNEMBEA-EXCLUDEDI __ _. ___ .. B AWC7023401012008 12/29/08 12/29/09� EL DISEASE-EA EMPLOYE $ ] 00Q QQQ I SPECIAL PROVISIOcribe underNS 1,000,0001 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYS WRITTEN BLD Renovations NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL ATTN: Brian Dubay PO Box 256 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Brewster, MA 02631 AUTHORIZED/ EP SENTATIVE ACORD25(2001/08) ©AC DCORPORATION1988 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License { +, ,License:.CS 83505 � rr .,BRIM 31 SEAMANSt-LN/PO�?BOX 2-56 :. x BREWSTER, MA 02fi31 Expiration: 9/25/2010 Commissioner, Tr#: 2523 Bott�d�IEtfli�6$3� RinifS>f�'a�'��fi�i9'siif= HOME IMPROVEMENT CONTRACTOR Registration•, 156162 Expraton;, 6/7/2011 Tr# 284969 Y. B.L.D. RENOVATIONS . , i-Ej BRIAN DUBAY 31 SEAMANS LANES ; BREWSTER, MA 02631 - Administrator f OCT-15-2009 21:36 FROM:BLD RENOVATIONS 1-5OB-25B-0077 TO:164684B75B7 PA � � z Towwn of Barnstable Regulatory Services HAS& $ Thomas K Geiler,Director. A. Building Division Tarn Perry,Buildfng Commissioner r 200 Main Street,Hyannis,MA 02601 tirww.tuwn.barnstable.ma.us Office: 508-962-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 4 t ,as Owner of the subject property hereby authorize-�r�.:� `� to ar..t on my behalf, in all matters relative to work authorized by this building permit application for. (AcWkss of Job) Signature of Owner V Date Print Name If Property Owner is applying for pen-rut please complete the Homeowners License Exemption Form on,the reverse side. CEILING SUPPORT BEAM OVER KITCHEN by Weyerhaeuser 2 PCs of 1 3/4" x 11 7/8" 1.9E Microllam@ LVL TJ-Beam@ 6.30 Serial Number. User:1 10/13/2009 1:37:16 PM THIS PRODUCTWEETS OR EXCEED_ S THE SET DESIGN Pagel Engine Version:6.30.14 CONTROLS FOR THE APPLICATION AND LOADS LISTED Product.Diagram is Conc+elitual. LOADS: Analysis is for a Drop Beam Member. Tributary Load Width:11'. Primary Load Group-Residential-Living Areas(psf):20.0 Live at 100%duration, 10.0 Dead SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Trimmers 3.00" 1.50" 1687/931 /0/2618 L2 None 2 Trimmers 3.00" 1.50" 1687/931 /0/2618 L2 None -See iLevel@ Specifier's/Builder's Guide for detail(s):L2. DESIGN CONTROLS: Maximum Design Control Result Location Shear(Ibs) 2575 -2195 7897 Passed(28%) Rt.end Span 1'under Floor loading Moment(Ft-Lbs) 9711 9711 17848 Passed(54%) MID Span 1 under Floor loading Live Load Defl(in) 0.294 0.503 Passed(U615) MID Span 1 under Floor loading Total Load Defl(in) 0.457 0.754 Passed(L/396) MID Span 1 under Floor loading -Deflection Criteria:STAN DARD(LL:U360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 15'2"o/c unless detailed otherwise. Proper attachment and positioning of , lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel@. iLevel@ warrants the sizing of its products by this software will be accomplished in accordance with iLevel@ product design criteria and code accepted design values: The specific product application,input design loads,and stated dimensions have been provided by the software User. This output has not been reviewed by an iLevel@ Associate. -Not all products are readily available. Check with your supplier or iLevel@ technical representative for product availability. -THIS ANALYSIS FOR iLevel@ PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS: -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel@ Distribution product listed above: -Note:See iLevel@ Specifier's/Builder's Guide for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: BRIAN DUBAY Matt Gustin BLD RENOVATIONS Mid-Cape Home Centers 108 HOLLY POINT RD. 465 Route 134 CENTERVILLE,MA South Dennis,MA 02660 Phone:508-398-6071 Fax :508-398-4559 nigustin@midcape.net Copyright ® 2007 by iLevel®, Federal Way, WA. - - .Microllam® is a registered trademark of iLevel@. . r ` CEILING SUPPORT-BEAM OVER KITCHEN - by Weyerhaeuser 2.Pcs of 1 3/4" x,11 7/8" 1.9E Microllam® LVL" - - TJ-Beam®6.30 Serial Number. User:1 10/13/2009 1:37:16 PM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 2 Engine Version:6.30.14 CONTROLS FOR THE APPLICATION AND LOADS LISTED Load Group: Primary Load Group ^ 15 1.00" Max. Vertical Reaction Total (lbs) 2618 2618 - Max. Vertical Reaction Live (lbs) 1687 1687 Required Bearing Length in . 1.50(W) 1.50(W) Max. Unbraced Length (in) 182 Loading on all spans, LDF = 0.90 , 1.0 Dead Shear at Support (lbs) 781 -781 Max Shear at Support (lbs) 916 -916 Member Reaction (lbs) 916 916 Support Reaction (lbs) 9.31 931 .Moment (Ft-Lbs) 3455 " t Loading on all spans, LDF 1.00., , 1.0 Dead + 1.0 Floor q Shear at Support (lbs) 2195 -2195 Max Shear at Support (lbs) 2575 -2575 Member Reaction (lbs) * 2575 2575 Support Reaction (lbs) 2618 2618 Moment (Ft-Lbs) 9711 Live Deflection (in) 0.294 Total Deflection (in) 01.457 PROJECT INFORMATION: OPERATOR INFORMATION: BRIAN DUBAY Matt Gustin BLD RENOVATIONS Mid-Cape Home Centers 108 HOLLY POINT RD. 465 Route 134 CENTERVILLE,MA South Dennis,MA 02660 Phone:508-398-6071 Fax :508-398-4559 mgustin@midcape.net Copyright ® 2007 by iLevel®, Federal Way, WA. - Microllam® is a registered trademark of iLevel®. - B.L.D. Renovations PO Box 256, Brewster, MA 02631 Tel. # (508) 255-4795 MA license# 083505 HIC Reg: # 139900 To: Town of Barnstable Building Inspector For: Changes to 108 Holly Point Road This is a brief description of the proposed changes to said address. These are the changes: 1) Remove old 9' slider in master bedroom and replace with new Anderson Frenchwood sliding door. Header remains the same. 2) Remove 30" wall in master bedroom closet area, non-bearing, patching as needed. 3) Remove master bath room door and install new pocket door track and solid core door, non-bearing wall. 4) Close-in open shelves in master bath room to make linen closet. 5) Hall bath room remove sink and replace with new 30" vanity and top. 6) Den area remove and replace existing entry door with a new 2/8 x 6/8 entry door and storm. 7) Remove 14'10" of wall between living room and kitchen and cut down half wall between kitchen and entry way. Install 2-11 7/8" LVL with double jack studs at either end and support lollys in basement if not lined up with existing. (Documentation enclosed) 8) In living room remove cellar door and reverse swing, same size as existing. Also remove old 6' slider and replace with new Anderson French wood sliding door. Header remains the same size. Around fireplace raised panels will be installed over brick along with a mantel and the book shelves on either side will have doors installed. 9) In spare room, remove existing closets and reframe to meet electrical code clearances (36" from face'of panel). 10) Four new basement windows, Anderson or the most energy efficient ones that I can find. 11) The owner is adding 9 '/2" of fiberglass insulation in the attic, which brings that to R-38 and 9 '/Zn of fiberglass insulation in the rim joist of the basement, R-30. There is also an option for encapsulated R-19 in the floor. 12) If allowed the owner would like a set of French doors installed in the 5' opening at the end of the living room to separate that room from the den:. I'm not sure what is allowed,with the septic size and,number of rooms? Please advise... Any questions please call Brian at 1-508-255-4795 Sincerely, Brian L. Dubay r ,2�! Assessor's map_.and , lot rnumber 1..:.:.... I• e e, � - :� TI,C Sewage Permit"number km,2 / gum 4`lPTH A iTTF SAI111.C ' AaR THE TOWN_. OF, BA•RNSTTA�RLE 'N n Z BAR33TAIME. w MA86 U:U ILL- D I N G i NaS P E C T 0 R r,r i63q. 0 �, e OR s ;/Ct..I'''s .� ....:. ..... C.�i.. .................�V.. .x.....�/�f . 'APPLICATION F PERMIT TO .............. ;;. TYPE OF CONSTRUCTION ........WOO. . ... :..........:.. -i. ..... �. . ..............197,5. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r � y • Location 1 1.4?.L.I.�/........�.Q..1.!!L ......... .Q.0... . .....:.....LeA e.n.V 1.1:.I.e,.. 1..!.1.. X5.1t...................... ProposedUse .......,.,1.v.v\.....Ae G:.k..................................................................:................................................................... ZoningDistrict .............. ��............................... Fire District . .� .c��r`..VI 1 �? I� . .fit.......... .... .. .... .. . ........................ yr I"�V..l.....!IR•.P,5 .k.....................Address ............N.O. ly. ........Po.i.!!1�.......Rip.. .. ..�......... Name of•Owner . .. .!.... ..� Name of Builder Ir.04h.kA;.n....so.....CrQ.. .........Address .3�...... .�� I.KrG1.4.r�'..✓...l.C. .e...,..�i d.a.d�............ .... ...... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior .....:..............................................................................Roofing .................................................................................... Floors ....................................................:.................................Interior ............................................................................... Heating ..................................................................................Plumbing ................................................................................... - a Fireplace ..................................................................................Approximate Cost .............:.................................. Definitive Plan Approved by Planning Board ________________________________19________. Area .'7..�0... ..................... Diagram of Lot and Building with Dimensions Fee ... ��...— ..... ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH AL I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ., .. . .�...�v.. ... .. ... ........ Dr. Paul Massik _ r No sewage No .17.9.64. Permit-for:;:.,.SvA.Ae.c.k............ ...... V.. i 4 �' �r i * .. . ....................... Locatiok tr- ...............�_.............. .................. . qt Oic ` Owner .Dr., ..RauL..Massik............................... . Type of Construction ..........k144d •�, �.:.. ......... ......:............................... ................... tq t Plot .. !232-41......... Lot ....................... ..... r 2 tv ry ,,"Permit.Granted Oatober�2. „19 75 ........ Date.of-Inspection ..................... f.:....19 Date Completed '..1 %� J: ! .....19 I, PERMIT REFUSED ....................................................... .. 19 ..................................................................... _ y� ........................................... ..............:....... . ..................................................... .......� �w ` ..... .............i .: ...........................^ tk' c' .�; ` Approved .. ................................... '': 19 _ , r..... ?' ............................................ A....................r �' • 1 3 f� - - :.� ............................................................................... ` Assessor's map and lot number ..... ............!.......... C/ R f — Id ? a Y Sewage Permit number `..rl-ylk �-�r '��� �QyO*7HET0�o' TOWNr OF BAR.NSTABLE •� i BARNSTAIiLE, i n "6 9 �' BUILDING INSPECTOR �`Q war°'• APPLICATION FOR PERMIT TO /r' ��,r� TYPEOF CONSTRUCTION ........ .....................................................:............................................................. TO- THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to 4the following information: Location .................`�.0 I �,..........�' ?. ...........� 5 �!. ...^'..........C.e'\4.P.Y`..�i i .4. �...^....5�....................... �. Proposed Use ....... j.!...............�. ............ ............................................................................................................,............. .... Zoning District , ...............Fire District .P! Per VI � c` S� ........................~............................. ....................a.. ..... ......................... Name of Owner �!ir.r... !:'.�.....1 f ASS k.....................Address H r1 ' v c� 1 c� a c. ......... ................ .......................................................... 4 Name of Builder ! „ ?........Address .�. ...... . �'{ CJl t G t/ r�.�.2. .... r`..:'�..... •w• r Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .........................................................:.......................... Floors ...............................Interior ................................ Plumbingi' Fireplace ..................................................................................Approximate Cost ................................................�................... Definitive Plan Approved by Planning Board ________________________________19________. Area ......:o...L76.................... Diagram of Lot and Building with Dimensions Fee f.(?4t6.................. SUBJECT TO APPROVAL OF BOARD OF HEALTH !t .I i 4 ✓ 1 • t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...�..�.t.YY/Q..�'�.....1 .:...:1........................... Dr. Paul Massik No sewage No ....... Permit for .Sn..IJeck•. •• ...................�.0�......................................... .... Location RQ1 y...Foint.-Rd....Gente le,.... I, ,.. ............. X Owner ......Dr- -Paul.••Mass.i. Wood Type of Construction .......................:.............................�....................... Plot ....23z-.41........... Lot Permit Granted ....Pc Ob r 2 .......19 75 Date.of Inspection ....................................19 Date Completed ........ _............................19 4 PERMIT. REFUSED T ........ 19 .... 4. ..................... ............... .................................... - - ................../..................... ......... ................... Approved ................................................ 19 ............................................................................... �I.. - ---=----- 60 - r, „ r Cp lD !r t GtW P,f if,.(t� ssJJ ��ii <i^^to 1 i I . '.�\ Catty• `�'' �CenC-�5.,.,-oc2J �l�v�C.,r" � � �. a \ � �;�;... `ne•w p�,n,c7esS.On V oor, ot� -CGY�G�� c3 a$rr 0-1 Ty f G'Sr` \ � :� � gym... � 7 ;. I ' w . `• r \ � ���-,;'e�.r e,'� 1 � - •JC ` f ' ��I! I ,:f L 1, - - t_ .. I • .. - - F � ., i `� • G,wPIIYtl� - j I new �.eo�� � d�err �v\ dew i. F7 ,�`� 5 D- . y , c F 3 . Is E v t�� Q 'o c a C� G � 9 ( , I er�� ' ao� mutls� 1 t� � _ , 1 I b _ 1 BEARSE POND SHALLOW BEARSE POJ�D POND,�\ WEQUAQUET LAKE LOCUS PLAN „ " '. SCALE:1.25,000 HYA.NNIS QUAD. < s rnOr'� Co rri m Co m � co ujo N _ • LA C W to 0 Go w • y I t— O N v EXISTING _J D WELLING w o �►- w' o v - Z cq - W o j c/) z LOT 62 L:C.f?. 20239 'C. a L.C.C. •189507 R=467.32,' L=127.00' PL�IN VIEW T ROAp SCAL 1 " = 30 OLLY Po�N H 40' PUBLIC WAY 0 15 30 SOFT. SHEET 1 OF -2 PLAN ACCOMPANYING PETITION OF , MALCOLMI 'K MONTGOMERY 108 HOLL Y POINT ROAD CEN't:rRVILLE, MA To MAA,NTAIN A PIER IN Q�ARSE POND FEBRUARY.4, 2010 ' SULLIVAN NGINEERIN.G, INC. OSTERVILLE, MASS. ` 4 J { BEARSE. POND ' SHALL OW BEARSE POD POND,�I 1 WEUA Q QU ET LAKE co . LOCUS PLAN' SCALE: 1 25 000 HYANNIS QUAD. > 0 0 N cnm � y r rn rn m r N r Z m C) rn Q a 1-51 Z--4 n CJ: EXISTING ci L DWELLING N �" e LOT 62 L.C.P. 20239 C . L.C.C. 189507 1 I. . R=467.32' L=127.00' PLN VIEW (� ROAD SCALE: 1 = 30'. Po�' HOLLY 40 PUBLIC WAY 30 60FT. SHEET 1 OF 2. PLAN ACCOMPANYING PETITION OF MALCOLMi IK MONTGOMERY 108 HOLIL'Y POINT ROAD'' CEN"T';ERVILLE, MA TO MAINTAIN A PIER IN 4ARSE POND FEBRUARY 4, 2010 : SULLIVAN:)ENGINEERING, INC. OSTE'FOVILLE, MASS. { yr EL: _35:0 X 2b.2 DECK - ELEVA-TI.ON _ EL...34.4: 33' A,CTUAL LAKE -- _ _ -EL-EVA-.TION X 29.9 FROM' CONDI TIONED LAKE EL. RAMP - — �.__OR_L0_W5. X - 8.-3, CCNQI TIOI ED--LA-K-E ELEVATION --- _ EXIST/NG DE X 31.6 X _ .4 PROFILE _ - . n SCALE: .1 _ 10' s 10__ -- 20F. X m: X 32.9 29.3 X •31.- O X 31.4 . _ X 33.1 32. 5 X 7 � 25 ' f o I - - do co rri � Zn � rrri r N z � �-o o � o ,� �,, �� PLAN V/EVI/ r*, �,. z o w G P G ' !n z z ,, v �, o SCALE: 1 1.0 DC � N Z � Q -5 10