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Home My WebLink About0041 LAKEVIEW DRIVE ,. ., 9 9 F G �. U y� � .. .. M a �.. ,. u ro .. ... u j !.. _ �� .. a .. .. _ �i4 e .. — 1 1 I y n C .. - -, 7 - _ - _ �7 � - �. � ` _ _ � o �. .. ., E F ... .. .. _ - ,�..: R: ... 0 �. 4 .. A ��. � ,. Town of Barnstable Building Post This Card+So That it4S Visible;=From the Street-Approved Plans;IMust be Retained,on°1o'b and',this Card Must'be Kept vsrau = M. . etwss: Posted;Until Final Inspection Has-Been Made. 'Permit !1 ° Where a Certificate-of Occupancy'is Required;such,BuildiAg shall Not be Occupied until a VFinal Inspection!has,been.made. Permit No. B-17-904 Applicant Name: SCHULZ, MICHAEL F&JULIE E QUINTERO Approvals Date Issued: 04/05/2017 Current Use: Structure Expiration Date: 10 0 Permit Type: Building- Deck p / 5/2017 Foundation: Location: 41 LAKEVIEW DRIVE, CENTERVILLE Map/Lot: 214-038-X_03 -- ,. Zoning District: RD-1 Sheathing: Owner on Record: SCHULZ,MICHAEL F&JULIE E QUINTERO Contractor N e: ADAM HOSTETTER Framing: 1 Address: PO BOX 688 I Contractor License:�,CS-094302 2 OSTERVILLE, MA 02655 Est. Project Cost: $ 2,500.00 Chimney: I Description: construct deck expansion at rear of house off.existin P g Permit Fee:P 145.00 a I t Insulation: Fee Paid: $ 145.00 Change of Contractor from Complete Home Group to Property Owner, r Final: Michael Schulz 6/1/2017 ; -,_�- -'' Date: 4/5/2017 Project Review Req: construct deck expansion at rear of house off existing ` Plumbing/Gas Rough Plumbing: i Change of Contractor from Complete Home Group to Property guilding Official Final Plumbing: Owner, Michael Schulz 6/1/2017 E This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. , All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. _ _ Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for'public inspection for the entire duration of the } work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:' 1.Foundation or Footing -- Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final` 7.Final Inspection before Occupancy g Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable " 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: B-17-904 Date Recieved: -3/31/2017. Job Location: 41 LAKEVIEW DRIVE,CENTERVILLE Permit For: Building-Deck Contractor's Name: ADAM HOSTETTER State Lic. No: CS-094302 Address: OSTERVILLE, MA 02665 Applicant Phone: ti (Home)Owner's Name: SCHULZ,MICHAEL F&JULIE E Phone: QUIN'TERO (Home)Owner's Address: PO BOX 688, OSTERVILLE,MA 02655 Work Description: construct deck expansion at rear of house off existing Change of Contractor from Complete Home Group to Property Owner,Michael Schulz 6/1/2017 Total Value Of Work To Be Performed: $2,500.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area r I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. - I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application: I understand that when a permit is issued,it is a permit to proceed and grants rio right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: SCHULZ,MICHAEL F&JULIE E 3/31/2017 QUINTERO Applicant _ Date Telephone No. Estimated Construction Costs/Permit Fees - Total Project Cost $2,500.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $145.00 1 3/31/2017 $110.00 12351 Check Total Permit Fee Paid: $145.00 i 6/2/2017 - $35.00 Cash EriXl ��MIXER,- uy TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel O Application # fs — f [V C Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis P�jr�oject Street Address �� Y��'d�16/�iy@ Ilage C-{'I'Arl-I Me 14 A Owner �i/�G�'jl� l F_ ��ylZ Address Tleph one o� �b 636�f 1 I Permit Request ( �� g -� c7 Co r\Ar a kam 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 Room Count 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# Current Use Proposed Use APPLICANT INFORMATION --- — - - (BUILDER OR HOMEOWNER). Name �'el�t+�/ = a ✓�v Telephone Number Address lwylle oiey A-1v-e License# Home Improvement Contractor# Email �'J��CG�✓l�(o��L1y�2/ArtJDG�f. GU�-y7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE &Y/b 7 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION x FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services l7Ar Richard V.Scali,Director Building Division * > Paul Roma,Building Commissioner 639. �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: 611117 Please Print JOB LOCATION: 7 u�l��/ �i�l�� (e/i I-Pw � numbed y street / village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 'e- ot. � s 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. t 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. ,gifnAure 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Town of Barnstable Regulatory Services sKAM Richard V. Scali,Director Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 V Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on nay behalf in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERNIISSIONPOOLS 27xe Coasutarns eat,zf Ma"ac1ru&ettr De wmwent crfrurlastriat'Accide?ds fJ,f ke o,f M.W-Igm`ions 600 Washuxgtou Street 190 Boston,IVA 02M immmass govIdlia '"Furlcers' Ccimpensafiun Insurance Affidavit:Buildexs/Cuntractm-sfEIectdcians/Phouhers APP f 1n:rw=f au Please Pr m Name AA(1�1t el F. Sc l Aclares q I -1411-e y,ekv j1)vie cityrstal �(�I �-y,%l e ✓�l/� DEG Phone s�� 36 636 Are you an employer?Checkthe appropriate bay ' T of project r _ 4_ I am a general contractor and I � p J ( mod}- b ❑ I ❑ employees(fLZ andfor part-timed* El hire4.the suer-contractors 6. I�iegr oonstzo�ifln ' 2.❑ I am a sale propdetor orpartner- Usted onthe.attached sheet 7 ❑Remoddmg slfip and Dave no employees These sub-cm rectors hale 8.,❑Demalitioa la dhare wo&ers' wonting for.rne in any � � �an 9. Q B.uildiag addifi-on. • JNo evaders' comp.imsu a„re comp-i=rzac $ 5. ❑ We are a corporaficnand its 10-0 Electrical repairs cr adr9tions 3. am a homseovrner doing all work officers have e=cised their 1 L❑Plumbingrepaim or additioms. right per MGL myself[No workers' '_ of exemptionP 1�`❑Roafrepairs .. inymmnce required,]i c.15Z§1(4k and we have no �.,1 employees.[Nowot oe& 13.Ly'�ther cam.insurance required.) ;Any WKc=tfiatcbeftboa#l— alsoffiouttheswdcmbe7awshavduzdie¢waleecompeam&npal"icyinff msaaa. Emneawnemwhosnta3ftsbisaffidavifim c submitanewaffidavitmdiculic sacb_ fCaut am fast checktfids box Wrest attached anaddiH®al dma shosi=g tlienzneof the sub-camxscto-a and ante whether or not 4mse enfitkslave employees.Tftheath-coatradoeshave employees,they pmsddedwir worken'comp.paliicy numbm I am art employer ffurt ispravidbW tvarkers'camperisatian irrsrira w for uzy employees Seloty is the ptrficy and jolt site informatiam Insmance,Company Name: Policy 4,or Self-ima ZiC_ pigatioa Date: Job Site Addte= cityfstzwz{ p: Attach a copy of the workers'comzpensationpolrcy-dedara4ion page(showing the policy giber and expiration date). Faiinre to secure coverage as required under Section 25A of MGL a 157 can lead to the imposition of criminal penalties of a fine up tm$1,SUD_O0 awYcir aae-Dear impFisonmen as w6A as civil peaalties is the fans of a STOP WORK ORDER and a f , of up to$250-00 a dap against the violator. Be advised drat a copy of this sWement.rmaybe forwarded to the Office of In-estigaffons of the DIA for imsursnce coverage y � .I do hereby cm1ify undeer the paten art taffies ofpetyu y tFuEtthe irtforma&n proi-i&d to bmg is true and correct Sis ature_ of Date- I Phone 0j jichd use c€nlp. D47 not awke in dth=a, be.cmrrpieted 6g taffy artenn oJoyciat City or Town: Fermitff&eme:g Issuing Anthao-r€ty(cir&onto): L Board of$eaIt#r 37.Building Department 3.Cityfrown Clerk 4 E1ectr_ ical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone it: — -- - - - 6 ormatian aura_ lastructions Macrarlmcetts Geheaal LawsffiapterI52 req=m all emgIoyerss'fn Fovrde workeaa'cnpensa ion fartiieu employees. p m this ,an employee is defined as-";every Person i a$ie service of another under a my contract ofliire, express or i[aplied,oral or wtitt " An.employer is defi-oed as"an=adhidaaI,par►nrship,association,coipmat on or other legal entry,or anY two or more of the foregoing=gaged is a Joint a t2:pdse,and including tho legal Feprese�ves of a deceased employes,or the receiver or trastee of an individual,per,association or other legal entity,employing empkyeeg- However tie owner of a dwelling house having not more tban three apazI eats and who resides therein,or the occupant of the- dwelling house of moSier who employs persons to-do Maintenance,c"=ftuj:'on or repay work on.such dwelling house or on the gromids or building appt¢fenmrtthemt-o shallnotbecanse of sash employmentbe deemed to be an employer" MGL chapter I52,§25C(�also states that aevey sfate or local licensing agency shall withhold ffie issuance or renewal of a Hr-mse or permit to operate a business or to construct btuldmgs in the commouYPealtii for any applicant has not produced acceptable evidence of cumpfianm with the hwi duce.coverage required-" Additionally,Ma,chapter 152,§25CM states aldeii3ir the comet a mwealth`nor zlyof ifs political subdivisions shall enter into any contract for the performance ofpubho work mrbl acceptable evidence of campIiancevtith Jhe insurance.• mmmrs,;e�f8 of this dhaptrr have Been presented to the Wig.anfhortty" z Applicants Please fa Out the worb='compensation affidavit completely,by checl® ffit-,boxes that apply to your situation and,if necessary,supply sob-cout[aCtr(s)nElqe(s), addre�es)and phOIIe mnnberCs) along with thffk certificates)of or LimitEd Liab " Pax-fnersbips(LLP)withno employees other than tine Liab - antes C) �y mst-nice. Lmmited .drfy CemP (� members or paat=r.,are not mquired to cant'warIc s'compensation insm7mce. If an LLC or LLP does have empIoyees,a policy is regnftD& Be advised that this atfidaylt maybe snbmittt--d ter the Department of Industrial Accidents for confirmation of insarance coverage. Also be sure to sign and date the affidavit The affidavit should beT-Dtomed to ffie city or town that the application for the permit or license is being req'ossted,not the Department of Lnj±aStrW.Ac:ci =:ts Should you have any questions regarding the law or ifyou are required to obtain a workers compensation policy,please call the Depa¢f neut at the mmmbea listed below. Self-fim red companies sbnuld en,'rr their self-m ter,ce license number on the appropriaie,]me. City or Town OfUcials Please be sure that the aidavit is complete and pxiniedlegibly. The Depazimenthas provided a space at the bottom ofthe.affidavit for you to fill out in tie event the Office oflnv lion has to cordsct you regardingthe applicant Please be sure to fill in the peamhlliceme mnaber which will be used as a reference nrnber. In addition,an applicant ffiat must sabmit multiple per Wlicm se applications is any given year,need only submit one affidavit indicating eun ent policy information(if necessary)and under"Job Site Addrese the applica±should write"all locations in (ciLY or o "ded to the e ortownm be r vi town)-' A copy of the-affidavittiiathas bey officially stamped or xnarlced by th cry � P filled oirt each _ affidavit must be fill ' or licenses Anew Izcant as roof that a valid affidavit is on file for fofnrepe�tts applicant P commercial veotn-e year.Where a home owner or citizrA is obtaining a license or permit not relate=d to any business or (ie. a dog lice me or permit to bmn leaves etc-)said person is NOT req�ed tD complete this affidavit The Office of Juvcstigaiions would hIce to thank you in.advance for your cooperation and should youav he any questions, please do nothe sitafe to give us a call. The Deparfinenf's address,telephone and fax er_ mt cf laftEstielACCUenta Office QfIt- tio-= 604 waslzb$m 3ti B MA Oil II Tf<L�617- -4900 fEt 4-06 or 1-977 MA S,SAFE Fax#617-72'-7M Ravised424-07 gf is Town of Barnstable 'Re ulat i g ory Services x &AIMASS.MSTABLE. $ Richard V. Scali,Director 163q. ♦0 A Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 E NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, 10JI( it / CXhy Jy ; owner of property located at L// ZA 4 f118w 'h1j V4 e'-n1Pn1J)16 /YEA , hereby certify that 61nn J-0 f-e 11viye A�/,O is no longer Construction Supervisor listed on the application for the project under construction as authorized,by building permit# 6 / 7- 'k , issued on WS 201_T. I understand that the project-under construction must cease until a successor licensed Construction Supervisor, is submitted on'the records of the Building Division. F ROPERTY OWNER a DATE q/forms/newcontr reference R-5 780 CMR rev:07/18/16 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel A. lication #' pp t6 l G Health Division Date Issued ,`'1-5 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 94Vy_,� Villagel j�G✓/�� Owner �Il �L_ �-{Tt�c,�� Address Telephone i Permit Request C'�..iS�,�,,`� ��-k- zxaa.�loj Square feet: 1 st floor: existing proposed 2nd floor: existing proposegfl/ tiotal new Y Zoning District I- I Flood Plain Groundwater Overlay Project Valuation 2�UD Construction Type T®� `�l ZO)j Lot Size D, 4 Grandfathered: ❑Yes ❑ No If yes, attach suup�&,i bfg6documentation. �4 Dwelling Type: Single Family E Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes U- o -On Old King's Highway: ❑Yes Jo Basement Type: Ca'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: CIGas ❑ Oil ❑ Electric ❑ Other Central Air: GYYes ❑ 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: sting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C,urv�ir. i� t �4.L-- Telephone Number ��A Address ° � e4—j id e��7 License # Home Improvement Contractor# Email �'a,�-'�Z 4P nA� . C-OAI\- Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 I FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _J THE Town of Barnstable Regulatory Services g y anaxMASS. E' � Richard V.Scali,Director EcM ►1� 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 o act on my behalf, in all matters relative to work authorized by this building permit application for: y/ "weal rro rive en em-'/G (Address of Job) **Pool fences and.alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Si@Kature of Owner Signatu e of Applicant Print Name Print Nam $/1/ 17 Date 03/31/2017 14:42 5089572781 MARK SYLVIA INS AGCY PAGE 01/01 AC R& CERTIFICATE OF LIABILITY INSURANCE DATEtMM/DD/YYYy) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.1 HIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETWEE;N THE ISSUING INSURER($). AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if Othe Certificate holder is an ADDITIONAL INSURED,the pDllcy(ie3)must have ADDITIONAL INSURED provisions or 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 a)- ACT PRODUCER Mark Sylvia Insurance Agency,LLC oME, Kris Ko reski 404 Main Street PRONE (C.No.EM)• 508 957-2125 rAA Na. 808 9) 57-Z 761 Centerville. MA 02632 Eo- OREs3;mark marks IviainsurnnCe.com ' INSURERS.)AFFpRDINGCOVERA_GE NAICN F131'eMt8,8i, INSURERA:Farm Family CaSUalty Insurance ome Grotip LLC INSURER 9: Street NSURER CA 02655 INSURER D MSURER E COVERAGES INsu F: CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE IISTED BELOW HAVE BEEN ISSUED TO THE INSURED EVISION NAMED ABOVE OR THE POLICY PERIOD INDICATED, NOTWITHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY DE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED l3Y 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. PUA A TYPE OF INSURANCE POLICY NUMBER POLI T EFF POLICY BX RCIALOENERALLIABRrfY Z001L6914 /YYYY M/OD LIMITS 12/4/2016 12/4I 17 EACH OCCURRENCE $ 1 AIMS•MADE �OCCUR _ OOO,OOO_ P t(IISEs lfa t eci •urren $ 100.000 VIED ExP(An one PargOn) S 5 000 EGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ 1,000,000 ECT []LOC GENERALAGGREGATE R 2,000,000 PRODUCTS-COMPIOPAGG $ 2 000,000UABILnY2001CS913 2/11/2017 2/71/2018 CO 9MED$I LELIMIT TO Es aeeidentL_ S 1.000.000 OWNED SCHEDULED BODILY INJURY(Par Pgreon) 3 AUTOS ONLY X AUTOS X HIRED NON-OWNED BODILY INJURY(Par aocidem) 3 AUTOS ONLY X AUTOS ONLY P OPERTY OAMAGE Per accident) 3 UMBRELLA UAe g OCCUR OTCE89 L1A9 CLAIMS-MADE nAELN RENCE $ 0 D RETENTION$ $ A WORKERS COMPENSATION 2001WBDz5 $AND EMPLOVERS'LIAaILITY 3/23/20173/23/2016ANYPROPRIETORIPARTNER/EKECUTIVI: I�YYIIIN-�� F E - OFF'CERIMEMPEREXCLUO$p7 I NI NIACIDENT(Mandatory In NH) '• $ 1,606,000_unlar N OF OPERATIONS below -EA EMPLOYEE $ 1,000,000•POLICY LIMIT $ 1,000,000 .E DESCRIPTION OF OPERATIONS/LOCATIONS/VENICLES(ACORD Tor,Additional Remarks Scbadula, General Contractor mey be atlNd1ed Irmore s)Ieaa Insurance coverage is limited to the terms,Conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurpnce shall be deemed to have al(pred,Waived or extended the Coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION (508)790-6230 Town of Barnstable SMOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Building Department ACCORDANCE WITHDTHE POLICY PROVISION3.E WILL BE DELIVERED IN 200 Main Street Hyannis,MA 02801 AUTNORRED REPIMSENTATIVE 4CORD 26(YOf Bl03) The ACORD name and logo are registered marks of ACOFlDORD CORPORATION. All rights reserved_ - — - - The-Commonwealth-ofMassachusetts_ Department of Industrial Accidents Office of Investigations. fir 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /l Please Print Legibly Name(Business/Oroanization/lndividual): Address: �7y� ,'►�1 � �i� Ci /State/Zi �'' t. tY P� � - Phone tr. Are yo employer?Check the.appropriate box: Type of project(required) 1. I am a employer with /Z 4. [] I am a general contractor and I employees (full and/or par'-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' [No workers'comp.insurance comp. insurance. 9. F1 Building addition required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work i officers have exercised their I I.El Plumbing repairs or additions myself. [No workers'comp, i right of exemption per MGL 12.❑ Roof repairs insurance required]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other i comn. insurance required.] •Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors'must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contactors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. !am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AN,�l� Policy#or Self-ins. Lic.#: 2t� 1�/�p�� Expiration Date: Job Site Address: /�-��1�/! � � i/� City/State/Zip- r-• is y� ce,6: 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 nder the pains and enaldes ofperjury that the information provided above is true and correct Sienature: Date— 3 Phone;EI: Z 2�j a I Official use only. Do not write in this area, to be completed by city or town official i City or Town: Permit/License# Issuing,Authority(circle on 1.Board of Health 2. $nilding Department 3..City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector j 6. Other Contact Person: i ( I Phone , Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-094302 Construction Su--Per,"-so; ADAM HOSTETTER 770B1 MAIN ST A OSTERVILLE MA 02655 Expiration: Commissioner 12/22/2017 - 7jr r iirnaartr rrr((ir r1 C'�lni,ar� ;rfJi . `•. O1rce of 6fisu?nzrAlTalrs dBusiness Reguhtea..,. :.icense or registration valid for individul use only } HOMc-IMPi20VEMENT CONTRACTOR before the expiration date. If found return to: ' Registration:isthation: 178455 Type. Office of Consumer Affairs and Business Regulation Expiration: 4/16/2018 LLC . 10?ark Plaza-Suite 5.170. Boston,MA 02116 - COMPLETE HOME GROUP LLC ?ADAM HOSTETTER 770 ALMAIN ST OSTERVILLE,MA 02655 Undersecretary TT'Not valid without signature - I i TOWN OF BARNSTABLE BUILDING PERMIT;APPLICATION .. . Map .' �/1 414 Parcel Application #; / 7 Health Division BU �N ®SP J- Date Issued Conservation..Division Qg U 2017 Application Fee Planning Dept. TOWN Permit Fee OF BARN Date Definitive Plan Approved by Planning Board ST�gB�E Historic - OKH Preservation/ Hyannis Project Street Address �` La tiA)7/jA�, Village / r Owner /MW3, 4 __..46. a117M AddressA3 Telephone Permit Request )O- � 'amok csa6�d�i � Ib�a1 1r Ate ;i. 17V1 Q® ;� GAW- Square feet: 1 st Boor: existing proposed 2nd floor: existing proposed Total new Zoning Distriar��f!.NI Flood Plain Groundwater Overlay Project Valuation Construction Type i 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: ❑ 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# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ..ke0A A6 cAs Telephone Number Address An License# 66 '074 ZZ Home Improvement Contractor# AN Email f orker's Compensation # agOR; 6c ALL CONSTRUCTION DEBRIS RESULTING FROY THIS PROJECT WILL BE TAKEN TO , ok , avoez ,as 'Vic—. SIGNATURE DATE FOR OFFICIAL USE ONLY 4 APPLICATION # t DATE ISSUED ' MAP/ PARCEL NO. -' J y . } ADDRESS "�� VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION - FIREPLACE a ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING r , DATE CLOSED OUT ASSOCIATION PLAN NO. I The Com onwealth o Massachusetts tom\ f Department of Industrial Accidents ' Office of Investigations x }. 600 Washington Sti•€€t - ' Boston, MA 02111 lM} Illass.govIdia Workers' Compensation Insurance Affidavit: BCinders/Contractors/Li lectricians/Plumbers Applicant Information Please T'ril�t L,e�ibly Name(Business/Organization/individual): Dartmouth Pools & Spas Inc. Address: 880 Mt. Pleasant St city/Stag/dip: New Bedford Ma,02745 Phone#: 508-998-7100 Are you an employer?Check the appropriate box: Type of project(required)- 1.N I am a employer with 10 4. Q I am a general contractor.and I employees(f 11 and/or part-time).* have hired the sub-contractors 6, ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9. addition [No workers'comp,insurance comp.iztsurancc.t" �Bulditt g required.) 5. ❑ We are a corporation and its l0.❑Electrical repairs or additions 1❑ 1 ant a homeowner doingall work officers have exercised their 11.M Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.J t c.152,§1(4),and we have no 13 employees.[No workers' ®Other In Ground POOI comp.insurance required,] , *Any applicant drat checks box#1 must also fill out true section below showing their workers'compensation policy information, t Homeowncrs who subunit this affidavit indicating they are doing all work and then lure outside contractors must submit a new affidavit indicating such. �Couh actors 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 it providing workers'compensation insurance for my employees. Below is the policy and jab site information, . Insurance Company Name: Firemen's Ins Company of Washington Policy#or Self-ills,Lie.#. W PA 0226069-18 Expiration Tate: 1/1/18 Job Site Address: City/State/Zip 17A aration page(showing the policy number and expiration date). Attach a copy of the workers'compensation policy decl 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 a ainst e violator. Be advised that a copy of this statement may be forwarded to..the Office of Investiglof fr- � everification. Z doherdea t e of per* r drat the information provided above is tare and correct. Snatu T�atc:Phone# 00 __ -,_ p y_ty _ . Oj%0a_l use only. Do not write do this area to be co»a deted b S6� r town vjfrcial. - City or Town: Permit/License# i Issuing Authority(circle one): 1.B,oard.of llealtil 2.Building l2.epartlnent:.._ .O:fyllowvn1etk 4,1 lectrical.Inspector 5:Plumbitg Inspector 6.Other Contact Person: Phone#: i DARTPOO-01 DCARVALH CERTIFICATE OF LIABILITY INSURANCE DAT /YYYY) 1/30/2D30/2017 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 have ADDITIONAL INSURED provisions or 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 License 1111780862 CgNTACT Diane Carvalho NAAME: HUB International New England PHONE FAX 222 Milliken Boulevard (A/C,No,Ext): (A/C,No): Fall River,MA 02722-9946 Rffifi s:diane.carvalho@hubinternational.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:ACadia Insurance Company 31325 INSURED INSURER B:Firemen's Insurance Company of Washington,D.C. 21784 Dartmouth Pools&Spas,Inc. INSURER C: 880 Mount Pleasant Street INSURER D: New Bedford,MA 02745 INSURER E: - INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD I WVQ POLICY NUMBER LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CPA022606816 01/01/2017 01/01/2018 pR M&ST EaoowErrence - $ 250,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑jECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A $ AUTOMOBILE LIABILITY EO aBldan SINGLE LIMIT $ 1,000,000 c ANY AUTO MAA022606718 01/01/2017 01/01/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY BO�DILY INJURY Per accident $ rx AUTOS ONLY X AUTOS ONLY PPe�acpdent AMAGE $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE R ANY PROPRIETOR/PARTNERIEXECUTIVE YIN WPA022606916 01/01/2017 01/01/2018 E.L.EACH ACCIDENT $ 500,000 Ka F n for EMBER EXCLUDED? � N/A 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 11 1 -t-, • •- • AND LICENSING BOARD if fo REGISTRATION NO µ "• yy,E c r RANT'S NAME r. ¢ ez58 •- ♦- 444 21 DRIVER Construction Supervisor Restricted to: Massachusetts Department of Public Safety Unrestricted-Buildings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed space. License: CS-074577 Construction Supervisor NORRY K ALVES,JR ' 880 MOUNT PLEASANT STREET zt NEW BEDFORD MA 02745 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS %i'�!t j r<z° Expiration: Commissioner 12/17/2018 "'flr Y;r nr rr;/rnu'a r/f License or registration v ft r .r>'lrr;p/li alid for individual use only si before the expiration date. If found Office of Consumer 4ffairs&S#utfnear Itr„ulahnn Office of Consumer return to: i = �`s HOME IMPROVEMENT CONTRACTOR 10 Park plaza_ Affairs and Business R Registration: Suite 5170 Regulation 9 109821 Type: Boston,, k` Expiratio 9/29 n/2018 Private Corporation 'VIA 02716 n. DARTMOUTH POOLS&SPAS NORRY ALVES 880 MOUNT PLEASANT ST, vat bout signatu"r—`—��t NEW BEDFORD,MA 02745 C ntieraecroary The Association of ' .APSP Poo!&Spa Professionals' 2111.Eisenhmvef Avenue,Alexandria.VA 22314 APSP.org 703.83&.0083"703.549.0493 fax"apspuniversity.arg Norry Alves,CBP Member ID: 3437616 Expires: 12/31/2018 CBP CERTIFIED BUILDING PROFESSIONAL"' r �TMETo�ti Town ofxBarhsiable } Regulatory Services 4N f Ric hard'VV So%Interim Director 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�1lf}igt F .6lAlD Z- M ,as Owner of the subject ptopetty hereby authorize `f to act on mp behalf, in all matters relative to work authorized by this.building permit y/ GgkCvi�yv �/LiyE .cEN�a?✓�cc�m� t` (Address"of Job) **Pool fences and alarms are the responsibility of,the,applicatit. Pools are not to be filled or utilized before fence is installed and all final` inspections are perfortxied"aizd'accepted: 44, Signature of Owner S ofA plicant e Print Name Print N ' Date INSTALL BOND BREAKER AND TILE STRIP BETWEEN 1 ft.3 in. DECK AND TOP OF BEAM. F� O \ . CONCRETE DECK ADJUSTABLE WEIR 4 °.;•: -.n.:...: E CD irY WATER LEVEL >;:: t:o _a :•:>: l a E BASKET I = PVC RETURN LINE RETURN OUTLET 41 SUCTION LI 2"EQUALIZER s: :y'o`: (TO FILTER) LINE IF USED Return Detail E , � Light Detail .i m EARTH PVC CLEANER LINE 0111 d4 9 CLEANER OUTLET •14: Skimmer Detail CONSTRUCTION JOINT WITH SEALER FOR ANY SEPARATE COPING PIECE MAIN DRAIN WITH CANTILEVER Cleaner Detail ANTI-VORTEX COVER STONE/CAP 1/4"/Ft. POOL FLOOR v x r'P CONTINUOUS V X 1'BOND :::;;e::: ;::o;:•:' �4!:;: I I SUCTION LINE S BEAM WITH 3 ROWS OF#3 BARS IN BEAM. EARTH HYDROSTATIC RELIEF ir11 in. 00 VALVE ;';i.'; 6"MINIMUM GUNITE/SHOTCRETE 00 WALLS AND FLOOR WITH#3 oo '3 I `. BARS @ 12"O.C./B.W. oo_ 18"X 18"X 24"GRAVEL SUMP WITH 3/4"STONE c OVERLAP ALL STEEL 18"MINIMUM Main Drain Detail Bond Beam Detail Construction Detail from Dartmouth Pools. Call (508) 998-7100 for more information GrBLE RBVG,Atemmcm!p n 10 tit 4' N Nom a r f �, t � M w _. , _ _ � v 41 Lakeview Drive Centerville AR Map 214 Parcel 038 • �� mot,-� 0 4 ' � � � �', cc6Ri�iet.,E CIO - a it I i t , t 1 Y Dartmouth Pools & Spas Designed by: SCALE: None 880 Mt. Pleasant Street Norry Alves Designed for: Mike Schultz New Bedford MA 02745 1/28/2017 Town of Barnstable f'lAg3ABi r°f . Tti.�. ]Building d_ ':��'.•t B u it d i n P sted Unt�f` Ina[�iln t�ec#on^FIaBeenMacle�� M�� fr^ B �s` �� Permit _. i� .: - Where�a�Ce= +,fi te:�of,�OccO an. '�� R,�u�red,<such�8uld�h ash 11 Not�be30cc�p�ede riti a F..inal�lris ect�on has been made: "_� Permit No. B-16-1324 Applicant Name: COMPLETE HOME GROUP LLC. Approvals � Date Issued: 07/13/2016 Current Use: Structure Permit Type: Addition/Alteration-Residential Expiration Date: 01/13/2017 Foundation: Location: 41 LAKEVIEW DRIVE,CENTERVILLE Map/Lot 214-038-X03 Zoning District: RD-1 Sheathing: � K Owner on Record: SCHULZ,MICHAEL F&JULIE E QUINTER y a Contractor Name PROPERTY OWNER Framing: 1 Address: PO BOX 688 x g ontractor;Llcense ONE REQUIRED 2 OSTERVILLE MA 02655 � °T � EstroJect Cost: $100,000.00 Chimney: Description: ADD 3RD GARAGE BAY.NEW 2ND FLOOR DORMERS A&T ROff AREA . Permitfee: $595.00 x Insulation: NEW 2ND FLOOR.HALF BATHIAUNDRY,BONUS ROOM FINISH AND ROOF DECK t Fee Bard $560.00 x s Da e 7/13/201fi Final' 7/8/16 NEW PLANS SUBMITTED SHOWING BQN SRQQM n t ' Plumbing/Gas RECREATION ROOM(NO SLEEPING)..JLL F � . . Rough.Plumbing: Project Review Req: ADD 3RD GARAGE BAY. NEW 2ND FLOOR DORMERS ALOFT �. .. AREA. NEW 2ND FLOOR. HALF BATH LA AI MY, ONUS ROOM Building Official Final Plumbing: FINISH AND ROOF DECK Rough Gas: 7/8/16 NEW PLANS SUBMITTED SHOWING BONpsioOM.AS Final Gas: RECREATION ROOM(NO SLEEPING).JLI: ,s Electrical This permit shall be deemed abandoned and invalid unless the work authorized by th�spermrt is ommenced�w�th�n six months after issuance. All work authorized by this permit shall conform to the approved application and the pro J liconstructaon documents for which this permit has been granted. . 3 Service: All construction,alterations and changes of use of any building and structures'shall ccoornplrancew�th the local zornng by taws and codes. This permit shall be displayed in a location clearly visible from access street or load amend haltbe ma�ntainedopen for public inspection for the entire duration of the Rough: work until the completion of the same. T - Final: The Certificate of occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Low Voltage Rough: 1.Foundation or Footing 2.Sheathing Inspection tow Voltage Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Health 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Final: 7.Final Inspection before Occupancy • Fire Department Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting With unregistered contractors do not have access to the guaranty fund" (asset forth in MGLc.142A). TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued 1 1 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Vi t��ree'�A�id�esl� /�/ �r�l-�✓i�l�� ;�/'�Y-� Owr�er�r. �G�IU / QV, /17 Address / La4eyte'o 0r✓� rTe��phone �� " T • Permit Request 6 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 0 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: ❑ 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 Q 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) N;r M c Aa 4 F A I/17— Telephone Nur PMP', NA34 :��V 50 11_ Ili CV J 4 P-A A�dd're°ss License # 6,en 4.ev' 006 5�a— Home Improvement Contractor# Email 20 5c�jv/2 �c��JZI NO�rn�f`64 /Yorker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE t;r u/ SIGNATURE '/ T FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE 3 OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services QIF Richard V.Scab,Director Building Division MMSTner:. = Paul Roma,Building Commissioner ILAM �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOME_OWNER LICENSE EXEAg''IZON Please Print 6 s3 /7 P13,10EAU ON number street village • �lalv>EawrrlR� /f/f�ahHG/ �'�c�i vlZ �8 �6 y 6 3�¢ - name home phone# work phone# G ADDRESS: 100' D' /��X IF Af 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 hermit. (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 requireme an that he/she will comply with said procedures and requirements. Si f�3o�eown_�� . . • .. ` 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 homeoners vvlto use this exemption are unaware that they are assuming the responsibilities of a supervis w or (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 My aware of his/her responsibilities,many communities require,as part of the understands the responsibilities of a Supervisor. On the last page permit application,that the homeowner certify that he/she p P p g this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\buildingpmmitformsEXPRESS.dDe 0620/16 r To-Wn of Barnstable Regulatory Services r Richard V.Seal4 Director i63¢ 16 Building Division. Paul Roma,Building Commissioner 200 M&Stree4 Hyannis,MA 02601 www.town.barnstable.maus Office: 509-862-4038 Fax: 50&790-6230 Property Owner Must . Complete and Sign This Section If Us' A Builder I, ,as Owner of the subject property hereby authorize to act on my behalf in aH matters relative to work authorized by this bu ding permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name Date Q:F0RMS:0WNE"EP3MSI0N?D0LS Ilse Comurorrivealth u•f Vassachusetts Departirre,7tt afrr du-tnalAcciderds r� Of-ce of rnvestigadom 600 Washington Street Baston,MA 02HI y wytmu tam gvvldia 'Wi rliers' Cumpensafian Inmmnce Affidavit$mldersIC,,Ontracturs lectriciansIPh tubers Applicant Inf n-matinu Please Print Lc'alW `�Ta e(Sussineess�r snia4ir+nllncF►v�rLai 4 4.0 / cC�1 v l x �l `'�l�t✓tt'W QirY C-enAo✓Ir,We- .41A moan Are you an employer?Chet:kthe appropriate bttr: ' Type of project(requi ed). I_❑ I am a employes with. 4 ❑I am a general contractor and I• 6 0 New construction employees(full andfor part-time)-* have hired the sub-contractors 2.0 lam a sole proprietor or partner- fisted on the attached sheet. 7. ❑Remode�ng ship and have no employees Thew sub-contractom have 8_,Q Demolition w[7 ^inQ for g c 1 employees andhave wodmre a in an 9. ❑Ruildmg addition [N4 tivt}dtw camp.irhsu=o corap.msuranL- j 5. We area corporation and its 10.❑Electrical repairs or adddi tom 3_r 9 lam a homeoum:er doing all work officers have exercised their 1L0 Plumbing repairs or additions myself, o workers' right of enremipfion per MGL �y � - 12_❑Roafrepairs fmrrance required-]i c.152, AIM and we have no employees.[No Workers' 13.❑Other camp-mstmance required.] 'eYay appFuant Brat chedcstox fti mast also 01vathe sectionb9ow sharing theirurorkere compmutiauporicy ifonnatiaa t Someoa+ners who submit This af5dmit imefrating they am doing zU wo$c and then hire cumde contmaorsnmst submit a new affidavit indicating sneTi fcontr=o stblt chWA this box,mast attached=additional sheet shoAmg the name of the sub-ctmtracDs and state whether or not thnse entities ham em pk yees.If the mb-camtotctetshase employees,dwy must pmride their workers'comp.policy number. I a77r tr7r errrployYrr tlrrrt isprm�ding workers'corirpe7trr�iu7r urszirarrca form}*eatpFa3�ees Below is 11tepo cy and a5 site irrformatia7s Insurance Compaq 'dame: Tolicy'or Self-ins-Lic-44L ExpirationDate: 4b. - aai y/ I�ikt city fs, r _CPrw,J/e �'Iq- oa63Z Attach a copy of the workers'compertsationpolicy declaration page.(showing the policy number andexpiration date). Failure to secure coverage as required.under Section 25A of MGL c 1572 can lead to the imposition of criminal penalties of a fide up to$1,50D 00 asrdlor one-year imprisouuwt,as w611 as civil penalties.in the form of a STOP WORK ORDER and-a the of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe Bmwanded in the Office of ' Iuvestigatians of the DIA for imurance coverage wrificatian- Ma hereby c&e dfyt 7t1t-der thepai7is a7rdpetialties vfpet jur}'thattfis in;f orrr atio t prorukd abmw.s fte wed Correct Phone ik t)fficiaL use anl. Da itot write in,deb area,to be campf-ded by city artotrn oJokia£ City or Town.: PermitEkense 4 Inning Authority(tdrde.one): 1.Board of Malt h 2.Building Department 3.ca3,irowu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9: • armatian and Instructions Massar-hasetts G&amal Laws clingier 152 reqa7xes all employers to provide wo3j-,eas'compensation for their=PIoyees- p this ,an Mq7Ivyj=is defined as."_-every person m.the service of aaother under any contract of hire, express or implied,oral or wrifiraL" An.Mayer is defined as"an i adividrA partaciship,association corporation or other legal entity,or any two or mare of the for m a joint entaprise,andinclad"g the legal regresco atives of a deceased employer,or the ��' to to . However the receiver or t ustee of an.i adividng padnam ip,association or outer legal entity,eozp Ymg m1Pees Y owner of a dwelimg house having not more than three apartments and who resides there",or the oca rpant of the- d nwelliag house of another who employs persons to do mafitm ce,consfructian or repair wu"-on such dwelling house or on.the.grounds or building appn ftmz t thereto shall not because of such emplaymed be deemed to be an employer. 1�rIGL chapter 152,§25C(6)also s`tab2s that"every State or local Reen agency shall withhold the issuance or renewal of a license or permit to operate a business or to contract buRdmgs in the commonwealth for any applic�ntwho has not produced acceptable evidence of compliance•with the mcnrance coverage required_ Additionally,MGL chapter 152,§25C(7)stairs,W6l r-r the cot on-wealfh nor�y ofits political subdivisions shall EntaIr inm any aas[xart forihe performance ofpubhG WDikuntil acceptable evidence of campIiancewith ihe;,,crr once. chapter have Been Mated to the=&ar-�audhodty_" requ�emenis of this chap pies Applicants Please flI obt the worker'compensation aidavit completely,by r_hwT ac Le boxes&at apply to your situation and,if necessary,supply sob-cont=t or(s)name(s), address(Ms)an l phone numbers)along with their cerfficate(s)of n�ce• Lim�Liability Companies(LLQ or Lmlited LiabzZity Parfncisbips(L P)w n n o employees other thin the members or par(nmrs,are not r5gid to cast'worlters' compensaion"smance If an LLC or LLP does have employees,a policy is regvhed. Be advised-(jiatthis afFidaylt may be submitted to the Department of Industrial Ac-ide�s for confirmation of fiISU=ee coverage- Also he sure to sign and date afuda pit The affidavit should be- etamed to$ w e city or ton that the application for the permit or license is being rr gae;sted,not the De r partment of T �Accidents. Should you have.any questions regm-dm.g the law or if you are reed to obtain a workers' compensation pohcy,please call the Depmfine�at the number Ustld below: Self-insraed eor�auies should enter their s elf-fi stnaace license numnber on the apprapniate line. City or Town Officials i Please be sine that the affidavit is complete and prh&Mdlegibly- The Departmeuthas provided a space at the bottom of the affidavit for you to frIl out in the event the Office of Investigations has to con act you regarding the applicant Please be sue to fill in floe peumitJIicense nwnber which will be used as a m:EEmace number. In addition,an applicant ear,need o sabmit one affidavit indicating coa t that must submit nluttipIe pennityUcense applibations in any given y �Y p olicy fijfbM atian (if neces`arY)and under"lob Site Address"tie applicaat should write�aII locate w ia (city or vided fn the town)-"A copy of the-affidavit fiat has b�officially stamped or maficed by the city or town may b e pro appliea>rt as proofthat a valid affidavit is on file for futtffe'petnnits,or licenses Anew affidavit must be fiI1ed out each year.•Where`a home owner or citizen is Obtaining a license or permit not related tQ any business or commercial ventin e (ie_ a dog license or permit to bum leaves etc_)said person is NOT req�red to complete tints affidavit The Office of Inves'dgafions would like to thank you is advance for your cooperation and should you have any questions, please do not hesitate to give us a C"a The Department's address,telephone and faxnumber: e C�).MnjoaWmi jtir of chnsatts' ' Delta dm mt of 1ud ial A cDid n ' �C:e of lave-t, fio-= Bow MA Oil 11 Tf,.L 4 617' -49-Go Qxt 406 or 14M MASS4FE Faxff 617-727 7M Revised 4-24-07 m ��-d Town of Barnstable Regulatory Services BUMMSTABi I E Richard V. Scali,Director 1639.o ram" Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601. Office: 508-862-403 8 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, /yJ��G��fl �Livl2 , owner of property located at y CPy,4/-'yi/le /�/�- OL6 32- , hereby certify that , Cow/i/-ter ,yl� �� j� is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# �o a , issued on �] �, 201(0 2 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 q/forms/newcontr reference R-5 780 CMR rev:07/I8/16 • l TOWN OF BARNSTABLE BUILDING PERMIT'APPLICATION pin zo��; o } Map Parcel D� Application # Health Division ` Date Issued Conservation Division G Application Fee Planning Dept. e j, Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address1 Village� �� ✓ft.t Owner hA I V 7 Address Telephone Permit Request �caS��f-� 1 �/ �v,Z�'i c� `►��? �i�,� } Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '51 6LO Construction Type ft3E..i Lot Size M Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Wr' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes B 1<o On Old King's Highway: ❑Yes JN"o Basement Type: C'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing Z 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: 2 i, as ❑ Oil ❑ Electric ❑ Other Central Air: W<es . ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER)— . Name d ` +r z Telephone Number Address �?b�' �( �� License # ^ MA-- d2 & Home Improvement Contractor# Worker's Compensation # GvG2- 91 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z� FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: { FRAME - - - - - �,iINSULATION.jug,- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL k GAS: ROUGH FINAL i FINAL BUILDING- 4:l f r t t DATE CLOSED OUT ASSOCIATION PLAN NO. x . o HN o aa o clam : a o ®® o ® 'ER Eo 00 o a s REDDO Boil 00 .,CoLLlWlrowx=vww off"apaawaa=mom popwasm `cam" OF 4%s,� ROBERT W. cyG g DENNIS JR. _ I CDSTRUCTURALr-`�-�- No. 13834 Ado Is �'``o�Q ,StSS'ONAL 3R4/14 jU 2X 10 ROOD LLDGM rASTBX TO oasnNG WALL SYM W W X s GALVI uw BCNlRJ &L"Nc HOLM S A 5"IN wo ROOT RAP1Ot AT 16.O.G. A CODE OD. . AS Hi)IgE lO 50 CDX PLWOOD.ASPHALT MATCH 698T.HO" BHMGI!TO MATCH a=Holm[ a 2I8 ROOT PAM AT 16`O.G. IXram �' (9)WBrAM.PAD wren R TO MATCH TRIM (3)2XC WAM,PAD IWMOR TO MATCH TWM ® ® NOW 2XG POST.CM CQER)OR WALL A8 VJW.K0%ACCCLAPBOARD NWW ROUND COLIM c� � 910RIG A9 Ri�D � A a AAA FRONT ELEVATION FRAMING DETAIL RIGHT 51DE FRAMING DETAIL cam+ ROBERT W. 9y� DENNIS JR. rn v STRUCTURA col L No. I3834 F�ISTE�``` SS�ONAIVal CBH c.J r�r MM14 J e, I ti, t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _ Parcel Application# 2 U SCO Health Division Date Issued o� ` 3 Conservation Division Application Fe J� Planning Dept. Permit Fee-� C � w i Date Definitive Plan Approved by Planning Board 11!3 Historic - OKH _ Preservation/Hyannis Project Street Address Village ('�1"e- "ECIL9 Owner ^r[_ (_ S G N U L Z Address LAV U.uevJ 'I iZ rE�r ,L Telephone Permit Request AM 'KA't'N-P."E em Z� 9 562w&-, � WAOU€ LALLY Gous-' �WTefib t- wcy Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation AC100 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s orting dL8umE8ation., Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) _ z Age of Existing Structure Historic House: ❑Yes ❑'No On Old King's:H'ighway:-YegCYICI- Basement Type: 21 Full 3 Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing ate- new � Half: existing Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: 5(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: 2e 3/xisting ❑new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER-OR HOMEOWNER) Name C� Telephone Number Address � z�J 51 License # l f 3o;t- O ?�r- t Home Improvement Contractor# isa I a� Worker's Compensation # 0 2-�g l se(D S x ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / S 3 lr t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED 4 t MAP/PARCEL NO. t j ADDRESS VILLAGE 1 F OWNER +}! DATE OF INSPECTION: FOUNDATION r FRAME P ` INSULATION 7 FIREPLACE ELECTRICAL: ROUGH FINAL s f PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT * ASSOCIATION PLAN NO. 4 • J The Commonwealth of Massachusetts Department oflndustrialAccidents DffCe-oflnvesfigations--- = -- ----- -- -- --. __ 600 Washin gton Street - Bostw;'AA 02111 www massgov/dia Workers' Compen' sation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information PIe. ase Print Le "bI - •Name(Business/DrymizatioatIndivi 25r /(A)e-�Ti;o. l GJS7' Address:I-7'� /►�IAei—S S`irb Ci /State%Zi D ` U UO_ AAA o A.reeyyou an employer? Check the appropriate bog; Type of project(required); I-Lg 1 am a employer with 4. [] I am a general contractor-and I employees(full and/or part-time)* have hired the sub-contractors' 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet, 7.' ❑Remodeling ' ship and have no emPto These sub-contractors es have 8• []Demolition working for mein any capacity• employees and have workers' 9. [No workers'comp,insuran comp.insurance. Q Building addition ce- required.] 5. E] We are a corporation and its 16.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp: right of exemption per MGL 12,0 Roof repairs .' insurance required.]t c. 152, §44), and we have no employees. [No.workers' 131� Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp•policy number. I am an employer that.isproviding workers'compensation insurance for my employees..Below is thepolicy and' b siteinformation - Insurance Company Name: 61- �(l -TA) Policy'#•or Self ins.Lic.#: Expiration Date: ?j vim : 13 Job Site Address: L �l� yT� City/State/Zip 'E;dT"1J LC �LId] Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section25A of MGL c. 152.can lead to the imposition.of criminal penalties of a fine up to$1,500.00 and/or one-year impriso=p*eat,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 viola-tar 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 irder thepains andpenalties,ofperjury that the.informationprovided above is true and correct; Signafore: Date: Phone#: Official use only. Do not write in this area,to be completed bycity or town offzciaL' City or Tdvim PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3 City/Town Clerk 4.Electrical Inspector. 5.'Plumbing Inspector 6:Other Cant�ct Parson Phone#• Jos TAYLOR DESIGN ASSOC., INC. SHEET No. of P.O. Box 1313 — Forestdale. MA 02644 c:.LcUL.crE-D_v�s DtiT- —l Tel./Fax: (508) 790-4686 4 t t_ �/�,s;k�- e C%;Lc i �ts-r t'c-o ,.mac Q4l!5.,'L a 0 QS P U t cocw►�-�.rV 1�w S T Svc (�,�.,. _ , b a Pam; >�•.� �CT�•a L�� Lv.•1 r� t�,rL , � = �o Psi �-c�,C, t CitJc� Z' e. 30o O P Z& DA• f4425 S Pc-F 44 isc> LZ• 4 L 17.E � 4 tc R o`C> 3.0 3`o k t4G 4- ent rn.0 10 x c3avr�O ''rod i 7 e' t2"sr4ry W okTME r�� Town of Barnstable -Re ato __Services - .-- — - gul ry — --- -- - -.- -- .+a Thomas F.Geiler,Director 16.39 Alm n " 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 sub ect l Ptop heteby authotize ;1 (�t � ��°�/5 to act oa my behalf, in all matters relative,to work authorized by this building pettnft . t (Address of Job) = Pool fences.*and alarms are the responsibility of.the applicant. -Pools are not to be filled or utilized before fence'is installed and all final , inspections.are petforrned and accepted: S e.of Owner Signatvte of Applicant. Paint Name Print Name - 1 - Da e .. QTORMS:OWNERPERNMIONPOOLS 62012: Town ofBarnstable HE lti Regulatory Services --.- - — -- anxxs�sr.�, t Thomas F.Geiler,Director' � Builduag Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038._ Fax: 508-790-6230 ' HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellinlrs ofsix units or less and to allow homeowners to engage an individual for hire who does not possess anlicense,provided that the owner acts as supervisor. t 1 \ 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. 14 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 tliat 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, t �. that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the page of this issue is a form currently used by several towns. You may care t amend and adopt,such a forrh/certification for use in your community Q:forms:homeexempt t r. � o.irir�orrruc�r///e u�01161/u��co/rr�c/!� License or registration valid for individul use only j Office of Consumer Affairs&Business Regulation before the expiration date. If found return to (' ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation istration: 152124 Tye' 10 Park Plaza-Suite 5170 Wxei piration: 802014 DBA Boston;MA 02116 WEST BAY MANAGEMENTTRUSTADAM HOSTETTER .770 A MAIN ST.OSTERVILLE,MA 02655 Undersecretary Not validwithout signaturee , , e Massachusetts Department of Public Safet. Board of Building; Regulations and Standards Construction Supervisor License License: CS 9M2 ARAM HOSTETTER .S 770 SUITE -I MAIN$T. OSTE RV I LLE,i',MA,'02M i. Expiration- 12/22/2013 Conuti6stuner:' Tr#: 7378 i 7 DATE IMWDDIWYn ACOR� INSURANCE� CERTIFICATE OF LIABILITY INSU , CERTI I ,2IZQ zQ,2 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 pallcy(les)must be endorsed, It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an andorasment, A statement on this certificate does not confer rights to the certificate holder In lieu of such andorsemen s. PRODUCER COME CT Donna Ostrowski Mark Sybla Insurance Agency,LLC PHONE No,S211. 508 957-2125 AAiac NoL(50 957-2781 404 Main Street _ E-MAJL - •mark marks lainsurance.Com Centerville, MA 02532 INSURE s AFFORDING COVERAGE NAICM I UAERA;MDntp@lIBrUS1nsCo INSURED INSURER B:Travelers Insurance Co West Bay Management Trust INSURER C 770A Main Street Osterville,MA 02655 INSURER DI INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION of ANY 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. INSSR PUL OR P CY EfF POLICY EXP LIMITS LTRTYPE DF INSURANCE POUCY NUMBER Mrrm A 4ENERALUABILITY MPOOCWOI012033 1214J2012 1214ITTiT EACH OCCURRENCE $ 1,000000 IMME TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ee $ 100-000 CLAIM9•MADE XX OCCUR MED EXP Arty mw oson) $ 5 000 ` PERSONAL&ADVINJURY S 1,000,000 GENERAL AGGREGATE s 2.000.000 GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2.000.000 X1 POLICY PRO LOC 9 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY-AUTO BODILY INJURY(Pei 124-0M S ALL OWNED AUTOS ULED BODILY INJURY(Per accldenQ S NON-OWNED PROPERTY OAMA 9 HIRED AUTOS AUTOS UMBRELLA LIABId OCCUR a EACH OCCURRENCE ! EXCESS LIAR CLAIM54AADE AGGREGATE i .QED RETENTI�NS } S B WORKERS COMPENSATION UB 7B159O5A 3/23/2012 3/23/2013 Y+IC STATU- X OTFF AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE❑P., E.L.EACH ACCIDENT 5 500 000 OFFICERIMEMBER EXCLUDED? _ - (MenAeEe/ytnNrli E.L.DISEASF.-EAEMPLOYE S SOO,000 Ir yyea deealbe under E.L.DISEASE-POLICY LIMIT S 500,000 OESERIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATtoms)V6NICLES(Aeeeh ACORD'IOI,Addltlonel Rw uft Schedulo,B mwo tpete is requlmd) Residential Carpentry CERTIFICATE HOLDER CANCELLATION (509)790.8230 SHOULD ANY OF THE ABOVE DESCRIBED POLIC169 BE CANCELLED BEFORE THECATE THEREOF, Town of Barnstable Building Department ACCORDANCEOWITH THE POLICY ROVIS ONSE WILL BE DELIVERED IN. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRMENTATIVE 9)1988-2010 ACORD CORPORATION. All rights reserved.. ACORD 25(2010I0S) The ACORD name and logo are registered marks of ACORD `, �t Town of Barnstable do Building Department - 200 Main Street ALE, Hyannis, MA 02601 9� 1639. (508) 862-4038 Arfo�A Certificate of Occupancy Application Number: 20062694. CO Number: 20070117 Parcel ID: 214038XO3 CO Issue Date: 06/14107 Location: 41 LAKEVIEW DRIVE Zoning Classification: Village: CENTERVILLE 4 Gen Contractor: NICKULAS BUILDING CO. Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Buildi Department Signature Date Signed TOWN OF BARNSTABLEBuilding��E Application Ref: 20062694 BARNSTABLE, Issue Date: 09/19/06 Permit r` 9 MASS. QjA i639• Applicant: NICKULAS BUILDING CO. rFp MAC s Permit Number: B. 20061204 Proposed Use: VACANT Expiration Date: 03/19/07 [Location 41 LAKEVIEW DRIVE Zoning District Permit Type: NEW SINGLE FAMILY HOME Map Parcel 214038XO3 Permit Fee$ 1,435.00 Contractor NICKULAS BUILDING CO. Village CENTERVILLE App Fee$ 100.00 License Num Est Construction Cost$ 350,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND SINGLE FAMILY-4 BEDROOM HOME THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: NICKULAS, LARRY D BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 507 INSPECTION HAS BEEN MADE. WEST BARNSTABLE,MA 02668 Application Entered by: LB Building Permit Issued By: THIS"PERMIT CONVEYS.NO'RIGHT TO OCCUPY ANYSTREET ALLY OR SIDEWALK`OR AN ART,THE H R TEMPORARILY OR PERMANENTLY: ENCROACHEMENTS ON PUBLIC PROPERTY;NOT SPECIFICALLY PERMITTED UNDEWTHE'BUILDING,CODE MUST BE'APPROVED BY THE JURISDICTION. STREET ORALLY;GRADES AS-WELL AS,'DEPTH AND*LOCATION OF PUBLIC SEWER$MAYBE"OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS: ; THE ISSUANCE OF.THIS PERMIT.DOES NOT,RELEASE,THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS AIINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTTTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS /0-7 FV 2 �� O114J�7 Z ��a� ��' 2 Cy�6 3 1 Heating Inspection Approvals Engineering Dept Fire D t 2 -�- t p 7 and o Health �P, �S• TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma jga g�i U y X Parcel Permit# 4 6Z Health Division Date Issued Conservation Division Application Fee �(ODk' Tax Collector Permit Fee Treasurer Planning Dept /o P �L a� �;,. •� Date Definitive Plan Approved by Planning Boardh�fc�� - Historic-OKH /1/0 Preservation/Hyannis 'VO aP pmt 'r Project Street Addres i /— Village Owner � / / Address T'U Telephone 3 l` Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total ne Zoning District Q Flood Plain Groundwater Overlay & iP-roject Valuation- 3:0 ` Construction Type Lot Size Y Grandfathered: ❑Yes O No If yes, attach supporting documentation. A f� r s Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes kN�o On Old King's Highway: ❑Yes: o Basement Type:*Cull ❑Crawl ❑Walkout Q Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new � r Number of Bedrooms: existing new _�pCD Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: )(Gas ❑Oil ❑Electric, 0 Other Central Air:Ks Cl No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size 2 9 Xly Attached garage:❑existing,.,�new size Shed:❑existing ❑new size Other: e—0 ZC Zoning Board of Appeals Authorization ❑ Appeal# ' Recorde Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use 5l BUILDE INFORMATION 3 Name Telephone Number 7 CS U Co ct Address License# _ Ind Z co Home Improvement Contractor# T/00) R - f� z ,? Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .< ��✓' ��! .T �C i SIGNATURE DATE f FOR OFFICIAL USE ONLY d+ J, PERMIT NO. LL' DATE ISSUED �, MAP/PARCEL NO. , ADDRES' VILLAGE f OWNER Y DATE OF INSPECTION: .• , FOUNDATION ® o 24 b(Q V09 L • ` f FRAME ! I f Ltd` INSULATION � 7 FIREPLACE ELECTRICAL: ROUGH FINAL �. PLUMBING: ROUGH FINAL GAS: ROUGH FINAL " FINAL BUILDING ,DATE CLOSED OUT ASSOCIATION PLAN NO. f ' f, , ppfNETpk� 7 d : BARNSTABM F7ASS 1. t 059• & C Town of Barnstable � = Zoning Board of Appeals Decision and Notice ' " C' Ramin Nickulas Appeal 2005-026- Special Permit- Section 240-91(F) Non-conforming Lots,Merged Lots ' Cjrj ca The applicant seeks to reconfigure three non-conforming lots not in to the 2-acre minimum requirementL� Summary: Granted with Conditions Petitioner: Gerald Ramin and Larry D.Nickulas Property Address: 300 Shootflying Hill Road,West Barnstable&35 Lakeview Drive,Centerville Assessor's Map/Parcel: Map 214 as Parcels 038W00 and 038T00 Zoning: Residence F and Residence D-1 Zoning District _a Background &Review: The applicants in this Appeal are seeking to reconfigure three existing developable,non-conforming lots into three new buildable lots that would not conform to the required 2-acre minimum lot area imposed by ti Resource Protection Overlay District. == From information submitted,the subject land area is a composite of four lots created by a 1914 subdiv' 'on of land entitled"Plan Number 4 of Property in Barnstable,Mass. Owned by Howard Marston",recor at the Barnstable Registry of Deeds in Plan Book 3,Page 81. The four lots are shown on that Plan as Lots N, O,P and R,ranging in area from 1.02 to 1.71 acres, and then totaling 5.05 acres. A 1936 Land Taking along Shoot Flying Hill,Road apparently reduced the area of Lot N below one acre. From a zoning.perspective,.M.G.L. Chapter 40A, Section 6 would have required adjuring undersized lots, held in common ownership,to merge. Therefore,Lot N would have merged with Lot O five years after the area was rezoned to a one-acre minimum lot area or, in 1979. Thus,it reduced the number of developable lots under Zoning to three. This Appeal seeks to take those three buildable non-conforming lots—Lot N merged with Lot O,Lot P,and Lot R-that now totals 4.71 acres, and recombine them into three new lots of a more equal size and shape, as shown on the proposed plan submitted entitled "Plan of.Land Prepared for Larry Nickulas,Barnstable,MA dated December 20,2004. The proposed new lots would all be over one acre,but would remain non- conforming with respect to the two-acre minimum lot area imposed by the Resource Protection Overlay District Regulations Procedural &Hearing Summary: This Appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on December 28, 2004. An Extension of the Time Limits for holding the Public Hearing and for the filing of the Decision was executed between the applicant and the Board Chairman. A Public Hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters in accordance with M:G.L. Chapter 40A. The Hearing was opened March 02, 2005, at which time the Board found to grant the Special Permit requested in Appeal 2005-26. Board Members deciding this Appeal were,Jeremy Gilmore, Gail Nightingale,James Hatfield, and Chairman Daniel M. Creedon III. Attorney Michael D. Ford represented the applicants before the Board. It was noted that only four members were present and that it would take a positive vote of all four members to grant the relief. Mr.Ford agreed to go forward with the four-member Board. Mr.Ford presented the history of the Lots,noting that in 1914 the area was subdivided into four lots shown as Lots N, O,P and R, on the recorded Plan. Those lots ranged in area from 1.02 to 1.71 acres. A 1936 Land Taking along Shoot Flying Hill Road reduced one of the lots below one acre. In 1974,the area was rezoned to required one-acre lots. M.G.L. Chapter 40A, Section 6 required adjoining undersized lots held in common ownership to merge. Lot N would have merged with Lot O causing the four lots to be reduced to three building lots under Zoning. Mr.Ford explained that the proposed new plan for the division creates no new lots. It is only a better configuration of the three building lots into more equal-size lots. He noted that granting of the Special Permit would not be a substantial detriment to the public good, and it would not derogate from the intent or purpose of the Zoning Ordinance. The Board reviewed the text of Section 240-91(F)Merged Lots and it was agreed that the proposal fit within that provision for the granting of a Special Permit without the need for any Variance relief. Public comment was requested, and no one spoke in favor or in opposition to the request. Findings of Fact: At the Hearing of March 02, 2005, the Board.unanimously made the following findings of fact: 1. The property(locus)is located on.Shootflying Hill Road and Lakeview Avenue in Centerville. It is shown on Town of Barnstable Assessor's Map 214 as Parcels 038W00 and 038T00. Property is currently owned by Petitioner Gerald Ramin,who has.contracted to sell the property to Petitioner Larry D. Nickulas. 2. The locus is also shown as Lots N, O,P and R on a Plan of land entitled"Plan No. 4 of Property in Barnstable,Mass. owned by Howard Marston", scale 1"= 100',recorded in Barnstable County Registry of Deeds in Plan Book 3,Page 81. As shown on the aforementioned 1914 Subdivision Plan,the lots are comprised of the various areas—Lot N(1.02 acres),Lot O (1.71 acres),Lot P(1.16 acres)and Lot R(1.61 acres). 3. As a result of a recent survey,it was determined that Lot N does not now currently contain an acre, having been diminished in size by virtue of a 1936 Road Taking. 4. As a result of the aforementioned Road Taking,Lot N and Lot O merged sometime around 1979 (five years after the date that the area was zoned a minimum one acre). Accordingly,there are three buildable lots currently on site—Lot(N and O),Lot P and Lot R. 5. Since October of 2000,the lots are now also located in an Overlay Zoning District—the Resource Protection Overlay District(RPOD)which has a minimum lot size of 87,120 square feet(two acres). 6. The Petitioner proposes to recombine the three parcels into three new lots, all of which have in excess of 1.5 acres. The three new lots are shown on the application plan. 7. Since Lots (N and O)have merged under the doctrine of merger, they are eligible to be reconfigured under the provisions of Section 240-91(F)Non-conforming Lots,Merged Lots of the Ordinance. The Special Permit requires that the number of lots not be increased. 8. The number of lots will remain at three and the lots will all be more conforming, in terms of area of a more even size than is currently configured as a result of the merger. 2 ti ti. 1 3 9. The Special Permit could be granted without detriment to the neighborhood or the public good, in that the reconfiguration of the lots will result in lots that more nearly comply with the area requirements of the By-Law. Decision: Based on the findings of fact, a motion was duly made and seconded to grant the Special Permit for the reconfiguration of three developable lots into three new developable lots. It may wish to consider the following conditions: 1. Re-division of the lots shall be as presented to the Board in a submitted plan entitled"Plan of Land Prepared for Larry Nickulas,Barnstable,MA",dated December 20, 2004, scaled 1"=40'as drawn by J.Doyle Associates. 2. An Approval Not Required(ANR)plan shall be prepared,reflective of the above-referenced Plan, and presented to the Planning Board for their endorsement. That plan shall reference this Variance, and both recorded at the Barnstable Registry of Deeds. Copies of the recorded Plan and this Decision shall be filed with the Zoning Board of Appeals Office within one year from-this grant. 3. Development on each lot shall be required to meet all Town of Barnstable,Health Division and all State Title 5 requirements without Variances from the Board of Health. 4. Development of the lots shall conform to all required setbacks, with the exception that no structure shall be located within 50 feet of Shootflying Hill Road, and only limited clearing shall be permitted within that 50-foot setback. The vote was as follows: AYE: Jeremy Gilmore, Gail Nightingale,James Hatfield,Daniel M. Creedon NAY: None Ordered: Special Permit 2005-26 is granted'with conditions. This Decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this Decision must be exercised within one year. . Appeals of this Decision, if any, shall be made pursuant to M.G.L. Chapter 40A, Section 17,within twenty (20) days after the date of the filing of this Decision,.a copy of which must be filed in the office of the Town Clerk. D Daniel M. Creedon III, Chairman Date Signed I,Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20)days have elapsed since the Zoning Board of Appeals filed this Decision and that no appeal of the Decision has been filed in the office of the Town Clerk. Signed and sealed this day of under the pains and penalties of perjury. Linda Hutchenrider,Town Clerk 3 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I MF L DATA i c - , y r % STATE OF SOUTH DAKOTA OTT* 'MINNEHAH<=r` ?3rd f o,EfIKE Town of Barnstable Regulatory Services ' $"'e1S1AB1 Thomas F. Geiler,Director MASS. fo Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: Project Address 41 4kev i gLj ��f. Builder: ic—k(JglS The following items were noted on reviewing: ff 3 k�re� Lk At-r 0.E 2 CLVA 1 S Reviewed Date: 2h Q:Forms:Plnrvw LOADING: SNOW 25 psf FLOOR 46 psf , Vt/ '2�3� OL 15 psf 'ti n.?tN , s®IL g,Q6 LC !3`i C 0 NT dL R� pos►-s �1� � tc 100, tJD�"C' 3EL\rZ VAR, g�.®Cfc1lj�i W3 X13 VA 7 7-77- f , uv Typ So(L BQ4 21< pS j=AMlc f c+.2249� 2359 N-�a� [Z..V-1 LL -Ts-Vvekv-- _._. ..L,:.t?..�. . 51C� Z 3 CAP �tw� -L 8 r t BeamChek v2004 licensed to:Jim Egan Reg#8111-1975 G1 Prepared by:jee, Date: 8/18/06 Selection W 12x 35 50 ksi Wide Flange Steel Lateral Support at: Lc=5.9 ft max. Conditions Actual Size is 6-1/2 x 12-1/2 in., Min Bearing Length R1=1.0 in. R2=1.0 in. Data Beam Span 24.0 ft Beam Wt per ft 35.0# Reaction 1 TL 10020# Reaction 2 TL 10020# Bm Wt Included 840# Maximum V 10020# Max Moment 60120'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/382 Attributes Section in' Shear inz TL Defl in Actual 45.60 3.75 0.75 Critical 21.86 0.50, 1.20 Status OK OK OK Ratio 48% 13% 63% Fb(psi) Fv(psi) E(psi x mil Values Base Value Fy 50000 50000 29.0 Base Adiusted 33000 20000 29.0 Adjustments YP Factor, Lc 0.66 0.40 Loads Uniform TL: 800 =A Uniform Load A ' 0 R1 =10020 R2= 10020 SPAN=24 FT Uniform and partial uniform loads are Ibs per lineal ft. Notes PAGE 1 SeamChek v2004 ncensed to:Jim Egan Reg#8111-1975 Prepared by:jee Date: 8/18/06 Selection W 8x 28 50 ksi Wide Flange Steel Lateral Support at: Lc=5.9 ft max. Conditions Actual Size is 6-1/2 x 8 in., Min Bearing Length R1=0.9 in. R2=0.9 in. Data Beam Span 16.0 ft Beam Wt per ft 28.0# - Reaction 1 TL '6624# Reaction 2 TL 6624# Bm Wt Included 448# Maximum V 6624# Max Moment 26496 # Max V(Reduced) WA TL Max Defl L/240 TL Actual Defl L/448 Attributes Section in' Shearfir?) TL Defl in Actual 24.30 2.30 0.43 Critical 9.63 0.33 0.80 Status OK OK OK Ratio 40% 140k 54% Fb(psi) Fv(psi) E(psi x mil Values Base Value Fy 50000 50000 29.0 Base Adiusted 33000 20000 29.0 Adjustments YP Factor, Lc 0.66 0.40 Loads Uniform TL: 800 =A Uniform Load A 0 R1 =6624 R2=6624 SPAN= 16 FT Uniform and partial uniform loads are Ibs per lineal ft. Notes PAGE 2 , I , BeamChek v2(O4 Ccensed to:Jim Egan Reg#8111-1975 F1 Prepared by:jee Date: 8/18/06 Selection W 8x 28 50 ksi Wide Flange Steel Lateral Support at: Lc 5.9 ft Max, Conditions Actual Size is 6-1/2 x 8 in., Min Bearing Length R1=0.9 in. R2=0.9 in. Data Beam Span 18.0 ft Beam Wt per ft 28.0# Reaction 1 TL 7452# Reaction 2 TL 7452# Bm Wt Included 504# Maximum V 7452# Max Moment 33534 W Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L 1314 Attributes Section in' Shear in2 TL Defl in Actual 24.30 2.30 0.69 Critical 12.19 0.37 0.90 Status OK OK OK Ratio 50% 16% 76% Fb(psi) Fv(psi) E(psi x mil Values Base Value Fy 50000 50000 29.0 Base Ad'usted 33000 20000 29.0 Adjustments YP Factor, Lc 0.66 0.40 Loads Uniform TL: 800 =A Uniform Load A 0 � � R1 =7452 R2=7452 SPAN=18 FT Uniform and partial uniform loads are ibs per lineal ft. Notes PAGE 3 • i • i t Member Calculations Report AUD-CAPE HOME CENTER 465 ROUTE 134 SOUTH DENNIS PO BOX1418 South Dennis,MA 02660 508-760-4410 508-760-4559 Level Name: SECOND FLOOR Status: Ready to Plot Application: Floor Non-Residential: No 2 i .� J.2' Design Date:8/16/2006 1:34:57 PM Report Date:8/16/20061:35:26 PM Me& Flush Beam#131 �p/— General, Product: 1 3/4"x 9 1/2" 1 9E Microllam LVL Plies: 3 eflection Criteria: Standard,Live Load L/360,Total Load L/240 Member Weight(plf)per ply: 4.8 Design Value Control Value Result Moment (Ft-lbs) 13056 20312 Passed Shear (lbs.) -3736 10898 Passed Live Load Deflection (") .3" .4" Passed Total Load Deflection (") .5" .6" Passed Reaction (lbs.) 4439 6891 Passed Bearings: Bearing Location Input Length Required Length 1 Column By Others#132 C 12' 1 3/4" 1 3/4" 2 Column By Others#133 0— 1 3/4" 1 3/4" Reactions: Assumed Member Weight(plf): 14 Location Dead Load Live Load Total Load Uplift 1 (lbs.) I I'11 3/4" 1824 2613 4437 0 2(lbs.) 1/4" 1745 2603 4348 0 Loads: Roof Load Duration Factor: 115% Load Location Live Dead Type Distributed(plf) 0 to 7' 0 to 0 81 to 81 Floor Distributed(plf) 7'to 12' 0 to 0 81 to 81 Floor Distributed(plf) 0 to 7' 0 to 0 4.5 to 4.5 Roof Distributed(plf) 7'to 12' 0 to 0 4.5 to 4.5 Roof Distributed(plf) 0 to 7' 330 to 330 186.7 to 186.7 Roof Distributed(plf) 7'to 12' 330 to 330 186.7 to 186.7 Roof Distributed(plf) 0 to 7' 103.3 to 103.3 0 to 0 Floor Distributed(plf) T to 12' 106.5 to 106.5 27 to 27 Floor See Trus Joist Framer's Pocket Guide for Product Trademark Information TJ Xpert 6.42 (#693)A Page 1 NICKULAS COLONIAL.JOB Z// GG'e. Design Date:8/16/2006 1:34:57 FM Report Date:8/16/20061:35:26 PM Distributed(P fl 1 T to 12' -16.5 to-16.5 0 to 0 Floor Notes: Design Methodology: ASD Only positive(downward acting)loads are detailed in the diagram above. IMPORTANT! The analysis presented above is output from software developed by Trus Joist(TJ). Allowable product values shown are in accordance with current TJ materials and code accepted design values. The specific product application,input design loads and stated dimensions have been provided by others,have not been checked for conformance with the design drawings of the building,and have not been reviewed by TJ Engineering. See Trus Joist Framer's Pocket Guide for Product Trademark Information TJ-Xpert 6.42 (#693)A Page 2 NICKULAS COLONIAL.JOB i Member Calculations Report MID-CAPE HOME CENTER L�/�oC�v; �✓ V/7 465 ROUTE 134 SOUTH DENNIS PO BOX 1418 South Dennis,MA 02660 508-7604410 508-7604559 Level Name: FIRST FLOOR � Status: Ready to Plot Application: Floor j`/ ` �(�AV--,, lZa.,fGyyt Q Non-Residential: No TT 13 Design Date:8/16/2006 1:36:02 PM Report Date:8/16/20061:36:14 PM Mect: Drou Beam#29 dal: Product: 1 3/4"x 9 1/2" 1.9E Mic LVL Plies: 2 eflection Criteria: Standard,Live Load L/360,Total Load L/240 Member Weight(plf)per ply: 4.8 Design Value Control Value Result Moment (Ft-lbs) -8075 11775 Passed Shear (lbs.) 4066 6318 Passed Live Load Deflection (") .16" .29" Passed Total Load Deflection (") .2" .44" Passed Reaction (Ibs.) 25007 25007 Passed BearinEs: Bearing Location Input Length Required Length I Wall#8 3 1/2" 5 7/8" 22' 2 Column By Others#27 1 3/4" 2 15/16" 3 Column By Others#96 4' 3 1/2" 9 1/2" 4 Column By Others#198 13' 3 1/2" 3 5/8" Reactions: Assumed Member Weight(plf): 14 Location Dead Load Live Load Total Load Uplift 1 (lbs.) 21' 10" 4132 11238 15370 0 2(lbs.) 1/4" 2252 5448 7700 0 3(lbs.) 4' 6753 18286 25039 0 4(lbs.) 13' 2292 7234 9526 0 Loads: Load Location Live Dead Type Concentrated(lbs.) 21' 10 1/4" 8478 3339 Floor Concentrated(lbs.) 21'10 1/4" -419 0 Floor Concentrated(lbs.) 4' 12474 5169 Floor Distributed(plf) 0 to 8' 689.6 to 689.6 206.9 to 206.9 Floor Distributed(plf) 8'to 22' 689.6 to 689.6 206.9 to 206.9 Floor See Trus Joist Framer's Pocket Guide for Product Trademark Information TJ-Xpert 6.42 (#693)A Page 1 NICKULAS COLONIAL.JOB Design.Date:8/16/2006 1:36:02 PM Report Date:8/16/2006 1:36:14 PM Concentrated(lbs.) 0 3859 2063 Floor Notes: Design Methodology: ASD Only positive(downward acting)loads are detailed in the diagram above. IMPORTANT! The analysis presented above is output from software developed by Trus Joist(TJ). Allowable product values shown are in accordance with current TJ materials and code accepted design values. The specific product application,input design loads and stated dimensions have been provided by others,have not been checked for conformance with the design drawings of the building,and have not been reviewed by TJ Engineering. See Trus Joist Framer's Pocket Guide for Product Trademark Information TJ-Xpert 6.42 (#693)A Page 2 NICKULAS COLONIAL.JOB r Member Calculations Report NUD-CAPE HOME CENTER G� 465 ROUTE 134 SOUTH DENNIS PO BOX 1418 . e � South Dennis,MA 02660 508-7604410 508-760-4559 Level Name: FIRST FLOO�R/ 1 � Status: Ready to Plot C Application: Floor /7 'A C" Y// y/�/i� � re.9' 'lion-Residential: No 1 2 3 Design Date:8/16/20061:36:02 PM Report Date:8/16/2006 1:36:23 PM Obiect: Drop Beam#28 General: — Product: 1 3/4"x 9 1/2" 1.9E Microllam LVL Plies: 2 Deflection Criteria: Standard,Live Load L 360,Total Load L/240 Member Weight(plf)per ply: 4.8 Design Value Control Value Result Moment (Ft-lbs) -7238 11775 Passed Shear (lbs.) 3684 6318 Passed Live Load Deflection (") .11" .27" Passed Total Load Deflection (") .14" .4" Passed Reaction (lbs.) 22113 22113 Passed Bearings: Bearing Location Input Length Required Length I Column By Others#24 0 1 3/4" 8 7/16" 2 Column By Others#25 8' 3 1/2" 3 1/2" 3 Column By Others#26 16' 1 3/4" 8" Reactions: Assumed Member Weight(plf): 14 Location Dead Load Live Load Total Load Uplift 1 (lbs.) 1/4" 7504 14622 22126 0 2(lbs.) 8' 2210 6906 9116 0 3(lbs.) 15' 11 3/4" 6375 14652 21027 0 Loads: Roof Load Duration Factor: 115% s Load Location. Live Dead Type Distributed(plf) 0 to 3 1/2" 544.2 to 544.2 0 to 0 Floor Distributed(plf) 3 1/2"to 14' 692.5 to 692.5 207.7 to 207.7 Floor Distributed(plf) 14'to 16' 692.5 to 692.5 207.7 to 207.7 Floor Concentrated(lbs.) 0 2699 4464 Roof Concentrated(lbs.) 0 4600 0 Floor Concentrated(lbs.) 16' 12220 5707 Floor See Trus Joist Framer's Pocket Guide for Product Trademark.Information TJ-Xpert 6.42 (#693)A Page 1 NICKULAS COLONIAL.JOB Design.Date:8/16/2006 1:36:02 PM Report Date:8/16/20061:36:23 PM ' Concentrated(lbs.) 0 599 2431 Roof Concentrated(lbs.) 0 4334 0 Floor Notes: Design Methodology: ASD IMPORTANT! The analysis presented above is output from software developed by Trus Joist(TJ). Allowable product values shown are in accordance with current TJ materials and code accepted design values. The specific product application,input design loads and stated dimensions have been provided by others,have not been checked for conformance with the design drawings of the building,and have not been reviewed by TJ Engineering. See Trus Joist Framer's Pocket Guide for Product Trademark Information TJ-Xpert 6.42 (#693)A Page 2 NICKULAS COLONIAL.JOB 1 ne t,ommunweacrn qj lr wzu.vn"ecisi Department of Industrial Accidents Office of Investigations e 600'Washington Street Boston, MA 02111 y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluffibers Applicant Information Pleas Print Legibly Name (Business/organization/Individual): Address: City/state/Zip: �-f ��l , b Phone#: Dr Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. New construction loyees (full and/or part-time).* have hired the sub-contractors 2. • I am a sole proprietor or partrler- listed on the attached sheet, $ 7. Remodeling and have no employeesThese sub-contractors.have S. ❑ Demolition working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information• t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees: Below is the policy and,yob site information. Insurance Company Name: Policy#or Self-ins.Lie, #: Expiration Date: Job Site Address: City/State/Zip: . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and'a fine of up to$250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under i pains and Denalties of perjury that the information provided a ve i rue and cor ec Signature: Date: Phone#: 2 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Peimit/License# Issuing Authority(circle one): 1_Hoard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal.entity, or any two or more of the.foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because'of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or . renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced'acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,.§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to cant'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 Depariment 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 perm/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: ` The Commonwealth of Massachusetts Department of Industrial Accidents` Office of Investigations 600 Washington Street Boston, MA 02111 Tel. t 617-727-4900 ext 406 or 1-a77-MASSAFE. Fax # 617-727-7749 Revised 5-26-05 wwGv.mass.aov/aia "t'^ k.�: ✓die y��own l(,� �C� w�cu ✓�/�aa�,a�c��ude�a BOARD OF BUILDING'REGULATIONS a� +, "License CONSTRUCTION SUPERVISOR • � �' „Number�CS� 002265 �teirthdate 01/18/195.5 i� Expires 0.1/18/2008 Tr.no- 14065., Regthicted LARRY D NICKULAS` f� PO BOX"5701_ \4 ;' W BARNSTABLE; MA 02668 : ~ �a Commissioner: �* Bk 19677 Po 322 `2i�900 04 ' 01-2005 ab 08 = 34 cL Quitclaim Deed - Property address: 300 Shootflying Hill Road West Barnstable and 35 Lakeview Drive, Centerville, MA I, Gerald Ramin, of Brookline, Norfolk County, Commonwealth of Massachusetts, for consideration of Seven Hundred Fifty Thousand ($750,000.00) Dollars paid, grant to Larry.D. Nickulas, of P.O. Box 507, West Barnstable, Massachusetts 02668, WITH QUITCLAIM COVENANTS,the land and any buildings thereon at Centerville,Barnstable County,Massachusetts, bounded and described as follows: PARCEL A: Those certain parcels/lots marked as N and 0 being shown on a plan entitled "Plan Number 4 of Property in Barnstable Mass. Owned by Howard Marston, Scale 1"=100', surveyed Nov. 21-24, 1914 by Vaughan D. Bacon-Barnstable, Mass." recorded in Plan Book'.3, Page 81, which lots are bounded and described as follows: NORTHWESTERLY by Seth Hinckley Road (now called Shoot Flying Hill Road); EASTERLY by Lots P andR shown'on said plan;-and SOUTHERLY by an unnamed way having a width of thirty (30) ` feet, sometimes called Lakeview Avenue. Excepting therefrom the land included in a Taking made by the Town of Barnstable for highway purposes and duly recorded with the Barnstable County.Registry of Deeds in Book 519, Page 45. PARCEL B: Those certain parcels/Lots shown as P and R as shown on a plan entitled "Key Plan of Property in Barnstable,Mass.owned by Howard Marston,complied Step. l st., 1915,by Vaughan D. , Bacon,Surveyor,Barnstable,Mass."recorded it Plan Book No. 1;Page 53,which lots are bounded . and described as follows: NORTHERLY by Seth Hinckley Road (now called Shoot Flying Hill Road); EASTERLY by land now or formerly of Marion P. Bond; SOUTHERLY by an unnamed way having a width of thirty (30) feet, sometimes called Lakeview Avenue; and WESTERLY by other land shown as Lot 0 on said plan. . . Excepting therefrom the land included in a Taking made by the Town of Barnstable for highway,purposes and duly recorded with the Barnstable County Registry of Deeds inBook 519, Page 45. L. r 'a 'L Subject to conditions,restrictions and reservations of record. Meaning and intending to convey the premises conveyed to me by two deeds of Beatrice Ramin,individually and as Trustee dated March 10, 1993,and recorded with said Barnstable County Registry of Deeds in Book 8489, Pages 306 and 308. IN WITNESS WHEREOF, the said Gerald Ramin has hereunto set his hand and seal this 3 1 day of March, 2005. Gerald Ramin COMMONWEALTH OF MASSACHUSETTS Norfolk, ss. March 3 i 2005 Then personally appeared before me,the undersigned notary public,the above-named Gerald Ramin,who is known by me,and to me known to be the person whose name is signed on the preceding document, and he acknowledged to me that he signed it voluntarily for its stated purpose. Notary Public Print Name: Richard B. Aronson My commission expires:. 6/3/05 780 CMR AppcnCUX J Trade-Off WOrksheet Enforcement Agencyr� . .ii I Permit it lt?s / %e Dat [�f Builder Name ��„ Builder Address �Q d ��S� /7 I Checked By �.. Zone#�=—_ I I Building Address � �� Q r /�� Phone Number d �� ? �' ' Date Submitted By — — — — Ceilings, Skylights, and Floors Over Outside Air Required Insulation U-Value x Area UA Description R-Value U-Value x Area UA oZ(o �Z Z3 v3 /1Z 2 m so. Ceiling -3 0$ l/ Floor Over Outside Air l 9 7 tt2 Skylight tt2 ft2 Ceilings:Total Area Z Walls,Windows, and Doors Required Insulation U-Value x Area UA Description R-Value• U-Value x Area UA Zt-/(,0 ft2 o�y Zl b P39 Wall z,o'8 to 6, - + Window _ 33 Z tt2 + 1 Door _ Sliding Glass Door iR tt2 ftZ Walls:Total Area (� p Floors and Foundations Required U-Value or Area or Insulation Insulation U-Value or Area or F-Value x Perimeter UA = Description Depth R-Value F-Value x Perimeter UA r c L tt2 // G tt2 Floor Over Unconditioned ft2 f t2 Basement Wall tt . tt Unheated Stab in. it ft Heated Slab in. Total Proposed UA Total Required UA Iota!proposed UA must be less than or equal to the Total Required UA is consistent with the building plans,specifications, of Compliance: The proposed building design represented in these documents and other calculati s submitted with the permit-application. s Dat Company Name il der IDes nor _ 53 r RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 V Change of Contractor/Builder $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE / square feet x$96/sq. foot= y"/x .0041= U / plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) / square feet x$32/sq.ft._ ( '/x .0041= < .� ACCESSORY STRUCTURE>120 sq. ft. >120 sf-500 sf $35.00 >500'sf-750 sf 50:00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 I .0 Affidavi ' o substantial Financial Interest t &ollows: � of Z fl— , on oath depose an state as 1• m an applicant for a building permit for the property located at Map , Parcel C3 -7 The address of the property is 1//.x-1—�/cc�� /� �� ' -• 2. 1 have legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above. �'� G C 3. Within in the last twelve months from today's date, which is , the following individuals or entities have had a 1% or greater legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address � � � � 4. Within the last twelve months, from today s date,which Is 1 have had :a 1% or greater legal or equitable interest in the following properties hich have been the subject of a building permit application: Map/Parcel Address 5. Within this calendar year, I have submitted building permit applications for property in which I have a 1% or greater legal or equitable interest. g. Within the last ten days, I have submitted building permit applications for property in which l have a 1% or greater legal or equitable interest. 7. Within this month, I have submitted building permit applications for property in which I have a 1% legal or equitable interest. 8. Within this month, I have receive c�G building permits for property in which I have a 1% legal or equitable interest. u , Signed under the pains and penalties of p erj ry,,thisse day of 200_ 2001-0050/affin 1 nit n-TERYIAFFIDAVIT r Parcel Lookup Page 1 of 1 QR f?n g ww Logged In As: Friday, Septemb• Nancy Larned Parcel Lookup Road Lookup Condo Lookup Multiple Address Lookup Search Options Search By I Street ( a Street# Street LAKEVIEW Name Village JAII Villages Seareh�n�,' <Prev Next> Page 1 of 1 Rows/Page Parcel Location Owner Village Index Map 214-038-X03 41 LAKEVIEW DRIVE' NICKULAS, LARRY D 7777 214038: http://issgl/intranet/propdata/lookup.aspx 9/22/2006 Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map - rb $ o Parcel Application # Health Division Date Issued I Z �� cz- Conservation Division Application Fee Planning Dept. Permit Fee �� • (s Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address ZACIZME kJ 1*22-2iliI Village 6ed 1T_e%J a L:E Owners L-- Address ° �� ZC�Im-ax Telephone Permit Request T5 N P1_,4Y1 0m T� �A�NIC^J i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed O Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .eo Construction Type W°°Z> Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family ((## units) Age of Existing Structure 7G"5 ? Historic House: ❑Yes alo On Old King's Highway: ❑Yes 11ko Basement Type: ❑ Full ❑ Crawl 21Walkout 3`6ther ,Tv1L 4wWt -t J BOXb?4WZ &ff?E� IWAY Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing �new Total Room Count (not including baths): existing 17 new First Floor Room Count '�=? Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal st e: 0-Yes O'ivo Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing F neW size_ CD Attached garage: &-existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 0S /464T Telephone Number Address 7�70 A 0) sr License# ��TvtytzLC, / 4 Home Improvement Contractor# a t Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l a J FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME 4.1 a • r INSULATION FIREPLACE r - t ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r 4 DATE CLOSED OUT ASSOCIATION PLAN NO. eet 600 Washington Str BOstor;MA 02111 . vwfv:mass.govaia Workers'.CompensattonIm rance Affidavit Builder's7Contractors/Elecfricians/Plumbers Applicant Information Please Print Legibly-t Name(Businesslorgmization/Individual): 05-V_36'd 1A�.+ " 'i b ^'1. . S C Address: Md4S ? City/State/Zip: (�ttLL�` : rF 0�65' Phone.# Jr0q= aS%a�5 Are you an employer? Check-the appropriate box: :Type ofproiect(required): 4. :I am a general contractor and I I.�am a employer with' 6, D New construction employees (full and/or part-time) * have hired the stab contractors ` 2.❑ I am a•sole proprietor or partner- listed-on the'attached sheet 7. D Remodeling ship and have no employees .'These sub-contractors have -9. 0.Demolition workingfor me.in an capacity. employees and have workers' Y P tY• 9. ❑Building.addihon . . • " o workers' co insurance compquir mrisrmrance•$ ed_ .5. 0,We are a corporation and its ~ 10.0 Electricalrepaiis or additions : officers have exercised their 11;❑Plumbing repairs or additions 3.El I am a homeowner doing all work + myself [No workers' comp right of exemption per MGL i2.E]Roof repairs insurance re ed t ja. 152, §1(4),and we have no q ] employees. o workers'. 13.❑ Other a S � comp,insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box.must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities,have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.` I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information I Q� Insurance Company Name: Ql� ��G ViA Policy#or Self-ins.Lic.#: 09_79 Sfo-6� Expiration bate i' Job Site Address: mNG V zw 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 vp to$256.00 a day against the violator., Be advised that a copy-of this statemerif may forwarded to the Office of Investigations of the DIA for insurance coverage verification. - X do hereby certify under the pdins•and penalties of perjury that the information provided nv is true and correct Si attire: Dates • 1 Phone#: Official use only. Do not write in this.area, to be:completed by.city.or town official City or Town: Perin%Ucense 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.# lvlassachusetts 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 enteiprise,and inchuling the legal representatives of a deceased employer,or.the- -—. .. .._ _... - .. receiver or trustee-of an individual,partnership, association or other legal entity,zing oymg employees. owever e owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 'dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced evidence of compliance with the Insurance coverage required." Additionally,MGL chapter 152, §25C()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 compliar ce with the in��nce requirements of this chapter have been presented'to the contracting authority." Applicants... Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s) of insurance. Limited.Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not requiredrto carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that thus 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 then self-insurance license number on the appropriate line. City or Town Officials. i 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 (Le. a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit The Office of Investigaiions would like to_ffiank 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: he CGMMIIWVMaIth ofMassarhuWtts Di�-Par meet of kdUStE as Acoid=t 600 Wad Q�Street R,ost MA€2111 1`el.# 617-727-400 ext 406 Or 1-M-MASSAAFE Fax#617'27," 4 Revised 11-22-06 of Barnstable Regulatory Services - 1 uilding Division Tot»Verry,Building Comm slocrer 200 Main StrccY Hyatujias,Tvlla 02601 Www.town,llarjistal}le.mx.us Office; 508-862AO38 Property Owner Must Complete and Sign This Section If UsinLy A Builder U L ,as Owner of the '= ' hereby autliorize in all matters relative to work authorized by this building perndit: (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Fool; Wuni tt are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. 40 Si c of Owner - Signature of Applicant Print Name Print Name a g- PPR51o1 'oOGS 6/2012 Generated by Camscanner from intsig.com CERTIFICATE OF LIABILITY INSURANCE DATBi6,201OrT2 a4rz2 THIS CERTIFICATE IS ISSUEQ 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 FOLDER. IMPORTANT.'.It the ceWficate hotder'Is an ADDITIONAL INSUREIX the.pailry(ies)'must to endorsed. If SUBROGATION IS WAPM,subject to the termsendrConafiporra of."Pal*,certain poHCies may require an wWbmemenL A statement on this certificate does not Conifer rights to the certitfcete holdertn fieu of such 0of CT AAaPr(O k SyWa it InSuteM10E AgertLy,t t,C i=rk�*s 508)428-0440 INC NoI:I5081420.9227 404 Matt Street l Wnsurancexom Cer1EeMII@, J•AA 02632IN9URER(b�AFFORtIMG COYFAADE NA1C 0 INSURER A t IVIOrItPOrMe US Ins Co m m a:'Travelem Insurance CO Alest Say Martsgenwit Tnist INsuRER c 7�70A Mein Street 0sterVHle,MA 0205 INSURER D e INSURER E: INI F: COVERAGES. CERTIFICATE NIUMI ER: 6 REVISION NUMBER: THIS IS TO CERTIFY THAT T14E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD malcATED= NormTHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH 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, EXCLUSHM AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SUER TYPE OF POLICY NMEM D EFF BPQICY UI111lT8 GewtALUAB>;rTY MP000G001008648 12/4R 11 2/4/'1012 FACHOCCURRENCE S 1.000,000 X CMRJERdAL GENERAL UABILrrY OAMAGE TO RENTED EWIpES(Eo ocaarenoet f 100.000 ClAan-MADE n OCCUR AnY(IMPermn, b 501000 PERSONAL SADV INJURY S 1,000,000 oENERALAGGREGATI: s 2.00_0.000 GENL_AGGREGATE LURTAPPLIES PER: PRODUCTS•COMPIOP AOG S 2,000,000 xl POLICY M 0 LOC I I Is ArM ,E LIABRJTY COMBINED SINGLE LIMB ANY AUTO BODILY INJURY(Per person) S _ ALLY SCHEDULED BODILY INJURY3AUTOS (Per arsidonl) 6 N OS NNOlPMED , PPROPERTY OAMA E S OS t,. s It1d8Ri llA tIAB OCCUR r2Acm OCCURRENCE 6 I>MM UAB CIANSMADE AGGREGATE S DEO RETENT N 8 g NrOR MU N U&7815805A 3123/2012 312=13 tn1C STIMt! X OTH � YINrROPRErOR5%RTKJTII N/A ° EL EACH ACCIDENT 8 50�,000 OMICIUMEMBEER EXCLUOM ,lltre6tiorrin_NT(j E.L.DISEASE•EA eMPLOYEE S 500,001) OF OPI RATIONS aalwr ~ E.L DISEASE•POLICY LIMIT s 500.000 t .*�. itta Sslndue.rt e b nr•• - - IIvrrD�l 01=OP�IAs1�t LACA7tON8 �BCLES 1� AoDr�101•Addtloml rrnn Iaots epee will PmkW M1 Garpentry CERTIFICATE BOLDER CANCELLATION g. (SOtt)428.1974 SHOULID'ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE H65te2ter Realty CO 1nC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 770A Math Street ACCORDANCE tADTH THE POLICY PROVISIONS, OstsMH*,MA 42655 . AUTMOREN RMEMMATIYE ®1988-2010 ACORD CORPORATION. All rightsreserved. ACORD?S( iQJ05} 4. . Jhs ACORD tame and logo pre mgtaEerpd maths of ACORD l i1 .' `_. w,,,,,;,,,, ,,,.,+.r.:...+w•:..wrr..wa......•,............w..t. ,,...r«.r..--+. ..... ...n..a'...,c.�. .....wu+.n,_ ` Ul�ooa�uaaa�uue�/l/r,oCrauc6uoe%Ca License or registration valid for individul use only office of Consumer Affairs&Business Regulation } before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation - egistration 152124 Type' -- xpiration 8/2/2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 • WEST BAY MANAGEMENT.-JRUST' • ADAM HOSTETTER\ , 770 A MAIN ST. OSTERVILLE, MA 655 Undersecretary _ Not valid with signature 02 Wit- iassachusctts- &Il ai-tsnent tjf,Pultlic �ifetc Boars!of Builctinz- Rc�nilutioni and Stand:u'tts Construction Supervisor',License i License: CS 94302 ADAM HOSTETTER 770 SUITE A MAIN ST OSTERVILLE,.MA.02655 Expiration: 12/22/2013 Tr=: 7378 1 . • TOI VN.ONBAI NSTABLE BUILDING PERMIT APPLICATION �� XP � T � Map Parcel Application # � � Mgrz 1�3J� � Health Division 10W�V 7 2016 Date Issued Conservation Division eARI STASApplication Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis em Ara- S Project Street Address Village C� J �� ✓/c�z,r_ Owner A4I Address Telephone 42�z-�O . Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed j5. S Total new Zoning District 1?7- ( Flood Plain Groundwater Overlay Project Valuation A>.) 4 Construction Type &�i;- Lot Size /, 17 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W7--Two Family ❑ Multi-Family(# units) Age of Existing Structure to Historic House: ❑Yes @'No On Old King's Highway: ❑Yes ZNo 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 , n including baths): existing 7 new First Floor Room Count Heat Type and Fuel: 8Gas ❑ Oil ❑ Electric ❑ Other Central Air: U es ❑ 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: Clexisting d`n`ew size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes u'No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��ni�l�f� L57_ 1240? LL,� Telephone Number Address '�'!0 4 �✓1�{-, �� License # S� Home Improvement Contractor# / Email (' �,T - T�w�►rJS , Lv,•� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE f 6 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. k ADDRESS, VILLAGE OWNER I(� DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE w ELECTRICAL: ROUGH FINAL . PI.UMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ACOR" CERTIFICATE OF LIABILITY INSURANCE, DATE(MM/DDNYYY) `� 1 04/01/2016 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()es)must be endorsed. USUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Donna Ostrowski Mark Sylvia Insurance Agency,LLC PHONE 404 Main Street o 508 957-2125 Fn c No): 508 957-2781 E-MAIL ADDRESS:mark marks Iviainsurance.com Centerville, MA'02632 INSURERS AFFORDING COVERAGE NAIC li INSURERA:Farm Family Casualty Insurance INSURED INSURER B Complete Home Group LLC 770 B1 Main Street INSURERC: Osterville,MA 02655 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 ADDL SUB POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD MMIDD I LIMITS A X COMMERCIAL GENERAL LIABILITY 2001 L6914 12/4/2015 12/4/2016 ;EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X❑OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMB APPLIES PER: jGENERAL AGGREGATE $ 2.000,000 X POLICY❑JE O- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO 'BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 'BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED 'PROPERTY DAMAGE $ AUTOS iegr accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE 'AGGREGATE $ DED RETENTION$ j $ A WORKERS COMPENSATION - 2001 W8025 3/23/2016 3/23/2017 PER OTH- AND EMPLOYERS'LIABILITY Y 1 N S ATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1.000,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) ),E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below iE.L.DISEASE-POLICY LIMIT $ 1,000,000 I A ' DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Contractor Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived or extended the coverage provided by the policy provisions. i CERTIFICATE HOLDER CANCELLATION (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD t Complete. _ Service Starts Here a - . . 770 Bl Main.Street: 508 428-2828,Phorie OsterviIle; MA 02655 5Q8-4281974 Fax To"W-h of Barnstable: Regulatory Services Building Division ; Mir..IHornas Perry, Building Commissioner 200.Main Street° Hyannis A- '02601,; June 14 2016- NOTICE TO THE BUILDING DIVIS:LON.OE LLCENSED CNSTRUCTION;SUPERVISO`R ASSUMPTION F RESPO:NSIBILITY I Adam Hostetter.; Const uctign iupefyo s. icense#0943.02 and<owner`of Complete Home Group l LC; Herby certify that Brian Powers Construction Supery sor'sFl icenseW079418,84ul'l,Yirne employee`of. Cornplete:'Home Group,LLC; wi[I assume responsibi:iity as projectwsupervisor for the.followingproject: . Brian Powers �#079418 41.Lake.view—Mike S6hul ° f Adam Hosletter::Licerise Holder Da�e; ` r ��E rO',sti Town of Barnstable Regulatory Services T, MASS- Richard V.Scali,Director 16.39. n►p� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,Na 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 / _r .� /' to act on my behalf, m all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections,are performed and accepted. A44—I-- .� Signa e of er Signature o plicant Tint Name Print Name Da k Q:FORMS:O WNERPERMISSIONPOOIS Town of Barnstable Regulatory Services �oF THE roiy� Richard V_ScaIi,Director Building Division snaxsrAsM Tom perry,Building Commissioner . W-1-11 1639- 200 Main Street, Hyannis,MA 02601 wvww_town.b a rnstab Ie.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION x _ Ptease Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone # CURRENT MAJLIlNTG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied ied dwellings of six i e t P P ,_ units or less and o 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,RuIes &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 formlcertification for use in your community. Q:\WPFILES\FORKS\building permit fomis\EXPRESS_doc Revised 061313 TTie ComrtsOMreaith of- assadirrsetts Deparkment&fr'ndrrstria1Acciderrts r� Offire of'Lrr►wtigadons. 600 Washington Street Boston,MA 021111 '"corkers' Campensafian Insurance Affidavit:BudIders/Ciantractars/EIeciiicians(Plu nbers Applicant Infarmafian Please Print f egiEt Name�SusinesstOrganizationffn�dual� �o��!t�i� �= � '?� ( L_e__ Address Citylsta,& JI Monelgk Are . an employer?Checkthe appropriate box: Type of project{required}_ 1. I am a employer with it 4 ❑I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6- ❑New consfrau fioa 2.❑ I am a sole proprietor or partner- listed on the attached sheet , 7_ ❑Remodeling. ship and have no employees. These sub--confrac#ors have g. ❑•Dentolitioa wnrk� forme in any capacity employers and have wosk-ers' ❑Building addition Sctxl err'camp.insurance . Comp_insuragt�$ 9.recgnired 5. ❑ We are a corporation and its 100 Electrical repairs or ad&tims officers have�es,erdsed their 3111 am a homeowner doing all work officers ❑Plumbing repairs or additions myself:[No workers'tamp- right of exemption per MGL 12.❑Roof repairs insurance required-]l c.152,§1(4h and we have no employees_[No,workers' 13.❑Other comp_insurance required.] •tkuy appliC=t&St cbec1sbox#1 mast else filloucthe swdazLbelowshowmg then wozkeis'ca®pevsadcapeIkyiaformadm3-. l Mmemners Who submit dais affidn a inuffratm_q they are fining all wool and rhea Meta autsidde coat roars amst submit a new afdwk imMcs�sudi ICantractocs that check this boat must attached an.additinnsl sheet showing the name of the snb-camicsoho-is and state whether or not those eadties hwe employees.I€thesnb-caatmctashave employees,they=srpindde their workers'ramp.palicg number. lam ait eiiiplger tliaf is pm dung workers'congmLsagaii irsszsrancc far my cmp£ol ces. $e£oov is the pvM7 mid job s&e informatiost, Insurance Company N;'ame: /' [�,� L✓i 4— Policy#or Self--ins_.Lic.#: L,D O l UJ 1�-n 2S lxpirat<on Bate: 'o 1- � r Job Site Address o'// t4lI 1�igri ry CitylStatel4p: , l>wz_ c.t.ri. wPr Attach a copy of the w•arkers'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-yearimprisolhent,as veep 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 rrtay,be forwarded to the Office of Itrvestigations o€the DIA for insurance coverage-vmdfrcatioa Ida hereby cettrfy a ar`the oflrer,jwy fliattlis hzfotma#iwiprmi&d abm e is&=mid correct $itnure: hate: 1 Phone ik `2 ` Z��Zn . l3,;okial use anfy. ,Do not 1rrfte in thb area,robe crrsnp£ete by carton offieiat City or Toga: Pernrit/Liee>yse# Issuing Authority(drde one): L Board of Health 2.Bu ding Department 3.OitffTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ` Contact Person: Phone#: ha.formation and fustrxctions ' Massa.chusetfs General Laws chaps 152 requires all eujpIoyers'ta provide vrorkeas'compensation for their employees. Pursi ant-to this stake,an vnP&yee is defined as.a-.every person i a the service of another under any contract ofbire, express or implied,oral or wrhzi." An mnpkyer is defined as"an individual,pmtaership,association;corporation or other Iegal entity,or any two or more of the foregoing engaged is a Joint enterprise,and including the legal represenfafives of a deceased employer,or the receiver or trastee of as individnal,partnership,association or other Iegal entity,employing emuployees. However the owner of a.dwelling house bavmg not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance.cous{ruction or repair work on such dwelling house or on.the grounds or butldmg appurtenar¢thereto shall notbecanse of s ich employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhoId$ie issaance or. renewal of a license or permit to operate a business or to construct bu fldkgs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage rf_- i ed-" Additionally,MCAT.chapter 152,§25C(7)states Neither the commonwealth nor a'ny ofits poIifical subdivisions shall enter into any contract for the performance of public woikumfil acceptable evidence of compliance with the insurance._ requirements of this chapter have been presented to the contracting author" Applicants , Please fill out the workers'compensation affidavit completely,by che&I the,boxes that apply to your situation and,if necessary,supply snb•contraetar(s)name(s), address(es)and phone numbers) along with their ceTt ificate(s) of ;,,cr,rance. Limited Liability Companies(LLC)or Limited Liab>7ity partnerships(LIP)withno employee$other tbnn the members or partners,are not required to cant'woikeas' compensation insarano, If an LLC or LLP does have employees,apolicy is required. Be advised that this affidayk may be submitted to the DepaL-iment of Iudmsrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit- The affidavit should be reti med to the city or town that the application for the permit or license is being requested,not the Department of L2dustrlg A_ccidentr. Should you have any gr esdons regarding the law or if you ate required to obtain a workers' compensation policy,please call the Department at the n=b=listed below Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sine that the affidavit is complete andpri3ted.le9bly. The Departmenthas provided a space at the bottom of the affidavit for you to fill out in the event the Office oflavestigations has to contact you regarding the aPPh�t Please:be sure to fill in the pennitllicense nuinber which will be used as a reference number. In addition,as applicant that must submit muttiple pen it/license applit:ations in any given year,need only submit one affidavit indicating cm-eat policy info=ation(if necessary)and under"Job Site Address"the applicant Should Ovate"aII lacaticns the Or town),"A copy of the affidavit that has ben officially stamped or marked by the city or town may be provided to the a applicant as proof that a valid affidavit is on file for furore peumifs or licenses Anew affidv1tmust be filled oi±each year.Where a home owner or citizen is obtaining a license or permit not=Iated to any business or commercial.venue (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 Ike to thank you i a 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 nTrmber_ The COMMMWMIft of MasE chns�1 s D:egartE amt of l idustial AocZenta �e��jgve�g�tZo� GQ4 waaftzan Sty laostan=I1 &oil I I Fax 9 617-727-7M Revised 4-24-07 v,. aas, g�dia t' Scmt d Of sud !d lr 1.-1"�CfiMe �.i ,i. _.t •.. le:ict t3 S rt 48z l:al it aslbc" CS-079418 BRMTPOWERt$ ! a 32 HEMEON RD , HYANNMS MA ;2, 1" , Cos7�n�ss,irrtel 08/01/2016 it'r:;niurvuirrr/�� `-l"�%Irr.l;rrr�rr c1/l orrice of Consumer Affairs& !Business Regulation License or registration valid for individul use only till ��` �:IHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: : 178455 Type: Office of Consumer Affairs and Business Regulation Expiration,:. 4/16/2018 LLC 10 Par[;Plaza-Suite 5170 Boston,MA 02116 ; COMPLETE HOME GROUP LLC r ADAM HOSTETTER 770 ALMAIN ST C OSTERVILLE,MA 02655 Undersecretary Not valid without signature J Town of Barnstable Buildin :.P st'Th�s„Card So That�t is 1/is�bie.From the 5#rest A � rovetl'Flans Must be,aRetamed on J.o.b and;this Gard Must�be,Kept Permit M"�• Posted Until Final Inspection Has Been Made -� h�� a � N. ,, � h R �ccu anc =is°Re aired such Build�n shall�Not�be Occu led uo#ii afFinal=lns ect�on:ha`s�been made �� Where a Cert�ficaterof..0 p y, q � � g p p Permit No. B-16-1324 Applicant Name: COMPLETE HOME GROUP LLC.. Map/Lot: 214-038-X03 Date Issued: 07/13/2016 Current Use: Zoning District: RD-1 Permit Type: Addition/Alteration-Residential Expiration Date: 01/13/2017 Contractor Name: COMPLETE HOME GROUP LLC. Location: 41LAKEVIEW DRIVE,CENTERVILLE s � Est Prop gttCost: $ 100,000.00 Contractor License: 178455 Owner on Record: SCHULZ, MICHAEL F&1ULIE E QUINTERO PermltFee $560.00 - Address: PO BOX 688 _.. Fee Paid $560.00 OSTERVILLE MA 02655 Date: i yY 7/13/2016 g Description: ADD 3RD GARAGE BAY. NEW 2ND FLOOR DORMERS AT LOFT AREA. NEW 2ND FLOOk MI ALF BATH LAUNDRY, BONUS ROOM FINISH AND ROOF DECK '- E'.4 1 ✓ f:: R 7/8/16 NEW PLANS SUBMITTED SHOWING BONUS ROOM-AS RECREATION RO{OM (N®SLEEPl'NG).JLL Project Review Req : ADD 3RD GARAGE BAY. NEW 2N'DFL�00'R DORMERS AT1LOFT AREA NEW 2ND FLOOR. HALF BATH LAUNDRY, BONUS ROOM FINISH AND R®OF DECK s : t W Z 7/8/16 NEW PLANS SUBMITTED SHOWING BONUS ROOM AS RECREATION ROOM (NO-SLEEPING).JLL ZPAS Ala � � Pk Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afte�-efissuance. All work authorized by this permit shall conform to the approved apple anon and the a n,pproved.costruction dosumentssfor wh ch Yhis permit has been granted. All construction,alterations and changes of use of any building and stf act ru esshall be incompliance with the local zoning by laws and codes. f This permit shall be displayed in a location clearly visible from access street or.road andshall be maintained open for public inspection for the entire duration of the work until the completion of the same. 4. The Certificate of Occupancy will not be issued until all applicable signatures"kiy the Building and Fue O#ficials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection _ 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION lG 3 Mao Parcel Application# y��. f _ -? �Health Division 00� -_ • r~ Conservation Division P" _ Permit# Tax Collector Date Issued. Treasurer Application Fee Planning Dept. �/ //[� ,S o< /9s36 Permit Fee 3.7 Date Definitive Plan Approved by Planning Board Historic-OKH /d Preservation/Hyannis Project Street Address �� -P —O/�• Village Owner c Address Telephone 60 Permit Request �d4�fc /C� X ,�(� = /lo Ize— � r Square feet: 1 st floor:existing proposed 2nd floor:existing - proposed Total new Zoning District Flood Plain Groundwater Overlay ` r� Project Valuation n Construction Type P,�cs cI cPwy r Lot Size /,�57 o, 3& Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single FamilyY/-Ir Two Family ❑ Multi-Family(#units) - Age of Existing Structure Historic House: ❑Yes o On Old King's Highway: ❑Yes wo Basement Type: Xull �6rawl Xwalkout ❑Other ` Basement Finished Area(sq.ft.) /V ti N-r Basement Unfinished Area(sq.ft) " Number of Baths: Full:existing new Half:existing new —C f'^ Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: as ❑Oil ❑ Electric ❑Other Central Air: �<Yes ❑No Fireplaces: Existing New C_� Existing wood/coal stove: ❑Yes 4<10— Detached garage:❑existing ❑new size'"`0 Pool:❑existing ❑new size Barn:❑existing ❑new size r� Attached garage:❑existing ❑new size`G Shed:❑existing ❑new stu"fi_ Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ � =� Commercial ❑Yes o If yps,site I n review# Current Use Proposed Use BUILDER INFORMATION e—U Z C� 9 ) Name /'�L Telephone Number CS � V� Address S License# (9©Z 7", f G -C Home Improvement Contractor# A 6 V 9 2 C (: _ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO G �-A / L SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. r# DATE ISSUED t . MAP/PARCEL NO. ` • is, � .., - ; ' ADDRESS VILLAGE OWNER , DATE OF INSPECTION: FOUNDATION 1 ~ FRAME u hl61 r 1 � 1 INSULATION ( 3)z per-- , c FIREPLACE k ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ®k�o Itzll�r 9•�G DATE CLOSED OUT I _ ASSOCIATION PLAN NO. ' l - L.D.NICKULAS CO. f. P.O.BOX 507•WEST BARNSTABLE,MA 02668 OFFICE:508-362-6295 FAX:508-362-5578 v � cdz Xr FARMERS PORCH HEADER TJ-Beam®6.$SerialN�er:7005 2263a`� 5 1/4" x 16" 2.0E Parallam@ PSL User.,,l 11/28/2000 10:33:47 AM - Pagel Engine Version:6.25.71 THIS PRODUCT MEETS OR EXCEEDS THE SET.DES'IGN CONTROLS FOR THE APPL'fCATION-AN�-- ADS L Overall Dimension:22' V 1 2 2' Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 1' Primary Load Group-Residential-Living Areas(psf):40.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(plf) Floor(1.00) 0.0 81.0 0 To 22' Adds To TJ-XPERT n Uniform(plf) Roof(1.25) 330.0 191.0 0 To 22' Adds To Uniform(plf) Floor(1.00) 107.0 27.0 0 To 22' Adds To SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Wood column 3.50" 2.29" 5288/3710/0/8997 L5 None 2 Wood column 3.50" 2.29" 5288/3710/0/8997 L5 None -See TJ SPECIFIER'S/BUILDERS GUIDE for detail(s): L5 DESIGN CONTROLS: Maximum Design Control Control Location Shear(Ibs) 7250 -6046 20300 Passed(30%) Rt.end Span 1 under Roof ADJACENT span loading Moment(Ft-Lbs) 30761 30761 65540 Passed(47%) MID Span 1 under Roof ALTERNATE span loading Live Load Defl(in) 0.312 0.443 Passed(U680) MID Span 1 under Roof ALTERNATE span loading Total Load Defl(in) 0.523 0.885 Passed(U406) MID Span 1 under Roof ALTERNATE span loading -Deflection Criteria:STANDARD(LL:U480,TL:U240).Additional checks follow. -Left Overhang:(LL:0.200",TL:2U240). -Right Overhang:(LL:0.200",TL:2U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 22'o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. -The load conditions considered in this design analysis include alternate and adjacent member pattern loading. t PROJECT INFORMATION: OPERATOR INFORMATION: 41 LAKE VIEW DR J Andrew Shakliks CENTERVILLE MID-CAPE HOME CENTER 465 ROUTE 134 SOUTH DENNIS PO BOX 1418 South Dennis,MA 02660 Phone:508-760-4973 Fax :508-760-4559 ashakliks@midcape.net Copyright O 2006 by Trus Joist, a Weyerhaeuser Business Parallam® is a registered trademark of Trus Joist. !T v WeyerhaeuserBusinas „ FARMERS PORCH HEADER TJ-Beam®60serial Number:7005122634 5 1/4 x 16 2.0E Parallam@ PSL User,1 EngineVersi n:6.2771 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 2 Engine Version:6.25.71 CONTROLS FOR THE APPLICATION AND LOADS LISTED ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ 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 TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code BOCA analyzing the TJ Distribution product listed above. PROJECT INFORMATION: OPERATOR INFORMATION: 41 LAKE VIEW DR J Andrew Shakliks CENTERVILLE MID-CAPE HOME CENTER 465 ROUTE 134 SOUTH DENNIS PO BOX 1418 South Dennis,MA 02660 Phone:508-760-4973 Fax :508-760-4559 ashakliks@midcape.net Copyright O 2006 by Trus Joist, a Weyerhaeuser Business Parallam® is a registered trademark of Trus Joist. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 i� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/O ization/Individual): ce Address: City/State/Zip: `JeS)' X/Vt ri 51/)C � Phone Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I . 6. .0 New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. t 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition. working for me in any capacity., workers' comp.insurance. 9. ❑Building addition [No workers'. comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work ; right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the and p lties of perju that the information provided above Is true and correct Si ature: Date: Phone#: �S 2 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions N 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 hide, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver.or trustee of an individual.,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more thar three apai tments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,*construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be_deemed to,be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a1icense or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant . that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would 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 an&fax number: The.Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-8.77-MASSAFB Fax 4 617-727-7749 Revised 5-26-05 www,mass.govldia I Town of Barnstable Regulatory Services � r 9 sT $ Thomas F.Geiler,Director i639:� g Buildin Division ° Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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. Type of Work: Estimated Cost Address of Work e— Owner's Name: C&ene Date of Application: e�cj O I hereby certify that: Registration is not required for the following reason(s): , ❑Work excluded by law ❑Job Under$1,000 OBuilding 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.142Aa SIGNED UNDER EN ZFRJURY I hereby apply for a permit as the agent of the er Date /gtraJt_oAignature Registration No. OR Date Owner's Signature Q:wpfiles.fo=-.homeaffidav Rev: 060606 Tsole J3.Z1b teoarinned) Prescriptive Packages for One and Two-17am4 Residential Buildings Bested with-fim0 l:uels MAJMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Hadng/Cooling Area'('/.) U-value= R-Valuer R-value' R-valu2 Wall Perinseta Eopmart Eff ci=cy� Package ' R-Value' R value' 5101 to 6500 Heating Degree Days' Q' 12% 0.40 38 13 19 10 6 Normal R —"121. 0-52 30 `i9: t9 T10 """"^—Non712l--7 S 12% 0.30 38 13 19 10 6 13-AME T 13% 036 38 13 25 NIA N/A Normal U 15% 0.46 31 19 19 10 6 Normal V iP/. 0.44 31 13 29 NIA NIA 35 AFUE W 13% OSZ 30 19 19 10 6 85 AFUE X 18% 032 38 13 23 NIA NIA Normal Y 18%. 0.42 38 1 19 23 NIA Nh Normal t 18% 6.42 31 13 19 10 6 90 AFUE AA I9% 0.30 30 19 19 10 6 90 AF TE 1. ADDRESS OF PROPERTY: - ;5-' U/ r 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS. ao 3. SQUARE FOOTAGE OF ALL GLAZING: Y 04::t 4. %GLAZING AREA(#3 DIVIDED BY 02): 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 q-forms-f980303 a RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= /,S 76 C x .0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from]below\if applicable) GARAGES(attached&detached) r square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 /20 rc-4 G V 464' 3 >500 sf-750 sf 50.00 J >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 ---------------- Relocation/Moving $150.00 (plus above if applicable) Projcost Permit Fee Rev:063004 t Town of Barnstable Regulatory Services xa A STA i e$ Thomas F.Geiler,Director PEED n► p�0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Gr , as Owner of the subject proper hereby authorize G G N to act on my behalf, in all matters relative to work authorized by this building peen it application for: (Address of Job 1 1� ee' Signature of Owner Date Print Name Q:FORMS:OWNERPERMIS SION Board of Building Regulations and Standards HOME IMP OVEMENT CONTRACTOR License or registration valid•for individul use only- Re ist'ation; before the expiration date.'If found return to: 1004 0 Board of Building Regulations and Standards +' /2008 One Ashburton Place Rm 1301 idual Boston,'Ma.02108 LARRY NICKUL 1 o' Larry Nickulas : _ �_... 20 CEDAR ST. � � c W. BARNSTABLE,MA 02668 �~ Deputy Administrator Not v ' out signature . ✓/ZC t07'I/I)tO72L�j 1.+`i7 -�... t30ARID OF BUILDING -' ULATIONS License CQNSTRUCTION,9001LRVISOR °I !! N,umogr' CS• 002265 I i = Brtth`�dute ,01/18/1955 ?IplFes RFf18F20D8 Tr..no: 14065 C Rest-iiced �6 LARRY D NICKULA$` s PO B0xC i W BAR C- .. . �`% � T BLE, t _ _ 6 E ooV N •v d N y 0 �/4 e S t G fu s SMOKE DETECTORS REVIEWED = .� EO, ]O'-O' Eq. B A BUILDING EPT. DATE " c r�1 � A � W v Aa FIRE DEPARTMENT DATE H -------------- — ------------------------- , H � R gpTH SIGNATURES ARE REQUIRED FOR KNOTTING - ---- --- -- (�]W PT SILL N/5/B XI]' C ARLMOR SO TS ILL 1 O O O MIN,RN PER SILL 6 11 FROM O5OL'r5 TYPIOAL; r MIN(7)BOLTS'ER SILL v ORoP TOP OF FRO5TKALL TO BOT.OF$AB Q "t FROSTAALL BELOWI F UNEXOAVATEO r ` I A N 4'4"MIN. BFROOTTVon rw TO BG-O A4 _ • _ lo^caNc.Fgos�wLL . _ WITH IZ"X]q(qNL. . FT65.1TYP.l t KRILL t WA REB RS 4'®INTO OL.V EX.LONG. LL FOVIEW.t SELURE WV EF EPO%T GROUT;REBAR - -O FR 12'MIN INTO NEW CM.I Fo - WALL FOOTING _ M =e m //�l //�/ ro `EXIST N'..DO .5LA6 `EXIST.DRAWL SPADE i oW o�U `o Gov mom mPi a� c Jac`- -, m tmi� � a nmooi_ucQ;mucu O V �------------- t �Cn EXIST.LOB.WALLS - Q -0 Q � •V cc FOUNDAT I ON PLAN y 7 J^4) O 5 L A L E: 1/4" = 1'-O' O VAN LL � 11 C Q � U . 'job no.: leo2 date OB MAY 2016 scale A5 NOTED drawn: MM rev. : rev. il" : Stlpoy A- 1 0 n ISSUED FOR CONSTRUCTION sht I of b 1 r= t� 0 1O N v i0 WALL/DEMO bENERAL PLAN NOTES F Y. W ALL ENT.WALLS TO BE O%4'5 Y Ib• +�• A OL APIESS NOTED OTMERM45EI L = ------- WALLS D ITEMS TO . AN BE REMOVED V -ALL INr.WALLS TO BE 3%45 A Ib' L G IC EXISTING KNJ-S TO OC, ESS NOTED OTHERWISE) REMAIN s = . -MOONS TO BE ANDERSEN*400 SERIES' E WIN NON-IMPALT-RSISTANT&LASS NEW YULLS AND PLYWOOD PANELS AND FASTENING 0- R 5Y5n31 AS SPECIFIED IN THE BTH ED.OF MA55.STATE 51 LODE DEMO NOTES (REFER TO ELEVATIONS FOR MXVN PATTERNS) E%ISTINNS DA5HED WINOOMLS 1 MULLS -REFER TO ELEVATIONS FOR WINDOT E TO BE REMOVED AND PATCHED AS RD.HEIGHTS ABOVE SIBFLOOR — NEEDED OR REPLACED AS NOTED. O Y W 0 ymfp O C r^ Ql W � 10-0' O•^ d ' A � A4 - k Ir T-0%T-O COACHMAN py\*`]��)IAIE Bo EvATiONSJ V i i A4 --_ o�.�mope uc Ea�rEo _-_ e6�� elm- ep`ga A < <a-- no, AN 9 m s 9L OFFICE DR. CAB. REPLACE EXIST.OA c o DOOR YV NEW 4-0%80 COACWAN ^- 6YCL AAA rD ELEvnnays) GARAGE LAB.; N _ V N ----------------------- .r SEAT cLeBla'MV a Q U ---------------------------------- ----------- N c w N — - � `REMOVE EXIST.WALLS HALL NEN WILT-INS A5 SNOMN N L REPLACE00 EXIST.OH. 1-00%E 6.CDD,IRLCZANN — FL BYLLOPAY TO ELEVATONS) fn c :3 j 0 VLL 4r ---------------------- U job no.: ibo] date Os MAY 2OIb scale As NOTED drawn: MM F I R 5 T FLOOR FLAN ^u rev. SCALE. 1/4' I-0" D 'TWY reV. ISSUED FOR CONSTRUCTION sbt 2 of e ' I £ e p A v o o A o P N y N t � C1 • o t WALL/DEMO GENERAL PLAN NOTE5 c, .Q (C EXISTING -ALL EXT.W 1-5 TO BE 2X4'5®16• O,C('A1LE55 NOMP OTHERWISE) e"v ED. EO. ------- I—LS AND ITEMS TO Y c BE REMOVED -ALL INT.WALL5 TO BE 2X45 0 16' W EXISTING WALLS TO E OC.(UNLESS NOTED OTI�RWISE) _ p p x REMAIN -A 065 TO BE ANDER5EN'400 SERIES" L WITH NON-IMPACT-RE515TAM GLA% W p '�W WALLS AND PLYWOOD PANEL5 AND FASTENING 5YSTEM AS SPECIFIED IN THE Q BTN ED.OF MA55 STATE BLDG LODE tD p �p'X (REFER TO ELEVATION5 FOR MUNTIN DEMO NOTES PATTERN5) EXISTING DASHED WINDOWS t WALLS -REFER TO ELEVATIONS FOR WINDOW TO BE REMOVED AND PATCHED AS R.O.HEIGHTS ABOVE SLBFLOOR y/.1 - A NEEDED OR REPLACED AS NOTED. N/d A4 y _____________________________ __ __________________________ �1 A 1X41PE LKING 5'-b' T'-I . - ON 2. T.TAPERED 36 2%RAIL NG/GAP mu3" xN V ya ROOF DEGK � �O '^' � y A i r ' A4 r r ' ON BATH 4 LAUNDRY STORAGE 4 LII5TOM -8- B'-B�' STORAGE ^�} TILE SHWR, 2-6%6-B POCKET 000 'ALIGN WALLS ALIGN WALLS •Ri WITH EDGE ON WITH EWE p OF STAIRS OF STAIRS „m i RECREATION ROOM-) - SLIDING _ WALL BARN u DOOR W/ _gm«o c Ilx o-� OFT C. L a ;a _a"Y9 w STORAGE EO. - ED. m'�? - « i _ Qem BOCKS BOOKS `c - r- --------------------- c u m m ___ pE5K5 - tI� j I r I l I ------------- -- ii-I--- -' O L) N U1 C �'LL .0 -a Q flS a- ICU•— to L N o CU o I% -mlxmlx -mlx ¢ �A mXA � N �s c T "I ^I ^I U o�°Ircl �I ��I 3°I J Z oar N ED. ED. EO. 6'-6' V b'fi• ED. U) EXISTING EXISTING i! W `l U job no.: Ibo2 date Ib MAY 2016 S E C p O N D F L O O R L A N Scale : A5 NOTED 5 L A L E 1/4' = I -O' drawn rev. rev. 0 A-3 E ISSUED FOR CONSTRUCTION 5nt 3 of e E ca A H v p � � R v�i A a tL W v w. cc s ua m v IdSJ ++ a+ o ea 1 9 i✓ t6:W 2X5 DORMER RAFTERS TO EEAR ON NEW STR.RIDGE L%HAN6ER 4 E NEVI 5M RIDGE 4X6 P05' (E)15/4'X 16"LVL 1 WITH ELLU CONNECTORS ICI AEOV Ea W FI l' (21 1 S/4'X 9 II]'LVL fjs Q12 4 t0 V TOP OF DEL.PLATE _ _ I Y� O ORiMER � EXIST.2X T CLG.JOISTS !i M .y EXIST.2x BONU5 - � �� LOFT W 0 RAF7ER5 I%4 IPE ON P.T.2X4 _ �?j ,�' RAFTERS j glnpLN TO � b? ROOM `SLEEPERS TAPERED DK q JI 1/8'PER 12' NEW DORME4. BATH 9. NEE 2Xb Gib.JOISTS - - i 7-7 � F — FLUSM WITH EXIST. EXIS7,71 T. , I' IC 2XIO DECK.IOIST$ FLR;GISTS 0 12"O.C.TAPERED DN. 4 L, 1 WINDOW TO BE o0P OF SUB FLOOR ry. REPLACED Ma PEAR IE/J RI.9BER A SECOND FLOOR _ TOP OF Ste,FLOOR 6 SECOfID FLOOR - i'�--4X4 POST ________ O Q� EXIST.2x10 2X6 RAFTERS 916'OL. - EDOWN TO Ol".5 -------- FLR.JOISTS � FOLtJD.WALL -------- Ex1sT. - HALL OFFICE s-EEL EEAM GARAGE STORAGE cc ROOMm' 6 MIL.VAPOR BARRIER OVER A 6'WELL-6RADED GRAVEL COMPACTED TO P A MAX. DRY DENSITY - TOP OP FJ..E FLOOR_. �� - •FIRST FLOOR TOPOF FRO5— _TOPOFFROSTNILL� EXIST.2X RR JOISTS Ir EXIST.CONC.SLA3 10'CONC.FROSTNAI - EXIST.FOUND.WILL ON 24'X 12' - BEYOND y CONC.FOOTING EXI5'.FOUND.WA'1 Q EXIST.FOUND.WALL AND FOOTIN65 AND FOOTiNG5 EXIST.CONL.1LA9 5EG71 ON �1 A SCALE, 1/4" 1-0' 5 E G T 1 O _ .� SCALE, 1/4' - 1'-0' - `o mar R-s`-``'-`e'E _ac e'R-ii a blv MIA V < 5<6m ocmall - -- 12 N EXIST.RIDGE 12 2X EXIST. M06'V BELOW TAPER o PI/OPE EXIST.RIDGE/ LSU CO. TOR TAPERED I/8'PER 12'BETWEEN EX RAFTERS (5)1 5/4'X 16' 13 O (1)TAPE STRUC.RAFTERS 2X6 ON TAPERED P.T.2x4 ^� LVL RIDGE ON RU' BBBt iM RANE ARLHITEGTLRIL AfXNALT 4� N A\ •L i .� RPOF 5HIN LEE,ON 15 LB.FELT ON 5/0"COX Fl.YM.5HEAT.41NS (S)1514'X 16 5GIRPE 2XB RAFTERS.16'O.L. - %FASLIAN ALUMI"GUTTER ECCU CONNECTOR 1 O I ECCU CONNECTOR C ' IX SOFFIT yp( 06 Y /1\ 0 u6016 BED YIOLO N5 ii N V—`/I 4X6 FY_POST \\ ON Imo%FRIEEZE UOAXB -�' ¢R •` v^ /'/�� p FASCIA i vJ v L.SHINGLES ON U ~ c - 2X CO%PLYWOOD Ix'AFf1T 2X45 o l6"04, YAO LVL-CAPER F8016 SEP MOLDING r 1 4X6 PSL POST 2X5 DORMER \ ON IX FRIEZEMEAD CASIN6 V RAFTER Q O O K O O EC CONNL'TOR (5)1 S/4'X 16" 4 job no.: 1602 LVL RIDGE p X$HCA.LA61NG Y date : 05 MAY 2016 SC8I8 As NOTED ORIDGE, POST d HEADER CON. DETAIL O RIDGE $ POST CONNECTION DETAIL O RIDGE RAFTER CON. DETAIL O EAVE DETAIL AT GARAGE O EAVE DETAIL AT DORMER re'v. MM SCALE,1 V2'F 1'-0" BCALE,I I..•I'-0• SCALE,1 1/2"F P-0' SCALE,1 I/2'F 1'-0" SOALM 1 1/2".1'-O' '=a '°�✓ rev. � � n1u�cTom°L c q_4 ISSUED FOR CONSTRUCTION sht 4 Of e E E„ o ci C A d o � v o As CA r <a A � � v g q E v CaJ A4 C L ^36C15-6 CUPOLA M R DY GAPE OOp CUFOLA s ASPHALT SHINGLES -- - - L TH.E. .. ....- ..__ �p O e8016 BED MOLDING ON® %FRIEZE/ 1111.1111 i HEAD OA51NG I NMI II II •N! OOP OP SUE FLOOR 5VONDFLOOR. - EX ST N61/0K.R — cc 0 Q 0 0 ci �E%ISTIN6 NOLSE a r / C� oOF OF D-.8 FLOOR TOP OF FOI.I:D.WALL — FRONT ELEVATION I,� 5CA:E. 1/4' 1'-0' As Lig FR A`RNALT SHINGL BE m=@F o o m c m 4 %ISTIN6 HOLSE 7 ° c .?r .. -- - - Nomu o - - AT ROOP DECK ..ORR--- E ` ,^ 7z ASPHALT SHINGLES ASPHALT SHINGLES -.—_. — R�LPLE EX.OH. W I - -__ T.ME. THE _ 6A�D00� W �/ ,�� BY CLORI I,wir/ W TOP Or SJB FLOOR yh�:.} -WMTOP OF SLE FLOOR I SECOND FLOOR- ... - -- Oa Q `EKISTING HOJSE -�e � O NDDMOINI GUTTER A�IN1 6uRER -- -- - ON - __— EED MDLp1N6 6 EED MOLDING ®If �I® W ^, _:.....-. ...� ON T.ME, GORNEREOARD5 X FRIEZE T.ME. / ..__ ^ E W C EXISTIN'6 _. ... i F1fE SUB R—FLOOR - -- -- roP of FowD.HALL 'foP OF Fouw. 1' lob n .. I603 o- date : 05 MAY 2016 1 SC2I8 AS NOTED drawn REAR ELEVATI ON LEFT ELEVATI ON rev. SCALP. 1/4" 1'-0' � d rev. SCALE: 1/4" 1'-0" ��. S„ H0 ` ry Yy➢'`FYW'fi� ISSUED FOR CONSTRUCTION snt 5 Of 671 C G 10. ALL PLYWOOD SHALL BE APA d GENERAL FOUNDATIONS MASONRY 3. CONNECTORS SHOWN ARE AS MANUFACTURED BY 51MP50N TO THE FO NGE RATED PANELS CONFORMING .STRONG-TIE CO. INC. SUBSTITUTIONS TO THE FOLLOWING MINUMUM REQUIREMENTS:' I. STRUCTURAL DRAWINGS ARE 1.THE ALLOWABLE PRESUMED 501E I. MASONRY CONSTRUCTION SHALL MUST BE APPROVED IN WRITING A. FLOOR-SPJRD-I-FLOOR TBG, EXPOSURE I, r c TO BE USED WITH THE ENTIRE BEARING GAPGITY 15 5000 P5F, CONFORM TO THE REQUIREMENTS BY THE ENGINEER. INSTALLATION F m CA 5/4",SPAN RATING 16". SET OF DRAWING5. WHICH 15 TO BE VERIFIED IN THE FIELD OF SPECIFICATIONS FOR MASONRY OF ALL CONNECTORS SHALL BE v BEFORE GON57RUCTION. STRUCTURES(AGI 530.1/A5GE b-aW. IN STRICT ACCORDANCE WITH THE g. WALL SHEATHING-EXPOSURE I, I/2", 0 1O i as STRENGTH OF MASONRY F'M=1500 P51. THE MANUFACTURER'S INSTRUCTIONS aU w 2. ALL SAFETY REGULATIONS 8 MUST EMPLOY ALL REQUIRED SPAN RATING 16". 8 t ARE TO BE 5TRGTLY FOLLOWED, 2. FOOTINGS SHALL BE CARRIED FASTENERS. a n METHODS OF CONSTRUGTION E TO LOWER ELEVATION THAN SHOWN 2.VERTICAL REINFORCING OF MASONRY C. ROOF SHEATHING-EXPOSURE I,5/5", a 1O ERECTION OF STRUCTURAL MATERIALS ON-HE DRAWIN655 IF REQUIRED TO WALL5 SHALL BE AS INDICATED ON SPAN RATING 16". + 15 THE CONTRACTOR'S RESPONSIBILITY. REACH PROPER BEARING CAPGITY. THE DRAW065. ALL GORES OF 4. ALL CONNECTORS SHALL BE MASONRY UNITS SHALL BE FILLED HOT DIP GALVANIZED. e WITH GROUT. REINFORCING BAR o 3. THE CONTRACTOR 15 RESPONSIBLE 3. WALL5 ACTING AS RETAINING WALLS LAPS SHALL BE 2'-b" MIN. DESIGN CRITERIA y FOR 0155EMINATION O= ALL SHALL NOT BE BAGKFILLED WITHOUT 5. INSTALL ALL CONNECTOR FASTENERS REVISIONS 8 REQUIREMENTS TO BRACING UNTIL ALL SUPPORTING 501E BEFORE LOADING THE JOINT. `� " THE SUBCONTRACTORS. B SLABS ARE IN PLACE 8 AT 3. HORIZONTAL JOINT REINFORCING I. APPLICABLE BUILDING CODE ADEQUATE STRENGTH. FOR MASONRY SHALL BE EQUAL MASSACHUSETTS,&TH EDITION TO DUR-O-WALL TPU55 MANUFAGTERED 6. SPLIT WOOD IS NOT ACCEPTABLE 1+1 J as 4. RESONABLE CARE HAS BEEN WITH WIRE CONFORMING TO A5TM A 52 FOR ANY CONNECTION. TAKEN IN THE PREPARATION OF 4. COMPACT ALL FILL UNDER FOOTIN65 € COATED FOR CORRO51ON PROTECTION 2. DESIGN WIND SPEED: I10 MPH w ALL DRAWING5 AND SPECIFICATIONS. E SLABS TO THE SPECIFIED DENSITY IN ACCORDANCE WITH A5TM A 155, H GLASS 5-2. ALL WIRE SHALL BE 1. ALL EXPOSED FRAMING MEMBERS HOWEVER THE ENGINEER DOES NOT $ VERI=Y. q GAGE MINIMUM. PROVIDE MINIMUM SHALL BE TREATED PER AWPA GUARANTEE AGAINST HUMAN ERROR LAP OF 6" $ USE PREFABRIATED T'S C2/Gq GGA 0.25 8 MEMBERS IN STRUCTURAL DESIGN CRITERIA ea 8 FOR THAT REASON IT IS IMPERATIVE OR CORNER SECTIONS AT ALL CONTACT WITH SOIL SHALL BE py ~ THAT THE CONTRACTOR SHALL CHECK WALL INTERSECTIONS. TREATED PER AWPA G23/G24 - FIRST FLOOR 40 PSF ILL V .r ALL DIMENSIONS $ DETAILS B MUST 5TRUGTURAL STEEL GGA 0.60.JOB 51TE FABRICATIONS 15 P5F DL MM c VERIFY ALL GOND'TION5,DIMENSIONS, GUTS $ BORES SHALL BE TREATED IN W °� $ ELEVATIONS AT THE SI-E. ALL 4. GOGNRETE MA50NRY UNI75 SHALL ACCORDANCE WITH AWPA 5TO. M.A. SECOND FLOOR 30 P5F LL V DISGREPANGIE5 SHALL BE BROUGHT I.DESIGN,FASRIGATION $ ERECTION CONFORM TO A5TM G q0. 15 P5F DL TO THE ATTENTION OF THE ENGINEER SHALL BE IN AGGORDANGE WITH w THE AISC SPECIFICATION FOR 5. ALL MANUFACTURED LVL WOOD FRAMING - AT7IC/5T0. 20 PSF ILL as STRUCTURAL STEEL FOR BUILDINGS, 5. CONCRETE BRICK SHALL CONFORM MEMBERS SHALL HAVE THE FOLLOWING 10 P5F DL 5. THE CONTRACTOR SHALL SUBMIT LATEST EDITION. TO A5TM G55. PHYSICAL PROPERTIES A5 A MINIMUM: - ROOF GSL 30 PSF SL COMPLETE SHOP DRAWING5 FOR 15 PSF DL ALL CONCRETE REINFORCING,ALL STRUCTURAL STEEL, 4 BOTH 2. 5TRUGTURAL SHAPES SHALL CONFORM E=LgXIO6P51.,FB=2S00,FV=240.6 GROUT SHALL CONFORM - EXT. WALL5/5TOR. 15 PLF DL 1 THE CALCULATIONS 8 SHOP DRAWIN65 TO THE FOLLOWING: . FOR ALL MANUFAGTURERED LUMBER REQUIREMENTS OF A5TM G 46 8 - INT. WALLS/STOR. 50 PLF DL PRODUCTS 8 THEIR CONNECTORS A.WIDE FLANGE MEMBER5 A5TM SHALL HAVE A COMPRESSIVE q. ALL FLOOR JOISTS SHALL BE AS FOR REVIEW PRIOR TO FABRICATION. Agg2 GRADE 50. STRENGTH OF 3000 PSI. MANUFACTURE BY GASGADE - DECKS/PORCHES 40 P5F ff AS SIZED ONN THE THE DRAWINANIN GS. ALL 10 PSF B.CHANNELS 8 ANGLES A5TM A36. �.VERTICAL S BOND BEAM FASTENING,BEARING,BRACING $ STIFFENING SHALL BE IN STRICT ACCORDANCE REINFORCEMENT SHALL CONFORM p G. H55 ROUND & RECTANGULAR TUBES WITH THE MANUFACTURER'S REQUIREMENTS. o Q)) CONCRETE TO ASTM A 500,GRADE B FY=46 K51. TO THE REQUIREMENTS OF A5TM A615. 10 ul 'm 10 I.ALL CONCRETE WORK AND MATERIALS 5. MORTAR SHALL CONFORM TO THE GENERAL NAILING s NE°u`E- IOMPH SHALL COMPLY WITH-HE 5PECI�ICATION5 3. ALL GALVANIZING SHALL CONFORM Wco FOR STRUCTURAL CONCRETE FOR BUILDINGS TO A5TM A 123. REQUIREMENTS OF A5TM G 210 JOINT DESCRIPTION aMBER pF M MBER OF NAIL SPACING O (AGI STRUC). AND SHALL BE TYPE M OR 5. COMMON NA1L5 Box NAILS W ROOF FRAMING BLOCKING TO RAFTER(TOE-NAILED) -BD -IOD EACH END CO 4. BOLTED CONNECTIONS SHALL BE WITH q. QUALITY A55URANCE TESTING 8 RIM BOARD TO RAFTER(END-NAILED) 2-160 5-IbD EACH END a � O 2. ALL CONCRETE SHALL HAVE A 25-DAY HIGH STRENGTH BOLTS IN ACCORDANCE INSPECTION SHALL BE PERFORMED N COMPRESSIVE STRENGTH OF 3000 P51, WITH THE SPECIFICATION FOR IN ACCORDANCE WITH THE WALL FRAMING top, J � WITH MAXIMUM I INCH AGGREGATE 8 STRUCTURAL JOINTS USING A5TM A 325 REQUIREMENTS OF ACI 530.1/A5GE 6/5V. TOP PLATES AT INTERSECTIONS(FACE-NAILED) <16D S-16D AT OINTS MAXIMUM 6%AIR ENTRAINMENT FOR OR A 4qO BOLTS. STUD TO ST6D(FACE-NAILED) EXTERIOR CONCRETE EXPOSED TO MOISTURE. HEADER TO HEADER(FACE-NAILED) '6D bp lb-O.C.ALONG EDGES N 5.ANCHOR BOLTS SHALL BE A5TM A 301. FLOOR FRAMING V 3. ALL REINFORCING STEEL SHALL BE FRAMING LUMBER ff CONNECTORS JOIST TO SILL.TOP PLATE OR GIRDER(TOE-NAILED) a-BD 4-IOD PER J015T O U W DEFORMED BARS OF NEW BILLET 5-EEL 6. WIELDS SHALL BE MADE BY OPERATORS BLOCKING TO JOIST(TOE-NAILED) 5_16 3-IOD EACH END yr / 77 O CONFORMING TO ASTM A 615 GRADE 60. CERTIFIED BY T-E STANDARD I. ALL FRAMING LUMBER SHALL BE BLOCKING TO SILL OR TOP PLATE TOE-NAILED) }IbD 4-I6P EACH FLOCK ^' L i QUALIFICATION PROCEDURE OF THE KILN DRIED Iq% MAXIMUM MOISTURE LEDGER STRIP TO BEAM OR GIRDER(FACE-NAILED) }IbD 4-IbD EACH JOIST Q 0 AMERICAN WELDING SOCIETY. CONTENT. LUMBER SHALL MEET .2 -0 cn N AS A MINIMUM THE FOLLOWING ca JOIST ON LEDGER TO BEAM(TOE-NAILED) B-BD 5-100 PER JOIST Y 'CD Iv^/ CD 4.CONCRETE COVER OF REINFORC';NG BARS = BAND JOIST TO JOIST(END-NAILED) }I6D 4-16D PER JOIST N SHALL BE AS FOLLOWS: DESIGN VALUES FOR SPRUCE-PINE-FIR: N (0 U 1. 'NEI DING SHALL BE IN ACCORDANCE BAND JOIST TO SILL OR TOP PLATE TOE-NAILED) 7-IbD 3-16D PER FOOT y, W ;5 A. 3" AT CONCRETE PLACED DIRECTLY KITH THE AW5 Dl.! CODE FOR WELDING A. 2X STUDS CONSTRUCTION GRADE ROOF SHEATHING Q Q AGAINST EARTH. IN BUILDING CONSTRUCTION. FB=800,FV=65,FG=150 WOOP STR,CTURAL PANELS ca N Y U) B. 2X JOISTS/RAFTERS NO. I GRADS RAFTERS OR TRUSSE5 5PACED UP TO 16"O.G. BD IOD 1 b"EDGE/b"FIELD B. 2" AT ALL OTHER'LOCATIONS. c 5.CONNECTIONS NOT DETAILED SHALL FB=1150,FV=10 RAFTERS OR TRUSSES SPACED OVER 16"O.O. DO DD 4"EDGE/4'FIELD BE DESIGNED FOR THE LOAD5 SHOWN GABLE ENDWALL RAKE OR RAKE TRUSS W/O&ABLE OVERHANG BD IOD 6-1 EDGE/b'FIELD .2 U ++ C 5. NO HORIZONTAL CONSTRUCTION JOIN75 ON THE DRAWING5 OR FOR LOADS G. =65T NO. GRAD= FB=800, -0 U N �. ARE ALLOWED,UNLESS SPECIFICALLY GIVEN IN THE STANDARD LOAD FV=65,FG=615 &AB:E ENDWALL RAKE OR RAKE TRUSS N1 STRUCTURAL ouTLOOKERs BD IOD 6"EDGE/6'FIELD SHOWN ON THE DRAWINGS OR ALLOWED TABLES OF AISC FOR THE SPAN, GABLE E"DWALL RAKE OR RAKE TRuss'w LpoKour BLOCKS BD OD a°EDGE/a^FIELD Q 0 IN WRITING BY THE ENGINEER. SECTION $ STRENGTH SPECIFIED. cE1LIN6 SHEATHING 2. ALL FASTENING OF FRAMING, GYPSUM WALLBOARD ED COOLERS - T"EDGE/10'FIELD fob no.: 1602 PLATES,SILLS,SHEATHING 8 6. REINFORCING EMBEDMENT STANDARD q. ELEVATIONS NOTED AS "TOP OF STEEL" OTHER WOOD MEMBERS SHALL WALL SHEATHING date ps MAY 2016 BAR LENGTH HOOK BE IN ACCORDANCE WITH THE HOOD STRUCTURAL PANELS Scala AS NOTED REFER TO THE TOP FLANGE OF ROLLED "a ''" 12' SECTIONS. DETAILS SHOWN & MINIMUM -sTups SPACED w TO 24'O.C. BD 1ov 6"EDGE/13"FIELD drawn: HIMv� 16" REQUIREMENTS OF THE 13' -I/]"AND 25/92"FIBERBOARD PANELS 1 9'EDGE/b"FIELD >6 20' 11" MASSACHUSETTS STATE BJILDING rev. -I/3"GYPSUM WA LLBOARD ALLBOARD SD COOLERS - T"EDGE/10'FIELD GODE STH EDITION. ,, uuu4a •T 14' IS" FLOOR SHEATHING „a�4\� rev. WOOD STRUCTURAL PANELS �' ISH -I"OR LESS BD IOD 6"EDGE/lO'FIELD �! eTaucTu"L m -GREATER THAN I' IOD IbD 6"EDGE/6"FIELD ,p �rh4TP7'T�� ISSUED FOR CONSTRUCTIO sht 6 Of 0 p E d o � N v O M O ~ u h n !C t .. a ci M O cc Y h s. o rn A4 A4 M w •d ----------- - ------ to1-4 ^FI 4, IA QJ A4 A4 2'O ER �iE%15�_EEAlL;, -� NEW 2X6 GL6.bT5. 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