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0021 PEEP TOAD ROAD
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T eLa OwN OF BARN$TABLE Building Inspectors Initials........Cl............................. a " Date Issued.....71-H- 2-0 SCANNED Map/Parcel............1. �.7. .....a ................. :2h,al-w TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVE S/WEATHERIZATION P PROPERTY INFORMATION 1 Loa ,o %OA 14 . �., 6� 1� 11e Address of Project: � NUMBER t STREET VILLAGE �y Owner's Name: /�u ,���'{ c Phone Number so9 - V�,b -140 6' Email Address: _ �� _ Cell Phone Number Project cost$ 7" 17 D0 Check one Residential . Y Commercial OWNER'S AUTHORIZATION As owner of.the above property I hereby authorize �/j SG�'GraY /G/l-en-r to make application for a buiUing permit in accordance with 780 CMR Owner Signature: Date: 107 2OZ TYPE OF WORK 0 Siding ED Windows(no header change)# ED Insulation/Weatherization ® Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to 60 FD re s 4 ccl/ W,-.5,1 love - 151-rvK �A ,D,'s lo o S!�- CONTRACTOR'S INFORMATION Contractor's name /�z x coo 5 G Z G Home Improvement Contractors Registration(if applicable)# �9% �y0 2 (attach copy) Construction Supervisor's License# 'I©� ��� (attach copy) " � y Boi& . C �64" p Email of Contractor a-G--6 S&Cc 1 t7`1 7� d Phone number .sD,1'-�6© - ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X I X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm4:30pm.Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number '— I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town o Bar able. Signature Date f)J O 7 Z®2� APPLICANT'S SIGNATURE Signature Date® � All permit applic are subject to a building official's approval prior to issuance. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructg Specialty , CSSL-106169r' �� # E�cpires:04/14/2023 ALIAKSANDR�G TURAtII 20 HORSE POND IROAD. WEST YARM6VTM MAW673. ¢< O �. Commissioner J • eJi'(/(j C��/�G/71,1�/ZCUG(.,�iGG� / /j' ,r Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement,C.brltractor Registration , 1. Type: LLC ALT CONSTRUCTION LLC • 22 HORSE POND RD � .�� Registration: 194702 - Ex iration: W.YAR : p '02/2 8/2021 MOUT02673 - ,; H MA ,. t l sCp i -� zo...... Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR-TYPE:LLC Registration valid for individual use only before the expiration date. If found return to: Reaistron Expiration Office of Consumer Affairs and Business Regulation 1947U2 02/28/2021 1000 Washington Street-Suite 710 ALT CONSTRUCTION Boston,MA.02118 ALIAKSANDR TUROCU � l G/I 22 HORSE POND RD W.YARMOUTH,MA'02673 " Undersecretary No slid witho g ature �� a.=•.�-,.�d,&"�-�.a�' %. �--. ,.:� x�.:�=+��,.. .� 'J�.'Y", ,« ._�, f .,-.4s�.�a� -fi9fi'"�alaa'^r�;:} .g s$•'.�ja�..� �� v `j �rl ? � "�k�'� � � e ,�. ' D COMPENSATIONFAN EMPLOYERSLIABILIT1f�INSURINC PL1GY=j .. � WORKf S #t ��- ��-.�� ""'{ �u•++ �§� ����:� �~ '�?',,�""#a�'�.�"t., ��.s-� ''irk ,�� ��z-�,�5 � �������'�"' "� Atlantic Charter Insurance Company VDAC NCCI Co. No. 29211 Policy Number WCV01420401 1.. INSURED: Prior Policy Number WCV01420400 ALT CONSTRUCTION, LLC Producer: Eastern Insurance Group, LLC 22 HORSE POND ROAD PO Box 79398 WEST YARMOUTH, MA 02673 North Dartmouth, MA 02747 .Federal ID Number 832032890 , ' .Business Type: Limited Liability Risk Id Number: SIC 1521 -236118 Residential Remodelers Other Named Insured: Other Work Places 2. POLICY PERIOD: The Policy Period Is From: 12/04/2019 To 12/04/2020 12:01 A.M. Standard Time at The Insured Mailing Address 3. COVERAGES: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states t listed here:MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A.The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ � 1,000,000 policy limit Bodily Injury by Disease .$ 1,000,000 each employee C. Other States Insured: Part Three of the policy applies to the"states, if any, listed here: - COVERAGE REPLACED 13Y ENDORSEMENT WC 20 03 06B r , D. This policy includes these endorsements and schedules: See WCE105 4. COVERAGES: The premium for this policy will be determined by our Manual of Rules, Classifications, Rates& Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Total Rate Per Estimated Code Classifications No Estimated Annual $100 of Annual Remuneration Remuneration Premium See WC 00 00 01 Minimum Premium: Deposit Premium: s $575 $7,409 Total Estimated Premium $7,175 Interim Adjustment: Annually Surcharge(s) 234 Servicing Office: Total Premium and Surcharge(s) $7,409 . 25 New Chardon Street Boston; MA 02114-4721 Issue Date 11/26/2019 Countersigned By: - Date Copyright 1987 National Council on Compensation Insurance Form:100mvnt4 r r JA r t r• � �� � .d � •,fit«:s �+.. �f.$. ..��i"1'. ,•,„�.t e{..- L t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# ,P_00: Health Division Conservation Division Permit# Tax Collector - Date Issued Treasurer Application Fee Planning Dept. Permit Fee *3 Date Definitive Plan Approved by Planning Board 4/3/6 7 Historic-OKH Preservation/Hyannis Project Street Address 91 e-e f� Village e .�. ' l C L 3 Owner �'�� M ( �� 1-4,P1 60 Address elo i 4._Z vi_V2 pz: Telephone d L) 3� Permit Request A, Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ' C" Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 411_�Two Family ❑ Multi-Family(#unfits-) / Age of Existing Structure Historic House: ❑Yes lPd6 On Old King's Highway: ❑Yes Basement Type: II 9 rawl ❑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 3 new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: UG'as ❑Oil ❑Electric ❑Other Central Air: ❑Yes O<o Fireplaces: Existing 60e_ New Existing wood/coal stove: O Yes Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑e size Attached garage:#4xisting ❑new size Shed:❑existing ❑new size Other: ,i vJ� �. Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name ri' i s �� � Telephone Number ^ Address License# n 65`I f AY1, Home Improvement Contractor# Worker's Compensation# t j C L 5 d v >> �� 2 06-7 ALL CONSTRUCTION DEBRIS RESULTIN.q9FROM THIS PROJECT ILL BE TAKEN TO SIGNATURE �� C"` DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER . ' a I. DATE OF INSPECTION: /` 7 .(FOUNDATION �{(�Sdt'6} (6� 164v— FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING Q �' r DATE CLOSED OUT ASSOCIATION PLAN NO. / The Commonwealth of Massachusetts Department oflndustrial Accidents " Office of Investigations. d 600 Washington Street Boston,MA 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization4ndividual): Address: City/State/Zip: e� �-✓�:l -. 2 6 3 Z Phone.#: S--' V z Are ou an employer?Check the appropriate box: -Type of project(required):. 1. I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction . employees (full and/or.part-time).* have hired the sub contractors 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' Y P ty. �. 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.officers have exercised their 11.❑Electrical repairs or additions 3.❑ I am a homeowne r doing all work ❑Plumbing repairs r airs or additions . myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: (r GG SUG S✓7 S-C O d Z G 0-1 Expiration Date: Job Site Address: I t��e� rawo A0 Ci /State/Zi : /- ty p L��a. �d � �✓�' Gv7 . Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the WA for imurance coverage verification. I do hereby certify un r the ains-andyeplties of perjury that the information provided ab7,271is 's true and correct. Signature: Date: Phone#• Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of$ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Intructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...ev ' person in the service of another under any contract of hire, express or implied,oral or written." An employer is,edefined as"an individual,partnership, sociation,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and inc l ding the legal representatives of a deceased employer,or the is reCeiver o dual artnershi assoc a'on or other legal enti employing employees. However the owner of a dwelling.house having not more than thre apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to d maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto s not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also.states that"every st a or local licensing agency shall withhold the issuance or renewal of a license or permit to;'operate a busines or to construct buildings in the commonwealth for any applicant who has not produced,acceptable eviden a of compliance with the insurance coverage required." Additionally,MGL chapter 152;§25C,(7)states"Nei er the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of publicfle' rk until-acceptable evidence of compliance with the insurance requirements of this chapter have been %piesented'to contracting authority." Applicants Please fill out the workers' compensation affidavit ompletely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),addles (es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies*(LLC)or '' 'ted Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry wor r ' compensation insurance. If an LLC or LLP does have employees, a policy is required. De advised that affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application or the per�mit.or license is being requested,not the Department of. Industrial Accidents. Should you have any questi regarding the law or.if you are required to obtain a workers' compensation policy,please call the Department the numberlsted below. Self-insured companies should enter their self-insurance license number on the appropriate-- 6. , City or Town Officials Please be sure that the affidavit is complete'an Tinted legibly. The D`�partment has provided a space at the bottom of the affidavit for you to fill out in the event Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a%eference number. In addition,an applicant that must submit multiple permit/license applidations in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicanAhould write"all-locations in (city'or town)."A copy of the affidavit that has been officially stamped or marked by e city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. %' a w affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not relatednybusiness or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to Sete this affidavit. l The Office of Investigations would like to thank you in advance for your cooperation d should you have any questions ,- please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwedth of Massachusetts Dopa�mmt of IndusWal A.mdonts Office of Investigations 6,00,Washingto-h Street Boston,MA 02111 TeL# 617-727-4900.ext 406 or 1-877-MASSAFE Fax 9 617-727-7749 Revised 11-22.06 www.mass.govIdia °FJHE� Town of Barnstable. Regulatory Services BAMSfABLE. ` Thomas F.Geiler,Director y MASS. � � `bprfp;p.cA�O Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I tY Q/-w 4. bject ro e� as Owner of the su, 1 a � J property rtY hereby authorize 4/ �x to act on my behalf, in all matters relative to.work authorized bythis building permit application for: . (Address of Job) STgna e of er Date u Lle m u � Tint NaLe Q:FORMS:O W NERP ERM I S S ION 1V TTJA %IA iJ"JLAA7MKti/aV ~° Regulatory Services t yE,$ Thomas F.Geller,Director %6:F9, � Building Division Tom.Perry,Building Conunissioner .200 Main Street, Hyannis,MA 02601 wwvr.town.b arnstabl e.ma.us Face; 508-862-4038 Fax; 508-190-6230 Permit no. Date AFFIDAYn HOME UYIPROYEMENT CONTRACTOR LAW , -SUPPLEMENT TO PERMIT APPLICATION MGL c, 142A requires that the"reconstruction,alterations,renovation,repair,inodernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing awnei-occupied building containing at least one but not more than four dwelling units.or to structures which'are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other 1equirements. c i Type of Work: s 2_ �Z ✓ Estimated Cost 60 <-V Address of Work: ! c� ��7 G �� tw}e✓�,i i �� /�. '� y �'3 Owner's Name: L)-g f' —T Date of Application I hereby certify that; Registration is not requured for the following reason(s); []Work excluded by law DJobUnder$1,000 OBuilding not owner-occupied ❑Owmeipulling own permit l . Notice is bereby given that: ()VnRs PULLING THEIR OWN PER�YII.T OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME WROYEN2NT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTYFUND UNDER MGL c,142A. SIGNED UNDER PENALTIES OF PERNRY I her, apply for a permit as the agent 7J0. er; 3 S h — Date Contractor tore. Registration No, OR Date Owner' Signature s Signat . Q;yrpfiles.farins.homeaffidav • Rev: 060606 RESIDENTIAL: SHEDS -POOLS—DECKS-OPEN PORCHES-GAZEBOS FEE VALUE W ORKSHEET APPLICATION FEE.' $50.00 BUnMING PERMIT FEES: ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 of-1000 sf 75.00 $ >1000 of-1500 sf 100.00 $ ' >1500 sf-USE NEW BUILDING PERMIT APPLICATION • � x$30.00 DECKS �) POR xS30.00 $. • CHES '• •. '. (Number) IN Ggpt SyVIMMIl�TG POOL 560,00 $ ABOVE GROUND SV�INIlYIING POOL $25.00 S RELOCATION/MOVING $150.00 $ (plus above fee if applicable) PERMIT FEE - S Q:forms:dkcost p,EVc 00004 r - � O��/G2GCCkkYClLuOp� ax. BOARD OF BUILDING REGULATIONS o+ License: CONSTRUCTION SUPERVISOR r Number CS. 005414 / 3irth6te 06/08/1954 Expires 06/08/200'8 Tr.no: 24791 6p 1 Restricted 00 t, l" i PETER J"APPLETpRI 37 BAIRD WAY \ 1` t + CENTERVILLE, MA`02632 Commissioner • a 01` ,° � ----- Board of Building Regulatio s and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registrati doon 103218 Board of Building Regulations and Standards Expiratron, 6/2008 One Ashburton Place Rm 1301 TYPe 'DBA, Boston,Ma.02108 x APPLETON CONSTRUCTION Peter. Appleton 37 Baird Way , �,tu,CZQ u.` I ��• _.._. . Centerville, MA02532 - `' Deputy Administrator ✓ Not valid without sign re NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES f The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 &30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5005786022007 03/16/2007 - 03/16/2008 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street-P O Box 527 Agency Inc Stoughton MA 02072 (781)344-3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 01/19/2007 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the ,NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER •�� D /I o u t --------------- j� 1 a rPObei-� -e PA aCC-k Fll--a,t t'/1-j q-t ; A.) �j E '. ` . f e f �- 111 s 4 i� �, j � �? � f� f �I i ,� � : + i t t j l �,\� { ,._ �' _; t r 2u`�, t,.o--� t _ . . �T d�.j E_ i i� I .(�{ y,F > � 4 fir^ r 17 { ! T KR r ,7 M � yy,,,,ss / ��! �yr.rem �+y ,I rv`�,.�I h•M , r r' �y t j f {,jai /F}r t i a {S.' s J' .,y' "M � } I. , ^". .', � ,.-. 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A .r F 7� 1 `.k q ..J i HI r•+n w»rig+ ..-::..:F- {.v.,,.,.,e,,..�.,r�.,, m•,+?,, ,Ys^ ` +' r 1'., g k.' }r "t t;r a ttVl , :.=.,:_,, r, >.4. ,'. ,,,,, t i 't... �, *4. ,1°"k rt�, Ott `,it's^ (5,. 1;�� I,aCr«u t.�'. , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /Map 1 '+3 Parcel (L Application# ' r° Health Division t t Conservation Division r� Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee 0��5 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address P e-/ /Wo � Village Owner 1 J, 1 t4 7 Il i-J L—Y 4 Qu Address doe f 04-0 a- Telephoned y � 3 4 Permit Request /4� as � ��Y AWN e491 6&/ ed�CQV rn 'I n1 C2Y)P `�0 M Square feet: 1st floor:existing proposed 347 2nd floor:existing a" proposed Total new 36 Zoning District Flood Plain Groundwater Overlay Project Valuation Je U, 0 uv° "Construction Type k--000 1"6?✓f� Lot Size S y 5 �� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentatiorf.� Dwelling Type: Single Family 41_�Two Family ❑ ' Multi-Family(#units) ' Age of Existing Structure (Z 5 Historic House: ❑Yes ZXo On Old King's Highway: ❑des 0 No Basement Type: llrull ❑Crawl ❑Walkout ❑Other �T? Basement Finished Area(sq.ft.) b Basement Unfinished Area(sq.ft) J a `"' C,r`t q Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing_ ? new __ Total Room Count(not including baths):existing new / First Floor Room Count Heat Type and Fuel: 1,ras ❑Oil ❑Electric ❑Other Central Air: ❑Yes <0 Fireplaces: Existing New Existing wood/coal stove: ❑Yes S-t o Detached garage:❑existing ❑new size Pool:❑existin ❑new size Barn:❑existing ❑new size Attached garage: xisting ❑ 9 new size Shed: xistin ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use _ Proposed Use BUILDER INFORMATION Name (F 1 O0'✓ Telephone Number Q J-,>- Address 3 ? r if f o d4`1 License# d 6 S yI Y e� Home Improvement Contractor# 3 d Worker's Compensation# CC-506 57 �dUQ ALL CONSTRUCTION DEBRI ESULTING FROM THIS P OJECT WILL BETAKEN TO 44. SIGNATURE '� DATE �- / s V G 1 't FOR OFFICIAL USE ONLY Y PERMIT NO. DATE ISSUED Mk/PARCEL NO. ADDRESS VILLAGE OWNER Ik ` DATE OF INSPECTION: FOUNDATION FRAME ✓''f 2-9��7 LN- 5/1 l I,7 11 INSULATION FIREPLACE r= ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL h GAS: ROUGH FINAL FINAL BUILDING r 4 I DATE CLOSED OUT ASSOCIATION PLAN NO. 4^ 4 >t' f The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600.Washington Street Boston,MA 02111 www.mass.gov/dia Workers}Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information `I 1 Please Print Le iVl Name(Business/Organization/individual): I`e l o o a w ) ),4 y ! 1 d Address: -? ✓�-� J ✓� y`'v4`� City/State/Zip: CTV'; e✓'J Are you an employer? Check the appropriate bog: _Type of project(required):. 1.E3"I-a—m a employer with A 4. ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h' 9. uilding addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.[]-Electrical repairs or additions officers have exercised their 11. Plumb' re airs or additions 3.❑ I am a homeowner doing all work ❑ g p myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomiation. t Homeowners•who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: R 5S a L 1 44 7 e J' FIA^2 I)I-ken ? Policy#or Self-ins.Lic.#: G.VGG lr 0 S7 5(70 2 uc �ji Expiration Date: 3 / a ' Job Site Address: I �� �'-4 /beV0 City/State/Zip:('—',fetr,), i/e, W'd d,1 3 Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIAfor insurance coverage verification. I do hereby certi und)rl..,,,pain s-a enalties of perjury that the information provided above is true rid correct. Si stare. Date: " O _ Phone# "SU 9' y "�Yl� U FOther only. Do not write in this area, to be.completed by.city or town officiaL n: Permit/License# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: intormatl®n anct instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. employee Pursuant to this statute, an is defined as"...every person in the service of another under any contract of hire, I express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant w o has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,UGL chapter-.152, §25C(7)states"Neither the commonwealth nor any of its political sub$ivisions shall enter into any contract for.the performance of public work until acceptable evidence of complanoe with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers'compens on affidavit completely,by checking th�box es that apply to your situation and,if necessary, supply sub-contractor(s)name:(s), address(es)and phone number(s')along with their certificate(s)of insurance. Limited Liability Companies(ELC)or Limited Liability Partner�ships(LLP)with no employees other than the members'or partners,are not required to c;;Nlorkers' compensation insurance. If an LLC or LLP does have . employees,a policy is required. Be advised thatXregathe b submitted to the Department of Industrial Accidents for confirmation of insurance coveragsign and date the affidavit. The affidavit should be returned to the city or town that the applicationr license is being requested,not the Department of Industrial Accidents. Should you have any questi law or if you are required to obtain a workers' compensation policy,please call the Department aed below. Self-insured companies should enter their self-insurance license number on the appropriate l City or Town Officials Please be sure that the affidavit is co ete and printed legibly. The Dep ent has provided a space at the bottom of the affidavit for you to fill out' e event the Office of Investigations has Wno ct you regarding the applicant. Please be sure to fill in the pe license number which will be used as a referen\--,,xnber. In addition,an applicant that must submit multiple pe t/license applications in any given year,need onlym�t ode affidavit indicating current policy information(if ne sary)and under"Job Site Address"the applicant shou 'te\`,all-locations in (city or town)."A copy of the fidavit that has been officially stamped or marked by the city or wn may be provided to the applicant as proo at a valid affidavit is on file for future permits or licenses. A new affi vi s ust be filled out each year.Wher ome owner or citizen is obtaining a license or permit not related to any busine s or commercial venture (i.e. aid g license or permit to bum leaves etc.)said person is NOT required to complete this of day t. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. �a The Department's address,telephone and fax number:_ • The Corn onwealth of Massachusetts Department of Industrial Accidents ' Office of Invut gations } 604 Washington Street Bostonz.MA 02111 Tel. 9 f 17-727-000 ext 406 oT 1-977-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia I f / E 1 V Yr 11 VA. JJ C&A AJL0 "LYA%;, ,Regulatory Services srxzvSTs , *' ` Thomas F,Geiler,Director MASS, Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town,barnstable.ma.us Rce: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which are adjacent to \ such residence or building be done by registered contractors,with certain excep ions,along with other requirements. Type of Work: /L,v� ���� �� Estimated Cost �C1/"L Address of Work: Ito 4 �° Z Owner's Name: �" t"f Date of Application: -2- ! O I hereby certify that Registration is not required for the following reason(s) []Work excluded by law DJob Under$1,000 MBuilding not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAYE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the er: Viso � � Date V Contractor SAattfre Registration No. OR Date Owner's Signature Q:wpm es Jor=:homeaffi d ay Rev: 060606 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE O square feet x$96/sq.foot= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/.sq.foot= 4-� vv x.0041= plus fro-in below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open.Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00=' (number) Inground Swimming Pool .$60.00 Above Ground Swimming Pool $25,00 Relocation/Moving S150.00 (plus above if applicable) PTojcost Permit Fee Rev:063004 r Table J&LIb(condoned) Prescriptive Packages for doe and Two-Family Residential Buildkngs"Heated with F'caiii Fuels MAXfMUM MINIMUM Glazing Glaring Ceiling Wall Floor Basement Slab Heating/Cooling Ama'(%) U-valuer R-value? R-value' R-value° Wall Paimew Equipment Emciency, pae'�sge R-value° R-value' 5701 to 6500 Heating Degree Days Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 115"AME T 15J. 036 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Nomtai V 13% 0.44 38 13 25 NIA NIA 85 AFUE W 13% 0.52 30 19 19 10 6 85 AGUE X 18% 032 38 13 23 N/A N/A Normal Y 19% 0.42 38 19 23 N/A N/A; Normal Z 18% 142 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: r� l l J e e /wo 2. SQUARE -' U S FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: S F 1, 4. %GLAZING AREA(#3 DIVIDED BY#2): e CP 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-5803 03 a 780 CMR Appendix J Footnotes to Table ALM I Glazing.area is the ratio of•the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expresse as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 of decorative glass may be excluded from a building design with 300 ft of glazing area. After January 1 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National,Fie tion Rating Council (NFRC) test procedure, or taken om Table J1.5.3a. U-values are for whole units:':.center-o glass U-values cannot be used. ' The ceiling\R-vaI do not assume a raised or oversized truss cons on; If the insu-lation•achievei=the full insulation thickness ove the exterior walls without compression, R 3 insulation may be substituted for R-38 insulation and R- msula 'on may be substituted for R-49 insulation. ding R-values represent the sum of cavity insulation plus insulating sh athing (if used). For ventilated ceilings ' lating sheathing must be placed between the conditioned space d the entilated portion of the roof. 'Wall R-values represen the s of the wall cavity insulation lus ' lating sheathing (if used). Do not include exterior siding, structural athm and interior drywall. For eam e,an R-19 requirement could be met EITHER by R 19 cavity insulation O R 13 vity insulation plus ulating sheathing. Wall requirements apply to wood-frame or mass(concrete,maso log)wall constructions, ut do not apply to metal-frame construction. 'The floor requirements apply to floors o r unconditionedspa es(such as unconditioned crawlspaces,basements, or garages).Floors over outside air mustme the ceiling tqu ments. The entire opaque portion of any individial,b ement wall ith an average depth less than 50%below grade must meet the same R-value requirement as above- de wal . Windows and sliding.glass doors of conditioned basements must be included with-the other glazin B meat doors must meet the door U-value requirement described in Note b. ° The R-value requirements are for unheated slabs. d ditional R-2 for heated slabs. ' If the building utilizes elgUric resistance heating a compy ce approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more one piece°of oling equipment, the equipment with the lowest efficiency must meet or exceed the efficien ,•equired by the selectedpackage. 'For Heating Degree Day requirements o e closest city or town see- a le J52.Ia NOTES: a)diazing areas and U-values are m uzi�acceptable levels.Insula'on°.R ues are minimum acceptable levels. R-value requirements are for insulati,n donly and do not include structural compents. b)Opaque doors in the building en elope must have a U-value no greater thaa\0.3 `•Door U-values must be tested and documented by the manufactu'er in accordance with the NFRC•test procedure o 'taken from the door U-value in Table J1.5.3b. If a door coma` glass and an aggregate U-value rating for that d'bor's not available, include the glass area of the door with your windows and use the opaque door U-value to deterntin compliance of the door. One door may be excludedfro this requirement(i.e.,may have a U-value greater than 0:3 :• c)If a ceiling,wall,floor bas ent wall,slab-edge,or crawl space wall component includes ' o or more areas with different insulation;levels, component complies if the area-weighted average R-value is gr \ted equal to the R-value requirement fo that component. Glazing or door components comply if the area- erage U- value of all windows or do•rs is less than or equal to the U-value requirement(0.35 for doors). 43 tH�E To Town'of Barnstable Regulatory Services BARNSCABM ` Thomas F. Geller,Director 9 MASS. `sp f0,59., Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, �. le "re n a^-' ,as Owner of the subject property hereby authorize pef C'R �,/©/'14 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) ignatutr of Owner Date Print Name Q:F0RMS:0WNERPERMISSI0N °F114E7,� Town of Barnstable Regulatory Services B/' MASS. ' Thomas F. Geiler,Director y nss. g' 039. .,6. Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: ga4may, Map/Parcel: 7 O�6 Project Address �-) Pe_e oad 94 Builder: )d" The following items were noted on reviewing: © Lt �'t'�u� ctC.kCc C, �. e c_�►os1.; ®,— le•E�c z L WIrs rut, cnle, n4 WCIA1 r'e-w.e-JzL I AoW h � n�1 f A-Cc'SS C-(XA wyv. Cc u J Si'-?e k lt4L - Reviewed by: Date: 117� z Q:Forms:Plnrvw w Board ofBuildin g Reg ulat ions fs an/ld� nas� _... HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only Registration_ before the expiration date. If found return to: 103218 lug Expiration Board of Building Regulations and Standards Z,6/2008 One Ashburton Place Rim 1301 1rYpe DBAy Boston,Ma.02108 APPLETON CONS7RCTION,'' ' Peter Appleton ' 37 Baird Way {x ,' Centerville, MA Deputy Administrator —'� ✓ Not valid without sign re ' i L�'T �"`I fie �aavnzo�ruaea� a���ae`ivar,/Xa ' j BOARD OF BUILDING REGULATIONS !' License: CONSTRUCTION SUPERVISOR Numbei:,CS, 005414 Birttadate U5J{�$l1954 itpireS 06i08/2d08 Tr.no: 24791 Rei trietdcl' ,,06 k t PETER J APPLETON 37 BAIRD WAY CENTE'RVILLE, MA ;I Commissioner °'� 1.•L-t C,—D!Yj, -G., ,C7. IY� mod'�' ,J ','k 1 1' ti. i i i `.1 , � 1F •r E ,S, -yf d J -* G" !. . ti . 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Q�PcIZEi.IGE Cc.�&%PLVG W IY1-t T► iZ: DE Li►-aE- AUK `,E1'l''-,ACIC C.'[QJit:EMe:uTS OF T1-1C�:. jOWLi Cj= tZEGIS cc ��n 1-AI-iG 6uZ��-YoI� Ct I f-Ati1 I> L. OT 1':Az,Gt:> 0✓4 AW 05TEZV%L-l.G o MA-54, ULD - . �i C;1... 11->it C::y j"�_> t�r._1 ��/trl��i t;. L,_O•'C" i_I N��.� - --� t NOTICE rs NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTR IAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22.& 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5005786022006 03/16/2006 - 03/16/2007 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street- P O Box 527 Agency Inc Stoughton, MA 02072 (781) 344-3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS l 03/23/2006 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER Permit# Permit Date REScheck Software Version 3.7.3 Compliance Certificate Project Title: Appleton Construction Co. Report Date:01/19/07 Data filename:C:\Program Files\Check\REScheckWPPLETON-deeptoad.rck Energy Code: Massachusetts Energy Code Location: Centerville(Barnstable), Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance)' Glazing Area Percentage: 25% Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 21 Deep Toad Rd Appleton Construction Co. Centerville,MA 37 Baird Way Centerville,MA 02632 508-428-7680 Ceiling 1:Cathedral Ceiling(no attic): 1340 30.0 0.0 12 Wall 1:Wood Frame,16"o.c.: `710 19.0 0.0 32 Window 1:Wood Frame:Double Pane with Low-E: 1- 0.330 46 Door 1:Glass: 42 0.400 17 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space: 310 19.0 0.0 15 Boiler 1:Gas-Fired Steam:88 AFUE Compliance Statement:The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 3.7.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Company Name Date Appleton Construction Co. Page 1 of 4 I REScheck Software Version 3.7.3 Inspection Checklist Date:01/19/07 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.400 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Boiler 1:Gas-Fired Steam:88 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑ When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity.The lighting fixture shall have been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: ❑ Ducts shall be insulated per Table J4.4.7.1. Appleton Construction Co. Page 2 of 4 Duct Construction: ❑ All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. ❑ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools must have an on/off heater switch and require a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Appleton Construction Co. Page 3 of 4 Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature(°F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(°F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low PressureiTemperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Appleton Construction Co. Page 4 of 4 BOISE- Triple 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Floor Beam\F1301 BC CALCO 9.3 Design Report- US 1 span No cantilevers 1 0/12 slope Monday, January 22, 2007 07:09 Build 057 File Name: P Appleton_Hartman.BCC Job Name: Hartman Description: F1301 Address: 21 Peep Toad Road Specifier: City State,Zip: Centerville, MA Designer: Joe Madera Customer: Peter Appleton Company: Shepley Wood Products Code reports: ESR-1040 Misc: 3 1 1 13-00-00 BO,3-1/2" LL 4680 Ibs B1, ILL 4680 lbsbs DL 2064 Ibs DL 2064 Ibs Total Horizontal Product Length=13-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib 1 Standard Load Unf.Area(psf) Left 00-00-00 13-00-00 40 10 12-00-00 2 Unf. Lin. (plf) Left 00-00-00 13-00-00 60 n/a 3 Unf.Area(psf) Left 00-00-00 13-00-00 20 10 12-00-00 Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 20400 ft-Ibs 63.9% 100% 1 1 -Internal Completeness and accuracy of input must End Shear 5415 Ibs 45.7% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U382(0.394") 62.9% 1 1 output as evidence of suitability for Live Load Defl. U550 (0.274") 65.4% 1 1 particular application.Output here based Max Defl. 0.394" 39.4% 1 1 on building code-accepted design properties and analysis methods. Span/Depth 12.7 n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 6744 Ibs 75.9% 73.4% Spruce-Pine-Fir ask questions, please call (8 B1 Post 3-1/2"x 3-1/2" 6744 Ibs 75.9% 73.4% Spruce-Pine-Fir 00)232 0788 before installation. BC CALCO, BC FRAMERO,AJSTM, Cautions ALLJOISTO, BC RIM BOARD TM, BCIO, BOISE GLULAM- SIMPLE FRAMING Member is not fully supported at post BO. A connector is required at this bearing. SYSTEMO,VERSA-LAMO,VERSA-RIM Column at Bearing BO analyzed for bearing only, column analysis has not been performed. PLUSO,VERSA-RIMO, Member is not fully supported at post B1. A connector is required at this bearing. VERSA-STRAND®,VERSA-STUDO are Column at Bearing 131 analyzed for bearing only,column analysis has not been performed. trademarks of Boise Wood Products, L.L.C. Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(L/360) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Connection Diagram f—►I b d a 0 O / c e 0 0 0 a minimum=2" c=7-7/8" b minimum=3" d= 12" e minimum= 3" Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 BO1$E" Triple 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Floor Beam\FB01 BC CALCO 9.3 Design Report-US 1 span No cantilevers 1 0/12 slope Monday, January 22, 2007 07:09 Build 057 File Name: P Appleton_Hartman.BCC Job Name: Hartman Description: FB01 Address: 21 Peep Toad Road Specifier: City, State,Zip: Centerville, MA Designer: Joe Madera Customer: Peter Appleton Company: Shepley Wood Products Code reports: ESR-1040 Misc: z 3 1 s. 13-00-00 J'. BO,3-1/2" LL 4680 lbs 61,2064bs 80bs l DL 2064 Ibs LL DL 064 Ibs Total Horizontal Product Length=13-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib 1 Standard Load Unf.Area(psf) Left 00-00-00 13-00-00 40 10 12-00-00 2 Unf. Lin. (plf) Left 00-00-00 13-00-00 60 n/a 3 Unf.Area(psf) Left 00-00-00 13-00-00 20 10 12-00-00 Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 20400 ft-Ibs 63.9% 100% 1 1 -Internal Completeness and accuracy of input must End Shear 5415 Ibs 45.7% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U382 (0.394") 62.9% 1 1 output as evidence of suitability for Live Load Defl. U550 (0.274") 65.4% 1 1 particular application.Output here based Max Defl. 0.394" 39.4% 1 1 on building code-accepted design properties and analysis methods. Span/Depth 12.7 n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 6744 Ibs 75.9% 73.4% Spruce-Pine-Fir ask questions, please call (8 B1 Post 3-1/2"x 3-1/2" 6744 Ibs 75.9% 73.4% Spruce-Pine-Fir 00)232-0788 before installation. BC CALCO, BC FRAMER@,AJSTM, Cautions ALLJOISTO, BC RIM BOARD TM, BCIO, SIMPLE FRAMING Member is not fully supported at post B0. A connector is required at this bearing. BOISE GLULAMT^'SYSTEM@,VERSA-LAM@,VERSA-RIM Column at Bearing BO analyzed for bearing only, column analysis has not been performed. PLUS@,VERSA-RIM@, Member is not fully supported at post B1. A connector is required at this bearing. VERSA-STRANDO,VERSA-STUD@ are Column at Bearing B1 analyzed for bearing only, column analysis has not been performed. trademarks of Boise Wood Products, L.L.C. Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(U360) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Connection Diagram t b —d a o � o c e 0 0 0 / a minimum=2" c=7-7/8" b minimum= 3" d= 12" e minimum=3" Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE I C w ���� C it wrs� y d� f I f I i I t i i I I ` I 1 G i 1 i tJN®d! s IMPORTANT ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS. NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS—THE ELECTNICAL "."T DOES NOT SATISFY THIS REQUIREMENT. I f .a I I �FEZ �(�" d•�• ` � 3 coy i ILt _ Y, . Pic oG I I I FU,��wr;ow �9 QtAM j YV 1 074 IZ t 0`� rvLj \ w L�tif� nor _ R Ir kc . v _. wNrU A l� h,U4,06+7 o w' Lrl ue'] e 0ao-,p Li I r r i c � r r 960 LO t i f 1 LA JD 12 , dn Vr a 3x �Zj Tt- e� ggz� fi i I wit x y1 lT� T1Q✓I,J✓�-U�� N1 t�'*S,)J� Lv L S Cu. l,L4L� i Y i �!G SiJ1' j , f N7 a- stl� 1 1 I i i I i V I ' I II Qco ` 4t•e- �✓�c/}v� f- a i .. d e — ti - s,s I f IC � iI -I T - - r J , a� --2 �o�s i a It, g4- � —w �5 os - i ti,��. • • 1vI-� � � x � - i ,� r : I 1 I ' I i I , - -_ I I s 1 i Will oavl tic 1414 ,,Q o ,-1- 0 Ai ;- i { OA : � � f i i I i r. I I i i i r , i r i -� --I I f j j ! _ 1 " I j 1 , , -.. f---_ a�� I , I I I i t .. � I i • —, -- — r I T � I I � . JLLoll , I —_ _. �— -- -- ----- — i : I I i I I j I t/ VI , a : i I f _ — ----— t i : , I I � • L i l i s ( 1 . , f , I h � I ' � f I ( , : I ( I I 1 " u , y i ' i ? ! 1 I I i ---- get— _ 1 ' , i v �v I I i Daniel E. Braman, RE 189 Harbor Point Rd. Cumniaquid. MA 02637-0361 T'� ct 6 q o r.G.0 V 1 12 k 23 c2 5 � a of ,r o DANIEI_E. sd� � vilka � c II I , I : I �N«0 te� I i•_i i ,�.W .1� ..... I fi e{ I .j i •1 � I �a .I 1 i a I e� r i�b � k �SeD 4kto coflan ..{ . b ; I I I , I i . I' , _ , I r , : I , r i , I I : 1 r •, : r : I , 1 r r j , i I : I' I r I : I I i I j ; i r I : f ; I I I I ' I ' 1. I : j I t I ,. I _ l �P . C. .w ....... _ . j. OJA ------_ er ( C ` g« ..._.... „ . t t , i IH4f 7� �� % _ lleAssessor's map, and lot 'number .. ............................. .... /7 L e Permit number ............................................... 2 TIBLE. House s e number ................................................ ............... ........ ae TOWN- OF -BARNSTABLE t INSPECTOR BUILDING�' APPLICATION FOR PERMIT TO ................................ ............ .. TYPE OF CONSTRUCTION .......w..01?.P................. 19."YA................................................................ . ....................9.........7... .......19.E y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby- applies for a permit according to the following information: RCI — Location ... ....... ............................. ................................/..........?-....q ...................................... ProposedUse ...............�q!!! !t.q.,A7..................................................................................................................................... (�y � �! e iv e— Zoning District ................ Q.............................................Fire District ......................... ............. ...... ............Address Name of OwnerAf.......................... ......V...dj. .... Name of Builder ........0. P....................................Address ...................... ............................................................... Name of-Architect .....Address .................................................................................... Number of Rooms ...........0/ ....................................Foundation .............. ......................................................... Exterior ............... 1:1 ./_>............................................Roofing ................... ................................................ Floors ................ .................................i.................................Interior .....................$.................................... ....................... Heating ............... a /-CA...........Plumbing ..........2............... f.... /xt...................... ........................................................... Fireplace ........ ...................................................................:........Approximate ......................... ......Cost ................ Definitive Plan Approved by Planning Board --------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ............Sen....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH T rl 3 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... �y Construction Supervisor's License ......... _r ARTMAN; HUGH & SANDRA 4065 Permit for BUILD GARAGE Accessory..to Dwelling........................ Location ..21' Peed Toad Road...........:............ r/ ,r -�' - _ •' ' .... .. . Centerville...................................... Hugh & Sandra Hartman Owner ' Type of Construction ...................................... ............................... r ............................................ o ( 1 1 , ...... .� `Plot .......................:.... Lot ................................ October 5 = �' 84 :• Permit•Granted ...... .................................19 r„ 1, M :Date of Inspe io ...........l........z 19 'Date Completed . ..` ...19 foil � , { r r � J111001 r f .r ►..to GA�AG� Gtz,�,� S�t-Ic TAtit� = 330,, Imo % _ 4-95 6.P.o. --- usue- c ooX:�3 rGAL . �15Po5AL PIT - USE. lvc3o GAL, �•s,rN So c�.RD. raur TOTAL �EStGtJ = d RZ7. ��( � fZGDlQT101.J Ql�TE IU Z�trt/u OfL LE«F. .44 ON } � �i�� to'�.'d I+y � 'l� f - �•(/, �►�`'J ��i.�T iC�f� �1�. ? oo.o 4. r: w Sepnc 1000 T�:� 63 ` T'iatitK INV. IW G4L. 964 �lED PI TA WAS41B'D STONE 1 Ir'•.� C1=lZTtFtEL'� pl.c�T F�t_.,Ci,t..I PRo F`t LI LOC.ATIC)" b�ATE tZ.(2rj�17 LC✓t�L I GGVTiV=-( T44AT T1-IC-- FvowownO4 %Aaw►J �t.t►,►.1 R�FEtZ�►•1C� Wt-- G:ms-1 fC>AAPLYS 510E Lt► F-- LaT �U AhlL7 SETt3ACIG♦\ �'C-4At�l�l✓NtEi•1TS GF TNt: Tdw►,.r of ,� ��r �..� �� PA.-TM PEA k3A 7CTCR- E 1QG_ RCGiSi''C.iZ�D t_AtlC'i 5U2��Yai~.S THIS PL.A►--1 15 WOT 13ASE.•D C)" AN 05TEf.Vtl_t.C-, o rIr�ASS� ttJSC%ZJAnt=e t;' >uQat Y .. TlaC: oF�y�T'�, 5tlowlx� APPLI CA.."T t-`ter C',�_ USCCL� �T`u t�i_rCL'M+N� LD`C' t_1Nir�.� � ... . . • �r �sessor's map and lot number vcf%TIC SYSTEM MUST BE. D 7 ce�/d I" STALLED IN COMPLIANCE Sewage .Permit number ..,.....,................................................. I WITH ARTICLE 11 STATE SANITARY CODE AND TOWN Q�OF71ET��4' TOWN OF BARN-�` T ABLE cf BASHSTODLE F BUIcID.IHG r INSPECTOR. i639 �� �.:; E MAI a 039 • fOR�PERMIT TO ... c 1 � ..... ..... .....:...APPLICATION� °4 TYPE OF CONSTRUCTION ........0.0,0. ........................ ....................:..:..................................:.................. _ Rqq +� ;r ..<.....................191 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according ,too the following information: / �/J/ Location ..4&t...�14.........tce ...../0.q_.0 ..... ('...�............. P..tn..fe.( . l..l.[..'P,. ...(...".LPL .�:............... ProposedUse ...... .l.t?. ..�l.e. �r..................................................................................................................................... ZoningDistrict ....[.1..0.........................................................Fire District ........ .............................................................. Name of Owner ))f'Ld1.'e_ud.... C?.✓..1. ''1...............Address Name of Builder .A_,6. t......97-U).e.`/...............................Address ........ 4G.LC.Se. Name of Architect ..................................................................Address Number of Rooms .....G.w...(................................................Foundation .... tr4tC?.1.P ................................................ r Exterior ....Q2ac£ r.......:5:LV* e:.5.................................� Roofing ......)45.).kc,1.f................................................... Floors .. G s.'?..e... .............. .............................................Interior .......-.,4.:�.P.7'I:Q.-cz.k......................... Heating ...�.�s.�..ho.aG .(:c.... �. �.....�' /.1.... Ptld.Plumbing �1. '..t fie. f�i� .9`. L°.K LL...................... Fireplace .. .. .................................................................Approximate Cost ........ ..ly QG? ...................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ...?.b �........... /. ..... Diagram of Lot and Building with Dimensions Fee ....C.�r..�o ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ac-d ... . ...~. ............ i Popovich, Andrew No ..19859.... Permit.for .....NAWAZ............ . .................... ..................... ........ .................. `[ Location .......Z1..ReaR..xoad..Rd........................ _ s. ............................Centervlle....... ................... . a Owner ...............Are.drew.P.opomlch...........I....... Type of Construction ........Wood......................... ..... Plot ............................ Lot ....10........................ Permit Granted .....,,•December 30 ,19 77 . Date of Inspection °Ll� . .......19 Date Completed ay.IA 7.� ... , PERMIT REFUSED ....f....... .p✓r....L� ............................................................................. .................................................. .......................... , . .................... .................................................... ._ Approved ......................................*........ •19 ...............I.............I..........._ ..... ............................ f ............................................................................... r ti �1