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"i �)������������������'.i��l,�Iiiiiii'l""I"',',,;kl�.l ­ !,.6 ,�"`,, '' � I t y" A A.WD.MV-MA1tKWDi W-MM.--i. 1" �.,. 1, , � , , , , , I , 1 '2�" ,lf.A.��.W,.,,�,�k,q,,��'R,,I'�l..- A i i i.,�!�,""",", "I'll""KI, 1%1'�,,;i. �, �.','��,.J Nit ��I'll, 1,�". I'll � � � t;,ii��,�i"",.rkk,-,t�,�,',',,���'l"""-","�',,�!��,,�,�,i'-','�,,��.�,',,,,',,;,�,.,,,*;,f�,,�,�,,,�;���','�l",!,��,,��,i,',,�i��;�"N�;"""i�, .I ,'I �I��� , � I I � " 14; M I (�,'i�'i,,�,,U��;k�li�il?'I,'�l-i�QW �Z,Vikitlbl���,,,�"i,L-,�,�tt�ll,�"g�,�i,�,V,i'.�ii5��Y.,',�,�lt"�,,t�',r��,,11,"�......... I 'T'' - 'T'' 'T'' 'T'' 'T'' 11 ., 'T'' ............ i "� I 4 iol,4;2vl�t�66�'Ll�i�)���ii'll'I , _W" . . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a I Parcel Application # - Health Division Date Issued 12 0';�' Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis . ,elA a/1 t Project Street Address i rep ed 1�G t�Pi Village Owner �V�h �wv\,5 Address m Telephone ulo Permit Request P c � d nS� l ort -1-i t e, Avf c rvIl e�3'01frf( 1+1 CA b ems +- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation q 3 ® Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's�_-Hi hway: O!Yes=fl No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other ~`' Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 7? Number of Baths: Full: existing new Half: existing nev5? -�� r- Number of Bedrooms: existing _new CO rn Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes )dNo If yes, site plan review# Current Use Proposed Use - - "- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name .�1 w C C�,k V�� C� 2Skve/ Telephone Number 50 8 2 q 8 0398 98 Address License # --[-c �& o�ra„r3►y�1� / i' �t ��� o� Home Improvement Contractor# Email Worker's Compensation # U 5 5 u(0 I��60 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE r ' FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VI LLAG E OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 14 -Theromnmonwealth of Maisachusetts 7 `YkDepartmerit of Industrial Accidents =` ` ` •'A ' 4 1 Congress Street;.Suite 100.,y x' i x ,F , , =n.+t Boston;MA-02114=201:7 jx r'-'.'-d— �Y r Y www mass gov41 NVorkers'Compensation Insurance Affidavit:Builder's/ContractorsLElectricians/plumbers. ., } F TO BE FILED WITH THE,PERMITTING AUTHORITY: y , Applicant Information Please Print Legibly , 1 Name(Busin..ess/Organization(Individual):Cape.Save Inc Address:7-D Huntington Avenue 6 City/State/Zip:South Yarmouth,-MA 02664 + phone#.508-398 0398 �� w # Are you:an empl yer r i o. .Check the appropt'iete box: P z Typ�e of p oject(reyuu ed) employer with!.`«15 I�:�employees(full and/orpart time)° ` t ''! t^' W i t _ 1_ i. 7 ' Ne construcrion 2,[]I am prie a sole protor or partnership and have no employees working.for me in ❑Remodeling .Y - .any capacity:.[No workers'comp.insurance required] .. 1 t — , +�t " ' 9 Demolition I am a homeowner:doin a11work ❑myself[Noworkerscmp., surancereidt ,..•10 Building addition " i 4.❑`I ani a homeowner and will be hiring contractors to conduct all work on my property:I will. , } ensure that all contractors either have workers'compensation:ipsurance-or are sole 11.[]Electrical repairs or additions t. Proprietors with no employees:. A r r - ;r r• x, 12. Plumbing repairs or additions : t 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. t These sub-contractors have em `w ployees and haveorkers'comp,insuianm*- 11E]Roof repatts i L.; ,6.❑We are a.corporationand its officeis have exercised their right of exemption per MGL c; 14. Other. Insulation. i 152,§1(4);and we have no employees..[No workers'comp.insurance required:] ' 4 :"Any'applicant that checks box#I1must also;fili out the section below showing their workers'compensation policy information. affi =x Y w i t Homeowners who submit'this davit indicating they are doing all:work and then hire outside contractors must submit anew affidavit indicatingsuch. l -Contractors that check this box must attached an:additional sheet showing the name.of thesub-contractors and state whether or not those_,entities have t employees. If the sub-contractors:have employees,they must provide.their workers'comp,policy number: r _... . p g R I am an employer thatris rovid nr workers'compensation insurance for my employees Below is thepglicyand job.site 3 .. 1nfOPniation. Insurance Company Name Star Insurance Co. Policy.#or Self-ins Ll.c. #: WC0855.40700 =px--_}t Expiration Date 4/9/2017. Job Site Address:_ 17 Thread Needle•Lane + =i City/State/zip;Centerville ^ ! Attach a copy of the workers'compensation policy declaration page(showing the pohcy.number and,expiration date).` , - - Failure to secure coverage as�required.under MG.L.,c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,M well as ci..I penalties in the form of a STOP WORK ORDER and a fine of up to$250:00 a ' ..day g py.against the violator:A.co of` this statement may be forwarded to'the •* e Office of Investigations of the DIA for insurance• :t coverage verifications o « e I do:hereby certify.under th ;pains andpenalties of perjury that the information provided above:is true and correct. 1 1 Si ature'r Date: 2 2/17 Phone#:508-3.98-039.8 t Official use only Do not write an this area,to be completed by city or town 60cid� City or Town, ':, . i. 1 ;� u �' ,. �K: 1' ..� - ". .`� +erinitlLicense Issuing Authority(circle one). %"_{ :%=1•s:.< r, .:7 _ 4: _ a.. _ 1.Board of Health 2.Building Department,3.City/Townberk 4.Electric alI,nspector 5.Plumbing Inspector - 6.Other 4 Contact Person: _ Phone#: _ ,��„�.',", i,[k t'+ �" 1r � « �,;.d:as;" +•1ri..s§.l,': �'�a ' ii .+;}. ;:' 'ir- A ® DATE(MR9tDD1YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/24/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les)must 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 COWACT NAME: Colleen Crowley Risk Strategies Company ac°No E (781)986-4400 FAC No:(781)963-4420 AIL 15 Pacella Park Drive ADDRESS:ccrowley@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAIC0 Randolph MA 02368 INSURERA:Liberty Mutual Insurance Co INSURED INSURER B A]lmerica Financial Alliance Ins Co 10212 Cape Save, Inc INSURERC:Ohio Casual t /Peerless Insurance 24074 7 D Huntington Ave INSURERD:Star Insurance Co INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER:CL16101422377 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL SUBR POLICY NUMBER MMIDD EFF POLICY EXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE X�OCCUR PREMISES Ea oocu Bnce $DAMAGE TO RENT 100,000 BLS1757246490 10/16/2016 10/16/2017 MED EXP(Any one person) $ 15,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY �� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIM Ee accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS Ix AUTOS A61BA46796600 11/6/2016 11/6/2017 BODILYINJURY(Peraccident) $ X HIRED AUTOSNON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAR CLAIMS-MADE I t..,; AGGREGATE $ 2,D00 000 DED I X I RETENTION$ 10,000 US057246490 10/16/2016 10/16/2017 WORKERS COMPENSATION 1 , ' officers included for ). ` X S EH AND EMPLOYERS'LIABILITY' - ' PER R — AW PROPRIETORIPARTNEWEXECUTIVE YIN NIA D Coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? , (Mandatory In NH) r._, VC0855407 4/9/2016 11/9/2017 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Evidence of Insurance / Insulation Specialists r , CERTIFICATE HOLDER CANCELLATION' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Barnstable CountyACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact 460 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02061 Michael Christian/CLC �� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) i T E5 SDupont Avenue I:South Yarmouth,.MA 02664I`569-56g.i926 ENGINEERING" vuww RlSEengineering corn OWNER AUTHORI ION FORM (Owners Name) Owne-r.of the:pt6pbrty located at: jIre, ale L (Property Address) -A4 A.A pi (Property Address) hereby.authonze: (Subcontrac' an authorized'subcontractor for R E Engineering,to act.on.my behalf to obtain;a building permit and to;perfor n work on my property This.form.:is Ohl ywalid with a signed;contract: ; The Permit,w 11 be secured by the insulation contractor;at no additional cost It is the homeowners responsibilityto:close out this permit by.contacting their municipality at the completion of this work. Owner's Sig atuce 1125/17 , ... . ....... Date 62016 Office of Consumer.Affairs and SS,RegulatI - ' 10 Park Plaza Su1te.5170 B"oSt1- Massachusetts 0211b:, Horne Improvement.Contractor Registratlori Registration 1:71380;. r Type Corporation y 1 ' • Expiration 3%14/2t318 Tr# 419291 CAPE SAVE.INC. . 1 11 -� �� F WILLIAM McCLUSKEY � � 7-0 HUNTINGTON AVENUE a- SOUTH 1'ARMpUTH; MA 02664 S ,�r<<° b 1 Update Address and return card 1Vlark rea"son for change. Address ❑::Renewal Employment .0 Lost Card 80A1 w` 20M-05%71. - V/l6�/JQ�IL77Ldltl!/.GLGI�fLQ•��"I��CI'11CLClLI/i1C�,S '� Office of;Consume,.r Affairs. Businss Regulation License or registration valid for individut use only HOME IMPROVEMENT CONTRACTOR before the expiration date If found return to Reg�strat�on '171380. Type: Office of Consumer Affa ndirs a Business Regulation r. Expiration 3/14/2018'. Corporation 1Q Park Plaza-Suite 5121t` Boston,.MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY H E 1,o HUNTINGTON AVE'NU .' SOUTH'YARMOUTH MA 02664 Undersecretary 'Not valid: i signature . ` Massachusetts-D.epartrrient 6f Pubhc Safety Construction Supervisor Specialty f Restricted to: Board of_Bui►dlna Regulations and Standards CSSL-IC-Insulation Contractor 1...11111t1 U�61i/Ii JL 11E f:vlsor ai Ia... 1p/G'.10♦ tjka - License CSSL 107776rZall Ur , WII,I,IAM J:MCU 37 NAUSET ROAt6 j 0 West Yarmouth MA Failure to possess a current edition of the Massachusetts Expiration Failure Building Code is cause for revocation of this license. Commissioner 06/28/201:7 DIPS Licensing information visit: WWW.MASS.GOV/DPS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 061t ICDC Map JL10 Parcel Q 1b Application # Health Division Date Issued Oho% kk Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address `7 IWMAO ld A,4 4 , Village CQ11, /L Vl LC. Owner TIH Ta� N USL_11' Address Telephone Permit Request 1,A7 r f K,- %S / J&l Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay :Project Valuation Construction Type_15eAgLb k6# Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure , �i�'66 -,,Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: O Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 13 rg Number of Baths: Full: existing 04 new Half: existing new Number of Bedrooms: 7' existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type anYYes el: YGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑ No Fireplaces: Existing/New Existing wood/coal stove: 4-Yes G1No (2 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing `❑ new size _ Barn: ❑ ex'(§frog ❑ new si Attached garage:4existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: : Y' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ i;5 ILI Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �, 5� '���y�. Telephone Number S'd e_ -7-7 LE- C Address 7� �l l� TIC . License # Ci� '���/( c� W Od-6 73 Home Improvement Contractor# Worker's Compensation # fr1d09CkSV3N 'M7 ALL CONSTRUCTION BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7 f A d`'7 /P T6W Dk, C z -44 AR . 0�_6 73 SIGNATURE r DATE 7 11 t' FOR OFFICIAL USE ONLY APPLICATION# _ DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER E- DATE OF INSPECTION: ,FOUNDA4TIONk FRAME -- - - - -. - y.-INSULATION i .m,_,1iJLA V. ULA 01 If FIREPLACE _ .ELECTRICAL:- -ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL F[NAL BUILDING`, f DATE CLOSED OUT ASSOCIATION PLAN NO. f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. ki ip. 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): Tupper Construction Co. , LLC Address: 79B Mid Tech Drive City/State/Zip: West Yarmouth, MA 02673 Phone #: 508-778-0111 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. $ ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL . 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AE I C Policy#or Self-ins. Lic.#: WCC 500559301201.2 Expiration Date: 10/0 3/2 013 Job Site Address: 221 Al cot t Rd City/State/Zip:E . Falmouth,MA 02536 Attach at copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for i ra e coverage verification. I do hereby certify under te 7td penalties of perjury that the information provided above is true and correct. Signature: Date: 9/3/13 Phone#. (5 0 8) 7 7 8-0111� Official use only. Do not write in this area,to be completed by city or town official City or Town:. Permit/License# Issuing Authority(circle one): 1.Board of Health 2..Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector '6. Other Contact Person: Phone#: i s A COI ERTrrCA-r' �.rArr„r EURAN t?ATf(M6R(1gyYYYY,: THIS GERTlFIGATfa fS ISSUED AS A MATTER QF INFt?Rft!kATtON ONt,Y AND GONEERS N. RIGHTS t)PQN THE GERTI�7GATE- t?7/03/2013 OERI IFICA CS ER NIC AFFIRISfIAT1VE4 Y OfR NEQA flYERY AMENR,E7GTEND aR All THE Ct1Yt RAGE:AFFQRt16fa BY TNE.P01 IOIES: HGl Et2 fiHIS. F�rFI,sJ1N, Tf1lS CERTIFICATE OF1NSURANtAE 9QES NOT CONSTITUTE:A GONTRAC7 BETWEEN THE ISSUING sNBURERfS1.AUTNQRCIES REPRESENTATIVE OR PRODUCEI%AND The CERTIFICATE H.OWER, IMPORTANT:If 1lt8 ueRlticatp hoidor iS art ADOITIQNAL INSl1RED,the poil4y(ies)must fie endersarl,If SUBRf1GATIQN f3 YYAIVER;Subloot tG the(cnT!5 and egnBltiDns of the pp)IGy,Certain paNcfas may Tequiro an endorsoment A statoment on:this, rl tfnatg doed not cDnte(N$hre co the cerfifiewe holder in III o>each endursamentls),. PR9lDIIGER. - SOutheltS#drli 16SUranlye. A enc Lora 'Lone Y Inc, `a'�o E 439 STrdte Rd. L�CRo,Ext): (508}997'-606190 — a�c N fS08}99Q=2731 P.O. Box 79399 an N. ElartRqul h; MA 02747 $1f814MERIDA .. Vie- 1 tglAPFo13�NGCOymm _ NAICA TyPPer- ;Constrwmion Go. II 1NiIRERA:. Arbei7a PVOTeCt90r) Insurance INSURER 8: AEI[ 27 Roberta Drive: 9NsuR�c.. CNA.Sarety ` INSURER 0c� .. West Yarmouth, MA 02673 _. ! _ . .=INSURgt.Ei: . -.-. GQVF.RgGES CERTIFICJ E NUMBER:2013/I4/! THIS'1$TQ CERTIFY THA hTHE POLICIES OF INSt1RANCE LISTED BELOW HAVE I III SSUED TO THE INSURED NARIUEQ AB VE FO pOUCY RERIOD': " INDICATED. NOTWn1-,&ANDINGANY REQUIRE;6lilT,1'ERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTMH RESPECT To Vill THIS CERTIFICATE AND n ISSUED OR MAY.PERTAIN,THE IN$URt1NCE AFFORDED Y'THE POLICIES DESCRIBED HEREIN IS SUBJi SUBJECT TO ALL THE TERMS, LI�EXCLUSIONS ANO CONDITIQNS OF SUC+i POLICIES.LINtITS SHOWN MAY HAVE BEEN REDUCED flY PAID CLAIMS.„„ . f TYPEOP INSURA NCB AD SUER- -- _ GE!!ERA4 R1ILnY NSR VND POUCY NUMBER jIt _. .. MMIDp API I. WMq$ 8500008143{11/01/2013 11101/2014 EACHOCCU E s !X GOMMERCA�GENIuA�1L!TY 1,000 00 I _ i CI-A(M$•MAaE:�-.00CUR. .. � _ t P tEe n S �OQs A t MEJEXPM�a !I `PERSONAL& V ill RY E QEMERAL 11000,00 'AGGP.EGATE S. GCN'.nP4R€4ATC LiM1T,tFRt:ES p2R.. , .Z,D(!O `(1O r i JPOLICY ~IPCC LOC 3' PRCGJGTS•C6MRfOFgGG S 2,U0(1,00 AUTgMppi! IJARIbITY , 506624000Di 12(01Ct013 13(0112014 MANED_IN01612 (fi a ' ANY AUT® lEa B cru) 1 900,Q0 _A"QYVyi Ell AUTOS. �Cf31lY)� hJuRY'Pp tl• � A IydfiEDtILF4r1Ut03 44 E BQDId3tFiYlPat»rr g Xx'' MtREDAUTOS- +i i� 1 NON•OlAUTpSIFv@cQdHIIDP�AhQE $ INC I., IRAIMUA UAB X OCCUR t -. ._ .. . .. excEss uAe 460005836 1110112013 1 I(0112U14 S A crAl�sseaaoE Act+occurtaenct s 1,000'00 TE - ( -'oc'DUCTIPL�.:�. . .... - AGGREGATES. $ _._.1,000,00 RETENTIONS § WORKM 001APENSATION - tt 4"DH7flpL0Y LIAIIILtTY WCC500S59301200 1ele3(2p73 10/03/2014 X F RYLI 1 I t S ANYPROPRiffORIF yERIEXF.CUsIVE YIN Y, U. B OFrtCERWOMBEREx ED2 [ NIA RICHARD TUPPER Y iM�l9aton(IANR!_ I �I-II FOR WC COVE �`�lr,GclD�rr 1� 1 OQO Q0 va.stesaAtA ta!Ger .. 8CRiPTIDN OA2Ri.TtOF"Spe.rny E:L OLSE.. SE:F.kkRIP..aYE s ,000 00 c:!_D!Ir�at;�FQWGY LIMIT .t 1.000 00 ?1 SCRI¢T'w"wr.wrtmIJUN31`=10M37vE}1tCt�lAtt4EhAQ4Re10l;AGdRlaneiRemarksSeRedutc ifmofgsp gla� � . Gi f{TIFIOA1b Fivt t;x CAaCEci AritNg. —71 SHOULD AMY OF THE ABOVE DESC. IBCD POLICIES BE'CANCELLED BEFORE 1 THE EXPIRATION,GATE- THEREOF. NOTIt~I VsIILl. BE DELIVERED FN ACCORDANCE WITH THE PO PROVISIONS,F2T forlltatlo�,PurAoses.OnT'y" Constructib Co t_LC 7i117NpR WED RFPRE&ENTATIVE nta ©r4.ve; uth, 'MA 02673 Lora Lowe ACORD 26(2009109) The AGORO name and I ®7968-200P ACCORA CORPgRAT10N:'q1)rl$hts rasorireii: ogO are registered marks Of ACORp ERiI1J3INtfl irtl!{PDXMANi3t t101is1 UTE,IWC' Massachusetts-Deoartment of Pifblic Safety ` 107 H nr Road,Saute 110 a �. f0-6daird of building Regulations and Standards j E"W t� Conwtruction Supervisor !' yWW.bpixwn License: CS-069058 s RICHARD S TUPPER.. 79 B MID-TECH DR. ` WEST YARMOUI'H ' 62 E. TOW t�?��F . D lMFMIOT" A �..G..- lJ. . �,'� ., Exp ration (SEE AEVEWOfFOR OMWOM Aa1DEXv1RATtNOATESi F, Commissioner 1z/31t2o1a ' Office orCoosamer Affrirs Bc 8d81ees��t�utaidoo K , ® People Helping People Build a Safer WorldTM m }tflMZ;1MpRCdEMi;NT CONTRACTOR 1NiERNA�tONAI ' ReQistrrEftlon• 4 5 TOO: CODE CODHCiC 812 14 IndividualI:x�3rsUon: 3 r y RIC ARD TUPPEft Richard Tupper k 't RICHARD TUPPEF2 Tupper Construction., 29 Roberta Drive x M ' Building Safety Professional ` ' r- W,YARIVIOUTH;MA 02Ct13*t.:na Undersecretary Member r###. 815811- , `Exp; 4I30/2014 :- 4 r �c , o ass save P CIPATIN CORMCMR PERMIT AUTHORIZATION FOR 1, Timothy Calise ,owner of the property located at: (Owner's Name,printed) 17 Thread Needle Lane Centerville (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X Owner's Signature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services.Participating Contractor to the above referenced project: y G� Participaiilig Contractor - Date In • ' SIB L�8�$' . , E � t For Wice us--Only Rev. 12132011 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O Parcel Application Health Division - Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board / Historic - OKH _ Preservation/ Hyannis Project Street Address 1-2 TYR(7—A T WE 6��IL- Village T41 Owner?tMc��"Ff�/AN 14521-frGi_Y �t-15 Address 5AInl,, Telephone /- t2" `i) ?2 1 Z Permit Request La 5 J Y2_Q C-r/OA) �64 l.p 4AUuAM41 Awp 05TMM 4 & f5 F(126 P264ek- iAf l in u6- N k i ch,(A) , 01>Si&L teL cx!2 S Square feet: 1 st floor: existing 21q roposed_?35'*' 2nd floor: existing Qproposed Q Total new Zoning District AD - Flood Plain Groundwater Overlay Project Valuati g 1 0_V Construction Type Lot Size �g Grandfathered: ❑Yes ❑ No If yes, attach supporting,documentation. k, Dwelling Type: Single Family , Two Family ❑ Multi-Family (# units) Age of Existing Structure �f Historic House: ❑Yes I(Vo On Old King's Highway: ❑Yes XNo Basement Type: 4.Full Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) 0 Basement Unfinished Area (sq.ft) 100 % �u Number of Baths: Full: existing new Half: existing new W Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: )kGas ❑ Oil ❑ Electric ❑ Other Central Air: AYes ❑ No Fireplaces: Existing _New _� Existing wood/coal stove: ❑Yes No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing new size _Shed: ❑ existing ❑ new size _ Other: f3 CD Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes _rU J�-No If yes, site plan review# ��-� �;,'�� Current Use Proposed Use =' f APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V�l j c 4 CAS /`b Telephone Number Address aC) g License# �- �f Home Improvement Contractor# � 6 f ),9A gLk)�aM_ // /7 ®,166 0 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7 Udh S SIGNATURE zAnFA96,DATE ! y i FOR OFFICIAL USE ONLY APPLICATION# - r DATE ISSUED_ f C.ZP/PARCEL NO. ADDRESS - VILLAGE OWNER II' DATE OF INSPECTION: FOUNDATION- CJ16%11 FRAME SWEAT1kZi3G L��11 P�O�>E ,� I ti INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I � GAS: - ROUGH ti "' ^' FINAL FINAL BUILDINGa0/ 101L'7Ill r DATE CLOSED OUT 3 4 ASSOCIATION PLAN NO. f 1 — t vwui, 4(&'C_0 AWC Gitidc, to J'Yood. Cons'11"Icto) .110 nip/r 1Yirrrl Loirc �4aSS,-1cI1t1SettS CliecIclist fol- Comp.Iiance (780 C'N'IR 5301:2.I.1)' Check -+, Compliance 1.1 SCOT �. Wind !peed(3-sdE gust) ............ .. .... 110 mph Wind Ixposure-Category ... ... ....., ................. (/ Wind Rposure Category ....Engineering Required For Entire Project ......::: C 1.2 APPLI:ABILITY v Numbe of Stories (a+roof which exceeds 8 in 12 slope shall be considered a story) stories s 2stories' Roof Pich 4� 12:1 (Fig 2) .,...... 2 MeanVbof Height ...,.. (Fig 2)............. ...................:: ........ ft 5 33' Building Width, W ... . .I..............I.... ....I............. ..,....... . .(Flg 3).................... I......,..... ft 5 80' ..}..a4 t 5 80 BuildingLength, L ...... ... ..,(Fig 3) .. 3 ...... :. ?f ` BuildingAspect Ratio (L`/W) (Fig 4) (sAR ,a�S _5 3:1 Nomin a''Height of-Tallest Opening2 ........ (Fig 4)......... 5 6 )`3 FRAM IfyG CONNECTIONS . N Generalconipliance with framing-connections...... .......,:..(Table2)....... 2:1zFOUNDATtON Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete Masonry „,??. ' ....... �.......:.... : ....... ..... . '.; : .. f��?/L ...:?''v,�� '...:. I� L . 13 2.2. ANCHORAGE TO FOUNDATION '.. `15/8"Anchor Bolts imbedded or 5/8'Proprietary Mechanical Anchors as an alternative in concrete only ' ;. Bolt Spacing' general . ... :. (Table.4) ... : ...: in. ,# Bolt Spacing from end/joint of plate ......................(Fig 5)............... _in. s 6' - 12" -� Bolt Embedment-concrete....... (Fig 5).............. .......... ....... -in. >_ T 4*413oit Embedment-masonry.................. (Fig 5)..:. ......1� � N r !7i P� in. 2: 15" ✓_ Plate Y✓asher,....... .. .. :,.,... ............... .(Fig 5) :,:>3"x 3"x./ 3.1 FLOORS r/ Floor framing member spans checked (per 780 CMR Chapter 55) Maximum Floor Opening Dimension.:, ........ (Fig 6)...... ....I... ....4:>ft 5 12' Fuil,Height Wall Studs at Floor Openings less than 2' from Exterior Wall(Fig 6)....:'.?aS.,.m ...flr •• Maxim etb um AoorJolst;Sacks ' Supporting Loadbearing Waifs or Shearwall ...............(Fig,7).............. ................. ........... ft 5 d Maxinibm Cantilevered;FioorJoists x Supporting Loadbearing Wails pr Shearwall .:......(Fig 8).....:, ......... ... . D f ,- t <d Floor.Bracing at Endwalis ...(Fig 9),...:... / Floor Sheathing Type ,. ..... . . . ..:(per 780 CMR.Chapter-55) ii T ... �i g � ...... Table 2 CMRd nails r55 ..,, .. .3/.y�/,..,, In.. Floor Sheathing Thic 1.kness " "(p P )' m edge/ in field Floor Sheathing Fastening ........ ... . ( ) � g 4.1 WALLS ' Wall Height, Loadbearing walls.... ..... (Fig`10 and Table .................5) Non-Loadbearing walls ... ~(Fig 10 and Table 5)..... .. .::..... . ft .520' !/ Wail Sfud Spacing .,(Fig 10 and Table 5) f�in. 5 24'.o:c. ; ........................ ..(Figs 7� 8 .. ,,....Alft Wall Story Offsets ( g )..., :,. — a 4.2 EXTERIOR WALLS' / t Wood.Studs . l Loadbearng walls1.................... (Table 5) ......., .....2x `7 ft in:, Non-Loadbearing walls (Table 5).......... x 2 - ftin ' Gable End Walt Bracing Full HeightEndwall Studs ..........................................:.(Fig 10)............. ................ WSP�Attic Floor Length.......:..::.....: .............................(Fig 1.1). Gypsum Ceiling Length (if WSP not used)....:..............(Fig 11). ft'>0.9W and 2,x 4 Continuous Lateral Brace.@ 6 ft. o.c. .. (Fig 11)............I.......... . ... ... .. ................... or Ix 3 ceiling furring strips @ 16"spacing min. with 2 x 4 blocking @ 4 ft. spacing in end joist or truss-bays Double Top Plate Splice Length .........(Fig 13 and Table 6)....... . ....... .... . ......... ft: _ _I If FTC Guir/e /o Wood Coays v(.rclion if/_f-li,{r/r 36'irld Zolle N [�rfgSSRCIIIISCtt,s C11eC.r(.JzSt for- C01111).Zi rlCe (780 CiWTZ'5301.2,I.1)1 Loadbearing Wall Connections Lateral(no, of 16d common nails)................................(Tables 7)..................................................... Noi-Loadbearing Wall Connections Lateral(no. of 16d common nails)................................(Table 8)......,................................................ Loaf Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans :...............(Table 9)...........................,...... ft� in. s 11` .............. Sill Plate Spans ........................................................(Table 9).................................. ft_in. s 11' r� Full Height Studs (no. of studs)...........'.............:...........(Table 9)..............:.............,...,....................... !� NonL.oad Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans........................................... .,........,..(Table 9)......,..................,..,... ft_in. 5 12' a/ Sill Plate Spans.... :.....................................I.............,'..(Table 9),.,,.,,............I.....I......... ff_ in. _< 12„ / Full HeVt Studs (no. of studs)....................................(Table 9)....................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Ninimum Building.Dimenslon,'W1 'Nominal Height of Tallest Opening2 ............................... ...............................i.............$ s 6'8" SheathingType..............................................(note 4)......,...,......................./,V...... b. Edge Nail Spacing................:........................(Table 10 or note 4 if less)........................ in. Field Nail Spacing......................:....................(Table 10)..........................:........I............. in. Shear Connection (no. of 16d common nails)(Table 10)...............'........I......I......I.., ............. Percent Full-Hel ht Sheathing Table 10 ................................................... 5%Additional Sheathing for Wall with Opening > 6V (Design Concepts).................... _ Maximum Building Dimension, L ` 1 Nominal Height of Tallest Opening z A �?�Z-.. O.. �-. .... s 6'8 Sheathing`Type...... ...'.'. .:....:......................(note 4)....:..................;,1Q...4;:�,(>Ar........... Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................in. Field Nail Spacing.......................................:.:(Table 11)........................................:.........— in. Shear Connection (no, of 16d common nails)(Table 11).........................................:........ t/ Percent Full-Height Sheathing........................(Table 11).............................................:....... 1 % Add itional ditional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?....'.. ..........`.......`...-.......................,...... ....,......,............,.................,..................., 5.1 ROOFS 4 Roof framing member spans checked?.......:................(For Rafters use AWC Span Tool, see BBRS Website) Roof Overhang ...................................................(Figure 19) ............. 1 ft s smaller of 2'or U3 'Truss or Rafter Connections,at-Loadbearing Walls Proprieta''r Connecfofs Uplift................................................(Table 12)............................................U=-;Wplf r/ Lateral.............................. . ...........(Table 12).............................................L=j__7 6plf Shear............................:.......,..........(Table 12)............................................S=72�2 Off . Ridge Strap Connectfons, if collar ties not used per page 21... (Table 13)...................... . - pif Gable Rake Outlooker...:....':-...-� .. (Figure ) ......:Fiure 20 ft s smaller of 2'or L12 !/ ...... Truss or Rafter Connections at'Non-Loadbearing Walls Proprietary Connector's (Table 14 Uplift.. b..................�... ......,...... )............................................U= Ib. Lateral(no. of 16d Comm n nails)...(Table 14).........:.............. ...............L Roof Sheathing Type..........l OQ.1 .............(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness m..................................:..... ->'...,................................ ...�S in. 7/16'WSP Roof Sheathing Fastening..:.............I...........................(Table 2)......F1.1......46, ... ............................_. Dotes: This checklist shall be met in its,entir' ty, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR 5301:2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. ' Steel Straps per Figure 5 b. 20�Gage Straps per Figure .11 c. Uplift Straps per Figure 14 d. All Straps per Figure 1`7 e. Corner Stud Hold Downs per Figure .18a and Figure 18b Exception:Opening heights of up io 8 ft. shall be permitted when 5% is added to the percent full-height sheathing -'requirements shown in Tables 10 and 1 i'. The bottom sill plate In exterior walls shall'be a minimum 2 in. nominal thickness pressure treated#2-grade.. r - -Daniel E. Braman,.P.E.- ... . . 189,� Point Rd. A-02637436 ` 1 ,mot 1�2c�s C ; ill: - - - �"far'T-�: « t ►�c c, C� Q >.-I C rs OU... 4sl®i?¢ ' O.� S _ t VJt t2. _ C�.3 RAMSBEAM V2 . 0 - Gravity Beam Design 4 Licensed to: Dan Braman, P.E. Job: Calise Residence,Centerville Steel Code: AISC 9th Ed. SPAN INFORMATION: Beam Size (User Selected) = W12X26 Fy = 36. 0Aksi Total Beam Length (ft) = 24 . 00 Top Flange Braced By Decking LOADS: Self Weight 0. 026 k/ft Line Loads (k/ft) : Distl Dist2 DL1 DL2 Pre DL1. Pre DL2 LL•1 LL2 0. 00 24 . 00 0'. 180 0 . 180 0 . 000 0 . 000 0. 480 0 . 480 SHEAR: Max V (kips) = 8.23 fv (ksi) = 2 . 93 Fv 14 . 40 MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft < ft ft fb Fb fb Fb Center Max + 49. 4 12 . 0 0 . 0 1 . 00 17 . 75 24 . 00 17 . 75 24 . 00 Controlling 491. 4 12. 0 0. 0 1. 00 . 17 . 75• 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 2 . 47 2 . 47 Max + LL reaction 5. 76 5 . 76 Max + total reaction 8 . 23 8 . 23 DEFLECTIONS: Dead load (in)' at ' 12 . 00 ft = -0 .260 L/D = 1108 Live load (in) at 12 . 00 ft = -0. 606 L/D = 476 Total load (in) at 12 . 00 ft, = -0 . 866 L/D = 33.3 . I RAMSBEAM V2. 0 - Gravity Beam Design Licensed to: Dan Braman, P.E. Job: Calise Residence,Centerville Steel Code: AISC 9th Ed. SPAN INFORMATION: Beam Size (User Selected) = W12X30 Fy 36. 0 ksi Total Beam Length ' (ft) 24 . 00 Top Flange Braced By Decking LOADS: Self Weight = 0 . 030 k/ft Line Loads (k/ft) : Dist1 Dist2 DL1 DL2 Pre DLl Pre DL2 LL1 LL2 0 . 00 24 . 00 0.. 315 -, 0. 315 0'. 000 0.000 0 . 630 0 . 630 SHEAR: Max V (kips) = 11. 70 . fv (ksi) = 3. 65 Fv = 14 . 40 MOMENTS: Span Cond Moment . @ Lb Cb Tension Flange Comp Flange - kip-ft ft ft fb -Fb fb Fb Center Max + �70: 2 12 . 0 0 . 0 1 . 00 21 . 82 24 . 00 21 . 82 24 . 00 Controlling 70.2 12 . 0 0. 0 . 1. 00'. 21. 82 24 . 00 --- � REACTIONS (kips) : Left Right DL reaction 4. 14 4 . 14 Max + LL reaction 7 . 56 7 . 56 Max + total reaction 11 . 70 11 . 70 DEFLECTIONS: Dead load (in) at 12..00 ft = -6. 373 L/D 772 Live load (in) - at" 12 . 00 ft = 0. 681" .L/D 423 Total load . (in) at 12 . 00 ft 1 ._054 L/D = 273 • i The Commonwealth'of Massachusetts i 1 Department of Industrial Accidents 1 ~x� Office of Investigations 600 Washington Street Boston, MA 02111 r cV www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LejZibly Name (Business/Organization/Individual): � Address. ;'C'n 1114A -(1- -j e City/State/Zip: 4 W/� Phone Are you an employer?Check the appropriate box: Type of project(required): l.❑ I am a er with employer 4. ❑ I am a general contractor and I P Y r 6. New construction employees(full and/or part-time).* have hired the sub-contractors ` listed on the attached sheet. $ 7• Remodeling 2.El I am a sole proprietor or partner- g ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. Nfficers workers' comp. insurance. 9. ❑ Building addition f' [No workers' comp. insurance 5. We are a corporation and its required] .have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself.'[No workers'comp. c. 15.2, §1(4),and we have no 12.0 Roof repairs " insurance required.] t employees. [No workers' 13.[1Other _ comp. insurance required.] *Any applicant that checks box#l 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_ s } Policy#or Self-ins. Lic. #: Expiration Date: , Job Site Address: _. City/State/Zip:, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of STOP`WORK ORDER and a fine of up to$256.00 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 ce of n th ans and penalties of perjury that the information provided above is t ue and correct ` Signature: ,: O P Date: Phone# `(� _ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is'defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do -naintenance construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed To be an employer." MGL chapter,152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the�commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely;by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. .City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit"to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any q"uestions, please do not hesitate to give us la call. , , , The Department's address,�teleph a ind fax number: 11: �•+ t 4 The Commonwealth of Massachu%setts ► �;' Department of Industrial Accidents, t" ' Office of Investigations 600 Washington Street Boston, NIA 02111 Tel. # 617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass..gov/dia I - r 4ofTHETpy2 Town of Barnstable regulatory Services � r + BA LVSTABLE, v Muss. $ Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Www.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6. Property Owner Mus t Complete and Sign This Section If Us inz'A Builder as Owner of the subject property hereby authorize ;R YatoM L,V f,by-?S JAI_ to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Forrn.on the,reverse side. Q:MRMS:OWNERPERMISSION ;Massachusetts - Department of Public Safet\ Boaed of Building Regulations and Standards Construction Supervisor License License: CS 12414 ----- Restricted to: 00 STEPHEN W BRITTON PO BOX 897/500.MAPLE ST W BARNSTABLE, MA 0266EI Expiration: 7/21/2011 r ( nuui in�irr Try: 1433 ,� Elie 'taomirnaruuecc�r� a�✓�2�aooac�zudell�. . r Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR J Registration 165568 >..� Expiration 3/2/2012 Tr# 293967 Type Private Corporation GRYPHON BUILDERS;INC STEPHEN BRITTON? 500 MAPLE STRE T WEST BARNST LE,:M -02668 Undersecretary 1HE Town of Barnstable �ypF tp�� BARNSTABLE. * y Regulatory Services MASS. °639. Building Division prED MAC p ' 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection S ATO TA)G Location I' i Ae E M) A)F,-b L c LA) Permit Number Owner Builder E One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 1)OUi3LC 40W pr NA-rL--s,3C. Nr-COE'b f;LT�v- p4CATI-MrJG (5=/-L-tPLAT 3 :�3 G2-71) /JAzLa� JG N�11�-7DE�lb GA-eAGC NEAi)r-rz PrWs;- f�E iJAT-LfE-D TU IDP PLATE PER E1�G4- AJAZLZ C. SPFc s <` G cog 3 ) i LIlu v Please call: 508-862-403-8-for re-inspection. Inspected by LWL, -- Date A> l J � V / oFrrur ti Town of Barnstablle. o �o.C� cD i �y "*Permit# Expires ri imirlhs jroiir Jssue rinl Regulatory Services 13ARv3rABLE, g Fee y a ASS- A j6J9_ Thomas F. Geiler, Director Building Divisipn (29!2jljj° Tom Perry, CBO, Building Commissioner 200 Plain Street, Hyannis, MA 02601 www.town,barnstab le.ma:us Offic e: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nor Yulid wi//foul RedX-Preis Inipriizl Map/parcel Number 076 Property Address I /MCA' ""3 /'Vk— T Residential Value of Wo4o]C-)116 d D Minimum fee of$35.00 for work underS6000.00 Owner's Name & Address T! Anfy p 045�1-6 G/►���t✓ Contractor's Narne A/(� Telephone_Number Home Improvement.Contractor License#(if applicable) 6 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESSPERMIT Check one: I am a sole proprietor )r(., 1 4 2010 I am the Homeowner ❑ I have Worker's Compensation Insurance TO1N�N OF.BARNSTABLE Insurance Company Name Workman's Comp.Policy{ Copy of Insurance Compliance Certificate must accompany each permit, Permit Request (check box) ❑ Re-roof(hurri.cane nailed) (stripping old shingles) All construction debris will be taken to ------------ ❑,Re-roof(hurricane nailed)(not-stripping. Going over existing layers of roof) ❑ Re-side 2 #-of doors. Replacement Windows/doors/sliders.U=Va ue J (maximum .35)# of windows *Where required: Issuance of this permit sloes not exempt compliance with other town depanrnent regulations, i.e.Historic,Conservltion,etc. ***Note:' Property Owner must.sign Property-Owner Letter of Permission. , copy f th.e Home Improvement Contractors License & Construction Supervisors License is kequi Tlle Commoirwealllr ofl fm—sadntse/ts -- ----- Departweril of Indrtsfrial,,lcciden& Office of Invesfigafions I 600 Washington Slreel t Boslon, ALI 02111 Werker•s' Compensation Insax-ince_Affi.dniit: Builders/Coutl;zctors,/Electlic ansMiimbers Applicant Inform!tion Please Plznt Lep_ibht `r Na131e(Bitsinesst�Orgavi?afian�Iudividr�al)-�j���V/� �(,{(L.��/�„S 11V � . Addre=ss: �!- CitWsfate%Zip: (,J&5 7— W S t—h&_-_,IC PhQ'Ile Are you an employer? Check the appropriate boa.: Type ofproject(required): L❑ I am a employe!-urith. 4• ❑ I am a geaeratl contractor and I employees(full and/orpart=ti-me). * have hired.the sub-contractors 6. ❑.Newconstntc.tion 1❑ I ani a sole proprietor or partrrea-- listed on:the attached sheet 7_ .Reinodeling slu encl have no employees These sub-contractors have p $. .Denwlition working :for ore in any capacity. employees and have workers' [No workers' comp,insurance coiup-insurance..Y 4• [].Building addition required:} 5. +e are a carporation.and.its 10.�Elr c:trical repairs or additions 3.❑ :I am a homemmer doing.all work affcess have exercised their 11_E]Plumbing repau-s or additions myself [No workers'comp. right of e^cemption per it'fGL 12.❑Roof repairs insamunce:required.]i c. 152, §1(4)., and use have no employees. [No workers' 110 Other . covrp::irrsurauce.req.true.d.] 'Any applicaut that checks box#1.niust also fill out the section below showing their wvyl-ers'compensa:tinn policy infoawtian. t Honneowmers who submit this.2f560 indicating they are doing alf-work and they birn air[side contradnrs must submit.a uew.affidavit indicating sAXII 'Ca4trac.tDrs that check this bent must waacbed an sdditionat sbe.et showing the nsure of the sub-contractors snd state whether or not those entitseshave employees. If the sub•-cantcactors:have employees,.11wy.must provide their workers'comp.policy number. I alll all >✓tploy r tdint is proi ir7irig}iro era':cotrrpaatsation hlsatmvice for n y ettrplayeRs. Eelowr'.is tliep.alicy and job site If�O,r'N[fEf101t. Instuance Company Name: Policy#or.Self--ins.Lc.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of.the ww-kers'compeirsutio❑policy declaration page(shotlring the policy number and expiration 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 S1.,500..00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK DRDER 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 f the D.lA for irrstsrance coverage verifcstion. I do hereby cue th ahis a tri psatat 'es of pr-ju ry t a a is forrrtr han praviderl.,a bowie is try.a,and correct. Si ture: Date: 11I,, Phone#: V FJ � only. Do not write in fills area,to be co}lipLeted by clay or town of rral n:. Permit/License# ozity( ircle cne)i . x . of 1KE royy RARNSTARLE, " ncnss, 16 $ T'ov�n of Ba :>1stible g9 �� plfD MAC A a Regulntory'Services Thomas F. Geiler, Director r Building Division Thomas Perry, CBO. Building Commissioner 2.00 Main Street, Hyannis, MA 02601 rvivw.town.barnstable,ma:'us Office: 508-862-4038 Fax; 508-790 6230 Property Owner Must Complete and Sign This Sectio�i ff Using-A, JBuildei I kwotkr Coats as Owner of the subject property hereby authorize �/ly/�/�'0/1,� /SG4/L,/�rIZS' 1rV to acf on my behalf, in all matters relative to work authorized by this building permit application for: `' 4 x (Address of Job) Signature of Knef to Print Name T. If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. r ` Town of Barnstable °^ Regulatory Services B.AjJSTABLE, ` Thomas F: Geiler Director cnsS. $ Bffilding.Division Tom Perry, Building Commissioner 200 Main`Street, Hyannis, MA 02601 www.town.barnstable.ma,us Office.- 548=862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION* Plense print DATE: 10D LOC ATION:TIO 1J . number street village "I-IOME.'OWNER I ame home phone N work phone# CURRENT MAILNG ADDRESS: city/town state zip code The current exemption for"homeowners;'was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor, DEFINITION OFfrON(EOWNCR Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be'considered a homeowner. Such"homeowner"shall submit�tothe.B,uild ink,Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) ,� } The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations: The undersigned"homeowner"certifies that.he/she understands.the Town of Barnstable Building Department minimum inspection procedures and requirements andwthat he/she will,comply with said�pfocedures"and,req'u'rements,, Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000�ubic feet or larger will be required to^complyWwith;th`e State Building Code Section.127.0 Construction Control: HOMEOWNER'S EXEMPTION. The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing ofconstruction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work, that such Homeowner shall act as supervisor." I a Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix.Q Rules&Regulations tor.. Licensing Construction Supervisors,Section 2.15) This lack of awareness oRen results in serious problems,particularly when the homeowner hires unlicensed'persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware.of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certiFication for use in your community.. 4 � 1 ✓lie "Panr��w�ru�ea� o�.�,czaaac�ivae%ta License or registration valid for individul use only. Office of Consumer Affairs&Business Regulation :before the expiration date. If found return to HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration -.s-i'65568" 10 Park Plaza='Suite 5170 Expiration 3/2/201i2 Tr# 293967 Boston,MA 02116 TYPesy Pnvate Corporation GRYPHON BUILDERS,ING STEPHEN BRITTON 500 MAPLE STREET '-- WEST BARNSTABLE M9:02668 Undersecretary Not valid without signature Massachusetts- Delnisrtment of Public Safety. Board of Building; Regulations and Standards Construction Supervisor,License License: CS 12414 Restricted.to: 00 i STEPHEN W BRITTON PO BOX 897/500 MAPLE ST W BARNSTABLE, MA 02668- ' r OBER Expiration: 7/21/2011 ('uunuissiuncr Tr#: 1433 - r ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ito cf Map Parcel ;Application Health Division .'Date Issued _ anon Conservation Division � p Fe,a Planning Dept. �� Perrfiit � Date Definitive Plan Approved by Planning Board fee, Historic - OKH Preservation/ Hyannis Project Street Address Village Owner Wk C9-/`� T.�%25 Address /1 redJ A is l Telephone Permit Request 4_ S� Square feet: 1 st floor: existingpl�lproposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay -*-Project Valuationigj' aMQ Construction Type Lot Size OPM Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ' Two Family ❑ Multi-Family(# units) Age of Existing Structure ; Historic House: ❑Yes )CNo On Old King's Highway: ❑Yes to Basement Type: XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ �L new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: X Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes X No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ..Name. tp Telephone Number �Do�` � « Address 7 ij� �t� _LCt� -License # �0,& UjqZf Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� _ DATE bn � f FOR OFFICIAL USE ONLY t APPLICATION# ' DATE ISSUED' ;: 14'l0Ec' MAP./PARCEL NO-,Z ADDRESS— _ VILLAGE r OWNER t DATE OF INSPECTION: F ' �FOUNDATION4 d P1 I ;==t FRAME "IINSULATIONUL -IK-J FIREPLACE a ELECTRICAL: ROUGH FINAL F� PLUMBING: ROUGH FINAL ROUGH R0,W,;-;GA FINAL � FINAL BUILDING 9 : 1_fl , r� f DATE CLOSED_O -`.T'> 4..'_;. F ASSOCIATION PLAN NO. :r '> The:Cominonwedlth''ofMassachusetts r Department ofXndustrialAL cidents (� o of h7vestigatfft - �600"Washington Street Boston, MA 02-111 sy wwmmass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricans/Plurribers .Applicant Information Please Print Le_ibly Name (Business/Organization/Individual):- ?/��e(,� Address: �� �i� 1442 City/State/Zip: Are you an employer?-Check the appropriate box: Type'of project('required): 4. I" a general contractor and I i.❑ I am a erployer with F].New construction erriployees'(full andlorgart-time),* have'hired the`sub-contracfors 6'__ 2.❑ m I a a sole propn listed on the attached sheet, 7. Remodeling ator.or partner-, : � •. 'ship and have no employees These sub-contractors have g Demolition workin for me in an capacity. s employees and have workers' fl g Y 9. .[] Building addition" No workers' comp. insurance comp. insurance. r wired.] 5., We are acorporation-and its, 10.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 1 1.D,Pltimbing 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 employms,_[No'workers' 13.� Other comp:insurance rcquired.]x *Any applicant that checks box#1 must also fill out the section below showing their workcrs''compcnsatioo policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such, (Contractors that check this box mustatlaehcd.an additional-shcct'showing the nih)cof the sub-contraeton;and state whether or not t.thosc entities have cmployccs. If thcsub-contractors tiavc`cmployccs,they must provide thcir'workcrs'comp,policyanumbcr.i v , I ain an employer that is providing workers' compensation insurance for iiy employees:, ;Below is the policy and job site' information Insurance Company Name: .Policy# or Self-ins. Lic, #: Expiration Dater Job.Site Address: ". ; City/State/Zip." Attach a copy of the workers' compensation policy declaration page.(showing the policy number and expiration date). Failure to,securc coverage as required under Section 25,A of MQL lea c:>152 can d 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 da ' against the violator. Be advised that.copy of this statemrofmay.be forwarded to-the Of ce'of Investigations of the DIA for insurance coverage verification:, `;.. I do hereby certify under the pains andpenalties ofperjury that thelnformation previded'above is true and c6rrect. _\SignatUTe: -a Phone Official ase only. Do not write to this area to h' completed by city,or town official ' �- City or Town, Permitt%License# Issuing Authority (circle one) 1. Board of Health I Building Department 3. City/Town`Clet-04 4. Electrical Inspector 5.-Plumbing Inspector` 6. Other x. Contact Person: Phone#: t. Massachusetts General Laws chapter 152 requires a1J�eniployers to provide workers' eomp.nsalion for their employees, Pursuant to this statute, an employee is defined as".;:every person in the service of another under any confracl of hire, express or implied, oral or written." 'An employer is defined asan individual; partncrship, association corporationtor other legal entity, or any two or more of the foregoing engaged in ajoint enterprise, and including the legal representaLives of a deceased employer, or [he receiver or trustee of a❑ individual partnership, associatiob or other legal'enbty,`employing employees. Hotivever the owner of a dwelling house having not more [ban three apartments and who resides (herein, or the occupant of the dwelling house of another who employs persons to do maintenance constriction or repair work on such dwelling house or on Lhe grounds or building appurtenaot thereto shall not because.of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states.that :'every state or,lo�a] licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant lYho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally MGL ch,apler 152 §25C(7) states "Neither the convnonwealth nor any ofits political subdivisions shall the insurance, any contract for the PC] rhaMr ofpublic� work until acceptable evidence of compliance with requirements of this chapter have been presented to the contracting authority:" Applicants., Please fill out.the workers' compensation affidavit'completely;by checking the boxes that apply to your situation and, if necessary,supply sub-contractors) name(s), addresses)and phone number(s)along with their certificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships,(LLP)with no employees other than the members or partners, are not required to carry Workers'• compensation insurance. If an LLC or LLP does have employees e policy is rcquired. .Be advised that this affidaVilimay,be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and data th-e affidavit, The.affidavit should be returned:to the cityortown that the app license,liaaGon for the permit.or cense is being requested,not the Departmenl of Industrial Accidents; Should you have any questions regarding the'law or if you are required to obtain a,workc: compensation policy please call the Department at the number listed`below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials. Please be sure that the affidavit is complete and printed legibl y, The Department has provided a space at the bottom of the affidavit for you to fill out in.the event the Office of Investigations�bas to contact you regarding the applicant. Pease be sure to fill in the perrniUlicense number which"will be used as�a.refercn ce number. In addition,an applicant that must submit multiple permiYlicense applications in any°given year, need only stibrnil one affidavit indicating current policy information(if necessary).amd under"Job Site Address" the applicant should write 'all ]o.'caiions in (c)ty or town),"A copy of the affidavit that has been officially stamped or rnarked.by_ihe city ortowa maybe provided to the applicaDf as proofthat a valid af5davif is on file for futurcpermits or licenses: Anew affidavitln t be filled otrt each Year. Where a home oYrner'Or citizen is obtaining a license or permit not relaled to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this aJEdavi(. The Office of lnvestigaLionswoL nrratinn and Should youhaye any questions, ` please do notbesitaie to give us a call. - The DeparLmcnt saddress, telephone and fax number: " The COrIIMODWealth of Massachusetts Department of Indusrial Accidents Office of Investigations m 600 Washington Strect Boston, MA 0211 l Te). 4 617=727-4900 ext 406'or 1-877-MASSAFE . u � Fax ## 617-727-7749 e F ; Revised 9-24-0.7 u www.mass:gov/d4 f Y ray Town of Barnstable,':'. I-o o Regulatory Services �� Thomas F. Geiler,Director NST Buirding Division` PrED '�k Tom Perry,Building Commissioner s 200 Main"-Sheet, Hyannis, MA.02601 R'WW.town.barnstable_tna.us ' Office: 508-862-4038 Fax:, 508-790-6230 HOINIEOWNER LICENSE EXEMPTION Plearo Print - DATE: 0 JOB LOCATION: I/ hzgz �/c za L vnum(b/,:rr� sheet �J Q village "HOMEOWNER;': name home phone# work phone# CURRENT MAILING ADDRESS: city/town statL zip code T c current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire whp does not possess a license;provided that the owner acts m supeIYlSOr. DEFINITION OF HOM3Owh'ER Persons)who owns a"parcel of land on which he/she resides or intends to reside, on which there is, or is intended to, be,'a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constrgcts more than one borne in a two-year•period sha11 Dot.be'considered a Homeowner, Such "homeowner"shall submit to the Building OfBcial on.a form acceptable"to the Building Official; that beJshe shall be " responsible for all such work performed under the building permit. (Section 109.1-1) The undersigned"homeowner"assumes"responsibility for camplianco with the State Building Code and other applicable codes, bylaws, Cult sand regulations. The undersigned"homeowner"certifies that-he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he'/she will comply with said,procedures and re ements. Signatiurc of Ho Gown Approval of Building 0]5cia1 Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to corn�ly with the State Building Code Section 127.0'Constrtiction Control: 4, ` HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing"work for which a building pernvt is required shall be exempt from the provisions of-this srctiqn,(Scction 1 D9.1.1 -Licensing of construction Supervisors);`provided that if the homcov,mer c gages a person(s)'for hire to do such work,that such Homeowner shall act as supa-visor." },-any homeowners who use this rxcnrption an unaware that they arc assuming the responstbilitics of a supervisor(sec Appendix Q, Aulcs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homcowmcr huts unlicensed persons: In this case,our Board cannbtprocced against the unlicensed persm.as it Would with a licensed " Supervisar. The homeowner acting as$upervisor is ultimatclyYcsponsib)c: To cnsurc that the.homeowncr is fully aware of hisAcr irspons b litics,many communities rzquirc,as part of the permit application., that the bgmeOFVner ccrtify`that hdshe understands the msponnbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may Cate t amend and adopt such a form/eet-tification for use in your community. Q:fornis:homccx cmp t � Yt r ti Town of Barnstable ` Regulatory Services 4 t =.LAlt6TABI.� r ` Haas �. Thomas F. Geiler,Director fo ��� ' - Building Division Torn Perry, Building Conarnissioner 200 Main Street, Hyannis, MA 02601 www.town.b arnstab l e.ma.us Office: 509-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) . t Signature of Owner Date Print Naive . If Property Owner is applying for permit please complete the Homeowners License Exemption-Form on the reverse side. Q:FORMS:OWNERFERMtSS10N COPY Affidavit I, Kathryn G. Green, Trustee of the Green Realty Trust a/d/t dated 8/7/01 and recorded in the Barnstable County Registry of Deeds in Book 14460, Page 261, of 17 Thread Needle Lane, Centerville, Massachusetts 02632 hereby state the following: 1. I purchased the property located at'17 Thread Needle Lane on January 15, 1999 by deed from Nancy E. Frangione being recorded in the Barnstable County Registry of Deeds in Book 11995 Page 51. _ 2. I conveyed my proprety to the Green Realty Trust u/d/t dated 8/7/01 and recorded in the Barnstable County Registry of Deeds in Book 14460, Page 261 in which I am the Trustee of the Trust. From the beginning of my ownership commencing with the Deed dated January 1.5, 1999, the property has always been a four bedroom residence acid will continue to be a four bedroom without interruption. Witness my hand and seal this day of August, 2010.. Kathryn"G. reen, Trustee COMMONWEALTH OF MASSACHUSETTS Barnstable, ss On this day ofI '; 2010, before me, the undersigned notary public, personally appeared Kat. ryn G. Green,.Trustee as aforesaid proved to me through satisfactory evidence of identification, which was a Massachusetts driver's license, to be the person whose name is signed on the preceding or. attached document, and acknowledged to me that she signed it voluntarily for its stated purpose as an authorized person for said Trust, r 'Notary Public: Commission Expiration: � )o DONNA M.ROBERTSON * nay Public _ cWIMil011wwa at ma66achuSCI1S . CSJRV lsslon EVbvs July 9,2016 Deed Restriction Whereas, Kathryn G. Green, Trustee of the Green Realty Trust udt dated August 7, 2001 being recorded in Book 14460, Page 261, is the owner of property located at 17 Thread Needle Lane, Barnstable (Centerville), Barnstable County, Massachusetts, by Deed recorded in Book 16855, Page 39, said land being shown on Barnstable Assessor's Map 210 Parcel 76 and being shown as Lot 12 on Plan recorded in Book %q/ Page ,�jt� Whereas, Kathryn G. Green, Trustee, as the owner of said Lot, has agreed to a , restriction as to the number of bedrooms which can.be included in anv home existing or to be built in the future on said lot'as.a pre condition to obtaining a building permit for this lot; Whereas;The Town of Barnstable, as a re-condition to P .granting the building permit for the conversion of a garage into a library/piano room existing on this lot is requiring that the agreement for the restriction of the number of bedrooms in any house existing or to be constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. Now Therefore,Kathryn G. Green, Trustee does hereby place the following restriction on the above referenced land in accordance with'this agreement with the Town.of' Barnstable, which restriction shall run with the land and be binding upon all successors in title: 1. Lot 12, Plan Book 191., Page 47, house# 17 Thread Needle Lane, Barnstable (Centerville), Massachusetts, may have a'house containing no more than four.(4) bedrooms. Kathryn G. Green, Trustee hereby agrees that this shall be a permanent.deed restriction affecting the above described premises. . a Cop i �s. For title see deed recorded in the Barnstable County Registry of DeedsiBook 16855., Page a 39 and Book 16778, Page 261. z ' Executed as a sealed instrument this cP7 day of° , 2010 ' Kathryn . Gr en, Trustee r COMMONWEALTH ORMASSACHUSETTS ; e y Barnstable, ss - .- + - • 4M w .. 1 .k:a r,r' On this day of �,2010,before me, the undersigned notary public,.s e personally appeazen Kathryn G: Geen, 'Trustee, .proved to,me through_,satisiactory evidence of identification, which was,a Massachusetts Driver's-License, to be the" ., person whose name is signed `on the preceding" or, attached, document and` �F acknowledged to me that she signed it voluntarily for ifs stated purpose, Nofary Public: Corn Exp . U 7/U�j l�vas F__7'� ' DONNA M.ROBERI SON * �,'Pubk ~'�i C Mlessachusetis . $ i Sk J*9.2D i ` r 5 a , Y _ r.. i • p 5 TRUSTEE CERTIFICATE I,Kathryn G.Green,Trustee of the Green Realty Trust u/d/t dated 8/7/01 and recorded in the Barnstable County Registry of Deeds,in Book 14460, Page 261, of 17 Thread Needle Lane, Centerville, Massachusetts 02632.hereby certify in accordance with the. terms of said Trust: 1. That I am the incumbent Trustee of the Trust; 2. That said Trust has never been.amended or modified to date. 3. That said Trust remains in effect and has never been tenninated; and 4. That the Trustee has been duly'directed by the beneficiaries,who are of full and legal age, owning 100% of the beneficial interest in:and to the aforesaid Trust to place a deed restriction on the property located at 17 Thread Needle Lane,Centerville for nominal consideraton and that the Trustee has the authority to execute such documents as the Trustee deems necessary in order to effectuate the above-described transaction. EXECUTED as a sealed instrument this Oi day of ; 2010, Kathryn G. G ee , Trustee . COMMO NWEALTH.OF MASSACHUSETTS Barnstable, ss On this o day of , 2010, before me, the undersigned notary public, . personally: appeared Kathryn G. Green, Trustee as aforesaid proved to me'through satisfactory evidence of identification,which was a Massachusetts driver's license, to be. the person whose name is signed on the preceding or, attached document, and acknowledged tome that she signed it voluntarily for its stated purpose as an authorized person for said'Tnzst; Notary Public: Commission Expiration: DONNA M.ROBERTSON * Notary PUNK cortmwe b of masmN seas My Cw n*sion E)rylras MY 9,2015 Py ,*THETo�o TOWN OF BARNSTABLE fob � HAUSTADLE, i M6 9 O M BUILDING INSPECTOR °,per {1Y{M�9 �" APPLICATION FOR PERMIT TO ..............�ftSiT !uU�......�� ��' �� <, l -g....... ............................... == r TYPE OF CONSTRUCTION ......... l7 ............` � �f Sh/4t's.��—' .`�i•%', �/. '' ................,a .'.°Z}...........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit. according to the following information: Location ..... .2........../...�I .Gl /�C! .. rl...... - �1 !1...� .......................................... ProposedUse ......... ..................................................................................................................................... Zoning District .............................................Fire District .......c..�_ /E. ............................. Name of Owner 4?'024p ....... b...... Jam..., ,/ �.�.�Fs� 'IiZO .........Address ..... ..... . ....... .......... ................................ Nameof Builder .... �°� .....� t � f,2�..................Address .................................................................................... Nameof Architect ............ ...................................Address ..................................................................................... Number of Rooms ............. .....Foundation .... ��/ "r.... <�`� ........................................ .... .... ................ / Y Exterior ....�.�,��:.....�- �.�'f.�..�.............Roofing ......:�.S .... .... ... .................................................................... Floors �lz? ........................................Interior ..... /1. e, ��-��.... .......... . Heating ...... 'e .. �. ...............................Plumbing .................................................................................. Fireplace E. .............................Approximate Cost Difinitive Plan Approved by Planning Board ___________________________ ___. Diagram of Lo and Building with Dimensions a ® DWI 0 ( m Z � Hh. cn Cj ' Z Q t� w d 0 (D �� m X� d � m � p Z w _ C.. C- >-- " g d ¢ Ld cn � � as Zoo O Z U7 a; 7 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above r construction. Na ae ' Mar�- J. ( ^ - ' No �_�����.. parmi� f����,.�noo..zz� . � ����.�.��''.�,.��������'�'����������' Location ..27..Zbre ..Lmoe_____.. ..................qqg!� 1.1e..................................... ' Owner ...........D�ry_J�.. | Type of Construction ................J����i----.. | —'--'—'~—^'------~------~—'---'' | . Plot ............................ Lot ................................ � ' ` | Permit Granted ___0ctcb ..� wa� 9___lg 70 Date of Inspection ------------lg ! Dowa Completed --�� m�~---lg 70, ' | PERMIT REFUSED ^-------^'---.—..------,. 19 ` ----..--....---.-.--..------.—.. � ---,—.--....---.--- .. / ... ---~--..— ' -.—..._—.-------.,...--...—.---.., \ '—~---^--`—`--'—^--'-^^^^—^^^—'~^^ ' | Approved ................................................. 19 . � ^ ' � .---------.----.....---..,...--.. . , .............................. ' - . > ` OFSHE rok- Town of Barnstable *Permit#„C-6 090/ 6 9' P� Expires 6 montlu from issue date T Regulatory Services Fee * g Y * BARNSTABLE, ' - v MASS. Thomas F. Geiler, Director A �A 1679. TfD At M Building Division � XoPS PERMIT Tom Perry,CBO, Building Commissioner 200.Main Street,Hyannis,MA 02601 MAR 1 3 2009 www.town.barnstable.ma.us. (Mice: 508-862-4038 Fax: 508-790-6230 T�1/�/Rl f± R 1 RI\I II CTn 1-k-PRESS PE t�'cMIT APPLICATION RESIDENTIAL i'IAL ONLYONLYari Pr a eI 1 A Not Valid without Red X-Press Imprint Map/parcel Number Properly Address �_� I hr(�elCl �7--� '/t � % l�l�nw t? ) G}�___..... 1Z�dential Value of Work Minimum fee of$25.00 for work under$6000.00 OWrler'S Name& Address__ t7 e a Cut"'141 1?a V��& .t Contractor's Name_ �. S N Telephone Numberj �y'��G/ � Bowe Improvement Contractor License#(if applicable) �) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance - he_g-_-:ne — --- ---- -- - — — I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name �� JJ Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to u21' ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance ofthis pennit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: roperty Owner must sign Property Owner Letter of Permission. A copy of the dome Improvement Contractors License is required. SIGNATURE. ;ll ; —Y Q: WPPIL.GS'.PORMS?b ilding permit ton EXPR SS.doc Revised 100608' s David Sawyer Construction 318 Meiggs Backus Road Sandwich,MA 02563 508-539-1992 Date q-o Proposal ubmitted To Work Place 41-a/ate �✓e,%� Work to be Performed: 5k,r JYk t 191�2_ &6�i I tdjl__� Flewl jw/� -C'l �U� Pi wood r, ,& r, wG 4, -�K " N-(L&k un CCU -6 a Vt4' r( —14 U, 3 Pr 10 ix dL kAA,10 6 CLEAN&REMOVE ALL DEBRIS FROM WORK PLACE AFTER JOB IS COMPLETED. ALL DEBRIS TO LANDFILL. TOTAL INVESTMENT FOR MATERIAL&LABOR:$ 7j 7j All materials guaranteed to be as specified,and work to be performed in the accordance with the . specifications submitted for the above work and om leted in a�substantial Qrkm iW manner. Payments to be made as follows Any alteration or deviation from e work specifications involving ex costs will be Nutenly upon written order,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Please remove and/or secure any fragile household items and cover items in attic.Not responsible for broken or damage household items. Five-Year LABOR WARRANTY/PLUS MANUFACTURES SHINGLE W NTY. We ay ithdraw this oposal if not accepted within 30 days. Respectfully submitted ACCEPTANCE OF POSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined abov . Date Signatur The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 �,, ,�•�' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information (� Please Print Le ibl Name(Business/Organization/Individual): . U Address: 22 i Phone.#: � City/State/Zip:Axe you an employer? Check the approp 'ate box: .Type of project(required):. 1.❑ I am a employer with 4. [] I am a general contractor and I * have hired the sub-contractors 6. New construction e gees(full and/or part-time), 7, Remodeling 2, am a'sole proprietor or partner- These on the'attached sheet. 0 g ship and have no employees These sub-contractors have g, E]Demolition 'working for me in any capacity, employees and have workers' 9 Q Building addition comp, insurance. [No workers comp, insurance 10.[]Electrical repairs or additions required.] 5. [] We are a corporation and its. re 3.❑ I qu a homeowner doing all work officers have exercised their 11.[]Plumbing repairs or additions am myself.[No workers' comp. right of exemption per MGL 12, of repairs insurance.required.]t c. 152, §1(4), and we have no 1 the employees. [No workers' 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 ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees, Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic,#: __ r1 'f Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up to$250.0, day against the vit or. Be advised that a copy-of this statement maybe forwarded to the Office of Investi ationsro the DIA for insur covers e verification, Ido hereb �c tify un�er th ai sand penalties ofperjury that the information provided above/is true �and correct. Si atur Date: Phone Official use only. Do not write in this area, to be completed by,city or town.official City or Town:" Permit/Liceuse# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector' 6.. Other Contact Person: Phone#: JLAXILU A All 641,Arty JUL "JUL 4-JL -2-Be IJnA %m �+amv msr� Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hue, express or implied, oral or written." . An employer is defined as "an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produce&acceptable evidence of.compliance with the insurance coverage required." Additionally,MGL ehapter..152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of coma pl ance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s), address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members'or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit.not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. ��4�.an�ealt of I�assacixt�setts Dgpartmmt of lad tr al Aceid=ts Office of In-VatigaftW as 600 Washington S.tre;et Bo:tWn,.IvMA 02111 Tc . # 617-727-4900 ext 406 or I-S77-M.ASSAFE Fax##617-727-7749 Revised 11-22-06 www.mass.gov/dia ti ,, f .. .. a =;!il(li � `.._'t!I:iiint)•. .;r..1 .-•i:!rtl:!i�(i• CS SL 98859 E(i t4: RF.WS . DAVID SANNIYER :. 3.18 ivIEIGGS BACKUS ROAD a SAi,IDV+IICH, 90,02563 1t271201 -------`—""• -r=-: 98859 and SidiFIR cs .`()aas° Xi t;C N ;''t=Z•etnt LZ'Ec l7nH!i!i2?Cz!EE5CCE5��E EC Be ldia"r Code .. .......:. ... `a`?'dgr�t`eiT[?(!f, sr g; ;icenne. v Board of Building Regulat ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 134313 Type: DBA Expiration: 10/24/2009 Tr# 259907 DAVID SAWYER CONSTRUCTION _ DAVID SAWYER 318 MEIGGS BACKUS RD. SANDWICH, MA 02563 Update Address and return card.Mark reason for change. 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REV.11 01 1 Jlc JOB NO. 1936 SHEET: 1 OF 1 ° 12 , - Lva.r— - ® [Effl a aETE-Q Q KtVIt!WI L7 s rs - FRONT ELEVATION TA Al DIN EPT DATE ., ,.. r , _., FIRE DEPARTMENT . DATE; •' 9.r .BOTH SIGNATURES.ARE REQUIRED FOR PER)WITTING 12_ .. MATCH- - . DUST. 12 .. - woor. ° • I , LEFT ELEVATION, y' RIGHT'ELEVATION f _ HIM 0 REARELEVATION PRELIMINARY DRAINING FOR DESIGN REVIEW, ORgo1O,� COTUIT BAY DESIGN. LLC = � � ; �,� - SCALE : DRAINING NO.: aE 436REWSTER oAo NEW ADDITION/REMODE .INC 1�=0R: Mi4SHPEE NIA..02649 w 1M.oRAWIINGSIFFO TM"'�"r 114" 1'- - c a CAUSE RESIDENCE COMM °E'EN A �° PH„ 508 .2�J4-1166 RTHEowh"NOTM.�o„+ER DATE : �� FAX(50 )539-9402 t w"eEMoWNGSREi�THE ,� 17 THREAD NEEDLE LANE CENTERVILLE,, MA M,o�9 ,:rwz;.. 1oilsrzolo ea - ar• Wr t , re• asr ra ANDERSEN ANDS µ� ADH� ��AT3t 33t3_ .lPtl__ iBUILUM 'CABINET . . .. EXIST. REMOD. 11 REMOD. i REMOD. DEC NEWANDERSERw MASTER „MI MASTER 6WaASF.P. FAMILY 4 B DE ROOM r'�' BATH VERIFYMFHR�2 m ROOM. b r pETA1L8 W(ONMERe , _ - L� I ----------- I PRY.Dow 1 I I I I POSTS NEWT SQ.STEEL I I Swam iCABA'IACHEND ET oP IEIM STEEL BEAM 1 W.I.C. i ' .I i4 8 I ` NEW ANDERSEN _ ------"---NEW STEEL SEAM ABOVE A410RIESWINDOW 3 ® - 3EK C°�W] s &M"", ,• OVEM I EXIST. REMOD. k REMO I I KRCHEN REMOD. DINING , BEDROOM BATH O I $ KITCHEN ANOFABEN B I RANDS REP ACN 3444 l p .11 EAST. © eR % ' °BST �----- 0 8 ----- -- NEW t ___ ;BATH q k CLOS. ® EXIST. BN M ® HALL _ NEWAN]ER6EN - - __ W JL, NE C- AµAN= _ se L'DRY. T t ® ® EXIST. I LIVING I I ° y EXIST. I CLOS, ® EXIST. L__ NEW I -BEDROOM r " 2T.&TEp GARAGE 4 4 BEDRO M $ NEW HALL NEW C�OSI I, MUDDROO CLOS. 1bp ANDEROEN NEWANDEitBFT1 tbWAN09i591 _ NEWANDERIEN - _ K ----`— C AAN . .' ' A893ESTYIImON -. ABESESNNWW - A•BERmswvmON -0N- ICO, - - N4TES 1.) Co TO VElIE02 ALL F30STIM CONDITIONS a wMENSIoNS.aN THE FlF�D a C� NEW g L) rON.TRACTOR.TO VEwFY al INTERIOR aE OMOR MATERIALS, ° CRAFT Z I,-, DETAILS;a FINISHES:IN THE FIELD VVITH OWNER era 3.) ROUGH OPENIINGHO.DIHEIGHTOFWINDOWS;AT �. FIRST FLOOR TO SE B'-10'ABOVE SUBFLOUR x � A v v t` 4.) ALL CONSTRUCTION TO'CONFORM TO::780.GMR MASSACHUSETTS y: _ STATE @UILDINQ CODE:•SEVENTH,EDRION &I 1tOMPHk7 ost"E9YVIN TONE t;PASPECT.RATIQ; MExffsNNDOIN o 7 Tj Y ALLSHEIEzT0S1}O{AFU:P LYY WN/)OODMCKAINQ SINTE EATDB R sa ra aTHNCEIDI DOES TfDG9n2'F►EtD NAILING E7 OR HOR f 8) ALL11vt LUM.BERSEAMS To-SE 1 l PILAI 010AD" B} SEE CEi27"FIED PLOT F�LA p gfl }ANDERS Y.P-E. FOR FIRST FLOOR P LA N AL1.PROPOSEp.i4Nh PgSiiN4 LS 10.)FOLLOW ALL 44moACTVRERS 4ftCIFICATIONS.FORINSTALLATION OF ALL SIMPSON co119RGNENrs LEGEND: t 1:)AIL.GON�REt>= �sEp Folt.FouI omm v*UA,FOOTIrI a Slays To'eE3000Psl.. EXISTING WALLS t2jVERIF[A1�P17JMBINGaELECTfiICAVQETAILS*OWNERSONTHESRE [__7 CONSTRUCTION TOBEREMOVED DUN FRAdq(NG cDNsTRu ON'. NEW CONSTRUCTION 19)TIMbER FRAMMIG TO BE SPRLiCEIplIJ1FIR t!Q 3 f3RROE r IECC2 IDEh1TIALfN#rFtIGY+EFFICIENCY DETAILS 009•I ID SMOKE DETECTOR CL�fATEZONE Sh.,{USE€TTHER PRE&GRIFTIVE dALIS OR RESCkIECK CALCULATION ®CARBON MONOXIDE DETECTOR TA3LE'4021 A.MINIMUM PRESCRfi?nW INSULATION a FENF , TION REQUIREMENTS) PENEBTiSATIpN,.EKYUO.tT;: GpI?Kp. w° FnAltm"Im PWOR '�'BASE11 WALC>eASEVENTISAB WIAWL3PACEWALL _ HEAT DETECTOR . wPActDR LLFACTOR RHA UE.;wVALtiE R vAL4 .,:R YALUE.. R.vALLIE FWALUE a35 1Oi3 IM3 tOR FT.DE81 _ NOTES: T.-Ft-7)Mw AIMIM ARE UMS 8 U•FACTORS ARE MAXIYUMB. - 21N13 MEANS R-10 CONTINUOUS[NSULATEO SHEATHING ON THE INTERIOR OR EXTERIOROF THE HOME OR , A R ER TO ECC 20D9 t7CNA?IER FOCAVrTY LR ALL IN9ul.ATION 3 B+IEROY REGURBENTSTION AT THE INTERIOR OF THEaASEMEliff w� ' � .COTUIT BAY DESIGN LLC ° `rc NEW ADDITION/REMODELING FOR: tNEBEDRAWIND3PRmR7DBTARTDE SCALE : DRAWING NO.: 43 NREWSTEFt-ROAD OONETRUDTION.THE FOR1Np0 OONTRADTON MASHREE MA. 02649 IN DRA NS EIB POWTAE C}rrERt .T It.`^. 1 tI C MMEN EDVANDBff NONFRUCTbN 1'4 t�5/ COMMENCER NITNOVT NONMNO THE ( CAUSE RESIDENCE DE& DPANT�R�3DR 01A66 oN5. PH. 506 2�/4-1166 TNEEEoR° LarPaRTNEusE FAX(50�)539=9402 DRAPnNDB REau�T°,�w� 17 THREAD NEEDLE LANE CENTERVI LLE MA °OTDOP�T 1o/2$/2010 ACT a t®0 . I _ I TYP. ROOF CONST. .2 x 12 ROOF RAFTERS 0 lV o.c. -5/8"CDX PLYWOOD ROOF SHEATHING -ASPHALT ROOF SHINGLES -15LB. FELT PAPER CONT, RIDGE VENT -11"HI-R BATT INSULATION CON!'. RIDGE VENT @ SLOPED CEILINGS(R=38) -11"BATT INSULATION (�FLAT CEILINGS(R=38) 2x 6's a 1G'o•c. .2 x 12 RIDGE BOARD 2 x 6's @ 1 G'o.c. -(2)SIMPSON H 2.5 HURRICANE CLIPS AT ALL RAFTER ENDS -ICE/WATER SHIELD AT BOTTOM 12 37 OF ROOF 12 MATCH •PROP-A VENT BETWEEN RAFTERS MATCH EXIST. -WIND WASH BARRIERS EXIST. TOP OF PLATE 2 x 12's(�16"o.c. TOP OF PLATE lam 2 x 12s @ 160.0. 3.1 3/4"x 9 1/4"LVL 5/8"FIRECODE GYP.BD. CONT.ALUM. ON 1 x 3.6TRAPPING 16" 3-11 3/4"x 11 7/9' SOFFIT VENTS o.c.IN GARAGE MULTI LVL HEADER ca TYP.WALL CONST. AZEK BEAD BOARD z NEW 1.2 x 6 STUDS @ 16"o.c. NEW NEW CAN ILIGHT/FIXTURESD 5 CONSTRUCT GARAGE END 2.1/2"PLYWOOD SHEATHING v GARAGE USING THE APAWOOD PORTAL WALL 3.0-(R=20)BATT INSULATION BATH M D ROOM H. C FRAMING FOR ENGINEERED APPLICATIONS NEW W1 HOLD DOWNS PER FORM NO.TT-100C 4. 1 t2"GYPSUM BOARD ►u "CONC.SLAB W/ (SEE ENCLOSED DETAIL SHEE 5,W.C.SHINGLE SIDING PORCH 1 6.TYVEK VAPOR BARRIER 6 x 6 WWF SLOPE 2" 4„CONC.SLAB ��.. TOWARDS DOORS 4��CONC.SLAB TOP OF FOUND. TOP OF FOUND. Jl 4"RIGID INSULATION (R=34) NEW 8"CONCRETE FOUNDATION WALLS NEW 8"x 18"CONCRETE W BELOW FOOTINGSTO B GRADE 4 9 E O MUDROCJM BATH SECTION GARAGE A SECTION A4 A4 --NEW STEEL BEAM WELDED TO STEEL COLUMN/PLATEIv- T'x T'x 1l2"STEEL PLATE "WELDED,.TO r x 4"x 114' EXIST.2 x 4 FAMILY STEEL COLUMN �` ROOM WALL + Kam\ I I AV EXIST.2 x 8 RAFTERS 8"x 8"x 1/2 STEEL PLATE �� I WELDED TO 4"x 4'x 1/4" STEEL COLUMN,DRILL& GROUT FOR 5/8"DIA.x T'LG. EXIST.2 x.6 CEILING JOISTS THREADED ROD W/NUTS! ' WASHERS OR SW DIA NEW STEEL BEAM TITEN HD BOLTS(QTY.4) FOUNDATION WALL LSLRINDOAND STEEL BEA DETAIL- STEEL BEAMPD A c7ER DETAIL- SCALE: 1/2" = 1'-0" SCALE: 1/2" ,��_011 LSL stmaD itgATNRIG f W.BR DGliu row PLATE +ttttt 4• tttit + tt + tt (3) - 13/4xA7?WLVL NEApp2 + + tt + 4 ++ + + + t t+ + + t } i LSTA24 STRAP LSTA@4 STRAP Tp1 FACE GF WALL) FASTa,roP PLATE ro NEADER FjAW IF TO("306 WRM ROOF .SHEATHING as RQWSm ULA t[M�R NMi.i AT 3•oc If ROOF SHEATHING EDGE NAILING FAVO MATHIFIG ro NEADER WM Rd C�MRIDN14 � ROOF RAFTER �VAN[2ED DGX NAU,S ZN 0•c,R[D PATTEIRI.AS PER PLAN ara 3• ac sR a FRANarc csnms,wcaarw 2X BLOCKING BETWEE ROOM=SH NGLES ANp sp u)TV. RAFTERS (NOTCH FOR VENT,TLATION IF REQUIR ♦ 5/8"CDX PLYWOOD SHEATHING REFER TO ARCHITECTURAL EDGE NAILING PLANS FAR MORE IWOL) 2 x 12 RAFTERS ♦ 15#FELT PAPER FUNK (2)SIMPSON H 2.5 HURRICANE CLIPS nx A PmwL SPLICE tt/ WIND WASH pmv-EDGES SWLL DE AND aCCUR VIM! •tF WD• 3'0"WIDE ICE/WATER SHIELD NEpiIT':Gf vALL a+G sNA1J. •- BARRIER %e sTRYCTURM.Pm6L SBEATHM DE OU70 Vtifl 191i ukl saleEleS ALUMINUM DRIP EDGE DOUBLE 2X TOP PLA E FASCIA,SOFFIT,$FRIEZE ROOF RAFTER PER PLAN. ( 1 x 3 STRAPPING W/ BOARDS TO MATCH EXISTING sT4 REFER TO ARCHITECTURAL 11 "GYPSUM BOARD WK$fxVxlk•KA19 WASHBR PLANS FOR RAFTER DIMENSIONS AND j H2.5A (INSTALL PRIOR EAVE TO BL13CKING AND. TYP.2 x 6 WALLS ' DETA% E 2X TOP PL PLYWOOD SHEATHING) 2X STUD t STNDt '' " •.':%r a �'� BEAM TSP (INSTALL PRIOR BC (INSTALL PRIOR DETAIL AT ROOF- SHEATHING).•• ; ' ' (IF `SHOWN ON PLAN TO PLYWOOD q pp���,, I7 WALL- SHEATHING �+�^. * " •' EMBEOMET+TYT •r' ° NdTE �7\i 2" Q" .. OR ON TOP OF DOUBLE 2X IF W2AI�IS USED!AT SCALE: �/ - • RAFTER T a ' TOP PLATE TRIP PLATES, PROVIDE 90* BEND TO EVERY RAFTER. SIDE' ELEVATION O . H . DOOR DETA LL NO SCALE THE DESIGNER SHALL BE NOTIFIED IF ANY } ERRORS OR OMISSIONS ARE'FOUND ON �+ FO�Rw THESE DRAWINGSPRIOR TO START OF SCALE DRAWING NO. : i COTUIT BAY DESIGN, L_ LC f, NEW ADD ITI O �N:IRI:EMO DELI NG CONSTRUCTION,THE BUILDING CONTRACTOR • WILL BE RESPONSIBLE FOR THE CONTENT / !1 "�» M� 11 43 BREWSTER ROAD �+ �A p IN THESE DRAWINGS IF CONSTRUCTION . MAS H P E E ,MA. 02649 0 COMMENCES WITHOUT NOTIFYING THE DESIGNER OF ANY ERRORS OR OMISSIONS. PH. 508 2�4-11 C6 RESIDENCE � THESE DRAWING oARE SOLELY HER SHE ou�� DATE c ALLE FAX 508 5�9-9402 ` a OF THE OWNER N 7ED.ANY T SE ' THESE DRAWINGS REQUIRES THE WRITTEN (. F THE DESIGNER UNDER THE QQ CONSENT O � ����7/2 ENTERVILLE , MA ARCHITECTURAL.COPYRIGHT PROTECTION 7 THREAD NEEDLE LANE ACT OF 19;O• ---- 30'.:+' 9'4" A � A4 ' -1" T-cr 3'4Y' �o-a' 5'4' Z-6' s'-1a' A A4 'i O ___ """1 _,.. .... ... .,,,. �'�"� �.... .. . .... ..... «.. � OPT P O F,....,...�..,.. -.*i....�.,, �.".. ..�. .,. .p•-,�..�....�r. 1 I i t Y f WALL AQDOOR OUN[�, r `1 rO O I ( 1 �. t } I 4"MIN. HEIGHT DIFFERENCE i I I' BETWEEN HOUSE SLAB& i I 4 CONC.SLAB I I NEW t► ,� ae GARAGE SLAB ' O o p I I GARAGE I NEW (4"CONC.SLAB W/ R DGE BOARD GARAGE & 4 I 6 x 6 WWF SLOPE 2' ' 2x12 � I '�` N 1 6 I TOW+4RpS DOORS) O I NEWS"CONCRETE FOUNDATION WAILS I � T I I pp I NEWW x lV'CONCRETE ors Ii' o TI G TO 4 LOW GRADE O N S BE F O Q' o SIMPSON STHD14 STRAP ON BOTH SIPFS OF THE GARAGE DOOR &CORNERS PER „ FORM TT-10OC APAWOOD PORTAL 4 CONK. - DROP TOP OF.FOUND. WALL FRAMING , I WALL.AT O.H.DOORS I u.�. ww. wrw .r.. .+►.. w.:4-w,wr w�,r ter. ,w�.-+.f`ww .w+. �... w:w ..... •w .++n wr!„ w+-. •w. ®-4 ;9/— /— R.r.3- 314"x 9 /4"LVL 3-1 3/4"X 11 7/r L'VL CONT,HEADER SOLID 2 x 8 BLOCKING IN THE OUTSIDE TWO RAFTER&CEILING JOIST SAYS or a 48"ox..ALLOW SPACE FOR AIR E.: FLOW ON THE UNDERSIDE OF ROOFCCbNSTRUCT GARAf�E END WALLS A USING THE APAWOO�D PORTAL WAIL q SHEATHING I A4 DRILL&PIN NEW FOUNDATIONFRAMING FOR ENGINEERED APPLICATIONS TO EXIST.FOUNDATION WALL Wl MOLD DOWNS PgR FORM NO.TT:1d0CTOP&BOTTOM (SEE ENCLOSED DETAIL SHEET) t1„ O' g'-6" 9'-6" 0" 11" 1,g� g,6" 1'6" 9'-8" 1'-9"6'-C, 24'-0' +� IC I �► LT Ir'RO F FRAMING PLAN- N :TES: ALL"'1�tOOF RAFTERS TO BE t x 12's 16, -0NSTALL a/8 ANCHOR BOLTS AT 71"o.a.MAX. UNL 5- S OTHERWISE NOTEC� W151MP50N BPS 5/8-3 BEARING PLATESAILIN SCIECE PLACE BOLTS WITHN 6-1�OF EACH 2.) USE:(2) SIMPSON H2.5 HURkkCANE,CLIFF`S E;' �� CORNER AND TO A 8"MINIMUM DEPTH 11 QMPH EXPOSURE 3 WIND ZONE AT A�.L RA�'7ER ENDS ,A ALL LI TTER TYRE/LAYaUTJOINT DESCRIPTION NO, OF COMMON NAILS NO. OF BOX NAILS NAIL SPACING 3.) W/ OWNEkS ra i El OOF FRAMING: 6a •- BLOCKING TO RAFTER(TOE NAILED) 2-&d 2-10d EACH END RIM BOARD TO RAF ER(END NAIL } 2-16 d 3-16d EACH END 1 STALL THREE FU L HEIGHT STUDS&TWO JACK 71"a,c. N, WALL FRAMING: $TWO AT EACH SIDE OF ALL ROUGH OPENINGS � TOP PLATES AT INTERSECTIONS(FACE NAILED) � 4-16d 5-160 AT JOINT$ 4 STUD TO STUD(FACE NAILED) 2-16`d 2-16d 24"o,o HEADER TO HEADIER(FACIE NAILED) 16d 16d 16"o,c.ALONG EDGES WINDOW ,(] FLOOR FRAMING: JOIST TO SILL,TOP PLATE OR GIRDER(TOE.NAILED) 4-8d 4 10d PER,JOIST 2 x 6 WALL _.� L 2-8d 2-100 EACH END BLOCKING TO JOISTS(TOE NAILED) BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-16d 4-160 EACH BLOCK BACK STUD © [!��(� 1, DETAIL. LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-160 EACH JOIST (BOUGH OPENING) '\� /"'�1 V V"O R BOLT JOIST ON LEDGER TO BEAM(TOE NAILED) 3-8d 3-10d PER JOIST BAND JOIST TO JOIST(END NAILED) 3-16d 4-16d PER JOIST BAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2-16 d 3-16c1 PER FOOT D B' R I NG WALL STUD" 1)E��� L L � � ROOF SHEATHING: WOOD STRUCTURAL PANELS(PLYWOOD) RAFTERS OR TRUSSES SPACED UP TO 16"o.c. 8d 10d 6"EDGE/6"FIELD ..1�.---- RAFTERS OR TRUSSES SPACED OVER 16"o.c. 8d 10d 4"EDGE/4"FIELD GABLE END WALL RAKE OR RAKE TRUSS W/O OVERHANG 8d 10d W EDGE/6"FIELD INSTALL TWO FULL HEIGHT STUDS&TWO JACK INSTALL 5/8"ANCHOR SOLTSAT 71"mc.MAX, STUD AT EACH SIDE OF ALL ROUGH OPENINGS W/SIMPSON BPS 5/6-3 BEARIN�PLATES GABLE END WALL RAKE OR RAKE TRUSS Sd 10d 6"EDGE/C"FIEI.p PLACE BOLTS W[THIN 6"-1'5"0 EACH W/STRUCTURAL OUTLOOKERS CORNER AND TO A 8'"MINIMUM CABLE END'WALL LAKE OR RAKE'TRUSS W/LOOKOUT BLOCKS ad 10d 4"EDGE/4"FIELD DEPTH WINDOW CEILING SHEATHING: P.T.2 x 6 SILL W/SEALER GYPSUM WALLBOARD 5d CQOLERS ---- 7"EpOE/10"FIELD. 2 x 6 WALL ------- t WALL SHEATHING: WOOD STRUCTURAL PANELS(PLYWOOD) JACK STUD STUDS SPACED UP TO 24"o,c. 8d 10d 6"EDGE/12"FIELD (RpL1GH OPENING) 1/2' &25/32' FIBERBOARD PANELS ad 3"EDGE/6'FIELD ANCHOR BOLT DETAIL 1/2"GYPSUM WALLBOARD 5d COOLERS ---- 7"EDGEMU'FIELD FLOOR SHEATHING. �� ► �� OD STRUCTURAL PANELS(PLYWOOD) ICI WALL N-LOAD � � � �."^7 SCALE: 1 t2 1 _Q WOT�JD DTAI L N 1"OR LESS THICKNESS rid 10d 6"EDGE/12"FIELD. GREATER THAN 1"THICKNESS 10d 16d 6"'EDGE/ta'FIE�,p THE DESIGNER SHALL BE NOTIFIED IF ANY ERRORS OR OMISSIONS ARE''FOUND ON « T DRAWINGS PRIOR O START OF �'''+ q « �-± THESE DRAW R T SCALE : Q WIN N LL �. T �T AY DESIGN, C CONSTRUCTION THE BUILDING CONTRACTOR r WILL BE RESPONSIBLE FOR THE CO ENT �4, ,�,,, w 4 'ROAD _lN`EW ADD :ITI:�O. EM0,D: E"Ll G O�R_ l IN THESE.DRAWINGS IF CONSTRUCTION COMMENCES WITHOUT NOTIFYING THE MAS H 'E E 'IItIA. 02649 PH, 5 S G 4� �v DESIGNER OF ANY ERRORS L OORTHNS. 0 N I ( ( , _ � 8:E RESIDENCE OF TH DRAWINGS ARE SOLELY FOR THE USEl '\VVI //� O>±THE OWNER NOTED.ANY OTHER USE OF DATE : FAX �Ir"i I 39-9402 THESE DRAWINGS REQUIRES THE WRITTEN fi�`fI'RVILL M �� CONSENT OF THE DESIGNERUNt"1EER THE17 THREAD '� ARCHITECTURAL COPYRIGHTT PROTECTIONI�� ..� I� E LANE ACT OF 1990.