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0028 LAKEWOOD DRIVE
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Town of Barnstable - Building, eSA" A Post This Ca'r`d So That it is Visible From tke Street ApprovedPlans Must be Retained on lob and this Card Must be Kept 16 �" WPohsteered Until Final In'spo eB fs ecn 3 F z spp r o a Cerifcte ofO ding shaNtebeOcc obeen made Permit NO. B-20-288 Applicant Name: Michael Maher Approvals Date Issued: 01/31/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 07/31/2020 Foundation: Location: 28 LAKEWOOD DRIVE,CENTERVILLE Map/Lot: 212-022 Zoning District: RD-1 Sheathing: Owner on Record: FARRELL, MICHAEL F&NANCY A Contractor Name MICHAEL MAHER Framing: 1 Address: 28 LAKEWOOD DRIVE Contractor License:• CS-109089 2 CENTERVILLE, MA. 02632 Est Project Cost: $3,000.00 Chimney: Description: air seal and insulate the attic, insulate the common wall Permit Fee: $85.00 Insulation: Project Review Req: Fee£Paid 585.00 p, Date 1/31/2020 Final: r� .. f Plumbing/Gas R, v Rough Plumbing: l= -.- Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterIssuance. All work authorized by this permit shall conform to the approved application and the:approved construction documents for which this permit has been granted. Rough Gas: x All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws'ond codes. This permit shall be displayed in a location clearly visible from access street or,7oad and shall be maintained open for Public inspection for the entire duration of the Final Gas: 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 providetl on this,Permit. Minimum of Five Call Inspections Required for All Construction Work:') Service: 1.Foundation or Footing M 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 7.Final Inspection before Occupancy Low Voltage Final' 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: O N l.rZyJ LC Town of Barnstable Building Post'This.Card So'That it is Visible From the Street Approved Plans Must be Retained on Jo- ',an and this Card Must be Kept unHsreei - f Ar Posted Until FinalInspection'Hes Been Made. 161 * 0" ri is TGN W fi`,ti R 4k n,x gym. 1 r Ptl�i my r .v Final'Inspection has been made Permit Wher a acertflcate of Occupancy:is Regwredt'suc�h Building shall Not beOccup ed,untila ` Permit No. 9-16-1202 Applicant Name: WENTWORTH, PERI S Map/Lot: 212-022 Date Issued: 05/25/2016 Current Use: Zoning District: RD-1 Permit Type: Shed-Residential-200 sf and under Expiration Date: 11/25/2016 Contractor Name: Location: 28LAKEWOOD DRIVE,CENTERVILLE - Est.•Pro'ect Cost: $0.00. Contractor License: s Owner on Record: WENTWORTH PERI S ` Permit'Fee $35.00 Address: 28 LAKEWOOD DRIVE � Fee Paid � $35.00 a . 7,, CENTERVILLE, MA 02632 Date 5/25/2016 Description: 10x14 or(16) - s Y / Project Review Req . - -a Buildin Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit;is commenced within six months after issuance. 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 corri'plidme with the 16cal zoning by IiiWt and codes. This permit shall be displayed in a location clearly visible from access street or road an d nd shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the f ilding and Fire Officials 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 Inspections 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). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT - Town of Barnstable TME'�wti Regulatory Services Richard V.Scali,Director , BAMAS&r`'B � Building Division 1639. �0 Tom Perry,Building Commissioner f 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMITS FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less- Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/P car el# gnature V Date Hyannis Main Street Waterfront Historic Districts �G U rl y L Old Kuig s Highway Historic District Commission jurisdiction? ,0 RECD You must file with Old King's Highway...y v Conservation Commission(signature is required) ' Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:040914 �c 201-0' LUT 5 ; 21,600 SF 2 — 1000 GAL PITS (1 SOLID WITH TEES) PER 1 AS—BUILT CARD (INSTALLED '1971) } UPPER DECK .cam 7.7' ` c DUSTING 3 OR Z DWELLING w 4 4. ell ,v t TOWN OF BARNSTABLE BUILDING.PERMIT APPLICATION Map- I Parcel x= Application' I Health Division Date Issue _ Conservation Division c Applicati ee Planning Dept.t.e Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address r,211� G� �C(-2C.Q/ lf71W i Village OwnerC. V Address 'G 'i1 01- Telephone Permit Requester l Cam✓ �.��' �` all a09 Square feet: 1 st floor: existing (3C61 proposed -F�'2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 9cr1 Lot.Size L13 6 S 6o r Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family UY" Two Family ❑ Multi-Family(# units) Age of Existing Structure ' 1 r S Historic House: ❑Yes alo On Old King's Highway: ❑Yes "-0-" Basement Type: Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 3 new$ Half: existing new Number of Bedrooms: . 3 existing,&new Total Room Count (not including baths): existing C, new First Floor Room Count 3 Heat Type and Fuel: ❑ (ids ❑ Oil ❑ Electric ❑ Other Central Air: Ik es ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing IrFnew size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: BUILDING DEPT. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# OCT 19 2016 Current Use Proposed Use TOWN OF BARNSTABLE -APPLICANT INFORMATION— (BUILDER OR HOMEOWNER) .Name tidy`fed t��/SIOS Telephone Number Address License # 00� G 5� Home Improvement Contractor# ���� y`1r: Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # 'DATE ISSUED MAP'/ PARCEL NO. 1 ' ADDRESS VILLAGE 1 i OWNER .t DATE OF INSPECTION: FOUNDX ON r FRAME ? INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL Y PLUMBING: ROUGH FINAL w GAS: ROUGH FINAL FINAL BUILDING s r DATE CLOSED OUT ` ASSOCIATION PLAN NO. F , Town of Barnstable Regulatory Services AKASEL Richard V.Scab,Director 6 Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs ' Office; 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder /F_'Z as Owner of the subject property . hereby authorize 1-104 ��s ��.� f(�s to act on my behalf; in all matters relative to work authorized by this building permit application for. _1 _Ve 'Cew ,.LAkebood I Al (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. „ ignature of et i Signature of=A lip Print Name Print Name -Date QTORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services ofTMs. Richard V.Scab, Director Building Division F Paul Roma,Building Commissioner MAM 639. �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Offlice: 508-862-4038 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMOTION Please Print DATE: JOB LOCATION: number stn et village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown state zip code .The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be,considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department mi-nin um inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s).for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. r The Camzmomvea s o,f Ha—warituse s ��p��erzt�� ncfr�t�cr�de� r 600 Wad6W= gaa�rs. ¢; -- Barston,3f4 f 2HI , Warders' CampensafrmQIusumce ffiirr wit:BaUdersXunf =t(ErsJFd r- „� bens AppHca3d1u:fhr=fi= j Please Frid city{ Are you an emploger?Checkthe appragriate bum : Type of project{require_ L❑ I ant a employer v . 4. ❑I am a gene al r cotdMetar and I * Nave hired tme suer-caadracfo 6 artdfor par��me�. - El New carmfzu ioa ��layees(fish 2.G! l am a sale prop Iz tar orpartaer-. Iisied onthe attached sheep 'f_ 0 Re—dew and have no 1 these sib-caafractam have ' �P. �fl`T`� •Sr 0 Demaldsaa • wodsng form is any capacity for zud hive Worms'_ El [ I4 4GOI Pl3'CotIIp.+nvttanr5 CQSIIp6 4nervartrr 9. Bt111dtn�addlf101Z , -1 5. We are a cmporativa and its 16-❑Eleciicai repairs cr ad&E-om of=ers have exercised 3_❑ I ama homeowner doing all wad 1L 0 Pl=lbingregaiss ar addifiams Mysa[No vaik ers'oamp_ riot of csemg n per MGL ❑ � ,s+cisanrP requkadj 1 c.M§In aadweBweno employees [Notvatloess' 13.0'other , • Beatr7et�sboxr-1Estdmffiautthesectfoahekw comp p. Y ® Pip sbsifieswodc� �,. a fi�fi�•e0-9lII4sst7�Ia salmmFt dris�3aaa`i�c�g����S1f WaQ3C s�fflPa]mE a�rts]eb•±tomradDaamst 5¢bmit anEW�d�eit mdirsSie�rnrx - AMmtxd 6fwt rleC r*ft box nmst Yt18 3L.4rlgit; 9I shad auming&an—of the sub-ccmt=,,,jamz d sImtE vhegIS or zot fame E�Sb8'i� eatgoieas�szegnastgMv,&tb&WMIMW comp.policy manbe prim tai eriip tlot is pnniding iwrkets'camper iarrr irzn&rar=fbr my emp£aj-em Belary is ilEa pgfrcy aim jab site Iaimranr a Company Name . . Po-ficy 41 or Self jM Iic. F gi iarxI3afe_ . Job Site Address` CitgfStafe{�.rp Attach a cape of the v arkers'compeasaflonp.olicy dFdaration page(showing the poRcp munber and ezghation date). Failure to,sew eavemge as requuedunder Sefian 25A of MCL a 157 can lead to the imposiliaa of m im�na4 penalties of a fine up to$UOD OU andlor one-gearimpriso as w6U as ci%E penalties m ffie fU=of a STOP WORK ORDER and a,rime of up to$ZS M a dap ag-iimt the violator. Se advised that a mpy of this statement maybe farvrarded to the Office of Investtafiom of the DJ4€ar i�sTr*anoff coverage ve an- X&hereby car-4fy under die ' psirafii s 'ihatt7rs u arzsra€ianpa�zdcdabot�s is trans caul correct Qjyki d us$only. Do nut tvrife in ffib ester,far be compTeW by clip arta:Fn official City or Tam= PermNr Tense# Leg rrrd�[cb'cIe flne�: - L Board of Reahk y BuMing went 3.�-,�ruvm G k 4�Electrical Fnspector S.Ph=Wmg Enspectnr E 6,Otha+r Coact Person: Phase 9: -•r .a.■ a i. - ■ .n.u: m.� _n ►um .r • m - • ■ �.u � .� ■a.■.:• : _n n o m: ..• n�:w n.. _�.•wrn•■ rn ■. _u w ■7 •.■� "_r. �■nt a _n• ••• • ■■n - - • ! ■ - • :11 /t. • ■n_ .-t .■rr-/.t• -..�-•wY...■1■ •1 •r■: -_ iltltl • �1t■l. •• .._ :nlr •• •� ' .n:■ ul:■R :■t■ •.• .�•.■- it a aln a /■ • r■n da • n" .1 •• •■•■1.1■:+■.r■r •l■ f 1 V!.i. •1 "..11 •'... ■lt ■I 1 .••- I..t� ■■■�` n ■-1 l• •:✓.It . ! .. iitlt• ■•.l:!.1 ■ 1::i..i• t• ■ ... 1.n ••y' ! �� ■ .' n t ■. 1 . ■- . rLY 11 ter, 1 n r•1 all V r is • ■1 1. !■ r■11■•. . ■. . .■ I r-■ r-. r. . - -• ■- . r 1 •It . 1 r- •' !1 !•.- u n - ■ _ ' ■■n•r. l � C� ■Jr lii `� r:•:. tiro� n nnul n1••�tt. ■. .n• • IR •■ u r. t r■ Y a• ■_1 tl■- u . .n• ►.■ ■ _r m u ■�r[rm.0 r • r•■► ••n.. nn■ :r.:r r.■ ■ • r! 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J■ ••:./•v ■- •■r�.r._r ..mod n r �:ww, ■ ■�.,tt. �. 1 ■r. •-• • HIS AWC Guide to Wood Construction in High-Wind Areas:11 D mph Wind Zone Massachusetts Checklist for Compliance(ego CMR 5301.2.1.1)1 Loadbearing Wall Connections ' Lateral(no.of 16d common nails)......................:........(rabies 7)......................................................—2— Non-Loadbearing Wall Connections Lateral(no. of 16d common nails)...............................(Table 8).................................................... —2— Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9).............................._10_ft_0—in.<_ 11' Sill Plate Spans ........................................................(Table 9).............................._3—ft_0—in.<_ 11' Full Height Studs (no.of studs)...................................(Table 9)..............""..".................................... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9).................................._3_ft_0_in.<_12' Sill Plate Spans...........................................................(Table 9)........... ......................_ft_in.5 12" , —n/a— Full Height Studs(no.of studs)................. _...:...............(Table 9)..................................................._(1)_ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 ..............................................................................._7'-0'—s 6'8" Sheathing Type................:...........:.................(note 4)...:.......................................... WSP Edge Nail Spacing.........................................(Table 10 or note 4 if less) in. Field Nail Spacing...:.....................................(Table 10)............................................. 12—in. Shear Connection(no.of 16d common nails)(Table 10)..............................................— FT 44/TT Percent Full-Height Sheathing...................."..(Table 10)................................................._21_% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Maximum Building Dimension, L Nominal Height of Tallest Opening 2.........................................................................._T-0"—<_6'8" SheathingType.............................................(note 4).............................................. WSP- Edge Nail Spacing.........................................(Table 11 or note 4 if less).....................-3—in. Field Nail Spacing.........................................(Table 11)............................................._12_in. Shear Connection(no.of 16d common nails)(Table 11)...................................................... 4— Percent Full-Height Sheathing.......................(Table 11).............."..............................:..._TF /o 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)...........:......... Wall Cladding SEE APA PORTAL Ratedfor Wind Speed?.............................................................................................................................. 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ..............."...................................(Figure 19)............._ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)"...........................:......... U=_269_plf Lateral................"............................(Table 12).......................................L=-176—plf Shear............:..................................(Table 12).........................................S=-77—plf Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T=. pif Gable Rake Outlooker.........................................(Figure 20)............._ft<_smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift............................:.....:.............(Table 14)..._............................: U........... = lb. —N/A—. Lateral(no.of 16d common nails)...(Table 14)..........................'.............L= lb. _N/A_ Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness.........................."..............:. ...:...................................._in 5/8.>_7/16"WSP Roof Sheathing Fastening...........................................(Table 2)8D@ 6°O/C EDGE&FIELD............ Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1-Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables.10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. AWC Guide to Wood Construction in High.Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Wentworth Residence,28 Lakewood Drive,Centerville, Ma 02632(GARAGE ONLY) Q Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust)...................................................................................................................110 mph WindExposure Category................................................................................................................................B 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) 1 1/2—stories <_2 stories RoofPitch ..........................................................................(Fig 2) ......................................._12:6_ <_ 12:12 MeanRoof Height ..............................................................(Fig 2)............................................_17_ft <_33' BuildingWidth,W ..............................................................(Fig 3).......................................... 24'_ft <_80' BuildingLength, L ..............................................................(Fig 3)........................:.................._24' ft <_80' Building Aspect Ratio(L/W) ................................... ...........(Fig4 2.00_<_3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4)............................................ _9_5 6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry............................................................................................ 2.2 ANCHORAGE TO FOUNDATION"' 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ................................. ........(Table 4).......................................... _28"_in. Bolt Spacing from endloint of plate ............................(Fig 5)...............................—12"—in.<_6"—12" Bolt Embedment—concrete........................................(Fig 5)..............................................—7"_in.z 7" Bolt Embedment—masonry........................................(Fig 5)........................................... in.>_ 15" _n/a_ PlateWasher...............................................................(Fig 5)..............................................z 3„x 3"x,/.„ 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6) ................................................._ft 5 12' _n/a_ Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)..................:.................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)...................................................—ft <_d _n/a_ Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)...................................................—ft <_d _n/a_ FloorBracing at Endwalls...................................................(Fig 9)............,....................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................................... Floor Sheathing Thickness ................................................(per 780 CMR Chapter 55)....................... in. Floor Sheathing Fastening..................................................(Table 2)..._d nails at in edge/_in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)......................_10'_ft <_ 10, Non-Loadbearing walls................................................(Fig 10 and Table 5)......................_10' ft <_20' Wall Stud Spacing .............................................(Fig 10 and Table 5 16"—in.<_24"o.c. Wall Story Offsets ........................................................(Figs 7&8)............................................ ft <_d 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls.............................:...........................(Table 5).......................2x_4"_ _ -_10 ft_0_in. Non-Loadbearing walls................................................(Table 5).....................2x 4'_- 10__ft_0_in. Gable End Wall Bracing' FullHeight Endwall Studs............................................(Fig 10).................................................................. WSP Attic Floor Length...............................................(Fig 11).............................................. ft>_W/3 _n/a_ Gypsum Ceiling Length(if WSP not used)..................(Fig 11)............................................. ft z 0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. .. (Fig 11).............................. ............................... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate Splice Length ........................................................(Fig 13 and Table 6).,,.................................. 6_ft Splice Connection no.of 16d common nails ' P ( ).............(Table 6).................................................:......_6_ AWC Guide to Wood Construction in High.Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CNm 5301.2.1.1)1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: _ i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment i -WHEN THE EDGE FMIS M PAAMING LWad NALLS ArsroJr- 11 11 tl 11 1/ 1 J 11 1! 1 W 1•I 11 11 11 1 11 11 11 If II 11 11 I ' - 11 11 11 I N 1.1 t 11 tl 1 K 11 IICC /1 11 1 Y 11 lY.r 1 ' O AI PY F' It 11 ii 448 1 F 11 11 � I1 R I1 Ir � 1 I co03 JI 11 1 2 n I t 11 I f 1 1). . 11 � 11 11 11 1 I 1r W i i ii L II W ii I l g 1 It z 11 11 p 1 I IL . 1 j t r It 1 1 1 V 11 1! �• 14 II II JI 1 11 fl I fl __ JI • 11 00y�,O..cc EDGE Yv MAILSPACM • � PANEL_ � t� Y See Detail on Next Page Vertical and Horizontal Mailing for Panel Attachment 5 • CONSTRUCTION DETAILS TOR'THE APA NARROW WALL RRACINGt METHOD FIGURE 1 NARROW WALL OVER CONCRETE OR MASONRY BLOCK FOUNDATION Outside Elevation Side Elevation Extent of header(two braced wolf segments) - i Extent of header one braced vro11 segment) f Top plate continuity is tt r, ( g ) ""F required per R602.3.2 r z F " : ' -`t • .d�.� n+ a ' 4,• , Sheathing filler if needed .ram e `ry a'.r ,s•.v-. vt., .,rv'N�+, ..+�,�' <g,.p"` .��+.K)t. +.., L�#- • � l• - �►* -- 2'to 18'(finished width) fp , 16d sinker Waifs t," Fasten sheathing to header with Sd common 7 t (0.148"x 3-1/4"') nails(0.131'x 2-1/2")in 3"grid pattern as shown in 2 rows @ and 3"o.c.in oil framing(studs end sills)typ' �a2�;�;" M: =r1 3 o:c.• ^« �,1,000 lb.header-to-jock-stud.strop.�' Sd' M rl . •ffi,. �M on both sides of.opening <� 1,f . �1,000lb.header- to-jock-stud strop (install on backside as shown on ;,, +? `* �, on both sides Max. ya` Side'Elevotion,Ref.No.LSTA24) + -.x height '- of opening(Ref. 10' Min.(2)2x4 typ: 1 No.LSTA24) t,, Braced wall M If panel splice is needed it shall *w x r occur within 24'of mid-height. segment per rr 31$"min. Blocking is not required. R602.14 5 { „ thickness wood 44 Min.width based on 6:1 No of i;l ` l ; structural panel + x r rw sheathing height-to-width ratio:For jack studs ;4 rt -V t< •1^ example.]6"min.fore height; per table I" 20°.for 10'height,:etc. R502.5(182) s i .� I ;.. Min.2"x2°x3/16°plate washer sr -- Anchor bolt per R403.1.6 7yp. Foundation per code Not to stole 'Or other code-recognized fasteners providing lateral resistance equal to or better than the prescribed nails. Note: This narrow wall bracing segment Sheets - the minimum requirements for wall bracing FIGURE 2 „ (racking loads in the plane of ine nail) The building designer should determinc what spe- EXAMPLE OF REQUIRED OUTSIDE CORNER DETAIL(IRC R602.10.5) ufc ticieils are necevwry is provide a complctc - - toad path hir using this bracing in tht siructurr _ corners,connect the t / 16d.noil of 12"o.c. _ two wails together as - outlined in this detail to provide overturning ,� Orientation of stud may vary restraint. Gypsum,when required; installed in accordonce with IRC-Chapter? Wood structur'ol pone) • t 6 AWC Guide to Wood Construction in High.Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7s0 CMR 5301.2.1.1)1 g a r 'EZa i i z r 6 V r � r r r r r r 'd r Qa Od rI I1 i FAMAINGWIVIURS EDGE ROYM T£ r f{ r �` 3"MIN. STAGGERED 3" Nd. KNIPATTERN PANEL PA1{IE � DOUBLE NAIL EDGE _EDGE E SPACING DFYAL Detail Vertical and Horizontal Nailing ' for Panel Attachment ' GENERAL NOTES AND MATERIAL SPECIFICATIONS: (Residential IRC Construction) $K-1 FOUNDATIONS I.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2.For site location and grading information,see Site Plan,by others. 3. Assumed net allowable soil bearing capacity,q=3000 psf,for a medium sand/gmvel composition. Other soils encountered, contact the Engineer of Record. 4. Concrete: Minimum 28 day strength,fc=3000 psi,3/4"aggregate,designed per American Concrete Institute Code,latest issue,maximum slump=4". a.) Anchor bolts ASTM A307 galvanized,min.5/8"diameter,12"long,w/2-1/2"hook spaced per Code Checklist,or in concrete piers w/Simpson ABU-series base;SPACED 2'o/c for slab-on-grade construction(i.e.Garage,Basement,etc.). b.) All walls to have min.2#4 top horizontal,2"clear,to prevent shrinkage c.) All walls longer than 25'shall have vertical control joint with waterstopping between wall joint. FRAMING I.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2.Structural Desi ,n Loads: Dead Loads:Actual Weight of Building Components Live Loads:Snow Load =30 psf(plus drift)with applicable reduction ATTIC Storage=20 psf Living Floor=40 psf Sleeping Floor=30 psf Decks and Balconies=40 psf Wind Load: Criteria used for 11 O.MPH Exposure B or C as noted per plans 3. Structural Steel: ,(as required) a. ASTM A572 Grade 50;shop paint with rust inhibitive paint.Thru-Bolts: ASTM`A307, 1/2"diameter;punched holes: 9/16"diameter. b. Welds: Shop weld cap and base plates to columns;shop weld bearing plates to beams;use E70xx electrodes. Alternatively,field weld by certified welders. c. Deflection Criteria: L/360 total,load deflection. 4.Timber Framing: a.All new timber framing:Spruce-Pine-Fir No.2 with Fb=1000psi,E=1;300,000 psi,or better. b Pressure treated timber(P.T.):Southern Pine with.Fb=1300 psi,E=1,600,000 psi,or better. c.Laminated Veneer Lumber:All L.V.L.shall be 1.9E L.V.L.with Fb=2925 psi,E=1,900 ksi,Fv=285 psi,Fc_per=750 psi, Fc_par=3035 psi. Parallam(PSL):All PSL shall be min. 1.9E;ES with Fb=2900 psi,E=1,900 ksi,Fv=285 psi,Fc_per-750 psi, Fc_par=2900 psi. Note that Microllam m and Paralla may be used interchangeably. 1. Deflection Criteria: L/480 Live Load,U360 Total Load 2. Optional: Provide shop drawing submittal of engineered lumber systems for approval prior to materials purchasing. 5.Metal Connectors: As manufactured by Simpson Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail holes filled,with the size nail as specified by mfgr.or herein. a. Ratter to Ridge Beam: Simpson LSSU-series,or Simpson Straps over top of plywood,spaced 16"o/c- Rafter to Ridge Plate: Collar ties min. i x6Q 16"o/c at top or Simpson Straps over top of plywood spaced 16"o/c b. Rafter ends to top plate: Simpson H2.5A c. Band Joist: Simpson straps at 4'o/c: CS-14R48"centered at band joist 6.Bolts: Bolts in wood framing shall be standard machine bolts unless noted otherwise..Bolt holes in wood shall be 1/32"larger than bolt diameter.Bolt heads and nuts shall bear on standard malleable iron washers,or square plate washers.All nuts shall be retightened at completion of job. 7.Blocking: a.Blocking shall be solid blocking,2x minimum.,and full depth of member. b.Stud Walls:provide blocking at 8"-0"o/c,maximum height. Corners to be blocked at 48"o/c with plywood edge nailing to this blocking for the first 48"of these building corners. c.Nailing Schedule: r Solid Blocking to Bearing 2-8d toenails ea side . Blocking Between Studs 2-10d toenails ea end,or 2-16d end-nails ea..End d. New Framing:Provide 2x blocking for 2 jaist/rafter bays and spaced.48"o/c in joist and rafter plane at all edges;attach plywood.edges to this blocking 8.Nailing Schedule: ' All nailing shall be in.accordance with the WFCM Table 31 unless noted herein specifically. Multiple Studs 16d Q'12"staggered - a All'nails shall be common wire nails. b.Sub-bore where;nails tend to split wood. s 9.•Headers less than 4'-0 use 2-2x6;.all others per MA State Building Code. f Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-006653uction Supervisor Constr Su ' or - CHARLES G PALT-,RIOs.,7L 183 LONGVIEW on CENTERVILLE kTA 7► Commissioner: Expiration: 09/22/2017 Con estricte 1On Supervisor Unrestricted s less than Buildings°f anY use space., 35,000 cubic feet(991 cubic which contain c meters)of enclosed Failure to possess Y State gLiddin a current edition g Code is cause for reoo�the Massachusetts DPS Licensin rrnatio 9 info anon of this �--- n visit: license. WW1N.MAS - S GOV%0PS -- . Office of Consumer Affairs&Business Regulation eG�a OME IMPROVEM l. . License or registration valid for in -F. ENT CONTRACTOR I before the expiration date. If found eturn to:only Registration:,-,1 11.4644 Type:Expiratio Office of Consumer Affairs and Business Regulation fi-0f_T24}-17 = � DBA 10 Park Plaza-Suite 5170 C.PALTSIOS BLDG = Boston,MA 02116. `I EIUIOQE � I . CHARLES PALTSI J 1ULONGVIEW DR CENTERVILLE,MA Undersecretary ? _. I of v & tho Ignatture I \ E � s racj?uw�ta$eq sdyFaFec�m tit i x713 Prir c.patl<pZ .,..,+-k� �:Omw A AS u. G , Parcel ID 212-022� I. - geVeloperLot LOT rJ Location.28 LAKEINOQD DRIVE prt Fronta a Sec Road 177777�1' a ......I , vinaye lCenterville Fire DistridC-O-MM Town sewer exists:at this address NO Road Index g0863. Asbuiit Septic Scan: "`~ t 212022_l. Interactive Map. ✓ W Owner WENTWORTH PERT S I ne %FARRELL MICHAEL'F Owei Street i28 LAKEWOQD DRIVE streeu r .. city ICENTERMLLE State MA zlP 62632 country ��0 ' 3 � i ' .� -uµ .Fhb-" ,.E z ,�,- ,. q,,,, '���,„ ,,„ �. 'RUtdf&tE.ni€�L,��£' fl%�w-.fc w ;�>•� � �" DIi, R�..3..J 4 r v . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION fps Map a�b!�, Parcel Ll a Application # J0 b Health Division Date Issued Conservation SDivision ��' Application Fee Planning Dept. r - - ``^ r: Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street.Address el G K e ©c c� ),AhU e Village CeP477CAVIl Owner P2C' I .S Wevl fkvovrrGi Address Telephone Permit Request ,�Q�Ter drmw Aaa461nl ,w _..L it YJ.1.a-ri 6 Square feet: 1 st floor: existing Lffa proposed 311 2nd 49eC existing851 proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 63T .T Construction Type �Zjc:.00j Lot Size J f,00GQ Sf Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 2"*'- Two Family ❑ Multi-Family(# units) Age of Existing Structure 410 Vit S Historic House: ❑Yes &No On Old King's Highway: ❑Yes W416 Basement Type: U ct ❑ 'Full Crawl 9 Walkout ❑ Other Basement Finished Area(sq.ft.) 51 S f' Basement Unfinished Area(sq.ft) 3a&, S r Number of Baths: Full: existing_ new 1 Half: existing new Number of Bedrooms: _ 4 _ existing _new ,Le,5,5 / j/ek, i T#L. 3 Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: was ❑ Oil ❑ Electric ❑ Other q ;`L Central Air: &Nes ❑ No Fireplaces: Existing Q New [ GXS Existing wood/coal stage U)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 k lei ~_ 3 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ =I NO ; Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name eS ,�L�S 1 O S Telephone Number SG 7/�/L/7G�` Address License # rewEC1411 C*G �2 _ _ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO J3,*1KS_rX 4e du"i J2 SIGNATURE - DATE K FOR OFFICIAL USE ONLY APPLICATION# DA"E ISSUED .MA.P1 PARCEL NO. I ADDRESS . VILLAGE OWNER F C ' DATE OF INSPECTION: FOUNDATION' Si�tarr� - FRAME I OQ L ' ul •INSULATION� tl�Il3 IL FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: . ROUGH FINAL s .FINAL BUILDING F -- .DATE CLOSED OUT ASSOCIATION:PLAN NO. The Cornmonweakh of&lassachusey Deparh�of Industrial Acczd mts 05ice of Irrvestigatiorrs 600 Washington gt Street Bosrop,_)ILI 02I11 >�mars goy/dia Workers' Compensation Insurance-Affidavit:Builders/Contractors/IIectziciaas/Pltimbers r Annbcant Information Please Print Legibly Name pwimdorgifimv.hdmdn4: �q Address: &,W-7 el!i City/S1 /Tip:Ce-17e vf�y ,Glo e26 2 Phone# G a—771 /y/G Are you an employer? Check the appropriate box: 1.❑ I am a employer with 4, ❑I am a general contractor and I TYPe of project(required): . �Inyees(fim and/or part-time).*. have hired the soh-contractors 6. .[]New construction 2.2 1 am a sole proprietor or partner-+ listed on f m attached sheet: 7. Remodeling ship and have no employees 'These sub-contactors have ❑ for me,in an c ac io g• F Demolition Working any rtY• � Y�and have workers 7�,,��;,,;� [NO.�eS'Conlp:inStn=r, co�.filmn nce.t 9• ❑" in addition . 5. [] We are a coipombon and its 10.0 IIecirical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised tbeII 11 per. myself✓ [No workers comp. right of exemption per MGI, .. 12 0 or.additions msUrance reced.] c. 152, §1(4),and we have no Roofrepairs eMplayees. No workers' 13.[]Other comp.;.,cr„ e Vie- *Any applicant that cheeks box#I mast also fIl out the sectiom below showing thds wmi=a c Homeowners wbo sabnut this affidavit m6-da thy arc ' roaftactom policy information g cY doing h woo:and fhm hire outside canhaelars mast snbmrt a new eidevit ind'icatxng �Canlxach�ts that checl;this box most afiacbcd an additional sheet showing the name of the sorb. 7PkP,*m If fc sob-contocrs have employees,they must ST one m and state whether or not&osc entities have p,vvide their wows comp.policy m�bcr. I am an employer that is providing workers'compensation insurance for infer =,Yort 'employees Below is the po£zry and job site hmn-dnca Company Name: - Policy#or Self ins.Lic.# Expiration Date: Job Site A dross: Attach a copy of the workers' compensation policy decEarafion page(showing city//e policy II Faihne to secure cov as re p. g ( g P cy umber and expiration date). erage quired under Section 25A of IvIGL c. 152 can lead to the imposi�o f gel penalties of a . fine t to 50. 00.00.and/or one-year maprisommer , as well ss civil penalties is the fgrm of a STOP WORK ORDER and a f ne of up to.$250.00 a day against the violator. Be advised that a c of this Iuvcgtigations of the DIA for' e co COPY stntemeztt may be forwarded to the Office of verage veafcation, I do hereby certify es of perjury tFrat the ircformaiion ravzded above ove is true and correct , Date: Phone# rya- .7�1�:.1 FrG- 0theer only. Do not write in this area;to be completed b3'czt}'or tatvn o�zciaL orTown: PerlmiflLicease# hority{circle one): Board Health 2.Bn�clnag Deparimeut 3, City/Town Clerk 4.Rlectrical Inspector 5.Plumb' mg Inspector SOII: Phone#: THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A�C(, I DATA C Guide' AWC Guidt AW j Massac' NtaSSaf a. From Ta►�' Sheathir b. Wood S< V r AyC.� AWC(A; ; M` L Residence: Pel Loa,' t 1.1 SCOPr Wind Spy,' �" � r MASS � T own of Barnstable Regulatory Services Thomas F.Geiler,Director. BUUWM- DivMs 01t. Thomas Perry,CBO ' Building Commissioner 200 Maid Street, Hyannis,-MA02601 r www.town. Office: 508-8624038 Fax: 508-790-6230 Property Owner-Muit Complete and Sign This Section If Using A Builder I Pskl. S �.���.I•i iw C1(�—T-)'` ;as Owner of the subject Property hereby authorize i '�-1 �= �i �J.l 7.�j to act on rnybehA in all matters relative to work.'authorized by this binding permit application for, (Address of Job) i of Owner Date Print Natne )17 If Property Owner is applying for permit,please complete the Homeowners License Eaenipitiion Forn oe the.: reverse side. gnature C:1Usets\decollik\AppData\LocW\Mcrosoft\Windows\Temporary Intemet Files\Content Outlook\DDV87AAZ\EXPRESS:doc Revised 072110 A Massachusetts Department of Public Safetl Board.of Building Regulations and St indards Construction Supervisor License License: CS 6653 CHARLES G PALTSIOS 183 LONGVIEW DR CENTERVILLE,_MA 02632 Expiration: 9l2212013 C�am!nissiuner Trt#: 2797 � ,� Office of Come Affa r��ifiines" tu o { License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR _ before the expiration date. If.found return to: Registration 114644 Type j Office of Consumer Affairs and Business Regulation Expiration 1;Q/,8%2013. DBA ` 10 Park Plaza-Suite 5170 Boston;MA 02116. C. TSIOS BLD.G,&REMODELING CHARLES PALTS,IOS, 183 LONGVIEW DR-` 4 � _ CENTERVILLE,MA 02632 �.✓; Undersecretary Not nature r APR-05-2012 08:02 From:MAP INSULATION To:15087711410 Page;V5 RES heck Software Version 4.4.3 Compliance Ifi Project Title: CHUCK PALTSIOS Energy Code: 2009 IECC Location: Centerville(Barnstable),Massachusetts Construction Type: Single Family Glazing Area Percentage: 25% Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 28 LAKEWOOD DR CENTERVILLE,MA Compliance:4.7%Better Than Code Maximum UA:279 Your UA:266 The%eetteror Worse Than Code ind"rVIKU noLv c"e to oonwt u v the house to booed on code trade-vir nda. tl DOES NOT proNde an e*-ete of energy use or oast oat*e to a nvn1n;an-o00 home. P a ` Ceiling 1:Flat Ceiling or Scissor Truss 1430 38.0 0.0 43 Wall 1:Wood Frame,1$"9,0, 510 21,0 0.0 - 29 Wall 2;Wood Frame,16"o.c. 1050 15.0 0.0 48 Window 1;Wood Frame:Double Pane 234 0.300 70 Door 1:Solid 42 0.180 8 Door 2:Glace 150 0.310 47 Floor 1:All-Wood JoisyTruss;om Unconditionad Space 050 30.0 0.0 21 Contplranee Statement The proposed bu*hng design described here la consistent with the building plans,specifications,and cater calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4A4 3 and to comply Frith the mandatory requirements listed in the RESchecA-inspection Checklist. Name-Title Signature p Project True:CHUCK PALTSIOS Report date 0"5112 Data filename: Untitled.rck Page 1 a14 RPR-05-EO12 08:02 Fr•om:MAP INSULATION To:15087711410 Pase:2/5 RESchec,i Software Version 4.4.3 Inspection Checklist Energy Code. 20091ECC Location: Centerville(Barnstable),Massachusetts Constriction Type; Single Family Glazing Area Percentage: 26% Heating Degree Days: 5137 Climate Zone: 5 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Trues,R--38.0 cavity insulation Comments: Above-Grade Walls- Wag 1:Wood Frame,16'ox.,R-21.0 cavity insulation Comments; ❑ We#2:Wood Frame.Wax,R-15.0 cavity insulation Comments: Windows: ❑ Window 1;Wood t=rame:Dovbie Pane,U-factor:0.300 For windows without labeled U-factors,describe features- Wanes Frame Type Thermal Break? Yes No Comments: Doors: D Door 1:Solid,U-tactor.0.180 Comments: ❑ Door 2:Glass,U factor"0.910 Comments; Floors: D Floor 1:Ail-Wood JoiWi7russ:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decldng. Air Leakage: ( Joints(fncludng rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,woatheretr;pped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubstshowers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are`t)type IC rated and ASTM E283 labeled and 2)sealed vft a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned apace are weather-stripped and insulated(without insulatilon campresston or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Q Wood-burning fireplaces have gasketad doors and outdoor combusftn air. 0 Automatic or gravity dampens are installed an all outdoor air Intakes and exhausts. Air Sealing and Insulation: 0 Building envelope air tightness and insiiiatian installation cwpliea by either 1)a post rough•iri blower door test result of less than 7 ACH at 50 pascals OR 2)the following items have been satisfied: Project Tide,CHUCK PALTSIaS Report date 0d{05t92 Data filename; UntMed"rck i Page 2 of 4 APR-05-2012 08:03 From:MAP INSULATION To:15087711410 Page:3/5 * (a)Air barriers and thermal barrier.Installed on outside of air-pettneable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceilinglattic:Air barrier in any dropped ceilingisoflat is substantially aligned with insulation and any gaps are gealed. (c)Above-grade walls;insulation is installed in substantial contact and continuous alignment with the building envelope air barrier_ A Floors;Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes,Batt insulation is out to fit around wiring and plumbing,or sprayed/blown insulation extends bound piping and wiring. (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (g)Showerltub on exterior;,ran:Insulation exists between showers/tubs and exterior wall. Sunrooms: 0 Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75,New windows and doors separating the sunroom from conditioned space meet the building therrnaf envelope requirements. Materials ldentfiication avid Installation: t] Materials and equipment are installed in acoordance with the manufacturers installation instructions. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided, © Insulation R-values and glazing U-factors are dearly marked on the building plans or sperfications. Duct lnsutsUon: Supply ducts in attics are insulated to a minimum of R-8.AJl other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: El Building framing cavities are not used as supply ducts. �j AN joints and seams of air duds,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealant$,gasketing or other approved Closure systems.Tapes,mastics,and faslerim are rated UL 181A or UL 1818 and are labeled according to the'duct construction.Metal dud connections with equipment and/or fittings are mean inically fastened.Crimp joints for round metal duets have a contact lap of at least 1 112 inches and are fastened with a minimum of three equally spaced sheet-metal screws. ExGeptionr,; Joint and seams covered wiittr spray polyurethane foam. Where a partially inaccessible dud connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on dugs operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria! (1)Postconstruction leakage to outdoors test:Less than or equal to 114.4 cfm(8 drn per 100 f12 of conditioned floor area). (2)Postconstruction total leakage test(including air handier enclosure):Less than or equal to 171.6 cfm(12 cfm per 100 11,2 of conditioned floor area)_ (3)Rough-in total leakage test with air handier installed;Less than or equal to 85.8 cfm(6 cfm per 100 ft2 of conditioned floor area). (4)Rough-in total leakage test without air handler installed:Less than or equal to 57.2 cfm(4 Orn per 100 ft2 of conditioned floor Brea). Temperature Controls: [] Where the primary heating system is a forced air-funtace,at least one programmable thermostat is iftiased to control the primary gating:system and has set-pointa initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle, [j Heat pumps having supplementary electric-resistance heat have c ontrois that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an Inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance With 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 603 and 604), Circulating Service Hot Water System&: 0 CIM stating service hot water pipes,are insulates!to R 2. �] Circulating service hat water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Project Title CHUCK PALTSIOS Report date:Mail . Data filename: Unlitled.rok page 3 of 4 APR-05-2012 08:03 From:MAP INSULATION To:15087711410 Pase:4f5 Heaping and Cooling Piping Insulation: d HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: d Heated swimming pools have an Orloff heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and punhp3 are present, t. t'xcepeoas: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-reeovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-17- Excep6ms: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy suurm.. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures Can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (0)40 lumens per watt for lamp wattage<r.15 (d)50 fumens per watt for lamp wattage>15 and—40 (e)50 lumens per watt for lamp wattage a 40 Other Requirements- * $now-and ice-melting systems with energy supplied from the seMce to a building shalt include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also Permitted to satisfy requirement'c'). Certificate. 0 A permanent certificate is provided on or in the electrical distribution panel Ilsting the predominant insulation R-values;window U4actors;type and efficiency of space-conditioning and water heating equipment,The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels, NOTES TO FIELD:(Building Department Use only) Project Me:CHUCK PALTSIOS Report date:04/06112 Qata filename: Untitled.rck Page 4 of 4 APR-05-2012 08:03 From:MAP INSULATION To:15087711410 Page:5/5 N110 2009 IECC Energy 1 Efficiency Certificate a Calling t Roof 39.00 Wall 15,00 Floor i Foundation 30.00 ; Ductwork(unconditioned spaces): Window 0.30 0.28 Door 0.31 0.29 Heating System:_ Cooling System: Water Heater. Name: ©ate: Comments: "*,. ft TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7,4 7- Parcel O2-'L Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee " Date Definitive Plan Approved by Planning Board _ Z1231it Historic - OKH _ Preservation/ Hyannis Project Street Address Zib L_AJ<E i70 0© D ©EA V C 66-/,-Jy)2,y1 Qs Village FJ`7y 1 CLt/i 1.� Owner Address Z,ZZ R( QS/2/�T PINS P�✓�Nv� Telephone W: 508. 7 0/ Cc 3 56t• T7 S.RK4 �o G�N�E12�/I c-i,1F__ 62 co 52, Permit Request Zi�mD✓L\-L, Pf INT45-POR, 1:1M914-T INCW011,26 k/Nk,, C,91UN4 ANa 5iloo1? P�itA 5 4 e�4 a v;N-L_ b F 5 ATAf- 004J - 66,ZI/J ci raxri 17 ot.) 26-m o vN, r_>r� (>N.-)C"II z a P(.t)M 6 uJ 4 rtX TZ/a/i . Square feet: 1 st floor: existing 11(07 proposed 2nd floor: existing proposed Total new Zoning District KD - 1 Flood Plain Nd Groundwater Overlay A F Project Valuation Construction Type WOOD vzw c-, '> Lot Size ®• 5-0 Acef,/7 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# nits) Age of Existing Structure Su �T�I Historic House: ❑Yes :� On Old Kin 's Highway: ❑Yes C�'No g g 9 Basement Type: ❑ Full ❑ Crawl C9Kalkout ❑ Other Basement Finished Area(sq.ft.) SI Basement Unfinished Area (sq.ft) A, Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: Ll existing _new Total Room Count (not including baths): existing 25 new First Floor Room Count? s= Heat Type and Fuel: 9 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes CINo Fireplaces: Existing 0 New Existing wood coal stove: ❑,. s 9/No .)..✓R "9.in i Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing .,p newi size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i w Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes W'No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION HOMEOWNER) Name Em 5. WGt-��J I>ko Telephone Number ?q Address ZZZ t'C��SC� �IN��j ,LTV& License # 1 Ce c-wll�- A C2-6 NZ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P! k) A, S ,TA--T'10.,L) SIGNATURE DATE 13 I��- f FOR OFFICIAL USE ONLY - , APPLICATION# DATEISSUED ; MAP/PARCEL N0. ADDRESS _ VILLAGE OWNER DATE OF INSPECTION: t FOUNDATION 1 e ? FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH - FINAL C PLUMBING: ROUGH FINAL GAS: ROUGH FINAL .FINAL BUILDING v DATE CLOSED OUT 1 ASSOCIATION PLAN NO. The Commonwealth of Massachusetts ep D artinent 6f Industrial Accidenh . .,. QjTxe•of Investigations , 600 Wqshington Street' "Bostotc,MA 02111 1 "` www.massgav/din t Workers' Compensation Insurance Affidavit:Builders/Contractors/Electlrician.s/Plumbers Applicant Information Please Print Legibly Name (Business/Orgatazzation/lndividna�: ,®-2 _ Address Z Z z City/State/Zip: CV" .�-i1 i�L L" /� phone 3 ` i F re you an employer? Check the appropriate hni: 4. �I mm a cantractar�d I 7[]R=odt-liog ct(required): ❑ I am a employer with generalemployees(M and/or part-time).* have hired the sub-contractors nstruction 0 I am a sole proprietor or partner- listed on the attached sheet ship and have no employees These sub-contractors have g. Demolition working for me'm any capacity, employees and have workers' 9. Bu din '-n� [No workers'comp.7r;c�r,-once comp.insurance.t ❑ g addition 17t,yi�q=cd_] 5• ❑ We are a corporation and its 10.[]Electrical repairs or additions 3.LL 1-I am a homeowner doing all work officers have exercised their ' 1 I1.❑Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL . 12 Roof repairs incrr,2„ce required]t c..152 §1(4) and we have no 0 employees. [No workers' 13.[] Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below.showing their workers'eompensahon policy information t Homeowners who sub mit this affidavit indicating they arc doing aU work and then hire outside coatraators must submit a new affidavit indicating such: xbDutractors 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 sob-contractors have employees,they must provide their workers'c oli member. camp.p �y I am an employer that isproviding workers'compensation insurance for my;employees. Below is the pa&cy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiratioii'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 imprisomnent, as well as civilpenalties 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 1-do hereby ce the andpen of perj the irsformation provided'above is true and correct Si titre: Rate: a Phone ?7 9YL/60 11c6c fficial use only. Do not write in this area,'to be conr�leted by city or town official ity or Town: PermitUcense# suing Authority(circle one): Board of Health 2.Building Department 3. City/T own Clerk 4.Electrical Inspector S.Plwnbing Inspector Other ntact Person: Phone#: ' The Commonwealth of Massachusetts Department oflndustrial Accidents ,. Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers Compensation Insurance Affidavit:-'Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name.(Business/organization/tndividual):. VO, D Address: 0 X Z City/State/Zip: ����S - -0L6 ©Phone.# Are you an employer?Check the appropriate box: '. Type of project(required):; 4. I am a eneral contractor and I 10 T.0 I am a employer with * � have hired , - b: ❑New construction . • ed the sub-contractors ontrac loyees(full and/or part-time). tars 2. I am a'sole proprietor or partner- listed on the'attached sheet 7. 0 Remodeling s and have no employees These sub-contractors have mP �P Y 8. ❑Demolition: working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.msurance.t 9. 0 Buil(: addition required.] 5. F0.We are a corporation and its 10.0 Electrical repairsor additions officers have exercised their 3.❑ I am a homeowner doing all work � 11. Plumbing repairs or additions myself: [No workers'comp. right of exemption per MGL 12. Roof repairs insurance required.]:t C. 152,§1(4), and we have no{-' employees. [No workers' 13.0 Other comp,insurance required.] *Any applicant that checks box#1 nmst 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.' $Cont 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 to r emp. yees. If the sub contractor have employees,they must providb their workers comp.policy number. lam an employer that isproviding 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 asrequired under Section 25A of MGL c. 152 can lead to the impositi6ii 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 WORKORDERand a fine' of up to$250.00 a day against the violator. Be.-advised brat a copy-of this statement maybe forwarded to the Office of Investigations of the DIA for insir-46e coverage verification - I do hereby certify under the pains 1 d en uries of perjury that the information provided above is true and correct: �:7 •� Si atiae: Date: Z Phone#: e2,5703"1 Zf, Official use only. Do not write in this area,;,to be completed by city or town official City or Town: PermitlLicense# 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#: Town of Barnstable Regulatory Services " sA MASS. E Thomas F.Geiler,Director 639. 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �-- JOB LOCATION: 28 L14Kf-U30p N 'b Z ��p2.0 I L L�, HA- number street village "HOMEOWNER77N l 502--7- 5 - q4q(o 5`-08-790- 9G 3'�1 name home phone# work phone# CURRENT MAILING ADDRESS: S A-lo`I l N£S NY F- _ Ca E-�JIT,r,Q I ALE- HA oz G 3 2- 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 faun 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 1.09.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. ndersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection (pr�oovejes a e uire ents nd thatbp/she will comply with said procedures and requirements. Signature of Homeowner t Approval of Building Official Note: Tbree-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control.- HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and I adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Loca]\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 I U Commonwealth of Massachusetts 5heet.MetaL Permit Ma�-' Parcel. ��. 'MP PER , .Date:. v ermlt d. 88 Estimated Job Cost:-$ �6dv NOV ZQ1� Pest Fee:'$ 1?lans Submitted YES, NO wV OF BARIVSTAB Reviewed YES Na LE Business,License# 3 9L I 1 Applicant License# Business Inforrnation n Property.'Owner' Jo�bL&ation:Information: :Name:. :c(- Name:: °Yl Street: Strut: /�6 N► w6i6 Cltyfrown: y ak City/Town: Telephone: ��1'��7� Telephone: 8 �7� equi red Cop ofPhoto Ltandhoto I;D " NO, - staff Iuitiai 3-1/ -1=unrestricted license J 2/M-2-restricted to dwellings 3-stories:or less and commercial:up.to 10 000 sq.f L/2-stories or less Residenttal: 1-2 family Multi-fa�ruly: . Condo I Towi�liOuses Other Comimerclal: Office .Retail Industrial- Educational Fire Dept.Approval Institutional Other Square Footage: under,10,000 sq. ft oyez 10;000 sq ft Number of Stories: Sheet metalwork to be completed. New Work: Renovation: IAC Metal Watershed;Roofing_ Kitchen Exhaust_System , Metal:Cbimriey/Vents:, Air.Balancing" Provide detailed descriptioii>of work to be.doae: i. INSURANCE COVERAGEc i 1 have a current jg }y insurance policy or its equ�vaienf"which Meets the requlrements':of M G L.Ch.112 Yes®:No°❑ If you have checked YjM indicate the type of coverage.by`checking the appropriate Mt below: 1 A)iabitityt:nsu ran ce policyx OEher type of indemni#y Bond;❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the'lnsurance coverage required by Chaptier 112 of.tfhe Massachusetts General:Laws and that my signature on this permit application. awes this requirement: %Che, Only. Owner ❑. Aget]rt;❑ I Signature of.Owner or Owner's A gent } By checking this bo em certify that all of.the details and information 1 have submitted(or.entered);iegarding`this appiic4tlo!.aie,true and: accurate to the best of.in knowled y ge.and that all sheet metal°work and installations performed.under the permit issued:for this appiic i#qn will'be in.como lance with-ail pertinent provi5lon,of theXassachusetts Building Code;and Chapter 9i of the General laws: Duct inspection required pr onto insulation installation:YES NO - prctress`�.Aections Date Comments a •Final. nsgection - Date Comments Type of license: 3y ❑Master []Master Restricted, .ityrrown : ❑Joiimeyperson . I: �eonii of #. Lice' e []Joumeyperson-Restricted — I _ License Numbe -Check at www mass g !jWW nspectorSignature;of.PermitApprova! .. r - t he.Commonwealth ofMassachuse&' � � Department-of Indus#na1�lcctdersLs • ®ffice:of Investigations . , . 600 Washington Street' Boston,MA 02113 ` UVI x�w►v.massgov/din . - Workers3 Compensation i[rnuce Afi"vit.,,ti&de.rs/Contraactors/Electncians/Plumbers: Al7nlicant Information °Please Print Le�ibIy "' Name(Businesslorganizaton/Individual) ::I� v� l vr•1L� 1-)P.ot:�-t*`' e3. e%1 P Address; (Z eccar, �l- CitylStawap: . L a�Mc>j ''`q� P-horie.# �� 39 7� g Are po an emtpl.yer?Check'the approprnat bog: `ype af'praject(requued) 1. I am a to er.with 4: ❑ I am:a geneial contractor and I , ` employer. . ' ❑New constructton•. Y =Ployees(hill and/or part time):*, have:hIred the sub-codiractors 2 ❑ I ama'soleproprietor orpartner= listedion the attached sheet 7. ❑Reniodeliug :ship aad`have.ria.employees r. These sub ontractorshave "8. ❑I)emolitiau for me iu an ac employees and have workers' wo�ng y. P rt3`. 9: ❑Burldsn g addition' insurance comp:msnrance;$ _[No workers-:.,comp. ..Its x r, sus of additions; r uv ed 5..❑ We are a corporation and its 10❑ ep 3 ❑ I am a homeowner doing. woik Officers have exercised their F 11 ❑Plumbing r�satrs ar additions myself[No workers'coiup right`of exemptton per:MGL: []Roof 12. F.15 i 4 ..and we-hive no: repairs i;,c�•�,�nce,required:]'fi § O,. ' - 13.❑Elther . employees.[No workers' ,- aoinp.insurance regf&edj: 3' A t. ,-Any appficaat that elixirs box#1 must also lift oat the section below:showing tbzff wotlozs':compeasahon policy information . IIameowaers whio sidint this affidsAt'indicating lhey are dotag au work and then hire outside contiactnrs hoist submit a new a davit mdtcatipg such. tContractnra:ttiatctieok this boz must attached an additioaal sheet sliowitig the mine.of the sub contractors and state wVb @ cr(F not those entities have employees. If the=b-cantractons bavo ea�hoyees,.;ttiey must grovidt that w�rkears'comp::pabcy number. d I am an.emptoyerthrtt:is providin workers ,;compensation insurance far_=.nry:employees; BelorV:ts the policy and job site informaion n. Instrrance 6mpany Nam. e:01)w. s"k 0 S t.�✓t�� \cs�. cv�M/` Policy#'Or Self insExpiration Date: lob Site Address:. L City/State/lap: Attach a copy of the:work_ers':comii6sSAon;pol'cy declaration page'(showing the policy n' L er.and"egpiratioa date); Faihue;to secure,coverage-as: ed under Section 25 MGL a 152-ca''Iead=to the' osition of criminal penalties ofa, SE as requrr ?mp f ne up to'$i,500 00 , year' oumen#, we as civil penalties m the'form of a STOP WORK'ORDEk and a fine:Of up.to$250.0 a day against v}ola Bead; ed t a copy of this statemerif may be forwarded to the,Office of Investi lions o DIA for ibSUn c .coves e: eri5 lion I do hereby certi „.pen o, er�ury - e is or7jtjdOn:provided abovo is trad,and correct Si Date. .. i 1 s S• a�3 G . : Phone'#: SL)q- 3gki-7')7 g Official use.only. ;Do:not write m this area,tij:be completed by etty Poo �oficaal ty or Topvui_ Pernait/License'#' Tssttig Authority{circle O'te) ; r' •, J.Board of Health. 2.Bu>Iding IDe_arfinent:3"Ci flown Clerk 4:Electrical ector.5:Plumbin Ins ector P tY }nsp g P Contact Person: Phone,#:. n . t ._�pan.-. --sr'S+•"�'ie.2ST.*y�r,;s�.zsc+ -?er .ex -. - ,Y., �..h ...k�,�.: F sa+' y .Mii+nr•-i.. s>= Y� �`�r d # � ���x��`��fi .�: ES"J ,,W0i. .n`iow, ,Lnc. r v` 8 Reardon�Circle r . South 16rmouth,°Massachusetts 02664 Phone-508-39+7778 Fax-508 394-8256 :. e-main-questions@efwinslow.com "• � ;. November 5,2 12 Town of Barnstable Tom Perry, Buildingt6m' missioner 200 Main Street a Hyannis, MA 02601 - - T Dear Mr. Perry,—` ^$ rk Stephen A.Winslow of EY Winslow Plumb"ing&'Heating Co, hic.authorize William Miller to pull all such permits needed to:complete building regulations inthe Town of Barnstable. Th ou,, r " Stephen A.Winslow' v c.a wn s�. Town of Barn tablo Regulatory Service i i Thomas F Getler,Drrector r Building Division :Tom Perry,Ivilding Commissioner. 200 Main Street,Hyannis,MA 02601 WWW-town.barbstable.ma.us Office; 548=8Q-4038 Fax 508=74076230 Property Qwner Must Complete and Sign This Section. If Using;A Builder ,. as,Owner.of ihe.subject property, hereby authorize_ to.act..on my behalf;, in:all'matters relative to work.authorized'by this building penaiit (Address of Job); -- Pool fences and alarms are the responsibility of the.applicant. Pools`: are not:.to`be filled before fence:is installed andpools are not to bit, r utilized until a final in '"Coons are performed and accepted: Signature of,Owner: Signature of Applicant c Pont Name Punt.Name <l 5ZI Date Q:FORMS:O WNERP'ERMISSIOM'OOLS � ®- •DATE(MMIDDIYYI'Y) • aco�o CERTIFICATE OF LIABILITY INSURANCE ' 11/5/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. ) PRODUCER Gannon NAME: Rogers&Gray Insurance Agency Inc PHONE FAX 434 Route 134 -7980 'C.NO E-MAIL South Dennis MA 02660 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:ArrOW Mutual INSURED EFWINSL INSURERS: E F Winslow Plumbing&Heating_Inc.. C:Excelsior Insurance Company 8 Reardon Circle INSURERD: South Yarmouth MA 02664 ro. INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1375232511 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 OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR • ADDL SUBR - POLICY EFF. POLICY EXP LTR TYPE OF INSURANCE - INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS B GENERAL LIABILITY CBP9919974 12/1/2011 2/1/2012 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occunence $100000 CLAIMS-MADE IR-1 OCCUR MED EXP(Any one person) $5000 X 1000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY PRO Loc $ comi C AUTOMOBILE LIABILITY BA8218494 12/1/2011 2/1/2012 Ea accident 1600006 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY Peraccident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS X AUTOS Per accident $ X $ B X UMBRELLA LIAB OCCU2` CU9918875 12/1/2011 2/1/2012 EACH OCCURRENCE. $2000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2000000 DIED I X I RETENTION$10000 $ A WORKERS COMPENSATION WC1684A 1/1/2012 /1/2013 X I WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N - ORY- EIR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500000 If yes,describe under - E.L.DISEASE-POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) - Plumbing&Heating Contractor ,< The certificate holder is an additional insured with respect to general liability when required in a written contract or agreement. Central Vacuum is a division of E F Winslow Plumbing&Heating Inc. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN., TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. SHEET METAL 200 MAIN STREET; AUTHORIZED REPRESENTATIVE HYANNIS MA 02601` ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD S