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'"' .I , � - - . ` , I � ,� �,,,�, ,�., kx..-,�--,","_N",�:�-_��,-,",'. , - - ,,,��;4'';��_` ,v ", ��,,�,,'.,?'-�" "'..- `��,�,_­­,,�', ',,', - " ',�.:I,�"`-.,_,�_,�.i::: �-_,-_�;,�., " - :li,:��­`,",,_�� ,,,,, , , :,L_,-._,_*':' �,��­_,�,�� �:�,-,�:��,-�: si���,, ,,�.;,� 1�1 , �,T� ,�,�,,,;��,�,t _�� �-- , ,- -�-,�,_,v,,L_�__:-,, "-, _'�� �: , �,__�__�,,_� : , , - - _1� - - - I- - _L AmG W .. comma A\1 T :7- A- p - EX15-rt 1,4G A,C.0 vAJ LV,.CD co v o AfEA-- EX I5-nNG 4t\Z-0 Yti�� , comgo L m.Li SMOKE DETECTORS EVIEWED D . l �ko oil l�i'l/G e o�o n BARNSTABLE BUILDING DEPT. DAT �� FIRE DEPARTMENT DATE PERMITTING So SIGNATURES AnP R 13WbOm fl 4I.tvG Lr)0Im fAMW ft `t2ltdWCt, ALA vD��ll i ! v I LP ......... ....................... vli TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued Conservation Division Application Fee p PlanningDe t. Permit Fee c.� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village ;rP �� Owner,�,K,4a)e 7'/Y1y1,Q��f� Address Telephone Z.4 /X P� Permit Request 1a xjj d z�a 'gKy: 2/4 d�/ � 4J Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation,?,Ze o. 0 Construction Type 1eA1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Or- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes -UNo On Old King ighwa)pi❑Y�q Io o. w , Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other c.. Ne 1. Basement Finished Area (sq.ft.) Basement Unfinished Area (sg7) Number of Baths: Full: existing new Half: existing �ew Ln Number of Bedrooms: existing —new NO n Total Room Count (not including bath;): existing new First Floor Room Coua ram. Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# —=Gurrent Use- _ _ _ -- _ - -=--Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name i �i9'�/6�� Telephone Numbers JOR 7,;7,5 Z A� Address �,�/�, �o !� License # , Ae 9 Home Improvement Contractor# v� Worker's Compensation #141 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE r, t ` FOR OFFICIAL USE ONLY h APPLICATION# DATE ISSUED MAP/PARCEL NO. '.i f S k ADDRESS VILLAGE OWNER r t .. C DATE OF INSPECTION: , _FOUNDATION ` FRAME INSULATION FIREPLACE s ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s FINAL BUILDING - DATE.CLOSED OUT �- •• - s '" r ASSOCIATION PLAN NO. i Y Fv - w OWNER AUTHORIZATION FORM , (Owner's Name) owner of the property located at � • f � �- 1. (Property Add ess (Property Address) hereby authorize (Su cont tor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner's Si atur Date �(ANSs t' I)clj,u'tn.tcnt of PuhliC tia VC1,.\ . liu;u'tl of 13tulilitt�ti I�c�ulation> anti �t:ultLuds Gonstruptiott Supzrvlsor Licensz Llcen 0s 100988 r t W, HENRY CASSI.DY 8 SHED ROW _� �w1= u F WEST `&ARMOUTH, MA 02673 Expiration. 11,/1112013 ( ,mill msivuc1, .. � Tr�r:'7620 b. 1 611 ffll /cl j '4 ti^S Office of Consumer Affairs and Busin6ss Regulation r , '1 Q Park Plaza - SUlte 5170 Boston; Massachusetts Off 16 l l nine llzzprovenient Coriti`actur Re istx atio'n, , Registration., 4,153567, Type:. Private Corp6ration Expiratio6: ;12/15/21b14' : ltti''23;t831 CAPE COD INSULATION, INC. HENRY CASSIDY .w 18 REAR'DON CIRCLE SO. YARMOUTH, MA.02664 Update Address and return card. N'ta rk reasint.for thane. Aildiess l2encwal Lrriploymcut ,� ILosfCal L7 L_I -I d fir.,:,.,t( f //(.I!/.r /If/"(�Y((C!( f`(�.:'!(r(J.11((:'![((1(�(J.,_. •.. License or resrtin itao vlilid, ur nvu use oy ,\ u171f e Ill f nusumct'nlluu's� Business llegulatiou. _ registration_ - fidiidl enl OME IMPROVEMENT CONTRACTOR d�elolr the expiration date if foundreturn to: registration: 153567 Type: Qlhce of Consumer Affairs and Business Regulatlioo 1r' xpiration: 12/15/2014 Pnvate Corporatiotl 16 Park Plaza-Suite 5170 Boston,MA 02116 . -. CA! LUIi IMSULATION 1NC. Ht_NkY CASSUi la i LAIC ON CIRCLE <. Y;1RMOUI l I. MA 02664 Unalci sca rclary ' ----of gal' .w1[hu_t n tt re . . . CAPECOD-27 SPURDY DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 4,24,2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. !. IMPORTANT: 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 - I NAME: Cape Cod Commercial I Rogers&Gray Ins.-Dennis Branch PHONE 508 398-7980 IA�,-No) (877)816-2156 ,1R 434 Rte 134 -_(A/c No;Ex1-( -) -- --- _.._ South Dennis,MA 02660 ADDRESS__ — — -- -- INSURERS)AFFORDING COVERAGE NAIC# INSURERA PEERLESS INSURANCE COMPANY - { I INSURERS COMMERCE INSURANCE COMPANY INSURED INsuRER — c Evanston Insurance Company y Cape Cod Insulation Inc -- 18 Reardon Circle INSURER D Atlantic Charter Insurance Company - - South Yarmouth,MA 02664 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 j 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - _ ---- __- —IADDL SUBR� --- - --- _POLICY EFF POLICYEXP. ---.- --' -- .LTR 1 TYPE OF INSURANCE INSR WVD .. ___.POLICY NUMBER _._ (MM/DD/YYl'YY� .LMM/DD/YYYY LIMITS - ------ ----- ----�---� F - GENERAL LIABILITY EACH OCCURRENCE I$ 1,000 000i i ! i DAMAGET6RENTED -- 1 A X I COMMERCIAL GENERAL LIABILITY CBP8263O63 4/1/2013 4/1/2014 PREMISES(Ea occurrence) i$., 100 00O CLAWS-MADE OCCUR MED EXP(Any one person) $ 5 OOOI . .I l._ . - PERSONAL&ADV INJURY I $ - 1 A00 000 I I ! + - NERAL AGGREGATE $ 2,000OOOI I GEN'L AGGREGATE PLII MIT APPLIES PER i PRODUCTS-COMP/OP 2,0 AGG $ 00,000 i _ POLICY JECT LOC ______ - _- - MBI D SINGLE LIMIT _....- - ------ AUTOMOBILE LIABILITY - -" - _ - - 1,000,00a CO NE _(Ea accident)_ - $ i B !ANY AUTO 112MMBCKVMK 4/1/2013 4/1/2014 BODILY INJURY(Par person) I$ ALL OWNED l SCHEDULED I BODILY INJURY(Per accident)r$ i AUTOS X AUTOS NON-OWNED - g. -PROPERTYDAMAGE - - $ �- . X 1 HIREDAUTOS X AUTOS - �(PERACCIDENT). --- _ -_i li I X UMBRELLA LIAB X 1 OCCUR EACH OCCURRENCE $ 1.000 000 I ---- ---- -- ---- _.I (, EXCESS LIAB CLAIMS-MADE XONJ453512 4/1/2013 4/1/2014 AGGREGATE $ 1,000000 1 --- -- -- I I4 WORKERS COMPENSATION - --._ OOOi-_. =L _ - - I - *_ _I X1 __ $ DED X RETENTION$ 1 O, - 'WCAOO525903 _ - 6/30/2012 6/30/2013 rE.L.EACH ACCIDENT DER $^-__ 1,000,000 AND EMPLOYERS'LIABILITY Y I N ! D ANY PROPRIETOR/PARTNER/EXECUTIVE ! I< +. - _ - EE�$ I OFFICER/MEMBER EXCLUDED? N N I A L _ _- (Mandatory In NH) L J -x- --' - - - f E-L.DISEASE_EA EMPLOY 1 000 0001 If es,describe under e I, I E.L.DISEASE-POLICY LIMIT l'$ 1,000,0001 DESCRIPTION OF OPERATIONS below 111 1 I ---.. .._----__----------__ ----- -- I .. .. ......._ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) - ICertificate Holder is an additional insured under General Liability when required by written Contracts or agreements. c CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 AU/T�HO�RII)ZED1 REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ' ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts ( Nnnt Form 1 y - Department oJ•Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Y / Boston MA 0.2114-2017 • . www.rrrass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaus/Plu III hers AplOicant Iit forination Please Print Legit Naunc. (business/l)rganization/individual): �f V�d2�r�t� � � Phone #: '0,re you <tit en►ployer7 Check tl a appropriate box: Type of project (required): I. Ian, a untl)loyer with �_� — 4. ❑ I am a general contractor and l ❑ rntplctyecs (full and/fir parC-lllllC).* have hired the SUb-contractors 6. New constrelcfrorr I luu a sole propriefOr or partner- listed on the attached sheet. 7. ❑ Retnodefing shill Lind-have no employees These sub-contractors have g. ❑ Demolition orknig li)r m.r. in any capacity. employees and have workers' 9. ❑ Building addition jNo workers' comp. insurance comp. insurance.l r��luiretf. S- ❑ We are a corporation and its 10.❑ Electrical repairs or additions I ant a homeowner doing all work officers have exercised thou I LE] Plumbing repairs or additions myselh. INo workers' comp. right pfexemption per MGL 12.0 Roohfe airs insurance reLluired_j .I. --c. l S2, fi l(4) and we have no employees. [Teo workers' 13.� Other T — comp. inSurance required.] _ 'Anc applicant that checks box 81 must also till out the section.below showing their workers'compensation policy information. I Ionnam leis who subruil this affidavit.indicating they are doing all week and then hire outside conu-ntors must submit it new affidavit indicating such. uuU'uelur,that check this box must attached an additional sheen showing the name of the sub-contt'actots and state wholher or not L1105C cntilics have rniployccs. 11 the sub-contractors have employees,they must provide their workers'comp.policy number• 1 am an employer that is providing workers'cornpensation h.is'urance for my employees. Below is the policy and job site iajort►tatian. n Policy Ii or Sell=ins. Lic. #: WGA 0 1-2 0 Expiration Date: f1 lob IIc, AddI-CSS:--'?'jf� � o� i�/ ,�� City/State/Zip• , —��� Z �. aZG 3 Attach a copy of the workers' compensation policy declaration page(showing the policy nunr,ber and expiration date) I MIUIV I0 r.cure coverabe.as required under Section 25A of MGL c. 152 can lead to the icnpositiop-of criminal penalties oi'a 1i11(: Crl) to $I,.i00.00 and/or one-year imprisonment, as well as civil penalties in the form of STOP WORK ORDER and a fine of up to.1;250.00 a day against the violator. Be advised that a copy of this statement may be 'forwarded to the Office of lnvcstigations ofthe DIA for insurance coverage verification. I do hereby certi%�.ittther tire ruitrs llrld penullies of erjury thin the information provided above is true and correct. Date: L /d I'Iunlc i�. v�� 71, ILI Official use one}'. Do not write in this area, to be►completed by city or tofvn.official. (Jo of-Town: Permit/License# Issuing Authority (circle one): I. I3ottrd of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plun►binl Inspector li. tither Conl,tct Person: Phone#: -- V I -7�1�1i� CAPECOD TOWN 0f B,ARN TIR;{E 4 A INSULATION �} � - Z 2013 JUL17 P-; 2= a 7 - - !IDlR 4L455 5[pMIElS SPRAT FOAM 9YSPENDED - ' - lATTS OYTTE0.5 INSYLA�ION C{ICINGS ' 1-800-696-6611 DI IS a Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: "71 V1 3 Dear Building Inspector Please accept this Affidavit as docurnentaiion that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner . Property Address Village , � t `-' / mil/ 4z 6, Cam, Insulation Installed: Fibe glass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( 0 3 ) ( ) (X Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( X) Sincerely hECasJr, President on Inc. 1 n ck �/LiirVLi�� Y ® / Al 'Z*L S Agdbalance' ." .. � • i lY o Spray Foam Insulation- e o a a Company Name Cape Cod Insulation Phone Number 508-775-1214 ( ^�� Q t; Applicator Name-'. ``+J,v�J _ i, Installation Date- Jobsite Address 219 Holly Point Rd. Centerville `' C A-Side Lot Permit Number B-Side Lot #'s 2 �k` a s. Walls,, 1LL� Attic Cathedral Ceiling - 9" 'J 40 `' 440 ' . � - � • r '817-640-4900 ® Info@Demilec.com '® www.DemflecUSA.com c8DEMILEC�;' HEATLUKT,o SPRAY POLYURETHANE FOAM Soy P"E��w (P 3,1,p filiV200 . �. } Company Name cape cod Insulation Phone-Number 508=775-1214 Applicator Name. I Installation Date JobSite Address 219 Holly Point Rd. Centerville A-Side Lot #'Sc2q Permit Number. B-Side Lot #'s g y Walls Attic Floor 4 1/2" 31 w. 400 . r • r. M . 81.7-640-4900 e Info@Demilec.com ® www.DemilecllSA.com Q4DEMILEC a " a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map a Parcel y Application #J U 0 g Health Division Date Issued a` Conservation Division gt ow -/ZO_�g Application Fee Planning Dept.t. Permit Fee a a� Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis Project Street Address Village s-«i/ i" /we/e-� _ Owneri�o9�f/ d/7.�1�� Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I-la aO .Construction Type Lot Size ,,� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 21 .Y Two Family ❑ Multi-Family(# units) Age of Existing Structure �� Historic House: ❑Yes �Jo On Old King's Highway: ❑Yes ❑ No Basement Type: ®'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) o4z)4��,Vt/?`casement Unfinished Area(sq.ft) � Number of Baths: Full: existing new Half: existing new Number of Bedrooms: -? existing _new Total Room Count (not including baths): existing new First Floor Room Count S Heat Type and Fuel:. a Gas ❑ Oil ❑ Electric ❑ Other Central Air: es ❑ No Fireplaces: Existing 2 New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ exit ing ❑ (,@w ,see_ Attached garage: Zexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: k t ' 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 ��F/l�t��G�✓1 Telephone Number 2oZ Address �/2 C119v/2~ Z&4po License # 1)Fl:,-)Ig40I e_" /9 v 2UL 6 Home Improvement Contractor# Worker's Compensation # J-ooU''NIJt ZOW ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `Sc 7 S SIGNATURE DATE ®-23 - Z I r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME o '7II N INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f b GAS: ROUGH FINAL FINAL BUILDING � 1 DATE CLOSED OUT c ASSOCIATION PLAN NO. 4 ti Town 'of Barnstable Regulatory Services SINE Thomas F.Geiler,Director Building Division BARNSTAB LE. : Tom Perry,Building Commissioner 9 ,6 9. �0� 200 Main Street,Hyannis,MA 02601 �ATED MA'S A Office: 508-862-4038 Fax: 508-790-6230 October 31, 2012 Andall Builders, Inc. Attn: Robert Crowley 42 Chute Rd. Dedham, Ma. 02026 RE: 219 Holly Point Rd., Centerville,Map: 232 Parcel: 071 Dear Mr. Crowley: This letter is in reply to application number 201206458 to construct a family room addition. Unfortunately, the application cannot be approved at this time for the following reasons: 4 1) Permit application number 200804410 remains unfinished at the above property. 2) Construction documents submitted are incomplete and fail to demonstrate compliance with 780 CMR. Respectfully, )J*L auL zon Local Inspector j effrey.lauzongtown.bamstable.ma.us (508) 862-4034 The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Com nsafio e p n Insurance Affidavit: Btulders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name(Business/Organizationa&vidnai):�/� — / - City/State/Zip: Phone#: F e you in loyer?Check the appropriate box: Type of project(required), am a employer with 3 4• ❑ I.am a general contractor and Iemployees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑De tion working for me in any capacity. employees and have workers'. [No workers' comp.insurance comp. insurance.$ 9. adding addition required.] 5. ❑ We are a corporation and its 10.0 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 subcontractors 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 and job site information Insurance Company Name: 0 SS�C,1•9�___'.� Policy#or Self-ins.Lie.#: dp�.���Uf � Expiration Date:_ I Z-,(2 Z Job Site Address:_.Z_i S'�r�L�•� �r7� /�Gi 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 u er the pains andpenalties of perjury that the information provided above is true and correct: Si tore: Phone#: -area,ea,zU'L;E—(_0-,Eli t u-� Or TOWn OffICL City or Town: PermitUcense# -------------------- Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 5.Tlumbing Inspector 6. Other Cont-4ct Person- Phone#: - I CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALI tK IHt GVV tKAtat Arrtncuty aT me T Vua.rc� 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(es)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). CONTACT PRODUCER - NAME: Malcolm & Parsons Ins. Agcy. Inc. PHONE 781.344.3200 N, 781.344.1425 6 Freeman St. ADDRESS: P.O. Box 527 INSURER(S)AFFORDING COVERAGE NAICS Stoughton, MA 02072 INSURERA: Northland Insurance Company INSURED Andall Builders," Inc. INSURERB: Safety Indemnity 33618 42 Chute Road INWRERC: Nautilus Insurance Company Dedham, MA 02026-5827 INSURERD: Associated Employers Insurance. INSURER E: INSURER F: - COVERAGES CERTIFICATE NUMBER: Master 3/7/12 REVISION NUMBER: IS IS TO CERT ',IES OF MURANCE LISTED 13ELOWHAVE BErN ISSUED TO THE INSURED VE 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ODLSU POLICY EFF POLICY EXP LIMITS LTR f? - INSR WVD POLICY NUMBER YYY WDDIY MID GENERAL UABITY WS133442 0110812012 0110&7013 EACH OCCURRENCE s 1,000,000, X I COMMERCIAL GENERAL LABIL"T PREMISES occurns=4 S 100,000 . CLAIMS-MADE n OCGi1R _ - ME)EXP(Arty one person) S 5,000 A - - PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE s 2,000,000 GEN'L AGGREGATE LIMB APPLIES PER: - PRODUCTS-COMPIOP AGG S 2,000,000 POLICY X PRO- JECT LOC S AUTOMOBILE LIABILITY 6205710 03/06/2012 03/06/2013 acriden s 1,000,000 i.'. BODILY INJURY(Per person) S . ANY AUTO B ALL OWNED IX SCHEDULED :" BODILY INJURY(Per acci S AUTOS AUTOS. Ix HIRED AUTOS NON—O"ED PROPERTY DAMAGE S AUTOS (Per acciderd) S UMBRELLA UAB X Qr,(MR AN-006020 01/0812012 01108/2013 EACH OCCURRENCE s 5,000.000 C• X EXCESS LIAB CLAIMSSMADE - AGGREGATE S 51000,000 DED I X RETENTION 5" s WORKERS COMPENSATION - WCC500774801201112f1712011 1211712012 X WC STATU-I I OTH- AND EMPLOYERS'LIABILITY ' " _ TORY LIMITS I ER ANY PROPRIETORIPARTNERIEXE Y J N - - - EL EACH ACCIDENT S 500,000 D OFFICER/MEMBER EXCLUDED? N N I A . (Mandatory in NH) - EL DISEASE-EA EMPLOYEE S- 500,000 I yes describe Under" EL DISEASE-POLICY LIMIT S 500.000 DESCRIPTION OF OPERATIONS tieloal DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(AUwh ACORD 101,Additional Remarks Schedule,if more space is requiredl arpentry - residential & commerical CERTIFICATE"HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Amne Parsons ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD AWC Guide to Wood Construction hi'High WhzdAreas: 110 mph ii'ind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)� Q Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust)..:............................................................... .................................................110 mph Wind Exposure Category ..........................................................B 1.2 APPLICABILITY \ Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story)__I—stories <_2 stories v s <1<:12 RoofPitch ..........................................................................(Fig 2) ............................... .—` Mean Roof Height ..............................................................(Fig 2).................................. ............�' ft _33' LL_ BuildingWidth,W ..............................................................(Fig 3)..:....................................... ft <_80, JG Building Length, L .................................................... .........(Fig 3 tf ft <_80' - Building Aspect Ratio (L/W) .............................................:(Fig 4)..............................................�• _�6 8" - Nominal Height of Tallest Opening ...................................(Fig 4)...............................................(�. - - 1.3 FRAMING CONNECTIONS General compliance with framing connections...................(Table 2)..............................................:................ Vol 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete........................:..................................................................................................... ConcreteMasonry.................................................................... ............................................................... 2.2 ANCHORAGE TO FOUNDATION''' 5/8"Anchor Bolts imbedded or 5/8" Proprietary Mechanical Anchors as an alternative in concrete only BoltSpacing-general ................................. ........(Table 4).............................................. in Bolt Spacing from endfjoint of plate ............................(Fig 5)......::............................ < "_in._6 2 _ Bolt Embedment-concrete..........................:.............(Fig 5).................................................�in._7" in.>_ 15" Bolt Embedment-masonry................... (Fig 5)........................................... , " Plate Washer................................................ (Fig 5)..............................................z ............... 3"x3"x /< 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55)...................................12' Maximum Floor Opening Dimension..............:................... (Fig 6).................................................—b ft_ -1� Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6).............................. ........ ✓ Maximum Floor Joist Setbacks O ft s d �J Supporting Loadbearing Walls or Shearwall................(Fig 7)................................................... Maximum Cantilevered Floor Joists IN Supporting Loadbearing Walls or Shearwall................(Fig 8).........:.........................................1AX<-d FloorBracing at Endwalls...................................................(Fig 9)...... ............................................................ Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)............................... .. Floor Sheathing Thickness ................................................(per 780 CMR Chapter 55)...................... n• Floor Sheathing Fastening.........:........................................(Table 2)..mod nails at-4 in edge/ K.in field 4.1 WALLS Wall Height Loadbearing walls........................... ............................(Fig 10 and Table 5)........................I 2y ` 10, V- Non-Loadbearing walls................................................(Fig 10 and Table 5)..................... �.ti "f0 <_20' �� Wall Stud Spacing ......................................:.................(Fig 10 and Table 5)..................._j,A;in._<24"o.c. i Wall Story Offsets ..:.........::.................. .............(Figs )...........................................�ft _< d 4.2 EXTERIOR WALLS' �►` Wood Studs • ........ able 5 .............. 2x - 1 ft m. ✓ Loadbearing walls..........:..........::...:............:........ R ) ....... � .� � Non-Loadbearing walls................................................(fable 5).............................2x�- ft in. Alz Gable End Wall Bracing' / Full Height Endwall Studs.......:....................................(Fig 10 •••• A WSP Attic Floor Length..............:............. .................(Fig 11 ft 2:W/3 - Gypsum Ceiling Length(if WSP not used)................. (Fig )Fi 11 ...... ..................................... ft'-0 9W . _ and 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11)..............................:.............................. or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate � SpliceLength .......................................I................(Fig 13 and Table 6).................................... — ✓ Splice Connection(no.of 16d common nails).............(Table 6).................................................... �j AWC Guide to Wood Construction in High Find Areas: 110 mph Rhid Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)1 Loadbearing Wall Connections Lateral(no. of 16d common nails)...............................(Tables 7)...................................................... Z+ Non-Loadbearing Wall Connections l Lateral no. of 16d common nails ............................... able 8 V Load Bearing Wall Openings(record largest opening but check all openings,for compliance to Table 9) Header Spans ........................................................(Table 9).................................._4_ft Q in. <_11' ✓� Sill Plate Spans ........................................................(Table 9)....................................a ft-_0L in. <_11' Full Height Studs no. of studs ................................... able 9 ............... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans...... ......................................................(Table 9)..................................L ft Z.•in.<_12, Sill Plate Spans...........................................................(Table 9):................................1 ft t in. 512" Full Height Studs(no. of studs)...................................(Table 9).......................................................� Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously° Minimum Building Dimension,W Nominal Height of Tallest OpeningZ ........................................................................"..(I�<6'8" Sheathing Type.............................................(note 4).........................................It16, _sue Edge Nail Spacing.........................................(Table 10 or note 4 if less).......................-4 in. _ Field Nail Spacing.........................................(Table 10)................................................yz,_in. _ Shear Connection (no. of 16d common nails)(Table 10).......................................:...........I � �-rt- Percent Full-Height Sheathing......................(Table 10).................................................... t% ✓" 5%Additional Sheathing for Wall with Opening>6'8" (Design Concepts).................... Maximum Building Dimension, L 4 a Nominal Height of Tallest O enin ............... 9 P 9Z............... ....... �r <_6'8' ✓ SheathingType..............................................(note 4).................................................;Uue �_ Edge Nail Spacing....................................:....(Table 11 or note 4 if less).......................4 in. Field Nail Spacing..................................:......(Table 11)................................................ j-,j, in. ✓ Shear Connection (no. of 16d common nails)(fable 11)...................................................3. " Percent Full-Height Sheathing......................(Table 11)....................................................W% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?............................................................... ............................................................... 5.1 ROOFS Roof framing g p d?_......................(For Rafters'use AWC Span Tool, see BBRS Website) Roof O e' member sans'checkerhng ... (Figure 19)..............U ft<_smaller of 2' or U3 �C Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12).............................................U=%plf Lateral.............................................(Table 12)............................................L=M plf ✓ Shear...........::................................. able 12 S=_A-�rplf Ridge Strap Connections, if collar ties not used per page 21... (Table 13)........... ...................T= plf Gable Rake.Outlooker....:....................................(Figure 20)............. •Z�ft<_smaller of 2'or U2 ✓"' Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift.....................:..........................(Table 14)............................................U= lb. Lateral (no.of 16d common nails)... (Table 14).......:...............................L= lb. Roof Sheathing Type...........................:.......................(per 780 CMR Chapters 58 an 9) ......... Roof Sheathing Thickness......................................:...: ... ..........................................s in. 7/16" SP Roof Sheathing Fastening...........................................(fable 2).......................................:.Po.............. Notes: 4 ) & 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5% is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. a P 4 AWC Guide to Wood Constructson hi High Wind Areas: 110 mph Wiixd Zorae Massachusetts Checklist for Compliance(78a CMR 5301.2.1.1)1 4. - a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7116"and be installed as follows: L Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment a --YN-M THE EDGE FEM ON PF'"ING MEW NAILS. ATfib c 1 11 1/ 1 11 1/ 1 u H - 11 1 11 11 11 11 ` 1 11 II 1[ • I 11 II O I 1 II It G [ tl 11 t u 11 4 1 m L Q a r p r so I I I I Z • m n it 1 II II g 1 IL LI Q II II 0 u IF 1 Iu r,� u � • I1 o 3 e u rr Y13i 1 EL I Q 1. er W I U u 11 H W t l tt J 1 1 11 n 1 1 aOl1 a MX;E NAILSPAGING 1 l„ v See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment I AWC Guide to Wood Construction in High.9,7nd Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (7so cMR 5301..2.1.1) a , �?� I G I� i W� CJ Q i i I FReWIIN6 MEM9ERS i - EDGE e+ITF�hA T£ CL i t � I _ STAGGERED — XAJL PATTERN PANEL PANE!—EDGE' DOUBLE NAIL EDGE SPACING DETAL Detail Vertical and Horizontal Nailing for Panel Attachment G �THE T Town of Barnstable Regulatory Services + sAJIMS- IX, v MA-9 �, Thomas F.Geiler,Director . �p i6g9. 10 . rFn rr►a�' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize d Vkk 7� OR 0 k/L C Y to act on my behalf, in all matters relative to work authorized by this building permit A . (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools afe not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner AwIatute of Applicant Print Name n inr Ta Date QTORMS:OWNERPERMISSIONPOOLS 6/2012 zKE r Town of Barnstable ti Regulatory Services Thomas F.Geiler,Director saatvsTas , Mass. L�. 9�b 1.659. ,�� Building Division prED MA'I�` 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: t 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 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:forms:homeexempt iViassachusetts- Department of Public S tfet�: it ��ie vran> ! Board of Building Otfice of Coosumer•Affairs&B smessRegulaton r Regulations and Standards � . Construction Supervisor License HOME IMPROVEMENT CONTRACTOR Type Registration 148137 private Corporatio License: CS-,45259 Expiration gI9/2Q13 > A LL BUILDE,R,99� ROBJERT V CROWLEY JR { I rM �€ 42 CHUTE RD . ,•¢ RQBERTEROWLE ` DEDHAM, MA 02026 g I 42.CHUTE:RD Undersecretary Q• DEDHAM,MA 02026 ��� Expiration: 5/22/2013 ('ununissioner Tr#: 16150 i ANDERSON STRUCTURAL, ENGINEERINO, INC. 764 PLAIN STREET NIARSHFIELD MASSACHUSETTS 02050 781-837-6949 FAX 781-834 6253 -November 13, 2012- Herb Kuendig, Kuendig Design 4 Brook Street Suite 23 :Scituate, MA 02066; Re: 12-142- Molfo Residence Addition; 219 Holly Point Road; Centerville,tv1A r IDS, Structurdl Review m ti , VIA bear Herb,, -As.iequested;.we have reviewed the above referenced project for conformance with,the wind wind gravify load cnterici designated in;the Eighth Edition,Massachusetts State'Build'ing'' =Code (One and Tvvo Fdmlly bwellings).With the addition of the structural items shown on`the attached drawings the new,construction will conform to said.require"menu: If you have any.questions or comments regarding this, please d'on't.hesitate to'call'. Sincerely, OF o KEYIN P,' �yG g BURLINGAME Thomas E Anders;on sTRucruRAL y :Senior.Project Manager No asoso. ss(oNAL ENG - Y .; .._..-_..�M._..,.-.--<-....�_,.._.._.._.._.. w_..,.... car..; ^__.__ . ..:........ �...�H+.�. .....:.vim...... j..,. : `py ..n� S w �. _ _.. . �... ..m ..�..:.�..,�<.�.,:-...��-..,�,..�..io�.b,r�«,..�. „�-.,�<�•��„�.,.,,,,,�..,,,. ,mow ; G? c• No�'� 219 HOLLY POINT ROAD SUE, AC4.*Me b, v AN ",tee 0 5TRUCTUR,4L. CONFORMANCE ® Date:Ii/13/t2 Anderson Structural Dn.8,,: TEA Pg d 'cv LV�. Gs wa : fit; y Engineering, Inc. 764 Pkft Sftet 6 LA,A 0 t,7,.& YPN Scale.AS NOW YanhfialA MA o2oso D412-id2-, 4 , 1' 4 TO 4 gwrs a It p� . A,C)Ok t. ' ` ,��..D����2 dllo c�l�. d N,4•r�yam. Pv5�(' r e t oc r.Vqj IG Z ee m k. 11 If t 1 y 4. I f +�d Xp rou'OPA (00 t4 VL FA,4 mi , f i; Qt" 2113 ROLL r POINT ROAD aeNTEWuE, MAGGAOUSEM STRUCTURAL CONFORMANCE Date:tI/13/12 Anderson Structural y,n av; TEA Engineering, Inc. 764 Ptah►street Dug.l2-142 -Fs II IAS NOTED ltarah I914 MA 02050 s I F ; ' 4 . c,2 '2 q. Z L lt[, t �' K x %� �' rani u�J �- ���`'191,f� k 1 jJA4 G kl . -------{J ----'--— -- yfiAA PS C oe. 1 2 i 43 I ==Mw= ® f yt 219 HOLLY POINT ROAD eart�eHu.r, nata�eeTrs JyA 5TRUCTURAL CONFORMANCE � Date:11/13/12 Anderson Structural D„�aw TEA Engineering, Inc. 764 Plain Street Scale:A9 NOTED 3(arsMie14 MA 02050 AM-12-142-� Frio 47 J T6 610 f-770 A4 6o CpPC A si ac td �j 219 HOLLY POINT ROAD STRUCTURAL CONFORMANCE Dater II/t3/12 Anderson Structural D,,.av TEA Engineering, Inc. Scale{A�JN0IF.D XarekfieeldMA 02050 GENERAL NOTES I., LOAD CRITERIA 1. Snow load-Ground snow load 30 psf 2. Live loads:First Floor 40 psf 3.Wind load design based on 8`s edition.of the 780 CMR 51.0 Massachusetts Residential Code and IRC 2009. Basic wind speed(3 second gust) 110 mph Exposure Category C H. LUMBER AND SHEAR NOTES: 1. Stress-grade lumber shall be in accordance with"National Design Specifications for Stress-Code Lumber and Its Fastenings" by the National Forest Products Association(latest revision).. 2. Framing lumber shall be SPF#1/#2 Fb=875 psi,E= 1,400,000 psi not including adjustments or approved equal or better. 3. All post loads are to be followed down to solid foundation.General contractor verify in field 4. All work io comply with state building code requirements unless superseded by more stringent specifications. 5. Any timbers and beams exposed to weather shall be pressure treated. 6. Provide a minimum double studs(nailed as a built up post)post under all floor beams or multiple joists and headers unless otherwise noted. 7. Provide suitable metal hangers fibrall flush members unless otherwise noted.Coordinate finish with material attached. 8. APA rated Sheathing:Wall'/2",Floor 3/4".Fastened per applicable IRC Table R602.3 and Figure R602.3 unless superseded by more stringent specifications. ; ` 9. Fasten all king studs to each exterior:header lamination with min.3- 16d direct nails.Connect bottom of header to face of stand alone studs with Simpson A34 10. Provide double exterior king stud at doors wider than 6'-0"and at windows wider than T-0"unless superseded by more stringent specifications.Provide Simpson H2.5T hurricane ties for all exterior rafter to wall connections. 11. Provide Simpson LSTA18 straps;connecting opposing rafters at ridge if collar ties are not used or installed per code. 12. Lap exterior wall sheathing at floor levels. _ .13. APA rated Sheathing:Wall 'h" Roof 5/8",Floor 3/4".Fastened per 780 CMR Table 5602.3.1 and Figure 5602.10.5 unless superseded by more stringent specifications. M. PRE-ENGINEERED LUMBER NOTES l. Laminated Veneer Lumber(LVL)shall have a minimum:Bending stress(Fb)=3100 psi, Modulus of Elasticity(E)=2,000,000 psi,Horizontal shear(Fv)=285psi,Compression perpendicular to grain(Fc)=750 psi.Any adjustment factors shall be approved by structural engineer. 2. Provide necessary bracing during erection to keep members plumb and secure. 3. Refer to manufacturer's specifications and notes for additional information. 4. All hangers noted are from`Simpson'or approved equal. IV. FOUNDATION NOTES 1. Footings shall be carried to elevations shown on drawings and deeper if necessary to obtain a safe bearing of 1.5 tons/psf 2. All excavations and foundation construction is to be in the dry and no concrete shall be placed in water. 3. No footing shall be placed on frozen soil. 4. Where it is necessary to raise the grade below footing,fill shall be placed in 8"layers compacted to 95%of ASTM D 1557, Method D Proctor Test. V. CONCRETE NOTES 1. All concrete work and reinforcing bar details shall conform to the latest A.C.I.Code and Manual. 2. All concrete shall have a mimmum,compressive strength of 3000 psi at 28 days., 3. Minimum protective cover for reinforcements unless otherwise provided for: a. Concrete placed against earth,3" b. Formed concrete exposed to earth,weather or water,2" 4. Reinforcing steel shall conform to ASTM A615-GR60. 219 HOLLY POINT ROAD COJTERv LLE, MAee COLMMS STRUCTURAL CONFORMANCE Daft:11/13/12 Anderson. Structural TEA Engineering, Inc. Scale.AS Yarsifdel$ MA 02050 •12-142-�9 ANDERSON STRUCTURAL ENGINEERING; INC. 764 PLAIN STREET' MARSHFIELD,MASSACHLISETTS 02050 781-837-6949 FAX 781-834-Q53 November 13, 2012 Herb Kuendig ZE Kuendig Design 4 Brook Street Suite 23 Scituate, MA 02066 Re: 12-142 Malfa,Residence Addition; ro 219 Holly Point Road: Centerville, MA Structural Review Dear Herb, As requested,wwe have reviewed the above referenced project for conformance:with the wind and gravity load criteria designated in the Eighth Edition Massachusetts State Building; Code (One and Two Family Dwellings).With the addition of the structural items shown on the attached drawings the new construction will conform to said requirements. If you have:any questions or comments regarding this, please don't hesitate to call. Sincerely, - OF Af O� KEVIN P. G ME Thomas E. Anderson 00 STRUCTURAL o AL � Senior Project Manager No.4so50. ti A�,cks QISTEP�G��'t,4'� Enel, NAL EN 'S .a LAY A V' sIP:� 2 K t•n R-�f-t�v� V'� ���r� OPP�s��6 � 27 �� c� to � Y i- ;x.+..-.w.._.�...•-vim......-�.�-.•-�._._.._._-........�.�..+y-.+..�•+.....-..._.-. ....n .N.�...r»-..••+-..._, ......._._.< e f _._ Y_.. s � r 4 f� +MVv!w y� �R'¢(x' exnxvnnyy� Qj Pit p lie ' N:.wu:4!4H1aR.'W - a'4f+Mn.wuri�6aN^ nY'+.Lwu3F4`.>i.1hW'q'.rrvgt6;lr'WWp:,ry� C? Now CErinM2l9 HOLLY POINT ROAD ,nu.e, MAMAC4US S • A a c3 STRUCTURAL CONFORMANCE 6M4 M10 t-`T4 (IA Date:nii3i12 Anderson ers�Inca °"' rea +� LA,�a� l Scala-AS NOTE Ya sh plat►ssroat " Y� ;,.�� � ��1,�' �v�c'�" �t4 xa oaoso D+w•12-142-� x Spy. COIIaAW PVW&&f tfk P.G �Ot,c 0 64-o CA4 d N Oe yL-- Qo5� i figr CLAA,) r .. ,, 4 •, , . � -v� ' �? 4? gee ; _ � � �� � Q' � �� � ; � � `� ��----�-�r;:--�—�• `-� -';`�"' � Ord— f F I i s 1 f r - i s r •� f i r P 1 219 HOLL`r POINT ROAD CfTBER+/ILLE, MAe9AC ISETr8 STRUCTURAL CONFORMANCE Date:11/13/12 Anderson, Structural v TEA Engineering,ineerti , Inc. 764 Plain Street Scala-AS NOTED mwsifiez4 MA 02050 Dw.12-1424. h 2 ►� c2 4� (� k r--- — ►c K K' t� I-� uJf G- ��� otiA �L"4wo 04 *5 S��W o C I lz f I s t � j S 4' lop, �pL �i �W • Cf�� 219 HOLLY POINT ROAD STRUCTURAL CONFORMANCE —AC.r �✓ �v Dat8:11/13/12 Anderson Structural B,F ?EA Engineering, Inc. 764 Plain Straat pWe•12-1�2_ t:' -- ^' Soale:il5 MO1ED Yarsh,ftK MA 02050 1 is A Alf, d, -e c 1A Ira �. A A 219 HOLLY POINT ROAD ce;rEWLLE, nAWAOA Ms STRUCTURAL CONFORMANCE Date:11/13/12 Anderson Structural n.,.sv TEA Engineering, Inc. 764 Plain Street Soale:A9 N01Eq Yarsh^61 L Ju 02050 DuAy.l2-td2-� v GENERAL NOTES I. LOAD CRITERIA " 1. Snow load-Ground snow load " '` 30 psf 2.Live loads:First Floor 40 psf 3.Wind load design based on 8"'edition of the 780 CMR 51.0 Massachusetts Residential Code and IRC 2009. Basic wind speed(3 second gust) 110 mph Exposure Category C H. LUMBER AND SHEAR NOTES: 1. Stress-grade lumber shall be in accordance with"National Design Specifications for Stress-Code Lumber and Its Fastenings" by the National Forest Products Association(latest revision). 2. Framing lumber shall be SPF#1/#2 Fb=875 psi,E= 1,400,000 psi not including adjustments or approved equal or better. 3. All post loads are to be followed down to solid foundation.General contractor verify in field 4. All work to comply with state building code requirements unless superseded by more stringent specifications. 5. Any timbers and beams exposed to weather shall be pressure treated. 6. Provide a minimum double studs(nailed as a built up post)post under all floor beams or multiple joists and headers unless otherwise noted. 7. Provide suitable metal hangers for all flush members unless otherwise noted.Coordinate finish with material attached. 8. APA rated Sheathing:Wall'/2",Floor'/4".Fastened per applicable IRC Table R602.3 and Figure R602.3 unless superseded by more stringent specifications. 9. Fasten all king studs to each exterior,header lamination with min.3 16d direct nails.Connect bottom of header to face of stand alone studs with Simpson A34. 10. Provide double exterior king stud at doors wider than 6'-0"and at windows wider than 2'-0"unless superseded by more stringent specifications.Provide Simpson H2.5T hurricane ties for all exterior rafter to wall connections. 11. Provide Simpson LSTA18,straps,connecting opposing rafters at ridge if collar ties are not used or installed per code. 12. Lap exterior wall sheathing at floor levels. 13. APA rated Sheathing:Wall 'h",Roof 5/8",Floor'/4".Fastened per 780 CMR Table 5602.3.1 and Figure 5602.10.5 unless superseded by more stringent specifications. III: PRE-ENGINEERED LUMBER NOTES 1. Laminated Veneer Lumber(LVL)shall have a minimum:Bending stress(Fb)=3100 psi, Modulus of Elasticity(E)=2,000,000 psi,Horizontal shear(Fv)=285psi,;Compression perpendicular to grain(Fc)=750 psi.Any adjustment factors shall be approved by structural engineer. . 2. Provide necessary bracing during erection to keep members plumb and secure. 3. Refer to manufacturer's specifications and notes for additional information. 4. All hangers noted are from`Simpson' or approved equal. IV. FOUNDATION NOTES 1. Footings shall be carried to elevations shown on drawings and deeper if necessary to obtain a safe bearing of 1.5 tons/psf 2. All excavations and foundation construction is to be in the dry and no concrete shall be placed in water. 3. No footing shall be placed.on frozen soil. 4. Where it is necessary to raise the grade below footing,fill shall be placed in 8"layers compacted to 95%of ASTM D 1557, Method D Proctor Test. V. CONCRETE NOTES 1. All concrete work and reinforcing bar details shall conform to the latest A.C.I.Code and Manual. 2. All concrete shall have a minimum compressive strength of 3000 psi at 28.days. 3. Minimum protective cover for reinforcements unless otherwise provided for: a. Concrete placed against earth,3" ' b. Formed concrete exposed to earth,weather or water,2" 4. Reinforcing steel shall conform to ASTM A615-GR60. 219 HOLLY POINT ROAD STRUCTURAL CONFORMANCE Dew:II/13/12 Anderson Structural Da. TEA Engineering, Inc. 7164 Pk"Street Scaie:A3 Mws► IA MA 02050 D�ee•12-id2-r9 ., ii ++. 't7 1 AM- r.� F I - ... .� ,WAY., r _ Tit got", ob AR .3. � 'E':�'�a'� Ili �� <•� '` �� Fn1dtU�lA37dlUlS G131(�YMA SfllON 113�1911 Yl�l' PLUS yPLO I �pp(E VYCOR'PIUS Y Town of Barnstable Regulatory Services �1He Thomas F.Geiler,Director Building Division HARNS'rnsi.e, : Tom Perry,Building Commissioner 9 i6 9. ��� 200 Main Street,Hyannis,MA 02601 ��ED MA'S A Office: 508-862-4038 Fax: 508-790-6230 October 31, 2012 Peter Molina PO BOX 4014 Dedham, Ma. 02027 RE: 219 Holly Point Rd., Centerville, Map: 232 Parcel: 071 Dear Mr. Molina: This letter is to follow up on the status of permit application number 200804410. To date a final p inspection has not been requested and upon a recent site inspection, it appears little p q to no work has been done since the last inspection on or about October 10, 2008. As the contractor of record one of your responsibilities is to ensure successful completion of all required inspections. Please contact this office immediately and explain why it appears you have left the job in an unsafe condition. By Order, g Local Inspector j effrey.lauzon(a�town.barnstable.ma.us (508) 862-4034 6 W ij C-Ar-E- T SLowLY , i } { J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MapJ, Parcel_ ZZ Application # Health Division Date Issued Conservation.Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board oK g1214sydl� Historic - OKH Preservation/ Hyannis Project Street Address 2/9 /L4LLy P,lW 7- R 1, CNR Village Owner Aj 1114414 ' Address 7 r7 PA140,v4s7' 5Z RGSLIMW&-- Telephone Permit Request 1_?X!6!5�"7_ FiWR)WelG Square feet: 1 st floor: existing proposed 2nd floor: existing proposed a Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 01_5'6e7v Construction Type Ar-ele Lot Size - 41 ,4&fig Grandfathered: ❑Yes ❑ No If yes, attach su i orting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure / Historic House: ❑Yes lo On Old King's H hway:`a❑Yes-`--; ❑ No Basement Type: 2 cull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 6jC�� ,c7- Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new Fiat Floor Room Count Heat Type and Fuel: r3Gas ❑Oil ❑ Electric ❑ Other Central Air: Wrres ❑ No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes FdNo Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: W reisting ❑ 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 gl° ' d (BUILDER OR HOMEOWNER) 7El- y92-J�ng Name' r" � n?. /old +�,� Telephone Number 08 92- Address 2.d. 3 d 0 License#.. Home Improvement Contractor# z_1 6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO t SIGNATURE DATE —l8 $ T - _ FOR OFFICIAL USE ONLY APPLICATION# , DATE ISSUED s r MAP/PARCEL NO. y t ADDRESS VILLAGE _ OWNER DATE OF INSPECTION: FOUNDATION q rlor z FRAME D j 0 l of INSULATION FIREPLACE , ELECTRICAL: ROUGH FINAL ? PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING { DATE CLOSED OUT" ASSOCIATION PLAN NO. 1 t I 4 ✓lie'Cow nzowwwaa o1✓1&aoadiu4etea Board of Building Regulations and Standards Construction Supervisor License CS 59104 Expiration-5/22.2010 Tr# 24026 # IFr t - F Rests do Q PETER M MOLINK,N�g PO BOX 4014 DEDHAM,MA 02027 Commissioner rY A.�omnzonusea��a�.�aaa¢c6uad2lCa �� � a Board of BuildingR 'Regulations and Standards 1cense or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ` Board of Building Regulations and Standards Registratlon. 11210,E Expiration 2/2d/2009 Tr# 129551 One Ashburton Place Rm 1301. i Boston;Ma.021.08 Type DBA i e.' PETER MOLINA CARPENTRY PETER-MOLiNA 278 MT VERNON ST G¢ L.DEDH�iM,MA 0202E. A Andnil r for , Not valid wittiout signature �ppTHEloy� Town �of Barnstable r Regulatory Services BAMSTA9 MAS&B1E�; Thomas F. Geiler,Director 16 9. - Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder, , I, �i�i4/Yx —77 /�/'���/� , as Owner of the subject property hereby authorize h��7�ded /V/'/y G/N.� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature o Owner Date. Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. • n�nRtfC•nWNFRPFRMI.CC1(lU , s Town of Barnstable �pF THE Tp�� Regulatory Services Thomas F. Geiler,Director w BARNSTABLE, �. 9 MAS3. %639. a,� Building Division lE0 MA't Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 ,ww.toyvn.b2rnstable.ma.us Office: 508-862-4038\ Fax: 508-790-6230 HO)\4EOWNER LICENSE EXEMPTI N Please Print DATE: — �/G JOB LOCATION: ! dLL tL� - I/lLIF number street /Z Ile "HOMEOWNER": �� L �ll� / O —D !e D name home,-phone# work phone# CURRENT MAILING ADDRESS: < T S T city/town state zip code The current exemption for"homeowners"was xtended to include of er-occu ied dwellin s of six units or less and to allow homeowners to engage an individu for hire who does not poss s a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, 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 undersign "homeowner"assumes responsibility for compliance with the State Building Code and other applicable code bylaws,rules and regulations. The undersigned' omeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspectio pros 'es and requirements and that he/she will comply with said procedures and requirements. Signature of owner r Approval of Building Official Note: Three-family ellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 12 �D 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 1o9.1,1-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. 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/Blectricians/Plumbers Applicant Information Please Print Lel�iblV Name(Business/Organization/Individual): e, z1R ✓nd L o Address: �,�, 73e;,. 4�8 tV City/State/Zip: Phone-#: �/j - ���3 --6 S 9 Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer.with 4. I am a general contractor and I 6. ❑New construction ,_, employees(full and/or part-time).* have hired the sub-contractors V�{� 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 camp.insurance., [No workers' comp.insurance 5. [] We are a corporation and its 10.[]Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions myself. [No workers' comp. t right of exemption per MGL 12.[]Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.❑ Other /JC"KcF� _/ employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =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 far 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 tip 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 imsurancr coverage verification. I do hereby under the pains-and penalties of perjury that the information provided above is true and correct SiLmaturek o� Date: A-113 -C� — Phone#: (�l - 6-4-3 - 6 R 22 -1 7 Official use only. Do not write in this area, to be completed by city or town offeciaL 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 representative's of a deceased employer,or the to receiver or trustee of an individual,partnership, association e or other legal entity,employing employees. However the dwelling house having not more than three apartments and who resides therein,or the occupant of the owner of a dw g g P 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,i.f 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 Towp Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call Ili The Department's address,telephone-and fax number: The e6mmonweaM of Massachusetts Depaitment of Industrial Accidents . Office of Investigations i 600 Washington Street Boston, MA 02111 Tel. #617-727-490.0 ext 406 cr 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www-.mass.gov/dia x FILE G3302 F�7ood 3 CENSUS TRACT I CL- : ra "I gssociaces xass. DIED WOK PAGE i - 04�N S. Paul I114 ' PLAN WK PAM LOT APPL Ptr J. wtalfaASSESSORS NOR T6A6•'E I• NSP € CTION , ' PLAa of LAND r i N .BA- RNS- TABLE SCALE: 40' O JULY 291 1988 LOT 3+ LOT 33 = 1 .49 LOT 36 LOT 3'] - : - Q1 CRY t fo l.17' *Za9 : 4.T17' oilyP RooA L CERTIFY TO .APPWSAL ASSOCIATES OF MASS., SENTRY FEDERAL SAVINGS BANK, AND,-,ITS TITLE INSURANCE COMPANY, THAT THERE- ARE NO VISIBLE ENCROAC NTS ' OR' EAM!IENTS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER W a IlDIATE SUPERVI$ION. THE .L OCAT-ION OF THE DWELLING AS SHOWN IS CONIPL.IANCE WITH. THE LOCAL ZONING BY TIN RESPECT - TO HOR IZQNTAL_ KEN + 1:40001ONAL -REQiR tTS. ` 990 [riltlPH EXPOSURE B WIND ZONE Checklist 1.1 SCOPE WindSpeed(3-seed gust)....................... ...................................... .......................110 mph WindExposure Category.................................................................................................................. ..B 1.2 APPLICABILITY Number of Stories ........................ .............. ..............,....(Figure 2),........... ! stories _<2 stories ..... .. . .. RoofPitch ........................................................................... (Figure 19) ............:............... p 512:12 Mean Roof Height ..................... (Figure 2)................................... 7. fL <33' BuildingWidth,W ...............................................................(Rgure 4).................................. f ft. 5 W .a BuildingLength, L ..............................................................(Rgure 4).........................:........ ft. s W Building Aspect Ratio(UIN) ...............................................(Figure 4)................................. 10 5 3.0:1 1.3 FRAMING CONNECTIONS General compliance with framing connections?.................. (Table 2)....................................................... 2.1 ANCHORAGE TO FOUNDATION Typeof Foundation............................................................. (Rgure 5). ......: a.: Foundation Anchorage Proprietary Connectors Lateral..................................................................... (Table 3).....................................U=? Pif Shear...................... .............................................. (Table 3)..........................,...........L=a pif . ............................................... (Table 3).....................................S=_ s` pif 518°Anchor Bolts _ BoltSpacing...........................................................(Table 4)...............................................f--/ in. BoltEmbedment.....................................................(Figure 5)............. ..... .. in. Washer Size...................................................:.......(Figure 5)........... „ ....x 3•...n... 1��.. thick 3.1 FLOORS Floor framing member spans checked?.............................. (IRC or WFCAO) ................................. ....................... Maximum Floor Opening Dimension...................................(Figure 6).................................... ft.•512, Maximum Floor Joist Setbacks Ply Su rtin�9 Loadbearing Wails or Shearwall................. (Figure 7)................... .:..........._ft. 5 d � Maximum Cantilevered Floor Joists n I Q Supporting Loadbearing Walls or Shearwali.................(Figure 8 I Floor Bracing at Endwalls....................................................(Figure 9)....................................................... Floor Sheathing Type......................::..:..........:....................(IRC or WFC 1. A .......................... Floor Sheathing Thickness:....................:...................,........(IRC or WFCA4)...................................._in. FloorSheathing Fastening..................................................(Table 2)................................................ _ 4.1 WALLS Wail Height Loadbearing Walls.................... ..:................................. (Figure 10).................................?.,5 ft. 510 Non-Loadbearing Wails................................................ (Figure 10)..................................T ft. 5 20' Wall Stud Spacing. .... ....................... .........................(Figure 10)..........................�in.5 24°o.c. Wall Story Offsets....................... . ................ (Figures.7--8)........................... —in. 5 d 4.2 EXTERIOR WALLS Wood Studs Loadbearing Wails.............................................. . (Table 5).....................2x , -7 ft. 0 in. Non-Loadbearing Walls................. ............... .......... (Table 5)......................2x_y -. 9 ft. in. AMERICAN FOREST&PAPER ASSOCIATION 5110 MPH EXPOSURES @ft9QN® ZOff➢P Bracing Gable End Wails - WSPAttic Floor Length.................................................(Figure 11).......................I........�ft. z W/3 Gypsum'Ceiling Length.................................................(Figure 11)............................._ft. z 0.9W Double Top Plate SpliceLength................................................................(Figure 13)........................................ 1 ft. Splice Connection (no.of 16d common nails) (T .. .. .. ..... able 6).......................................... .. Loadbearing Wall Connections Uplift. (proprietary connectors)......................................(Table 7).................. . ..............U lb. Lateral(no.of 16d common nails)................................(Table 7)................................................ Z Non-Loadbearing Wall Connections Uplift. (proprietary connectors)......................................(Table 8).....................................U= lb. Lateral(no.of 16d common nails)................................ able 8 Wail Openings HeaderSpans......................................................" .........(Table 9)....................... 3 ft. P— in._<11- Sill Plate Spans. .............................................. (fable 9)....................... _ft._in.512' Full Height Studs(no.of studs).....................................(Table 9) .................. 2 ... ........................... Connections at each end of header or sill Uplift. (proprietary connectors)...............................(Table 9)...........................................bS�;r2ib. " Lateral(proprietary connectors).............................(Table 9).............................................6 YY lb. Wall Sheathing Minimum Building Dimension,W Sheathing Type.................... .............................. (Table 10).......................................Yo ff EdgeNail Spacing....................................................(Table 10)......................................... S fn. Field Nail Spacing................................................... (Table 10).............................. in. ..... ... Shear Connection (no.of 16d common nails)........(Table 10)........................................... Hold Down Capacity.. .................... .........(fable 10).................................... lb. Percent Full-Height Sheathing................................(Table 10)............................................I—V CY° Maximum Building Dimension, L SheathingType......................................................(fable 11)....................................... 2 EdgeNail Spacing.................................................(fable 11)......................................... 4 in. Field Nail Spacing........... ...................................... (fable 11). ..................................... /Z in Shear Connection (no.of 16d common nails)........(Table 11)...............................................W- Hold Down Capacity. ..................................(Table 11).......................................kzfo� lb. Percent Full-Height Sheathing................................(Table 11)...:....................................... Wall Cladding Ratedfor Wind-Speed?.........................................:..............................4�:.'.°QS ...,��.:: SST,................... 5.1 ROOFS Roof framing member spans checked?..............................(IRC or WFCU#).............................................. Roof Overhang. ............................................................... (Figure 19)..........................aS ft.:92'or U3 Truss, I-Joist,or Rafter Connections at Loadbearing Walls Proprietary Connectors Laleral.................................... . ............. . .........(Table 12)...................................U �1b. .......... ...................................... (fable 12)....................................L�lb. Shear.......... .. ..... ....... " .........(Table 12)............ .................S=�lb., . Ridge Strap Connections-Tension.............. ................(fable 13)....................................T=MI. PH Gable Rafter Outlooker................................. ....................(Figure 20)....................®ft. fL 5 2'or L/2 Outiooker Connections at Non-Loadbearing Wails Proprietary Connectors Uplift.......................................................................(Table 14)...................................U= Lateral........................................ ..........................(Table 14)....................................L= lb. Roof Sheathing Type...........................................................(IRC or WFC".......................... . Roof Sheathing Thickness........................ . ......... ........................ .............-. ...in.�3180 wsp Roof Sheathing . Fastening enin ,......,g....... . ..................................(Table 2).�..��s�......�..:��:.<.�...............8� AMERICAN WOOD COUNCIL A// dodo bear� BJc�.r �a.r, �s Z Y •� l ` ��OJSG 3 7 ?�ecac Ada d 3. NO ems. reT � �... G� �.�-� �� l�✓"�►����: 1�c��+a�� a s ���' � tie.s S C'j A _ I yl - - ee • All-..W?.'.A-R.T.. I...Y.u.. mil......._./�%„�..�-......�._._..__..-.__........_...._...,--..... . r AooJe 4-allSc.clole S�re,vs V ``•` 14 0 Pe)641n vaU+ ._...-_..___....-_ ._._ .__...__....._........... . cep teo j 3r�dc�!n S oc _q 3 AY I - sCAL to ,C r' Pas d �� �.-®d14",6 Lam..Cam,-.' �f{.d'�oJ't:•, y4. �O�(tr i.�- e 6, S / aP te J 2 7!-Ja.d a OIL 4 .` � Seal( � PI +t e 5 , 2-zKY77 i It I r • ., � e i ill � � � ��� r-ory%er kok C-4,)0v�g a .. 14 _C,�r•�°C,,�•e. .��`i��(t��....s /e.�����, �_ d�L�-�Ct�st_evt�,���.���'C��_(a.__. PooC , t ► 1 .. �.� .... . t t•, i Ili i ' 1 .. +' ry 1 t d...l • 1..r. ._�. � lam) •1�•,. 1�1 1�, ,_, "� I_li �..� 1_/ !_� il.l� 1�1 ..�lol • � 1 � 1 � �d� Gre , 1• 1 �.•' i r 4�i'.f � � ' A opY ,d� • 1 i 41 Lim.- ii giw iii .+• ram. 1. • • 1 r , �fool • • . , , . 1• 1 goo .0-0000 • ��„t„ J ice,.••• ' NOCl.C` _ �o c 4-A- j _ x GroLj d I ,. a 4C , I I I �-- 16 lud") Foo K g -(-o Co c�G.. ( �je l p 4a G CCJ. �6/ Y'r.:t.'W» 1 tl'.iN.=(r:�,�. A.•..v.;rr:t�Wii.vY.:v::l, 7h 1.' i 1 ► I ' WOO AUte _ __.... POO 6.�r.w .+ '7• +� 4 i r �. + II, •' ..; •ist++aw�nxo�,m�n�i�.:.rmt:N..v177!nstrr,.l 7F, I;�/ ' PRE s1' i 1 r r' _ -i tit ' It goo,, , t� it a �, 8,,.���I�.• .� .�o��� JT Ll ` f CAn a o' 000 .00 �..00�"!� r . p R". ie. ' �o�•� • 5 _ /� •.-�,•� . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /�arcel Application c9 (n Health.Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board } . Historic - OKH _ Preservation / Hyannis Pro�Street Address Vill g�. Owne �� le j-" Address ,S?� o ,Telephone Permit Request 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.ft) Number of Baths: Full: existing new Half: existing new „ Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor mom Count ' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/[{coal stove'$ ❑Aes 0 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing O;new,-r,9ize_ 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) .r Name a✓l phone Number--`ln // A dress}" - �Z; " • 0 Leense'# .. .. , Home Improvement.Contractor_ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �DAf TE -;/— I's FOR OFFICIAL USE ONLY 1,3A APPLICATION# M x DATE ISSUED c MAP/PARCEL NO. L ADDRESS VILLAGE OWNER 'k 3 rt DATE OF INSPECTION: FOU:NDATION: • •• _-. ,j - r , FRAME `a INSULATION FIREPLACE ; L ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t y DATE CLOSED OUT t ASSOCIATION PLAN NO. EK f The L•ommonweattn ofmassacnuseas - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le "bl Name(B s/Organizarion/tnd : . �/ EGG` Sale Z ©Za ' Address: ���,�il'-�-i A_7I A, - Z .' • r.city/state/zip.. Phone#: �� Are you employer? Check the appropriate'bog: :Type of project(required):. 4. I am a general contractor andl 1. am a employer with` 0 6. ❑Ne construction. 1 employees (full and/or part-time).* have hired the shb-contractors 2:❑ I am a sole proprietor or partner- listed-on the-attached sheet 7.` emodeling ship and have no employees These sub-contractors have g; D Demolition workingfor me in an capacity.aci employees and have workers' Y P t3'•` t• 9. ❑Building addition [No workers' comp. insurance comp.insurance. re required'-] . 5. We are a corporation and its 10.❑Electrical repairs or additions j�3.0 I am a homeowner doing all work officers have exercised their 11.E]Plumbing repairs or additions I myself. [No workers' comp. : right of exemption per MGL 12.0.Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensatim.policyinformation. 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 cy and job site information Insurance Company Name: .�SSCJG/d¢/�7� �?�/�f�yG � �i✓Sc/��¢o� Policy#or Self-ins.Lic.Mw e'C rr)01 206 O/ZO// Expiration Date:. Job Site Address: City/State/Zip: (�/GGe Attach a copy of the.workers' compensation policy declaration page.(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1'500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to.$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of Investigations of the DIA for insurance coverage verification I do hereby certify un r the pains•and penal ' penury that the information provided above is true and correct fSi "aturwe '`,� Date: Phone•#' �%��`��Z/—®�Q� - �­ Official use only. Do not write in his area, to be completed by.city or town official, City or Town: Permit/License# Issuing Authority(circle one) J.Board of Health 2.Building Department 3.City/Town Clerk. 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: ; Phone#: Information and Ins ructions 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 m.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 o er egal 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 151, §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 theInsurance 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 mrith the ins ance 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-contiactor(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 permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the,-law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials, Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to.contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pemiit/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 io any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person,is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The C-Qm mouwWth of Mmsaohuwtts 1 Tartme 1t of liidust6al Accident's Office of Inver t o-ns - 6QO Washingt6 Sit Boston,MA€..111 Tel.# 617-727-4900 ext 406 or 1-977 MAC SAFE Revised 11-22-06 Fax#61'�-727-7749 w .mass gov/dig .. . VE Town of Barnstable' Regulatory Services 9 S.. '� Thomas F.Geiler,Director s6;q. Enru ` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA'02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner.Must Complete and Sign This Section If Using A Builder I, �:7 /Y� . , as Owner of the subject property hereby authorize _ {�� (J/LO/-=�S to act on my behalf, in all matters relative to work authorized by this building permit „ .91g 11�uy �O��r.RIPR (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. Signature of Own ,a of Applicant Print Name:'. .... Print Name` Date Q:FORMS:OWNERPERMISSIONPOOLS. J Massachusetts- Dcpat-tmcnt of Public S IfctN Officeo Consnmer B sine Affaiers¢�� os� stR go�lati u Board oYBuildin;t Regulations unit Standards u� dCC d HOME IMPROVEMENT CONTRACTOR Construction Supervisor License- Registration- 148137 TYPe: . . License: CS,-45259 Expiration: _9/9/2013 Private Corporatio E A LL BUILDERS -INC: N. 'ROBJERT V CROWLEY JR ROBERT-CROWLEYJR 42 CHUTE RD 42 CHUTE RD. DEDHAM, MA 02026 4 DEDHAM, -:, Undersecretary F - L _ Exp"`c ii.; # , !�-�- anon: 5/22/28'1:3. —"— — - ___-- ('unnnissinlicr Tr#: 16150' - - ---- ,. o Town cif Barnstable Regulatory Services sn MASS. Thomas F. Geiler, Director .q `MASS. $A . 639 �0 TFo. ta Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 a _ Office: 508=862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF . CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner.of property located at 11//L C y hO l hereby certify that A 5_yrn AW-1 /'is no longer Construction Supervisor listed on the application for the project under construction as authorized by ,200$" building permit # .2406-0 yylo, issued on 444t, I understand that the project under construction must cease-until a successor licensed' Construction Supervisor, is submitted'on the records of the Building Division. PROPERTY OWNER DATE t q/forms/newcontr . reference R-S 780 CMR rev:1104I0 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDIYY `) *� 11/26/2012 THIS.CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY'AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTf,FIEATE 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 the certificate holder in lieu of such endorsement(s). PRODUCER - - - - NAME:. - - .. Malcolm & Parsons' Ins: Agcy. Inc. AHONN 781.344.3200 a Na.781.344.1425 6 Freeman St. _ .. E-MAIL - - ADDRESS: - P.U. BOX 527 INSURER(S)AFFORDING COVERAGE NAICft Stoughton, MA 02072 iNSURERA: Northland Insurance Company INSURED Andall Builders, Inc. INSURERB Safety Indemnity 33618 42 Chute Road INSURERC: Nautilus Insurance Company Dedham, MA 02026-5827 INSURERo: Associated Employers Insurance - INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: Master.3/7/12 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 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:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD�Y MMIDDW LIMITS GENERAL LIABILITY WS1334420110.812012 01/08/2013 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea,occurrenoe) S 100,000 CLAIMS-MADE n OCCUR MED EXP,(Any one person) S 5,000 A PERSONAL&ADV INJURY S- 1,000,000 . GENERAL AGGREGATE,: S 2,000,000 ' GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 POLICY .X :PRO- JECT LOC S AUTOMOBILE LIABILITY 6205710031D612012 03I06/201$ (Ea accident) s 1,000,000 ANY AUTO BODILY INJURY(Per person) S B ALL OWNED X SCHEDULED BODILY (Per S ` AUTOS AUTOS - ( ) _ X NON-OWNED PROPERTY DAMAGE'Ir HIRED AUTOS X AUTOS (Peraccident) S S UMBRELLALIAB X OCCUR' AN-00602001/0812012 01/09/2013 EACH OCCURRENCE. S 5,000,,000 C X EXCESS LIAB. CLAIMS-MADE AGGREGATE S 5,000,000 DED .X RETENTIONS WORKERS COMPENSATION-- WCC50077480120111211712011 12/17/2012 X WC STATU- OTH- AND EMPLOYERS'.LIABILITY TOR Y LIMITS ER ANY PROPRIEfORIPARTNER/EXECUTIV YIN E.L.EACH ACCIDENT r SL SOO OOO D OFFICERIMEMBER EXCLUDED?- . N NIA - - - - , (Mandatory in NH) - E.L.DISEASE-EA EMPLOYE S 500,000 If yes,describe under rDEICRIPTIONOFOPERATIONSbelow. E.L.,DISEASE-POLICY LIMIT 'S 500,000 - j DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) arpentry residential '& commerical R. E: 219 Holly Point Road.. . CERTIFICATE HOLDER CANCELLATION _FAX: 508.790.6230: SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE ' - THE.EXPIRATION.DATE THEREOF,NOTICE WILL BE DELIVERED IN - - ACCORDANCE WITH THE POLICY PROVISIONS. M AUTHORIZED REPRESENTATIVE Ton of Barnstable' Amne Parsons ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105). The ACORD name and logo-are registered marks of ACORD 1 TOWN of BARNSTAB ~# 2012 OCT 23 ti Fj: 57 Y y yap'-'sue ,.�..' N ftdYrutr ass 7FF�co+aw h lJ WG ftW✓I I u 4 °} I Ve Lo sutra-' C�4 QN Twlwa. C.xi � erg " 622 n, A I z I. cl sue'. bt b f�10�ycr g-`4 i-A04, 3-0' S-10' tp' � tU' �•''L' ��,�'` 6-D•' 3:to' - � �k IL e•h4� tt�v�#'1 // Ah kW tj LaG t e is Kg lL 10,It Gk J lug �'-O'.� 30 t s I�JM� O D dw V - sDo D i G l teisf II DuG s cow �_ Ooot,-w e zso zt4 JLIN we. YT aw > i v � � _ aMc d►i. � �, • �_ x It v�k � � rT Oft a i CO3.1�P.� 1, r G 1 ' . Cca7 Ito urn cJrHn Laor] a 9I foSl�o c* u4s 10� 0o mr- Nluarl �f q.,o,,