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'to q _,X) t kk, 4 po i, O'��P Al a I t V�, y,w ` "', , . - . to 1TNf lot -a r to if 0� if vj % ��N5 T J N. p 1 0 4T., I p 4P So to X*4 N_ if 4'�� �, uq, 4.0 pq� 04 �,�4 dmuY IR is 1k Zu -wo ty ,,,X t, Alois Its T41,IN -75, "N"g Pe , F,'r ," " " ;,L, IrAl ;? elk, 44 1, ,1, K ''Ply 1w,- T U F I 97 "'t bin W4, i 7 q1 9, 1A h Tu '�­r aw N s.1'::" it A Y-F, ;0 to, U, " 'd , 5141 wo P, ot Q *# 41 if, 0. VO 't 0 Ikv �11 KID t !Y. p 4 40 to -1' 1, lip A de, ID 44 "'s vt A. Ni J,'m q%', 1 11 11.fl, - , jr 42 Ir WEN, o"i '4'gs F ti er 171 IFIIZI Will r ak Im WM3 .FMI S 4 lAi RN �" % grzi wl, FIE �!Uwf, Ki M iw� 1.4�,IlWj '0 3a �Vi6) Mr, -1 TI AW , lo rV ig, 'A, jrl�4 or li.wf. -i I c", r U 4A Q,"W��4,',' Y JT"i o't 'g, o� �17 to iz o oq I P.D ve, toy rN 'CA 5�T,01 �p I I f;111 1 11 *U "I Y! IS V1, �,s All -Ili 01 -- I e, 'j� *-,I 0 i 4i R (6. 41 41 ,AA A f Ki, P,�4�44* ch "I M, 4 _30 K�k. ?, N_P" "lip , .7 .11 , St. - ic'A 4. .Pr IT111 �t. 11 W4 Yi uOR1 'Wpogb Ri T pf� In vV VA 'rill g".1 A, f 1' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map G 4d4 Parcel f70 Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 5 y6 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 161 Village %gv/—&-;K GE��c�2 Owner/1/I/<6 /A;� Address % L o.✓T.M > Telephone .'17' V-PV-�16 7V Permit Request L7yJ7z_,a4 /���Y& ✓> ZX V/) '6wdIIAJ6 136) , G?c/J jai✓G� �� %`�G'.�� Square feet: 1 st floor: existing2o7 proposed Jet* 2nd floor: existing A14 proposed IV.g Total new AA� Zoning District �)'l Flood Plain Groundwater Overlay Project Valuation/:` �G�• " Construction Type Lot Size � S b .XL-f Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 5 �" S` Historic House: ❑Yes A No On Old King's Highway: ❑Yes , No Basement Type: C3 Full ®'Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 5j Number of Baths: Full: existing new Half: existing new U Number of Bedrooms: existing D new Total Room Count (not including baths): existing I new First Floor Room Count op Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑Other BUILDING DEFT Central Air: JAYes ❑ No Fireplaces: Existing New Existing ,00d/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ 2.3 X TOWN OF iEAFFIN IABLE Attached garage:Aexisting ❑ 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) T - - ��q6777 1�hf Name A- � � - Telephone Number 6V40 e—��/f Address %�0 X 2b6 License# 0D5'0�S 7 60?v Home Improvement Contractor# Email �'lei�G' � Worker's Compensation # ��a/C7� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Z: SIGNATURE DATE /A S11 7 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The CoWnromveakh orjflma gad,=etls L� Depar iaeut af sb ial Accide ts- -- Boston, 02M .. - t-PfV1'fLTllffS�,�t7P��i[l . Wulmrs' Campensatiauh u-mce fadav +-Builder-JCantr-actarsMechic:gn ffllu bei•s Applicwd Iufarmaf nu Please p liut FJe� v If, Addre= IDO � Are you an employer?.Checkthe appropriate bow Type of project(reed)= L I am a employer veittz 4 ❑I am a gezresal cor�ctor and I 'have hired tfze subr CvMtadors 6- ❑l�ew oansirucEi.n • employees(fall andfor paw-#ime).*. . 2.❑ I am a sale prapci4or orpartaer- fisted mthe attached sheet' 7_ .ARP-ModeHng These sob-can�ctoss have s9up and have as emplayees S_.❑Demnlifiort w rynQ forme in any capacity_ emplorw and have WO&Ers' LNo 'gyp,;umn—An a Comp_:,,� I 9. ElBuilcimg addition, 5- 0 .We are a corpora6m and ifs 1�ElElechical repairs Cr ad�ns re ;a h I officers have exercised dzir 3_❑ Iam.ahomeo�erdaingall,eodc 1L❑Plumbiag re-pairs araddificas �I MYzdf[No zuodmrs'Camp- x t of egeazgfiou ger.MGL 12.❑Roofrepairs insurance regaired-]i C.152,§i(4k andwefiweno. eusployees_LNG Wodoers' a0other Coo kmrarbw l *Any aPPUCzatBsatcbe rl— Elm ffioA*esectioubekwshummgfnTrwa EemmpMMffi,,•poRgJriIffocros¢= #��+TM�oaraers Who suit sfris�da�a ineiuurtmg they azetiaia�a1F;aadr sad d�hixx antsidt ea�ac{nxsnmst snirmit a new s�dsertt indi�n�sacfi _ , fCa es ebsc3ci}¢sbaxmustattecked=addilinnalsheet.sb=i=gthemmneofthe gsndstatawhethezarnottbnseeahtieshave empbyees.IftireSuh-caatradacsIuve emgIayeer,dLe}'tmisrprav*I&thudr sradime imp•PQHU MmobeL I ant an eutplayw thatisprat-atiirrg ivarkets'campertat ion Luair-arwa for my exw1ay-em Below is tfieparlicy and jab site i�c�arm�n • x. ✓ _ Iasarance Company' N- ma: gu o c� Paficy 41 Cr Sdf-i €Iic_ (rt/C7S ?Jn 3 pi ouDate= 7//at / `7 Job Site Add mod%� ✓ cityrstawzip_ %G �r_t���!✓t G'- 3 v Af aach a copy of the warkers'compeasationpolicy dedarafio i page(shaving the policy Sher and expiration date), Fafhire to secure-caveeage as required under S=kbn 25A o€MGL m 157 can lead to the imposition of criminal pamIges of a free up to$1,500:OU andfor one-yearimpFison--d as welt as civil peualties.in fe farm of a STOP WORK ORDERand a fine of up to$2 50-00 a day against the violater_ Be advised that a copy of this sblement maybe farwarded to the Of of IMMsEgations of the DIA for cnet mce coverage SL'eciSca ion_ I da if eraby the is per�afties ajf�ce MY thattlLe hZf0rwxa#iarrrm pUrfAd abMI8 15 bare and correct . fijosaatnr�- G 'Date: Phone ajoCird am wily. Do uat wrke in this oxen,fa be wmpktoi by city arf pru gjok al ky C or Ta wa: Permit Ucense 9 Iss�g Aufl€arity(ca cIe one): . L Board of$eaIffi I BudaT� fn�g Depart 3.6tyirown Clerk 4.Electrical hupector 5.Phrmbing Inspector d.other - • Comet Person: PhonE 9: laformation and Instmetiolas ; �'copeusation fir fbea eazgloyees- 1�.acear]-rt�c�f5 lSmur.�a+L3�YB C �IeQIIIl"ES 31I e�plOyP� ' pmsua�to.this sue,an�IO3'�is defined ss¢.may persdn In&a seavi �cm of oi3er ceder a¢y ca�ract oflaix e� cypress or implied oral or wzfth=" associafion,anpora ion or other Iegal entif9,or any two or mr= An.�Iaym•is defined as"an indryidut'�,p eutafives of a deceased emplaye�,ar the ofthe fiaregoing��is a joint eotr.LTd=,and.mclndmgthe legal s asso=±Dn or otherlegal entity,�°Ymg omPmY�- However the receiver or tragtee:of an individual,P�=A or the o of the - owner of a.dweITmg house having not more tbam three aparimeuts and.who resides tb fi3, _ d*mIlmg house of aaoffim who employs persons to do maw,c^asLuct on or reps woI.on.such dwelling house or oa the glvunds or building agpmieo�iiiereto shaIl.nntbecanse of each employmentbe deemedfo be an employes"7�IGL chapter 152,§25C(6)also sfafrs tip"every sit tin or local Rcm. ng agency shall wiiiibold ffie israancg or renewal of a&cease or permit to operate a business or to construct bmTdbags is the commonwealth for any applic=tWh.o has aotproduced acmptahle evidence of cdmpr ce with the hEurancz coveirage required." Add onally,MOrL chapter 152,§25CM gfafes-Neither the nor aag Of-its Political subdivisims shall efr into any coat act far the perfvmlance ofpublic WMk until acceptable evideoce of compliance wide the ice. regzm emus of lais cbapt=-bave been pres to the co—nf acCm,a a afhoi tY." AFPIica'r(s Please fill oil ttie wow'compensation affidavit completelY,by�g the boxes�aPPIY to Y�r sifvation and,if nmesssarY,SUPPIy su�oafr�r(s)name(s), addresses)andphonenumber(s),alongwitlitb)D r= acate(s)of mere-ice- LmmitedLiab�ity Compames(L-c)orLimj Liabz7ity-Parfocsbips.(LU)withno employees other t�$ze me=bers or parf�s,are not rbecm�d.fa cagy workers' compensaf<on ms[nance_ If an r Tr or 112 does hate employees,a.policy is rmpftud. Be advisedtbatfhis a$dayltmaybe sobn�d to the Department of Indnsixial Accidents for co�ation.of in,oz coverage Also be sure to sign and date f�[e afdavit The affidaYit should be retnmed to!he city or town that tba appficat m for the permit or license is being not the D eParfineuf of kdnstrial Accidents_ nouldyou have any gmstouslegasEng the Jaw or ifyou are repaired to obtain a workers' co ensafionP obey,Please call the Department at the number list cd below. Self-funned�panies should entcr their s elf-in�d license nDmbet an the appropriate lie- City or Town.Officials Please be sine that the affidavit is complete and primedlegiibIy. The Department has prodded a space at.ffimbottom of the affidavit for you to fiIl out in the event the Office OfInvesdgati�h� co You g the applicant Pleas e b e sine to f M in the pewlicense number vl ich wM be used as a rsfereace number. In-addition,an applicant that must submit multiple,p ermWHccn se applibaiions in any given year,need only= mit One affidavit indicating current policy intimation.(if Leccsssary)and under"Job SiteAddress"tie applicant shouldwrite:"all loc�.ns in (citY or_ town)-"A copy of the•affidavit that has been officiaRY stamped or maric:d by the city or town may be provided to the applicant as.proof that a valid affidavit is on file for&M permits or Iicrosm A new affidavit must be fined out each year.There ahome owner or citizen is obtaining alicemse or pemlitnotmlatcdto any bII.sincss or commercial tyre (ie-a dog license orpMit to bum Leaves eft.)said person is NOT md to courplete this affidavit The Office of jUtrSfigE fl would like to thank you m advMce for your coop=z crn and should you have any questions, please do not hMS233tM to tip us a eaM The Dep.t,nf'S address,telephene and fax=Mb a-- 9zml$E Of lent GfIadasti AoDident am=Qf r rn,MA G2111 AFE Fax 9�'����M Kevised4-z4-47 .. .. 1 ,a►6o 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `� 1 01/25/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: RISK STRATEGIES COMPANY PHONE I FAx C o Ext: AIC No): 15 Pacella Park Drive E-MAIL Suite 240 ADDRESS: Randolph, MA 02368 INSURER($)AFFORDING COVERAGE NAIL# INSURER A: INSURED INSURER B: AnnGUARD Insurance Company 47390 A I Enterprises Inc INSURER C P.O. BOX 2056 INSURERD: Cotult, MA 02635 - INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXP LTR TYPE OF INSURANCE rm%n wvn SUER POLICY NUMBER MMILDCDM/YY I POLICY YY LIMIT$ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ TO CLAIMS-MADE PREMISES OCCUR ES(RENTED PREMI occurrence) MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY jECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ a accdent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY - (Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS UAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE DER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1.000.000 B OFFICERIMEMBEREXCLUDED? N NIA AIWC753038 07/18/2016 07/18/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1,000,000 . DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE f� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services u�aa Richard V.SmIt,Dbvdor.. Building Division Psnt Roma,Auflftg Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstuble.mams Office: 508-862-4038 Fax: 50B-790-6230 j i Property Owner Must Coatnplete and Sign This Section If Usim A Builder L k C-o,ne— ,as Owner of the subject property I hereby authorize— ��7CA f�� �7P to act on my behalf, j 's i in an matters relative to work authorized by this bWH4 permit application for: ; (Address of Job) 1 **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized befort fence is installed and all f nal inspections are performed and acce:?e td Signature of Owner of Applicant i i J�Erto, /0A4,t /!/ Print Name Print Name. Date i I Q:PQRMS:OP��P�IISSIONPOOLS I i i i i Massacnusens veparEmeni or ruuiic oal—y Board of Building Regulations and Standards License: CS-050457 f Construction Supervisory PETER M POMETTI PO BOX 2066 a COTUIT MA 02635 (�..nn l.� Expiration: Commissioner ' 04/19/2018 ". U/2,e rp00�t��TldrzcueCLLU2 o�U(/GCi/J3cLc12cc¢e� ,' •. - Office of Consumer Affairs&Business Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR _ i' before the expiration date. If found return to: Registration:""",,]09606 Type: Office of Consumer Affairs and Business Regulation •Expiration:: W1/2018 . Private Corporatkon' 10 Park Plaza-Suite 5170 Boston,MA 02116 TO. -A I ENTERPRISES INC;s i PETER POMETTI 140 LITTLE RIVER RD", COTUIT,MA 02635 - Undersecretary. i Not valid without signature ', �_��'K.C�J � .a 1 f ��, ��" a t ' � ��1 1A I I�C..� 4 ����� .�i � � ��� . —� �� �� _. � �.. F : . �. �A _ _ -__a _ m� �. 5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _ 1_ Parcel lo (j© Application #C30 U Health Division Date Issued0. Conservation Division SA"_ Application Fee Planning Dept.t. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis Project Stre t Address (Wi-I Z Village Owner 1 U� S- Address Telephone bl. Permit Request r1 s c an Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District _Flood Plain Groundwater Overlay Project Valuationa_,��5 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing a -new z= Number of Bedrooms: existing _new ; GC; 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: 0`•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 ORI MEOWNE IR Name � ' tl �(��C -f-t� �1 �. Telephone Number Address M'� ,. License # ftA CA (�y'� Home Improvement Contractor# Worker's Compensation # I. ALL CONSTRUCTION DEBRIS RESULqING FROM THIS PROJECT WILL BE TAKEN TO 'Fao1 & cf- 6& A k SIGNATURE DATE 1 pc I�7 c FOR OFFICIAL USE ONLY ' APPLICATION# 4 DATE ISSUED I''k MAP/PARCEL NO. ti ADDRESS VILLAGE i OWNER is {' DATE OF INSPECTION: FOUNDATION FRAME .1 INSULATION FIREPLACE ' . ELECTRICAL: ROUGH FINAL K PLUMBING: ROUGH FINAL r� GAS: ROUGH FINAL fi . FINAL BUILDING I' „t r DATE CLOSED OUT ,4 • ASSOCIATION PLAN NO. The Commonwealth of Massachusetts• Departinent of Industrial Accidents W 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 gib Name(Business/Organization/Individual): Address: City/State/Zip: Phonet � jf—��_1I� Are you an employer? Check the appropriate b x: :Type of project(required):. 1•❑ I am a employer with 4. I am a general contractor and I full * have hired the sub-contractors 6 [:]New construction . "employees( and/or part-time). Remodeling 2:❑ I am a sole proprietor or partner- listed on the'attached sheet.ship and have no employees These sub-contractors have g• []Demolition employees and have workers' working for me in any capacity. 9• ❑Building' comp, insurance.$ [No workers comp.insurance 10.❑-Electrical repairs or additions required.] 5. 0 We are a corporation and its 3.❑ I am a homeowner doing all-work officers have exercised their I L[]Plumbing repairs or additions myself. [No workers''comp. right of exemption per MGL 12•Q Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.[] Other employees, [No workers' comp,insurance required.] *Any applicant that checks box#1 must also filfo.ut the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information.' Incur Pan Insurance Company Name: 1/ Y Policy#or.Self-ins.Lic.#: 7L GA,- ���� / �a � Expiration Date: IEDI 2, . Nkn Job Site Address: Wu`' City/State/Zip:fit Attach a copy of the workers' compensatio olicy claration page'(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up to$250:00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covera e verification• Ido hereby certifyunder thep andpenal es ofperjury that the information provided abo e is true and correct. Si' afore: - Date: Phone#: Official use only. Do not write in this area, to be completed by,city or town official City or Town: Permit/Licease# ` 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#: 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 Hie, express or implied, oral or written." An employer is defined as "an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter.152, §25C(7)states "Neithe.r 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 wrkers'compensation affidavit completely,by checking the boxes that apply to your situation and, if, necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their ceitificate(s)of insurance. Limited Liability C6mpanies'(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 antler"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 io any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massaehu,5QUS Departnent`of IndusWai A cQidemts Office of Investigations 600 Washingtari Street Boston,.MA 0.2111 Tel. ##61 7-72`-4900 cxt 406 or 1-&77-MASSA.FE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable . �oFt�ray Regulatory Services Thomas F, Geiler;Director "6y P- Building Division ED Tom Perry, 131hilding Commissioner 200 Maiu•Sfreet,_Hyannis,h A 02601 ,� R�wSv.f o wn_b arnsta bl e_ma_us Office: 508-862-F03 S Fax. 508-790-6230 f HOWOWr,E LIC]!NSE=MMON •� 'I _. Platt Print DATE: _J JOB LOCATION: h 1k, r num er ` strrst vi lagc Cta name 4 shame bne# work phone# e : < ` CURRENT MAILING ADDRESS: ntyhawo ;, state code y The current cxtmption for"homeowners";was extent-ed.to include owner-occupied dwellinZS of six units or less and to allow bomeoptcrs to engage an individual for•hire rwho does not possess a license,providcd that the owner acts as sllpery sOr_ DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which.thcre is, or is intended to bc, a one or two family dwelling, attached,or,detached structures accessory to such use and/or farm structures. A person who constricts more than tine home in a two-year period shall not be considered a borneowncr. Such horneowncr shall submit to the Building Official Ma form acceptable to the Budding Official, that he/she shall be responsiblc for all such work performed under the building permit (Section 109.1.1) The umdcrsigncd `homeowner"assumes responsibility for compliance with\the State Building Codr and other applicable codes, bylaws,rulers and rcgalations. - The undersigned&omeowncr" ccrtifies that.bchbe understands the Town of Barnstable Building Dcpartmcnt ' inspection proccdures and requirements and that he/she will comply with said procedures and rc ts. i / gn rc of Ham' Appraval`ofBusldmg,Officia] 4 t ! �` Note: -Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the Sti, Building Code Section 127.0 Construction Control. ~� . HOMEOWNER'S EXEMPTION .The Code stales thaC "Any hontcowaa poforrmng work for which a building permit is required shaD be exempt fmm the provisions of this section.(Section 109.1.1 -Licensing of construction Superyisors);provided that if the homeowner cngagcs a pason(s)for hire to do such work,that sup h HamcOwncr shall act IS supervisor." hfany homeowners who use this exanption arc unaware that they are assuming the msponstbtlitics of it supervisor(see Appendix Q, Rules&Rcgblations for.Licarsing Construction Supcvisors,Section 2.15) This lack of awanmess.bhcs results in serious probleras,particularly when the homcown r hires unlicensed persons- in this ease,our Board cannot proceed against[hc unlicensed person as it would with i licensed Supervisor. The homcowna acting as Svperyisor is ultimately responsible.To ensure that the homeowner is Mly await of his/her icsponssbilitics,many communities require,as part of the permit application, that'thc homcbwna certify that he/she understands the rcspannbilities cf a'Supervisor. On the last page of this issue is a,form currently used by several towns. You may care t amend and adopt Such'a forrnlcertifieation for use in your community. rrzu �THE 7p�t Town of Barnstable 0 Regulatory Services • sAxxsres[.� M $ Thomas F. Geiler,Director t63� �m Building Division Tom Perry, Building Coinrnissioner 200 Main Street, Hyannis,MA 02601. www.town.barnstable.ma.us Office: 508-862-403 Fax: 508-790-6230 Property Owher Mus ' mplete and Sign This, ectorx t '" �'If Using A B ui1 r. f L j'�' , as Owner of the�,subject property hereby authorize to act on my behalf, j in all matters relative to work autho d by:this building rmit application for. (Address of Job) as Signature of er Date Print ame • If Propedy Owner is applying forpemzit please complete. the Homeowners License Exemption Form on :the reverse side. C45E30 CENSUS TRAC I/ e : Hunzikvr ,, McDcrmo t�, Kirk DEED D BOOK PACE R : 7am< :; SLnLI� toll, (,I_ux _ _ PLANBOOKL$LICANT': I wi .l .I I.un - CI("l , lr. , it iix^ ASSLSSO(2SPL%1N PACs LOT _ PLOT t� ;MORTGAGE I NS- PECT I30N PLAN of LAND 11 B -ARNSTABLE SCALE : 1 = 50 MARCH 19, 1955 LOT H.. t, �.. 137, 97 ' LOT 41 z `U PR©POSEb N (. A )urr»w w r---I 1� - LOT Li `o STORY CD i PATI 00 00 r __4 W - 1 01 -W E S: T W A Y .,In f- 117 - 46 1 CERTIFY ,T0- Ei UMZIKER, MC.DERMOTT, KIRK R RUSSELL , PLYMOUTH SAVINGS BANK AND ITS TITLE INSURANCE COMPANY , THAT THFRE EASEMENTS EXCEPT AS SHOWN AND THAT THIS PLAN WASPREISIBLEI.1 UNDER AC IMENTS OR SUPERVISION , IMMEDIATE THE LOCATI ON OF THE DWELL I NG AS :SHOWN HEREON is I N I COMPL I ANCE WITH THE LOCAL APPL I CA.BL.F �,�••�•�,��7.0N] NG BY-LAWS 1gITH" RESPECT TO: HOR1ZO�ITAL �•'* . . ;'I ` 'ti M MENSIONAL REQUIREMENTS r DOES NOT FALL WITHIN THE DWELLING SHOWN HER A SPFP 1 AI ci nnr% . . _ ����� ��, .. ? �, t r z .. a ,� , ? -. •,s . �`� ,� .. .� �1. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Ap 6rd '`Application It Health Division -c � �� „ Date Issued a' Conservation Division r . Application Fee f Planning Dept. ''Perm it Fee Date Definitive Plan Approved by Planning Board U Historic - OKH Preservation/ Hyannis Project Street Address Village Owner /�/ �f�t� l �/ Sctc Address /7/� c , ti� eg �� Telephone fD/7 �-17 �✓� Permit Request /�"/� /�G t�z9 l X/ E� QJ' GYrid 7D �0)V2 17,/ I 6_.fVA o0R i'1 Square feet: 1 st floor: existing proposed 2nd floor: existing" proposed �� Total ew T Zonin District Flood Plain Groundwater Overlay 9 _ Project Valuation '96>04 va Construction Type ` Lot Size ��-�',,'�70 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,W/ Two Family ❑ Multi-Family (# units) Age of Existing Structured Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: R Full dCrawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) , ' �� Basement Unfinished Area (sq.ft) 6?J� Number of Baths: Full: existing new / Half: existing new e� Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing eo.i new First Floor Room Count Heat Type and Fuel: Lit Gas ❑ Oil ❑ Electric ❑ Other Central Air: U Yes ❑ No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes R No Detached garage: ��❑J�existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: 2"e'xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal It Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review If Current Use Proposed Use = ` ' _._ ,APPLICANT INFORMATION (BUILDER OR HOMEOWNER) tl ' PC-7N2. C cfe77'7 Name .4 eiJ;9fId f _ Telephone Number Address ?a / tcX os-2� License # J�0 i�7 JItJC�� f� Home Improvement Contractor# /6 e� Worker's Compensation # ���i -off/tI?41,2 7'0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT-WILL BE TAKEN TO SIGNATURE DATE � � �� ti ' t FOR OFFICIAL USE ONLY x, APPLICATION# DATE ISSUED Y MAR/PARCEL NO. r ADDRESS VILLAGE OWNER f DATE OF INSPECTION: _. ..FO_UNDATION't ) lWf a)$00403 a►c ?-��S�l( ,, p fr, i FRAME S F�f �/ryhl 3lidt( �r 1 INSULATION 3 8`61 3Lzl lit AI*4k— FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:°` : - ROUGH FINAL •' FLNAL BUILDING= ° Z3 / '_� m� � b 11 t DATE CLOSED OUT - ASSOCIATION PLAN NO. E , t r� The Commonwealth ofMassachusetts Y .Department of Industrial A ceidents Office of Investigations 600 Washington Street t� F Boston,.MA 02111 .�jy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Naive (Business/Organization/Individual): ` =1� � � Address: �O ,�z.�c ;2"00 Ze City/State/Zip. �7UGr �-t Due 3J Phone #: —�a`8 �l Are you an erployer?-Check the appropriate bo.x: Type ofproject(required): 1. LI[I I am a employer with J 4. ❑ I am a general contractor and I * have'hired the sub-contractors.. 6. ❑ New constructioneiriployees�(futl and/or part-tune), - - - ---•------ - • - - 2.❑ I am a sole propnetor.or partner- listed on the attached sheet. 7. [] Remodeling ship and have no employees These sub-contractors have g• 0 Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. [1 Building addition [N.o workers' comp, insurance comp. insurance.4 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.[] Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c_•T52, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance requir(-,d:) *Any applicant that checks box il) must also fill out the section below showing their workcrs'compensation policy in formation. t Homcowncrs who submit this affidavit indicating they arc doing all work and then hire outside conhactors must submit a new af-idavit indicating such. 1Contraetors that cheek this box must attached an additional sheet showing the name of the sub-contractors and stale whether or not those entities have employers. If the sub-contractors have employees,they must provide their workcrs'comp.policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: 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 a 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 eert� er the p and penalties ofperjury that the information provided above is true and correct. Si nature: -� Phone# �' Official use only. Do not write in this area, to be completed by city or town official City or Town: PermitlLicense# 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#: y Information aria bstructzons Massachusetts General Laws chapter 152 requires a)) employers to provide workers' cornpe.nsation for their employees,. Pursuant to this statule, an employee is defined as ".,.every person in the service of another under any contract of hire, express or implied, oral or written." r more n employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two o An DP the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of a❑ individual, partnership, associalion or other legaJ entity, employing employees. However the ccupant of the owner of a dwelling house having not more than Ihree apartments and who resides therein, or the o house dwelling house of another who employs persons to do maintenance, constriction or repair work on such dwelling or on Lhe grounds or building appurtenant thereto shalJ 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 reneW2) 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 m enter into any contract for theperfonnance of public--work until acceptable evidence of compliance with the rnsurancc requirements of this ehapterhave beenpresented to the contracting authority." Applicants Please fill out.tbe workc�s' compensation affdavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s) name(s), addresses)and phone number(s)along with their cerlificate(s) of insuance, Limiled Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the r rnembers 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 th-e affidavit. The affidavit should rn be retued to the city or [own lbat-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 perrniUlicense number which will be used as a,reference number. In addition,an applicant that must submit multiple pcnmt/license applications in any given year, need only submit one affidavit indica Ling current (city or Policy information(if necessary)abd under"Job Site Address" the applicant should write"a11 locations in _ town),"'A copy of the affdavit that has been officially stamped or marked by the city or town may be provided Lo the affidavit is on file for future permits or licenses. Anew affidavi t(nust be filled nut each applicant as proof that a valid a year. Where a home owner or citizen is obtaining a license or permit not relaled to any buSineSSor commerci a 1 venture (i,e, a dog license or permit to burn leaves etc.) said person is NOT required to complete this ajEdavil. The Office of nnr Investigations wou ikeTo 1hb��� j`D ralinn and shou➢d you_have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: -The.Cornmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or l-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia Town of Barnstable Y � p Regulatory Services Muss. Thomas F. Geiler,Director i 639. ti� �Eo Building DIVIS10n Tom Perry, Building Commissioner 200 Main Streei;'Hyannis, MA 02601 www.town.barnstable.ma,us Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must Complete and Sign.,This'Section If Using A Builder T, '\Q i (/!•e��{rlq00 as Owner of the subject property hereby authorize / C�%tom � j to act on my behalf, in all matters relative to work authorized by this building permit application.for. (Address of Job) - j qsn!a o�(o ner ate Pent Name . If Propezty'Owner is, applying for'pen-nit please'Complete the Homeowners License Exemption Form on the,reverse side. Q:FORMS:O WNERPERMISSION Town of Barnstable o�rrsr r�o - Regulatory Services Thomas F. Geiler, Director Mesas. 1659 ,$� Building Division PrEo µay� Tom Perry,Building Commissioner 200 Mairi.Strc . Hyannis, MA.02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EfOhZEOW)VER LICENSE EXEMPTION Please Print DATE: JOB LOCAMN: v C—S 41. J� number streot will ge "HOMEOWNER": r�1 A s Lb0o C- <o tom-51 G G. e6 name home phone# work phone# CURRENT MAILING ADDRESS: ��Iv>�Onf rym city/town state zip code The cturent 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 no't'possess a license,"provided that the owner acts as supervisor. DEMMON OR HOMEOSYN'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 home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Of Cial 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) 'Ilre 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 and that he/she will comply with said procedures and require en Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is rcquirrd shall be exempt from the provisions of this scction.(Scetion 109.1.1 -Licensing of construction Supervisors);provided that if the homcowna engages a person(s)for hire to do such work,that such HOmeowna shall act as supervisor." 14any homeowners who use this exemption arc unaware that they arc assurrring the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness oficn results in serious pmblrms,particularly when the homcowna 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 ultimatt)y responstblc. To ensure that the homeowner is fully aware of hisAcr responnbilitics, many communities require, as part of the permit application, that the homeowner citify that he/she understands the responnbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may cart t amend and adopt such a formicc ti6cation for use in your community. Q:for MS:homccxcmpt RightFax C1-1 11/22/2010 5:02: 16 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE 11/22/2010 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. It SUBROGATION IS WAIVED,subject to the terms and conditions of lire policy,certain policies may require and endorsement- A statement on this certificate does not carter rights to the certificate holder In Ileu of such endorsement(s). PRODUCER -CONTACT NAME: PHONE FAX HORGAN INS AGCY INC (A/C,No,Ext): FAX (A/C,No): 44 BARNSTABLE RD B E-MAIL ADDRESS: PO BOX 250 PRODUCER HYANNIS,MA 02601 CUSTOMER ID#: 28XBF INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: CONTINENTAL CASUALTY COMPANY INSURER B: A I ENTERPRISES INC INSURER C: INSURER D: PO BOX 2056 INSURER E: COTUIT,MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. LINTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM, INSR ADOLSUBR POLICY EFF DATE POLICY EXP DATE TYPE OF INSURANCE POLICY NUMBER (M7kfMYYYY) (MMMYYYY) LIMITS LTR MR WVD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) IVIED EXP(Any one person) $ PERSONAL&&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Par person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $" WC STATUTORY LIMITS OTHER WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN UB-0276M742.10 D7/18/2010 07/18/2011 E.L.EACH ACCIDENT $ 500,000 ANY PROPERITOR/PARTNER/EXECUTIVE N E.L.DISEASE-EA EMPLOYEE $ 500,000 OFFICERIMEMBER EXCLUDED? - wandau"in NIQ E.L.DISEASE-POLICY LIMIT $ 500,000 It yes,describe under - DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION THERASA EGAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 552 MAIN ST. WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE COTUIT,MA 02635 Dennis Chookaszis ACORD 25(2009109) 1988.2009 ACORD CORPORATION. All rights reserved. I Massachusetts- Department of Publ:c Saf0 Board of Building; Regulations and Standards Construction Supervisor License License: CS 50457 Restricted to: 00 PETER M POMETTI PO BOX 2056 COTUIT, MA 02635 Expiration: 4/19/201.2 (ummissiuner Tr#:"21436 • � OfTice ofAn� �fairs"'�'c`B�_es e HOME IMPROVEMENT CONTRACTOR ATRegistfi&n: A09606 TYpif Expiration �/21�2012 Private Corporativ PRISESINC._.sr PETER POMETTI t 140•LITTLE RIVER,Ab'-" COTUIT,MA 02635 Undersecretary r i Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive,Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR:A ®,7 /�! . JOB SITE ADDRESS: 10 k/®f7- Mot)( . DATE 'I AREA THICKNESS R-VALUE - Ceiling Cathedral Ceiling t Garage Ceiling Basement Ceiling Slopes q Exterior Wall G arage H se. W all W alkout W all Cathedral W all Blockers Overhang Stair/Risers All R-values and thickness measurements are deemedto be accurate by the following installers: r . TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM 4 , �:72 CORBONM III Spray Insulation System Technical Data Sheet TypIcal Physical Pro ertles ASTM Method CORBOND III Nominal Density D-1622 2.0 lb/cu.ft. Compressive.strength (1") D-1621 25 psi Compressive Strength (Y) D-1621 20 psi Closed Cell Content D-1940 >90% K Factor C-518 (initial) 0.15 (aged) 0.16 C-1029-07 (181)day) R Factor C-518 (Initial) 6.6 (aged)* 6.2 C-1029-07 (180 day) Water Absorption D-2842 0.020 (gm/cc) .Water Vapor Transmission E-96 (calculated) 0.90 perms 0 2.5 Air Infiltration E-283-04 75 Pa 0.001 L/S/m2 (1.57 pst) (<0,001 cfm/ft2) 300 Pa 0.001 L/S/m2 (6.24 psf) (<0.001 cfm/ft2) Air Permeance E-2178-03 75 Pa 0.000055 LIS.m2.Pa 0.000117 ft3/min.m2.P0 300 Pa 0.000024 L/S.m2.Pa 0.000051 ft3/min.m2.Pa Sound Transmission Coefficient (STC) E-90-90 & E413-87 36 (STC) 2 x 4 wood stud,16"on centers, 2.76"of COIISOND®.15/32"exterior 05B sheeting,'/,"gypsum wallboard, Recycled Content 16.5% NOTES: 1.This Information is intended only as a guide for design purposes. The values shown are the average values obtained from sprayed laboratory samples. The test meth' ds'were performed per the ASTM Book of Standards. 2. K Factor varies depending on age and use conditions, * Aged 180 days per Federal Trade Commission 16CFR Port 460 The information herein is to assist customers to determining whether our products are suitable for their applications. We request that customers Inspect and test our products before use and satisfy themselves as to content and sultobllity. Our products ore Intended for sale to industrial and commercial customers for processing, we warrant that our products will meet our written specifications.Nothing herein shall conslltute any other warranty express or Implied,including any worronty of merchantability or fitness,nor is protection from any low or potent to be inferred. The exclusive remedy for all proven claims Is replacement of row materials and in no event shall we be Roble for special,incidental or consequential damages, Corbond Corporation ozo an,MTn 597R5ad CORBOND® BE. r Performance Insulation System, Ton Free:(888)e4e-9089 Fax:(403)586.45Ba I"Horover�n www.coftnd.com ealesocarbond.cam SEP-09-20U%W") It Lunounu Properties and Processing Characteristics mbient temperature and tho Reaction ties are affected by a Liquid Component Properties temperature of the substrate. Viscosity 190 •Sprayed through Gusmer Model H-il proportionerroceasing Component A(cps) goo cps @ 72" F dap Pro dun with 01 chamber at recommended p Component B(cps) temperatures and pressures. Specific Gravity®70°F 1.2 50% Temperatures Mixing Retlo Component A Rscommended Substrate Mixing Ratio Component 5 `�� At time of application venter Fa111Spring 30°F 45OF Flammablllty Characteristics Minimum 60OF 900E Surface Burning Characteristics"-ASTM E-B4 Maximum Flame Spread:<25 For applications below 35°F,Corbond CorporationPasses should be al Smoke:<450 personnel should be consulted. 'Flesh'p (Spray applied,3rd Party labeled at 1.1/2 inch,4 inch and 6 avoided during cold wreather applications. Inch thicknesses applied to 114"Cement Board) gpmying *Note,.This numerical flame spread and all other de anted by This spray system maybe applied in passes of uniform presented is not intended to retied the hazards pros thickness from a minimum of 112'to a e maybe aPPloied this or any other material in actual fire situations. maximum yield and productivity,the product The use of polyurethane foam in interior applications on In a single pass to the specified thickness or up of 3" walls or ceilings presents an unreasonable firs risk unless maximum pass(exceptions may exist when sheet metal or onsult protected by an approved thermal barrier with a finish rating sum wallboard substrates eFlash encountered. or a thin pass of not leas then 15 minutes. One Building Code definition of application guide on page 3). an approved"thermal barrier"Is a material equal to k of less than 1'on cold surfaces is to be avoided and may gypsum well board.Consultation with building code offtalais result in loss of adhesion of subsequent passes and yield. before application is recommended. Thicknesses over 3'require multiple passes. Allow product Caution:Polyurethane foam produced d from fire o these sxcematerials a heat curing and cooling between each pass;over pass cure time may present a fire hazard if expos minimum 10minfinch. 3 inch pass requires minimum)cation (i.e.cutting torches,soldering torches etc.).Each firm, minutes.Hot substrates may require longer,see app In e person,or corporation engaged In the use,manufacture, vide on page 3.CORi90fyD•lit must never be applied production or application of the polyurethane foams sickness exceeding 3 inches in a single Pass. If this produced from these resins should carefully examine his thickness Is exceeded It will seriously affect the quality and construction sequencing and and use to determine any physical ro amiss of the finished product and the internal potential fire hazard associated with such product and to amperaturs building up within the foam may cause.charring utilize appropriate precautionary and safety measures during inside the foam bun and broad loafing.Under certain cause construction. conditions,applications exceeding f this thickness may spontaneous combustion of the foam to occur,even hours Equipment after product was applied. Proportioning equipment shall be manufactured by i_ Greco/Gusmer or Giesscraft and shall be capable of Clean Up-Liquids metering each component within t29t,of the metering ratio Non-flammable yourbsolvent anufaucturer MSDS,for handli used for clean ng previously noted. The gun should be of the internal mix type precautions. which provides thorough blending of the two components. The equipment shall be of the boated oldess type capable of ul mart maintaining 125OF at the gun by use of both primary heaters ProtectivefEgi Equipment foam results in the atomizing of the and heated hoses.Hose thermal sensor In 9 aide.The use he liquid components of a fine mist, inhalation end exposure to the of 2:1 feeder pumps Is recommended for supplying im should be The following components to proportioner,especially during winter atomized pequlipment 18 recom ended; �, g operations. s.Full-face mask or hood with fresh air source. Processing Characterlatica and Recommendations b.Fabric coveralls. , t Prehester Hose c.Fabric or ribber gloves. ? . Component A 90-120'F 110-125°F . Shelf Life&Storage of Raw Materials'. Component B 110-125°F min 1100, si All materiels should be stored in their Material's containers and Gun Pressure at Tip(static) p away from heat and moisture,especleliy after the seals have been broken and the containers have been opened. Shelf These temperatures are typical of those required to produce life is 3 months when stored Indoors at a temperature mixed product using conventional Graco/Gusmer equipment between 60OF and 70°F.Storage below 00"F may result In under various conditions. Environmental conditions may compound stratification of B and/or crystalyne formation in A dictate the use of other temperature ranges. However,under component. Temperatures above 75°F may decrease the no circumstances should is temperature of 130°F be shelf life. Containers should be opened carefully to allow exceeded. It is the responsibility of the applicator to any pressure buildup to be vented safely: Extensive venting determine the specific temperature settings to match the of the B component may result In loss at blowing agent, environmental conditions,.his own equipment,and these higher density foam and reduced yield: Temperatures below materials. 65°F will Increase the viscosity of the components making .Mix at recommended temperatures' them difficult to pump. Both components are adversely Machine Winter Fall/Spring g affected by water and humidity. Freight glass 55(A or 9) Riae/Tack Free Time 3-4.5 sec, 4-6.6 sec. Resin Compounds item 46030 Cure Time 4 hours 4 hours N01BN Non-Hazardous Ri Pone 2 Revised 01/2009 .r Assessor's office(1st Floor): L �� Assessor's,map and lot number Board of Health(3rd floor): � SEMSYMN MST ISEIs:- ( Sewage Permit number - , ^ T - ,13 INSTAUMINCOMPLMCE _ Z BARIST►DLL, i Engineering Department(3rd floor): / f f fi �8 rasa M139- House number / E V[ROX AL CODE AND G��0 Definitive Plan Approved by Planning Board RWVLATIONS APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only . TOWN . OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 O/ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following,information: Location WE57- 4�z&�;e, Al"AlAblAk Proposed Use � �rao r cam' Zoning District D f? Fire District Name of Owner (.Wt L[,14 M C-el- e!sj Address Name of Builder r' _ r-�S T�-100P , Address P,3 cr Name of Architect Address Number of Rooms C ,yr Foundation Exterior Roofing Floors Interior Heating //�a;n25'/l — !! L Plumbing Fireplace Approximate Cost �d=�� Area ~ Diagram of Lot and Building with Dimensions Fee X[5r*14- 113xty � l � r ( I I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name t 4 Construction Supervisor's License .�� �� J CLEARY, WILLIAM L No 32873 Permit For Build Additzon Single Family Dwelling Location 10 West Way We,si y,@4+n, wort k Owner "j .William Clear Type of Construction Frame k . A Plot Lot-- Permit Granted May 4 , 19 s 8 9 Date of Inspection 19 i tea Dat�,6ompleted 19 ri tr �g 94 ns Y a 1 .....`r . .! i. f'Jw-s+..+ � • „" �.. �t' �a,�;� ., .w � ^�,{a, Lam. ,�a#"+vt'.rrs•'t� V�'..;i n�..+1�~• ...:'.., '�''i+�+X,�',.St ;.- .l �— Assessor's office.(1 st Floor): ma and lot number Assessor'sp � Board of Health(3rdJloor): Sewage Permit number Engineering Department(3rd floor): e ,!J� rnsa House number 1639- Definitive Plan Approved by Planning Board 19 �0 MAI APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �7 d� T✓D �� TYPE OF CONSTRUCTION 19 c�/ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby //applies for a permit according to the following information: Location W EST" Proposed Use Zoning District Fire District � j f 10 A,/01 Name of Owner lt//Z L /t1 N'1 �f�.GAQ. l Address Name of Builder / �c�5 77F-,,OP . Address f d 4 4-Y_Al e,,- Name of Architect Address Number of Rooms Ur A/,5— Foundation -c-JG2ls�"�" 2-aGt� Roofing tea-f/%�E _ r Floors tUD4!� Interior �97 - Heating T' ���7�rA ` ©�° L Plumbing Fireplace " Approximate Cost Area Diagram of Lot and Building with Dimensions Fee �t� 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License .� CLEARY, WILLIAM A=246-163-001 LAIC & 00 No 32873 Permit For Build Addition Single Family Dwelling t Location 10 West 'Way N Iq i pig 9g;-+- Owner William Clear Type of Construction Frame Plot Lot Permit Granted May 4, 19 89 Date of Inspection 19 Date Completed 19 f ,ram r FILE # C4580 _ ' CENSUS TRAC I/ _ CL_IEUT : Hunziker, MCDermo'tl-, K irk lv E:ri .<.;c.,l1. DEED BOOK PAGE OWNER : ;lame ; ;;t.nLl, tc�n, c r, ux _ _ PLAN ROOK _ PAGE u APPLICANT : wi .l .lr, n ;l. C.lc ..ir 7r. , et ux ASSESSORS PLAN PLOT MORTGAGE INSPECTION PLAN of LAND I N B A R N S T A B L E SCALE : 1 "= 50 ' MARCH 19 , 1985 I LOT H 137 , 97 ' LOT 41 *1 �. w LO Lo f1 p u r r/vtv w O� t � Lo I STORY LOT 42 `D 0 PATI 00 00 W rx ' O 1 WEST WAY I CERTIFY TO HUNZIKER , MCDFRMOTT, KIRK R RUSSELL , PLYMOUTH SAVINGS BANK AND . ITS TITLE INSURANCE COMPANY , THAT THFRE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOWN AND THAT THIS PLAN! WAS PREPARED UNDER MY IMMEDIATE SUPERVISION , THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY-LAWS WITH RESPECT TO HORI7_O!ITAL •'' ' ' `�r r '�+ DIMENSIONAL REQUIREMENTS , _ �r THE DWELLING SHO'1IN HERE DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD 7nNF Ac nr-r , KIC Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 1'f CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR: JOB SITE ADDRESS: I D tAJI,4-W vvol DATE ` AREA THICKNESS R-VALUE Ceiling Cathedral Ceiling Garage Ceiling Basement Ceiling Slopes Exterior Wall Garage Hse. W all W alkout W all Cathedral W all jY' B I o c k e r s Overhang S tair/R isers All R-values and thickness measureme s re deemed to be accurate by the following installers: TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM CORBOND011 Spray Insulation System Technical Data Sheet .b Typical Physical Pro ernes ASTM Method CORSOND III Nominal Density D-1622 2.0 lb/cu.ft. Compressive strength (1") D-1621 25 psi Compressive Strength (Y) D-1621 20 psi Closed Cell Content D-1940 >90% K Factor C-518 (initial) 0.15 (aged) 0.16 C-1029-07 (180 day) R Factor C-518 (Initial) 6.6 (aged)* 6.2 C-1029-07 (180 day) Water Absorption D-2842 0.020 (gm/cc) Water Vapor Transmission E-96 (calculated) 0.90 perms 0 2.5" Air infiltration E-283-04 75 Pa 0.001 L/S/rn2 r (1,57 psf) (,40,001 cfm/ft2) 300 Pa 0.001 L/S/m1 (6.24 psf) (<0.001 cfm/ft2) Air Permeonce E-2178-03. 75 Pa 0.000055 L/S.m2.Pa 0,000117 ft3/min.m2.P0 300 Pa 0.000024 L/S.m?.Pa 0.000051 W/min.m2.Pa' Sound Transmission Coefficient (STC) E-90-90 & E413-87 36 (STC) 2 x 4 wood stud, 16"on centers, 2,76"of COnSOND®.15/32"exterior 058 sheeting,''"gypsum wallboard. Recycled Content 16.5% NOTES: 1. This Information is intended only as a guide for design purposes. The values shown are the average values obtained from sprayed laboratory samples. The test methods were performed per the ASTM Book of Standards.. 2. K Factor varies depending on age andvse conditions, * Aged 180 days per Federal Trade Commission 16CFR Part 460 The information herein is to assist customers In determining whether our products are suitable for their applications. we request that customers Inspect and test our products before use and satisfy themselves as to content and suitability, Our products are Intended for sale to industrial and commercial customers for processing, we warrant that our products will meet our written specifications.Nothing herein shall constitute any other warranty express or implied,Including any warronty of merchantability or fitness,nor is protection from any low or potent to be Inferred. The exclusive remedy for all proven claims is replacement of raw materials and In no event shall we be liable for special,incidental or consequential damages. Corbond Corporation32404 ND, Soze Ro CORBOmaan,MTV Fixi59715 ad www.caftnd.com eralesaoorbond,com Performance Insulation.ayeten'fe Toll Free:(NO)949-9089 Fax:(406)586.4584 \'Nerrovet�n I �l �/ - SEP-09-2009tWtU) ic: �1 uu►counu Propertles and Processing Characteristics ► nt temperature and the Reaction times are affected by amb e P Liquid Component Propertles temperature of the substrate. ortioner, Viscosity 190 *Sprayed through Gusmer Model H•II prop Component A(cps) dap Pro Gun with 01 chamber at recommended processing Component 900 cps(�72 F Went B(cps) temperatures and pressures. Specific Gravity®70°F 1.2 5096 Temperatures Mixing Redo Component A Recommended Subatnts Mixing Ratio Component a �� At time of application Winter Faill$ptfng 3011E Fiammablilty ChoraCteristtcs Minimum 60°F 90'F Surface Burning Characteristics"-ASTM E•84 Maximumration Flame Spread:<25 For.appllcations below 35°F,Corbond Coe passes should be al Smoke:prea personnel should be consulted. 'Flash'p (Spray applied,3ro Party labeled at 1.1/2 inch,4 inch and 6 avoided during wild weather applications. inch thicknesses applied to 114"Cement Board) spraying *Note:This numerical flame spread and all other dot Presented by . This spray system may be applied in passes of uniform presented is not intended to reflect the hazards Pre thickness from a minimum of 112'to a ma llmul ba applied this or any other material In actual fire situations. maximum yield and productivity,the product The use of polyurethane foam in interior spplications on In a single Pass to the specified thickness or up to 3" wails or ceilings presents an unreasonable firs risk unbss maximum pass(exceptions may exist when she consual lt for protected by an approved thermal barrier with a finish rating sum wallboard oard substrates$Fla encountered. passes or a thin It of not leas than 15 minutes. One Building Code definition of gypsum guide on page 3). of approved"thermal banter~is a material equal to h of less than u e cold 1surfaces is to be avoided and may gypsum wall board.Consultation with building code officials result in loss of adhesion of subsequent passes and yield. before application is recommended. Thicknesses over 3*require multipl89Psa over sec cure time Caution:Polyurethane foam produced from these materials do and cooling between each p P may present a fire hazard R exposed to fire or excessive heat minimum 10minnch. 3 inch pass requires minimum 30 (i.e.cutting torches,soldering torches etc.).Each firm. minutes.Hot substrates may require longer,see application In a Corporation engaged In the use,manufacture, onpage 3.CORBONif III must never be applied arson,or corpo guide s• (f ths P foamssingle as production or application of the polyurethane thickness exceeding 3 inches in a s g A produced from these resins should carefully examine his thickness is exceeded It will seriously affect the quality and construction sequencing and end use o determine any physical sales of the finished product and the Internal potential fire hazard associated with such product and to temperature building up within the foam may cause charring utilize appropriate precautionary and safety measures during Inside the foam bun and breed loafing.Under certain construction. conditions,applications exceeding this thickness may cause spontaneous combustion of the foam to occur,even hours Equipment after product was applied. J � `y Proportioning equipment shall be manufactured by r Greoo/Gusmer or Giasscreft and shall be capable of Clean Up-Liquids metering each component within t2%of the motoring ratio Consult your solvents t s should be u.0d,for clean up. MSDS for handling noted. The gun should g previously ld be of the Internal mix type which provides thorough blending of the two components. precautions. The equipment shall be of the-heated alrless type capable of maintaining 12511E et the gun by use of both primary heaters Protective Equipment in the and heated hoses.Hose thermal sensord rIn 8 side.The use e liquid comSpraponentsof p of a fine mist, Inhalatiorethens foam n and exposure o these of 2:1 feeder pumps Is recom components to proportioner,especially during winter prate uipment Is should recomm nded The following operations. a.Full-face mask or hood with fresh air source. Processing Characteristics and Recommendations . b.Fabric coveralls. Preheater Hose c.Fabric or ribber gloves. ; fr Component A 90-1206F 110-125°F Shelf Life S Storage of Raw Materials" Component B 110-12511F min 1100 sl All materials should be stored In their original containers and Gun Pressure at Tip(static) P away from heat and moisture,especially after the seals have been broken and the containers have been opened. Shelf These temperatures are typical of those required to produce life Is 3 months when stored Indoors at a temperature mixed product using conventional Graco/Gusmer equipment between 60°F and 70°F.Storage below 60'F may result In under various conditions. Environmental conditions may compound strattrication of B and/or cryatalyne formation in A dictate the use of other temperature ranges. However,under component. Temperatures above 759F may decrease the no circumstances should a temperature of 130°F be shelf life. Containers should be opened'Carefully to allow exceeded. It is the responsibility of the applicator to any pressure buildup to be vented safely. Extensive venting* determine the specific temperature settings to match the of the B component may result In loss at blowing agent, environmental conditions,his own equipment,and these higher density foam and reduced yield. Temperatures below materials. 85°F will Increase the viscosity of the components making • them difficult to pump. Both components,are adversely Machine Mix at recommended temperatures Winter Fon►sp affected by water and humidity. ,a ;w Freight class 55(A or 8) ,. Rise/Tack Free Time 34.5 sec. 4-5.6 sec. Resin compounds item 46030 I i Cure Time 4 hours 4 hours N01BN Non-Hazardous Il; ?°� Revised 01/2009 p IMPORTANT , N z TION THAT INCREASES LIVING SPACE N a ANY CONSTRUCTION . CONT.RIDGE VENT ' •^. , REQUIRE THE - W Q 2 m- INSTALLATION ADDITIONAL z r, N BEYOND 1200 SO. FT PER LEVEL MAY 2XIDRGE BD. _ - ' ALLAxT OF"ADDI L SMOKE DETECTORS. t. °z w, 2X8 RAFTERS @ 16'O.C. _ ' ] 1/2•COX PLYWOOD 5HF.ATHING _ _ NOTE; A 'SEPARATE PERMlT IS REQUIRED FOR THE CARBON MONOXIP9 4 � i W ROOF 5111NGLE5 TO MATCH EXI5TING - �� IIMS MUST BE IN$��ILLED PER o Q a p 2X CEILINGJ015T5@ IG' 1NST ION OF SMOKE DE ELECTRICAL o 8 H 2.5A CLIPS EACH RAFTER To HEADER- - -' . PERM OES NOT SATISFYT I IRE ENT. PX15TtIJG°IJF1N15HED - MASSACHUSETTS$01LDING CODE �Zo OONTINuous(3)a&'DR ..� - BASEMENT7-8 W'o %6 T G CENTER BEAD WOODCEILIIJG TOP PLATE®PORCH _ ROPOSED WDW WELL (ALIGN 90FFIT TO IXI5TII4G) � ---- --.------------ -- � � L' ,(VERITY SIaE) �za�r� ��� —USE AC6/LCE6 P05iGAP5-P05T5 TO HEADER _ F- - I-J I. I�'I I'll F r-1-7 l m'PICAU �, I / 'Y..: r, 7,:,`I. _ U •. 1 14—I I-1 1 z � I — 1 4XG P.T.PORCH FRAME II ICI III II II -0 R_I_I III - y - a ^ .J - m I; I ^ .y I - Q Ill IIIII-1�IILIo IIIIIII. I 8 u ul •EASY CHANGE'COMB.UNITS h-- r— —11 1—I—� 4—-ICI I S - - NEW B"CONCRETE BLOCK FOUNDATIONYR05T - O L VERIFY5I_aE5 _I--1 �_I nn j< �, . - WALL ON VO G'CONTINUOUS CONC.FOOTING. - J ` -JJ LLI�"�-� L- -1 AJJ O - BOTTOM TO BELOW FR05T LINE . z — z ¢ (TYPICAL) . .- _ TYPICAL AT ALL NEW WOWS y RE JOVEEXIST SINGtP WDW %4 MAHOGANY DECKING � 1�.- = J+ RE IACE WITH(2)DH WDWs • - _ EXISTI W/O ~ - a 10 P.T.DECK JOISTS@16'O.C. -•.��I PROP05ED WW✓WELL �l• Y P�w�51ZE) I I I USE INVERTED AC6/LCE6 POSTCAP9-POSTS TO RIM BFAMS FIRST FLOOR @ Al—KA 5 O (+/-) 7_G" O - (VERIFY SIR) Ii2CL (3)2%I O RIM BOARDS I - SOLID 6XQ PO2T5 B1NM. (3)2X 10 RIM AROUND PERIMETER - 9 DOOR/WPW51_TYR) I. X X 'EX15GTINNG 'EXISTING UNFINISHED ., . ABU66 PO5T tlA5E5 //��50NOTUBE5 BEHIND _1-- _., ` _ �.rt �s4.LY..G BASEMENT TO 5ONOrUBg5-T R,) ( _l. (BIGrOOT AT SIDES ONLY) - �, .. - L--J LJ LJ .,,i 6-1o•ct1iE+G Hr. x FXI5TING - ,. - � PLATFORM. + -... . .. .IXISTING GIRT ANDIXISTING REMOVE IXIST.SINGLE WOW - -FURNACE 3 T REPIACE WTH(2)DH WOWS I COLUMN5 O O EX15T.6 XIO GIRT f _— _—_— —— —— .. — -- (VERIFY 510,) PROPOSED $ k, II ----.,-------- E%1sr.— --- -- — -- --- s�' SECTION @ PORCH 3$ N _ I. o w o m 1srn NEW m _ A 3 N 1/q.,_.1 0' ..�'- i I J m y • V o m _ 1MIa BATH . PROPOSED r U PLAYROOM NJ IX15TING BASEMENT• 5EE OWNER FOR FLOORING �" #4�REDARS "'S (+/-) _ _ _ O - - '.. DRILL 6 GROUT+' III IXISTING - U TYPICAL AT NEW/EXIST. ..,.�. +III uPaR $�I 0" '\ + PL FOUN DATION CONNECTIO15,. - � WALL AT PERIMETER 4:::::: tJ AND 51MP ON, CCE55 NEW (BO%IN) w >a - r HID IO-3 r $2 I ,.PROPOSED G- LAUN. - 515TER NEW RAFTERS TO NEW RIDGE VENT - - N h , I x I ' - IXISTING 2X6'S - '� 4 N I X CRAWL SPACE I I I'MCOLU1RTIE5 - "13'-5 1/2' - ;G 6 1/2" - 3 @ EQUAL 5PACII4G SIMPSON �I \ O HUC210-3 NEW VELUX SKYUGHTS 2%10 RIDGE -- -----_ --- 2 7 - 'S I•STONE STEP AB VEXx . SEE SPEC' St - \ i 51/2" (BLUE sroNE) - S1r`�8 USE(2)5/8 BOLT5 EACH END / - -- - - + FOR TIE CONNECTOR ��� ._ A IV COLURTIES , N: < II.. w ON I I'-O I/2" 1A 9-3 /2" Z - 12 REIdO (STING .3^ '.. 5'-10" '5'-I O`6 5 O 3 - _ rRuss tf1UNc II II II II II II .— — _ — ---- --- !Y/ — IIJSTALI A \ °'- \ \. .-cA4 DPaL CI-G. 11 III IF s.@III II m /�I \ F _ H 2.5A CLIPS Xl" AT IXISTIIJ� VING ROOM / _ (ONE EA.SIDE OF -�--,` --'— -----4 ------ '-- — —---- 1 IXISTING 2%IO FUR,JOISTS () --.---- ,---� ----LY— ALIGN WITH IXISTING TOP PLATE. -_ --- ----- / @16'O.C. ®. —— RAFTER PAIR) Z- \ \ - - FLU5H BEAM-(3)2X 1 O P.T. \_ - W \x\' +.. H.2.A DLIPS '" - _ 12.50NOTUBE5 TO BELOW R05T.' / A 5 - - J ON EA SIDE of _ S3 �- F O IXISTING RA R PAIR) - NEW 8"CONCRETE BLOCK FOUNDATION.FROST - J +. _ LI VI N ROOM ^f WALL ON 81I 6+CONTIN0005 GONG_FOOTING z O BOTTOM TO BELOW FR05T LINE(a'MIN.) F , LINE OF SCREEN PORCH ABOVE ANCHOR BOLTS.@ 4'O.C.W/3'X3-X3-X'�'PLATE W 1. yj NEW WDW TO - -WASHERS.BOLTS TO EMBED INTO CONCRETE ® f _ z ' Y , MATCH IX15TIIJG - 1 BLOCK CELL5 MIN.15'. FULL GROUT CEL15 WITH k 2 Q I' 18'-O" -f 0'-7" BoLT5. ALIGN WITH IXISTING FIRST FLOOR .. � � � EXISTING 105 NEW P.T.DECK J015T5 - �. - .- (,1 CL .. LU Z y 0 IXISTIIJG I IXISTItJG - �q _ + � t 6 BEDROOM BASEI\�IENT PROPOSED ; Q (TOBEPARTIALLYFINISHED) - FOUNDATIO N PLAN ® � 49 c O MARK A. 49 McKEN21E - Lu PROPOSED S2 .-SECTION` @. LIVING ROOM T w. _._ _ T , , ,,4 DA E' 2 /2010 cg�STE�� `mil[S�t ONAt E SCALE: AS NOTED DRAWING#: Al - 3 N N N Z O MARVIN WINDOW&EXTERIOR DOOR SCHEDULE N - gm Qi m II KEY ROUGH OPENING W x H ITEM# STYLE NOTES m Q 4 (� Q FRONT DOOR WITH SIDELIGHTS SEE OWNER 100 LL Z a Z a r © SEE MANUF.SPECS. 3'-01IX6'-9"EASY CHANGE COMB.DR © SEE MANUF.SPEC'S. 2'-6"X6'-9"EASY CHANGE COMB.DR J O o Q e U • QD 2'-6-11WX 4'-4-7/8" 2442 DOUBLE HUNG WOW MATCH EXISTING-VERIFY QS p N QE 6'-0"X 6'-8" 6068 6'FRENCH DOOR O N QF 3'-01,X 6'-8" 3068 T FIXED FRENCH DOOR U S O W IS fD © 2'-6"SCREEN DOOR QH 30-1/16 X 45-3/4" 306 SKYLIGHT VELUX(verify type with owner) U OI 2-6-1/8"X 3-4-7/8" 2432 DOUBLE HUNG WOW MATCH EXISTING-VERIFY I- EOJO 4'-9"X 7-5 3/e" CW235 MULLED CASEMENT WOW MATCH EXISTING-VERIFY 52 I I Al I IXISTING ' KITCHEN 7�-6• (CATHEDRAL CEIUNG) SKYLIGHT AND COLLAR TIE NOTE5: DOUBLE ALL RAFTERS AT UVIIJG ROOM FOR NEW CATHEDRAL CEILING, PIACE COUAR TIE5 OIJ BOTH SIDES OF DOUBLE RAFTERS. -I FEUD DETERMINE WHAT SIDE OF RAFTER TO DOUBLE IN OROER TO ACh5VE EQUAL 5PAON6, - /-, • COLLAR nEs TO BE CASED IIJ FINE, PROPOSED VJDW WELL , O m (BELOW) R VERIFY WALL AND WOW LOCATIOIJ9 - EXIST.BEAM ABOVE - IXISTING . I BATH IXI5TING - - / IXIsnNG o I P GUEST BR SITTING . n n _y n I o I m (FLAT CEILING) • - PROP05EDWDW NTLL - m (BELOW) - vEwFrww✓LocAnoN __y I( =6 IXISTIIJG I e - R(sF�IJorES) w II BREAKFAST GARAGE (FLAT'CEIUIJG)' .IXISTING - ` 1 wOGE UNE L Fur -- - HALL - 'lL CL - - EQUAL EQUAL EQUAL EQU L qx^' p ^ IXlsnwc CL ' N 10e BEDROOM i LIVIN ROOM I NEW CATHEDRAL CEIUNG�-I-� - - d I Li WITH NENt( - TIES L IXISTING ER W Q BEDROOM IXISTING '-7 3/4' O (REA IXIST CL05.). - - BATI-.I 4'-7 3/4' I 8'-5 114' 6'-4 I/4° - - . 0 - F I - IXISTIIJG ADD WOW :REPLACE --- -_ ' N �C [OOP.. IX15TING - - OW FROM BATH IXIST.WOW FI%P.O NEV,6'FREN H Ok <, (2 2X8' OR C L PATIO F (ALIGIJ FLO PS) ' (2)II 4X-I/2-LVL'S !8"%24' _ - .. WINDOW %t` AICCI-To CRAWL •exlsrlllG m I E TRY a ee o IXlsr. BATH . N © OD dL HALL ,y�HOF - S2 b -3 112' _. . E - PROPOSED 1 i r O I 1— ©, i. . SCREENED PORCH G 2 W N m N (M1IAHOGAIJY WOOD DECYJIJG I - �. MNCENZiE _ - OVER P T FRAME) I 2 P _ c�� ' • ST _ - E (VAULTEDCSUNG) - I © _ N IJEW • S'..` 3- _ � ® LU t o F IXISTIIJG _ H W Z 77 PORCH ® r ¢ i oilE I(BLUe5TONE) BEDROOM 0 W a N �B E� s LU 3-O" 3-0- 3'-0" �ONAI 3-0- 3 O" _ - j��f� S �� ® y J 7 I/2' -5' 5- 5' 5' 7 I LL m F - ' p• U) H W U) INTERIOR DOOR SCHEDULE I O'-7' 16'-0' KEY ROUGH OPENING W x H SIZE STYLE NOTES a ILL 1O 67 X 81" 5'-0"X 6'-6" 5'DOUBLE DOOR MATCH EXISTING U T-0"X 6'-6" 3'LH FIBERGLASS 6 PANEL O r • 30 32"X 81" 2'-6"X 6-6" 2'-6"LH 6 PANEL 4O 32"X 81" 7 "X 6'.6' 2'-6"RH 6 PANEL ' - PROPOSED � - DATE: 12/14/2010 FIRST F L O O R P L A N 38"X 81" 7-0'X 6-6' 2'-6"LH 6 PANEL 4 © 62"X 81" 5'-0'X 6'.6" 5'DOUBLE DOOR SCALE: AS NOTED DRAWING#: A2 ® 3 ry z J D O vb Q z m Ow o za w e Q'a u RAKE TRIM TO MATCH EXI5TING } O X W.C.SHINGLES Qa EXPOSURE W p m TO MATCH EXISTING I F Q O NEW SHED ROOF _ SHINGLES TO MATCH EXISTING I U ® 12 ® 1 (EXISTING) (+/-)8 ® Q 12 MATCH EXIST.(+/-)8 SOFFIT DETAILS TO MATCH AND AUGN TO EXISTING I . III III I I I I I I I I I IIIIIIII I I I i l IIII IIIIIIII _ALIGN WITH EXISrING TOP PLATE WDW HDR ADD NEW DH TO EXISTING ® ®® ® Q TO MAKE MULLED UFILNIT�. — ®® 8 - B IIIIIIII' - _ ;IiI 8 ®' IIIIIIII i ' ALIGN WITH EXI5TINGFIRST FLOOR s-0°PANELS I I I I I I ® I. I FIRST FLOOP,61 MAIIJ USE III I IIIIIIII EXISTING FIRST FLOOR _ FIRST FLOOR N1 SIDE ' . � — -� 'III I �• ___ NEW BLUESTONE STEP EXISTING BEDROOM WING NEW SCREENED ROOM AND ENTRY EXISTING GABLE,CONNECTOR,ANo GARAGE TO REMAIL AS IS PROPOSED - FRONT ELEVATION ` 1/4"=1'-0" - - SHOWING GLASS PANELS z O m (4)NEW VELUX SKYLIGHTS - CONTINUOUS RIDGE VENT, NEW COLLAR TIES®IG'O.C. SEE SPECS. '" - , _ ROOF SHINGLES 12 TO MATCH EXISTING �(+/-)8 NAILER-(4)IOd NAILS/RAFTER TO NAILER • - 2XG RAFTERS s0 1 G.O.C. + Y _ ^�Z41 I/2'COX I L OOD 5HEAMING TRUSSED�eIUIJG ROOP SHIIJGLES TO MATCH EXISTING �. 12 12.5ACU15 12 NEW Cq R TIES // —3 4(+/-) 2XC aIUIJG JOISTS Q I G'O.C. Q 4 NEW SHED ROOF BEYOIJD) IJEYV Cf1TH DRAL CW. / H2.SA CLIPS AT EXI5111{G�IVIIJG ROOM //H2 5A CLIPS i Z Pare- . ' _ --- FIAT CEIUNG Be ND AUGI!W TH EXIST.SOFFIT 'BABY CHANGE'COMBINATION - (2)I- 'XS-I/2'LVLS NEW �. J — III STORM AND SCREEN DOORS EXISTING - EN RY LIVING ROOM' I IJewPRGIJrIXJDR D IIIII B I III I - New ENTRYGL05er W I`III IXI EX TING F.P ® f 5TIIJG FIRST FLOOR III EXISTING- FIRST FLOOR EXI5TIIJG FIRST fLOOR Z . .. _ EXISTING 2XI05 -2X85 I G'O.C.. Ip __ W EXISTING GIRT IJEW STRAPPIIJG AN GYP.BO. JEVJ CRAWL EXISTING HOUSE TO REMAIN AS IS I I pI IQi IIII - EXISTING WALL EXISTING r I IIIII }p O IIIII I NEW SCREENED PORCH ADDITION EX15T. - BASEMENT IJEW BLUESTONE FRONT STEP Q Z e_=— -sz�J_y (BEYOND) B'THICKPOUREDFOUNI)ATION-1-L O TO BE PARTII LL FINISHED) BOTTOM OF FTG:TO BELOW PRO5TLINE NEW 2X4 FPJIM WALL 4`THICK SLAB f I— UIST.CHIMNEY 5c EX15TII4G FOUNDATION WALL Y) Q 0 W > NEW WINDOW WELL NEW WINDOW WELL 3: w (VERIFY 512E) (VERIFY SIZE) ___ ___J �/� J PROPOSED I LEFT SIDE ELEVATION RAARKA "� o _ PROPOSED 1/4"=V-0" .SHOWING GLASS PANELS S3 CROSS SECTION / DATE: 12/14/2010 A 3 1/4"=1'-0" • �� I�{ '0 SCALE: AS NOTED am L� _ Ok%L G�G DRAWING#: A3 ®3 3 _ 1 ' r r ELECr—FAO �LE, $ Po "> OFF= �s D 2�M �wOkLn 12EQuF SVKokE DE'r��'�rz - C , ANT) a , Felt RAW r , h'•'iYi a�S�� ^, j AV. Gyp PARCEL AV5 �"�'■ �"" 'I Sol L EvAI� u s � FLOOD ZONE: �DA IkK7-A� W I TtSS REFERENCE: LA,4 o Co v�-T �.�hr� ��ZI�3 DATE:F! . PERCOLAT Y a - TH- I. �H OF MCI r L'WO^ o R E s P, SA�'0 �ti LOCATION MAP�N-t'S� �rER No. 1140 0 ��Q►sTti�� b� S��� SA IV I TAM�` I C 90 SE � o DWELLt _ Ta f= a, 2sa3 � I l _' �t2� ' + 110 y =7bftic WANk C�� F-L 27•S? S DMth AS 3 Inv z 0 m o pOy Na Q D YS > N z WOruUGE W.C.5MINGLE5 tlwrtU RAKE TRIM J a u 4 CKIOK.T 2ke K MRS®1 G.O.C. TO MATCH EXIST. TO MATCH EXISTING fttifNN.) I/2-CW YLYWO0.5ntATNNG 2 KOOP SHINGLES TO MATCH EXISTING K E%15T.YRCM 0 v 2k6 CEILING JOISTS®1G'O.C. NEW i 2 (MATCH (EXI5TING) I i Q KL S INSJIATICN : CRICKET Q(+/-)8 EXISTING) V[KIFY CkIST1NG I Iiril"ll ffi N 4( ' Tor YI_ATe_ (ALIGN SOFFITS)13113/4' 91/2-LVL t'M. II _1 (ALIGN TO CXI5T.SOPPR)fw9n1l ® ® A II i � IIII YX19T. E%19TING II 1 T ® ® ® HALL BEDROOM II 11I I I I I 1 2%6 W.f.MEU WALL NEW D (REPLACE WDWS) I 11 I K21 IN5UUTION { 11 =1 (NEW WINDOW5) I I `I �Ex15T.BEUKOOM rLooK 111,1111 _�_ _�_`(Si�T 2°oK �ML�' NN�111111111111 I I I I EXIST.rI K J015T5 2%b5®1 G O.C. A.,:—tlOLT5 EXISTING K-30 INS—TION CRAWL NEW NEKIrY DEYfnI CRAWL L EXI5TING GARAGE I, NEW ADDITION NEW DICK M5TING KITCHEN 8'THICK YOJKEU 1O N.-ION WALL ON CONTINJOJS S'X 16-rOOTING ` U OM CF rTG.TO UELOH FN05TUNE PARTIAL PROPOSED a•THICK5uu REAR ELEVATION s� CROSS SECTION s, 5'-7' 12'-6112' (REPLACE WOW) S 1a50,O'E5 (EQUAL) (E(DUAU ¢ TO MI-ON lW5T I l I � • • UW I I I Y.T.Z 2% -7 7 71 B'THICK YOJKEU FNUTN.WALL I I 2X8 RAFTER$!10 C. I I 1 I ON COOINJO05 B'X I G'TOOTING I I I I WITOM or RG.TO UELO W FK05TLINE 1 t? IT.2%J5T5. I I I 1 LANCHOKWLT5® O.C. 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FLOOR PLAN JA�� 2 6 2�J 1/4"=1'-0' ,/4,_,�-(r SCALE: AS NOTED LE DRAWING# -vo\NN O'V�:A� %SI03J Al - 1 ASSESSORS MAP: 'L�tb _ TEST MO LA e a go AV �.` PARCEL:W$ °�"" '� � t SOIL EVALUATO FLOOD ZONE: [V0(�1 �� WITNESS: P REFERENCE: L.pt4 p Co q,-v ?Ltrlfi�' DATE: FeZWA PERCOLATION P ai TH- 1 EL '. LD sRN�G zH of MA 1 Loh" s D R E G�� Sk*��O �fl�R �i N LOCATION MAP(Nrt'S• EVER 3q- H No. 1140 ME17t1M4 GI 87E• ANRI ITAI+ _ s t32'' s . z Q SEPT ' FLOW ae1 i 377.9 1 SEP1 2a 2 SE �tc, 33c USE SOIL V. EXrsr]N� , 44% S E P I fia F: Top- E a, 2sa3 � 22 {2� 30cyll I ` 7S• �. \ Z� T4 =7bPoF WA-MQ CtA M EL 27•S7 OUS bA47,I A'S50MW F c 4 . W , O 2 S - u z W W