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0206 LONG BEACH ROAD
N 3 u a o o - ° a ( s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- �0 Parcel-0( A pp lication # - -v I �U����fUCi Health Division rig P- T Date Issued Conservation Division z®� ' Application Fee Planning Dept. 7'0T4 Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH _ Preservation/ Hyannis Project Street Address i0(o Lorno E'Q D Village C G� ' 11 Q Owner U i r l Yl 9-C couc Address `f e� C V QC �I h Y► Telephone 61-7 G Permit Request _ F6.kAV4,:% Z &&AL6 6X I•Li d1t16 e,r If Square feet: 1 st floor: existingA00 proposed 2nd floor: existing proposed Total new Zoning District CW1 ,_�.1�a67 Flood Plain Groundwater Overlay Project Valuation QaD Construction Type wo s Lot Size 0 CLCrR.5 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure IgID Historic House: ❑Yes �$No On Old King's Highway: ❑Yes XNo Basement Type: �Full Crawl ❑Walkout ❑ Other Basement FinishedArea (sq.ft.) � Basement Unfinished Area (sq.ft) .5760 Number of Baths: Full: existing_ Jn .e I�� 1 new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count 4 Heat Type and Fuel: )d Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes *No Fireplaces: Existing New Existing wood/coal stove: ❑YesXNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded 0 Commercial ❑Yes *lo If yes, site plan review# Current Use ['ISZ.S� n"i 1 Q' Proposed Use S Q APPLICANT INFORMATION 1 (BUILDER OR HOMEOWNER) C 2 '1 ' f Name W\e( AaOpuc G2osJc-uA%-D�TeIephone Number M - J J(q h d�" Address l r o,\ hN d��`c� i� , `oZ 4 License # Q_ I"L CL I� I -L� o� �'t q Home Improvement Contractor# Email j (�}'a11 �1�C r c.c.C1� CAI Worker's Compensation # V�Y l� �a �q.1. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (7(1(ZdyE5 SIGNATURE /1►I-N- L1 DATE ti FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. 4 ADDRESS VILLAGE OWNER { DATE OF INSPECTION: ti FOUNDATION FRAME o,' r INSULATION *� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Office of Consumer Affairs&Business Reguiation HOME IMPROVEMENT CONTRACTOR ,�i} y Yypo. Corporation :11Q373 1011912016 Miller Starbuck Con*uction,Inc..: Philip Miller,Jr. 40 MIll Pond Way Falmouth,MA 02536 Undersecretary t Massachusetts-Department of Public Safety Board of Building Regulations and Standards i COmtructlon Superwiw License:CU43338 t . poHILIP Tt� ` 10 � FALMOUTH ArBOX 726 k 02 - °✓'� :.1J,cSc.,a►�4�; Expiration Commissioner 03114/2017 i s is 1. s ToWn of Barnstable Regulatory Services t F MASS Richard V. Sc4 Director ' Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabf e.ma.ns Office: 508-862-403 8 . Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using; A Builder as Owner of the subject property hereby authorize ���.�.�� S�(�rOv� , c-ou cyc\��.� to act on ray behal� in all matters relative to work authorized by this budding permit application for: 7-06 M�, (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. e ner Signature of Applicant Print Name Print Name Date Q.F0RMS:0WNMERMMSI0NP00L5 Town of Barnstable .Regulatory Services �Ila 1br Richard V.Scali,Director Building Division RARxcrAR„p : - Paul Roma,Building Commissioner sresa. . 1639. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 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 dwellings of six units or less and to aIlow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such `homeowner' shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility'for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control.' '^ HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner -engages a.person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of-a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often serious problems, articular) when the homeowner hires unlicensed persons. In this-ease,our Board cannot results ins p ,particularly 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 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 The Commonwealth of Mcassachusedts Daepartrneanit of Industrial Aceidreants 09rce of Investigations 600 Washington Street Boston,AAA 02111. wn*iuntaSS gov1dia. Workers Compensation Insurance Affidavit: BuddersCContractors)'Electricians/Plumbers Applicant Information Please Print T eib Name(Elusive anllnvidoal}: c e.c( Q. C �c;e � J Address: 7 6 6 FQ v,10.0 _ a City/Statdzip:. C S Phone# o eJ q' 1.a N'. Are you an employer?Check the appropriate boa: general contractor and I Type©i project(required): 1.[ I am a employer with4. 0.I am a g employees(Jul and/or pact time)_s have:hired the subcontractors 6_ ❑New aonsf ucLion; 2.❑,I am a sole proprietor or partner- listed on the attached sheet. 7_;K Remodeling " slip and!gave no employees '�ese sob-contractors have 8_ ❑Demolition working for mein any capacity_ employees and have viorkers' 9_ ❑Building addition: (No workers'comp:insurance comp.insurance -� 5_ ❑'Mlle are a corporation and its 10.El Electrcal repairs or additions required 3.❑ I am homeowner doing all.work officers havve exercised their 11.❑Plumbing repairs,or additions 1£ o workers' right of exemption per MGL ' mom° 12.❑Roof repairs �,�„rp rid-]1 c: 152,§1(4�and we.haveno employees-:Vo workers' 13_❑Other camp.insurance required.] 'Any appEcaur disc cbeedrs boa#1 must also fill out are section below sbuwimg dL&wmzkers'compensation policy infarmatiaa Houwwmrs wlm sm1und this affidavit indicating they are doing all wad and then hire outside contractors nos.#.submit a nee affidavit indicating such_- k—entractors that the X this box must attached an additional sheet dhowing the name of the sub-couti mctors and state whether or not those entities have employees. If the sub-contractors have empliiyees,they must pmvide•their workers'comp.policy number_ lam an employer that is provi trig workers'compensartiasnt insurance for my ennp[nyees: Bdotw.is the policy aandjob site innformaden. Insurance Company Name` w_CIM C_k W r l Policy#or.Self--ins_Lic_# ::C9 01. ( nation Date: n j Job Site Address: o G L b ' _`' l City/Statel7np: • ,,.: Attach a copy of the workers'compen lion policy declaration page(shoving the policy number and expiration date).. Failure to sectme 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-m4 somnent,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 yerifixcation_ .I do hereby certify na er tine pains andR"aWes d ury that tide information provided above is trace andcorrftt h L. Bate: Phone#: Official use only. Do not rwrite in this.atrga, *be completed by city®r totvnt a>ffldaL City_or Town: Perdt/License i€ Issuing Authority(circle one): 1.Board of Health 3.Building Department 3.+City(town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: MILLSTA-01 CCOSTA ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D°"YY„' 12/2/2016 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(les)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 Ileu of such endorsement(s). PRODUCER CQNTACT N ME: Mason&Mason Insurance Agency,Inc. PHONE FAX 458 South Ave. A/C,NO, Exq:(781)447-5531 (A/C,No):(781)447-7230 Whitman,MA 02382 E-MAILES certificates@masonandmason!nsurance.com ADDR INSURERS AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance 29939 INSURED INSURER B:Star Insurance Company 18023 Miller Starbuck Construction Services,Inc. INSURER C: PO BOX 726 INSURER D: Falmouth,MA 02541 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. NOTVVITHSTANDING 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR D WVD M D Y LIMITS - A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX] OCCUR MPF1100Y 12/01/2016 12/01/2017 DAMAGE TO RENTED 500 OOO PREMIS S Ea occurre ce $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC 2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ I ppy�N AUTOS ONLY AUOTOS ONLY PeOacc ZtDAMAGE $ $ A UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE CUFI100Y 12/01/2016 12/01/2017 AGGREGATE $ 5,000,000 DED I X I RETENTION$ - 10,000 B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STAT TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE WCO220915 03/27/2016 03/27/2017 1,000,000 FFICER/MEMBER EXCLUDED? ❑N N/A E.L.EACH ACCIDENT $ Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,U00 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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. Barnstable, MA 02632 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MEMBER REPORT Level,Floor.,Drop Beam PASSED s9TORTE \ 4 piece(s) 1 3/4" x 11 1/4" 2.0E Microllam® LVL Overall Length: 13'9" 0 o 13'9" All locations are measured from the outside face of left support(or left cantilever end).AII dimensions are horizontal. Desi n Results s ` Actual�'locaL Allowed ,,„ Result , ,r LDF load:Combination(Pattern) " "x";;" System:Floor Member Reaction(Ibs) 9201 @ 2" 10413(3.50") Passed(88%) 1.0 D+0.75 W+0.75 L+0.75 Lr(All Member Type:Drop Beam Spans) Building Use:Residential Shear(Ibs) 6822 @ 1'2 3/4" 14963 Passed(46%) 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC 2009 Moment(Ft-Ibs) 27188 @ 6'10 1/2" 32274 Passed(84%) 1.00 1.0 D+1.0 L(All Spans) Design Methodology:ASD Live Load Defl.(in) 0.368 @ 6'10 1/2" 0.447 Passed(L/437) 1.0 D+0.75 W+0.75 L+0.75 Lr(All Spans) Total Load Defl.(in) 0.631 @ 6'10 1/2" 0.671 Passed(U255) 1.0 D+0.75 W+0.75 L+0.75 Lr(All Spans) Defection criteria:LL(L/360)and TL(L/240). Top Edge Bracing(Lu):Top compression edge must be braced at 13'9"o/c unless detailed otherwise. Bottom Edge Bracing(Lu):Bottom compression edge must be braced at 13'9"o/c unless detailed otherwise. a g s eeanng Length { - Loads to'Simoports(Ibs) , SU{7POItS Total Available Required. Dead ��rove Wfnd'r Totals Accessoriesg ti .�..�, � t w ,. � 1-Stud wall-SPF 3.50" 3.50" 3.09" 3839 4469 2681 10989 Blocking 2-Stud wall-SPF 3.50" 3.50" 3.09" 3839 4469 2681 10989 Blocking •Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member.being designed. t TIII u " Dead Floor lave Wmd Loads ,, Location($ide W dint . 0.90) �'(3.00) (1:60) Comments„ 0-Self Weight(PLF) 0 to 13'9" N/A 23.0 1-Uniform(PSF) 0 to 13'9"(Front) 13' 12.0 40.0 Residential-L wing Areas { Residential-Living 2-Uniform(PSF) 0 to 13'9"(Front) 6'6" 10.0 20.0 - Areas i 3-Uniform(PSF) 0 to 13'9"(Front) 13' 18.0 30.0 Residential-Living Areas 4-Uniform(PLF) 0 to 13'9"(Front) N/A 80.0 " WE'}/erftaeUSE'C NOt@S SUSTAINABLE FORESTRY INITIATIVE' Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. . Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR-1153 and ESR-1387 and/or tested in accordance with applicable ASTM standards. For current code evaluation reports refer to http://www.woodbywy.com/services/s_CodeReports.aspx. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator r Forte Software Operator Job Notes I 2/8/2017 9:24:57 AM D:,vtd McLee,, MCCO'URT Forte v5.2,Design Engine:V6.6.0.14. Falmouth Lumber LONG BEACH ROAD 1508)54"8 8 CENTER`JILLE.MA d�vami�fal.r:;cuthiu;r:ber.ce;r� ' ........ __ . Page 1 of 1 ZV Reply all ® Delete Junk v X r Re: Building Permit M Mccourty8 <mccourty8@ao1.com> - Reply all 0 Today, 11:11 AM Nataliya Mazhula vv Inbox authorize Miller Starbuck to renovate my home on Long Beach Rd. Thank you Virginia McCourt 2/9//2017 - -----Original Message--- From: Nataliya Mazhula<nataliya@millerstarbuck.com> To: Ginger McCourt<mccourty8@aol.com> Sent: Wed, Feb 8, 2017 4:57 pm - Subject: Building Permit Hi Ginger, hope all is well! We are going to file for a building permit very soon and will need Homeowner's Authorization. Could you please send me a quick letter stating that you Authorize Miller Starbuck to perform work/renovation at your residence? It can be short and simple... Please sign and date... Thank you! Nataliya Mazhula Project Coordinator Miller Starbuck Construction Services, Inc. 766 Falmouth Rd. unit D20 -------------------------- Mashpee, MA 02649 www.millerstarbuck.com Mon-Thurs 8am-4pm Office Hours (508)539-1124 tel (508)539-1125fax "like"us on Facebook www.facebook.com/millerstarbuckcons#ruction 1$18 1a i11111,1111 is,I iC. t Town of Barnstable ermit#� 4 C) ? ,$ Regulatory Service %63g. .0 Thomas F.Geilbr�Director Building Division Tom Perry, Building Commissioner SEP 16 2005 200 Man Street,.Hyannis,MA 02601 r01/�/N OF BA office: 508-862-4038 RNSTABLE Fax., 508-790-6234 LA EXPRESS PERMIT APPLICATION - RESIDENTIAL,ONLY' Not Valid without Red X Press Imprint cap/parcel Number" ropertyAddress Z.0�' Ze;;y3 ��e�c/� �u�- �4�+�*�•ais'��aC_ � . kkesidential Value of Work Z 4 q q s,`0 Minimum fee of•$25.00 for work under$6000.00 )wner's Name&Address.' F1 GLewA yk.(C-vr+- ' � ( �e�r vi 3 Lorv�•t '�'NiN�O'� ,/Ida . t9�D d/� ` ;ontractor_s_w=��� � h�ne,-e. "IP�+s�s / �- L Telephone Number_6S° � acme Improvement Contractor Sacense#(if applicable) 114/ :. .'onstruction Supervisors License#(if applicable) 3Workzn&s Compensation Insurance ' Check one: . ❑ I am a sole proprietor, ❑ I am the Homeowner I have Worker's Compensation Insurance [assurance company Name i���►' a� )'z'ti- /ems- Workmaes Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box). (� Re-roof(stripping old shingles) All construction debris will betaken to 1vn/4./, /Cd� y e�►�,t t - ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Rcplacement Windows. U Value (maximtma.44)• *Where required: Issuance of this permit does not exempt cornpliance with other tows department regulations,i.e,Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ome ov tractors License is required. Signature X` Q:Forms:expmtrg Revisc063004 ; Town of B arn..stable os Regulatory Services x Thomas B.Geller,Director Building Division AT sD n+A� TomPerry, Building Commissioner • 200 Main Street, Hyanub,MA 02601 . - Www.toWn.barnstablesna,us --- �ax: 508-790-6230 Office. $08=862-4038 roe Qvmer-Must - property rty' -_ _ - C:omplete and Sign This Section _if Using ABuilder v tf '' V ` . ,as Owner of the subject property .'to act on mybehaif; - hereby authorize in matters relative to work authorized by this building permit application for. = A ss of jo �.. l $"gaa'ture of OwnerDate - — Pxint name The Commonwealth of Massachusetts Department of h dastrial Accidents ' Office of Investigations• 600 Washington Street < Boston,MA 0.2111' www mass.gov/dia Workers' Compensation Insurance Affidavit: Buialders/Contractors/Electriciads/Plumbers Applicant Information Please Print Leib v Name (BuSinesslorganizationlIndividuan• Address• - �x I CC ✓>?Ili M4 , ZA20- ,Z.(�?7� Phone#: ��� City/State/Zip: : Are you an employer? Check the-appropriate box:. ;Type of project(required): 1.01 am a•emplo.er 4. ❑ I am a general contractor and I 6 ❑New construction employeesor art time).* have hired the sub-contractors p 7. ( Remodeling listed'on the attached sheet$ l • 2.❑ I am a sole proprietor or p ariner- ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any'capacity, workers' comp.insurance. 9. ❑ Building addition [No workers' comp.insurance 5• ❑ we area corporation and its 10.❑ Electrical repairs or.additions required.] officers have exercised their ri t of ex lion er MGL 1'1.❑ Plumbing iepairs or additions 3.❑ I am a homeowner doing an work . p . • c. 152,§1(4),and we have no .. 1. Roof repairs myself.•(No workers comp. employees.(No workers' insurance required].t 13 ❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonnatioa:t Homeowners.who submittbis affidavit indicating they are doing all-work and thenhire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and then'workers''comp;;policy inforlrration. I am an employer that is providing workers'compensation insurance for my employees.'Below i9 the policy and job site information.. ' Insurance.Company Name: L I'�•'✓ '�`'� ""�'ri �. sYro�'�+. Policy#or Self-ins.Lic.#: 1 y� Expiration Date: Z Job Site Address: City1State(Zip: // Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Fame to,secure coverage as required under Section 25A of MGL c. 152 cai lead to the imposition of criminal penalties of a mprisonment, as well as civil penalties in the form of a STOP'WORK ORDER and a liine fine up to$.1,500.00 and/or one-year i of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to.the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pai s a pe alties of penury that the information provided above is true and correct Si atnre: Date:. • /� y®:� Phone# yo r 9 � Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermitUcense# Issuing Authority(circle one}: 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ContactPerson: Phone#• Inform ation aid Instructions achusetts General Laws chapter 152 tequires all employers to provide workers' compensation for their employees. Map mot to this statute, an employee is defined as"...every person is the service of another under nay contract of hire, •�„ • express or implied,oral or wn . • ^. : artpersip association, rporation or other legal7tity,or any two or more employer is defined a "aapcvi¢aal,•,P to er,or the of the foregoing engaged m a joint enterprise, and inchiding the legal representatives of a deceased emp y artn , association or other Legal entity,employing employees• HoweY.e1:the' er or trustee of an individual,p ership . or.the occupant of the receiver ides then rec ' d who resides therein,owner of a dwelling house having not more than free apartments an dwelling house of another who employs persons to do maintenance,construction or repair woik-on such dwelling house or on the grounds or building appurtenant thereto.shall not because of such employment b e 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 pew to operate a business or to construct buildings in the commonwealth for arty . applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." Pp ter 152, 25 states"Neither�e commotmwealth nor any of its.political subdivisions shall Additionally,MGL chap .. § �� enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance iequirememrts of this chapter have been presented to the contracting authority." Applicants ensation affidavit•completely,by checking the boxes that apply to Y9m situation and,if. Please fill out the workers' d hone number(s) along with.their certificates)of Supply sub-contrac�r(s)narne(s), address(es)an p to ees other than the necessary, PP m(s or Liiimited Liability Partnerships(LLP)with no erV ,y insurance. Limited Liability Comp or LLP does have members orpartners, are notre*ed to carry workers' ma sation_be submitted to the Depance. If an Cartment of Industrial employees,apolicy is required. Be advised that thus affi. . Y Accidents for confirmati°n of insurance coverage.. Also be sure to sign and date the affidavit. The a�.davtt should ; • ' or gown that the application for the permit or license is being requested, not the Departnneht of be returned to the czry uestions regardingthe law er if you are required to obtain a workers' Industrial Accidents. Should you have any q anies should eater thefr comstrial Accidents please call the Department at the number listed below, Self-insured comp . self insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Deparhn�c you regarding tht has provided a space ate hapPhcanm of the affidavit for you to fill out in the event the Office of Investigations has u Y applicant' Please be sure t4 fill in the pmnitIcense number which wfilbe used as a reference number. In addition,an submit one affidavit indicating current en ear,need a in , ' ns in an Y � �` write ermit/license licatro Y gn' that mot submitmu141 p aPP policy information(if necessary)and under"Jab Site Address"*or ap by the plicant tshouldTy or town locations be provided to the or 10ynj)"A copy of the davit that has been officially tamp applicant as proof that.a valid affidavit is-on-file ford use permits not elated to anyabffiidness commercr'al venture year,Where a home owner or citizen obtaining a P (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 t6 give us a call. The Department's address,telephone and.faxmabber: The ConMOiwealth of Massachusetts . I -rtment of Industrial.Accidents ..Office f Itivesti attons .Cl g 600-Washingtol�Street V Boston,MA 02.111- ' Tel. #617-727-4900 ext 4G6 or•1-877 MASSAFE Fax#617-727-7749 Revised 5-26-45 www,mass.gov/din 0 i • f t Board of f Building Regulations and and St HOME IMPROVEMENT CONTRA RegiS�tioh: CTOR 134:443 . it�Q� 10/29/2007 r ., ENTERp Yj e r�t !ability Co�o�tion RISES Ll� KEITH GILMORE 28 HIDDEN VALLQ MARSTONS MILLS fV11 t)2648 G.Gl` ..� Administrator TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel,Parcel .'Application # Health Division Date Issued Conservation Division ��1C. 1 (� � !U/ t1 '`'� Application Fee Planning Dept. 12 08• ' "Permit Fee —� Date Definitive Plan Approved by Planning Board !J aW Historic - OKH 0.D.� _ Preservation/Hyannis P' Project Street Address 206 4 ate. Village odumw ILLEL Owner G!f Aa1� + V l �6 I IJ ( i M Ct c�� Address to J Aeru i S Telephone •�l �—�'T"1 - 1� Permit Request 'D C� °C S WAti d GJAID(L QC f 77 NC, 9ES( 1. :4WIF Square feet: 1 st floor: existing proposed 2nd floor: existing proposed �SI otal new ZoningDistrict C ED Flood Plain — Groundwater Overlay •� �� Y Project Valuation AD. 900 Construction Type Lot Size ,�P 000 +-1— Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure ° Historic House: ❑Yes JI No On Old King's Highway: ❑Yes XNo Basement Type:>1" ull ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) dA Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 4Zd new Half: existing Al new Number of Bedrooms: N existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑ Electric ❑Other Central Air: I(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: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C) Commercial ❑Yes ANo If yes, site plan review # µ` ' Current Use e • ttq 00S I d-e. 'p, Proposed Use S A44 6 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ktLU3 S 1(J, et)MSOW(71ot ' plCj Telephone Number Address e b MY `7� License# CS 4 3336 Ff4t ntIT- 1 Home Improvement Contractor# 110'�>73 Worker's Compensation # P611,21 02110q 11�5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO *L)XA/e_, SIGNATURE L DATE II i FOR OFFICIAL USE ONLY APPLICATION# ::S DATE ISSUED " i' E,.` ;�`iMAP__/PARCEL=NO; ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' a FOUNDATION s.. ;�:: E �;ji'1111 it , i -,-- t. FRAME 0 `LILY L . AlINSULATIONI ,N z FIREPLACE ELECTRICAL: ROUGH FINAL � r - t PLUMBING: ROUGH FINAL 6:1, GAS ROUGH ' ., c FINAL LDRFJNAU BUILflINC� i*.DATE:CLOSEDOUT_J, 4 : ) ASSOCIATION PLAN NO.-. �opTHF> � Town of Barnstable Regulatory Services EARNSTABLE Thomas F. Geller, Director 4'p)�D Y9' a, Building Division Thomas perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 _ �vww.town.barnstable.ma.us , Office: 508-862-4038 Fax: 508-790-6230 PLAN REWEW Owner: Map/Parce1: Project Address LotZ SE4�A /eu. Builder: The following items were boted on reviewing: o►n C..t�r�'�Orw t t�� � r r -�-0 �k► d� CO e o -�3/. --------------- �I��I•IZ- Dom ' f Reviewed by: �• - n,,eSS4�G u1 i� Date: �z/L11 / �Torms:Plnrvw t .. . (HE Town of Barnstable Regulatory,Services 9 BI MAN.E Thomas F.Geiler,Director 039 Building Division Tom Perry,Building Commissioner x 200 Main Street,Hyannis,MA 02601 Offi6e:':508-862-4038 h Fax:. 508-790-030 "December 22 2011` ;Miller Starbuck Construction, Inc. Attn: Philip Miller 40'Mill Pond Way East Falmouth, Ma. 02536 RE: 206 Long Beach Rd. Centerville, Ma. Map:206 Parcel: 001 Dear Mr. Miller: r P This'letter is in response to application number 201106926 submitted to do work of the above referenced address. The construction documents as submitted seem to show non compliance with the Town of Barnstable Zoning Ordinance(s) 240-131.6 and 240-8(G) (2). A variance granted by the Zoning.Board of Appeals would be necessary in order to issue a building permit. Therefore,your application can not be approved at this time:If you have anyquestions regarding this matter, please do not hesitate.to call this office. Respectfully, Oi�L�&auz`on—1 Local Inspector 508) 862-4034 n 1 License or registration valid for indvid4�1 use only ' $ d� yY(xMt�. before the expiration date: If found:returnto Office of Consumer Affairs and Business Regulatuin 10 Park Plaza-Suite 5170 s ' Boston,MA 021163� ' S f 7 1l si Not valid without signa e ' � ; The Commonwealth of Massachusetts Department of IndustriatAccidents Office of Inv"dgadons 600 Washington Street Boston,MA 02111 www.mass gov/dia . Workers'Compensation Insurance Affidavit:Builders/Contiractors/Electneians/Plumbers Applicant Information Please Print Lezibiv Name(Business/orgauizationftdividual): j�t tl.�►�ijZ��A�L LCC. 49Mk- 1 4- Address: V7 , &,!2&.h V rt►c Z o�3.i City/State/Zip: &_JZV40 AAk Phone#: Are u an employer?Check the appropriate box: 'Type of project(required): I. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction " 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' . Y9.)4-Building addition [No workers'romp.insurance comp.insurance.' required.] 5.❑ We are a corporation and its 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all work_ officers have exercised their I L❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]3 c.152,§1(4),and we have no cmployees.[No workers` 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the sectim below showing theirwprkers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work"and then hire outside contractors most submit a new affidavit Indicating such. 20ontraetors that cheek this box must attached an additional sheet showing the name of the sub-eamtcactors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. Ism an emp/Dyer that is providing n+orkers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: R• H•S�itXt/YC� Policy#or Self-ins.Lie.#: WC d-4Z Q c J S Expiration Date: --1.-7--ZO 1 �- Job Site Address: { City/State/Lip:, CaJ f LQ Je, M A' -- Attach it 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 e,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 line of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains and penalties of perjury that the informadon provided above Is true and correct i a e: D to h, ' Phone �a3 1 Official use only. Do not write in this area,to be completed by city or town ofciaL 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#: { ACORQ, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDbNM 12/07/2011 THIS CERTIFICATE 18 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 13ETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED,the polloy((es)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder in lieu of such endarseme s. PRODUCER NAME Nen Vosburgh Mason & Mason Insurance Agency, Inca acNoe : 78i.447,5531 A1C,Not:781.447.7230 458 South Ave. . .. f ED RESS: Whitman,.MA 0238z PRODUCER _ sTo,Nt Gwen Vosburgh INSURER AFFORDINGCOVERA©S NAIC6 INSURED INSURER A: Main Street America Assurance 29939 Muller .Starbuck Construction.Services, Inc INSURERS: Star Insurance 000204 PO Box 726 INSURERC: Falmouth, MA 02541 INSURER D INSURER E. INSURER P: COVERAGES CERTIFICATE NUMBER: II/12 GV built REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 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. IN ApoL R P EFF PO P LIMITS LTR TYPE OFINBURANCE INSR AND POLICY NUMBER MMID MMloU GENERAL LIABILITY MPF1100. .1210112011 12101/20121 EACHOCCURRENCE Ti 2,000,000. X COMMERCIAL GENERAL LIABILITY LIABILITY PR p�ES IEa oequtt $. 500,0001 r ' CLAIMS-MADE , -' OCCUR MED EXP(Anyone pafson).. $ 10,oO A PERSONAL&ADV INJURY, S 2 000,000 GENERAL AGGREGATE & 4,O0O 1— GEN CAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY JEC LOC $ AUTOMOBILE LABILITY COMBINED SINGLE LIMIT (Ea aWdenl). ANY AUTO BODILY INJURY(Par person): " ALL OWNED AUTOS BODILY INJURY(Per eadldenl) SCHEOULEDAUTOS PROPERTY DAMAGE $ (Par awident) HIRED AUTOS NON-OWNED AUTOS S UMBRELLA LIAR,' OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTION I S WORKERS COMPENSATION WCO220915 03/271201.1 03/2712012 W0Y'IMI�� oTR AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERAXECUTIVE� EL.EACH ACCIDENT $ 17000 00O B OFFICERIMEMBrR EXCLUDED? N 1 A (MerldetaryInNH} OFFICER TS INCLUDE E.LDISEASE-EAEMPLOYEE $ 1,000 U0 If as describe undor E,L DISEASE-POLICY LIMIT $ .] 000 00 D GIRIPTION PERATIONB slow DESCRIPTION OF OPERATIONS I LOCATIONS I VENICLBS(Attach ACORD 101,AddlBanat Remnrka Sehedule,If Mara apace le rgqulrod) peratians: carpentry . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED. IN ACCORDANCE WITH THE POLICY PROVISIONS. Town' of Barnstable I- AUTHORIZED REPRE NTATIVE, 200 Main Street 1 HyziInnis, MA 02601 David H Ma Q 1 See-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Of THE Town.,of Barn-stabbe t Regulatory Services �Thomas F.Gefler,Director , • `' �En Building DIMSion , Tom Perry,Building Commissioner ' 200 Main Street;Hyanais;MA 02601 www.town.barnstAlexja.us. - Office: 508-8624038 ,,- :Fax: 508-790-6230 - Proper"-t-y Owner Miist' £. Complete and.Sign This Section' _ If Using A Builder I Owner of the subject prnperty ' hereby authorize I{-i.eRS &JC;K (�f� 1�1C-77 t}ll�Midi(moo act on my behalf, x in all inatteks relative to work authorized bytlus liuilding:pexxnit application for e TLY / Slgna e of Owner' Date --r , , 7f Property Owner is'..applying for permit please complete:the Home wnersPLiceriseExemptio:n Form on;the reverse side, Q:FORMS:O WMERPERMISSIOTI ' e. t n 1assachusetts- Department of Public Safet% Board of Buildim-, Re-ulations and Standards Construction Supervisor License r License: cs 43338 PHILIP M• MILLER. PO BOX 726. �k FALMO.UTH, MA 02541 �--4— Expiration: 3/14/2013 (bnunisiuncr Tr#: 10515 ----� .ice >° Office of Consumer Affairs&B mess Regulation < HOME IMPROVEMENT CONTRACTOR Registration: --�A10373 Type: VCLR Expiration: 10%20/2012 Private Corporatio oTARBU 1S�fRU_-gh N,INC. PHILIP MILLER JR� +` 40 MILL POND WAS' EAST FALMOUTH MA,-4 m Undersecretary _ K 5. JOB �.c�tJQo-'� Ld.�✓• ( Lj TAYLOR DESIGN ASSOC., INC. SHEET NO. L OF P.O. Box 1313 «�•• { fob Forestdale, MA 02644 CALCULATED BY �Z \ DATE Tel./Fax: (508) 790-4686 CHECKED BY DAT _A zo i® t•eyla �.C�7T��6/ SCALE OF ,..._.... .. C ..... ........ aC ...._.. . .._. sm TV_ z. : _........_!..._-....._.._..._..... ...... ..... ... ...... .............. G. .._--....,tom:®... .�_�..... ... t 5 X_v 01.5 _ . tie .... ........c9 t..... t fz .............. .... ...:......... .... Ir .. .......... ........ .. . . : .. ......... ..........: . ... �-- ...._ - - - .... ....:.... ►. t�..�.... ( . ..p :> ... ........:. . 9 4ey � V_f-A 4.......... �o.v.iv-c.crr�..++�.i�>t�,oat..�'.�-._I�-t.1.�?.....,...:-._....... .�c�4_ . ... A..' —t r`f(. Ir ... . 14 i q��pTNE Tp�� Town of Barnstable �7 O� BARNSTABLE. • Regulatory Services 7i MASS. e t619- Building Division plFD MA'S A, 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection _J-I-5(A LAc�6 rJ Location -� '�� Q QA- P-A Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: NO Please call: `508-862-403-8nfor re-inspection. Inspected by Date 1ZLI( 1 � MOWN OF BARNSTABLE BUILDING PERMIT APPLICATION" Map `.�C�cO Parcel Permit# Health Division C rc f 01 l N a al Fee °06 of" roa.xS' �av� Tax Collector b� Treasurer Planning Dept.. 45 Date Definitive Plan Approved by Planning Board ` Historic-OKH Preservation/Hyannis f Project Street Address E�r�c, Village Owner ✓Jr /Kjz —, Address AV(. Telephone 7 7 Permit Request-" A2 It Una 5rg_dcr t eC6 -rx &aeAre,,g� tW66 4y ,v✓mgr 4 1?e Mr 1?,o(e Square feet: 1 st floor: existing ' proposed 2nd floor: existing /L proposed J 'Total newer 5 .Estimated Project Cost YD p Zoning District Flood Plain Groundwater Overlay � Construction Type 2 c AV a Lot Size 2 /�GY� Grandfathered: ❑Yes, ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family .❑ Multi-Family(#units) Age of Existing Structure -s Historic House: ❑Yes No On Old King s Highway: ❑Yes G�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 1 -� new 1 First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �6 No Fireplaces: Existing / New d Existing wood/coal stove: ❑Y No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size _�- ' Attached garage:Aexisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes XNo If yes, site plan review# Current Use --Sk +tee✓ ,o Proposed Use eS ,k-►n e-., BUILDER INFORMATION Name /y� �'✓ -S/2 �'� //o'''� Telephone Number 6 g S 3 cJ- a y Address_w �� 7 � License# C S 3 3 3 g �? 411 / S S D a1 ���l Home Improvement Contractor# ) )T5 3 '7 3 Worker's Compensation# IN wA 19 S l a L/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO `.l� SIGNATURE DATE r , t - t _ o FOR OFFICIAL USE ONLY _ - RMIT NO. e ? DATE ISSUED MAP/PARCEL NO. ' VILLAGE ADDRESS ,,, , OWNER r ,4 DATE OF INSPECTI ' FOUNDATION FRAME INSULATION 2i i i FIREPLACE E ELECTRICAL:, ROUGH FINAL u a PLUMBING: " ROUGH FINAL- GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. , . IHETp� ' The Town of Barnstable BARM6, Department of Health Safety and Environmental Services t639. °TEo,�•.. Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection .2 ---�— Location co ji,, al Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. 6 The following items need correcting: ( `-t- Cod} �-s 4 s4-T-r CA— �a n I&M 2 2CZ 0 Please call: 508-862-4038 r re-inspection. Inspected by Date G 2 5 2 0 0 r THE tq�,� ILI 'Y • The Town of Barnstable �rrsr�sLe, t 1659. Department of Health Safety and.Environmental Services FD nnA+° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: >,..7 Je,1 Estimated Cost Address of Work: S c: e Owner's Name: t)l ✓ 1�� z C ' Date of Application:_ f1 - I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied rzOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I I hereby apply,for a permit as the agent of the owner: 11(� 3 f3 �� , �k,w b.�✓ Date Contractor Name Registration No. /wo"5 e OR Date Owner's Name q:forms:Attidav .---' The Commonwealth of Massachuseln Department of Industrial Accidents ::_-.�. • •— Offlceol/�esUgat/oos 600 Washington Sheet r-` - Boston,Mass. 02111 workers' Coal ensation Insurance Affidavit ci S_S• C� � Jµ v w 9- S . ❑ I am a homeowner pedorming all work myself ❑ lam a sole etor and have no one................... 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I do hereby ratify wider du pains mid p of parry that the information provided above i r trw andd coffedq Sigaatme / Date Print name , Phone# ------------ of rlA use only do not write in this area to be completed by city or town omdal city or town: permitillcense# OBuilding Departnmt QLiceatitg Board ❑checkif immediate response is required ❑Selectmen's OIDce []Health Department contact person: phone#; - ❑Other 0avam 9195 P1N 1 � •• � 1 1 � 1 � 1 will I • - - 1 • �• • •11 1 - 1 a / / • ' oil�• a • •1 1 1 - • 1• 1 tit It• " .1/ •'••1� • t w••• • 111• �• • • 1 till • 1 J / / % 1 1 at 1• • e 11:/ t • •M .1■ •1 • •• • •1 • • 1 - till 1 • 1 • • • 11• • 1 - • " ' • / • till • �• 1 • Ii :1/1 • 1• 1 • 1 ' 1 J: • .�will Y. • • 1 �• �/1 • • •I It wl • • • 1 1• 1 • k VION4q,4049W. •M • •1• • • 1 - - •I% :111.1 :attn • 11 • GIIU • • • 11 • • 1 A • • • 1 • 1 • 1 11 • 1 • 11 • 1 1 1 • •11 wltl t 1 1 • w •:.� 1�/ w/11 • 11 - • 1• 11 • 1 / • 1 • 1• • 1 • 044 1 • tilt ll• • •a •ll • 1 • 11 ki Ito till 1 Y' •II ■ • •II • " • • •. •II 1Welffs oo,, 1I • 1 • • •11 11 L • It• • • / 1 • • • 1 tilt 11 tl w/ MUS1 1 • ► • I wf1111 • 11 till • /iw.11-• • 1 1 w111•I • 1 • a • •11 • Y.1r—'91 11 .1 1 rl oLjli t4L.jqwl 1 1 1 1 11 1 1 1 1 1 :.. 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I jjjjjjjjj��j�jjj/jjjjjjj��j��jj�j���j��jjj�j�j�jjj�������/�� 1 1 • k •11 w•Il • so w • 1 •II 1 l •,•. 11 111 •:t 1 1 11 11 1 1 t 1 •`- ' 1 111 1 1 1 1 1 1 1 1 I I 1 1 1 1 1 1 1 I 1 1 . 1 Ill t • ' Il It 1 ' 1 - =CZMAfPwWkj TaWo.&=( vet Front ipttM P2Cknes for daa and TwOWsmily Readeaulat Buildlal�Sated with Fad FaeL MAXIMUM M1211MUM cc cdriss Will igmw 11— Slab H B ) n valoai t4wlae &via` &"fue, Watt Pdmm yy t'admae &Vafwo wvaww 11"I tome Heatfax DeEeee Data' g129A 129A 0AO 13 19 10 6 Normal am 30 19 19 . 10 6 �r°al 12� —OM 3tt-- 13 19 l0 6- NAFUE 15% 0.76 1: 13 2s WA N/A . Normal IL46 g 19 19 t0 6 Normal 3>91 IINi4 �� ': 22. Fins :�::. ftS AlZ]E5% 03Z 30 19 19 t0 . 6 WAM >r/. a3Z 3= t3 23 NM W Narnmi a's OL42 3= 19 25 WA wA Normal ots 0.42 311 13 19 t0 6 90AFUE ars 0.50 30 19 19 10 6 90AFUE 1. ADDRESS OF PROPERTY: G► �� te— J- f" P s S 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING,AREA(#3 DIVIDED BY #2): •3 S S. SELECT PACKAGE(Q—AA see eh above): Ale. I, NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a F 780 CMR Appendix J Footnotes to Table J5.1lb: i ts, and Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, sky igh basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wa11 .U to 1%of the total g area may be excluded from the U-value requirement. area,expressed as a percentage p excluded from a building design with 300 R=of glazing area. native ass may be exci g example,3 fl of deco g1 Y For p e, b s After January 1, 1999,glazing U•values must be tested and documented Y the manufacturer in accordance with the National Fenestration Rating Council (NFRC) Lest procedure+ or taken from Table J1.53a. U-values are for whole tmits:center-of-glass U-values cannot be used 3 The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thicimess-over the exterior walls without compression, R 30 insulation may be substinited for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placd.between the conditioned space sus tic vwddld pG dOn of tha.•O :: 'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R 19'requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing..Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. I The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. "The entire opaque portion of any individual basement wall with an average depth less than 500/a below grade must meet the same R-value requirement as above-grade wags. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements:are for unheated slabs.Add an additional R-2 for heated slabs. •If the building utilizes electric resistance heating use compliance approach 3, 4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.1 I a - NOTES: le levels. a)Glazing arras and U-values are maximum acceptable levels. Insulation R values are minimum acceptab R-value requirements air for insulation only and coo not include structural components. b)Opaque doors in the building envelope must hw-9 a U-value Mgmater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door tt•value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement e, wall lue component includes er two or more areas with c)If a ceiling,wall,floor,basement all, g different insulation levels,the component complies if the aria-weighted average R-value is greater than or equal to die R-value requirement for that component. Glazing or door components comply if the area weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 { ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE 13 square feet X$55/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X $20/sq.foot= DECK % li square feet X $15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost g990915b 4 h Safety and Environmental- ,,-, ` ,_1 Building Division I ' tLAPPWAI e. ' 367 Main Street,Hyannis MA 02601 �►sa 1659.t� Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION f p q Please Print DATE: JOB LOCATION: ® number street Lj village �1 "HOMEOW ? �yNER": ll ✓ /�!12 0- .✓- rl d j" /n,S'_ �7/'/// 4/7" V24/ nam home phone# work phone# CURRENT MAILING ADDRESS: 2q V—e . cily1tovd. 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) T1-.e 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 d require ents. signatdie o3mom&wner , 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. Q:FORMS:EXEMPTN 1 Sid CKE DETECTORS 0.1.. .C.J� T- T ( IJ 1 -__---.--_ 6.6..xrt'i J' ./."�.i -•-�-Pri •. 1 I I L!w .� ' c nNt141_ / N 'rl�(2 s , h•. 1 I41 i I ( ( i 1 Te jr --------------- 1 j W�MOaL.1S TI.T.1 FaOGG ./dfT.S . Tel �______ _ .:_____•__ �. __' � 9.4:M^'i j IOZ - __ _— __ __ �AHIE STTwA o �_. i. TF/1ro •n: ,y�'.,0 6i•� - ___ 1 �--�_�' EX IST 1Jt.1-tali--[b lCA A/•..�1 ib��y�» �4W V ` - •'9 ; f .II.W 6W 6�5t(,Jp W..ua.b - Cw.+ - 60- � "-- � \ 1.1.-is ... � '+=•P _ i � PHONP J4c.1� �F� �� tiE W_POICGN �?'� ZD(o 4.o�C IJc1\G[-1 'iS G4. 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Q �-- - ',> - .• _..m \� I a I ��h v ��' �" 1� PS 1. � _ _ IN u1 tit �� � 1 ry l L1.'U Ei�t♦f�1• :. .� I I I I gxl 41w - � - K LG as E✓-b 4Ah I 12 4 — _- -- III s I Tr fI —. ..... . wm ' - ---' Q �J �J y_ a�.T?u�-.cjacaav�02•FTzogAwGl W,.I,o, $ (b� 1"L.iA1- ILO�F �K4M1��•f �4".14 - I V ggg I � VOA VA 'C ) C L.. I d ��Ni14✓ 1�1 o-fe•41 - � - ,. .. pvu,wAw _ _ T - p OINDAnon noTM � � • l L m d,U'Mow finish aide.nr d.1p..d - 1 `ii'c-(Q 1. 12'u2 plrts.-J; W I� I. All fm,daom,finings s1u11 be amd dean lo.m�nunn fw,im,"IW disign slusm - n .. ' mil_ - r_rr.to cbvnauR wtl prarng posmmdlloru l,c'V'use ^. 4 MlvJFs,�'S3©Gli F bvtdonW rcd salbenna sa0rtirydlsmol11 Pest re fed bN inn gMdfvi nuserisl wilba - yFTra I z :. nlWfod nos stun t<dsadmnndm.,bm I;a WV q-'.!1 BOT ,mu d Asnsns of 93%. - �IL'( II.W',�DI.1 tIJ ItW Goa.d7. ��/Eslfsl GK'4 Fru.� V -F ). All foWvg dull be lwmd in lb.dry*MY. <. !lo fooling dull be W"rd r Doan annmd. - ... .• W-`ry s. nr mi m radon ng r«.n famdgnm_11,pun a x-x,inn n,M uP•d uollwn. Dar FT 4' E t muinuors a ssOh nmdssaflsaa - - _ P - M,J.G�O I!'aa•q!�' 6. L.V sllbrtiO eian,dm.d P°'r�aasc ban. - - - - F,J INN GM1�OL. - - F 7. An,dnfaan,cm:ASIMA61760,VM'FAIgs. CONCRET%NOTYS 1. All ,ydmom wwpmhw gmnglb of }a W 1W in i 3. Iduimum gom9 pull nos elmod P:sd msaimum m,rtc eggrwplc sia Wsa nq esmd _ _ _ • ' - - l di.. 5. All corcsge gebs shall be P-W in 9g0 4'grt rslm W nels.nunnmlm:a.povidc .. t ' .�- oaagrrelxslnbaldlcNe9onnxbgi0 nrOOD NO7YS: .. - . a .. I. All lomM 0.111u t.molglne,psllmldgolsmrtllan 19%- e• e, r - .._..._. _ 2 AlIV6AIllumM dull he 6PP.ahcllnMvl°a�mm�mnm. - - - - �1,00O 9A.f-io pal E-1,500,�Yse. ddxmin' n .. - - - -.-- 5. All L V.L.lusobes dc-W m PIM g54.wo Pd.f-235 pi.E-2,0o0A00 pi. - <. All),-W—shall havw9nerosvdl'st'gm bridging midspsn sd,w swat lbsn g'-0-o.c. S. PmAdc solid Waging a blo kiry q 0 b adf�u/le grtngW. _ I U)'.. T 1 6. Psovidc u—nY aWl W°blr 1. All col—A76.slat OIM A66 Ded.6.. 5. Edli.A525.mlhm bolls:A107.. _ - - i A40* _LT _ - (I I �71 • jj f Ir _ S { Assessor's Office(1st floor) Map Parcel Conservation Office(4th floor)(8:30- 9:30/1:00-2Q00) Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45)T __X?4G1=� Fee HO Engineering Dept. (3rd floor) House# 2 1NE Planning Dept. o, /School Admin. Bldg.) SEA $T BE IN ST B.�NCE Definitiv an A rov by Planning Board 19 g NVIRONME CODE �� TOWN OF BARNSTABL TOWN R1 ,77 P�R n� r., - , Building Permit Application , Project' reet A ess o, Village Owner v- Address L-11 b J C"L'A Telephone Permit Request q First Floor Q a y 0 square feet Second Floor square feet Estimated Project Cost $ j aZ 5 ,,QO 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use _-<'c s�tQ,•-. I- \ Proposed Use S c.�L Construction Type i_)Or)b Commercial Residential Dwelling Type: Single Family v. Two Family Multi-Family Age of Existing Structure 5U-+- Basement Type: Finished_ V\IOV\L Historic House . Unfinished Old King's Highway Number of Baths +; No. of Bedrooms y Total Room Count(not including baths) First Floor Heat Type and Fuel G a S Central Air Fireplaces (. Garage: Detached L),V\,(9 C ✓ Other Detached Structures: Pool 7c Attached Barn X None Sheds k Other x Builder Information Name I �ffn�G:3 �_.. �("�oc,c, v _ Telephone Number 7 S 2 700 Address '-1 j?��,,, �,,,,� License# 6 �2 (Q -7 / ✓���'� l /1 Home Improvement Contractor# ZQ O-7) Worker's Compensation# e�a l p-e4 P3 z I-r/UG NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRISRESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR TH FOLLOWING REASON(S) Fk FOR OFFICIAL USE ONLY - _ r - PERMIT NO. DATE ISSUED , MAP/PARCEL NO. - ADDRESS VILLAGE r OWNER ' DATE OF INSPECTION: + FOUNDATION 4 _ FRAME - - INSULATION , FIREPLACE' - t ELECTRICAL: ROUGH FINAL w , } 1 - PLUMBING: �OlGH M FINAL GAS: H CC C, FINAL , FINAL BUILDINGoff DATE CLOSED OU r to 3 i j} 'ASSOCIATION PL r i THE I; The Town of Barnstable SAE.MASS. Department of Health Safety and Environmental Services $ h i639' �e Building Division 367 Main Street,Hyannis,MA 02601 i Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location � f Z-LZBe4.,tt5j Permit Number Owner Builder (� One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Q l a o S In Q, c c a d 6 �. \-JD � Clea✓l. V �Fjnn k-kJ Q e2i&LA-CA, N--�o &A& b, M 611-U (L 6 - 61-J Please call: 508-790-6227 for re-inspection. Inspected by Datelr A t e 7 .Y'• w The CUnlnionwealtlt of Massachusetts • l ,s..lit.__:=`_ __•.�� Department of Industrial Accidents �:I A . ii tj;?' 600 If ashittrtnn Street � • :• Bustnn,111itss. 02I11 Workers' Compensation Insurance AMdavit _w Please PRINT',e jh�y z','. AR�iJc�nt mtormation _• • name �fG�tic,�< ► r l�c� location- ;1, phone# —2-2 220Y) cin Ce � ���. �. ' V►' `'tl 0 1 am a homeowner performing all wort:myself. 1-1 1 am a sole proprietor and have no one working in any capacity _...ASP.- .�...e�'e!^-eTr:.T7T— :.: ^llC�. .. .•. ,.... . .. .••�.a.ar,p. Q-i am an employer providing workers' compensation for my employees working on this job. n c, cam. d- �l�L address L-1 y 'x C,«A` sjj)• C r �., v,LA_ phone#• +�"BL U U mcorince co policy# / /i/0-bR--73/Zf /U/.--Q -9S 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired= ontractors listed below who have the following workers' compensation polices: comijany nn e- address• phone#• policy# - .•. -- Tar" •ne,-ear•r•s"�T•eZ•�er•+SGa.or �I�4GPi�Jr47� 7t'TT"A4 rn..re..r +.� comnanv na e• tiddress: cite phone#• insurance policy# ;Attach addiddnal'sheef itaeeessa Faiiurc to secure coverage as required under Section 25A of 1%1GL 152 an tend to the imposition of criminal penalties of a fine up to S1.500.00 and/or one.ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me• I understand that a cop),of this statement may be forwarded to the Office of Investigations of the DIA for coverage verifleatioo. I do hereht•certify under die pains and penalties of pei jury that the information provided above is true and come Si_naturc '': Date Print name C-,� � r . Phone# -7 7 5 a 70U r official rise only do not write in this area to be completed by city or town official cih or town: permit/license# nffuilding Department E juceusing Buard check if immediate response is requiredMee Selectffice p tme' Ofialth Department g contact person: nOther phone#; (Mired if9S PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for them employces. As quoted from the"faw", an cmplityee is defined as every person in the service ofanother under any contract of hire, express or implied. oral or written. An cnrpinrcr is defined as an individual, partnership, association. corporation or other legal entity, or any two or more the foregoing engi,,cd in a joint enterprise, and including the le-al 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 dweilinL house !raving not more than three apartments and who resides therein, or the occupant of the dwcllin,, !rouse of another who employs persons to do maintenance , construction or repair work on such dwelling lion:: or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or 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 in coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter lm. been presented to the contracting authority. 71 .. .�.—.. _ .. h:: .—�s!�:'•.'1" i17�:: .•i:r.�•7.'.+: �S.•:: 777 ^" _'+..� ..��. Applicants Please `;I1 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. ..,. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant_ Plea, be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be.returned tc: the Department by mail or FAX unless other arrangements have been made. The Office of inyestications would like to thank you in advance for you cooperation and should you have any questions: please do not hesitate to ;give us a call. 7.i. .. _ _ ..+::�i:.b: .•..e..' :fir 77. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents - Office of Investigations 600 «'ashington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 I Assessor's office(1st Floor): Assessor's map and lot nu bar (� 0 / j THE � eyoT Conservation Board of Health(3rd floor): ' ti asaEMaiL Sewage Permit number Engineering Department(3rd floor): o�sa q. House number ,o esr r. Definitive Plan.Approved by Planning Board t9 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only, TOWN OF BARNSTABLE 6UIMING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 l Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following in rmation: Location Proposed Use Zoning District Fire District Name of Owner eL AA OAI Address Name of Builder ��-�L/ / Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost v " Area Diagram of Lot and Building with Dimensions Fee �®� ---, I i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the abo cons a n. Name Construction Supervisor's License I���3 OHNSON,/NANCY- _ r Now- Permit For RE-ROOF /SIDEWALL + Single Family Dwelling Location 206 Long Beach Road 1 Centerville Owner ' Nancy Johnson Type of Construction Frame + Plot Lot Permit Granted August 27 , 19 92 Date of Inspection 19 ; r Date Completed a)a y/ ��19 i 4 , ' � Y I I a I COMMONWEALTH DEPARTMENT rOF PUBLIC SAFETY -- ' aOF MASSACH 1010 COMMONWEALTH AVE. USETTS SOSTON,MASS.02215 I • EXPIRATION DATE ' LICENSE ENCLOSE CHECK OR MONEY ORDER 06/30/19g3 39t 3 i CONSTR. SUPERVISOR FOR REQUIRED FEE, I RESTRICTIONS EFFECTIVE DATE I NONE L►C-NO. 01 MADE PAYABLE TO 06/30/1991 ,;001394 "COMMISSIONER OF PUBLIC SAFETY" WILLIAM H COVELL SS At 014-38-2532 26 EVELYN CIRCLE n (DO NOT SEND CASH). CENTERVILLE MA, 02632= p EASE #OTF�FE,E. INCRE PNoio oN�rl FEE: 100.00 ASE f •�,fy�'f% HEIGHT: NOT.vnuD UNTIL SIGNED B - O -E r LICENSEE AND OiFIC1A E C T I V Llr ' 198- 9DOB: . SAMPED OR SIG`ATUR 1 F THE CO M R . - . 021948 THIS DOCUMENT MUST B'G - CARRIED ON THE PERSON OF ) NOT ' D E TA C'H�'L, ►1 l�OTHERS RIGHT THUMB PF,P1T THE HOLDER WHEN ENGAG S NATURE OF N i7E STUB ED, IN',Tt11S OCCUPATIO EE J« SIGN NAME IN FULL,A80VE SIGNATURE LINE I M-2n$7 81429 per, AM/�!`4C� COMMISSfONER F l r � . 4VAL w 1 rn U N LLL1 f NEW SHAFT ROOF Z 1 �IJ- O VVF OMME71 E:Immm o0 00 aaoa z oQ . ME=M OWE ooao LL� z J Z~ W _I EAST ELEVATION WOW W F- �v SCALE: 1/4° 1'—On (Y— O ON /Al v J08- 1101 DRAWN SY: KW PERMIT SET DATE: 1/13/12 e1 � w 3Q 3!Z INFILL ✓ ' I ILL EXIR NF > a, EXISTING DOODOOR FM� MIRY PIER S �CEILIN4 WiD / REMOVE w v HEIGHTj STACK WALL RELOCATE OVE EXISTING WALL z O WINDOW V 1 O BATH ® a BATH RELOCATE ° EXISTING FLOOR t0 EILING WINDOW 3Q C JOIST CUT OUT EXISTING SLAB 28' 8" Q HEIGHT 6' GREATER THAN THE 41 3/4°4 3' LIFT n, m v FOOTPRINT OF THE MACHINE. OL O v ' 6° FOOTING W/ #6 REBAR LIFT W-1 1/2° 2' 5° 12"O.C, EACH WAY. TOP OF rer v a n = { FOOTING 2 LBELOW TOP OF EXISTING V 1 x S2 .xs 77, co s i U { BASEMENT ENTRANCE PLAN FIRST FLOOR PLAN EXISTING FIRST FLOOR PLAN SCALE: 1/4" m 1'-0" SCALE: 1/4" a V—O" SCALE: 1/4" V—O" { ( UPPER ROOF DECK SECAOND • OQ 1 3 � Q • Q OQ ROOF ACCESSS FLOOR Q DECK Q ` - _II ROOF DLu ECK T� Lu WZ� Z _ 3Q I I W O Z Q —1--40 P, J W ELECTR� � o AARDwi0 AMP SE LINE GE AND CANTROL� LIFT m WORK LIGHT W/ PULL CHAIN Q INTO THE TOP OF CONTROLIFT v AND GFI OUTLET CENTERED V PANEL. CONTROL PANEL REQ. W-1 1/2' ON THE CEILING OF THE HOISTWAY CEILING 10 1/2"X42" R.O. TOP 72' ABOVE I ACCESS CEILING MUST BE MINIMUM q8° ABOVE UPPER u FLOOR. CONTROL MUST BE NO HAtGH LEVEL FINISHED FLOOR MORE THAN 18" FROM STRIKER € ,:. - SIDE OF CONTROL ROOM DOOR. SECOND FLOOR ROOF DECK PLAN SCALE: 1/4" 1'-0" JOB: 1101 DRAWN BY: KW PERMIT SET DATE: 1/13/12 • ' A 1 1/2`ZIP PLY SHEATHING/ 30 YEAR ASPHALT SHINGLES MATCH,EXISTING .o TYP_ WALL z SIMPSON442.5 FASTENERS A �' l FASTENERS AT ALL 2x6 • 160O.C. v RAFTER / TOP.PLAT WIND STORM VERTICAL 5 JUNCTIONS TYP. VERTICAICA WIND PANELS WC SHINGLES MATCH EXISTING W {+I EXISTING PARAPET WALL TOW ENERAT EXISTING ROOF DECK W (f - - ==-- - -- -=----- 4 -- ------------------- MIN �' ABOVE FIRST FLOOR L—_J 7 z SHAFT HEADERS V 1 (2) 9 1/2' LVLeLn O O `F i 6/8' FIRE CODE LEXISTING FIRST FLOOR W/ JOINTS TAPED AND FLAT ROOF SYSTEM z i MUDDED 1 Q � �co O= FIRST FLOOR. 0 FIRST FLOOR SHAFT HEADERS (2) 9 1/2' LVLs i i EXISTING FIRST FLOOR FLOOR SYSTEM Z _O Q LIFT SYSTEM BASEMENT Q 4 = i U W O Lu Z Q ma O SLAB U - Jz W —CUT OUT EXISTING SLAB W Z (f) 6' GREATER THAN THE W NEW RE—INFORCED SLAB FOOTPRINT OF THE MACHINE. �— U 2' BELOW EXISTING SLAB 6' FOOTING W/ #S REBAR Q W/ #6 REBAR DOWELS t2'O.C. EACH WAY. TOP OF INTO EXISTING CONCRETE FOOTING 2' BELOW TOP OF 0 FOUNDATION WALL EXISTING SLAB. • U 1 SECT I ON !II SCALE: 1/2" m V-O" /A3 JOB: 1101 DRAWN BY: KW PERMIT SET DATE= 1/13/12 • 4P NEW COTTAGE : STYLE DBL HUNG (3) FELLA DH 2965 ?/1' WINDOWS. - COTTA6E STYLE R.O. 29 3/4"x65 3/4" : FAMILY ISLAND IBM .I ; , KITCHEN .. - r ED RELOCAT x ,. • . J ISTING GAS. (3) 11/�18" LVL BM ABOVE • J ---- --- - --------------------------- NON-STRUCTURAL . COLUMN + BEAM I . ROOM DELINEATION' z PANTRY ., WET BAR DINING LIVING PA i ,i• d4 z 1'\\�""`jam\ I. I io V _ , V a a a d. r `.l §a mog WOM if MIS �� ,�. �� , �N' I •_.,�u���- L ".�,�'_'+� ✓y 3fi- §,.� � .�a2- �°� ma's.. jj r. 5• Y c H 1 z : ti., r E_ '" „ ,._.� r, - . _, 'Leh r .>• _; .,a7"o-4 _« ...x.... .. .. - , ., ..-c s .a..<,. : .,_ \ 4 `4.... ,^�->._. -s_.c _>. z .. �. .. _ r_ _ ,.c4 �:: ,/....•c:f _�:--f .�,-_..heel ,w.. ...:... .:._ -. .. _ a,. -y - j. 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I , .. .-..,. ___, .X ST. c ._.: .:. :,.... - eicietir :bu' dt im n n-,., - .., .. .. ,..-. ._..... :....... .. _ F I W cC Ca-k- -rs .3. tY 1 .. - -.`. -r,. - '.i ±b .. :_..,.... y:_ ._ .,.r.:r o -_.,.,. -'io',:4o:e3nstruMion<,:Disere-... a., .. .._. ,..:.. - - .r. - .._ e1., - `Pr .Den a;h - _,..... � .a .. ..:.,, _. T�-'F=,�_ �.. r� �cies'.be twreer.�trte. n __.. - _ -. - n. -.... ... z _ diaerisions.:.and:field;'nerified�dimersionsao.De'Dre ...,: _ - :_ -..> •'ft�e [SLD Cfck _ a: r:__t are t$ :. 'I r1K. - - -I - - - Ito'the attention of:tAe..ErlgineeP:'.Drio .`tc.:coitstruetior ...., ,:.,r:: :.- ...•.. .a-,. . , r I :. -,,..;., .. ..:�- _ n KF,PI/,' Edl�l.i'rtTIG - - - d) _ '=The` iieeer'srial be'.,cohtacted=.b tha:Coritracfdr-'infield ..11 . ,:.,._,. , .' :. .. - Plobr:after house' . ,.,... :..:._., ,. „ r .,z-. _ ifp a amid be Pirst .,..,. 1>. I . - - lifting 1 a.:,. ,-, . ,-.... .--. r, .. ,. % - ..._.-. _ : .. a�d'_shoring ot:all _ I _ - _ vtingsa components Lo permit,the,- exla d-new .rYC tur C . : _ ... ( _ ( c - - , aaoe-.install tionsa_nd.comrary etr 6 I � - �-,n. 1 _ - _ '_� -damage dasage-to. ro rt and witDout n-of all:vdrkrilhout I,_� - - P Pe Y jeopardising tnesafety r -. - �. . - t �I of any persons) . r .: - ..eXFZT.�:C. U..T:.F.). 11 ( ... _ .. :,. - �" ::,.' .. e:,% .;::... s .I mI pl �1 - 2dndre con ressI ve'sire the f c_i000 si�m .m r. Gn _ 7 11 ay >n u ::: :.... „ s' �+ ____ �-:wr ,r, _ `Use 3/b•;maximum`aggregates oI'hard stone." Minim='. _ — },..: : -• --- - - -_I ,; r�1 - 1 - _..cement,factorx 6,00 9u,T� -sacks per cu p3.-of Concrete .. _ - - --I .I-jf) haximum,s I - - - - `noC TI H4 Bt;%LOr�1:D PATIO I ,. - tW .f I 1 - - ,,8 einfo^tine Stoel: New billet steel, AS_, A6i5• 6:•ade-60. '.O - 9&1->` __ I - i-xi J ai II - : A11' bending details and bar clearance to conform %?th . . I E.. - I -.3 NI ai , - _ II latest reyuire�ents of the ACI 2uilding Code. - I . -1 I _---__. I:. I bI - . Provide additional:'einforc4nr around opening_with . ,-_ +I f Ir. I - ., -r:G. >c!i_ �•_ Z ea. .xc"s -_l, 5 eG sP:�e __iy _ lopmen lerxgth heYon? sr.ch ogee^.:rxbs. c•I .5 -su ficient tleve t i �� - _ - �` T �T - - «. _ r-arid. ¢4 horitontal corner Lars, 2'0- x 2.0" f 12" o.c. - '. i I f ' I t- 1I 1�- �; ve .ically. near projecting corner face of concrete walle. . __tom 1 I 1 `}�,+. r I �) N - I r _1 .- , r ) rr l- r --I �r - - -9.: Pr vide teaporary drains or trenches far oa<_s=.ge o` wit-r _r � J I Pr 3-2-.';e^ rr+•^�•'�'>rs. rr . f ��11 -_ ! �, ----y-__.�.-. _ _ kv i'_ding ezcavatiors and su;,grades to tempura-,y -I. 7_ I---. - '-�- -r- , 1 ;-- �..:1 I - s:.p er other location to i:Esure interior drainage i 1 I 1- _-I 1 I - - J I r'J L -J I_) I I dur_r.g con_,. u^ o :<: 1-1 1 �, �%F F� fY•�YL • r4J _IA_..,, - I 10. :�ocrLe._: ,e s r treated Sout:^.ern nine. itF. b iJi�J 1 -. T yr2-Su a:a��r 1�! W6DRJ ED ''�-:9 G'_.,Ju F or better. rl corSea� =hall be •-�• a E`L-7. I - splicd fo^,rcn__^airy. a ee a -d, a: ^scan o: 1.,1:.Z'c, , ice, I -cr J C :.=1! I -- P ;� / co.n'sy .. a_t 2x -- _c„_f. J_''fc- - -- d )- , I i N I ; , 11 Co- -ctcr ate,: - ens: s_ 1, dtar.ter -_ lor; _ _ r1 �Q I 1 .>o s arc nd�;ec�a :er for sill plate 1 1 — `4 - - I N I G i - J i ': c _ FILL sus_ T:+ __ �'; NI _ v I r ��`o n a ion I 9I - M, e, -7 o I t - —— --� Ga arizec Steel 'cist a c Sxa,pson Strc:u� Sic,Cc. I I T E_ 1 __-.-_-�_,_..,--�- I es e- b ,ere .z11 bF _ :,:_'ea st e-h joist :o sEli W I - T - �_ ' I ,I ^� x' _ I I I I- I ' I 1 ! In,-all ll a_1 ....:a1 co:net,o r Y.^.orn i ccr r,ce - i .I F«� o _ �� I I 4"I-t [4 . , , } e I 'I >fl � I K,%iENC�,4(E� I - - _"__I - i aac:u^E' -ec__:c_t_o:=. ,_,h al; %. es - i I 1» _ III -.- - _„�..� ' �2 - _ _ ' 11cu56LIFTNCq A1;7 'I Zf P f `^I I 1 I I c,{.�L_ ea c ; S. f. F— a srep��iu:.,_,IllC,�5r I ,, �. . L — - ; I .hJ -ed F a �s 1 A'e 5�'-(r:E+DS .'t I FP I :c: I A. •ja ECf ,_Nr": I 'i -e r- ct _412. 11 L 1— To °-E cELO vBR. 1+` i:.. r E' rt -I.. rh"'FA xP: A � ; ! �� ..i .. 7., :n.,.. �_. � f I ♦ I '�J_JJ III I -G'�J ': I,f�F- - I - t 1' ! _ I l 1 I ��I 'tb lS-( %sue '-is !✓•-.- I. }I G, _ k„i_ - } EArI•YiNG S E I I Iq; . I _ :JS z, _�1 a I , I ti' i--� Z-C £%I�T.'' GAY1.�L -I e-t 4' ..I ..* - z 1_ , I THfS Ae�S J P61� Fc2 L., J '. : r I I '1 .I - - - t7GAM R'Krtr: d' � I-i- 1 I ! PA?-�1N4 GP VM.HIGLE a1I ~I - p : L __ r -- - �...i 4 YQtD x� ! fI NI L I I.., I Si12 E_:¢A(3j' tiSg;, <1:I r-T3 Zr121e < Y, t -1_—_= - _ T i.—�I -kA e,:0 r TyP- _ I ,,�. III c'1:5:o(TE2x \P I _I I I d I F. I LFFAr1 r 1�s@:12 cede �— l- I I a, :] I _ < I _1�I I I r2 5( I r rn a y5 dw I i 1 i' Q: I [arlsT�.TrInT� I ,VA,.� :h� r.�__,-.•c!+s I 2 - ,,LA.•-vu,-r ,X� ''a. I I I%r'I 1 I ' — I •' — — — — — — — — �i I ; - ,1J.1 r F , ,.,4�;`r•�rh I I -- - - - - - — — ill -- --- , — ' I I . II_- -N -— —-—- - —._ -,- -- - - -_ y_ - - _ i � ICI . t. - - 1 _ 21 O" •„ - I I ..Z,4,.e,T_:Av*Y W,ILER , - i � - _ ( _IZI.p4 - - _ F, �G1'�� - -- LLL."------- ' _ �{ - d iEa ATr/<i;''x/"�fK-t4tlE-S - . . I T oho PO S-�__ OJhQF T1011_ __ E%I•sHai 441?+(i ' >t. 1 . � 'Zt .P!W,ilu,ED _ 6ecT3 fs� CEtA;:-5_ P•T:.3-2„12 2EAr-1 GN.fST. Fi I P.T 2x4r U-51M _ .. . _ _ ,p.. �P.T(3)2Fi2 �t1TiA - _L e6AN ^r/Cb6m Fleur. �I 4z- - -. � �., .: , - .-' rrr zlsTz fv.Lf.� % . I sE �t.•trsod ToP Fun4e+aa:yEc LSS-7• t0,FsUHDATIOd 6L 12.or .... .. _ NA,t ., - --- - .. - Simp'�N.U2B '•!."•Hcjer-S E)C•s ,y+Pi,Y •tf S ,L•',iA!,1b eeA•r ' )L v` �V _. .... A. . _. _ Axe g_11-aBTt'd f oPaNlt14' • � c lh�,,,;.,4:rAy - - . I .I I . I ' . 11 . . iz . . I . . I ti .,- r> , a N�E'F. .. ¢+i5 -•(IDS I certify that the design specif cat:ans and I_K P.L 70"-- - v>•GaT G1N•4�1 tD T.o HaE.r. _ tI. _4 method of construction are in accordance with ! I , MA / rrYP) - .accepted Standards of practice for meeting - _ - - the pro i� on o Section._or. 2_ 2.3 0 .he 5 11 OB -.mt9kt.4o ' Q Edition oft. 7achusettsO State Building, ', .'k.1 KJDR_ N ,„:s 'C. \N et�f tr,� - PIN,GRADE --. EX19EXT. RACE - 1 ot`�`taa �s .- .. " - Tie; aS- , '. A IZ'�, 12 - _ 3 s rL•r - dCCED r4,5TA125,E+-:c-1_.IATc a 5-2. 1 1•b,rz1.1439 oFt -p -`. VIX13T,Ni.cirA..:;E_ w ExlsrtNT4RAD0 ExlsT,6,r-A.C� -..c _ srn�0cruwat H ',I,V-0PO`,EP - _OQQ EO_L _ Q _ 1NIN• 1 ::.RT - �• tp� 3<4E.M TT ., .. srt�yc�� _ 20(P.LOh1�i E,ELH KR,GEN_eP LEAI"(A .Bo - . t .. - 'tt'M7MAL " .. .." > G (o.^ : M� {s NOTED' .amoveo e+ on,.wB e ::; I. ,, - _ e 6 ,,, , wa 1G rt .. - - -_ ,- _ s. Pcy1eL7FATCA :. ,y��, i O' Eft/ t% o..e.•5F-�i9,199 r.Ia F('IYR) . M E s siDENG�_.UP RhDE r - ;: ELE TUDO P.E. xI .TIN 4 ._'t, -- �w••1. - D 2 4 a. .., ... s .Itin� �Struciai'rdJ°Englrieer - _ ...<, - , Et-.O -. - „ - - _ .r 'Con u 9 G ,,_r . _ „- �. .. , .. . ,..:,,, .ear,' .. rIAN�Y' v`O#I oN - .. . s_ a 2 3 3 , - ;_: .._ 0 2 1 1 1 _ �. t.,,.... -,,.,... ,.#, .,.,,, 8 .::::, -, __ .... - - -- 'E_,. > ,f ,, ;crag rnot.oe;een.omn'Jivsinladol -.20(0 LOHq BEAcFI crrli-rEKv t{E MA 5- er 11, ...:s,y::.1,-pT -f-r ,>.. .: erg. I_o. ,.r�, ",y-'<' -�/8•.Y-o. _ .. In con«nooa ivw L cae.,.. �-. j N " ,. e F .._ .. a f - - - F x , .._ ,.-.>.. , .. .`tie,.... _ ..._• .... -.,i�.. .: J. -Y.. 4 __�_--....---•, —...�.,,,_ _-- __,..-. .-..--•-a- -•---��. — __ ___.-_ -_— _ .� . , _.,.4 ..,a,.. _ .. ..-_. __..___-_�__ _ -..,.—_ ____ �._ - _r.. - ,.. ---- ------ .. . �- _1 NOTES deteriorated or dasaged timbers shall be removed apd re Alllaced _ - ; - - t Sheathing: Installation shall provide continuous • - ��- - ...coverageF from top.ill through first floor joists.-nailed - fARAL1Av1 �Yz", _ I -: tRAIL.flnT4 4- to all membe cempon h galvanized nails• 9'K� _ ': to wi 1 .. 4- ., .LJ - Yoh ct Pr ami New ptessurettreated.timber. with"Fb=1300 psi. 2 .. r PTA KG p=rx c j r, — y f P r c _ A-307 xl -{ - Floorbeams to be Parallam, ctura (JZ J WALLAM'�re°x III" L. y joist Nacmillian. with PD=292 psi�E�--2a00 nypsgu9 = - - s .._ Press uretreated.0. Connectors and Fasteners: -Simpson Strong-Tie eomnectors.� ' hot dipped galvanized or as specified on the details, t 0'. be handled and installed per manufacturer snecifzca ions.. . .T.. 2.10 LEDG 62 using the number and size nails shown herein with all: Rn CAP:J i _>naii holes filled_ T - > S• Stair and Rail Details by others, per Building Code X _ 6.. See Drawing S-1 for further Notes. .. _— a• II - ... - _"�Ralcerl 99 . 7e" IN PT.FA?ALLAM P�5T - h:- - - - . •. '"PT 2.1 LE E✓`- I 51MProN P95T 6456= 2 J PB- '�Iw f}AIL - - ' - - - fitl•GRADE "FUN•V Sme - , -P� • . � - ,- 8'0 cwlcCETE FdlED ..... , -CL_2.xi2 LEGraEft I - - . I I I I , _ TYPICAL pELK F�TIN��FRAMING . - Ei(I•s TiH4 GkAMING P.AISED - - To a L.. 12.7 5 k,VLFL. - I 2' i f _ I � HDA 5� IMF-cN �17T rIAiJC{".,L= - `.?cUpcu wAv, - w2Q ylod,rails _ IcNINN"�Y t� 'RU'YI i a � `^ c1i �C(BPJzF GFGf; AT'fc:C•`!`ii:•^IT J "I r _ - Pt?oPo-5Hi MDPOtSO AboVE 4ARACe - - - - - fR.+.H�N4 ?'�N -F7IMING PLAN PF�Po�EC rIF_5T F;-aor_ eP-1 MI PLAN 4 s _ JytN OF TUDOR cHELE f3SpNAL L�' - q_ p�GFoSED WISED DEckS�Ae;ovV 4AeA4E GLm2 n MICHELE C. TUDOR,P.-E. exlt, Ke6ibENCe UPGRADE .ConsaltinA Structural Engineer rR= NANCY 'TOM 5-(O - m�....�ae^.•c.+r...�e.�.mnv.m.m.xa� 2A(v LOHG 5eA 2-D..GEN-IE2Y11LE, S 2 oft L-� � NC 7-e6 IQ I�f i,nilll�Jrs? O� 7L f7D u rs P r i a� -(Ta �'7harZ�" c�f G 41ti,5�+'^cJ C 1�7ClI"? L IF IK I S -: ' II C4 )�T15G�'D " „� / i •I- �j G� tjjC fr Crl/Cr!/� ! -- I Gc:Z,pov.� � Ip� �Juvv �ac fillc � Wtl'1 '.54r1c� Os�'r �.//c Lt/ultr Dcout -Yv caf u�i/if�CS. z ` uctvral dcs,jn of -- 4" CAST IRON PIPE (OR EQUAL) MINIMUMIR PROPOSED I PITCH 1/4" PER FT. I ��' �` o'�CONCRETE COVERS CRAIGVILLE BEACH TOP OF FOUNDATION T ELEVATION = ��rt i E ,O N G V G I 12'M AX JO'O G.-,gaC 9.O i 6� i 4" SCHEDULE 40 P.V.C. PIPE - -- - -- 1` � MIN PITCH 1/8" PER FT. LOCUS ��OL1trc B.O FL ?` P&A 1"O1JE o 4 ' PVC- S(-H 4 p - - OW LINE _ I I --A ELEV. ELEV. _ 7,1 ( iIli0 MIN. SEE TABLE I J - ^^ - 9i.� L' -1'�' was s*v Ne F _ 7. 1 /3 ,0L I 6 g 2. 9 ASSESSORS MAP 206, PARCEL 1 ' I LOCATION MAP l i I' �oi �, � rYIHW Eic Z.ob 1�•G.J � /-To o - GALLON SEPTIC TANK `- � LIQUID DEPTH IN SEPTIC TANK DEPTH OF OUTLET TEE BELOW FLOW LINE LEGEND: 4 FEET 14 INCHES i DESIGN CALCULATIONS i 5 FEET 19 INCHES BUSH OR TREE 6 FEET 24 INCHES i � L - - - - - --- -- - - -- - -- - _ ---� I NUMBER OF BEDROOMS -- GARBA TESTHOLE SEWAGE DISPOSAL SYSTEM PROFILE NOTES: TOTAL ESTIMATED OAFLOWT OS CESSPOOL NOT TO SCALE 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. I ( GAL./BR./DAY X BR.) J_GAL./DAY TITLE 5 AND THE TOWN OF c iKWSTA13u RULES AND I RFQUIRED SEPTIC TANK CAPACITY wv i �2re c2_G A L./D A Y N WATER GATE REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. ACTUAL SIZE OF SEPTIC TANK L47 .7 GAL. !DAY [>Q GAS GATE C E N TE R VI LLE RIVER 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO i LEACHING AREA REQUIREMENTS EBB WITHIN 12 OF FINISHED GRADE. ELECTRIC _ (TIDAL) I BOTTOM AREA ___-_' _ GAL./S.F. i I 3.9 SPOT ELEV. EXISTING STONEWALL 3. VARIANCES FROM BARNSTABLE BOARD OF HEALTH REGULATIONS D.P.W. LIC. #1735 GRANTED ON say: I I FACHING CAPACITY BOTTOM GAL./DAYONLY _ FLOW NOV, 19, 1935 I EXISTING DOCK 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF I WITN�TAtinIK1G H-1n `nAD!NC U1NL�C` T :.;' ter, ,T 0.2 _ S HE �E UNIDEI< OR 411I71N DEQE FILE # SE3-2528. --+ -0 2 _ `- �-3 Imo.",: =�•-�- �� 0 2 10 FT. OF DRIVES OR PARKING .AREAS. H-20 GOADING SHALL 8E - - - WATER LEVEL ADJUSTMENT 3.6 -� �� USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. -0.4 3 6 3"7 I TEST DATE 4.3 �2„ 5. ANY MASUNERY UNITS USED TO BRING COVERS TO GRADE SHALL i ------- WATER LEVEL_______ 3.8 l ._: V:'__ r,_ ;-r .. o WADTER EX WLEVEL RANGE ZONE ELL 4.0 -= � - � • BE MORTARED IN PLACE. i --_------ 4.3 r ~':' -0.6 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEPTH TO WATER LEVEL FOR INDEX WELL DEEDED OR ZONING REGULATIONS. OWNER \APPLICANT IS TO rc a r.l.n..r7,;,��r, ot^ /p' �ru.r+ Sc.r;r,..�o// __ FOR MONTH OF:-0 5 3 1 , OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. .5,000 SF o trG eroir-c +c.-i n� s�Q..,_ .�c���, c;� cc��a } 3.7 -6.7 WATER LEVEL ADJUSTMENT --_-----_- f 0.35 AC -2.9 DEPTH TO HIGH WATER --0.5 4.1 4.1 J 3.8 k�p0o �� 7. FOR FIELD NOTE INFORMATION, SEE BOOK 2\94 PAGE 1-36. ----- - - - - --- --� i -0.6 8 x � 'i.�y ✓�i.rycS ac rc%car- / us �)�.- /cam' •, I LEGEND: LIGHT - I EXISTING SPOT ELEVATION X 00.0 ` POLE -�% 4.0 \� t�ccoMo�dfC s�•�>lic. s�sfrny cor�.strut �`•io7 0.8' 4.1 N --- EXISTING CONTOUR ------XX-- 4.0 /c �� - --- --- - - - ---- - - - --- - --- - -- --- FINAL SPOT ELEVATION 00.0 i t�O -t•D FINAL CONTOUR ELEVATION STOOP 04•3 3 5 \; I PERCOLATION SOIL TEST ; SOIL TEST HOLE LOCATION 1.5 4'1 = 4.85 N.G.V.D. DATE OF SOIL TEST -sue,_{�� 4 TOWN WATER W _= -- 2 STORY W\F = -- /3.8 } TEST BY _�� SEPTIC TANK _ i BLDG WALK 0.7 1.54 PRa aosdu TGP �� / WITNESSED BY G7. 13ar,4+ DISTRIBUTION BOX 4.5 O. 1.6 PERCOLATION RATE _r�yQ_-MIN./INCH 3i= r Lw 12,c] NGV::% / 4.2 - ! -, E. P. 3.7 %_�.6 - --- -- -- ----- - - - -- --- - - - _ ------- - ;--" OBSERVATION HOLE 1 -_ -- - - --- FENCE 3.8 �,� / 1.5 ELEV.=_4'�- ✓a - 3 '. 95 -- sts . �r�_ I <SHED 5 wv Taposa.i t 1 ¢ INITIAL ISSUE D.o'N 7 PAVEMENT ^ � 3 7 I l N0. DATE DESCRIPTION BY 3.9 - PROPOSED SEPTIC SYSTEM UPGRADE i4.3� _ a' DECK 6 1.»a/ I FOR 6. << - Q \ d«i, .,^:` , 4. - c3bs�. ,. J l�a►er - O. A/GU1a o / 3.8 0. I "A NC Y 'rOl A45 7-0 A./ \ T Lf � Q 3 j 8 T POLE •'� �� ii ----'-- v I NG Lvv3EAc w Ab.,#c 2a6 �o I BOTTOM OF TEST HOLE OR WATER ELEVATION------ 9.8 �NT tkv/ i>As5 . i r I T- a _-_ V -\ 0 ' CBNDH -- .,:.,-' 3.9 Q C.1'; F1 t} �� �j z4 TOP FNDN= I 12.0 NGVD. J j ------ -- PARCEL 2 83 c44 APPROVED : BOARD OF HEALTH I ���°' SCALE : '"_=-20�- ___---- JOB # S2010594--- STEPHEPd -- OWNER OF RECORD: " 4.8 _ _ _ X ALLYN ► - I DANIEL M. PACKARD ®Gv ; �; PARCEL 3 FIRST FLOOR - 'I?' DANIEL D. 0 NFILL DATE AGENT wlLso�� ; 10.7 "" G4� EL s.o5 Ncw �,No.30216 PROFESSIONAL LAND SURVEYOR DEED BK. 4386 PG.15 UTILITY I i OWNER OF RECORD: I CLUSTER MARJORIE D. CHITTIM BOX 307- 36 PUTTER LANE ! 32 ' PERMIT # _---------__-___- WEST HYANNISPORT, MASS. 02672 DEED BK. 1911 PG 210 508- 771-7217 - --- - 1 1 ID y NOTES: 6 - 1 . All deteriorated or damaged timbers shall be -removed and 'o replaced. 4410 --� - 2. Fxterior Sheathings Installation shall provide continuous AIL DST 4=-_ coverage from top -sill through first. floor joists, . nailed 1 member components with galvanized nails. T -T- , T 114 v O I► --� ___'" —-- i 3• E=1.Deck Framing:0 000 psi. pressure treated timber, with 'Fb=1300 psi AtLAM�{�,x.11/8 O dJ Floorbeams, to be Pallam PSL, as manufactured by Trus I - - "-- 'p" X �Joist Macmillian, with Fb=2925 Psi. E=2,000.000 psi, n12' pressure treated. 4. Connectors and Fasteners: Simpson Strong-Tie connectors, hot dipped galvanized or .as specified on the details, to _ I _ x ���� _ _ c• =p using thednumberand sizepnailsnshoxn herein, Cwithaallns posT gyp; nail holes filled . 5• Stair and Rail Details b others, r,€ - — --- - �! Y per Building Code . _ PAQ�LLAMI $--' -.�L 6. See Drawing S-1 for further Notes. t i .; IZ-IxpaE� P5T Dk'.76= 44,NcrZ _ ! N ! 8 -TYP-��4C- DfGT - "tNAMI N4 f -BX15 iNg - - - -- • Tp >✓L. 12.7 5 --------- ------ --- -_.___ - _ - - -- ---- FJAM=�--� fin=- -_� -11120Vf I0j HAILISP INC- ---- EM I _ ( -4u- :Z&-- p—_ -- - -FRAMING Pl.-AN - --f�ZAMIN4_ �0P0i5D-- r1IK-,5T LOOP, HAM1N4 --TEM --- OF Af,�(�7- - MICHELE C. s TUDOR s,'. •� No 34774 STRUM S& rSsjoi At �.._`"__-- SCALE: S— Ll a APPROVED BY DRAWN BY ��f�- • DATE: Now' 29,199 MICHELE C. TUDOR, P.E. ENce UPG?-ADE Consulting Structural Engineer -TO H 45Td N RRAWING NUMBER .c ma6o,- 2CXc L.' C t �,�4 { 2 C NOTES ?ND LATFRTAj, SrECIFICATIONS The existi:4 residential structure is located in Flood _one A13 , _71evation 11 , as determined by the Site Plan Engineer . 2 . For site location and grassing elevations, see the Proposed Septic System Upgrade Plan by Daniel D. O' Neill, P.L.S. , Revision 2, March 1 , 1995• '-' _l ___ _ __ 3 . All workmanship to conform to the requirements of ril-' the Massachusetts State Building Code, 5th Edition. v i_ 4• Electrical, heating, ventilation, plumbing, air -- - - conditioning and other service facilities are not to . —1� be located below the base flood. elevation. E1.- 11.0 . � DO�_ _ - - 5. Contractor to field verify all existing building dimensions prior to construction. Discrepencies between the plan - " r- dimensions and field verified- dimensions are to be brought to the attention of the Engineer, prior to construction. T._iD 4 The Engineer shall be contacted by the Contractor to field co - �j ap 14 — verifyall framing ng below the First Floor after house lifting. i o. Provide sufficient temporary bracing and shoring of all existing and new structural components to permit the _ $� safe installation and completion of all work without damage to property and without jeopardizing the safety !(a�o.c. - _--- :-- 'p _� of any person{ s) . 7. Concrete 4Z N 28 day compressive strength, f' c=3000 psi minimum. s 1-� Use 3/4" maximum aggreggates of`hard stone . Minimum ' cement factor: 6 .00 94 lb. sacks per cu yd. of concrete . z �KT�TT? � �L05t✓D �'Io— I -� a+ Maximum slump 411. 8 . Reinforcing- Steel : New billet steel, ASTM A615, Grade 60. 15ED _ J d All bends details and bar clearance latest requirements of the ACI Building Code . with ng d e . Provide additional reinforcing around openings with - $Cis• EQ• -� sufficient development length beyond such openings. Provide #�4 horizontal corner bars, 2'0" x 2' 0" @ 12" o.c. t vertically, near projecting corner face of concrete walls. cQ N ,- l r 9 . Provide temporary drains or trenches for passage of water ItV from building excavations and subgrades to temporary I sump or other location to insure interior drainage 1 --�' -- -- ~ - L ' _ J L z J� L, J during construction. '- � I 0. Floorbeams : Pressure treated Southern Pine, with Fb=1300 LAP psi, E=1 , 00, 000 psi, or better. Floorbeams shall be 'SiM E-,V+�a 1- QIkC�K�4DE � :�.2'Sf j� spliced for continuity, as required, at 1/3 span a - a-{' �� = -- _point-s, in alternating 2x sections. ' tJ �a $ 11 Connectors and Fasteners: Use 1/2" diamter x 12" long 1 ,c a s N S N ? ASTM A307 anchor bolts around perimeter for sill plate — _ ° attachment to foundation wall. �y , �i1 �G'� - �:, �Z N K M - Galvanized steel joist anchors, Simpson Strong-Tie Co. _ 14 or better, shall be installed at each joist to sill f—FT __ �- ► f� - L J — connection with 8d nails. a f - --- >JP Install all metal connectors shown in accordance with P•-ira -- - manufacturer. spa c ,�( -M�►� . .4� - N — rsr�_,� r�4 �T-- �Xl _ ificatlo with- alls nail holes filled. e ns 12 . Louvred ODening-s: r I L J L_ _J _ ; — Total Enclosed Area 1785 s. f.. _ Louvred Area Reauired=1785 s. i . - - - --t j - - _ ! Total Area Provided = 19(8x16)=2432 s .i. Allows 75% unobstructed area u I -T- --�--i J�� � � l � ,,, ;�7 � --�-��Lt�:------� ����-_mot=-�xi•���Q-- �;� ' rems& --- — c _ -- _ I � , — RA` e L_ ir✓ItiX� - i ,- — N L O h� - _, t�tGT� iti{ GLDi�tr�tjGfc wl --- - i 4- - = o X N - N 1LL-17 --- - iv r TO K IQ L 1 i L _ _' x � - - -- - - t 5" "� W 1 � T;2161�10 -�—- --- - - --- -- _v - - - ---- Dis i - _ - - - � T7E1�iCS^ �y 12 �rvlf- -x l �ryt= _ r�clhl• _- tv� _ cal._-WP FLAKgS ii�c*I(1Sr_1-1VZ12-3TF - - `^y I b d-�lAi1-S - D.- �tDTlot1 �L.1'l.p� ---- _ ��Ylgr-� T. �Mtr�. - -- -- ___ __- _-- - L _ - --- , R aPT i /�ti= UN� - ties'ay.VaTIL.� �t p .-- �� I certify that the design specifications and off ' Y�6R.T. method of construction are in accordance with ZZ - -3 T accepted standards of practice for meeting 1L - - - - the provisions of Section 2102. 3 of the 5th Edition of the Massachusetts S _ &: lding Code. NlCffE a E j �. Iqla 4C _ �EYrs loNs-�re�_ }bt1s1>�..�FttKq. v < Z Tu0c�9 y i 995 ��� p�Ks, 5T+41 , EN�{•.PAT►o s-2 ilii �ll�+D�' �cl U No%21,I i;5 ` STRUC URAL ( rrJ- Ep Q � _ 7ljT _ r i '� DAI Zfl _ L off 4 , c� rs✓fz.Y — _, . s-r�. SCALE' APPROVED BY DRAWN BY (� E ��PI` Z- Z� ``f� DATE:.:L .J.9.1'1 1 - - ---- - _- - - M I C H E L E C.-T U D O R, P. E . - _ Cor1T.- -G`� Consulting Structural Engineer - - �._ NO NUMBER 123 Cott«,wooa bone•CentWV10-MC=0axaemo2632•csoe)nla601 _ZGz L-OL`Q=� •�o}��7o DRAwi — 1 Le-- .�i__ C-C-N7r:;A 1t AAr1A � of POST 18AB.20 -24 x 3d REVISIONS: NO. DATE DESC. i CENTERVILLE RIVER STONE REVETMENT — D.P.W. LIC. #1735 — EBB NOV. 19, 1935 — i .� 0.1 — b. — FLOW FOLLOC V=F 230f `� —0.3 ! —0.2 3.4 I 3.6 v —0.4 .4 POST / \ \ O ASSESSORS LOT 1EXISTING '�"� 1 Q � F. DEQE FILE DOCK 6 , S•0 0 ,ram CRAIG A. ( \ #SE3-2528 FlE�D .38039 POST No � 0. 35 ACRES I � o / POST POST 35' BUFFER DECK \ ,/ 0.5 2.8 PRO ESSIONAL LAND SURVEYOR DATE I lr ` _ _ PLAN OF LAND 0.7 3,7 I DECK o S TO ACCOMPANY 3. #106 -1.2 A REQUEST FOR I i EXISTING 2 STORY / WOOD FRAME DWELLING DETERMINATION / TOP OF FOUNDATION PROPOSED ELEVATION 12.0. N.G.V.D PERSONAL �ECK ELEVATOR 3 ( R . D .A. ) 5.33'x5.33' NO 94-- — 3 —0.8 MET Fo�P � #206 LONG BEACH ROAD \ I I PORCH �,� ` �°j \:.:.:. I / " 1 ?� _ IN C ENTERVI LLE ABUTTERS / / I 1 �� SHED I I j ET �Q l MASSAC H U S ETTS (BARNSTABLE COUNTY) 5— SITE PLAN s I \ l \ Eki OCTOBER 25, 2011 1 \ J J PREPARED FOR: RICHARD & VIRGINIA McCOURT 21 JARVIS AVENUE LEGEND \ ` \ s'�40wE / I LOCUS INFORMATION HINGHAM, MA -� i— 02043 50.9 X SPOT ELEVATION \ I \ 0 3 II C.B. ® CATCH BASIN \ ?6MARK 5 CURRENTOWNER: VIRGINIA McCOURT BIO. ® BIOCLEAR SYSTEM OF CONIC TEL\ Iz o SMH m SEWER MANHOLE WALL. ELEV BOX I I TITLE REFERENCE: CTF. 153897 TMH (D TELEPHONE MANHOLE 8.55' NGVD CI OX N UPTco, UTILITY POLE / TRANSFORMER I I PLAN REFERENCE: LCP. 24676—A - Cp, UTILITY POLE —E— ELECTRIC LINE ASSESSORS MAP: 206 I I I PARCEL: 001 The BSC Group, Inc. o EHH ELECTRIC HANDHOLE ! / I I I ZONING DISTRICT: CBD—LBSD O GMET GAS METER —G— GAS LINE � SETBACKS: FRONT 20' I I SIDE 15' (20' FOR VIEW CORRIDOR) G GAS GATE I I REAR 20' wv I NITROGEN SENSITIVE 349 Route 28, Unit D WATER GATE ! I ZONE: NOT A ?ONE II West Yarmouth, Massachusetts —W— WATER LINE FEMA FLOOD 673 lla TEST PIT I 2 I ZONE DISTRICT: "A-13" ELEVATION 11 508 778 8919 7/2/1992 PA EDL NUMBER 250001 0016 D © 2011 The BSC Group, Inc. EXISTING TOTAL LOT AREA: 16,000t S.F. � I SCALE: 1" = 10' EXISTING BUILDING COVERAGE: 0 1.25 2.5 5 ►ETM I DWELLING / DECKS / PORCH 3,340t S.F. (20.8%) 0 5 10 20 Fm PROPOSED BUILDING COVERAGE: ....--- NOTE: � I PROJ. MGR.: N. HAYES DWELLING / DECKS / PORCH / ELEVATOR 3 369t S.F. (21.1%) FIELD: P.H. A. D. THE PURPOSE OF THIS PLAN IS TO PERMIT THE I / CONSTRUCTION OF A RESIDENTIAL ELEVATOR FOR THE I OVERLAY DISTRICT: DCPC CALC./DESIGN: K. HEALY OWNERS TO ACCESS THE FIRST FLOOR ABOVE THE GARAGE. I CBD 2000 S.F + 6% OF LAND OVER 15,000 S.F. DRAWN: K. HEALY 2060t :>.F ALLOWED FOR BUILDING COVERAGE - CHECK: C. FIELD FILE: 49629/4583800/5838-SP-I .DWG DWG. NO: 4043- � JOB. NO: 4-9629.00 SHEET 1 OF 1