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0074 POND VIEW DRIVE
�, _ . . . . . .+ _ .,a .. r .. . , 1 W' ., .. � ',. ` V _ - o ,. ., r I � - (, ,. e f e _ � ,. ,. r � o � � „ � - - S ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION OF Map Parcel Application # _ 1-7- clq-7 Health Division " 6 F-; 9• Date Issued Conservation Division Application Fee Planning Dept. of _�r�� Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis r Project Street Address P�N '� U�+ �.vJ b Ike L3,.>— Village Owner -Y").0 kA-kn ke rcusv_�_- Address Telephone —C Permit Request 2 G �. �.�►�. 'L 3, Z'� l C.e�t,�Jf� P(26,,A Qp) R(0-3N - L� cc I oA ro -Fo ((ok� �..,S Jkc 1.e A-iAz_ c7 re feet: 1 st floor: existing proposed 2nd floor: eAst`ing proposed Total new p ov/ Zoning District Flood Plain Groundwater Overlay Project Valuatio ., DD Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name (�Q�� L:�v sJ�C hd� Telephone Numbers Address License# I d 7 C ON �, a a'7 ? I Home Improvement Contractor# Email iOeTe -7 7�� .,fir, Worker's Compensation #'' 6PY3 C� d/ 00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # ' DATE ISSUED MAP/ PARCEL NO. z ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. TOW11 of Barnstable �znrc a�a Richard''.Scati,Director $A rb3g. ti0 : p uIlding'Divisio Tom Perry,'Bu ld ng C:urrunismtier 200M.,dn Stree2;11pariMis, 02601 s�>�r t�.tc�cvrz..l�arn5ta:lile.rna:u.s Office: 508-562 1,035 •Fay:: 508-790-6230 Property C.3v4aezMuse Complete .'h s Section fff Usiu�ABujfdcr ' 'I'---J,64vj {r rZ c uS tic C _ ;ws Owners the subjeLr propail;y e=cl� uchc� �r, �: 1 ... .__�:.........._...._ _ to s:cto ybenalf. m-A maucrs:-ehi e to-,vorkautholl,M a.b ,this buil in rr�rit.ap�l:.c_e Tor- 21 iclx ss of iob "Tool fences and alarms a the zcspwOblit o t�tt� � iic t.:�. r -( p le ore fence ll.a .rexattyLe l zta e t al mspecwns ar _1 t txg�necl anci ac�ej�tt cl ✓I, l'suit Nam Priat N?u The Commonwealth of Massachusetts Department of lndustrWAccidents 1 Congress Street,Suite 100 Boston,M4 02114-2017 www mass govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electridans/Plumbers. TO BE FILED W t WITH THE PE RMITTIi�G AUi`FIORiTY: Applicant Information Please Print Legibly Name(Business/Organiaabomgndividual): t2 4CJVZ { 71 �ni S,)(A�'1 611) Address: City/State/Zip: LMI� Phone#: �� f � `� +' d y Are Zpioyer?Cbeck the appropriate bon: Z J,7 7 f Type of project(required): 1ployer with__L.�_aaployees(full and/or pair time).' . 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me m S. ❑Remodeling any capacity.(No workers'comp.insurance required.) 3. I am a homeowner loin all work 9. Demolition ❑ g myself[No workers'comp.insurance reguired.)t 4. I am a homeowner and wrll be 10❑Building addition ❑ hiring wntractors to conduct si]work on my property. I will ensure that all eotrtratxors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no anployees. [j 5.©I am a general contractor and'I have hind the subcontractors listed on the attached sheet 12. Plumbing repairs or additions These sub-contractors have employees and have wormers'comp.insurancet 13. Roof repairs 6.❑We area corporation and its officers have exercised their right of exemption per MOL C. 14.EP00ther w 6✓i1iel`• L d ,) 15Z§1(4),and we hzve no employee&INo workers'comp.inszuanee mquhcd.) Any aPPIicant that checks box 91 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 roust 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 ties have employees. If the sub-contractors have employees,•they must provide their workers'tromp.policy number. lam an employer that is provk ng workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name• 2 �nJ f C O Policy#or Self-ins.Lic.#: �,J C d Y d�a c� D y Expiration Date: C� 2 Job Site Address: � /'0/�✓, j/� ,✓ /� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiratiofi date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to,$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify raider I th p zs and penalties of perjury that the information provided above is true and correct Signature: a Date: b q 1 t Phone#: Z7 1 4- �S 4T Official use only. Do not wkle in this area,to be completed by city or town offidaL ' L ty or Town• PermWLicense uing Autho (circle one):Board of Health .Building Department 3.City/'I'own Clerk 4.Electrical Inspector 5.Plumbing Inspector Other ontact Person: Phone#: 11141 Office of Consumer Affairs and Bus>ness Regulation 10 Park Plaza- Suite 5170 • - Boston,Massacyusetts 021 16 Home Improvement -Otactor Registration f -'=- — Y=' Registration: 160461 i w . Type: Private Corporation :. •'_V i�i` Expiration: 7/29/2018 Try 289184 RETROFIT- INSULATION, INC. JOSEPH REILLY �} =`' ' ' t �Y•: w .�.� )+fir. P.Q. SOX 105 ''; SEEKONK MA 02771 Update Address and return card.Mark reason for da"ge. scA, 2oM o�,y Q Address 0 Renewal � Employment El Lost Card VJte [OQ'nv1'LOhI,UJo�td�vGaCJac��cl4B�ld• ' U£aice of Consmer Affairs&BusWas Regulation License or registration valid for individual use only. HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registratlon:t'.,3912fl9$ Private Corporation"jgoggq Type.• Office of Cooronmer Affairs and lusiness Regulation txpirdtlpn_ ; -" 101ParkPlaza-Suite S1.70 ,_�l . =,.:,�,_=__•;--A. -:,: Boston,MA 02116 RETROFIT INSUTAl;i5t 118 :_'' JOSEPH REILLY 644 ROAMAN ST FAU RIVER,MA 02721 Undersecretary N&valid without signature • t r t Commonwealth of Massachusetts y®� Division of Professional Licensure Board of Building Regulations and Standards Constructipon+5�0�r Specialty - `� ff CSSL-102771 "4 L ires 06/05/2019 JOSEPH J REfl-LY, PO BOX 105 SEEKONK MA 02"r of --A Commissioner v AC RETRINS-01 RBLACKI �- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDWYYYY) 8/1112016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HO.LDIR.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONS1ITl1TE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INS.UK—,the pourry(ies)must be endarsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the polity,certain Policies may require an endorsement.A statement on this certificate does not confer rights to the . certificate holder in lieu of such endorsement(s). PRODUCER License 9 i78.0862 CONTACT HUB International NeEngland NAME: 222 Milliken Boulevard Ext:(508)676-1971 a Na:(508)678.2750 Fall River,MA 02722.9946 F�MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE. NAtCtI INSURER A:Selective Insurance Company of South Carolina 192 INSURED INSURER B:Star Insurance Company 118023 RetroFit Insulation,Inc. INSURER c: PO Box'105. INSURER D• . Seekonk.,MA 02771 INSURER E- _ INSURER F COVERAGES CERTIFICATE NUMBER: T HIS IS TO SION NUMBER: CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INAM D ABOVE FOR THE POLICYPERIOD ICATED NOTWITHSTANDING My REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUv1ENT.WITH RES.PECTTO WHICH THIS RTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJE&rTOALLTHETERMS, AND CONDtTiONS OF SUCH POLICIESLIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A TYPE LGENE INSURANCE LIABILITY I D POLICY NUMBER MM/DDYNYYY MMlDDY IXP LIMITS A X COMldERCWLGENERALLWBiL1]Y EACHOCCURRENC.E 5 1,000,000 C(A1MS4AADE Q OCCUR n S21876.53 0811512016 081t512017 PREMISES Ea oauirence 5 100,000 MEDECP(Anyeneperson) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE S 2,000,000 POLICY"jE,,C(,T, LaC PRODUCTS-COAAP/OPAGG $ 2,000,000 OTHER: $ A TomoBILELIABILITY COMBINED SINGLEUIyUT A Ea aeddent $ 1,000,000 ANYAtITo SIOO18200 OW1112016 0811112017 BODILY INJURY(Per person) S ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Paraccidettt} $ X HIREDAUTOS X. NO-OWNED PROPERTY DAMAGE . Poracddent S X UMBRELLA UAB $ OCCUR EACH OCCURRENCE S 1,0OO,OBO A MESS Lu►B HCLAJMS-.MADS 52187653 0811512016, 08/1512017 AGGREGATE S'. DED X RETENTIONS 0S 1,000,0.00 WORKERS COMPENSATION - ! PER 0TH- AND EMPLOYERS!LIAaiLiTY STATUTE ER B ANY PROPRIETORIPARTNERIECECU7NE YIN C0845201 0810212016 0810212017 E L EACH ACCIDENT $ 1,000,000 OFFICER1ME 011EXCLUDED? NIA (Mandatory in NH} E.L DISEASE-EA EMPLOY S 1,060,000 Ifyes descime under OESCRIPTIONOEOPERATIONSbetovr E.L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101.Additianal Remarks Schedule,maybe attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 WaSWEIgtorr Street ACCORDANCE WITH THE POLICY PROWSIONS Westborough,MA 01581 AUTHORIZED REPRESENTATIVE 0 T988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION s Map Parcel O J I Application # - — PP o Health Division Date Issued t ^ 17 Ff Conservation Division r BUILDING DEPT. Application Fee Planning Dept. Permit Fee � n y Date Definitive Plan Approved by Planning Board JUN 15 2017 Historic - OKH _ Preservation/if a"MisOF RARNm TA , Project Street .Address _ Village Owner. ���,� Address '7�i lac �cecr, Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation "PT& Construction Type Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O� Two Family ❑ Multi-Family (# units) Age of Existing Structur L� Historic House: ❑Yes J o On Old King's Highway: ❑Yes Basement Type: C�'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.)_ Basement Unfinished Area (sq.ft) :Q5— Number of Baths: Full: existing new Half: existing new Number of Bedrooms: -3 existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: B'Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes o Fireplaces: Existing I New Existing wood/coal stove: ❑Yes C�-Rd'o Detached garage: existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes �<o If �es site plan review# Y Current Use Proposed Use 40, eO� -APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Telephone Number '"74( 9 Address4,�y ,.,6 k License # n?T-J 3 ( LI Home Improvement Contractor# 47 Email agct,�4 op Worker's Compensation # , w s"Wb 4" ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE & I4 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: " FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDINGV�ZS e`l 1 It DATE CLOSED OUT ASSOCIATION PLAN NO. I 17m CommomveaItit of- sr diusetts. Department afl'iudusaid Acciderds Off we afbntw-sftga6o= ei 600 FPashizigtou&reet Boston,.CIA 02HI topientass_govIdia Warlmrs' Campensxffun.Insu-mce Affidz it 13,iiiIdex-s/Cmtrartors/Mectdzian!;/Phanhers AppHcantEdwmafinu PleasePrint Naaae on iuess ,xdtid(sh'6�1�ar ert t v�-,Q City/State,( Phone'-4:,`-- -7 96 a Are employer?fheckthe appropriate bom ' Type of project(required): I_Z I am a employers wffi EJ 4 ❑I am a general conirsctor and I 6. ❑New omstructioa employees(fish andfor part-ime).* have hired•the sub-contractors I_ [�R/ 2.❑I am a sole prcpzietor or partner- ste10 n the atta6ed sheet;. nlodedtag 'lltme smb-confractors ha e ship and have na empl�ees • $_,❑17etnalifioa Wading forne in�Y capacity. es andhace wod:rs 9. Budding ad$itiutP ts'LNO wod:e comp.insurance comp_in ran�ce, ❑ required-] 5- ❑ We area•ootporaiim and its 10❑Electrical repairs or addifb= of have�est dsed their 3_❑ I am homeovmer doing all work1L❑Plumzbingrepaus or additions• . mysdE o wok1m'comp- might of exemption12 ins,�ance reed]1 c_ ,§ (� per MGL ❑ I52 I and we bare no Rtyafr 1 13-❑other _ employees.[KC,wa�ess . cotter_inmrmim required] •AnyW 62tdieclaboa#1masta1sufiAoutthesetBottb�imrsbmdag eirwo3ceb'mmpevsatinupo yi�vEmsao� �Saoteovirays�rho sabmit r�tis�dacu i�cating Sw_y srgtioing alfvra¢3t radthealuix anisid�ca�ac��+-�zmtct so'hmita nemsffida�t indif9�Sx�rFi rCoattactpsIffi ebeathis box mastate=zri iK-21sheetshowingthannneofthesub-camtzctom2ndstwtevrhe&etormotfhosemffinbrm emp3oyees.7fthesnh caatn�Esiu�e empIapees,they pmui&their uvdkes'comp.parmy a>msber. lam art HdowisMerpa cyandiabs'ite infornzat om Insurance Company.Nt ame: j Policy or Self-ins.Zit:_ XLJ.S '�'--7� ��1�' iFatiou Date: . Job�Addt� '7� D� U GttaJ ID ° City/State Zap:Agg CaAr&3 Attach a copy of the warltier a coampmsationpolicy-decL-irafion page(showing the policy number and expix-ition nte). Failure to secure coverage as requiredunde:r Section 25A of MGL c-1572 can lead to the imiposibm of nrinninai penalties of a �irre up to$l,SUa Oa anNor one-year imprisonment,as w6U as civil penalties,in flee fora of a STOP WORK ORDER and a fine of up to$250-00 a day againd the violator. Be advised drat a copy of this statement maybe forwaided to the Office of InvesEigaffi=ofthe DIA.for insurance coverage Aimrficah 'Ida rfawby Conte rudder tl- of f7iatfJts utfartrieaiimrprm rl�d abates i�bars a�td correct Simtafure-Ld Bate Phone it ?�( ' "(3 96 O,, Trial use anry. D-a,(.tot wHe inn dds uxalr,to be-cmmpleterl by dry arton?i official . City or Town: PerrmtT1cense# Lwuing Aufiwrity*(circle one): L Board of Real& 11 Building.Departmcut 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: laf'ormation Wai d fustruefiouS > General Laws M regmms���'�provide work'ComP for their employees_ polsaatte this sty,an MPIoy=is defined as.";evergpeasanin.$te service of another under anY cOl ft3d ofhfi express or implied,oral or vh•." associ.ory corporation or other legal e�y,ar any tWe or more ,.qn�Fvyer is defined as"aa in P��� h of a deceased employer,or ibe of the foregoing m a Joint ,and mclndmg tiie Iega1 repres ''`` receiver or trastes of in�idilaL p ,association or other legal entity, Y �PIDY - However the hone not m than tbree apartments andwho resides t hero,or the occ�of the- ownez of a dweIIii?g having co skull on or as wak oa such dwelling house dwelling house of ann�who ernploys P to al mai�an ce, „ or arl the g�aunds or but7dmg agpurten�th to shaIlnntbecanse of sucb.empl be deemed to be an e•.mployer. MGL cbap�I52,§25C(t7 also stems that¢eV sf�or local Iice ln agencg s zIE aId$ze issuasice or renewal of a*cense or permit to operate a basin or to constmct b7uZdb gs in/the� Dawealth for any covexage r " applic�ntw•ho has notprodnced acceptable eYiden of compliance'FPitli tbm; ��- AdditionaIIy,�[GL r ter ISZ,§ZSC(7)slb s¢l�Teith the comoia eslfh nor arty of political subdivisions sliaIl enter tutu any caairac#for the pert ancd ofpublic wn acceptable evidence of regtt>reme of this r3sptur have Been p==Jr'd t o the i AppIican-�s ' ease fill ort the wow'compensation affidavit completelY,by ec g f e b• that apply tD Your sifnaiion and,if PI o necessary.supply sib-con= i(s)name(s), addresses)andphone er(s) ngwlathea cerifficate(s) f T,�nce. L=it�dLiabR4�PaMCS(IEC)or Lion e Liability s(LI P)wino employe s other than the mem ebers or patin ns,are not ibqua-d to cant'WM30 zsr co"Pensati If an LLC or LLP does hate - m e to file Dep arbnent of la&lsbrial � Io ees a oli isrequn-ed. Be advised thatthis affidaYrt ay _ emp Y P GY nE mation.of il=Snce cove-agb Also be sure sign date e of daYri= ITie affidavit should ccidents for ca . � nottheD. arLznentof beref=ed to$e city or town that file application for the permit Ii a is eing reques A. ep Tn ustriai�4_cc rim �honldYon have any qu�ons regarding e Iaw or ifyo are requaed to antes a wori�rs' compensation policy,please call the Deparime�at the numb ow: insured companies should enter their self-insurance Reese z�ber on the appropriate Ise. City or Town Of EiciaLs Pleases be soa-e that the affidavit is complete and at the bottom pri�ei . 'Ihe Department has vided a space of the affidavit for you till out in iha event the Offi o tigatinns has to combo ouregazdmg the applicant_ Please be star-tDfMinthepermWHceaseminber be used as areference er. Inaddition,anapplicant le e�flfcense in givenyear,need only submit a affidavt iadiraiing cusent tbaf mus�E submit mu1t� p aPP policy inrornation�if necessat3')and under"Tob R s"the applicant should wee locations II ( 'or town)."A copy of the-affrdavittliathas beea oP ell or maimed by the city or maybe provided tD fiie " applicant as proofthat a valid affidavit is on s permits or licenses A new at�da Est be tiIIed out each year.-Where a home owner or cYL=1 is o license or peamit not related fo any busincs or commercial vesdi� (Le.a dog licenseorpeunittoburn leaves ,.) dpersonis NOT IcT*edt)complelet d, vit the Office o f�v would]i(�e youui advance far your cooperation and.shouldy u have any qacstions, please CID nothesitate to give as a call the Ilepartmenfs address,tnlepbone faxnumber. 1 ' M-VjeStbE of ch Bwto ,Irk EMI 11 -Tr--.4 G17- -4 Qxt 4€96 W I--977 MA&V-FE Fax 617-'2'-7M IZ.evised•�2.4-•07 - ��-��- r . C)AC� DATE(MMIDDfYYYY) ®� . 11% C CERTIFICATE OF LIABILITY INSURANCE 6/1/2017 THIS CERTIFICATE IS ISSUED AS A MATTER`OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and Conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer,rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jane Logan Gordon Atlantic Insurance PHONE (761)659-2262 FAX AIC No (781)659-4725 306 Washington Street ADD ESs:jape@gordonatlanticinsurance.com INSURERS AFFORDING COVERAGE NAIC# Norwell MA 02061 INSURER A-liberty Mutual Agency 6201012 INSURED INSURER B:Commerce Ins. Co. 34754 Lux Renovations, LLC, DBA: Owens Corning of New INSURER C:Peerless. Insurance Co. 24198 60 Shawmut Road INSURER D-liberty Mutual Agency 6201012 INSURER E: Canton MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER:Kaster JL 9/16/16 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE WSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CON.DITION�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 DL S B POLICY EFF POLICY EXP LIMITS LTR - POLICY NUMBER MM/DD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CWMS MADE OCCUR DA AGE ToPREMISES Eaoccurrence)RENTED $ 100,000 CBP8512851 9/5/2016 9/5/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 21000,000 X POLICY PRO- JECT $ LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT . Ea accident $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ BI & PD.CSL ALL OWNED SCHEDULED AUTOS X AUTOS LP7677 4/4/2017 4/4/2016 BODILY INJURY(Per accident) $ BI & PD CSL HIRED AUTOS NON-OWNED LP7677 PROPERTY DAMAGE AUTOS 4/4/2016 4/4/2017 peraccldent $ BI 6 PD CSL $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB X CLAIMS-MADE z AGGREGATE $ 1,000,000 DED X RETENTION$ 1.0 000 CUS511953 9/5/2016 9/5/2017 $ WORKERS COMPENSATION - X PER OTH- - AND EMPLOYERS'LIABILITY Y/N - STATUTE ER - ANYPROPRIETOR/PARTNERIEXECUTIVE XWS57350449 5/24/2017 D 5/24/2018 E.L.EACH ACCIDENT $ 1,000,000 OFFICEWMEMBER EXCLUDED? N I A (Mandatory In NH) XWS57350449 5/24/2016 '5/24/2017 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under D ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT -$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) Cert Holder included as Additional Insured to General Liability Coverage per Blanket AI form 22-133 and Umbrella as coverage is "follow form" where required by written contract. WC excludes Dan Bawabe & Paul Deguglielmo, both LLC Members CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE INSURED'S COPY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jane Logan/LOGAN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo ari registered marks of ACORD iNS025 r?n1An11 II - w� Office of Consumer Affairs and Business Regulation ' 10 Park Plaza- Suite 5170 Boston, Mcusetts 02116 Home Improvem4 ntractor Registration Type: Supplement Card LUX RENOVATIONS, LLC. ; �w - Registration: 137943 Expiration: 02/04/2019 60 Shawmut Rd ,+ Canton, MA 02021 J SCA 1 20M-OS/11 Update Address and return card. Mark reason for change. % ❑ a3 s flAenewal El Employment 01.Lo,- sates ;,,, �e�ommoauaea�a�C>r�caa�cclttt6el�v ' Office of Consumer Affairs&Business Regulation 5 HOME IMPROVEMENT CONTRACTOR - � ,. Registration valid for individual use only TYPE:Supplement Card before the expiration date. if found return to: y =_ egistcationExpirationOffice of Consumer Affairs and Business Regulation y 02J04/2019 10 Park Plaza-Suite 5170 — Boston;MA 02116 LUX RENOVAT:IQ } D/B/A Owens Cgrtx�[}g&Bement Finishing Systems EDWARD ALLEI,60 Shaw Lit Rd k U Canton,MA 02021 Undersecretary Not valid without signature -------- —-----.--.. _--- ------------------- Massachusetts Department of Public Safety Board of Building Regulations and Standards License; CS-075131 Construction Supervisor EDWARD T ALLEN 30 STORMY HILL DEDHAM MA 02026 n -Expiration: a %Commissioner 02/27/2019 • r o Owens Corning Basement Finishin • g Systems of New England Petercluskie,John Contractor / Agent Authorization From 14'Pona View.Dr Centerville;NU 02632 508-951-2964 ,,' 1 �' [� J, �`�' C vS authorize Owens Corning Basement Finishing Systems of Boston to sign the building permit application on my behalf,to perform the work at: Home Owners Signature: Date: Project Manager Signature: Date: 60 Shawmut Road • Canton, MA 02021 • Phone: 781-821-0060 • Fax: 781-821-8552 • www.ocboston.com ° -PON �� �* � � 9-e� z E FI-P Petercluskie,John 74 Pond View Dr CONTRACT Customer Name_ Centerville,MA 02632 Customer Signature SKETCH , Contract Date_ 508-951-2964 Sales Representative Signature -— ATTACHMENT Customer Phone_ Contract Price 21 1 2 3 4 5 4 7 0 9 10 11 12 '13 14 15 19 17 1 19, 20 21 1 23 24 25 29 27 29 29 30 31 32 33- 34 35 39 37 35 39 '40 41 42 43 M 45 45 47 a 49 50 52 59 54 55 59 57 55 59 60 AWL i . r 11 , ILA it — 11 _ 9 — - — — --—' --- i -- -- -- A a =E- j -.r__(.__ •— �__._...__._..__._.._ ..- I .._ ......_..__ _'Il_.. ....I'_._ .. —_ _ _ - 13 14 7- is .. ._ I •_ i T _._.._._. ! I t , to - - ++ i 22, 23 24 •__. - F ! -- �' I--- I l i- I__f--.-.. _._ .._l.—..._ -- '--'-I-----'-•--t--�----�--!'—�--j-- j -.28 --_-1-- 1 I i - I i 28 .._ ... .... ._. .. .. ,...._.. � _.;.._ ___I..._.�.- .....___...... !. .. - —__— _TL_.__• �•i_--�.. .I, �. .i ., I, _.___t__._........� 1 30 31 .33 --r 34 NOTES: I Each box equals one loot unless otherwise noted.This sketch is a good faith t representation of the work to be done,it is understood that all dimensions > derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,jacks and/or switches are subject to change if necessary. f Town of Barnstable oK sli�l�� , THE Regulatory Serv-FM QE BARNSTABLE ` Thomas F.Geiler,Director M S&�`�' ' Building DivisioWOB ATR 22 6.39. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 i www.town.barnstable.m h j Office: 508-862-4038 Fax: 508-790-6230 PERAUT#� I FEE: $ i i SHED REGISTRATION 200 square feet or less �\ (z c �4eirv1, Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/Parcel# 4122113 Si a e Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway 1 Conservation Commission(signature is required) Sign off hours for Conservation'8:00-9:30&3:30-4-30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. i THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:05201 I i - 2 AV 0 I 10.2'f PROPOSED GARAGE v EXISTING �—PROPOSED DWELLING ADDITION LOT 21 A CB FND _ 14,471a SQ. CB FND cy p� 1-73 o 161_50, a- CB FND rn IOB# 04-307 z, WILDING PL 0 T PLAN t OR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR: 74 POND VIEW DRIVE JOHN PE TER C USKIE OCATION = CENTERVILLE, MASS. Ko oFztu:r 'Town of 113arnstable ermit# yam` ti� Expires 6 niar.hs fro issue.date Regulatory Services Fee 7 w BARNSTABLE, s� MASS.. Thomas F. Geiler, Director q ArED MPt Building Division Tom Perry, CBO, Building Commissioner 200 Main'Street, Hyannis, MA 02601 www.town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Prop 4'rty Address--- CJNil `ew l�{�/� C'� "j/?11 � Xpq � l'�` Residential Value of Wort. ��. G-00"^ —19rinimum fee of$25.00 for work under$6000.00 Owner's Name&Address , k /y Pe4,rr t1,�Ikt', 7 VJ l eo nk Contractor's Name- J Aj m es A 0/1/ Telephone Number C,2/'COO I tome Improvement Contractor License#(if applicable) � � Construction Supervisor's License# (if applicable) �kman's Compensation Insurance p P� PERMIT Check one: ❑ I am a sole proprietor ❑ I m the Homeowner SEP u 2 2OQ21. I have Worker's Compensation Insurance VN aFA1VSTA3L Insurance Company Name ewollv Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to. ' ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ R de ,�— .Replacement endow /doors/sliders.U-Value (maximum .44) ' *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. "'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: �?.`WPFILI:SU(7RMS\huilding permit forms\EXPRESS.doc Revised 100608 f y r . e eus> fttsWinrr Vatna. :Year Rutlt 1.� by hndersen_of Rhode 4ddress: #` Cus omrt Sl? Cd1 C n1 . 2� � , .6h aP Sales A reerrzent —/'�-`��y�� C t State,!t 113 {�,]�„ o ry P. -Gam. a � �zde �unb.r.: t -shot c I'onte:. �^ p• .• /'�/4] �'7outesov'irR�1 02895. D .;W.ho017`:R6ALACEtAEPIY. nPaxfia C.Gm(a'+Y ",' �: , �L:1�QC1��ZJ�-_----....--����'+/ �. 1Xle Pagr: L of Date_. ; dirense#R[ 3C839 R.-:2 59 I1A..; !S7 Pha1e JSiS:( C=5627'5�.. ".11 Te"cal hteascm Uh1fT5 GRILLES co Y. $jT;t't „cr•:. :,a :. '. ::t`n .;s'L'.. YR. 3; a. S _Room ' t;E. ;-5`� :S:Y. .:...wSc 'w _ & NS1. - $PRICE:S::' .... :z. .Dez2npUon, g$ �> + n.. .. L —8Sk 7 C, f-3 r t 0. V .:0 x-3 Y-3 i ` fij coy NT'-ji140...i 3 ✓ So. tj 3 - 3��o a S Jqq YaZ_ - 1.... lid M. �Z4 _. l- _ Prvlsas al;:All tdra'.t,rnx,amkr nrd ate hepwrldalM .gofaeaawnnstadtatuc ..rn.1Le ��..t1trollanrols(.:rrtL'rs r1�� .n.� - SubTatataur,t mertt,MetllOd�' . m! U. m>ewpaare ig, 4lxcnan.mul Narxrv:i?am�.M��xn Mamgexsa (Stalniagi U:,yr >r A<µu tt?xe 9 e..� amcr.. kl for%Ie�.avdn, egam .............r,l�r Mn w) "'J ?aatn.soaas D •I nonlNotes SRir.5 �rr p Ciietk SY Q`p �f Y+1 aK I/,rtac t7WA�9 cr+� _S !�� w6Tofn3 _ 00/? M. Rrn awlcnmsalsexrpa• p,u:, �^���� _ 't�t71� �85 y. CustonciAcv Oncw.Yauicnhn and sis'adeofwalahs.Umsodowariddarns ufwuua ,his - 'rJi..1�____.._. //}} / t,w.o ` C.Cteddtsor J�{-Cr 7jj cp 9}: *r9Wr. Pam' � )�Oa' r1`�/ZIf V�'r7/�l�s-+r•�r+ Fact+enses �X� �.IZ- . ay-v art 7o..e..sh arc.urArsgcxd.gnm ea pq M.xmm,ru anal d r y}mmcm av!u�-ntniag to du acra kratooe _____.. . See Reverse Side for Terms and Conditions of Sale.You;the buyer,may cancel Total Q Pinantirtg 7o�,F1 this transaction at any Prig to midnight of the tbird business day after Cite daze of this trnnsa n.1' -se see actnahed entice nf.cancellation.for an Sales Tax ..off. W,.i' n explan Of eh18„ it.: Tom!blls..ettatxo•,u Catdlti et Exornsea 1aaPm*���Iyy?"Q[i� — ism"^f.rs,—�""'•""'� r nttx mal to niv ctnl8/tapnat:m _ i r orw mA ium Vor nit 651 fih _ tFlwr<iktb UtlW rryl7� (.utauu A Srcrint Order Neon Total Amount of Agreement "D— .... ....... YM. bAnda u co,u stmtaD PoWae r s 9+eadmv nrry o&a�s•s..>vimrem -xmam+As..aersen P+urwartia:so�tmon okamms.a,erwsa,mnd:romamrtp vag t4iWnca Due en Wm lelion. + pip>inp n4.n:�J deerr:C gcmmm me WxM1:acr a+r sem d+<=aWxa<rwtt�impaaem daces,. _. ; -N - v bf tardoi .mrind�rd Nt,d xiTrulwMmr +otb att cesra-fllN at 'fl:a xred dmlrgti>taFaoonvx r+it w-a4a I i fpda anrn toeaoyn eMr env mkt Brc rataner oeaess raw aAar9a Yau!rman*ai GsWsn�mrtnacc�y ai s;itt i.^.e:ud: iafw, arrruU.inuallatiun. wFc nmM a6nx. era Nsml4vt. cdutWv nmad, Ai Ur:endm du%eaecaenu:nmdebnr;f W .a+slmvmnRlp:xno,a°nbarn aw Whfte•Renexml iyfa.dcrsen 14ftaw•Imtaltunor. Rnk•Xameawrtr tcsrunnl,ad d!sF ni aiprduoa rr{�lamL Customq�� 'Custom55r,���,,,��� Custome G 7ussawianan. 'altials:UK - miUsk: initials: ���/yl+� t..Jy y—� p _ L. ,t e TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION Map Parcel 03 , Permit# 7 7 2 P Health Division qC --)--3� 11(`�-a--� Date Is ed Conservation Division & 7,/0,5— Fee T Tax Collector Application Fee Treasurer v Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By !�D4 Historic-OKH Preservation/Hyannis Project Street Address A0,1dV etd VriV° , Village &g l g rcu We- Owner n -./ P`f✓ l �E W 5 K(C, Address o"20 &ti 1 9/1 Blckzg�S A��„Alf Telephone SOY c7W- 1.576 - Permit Request >o� ®� eW ®r�l e_o oIl'er frZ n 7 r ' e r c7 c� , � N � Li W Square feet: 1st floor: existing /CV proposed 2nd floor: existing 900 proposed Sal Total Valuation Q 00 -0 0 Zoning District Flood Plain Groundw Lr Overfgy' Construction Type W90d Lot Size 0• 9 Grandfathered: ❑Yes O No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes &<o On Old King's Highway: ❑Yes Wl o Basement Type: &Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Od Number of Baths: I Full: existing I new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new f� First Floor Room Count Heat Type and Fuel: ❑Gas ef Oil ❑ Electric ❑Other Central Air: ❑Yes a o Fireplaces: Existing New Existing wood/coal stove: ❑Yes a'No Detached garage:Zexisting ❑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 0 Commercial ❑Yes OrNo If yes, site plan review# Current Use ,� (��t'l�l d�. Proposed Use p1 BUILDER INFORMATION �/ Name �yr08'� KeLefi6tie �c����t�S �ephone Number 'I'77-1-36 7 Address 5 6-eAn S�&i t k Da� License# 62,31210 C3a 3�L Home Improvement Contractor# Worker's Compensation# WW- ALL&ONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE � �rZs FOR OFFICIAL USE ONLY PERMIT NO. / DATE ISSUED MAP/PARCEL NO. > ' ADDRESS- VILLAGE > 1 OWNER r. � f DATE OF INSPECTION: FOUNDATION I FRAME INSULATION FIREPLACE � � I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 3 ' - r GAS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT ASSOCIATION PLAN NO. f i o �c1HE'I . Town of Barnstable Regulatory Services •miss. Thomas F.Geiler,Director Building Division Tom Ferry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Ommer Must Complete and Sign This Section If Using A Builder I '10k v, -J• P-e'(-C U5 V- f' ,as Owner of the subject property hereby authorize Sea'V► -T° -goy Cam® to act•on my behalf; in all matters relative to work authorized by this building permit application for: OV . j (Address of Job) 1e `pb Wledof Owner Date t� s Fit jZ, cv S K r �, Print Name Q:FOR a:OWIERMRMISSION i 4 'r C f� i f t IEB L% 77 lo K D .. I y X PROPOSED .�'� o �O• 10.2 f GARAGE ti am 4 0. A3 ho So. � �. �• Est 5� ii � sp•25' v a• A �c EXISTING PROPOSED DWELLING ADDITION LOT 21 A CB FND 14,471 t SQ. FT. -H CB FND N am O 16j 50, CB FND JOB# 04-307 BUILDING PL 0 T PLAN OR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR: OCATI ON ; 74 POND VIEW DRIVE JOHN PE TER C USKIE CENTERVILLE, MASS. ;CALE : 1" = 30' DATE SEPTEMBER 27, 2004 2EFERENCE PLAN BK 95 PC 11 ASSESS. MAP 229 PCL 39 HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE .,ROUND AS SHOWN HEREON. H OF INAS c� S 9 off. 508-362-4541 �o`�� ARNE C,SGN I fax 508=362-9880 U H. sown cope engineering, inc. OJALA N No.26 8 CIVIL ENGINEERS LAND SURVEYORS �` 7-9:�G/ 139 main st. yarmouth, ma 02675 DATE REG. L RVEYOR i POURED ' 10.11t CONCRETE FOUNDATION A . 3`3�c EXISTING PROPOSED DWELLING ADDITION LOT 21 A CB FND 14,471 t SQ. FT. CB FND N o . 161,500 d • JOB# 04-307 CB FND FOUNDATION. PLOT PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR: 74 POND VIEW D IR� JOHN PETERCUSKIE ; LOCATION CENTERVILLE, MASS SCALE 1" = 30' DATE OCTOBER 26, 2004 REFERENCE PLAN BK 95 PC 11 ASSESS. MAP 229' PCL 39,' HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. off. 508-362-4541 O SRN€ fax 508-362-9880 M down cape engineering, Inc. CIVIL ENGINEERS LAND �SURVEYORS . s E•c�.2 G,2ac�y . _ 939 main st. yarmouth, ma 02675 DATE REG. LAND URVEYOR TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 229 Parcel 39 ,•;.,; Permit# r7 c�89 2— r e { ti"._4..Health Division c �3-'� f0/1/Q y ''`` ``, Date Issued 1611.5 Q y fill Conservation Division /- I� ' v E r / ,� 1:� Application Fee a Tax Collector Permit Fee � 7 ,�— Treasurer 41 + Planning Dept. EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LINKED TO,�5.0 OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address — ' O ml!�, V I e kd d Village C E WI:L-=P-NJ I L.LE Owner JOHhJ PC—IE IZ C U 6 K I 'C Address 90 01,1104 �T � 86f44,ks7_ E I` k Telephone 4 O8 - 8&_ - 8257 Permit Request 4Jb 1 v nkl %�'} m&6n Itl(n 67i IJ671)ieE_ t3 F Ofifff_ RMPxorn ' 6d6 o file- Fuu, Si+r-( ex&A6 eiTuled Si �S 1Y26 V6- LIQ4 g 6,4"6C_ Square feet: 1 st floor: existing proposed 2nd floor: existing IA proposed 3 J 8 Total new Zoning District Flood Plain Groundwater Overlay Project Valuation >'�® ®�� �.. Construction Type vlo0 Lot Size A 4-77/ !�Q -1� Grandfathered: ❑Yes �No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age Age of Existing Structure Historic House: Cl Yes VNo On Old King's Highway: ❑Yes �No Basement Type: Nct Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing IVIAnew ✓//-� Number of Bedrooms: existing new Total Room Count(not including baths): existing 4- new First Floor Room Count Heat Type and Fuel: V Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes G(No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes t(No Detached garage:0 existing V new size 16X;?I Pool:O existing ❑new size Barn:❑existing 0 new size Attached garage:t((xisting 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use �i BUILDER INFORMATION Name 6=�fJG �(fL f1 [J�� Telephone Number J a- :/1 �1 Address 3 g J I)6 License# Home Improvement Contractor# Z oQR S Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l0 / T FOR OFFICIAL USE ONLY 1 PERMIT NO. DATE ISSUED d MAP/PARCEL-NO. ADDRESS: ) — rt t VILLAGE ` t ' OWNER DATE OF INSPECTION: FOUNDATION (U to12aGoYA/v(-- 1121 _ 1 y ' FRAME F. INSULATION FIREPLACE f ELECTRICAL: ROUGH 71 FINALS - r PLUMBING: ROUGH E FINAL< GAS: ROUGH xr FINAL% ' Sy /. FINAL BUILDING DATE CLOSED OUT; ASSOCIATION PLAN NO. C3 a RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE 717 square feet x$96/sq. foot= 13 x.0041= 63 03,a7 plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE -square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq. ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) _ . F4re e i x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) - - Permit Fee ` Projcost �Z L ;Rev:063004 A - oF"Er° Town of Barnstable . Regulatory Services EAMST'ABU. ' Thomas F.Geiler,Director MM $ Building Division Tom Perry, Building Commissioner 200 Main Street, Iiyannis,MA 02601 www.town.barnstable..ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property to act on m behalf, hereby authorize. C ilcr�.�C_ �yS S Ayt„ T" my behalf, all matters relative to work authorized by this building permit application for. 1 PG,,J® V 1 �Lo (Address of Job) C rZ O nature a er ate Print Name i QT0RMS:07R4 PERMISSION Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoflware Version3.6 Release 1 Data filename:C:\Program Files\Check\REScheck\#4502.rck PROJECT TITLE:New Custom Addition CITY:Centerville(Barnstable) STATE:Massachusetts - HDD:6137 a CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) WINDOW/WALL RATIO:0.10 DATE:09/30/04 DATE OF PLANS:08-23-2004 PROJECT DESCRIPTION: John&Judy Petercuskie 74 Pond View Drive Centerville,Ma. 02632 DESIGNER/CONTRACTOR: Gene Dussault 43 Braley Jenkins Centerville,Ma. 02632 PROJECT NOTES: MaCheck by Cape Cod Insulation INC. .#4502 COMPLIANCE:Passes Maximum UA=229 Your Home UA=207 9.6%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Pe ' e r R-Value R-Value -F c or UA Ceiling 1:Flat Ceiling or Scissor Truss 398 30.0 • 0.0 14 Ceiling 2:Cathedral Ceiling(no attic) 156 30.0 0.0 5, Wall 1:Wood Frame, 16".o.c. 1512 13.0 0.0 110 Window 1:Wood Frame:Double Pane with Low-E 110 0.340 37 Door 1:Solid 20 0.400 8 _ Door 2:Glass 20 0.280 6 , Door 3:Glass 20 0.330 , 7 $ i , r Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 432 39.0 0.0 20 Boiler 1:Other(Except Gas-Fired Steam),82.7 AFUE r 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 RES checkVersion 3.6 Release I (formerly MECchec)o and to comply with the mandatory requirements listed in the RES checkInspection 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 Date 6 � t ' ! r f AEScheck Inspection Checklist Massachusetts Energy Code REScheckSoftware Version 3.6 Release 1 DATE:09/30/04 PROJECT TITLE:New Custom Addition Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: - [ ] 2. Ceiling 2:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: - Above-Grade Walls: [ ] 1. Wall 1: Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: � T . Windows: [ ] 1. Window 1:Wood Frame:Double Parie with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: - #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: Doors: [ ] 1. Door 1: Solid,U-factor:0.400 Comments: [ ] 2. Door 2: Glass,U-factor:0.280 Comments: [ ] 3. Door 3:Glass,U-factor:0.330 Comments: Y Floors: [ ] 1. Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: ` Heating and Cooling Equipment: - [ ] 1. Boiler 1:Other(Except Gas-Fired Steam),82.7 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. [ ] C 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. I 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfin(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 1.571bs/82 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. 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:- [ ] I HVAC piping conveying fluids above 120 T or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pine Sizes Heated Water Non-Circulatine Runouts Circulating Mains and Runouts Temperature 1 F) lip to 1„ Vp 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 Pining System T}pes Range F 2"Runouts 1"and Less 1.25"to 2" 2.511 to 4" Heating Systems Low Pressure/Temperature 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, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0. 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) I� Do• 10:2'f PROPOSED e ' Q- GARAGE 0 XX O �•, SO.25 5 EXISTING PROPOSED DWELLING ADDITION LOT 21 A CB FND 14,471 t SQ. FT. CB FND rn N rn p 16l 50, CB FND JOB# 04-307 BUILDING PLOT PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR: LOCATION 74 POND VIEW DRIVE JOHN PE TER C USKIE CENTERVILLE, .MASS. SCALE -17 30' DATE SEPTEMBER. 27, 2004 REFERENCE PLAN BK 95 PC:"11 ASSESS. MAP 229 PCL 39 i HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. �ZH OF bf4 off. 508-362-4541 ��� ARNE. yGm fax 508-362-9880 o H. down cope engineering, inc. " OJALA N No. 263, 8 CIVIL ENGINEERS LAND SURVEYORS l.� Y 939 main st. Yarmouth, ma 02675 DATE REG. L RVEYOR BC CALC®2003 DESIGN REPORT- US Tuesday,October 12,200412:48 Single 14" AJSTm 20 MSR File Name: Gene Dussault,John Petercuskie Res.:J01 Job Name: John Petercuskie Res. Description: Address: 74 Pond View Rd. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Me. Designer: None Customer: Gene Dussault Company: Code reports: ISR-1144 Misc: Standard Load-40 psf 110 W PC Spacing 1 G' v BO,1-1/2" B1,1-1/2" 587 Ibs LL 587 Ibs LL 147 Ibs DL 147 Ibs DL Total Horizontal Length-22-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value OCS Dur. S Standard Load Unf.Area Left 00-00-00 22-MOO Live 40 psf 16" 100% Member Type: Joist Dead 10 psf 16" 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 4033 ft-Ibs 76.1% 100% 2 1 -Internal Slope: 0/12 Neg.Moment 0 ft-Ibs n/a 100% OC Spacing: 16" - End Reaction 733 Ibs 64.1% 100% 2 1 -Left . Repetitive: Yes Total Load Defl. U439(0.602") 54.7% 2 1 Construction Type:Glued Live Load Defl. U548(0.481 87.50/6 2 1 Max Defl. 0.602" 60.2% 2 1 Live Load: 40 psf Span/Depth 18.9 n/a 1 Dead Load: 10 psf Partition Load: 0 psf Notes Duration: 100 Design meets Code minimum(U240)Total load deflection criteria. Disclosure Design meets User specified(U480)Live load deflection criteria. Design meets arbitrary(1")Maximum load deflection criteria. The completeness and accuracy of Minimum bearing length for BO is 1-1/2". the input must be verified by anyone Minimum bearing length for B1 is 1-1/2". who would rely on the output as Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing evidence of suitability for a particular application. The output above is based upon building code-accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions,please call (800)232-0788 before beginning product installation. BC CALC®,BC FRAMER®,BCI®, BC RIM BOARDTm,BC OSB RIM BOARDTm,BOISE GLULAMTm, VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, VERSA-STRANDTm, VERSA-STUD®,ALLJOISTO and AJSTm are trademarks of Boise Cascade Corporation. Page 1 of 1 BC CALC®2003 DESIGN REPORT- US Tuesday,October 12,2004 12:48 Double 1 3/4" x 14" VERSA-LAM®3100 SP File Name: Gene Dussault,John Petercuskie Res.:F601 Job Name: John Petercuskie Res. Description: Address: 74 Pond View Rd. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: None Customer: Gene Dussault Company: Code reports: ICBO 5512,NER 629 Misc: n Standard Load-40 psf l 10 psf Tributary 01-04-00 „,^ � 'y'�' -n ua Y`1 a ti MR .z4 ..s ra.r -v a AL BO 81 703 Ibs LL 981 Ibs LL 332 Ibs DL 413 Ibs DL Total Horizontal Length-22-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 22-00-00 Live 40 psf 01-04-00 100% Member Type: Floor Beam Dead 10 psf 01-04-00 90% Number of Spans: 1 1 Reaction from EConc.Pt.302 aRightingO5-00-00 05-00-00 Live 510 lbs n/a 115% Left Cantilever: No Dead 148 Ibs n/a 90% Right Cantilever: No Controls Summary Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location Tributary: 01-04-00 Moment 6651 ft-Ibs 19.9% 115% 3 1 -Internal Neg.Moment 0 ft-Ibs n/a 100% End Shear 1300 Ibs 11.9% 115% 3 1 -Right Total Load Defl. L/722(0.365") 33.2% 3 1 Live Load: 40 psf Live Load Defl. L/1041 (0.254') 34.6% 3 1 Dead Load: 10 psf Max Defl. 0.365" 36.5% 3 1 Partition Load: 0 psf Duration: 100 Notes Disclosure Design meets Code minimum(L/240)Total load deflection criteria. Design meets Code minimum(L/360)Live load deflection criteria. The completeness and accuracy of Design meets arbitrary(1')Maximum load deflection criteria. the input must be verified by anyone Minimum bearing length for BO is 1-1/2". who would rely on the output as Minimum bearing length for B1 is 1-1/2". evidence of suitability for a Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+112 intermediate bearing particular application. The output above is based upon building Connection Diagram code-accepted design properties Consult project design professional of record or BOISE technical representative for connection design and analysis methods. Installation Member has no side loads. of BOISE engineered wood Concentrated loads are not considered in side load analysis. products must be in accordance with the current Installation Guide Connectors are:16d Sinker Nails and the applicable building codes. To obtain an Installation Guide or if a=2" you have any questions,please call b=3„ — d (800)232-0788 before beginning c=3-3/8" —L— product installation. d=12" a T— BC CALC®,BC FRAMER®,BCI®, C BC RIM BOARD- BC OSB RIM _l BOARD-,BOISE GLULAM-, • • • VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, VERSA-STRAND-, • s VERSA-STUDS,ALLJOISTO and a AJS1m are trademarks of —I b Boise Cascade Corporation. —} Page 1 of 1 I ��Ery BC CALC®2003 DESIGN REPORT- US Tuesday,October 12,200412:49 Double 1 314" x 14" VERSA-LAM®3100 SP File Name: Gene Dussault,John Petercuskie Res.:F1302 Job Name: John Petercuskie Res. Description: Address: 74 Pond View Rd. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma Designer: None Customer: Gene Dussault Company: Code reports: ICBO 5512,NER 629 Misc: Standard Load-40 psf 110 psf Tributary 08-06-00 F-In Elm 10 V111" IN BO B1 510 Ibs LL 510 lbs LL 148 Ibs DL 148 Ibs DL Total Horizontal Length-03-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 03-00-00 Live 40 psf 08-06-00 100% Member Type: Floor Beam Dead 10 psf 08-06-00 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 494 ft-Ibs 1.7% 100% 2 1 -Internal Slope: 0112 Neg.Moment 0 ft-Ibs n/a 100% Tributary: 08-06-00 End Shear 146 Ibs 1.5% 100% 2 1 -Left Total Load Defl. U72094(0') 0.3% 2 1 Live Load Defl. U93050(0-) 0.4% 2 1 Max Defl. 0" n/a 2 1 Live Load: 40 psf Dead Load: 10 psf Notes Partition Load: 0 psf Design meets Code minimum(U240)Total load deflection criteria. Duration: 100 Design meets Code minimum(U360)Live load deflection criteria. Disclosure Design meets arbitrary(1")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for B1 is 1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+112 min.end bearing+V2 intermediate bearing who would rely on the output as evidence of suitability for a Connection Diagram particular application. The output Consult project design professional of record or BOISE technical representative for connection design above is based upon building Member has no side loads. code-accepted design properties and analysis methods. Installation Connectors are:16d Sinker Nails of BOISE engineered wood products must be in accordance a=2„ with the current Installation Guide b=3" d and the applicable building codes. c=3-3/8" L To obtain an Installation Guide or if d=12" a • you have any questions,please call —( (800)232-0788 before beginning C product installation. BC CALC®,BC FRAMER®,BCI8, BC RIM BOARD-,BC OSB RIM BOARD-,BOISE GLULAM-, • • VERSA-LAM®,VERSA-RIM®, a VERSA-RIM PLUS®, T—I .VERSA-STRAND-,,. 7 b VERSA-STUD®,ALLJOIST®and AJSTm are trademarks of Boise Cascade Corporation. - Page 1 of 1 . 9 . BC CALC®2003 DESIGN REPORT - US Tuesday,October 12,2004 12:49 Double 1 3/4" x 14" VERSA-LAM®3100 SP File Name: Gene Dussault,John Petercuskie Res.:FB03 Job Name: John Petercuskie Res. Description: Address: 74 Pond View Rd. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: None Customer: Gene Dussauft Company: Code reports: ICBO 5512,NER 629 Misc: \17 Standard Load-40 paf l 10 psf Tributary 01-04-00 f Wi 4 AL BO B1 604 lbs LL 1039 lbs ILL 290 lbs DL 421 lbs DL Total Horizontal Length-18-03-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 18-03-00 Live 40 psf 01-04-00 100% Member Type: Floor Beam Dead 10 psf 01-04-00 90% Number of Spans: 1 1 Reaction from CConc.Pt.304 a-Righting07-00-00 07-00-00 Live 160 Ibs n/a 115% Left Cantilever: No Dead 68 lbs n/a 90% Right Cantilever: No 2 Reaction from CConc.Pt.302 a-Righting02-00-00 02-00-00 Live 510 Ibs n/a 115% Dead 148lbs n/a 90% Slope: 0/12 Tributary: 01-04-00 Controls Summary Control Type Value %Allowable Duration Load Case Span Location Moment 4964 ft-lbs 14.9% 115% 3 1 -Internal Live Load: 40 psf Neg.Moment 0 ft-lbs n/a 100% End Shear 1367lbs 12.5% 115/0 3 1 -Right Dead Load: 10 psf Total Load Defl. L/1193(0.184') 20.1% 3 1 Partition Load: 0 psf Live Load Defl. L/1736(0.126") 20.7% 3 1 Duration: 100 Max Defl. 0.184" 18.4% 3 1 Disclosure Notes The completeness and accuracy of Design meets Code minimum(L240)Total load deflection criteria. the input must be verified by anyone Design meets Code minimum(U360)Live load deflection criteria. who would rely on the output as Design meets arbftrary(1')Mabmum load deflection criteria. evidence of suitability for a Minimum bearing length for BO is 1-12". particular application. The output Minimum bearing length for B1 is 1-12". above is based upon building Entered/Displayed Horizontal Span Length(s)=Clear Span+12 min.end bearing+12 intermediate bearing code-accepted design properties and analysis methods. Installation Connection Diagram of BOISE engineered wood Consult project design professional of record or BOISE technical representative for connection design products must be in accordance Member has no side loads. with the current Installation Guide Concentrated loads are not considered in side load analysis. and the applicable building codes. To obtain an Installation Guide or if Connectors are:16d Sinker Nails you have any questions,please call (800)232-0788 before beginning a=2" product installation. b 3„= d c=3-3/8" —!r BC CALC®,BC FRAMER®,BCIS, d=12" a BC RIM BOARD-,BC OSB RIM �— BOARD-,BOISE GLULAM-, C VERSA-LAM®,.VERSA-RIM®, VERSA-RIM PLUS®, • —• • VERSA-STRAND-, VERSA-STUDS,ALLJOISTO and AJSiA°are trademarks of • • Boise Cascade Corporation. a r � b Page 1 of 1 - L BC CALC®2003 DESIGN REPORT- US Tuesday,October 12,2004 12:49 Double 1 3/4" X 14" VERSA-LAW 3100 SP File Name: Gene Dussault,John Petercuskie Res.:FB04 Job Name: John Petercuskie Res. Description: Address: 74 Pond View Rd. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: None Customer: Gene Dussault Company: Code reports: ICBO 5512,NER 629 Misc: Standard Load-40 psf 1.10 psf Tributary 02-00* w. BO 131 160 Ibs LL 160 Ibs LL 68 Ibs DL 68 lbs DL Total Horizontal Length-04-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 04-MOO Live 40 psf 02-00-00 100% Member Type: Floor Beam Dead 10 psf 02-00-00 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 228 ft-Ibs 0.8% 100% 2 1 -Internal Slope: 0/12 Neg.Moment 0 ft Ibs n/a 100% Tributary: 02-00-00 End Shear 95 Ibs 1.0% 100% 2 1 -Left Total Load Defl. L/117290(0') 0.2% 2 1 Live Load Deft. L/166843(0') 0.2% 2 1 Live Load: 40 psf Max Defl. 0"Live 2 1 Dead Load: 10 psf Notes Partition Load: 0 psf Design meets Code minimum(L/240)Total load deflection criteria. Duration: 100 Design meets Code minimum(L/360)Live load deflection criteria. Disclosure Design meets arbitrary(1')Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for B1 is 1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+V2 intermediate bearing who would rely on the output as evidence of suitability for a Connection Diagram particular application. The output Consult project design professional of record or BOISE technical representative for connection design above is based upon building Member has no side loads. code-accepted design properties and analysis methods. Installation Connectors are:16d Sinker Nails of BOISE engineered wood products must be in accordance a=2" with the current Installation Guide b=3„ d and the applicable building codes. /8"= 1 To obtain an Installation Guide or if c d=1 3-3 3 a • you have any questions,please call �— (800)232-0788 before beginning C product installation. BC CALC®,BC FRAMER®,BCIO, BC RIM BOARD-,BC OSB RIM BOARD-,BOISE GLULAM-, • • VERSA-LAM®,VERSA-RIM®, a VERSA-RIM PLUS®, f b VERSA-STRAND TM', } VERSA-STUD®,ALLJOISTO and AJSTm are trademarks of Boise Cascade Corporation. Page 1 of 1 _MSEry BC CALCO 2003 DESIGN REPORT- US Friday,August 06,2004 12:08 Single 14" BCIO 600s SP File Name: BC CALC Project:J01 Job Name: Description: Address: Specifier: Rick Lowe City,State,Zip:, Designer: Customer: Company: Code reports: NER 594,ICBO 5208 Misc: 4 2 3 1 Standard Load-40 psf 110 psf OC Spacing 16" WNW ors-eltt - "'.J k' i `ru• c' r ^` b -' "� �., x. _.:. AL BO,1-3/4" B1,1-3/4" 768 Ibs LL 973 Ibs LL 237 Ibs DL 340 Ibs DL Total Horizontal Length-22-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value OCS Dur. S Standard Load Unf.Area Left 00-00-00 22-00-00 Live 40 psf 16" 100% Member Type: Joist Dead 10 psf 16" 90% Number of Spans: 1 1 ceiling load. Conc.Lin. Right 02-00-00 02-00-00 Live 150 plf 16" 100% Left Cantilever: No Dead 60 plf 16" 90% Right Cantilever: No 2 roof load. Conc.Lin. Right 02-00-00 02-00-00 Live 150 plf 16" 115% Dead 90 plf 16" 90% Slope: 0/12 3 ceiling load. Conc.Lin. Left 03-00-00 03-00-00 Live 63 plf 16" 100% OC Spacing: 16" Dead 25 plf 16" 90% Repetitive: Yes 4 roof load Conc.Lin. Left 03-00-00 03-00-00 Live 63 plf 16" 115% Construction Type:Glued Dead 38 plf 16" 90% Live Load: 40 psf Controls Summary - Dead Load: 10 psf Control Type Value %Allowable Duration Load Case Span Location Partition Load: 0 psf Moment 4687 ft-Ibs 69.5% 100% 2 1 -Internal Duration: 100 Neg.Moment 0 ft-Ibs n/a 100% End Reaction 1313 Ibs 91.3% 115% 3 1 -Right Disclosure Total Load Deff. U379(0.696") 63.3% 3 1 The completeness and accuracy of Live Load Defl. U492(0.537") 97.6% 3 1 the input must be verified by anyone Max Defl. 0.696" 69.6% 3 1 who would rely on the output as Span/Depth 18.9 n/a 1 evidence of suitability for a particular application. The output Notes above is based upon building Design meets Code minimum(L/240)Total load deflection criteria. code-accepted design properties Design meets User specified(U480)Live load deflection criteria. and analysis methods. Installation Design meets arbitrary(V)Maximum load deflection criteria. of BOISE engineered wood Minimum bearing length for BO is 1-3/4". products must be in accordance Minimum bearing length for B1 is 1-3/4". with the current Installation Guide Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing and the applicable building codes. \ To obtain an Installation Guide or if you have any questions,please call (800)232-0788 before beginning product installation. BC CALCO,BC FRAMER®,BCIO, BC RIM BOARD-,BC OSB RIM BOARD-,BOISE GLULAMT , VERSA-LAM@,VERSA-RIM@, VERSA-RIM PLUSO, VERSA-STRAND-, VERSA-STUD@,ALLJOIST®and AJSTM.are trademarks of Boise Cascade Corporation. o,T�E�o The Town of Barnstable • Department of Health Safety and Environmental Services ' Building Division 367 Main Street,Hyannis,MA 02601 e: 508-8624038 508-790-6230 PLAN REVIEW Owner: �2 resi 2 Map/Parcel: Project Address: 7�( PUnc� e4.J '� Builder: b L4 5-sA T - i The following items were noted on reviewing: v �Nn�U Win r 0.1,��►'\o f i La��o.^ `�� :i!�Co n.,o�•�'�e, ✓- �I qX � 11 o - OlIgjoy Reviewed by: Date: )0) F-Joy BO�SE BC CALC®9 DESIGN REPORT- US Monday,March 28,200513:38 Single 1 3/4" x 91/2" VERSA-LAM®3100 SP File Name: BC CALC Project:RB01 Job Name: `' Petercuskie Addition "Description:" Address: 74 Pond View Rd. Specifier. City,State,Zip:Cenrerville,MA Designer. Customer. Desalt Builders Company: Turning Mill Consultants Code reports: ICBO 5512,NER 629 Misc: LVL Beam Qo 12 1 :.::•::::.:::::::::.::......:;.:::::............:::::::::•::...::•:::•::::::..•::::::::::::::::..::::::::::::::: ::... .......... ....... BO,3-1/2' B1,3-1/2' DL 657 Ibs DL 657 Ibs SL 1031 Ibs SL 1031 Ibs Total Horizontal Product Length=13-09-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref., Start End Type Value Trib. Dur. 1 Standard Load Unf.Area Left 00-00-00 13-09-00 Snow 25 psf 06-00-00 100% Member Type: Roof Beam Dead 15 psf 06-00-00 90% Number of Spans: 1 Left Cantilever. No Controls Summary Right Cantilever. No Control Type . Value %Allowable Duration Load Case Span Location Pos.Moment 5423 ft-Ibs 77.7% 100% 3 1 -Internal Slope: End Shear -1444 Ibs 44.9% 100% 3 1-Right Total Lod Deft. U231 (0,69") 103.8% 3 1 Live Load Defl. U379(0.421°) 95.1% 3 1 Max Defl. 0.69" 69.0% 3 1 Disclosure Span/Depth 16.8 n/a 1 The completeness and accuracy of the input must be verified by anyone Bearing Supports who would rely on the output as %Allow %Allow evidence of suitability for a Name Type Dim(L x W) Value Support Member Material particular application. The output BO Post 3-1/2°x 1-3W 1688 Ibs 38.0% 32.4% Spruce-Pine-Fr above is basecl.upon building B1 Post 3-1/2°x 1-3/4° 1688 Ibs 38.0% 32.4% Spruce-Pine-Fir code-accepted design properties and analysis methods. Installation Cautions of BOISE engineered wood Member is insufficient to carry loads for User specified load deflection at limit of U240. pr1oducts must be in accordance Post at Bearing BO analyzed for bearing only,column analysis has not been performed. vn the current Installation Guide andd the applicable building codes. Post at Bearing Bi analyzed for bearing only,column analysis has not been performed. To obtain an Installation Guide or if Notes you have any questions,please call (800)232-0788 before beginning Design meets User specified(U360)Live load deflection criteria _ Design meets arbitrary ' product installation. 4 .� ry(1 )Ma)amum load deflection criteria Member Slope=0,consider drainage. BC CALOO,BC FRAMER®,BCI@, Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing BC RIM BOARD'"',BC OSB RIM it BOARD-,BOISE GLULAM-, L1,55 /�, { a o i— 7"s z C .7a C. tb r U 13 C)Or VERSA-LAM®,VERSA-RIM@, VERSA-RIM PLUS®, 7-1 rur 15,6A . ` VERSA-STRANDTm, VERSA-STUD@,ALLJOIST®and AJS"`'are trademarks of . Boise Cascade Corporation. fIANRom top � qa� Page 1 of 1 r t IMPORTANT —UPGRADE REQUIRED Y STATE BUILDING CODE REQUIRES THE UPGRADING OF (� z/z SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN �T rA S ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. - -- -- - - - -- - - - - - , g I b NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. LJ. � I I i Nap- ba��1►� aY � 1 I MA P5 I ` b I j L O(AraU I "I =o� I -o FE brOHIL)EA I I J7lu FIGi-d 21' 7" 10N SMOKE DETECTORS REVIEWED D E BUILDING DEPT, DATE FIRE DEPARTMENT DTAE RMITTINBOTH SIGNATURES ARE REQUIREDR ICO _ I I I I Fo1)kih&To� i I 5GA L E {w E 4-1 V7- 6f fi)uud"&.Tou - a�-I�► � rub PTE��usKl � , 8 �LT5 for of Fob Jp,AT,o4 ro arc-N E 9 1/,T, ffl� �b O.� p o .a -7- r- - - - - l --- -- - - - - - - - - - - - - I /. 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