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0682 SOUTH MAIN STREET
i cv d� C P O cl,. :..m c L'p: ,.: s, .-..:R 'F<;m ...:,,;. .. �' � -.=.a... n .� _� - - - ------ ,__Q�e�� i I r '----- i j � , �- r r .o� Town of Barnstable TIR RARPMABLE Regulatory Services 1639• \a� Building Division 7 prEb 11M'�p 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection I`i^,,l Location GVZ 5. Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The followingitems need correcting: g a , Scion. do,,o,, -4 T7 a e —gyJ- y�,etS1 S I,—. T tj 4F� /li'�GU G%/1JCy USA= it°3y Please call: 508-862-499$for re-inspection. Inspected by Date lif3°% U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 Federal Emergency Management Agency Expiration Date:November 30,2018 National Flood Insurance Program ELEVATION CERTIFICATE Important:Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. Marianne D.Triplette A2. Building Street Address(including Apt,Unit,Suite,and/or Bldg.No.)or P.O.Route and Company NAIC Number. Box No. 682 South Main Street City State ZIP Code Centerville Massachusetts 02632 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Barnstable Assessors'Map 186,Parcel 038-Shown on Plan Book 561,page 51,at the Barnstable Registry of Deeds. A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. Latitude/Longitude: Lat.41-38-16.11 Long.070-21-12.43 Horizontal Datum: ❑NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 2A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 580.00 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 7 c) Total net area of flood openings in A8.b 728.00 sq in d) Engineered flood openings? x❑Yes ❑ No A9.For a building with an attached garage: a) Square footage of attached garage 518.00 sq It b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 4 c) Total net area of flood openings in A9.b 416.00 sq in d) Engineered flood openings? ❑x Yes ❑No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3. State Barnstable - 250001 Barnstable Massachusetts B4.Map/Panel B5.Suffix B6. FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO,use Base Flood Depth) Revised Date 25001CO563 J 07-16-2014 07-16-2014 AE 12 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ❑FIS Profile ❑x FIRM ❑Community Determined ❑Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑ No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date:November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 682 South Main Street City State ZIP Code Company NAIC Number Centerville Massachusetts 02632 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑Building Under Construction" ❑x Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,ARIA,AR/AE,AR/A1—A30,AR/AH,AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only,enter meters. Benchmark Utilized: M 28 QS IVertical Datum:NGVD 1929 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 Z NAVD 1988 ❑Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 3.00 ❑x feet ❑ meters b) Top of the next higher floor r 8n Z feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑ feet ❑meters d) Attached garage(top of slab) - 8.40 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 3.30 ,0feet El meters (Describe type of equipment and location in Comments) a f) Lowest adjacent(finished)grade next to building(LAG) 7.50 ❑x feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 8.30 ❑I feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including 8.00 -❑x feet ❑ meters structural support SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available.I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑No ❑Check here if attachments. Certifier's Name. License Number Richard R L'Heureux MA LS 34312 tl� Title Registered Land Surveyor-Owner } Company Name QtiG� X CapeSury t12 s Address 23 West Bay Road,Suite G City State ZIP Code / Osterville Massachusetts 02655 Signa Date Telephone Ext. 02-15-2018 (508)420-3994 Co6y all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agenticompany,and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable) Lowest mechanical:the heating system&water heater are raised above the cellar floor 0.3 to EI=33. FEMA Form 086-0-33(7115) Replaces all previous editions. Form Page 2 of 6 I OMB No.1660-0008 ELEVATION CERTIFICATE Expiration Date:November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 682 South Main Street City State ZIP Code Company NAIC Number Centerville Massachusetts 02632 SECTION E—BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A.B,and C.For Items El—E4,use natural grade,if available.Check the measurement used.In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a) Top of bottom floor(including basement, crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b) Top of bottom floor(including basement, crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 1-2 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only:If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA4ssued or community-issued BFE)or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date:November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 682 South Main Street City State ZIP Code Company NAIC Number Centerville Massachusetts 02632 SECTION G—COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10.In Puerto Rico only,enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer,or architect who is authorized by law to certify elevation information.(Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. Q New Construction❑ Substantial Improvement G8. Elevation of as-built lowest floor(including basement)' of the building: ❑feet ❑ meters Datum G9.• BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑ meters Datum G10. Community's design flood elevation: ❑feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments(including type of equipment and location,per C2(e),if applicable) ❑ Check here if attachments. FEMA Form 086-0-33(W15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date:November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 682 South Main Street City State ZIP Code Company NAIC Number Centerville Massachusetts 02632 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6.Identify all photographs with date taken;"Front View"and"Rear View";and,if required,"Right Side View"and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8.If submitting more photographs than will fit on this page,use the Continuation Page. s✓ _ x Photo One Photo One Caption .Front(04/19/2017) Clear Photo One flo wFly J nYl•pew'. :--- _ 4 x OAA '+�, �� �� i.. ",4�' q..�r� s a T■■„ .gin <. a - Y , Photo Two Photo Two Caption Rear(0411912017) Clear Photo Two FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date:November 30,2018 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 682 South Main Street City State ZIP Code Company NAIC Number Centerville Massachusetts 02632 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View": and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. Tk t Photo Three Photo Three Caption Right Side(04/19/2017) Clear Photo Three a �a =ate '•�--s��.�. W Photo Four Photo Four Caption Left Side(04/19/2017) }Clear:Photo Four: FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 T S ZonP REFERENCES: `S 1' sus Assessors Map: 186 F d11000 Parcel: 038 Deed Book 200491300 MOB FEB 22 A. 10: 01 ZONE:RD—1 s D4 V7R, ��o�T �� Setbacks: Front:30'min Side: 10'min sAss�s Top of Foundation E1=10.04' - Rear: 10'min. Top of FF Deck E1=11.03' 0'� Craw( Space'Slab EI=6.4' Bulkhead.. FLOOD ZONE; A10(EL11), B, & C 25.4 Communit Ponel 2 Story . Wood Dwelling .. 250001 0616 D # 12.5' #682 Rev.: July 2, 1992 N ' CB/DH o Fnd J 3 :s o, �'so /, V) 90 9 60.6' �° Jl New Concrete Foundation <e y�o 4NOF o I certify that the new r �9 RIWARD foundation shown hereon �J �a LHEl1REUX conforms to the setback O o 3a3ti2 requirements of the Zoning I,on Pipe \oar Bylaws of the town of ti�Aro �syoQ Barnstable. , PLOT PLAN At 682 South Main Street Zo�F���oB NOTES: BARNSTABLE (Centerville) a' 1.) The structures shown were located on the ground MASS. by conventional survey methods on (or between) DATE: 19/FEB/08 SCALE: 1"=30' 27/JUN/01 arid 14/FEB/08. 0 15 30 45 60 FEET 2.) The datum used is NGVD '29. Benchmark used is "M28 QS" a USC&GS and MGS Disk in concrete bound. PREPARED FOR: Marianne D Triplette 3.) The property` line information shown hereon was 328 Indera Mills Ct compiled from available recordi information. Winston-Salem NC.27101 . PREPARED BY: CapeSury 4.) This plan is not for recording and is not to be used for construction layout or deed description 7 Parker Road purposes. Osterville MA 02655 .DWG #: C492g1 FIELD BY: RRL/MLL/DWB (508). 420-3994 / 420-3995fox Application number....?-s....�. .... .�. ...1.. ' ? .. Fee...........::....... ............................................ KAM s JUR 28 2019 Building Inspectors Initials...... ............................... BLE TOWN O� bARNS Date Issued.............................:................................... G Map/Parcel.....�.Q ��. ........................................................ TOWN OF BARNSTABLE .EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 11 #W � ��• � f/�/f 4 �U �1 ����l�� NUMBER STREET p/�J�7 MLAGE Owner's Name: r ,�,(� r_J_ hone Number ��-3-2 Email Address: Cell Phone Number Project cost Check one Residential. commercial / OWNER'S AUTHORIZATION As owner of the above property I hereby authorize 1� to make application for a building permit in accordance with 780 tcL Owner Signature: Date: CD q OZ VI TYPE OF WORK D Siding 0 Windows (no header change)# Q hAtlation/Weatherization Doors(no header change) # Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to /2 1 CONTRACTOR'S INFORMATION Contractor's name P Home Improvement Contractors Registration(if applicable)# 1537 attach co Construction Supervisor's License# </ l (attach copy), Email of Contractor C&t�9--t& f(`" Pho�e mber ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR 1F 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 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 Fuel source being used LP tank 201bs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. 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 pm-4:30pm. 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 of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date `l All permit ap ' ations are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street ' Boston,MA 02111 ` www mass.gov1dia .w Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Aw Address: 2G. C �'ti City/State/Zip: G - Phone#: 3 ? T5 �- Are you an employer?C eck the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction. 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor mein an capacity. employees and have workers' Y P h'• 9.. ❑Building addition [No workers'comp.insurance comp.incirrance.$ required] S. ❑ We are a corporation and its 10:❑Electrical repairs or additions q officers have exercised their 11.' Plumbing repairs 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.El 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: i0 ;� S� ( - IS gq �3�01(9Expiration Date: Q _ )C,/ Job Site Address: Y City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. , I do hereby certify un r.the pains andpenalties ofperjury that the information provided above is 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 Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ' Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . 4 Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. e Department's address,telephone and fax number: The Commonwealth of Massachusetts Department.of Industrial Accidents office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#61.7-727-7749 vvww.mass.gov/dia ®� Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Con stru it%bp,tprvisor CS-104107 Aspires 08/25/2019 i c;CARLOS H FIGUEIRw,, 20 CAPTAIN YES SOUTH YARM11g"' 26G4 �0 Commissioner CL jauOissiwwOO - � Z, 04i-'0gW21tlA N1f10S r O t!S3J.QN NIV103 OZ Y'--^ nbil:j Hso1av�'�; l san 6t.ozrszl90 A0 lOsitiS!�ttPi3suo0 _ 6wpllnl3 l0 p�eog spiepuels Pue suollelnhaa euoissalold 10 uotslA'(3 amsua���I eamuounuo0 s11asnU:)esseW 10 Ull Office of Consumer Affairs&Business Regulation. HOME IMPROVEMENT CONTRACTOR Registration valid for.individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration j Office of Consumer Affairs and Business Regulation 1537J2 01107/2021 ; 1060 Washington Street=Suite 710 C 8 F REMODEUN43}NC Boston,MA 02118 CARLOS H,FIGUEIRQA 20 CAPTAIN NOYES RD .. S.YARMOUTH;MA 02604, Undersecretary Not valid without slgflature Town of Barnstable Building Post This CardSo That�t is Uisib,le From theStreet ^App,roved,,PlansMust be Retained on Jab and this CardM�ustbe Kept .: iNRNt3CABL6. '� "+. z ¢ & - ' ;� �„ Ir- '" s r • Posted Until Finat Inspection Has Been Made ~� y r �:> s W;here a Cert�ficatef Oscu ancy:;is Required,suchBuildmgshalt Not be Occupied until a Feat lnspectron;has been�made Permit � �r. p , �,.., Permit No. B-19-1111 Applicant Name: Henry Cassidy Approvals Date Issued: 04/05/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 10/05/2019 Foundation: Location: 682 SOUTH MAIN STREET,CENTERVILLE Map/Lot 186-038 Zoning District: RD-1 Sheathing: � Owner on Record: TRIPLETTE,MARIANNE D ` Contractor:Name ,HENRY E CASSIDY Framing: 1 Address: 682 SOUTH MAIN STREET Contractor License; CS400988 2 CENTERVILLE, MA 02632 Est' ,ro�ect Cost: $3,500.00 Chimney: 4 Description: Insulation/Weatherization Permit Fee: $85.00 Insulation: Project Review Re (""� ��� fee Paid $85.00 1 4 f Ate, Final: g Date 4/5/2019 Plumbing/Gas Rough Plumbing: ti Building Official ' Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application;and"the approved construction documents9for which this permit has been"granted. ' Rough Gas: All construction,alterations and changes-of use of any building and structurLmshali be in compliance with the local zomng by laws`and codes. This permit shall be displayed in a location clearly visible from access street or'r•oad and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officals areprovided on this,_permit. Minimum of Five Call Inspections Required for All Construction Work " Service: s 0, zs 1.Foundation or Footingos 'v 2.Sheathing Inspection z` ` A Rough: 3.All Fireplaces must be,inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Pe ntracting with unregistered contractors do not.have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: c� _ _ TOWN OF-BARNSTABLE BUILDING PERMIT APPLICATION- Map Parcel Application#c2/)67/) Health Division 6 ' Date Issued r W Conservation Division !� � _ .y `Application Fee Q Tax Collector _ _ = -Permit Fee ( �3 • �� Treasurer Planning Dept. �- f, Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis r "� Project Street Address Qsa MAW Village V C Owner f�� Address boo( $DNV I VLf- o 5re -."T Telephone Permit RequestAAILI) Qq K 04 ADN'Tl W M a lSMZ RG X M 44005E i.,QH U4NOV Nf —CK— ma Square feet: 1 st floor:existing roposed 2nd floor.-existing proposed Total new { Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes Xo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes *0 On Old King's Highway: ❑Yes XNo Basement Type: ❑Full ,166rawl ❑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:XYes ❑No Fireplaces: Existing New Existing wood/coal stove: LJ Yes-, XNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new. size Attached garage)—T"" isting ❑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 BUILDER INFORMATION Name ` .. Telephone Number Address L� bo t u) C6 C�AJ7 License# C S 007 b%o—tt C TWV t LAL, PAA Q O�DL Home Improvement Contractor# Worker's Compensation# 'C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE J ' Y I + b FOR OFFICIAL USE ONLY APPLICATION# DATEI�;SUED MAP/PARCEL N0. ADDRESS I VILLAGE 'R OWNER �+ 1 •P R'er C �t_G4 vs CO a- DATE OF INSPECTION: O V TS l FOUNDATIONFg17 /Q j6JJG, Jim .l.b� i FRAME 0 9)7 0� INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT 4 ASSOCIATION PLAN NO. ; J Town of Barnstable Regulatory Services BARNSPABLE, Thomas F. Geiler Director 9 MASS. g" f 16 u+°�� Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barn stable.m ams Office: 508-862-403 8 Fax: 50&790-6230 PLAN REVIEW 0 Owner: -FkJRLC-rrE MapMarcel:)`�G 03S Project Address Ma,- Builder: K, R JeFM4DEUTMG The following items were noted on reviewing: E 'b ELVE PLAtj s W i-41 t.Cr)6 2- `5 sE,FS OF ?LNos N£EaEM ST7NvhPET9 FOP, S7V%0KES 6ApGieA,0J• pir_-EoE1)� IIfJ `-QIa►Q pl}TI o f3. 1aST SE E$J:6I1 Cb f`o tz pL�csa o r+E 'A' C.a�r�ca�•t7u�� U�low S -5 _f1 t.e nw K � k reAJ -�v.- ll s�r�,.��+•�-1 e�e,,.�.. ;k•y mat_ Reviewed by: 633 9 s P°k-c Date: 1112,610 .. lll��V7 Q:Forms:Plnrvw The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations , a 600 Washington Street t Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Oro nizatiow7ndividual): . Address: _ [)1(,� City/State/Zip: L,�i Q Rk 0"4 e.#: Go-02 f(P j Yempl. an employer? Check the appropriate box: Type of project(required):. m ae to r with� 4. I am a general contractor and ImP 6. ❑New constructionoyees full orpart-time).* have hired the sub-contractors 2.❑ I am a sole 'oprietor or partner- listed on the-attached sheet. 7. ElRemodeling 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 comp,insurance [No workers' comp.insurance . required] 5. We are a corporation and its 10.❑Electrical repairs or additions '3.❑ I am ahomeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myselL [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#P1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: � � V 1 Vld��� N N � LIcJ►° rl� -Policy#or Self-ins.Lic.#: 1AJl'� V� "� �V�(J�Vt/� Expiration Date: Js L� Job Site Address: lSl ll� (/lJ�/ 1�'C (1y City/State/Zip: f�`rm I Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cetWft under the pains-and penalties of perjury that the information provided above is true and correct: Sienature: Date: Phone#: w Offl-cial use only. Do not write in this area,to be completed by city or town ofJ71ciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the' dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." mGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insmnce requirements of this chapter have been presented't:o the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference`mumber. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to buim leaves-etc.)said person is NOT required to complete this affidavit. The office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 washingtcai Street Boston,MA 02111 Tel. #617-727-490.0 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11-22-06 ww.mass.gov/dia I E��y Town-of Barnstable yP °� Regulatory Services * s Thomas F.Geller,Director Mass• $ `b. `� Buildincr Division plEp M b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 Permit no. AFFIDAVIT HOME MROVEMENT CONTRACTOR LAW; SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: )k_DD M© • S Estimated Cost ,Address of Work: Lora 5001% MICV03 15-rQST com I DW I L. ;f p ,i � Tit PLP Owner's Name: - -. Date of Application: I hereby certify that: Registration is not required for the following,reason(S)2 � FlWork excluded bylaw ❑Job Under$1,000 ~ Building not owner-occupied ❑Owner pulling ownpermit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. • R � , Da Owner's NarM Q:fm=:hcmeEffidav r tioF r Town of Barnstable. Regulatory Services AB '$ Thomas F.Geller,Director `bArEc�1� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder• I, ���f � , as Owner of the subject property hereby authorize (� -Tfl ft&Ikf 10 Et to act on my behalf, in all matters relative to work authorized bythis bin7ding permit application for, . (Address of job) Xc �5ignature of er Pnnt Name Q:F0PM5:0 WNERPERMI55ION FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B..No. 3067-0077 T; NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE t Impoftt Read the instruction on paM 1 7. SECTION A-PROPERTY OWNER INFORMATION For Irwrance Amy Use. BUILDING OWNER'S NAME - Policy Ncamber' Robert E.&Marianne D.Tri lette BUILDING STREET ADDRESS(Including Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company.NAIC Number 682 South Main Street CITY STATE ZIP CODE Centerville-Barnstable MAf PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Assessors's Map 186 Parcel 038 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary:) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type): (##*-##-#Ak.#fF or ##.a ®NAD-1927 - ❑NAD 1983 ®USGS Quad Map ❑Other: + SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2 COUNTY NAME B3.STATE Bmr table25=1 Barnstable MA MAP AND PANEI B5. IX B7.FIRM PANEL B9.BASE FLOOD ELEVATIONS) NUMBER B6.FIRM INDEX DATE EFFECTNE/REVISED DATE one AO, D 1992 1992 A10 2500010016. - B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. ❑FIS Profile ®FIRM ❑Community unity Determined ❑Other(Describe): B11.Indicate the elevation datum used for the BFE in 89:®NGVD 1929 ❑'NAVD 1988 ❑Other(Describe): 0 PA? Yes No Designation Date1992 B12.Is the build located in a Coastal Barrier Resources System(CBRS area o Otherwise Protected Area( ) ❑ ® _ building ) SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Building elevations are based on:❑Construction Drawings* ❑Building Under Cor>stuction*, ®Finished Construction *A new Elevation Certificate will be muted when carstnrction of the building is con plete.; C2.Building Diagram Number 2(Select the building diagram most molar to the buildirg for Mich this certificate is being completed-see pages 6 and 7. If no drag aan acaaatu ly represents the building,provide a sketch or photograph.) C3.Elevations-Zones Al A30,AE,AH,A(wffh BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,AR/A1A30,ARIAH,ARIAO Corr>Plete Items C3.-a4 below acca ng to the building dagam specified in Item C2.State the datum used.If the datum is different tram the daUn used for the BFE in Section B,convert the datum to that used for the BFE.Show field measu irnen s and datum conversion calculation. Use the space provided or the Comments arm of Section D a Section G,as appropriatle,to document the datum conversion: Datum NGVD 29 ConversronlCorrnents Elevation reference mark used RM 27 Does the elevation reference mark used appear on the FIRM? ®Yes ❑NoOF ❑ a)Tap of bottom floor.(ndudng basement 6r enclosure) 4. 61 ft(m) � m ❑ b)Tap of next high floor` 10.48 ft(m) a o a c)Bottom of lowest horizontal structural member(V zones only) ,NA._ft(m) 0o ❑ d)Attached garage(top of slab) 10:04 ft(m) w r- go ❑ e)Lowest elevation of machinery ardor equipment !4 servicing the building(Desaloe in a Comments area) TAM ❑ f)Lowest adjacent(finished)grade(LAG) , 8.53 tt(m) Z O1 ❑ g)Hilt aclacent(finished)9ade(FLAG)- 9. 75 ft(m) ❑ h)No.of permanent openings(flood vents)within 1 ft above adjacermt grade 3 : x ❑)Total area of all permanent openings(flood vents)in C3.h 896 sq.in.(sq.an) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,.or architect authorized by law to certify elevation information. l certify that the information in Sections A,B,and C on this certificate represents my best efi'orts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. CERTIFIER'S NAME Peter Sullivan LICENSE NUMBER 29733 TITLE P.E. COMPANY NAMESullivan Engineering,Inc. ADDRESS CITY STATE ' ZIP CODE 7 Parker Road Osterville MA 02655 i O - DATE TELEPHONE 17 04/16104 508-428,W 7__ L. A I&ORTANT: In these spy,copy the corresponding information from Section A For.Ir are Company u er BUILDING STREET ADDRESS(Indudng Apt,Unit,Suite,andror Bldg.No.)OR P.O.ROUTE AND BOX NO. Polity Numt�er 682 South Main Street CITY STATE ZIP CODE Gamlm yNAIC Number s Centerville-Bamstable MA 02532 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Cerfiificate for(1)ca nitmily official,(2)insurance agentIc mpany,and(3)building owns. COMMENTS C3.e)Fumace @ 4.61,Water Heater.@ 4.86,Circuit Btaker@ 8.71 C3.h&)This Elevation Certificate-only certifies the number of flood vents,and the arm of those flood vents.This does NOT certify that the coverings over the flood vents permit the automatic entry and discharge of floodwaters: ❑Check here if attactwo is SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE A0 AND ZONE A(WITHOUT BFE) - For Zone AO and Zone A(without BFE),complete Itemm E1 bough E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be con pleted . E1.Buildirg Diagam Number_(Select the building dagam most sinner to the building forwhich this certificate is being completed—see pages 6 and 7.if no diagran acarat ly represents the building,Provide a sketch or photogr-aph.) E2.The top of the bottan floor(including basement or enclosure)of the building is ft(m)_in.(an)❑above.or ❑below(check one)the highest a*cent grade. (Use natural grade,if available). grade. Canplete items C3.h and CW on front of forth: E4.For Zane AO only: If no flood depth number is avalable,is the top of the bottom floor elevated in accordance with the community's tloodplam management ordnanc e? ❑Yes ❑No ❑Unknown. The local official must cerW this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owners mmer's authorized representative who completes Sections A,B,C(Iterm.C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community- issued BFE)or Zone AO must sign here. The statements in Sections A,B,C.and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OVVNER'S AUTHORIZED REPRESENTATIVE'S NAME Peter Sullivan,Subs n Engira rg,Inc. N ADDRESS CITY, STATE ZIP CODE 7 Parker Road Osterville MA 02655 DATE TELEPHONE 04/16104' S08 428 3344 COMMENTS Check hem if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authored by law or ordnance to administerthe community's floodon management ordnance can comnplete Sections A,B,C(or E),and G of this Elevation Certificate. Complete the applicable item(s)and sign below. G1.❑The intamuation in Section C was taken from other doamentafion that has been signed and embossed by a licensed surveyor,engineer;or architect who is auth med by state or local law to certify elevation information. (Indirafe the source and date of the elevation data in the Comments area below.) G2.❑A community official completed Section E for a building located in Zone'A(without a FEMA-issued or community-issued BFE)or Zone A0. G3.❑The following information(Items G449)is provided for community floodpWn management purposes. G4.PERMIT NUMBER G5.'DATE PERMIT ISSUED. 7 DATE CERTIFICATE OF COMPLIANCEIOCCUPANCYdSSUED 7 G7.This permit has been issued for.❑New Coist uction ❑Substantial Improvement G8.Elevation of as-bu ift West floor(including bacement)of the building is: _ft(m) Datum: G9.BFE or(in Zone AO)depth of flooding at the building site is: : _fL(m) Datum: LOCAL OFFICIAL'S NAME - TITLE. COMMUNITY NAME TELEPHONE SIGNATURE. DATE COMMENTS Check here if attachments Timer 111UU AM TO, W7,1Dvoravvnay. - Client#:9580 2KPRE ACORU. CERTIFICATE OF LIABILITY INSURANCE 091110107°'YYYY' PRODUCER I . I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyanough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Associated Employers Insurance Compa Kenneth Perry D/B/A INSURER g K.P.Remodeling&Construction INSURER c 19 Guildford Road INSURER U. Centerville, MA 02632 INSURER e COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HkVE BEEN REDUCED BY PAID CLAIMS. I POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR S TYPE OF INSURANCE POLICY NUMBER D TE /D E Y GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDBncel $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO-JECT LOC 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Es accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIR�AUTOS BODILY INJURY - $ NOI�WNEQ7&U,fOS (Par accident) PROPERTY DAMAGE $ .. ....-. .. __._. (Per accident)- GARAGE LIABILITYZ I�-" AUTO ONLY-EA ACCIDENT $ .EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ""ICJ CLAIMS MADE AGGREGATE $ r $ DEDUCTIBLE $ RETENTION $ ' lw $ A WORKERS COMPENSATION AND WCC5005450012007 06/13/07 06/13/08 X OR I IMIT Ell EMPLOYERS'LIABILITY - - E.L.EACH ACCIDENT $100 000 ANY OFFICER/MEMBER EXCLUE ED ECl1TIVE D - E.L.DISEASE-EA EMPLOYEE $10O 000 If yes,describe under E.L.DISEASE-POLICY LIMB $500 000 SPECIAL PROVISIONS below j OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - **Workers Comp Information*` Voluntary Compensation Massachusetts Limits of Liability Endorsement form#WC200301 Edt Date:04/01/84 (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable Bldg DIY. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN Attn:Tom Perry-Commissioner NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Hyannis, MA 02601 REPRESENTATIVES. - AUTHORIZED REPRESENTATIVE - ACORD 25(2001106)1 of 3 #49038 JMH 0 ACORD CORPORATION 1988 ` REScheck Software Version 4.0.1 Compliance Certificate Project Title: ADDITION TO EXISTING RESIDENCE Report Date: 10/30/07 Data filename:C:\Program Files\Check\REScheck\TRIPLETTE.rck Energy Code: Massachusetts Energy Code Location: Barnstable,Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 22% Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 682 S.MAIN STREET MARIANNE TRIPLETTE KEVIN WERNER CENTERVILLE,MA 02632 FINE LINE DESIGN 8 WEST BAY ROAD OSTERVILLE,MA'02655 . •508-420-1296 �All h s TOTAL CEILING:Flat Ceiling or Scissor Truss: -1641 38.0 0.0 49 TOTAL WALLS:Wood Frame,16"o.c.: 2213 13.0 .0'.0 138 TOTAL WINDOWS:Wood Frame:Double Pane with Low-E: 328 0.340. 112 Door 1:Solid: 42 0.280 12 Door 2:Glass: 155 0.380 59 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space: 1106 19.0 0.0 52 Furnace 1:Forced Hot Air.88 AFUE Air Conditioner 1:.Electric Central Air:13 SEER 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 4.0.1 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. Name-Title Signature Date Project Notes: ENVELOPE OF NEW CONSTRUCTION 1 f REScheck Software Version 4.0.1 Inspection Checklist maw Date: 10/30/07 Ceilings: ❑ TOTAL CEILING:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: . ❑ TOTAL WALLS:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments: Windows:. t ❑ TOTAL WINDOWS:Wood Frame:Double Pane with Low-E,U-factor.0.340. For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.280 Comments: ❑ Door 2:Glass,U-factor:0.380 Comments: Floors: ' ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Furnace 1:-Forced Hot Air.88 AFUE or higher Make and Model Number: ❑ Air Conditioner 1:Electric Central Air:1.3 SEER 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 are sealed. 0 When installed in the building envelope,recessed lighting fixtures#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 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled: Vapor Retarder: 0 Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials identification: 0 Materials and equipment are identified so that compliance can be determined. 0 Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values,glazing Wactors,and heating equipment efficiency are clearly marked on the building plans or specifications. Insulation is installed according to manufacturers instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation.' Duct Insulation: Ej Ducts are 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,are sealed using mastic and fibrous backing tape installed according to the manufacturers installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. The HVAC system provides a means for balancing air and water systems. Temperature Controls: ❑ Thermostats exist 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 is 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 AA Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in.Table 1. Swimming Pools: sLl All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. ` it 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" 170-1.80 0.5 1.0 1.5 2.0 140-160 0.5 05 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 Pressure/Temperature 261-250 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 1.6 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)' r V Ju T i'Board oflBunuue�t�/z, \ Construction Supegulstions any ;l ' Standards ' eryisor'License e: I Licens CS B�rthdate� 76820 8 2&1965' r ,�ExpiratlQn 8!7' 009 - r r# 2373 - nhs 00f 9U ENN GETH O PE\RYA { f . ORD ROAD tr �; CENTERVILLE, ✓ _ : i. _ . . MA 02632"� J II - Commissi _ une'r , Board of Building'Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: FRegistration `132282 Board of Building Regulations and Standards; - g g One Ashburton Place Rm 1301 ! r Expiration 1ti21/2008 Tr# 124628 Boston T' e, DBA`` ;Ma.02108 _ E K P.REMODELING p . KENNETH PERRY ff; 19 GUILDFORD RD. ." �% Centerville,MA 02632 Administrator . Not valid witho t e t Nov, 21. 2001 8:5 i AM A H HARRIS, No, 4052 P, 2/3 E_ag!neered Flood Openings Ceriaficate ' To satisfr�a�ements of the National Flood Insurance Program - This certification must be submitted to,and kept on file by,the local jurisdiction's permit authority. A copy l should be retained by the owner to demonstrate compliance in order to receive the best flood insurance ratitltg. The Smart'VENT6 and Flood'VENT-Foundation Flood Vent is certified as meeting the flood opening requirements for engineered openings as set forth in the Federal-Erzrergency Managarne i Agency's National flood Insurance program regulations(44 CFR.60 3(c)(5))and ASCE 24- 98,provided it is installed according to the those rcfe•ram,as summarized below. Flood openings are required in enclosures below elevated buildings,attached and detached garages,and accessory structures that meet the required limitations. For a copy of the report documenting this certification dated luny 2l,2002,and a copy of the National Evaluation Service report Nbit 624,contact Smart VENT,Inc.,at 877/441-B368 or visit www.sma(tveiit.com I do hereby certify that the SMart VENTO Louvered liouodation Flood Vent and the FloodVEN -M! Insulated Foundation Flood Vent opening(s)is designed for installation in blaildings,will allow for the automatic equalizing of hydrostatic flood forces on exterior walls by allowing for the automatic entry] and exit of floodwater during floods tap to and including the base(100-year)flood, One Smart VENT® or one FloodVEN.TTM for every 200 Sq.F't. of enclosed area will provide sufficient hydrostatic pressure; equalization during a flood provided the iiastallation limitations and instructions are followed as listed below. To Calculate the required.number of Smart VENTST or FloodVENTSTm divide the Square Feet of enclosed area by 200. Example:A 2000 S .>+t. enclosed area requires 10 vellts. 0=10 Vents (Signature -- _ pNWEq 'Title Sa.4101C ,, ,,E p at ceri:rto i T of License vllosster i i }'� 13_iPR� PrtoFt�srod� ,,��p� License Number STVEiV 141,!iRICN EWMIeR *Project Name q No *Project Address 0,y�S t t�V t�` *Date Submitted *Required Fields* Professional Seal i Inst ((Woe Limitations and Instructions .I. The Sttart VENTO or FloodVENTTM unit provides sufficient automatic equalization of hydrostatic premute on wails and f0uridtiom of buildings located in flood hazard areas where the rate of rise is expected to be less than or approximately 5 feet per hour. 2. Enclosed areas below otherwise elevated buildings,non-elevated attached and detached garages,and certain non-elevated accessory structures located in flood hazard areas are to be used solely fot parking of vehicles,building access,or storage. 3. Each enclosed area shall have at team two flood openings,installed on different sides of the enclosed area, 4. The bottom of the flood openings shall be no more than one foot above the adjacent finished ground level, 5. Installation must be in tttcordance with manufacturcr's instructions. "RISFERENCE ONLY"From FEMA TB 1-93 Guidance for Engineered Openings Openings in Foundation Walls i. `atioucal Flood Insurance Program NFIP Technical Bulletin TB 1-9 i "in situations where it is not feasible or desirable to meet the openings criteria stated previously, it design professional (registered engineer or architect) may deiigrr qnd cartify openings. This wodon provides guidance for such engineered designs. For opcnings nor meeting all four i requirements for eon-engineered openings listed ou page 2 and 3 of TB 1.93, cettification by a registered professional engineer or architect is ' / required. Such certification must be submitted to,and kept on file by,the conrimnity. These certifications must assure community officials that the openings are designed in accordance with accepted standards of practice. A certification may be affixed to the design draveings or subrritted separately.It crust include appropriate certification language,and the name,title,address,signature,type of license,licerise number,and professional seal of the certifier." ("111 1-93 is amitabic through Sman VENT`®or online at www_fema.gov) Form:SMRT100 Rev.A This form is the property of Smart VENT Inc Modification or Duplication Is Strictly Prohibited without auttierization. NC'J, 21, 20071- 3:47AM A H HARRIS No. 4054 P. 1 SMART VENT +� ,{��.,�.; ..,.k.: .i•'lJ7 r.},,P-r„ ii�`,y .,�..:-.,..as•:+.,•....,;.F:,.:P'•:y;.r: GI100SS as correct stifi -- 4i; a'r--9-7 r...ON In addition to sizing options,we offor two style '''T' "'`'r" choices,The first is a dual function model that o t c r will give yo.0 automatic flood protection along Easy installation{all hardware is included)makos this with automatic ventilation.The second is our model ideal to retrofit into an existing garage door,A insulated model that seals out the cool or warm white powder coated stainless steel frame cleanly air,but opens as flood water rises. installs into the garage door with onlyfour(supplied) stainless steel screws and nuts. V ' u Model#: 1540-514(Smart VENT"I 1940-524(Insulated Flood VENT) 1540-574(Insulated Flood VENT) Installation Type:Overhead Garage Doors Style:Louvered or Insulated 2 Sizes Available: Model 8: IW-510 Dimension,6"x 16"(514-524' Installation Type: Masonry Wall Rough Opening:16%"x 7%" (cut through door] Style: Louvered Dimension:14''A"x V"1574) dimensions:8"x 15" Rough Opening: 14%:"x 8 Y4" Finish:White(Standard) Rough Opening 16Ya'x 8 i' h block,or CMU) Finish: Stainless Steel(Standard) One 9"x 16"or 14'�x @/a vent is certified to cover 200 sq/ft of enclosed area for flood protection, One 8"x 16"vent is certified to cover 200 sq/ft of enclosed area for flood protection and 51 wjin for ventilation. The Wood Wall Flood Vent is designed to fit between wood studs spaced on 16"centers.One vent covers 200 sq/ft of enclosed area,and it is an easy ratro`,it, This vent is only available in our insulated modei. Model l: 1540-52D Model s: 1540-570 Installation Type:Masonry Wall Installation'hips:Wood Stud Wall Style:Insulated Style: insulated Dimensions:a"x 16" Dimensions: 14Y,"x 0yp" Rough Opening:1634'x 8yo"(1 block,or CMU) Rough Opening:102"x 8%4" _ stnish:Stainless Steel(Standard) Finish:Stainless Steel(Standard) One 8"x 16"vent is certified to cover 200 sglft of One 14 V2"x S VY vent is certified to cover 200 sglft erclosed area for flood protection. of enclosed area for flood protection. 3 �j 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - Map Parcel :Application # Health Division Date Issued v Conservation Division :�-_Application Fee if/ Planning'Dept: Permit Fee: , _ Date Definitive Plan Approved by Planning Board f '7/3/�� Historic = OKH — Preservation/ Hyannis ; Project Street Address A Village i MA an : Owner I rip Address Telephone �.J '� q 1 U q,q Permit Request :ems 0 RM,-Ai PU -SIM --�p As sckff V(n ro*, -so Square feet: 1st floor: existing proposed '2nd floor: existing proposed Total new Zoning Districts Flood Plain Groundwater Overlay Project Valuation °� Construction Type Lot Size , Grandfathered: ❑Yes ❑ No liyes, 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 Ro6t Count- C Heat Type and Fuel: '*Gas ❑ Oil ❑ Electric ❑ Other Central Air: Ayes ❑ No : Fireplaces: Existing New Existing woo( oal stogy: ❑Nes @ No Detached garage: ❑ existing 0 new size_Pool: ❑ existing ❑ new size _ Barn: ❑ xisting st hEg size_ 0 Attached garage existing ❑ new size _Shed:kexisting ❑ new size _ Other: . : ^ Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number C `'t - a" n7 Address 1 �1 D License # li� � � Cbf,jTt-" Lip", M/`1, Home Improvement Contractor# '5�?R 9 Worker's Compensation # r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE V i r • f FOR OFFICIAL USE ONLY APPLICATION# DATE.ISSUED MAP/PARCEL NO. _ 1 ADDRESS VILLAGE Y OWNER DATE OF INSPECTION: - FOUNDATION q16 FRAME _ r INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL T - GAS: ROUGH FINAL FINAL BUILDING 711 t F DATE CLOSED OUT - ASSOCIATION PLAN NO. t • The Corntnonwealth of Massachusetts Department of Irtdustrial Accidents' Office of Investigations 600 Washington Street .Boston, MA 02111 www.m ass.go v/dia Workers' Compensation Insnrance AMidavit: Builders/Contractors/:Electricians/Plumbers A Ucant Information Please Print Le 'bl Name (Business/Organization/Individual): �` fi sft? t Address: City/State/Zip: Phone.#: a A,re you an employer? Chec the appropriate box: Type of project(required): 1 I am a employer with 1:� 4. [� I am a general contractor and I 6. ❑New construction . employees (full and/or part time).* have hired the sub-contactors ❑ listed on the attached sheet 7. [J Remodeling 2. I am a'sole proprietor or partner- ship and have no employees These sub-contractors have g• Demolition working for mein any capacity. employees and have workers' 9 Building addition [No workers'.corup.-insurance comp. insurance.$ required..] S. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ T am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4), and we have no q-� employees. [No workers' 13 Other +�!���5 comp,insurance required_] 'Any applicant that checks box#I must also fil 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. tContracton that check this box must attached an additional sheet showing the name of the sub-contr ctors and state whether ar not those entities have employers. If the subcontractors have employees,they must providb 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.#: Expiration Date: Job Site Address: (O '�'C�1 1�+ 1 1.a WK*y/State/Zip; l$1� 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 c-tal penalties of a fine tip 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 bIA for insurance coverage verification. I do hereby ce nder the pains•and pe es o 'ury that the information provided ab 'e is tru and correct Si nature: Date: _ Phone#: 0h 1-1 .LOfficial use only, Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one); 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector. 5. Plumbing Inspector. 6. Other Contact Person: Phone#: Information, and Inst 'Uctions , Massachusetts.General Laws chapter 152 requires all employers to provide workers' compensation for their.employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract,of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing.engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees, However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do,maintenance, construction or repair ork on such dwelling house w or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall enter.into any contract for•the performance of public work until acceptable evidence of coinplizncc with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if accessary, supply sub-contractors)name(s), address(cs) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LI2)with no employees other than the members or partners,arc not required to carry workers' compensation insurance•.If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and data the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,Incase call the Department at the aurgbcr listed below. Sclf-insured companies should enter their self-insurance license number on the appropriate line. City or Towp Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom Iavcsti ations has to contact you regarding the applicant. of the affidavit for;you to fill out in the event the Officc of g Please be sure to fill in the permit/liccrse number which will be used as a reference number. In addition, an applicant y given year, aced only submit onp affidavit indicating currcnl that must submit multiple permit/licensc applications in an policy information(if pecessary) and under`Job Site Address" tha applicant should write. all locations in (city o town)."A cbpy of the affidavit that has beta officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Whcro a home owner or citizen is obtaining a]icons e or permit not related Eo any business or commercial venture (Lc. a dog license orpermit to barn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would hlce to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,tclephone•and fax number: The C6mmoi1w(-,J.th of MassarhU5seits Depaztmmt of ladustdO Ac�cidQ;ats Office, of lzyestigati.uas 600 Was imgton Stet Boston, MA 02111 TQ1. # 617-727-490.0 ext 4-06 or 1-S77-MASSAFE Fax# 617-727-7749 Revised 11-22.06 WWW,MaS.,gov/dia f �oFVHF Town of Barnstable a Regulatory Services vsAAMMMAB LE'� Thomas F. Geller, Director Building ]division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 , www.town.barnstable.ma.us Office: 509-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section ` t ff Using A Builder 1 ' TV(ftaE as Owner of the subject property hereby authorize �' d� J'(�G tT �e ( lF to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Ow er Dale !1�1 �-1 �� �L67� Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. Town of Barnstable y���op THE rq�yT Regulatory Services Thomas F. Geiler,Director • BARNSTABLE, MASS.sdgp• N� Building Division PTfO M��p Tom Perry,Building Commissioner 200 Main Street, Hyannis_, MA 02601 wwjY.town.barnstable.ma•us Office: 508-862-4038 Fax: 508.-790-6230 H0n4EOWNER LICENSE EXEMPTION Plense Print DATE: ,j� j JOB LOCATION: w number street village "HOMEOWNER": work hone# name home phone N p , CURRENT MAILING ADDRESS: state zip code city/town The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF FI0114E0WNER Persons) who owns a parcel of land on•which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on.a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109,1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department mi umum inspection procedures and requirements and that he/she will comply with said procedures and requirements, Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section lo9.i.i-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work, that such Homeowner shall act as supervisor," Many homeowners who use this exemption are unaware that they are assuming the responstbilities or supervisor(see Appendix Q, erious problems,particularly Rules&•Regulations for Licensing Construction Supervisors;Section 2.15) This lack of awareness often results in s when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. 1 HOMEIMPROVEMEN 'CO Rr RACTQR Registra�lolt 132282 r �1 1/2010 f k i � Tr# 278840 .,j g p KP REMOOELI r{ � }` NG. u KENNETH T ERRS. 4` 19 GUILDFORD RQ I Centervtlle,:.MA 0 2ti32�� e`` ` � T Adinimstr � �a � ator' 111 l (I Re ulations and Standards € ' Board of Building _ g �cense ery i s&L Construction Sup. ! Lice se 'CS -76820 Birthd`ae 812811965. Trt� 2373 Expiration 812$12009 ; t l00 KENNETH O FERRY 19 GUILDFORD ROAD_: MA 02632 m Comissioner CENTERVILLE, t f w ' _.registration valid for individul use only t License or reg 1 ' before the expiration date.. If found return to. Regulations and Standards F Board of Building g j301 i f One Ashburton Place Rm Boston,Ma.02108 Not.vald without signature t t Ite: 6/25/2009 Time: 9:50 AM To: @ 9,15087906230 Page: 002 Client#: 9580 2KPRE ACORD,. CERTIFICATE OF LIABILITY INSURANCE 6/25/2009 ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 973 lyannough Rd., PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Western World - Kenneth Perry D/B/A INSURERS: Associated Employers Insurance K.P. Remodeling&Construction INSURER C: 19 Guildford Road INSURER D: Centerville, MA 02632 INSURERE: ; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR DATE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY NPP1203292 .. 03/04/09 03/04/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMPREMISES(Ea occuE TO E mca $5O OOO CLAIMS MADE a OCCUR MED EXP(Any one person) $5 000 X BI)PD Ded:500 PERSONAL&ADV INJURY $1 00Q 000 GENERAL AGGREGATE s2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1 000 000 POLICY PRO- LOC - JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS ' BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ ' OTHER THAN AUTO ONLY: . - AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ _ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE r .. $ RETENTION $ - - $ B WORKERS COMPENSATION AND WCC5005450012009 06/13/09 -O6/13/1O X WCSDRYTATU- OTH- EMPLOYERS'LIABILITY FIR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? YES E.L.DISEASE-EA EMPLOYEE $100,000 It yes,describe under - SPECIAL PROVISIONS below E,L.DISEASE-POLICY LIMIT $500 000 OTHER S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE:682 South Main Street, Centerville Operations performed by the named insured subject to policy conditions and exclusions. Kenneth Perry is excluded from the workers compensation policy. . G +g:, N 00 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC , D BEFORE EXPIATION Town of Barnstable Bldg Div. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO DAYS WR�N Attn:Tom Perry-Commissioner ' NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT ILURE To DOO���SO SH. q L 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INS•RER,ITS A& "S 001 r Hyannis, MA 02601 REPRESENTATIVES. AUTHORIZED R PRESENTATIV�E^ ACORD 25(2001/08)1 Of 2 #S59065/M59064 LS1 © ACORD CORPORATION 1988 f JJ I� 8" 2 1ZVv S' �cF� .S,I c = T REFERENCES: r, .�.df1 moo, s� r°°` .. Assessors Map: 186 ° Parcel: 038. Deed Book 200491300 0 ZONE:RD-1 " s o Setbacks: FS Front: 30 min Side: 10'min Top of Foundation EI=10.04' Rear: 10'min �- Top of FF Deck E1=11.03' Crawl Space Slob EI=6.4' Bulkhead.. FLOOD ZONE; j A 10(EL 11), B, & C 25.4' Community—Panel # 2 Story'. Wood Dwelling . 250001 0016 D Rev.: July 2, 1992 12.5' r682 0 CB/DH o Fnd 3 sod V in 90 9 60.6' RN rn °0 New Concrete Foundation ie yl0 t�OF. I certify that the new 19 RyCHARD ��. foundation shown hereon �N e� R �\a EUX �. conforms to the setback As �z requirements of the Zoning Iron Pipe 9. ._,,,,_ off' Bylaws of ,the town of (q�Ea�V�v Q Barnstable. . PLOT PLAN ` At 682/South Main Street 20/F,E��o B Bf'�R/VS /�"1 BL NOTES: (Centerville) 1.) The structures shown" were located on the ground MASS. by conventional survey methods on (or between) DATE: 19/FEB/08 SCALE: 1"=30' 27/JUN/01 and 14/FEB/08. 0 15 30 45 60 FEET 2.) The datum used is NGVD '29. Benchmark used is "M28 QS" a USC&GS and" MGS Disk in concrete bound. PREPARED FOR: Marianne D Triplette 3.) The property line information shown hereon was 328 Indera Mills Ct compiled from available record information. Winston-Salem NC 27101 PREPARED BY: C apeSu ry 4.) This plan is not for recording and is not to be used for construction layout or deed description 7 Parker Road purposes. Osterville MA 02655 "DWG #: C492gl FIELD BY: RRL/MLL/DWB (508) 420-3994 / 420-3995fox EScheck Software Version 4.2.0 �A R S tA B Compliance Certificat�,, SEP 16 PM l: SS rProject'Tifle:682'SouthsMain'St I I"� P Energy Code: 2006 IECC Location: Centerville(Barnstable), Massachusetts Construction Type: Single Family Project Type: Alteration ` Building Orientation: Bldg.faces 180 deg.from North Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 682 South Main St Centerville,MA 02632 • Compliance:13.4%Better Than Code Maximum UA:350 Your UA:.303 i a Cathederal:Cathedral Ceiling(no attic) --- ___ ___ _-- --- Exemption:Framing cavity filled with insulation. 1 st Floor flat:Flat Ceiling or Scissor Truss --- --- ___ ___ __- Exemption:Framing cavity filled with insulation. - 3rd Floor Flat:Flat Ceiling or Scissor Truss --- --- ___ ___ --- Exemption:Framing cavity filled with insulation. Cathederal Flat:Flat Ceiling or Scissor Truss --- ___ ___ _-_ --- Exemption:Framing cavity filled with insulation. Garage Ceiling:Flat Ceiling or Scissor Truss --- ___ __- --- Exemption:Framing cavity filled with insulation. Overhang:Flat Ceiling or Scissor Truss --_ __- --_ --- Exemption:Framing cavity filled with insulation. 3rd floor slopes:Cathedral Ceiling(no attic) - --- --- --- --= --- Exemption:Framing cavity filled with insulation. Unvented Roof:Cathedral Ceiling(no attic) __- -__ ___ --- Exemption:Framing cavity filled with insulation. Crawlspace and platform:Flat Ceiling or Scissor Truss --- --- --- ___ --- Exemption:Framing cavity filled with insulation. Exterior Walls:Wood Frame, 16"o.c. _-- ___ ___ __- --- Exemption:Framing cavity filled with insulation. Window 1:Vinyl Frame:Double Pane 12 0.032 0 Window 2:Vinyl Frame:Double Pane 12 0.032 0 Window 3:Vinyl Frame:Double Pane 12 0.032 0 Window 4:Vinyl Frame:Double Pane 12 0.032 0 Window 5:Vinyl Frame:Double Pane 12 0.032 0 Window 6:Vinyl Frame:Double Pane 12 0.032 0 Window 7:Vinyl Frame:Double Pane 12 0.032 0 Window 8:Vinyl Frame:Double Pane 12 0.032 0 Window 9:Vinyl Frame:Double Pane 12 0.032 0 Window 10:Vinyl Frame:Double Pane 12 0.032 0 Window 11:Vinyl Frame:Double Pane 12 0.032 0 Window 12:Vinyl Frame:Double Pane y" 12 0.032 0 Window 13:Vinyl Frame:Double Pane 12 0.032 0 Window 14:Vinyl Frame:Double Pane 12 0.032 0 Window 15:Vinyl Frame:Double Pane 12 0.032 0 Project Title: 682 South Main Sty Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 1 of 7 f Window 16:Vinyl Frame:Double Pane 12 0.032 0 Window 17:Vinyl Frame:Double Pane 12 0.032 0 Window 18:Vinyl Frame:Double Pane 12 0.032 0 Window 19:Vinyl Frame:Double Pane 12 0.032 0 Window 20:Vinyl Frame:Double Pane 12 0.032 0 Window 21:Vinyl Frame:Double Pane 12 0.032 0 Window 22:Vinyl Frame:Double Pane 12 0.032 0 Window 23:Vinyl Frame:Double Pane 12 0.032 0 Window 24:Vinyl Frame:Double Pane 12 0.032 0 Window 25:Vinyl Frame:Double Pane 12 0.032 0 Window 26:Vinyl Frame:Double Pane 12 0.032 0 Window 27:Vinyl Frame:Double Pane 12 0.032 0 Window 28:Vinyl Frame:Double Pane 12 0.032 0 Window 29:Vinyl Frame:Double Pane 12 0.032 0 Window 30:Vinyl Frame:Double Pane 12 0.032 0 Window 31:Vinyl Frame:Double Pane 12 0.032 0 Blockers:Wood Frame, 16"o.c. 90 13.0 0.0 7 Garage House Wall:Wood Frame, 16"o.c. 234 13.0 0.0 19 Cathederal Ext Walls:Wood Frame, 16"o.c. 120 13.0 0.0 10 Garage Ext Walls:Wood Frame, 16"o.c. 394 19.0 0.0 24 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space --- --- --- --- --- Exemption:Framing cavity filled with insulation. Furnace 1:Forced Hot Air 92 AFUE Air Conditioner 1:Electric Central Air 13 SEER 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 2006 IECC requirements in REScheck Version 4.2.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Notes: KP Remodeling Project Title: 682 South Main St Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 2 of 7 I REScheck Software Version 4.2.0 Inspection Checklist Ceilings: ❑ Cathederal:Cathedral Ceiling(no attic) Exemption:Framing cavity filled with insulation. Comments: ❑ 1st Floor flat:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: ❑ 3rd Floor Flat:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: ❑ Cathederal Flat:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: ❑ Garage Ceiling:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: ❑ Overhang:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: ❑ 3rd floor slopes:Cathedral Ceiling(no attic) Exemption:Framing cavity filled with insulation. Comments: ❑ Unvented Roof:Cathedral Ceiling(no attic) Exemption:Framing cavity filled with insulation.' Comments: ❑ Crawlspace and platform:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: Above-Grade Walls: ❑ Exterior Walls:Wood Frame, 16"o.c. Exemption:Framing cavity filled with insulation. Comments: ❑ Blockers:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: ❑ Garage House Wall:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: ❑ Cathederal Ext Walls:Wood Frame, 16"o.c.,R-13.0 cavity insulation ` Comments: ❑ Garage Ext Walls:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Windows: Project Title: 682 South Main St Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 3 of 7 f ❑ Window 1:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 3:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 4:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 5:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 6:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 7:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 8:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 9:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break?—Yes No Comments: ❑ Window 10:Vinyl Frame:Double Pane,.U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 11:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 12:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes. No Comments: ❑ Window 13:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: Project Title: 682 South Main St Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 4 of 7 #Panes—Frame Type Thermal Break? - Yes No Comments: ❑ Window 14:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes—Frame Type Thermal Break? Yes No Comments: ❑ Window 15:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 16:Vinyl Frame:Double Pane,U-factor:0,032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 17:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 18:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 19:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 20:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 21:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled 0-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 22:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 23:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 24:Vinyl Frame:Double Pane, U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 25:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Project Title: 682 South Main St Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 5 of 7 ❑ Window 26:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? -Yes No Comments: ❑ Window 27:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes—Frame Type Thermal Break? Yes No Comments: ❑ Window 28:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 29:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 30:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?_Yes No Comments: ❑ Window 31:Vinyl Frame:Double Pane,U-factor:0.032 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break? Yes No Comments: Note:Up to 15 sq.ft.of glazed fenestration per dwelling is exempt from U-factor and SHGC requirements. Floors: ❑ Floor 1:All-Wood Joist/fruss:Over Unconditioned Space Exemption:Framing cavity filled with insulation. Comments: Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:92 AFUE or higher Make and Model Number: ❑ Air Conditioner 1:Electric Central Air: 13 SEER 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 are sealed. ❑ Recessed lights are either 1)Type IC rated with enclosures sealed/gasketed against leaks to the ceiling,or 2)Type IC rated and ASTM E283 labeled,or 3)installed inside an air-tight assembly with a 0.5"clearance from combustible materials and a 3"clearance from insulation. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: ❑ Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. Project Title: 682 South Main St _ Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 6 of 7 ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ❑ Ducts in unconditioned spaces or outside the building are insulated to at least R-8. ❑ Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R-6. Duct Construction: ❑ Air handlers,filter boxes,and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. ❑ All joints,seams,and connections are made substantially airtight with tapes,gasketing,mastics(adhesives)or other approved closure systems.Tapes and mastics are rated UL 181A or UL 181B. ❑ Building framing cavities are not used as supply ducts. ❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. ❑ Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: ❑ Thermostats exist 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 is provided. Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Mechanical Code. Circulating Hot Water Systems: ❑ Circulating hot water pipes are insulated to R-2. ❑ Circulating hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: ❑ HVAC piping conve ying in fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-2. Certificate: ❑ A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment. NOTES TO FIELD:(Building Department Use Only) Project Title: 682 South Main St Report date: 09/15/08 Data filename:c:\Users\DCLeonard\Documents\2007-06(Jun)\Desktop\682 main st.rck Page 7 of 7 C2006 IECC Energy �J( Efficiency Certificate 0 0 Ceiling/Roof 19.00 Wall 13.00 Floor/Foundation 0.00 Ductwork(unconditioned spaces): 0 0• o,� a Window 0.03 0.03 Door a o 0 0 0 0 Forced Hot Air Furnace 92 AFUE Electric Central Air Conditioner 13 SEER Water Heater: Name: Date: Comments: I I: Lan'Accailxlmodate,Any Insiallation a ,7 :1. Conflum on Options Single vents are available in stacked or quad configurations,Stacked modals are twice as efficient as a single Unit and are generally used to provide protection in larger dwellings or where adequate wall space is not available.•Quad models are an excellent solution for larger commercial projects and are not normally used in residential dwellings. Smart VENT"offers two UL-certified Fire Damper models.A masonry installation model(1340-530)and Model# 1540.5 VENT®) a wood wall installation model(15*637).The fore 15A0 521(Smart 111nsu1ated Flood VENT! damper is certified to provide two hours of fire resin, Insto IIa6oaTypa:Masonry Wail tance.11 is intended to be used where fire proofing is required on a wall in which flood venting is installed, Style:Louvered or Insulated usually In a garage or vestibule. Dimensions: 16"x 16" r Rough Opening: 16%'x 10 W(2 blocks,or CMU) The Trim Flange unitiits into the rough opening to one 16"x 16"vent certified for 400 sq/ft.of enclosed provide a clean finished look on the interior wall.Trim area for flood,and 102 sglin for ventilation flanges are available for use with standard rnasonr/ flood vents 1,,1540-533)and Srnart VENTe Wood Wail Models•(3.5-depth 1540.573 and 5"depth Model t 1540-55015mart VENT) 1540-573-91.Optional colors are available 1540-550(insulated FlnodVENT) (Please refer to color chart). InstaltationTjpe:MasonryWall Style:Louvered or Insulated The stainless steel sleevc lining is available in two Dim®neior.s,32"x 18" sizes.Model 1540-532-12 is adjustable from e"to 12`"and model 1540-532-15 is adjustable from 10"to 15'. Rough Opening:32'/:"x 16'A"14 blocks,or CMU) One 32-x 16"unit certified for too sglft of enclosed r 1 r area for flood,and 204 sq/in for ventilation All verts,with the exception of our Overhead Garage Door models,come in a standard stainless steel fir- s ish, The Overhead Garage Door models are available The Smart VENT®MasonryVJalf Buck is made of high in a standard white Finish. Color is applied to units using a specially strength PVC.,Each buck accepts model 1540-510 or all re formulated powder casting process. consis 1540-520. Fully assembled units are shipped reedy to. Color finishes are consistent,durable and extremely install with a protective film and wood bracing that weather-resistant. Optional colors shown below are protects the buck and flood available on all models via special order, f veal when the wall is poured, The Smart VENr Masonry % Wall Buck,isl0�"x10�'and comes in several widthsto Wh accommodate most standard White Wheat Gray slack stainless well thicknesses. L d �?b '�N SIybH H y bvEp B ciJOV 'Z 'A ON - la•tlNater .I'-a' L']I/t•' 5'-A 12' 6'Ip �'-9' G'9' ° �erO..a .e�roce. TOWN Of B ARINSTAELE v1 0 01.9.03 ^ BEDROOM �.._ .. I}1�Jr5•�r� _� III ... ECCKI— U ui REAR DECK FRAMING PLAN SMOKE DETECTORS REVIEWED d- 6CdLE:I/G' I'-P' --- �c i b .tea 3 0 9 = Q 19 —_... - .. ...I. .... F (5) ILDING DEPT. DATE � /V) FIRE DEPARTMENT DATE �T� Q Flu BOTH SIGNATURES ARE REQUIRED F0,R PERMITTING I"�'1 c, ci a EATli G� rl 9'6• O. A-1 BATH . $I pe W Z fill IL o ..�nA• KITCHEN co 6L. C �e I BEDROOM - g. I ® LAUNDRY i 101 Q I pi I A { § W as W iJ�,` LIVING Urp!-' z ; : :p Fl� ° p' a e'-0' i pm.•li•a.C. F� {.I. .. - - - ' - - Z 1 w b wa rt1 i5 • --— -- '^ � 111 ,. ;:_a° m "'•''w DOOR •'^'"'oc°R - FRONT DECK FRAMING PLAN �9r ' facRETe 4PRM . SCALE:I/G'.I'-0' �- SWEET 2.0F 7 z 9^ 9 w s 9 eRl - �moo• G'-G° ]9:_e. 9z'_p ,g2 'FIRST FLOOR PLAN . SCALE:I/4'•I'-O' _-__._.... 032E . eeuraw ww.0 DRAWN BY: KW REVISED: 7/B/09 DATE: II/1/07 4'-6' IS'-0' q'-0• 00 I r 1 . g 19 b' w • O _ a I! �l a � u ° ° � '. —_ ww.4s srsrd.rwiw•eove _ z i. A m m D N� m i i TRIPLETTE RESIDENCE FINE LI E ARCHITECTURAL DESIGN 682 S. MAIN ST. CENTERVILLE, MA `un°w o 8 WEST BAY ROAD OSTERVILLE, MA 02(555 s m PLAN PHONE: 508-420-1296 �\............. ► / �y �i M 565.84' / \ 9°� ——o -r-- Tree Line oh 00•... �..... \ \to 1 ' C/O CS 1 13 Use / I ` \ '� •eN! Ln eel jel \ t< Bituminous Drive Z, \ , '0 675 53' b ® 4 S . - - � � / \ • Picket Fence 10 9 e� z 94 `v iv L 2 l /����, �' W z �- w CD J m Q Q o z Q \ THE Town of Barnstable ' F 1p� Regulatory Services . Thomas F.Geiler,Director • RARNSrnat.E, • 9�A ,M�; ��� Building Division Tom Perry,Building Commissioner , 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERNIIT# n Z FEE: $ SHE GISTRA ION 120 square feet or less �P 802 S /dJ S/�2��✓ �`//U1�`�ZU/C /- Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) peg Sly/C LfL,A/ Ol f/05 PLEASE NOTE:, IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE, COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 l .............. JQae \\ S 46 23'00' E I I _ '` _ GOoota ohw } 11 \\ 565.84' \ \ Tree Line E oh \ a° � c i \' / ..• .i .......0oa• .. • ��••••.. \\ Doti . r \o • - ...;.,y l,. f OJ�µb O`r•\\��... \ Gob y AR oa b 11 ' `t�0 6 \ t�`11e o GO d 13 a a 1 7 O `n° 1 °e 1 w in _ Bituminous Drive \ 13 of \Q Lo I \ 0 4 o S 46 08'20' E O \ 9 P at Fence \ \4 0 �1�ap11�1 O c�'�d'`L• fl rl Il Q to T o Lu oN cn _ Z w Q ,00�r z �. R I'�R m e��e pp`pFfHETp Town of Barnstable BARNSTABLE. * Regulatory Services MASS. MA'S t6M Building Division pfFD s 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection f 4 Location &Fa. S. M�'... S 4' Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: rw,rcl Sc-' er\, JUur 2-Ai J 3 � / RCAym,� � T. ���sc� � rtl� 0; k� -4c� a 110we-�C rl 2 M'� ) 2.s/ CLO 5- -rn514 J-e.J -.PjeX dkc. be-low 9EE Cnawl SD4ce ? cj�3r� Please call: 508-862-403-9for re-inspection. Inspected by �� 1 Date Nov, 21, 2007 8,51AM A H HARR.S No. 405/1 F. 1/3 LEGACY REPORT NER-624 Reissued July 1,2005 ICC Evaluation Service, Inc. gWAWAIMINAl OMM m SW ywxi W ME P13W,whtrtff,OVUM 9W.(SM ems:, Is Raglonot pilau•900 Montoleir Road,Suite&birttmlrtgham,Alsbafna 36213■(205)599-98M wiwwAcc-S's.Ot g &glWW 016W 0 401 W36t FimmoorRcad,GbunbyClub HtiS,llhllois 60478 a(708)7WMW Legacy report on the 2000 tntiarnattonel Vulldirtg Codes,the 2000 International residential Codes,the 2002 AccumulatIve Sraprlement to the)ntematlannif Codes'",the BOCA"Notional Bulking Codet1999,the 1999 Standard Btdiding CodeA,the 1997 Unyorm Btllldiing CVW,the 1998 International One-and Tway-Family D*vIlIng Cods P,the 1995 CABO One-and Two-P'amfly Dwelling Code,the 1098 International Mechanical Codel,and the 1995 lnternatlonal 1Nechardcal Co&P DIVISION'10—SPECIALTIES flowing floodwater,the patented floating device instantly uses Section 10230—Vents the force of tho flowing floodwater to open the door,The vents are completely bl-direcfonal and automatically allow SMART VENT►,INC. floodwater to exit as well as enter unobstructed through the 450 ANDONO,DR,SUITE 2B foundation walls. In order to comply with the engineered PIT,M^JN 08071 opening requirement,one vent unit is required for every 200 (877)441.0388 square feet (19 m) of enclosed area below the base flood ®Val�smartventcom elevation to meet flood mitigation requirements. MtYrw.smartwrent.t�nt The Smart VENT(D is also capable of providing 50 square 1.0 SUBJECT inches (0.30 ml) of net free area to supply supplemental natural ventilation to occuplable and habitable roams and 1.1 FloodVENTry, Model#1540.520 spaces and as a supplemental opening to an under-floor 1.2 Smart VENTt)Model#1540.510 space between the bottom of the floor joist and the earth under any budding. 2.0 PROPERTY FOR WHICH EVALUATION IS SOUGHT 4.0 INSTALLATION Smart VENTO and FloodVENT rm are designed to be insta{led 2.1 Floodwater Venting into foundation walls of existing and new construction without 22 Natural Ventilation the use of tools completely from the exterior side of the wall. The Installation of she vents shall be in accordance with the 3.0 DESCRIPTION manufacturer's instructions dated February 21,2003,and this evaluation report. The patented mounting straps allow Smart VENTQD, Inc.'s Smart VENTO Modal #154D-510 and mounting In wood and masonry walls up to 12 inches (305 FloodVENT"m Model#15d0.520 reduce hydrostatic pressures mm)thick.One vent unit is required for every 200 square feet of floodwaters on foundations and buildings caused by rising (19 m) of enclosed area below the base flood elevation to and falling floodwater. They open automatically to rising meet flood mitigation requirements. floodwater pressure from any direction, quickly equalizing hydrostatic forces on both sides of the foundation wBl. 4.1 EXISTING l3UILDINO INSTALLATION The vents are designed to fit an$byf 5 inch(203 by 406 mm) Smart VENTO and FloodVENTrm are Installed Into foundation opening and provide a 76 square inches(49 020 mm 2)net walls of existing buldings located in flood prone areas, free area for flood mitigation.The Vents aro made from Type Remove existing 8 by 16 inch(203 by 406 min)foundation 304 Stainless Steel or teller and have a screen cover with 114 vents found within 12 Inches (305 min) of the ground and square inch(161 mm')holes.The vents have been tested to clean the opening in accordance with the instructions.If there show that they meet the design principle of ASCE 24-98 and are not sufficient number of wdsting vents as required by code. FEMA Technical Bulletin 1-93 for a minimum rate of rise and for the sae of the enclosed area, out an additional A by 16 fall of 5.0 feet per hour(152 mmis). (203 hy406 mm)operdkg In the foundation walls foreachvent required.Install in acoordance with the instructions. The vents pivoting door is locked in the dosed position by means of a patented floating release device,which resists the 4.2 NEW CONSTRUCTION INSTALLATION entry of rodents and other pests. In the event of a flood,the rising water causes the release device to rise,while flowing For each vent required,provide a standard 8 by 16 inch(203 flood water immediately opens the dcor,quickty equalizing 1110 by 406 mm)hole in the foundation walls,12 incites(305 mm) water level on both sides of the wall and thus equalizing the or less above grade. The wall lace must De vertical,flat and lateral forces on the foundation walls. In the event of fast smooth,The vent's frame Is first installed into the wall using ICC4S tegday rr,wrra art nal fo ke mwtrwd AF repneS6ndrRq deathelt47 or a'ry 4 er attribatea ndfapeUfudl y addreraed nr/r are Y M k9 G©nbrrued 4d ar endorsement 0 At subjacr vj t6 raport or a rwwPkwdadon fnr fta we.?Rare is no niranty by[CC Evd[MrtNon Service,bte.,upreas of implied ds to any r fwdfag or Ofhv mercer to dd5 rel vn,Qr as ro any product envenom by the report ['apytight Q 2f105 Re ge t of 2 Nov. 21, 2007 $;52.AM A H HARRIS �s iNo„4052;Q��P. 313tity 500 C Street SW Washington,DC 20472 .obTrer�., FEMA . CIS , Michael Graham NOV 2 1 243 General Manager,SmoitVE T 200 Warrick Avenue Glassboro,N7 080208 Dear Mr.Graham. lam writing in response to your letter of August 11,2003 to Paul Terrell,an engineer ou my staff. Your letter concerns the use of engineered openings in foundation walls in Special Flood Hazard Areas and the use the STnartYENT product.Your letter states that there is a lack of awareness that flood openings can be, engineered and certified. In addition,you make specific suggestions concerning: 1)the elevation certificate, 2)NFF Insurance Agents Manual,and 3)a Broadcast Advisory to NFIP Stakeholders. Enclosed in your letter is an evaluation report,NER-624,that addresses the flood vents that your company manufactures. With the transition to the International Building Codes,the international Code Council(ICC)Evaluation Services now issues evaluation reports. NER-624 is a legacy report from the transition from the National Evaluation Service to the ICC Evaluation Service. Concerning your suggestions about increasing the awareness of engineering openings,FEMA will consider your suggestions,but may detamm ine that another course of action is more appropriate.We will keep you apprised as to our decision in this matter but please understand that we are prohibited from promoting or helping to market specific products. However,I would like to discuss the information you have provided about the SmartVENT products. . Evaluation reports are often used by building officials as evidence of the compliance of a specific product or material with the requirements of a model building code or standard_ As with all evaluation reports,the local building official,or the authority having jurisdiction,makes the final determination as to the appropriateness and acceptability of using the material or product in a specific application. Communities that participate in the National Flood Insurance Program(NFIP)Trust adopt and enforce ordinances that meet or exceed requirements described in 44 CFR. The NFIP regulations require that all eeclosures below the Base Flood Elevation(BFE)in A zones be designed to allow for the automatic equalization of hydrostatic forces during a flood event. Section 60 3(c)(5)of the NFIP regulations states that a Community shall: Require,for all new construction and substantial improvements, that,f tlty enclosed areas below the lowest floor that are used solely for parking of vehicles, building access,or storage in an area other than a basemsnt and which are subject to,flooding shall be designed to automatically equalize hydrosgaiic flood forces on exterior wails by allowing for the entry and exit of floodwaters,loodwaters, Deslgns for meeting this requirement must either be certified by a registered professional engineer or architect or meet or exceed the following minimum criteria: A minimum of two openings having a total net area of not less than one square inch for every square foot of enclosed area subject to flooding shall be provided. The bottom of all openings shall be no higher than one foot above grade. Openings may be equipped with Screens, louvers, valves, or other coverings or devices provided that they permit the automatic entry and exit offloodwaters, www,fetne.gov -� Town of Barnstable • F ZME� �Ptio, Regulatory Services , Thomas F.Geiler,Director • saiwsznB�. • 9 '""SS. i63q• Building Division �0 QED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 00 Fax: 508-790-623( PERMIT# � 1 FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name Telephone number l� Z /al C:) ; Size of Shed Map/Parcel# w CC Ci CA- Signature Date r_ _ rn ` Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) �>�13fY. S�ccL, oN �2 sips Sign off hours for.Conservati n 8 00=9 30, 3:30.4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM. MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042506 \ ..... - i g. dad° I \ \\ S 46 73 DO' E I I — ` C,& ot,► t} 565.84' — \ 4t Ties Line EE oh CA. \ —• ,....• v� r......••oa-. �•. . .. •\''' • Goa \m cy / 0 pt 3�00 13 ee�'� i Ttr1 el 1 �\ I(se `°5fsa°� 11 I altu0U9 Drive ❑ Z a Ei \ I Qa CIO I o 0 675 53' SOVB 0 E ® • W P/cket Fence NO C � 44, oCP J Z U Qi LLJ ¢ ade fv Svc: Pe! /tee&7J"� a o o � r•— U W CDJ Co Q � oo� z ., a Q C �,�-� a� � � ��� G'� ` . . 5 Town of Barnstable *Permit# Expires 6 months from issue date 4 Regulatory Services Fee elf Thomas F.Geiler,Director Building Division X-PRESS PERMIT Peter F.DiMatteo, Building Commissioner 200 Main Street, Hyannis,MA 02601 JANy 2 s 2006 Office: 508-862-4038 TOWN OF BARNSTABLE Fax: 508-790-6230 --EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X Press Imprint Mapiparcel Number ' Property Address ��� ( - �/`4 , , c � t �� v �`►� 0 Z nY 4 Residential Value of WorkOOD„i�3`Z d r C O �q n i n Owner's Name&Address i�IIS , Il�\&U ci li yu/LQ z '545 . Wc UA 4-1 La_A �u r U MA- M02 i5 7 25S) Contractor's Name Ckscc, Z Telephone Number !TD8 _35A t'_:�l I Home Improvement Contractor License#(if applicable) 1 q 3 Construction Supervisor's License#(if applicable) %6-5?0 ❑Workman's Compensation Insurance Chec one: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name X s .Policy# ��-�"Mo 7 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over . existing layers of roof) ❑ Re-side ,Replacement Windows. U-Value m-Z)f (maximum.44) -* -C) A%,,dt j CL4 &U6... . ❑ Other(specify) , 'where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e.Historic,Conservation,etc. �Signature � `. 1 25 U Q:Forms:expmtrg Revised121901 �pFTHE goy, Town of Barnstable P 1' Regulatory Services * BARNSPABLE, M i v Ass. �p Thomas F.Geiler,Director OpA 039. ♦0 rEo r,,►+" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT I Ill✓l eZ , Construction Supervisor License an c4vtC #�2 ��Z� ,hereby certify that I am no longer the ction upervisor listed on the application for the project under construction as authorized by building permit # ,issued to (property address) �� -e _ y 0 Cam/ e-7ZC�`3 2, on , 2006�-? I also certify that on ; 2004-1 I notified the property owner, that the 7L project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. M6-c (, LICENSE HOD :bD)Al q/forms/newcontr reference R-5 780 CMR rev:080102 1 } } Town of Barnstable *Permit# IF `1 IT3 Expires 6 months from issue date X-PRESS PERMIT �s Regulatory Services Fee 0 MAR 2 7 2006 ' Thomas F.Geiler,Director• - Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p� 32 Not Valid without Red X-Press Imprint Map/parcel Number Z L' — o �_ Property Address 6P O A !J 0 UT/' T [!�'I esidential Value of Work/��-�� � nimum fee of$25.00 for work under$6000.00 Owner's Name&AddresslTL- c, Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name 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) ❑ Re-side GWIwpGGris ,T'U �'vc eplacemt;t Windows. U-Value (�b (maximum.44) Pj C� '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. Home Improvement Contractors License is required. SIGNATURE: Q:Fomu:expmtrg Re"e071405 The Commonwealth of'Massachusetts '~ Department of Industrial Accidents Office of Investigations 600 Washington,street Boston, MA 02111 °�h ,.•� wbww.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/Electricians/Plu hers Applicant Information Please Print Le0bly Name (Business/Organizationdudividual): G'�'/, /�� �L111l— Address: ^& ZZ2&AC) 5�' City/State/Zip: ��T� ,�///( lam_ &gPhone #: S 3,1, Are you an employer? Check the-appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 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 $ ❑ Remodeling ship and have no employees These sub-contractors have S;. ❑ Demolition working for me in any capacity.' workers' comp.insurance. 9. ❑ Building addition ' insurance 5. ❑ We are a corporation and its �o wo ers romp. 10.❑ Electrical repairs or additions r ] officers have exercised their 3.1P I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself.[No workers' comp, c. 152, §1(4),and we have no 12.❑ Roof repairs _ insurance required.] t employees. (No workers' 13.❑ Other / comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such iContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'corn).policy information. I am an employer that is providing workers'compensation insurance for my employees: Below is the policy and,fob site information. Insurance Company Name: Policy#or Self-'Ms.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy.number and expirationdate). 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 finprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si mature': Date: o� 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 Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector I 6. Other Contact Person: Rhone#: Information and Instructions . r Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the . receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Departsent of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-077-MASSAFE Fax u 617-727-7749 Revised 5-26-05 www.mass.gov/ma Town of Barnstable *Permit# 4 Erpiurs 6 rnEnrrhs jrom issue dote • elf Services Fee `0MAM $ Thomas F Geller,Director 2 7- 6 Building Division X-PRESS PERMIT Peter F.DiMatteo, Building Commissioner JAN 2 6 2006 7TK- 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 TOWN OF BARNSTABLE Fax: 508-790-6230 -EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address& - yl L(U c-1 e qrcv L t (l 1e_ VN4 Q ZG 3 Z Residential Value of WoJ-Z Owner's Name&Address OA a v h 6iwAe e-th Q I-e T 1 VV Contractor's Name UAP3G0 �Z __ __ Telephone Number `35 • [S1 L Home Improvement Contractor License#(if applicable) I Construction Supervisor's License#(if applicable) Q(ar'/6 f10 ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance '� Insurance Company Name �y�.✓`- W1 ;�cC44 Policy# RD 2�6716 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over. existing layers of roof) ❑ Re-side rr .Replacement Windows. U-Value d'b f (maximum.44) 6e rt�4ac) W 1t� ❑ Other(specify) . 'where required: Issuance of this permit does not exempt compliance with other town;department regulations,i.e.Historic,Conservation;etc. Signature 2� Q:Forms:expmtrg Revised121901 k, w. ' f��1�f�raZt�zo-nr�ets�lit-ra�fUGt7�1[iGfLtt�ly., �i :..' . Board of Building Regulations and Standards W�' j HOME IMPROVEMENT'CO.NTRACTRegistration 124793 Expirati9n /25/2007" Type Individual Vasco E.Nunez,111 Vasco Nunez,.III 79 Mayfair Rd: S.Dennis MA 02660 Adnuaistrator ti ✓��e�rnrc�aaaaFeal� ���riva w BOARD OF BtJILDI REGUL!i fpNS s ;« - License CONSTRIJGTION SUPEIUISO kill '. Number G.S 069660 Birthdate 1 M /1948 xp 03/2006 Tr no: 2545 Restricted w1 G r • YASCO E NUNEZ III - ; - 79 MAYFAIR RD ' - ' S DENNIS, MA 02660 � ., Commissioner z: a�opo153 VASCO.NUNFZ=CARPENTRY 79 Mayfair Rd. ;SOUTH._DENNLS, MA.Q266Q MA Lic. ::#.069680 #124793: (866) 398 1511 • Toll Free (508) 398 1511:• Dennis, MA PHONE.`; DATE TO Ms Ma.:rianne Tri.plette 336';416 9994 . 10./11/2005 6$2 South Main St JOB NAME/LOCATION Centerville MA 02632 . And windows Exterior 'trim -repair JOB NUMBER iol PHONE 9 994 ;: 5;08 790 9255: We hereby submit`specifications and estimates for: 1 Remove ten wooden double hung windows from upstairs be.d r6. closet bath`;room ;and den Instaal ten Andersen tilt wash 400 series double hung windows :in same locations. New windows will; have.:white .vinyl clad: exte;rior .with :white..prefnished interior; white screens:,: white hardwares—and 6/.6 wooden snap n ..grilles prefin.ished white. 2.:.:Remove: five :wooden.: double bung windows: from..down stairs living room, bath :room,:':and bed room:"Install .five Andersen tilt wash 400 `series double_hung windows in.same locations :..New Windows* will have .white vinyl::clad exterior .with white prefiri hed .inte;rior,..;white :screens, white hardware,::`:=and :6/6 wooden snap .in grilles. prefnished white. 3, Remove,exter or`.:trim from. front..<dorme:p. ( corner boards,.* s;ophet:.board; facier _board,. :freeze board, dent:al ,moldin g, and. skirt board ) ; and:. replace with Azek PUC. plastic .trim 4. supply interior/exter.ior trim for. new Andersen windows. Exterior trim will:;be Azek .PVC plastic tr mend interior .trim will:..match existing trim: 5. Take old. .windows and any debris from this job .to town landfill 6. Make arrangement for delivery of new Andersen windows.. 7. Supply town buildin ermit:. Pp Y g A. * This proposal:,doesnot. include...any pain.ting. or staining * All Andersen .products: .described. above will be. prepaid by owner. .. .. ,F ** If this proposal is satisfactory, please sign the YELLOW copy and return with payment schedule. ** Please make a check payable to Fairview Millwork Inc. in the amount of $.4335..75 for your new Andersen.,mindows described above, and please include this check with your signed _Dropasal�._Allow_3-4 _weeks for_delivery,_._this is -- factory order. ACCEPT VISA/MASTERCARD FOR PAYMENT OF LABOR BY SWIPE ONLY *** We Propose h Tabor—complete in accordance with the above specifications,for the sum of: Six Thousand Twenty and 00/100 Dollars dollars($ 6,020.00 ). Payment to be made as follows: Labor: 50% Down payment to start. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3010.00 Labor: 50% Upon completion at time of completion. . . . . . . . . . . . . . . . . . . . . . ... . . .$3010.00 All material is guaranteed to be as specified.All work to be completed in a professional * r_ manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by workers Compensation insurance. withdrawn by us if not accepted within 30 days. Acceptance of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be.made7;ned above. Signature ature � - Date o cceptance: .. PRODUCT 728M USE WITH 771 ELOPE NEBS To Reorder.1-800-225-6M or www.nebs.com PRINTED IN USA. ,kl �a c�� oG�� 9 j C�,�-f, I�G,/a3� � � �� y/o ff Uniformlv Loaded Floor Beamf AISC 9th Ed ASD 1 Ver:6.00.81 Bv: Richard Bertrand ,.RICHARD J. BERTRAND, P.E.on• 09-05-2007 : 10:13:50 PM Proiect:•1RIPLETv'E RESIDENCE-Location:Observatory_Floor Beam, Summa• -- - _ - A992-50 W10x45 x 20.0 FW Section Adequate-By: 177.5% Controlling Factor: Moment of Inertia Deflections: + Dead Load: DLD= 0.11 IN Live Load: ` LLD= 0.24 IN=U999 Total Load: TLD= 0.35 IN=U680 Reactions(Each End): Live Load: LL-Rxn= 4800 LB Dead Load: DL-Rxn= 2250 LB Total Load: TL-Rxn= 7050 LB Bearing Length Required(Beam only, support capacity not checked): BL= 1.12 IN Beam Data: Span: L= 20.0 FT Unbraced Lenqth-Top of Beam: _ Lu= 0.0 FT Live Load Deflect.Criteria: U 360 Total Load Deflect. Criteria: U 240 Floor Loadinq: I Floor Live Load-Side One: ,.�j} LL1= 40.0 PSF Floor Dead Load-Side One: C DL1= 15.0 PSF Tributary Width-Side One: TW1= 6.0 FT Floor Live Load-Side Two: LL2= 40.0 PSF Floor Dead Load-Side Two: DL2= 15.0 PSF Tributary Width-Side Two:. TW2= 6.0 FT Wall Load: WALL= 0 PLF Beam Loadinq: Beam Total Live Load: wL= 480 PLF Beam Self Weiqht: BSW= 45 PLF Beam Total Dead Load: wD= 225 PLF Total Maximum Load: wT= 705 PLF Properties for:W10x45/A992-50 Yield Stress: Fv= 50 KSI Modulus of Elasticity: E= 29000 KSI Depth: d= 10.10 IN Web Thickness: tw= 0.35 IN Flange Width: bf= 8.02 IN Flange Thickness: tf= 0.62 IN Distance to Web Toe of Fillet: k= 1.12 IN Moment of Inertia About X-X Axis: Ix= 248.00 IN4 Section Modulus About X-X Axis: Sx= 49.10 IN3 ._ Radius of Gvration of Compression Flanqe+ 1/3 of Web: rt= 2.18 IN Design Properties per AISC Steel Construction Manual Flanqe Bucklinq Ratio: FBR= 6.47 Allowable Flanqe Buckling Ratio: AFBR= 9.19 Web Bucklinq Ratio: WBR= 28.86 Allowable Web Bucklinq Ratio: AWBR= 90.51 Controllinq Unbraced Lenqth: Lb= 0.0 FT Limitinq Unbraced Lenqth for Fb=.66*Fy: Lc= 7.18 FT Allowable Bendinq Stress: Fb= 33.0 KSI Web Heiqht to Thickness Ratio: i h/tw= 25.31 Limitinq Web Heiqht to Thickness Ratio for Fv=.4*Fy: h/tw-Limit= 53.74 Allowable Shear Stress: Fv= 20.0 KSI Design Requirements Comparison: Controllinq Moment: M= 35250 FT-LB Nominal Moment Strength: Mr= 135025 FT-LB Controllinq Shear: V= 7050 LB Nominal Shear Strenqth: Vr= 70700 LB Moment of Inertia(Deflection): Ireq= 89.37. IN4 1= 248.00 IN4 ►►���AA OF Mgss9ti - � c � RICHARD GJ, BERTRAND t v STRUCTURAL � ; NO.29894 ► D'9p��FGISTEPNG���'o, ►►SSIONAI,ad Uniformly Loaded Floor Beam[AISC 9th Ed ASD]Ver:6.00.81 By: Richard Bertrand , RICHARD J. BERTRAND, P.E.on: 09-05-2007 Project:TRIPLETTE RESIDENCE-Location: Observatory Floor Beam Summary: A992-50 W 10x45 x 20.0 FT Section Adequate By: 177.5% Controlling Factor: Moment of Inertia SHEAR, MOMENT,AND DEFLECTION DIAGRAMS Load combination shown: Controlling Shear/Moment/Deflection Diagrams 8000 7050 Ibs @ 0 ft 4000 Shear (Ibs) 0 -4000 -8000 -7050 Ibs @ 20 ft 40000 35250 ft-Ibs @ 10 ft 20000 Moment (ft-Ib) 0 -20000 -40000 -0.3 -0.15 Deflection (in) 0 0.15 0.3 0.24in@10ft Span =20 ft Controlling Load Cases: Shear: Critical shear created by combining all dead and live loads. Moment: Critical moment created by combining all dead and live loads. Deflection: Critical deflection created by live loads only. r Uniformly Loaded Floor Beaml AISC 9th Ed ASD 1 Ver:6.00.81 _ Bv: Richard Bertrand , RICHARD J. BERTRAND, P.E.on:09-06-2007 :00:48:45 AM ET Proiect:'TRIPLT� RESIDENCE;Location:;Rafter.Support Beam Summary: A992-50 W 12x30 x 24:0 FT> Section Adequate By:7.7%' Controlling Factor: Moment of Inertia • Deflections: Dead Load: DLD= 0.42 IN Live Load: LLD= 0.69 IN=U416 Total Load: TLD= 1.11 IN = U259 Reactions(Each End): Live Load: LL-Rxn= 7680 LB Dead Load: DL-Rxn= 4680 LB Total Load: TL-Rxn= 12360 LB Bearing Length Required (Beam only, support capacity not checked): BL= 0.74 IN Beam Data: Span: L= L24:0 . FT Unbraced Lenqth-Top of Beam: Lu= 0.0 FT Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 240 Floor Loadinq: Floor Live Load-Side One: LL1= '*80.0 PSF Floor Dead Load-Side One: DL1= *4 F Tributary Width-Side One: TW1= 8.0 FT Floor Live Load-Side Two: �XXAAA LL2= 0.0 PSF Floor Dead Load-Side Two: '�!��N OF M4S�,, DL2= 0.0 PSF Tributary Width-Side Two: �p Sq�, TW2= 0.0 FT Wall Load: �S� yG o WALL= 0 PLF Beam Loadinq: o RICHARD Z Beam Total Live Load: BERTRAND wL= 640 PLF Beam Self Weiqht: BSW= 30 PLF Beam Total Dead Load: STRUCTURAL C" wD= 390 PLF Total Maximum Load: N� 29B94 • wT= 1030 PLF Properties for:W12x3O/A992-50 0109 w Yield Stress: ••��F FGIST�c�OG��'• Fv= 50 KSI Modulus of Elasticity: ,►j SSIONALEN�! E= 29000 KSI Depth: d= 12.34 IN Web Thickness: /`- tw= 0.26 IN • Flange Width: bf= 6.52 IN Flanqe Thickness: 0& sfj;-j 2GL�� tf= 0.44 IN Distance to Web Toe of Fillet: k= 0.74 IN Moment of Inertia About X-X Axis: Ix= 238.00 IN4 Section Modulus About X-X Axis: Sx= 38.60 IN3 Radius of Gyration of Compression Flanqe+ 1/3 of Web: rt= 1.73 IN Design Properties per AISC Steel Construction Manual: Flanqe Bucklinq Ratio: FBR= 7.41 Allowable Flanqe Buckling Ratio: AFBR= 9.19 Web Bucklinq Ratio: WBR 47.46 Allowable Web Bucklinq Ratio: AWBR= 90.51 Controllinq Unbraced Lenqth: Lb= 0.0 FT Limitinq Unbraced Lenqth for Fb=.66*Fy: Lc= 5.84 FT Allowable Bendinq Stress: Fb= 33.0 KSI Web Heiqht to Thickness Ratio: h/tw= 44.08 Limitinq Web Heiqht to Thickness Ratio for Fv=.4"Fy: h/tw-Limit= 53.74 Allowable Shear Stress: Fv= 20.0 KSI .Design Requirements Comparison: Controllinq Moment: - M= 74160 FT-LB Nominal Moment Strength: Mr= 106150 FT-LB Controllinq Shear: V= 12360 LB Nominal Shear Strength: Vr= 64168 LB Moment of Inertia(Deflection): Ireq= 220.91 IN4 1= 238.00 IN4 p�SIGiJ LUfFD� P-CoF :. LI_ TP-IS= £ % D (= AT-trG I-t. - t FSF V - ' lad MF 30 PSF PL- - IS- W + Icy # IS = 4f,SF Uniformly Loaded Floor Beam[AISC 9th Ed ASD]Ver:6.00.81 By: Richard Bertrand , RICHARD J. BERTRAND, P.E.on: 09-06-2007 Project:TRIPLETTE RESIDENCE-Location: Rafter Support Beam Summary: A992-50 W 12x30 x 24.0 FT Section Adequate By: 7.7% Controlling Factor: Moment of Inertia SHEAR, MOMENT,AND DEFLECTION DIAGRAMS Load combination shown: Controlling Shear/Moment/Deflection Diagrams 20000 12360 Ibs @ Oft 10000 Shear (Ibs) 0 -10000 -20000 .-12360 Ibs @ 24 ft 80000 4160 ft-Ibs @ 12 ft 40000 Moment (ft-Ib) 0 -40000 -80000 -2 -1 Deflection • (in) 0 1 2- 1.114in@12ft Span =24 ft Controlling Load Cases: Shear: Critical shear created by combining all dead and live loads. Moment: Critical moment created by combining all dead and live loads. Deflection: Critical deflection created by combining all dead and live loads. • r f , Multi-Loaded Beamf AISC 9th Ed ASD 1 Ver:6.00.81 Bv: Richard Bertrand , RICHARD J. BERTRAND, P.E. on: 09-06-2007:00:49:15 AM Proiect:TaRIPLETTE,RESIDENCE Location:_Ga-rage_Beam Summary: - - ---- A992-50 W12z26 x 22.0 FT(10+ 12) Section Adequate By:434.6% Controlling Factor: Moment Left Span Deflections: Dead Load: DLD-Left= -0.01 IN Live Load: LLD-Left= -0.01 IN =U8822 Total Load: TLD-Left= -0.02 IN = U6333 Center span Deflections: Dead Load: DLD-Center= 0.02 IN Live Load: LLD-Center= 0.04 IN=U3276 Total Load: TLD-Center= 0.06 IN=U2279 Left End Reactions(Support A): Live Load: LL-Rxn-A= 0 LB Dead Load: DL-Rxn-A= -206 LB Total Load: TL-Rxn-A= -206 LB Desiqn For Uplift Loads(Includes Uplift Factor of Safetv) Rxn-A-min= -932 LB Bearinq Lenqth Required(Beam only,support capacity not checked): BL-A= 0.00 IN Center span Left End Reactions(Support B): Live Load: LL-Rxn-B= 5011 LB Dead Load: DL-Rxn-B= 2358 LB Total Load: TL-Rxn-B= 7368 LB Bearinq Lenqth Required (Beam only, support capacity not checked): BL-B= 0.68 IN Center span Riqht End Reactions(Support C): Live Load: LL-Rxn-C= 6275 LB Dead Load: DL-Rxn-C= 2831 LB Total Load: TL-Rxn-C= 9106 LB Bearinq Lenqth Required (Beam only, support capacity not checked): BL-C= 0.68 IN Dead Load Uplift F.S.: FS= 1.5 Beam Data: Left Span Lenqth: L1= 10.0 FT Left Span Unbraced Lenqth-Top of Beam: Lu1-Top= 0.0 FT Left Span Unbraced Length-Bottom of Beam: Lu1-Bottom= 10.0 FT Center span Lenqth: L2= 12.0 FT Center span Unbraced Lenqth-Top of Beam: Lu2-Top= 0.0 FT Center span Unbraced Length-Bottom of Beam: Lu2-Bottom= 12.0 FT Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 240 Left Span Loading: Uniform Load: Live Load: wL-1= 0 PLF Dead Load: wD-1= 0 PLF Beam Self Weight: BSW= 26 PLF Total Load: wT-1= 26 PLF Center span Loading: Uniform Load: Live Load: wL-2= 480 PLF Dead Load: AAA wD-2= 180 PLF Beam Self Weight: ►OF MAS��� BSW= 26 PLF Point LoaTota d 1 I Load: ♦ �� S : wT-2= 686 PLF Live Load: PL1-2= 4800 LB Dead Load: oZ RICNARNp PD1-2= 2250 LB Location(From left end of span): BERTRA N No, X1-2= 10.0 FT Properties for:W12x26/A992-50 42 cTuaAL ► Yield Stress: v s No.2g8g4 s Fv= 50 KSI Modulus of Elasticity: 4 A 9� P�O�`��� E= 29000 KSI a 9 Is d= 12.22 IN Web Thickness: i�FFSSIONA����� tw= 0.23 IN Flanqe Width: ►r bf= 6.49 IN Flange Thickness: - �� tf= 0.38 IN Distance to Web Toe of Fillet: k= 0.68 IN Moment of Inertia About X-X Axis: Ix= 204.00 IN4 Section Modulus About X-X Axis: Sx= 33.40 IN3 Radius of Gyration of Compression Flange+ 1/3 of Web: rt= 1.72 IN Design Properties per AISC Steel Construction Manual: Flanqe Bucklinq Ratio: FBR= 8.54 Allowable Flanqe Buckling Ratio: AFBR= 9.19 Web Buckling Ratio: WBR= 53.13 Allowable Web Bucklinq Ratio: AWBR= 90.51 Controllinq Unbraced Lenqth: Lb= 0.0 FT Limiting Unbraced Lenqth for Fb=.66*Fy: Lc= 5.81 FT Allowable Bendinq Stress: Fb= 33.0 KSI Web Heiqht to Thickness Ratio: h/tw= 49.83 Limitinq Web Heiqht to Thickness Ratio for Fv=.4*Fy: h/tw-Limit= 53.74 Allowable Shear Stress: Fv= 20.0 KSI f 1 Page:2 Multi-Loaded Beam[AISC 9th Ed ASD 1 Ver: 6.00.81 By: Richard Bertrand , RICHARD J. BERTRAND, P.E. on:09-06-2007 : 00:49:15 AM Proiect:TRIPLETTE RESIDENCE-Location: Garage Beam Design Requirements Comparison: Controllinq Moment: M= 17181 FT-LB 9.0 Ft from left support of span 2 (Center Span) Critical moment created by combining all dead loads and live loads on span(s) 1,2 Nominal Moment Strength: Mr= 91850 FT-LB Controllinq Shear: V= 9106 LB 12.0 Ft from left support of span 3(Right Span) Critical shear created by combining all dead loads and live loads on span(s) 1,2 Nominal Shear Strenqth: Vr= 56212 LB Moment of Inertia(Deflection): Ireq= 22.42 IN4 1= 204.00 IN4 1 r ar Multi-Loaded Beam[AISC 9th Ed ASD)Ver:6.00.81 By: Richard Bertrand , RICHARD J. BERTRAND, P.E.on: 09-06-2007 Project:TRIPLETTE RESIDENCE-Location: Garage Beam Summary: A992-50 W12x26 x 22.0 FT(10+ 12) Section Adequate By:434.6% Controlling Factor: Moment SHEAR, MOMENT,AND DEFLECTION DIAGRAMS Load combination shown: Controlling Shear/Moment/Deflection Diagrams 10000 6176 Ibs @ 10 ft 5000 Shear (Ibs) 0 -5000 -10000 -9106_Ibs @ 22 ft 20000 17181 ft-Ibs @ 19 ft 10000 Moment (ft-lb) 0 -10000 -20000 -10622 ft-Ibs @ 10 ft -0.05 -0.014in@5.8 It -0.025 Deflection (in) 0 j 0.025 0.05 0.044in@16.7ft � Left Span = 10 ft F Center span = 12 ft Controlling Load Cases: Shear: Critical shear created by combining all dead loads and live loads on span(s) 1, 2 Moment: Critical moment created by combining all dead loads and live loads on span(s) 1, 2 Deflection:Critical deflection created by live loads only on span(s) 1,2 I Ln 12 T PLATE------ I i ' r �. EXISTING t1' U w _ mm L -- -- - _ i I r - - IXISTING FIRST FLOOR ' EXISTING FOUNDATION— - .. _ 1JJ O a .I .ADDITION EXISTING EL 10%' J � � — —_, ,,_ _ADDITION I ADDITION — j FRONT ELEVATION REAR ELEVATION W SCALE: 1/4" 1'-0' - I - i - - Z - - -' SCALE: 1/4" - I'-0' - - - -- IXISTING DIRT FLOOR ..- _ SMOKE DETECTORSREVIEWED . co a- i .... _— IMPORTANT ®'UPGRADE REQUIRED RL-L--, n STATE BWLDING CODE REQUIRES THE UPGRADING-OF B S BI _BUILDING DEPT: DATE I SiIAO{!E DETECTORS FOR THE ENTIRE ---- WHEN - ONE _ OR MORE E AREAS A _ OR D ppIIppp Q OR SLEEPING ARE ADDED CREATED, �11lY.LL' I -_ .. .. } NOTE: A - FIRE DEPARTMENT DATE SE�RAi-E`pER14�T IS REQUIRED FOR THE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING INSTALLATION OF Sft40KE DETECTORS-THE ELECTRICAL /'� �\ ' � PERMIT DOES RIOT'SATISFY THIS REQUIREMENT . _ - CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE _ Q Q Y N U Q _..� � FF . W � � I =� -- Z - { 1 W Q ADDITION 'I. _ EXISTING - ADDITION l—L —i• ` n RIGHT ELEVATION - - - -- SCALE. 1/4" . p-0" - _. ---_ -_ - - _ - .. i SHEET I OF 7 — Al so-' NEW FIRST FLOOR } - - - EL �$ NEW_FOUNDATIC!l " { LEFT ELEVATION .. __A_DDITION _ 26'0" EL lo.oa - — I SCALE 1/4 1'. .—0° ..... _ DRAW 03211 - . so_NEW FOUNDATION SLAB - 1' .. - - N KW SY: r' '— 4'-5' i ry�yjyly rn ze.1 2. .I j i All Co law I I i j I I l nl "�I I }WC Y1f ME i71 \ARM A i 2_ I pow eeove -) II�I I I s - if KITCWrN i j LALN 2k nI r+ae I tm r . » IG - LIVIWG _ z � oz tu 11 CnI 624lu a7 if II ♦ 1 '�r �° .4✓.c jai i � ;i !L+J - .Y.YaI I:C17R MO'as�JA i I ma mom MC ,T.. 4r-4. �'�' MC 7S1o1®MTIG—"mq _—_ I Aunt d00!P�G.1 EWMD�xe9- r1�' �•-•- W &Wk ORAYR FCK1R ' ----— — --- ---—° FIR5T FLOOR PLAN .varw cnvc scar e, va. . Ir_o. RErourID WALL' — ell CRA Lz Cot _-- UL . DECK -.----MiTm BXI3TIM - AWM 5'3• . f WLLF WALL - I AUM VIFYI AYgtlt m Y « _ - BATW m - IJr AW2M a1VtlB1 r 4 • - f I. f I _._--_---___ _-- z--_- I — . ul 240 RZOFtu nwen I� �OF I _ w _ STA_Oe%P w RWF -- I J y�c o 0 2�-0. _j d — a � -------- ---J o — a 4 0• w'a �41-0• Y n�a __ _ SECOND FLOOR PLAN z,'_y o V4' co m No � F OBSERVATORY FL OOR P e1NSHEET 3 of 7 7-3• 3'-9' ' ' 74., ...3'-9• 2`0 - - EGA_M+ 1/4' . i'-al 2&-0• 4'-e - - _ � •• v _JC6, 0328 DRAWN HY: .KH a DATE, 11 1/07 UN ` cIr -- - - -- --- =-- �•� - • : FCC =1-' •� c-� �.� AS—BUILT FRONT ELEVATION AS—BUILT REAR EI UATION AS—BUILT RICmHT ELEV TfOIV SCALE, 1/4' - r-a r AS—BUILT LEFT ELEVATION scaLE. v4' . r-a IIQ.I; - SCALE, I/4' - 1'-0'FAIJI AT- BAM4 00 1 y tu t Z Q - �- A LIVING - Cl �.. u 5HEET 4 OF 7 i !IJ - AS-BUILT FIRST FL ELAN AB-BUILT SECOND F oog PLAN WALL, V4• - P-0' - - SCALE. v4• p_y- DRAWN a r iCYJ DATE, 10/22/O7 y r _ .. _ 4'_0.. 16'_O' _ - 1 --------------- ------------ ---------- ---------- I r -- — )) 52MART1 VENT I -2-200 GIRDER o I MODEL 610 I - _ 'A P T POST 1 m� zAw.METAL POST ANCHOR 'Somo TUBE'PIER TYP, 1 1 L I I Q o I 4'-10' 51-0" ci . .� - - a �.• -- - - - � _ '�1 �agoI ji. oP� - - IiIIIIIIIIIII I ';'.;•'!:.:`:��;i.:II�IIIIIi�IIIII�' '. 'IIIIIIIIII..,.-iiz,.�,IL�IIIIiI lI. --m_v_m=�O'�IFaF-S Y•i �_o,� LI —A----J—IIII .< i:IIIII �tI I�IiII—II I II•�IE�r�i�Ef 8'fI ba;f _ - - -- - L- (2 L ;.. )Y j— ——— -- 10 I EXISTING 6 BULK 14FAD NOTE. PER 200 SF 1200 SF FOUND(1) REQUIRED FLOODVENT THEREFORE (b) VENTS ATION PT?KID 3RL7TYy. NTE: IMSTRONG TIE ANCHOR STRAF!o FROMSOONCRETE TO WALL SHOE PLATE 4 ' EW FROM ALL CORNERS SMAPtT NT MODEL 61 — — — EXISTING J NOTE: (1) REQUIRED FLOOD VENT. Lu > PER 200 5F 600 SF FOUNDATION THEREFORE (3) VENTS Z WZ— 'l1\�t�/�i v>�TW•r`/!l1' Z W W (2) GARAGE o v WZ W RTVETSMA W 3 1/2'.DIA.-STEEL COLUMN 3693v12'CONRETE PAD 514EET 5 OF Q 7 24'-0' 4'-4' 23'_BnCRAWL SPACE '�L•.� � „ - " -f , r v! FOUNDATION—PLAN M %r u DG... r - SCALE: 1/4" . p_0„ JOB DRAWN,SY: KW a � 4a wa 4a �11 NRAtRICAOIR CUP' T ALL FAFM 11 AT PLATE . - .IIACTfOM M I'M Ph" 2nda w ���...JJJ III�IP';I NEO PAL UOBIIL,/ p.PL. � . F Wig'PLYW100D BNHATNINW/ F\ AttlP11ALT DNINWLWW v - ----- cA P✓AatCJA,IN eBGmIDjr-�� IUL �� 1 wAreR vlsw " w fNAMM Atl0/II/G 1R1O171 1I ppA . 1 WRl8.SWAN TYPE—w � l ' Os1N�mcr.snroe w w au �� (�'y . \s f(L PQ. 811�14T{IIII�1/ (I 11 D ILI��I TORAGE lYVllf weAP/VTNTL a1Gx�W. - - qQ�g� AJ P6,INB"L •A �WiIOWl gp(L.�aNf69WCT DOW'1�PACs 0 IIN lrto aes _ n t f r w�alLuo�sIDro ooWmNa _ oavasc a , alws•la%c —- —— C=Z tMi,u�eP1il9 - wnevcwrn Q.iP' - '- �L a � _ g ' i4is'177�tB AT ALL 41 JUNCTIC/4'OP PLATE ` t JIAICT1a0s TYP. STIM mom ML Q li•G.W O m QGARAGEcacw uNIwnNW s ML VAPaene a0�1�lIR _ _ .BILLING a t ma tu ..' cc". r PaL— CRAWL SPACE i CRAWL SPACE J RT.WILL AN�4'4 Ol4- T CQlC01CfE 0116T CM I G- T - Me s'-Y camcrCTE �n - 6 ML VAP07t 9ARWImt� P.T.WILL ANOLM=44 G.C. gxwr#40VMORf S P.T. W J F .. ., �.,• OW Omantow F MU&S ;�i VIA n'-'P a7YR@TL Eli dT!ANCHOININD 4•A GC. V NL •� - - - OPM PROW BORN GRACE- - —_ _ - _ NPMq",.ca0va WW PG17TiNq VMV PVAW OUPA 4✓fUOQ H �? ADSK'C9Itl711✓1101N POOTTIIPr lu Q Z Z 'I JU !L SECTION "A-A" a {I- SCALE. V4' . I'-& SECTION I'B-8" SECTION "G" LW G SCALE, I/4' p_O- _ SCALE 1/4' Z . co .. 541EET 6 OF 7 _J061 032d DRAFIN BY. KW i DATE, 10/22/07's .. ., f . . . . . . . . . . . . . _ J. .. i •Wb a � PRAI'S<OTAUt QYNWi -� ._ � � ����I - 5 �W 9 VP LVL - &rAlkl - �l.�.11 (U Il i. FIRST FL=R s . FRw wrlr=_ �J gCqly . . aFCnti7 FLOOR F2AMI St �� 7•_1, p� s f SCALE, 1/8' I'-O° 9CALF 1/5' 1'-d r _ WA tu --_ , IIu to j tu N N -- 6L t to Ncrre. , 019 ALL avrim 2eo aY Oc SNEET 7 OF 7 ROOF FRAMING PLAN ° - - SCALE, fro' p_O• JOB. 0328 DRAWN BY, KW _ !} - DATE+ 10/22/07 L _ 02- OLY , � y - t U L`J Kern door KPH j u IJ 1 u 52 -0 4'-011 # 6 -011 00 - - - - - - - - - - - - - - - - - - ________________________________________ ------------ 0 � ' : 1 SMART VENT I =2-2x10 GIRDER I a o I MODEL 510 I I 4x4 P.T. POST _I I I GALV. METAL POST ANCHOR h I I 1 12" "SONG TUBE" PIER TYP. �-- I is �q " I IC4 U ll I 1 I 4'-10" 5'-0" -104 " I - i a a 77 L- - - - - - - - - - - - - - - - - - - - CRAWL SPACE 1 OO 1 �- - - - - - - - - - - - - - - - - - (2) SX16 SMART VENT _ I I MODEL 510 I EXISTING I BULK HEAD � o o NOTE: I X _� N - (1) REQUIRED FLOOD VENT u I ;'; 1 � PER 200 SF 1200 SF FOUNDATION n o . „ ( a THEREFORE (6) VENTS I O n o 1 Ln ffE - - - - - O o I (1)PT 2-1<10 6r{f-T TYf. 1� 1 �0 LL NOTE: 1 SIMPSON STRONG TIE ANCHOR STRAP FROM CONCRETE TO WALL.. SHOE PLATE x 1 4 ' EN FROM ALL CORNERS _ r (2) sx16 Q. r✓�G SMART V NT MODEL 51 Lo�PY � - - - I �- - - - — — — — — — — — — — — — — — — — — o EXISTING LLJ NOTE: I 1 i � (1) REQUIRED FLOOD VENT I U ti I PER THEREFORE (3SFVENTSLLJ FOUNDATION I I Z Lu ) �-U W U A 1 1 (2) ax16 GARAGE I I �-- o I I SMART VENT i N I I I 1 1 I o LU (n 1 I L 1 12'-011 J ax16 I 1 - (n ( SMART VENT) o {.- 3 1/2" DIA. STEEL COLUMN I I o 1 I co 36"x36"x12" CONCRETE PAD I I N d) : I L — — — — — — — — — — — — — — — — — — — — — — — — - SHEET 5 OF 7 OF VA 24'-011 4'-411 23'-8" .r o� RICHA<< G�i g 13ERTRAND ► 52'-011 w sT O,29894 NO.258�4 42 FOUNDATION PLAN 20 P JOB: 0328 SCALE: 11411 a 11_011 DAB" `-1 /20/0 u 1 u 1 12 4� O TOP PLATE EXISTING 04 =Lu FEE [E] El U W o � 6 U b� N ® 0 000 000 � N EXISTING FIRST FLOOR ------- EL 10.93' --� J I H I 0--o O EXISLn TING FOUNDATION ----FOUN ADDITION EXISTING EL - 10.25' ,, ADDITION ADDITION I I w FRONT ELEVATION I REAR ELEVATION z I SCALE: 1/4" = 1'-0" I w I I SCALE: 1/4" = 1'-0" O L — — — — — — — — — — — — — — — — — — — — — — — — — — ---EXISTINGx DIRT FLOOR ELa4.61' w w � z w � w Qz � w �-- w U w --� w z w - ADDITION 1, EXISTING L ADDITION I RIGHT ELEVATION d0 SCALE: 1/4" = 1'-0" ILLLA IEEE] I E SNEET 1 OF 7 o �p h NEW FIRST FLOOR-------- T - - - - - - - - - - ---� - - EL w 11.00' NEW FOUNDATION LEFT ELEVATION ADDITION 26'-0" ,JOB: 0328 --EL - 10.04' -- SCALE: 1/4" = 1'-0" I DRAWN BY: KN NEW FOUNDATION SLAB I - - - - - - - - - - - - - - EL - 5.54' �--T - - - - - - REVISED: 12/20/07 DATE: 11/1/07