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HomeMy WebLinkAbout0686 SOUTH MAIN STREET ��� sd������ � sir :- - _ - t o .� .5 . . . � n , , n Y . h , o � . � ,, ., m _., � ,.. a u i•` n ., i �. � -- v;.. .. E o � �. �� _ .. o. gyp.. �..� ., c. .,. n ,� e A m �, , w„ e -� „ , � t a ri,a �, ,, .. a �. `� ,.. e ,. _ e _. n :. ,'. � ,� 4 _ � � - 0_3 � � ., :. � ., o ._ p „ a .. . ... z _ ,. � �. . -.: � ,� .. ., .:,_ _ ., .� ,. as ., a , „ ,. ,, ., r H. .� ;a �4� � �• _. �. , �. - . A ., i u as a � ...n - .. ., h � r r a _ a � '� .. - 4 ,. .. � ._ 5 _ ., � F< -,,,, �� - a. - o ,' u _ .. ., � a - � .. ., R" c � � ., .. (, �. ,. .. ti . ..' �, .� „ ,. .. '„ o. 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'�... y, � i, ,. ¢� c. _ .T � c �q � .r � � � 0 .,. a � n. .. � - � � r :. � � �a 'W" -a. _ '- .. f y, '"' C o _ _ 5 o Town of Barnstable Building ng Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept } a ee�e `Posted Until Final Inspection Has Been Made k - ,as� a. � � �n. �� Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a!;Final Inspection has been made ... .. _. .,-. n, Permit No. B-17-3960 Applicant Name: Brendan E Driscoll Approvals Date Issued: 11/14/2017 Current Use:. Structure Permit Type: Building-Smoke Detector-Fire Alarm Dection Expiration Date: 05/14/2018 Foundation: System, Map/Lot: 186 037-001 Zoning District: RD-1 Sheathing: s Location: 686 SOUTH MAIN STREET,CENTERVILLE _ ;� Contractor Name: Brendan E Driscoll Framing: �G s� r Owner on Record: 700 SOUTH MAIN LLC. Contractor License 34220 2 Address: 549,WEST FALMOUTH HWy µEst Project Cost: $0.00 Chimney: WEST FALMOUTH, MA 02574 permitxfee: $35.00 i Insulation: Description: install replacement smoke/co detectors i I Fee Paid:, $35.00 Project Review Req: Q Date 11/14/2017 Final: /g RKti Plumbing/Gas Rough Plumbing: , uilding Official ' I 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 applicaticn_and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and str`uctures,shall be in compliance with the local zoning by-Iiaws and codes. This permit shall be displayed in a`location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. # , Electrical The.Certificate of occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit. Minimum of Five Call Inspections Required`forAll Construction Work. K' Service: 1.Foundation or Footing _ Rough: 2.Sheathing Inspection '3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final:. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ^ Fes" : ,• a,, ,•, � { ��. ........ ! -. ..... POT y _ • _ _ a -. SMOKE pETECTORS.REVIE 1 BARNSTABLE.BUILDING DEPT. �. . .. T DATE' , Vw � FIRE DEPARTMEN � s BOTH �IGNATURESARE REOUIRED FOR PERM ITING F FC, CE: Application Number....N... ..1... .......... ............. O,A Vicc`' * sARN6PABI.E, * Permit Fee................... .�d..........OtherFee........................ MA88. 1639. �FG A Total Fee Paid TOWN OF BARNSTABLE PermitApproval by......... ......... .............On........................... BUILDING PERMIT MParcel............................................. APPLICATION ........................................ e Section 1 — Owners Information and Project Location If 68(o S uT \ i 11A\n Village_ G-ff1TE(\J4r-_ Project Address o �(�.�T Vill e Owners Name Owners Legal Address ��1 n iyf� ( Q00 City co-yK.", State Zip ❑off Owners Cell# 313C\ E-mail 0 n'ZWTaC`Q C Vk M-W-V� .0 0<1\ Section 2—Structural Use §k&l_e/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty C9 Fire Alarm Rebuild ❑ Deck Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify. w Section 4—Detail Cost of Proposed Construction Square Footage of Project 800c crx �S'C�r�Q Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updated: 11/7/2017 Section 5 - Work Description 7 -gz- V E- % Section 6—Project Specifics Wiring ❑ Oil Tank Storage Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or ad j acent to a wetland,coastal bank? Yes ❑ No `E Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/7/2017 I Town of Barnstable Regulatory Services ' RAM Richard V.Scab,Dhvctor ors` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www1own.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder j, David L Newton ,as Owner of the'subject property hereby authorize I Driscoll electric to act on my behalf, in all matters relative to work authorized by this building pemait application for: 686 South Main Street,Centerville (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspecidoWe performed and accepte Signature of Owner Signature of Applicant David L. Newton Print Name Print Name 11A4-2017 Date Town of Barnstable &AIUMAEIM Building Department _ 200 Main Street Tel.(508)862-4038 ELECTRICAL PERMIT Date:-. 10/26/2017 Fee: $30.00 Construction Cost: . $500.00 Permit No: E-17-2022 Building Location: 686 SOUTH MAIN STREET, CENTERVILLE Applicant Name: Brendan Driscoll Purpose of Building: Residential T _ T v - Type of Work: Electrical Smoke Detector and Alarms . 1 700 SOUTH MAIN LLC 549 WEST FALMOUTH HWY WEST FALMOUTH MA 02574 (781)760-1445 Owner Name Address- City State Zip Phone Existing Service: 0.00. 0 0 New Service: 0.00 0_ 0 Amps Volts Overhead 7—Undergrou6tb.of Meters Amps Volts Overhead Underground No.of Meters Description of Work to be Done: Updating smoke detectors Contractor Company Address j City _State u Zip. Phone Lic.Type Lic. No Lic. Exp DBA Brendan E Driscoll 83 NEWBERN AVE MEDFORD MA 02155643 (617)590.. Journeyman 34220 7/31/2019 - 0 0015 Electrician Class E 83 NEWBERN AVE fMEDFORD MA 02155643 (617)590 Master 17303 7/31/2019 0 .0015 Electrician. Class A The recipient of this permit accepts this permit on the condition that,as.owner or as agent of the owner,he/she agrees to comply with all Building&Zoning Ordinances of the Town of Barnstable&the State Statutes of the State of Massachusetts regarding the use,occupancy&type of building to be constructed,added to,or altered.Additional conditions listed below: All permits approved are subject to inspections performed by a representative of this office. Requests for inspections-must be made at least 48 hours in.advance. 6- 10/26/2017 Electrical Inspector Date Utility Authorization No. i OFTHETO Town of Barnstable t STAIR 200 Main Street Tel.(508)862-4038 TfDMA<A INSPECTION REPORT Date: 10/27/2017 12:07 PM Inspector: amaraw Permit Number: E-17-2022 Name: 700 SOUTH MAIN LLC Address: 686 SOUTH MAIN STREET, CENTERVILLE Unit No. Inspection Type . Inspection Item Status Comment Electric Smoke A- Inspection Results PASS Smokes added passed Inspection Overall Comment: Smokes added passed Overall Inspection Status: PASS Re-Inspection Date: Inspector Initials: Person in Charge Initials: Total Score: 100 i ACo CERTIFICATE OF LIABILITY INSURANCE °ATE(MM/°°"""' 111/14/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTANAME: Patricia O'Neil The Driscoll Agency PHONE 781-681-6656 FAX 781-681-6686 93 Longwater Circle E-MAIL (Ax Norwell MA 02061 .toneil@driscollagency.com INSURERS AFFORDING COVERAGE NAIC# wsuRERA:A.I.M. Mutual Ins Co INSURED 220723 INSURER B:Harle sville Ins CO. 23582 Driscoll Electric Co., Inc. INSURER C:Harleysville Worcester Ins Co 26182 83 Newbern Ave INSURER D Medford MA 02155 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1053211520 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR ADDLISUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY B X COMMERCIAL GENERAL LIABILITY Y Y SPP00000082842X 6/1/2017 6/1/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X�OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JET LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY Y Y BA00000082841X 6/1/2017 6/1/2018 Ea BIKED SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ X AUTLL OWNED X AUTOS BODILY BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PR AUTOS OPERTY DAMAGE $ AUTOS Per accident $ C X UMBRELLA LIAB XJ OCCUR Y Y CMB00000082843X 6/1/2017 6/1/2018 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X I RETENTION$25,000 $ A WORKERS COMPENSATION Y 2000501 - 6/1/2017 6/1/2018 X PER OTH- AND EMPLOYERS'LIABILITY Y/N _ STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N NIA s (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500.000 B Installation Floater SPP00000082842X 6/1/2017 6/1/2018' Limit $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - CERTIFICATE HOLDER_ CANCELLATION 30 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE, Town Of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE rf G'�iis;cf r .tCe - @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD S Please'visit our Web site at hftp://www.mass.gov/dpi/`boards/EL BRENDAN E DRISCOLL DRISCOLL ELECTRIC CO INC ,(EL) 83 N.EWBERN AVE MEDFORD, MA 02155-6439 Fold,Then Detach Along.All Perforations.. ,.v ,QOMMONN/EALTH OF MA$$ACHUS TT BGAHQ OF ELECTRICIANS �:=ISSUES THE FOLLOWING LICEt4SE AS'A REGISTERED MASTER ELECTRICIAN BRENDAKE DRISCOL{ DRFSGOLL ELECTRIC.CO INC W' 83 NEWBERiV AVE MEDFORD,MA 0215&6430 f f 17303 a :``07131/2019 74239 t r Please visit Our web Site at http://www.mass.gov/dpi/boards/EL BRENDAN E DRISCOLL, 83 NEWBERN AVE (EL) MEDFORD,MA 02155-6430 Fold,Then Detach Along All Perforations . COMMONWEALTH OF MAS3ACHUSETTS BOARD OF ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS A REC'•JOURNEYMAN ELECTRICIAN BRENDAN E DRISCOLL 83 NEWBERN Ave MEDF0017,MA'02155-643Q U220 07/31/2019 74240 e 0. The Commonwealth of Massachusetts Department of Industrial Accidents Ofce of Investigations ' I Congress Street,Suite 100 Boston,MA 02114-2017 " www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legiblv Name (Business/OrganizationlIndividual): Driscoll Electric Co Inc Address:83 Newbern Avenue City/State/Zip:Medford, MA 02155 Phone#:781-960.1445 Are you an employer? Check the appropriate box: Type of project(required): 1.r I am a employer with 50 4. ❑ I am a general contractor and I employees.(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑'I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling shipand have no employees These sub-contractors have 8. ❑Demolition. working for mein any capacity. employees and have workers' 9. ❑Building.addition [No workers' comp. insurance comp. insurance required.] 5- ❑ We are a corporation and its 10:❑Electrical repairs or additions 3.`❑ I.am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself.. [No workers' comp: right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13•❑ Other comp. insurance required.] *-Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all.work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If,the sub-contractors have employees,they must provide their workers'comp.policy number. lam. an employer that is providing workers'compensation insurance for my employees Below is the,policy and job site information. Insurance Company Name:AIM Mutual Insurance Company .Policy#or Self-ins.Lic.`#: WMZ-80080-06780-2016A Expiration.Date: 06.01.18 Job Site Address:_686 South Main street City/State/Zip: Centerville, MA 02632 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. i 52 can lead#o 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 under the pains a 'es' erjrtr at the information provided above is true and correct. Sign Date: 11/14/17 Phone M 781-9601445 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;Z;Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ContactPerson: Phone#: Vf' all, Section 9-Cons sor - Name_Dt �\ Z\y_ r c Ca��nc �rt�'elephone Numb re S l- o1 Address TS a)�Cuc\ City t State Zip License Number A 1`1 S0 License Type Expiration Date 7[ S 11 ks Contractors Email�A?�JA1�AC�(�6( �✓�nit5Cc1��S`��T�i c Cell# CAI"�- S°IO- C901 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 requure 7 0^CMR a�theown of Barnstable.Attach a copy of your license. r Signature Date J 1 1 y I 1'1 Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners 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 SIGNATURE Signature Date Print Name F1(\C_ A'161 Mr arl�' Telephone Number E-mail permit to: �P�b(P►h�r�S�n �S�O1\ f��M't�C fl�� Last updated: 11/7/2017 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 —Owner's orization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to wor tho ' ed by this building permit application for: i (Address of job) Signature of Owner date 4i Print Name i' Last updated: 11/7/2017 Town of Barnstable Building PostTfiisCard So That�tt�isUisible Fromthe StreetA „roved Plans.Must�be Retained on Job and,this Card Must be Kept x SARNSTA 165 PosteUntil Final InspectlonHas BeenMade �� a � , �A Permit Wheed a GertificateofOcpancya�s R�qu,�red,�Buildi g shalltbe O pied until Fnallnspectn has been made Permit No. B-18-1675 Applicant Name: DANIEL O'NEILL Approvals Date Issued: 06/18/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 12/18/2018 Foundation: Location: 686 SOUTH MAIN STREET,CENTERVILLE Map/Lot 186-037-001 Zoning District: RD-1 Sheathing: Owner on Record: SEGERSON,RICHARD E&ANNE M. j r F : Contractor¢N me DANIEL O'NEILL Framing: 1 L 1� Address: 700 SOUTH MAIN STREET Contract or:License CSFA-105994 . 2 CENTERVILLE, MA 02632 Est Project Cost: $3,800.00 Chimney: Description: INSTALL 2 NEW WINDOW UNITS.SEE FAME PLAN Perm�tFee: $85.00 h . Insulation: Project Review Req: Fee Paid , $85.00 n Date 6/18/2018 Final: z - 'P' Plumbing/Gas ` "•- /�-.-ate�' i �E Z Rough Plumbing: ` 21 ,u.Building Official fir " g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorzed by this permit is commenced within six monthsafter issuance. Rough Gas: All work authorized by this permit shall conform to the approved appiication and the approved construction documentsa: w-for, hich this permit has been granted. All construction,alterations and changes of use of any building and structureall be in compliance with the local zonmgAby laws and codes. Final Gas: s h This permit shall be displayed in a location clearly visible from access street orjroad and shall be maintained open for public mspeetidiri for the entire duration of the work until the completion of the same. Electrical f Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided�on this permit. Minimum of Five Call Inspections Required for All Construction Work:' Rough: .- 1.Foundation or Footing s •-, ?:, , „_ ,_ ,„ ,, u -. 2.Sheathing Inspection Final 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final' "Pers s tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department ��t Building plans are to be available on site Final:4�j�' All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ApplicationNumber............................................................. lluk* 3 �`' ' rd Permit Fee.I... .. ...........Other Fee........................ asess. 1639. A1� .4Y,2� s TotalFee Paid...........:................'...L............................... ...... � TOWN OF BARNSTABLE Permit Approval by..................._........... BUILDING PERMIT ....�. ........:..........:.paw............b .. APPLICATION Section 1— Owner's Information and Project.Location Project Address G S(o so-,i-h may;I Village Ceh t-y Owners Name R i dn.-, ( UJ Owners Legal Address 7ZGy S��tL. ,AAc-, C State Zip 0,;,6 3 Z Owners Cell# 0 3 �/ - G'/d I E-mail Section 2—Use of Structure Use Group ❑ µCommercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet O 'Single/Two Family Dwelling Section 3 —Type of Permit New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar H Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description ?�S�•l� oC 11Q.w wi�w(uw �.�ti��) . Sec �rr,^e- 1�lah T Act Tmdated:2J9=1 8 Application Number.................................................... Section 5—Detail Cost of Proposed Construction 3,.900 Square Footage of Project Age of Structure ./I`'�6¢ ova�s , .. Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage r •❑ Smoke Detectors ❑ Plumbing Gas '-❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ,❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard' Required Proposed Rear Yard Required _ Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No v92018 Last=dated. Application Nui fiber..............:............................. Section 9—.Construction Supervisor Name Don O Vie;/ Telephone Number sue 7 3 73 / Address 3 S/ A►6"cr, city l-{yu h n;s state C0 f License NumberCS.F4^!ds qP License Type/I emu*• Expiration Date /0 3 - I R Contractors Email 01-0 Cell# S0°-. 7 3 7 — 3 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CUR the Massachusetts State.Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Bamstable.Attach a copy of your license. Signature ,��,.. - Date s �� /,5 Section.10—Home Improvement Contractor Name OGh 0 Vt. ! ( Telephone Number S-0-9 3 7 3 -71 9 Address 3 S 44 t Z«, City en State Zip C�Z6 0 J Registration Number/4V 12 Expiration Date s '/ 2 o � I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation, re, ed by 780 CMR and the Town of Bamstable.Attach a copy of your HZC... Signature C--1 Date Section 11-Home Owners License Exemption Home Owners 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 docamentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature �--, S-o?�/ Date 8 Print Name 1 C) Telephone Number -f 3 7 - 3--7-♦9 E-mail permit to: D/y CC.v` en x G1 rrn . G o 4 mm/lin-1a Section 12—Department Sign-Offs Health Department © Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ ` -'` ' Conservation ❑ For commercial work,please take your plans directly to the fire department for approval{ � f _ � Section 13—Owner's Authorization I as Owner of the-subject property YherebY , authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner - {, R�, ! date I ` f •. ;,, Yam.... C A Print Name i i i { I f J -`- Last undated 2192018 The Coninionwealth of Massachusetts _ Depaphnent of Industrial Accidents b'.t Office of Investigations 600 Washington-Street Boston,AL402111 tee.ra2ass.gvv1diau,. .. .. Workers' Compensation Insurance Affidavit:Builders/Canti%a�ctarslElec#t ac ansmiimbers Applicant Information Please Feint I.eWbl�r.. ... ...:. Name(Boo for h tlndevi6.1) Address: 'r CityJStatelZtg N. r..+«,, o�6� d . 5a. 3 3 19 Are ou an employir?Check the appropriate bog _Tye of project(required): 1_ I am a employer with 4• ❑ I afn ai general contractor and I employees(fu11 andlor part tiffie)- have hired the sub-contractors 6. ❑NNe/eu:constzuction 2.El am a sole proprietor or partner- listed on the attached sheet. 7_.[�]'R�odeling Thee sub-contractors have slap and have no employees - -_ ... ' ..�.-.❑..),}ernolitlOn. working for me many capacity employees and have watd=s' (No workers'comp.insurance comp_insurance✓. Y '9_.❑Standing addition . required-] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions 3_❑ 1 am a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions i myself [No workers'comp- right of exemption per MGL 12.❑Roof repairs. insurance required.]€ c. 152, fl(4 and we have as employees.(No workers 13_❑Other comp.Insurance required.] •Any applicsntehat chit 9cs tioic#1 most also fill out the auction below showing then woAers'compensation policy infonnattan. Homeown us who submit this affidavit indicating they are doing all wank and then hire outside contractors nmst submit a new affidavit indicating sudL tCanuactors that check this b=mast attached an additional sheet showing then of ehe sub-eontmaors and state whether or not those entities have employees. If the sub•candtactots have employees,they mustpmuide their workers'coup.policy number. 1 am an employer that is providing urorkers'eonepeustation itasaerarace for erryr eterployers Below is t)te poliew and job.site infortuadon. Insurance.Company Name AS&Q',f l G••^p�� eP� �5� c� �r+.Po..y T'T .�0Po Policy 9 or Self-ins-Lic_#tb' .5700 Exgirstxoamt e. +L%yc iyutateh /Job Site Address: lTp: C�Z�3Z Attach a copy of the workers'compensation policy declaration page(Ahowing 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$1,50Q.00 andlor one-year imgaaisonment,as well as civil penalties in the farm of a.STOP WORK ORDER and a fine': of up to S250.00 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 verfication- 1 do hereby verb under the pains and penalties of per uq,that the information pm ded above is trace and correct Si ature: c• Date.: � Phone#_ 73 7_-.37-o d7ffla'al use only..Do not write in this area,to be completed.by ciV or town official. City or Town PerruirtfLicense Issuing Authority(cu°cle one):- 1.Board of Health 2.Building Department 3.Cityf'Town Clerk:4.Electrical Inspector 5..Plumbiakg Inspector b.Other Contact Person: .. Phone#: Town of Barnstable Building Department Services _ e : e"xr'sr"B`E Brian Florence,CBO MAss. 1639' `� Building Commissioner °tFo nw+° 200'Main Street IIyanms,MA 0260`lM. www.Town barnstablema.us Office 508=862 4038 Fax 508=790 6230 Property Owner Must Complete and Sign This Section I f Using A.BuildF. er - ,.as Ow f the sub- t.property ner o . hereby autlionze n /�.� �� Q/ (. _to act::on my behalf, m all matters relative to work authorized by this bulidirig permit application for 61 cS�f ee C fir► of ob: (Address J ,) 'k'kPool fences nd a alarms are the res onsi p b ty of.the applicant,- bos are riot to be filled or.utilized:before'.-fence is nstalled and all.final a inspec ons are performed and.accepted. : S gna e of Owrier Signature of Applicant .Print Name Pruit-`Name 3 l Date Q 1 ORMS OWNERPERMISSl0NP00LS r a 68 •SDk t Mar tA AAA S'I•�L II &Ie a All V0 u^ 3 Tway 10 k x 1 r7) Ytif �`7 y t rd�, - d Nd I ,a f G 8G So AA f ov% Io,l Above VL sills T � T `', s �-�'�,�h a ' Commonwealth of Massachusetts k Division of Professional Licensure Board of Building Regulations and Standards ConstructionN54tief "iterl & 2 Family i Registration valid for individual use only-before.the-expiration date. If found return to: CSFA-105994 ff�pires: 10123/2019 off ice of Consumer Affairs and Business Regulation yy f• -i 9 J, _ 10 Park Plaza-Suite 5170 DANIEL O'NEILL 'tk­ HYANNISBoston,MA 02116 �#351 MEGAN ROAD MA 02601 v N Not valid without signature f , ,�.- •- Commissioner C L �i ���e �c,cca>rzrrr<aecc/(l c/n�l�r,tsar.•�cc�ellt i -Office of Consumer-Affairs&-Business Regulation`- -Construction Supx a >> HOME IMPROVEMENT CONTRACTOR eryisor 1 8 2 Family J0 TYPE:Individual Registration Expiration 168722 05/14/201.9 DANIEL O'NEILL_ - ...`- D/B/A DAN L.O NEILL"-CARPENTRY DANIEL-O'NEILL 351 MEGAN RD �� Ck HYANNIS,MA 02601 Undersecretar` Failure to possess a current edition State Building Of the Massachusetts ` Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit WWW.Mass.gov/dpl I TOWN OF BARNSTABLE PERMIT CHECKLIST Sign Off hours for Health and:.. Conservation are $-9:30 a.m. and. 3:30-4:30 p.m. A completeperrnit application includes filling all sections 1-.13 1. NEW STRUCTURES/REMODELING/RENOVATION/ADDITIONS ❑ Site Plan showing setbacks of proposed and existing structures ❑ Commercial—One complete set of full sized plans one reduced 11"x17" (plans may require a stamp by an architect or engineer). Residential -4 Sets of floor plans no larger than 11"x 17" smoke/co detectors marked El Worker's Comp.Affidavit and policy(if required) Res Check or COM check from the 2015 International Energy Cod Council(IECC) ❑Letter of financial Interest for new houses only(not required for rebuild after teardown) ❑Performance bond made out for$4.00/foot of road frontage (new construction only) 2. DEMOLTION OF A BUILDING (NOT PARITIAL) ❑ Everything above plus shut off letters from following utility companies: ❑ Gas ❑ Electrical ❑ Water ❑ Sewer(if required) . 3. DECKS/PORCHES/GAZEEBOS/INSULATION/SOLAR/POOLS/SHEDS ❑ Site Plan showing proposed location ❑ Construction plans showing framing detail (if new framing), ❑ Pools—Barrier details,pool specs (engineers design) ❑ Workman's Comp Affidavit and policy (if required) . FAMILY APARTMENTS :11-Section'l Plus: , ❑ Family Apartments are subject to approval from the Building Commissioner. Agreement must be signed, notarized and recorded at the Registry of Deeds and returned to the Building Department. NOTICE y x NOTICE TO w TO e m a EMPLOYEES `7�-4 44 EMPLOYEES ay eu�a The Commonwealth of Massachusetts, DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston., Massachusetts 02114-2017 617-727-4900 As required by Massachusetts General Law,Chapter 152, Sections 21, 22, & 3-0,this will give you notice that I (we)have provided payment to our injured employees under the above mentioned chapter by insuring with: Associated Employers Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC-500-5016201-2017A 07/12/2017- 07/12/2018 POLICY NUMBER EFFECTIVE DATES 434 Route 134 Rogers & Gray Insurance Agency Inc South Dennis, MA 02660 NAME OF INSURANCE AGENT ADDRESS PHONE Daniel L. O'Neill Carpentry 351 Megan Road Hyannis, MA 02601 EMPLOYER ADDRESS 06/08/2017 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment -to furnish -adequate -and reasonable hospital -and.medical services -in accordance with the provisions-of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER Parcel Detail Page 1 of 3 TH All ASS', i . .. iYffl�fit y .t�D MAy d: �_��i�(/ .Lief!- ril�YJ- - �!-•.s.,,�' /7 Logged In As: Pa rice( Detail `T R Wednesday,February 82017 Debi Barrows F Parcel Lookup Parcellnfo Parcel ID 186-037-001 -I Developer Lot Location 1686 SOUTH MAIN STR� Pri Frontage Sec Road I Sec Frontage Village lCenterville I Fire District C-O-MM I Town sewer exists at this address NO .I Road Index 1507 I .. - _ Interactive Map - fi}- � �, •' Owner Info —_ -- - -� Owner 1700 SOUTH MAIN LLC I co- Owner Streets 1549 WEST FALMOUTH II Streetz I PO BOX399 r!I city IWEST FALMOUTH I state MA (zip 102574 I country F I Land Info Acres 11.45 I use Single Fam MDL-01�I Zoning RD-1 I Ngnbd 0109 Topography Level I, Road jPaved utilities jPublic Water,Gas,Septic Location I - I + Construction Info Building 1 of l Year 1939�I Roof Gable/Hip �.I Exc Wood Shingle I Is Built Strut Wall Living Roof -AC 4 WDK.I 4, Area 1014 I cover Asph/F GIs/Cm p Type Central is Style Conventional wall Wall Brd/Wood Room=12 Bedrooms J Model Residential Flog Pine/Soft Wood Rooms 1 F�UII-0 Half 31 HAS Grade 1,Average I Type Total JHot Water I Rooms 15 stories 1 Story I "eat Gas FO nd Piers Fuel ation Gross 1 Area262 Permit History Issue Date' Purpose Permit# Amount Insp Date Comments 12/23/2014 Other 201408599 $2,500 DEMO CHIMNEY' 1/5/2006 Remodel 89503 $450,000 2/12/200712:00:00 AM http://issgl2/intranet/propdata/ParcelDetail.asi)x?ID=107469 2/8/2017 Parcel Detail Page 2 of 3 (10/25/2005 Remodel 87904 $5,000 4/27/200612:00:00 AM 1/28/1999 Addition 28591 $60,000 7/1/199912:00:00 AM Visit Histo Date Who Purpose 10/23/2015 12:00:00 AM Tony Podlesney In Office Review 4/2/2015 12:00:00 AM Susan Ricci Cycl Insp Comp 1/12/2015 12:00:00 AM Anne Leonelli In Office Review 6/12/2014 12:00:00 AM Jeff Rudziak In Office Review 11/21/2008 12:00:00 AM Paul Talbot Drive by inspection only 6/25/2007 12:00:00 AM John Greene New Construction 6/19/2007 12:00:00 AM Martin Flynn Bldg Permit Completed 2/12/2007 12:00:00 AM Martin Flynn CALL BACK 4/11/2006 12:00:00 AM Paul Talbot Bldg Permit Completed 12/14/2005 12:00:00 AM Gary Brennan Drive by inspection only 8/15/2005 12:00:00 AM Gary Brennan Cycl Insp Comp 1/21/2005 12:00:00 AM Paul Talbot Meas/Est 7/1/1999 12:00:00 AM Andrew Machado Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 4/3/2014 700 SOUTH MAIN LLC C203014 $1,241,198 Assessment History Save Building Total Parcel # Year Value XF Value OB Value Land Value Value 1 2017 $78,300 $3,100 $5,100 $285,800 $372,300 2 2016 $78,300 $3,100 $5,100 $281,200 $367,700 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=107469 2/8/2017 -.i. -. a�3_,. E� ��}...A1�3.e,Yg �C xa�`e�• 44,k�� iSi z a 'G;, fi � 4� 1-a", ,mot r p wil I a- . 44 r Fp' C,:r ,jy r y >R ,q t y A,? n �.• s:- rc1 ® ,-- r yr r -�4,' 7 . 't� -0'.ytiF ,l��v. D U C F � 4 YY k ,u_ - >S�s•�d: bS �._ t A � a'• � Iti f ] I�a t`g ' i �,� � c� �-' 1 �• - `� f-- .ra c$ .fit s� Y�.^ � ,�z ��"` _. r+, f t'Y"Y5t� f' 07/17/2013 It �? 07/17/2013'- " �s•iffi+(f��`�t�i6, °3 [�'� s:°. . 1 — sr- .. It rI - � c 07/17 rz013 " 07Nt�1,/2013 fie-}, �' "''��' �10 ' �'�.. " °a-' ntrzooslosrama''s"�r � rk e� �~ Parcel Lookup Page 1 of 1 Logged In As: Wednesday, February 8 2017 Debi Barrows Pa rce I Lookup Road Lookup Condo Lookup Multiple Address Lookup Reports Search Options Search By IStreet Street# Street Name South main ,. Village All Villages 5 Search <Prev Next> Page 9 of 12 IM Rows/Page: Flo v Parcel Location Owner Village Index Map 615 SOUTH MAIN STREET- Multiple Address 186-051 MAVROGIANNIS, MARY CENVIL 1507 186051 (609 SOUTH MAIN STREET- GARAGE APARTMENT) 615 SOUTH MAIN STREET Multiple Address 186-051 (615 SOUTH MAIN STREET- MAVROGIANNIS, MARY CENVIL 1507 186051 MAIN HOUSE) 186-062 627 SOUTH MAIN STREET CLOUGH, DEBORAH CENVIL 1507 186062 SYLVESTER,'CARL C & 186-042 630 SOUTH MAIN STREET CENVIL 1507 186042 DEBRA J 186-061 633 SOUTH MAIN STREET' CLOUGH, DEBORAH CENVIL 1507 186061 186-041 642 SOUTH MAIN,STREET POSKEL, CLAIRE E TR CENVIL 1507 186041 TOBIN, JON S & JEAN 186-040 656 SOUTH MAIN STREET TRS CENVIL 1507 186040 186-039- 664 SOUTH MAIN STREET BARNSTABLE LAND 001 TRUST INC CENVIL 1507 186039001 TRIPLETTE, MARIANNE 186-038 682 SOUTH MAIN STREET D CENVIL 1507 186038 186-037- 686 SOUTH MAIN STREET 700 SOUTH MAIN LLC CENVIL 1607 186037001 001 i A http://issgl2/intranet/`propdata/lookup.aspx 2/8/2017 wmerws�' rUM Md Town of Barnstable Planning Board Notice of Approval Not Required(ANR)Plan Endorsement - 700 South Main,LLC. Owner/Applicant: 700 South Main,LLC Property Address: 700 South Main Street Centerville,MA Assessor's Map/Parcel: Map 186 Parcel 037 Zoning: RD-i and RPOD , At the regular scheduled Planning Board meeting.of November 24,2014,the Board unanimously voted to endorse the land division plan entitled"Plan of Land for 700 South Main LLC Showing a Subdivision of Land Court Plan i287oA j0o South:Main Street.Centerville,Barnstable,MA"dated August 20,2014 as drawn by Holmes&McGrath,Inc.,and stamped by Michael McGrath,Professional Land Surveyor,as an Approval Not Required Plan. The purpose of the plan is to divide a 3.45-acre parcel of land(2.35 acres upland and 1.1 acres wetland)into two lots pursuant to.MG.L Chapter 41 Section 81-L that exempts for subdivision control"the division of a tract of land on which two or more buildings were standing when the subdivision control law went into effect in the city or town in which the land lies into separate'lots on each of which one such buildings remain standing..." The plan divides the parcel into two lots. Lot i is shown as an 81,138 sq.ft.lot with 65,453 sq.ft.of upland (1.5o acres)fronting 278.71-feet on South Main Street. That lot encompasses the larger,3-bedroom dwelling. Lot 2 is shown as a 63,293 sq.ft.lot with 37,143 sq.ft.of upland(o.85 acres)fronting 2o.o5-feet on South Main Street. That lot encompasses the smaller,2-bedroom cottage dwelling. Neither lot conforms to the 2-acre upland minimum lot area requirement of the Resource.Protection Overlay District nor do they conform to the maximum lot shape factor requirement for residential lots.'Bulk Variance No 2014-027&036 has been,issued by the Zoning Board of Appeals for the proposed new lots. The Variance is filed with the Barnstable Land Court Registry as Document 1,253,80.2. The ANR application and plan were submitted to the Town Clerk's Office on November 18,2o14,and processed in accordance with MGL Chapter 42,Section 81-P,Approval under the Subdivision Control Law Not Required. A copy of the.plan can be found in the Town Wide Drive—T,under GMD—Planning Board— Approved ANR&Subdivision Plan-"ANR—186-037-000-700 South Main Street LLC". Respectfully submitted on behalf of the Board Arthur P.Traczyk,R6 lato.ry Review/Design Planner Dated Copy: Applicant(c/o Attorney Eliza Cox) Jeff Rudziak,Director Assessing Department Frank Schlegel,DPW �. 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DEi9 ,I \q.\ , % t�-, - ".`T`�.s 2, -:..'•y IUM G'.Iwybf , °°:"if\•.r •18•i°•r -yam\ : Y��, �aiso 4.. - D81DI1IF..C//a11lME G 70-Y-aY N'O.00 �3'y�.f < A°�1•(„`y' ACF&AC�'YI.EOW.f( 0)STAIDAI81'OFNABW � :Da• -- /`�w. lld�/.�q.� LOT 1 . Zg� ALL'YFA9IM.IXI6 TNR11..Y1T1 DYI Up(SS..OTIEANI$NO1FD. L'tt CDH \. OT.I.IEY A'F.tt)iK ` Y %.a' qry . 'I :.uO.Je (B9�5C;SI..IPLANO) \. ♦:M1� . `q . : .NEI✓EEf'aRT1�'1NAT iNE LOR. n tTlA% sr noP a �/ ` _ . .. sww ON T34 PLAN 11AYE RINITA L \3., .1 . . ON A PON1C NAT:RNT.Wy 9fO11N q1 ♦ q, I t CA . 'AAOO�weLM'.9�IW a .. _ � ''r i I�1..A;, CONSIIR l/.Yl Ef AT IG/ut 91d1 4 P 4 A.cL f88P93 1 OIStIYI K 11N'Y-JJ;l4 IND'1 f2WJ6D. ry \ a J7� .. .p"?`w'was�a �' _. . K w `G: ) -m..ar —'_ 11 NotL6 ARO'Meat�RE WC. 0 °.S <. �e '"fA y \\y L �� A1N � PP N{!SY RNrtTAB.,,Amkm BOARD' 'ti{ eARNSTA9EE PUNNWO'HOARD APPRQVAI UNDER - iNE.$LI�Dlk190N CdE11ft0E UW NOT•RF�I11RE6 ' 4ATE"_ - ), _ -_ �' ' I. - Na'DE]EKMMMICM':W:xO OO/APIIAXCE.RnN THE : ;, .ZONw$:�+oDaNDE RtroilwoJeNTs NAS'HE'(TT' HARE,,BJTFJJOEO$Y:HiE'Ae0�E'ENDORSEMQET:. i t _ - ', 1. - - _ ujTItTTlATON1. ' - AI TTRNATF TRFST LNF - +" OE'TAI G+rTmu �,nBT C0IJN7Y.LAYOt_rc' 4 % jai.. d . '"ar,PS xAir<.1• -P't ,.I—, t(dF NAND - EfU+o :. �: _.z<.y .__ a _ - .. .. ,,,,o.'W a -- •.mts cw oa.Tn'+" �Ji :,>oo.5oUR1 MA)N.LLC ..��'�' '� 1wY mufY( im ' m " •SHOMING A"9i6D14L90N'-OF UNO ONJPT FLAN'12BTOA 'Oam - Iy rovva �INS 'T0D SOUTH'MAIN*STREET 4 oNo 4 q I� OENTERL•ILLE �ARNSTABLE MA �I _ SOE)TH MAn'E .stREETg i 1S. (18 b'T lE,PoP�A YOU A:ALlE12D Y�.957 0QA+T POUT:- A¢4.81�.,ID1{� 1 3�'4 MD AKD 3MiAOE'. k� f� t olmes and mc�it rchIric : _ 104 _�. .. D ANN 1NH CNECNfD' ..':'�bB'NP'¢1k200 WC:NQ:::EB-M2^.SHEE!f Y I � . . . . y .. t. ' ti O r fay e-r past z. SE ACCEPT . - TOWN OF Fk , 2014 2014 J is hereby notified that their bid f Bid dated in the amount of$ has be It is requested that acknowledgement of this ACCEPT .s 11 --`representative of the contractor, and the original be return Hyannis,MA 02601. .,A formal Contract will be drawn.up based on the terms of t final approval.by t6'Town Manager of the Town of Barnsta current certificate of insurance naming the To`wn'of Barnsta contract with five days after receipt of the contract in accor 4 TOWN.OF BARNSTABLE BUILDING PERMIT APPLICATION OFBAPAIS Map 6 Parcel• 0 3`� ! Application # Health Division °bate Issued Z-/2-3h V Conservation Division = Application Fee All Planning Dept. `Is � Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis (_q-6, Project Street Address q-6'r SO L." Mo,n Sv ee, Village CeA,,Vea-v�eke , \DPP 0 2-b 3 3). Owner �� �—�� Address q00 50,AA, (no"-n Telephone SCfd-!5qq Permit Request cy�rMne_!q �)ey�nc�On o n Square feet: 1 st floor: existingr9Q00 proposed 94A5 2nd floor: existing proposed 0 Total new a a 5 Zoning District Flood Plain 0 Groundwater Overlay Project Valuation a►500,00 Construction TypeCA&Sgc1o" Lot Size I A5 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure \1ao Historic House: 29 Yes ❑ No On Old King's Highway: ❑Yes No Basement Type: ❑ Full Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) �A o,n2. Basement Unfinished Area (sq.ft) A8 5! � Number of Baths: Full: existing new \ Half: existing new \ Number of Bedrooms: 3 existing —new Total Room Count (not including baths): existing 10 new 1 First Floor Room Count Heat Type and Fuel: A Gas b,;rJiI ❑ Electric ❑ Other Central Air: 2(Yes ❑ No Fireplaces: Existing Lk New Existing wood/coal stove: ❑Yes No Detached garage:'existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed•❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - - _ (BUILDER OR HOMEOWNER) - I Name r5_ :o-=\3 53 C N iJ�iJ � �vo��►-S Telephone Number rJO� i Address Ok aa. License # ►_CS_-7-0--fo1 Ala' o.�Mw O 3LSLm Home Improvement Contractor# \ "1 Worker's Compensation # LA CR 0073,11 a a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 'R>O o flrl . SIGNATURE ATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS .. 'VILLAGE OWNER t DATE OF INSPECTION: FOUNDATI.QN r FRAME INSULATION, a r FIREPLACE F • ' ELECTRICAL: - ROUGH FINAL PLUMBING: ROUGH 1 FINAL f - F i GAS:_ _ -ROUGH FINAL a t t. - FINAL BUILDING- DATE CLOSED OUT ASSOCIATION PLAN NO. ; 1 Client#:3248 2NEWTONCH ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)1v19/2o14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require:an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT - - NAME: Dowling&O'Neil PHONE 508 775-1620 FAX Insurance Agency INMA�o El): A/c,No): 5087781218 ADDRESS: 973 lyannough Rd., PO BOX 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Acadia Insurance INSURED - - - INSURER B C.H.Newton Builders,Inc. PO BOX 399 - .r J INSURERC: West Falmouth, MA 02574 INsuRER D INSURER E: - - INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,' TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS-OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB - - POLICY EFF POLICY-EXP - LIMITS LTR INSR WVD POLICY.NUMBER MMIDD MMIDD A GENERAL LIABILITY CPA005747625 1/01/2014 01/01/2015 EACH OCCURRENCE . $1 000 000 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED PREMISES Ea occu rence $250 000 CLAIMS-MADE 51 OCCUR' _ - ` MED EXP(Any one person) $5 OOO X BI/PD Ded:250 PERSONAL&ADV INJURY $1,000,000 - GENERAL AGGREGATE $2,000;000 GEN'L AGGREGATE LIMIT APPLIES PER:. .- PRODUCTS-COMP/OP AGG $2,000,000 - POLICY PRO- JECT LOC - $- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - - Ea accident $ ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED �SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ - - - - NON-OWNED - PROPERTY DAMAGE $ HIRED AUTOS -AUTOS- - - - Per accident UMBRELLA LAB OCCUR - - EACH OCCURRENCE $- EXCESS LIAB HCLAIMS-MA DE AGGREGATE DED I I RETENTION$ "" $ - A. WORKERS COMPENSATION WCA007321122 1/01/2014 01101/2015 X WCSTATU- OTH AND EMPLOYERS'LIABILITY YIN, ANY PROPRIETOR/PARTNERIEXECUTIVE - - E.L.EACH ACCIDENT $500 000 - OFFICER/MEMBER.EXCLUDED? a NIA - (Mandatory in NH) - - - - E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under - - - - - DESCRIPTION-OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT. $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,.Additional Remarks Schedule,if more space is required) - - Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable-Bld Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE gTHE EXPIRATION DATE THEREOF, NOTICE WILL BE 'DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. `. Hyannis, MA 02601 . - AUTHORIZED REPRESENTATIVE ©1988-2010.ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) ' 1: of 1 The ACORD name and logo are registered marks of ACORD #S141794IM141793 ,LS1 E 5 V C�e �(ia�rr�iizoiiu✓etcl�%C�/li�iaaac�%%c�rlG� Office of Copsumer Affairs&Business Regulation ' OME IMPROVEMENT:CONTRACTOR egistration 107888" Type: 2 Expiration —8/10/ 016 Frivate:Gorporatior r C.H. NEWTON BUILDERS,IN David. Newfon NZ 549.Main Rd 28A W.Falmouth;MA 02541. Undersecretary, t License or registration valid for,individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 No ' ►d w th u e Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-046192 IS DAVID L NEWTO 106 WHITMAR RD Cotuit MA 02635 'j N Expiration Commissioner 09/19/2015 I The Cotnmonwealt& of Massactauseaas Department of IndustrialAccidents Office of Investigations - 1 Congress Street, Suite 100 Bastar;.MA 02114-2017 wwrumass.gov/dia davit: Builders/Contractors ectricians/Plumbers Workers' Compensation Insurance A> Applicant Information Please Print Lea 1y Name ghisiness/oganizationdn ividual}: C 1A Q.w\-t n V u l 1 m-,s Address: Q o -bo)1 Olaf City/State/Zip: �a... Mou�L Mf\ 0 a5 a\ Phone#: Are you an employer?Check the appropriate box: Type of project(regnn ed): 1. I am a et plover with LA5 � ❑ Z�a general contractor and I 6. ❑New construction employees(full and/or part-time).* have lured the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and hay e no employees These sub-contractors have S. Demolition R-orking for ine in any cagacit-y _ employees and have workers . f❑Building addition [No workers comp:incurstince comp.insurance,* required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.El Plumbing repairs or additions myself. [No work comp. right o£exemption per MGL I2.❑Roo£repairs insurance required.]t c. 152,§1( },and R%e have no employees. [No«otters' U-❑ Other Gomp. inset-ante required.] 'Any applicaat 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 subcontractors 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 anployer that is providing workers'con;pensation.insurance for my employees Below is the po0cy and job site information. Insurance Company Name: c fr7 �- U•i rnP �� Policy#or Self-ins.Lac.#: t,J A OX�)_-7 2,-- i 1 12 Expiration Date: I a aD 1 Job Site Address: 9 00 S o" N�� S�r City/State/Zip: CeX4*'V-i p'� Oa: a— 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 agabist the violas Dr. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of t ed bLD for insarance coverage verification. I do la �.b,, uri the eririlties of erjun�that the informtation provided ahot�e is true and correct. Si�tatur 771Date: �a' —� Phone# ..official use only. Do not write in this area,to be completed by cih.,or toavn official City or-Town: Permitlhicease# Isming Authority(circle.one): 1.Board of Health 2.Building Department 3.City/Tov%, Clerk 4.Electrical.Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Mass. Corporations, external master page Page 1 of 2 w. - j aY �` Corporations Division Business Entity Summary ID Number: 001132095 1 Request certificate' FNew search Summary for: 700 SOUTH MAIN LLC The exact name of the Domestic Limited Liability Company (LLC): 700 SOUTH MAIN LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001132095 Date of Organization in Massachusetts: 03-27-2014 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 City or town, State, Zip code, WEST FALMOUTH, MA 02574 USA Country: The name and address of the Resident Agent: Name: DAVID NEWTON Address: 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 City or town, State, Zip code, WEST FALMOUTH, MA 02574 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER DAVID NEWTON 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 WEST FALMOUTH, MA 02574 USA In addition to the manager(s),.the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.... 12/9/2014 Mass. Corporations, external master page Page 2 of 2 REAL PROPERTY DAVID NEWTON 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 WEST FALMOUTH, MA 02574 USA r r Confidential 0- Merger r Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report , Annual Report - Professional Articles of Entity Conversion ' Certificate of Amendment j View filings Comments or notes associated with this business entity: FNew search J http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary..... 12/9/2014 Mass. Corporations, external master page Page 1 of 2 it 1 �r b i rs.',.:�7 S l 9 lot Corporations Division Business Entity Summary ID Number: 001132095 Request certificate New search Summary for: 700 SOUTH MAIN LLC The exact name of the Domestic Limited Liability Company (LLC): 700 SOUTH MAIN LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001132095 Date of Organization in Massachusetts: 03-27-2014 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 City or town, State, Zip code, WEST FALMOUTH, MA 02574 USA Country: The name and address of the Resident Agent: Name: DAVID NEWTON Address: 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 City or town, State, Zip code; WEST FALMOUTH, MA 02574 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER DAVID NEWTON 549 WEST FALMOUTH HIGHWAY, P. 0. BOX 399 WEST FALMOUTH, MA 02574 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.... 12/9/2014 Mass. Corporations, external master page Page 2 of 2 REAL PROPERTY I DAVID NEWTON 549 WEST FALMOUTH HIGHWAY, P. O. BOX 399 WEST FALMOUTH, MA 02574 USA 03 GJ Confidential 0 Merger t - Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS � Annual Report P Annual Report - Professional Articles of Entity Conversion Certificate of Amendment View filings Comments or notes associated with this business entity: w New search, http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.... 12/9/2014 Client#:3248 2NEWTONCH ACORD. CERTIFICATE OF LIABILITY INSURANCE' DATE(MMIDD,YYYY) 11/19/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES . BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT'CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED -REPRESENTATIVE OR PRODUCER,AND THE.CERTIFICATE HOLDER: IMPORTANT:If the certificate holder is an ADDITIONAL INSURED;the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT - NAME: Dowling&O'Neil . PHONE 508 775-1620 FAX 50 A/C,No,Ext: A/C,No: 87781218 Insurance Agency. E-MAIL ADDRESS:. 973 lyannough Rd:, PO Box 1990 . INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A.:Acadia Insurance INSURED - - INSURER B:C.H.Newton Builders, Inc. " INSURER C: - PO Box 399 West Falmouth,MA 02574 INSURERD: INSURER E: ' - . - INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE.POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE.POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSRADDL WVD POLICY NUMBER - MMIDDY EFF MM/DDY EXP LIMITS- - A GENERAL LIABILITY CPA005747625 1/01/2014 01/01/201 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea ouTUE nce $250 000 CLAIMS-MADE A OCCUR - - - MED EXP(Any one person) $5 000 X BIIPD Ded:250 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000. GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS:-COMP/OP AGG $2,000,000 POLICY JECOT- LOC $ - - AUTOMOBILE LIABILITY - _ - COMBINED SINGLE LIMIT Ea accident $ _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED -SCHEDULED` - BODILY INJURY(Per.accident) $ AUTOS AUTOS - HIRED AUTOS NON-OWNED - ., .. PROPERTY DAMAGE $ - AUTOS Per.accident UMBRELLA LIAR HOCCUR - _ EACH OCCURRENCE - - $ EXCESS LIAB CLAIMS-MADE - AGGREGATE $ ' DED RETENTION$- - - $ - A WORKERS COMPENSATION - WCA007321122 ` 1/01/2014 01.101/201. X WC STATU- OTH- AND EMPLOYERS'LIABILITYIER ANY PROPRIEfOR/PARTNER/EXECUTIVE Y 1 N E.L.EACH ACCIDENT $SOO OOO OFFICER/MEMBER EXCLUDED? N 1 A - (Mandatory in NH)- E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under -- DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule(,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by.the policy provisions. CERTIFICATE HOLDER CANCELLATION Town.Of Barnstable-Bldg Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE - 4,. C� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1417941M141793 LS1 Page 1 of 1 h t - �, € ad if ti Po4 �w k 'hfi µ' E 6�e# 6�— a" 1. € 3 RIMY �a V `m& a gg fit.4l5aPd lisp! € ' Yn Tow > , 'XF " XRaw .b nc�J, y R €t.e t, E +fir"+ s G f + .i " �' w_. p " " �" €° aY.-i °a, AwZ a Tzi fl omm e s �;� �° �« k .& �P �� t ° �� y Y 1-1 NO Iq K aa AIIw. p i lii e M � �. A„`.r" = 'I� � �k4.a.^�-�'"�'' �.tr� w'r" +.i•r�Y,i� '��,, €f, �, e err ,rr�-, _ ' r 6 'z rya a' e sit T7 file:/A\isvisions\images\00\00\95\88.jpg 12/9/201 G f — F 11 'ICC N.-$ SERVICE IMES Evaluation Report ESR-1826 Reissued February 1, 2013 This report is subject to renewal February 1, 2015. www.icc-es.ora 1 (800)423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council® DIVISION:07 00 00—THERMAL AND MOISTURE` 3.0 DESCRIPTION PROTECTION Section:07 21 00—Thermal Insulation 3.1 General: Icynene LD-C-50Tm and LD-C-50 v2 are low-density, open- REPORT HOLDER: cell, polyurethane foam plastic insulations and air barrier systems that are 100 percent water-blown with an installed ICYNENE,INC. nominal density of 0.5 pcf (8 kg/m3). The insulations are 6747 CAMPOBELLO ROAD two-component, spray-applied , products. . The two MISSISSAUGA,ONTARIO L5N 21_7 components of the insulation are polymeric isocyanate CANADA (A-Component, also known as Base Seale)and proprietary (905)3634040 resin (B-Component, LD-C-50 or LD-C-50 v2 Resin, also www.icvnene.com known as, Gold Seal®).The A-Component must be stored at a temperature of 50°F(10°C)or greater, and has a shelf. EVALUATION SUBJECT: life of six months. The B-Component must be stored at temperatures below 100°F (37.8°C), and has a shelf life of ICYNENE LD-C-50Tm AND LD-C-50 VERSION 2(v2) six months. . 1.0 EVALUATION SCOPE 3.2 Surface Burning Characteristics: Compliance with the following codes: When tested in accordance with ASTM E84/UL 723, at a thickness of 6 inches (152 mm) and a nominal density of ■ 2012 and 2009 International Building Code®(2009 IBC) ` 0.5 pcf(8 kg/mi), Icynene LD-C-50 and LD-C-50 v2 have a ■ 2012 and 2009 International Residential Code® (2009 flame spread index of 25 or less and a smoke-developed IRC) index of 450 or less. Thicknesses of up to 71/2 inches (190.5 mm)for wall cavities and 111/2-inches.(292 mm)for ■ 2012 and' 2009 International Energy Conservation -'ceiling cavities are recognized based.on room corner fire Code®(20091ECC) testing in accordance with NFPA 286, when covered with ■ Other Codes(see Section 8.0) minimum 1/2-inch-thick (13 mm) gypsum board or an equivalent thermal barrier complying with the applicable Properties evaluated: code. ■ Surface burning characteristics 3.3 Thermal Resistance: ■ Physical properties Icynene LD-C-50 and LD-C-50 v2 have thermal resistance ■ Thermal performance(R-values) (R-values)at a mean temperature of 75°F(24°C)'as shown in Table 1. ■ Attic and crawl space installation 3.4 Air Permeability: ■ Fire resistance Icynene LD-C-50Tm and LD-C-50'v2 spray-applied foam ■ Air permeability plastic insulations, at a minimum thickness of 31/2 inches " ■ Noncombustible construction (89 mm), are considered air-impermeable insulation in accordance with IRC Section R202, based on testing in 2.0 USES accordance with ASTM E283. Icynene LD-C-50Tm and LD-C-50 v2 are used to provide 3.5 Intumescent Coatings: thermal insulation in buildings and to seal areas such as plumbing and wiring penetrations against air infiltration, in 3.5.1 No Burn Plus XD: No Burn Plus XD intumescent Types I, II, III, IV and Type V construction. (IBC):and coating is a latex-based coating supplied.in 1-gallon (4L). dwellings under the IRC. The insulations may be used in and 5-gallon (19L) pails and 55-gallon (208 L) drums. The fire-resistance-rated construction when. installed in coating material has a shelf life.of 12 months when stored accordance with Section 4.5 and in Types I through IV in factory-sealed containers at temperatures between 40°F construction when installed in accordance with Section 4.6. (4.4°C)and-90°F(32.2°C). ]CC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use.There is no warranty by/CC Evaluation Service,LLC,express or implied,asa to any finding or other matter in this report,or as to any product covered by the report. mrc � 000 Copyright 0 2013 Page 1 of 6 ESR-1826 I Most Widely Accepted and Trusted Page 2 of 5 3.5.2 DC 315: DC 315 intumescent coating is a water- 4.4 Attics and Crawl Spaces: based coating supplied in 5-gallon (19L) pails and 4.4.4 Application with a Prescriptive Ignition Barrier: 55-gallon (208L) drums. The coating material has a:shelf When Icynene LD-C-50T"^ and LD-C-50 v2 foam plastic life of 24 months when stored in factory-sealed containers at temperatures between 41 OF(5°C)and 95OF(350C). insulations are-installed within attics where entry is made only for service of utilities, an ignition barrier must be 4.0 INSTALLATION installed in accordance with IBC Section 2603.4.1.6 and 4.1 General: IRC Sections R316.5.3 and R316.5.4, as applicable. The ignition barrier must be consistent with the requirements The manufacturer's published installation instructions and for the type of construction required by the applicable code this report must be strictly adhered to and a copy of these and must be installed in a manner so that the foam plastic instructions and this evaluation report must be available on insulation is not exposed. The insulation may be installed the jobsite at all times during installation. in unvented attics in accordance with the 2009 IRC Section 4.2 Application: R806.4 or 2012 IRC Section R806.5, as applicable. Icynene LD-C-50TM and LD-C-50 v2 foam plastic 4.4.2 Application without a Prescriptive Ignition insulations must be applied using spray equipment Barrier: Where Icynene LD-C-50,and LD-C-50 v2 foam specified by Icynene, Inc. The insulation must not be used plastic insulation is installed in an attic or crawl space in areas which have a maximum service temperature without a prescriptive ignition barrier, in accordance with greater than 180°F (82°C). The foam plastic insulation Sections 4.4.2.1, 4.4.2.2, 4.4.2.3 and 4.4.3, the following must not be used in electrical outlet or junction.boxes or in conditions apply: contact with rain or water, and must be protected from the 1. Entry.to the attic or crawl space is only for service of weather during and after application. Where the insulation utilities and no storage is permitted. is used as air-impermeable insulation, such as in unventilated attic spaces regulated by IRC Section R806, 2. There are no interconnected attic, crawl space or the insulation must be installed at a minimum thickness of basement areas. 3.5 inches (89 mm). The insulation can be installed in one pass to the maximum thickness. Where multiple passes 3. Air in the attic or crawl space is not circulated to other are required,the cure time between passes is negligible. parts of•the building. 4.3 Thermal Barrier: 4. Combustion air.is provided in accordance with IMC Section 701. 4.3.1 Application with a Prescriptive Thermal Barrier: Icynene LD-C-50Tm and LD-C-50 v2 foam plastic 5. Attic ventilation is provided when required by IBC insulations must be separated from the interior of the, Section 1203.2 or IRC Section R806, except when building by an approved thermal barrier, such as1/2-inch air-impermeable insulation is permitted in unvented (12.7 mm) gypsum wallboard'installed using mechanical attics in accordance with Section R806.4 of the 2009 fasteners in accordance with the applicable code, or an IRC or Section R806.5 of the 20121RC. equivalent 15-minute thermal barrier complying with the 6. Under-floor(crawl space)ventilation is provided when applicable code. When installation is within an attic or required by IBC Section 1203.3 or IRC Section crawl space as described in Section 4.4, a thermal barrier R408.1,as applicable. is not required between the foam plastic and the attic or crawl space, but is required-between the foam and the• 4.4.2.1 Attics — LD-C-50 and LD-C-50 v2: 1n attics interior of the building_ Thicknesses of up to 71/2 inches Icynene LD-C-50Tm LD-C-50 Q. foam plastic insulation (190.5 mm)for wall cavities and 111/2 inches(292 mm)for may be spray-applied to the underside of the roof ceiling cavities are recognized based on room corner fire sheathing and/or rafters, as described in this section. The testing in accordance with NFPA 286, when covered with thickness of the foam plastic applied to the underside of minimum '/z-inch-thick (13 mm) gypsum board or the roof sheathing must not exceed 14 inches (356 mm). equivalent thermal barrier complying with, the applicable The thickness` of the spray foam insulation applied code. to vertical wall surfaces must not exceed 5.5 inches (140 mm). The insulation must be covered on all surfaces 4.3.2 Application without a :Prescriptive .Thermal with one of the coatings described in Section 3.5. The Barrier or Ignition Barrier: The prescriptive 15-minute coating must be applied over the insulation in accordance thermal barrier or ignition barrier may be omitted when with the coating manufacturer's instructions and this report. installation is in accordance, with this " section. The Surfaces to be coated must be dry, clean, and free of dirt, insulation and coating may be spray-applied to the interior loose debris and other substances that could interfere with facing of walls, the underside'or roof sheathing'of roof adhesion of the coating. The coating is applied in one coat rafters, and in crawl spaces, and may be left exposed as with low-pressure airless spray equipment. The coating an interior finish without a prescribed 15-minute thermal must be applied to a thickness as follows: barrier or ignition barrier. The thickness of the foam plastic applied to the underside of the roof sheathing must not ■ No Burn;plus XD at a minimum dry film thickness of exceed 14 inches (356 mm). The.thickness of the spray 4mils(6 wet mils)at 270 ftz per gallon. foam insulation applied to vertical wall surfaces must not ■ DC 315 at a minimum dry film thickness of 3 mils(4 wet exceed 6 inches (152 mm). The foam plastic must be mils)at 400 ftz per gallon. covered on all surfaces with DC 315 coating at a minimum thickness of 13 dry mils, 20 wet mils, 80 ftz per gallon. The The coatings must be applied when ambient and coating must be applied over the insulation in accordance substrate temperature is at least 60°F (16°C) and no more with the coating manufacturer's instructions and this report. than 95°F (35°C). All other surfaces (including glass)must Surfaces to be coated must be dry, clean, and free of dirt, be protected against damage from the coating. The loose debris and other substances that could interfere with insulation may be installed in unvented attics when the adhesion of the coating. The coating is applied in one coat foam plastic is applied at a minimum thickness of 3.5 with low-pressure airless spray equipment. inches (89 mm) as described in this section in accordance Q ESR-1826 1 Most Widely Accepted and Trusted Page 3 of 5 with the 2009 IRC Section R806.4 or Section R806.5 of the face, attached with 8d box nails, 21/2 inches (64 mm) long 2012 IRC. and spaced 7 inches (178 mm) on center along the studs 4.4.2.2 Attics — LD-C-50.v2: When LD-C-50 v2 is for the face layer and 6d cement coated box nails,2 inches applied in unvented attics conforming to 2012 IRC Section (51 mm) long and spaced 24 inches (610 mm) on center R806.5 or 2009 IRC Section R806.4,the insulation maybe along the studs. The stud cavity contains Icynene applied to the underside of roof sheathing and/or rafters to insulation nominally 2 inches(51 mm)thick. a minimum thickness of 51/2 inches (140 mm) and a ,Axial loads applied to the wall assembly must,be limited minumum thickness of 11/2 inches (38 mm) over the to the least of the following: rafters; and may be applied to vertical wall surfaces to a ` minimum thickness of 51/2 inches (140 mm) and a 0 1,805 pounds(8029 N)per stud. minumum thickness of 11/2 inches(38 mm)over the studs. ■ Design stress of 0.78 PC. Maximum thickness on the underside of roof sheathing or on vertical wall surfaces is 20 inches (508 mm). The • Design stress of 0.78 Fc at a maximum Ie/d of 33. insulation may be left exposed to the attic.without a 4.5.3 Assembly 3 (Floor/Ceiling): Minimum nominally prescriptive ignition barrier or an intumescent coating. > > - 2-by-10 [1 /2 by 9 /a inches (38 mm by 235 mm)] Douglas The attic must have attic access complying with IRC fir, No. 2 grade wood joists spaced 24 inches(610 mm)on Section R807, horizontally placed in the floor; and opening center, with minimum 1-by-3 [3/4 by 21/2 inches (19.1 by outward toward the living space. Items penetrating the roof 64 mm)] spruce bridging at mid-span. Floor decking must be minimum '/2-inch-thick 12.7 mm exterior grade deck or walls, such as sk li ht wells and vents must be ( ) 9 Y9 covered with a minimum of 5'/2 inches (140 mm) of the plywood installed perpendicular to joists and fastened with LD-C-50 v2 insulation. 2-inch-long (51 mm)ring shank nails 6 inches(152 mm)on 4.4.2.3 Crawl Spaces: In crawl spaces, Icynene LD-C- center at the joints and 12 inches (305 mm) on center at 50 and LD-C-50 v2 insulation may be spray-applied to the intermediate joists. Plywood joints must occur over joists. Icynene insulation must be applied to the underside vertical walls and the underside of floors, as described in . of the plywood deck between the joists to a depth of 5 this section. The thickness of the foam plastic applied to inches (127 mm). Two layers of minimum 5/8-inch-thick the underside of the floors must not exceed 14 inches (15.9 mm), Type X gypsum wallboard must be attached (356 mm). The thickness of the spray foam insulation perpendicular to the joists on the ceiling side of the applied to vertical wall surfaces must not exceed 3 /2 assembly. The first layer must be attached with 1'/47inch- inches (88.9 mm). The foam plastic does not require an long (32 mm), Type W drywall screws, spaced 24 inches ignition barrier or a coating. (610 mm) on center. The second layer must be applied 4.4.3 Use on Attic Floors: When used on attic floors, perpendicular to the joists,offset 24 inches(610 mm)from Icynene LD-C-50W and LD-C-50 v2 foam plastic insulation the base layer. The second layer must be attached with may be installed at a maximum thickness of 111/2 inches 2-inch-long (51 mm), Type S drywall screws spaced'12 (292 mm)between joists in attic floors. The insulation must inches (305 mm) on center. Additional fasteners must be be separated from the interior of the building by an installed along the butt joints of the second layer, securing approved thermal barrier. The coatings specified in in the two layers together. These fasteners must be 1 1/2-inch- Section 4.4.2.1 and the ignition barrier in accordance with long (38 mm), Type G drywall screws placed 2 inches IBC Section 2603.4.1.6 and IRC Section R316.5.3, may be (51 mm) back from each end of the butt joint and spaced omitted. 12 inches(305 mm)on center. The wallboard joints on the exposed side must be treated with paper tape embedded . 4.5 One-hour Fire-resistance-rated Assemblies: , in joint compound and topped with an added'coat of 4.5.1 Assembly 1 '(Limited Load-bearing Wood Stud compound,.and,the fastener heads must be coated with Wall): Minimum nominally 2-by4 [11/2 by 31/2 •inches joint compound in accordance with ASTM C840 or (38 mm by 89 mm)]southern pine (G =0.55), No. 2 grade GA-216. studs spaced 16 inches (406 mm) on center with a base 4.5.4 Assembly 4 (Non-loadbearing Steel Stud Wall): layer of 1/2-inch-thick (12.7 mm) wood fiber sound board Nominally 6-inch-deep (152.4 mm), No. 18 gage, installed horizontally on each face. with vertical joints galvanized steel studs spaced 16 inches (406.4 mm) on located over the studs, attached with 6d box nails, 2 inches center, are .friction-fit into No. 18 gage.galvanized steel (51 mm) long and spaced 24 inches (610 mm) on center floor and. ceiling track with a. layer of 5/8-inch-thick along the studs, and a second layer of /8-inch-thick e (15.9 mm)Type X gypsum wallboard installed verticallyon (15.9 mm),T Yp X gypsum board applied to the interior side with,the long edge parallel to steel studs and secured each face, attached with 8d box nails, 2 /2 inches(64 mm)long and spaced 7 inches (178 mm) on center along the using No. 6, 1,/a-inch-long (31.7 mm), self- drilling drywall. studs. The stud cavity contains Acynene, insulation screws spaced 8 inches (203:mm) on center around.the nominally inches(51 mm)thick. perimeter and 12 inches (305 mm) on center in the field. The gypsum board joints must be treated with vinyl or Axial loads applied to.the wall assembly must be-.limited casein, dry or premixed joint'compound applied in two to the least of the following: coats to cover all exposed screw heads and gypsum board er stud; F. butt joints, and a minimum_ 2-inch-wide (51 mm) paper, E 1,805 pounds(8029 N)� plastic, or fiberglass tape embedded in the first layer of ■ Design stress of 0.78 Fc. compound over butt joints of the gypsum board: The stud ■ Design stress of 0.78 Fc at a maximum le/d of 33. cavity is filled with Icynene insulation up to 6 inches �152 mm) thick. DensGlass Gold Exterior Sheathing, 4.5.2 Assembly 2 (Limited Load-bearing Wood Stud /2 inch (12.7 mm) thick, is installed parallel to steel studs- Wall): Minimum nominally 2-by-4 [11/2 by 31/2 inches with vertical joints offset a minimum of 16 inches 406 mm) (38 mm by 89 mm)]southern pine (G =0.55), No. 2 grade from the vertical joints of the gypsum board and the studs spaced 16 inches (406 mm) on center with two horizontal joints offset a minimum of 24 inches (610 mm) layers of 1/2-inch-thick (12.7 mm) Type X gypsum from the horizontal joints of the gypsum board. The wallboard installed vertically with joints staggered on each sheathing is attached using No. 6, 04-inch-long ESR-1826 1 Most Widely Accepted and Trusted Page 4 of 5 (31.7 mm), self-drilling drywall screws spaced .8 inches 5.1 This evaluation report and the manufacturer's (203 mm) on center around the perimeter and in the field. published installation instructions, when required by Hohmann & Barnard DW-10 brick ties, 6 inches (152 mm) the code official, must be submitted at the time of long by 11/2-inches (38 mm) wide, are spaced 16 inches permit application. (406.4 mm) on center vertically on each steel stud, and secured, using two 1 s/8-inch-long (41.3 mm) self-drilling 5.2 The insulation must be installed in accordance with the manufacturer's published installation instructions, screws,through 4-inch (102 mm)red clay brick.[3/2 inches this evaluation report and the applicable code. If there (197 mm))]] laid in a running bond pattern with Type S ( m by 2 /a inches (57.1 mm) by.7/a inches is a conflict between the installation instructions and 97 � , mortar, leaving a nominally 1-inch (25.4 mm) air gap this report,this report governs. between the brick and the exterior sheathing. 5.3 The insulation must be separated from the interior of Optional: It is permitted to add code-complying, . •the building by an approved 15-minute thermal expanded polystyrene (EPS), extruded polystyrene (XPS), barrier, except when installation is as described in foil-faced, rigid polyurethane board stock or polyurethane in S described n Section 44 , Section 4 in attics and crawl spaces as spray foam on the exterior of the wall (between the . .2 and,4.I DensGlass® Gold sheathed wall and the brick), while. 5.4 Since the performance of LD-C-50 v2, when installed maintaining the 1-inch (25.4 mm) air space. The length of in unvented attics without a code-prescribed ignition the brick ties must be increased to account for. the barrier or an intumescent coating, is based on fire thickness of the insulation. performance of an unvented attic, the installation 4.6 Exterior Walls in Type I,11, 111 and IV Construction: must be approved by the code official as conforming with the provisions of Section 4.4.2.2 and Conditions 4.6.1 General:When used on exterior walls of Types I, II, 1 to 5 of Section 4.4.2. III or IV construction, the assembly must comply with IBC 5.5 The insulation must not exceed the thickness and Section 2603.5 and this section, and the LD-C-50 and density,noted in Sections 3.2,4.3, 4.4,4.5 and 4.6. LD-C-50 v2 insulation must be installed at a maximum thickness of 6 inches (152 mm). The potential heat of 5.6 The insulation must be protected from the weather Icynene LD-C-50 and LD-C-50 v2 insulation is 494 Btu/ft2 during and after application. (5.6 MJ/m2) per inch of thickness, when testing is in 5.7 The insulation must be applied by licensed dealers. accordance with NFPA 259. and installers certified by Icynene, Inc. 4.6.2 Exterior Face: Nominally 6 inch-deep (152 mm), 6.8 Use of the insulation in areas where the probability of No. 18 gage, galvanized steel studs spaced 16 inches termite .infestation is "very heavy' must be in (406 mm) on center, are fastened to No. 18 gage, accordance with IRC Section R318.4 or IBC Section galvanized steel floor and ceiling track using No. 8, 2603.8, as applicable. /8-inch-long (22.2 mml, self-tapping pan head framing screws. GP DensGlass Gold Exterior Sheathing, 1/2 inch 5.9 Jobsite certification and labeling of the insulation must (12.7 mm) thick, is installed over the exterior side of steel comply with IRC Sections N1101.4 and N1101.4.1 studs with the long end perpendicular to the steel'studs, and IECC Sections 303.1.1 and 303.1.2, as using No. 6, Type S, 11/4-inch (31.7 mm), self-tapping applicable. bugle head screws spaced 8 inches (203 mm) on center 5.10 When, LD-6-50 v2 insulation is installed under around the perimeter and in the field. The stud cavity is Section 4.4.2.2 of this report, a certificate must be filled with Icynene insulation to a nominal thickness of placed in the attic'stating that the foam plastic 6 inches(152 mm). insulation has been installed in accordance with 4.6.3 Interior Face: Type X gypsum board, 5/8 inches Conditions 1 to 5 of Section 4.4.2 and the terms of (15.9 mm) thick, is installed with-the long dimension Section 4.4.2.2 of ESR-1826; any alterations to the perpendicular to steel studs with No. 6, Type S, 11/4 inch- attic or insulation must be consistent with those long (31.7 mm), self-tapping, bugle head screws spaced 8 requirements. inches(203 mm)on center around the perimeter and in the 5.11 A vapor retarder must be installed in accordance field. The gypsum board joints must be treated with vinyl or with the applicable code. casein, dry or premixed joint compound applied in two coats to cover all exposed screw heads and gypsum board 5.12 Icynene LD-C-50 and -LD-C-50 v2. foam plastic butt joints, and a minimum 2-inch-wide (51 mm) paper, " insulation are manufactured in Mississauga,Ontario, plastic, or fiberglass tape embedded in the first layer of Canada, under a quality control program with compound over butt joints of the gypsum board.. inspections by lntertek Testing.Services(AA-691). 4.6.4 Exterior Wall Covering: Details of the exterior wall 6.0 EVIDENCE SUBMITTED covering must be provided to the code official by the report 6.1 Data in accordance with the ICC-ES Acceptance holder, designer or specifier, with an engineering analysis Criteria, for Spray-applied Foam Plastic 'Insulation demonstrating that (1) the exterior wall:covering conforms (AC377), dated June 2012, including reports of tests to ASTM E136 and (2)the addition of the wall covering to in accordance with Appendix X (Section 4.4.2.1),and the assembly described in this section does not negatively Appendix C(Section 4.4.2.2). affect conformance of the assembly with the requirements of IBC Section 2603.5. 6.2 Test report on air leakage rate in accordance with ASTM E283. 5.0 CONDITIONS OF USE 6.3 Reports of room corner fire testing in accordance with The Icynene LD-C-50Tm and LD-C-50 v2 spray-applied NFPA 286. polyurethane foam.plastic insulations described in this report comply with, or are suitable alternative to what is 6.4 Test reports in accordance with ASTM E119. specified in,those codes listed in Section 1.0 of this report, 6.5 Test report in accordance with NFPA 285, and related subject to the following conditions: engineering analysis. ESR-1826 1 Most Widely Accepted and Trusted Page 5 of 5 6.6 Reports of tests in accordance with NFPA 259. 8.2 Uses: 6.7 Reports of fire tests in accordance with ASTM E970. The products comply with the above-mentioned codes as 6.8 For LD-C-50 v2, an engineering evaluation, including described in Sections 2.0 to 7.0 of this report, with the full-scale fire testing, small-scale testing and fire revisions noted below. modeling. ■ Application with a Prescriptive Ignition Barrier: See 7.0 IDENTIFICATION Section 4.4.1, except attics must be vented in accordance with 2006 IBC Section 1203.2, and crawl All packages and containers of lcynene LD-C-50W and space ventilation must be in accordance with 2006 IBC LD-C-50 v2 must be labeled with the lcynene, Inc., name Section 1203.3, as applicable. Additionally, an ignition and address; the product name; the flame spread index barrier must be installed in accordance with 2006 IRC and the smoke-developed index; the shelf life expiration Section R314.5.3 or R314.5.4, as applicable. date; the label of the inspection agency (Intertek Testing Application without a Prescriptive Ignition Barrier: Services); and the evaluation report number(ESR-1826). See Section 4.4.2, except attics must be vented in Intumescent coatings are I identified with the accordance with Section 1203.2 of the 2006 IBC or manufacturer's name and address,the product trade_ name Section R806 of the 2006 IRC, and crawl space and use instructions. ventilation must be in accordance with Section 1203.3 of 8.0 OTHER CODES the 2006 IBC or Section R408 of the 2006 IRC; as applicable. 8.1 Scope: ■ Jobsite Certification.and. Labeling: See Section 5.8, In addition to the codes referenced in Section 1.0,'the except jobsite certification and labeling must comply products recognized in this report were evaluated for with Sections 102.1.1 and 102.1.11, as applicable, of compliance with the requirements of the following codes: the 2006 IECC. ■ 2006 International Building Code®(2006 IBC) ■ Protection Against Termites: See Section 5.7, except ® use of the insulation in areas where the probability of ■ 2006 International Residential Code (20061RC) termite infestation is "very heavy" must be in ■ 2006 International Energy Conservation Code® accordance with Section R320.5 of the 2006 IRC. (2006 IECC) Al TABLE 1—THERMAL RESISTANCE(R-VALUES)FOR LD-C-50 and LD-C-50 v2 THICKNESS(inches) R-VALUE(°F•ft2•h/Btu) 1 3.7 2 7 3 11 3.5 13 4 14 5 18 5.5 20 6 22 7 25 7.5 27 8 29 9 32 .9.5 34 10 36 11.5 41 14 50 ,,20 74 For SI: 1 inch=25.4 mm,1°F•ft2•h/Btu=0.176 110°K•m2NV. 'R-values are calculated based on tested Kvalues at 1-and 3.5-inch thicknesses. 2R-values greater than 10 are rounded to the nearest whole number. Roo `S= International fireproof Technology, Inc Paint To Protect'"" y 17528 Von Karman Ave.Irvine,CA 92614 949-975-8588 DC 315 applied over Spray:Polyurethane Foam (SPF), If a coating has not passed a full scale test on a manufacturer's foam it r is,an Alternative.,Barrier System -in "Section 2603.9 4 cannot be used on that foam;there are no exceptions in the IBC Code `E3 Special Approval" as a thermal, barrier.-To be:approved g ormance Requirements for SPF: as an Alternative Barrier System,.DC 31S is applied over The'I"W adt onlal 6i ding Code (IBC) mandates that SPF be separated a manufacturers SPF and tested to the criteria,of an from the interior of the,building by a 15"minute thermal barrier,or other Ec I ' NFPA 286, UL 1715, UL 1'046, or FM 4880.for duration approved•cove ring.„,;DC 315 passed certified NFPA 286 and UL 1715'test ti of 15 minutes by an accredited fire testing facility. over a vanety.of open and„closed cell-spray applied urethane-foams that Products that pass an ignition'barrier tested under AC w .._ were conducted by ISA certified testing facilities. All tests performed 377 Appendix X are. not appropriate alternative comply with the requirements of 2006 IBC Section 803.2.1 & 2009 IBC thermal barriers and cannot be used..Depending,on,your particular ,:' Section 803.152,and Section 2603.9;2012 IBC Section 803.1.2 and Section application, either-ignition.or thermal barriers are.required.by the '2603 10 under ."Special Approvals for Thermal Barriers over Foam International Building Cade (IBC). .Plastics". DC-315-is WHI marked and-certified via 3`d- party inspection for Properties Value quality assurance and consistency. Finish Flat Alternative 15 min Thermal Barrier Assemblies(e.g:Exposed SPF or SPF with a Thermal Barrier Protective Covering) Color Ice Grey The assembly mustremain in place for 15,minutes during specified large- V.O.C. 7g/L fire tests;,such as.NFPA 286,UL 1715,UL,1040,or FM 4880- _. 4.N ,scale;r' Solids ByVolume 67% Alternative Ignition Barrier Assemblies DC 315'-meets he'requirements j for,ignition barrier per AC 377,Appendix X `Specific'Gravity. "1.30+/-0.05 g/cc z Application Equipment Drying Time @77'F& 50%A.H.—To touch 1.=2 hours ,to- DC,y315 can be,applied by brush,roller or airless sprayer.,: recoat if required 2 to 4 hours „ For maximum yield and coverage spray application,is recommended. Flash Point .,'None '.Sprayers:, Reducing or Cleaning Water, Pump,d (Graco)UltraMax 695 or equivalent PSI: 3000 Shelf Life 1-year from date of manufacture in "unopened containers and stored at,:10"C to 27.°C(5071to, - GPM: " 100 , 0, Tip: 517 r,521,or equivalent: S Gal.Container Weight 8lbs. Filter: 30 mesh,removal of filter is recommend from gun and machine; Advantages of Using,DC315 SPF Hose: 3/8"diameter airless spray-line for the first 100'-from pump and%„x 3,whiP ■ DC 315 is the only 3`. party inspected fire protective coating for SPF Pump: (Graco)TexSpmy Mark 5 or equivalent ■ Marked and Listed by Warnock Heresy Intertek W/N;20947 PSI: 3300, t • Single coat coverage reducing labor and material"costs equaling GPM:, 1:35: - higher profits Tip „517-523 or.equivalent. Industry leading spread rate 1. Filter Passed CAL 1350 safe for use in schools and high'occupancy 30 mesh,removal of filter is recommend from gun"and • machine,. buildings • Passed strict EPA—V.O.C,and AQMD air emission requirements(for , Hose:. 3/8"diameter airless spray line for:the first 100'from pump all 50 states) and'/+"x3'whip. ■ Approved for Incidental Food Contact complies with NSF/ANSI-51 Pump: (Graco)GMAX 7900 or equivalent i requirements of USDA • Easily applied with a sprayer,"roll'er,or bftush with no complicated PSI:v 3300" € mixing GPM:' 2.2 • 1 year shelf life Tip: 517 529 or equivalent ■ Fast and easy clean-up,with no waste and fast tuenaroundtime Filter 30 mesh,removal of filter"is recommend-from gun 'and • Compatible with any paintable construction mater-ial machine' > ■ Meets Life Safety Code 101 Hose ''3/8'diameter airless spray line'for the first 100'300' from ■ Meets LEED's point requirements , pump and/ x 3'whip • ,. No formaldehyde Pump (Graco)GH 833 or equivalent DC 315 is the'mosttested and approved p'roduct"in the world for use as PSI: ,4000 an,"Alternative Thermal Barrier Coating System.over Spray ; `: GPM... . 40 ,.. Polyurethane Foam(SPF). Tipi 517 529orequivalent. Filter 30 mesh,'removal of filter is recommend-from gun,and Visit us atour website www.painttoprotect.corr1 to 6btain'a current rnbtrIX machine of all the=manufacturer5j9ams DC.315 has been tested and approved as - Thermal or Ignition barriers in compliance with current.IBC codes .. Hose 3/8"diameter airless spray line for,the first.100'-300: from - >_, pump and X x 3'whip Prior to Applying DC 315 to Ensure Proper Adhesion .Surfaces must r. - General Safety,Toxicity;Health Data be clban,-dry and free of all foreign"matter.Adhesion of a coating to SPF Material Safety:Data Sheets are available on this coating material. Any requires the foam surface to have a slight profile or texture similar to:en individual who may come in contact with,these products should read and tt orange peel. Smooth or glossy foam surfaces must be flash coated with a understand the M S:D 5: In°case of emergency contact CHEMTREC` g light 3 -4 mils Wet Film Thickness.(WFT) of-DC 315 and allowed to dry EMERGENCY NUM BER..at 800-424-9300: i before applying the full application.- Flash coating is a quick burst of a primer or DC 315,via airless sprayer over an,area needing treatment We WARNING Do not allow product to freee.Store above l0°C(50°F)at all also recommend flash coating around all pipes and air ducts. times Product Application WARNING"Avoid eye'contact with the,liquid or spray mist. Applicators In order to validate warranty and confirm the installation complies with . should wear-protective clothes,`gloves and use protective cream on face, IFTI's best practices installer must obtain,and read all curreritinstallation hands'and other exposed areas: documents.Installation documents include L Application Guide,' EYE PROTECTION:k` Ventilation Guide and Job Work Report These documents can be downloaded_it www.painttoprotect.com or by : Safety glasses;goggles,or a face shield are recommended calling IFTI at 949:975.8588. "Job Work Records ar'e'.an excellent way to SKIN'PROTECTIONr track your:installations and confirm compliance to your Building Official or ; Chemical resistant gloves.are recommended; cover as much of the I Authority Having Jurisdiction. In the,event':of a;concern on a job`,the exposed skin'area as.possible writh appropriate clothing:, installer is-able to provide documented proof of the installation;for this's` reason IFTI recommends using these forms for all thermal barrier jobs." RESPIRATORY PROTECTION is MANDATORYi Respiratory.protective equiprn6nt,•impervious foot wear and protective Material`Preparation clothing are regwred at.ail times duringspray application. DC315 must be thoroughly,,mixed prior to application,;Failure to-do,so`innll x L. compromise the>materials' performance_ and"may?.create issues with° INGESTION:Do not take internally equipment used for the application'of the poduct Mechanical'stirring �� •-: ,With a high speed drill and a paddle,'approprike, for•the container,siie is Consider the application and.environm'ental concentrations in deciding if recommended. Material should be stirred;from therbottorn up mayk ng additional protective measures are necessary. sure the bottom and sides are scraped with a:paint stick during the mixing .process -to ensure all materials are completely mixed prior:to',.the Limited Warranty '} I application. Material should be mixed to a'creamy-consistency with no " This product will perform as tested if applied and maintained according to lumps. Thinning is not usually needed, but if tFie material'has been our directions;instructions and techniques:If this product is found to be exposed to prolonged periods of high temperatures:during:storage, defective`upon inspection by its representative, the seller will, at its evaporation of the waterbased material may have taken place.Typically• option,eitFier furnish an'equivalent amount of new product or refund the the liquid level should be'about 3 inches from the top ofthe 5 gallon pail: purchase price to the original,purchaser of this product.Seller will not be If the level of'materiai is lower,water may be iccled-clurini the mixifi jto liable for any representations made by any'retail selle'ror;applicator of the' address this issue. product.THIS WARRANTY EXCLUDES (1) LABOR OR COST OF LABOR FOR THE'APPLICATION,OR REMOVAL OF THIS.PRODUCT ;OR.ANY OTHER . Temperature andMUinidity PRODUCT,-THE REPAIR OR REPLACEMENT OF ANY Y SUBSTRATE,TO WHICH' Ensure temperature and humidi ty are within specified limits for THE' PRODUCT IS ,APPLIED" OR THE APPLICATION OF REPLACEMENT -application. Failure to monitor and`compensate for increased humidity PRODUCT, (2f ANY INCIDENTAL,OR,CONSEQUENTIAL DAMAGES. OTHER may lead'to blistering and/or'delamination and will void warranty.-Obtain —LIMITATIONS APPLY.For the complete terms of.the limited warranty,go to a ventilation guide prior to commencing installation. Ideal tonditions are wwwmainttobrotect.com.' Some 'states/provinces do not allow the 16°C-32°C(62°F to 90°F)and a maximmu of 65%Relative Humidity. exclusion or limitation of incidental,or'consequential damages, so the above limitations may not apply to you.'To make a.warranty claim,write Ventilation to Technical`Service,`International Fireproof Technology; Inc., 1Z528 Von When.spraying in enclosed spaces,regardless of size~adequate ventilation.' Karnian Avenue, Irvine, CA: '92614 or email Customer Service at is required to remove excess moisture,from the application area.The use.- of,fans may be required in some cases to ensure a'minimum,of 0.3`air changes per hour: Prior to starting<a job please'be'sure:to"download a complete current ventilation guide:at wwwpainttoprotect.com s -f f - Rev:11/25/2014-9:41 AM- Job.Work Record Should be Filled Out For Each'and Every Job:Completed Work Records Must.be Submitted To workrecords@painttoprotect.com Within 10 Days;of Job Completion. f 1202014 APPROVED(SPF) R �tr10 i, I IT" ri, I I r I I x 6 yaj�k. `` r 1 ' • • 1 r - r I r 11 I I t t i i i J APPROVEQ, TEGHNIGAL INTERNATIONAL -VIDEOS HOME-".' - a- s PRODUCTS GOIHTAGT FIREST.OP (SPF) DATA 'DISTF3BUTQRS' _ -'A PRESS RELEAS � sRil rs StG1T1S ern r nv r ii c a� ` Y m PREMIUM P L tl 8`6PRA�iOAM I �:... dGreen � GUARDIAN Kz NcC)F' „A a CertainTeed�O hnsMartvltteii��H�� �� „ ni m Ul(ll(t ,� Q,u.w r s.otnco �Lll.o YY L'.J 1 L, _ <.., * $� ELASTOClEM dF`K, • ,/ �Rh�no 11 Ic ` -ayMg t' �= Sprc�yFonmPolymers CORB0 YNENEa ,., e«�^'^' own oa p 2rove oam Matrix DC315 Approved Foams Testing Matrix s PAINT TO PROTECT DC315 THE PROOF IS IN THE TESTING a All tests were full scale,which are required to comply with all requirements of 20061BOSection 803.2.1;2009 IBC Section 803.1.2 and Section 2603.9;2012 Section 803.1.2 and Section 2603.10 Special Approval for Thermal Barrier Alternatives.DC315 also meets the requirements as an Ignition Barrierper AC T (,Appendix X at an Incredible spread rate of 400.sq.ft.per gallon. As an Industry we have an obligation to our end users safety. Intumescent coatings offer the Spray Polyurethane Foam (SPF)industry'a.more economical solution to Code Com Barriers,and a method to apply a barrier where access is difficult. Sorting through the codes on when and where an Ignition and Thermal Barrier is required is hard enough,but buying a c is simple if you remember to always lead with one simple question;"Has your coating been tested on the foam being used Approved(SPF)Spray Foam Manufacture and Type Wet ON Coverage Rate. ITest Reports with DC315 as Alternative Thermal Barrier ES Report Air Tight CC 2 Ib. 18 12 89 sq,ft.per gal Thermal Barrier DC 315 Firelok&Air Tight CC 2 lb. ESR 2629 Air T1ghY0C 0.5 lb. 1 20, 13 80 sq.ft.per gal jThermai Barrier De 315 Firelok&Air Tight OC O.S lb. ESR 2947 Arnette Agriculture Base CC 2 lb. 20 13 180mft.pergal Thermal Barrier Aroette Agriculture Base CC;Ib. BASF Enertite°US OC 0.5 lb. 21 13 76 sq.ft.per gal Thermal Barrier BASF Enertite°US OC O:S 16, ESR 3102 BASF Enertite°NM OC 0.5 lb. 18 12 89 sq.it.per gal Thermal Barrier BASF Enertte°NM OC-0.S Ib. ESR 3102 BASF 158 Spraytite®CC21b. 20. .13 80 sq.ft.per gal Thermal Barrier BASF Spraytlte6150 CC 2 lb. . . BaySeal"OC 0.5 lb. 22 14 73 sq.ft.per gal ; Thermal Barrier Bay5eal-OC 0.5 lb. ESR 1655 BaySeah CC 2 Ib. : .18 12 .89.sq.ft.per gal Thermal Barrier BavSeal-CC 2 lb. ESR 2072 BaySeal CC Polar 2 lb., 18 12 89 sq.ft.per gal Thermal Barrier BaySeal-CC Polar 2 lb. ESR 2072 - BaySeal-CC X 2 lb. 18 12 89 sq.ft.per gal Thermal Barrier BaySeal-CC X 2 lb. ESR 2072 BaySeah CC XP 2 lb. 18 12' 89 sq.ft.per gal : Thermal Barrier BavSeal-CC XP 2 lb. ESR2072 Convenience Touch N'Foam Professional Class I FR CC 2 lb. 20 13 80 sq.ft.per gal ThetmaLBarrier Touch N'Foam Class I FR CC 2 lb. Convenience Touch N'Seal Class l FR CC 216. 20 13 80 sq.it.per gal Thermal Barrier Touch W Sgal Class I FR CC 2lb DOW Styrofoam CM 2045 CC 2.lb. 18 12 89 sq.ft.per gal Thermal Barrier DOW Styrofoam CM 2045 CC 2 lb. ESR 1659 DC 315 Primer 4 �40 sq.ft.per gal DOW Therinax'"Insulation Board 18 12 89 sq.ft.per gal Thermal Barrier DOW Thermak-Insulation Board ESR 1659 DC 315 Primer 4 3 .400 sq.ft.per gal EcobayTm CC 2 lb. :18 12. 89 sq.ft.per gal Thermal Barrier EcoBay-CC 2 lb. ESR 3076 EcobayTm CC Polar 2 lb.- 18 12 89 sq.ft.per gal Thermal Barrier EcoBae CC Polar 2 lb. ESR 3076 . Elastochem Insulthane CC 21b. 18 12 89 sq.ft.per gal Thermal Barrier Elastochem'"Insulthane CC 2 lb. ESR 3541 Elastochem Proline Plus CC 21b.' 18 12 89 sq.ft.per gal Thermal Barrier Elastochem'"Prollne Plus CC 2 lb. ESR3541 Gaco Western 183M CC 2 Ib. 20. 13 80 sq.ft.per gal Thermal Barrier Gaco Western 183M CC 2 Ib. .. IRR-1002 Gaco Fire5top2 S0010.5 Ib: 18 12 89 sq.ft.per gal Thermal Barrier Gaco Firestop2 50010.5 lb. :: IRR-1009 Gaco Pro Max 5002 0.5 lb. 18 12 89 sq.ft.per gal Thermal Barrier Gaco Pro Max 5002 0.5 lb. IRR4008 Gaco Green 052 OC O.S lb. 20 13 80 sq.ft.per gal Thermal Barrier Gaco Green 052.OC 0.5 Ib; ESR.2478_ Gaco Green 052N OC 0.5 lb. 20. .13 80 sq.ft.per gal Thermal Barrier Gaco Green 052N,OC 0.5 lb. . .. ESR 2478 .`.. . GuardFoam SS CC 2 lb. 18' 12 89 sq.ft.per gal : Thermal Barrier DC 315 Firelok&GuardFoam CC 21b. ESR 2629 GuardFoam 55 OC 0.5 lb. 20 13 80 sq,ft.per gal Thermal Barrier DC 31S Flrelok&GuardFoam OC 0.5 Ib.' ESR.2827 Guardian Energy Technologies Foam It Green Class I CC.2 lb. IF 20_ 13 80 sq.(t.per gal Thermal Barrier Foam It Green Class I CC 2 lb. http://wWw.pai nttoprotebt:com/APPROVED-SPF-_%approved-spf-_.htm l - 1/3 12/3/2014 APPROVED(SPF) . Flenry Permax CC 1.8 lb. 18 11 12 1189 sq.ft.per gal (IThermal.Barrier Henry Permax CC 1.8lb.: I ESR 3547 Henry Permax CC lb. 18 12 .1189 sq.ft.per gal Thermal Barrier Henn Permax CC 2 Ib. ESR 3S47 Henry Permax LV OC 0.5 lb. 18. 12 89 sq.ft.per gal Thermal Barrier Hennt.Permax LV OC 0.S lb. ESR 3646 Icynene ProSeal(MD-C-200 V3)CC 2.0 lb. 24 15 67 sq.ft.per gal Thermal Barrier IoMene ProSeal(MO-C-200 V3)CC 2.0 lb. ESR 3S00 Icynene ProSeal Eco(MD-R-210)CC 2.0 lb. 22 14 73 sq.ft.per gal 11nermal Barrier Irynene MO-R-210002 lb ESR 3493 MD-R-210 must be flashed with 4 mils of OC 315 or primed with 4 mils of a Primer let dry for 20 minutes before applying DC US Icynene LO-C-50-OC 0.5 lb. 20• 13 80 sq.ft.per gal Thermal Barrierlcvnene LD-C-SO"OC 0.S Ib. ESR 1826 Icynene Classic Max OC 0.5 lb.(LD-C-so"v2) 20 13 80 sq.ft.per gal : Thermal Barrier Irynene Classic Max OC 0.5 Ib:(LD-C-SD®v2) ESR 1826 Icynene Classic OC 0.S lb. 20 JF_13 80.sq.ft.per gal Thermal Barrier icvnene Classic OC O.S Ib. . ESR'1826 Icynene Classic Eco OC 0.5 lb. 20 13 8o sq.ft.per gal Thermal Barrlerirynene Classic Eco OC 0.S lb. ESR 1826 Icynene Classic Plus OC 0.5 lb. 20 13 80 sq.ft.per gal Thermal Barrier Icvnene Classic Plus OC O.S lb;, ESR 1826 1M Corbond MCS- CC 2 lb. 22 14 . 73 sq.ft.per gal Thermal Barrier JM Corbond MCS- CC 2 lb. ESR 3159 M ocSPF-OC 0.S Ib. 2I 14 73 sq.ft.per gal Thermal Barrier JM ocSPF-OC 0.5 lb.' ESR 3086 JM Corbond III CC 2 Ib.. 18 12 89 sq.ft.per gal Thermal Barrler JMCorbond III CC 2 lb. 18 12 89 sq.ft.per gal Lapolla FL 2000 C[2 lb. Thermal Barrier DC 315 Firelok&Lapolla FL 2000 CC lb: ESR 2629 Lapolla FL 2000 Solstice 4 G CC 2 lb. 18 12 89 sq.ft.per gal Thermal Barrier DC 315 Firelok&Lapolla FL 2000 4-G CC 2[be Lapolla Open Cell Retrofit Foam 20 13 80 sq.ft.per gal Thermal 8arrierDt 3IS Firelok&Lapolla OC Retrofit Foam ESR 2847 Lapolla FL SOO OC 0.5 lb. 20 13 80 sq.ft.per gal Thermal Barrier Dc 315 Firelok&Lapolla FL SOO OC o.5 lb. ESR 2947 Natural Polymers Natural Thermal CC 2 lb. 21 13 76 sq.ft.per gal Thermal Barrier Natural Thermal CC 21b Natural Polymers Natural Thermal OC 0.5 lb. 20 13 80 sq.ft.per gal Thermal Barrier Natural Thermal OC 0.5 lb. Natural Polymers Nu-Seal TM 0.50 PCF 20 13 80 sq.ft.per gal Thermal Barrier Nu-Seal-0,50 PCF Natural Polymers Nu-Seal-2.0 W PCF 21 13 76 sq.ft.per gal Thermal Barrier Nu-Seal"2.0 W PCF NCFI InsulStar®CC 2 lb. 18 12' 89 sq.ft.per gal Thermai Barrier&NCFI InsulStar"CC 21b. ESR161S NCFI InsulBloce CC 2lb. 18 12 89 sq.ft.per gal Thermal Barrier NCFI InsulBloc°CC 2lb. ESR 161S NCFI Sealite-OC O.5 lb. 22 14 73 sq.ft.per gal : The!Mal Barrier NCFI Sealltee OC O.S lb. . ESR 11S4 Premium Foamsulate-210 CC 216.. ..20 11 80 sq.ft.per gal .. Thermal Barrier Premium FoamsulaWl 210 CC 2 lb. Premium Foamsulate-220 CC 2 lb. 18 12 89 sq.ft.per gal Thermal Barrier Premium Foamsulate"220 CC 2 lb. Premium Foamsulate-50 OC 0.5 lb.:. 20. 13 80 sq.ft.per gal Thermal Barrier Premium Foamsulate^'50 OC 0 Sib Quadrant,Quadfoam CC 2 lb. 18 12 189 sq.ft.per gal The mal Barrier Quadrant Quadfoam CC 2 Ib, ESR 0272 Quadrant,Quadfoam 500 OC 0.5 lb. 16 11 100 sq.ft.per gal Thermal Barrier Quadrant,Quadfoam 500 OC O.S lb. ' ESR 0271 DC 31S.Primer 4 11 2 1 400 sq.ft.per gal Quadrant,Quadfoam NatureSeal 500 OC 0.5 lb.: 16 11 100 sq.ft.per gal Thermal Barrier Quadrant,NatureSeal Quadfoam SOO OC 0.51b. ESR 0285 DC 315 Primer 4 2. 400 sq.ft.per gal; Rhino Linings--DuraTite®2.0 CC 2 lb.g 20.. 13 80 sq.ft.per gal Thermal Barrier.DuraTite 2.0 CC 2.Ib. Rhino Linings-BloBased 5010 OC O.S lb. 16; :12 89 sq.ft.per gal Thermal Barrler SO1We OC 0.5 lb. Specialty Products,Inc.(S.P.I.)ENVELO-SEAL CC 2 lb. 21. 13 76 sq.ft.per gal Thermal Barrier(S.P.I.)ENVELO-SEAL CC 2 lb. Sucra5eal OC 0.05Ib. 18 12 89 sq.ft.per gal Thermal Barrier Sucra5eal OC 0.05 lb Sucra5eal CC 2 lb. 18. 12 189 sq.ft.per gal Thermal Barrier Sucra5eal CC 2 lb. SWD-QulkSheld 106 OC 0.9 lb. 24 15 67 sq.ft.per gal Thermal Barrier SWD QuikShleld 106 OC O.S lb. SWD-QuikSheld 112 CC 2Ib. 22, 14. 73 sq.ft.per gal Thermal Barrier SW D QuikShleld 112 CC 2Ib. DC 31S Primer 4. 2 400 sq.ft.per gal IThermo5eal 2000/2100 CC 21b. 18 12 89 sq.ft.per gal Thermal Barrier ThermoSeal 2000/2100 CC 21b.. .. Thermo5eal 500 OC 0.5 lb. 18 12 89 sq.ft.per gal Thermal Barrier ThermoSeal SOO OC O.S lb. ITVM Building Mega Fill Pro FR CC 2 lb. (I:'20 II 13 �80 sq.ft.per gal : Thermal Barrier TVM Building Mega Fill Pro FR CC 2 lb' Versi-Foam®Class I CC 2 lb. 20. 13 1180 sq.ft.per gal Thermal Barrier Versi-Foam®Class i CC 2 Ib Approved(SPF)Spray Foam Manufacture and Type Wet Dry Coverage Rate Test Reports With DC 31S to Appendix X Ignition Barrier ES Report Air Tight OC 0.S lb: 4 3 . 400 sq.ft.per gal Ignition Barrier DC 31S Firelok&Air Tight OC 0.5 lb. ESR 2847 BaySeal"'OC 0.5 lb. 3 400 sq.ft.per gal Ignition Barrier Bayleal"OC.OS lb. CertalnTeed,CertaSpray O¢0.5 lb4 ;.3 400 sq.ft.per gal Ignition Barrier CertainTeed,CertaSoray OC O.S lb.: Gaco Pro Max 5002 OC O.S Ib 4 3' 400 sq.ft per gal Ignition Barrier Gaco Pro Max S002 OC 0 5 lb, Gaco Green 052N OC 0.5 Ib. 4 3 400 sq:ft.per gal ignition Barrier Gaco Green 0521409 0.5 Ib. ESR 2478 Guardfoam 55 OC,0.5 lb. 4 ' 3 400 sq.ft:per gal ignition Barrier DC 31S Firelok&Guardfoam 5S OC 0.5 Ib. ESR 2947 Henry Permax OC 0.5 lb. 4 3 .400 sq.ft.per gal. Ignition Barrier Henry Permax OC 0.5 Ib.. Henry Permax LV OC O.S:Ib 4 3 400 sq.it.per gal Ignition Barrier Henry Permax LV OC 0.5 lb: -, ESR 3646 http:/Mrww.pairlttoprotectcom/APPROVED-SPF-lapproved-spf-_.titml 213 12/3/2014 APPROVED(SPF.) . K licynene,LD C_50 OC 0.5 lb. (I" II I400 sq.ft.per gal Ignition Barrier Icynene.LD C 50 OC 0.5 lb. ESR 1826 Icynene,LD R_50 OC 0.5 lb. 8 5. 200 sq.ft.per gal I nation Bawler I ene,LD R 50 OC 0.5 lb.' ESR 2715 Icynene Classic Max OC 0.5 Ib.(LD-C-50*v2) 4 3 400 sq.ft.per gal lenRion Barrier Icynene,LC 70 OC 0.7 lb. ESR 1826 Icynene,L C 70 OC 0.7 lb. 4 3 400 sq.ft.per gal ignition Barrier Icynene MD-R-200 CC 2 lb. q .8 cynene Classic Max OC 0.5 Ib.LD C-50 v2 ESR 3493 Icynene,MD-R-200 CC 2 lb. 4 3. 400 s .ft.per gala I ninon Barrier I Icynene ProSeal(MD-C-200 V3) 6 11 4 268 sq.ft,per gal Ignition Barrier Icynene ProSeal(MD-G200 V3) ESRB500 JM Corbond III CC 2 ib. 4 3 400 sq.ft.per gal i nitlon Bawler JMCorbond III CC 2 lb. Lapolla,FL 500 OC 0.5 lb. 4 3 400 sq.ft.per gal Ignition Barrier OC 315 Firelok&Lacolla.FC500 OC 0.5 lb_ ESR 2847 NCFI Sealite-OC O. lb. 4 3. 460 sq.ft.per gal Ignition Barrier NCFI Seailte-OC 0.S lb .. Premlum Foamsulate—50 OC 0.5 lb. 4 3 400 sq.ft.per gal Ignition Barrier Premium Foamsulatef SO OC 0.5 lb. Quadrant,QuadfoamS00 OC 0.5 lb. 4. 3 400 sq.ft.per gal Ignition Barrier Quadrant.,Quadfoam 500 OC 0.5 lb.... ESR 0271 Rhino Linings-BloBased 5010 OC 0.5 lb. 4 3. .400 sq.ft.per gal, !gnitlon Barrier 501WO OC O.S lb. w. http://w m.painttoprotectcom/APPROVED-SPF-/approved-spf-_.html 313 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parc I A) Permit# 7`W C�4 Health Division �N��DO Date Issued _&;�� - °Conservation Division �� Application Fe - Tax Collector /D%7/OS Permit Fee , e� Treasurer P Planning Dept. Date Definitive Plan Approved by Planning Board - Historic I N TCJ�'``0 4regfvatio N/ annisoy- 00 IbI Zt) Wt Project Street Address . _760A S0 JTT+ M A i K) 5Tf_i6l_ _(�VwV-r gAJ Village C c N 7E-P\f t Lt E Ph 0"2-6 3 Z Owner W I LL4 A M /kND S u SArl 6-0L_D9Au ME-aCT Address -7()0 SOs'1-- PAIN SF. ' Telephone 50 cf5 N Permit Request �-'D L {� _v✓t0 4-i 7"i OYII D t r/�V i TF2ram? 5772 i P -r72 v T72 -�v Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 5(79 D` 0 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) 3 Age of Existing Structure �720 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes No c , Basement Type: ❑Full �d Crawl ❑Walkout ❑Other ; Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 'Z�g' �`� •' Number of Baths: Full: existing a`— new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing O new First Floor Room Count _ B" Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑Other - Central Air: ❑Yes No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes No Detached garage: existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:O existing Cl new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes,site plan review# j Current Use_ Proposed Used - - BUILDER INFORMATION Name 0 N9c-/rbt`I `E�vf t,D MeS Telephone Number IFS- Li ae Address "I' License# a_!-(o f Z_ R4 b 7-54'1 Home Improvement Contractor# I_00 Worker's Compensation# 1N C 9-7 6 9 Sb 4_7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE 10 /1-7 lb�r rY or FOR OFFICIAL USE OY PERMIT NO. { DATE ISSUED f� MAP/PARCEL NO. ` x ADDRESS VILLAGE', i OWNER DATE OF INSPECTION: FOUNDATION { FRAME INSULATION FIREPLACE �A ELEC LRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING - 1 - DATE CLOSED OUT ASSOCIATION PLAN NO. ti •ti m �o m . N C9 91te -&-mixvimioaa W,,A4&zadw,6ea 0J Ln Board of Building Regula ions and Standards One Ashburton Place - Room 1301 CD - Boston- Maawhasetts 02108 a Home Im rovemea � 4gtra.ctor Registration 0 Ln - Registration: 107888 == - a Type: Private Corporation Expiration: 8/10/2006 C.H. NEWTON BUILDERS, IN% David Newton PO BOX 922 >� - , , ;` ----- _ -- --------- . Falmouth, MA 02541 ---- --- - E Update Add turn card.41ut rman for chars e rem and re 1 Card Address wrsl Employment ust[iene OPSC'.h1 43 SflFE•Q#Ak3-616FZto FTl --- — ............. ..... .: .. _.. _. ..... --- _. -•-- -- ----.. ._ ---- --. .. .. ..... .. ... ,/1�6-G�'dl�d9➢It692[t+P�Lf/R *� 6Y6A42CJFIdd� -- � O r. ✓ Z Hoard of Building Regulations and Standards License or regisn-Ation Yatid for individul use only .v HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards liellmra'tlotp:_107BSB One Ashburton Place Rm 1301 . i 2 4rt �J1QJ2t]p6 Boston,Ma.02106 f?Fgti;ate GorPOFaffQn C.H.NEWTON 1 ALMERWiNC__ ` David k�%lon ==_ 549 Hain Rd 28A "[`d _. '. r��¢✓ _ .��� W.FaI Fnouth,MA 02541 Administrator Not valid without signature D m - m ete: 1/13/2005 Time: 9:46 AM To: @ 7,15085484290 Page: 002-002 i \ Client#:3248 2NEWTONCH ACORDTa CERTIFICATE OF LIABILITY INSURANCE 0DATE 1113/05°h-Yyy) 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 222 West Main 5t.PO Box 1990 ALTER THE.COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: Acadia Insurance G.H.Newton Builders, Inc. - INSURERB: Fireman's Companies P.O.Box 922 INSURER C: - Falmouth,MA 02541 INSURER D' 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 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. NSR DD' EXPIRTI LTR NSR TYPE OF MSURANCE POLICY NUMB POLICY EFFECTIVE POLICY ER DATE MMIODIYY DATE NMiDDAIYVON LIMITS A GENERAL LIABILITY BINDER226444 01/01105 - 01101/06 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 5250 OOO PREMISES Ea ocnm�uT CLAIMS MADE F-X�OCCUR MED EXP(Any we persai) 55,000 .. PERSONAL.d ADV INJURY S1,000,000 X OCID _ GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMPIOP AGG S11,000,000 POLICY I PRO- - JECT LOC B AUTOMOBILE LIABILITY SINDER226448 01101/05 01101106 COMBINED SINGLE LIMIT S1,000,DOD X ANY AUTO - (Ea accident) ALL OWNED AUTOS - BODILYINJURY S SCHEDULED AUTOS (Per perscn) X HIRED AUTOS' BODILYINJURY $ X NON-OWNED AUTOS - _ (Pei'aradern) X Drive Other Car PROPERTY DAMAGE (Per acodan) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESSOMBRELLALIABILITY BINDER226452 01/01105 01101106 EACH OCCURRENCE $1.0 000 000 X I OCCUR CLAIMSMADE AGGREGATE $19 00O OOO y RDEDUCTIBLE - 5 X RETENTION so $ wcsTATu A WORKERS COMPENSATION AND BINDER226450 01/01105 01101/06 - OERTH- EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT S500,000 OFFICER/MEMBER EXCLUDED"? - E.L.DISEASE-EAEMPLOYEE $SDO OOO I7 yes:desaibe under SPECIAL PROVISIONS below E.L.DISEASE.-POLICYLIMrr 5500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions" and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORETHE EXPIRATION Town Of Falmouth-Building Dept _ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL 1.0_ DAYS WRITTEN Attn: Eladio Gore NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 59 Town Hall Square IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR . Falmouth, MA 02540 REPRESENTATIVES. AUTHO'RJZED REPRESgglVE ACORD 25(2001108)1 of 2 #36986 -S1 ACORD CORPORATION 1988 I Board of Buildilce, Hrn Reulations . One Ashburton 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Number: CS O46192 Expires: 09/19/2007= . Restricted To: 00 DAVID L NEWTON PO BOX 922 FALMOUTH, MA 02541 Tr. no: 5359.0 Keep top for receipt and change of address notification. •-CA1 % 5OM-04/05-PC8698 - ✓/ seal ,/lZcr�aar�cuaets t ze arwmor�u z d � BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS O46192 Expires: 09/19/2007 Tr.no: 5359.0 Restricted:. 00. DAVID L NEWTON` PO BOX 922 C FALMOUTH, MA 02541, Commissioner i t In accordan= with the provisions of MGL c-40, S M, a condition of Building Pertitit Number _ is that the debris resulting from this work shall Me disposed of iri a prepe;ly licensed solid waste disFes<,l f2ciity as defined by 1viGL c 111, S 150A. The debris will be, disposed of in: { Bourne (Location of Facwt-o° ra to e F� -�i t A Applicant tcant David L. Newton ^ - i Town of Barnstable Regulatory Services r. r Thomas F.Geiler,Director 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. nn Type of Work: Ud 427 A-Y /N7509­16e Estimated Cost ?bvr�/�S fiv��S'� G f37✓AL-�SiS ,8���/L13/2S /L �" Address of Work: _7C� '`Sc>y-n-f N/A-/A/ ST. C 8FAi T�v L-U Owner's Name: W 1'1_t 1 A-/?7 L1"r✓1J S v��i n/ ,�—oLi� 8 6- Date of Application: /0 AVo S I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT 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: D e Contractor Name Registration No. OR Date Owner's Name Q:forms1omeaffidav Get 17-05 10:26a BIII Golderberg 508-778-0036 PI a� Tom of Barnstable j ° Rtgaatory Services XAM Building]?union TmaTeriq, Bullftg ConW*SlOnsr 200 Mem strw� $yards,MA 02601 w".town..b tmstsbIP_='U8 Office: 50W62-4038 Fax: 508-790-6230 ` . 1 Propelty Owner Must complete and Spa This Section if Using A.Builder I, Williaii, Goldenberg -,as as Owner of the subjecdpropertp herebq aurize. C. Newton Bu Ider s to ace an behalf, j • M LU mtes reati a to ork auhorzed bqtbis bnidg permit apeicaton for: - 700 South Mainz Street, Centerville, MA 02632 i aess of Job /0 47 5�_ x Sigsahire of er Date a� Gt M Print Warne The Commonwealth of Massachusetts Department of Industrial Accidents office ofinyesti9ations 600 Washington Street y Boston, Mass. 02111 Workers' Compensation.Insurance Affi/ddavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worlds in any capacity %/%///////%//%%%/%%%O////O/%%/%////l//%/J/%///l0////i�i��/ll/D%/////(%//O/%%/%///O/%%%%/�/%//O%//G�/l/DITI /�/C/�,, C...I aman.employer providing,workers'compensation for my employees working on this job. .company>name:->::.;. ........:;.:•.-. . .:.,.......... ...: ..... 4'�. r �n�.•.: .::....:.:.::...... <...:a :::.::....::........... .....:...:.......7...SSA cttY-::..... ............ .. . ins :::::,.::.. :::::.:.::::::::.: ::::...:.::::::::::.::_.::.:::.:.:,: oiic .#:,.::::C�E3. t�-' :}4' ;.:;.>-:;:;:-.;:.:???:;:<:::::-?::-: ....;:_.?; ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have lured the conirado=&ted below who have the following work=' compensation polices: :•... cotapan n m ages - .•:1► :?'-:•:,;_�i:;_i.?h?.�:..{:{,:i: :::�iii:C�v?r��:$:iiiti "�A-�,,'�i..;A4i:{i;..... .?t\w:?:''�Y::��:.v.•.�:.�:v:::::•:?:•v::.is::v::::w::::.�: .:i.�::>ii:i>::i::�:.r::::?i.C�:`.}:i'.ti:: v.. •.-:i}%:y?j:::_:iii:{{:::-iiFti:i::-f,•:tiii:?�:::�:?�iJ:SSti�itifrn}:•?:i-i,+.-�::�ii:�::?:•::::!:•:::::v::•i:::iw::::!,::::::::::. vjfiiF^.:....:......... .Y-??:-?::•?:n:i:i:..:::i::4.:::::5:2}}:v. x........,...n....nwc.ww...>..•».1!L::.wtivi7:{ ::HOC;;:-:.�:::::::::.:....::.:,::::,.;�:._.;:.::,:.;::.:::.�:.:_:.�;.,,:.:.:.�.,:.::�:;.:.:.:.,;.,�;.;•.,:-:::�:.�.,�::.::::.�..;;.;.;:.;.-.;:,.�:.;,,._,.�,.;•-:-:- O tq.#•.;•:.;:;.:.:..:?;�:::-?:•:;.:.?.::::::•?::•::�:.>:;:::::::: ::•:::::•:::::.�::::::--::-:._::::::::::::::::::•:::::: ih3nralt¢L` F111tLJ�a - ........:::: • <:.?<;::>::>:�»::;:.:.»:�»>;:::>:.;>:<:::•»>::»:=;>::;::;:<:>:�;>>:::;::::<:�:?:»>;:::::::>::»::>:: <»:::::;�:•;s::>s;?;;:'-:�?:::.�-:::.�:::::::.�:::�:.:.:::.::.::::.�. one ....... :::::......::::.:.:::._::::::.::::..:.......- ..::.::...........:.:..::. .............:.::..::.:::::::. r nmrsn Fsib=to secmz coversv as regained ender Section 251 of MGL RE can lead to the imposition of criminal pemltla of a&a up to S1,So0.00 and/or am years'imprisomnmt as wen as civil penalties in the form of a STOP WORK ORDER and a nne of$100.00 a day a;sinst me. I mdershmd that a copy of this sbtewpt may be forwarded to the OMr_e of Investigations of the DIA for covamge verlilstlom I do h rrti pairs and penalties ofPerjurY that dw information provided abow is&v,and corm.. Signa Date Print Tian David L. Newton Phase# 508-548-1353 C al use only do not wrfLe in this area to be completed by city or town official r town: permiu/licesse# 0Bulidtns Depsrim mt CIS Board eckifhmaediats resgodseisregnured ❑Selectmen's Oinae _ ❑HealthDepartment ct person: phone#; ❑Other Devised 9/95 PJA i • - 11E] _ - ® ® enw� WLSESURMA•lONES-ARCHfIECIS - I IFFT i o O ilvgp r ___ ❑ Ti # O eell.von �mr O � � �ud , • . Aloe O O O m -w f r i ® $I ,� �F oeam even mE 1�1� IIIL IpL mmg3 m-s4 IM WINDOW SCHEDULE . •— — •�'""' - - THE GOMENBERG HOUSE o " a Tao SOWN MwDr rlReer FLOOR PLANS �—^""'•'^ � SCAIE AS N0IFD ❑ ❑ ❑ ❑ DAIY OceEc 5,2W3 - FIRST FLOOR PLAN - nMwN'm SECOND FLOOR PLAN Da—NO M A-01 ElEl - .. WISE•SURMAIONES-ARQI[IECIS ® _ Roa uaiy.�bmmammR NOTES - woaepnlmagm.glwepom . b melq,ubfiv SIDE ELEVATION - FRONT ELEVATION . � uEVLs�DNs: —- — — ® -— -—-— THE cotoEtaeEec House ® ]0090U]H MAW SIRHET OSIY1tVt11P,MA i - 'arEbv+tiom Exmrr SCALE ASND I I / DAZE SepmLv Ifi,2005 II4- J DMWN:N SIDEELEVATION DEAwWDNUMem a A-02 EF . - WISE SURA1AdONESAR63DECIS . ' O --_--- gZ II . - 8 NOIP9 • a Roof Fuming Pbn • _� Master BathF—Pin _ w.•im-�e .. '`.,,h:r�:•_.Wit.. _�,''-t.•i` ..i .°i.°uo...u..® -zz UN- v °m eau THEGOLDENBERGHOUSE t Typlaal Foundtbn Detail r �tb SOLlIH MAW SIHFBf `4''?t�:4°e.'-'i41+:+�;'ti?3�'.A� �.o•wmnv+.�. MALI HATH ADDMON . .... PLANS AND DECAlLSAIIS ' DATE:A°,rn 31.3W3 FountlaHon Pbri ' i DRAWN:W . �1m•ro DIfAWINO NUA�FR 1 A-03 F ewtgs,uuu raxR,uaR1An ' R75ESURMkIONESARCHfIECIS , ' i¢rur.e � ' NdIFS - " , s"v,en,"m,r,crseo // �j evrnre�vec ^ x�m�,m ommuua an< ®®®® ve,nmmvmmem EiEl 't eur - mnear,uiu v mvmnslownxrYr ., a � . p•e•,ap,pp� THE GOLDENBERG HOUSE . MSOt a srntBr cis sxnoo o�w�.to - M..Barenam- - svuz ws Notes - owRw�rvn m,vms _ onwvmro NUAfBOt A-04 ' N7SE•SURMA•IONES-ARL'Hi1FCIS s'— EIE] , LAW Outline of Stairs to ti AHic-Dashed Stacked -_ r - ' I .Washer& ❑ -- \� i' \� i ss`' xor[-s . i, Dryer er Pull Hamper - , ®®❑❑ Drawers Cabinet Sink Base Drawer 171— Base Floor to Ceiling Cabinets e e #2-Rear Hall. #I-Laundry i 1 - Book cae ❑ _ . Desk Top � . OOOO � .0 RRvssroxR. IL Base Cabinet with Flp-Up Knee Space Drawers Bookcase Tops to Access Storage I -El � 9# -Powder Room/Bock Hal Bev. #4 1 . - THE GOLDENBERG HOUSE ROVILLB,W'SITlPFI' ossmvELP•A+A TITLE INTERIOR ELEVATIONS DAK Ovebv l.1a15.YIM DRAWx:al - - DRAWDiDxUNBRR A-05 MAScheck ;NSPECTION CHECU MT Massachusetts Energy Code MAScheck Software Version 2.01 Renovation and Addition to the Goldenberg Residence DATE: 11-28-2005 Bldg- [ Dept- [ Use I I - I CEILINGS: E 3 1 1. R-33.3 I Comments/Location E 1 1 2. R-30 l Comments/Location I WALLS: E I 1 1. Wood Frame, 16" O-C-, R-15 I Comments/Location i I WINDOWS AND GLASS DOORS: E .3 1 1. U-value: 0.34 1 For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? E 3 Yes E ]I No I Comments/Location i I FLOORS: E I 1 1. Over Unconditioned Space, R-30 I Comments/Location I HVAC EQUIPMENT: E 1 1 1. Boiler, 83.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: E I I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.❑ cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I i VAPOR RETARDER: E 3 I Required on the warm-in-winter side of all non-vented framed 1 ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: Q 3 I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be 4 � w I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-28-2005 DATE OF PLANS: October 2005 TITLE: Renovation and Addition to the Goldenberg Residence PROJECT INFORMATION: 700 South Main Street Osterville, MA COMPANY INFORMATION: Wise Surma Jones Architects V-Philbrook-Structural Engineer Sun Engineering-HVAC Engineers C.H.Newton Builders, Inc. COMPLIANCE: PASSES Required UA = 518 Your Home = 514 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 144 (33.3 0.0 5 CEILINGS 2458 130.0 0.0 87 WALLS: Wood Frame, 16" O.C. 1848 151.0 0.0 142 GLAZING: Windows or Doors 577 11 0.340 196 FLOORS: Over Unconditioned Space 2603 3`00 0 0.0 85 HVAC EQUIPMENT: Boiler, 83.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. 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 selec e o heat or cool the building shall be no greater than 125%. of th de gn load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date �V ❑ 0 ARC O.JpyFc*��_ o S.DART OUTH, w [ � s�o MA v�Jy „ 0 w 2 P I provided Insulation R-values, glazing U-values, and heating I must be clearly marked on the building plans equipment efficiency I or specifications. • 1 1 DUCT INSULATION: E I 1 Ducts shall be insulated per Table J4.4.7.1• 1 1 DUCT CONSTRUCTION: 1 and return E I I All accessible joints, seams, and connections of supply I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed i using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I i TEMPERATURE CONTROLS: E I I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: E I 1 Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 760CMR 1310 and J4.4• I E I 1 SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. E I 1 HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) '. PIPE SIZES (in.) TEMP (F) 2^ RUNOUTS 0-1" 1.25-2" 2.5-4" I HEATING SYSTEMS: 1 Low pressure/temp• 201-250 0. 1.5 1.5 2.5 1 1 Low temperature 120-200 .55 1.0 1.5 2.0 1 Steam condensate any '0 1.0 1. 2 0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 1.75 1. 1 refrigerant below 40 1.0 1.0 1.5 1.55 E I I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in. ) : 1 PIPE SIZES (in.) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 1 1.0 1.5 2.0 I 140-160 0-5 1 ❑.5 1-0 1.5 I 100-130 0.5 1 0.5 0.5 1.0 ----NOTESrTO 'FIELD (Building Department Use Only)------------------------- FAXED TO 549 .� Et+l.GifalE IiV.G FIELD REPORTMORKS.d•UT ! Project No: b:k heat Na: of . ' t k4EM10 FfyI APECORD: 18 December 2005 1.9ublocE. Frame/Foundation Repair inspections thru 12.0 2000 j Q04DENBERG Residence Location: 700.South Main Street, Centerville,MA Builder...C:11. Newton Builders,inc. Project No:. P08-19 ; Notes from:Inspection: j 1. {Rlork has continued an the Interior demolition. All the let floor was removed back to the exlstlau kitchen. Foundation and framing.plans were prepared,and Work started. (Plans for the sunroom and for the rear are not as advanced. . F.otandetion;this main foundation work is complete; A slab for the main crawl along w/a 2nd fireplace slab Are done. The perinr�star:bl�ecl4vat- ward IniUlied and baring for the replacernerrt mists prepared. ;Cuts to-to,ngw sunroom j still need to be done once the sun room plans.are finalized. 1st Floor; framing layouts were sketched and sot to the architect. These were l styll2.ed for the a.lae'of the chi mnsy base and the new,wkler stairwayto the �o I 2rtid floor. Working plans were sent:back and Ahe fioor was.refranted.uei.ng the heavier engineered wood stock for both girto and joists. H 'ader '*d trirnmers along wl.the guts are all 2..6E ParaiLam P$L stock. The jol s 0e:1.9.15.ffllrcaLarrr LV'L stock. These are set 46" o/c and span less than 18 ft In a 9.V deotts. 3. The following detail specific work requirements or cha,ks of work completed: • Blotched Floor Joists; installation of the let-in lala•ts requited some slight under notches at the bearing ends(which are very wide&ample). The L1/L joists are 9.5"deep as noted.. Searing notches.ftom.slim to 2140.'were ineedod. . to match the proposed floor height and pickup the elevation of the sill beams, f The.joists was checked for span as a 84"deep members clear.apenrtirig 161" i incf found to be,9K for bending etren9lh and maximum deflecOon-44<Lt240, This notching work complys.w/Para.3403.5..5 of the Stata ftildina.Code. t e The new 314" plywood subfloor will be a primary lateral tie for the 1st floor. Due to the pre-existing post and beam construction the now subfioor will not { run under all ther-posts 4nd•studo that remain, 16 order•toaddr••asa-the-laterreil tie work the following setup is specified. Now PT sill.(seams,will.run compteitly under all construction. Existing posts and studs will be fastened down, Now f ln4ill 24'x 4" PT/2"x 44" SPF double be torn mitts will be ihstallsd.; T1te 314" ply- wooed will be run tight to.the bottom PT sill. it will t►e glued ane#Haile¢w18d ! ring•ehank A 8"oic around the entire foundation porirnetw Intp tits PT sill beams. This will connect the perimeter framing Ito the floor field framing. e A similar probiam at the top of the wall 01066efftA-fteif"in hO it the`eatlgt11mg rtrot framing bears down on the perimeter 2nd floor beams. Once tite existing 2nd s floor is removed the Lateral connections(weak m.4r0;je&tjonnan)wIR be Lost I To address this new MlcroLam LVi_rimjolsta will be inatalled. The 3rldfloor ! jols$s will frame to the rim Joists as In platform obnstruction. The ft joists wilt..conna t.to the main posts however new In-fill 2"x4l'wood;frarned wall I parcels will be fabricated to tie.the Pow.-tsageth.ef.and, pnnept tft r6tn joists i E to the framing. The exterior board wall sheathing will be attached to the new in-fill wall panels via, screw* through 2"x 4"horixontal PUrHhs"roughly set top,bottom A 24" -30" o/c horizontally. one of.these purtins.will be aligned i wlths.horizontal break betwean the board sheathing and the new 3/4" Pt plywood sheathing wrap(rein along the sill bearn at grrtade leveh. i. p fhq top of watt regaairs will$ls,p be used when the roatis:l2®ink rebcellt go proms: Me a rnueh rnore positive conneptlom,Subloatto a-fi-nal:eavalino alevatloh,.. !. the anew root wlil affect vely be pjst!o� vlrr the 2r�d floor fr imirto. A 2°'x 8"or wider piste will be installed to receive and conned the rafters m the floor. .As ' �. such the eavetlrre will probably be fsbrlcated wl�et4.•blocks and some form of 3irrmpson<ti"own will be needed-at all rafterfptAte•bearing conrtectlorrs, i 3 P82-FRuv-7 ' �NQINEaI>Vtt FIELD REPORTMIORKSKEET Project No. . PCs 'i _ I MEMO FOP.(RECORD-. 13 Decerrnbor 2006 3. ConY.d.. •Suproom framing and layouts were altered to provkdsample rdom in.a now ! 006rete crew!space for the HVAjC equlpment:and the main duct ptehums'. � Framing reverses so there is no need for a center.gist..In addhtion,_using LVL. lolst.stock the depth of the.Joists.can be reduced to 1.75"x 7.5"-a 44 Ofe. � This will sefoly support 40 t.b aq#live toads and 20 1151Aq:ft dea;O loads and rheot the manna stringent-U60O deflection regtjIr#Jm*rf fevr t IO/sitonework.. The shallower joist can provide-2 additional-inches:of headroom, if needed.. 4.: Ooth work 8 sit3Inspections will continue, The next round:ofwork an r®lata d. ins.Pel bons will be rebulfding of the exterior walls and the Start of the 2nd fdci 9r., in the:rnear► tt�e the above,lnslaeate�i units need their sharCfalla cQr u 4 e PNI1�gr^ . ..Z Z T,.VAit�ILl1�I1 I�MILF3 QAK,P.�. ►�ECr�Ak,4iO phllli%qli nglneer ng N6. 3Q' I i i 1 I i f 1 7 + J ! I I i 1 I ' 1 i t f i t I (COO Py P82-FRW-7 i v VIN LOB` 1.55 AC.UPLAND 0.7b•.AC.WETLAND p 2.25 AC.TOTAL 0� e - ,� 0Rti sP � 'X 'Fr �5• . 1.20 AC,UPL �. 'LAND 1 Q ( 0 ryry, "y� f • J �40, STUDY PLAN FOR BARNS I ABLE (CENTERVILLE) MASS. 3 FOR ' JOHN WILLIAMS SCALE: I"=40' DATE:DULY 20J95;. BAXTER 8 NYE, INC. REGISTERED LAND SURVEYORS CIVIL ENGINEERS OSTERVILLE, MASS. ji y `�y ft T1e r b�� .. :� � The Town ., .� I Services e$1 Department of ile�Ith Safety and Environments it go.11%6 $tiIIdIII �IYISion 367 Main Strut,Hy=nis MA 02601 Raicn C Office: 509-790-6Z7 Buii" z cz: Fax: SOS-7,90-6Z 0 For office use only Permit no. Date AFTMAVIT HOME MVROVLMENT CONTRACTOR LAW SUPPLE1 EMN- T TO PERMIT APPLICA77ON ' repair, moderaizrzien. MGL c. 142A requires that the "reconstruction, alterations, renovation, re-ezistir.^ conversion, improvement, removal, demolition,one bnt�o t�moreon f than fouron to any dwelling salts or to owner occupied building containing registered contractors, structures which areladjacent to such residence or building be done by certain exceptions.along with other requirements. � �� Est. cast Type of Work: e"'ee�� r i 1 Address of Work : >' , Y" CSV V c Y Owner's Name Date of Permit A iic=tion: " Da PP _ I hereby certify that: Registration is not required for the foIIowing rcuon(s): Work excluded by law Job under 51,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: (JjYRECs;Eir OWNERS PULLING i� THEIR OWN PERMIT OR DEALING WITH CONTRACTORS FOR APPLIC.�B� HO oRB1'�RovEvImT�RANTY FUND DER MGNo I4Z.� � AC=—S TO THE..NITRATION PRO GRAM SIGNED [INDER PENALTIES OF PERJTJR1' I hereby iy for a pe the sgent of the owner. Contr2ctor Name Res istrstioa l`lo- Date i The Cohn oitiveahlt of.4tassachusettt Department of Industrial.4ccidents OlTceaf/nvest/gat/ans ei w 600 !f'ashitt,,,,tun Street A1aas. O2111 Workers' Compensation Insurance Affidavit - 4 " i li �int-ininformation': — PliFie PR►NT leg y name: Inc,ntion- city phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .... �w. / ~y ..r.+�.:a��.s.•i.fw7[�4s..'wan++/�?'°�..'._'r'�'.^+y".w'!p!19��r...�ww�.�.....•�..+...r•.�.w.�r+....w�.�r..wr+.._.... .�� 1 am an emplover providing workers' compensation for my empiovees working on this job. conttmov name: c4�e—C,19 •f• as,( I n ro Q+ address: 60y I) qq city: ©s�e�u; LjZt h1a phone#• ..��0sr,�_..�- insurance en. Itolicv# M I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: cmmlianv natne- atidresr. city Jthnne#• insurance co. nnlicv# � .. •i.::•+.. y"^ _ � �..a...;:.._..y._� _� err_n:::�'14:v•v,�sw. ._�.:,_ ...e-r.....�....�...-�_ comn1nv name: atldress city: Phone#- insurance co. �toiicv# .Attach additio_n21 sheet if necessary =. r _ + --+�_ ""•%r. ,'"'^`*� _---" Failure to secure cuvcrat:c as required under Section 25A of n1GL 152 can lead to the imposition of criminal penalties of a line upto S1.500.00 andiur une i cars'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and it fine of 5100.00 a day against me. 1 understand that a cope of this statement may be forn•arded to the OMce of-Investigations of the D1A for coverage verification. t do herebt•certijr rutde the parrs rind •unities of perjun•that the information provided above is true nd c rrect. a Signature C Date ! 2 of Print name Ll— ,l Ylr1 a`r Phone `i Zl�—o 3Z3 official use univ do not write in ibis area to be-cumpicted by city or town official cM.or town:. permit/license a# riBuilding Department Licensing Board check if immediate response is required oSelectmen's Ufftce. f h Department contact person: phone 4: �Uther a i. r information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for if,, employees. As quoted from the "laW". an empinree is defined as every person in the service of .:nether under any contract of hire, express or implied. oral or written. An camP .lurer is defined as an individual, partnership, association, corporation or other legal entity, or any two or me the foregoing_ eimaued in a.joint enterprise. and including the legal representatives of a deceased employer, or the receiver or tnistee of an individual , partnership. association or other legal en`ity, employing employees. However ,. owner of a dwelling house haying not more than three apartments and who resides therein. or the occupant of the dwclling house of another who employs persons to do maintenance , construction or repair work on such dwelling h� or on tile ;_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioy MGL chapter 152 section 25 also states that every state or local licensing agency sliall withhold the issuance of- - rencival 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, 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 been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying= company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are require to obtain a workers* compensation policy. please call the Department at the number listed below. . City oC rowns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P1 be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returner the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questic 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 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 I 40 BROAD STREET, BOSTON, MA 02109 REFER TO THIS 1 PHONE-(617)542-8402 ACCOUNT NO. NOTICE OF ACCEPTANCE IN ALL CORRESPONDENCE 20-13584-0 TOTAL PREMIUMS DOWN PAYMENT AMOUNT FINANCED FINANCE TOTAL OF PAYMENTS ANNUAL PER- CHARGE CENTAGE RATE 2,743.00 549.00 2,194.00 177.32 2,371 .32 19.00% INSURED(NAME AND ADDRESS) AGENT OR BROKER SUBMITTING AGREEMENT(NAME AND ADDRESS) CAPE COD AND ISLANDS PROPERTY DOWLING & 0 NEIL INSURANCE AGENCY MANAGEMENT, INC. 222 W MAIN ST AMOUNT OF INSTALLMENT P.O. BOX 1144 PO BOX 1990 9@ 263.48 OSTERVILLE MA 02655 HYANNIS MA 02601 DATE OF NOTICE&ACCEPT FINAL PAYMENT DUE DAY DUE I NO.&FREQ.OF INSTS. 01/14/98 M( YR 98 14 9(MTH) - - - SCHEDULE OF POLICIES FULL NAME OF INSURER AND GENERAL AGENT(S)• `COVERAGE TERM N PREMIUM POLICY PREFIX OF POLICY OTHER THAN SUBMITTING PRODUCER TO WHOM MONTHS AND NUMBER OR ANNUAL COPY OF THIS NOTICE WAS SENT FINANCED INSTALLMENT MAR..iM CAS BVPREM. WC3355303 H 01/14/98 GRANITE STATE INS CO WC 12 2,743.00 ADDITIONAL INSUREDS: LOC:381 OLD FALMOUTH ROAD, MARSTON MILLS, MA TO THE INSURED: We are pleased to notify you that we have accepted Q If this is a regular monthly payment plan, your your premium finance agreement subject to veri- coupons are enclosed. fication by the insurance companies. We have credited the down payment to your account. ® If your payment is other than monthly or on a special monthly advance billing, we will remind We urge you to read your premium finance agreement you of your installment payments. so that you are aware of your rights and duties under that agreement as well as possible penalties PLEASE SEND THE PROPER NOTICE AND WRITE _ that might be assessed against you in the event that YOUR ACCOUNT NUMBER ON YOUR CHECK OR the terms of the agreement are not complied with. MONEY ORDER TO INSURE PROMPT CREDITING OF THE PAYMENT TO YOUR ACCOUNT. If you have any questions, please contact our processing center for assistance PO BOX 8440 KANSAS CITY, MO 64114 . 3 TEL 800-288-6901 •_PLEASE NOTE: IF THE PREMIUMS BEING FINANCED ARE FOR THE PURCHASE OF INSURANCE FOR PERSONAL, FAMILY OR HOUSEHOLD PURPOSES (NOT BUSINESS) YOUR INSURANCE AGENT SHOULD HAVE GIVEN YOU A NOTICE TITLED " REQUIRED FEDERAL TRUTH- IN-LENDING DISCLOSURES FOR PERSONAL LINES INSURANCE ". IF YOU DID NOT RECEIVE THIS NOTICE, PLEASE CONTACT AFCO AT ONCE SO THAT WE CAN GIVE YOU THE REQUIRED NOTICE. AVOID JEOPARDIZING YOUR INSURANCE PROTECTION AFCO Credit Corporation BY MAILING ALL PAYMENTS IN TIME TO REACH AFCO 08 BB (02/90)Copr.1990 ON OR BEFORE THE DUE DATE OF YOUR INSTALLMENTS. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) 77 rww rA lit o,�� A'r"r, r NL S U''R'A N' , t;05iAP Ai"�'f ' 3;f 02 58 W3�3�553-0 '' �r�'!►c:citlii:5ro;Va�h1Ct� 1o:„ � i � r+ ; R ;« + IC,n x` tT.Ti�ftNATIpNRI.CU,. a ` ° •stt �" '.,e',�}a � .'.j. NYi" � Is.r� trjl}l i al +c�t,sx U t }: ��b tr +}"rs'rt fi Y1t ! a 1'.!: SIPPANN', N) 07054-0409 ''lit idE 1-bCJ(,•Gt.4:2259 ; p�A?E ` C+^, E M,ENTrilk Mombar Cnmpanias r6t , t rnerican IntsrnatfanaF:Graupt, E057c.F;'1,,. EXECUTIVE C+FNICEs: i i Plt%lE s1,AFF-'T, NEV`a YGRK;IV,Y 102T0 r. • F ^� .� 'Nt'�:�tKERS C:�Vr�'�r d�i:OL a��Jt`L» ��t« Eb " tJO'e<i_ 1 � ;1'N 1"(,! f NSUR.ANCE AG z EMPLOYERS tt?f':.f°i'!' fly±ICY f 2 2 `leiE S7 f°tA. i rl TRE> 7 MA. 0260`1 M .. rvG`'r S)+ • f t (.ti� 2 1 AL a 1 --7 +r*f+dt ri ri ,..'9. i ttr �:! �•7�1AL 'Fi. 3Jf1:Q8+'Sb S Ur[1f:;':) j'Ftr t,Ji{LrC G,Z.iiLF R()P.iBS t.. ;hd rf,'rf.-.?.t„ Cc,rY7ME'.,Sflrl{711'id'lJ of the 1 re h r a Pal `.r) t t ? $ J1'e.ti;'y to)r,.!A): +C .tie oac r tfrf? A. U6t'1o' Ct, a.. 8tz- i}lc 1 iy0u t•+ , + !f j rSr.,rJgo.t ......... " 09ch a9cid6ht n :1•)d _..�._._. .I fO 0" ? nttt;h eir�i 10 Y` p V96 d ,�fit,}a ..• ___ ____ .._,.._ _. .. .. ._. __.....___.__.__.__ .__..._._._._._ , !''9 f,' 7 .. �. ! !�,. .f ht. fLRt , t ? h-,,• fi..i f`;i 1 i. ,. L{i r i r, r Yf� & iiS 8'.b 5 +5 Fiot'�5 r'�tC f?d•.'rt�, pt,gd,3 si A. .lrs..r ,.Hr,p ` a F f r' «. e ,...ti. . v yft S,+r4S1 d r?E+•^I.rts � ,.+ __ . ._ 4. - -__ __ .... _. ,.. _... L .. iu �i3L'AS6rA_h 5EE k ";, EU ,14F y. t s v�*xl.r +cre"u'o:Ue+t, #, ) rUvltiZ;i`�}jd'j3974 . Engineering Dept. (3rd floor) Map Parcel Permit# House# 7,40 3 Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) "' Fee Conservation Office(4th floor)(8:30- 9:30/1:00=.2:00) Planning Dept. (1st floor/School Admin.,Bldg.) SEPTIC SYIVE EE Definitive Plan Ap Love Planning Board 19 INSTALLEDNCE _WITTOWN OF BARNSTABLEIRONME AND TOWN REGULATIONS Building Permit Application Project Street Address '1 0 0 S. VA C,ti-n S"T le Village Owner te-51 Lc, - c.,,...;\ 1M"Y-.a�So v, ,., Address 7®O S-7 Telephone S09- `t Q 0 Q z,1.5 - -Permit Request i h 5-�-,,r 11 r\e �j v, C etib ��ne�S S I r vP WOA S % v\ 3 (Zoo m-s 1 •�o .2v,$ula� new 1�+.-tca� g El1w.�h� \�t 'a `oe��ow.• ` 4-bm Q Poccjh First Floor square feet Second Floor square feet Construction Type ( C, ,,1® 4,� Estimated Project Cost $ Go ®lap Zoning District Flood Plain Water Protection Lot Size 3 , 49 Grandfathered ❑Yes ❑No Dwelling Type: Single Family Ly`- Two Family ❑ Multi-Family(#units) Age of Existing Structure Q00 t Historic House ❑Yes ' I'No On Old King's Highway ❑Yes ❑No Basement Type: Bull Brawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) n z) Basement Unfinished Area(sq.ft) a Number of Baths: Full: Existing_3 New Half: Existing New — No.of Bedrooms:, Existing New q -, Total Room Count(not including baths): Existing New a First Floor Room Count 3^ Heat Type and Fuel: VGas IFNI ❑Electric ❑Other Central Air f�'es ❑No . Fireplaces: Existing New Existing wood/coal stove ❑Yes &N' o Garage: [Detached(size) 3 Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None @ Shed(size) a, ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name P ry VA V0LW\c".-r� Telephone Number Address 'l w i CZ License# Home Improvement Contractor# Worker's Compensation# WC, 3 3 5' 5 3 03 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO VD Mqc omn e,< ? I u SIGNATURE c DATE BUILDING PERMIT IED FOR THE FOLLOWING REASON(S) w t _ FOR OFFICIAL USE ONLY PERMIT NO. Al Al DATE ISSUED_ - Y MAP/PARCEL NO. ADDRESS VILLAGE OWNER 1. DATE OF INSPECTION: FOUNDATION FRAME INSULATION 2 U act) _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING:~ �R�O-GH FINAL tx GAS: �6CqV� H O �� .FINAL r FINAL`BUILDING:'; ® _ 1 0E ==; y r , DATE CLOSED OUTS } ASSOCIATION PLAN;,NO. FROM 15T PROP. i9Gl1T. NO. Jan. 29 1998 03:38RM P1 r J , LOT A ' 658 AY,UPLAND 2,25 AC.TCrAL /! 1.20 AC.UPS. �. tiLAlID Y� ^aA \ C � F�o +ao FOR \ R N ^T -' C,I C" rf CC JvHN WILLIAMS SCALZC i%40 3A7E 'ULi e. 3AXTER 8 NY��, INC. REGISTERED LAND SURVEYGRS P, IViI £NCINEE?S CYST hViL_t" MASS. t '7o Souk Ala(, TO ALL NEW BUSINESS OWNERS Please Fill in: APPLICANT'S NAME�Jae6v - HOME ADDRESS: IUAIA _ e TELEPHONE NUMBER:_�d$� p, 4C (Please give us a number where you can be reached) NAME OF NEW BUSINESS TYPE OF BUSINESS VdD DO([ IS THIS A ATIO ADDRESS OF BUSINESS .3(S IMF f�lA(�S Sr O 2(op 1 COUP / MAP PARCE�E O NU[IARER 2 :r When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatut es, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall). 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This individual has en informed of any permit requirements that pertain to this type of business. Authorized Signature COMMENTS: e i r Yn t.c�' ' cam_. d Si 2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) -(3RD FLOOR SCHOOL ADMINISTRATION BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: After obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 for 4 years). A business certificate ONLY registers your name in the town of Barnstable - it does not give you permission to operate - you must get that through completion of the processes from the various departments involved. f r - � ✓he -C/�ry7yYiIY000'LC�/P,a�C� O�v%ZcYJJCG��L�P.C�J �� OEPARTNENT OF PUBLIC SAFETY r " CONSTRUCTIOk.SUPERVISOR LICENSE { Nulber I" ` Expires: � � ' Restrtcted'To: _'1G KEW N'_NCNANARA APO BOX 1144 t gtERVILLE, NA 02655, �� s, � ,,,, ,..,,„�. r ......�"r,,.,Y,.._ r *FT".�^.�^t"n—Viz,-+•.�r-,r z - th1��a� � �i ula ��is ai�ISSa�i� ��s � � One .Ashburton Place ,.-.-Room 1301 , Boston, Massachusetts 02108 HOME °IMPROVEMENT. '! TRACTOR ; r £lm 1 C Registration 1 `ExPiration 02/01/99 uh L Typ, PRIVATE ads�TION 3� �: le ;: kg t tb CAPE COD f& I SL_ANDS :PROP' MNGMNT I 1YPe PR '60 I K_ERRY M MCNAMARA E xP ioh a OtJ "irat 37 WKI TMAR RD MAR�a0N5 MILL E, I GAPS COD C � KERRT M 1ff4, � �.I 3 7 s ➢ � F .} ,.„{.� S 'T< x - � C.��Jr7 R.rJ y"7 (7}��� �.z° � ��'�a j } ADMINISTRAIIR fW�°"�