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HomeMy WebLinkAbout0067 LAKE ELIZABETH DRIVE 4 r '+33 nR4 p i 1 .: h ;,it rt. "^`",c�'x,i..:� :,�F ._ ,k ..+� .r,.•,. ...,. �. 1';� rz° :� e A d c�Mb;�+. ,f° i .� y xy 14.. s., - r - ... ° n <ar a n Y ° e• ° s p m , ° e 0 w p . , o h � �y u . ° p r < N �- < a "1 " o. T °.� „ .a.. a s. �,t ° � • °$ m a. m 0 " G ° a 0 o , o. " ° w n, ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map b Parcel 5 Application # C�6 Health Division Date Issued Conservation Division Application Fee f Planning Dept. Permit Fee 2<' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address b L0, �+zab?ZJti wl vt Village CeA-ier Y i I' Owner J &O a G oL q 1- I� Address SUM Pr Telephone 5b$ ' :P-5 - 9 8 Permit Request �en3e p ol-CI� �►o►��S Wi �" 3 CeNAOS�� Ai Se6,� '� al�iG no a b tLiemeA4 tylika �in Irl, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 5 too 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 Room Count Heat Type and Fuel: 9 Gas ❑ Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No CD Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ riew size_ Att6ched garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial- ❑Yes )-g(No If yes, site plan review# _ Current Use Proposed Use 4 APPLICANT INFORMATION m I (BUILDER OR HOMEOWNER) NameAt101itt1 \'rG C t �8 J Telephone Number 56g ' 3 9$ - 03 9U Address n License # �- Home Improvement Contractor# 3 U b Worker's Compensation #Twc x'�k?Q0 T ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 cxt`mo, h j SIGNATURE DATE 0 ( 96k FOR OFFICIAL USE ONLY ry APPLICATION# DATE ISSUED r MAP/PARCEL NO. z Y . ADDRESS VILLAGE ti OWNER t - DATE OF INSPECTION: s .FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - . GAS: ROUGH FINAL FINAL BUILDING t - r DATE CLOSED OUT r ASSOCIATION PLAN NO. Building Permit Authorization .a As owner hereby give my permission to CAPE SAVE. W.EATH. ERIZATION ' 7-C Huntington Ave. South Yarmouth 02664 (508)398-0398 to take all necessary steps to obtain I I-a building *f permit to perform to work at my, property, located at � � �C l>ZQ , � � �� O Si ned � Date ��a4 12- g 4 The Conintoil!we'alth of Massachusetts - Department of Industrial Accidents r Office of Invgstiaatiolts 600 Washington Street Boston, MA 02111" wwminass.b ovIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizadon/Individual):Y p d�YC r1 c Address: D Hwnting+on City/State/Zip: ,, �* + Yac-mouA MR 0a(o64 Phone 4: Are you an employer?Check the appropriate box: Type of project(required): 1.� I am a employer with t�_h 4• ❑ I am a general contractor and I• ' employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling . -, ship and have no employees These sub-contractors have' g ❑Demolition working for me in:any capacity.: employees and have workers' _ o workers'com comp insurance.t 9. ❑Building addition [N p.insurance p• required.] 5. ❑ We area corporation and its 10.❑Electrical repairs or additions 3.❑ I am a horrieowner doing all work officers have exercised their 11.❑Plumbing repairs or additions* - myself.[No workers'comp. • right of exemption per MGL t C. 152 O 12•[]Roof repairs insurance required.] ,§1 4 ,and we have no ' employees.[No workers'. 13; Other_7,n .comp.insurance required.] . . °Any applicant that checks box f1 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 indicatin $Contractors that check this box must attached an additional sheet sh g such. owing 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. 1,am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Te_o ,no I ody - C Policy#or Self-ins.Lic.#: C 3 3 g j 'Expiration Date: y 3 Job Site Address: Zq, ���'1 �( ,r Ci /State/Zi 1 n' p• 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 mell 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 Investieations of the DIA for insurance coverage verification. ' I do hereby certify under the pains and penalties of perjury that the informationn provided above is true and correct. -Sienature: Date: / Phone#: J O O " 3\�5� n 3 4 R Official use only. Do not rurite in this area,to bee /lip Yb—city or town OfflciqL. City or Town: Permit/License€ Issuing Authority(circle one): 1. Board of Health 2. Buiidin;Department 3. City/Town Clerk 4.Electrical Inspector. 5.-Plumbin;Inspector 6. Other Contact Person: Phone# f / ' 1 ®� • DATE(MMIDDIYYY`) �cRo CERTIFICATE OFLIABILITY INSURANCE 5/10/2012 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(iss)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 NAME Risk Strategies Company, Risk Strategies Company PHONE (781)986-4400 Fa (781)963-4420 15 Pacella Park Drive a E-MAIL ADDRESS: Spite 240 INSURERS AFFORDING COVERAGE NAIC III Randolph MA 02368 INSURERA:Selective Insurance INSURED INSURERB:Safety Insurance Company 33618 Cape Save, Inc JNSURER C-Technology Insurance Company 7 D Huntington Ave INSURER D INSURER E: " South Yarmouth MA 02 644 1 INSURER F: COVERAGES CERTIFICATE NUMBER-CL125948081 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. INS POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER D M DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO REN MITZOO OOO X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ r A CLAIMS-MADE I X1 OCCUR CPPS1994480 0/16/2011 0/16/2012 MED EXP(Any one person) $ 10,000 ` PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIESPER: PRODUCTS-COMPIOPAGG $ 2,000,000 X POLICY PRO-lFrTLOC $ AUTOMOBILE LIABILITYY 1 81 tlSl GLE LIMIT 1,000,000 ANY ALTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 ,BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE• $ X HIRED AUTOS M ALTOS (Per accident) X i Undednsured motorist BI split $ 100 000 X UMBRELLA UAB OCCUR EACH OCCURRENCE $ 2 -000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION r i PPS1994480 i 0/16/2011 O/16/2012 $ C WORKERS COMPENSATION y x WC STALIMTU- OTH- AND EMPLOYERS'LIABILITY YIN ' ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ SOO OOO OFMCERIMEMBER EXCLUDED? NIA 3318007 /9/2012 /9/2013 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yyes,desrnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsch Engineering, Ine. is listed as additional insured as respects Geneical'Liability as•required by written contract. G � CERTIFICATE HOLDER • CANCELLATION ' msong@capelightconipact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ' THE EXPIRATION DATE THEREOF, NOTICE WILL" BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. s r Cape Light Compact Attn: Margaret Song AUTHORIZED REPRESENTATIVE - PO Box 427/SCH 3195 Main Street ' Barnstable, MA 02630 Michael Christian/BAM. ACORD 26(2010106) ®1988-2010 ACORD CORPORATION.,AII rights reserved. y G INSn25 r7nimm nt �' Thn ARARII nam&and lnnn am ranie*nrorl marlre of ar npn i �lass:tchusetts- Department of Puhlic Safct` Board of Building Reluulations and Standards Construction Supervisor Speciality License License: CS SL 102776 ; Restricted to: IC` " ' WILLIAM MC CLUSKY j '37 NAUSET ROAD :; WEST YARMOUTH, MA 02673 ' Expiration: 6/28/2013 ('.,oil)issi,mc,. Tr,:'102776 4 Office of Consumer Affairs and Vusiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Y ' Registration: 171380 _ Type: Corporation = Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. - - WILLIAM McCLUSKEY = e 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 a Update Address and return card.Mark reason for change. - L-Address Renewal Employment (i Lost Card PS-CA1 is SOM-04/044101216 } _ �^ Consumer Affairs & �"1 l License or registration valid for individul use only Office of Consumer Affairs&Bdsines Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - �� Registration:_:T171380 Type: +' Office of Consumer Affairs and Business Regulation` i 10 Park Plaza-Suite 5170 `MR—f Expiration 3/1M2014 Corporation Boston,MA 02116 CAPE SAVE INC.; - WILLIAM McCLUSKEY f "p. , , .. �. � ,•� • � 7-D HUNTINGTON AVENUE SOUTH YARMOUTH MA U266C ' Undersecretary - Not valid wit o signa -- :' 1, r j Cape Save Inc. Tot�qf. 01— P i s 7-D Huntington Avenue South Yarmouth, MA QA66 4 Tel: 508-398-0398 Fax: 508-398-0399 517 R 11/9/12 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 } RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 67 Lake Elizabeth Drive.Centerville has been inspected by a certified Building Performance Institute(BPI)Inspector. Walls: R-13 dense pack cellulose All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Y , Map Parcel Permit# �/8' Health-Division Date Issued Conservation Division Fee � 5 Treasur 4 . SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive,Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis y. ` Project Street'Address Zg ke. Z.q be, In• r ' YVillage LAddress. — . ' Telephone Permit Request Coy,46j c+ 9 /Z x/G e Gon cX ���y gc.P�i 4-1 O r� Square feet: l st floor: existing proposed _'2nd floor: existing ( proposed Total new Estimated Project Cost 2 rW Zoning District Flood Plain Groundwater Overlay Construction Type l.J . Lot Size 3 Grandfathered:' ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure O o-5 . 4 Historic House: ❑Yes 0'I<o On Old King's Highway: ❑Yes �o Basement Type:. a ull or/crawl ❑Walkout ❑Other �A A 9&_ Basement Finished Area(sq.ft.) 41&1 4t- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing " /' new Half: existing new Number of Bedrooms: existing_ e new Total Room Count(not including baths): existing 9 new © First Floor Room Count Heat Type and Fuel: ��G s ❑Oil ❑Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing New 'W Existing wood/coal stove: ❑Yes o Detached garage: existing ❑new sized ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 4 �s�� l�l�:�c�-� Telephone Number P Address 7 2. .� � yc'Ile: License# efb! 9-Ye- (3 ' / �' pr Home Improvement Contractor# /O/ C/o-) Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &Qf eus <64_- SIGNATURE � �- -�--,� DATE _ ' 1 f FOR OFFICIAL USE ONLY PERMIT NO. DATE'ISSUED t.... MAP/PARCEL NO. ' - '..-•_'•- •1 ..is~ ; e y`, ! '� ' t ADDRESS` i` VILLAGE } OWNER < DATE OF INSPECTION: FOUNDATION FRAMEYj E r INSULATION FIREPLACE _ ,'.. I M • - ELECTRICAL: ROUGH: '' FINAL vlr PLUMBING: ROUGHS FINAL T n - _ GAS: ROUGHa - . FINAL • i FINAL BUILDINGy ;� T DATE CLOSED OUT fi ` ASSOCIATION PLAN NO. . r BEAM"A" TJ-Beam— v5.20 Serial Number:708001345 2 Pcs of 1.75" x 9.5" 1.9E Microttam®LVL BEAMUSA 1111 12/21/98 1:55:25 PM Page 1 of 1 Build Code:070 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED Di i121 10' Product Diagram is Conceptual. LOADS: Analysis for BEAM MEMBER Supporting FLOOR-RES.Application. Tributary Load Width:6' Loads(pso:40 Live at 100%duration, 12 Dead,0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER 1 2x4 plate 3.50" 2.25" Left Face 1185/401 /1586 Detail A3 1.25"LSL Rim 2 Parallam®PSL,PPCB 3.50" Hanger Right Face 1215/411 /1626 Detail H1 -See TJM SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3,H1. HANGERS: Simpson Strong-Tie Connectors® REVERSE T.F. T.F. NAILING MODEL SLOPE SKEW FLANGES OFFSET SLOPE FACE TOP MEMBER Right Top MIT49.5 No N/A No 0 2-16D 4-16D 2-N10 -Multiple plies of 1.75"Parallam®PSL may result in lower hanger capacity.See Hanger Manufacturer's literature for limitations. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 1532 1278 6317 Passed(20%) RT.end Span 1 under Floor loading Moment(ft4b) 3655 3655 11775 Passed(31%) MID Span 1 under Floor loading Live Defl.(in) 0.104 0.318 Passed(U999+) MID Span 1 under Floor loading Total Defl.(in) 0.139 0.477 Passed(U822) MID Span 1 under Floor loading -Deflection Criteria:STANDARD(LL:U360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8" o1c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of its products by this software will be accomplished in accordance with TJM product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJM Associate. -Not all products are readily available. Check with your supplier or TJM technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST MacMILLAN PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the TJM Residential product listed above. -Note:See TJM SPECIFIERS/BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION OPERATOR INFORMATION: GAVITT RESIDENCE Botello Lumber Co Stephen Botello POBox V Osterville,MA 02655 508-477-3132 508-477-4279 Copyright 01998 by Trus Joist MacMillan,a limited partnership,Boise,Idaho,USA. TJ-Pro1°and TJ-Beam-are trademarks of Trus Joist MacMillan. Microllam@ and Paratiame are registered trademarks of Trus Joist MacMillan. Simpson Strong-Tie Connectors®is a registered trademark of Simpson Strong-Tie Company,Inc. b 'I BEAM„B,r TJ-Beam"' v5.20vSeral Number:70N01345 3 Pcs of 1.76" x 9.5" 1.9E Microllam®LVL - BEAMUSA 1111 12/21/98 2:00:14 PM Page 1 of 1 Build Code:070 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED 1 �i !0 12'6" Product Diagram is Conceptual. LOADS: Analysis for BEAM MEMBER Supporting FLOOR-RES.Application. Tributary Load Width:6' Loads(psf):40 Live at 100%duration, 12 Dead,0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH 'LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER 1 2x4 plate 3.50" 2.25" Left Face 1500/536/2036 Detail A3 1.25"LSL Rim 2 2x4 plate 3.50" 2.25" Right Face 1500/536/2036 Detail A3 1.25"LSL Rim -See TJM SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 1982 1683 9476 Passed(18%) LT.end Span 1 under Floor loading Moment(ft-lb) 6028 6028 17662 Passed(34%) MID Span 1 under Floor loading Live Defl.(in) 0.177' - 0.406=- Passed(U826) -MID Span 1 under Floor loading Total Defl.(in) 0.240 0.608 Passed(U608) MID Span 1 under Floor loading -Deflection Criteria:STANDARD(LL1/360,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of its products by this software will be accomplished in accordance with TJM product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJM Associate. Not all products are readily available. Check with your supplier or TJM technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST MacMILLAN PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code NER analyzing the TJM Residential product listed above. -Note:See TJM SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION OPERATOR`14FORMATION: GAVITT RESIDENCE Botello Lumber Co Stephen•Botello POBox\h Oster4tlle,MA 02655 508-477-3132 508-477-4279 Copyright 01998 by Trus Joist MacMillan a limited partnership,Boise,Idaho,USA. TJ-Pm-and TJ-Beam-are trademarks of Trus Joist MacMillan. Microllam&is a registered trademark of Tigs;Joist MacMillan. �f , 730 CUR Appmda 1 ' Table JS 2.1b(continued) Prescriptive Packages for 0ae and Twe•F&sady Residential Buildings Aated with Fad Fueb MAXIMUM MINIMUM Glazing (flaring Ceiling Wail Floor Basement Slab Heating/Cooling Area'(Ye) U-valuer A value' R-value' R value] Wall Paimeter Equipment EfLcienry' Package R value' R value' 5701 to 6500 Ha re' Heating Degree Da Q 12% 0.40- 38 13 -19 r 10 6 Normal It 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 25 WA WA Normal U 15% 0.46 38 19 19 10 6 1 Normal V 15% 0.44 38 13 25 WA WA 8S AFUE W 15% 0.52 30 19 19 10 6 8S AFUE X IS% 032 38 13 23 N/A N/A Normal Y 19% 0.42 38 19 .25 WA WA Normal Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 10 6 90 AFUE I. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: S� 3. SQUARE FOOTAGE OF ALL GLAZING: le 4. %GLAZING AREA(#3 DIVIDED BY#2): b • o S `'' 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-fomu-f980303a 780 CMR Appendix 1 Footnotes to Table J5.2.1 b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and;, basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include' exterior siding, structural sheathing, and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces,basements, or garages). Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 -- -- -- The Commonwealth of Massachusetts =_ = �s+ ==;,-- Department of Industrial Accidents : _. Offict-of/nylestigatians 600 Washington Street J; Boston Mass. 02111 Workers' Com sensation Insurance Affidavit R name: e— eJ w-� location: / L Z. city hone# Z c�,' ❑ kam,a homeowner performing all work myself. I am a sole proi3rietor and have no one working in any capacity ❑ I am an employer providing workers compensation for my employees working on this job. comnnnv name: address: city: Phone* insurance ca. niicv# r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compensation polices: companv name- ... .::::.. ....... address: dtv: Phone msarnnce ca. nlicv# i / //i/i�oi%//%/%////%////////a///////ail%////�7///////////////////%///////////////////////////%i/////// i//%/ �///%%%/: ...::: comnanv name: address: city- ... phone#: ::.......:.:. iruurance co. pollev# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copy of thas statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby cerrij der the airs d penalti ojperjury that the information provided above is rum and correct Si,nature Date _ Print name Phone H el,-7 e 7C7rz-�-5 of[Icial use only do not write in this area to be completed by city or town official city or town: permit/Heense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's OlUce ❑Health Department contact person: phone#, ❑Other (rmsea W95 P1A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any corn 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 receive: c: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides=therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa: 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,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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Once of Imlestl0atloas 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext 406, 409 or 375 The Town of Barnstable - 9 NA �0�' Department of Health Safety and Environmental Services Ec g. Building Division 367 Main Street,Hyannis MA 02601 office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more Than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. I ` p Type of 'tt�✓► �f jf 7 o.c yp T � 9 �—/ r� �o�• Estimated Cost �3 Address of Work: �q�.e z— /�Ldoel Dr. Owner's Name: DQv-e_ �c C--;v 4 Date of Application: t J e c J '97 c I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the own i 4,4A to/1'/;0 ate Contractor Nam Registration No. OR Date Owner's Name q:forms:Affidav • \` EXISTING DOCKC Ws �. �s� two QARAct EDGE OF tAIcE / (APRIL 19, 1906)1 s t' �. 7✓t f ill THIS PLAN IS NEITHER INTENDED 11 9B NMAL I U PA FO'R NOR SHALL IT BE USED FOR NO DATE CR PTI N Y MORTGAGE LOAN PURPOSES, PROPOSED ADDITION 70 LAKE BLIZABETH-DRIVE BARNSTABLE, MASSACHUSEM JULIA G. GAVITT I CERTIFY THAT THE EXISTING !gut SCAM.1" = 4D*I JOB No. l§DO/18Q0_ti2 FOUNDATION SH N ON THIS P N I Lhw ® 40 d0 LOCVTEON E AS A ED. -A w LE , 8 gDG do AG A T REGIS' LAN gI8>s m W1p6C n ACIOIm* PIERS II o SUI m S'CRI►1�ERRY HIM RD, crowgwttx wa Aft" 70 Lake Elizabeth Or ., Craigville, Ma • N 77-6 . _�--- _ r A 1 � ° v J� B ` ti2� q e6. 7y 01 N 89 v G lA" 9 Scale 1 "=30F7 h I m 1 m 1 I \ EXISTING DOCK I d \ ` EXISTING HOUSE PROPOSED AOOITION EXISTING I� GAaAGE ! ` 1/ cq I N 10 / ,� �� EDGE OF LAKE ELIZABETH N ` 9,1 �/ (APRIL 19, 1996) N N N / in / N i PRELIMNARY PLAN .\ 70 LAKE ELIZABETH DRIVE CRAIGVILLE SCALE 1"= 30'; JOB #1800 • SAW; 5/8/96 NVV-17.0—Vo Inv VP—op r o ��• • .,. •�••�� ... - e L � EXISTING DOCK i I, EXISIING CARACE l EDGE OF LAKE ry ELIZASETH` 1 1 1 1 / (APRIL 19. 1996){ 1 _...._ i I I THIS PLAN IS NEITHER INTENDED ' " 5 88 INITIAL ISSUE IPAL FOR, NOR SHALL IT BE USED FOR NO DATE DESCRIPTION BY MORTGAGE LOAN PURPOSES. PROPOSED ADDITION 70 LAKE ELIZABETH-DRIVE q I BARNSTABLE, MASSACHUSETTS I JULIA G. GAVITT I CERTIFY THAT THE EXISTING PAUL SCALE:1'' = 4D*l JOB NO. 1800/1800_12 FOUNDATION SH WN ON THIS RL N f A. 0 40 . 8p LOC TEO ON E AS A E0. W 10617 { c LEVY, ELDREDGE & YIAGNER MUM INC. T R E GI S LANDS sucaisals M=t lmm, PlAiliB113 m susum 86 STRAWBERRY HILL RD. CF. PRViTia Ue MA" .. .. — 'NOW S.—MOM AWM.ove . f\E1"IpVE�.R6ikls(�FaCtsYfN¢5►f+kK�s "' r 61lV D - �I �'T�'�•'T.�'t,� 1 ow Ito ,& Coor - is off_. :- i Ile imi No F_-- Qe*4nvF 4 e�cncF> +sna s► g!.... _. . - —= i - i REAR ELEVATION. 1/4"=I FOOT t NEWAPPIPOAF 2.&°F� oo� LLILI S6 0 - �• U - � •- --�--�- �--- - --- - � GAVITT RESIDENCE . m •r ' PROPOSED ADD! TO LAKE ELIZABETH DRIVE— ' m LEFT SIDE ELEVATION'ii4"=IFOOT CRAIGVILLE W30MG l of4 m 1 i 1 1. INTERIOR. WALLS 8 TRIM TO BT�M I I MATCH EXISTING. -- I- 2.ANDERSEN WINDOWS. all TI � � — -- �-— I — 1 it I II 1 i PI I I vp k�pvFcruEEx�snaq�-�y�I _ Ist FLOOR.ADDITION AREA = 108sq.ft.. n roxp_�t' TOTA L AREA-204sq.ft. Ekr>zr PROPOSED_ FIRST FLOOR PLAN 1/4"=IFOOT • GAVITT RESIDENCE PROPOSED ADDITION "- 70LAKE ELIZABETH DRIVE CRAIGVILLE V A MA. 11/30/9'8 . 7 .1 �•2 of4� O— �,rrEND .UP�FR,�R7fN-O -k-�uyriny ynrlr� • u�-6 .g. I Y I L I WgLK=1N I NO- LXH.ILKT IZ•'O� I .6=Dk9ca j 0 FRAMING PLAN v4"=I FOOT i i . I +rs.rttit.apt sa 0 0 �'f sL4rr<o 517r/114-Pcoe1.....--� r — 2 nd FLOOR ADDITION: AREA =.168sq.ft. I I I SECOND FLOOR PLAN li4"=IFooT GAVITT RESIDENCE PROPOSED ADDITI,QN.. .��STER 70 LAKE ELIZABETkIs.Of21:VE CRAIGVILLE VILL'AGEt.MA ;.'.. 11/30/96 WE ...... ....�... "DETAIL 8" - j b - 1 �: �rrp Gs ►- i jJ Je.Cc R fly �revacee..y� ( ——�_ -- -1 rlcY�A�TS+rrtaatc+c �i�• VirnW DaisFyyv �xarour IL'a - 1 3'•m'�g,�.oM,y� ' b� DETAI • r 1 rl �laoGoic gyt,._ L t/ram: o DETAIL 'A i x iLy,6o6.}'i. fit :Sfb?16 r7DuNAAT/0 1 1 it •d_!�i�, � A.Bi.°`"` I F I -ian�uui✓� � � of ' QL J a . FOUNDATION .PLAN v4"=1FOOT -- DETA1L X1i2"=1FOOT GAVITT RESIDENCE. PROPOSED ADDITION 70 LAKE E .1 BETH DRIVE CRAIGVILLE'VILLAGE MA. _ IhF,: .•:::e..o.<... ruso� 4Of 4