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0038 CROSBY CIRCLE
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" , ,� - ,,I.,,, .lly� i!.;,,'131i, 1 � - - I"l � - " _;-A 0 , "�� �, � �, �� 'm , , 1, , , __,. /if 7�i ,�_ '' - �141 �". T", , l*_j,!._9A_,%1 't ,� , ,?t, __1;,", ,"J., �, _` .,", ,I _ - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 060 Application Health Division Date Issued < Conservation Division Application Fee Planning Dept. Permit Fee ' Z� Date Definitive Plan Approved by Planning Board 0l� 3lg')1 Historic - OK H _ Preservation / Hyannis Project Street Address 30 Grbs6$e Gr`/e- Village Owner -TtleLi TPJfJ- Myrffu Address If Sew,w,e� /�r:.� f,�►:,. ,.� M� Telephone ?5)/ 7`f9- 5-31/10 i � Permit Request ,. ARev� pfa, . F.'•,r/�rh v /1 0&' his: '°'c t� 4 G.I /7�C¢ I"�D dlJ� .O �/M c�irs.✓� Square feet: 1 st floor: existing $So proposed s 6 2nd floor: existing q%4 proposed it; Total news��K -_, Zoning District Flood Plain Groundwater Overlay Project Valuation /yd OOb Construction Type Lot Size 0 , 13 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) ` Age of Existing Structure 117ST Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 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 gNo Fireplaces: Existing/New Existing wood/coal stove: ❑Yes �f No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:11 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: aAXAy Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes #No If yes, site plan review# Current Use Reiide,,J,'u ( Proposed Use Res�� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 6r4c r /c.-►n Telephone Number .��� �G� �✓S" Address J,49 Svny r e_ /eve. License # A of M 0�.�-G.; rv/,9 O-L3G C, Home Improvement Contractor# i6 5-7 r,5- Worker's Compensation # 3/S -3 7a:c*'3 0J a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO A MrS s IA I&!; L 04- R 17 J ytt y►S r �at.�l � SIGNATURE DATE a - FOR OFFICIAL USE ONLY 't APLICATION# RATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE ' OWNER 4 DATE OF INSPECTION: FOUNDATION ' o-rSNGs d FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL Ib PLUMBING: 7OUGH GH FINAL GAS: FINAL FINAL BUILDING 1ti '719 DATE.CLOSED OUT ' ASSOCIATION PLAN NO. • f 'f Town of Barnstable pP tNF Ip��n Regulatorys.*5ervices BARNSTAHLE • Thomas R Geller, Director gy MASS. BUildinLy Di vision, : Thomas perry, CBO,Buildjng.Con riiissioner a, �. 200 Main Street, Hyannis MA 0260-`I www.town,barnstable:ma.us Office: 508-862=4038 Fax: 508-790.6230 . PLAN-RE VfE'�?V - •...a _ Owner: ear Map/Parcel. Project Address 3$ Cro,6 0,' Builder:` atilt Gin r c The following items were noted on reviewing W c-v O , 'na W GSM , y. 0CLA S .Sk i I e r C� r 1,LT') �l1l�tl a r); t ;:Z, �e o►�� Co x u _ , r . . m ¢ r Reviewed by: S(�0 Date: 7X- :Forms:Plnr'v�i � '_ I The Commonwealth ofMassachusetts, Department of Industrial Accidents yy I Office of Investigations 1 EC�;u 600 Washington Street Boston, MA 02111 } wwfP.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leffibly Name(Business/Organization/Individual): �� riinw 1>P K:nl �y►S 1 Rev►a��fic.� Address: � AC Scsr n,'s Ave- City/State/Zip: Qf P"aLof-A MA ' aa,36o, Phone #: S'n1V Are you an employer? Check the appropriate box: i Type of project(required): 1.FJ I am a em to er with 4. Q`I am a general contractor and 1 P Y 6. El New construction employees (full and/or part-time),* havelhired the sub-contractors ` 2.'� I am a so le.proprietor or partner- lusted on the attached sheet. 1 7. [Remodeling - ship and have no employees These sub-con tractors have 8. [f Demolition workingfor me in an capacity. workers' comp,"insurance. Y P h'• 9. 0 Building addition. [No workers' comp. insurance 5. ❑ We are a corporation and its . required.] officers have exercised their ]0.� Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I:0 Plumbing repairs or additions myself. [No workers' comp,., c 152, §1(4), and we have.no I IEJ Roof repairs insurance required,]t employees, [No workers' comp. insurance required.] ]3. Other *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 iriustattached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. r am an employer that is providing workers`compensation insurance formy*employees: Below it the policy andjob 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$1,500.06 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 ofthe DIA for insurance coverage verification. 7 do hereby certify and the pains and penalties of perjury that the information:provided above is true and correct. Signature: Date: .23 Phone#: � --Z6y' Ofjiclal use only. Do not write in this area, to be completer,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.Plum bing Inspector 6. Other 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 aJoint 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 ill 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 S 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 Departmenthas 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 perniit/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 Off►c-, of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call, The Department's address„telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 i THE rti Tows of Bar nstabre Regulatory Services y hues. 'Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis, MA 02601 `- wwFv.fown.barnstable.ma.vs Office: S08-862-4038' Fax: 508-790-6230 Property Owner Must Complete and Sign This. Section,. If Using.A Builder T...TuAv l e eau It_ u h as Owner of the subject property here b authorize i c 4r C,1Q__+_Me n y�,t y �a hen to act on my behalf, m ail matters relative to work authorized by this buil&ng permit application for. (Address of ob /0 // ' nA4t Af ner ate i�w t 112 EA U LT M Pant Na&e If.Property Owner is applying for-pe nit please complete the K P Homeowners License Exein Lion Form on the reverse side. , Town of Barnstable ��opYHe ray . Regulatory Services STAB Thomas F. Geiler,Director '65 9. Building Division PrFD �a Tom Perry, Building Commissioner 200 Maih-Street _Hyannis, MA 02601 RwW.town.barnstable.ma.us a a' Office: S08-862-4038 Fax: 508-790-6230 HO EOV, ER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# , CURRENT MAILINO ADDRESS: city/town state zip code Tlhe 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. DEMMON OF BON EOWNER persoa(s) who owns a parcel of land on which he/she resides or infends 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 than person who constrgcts more an one home in a two-year period shall not be. considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsihIc 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. t The undersigned "homeowner"certifies that.he/she understands the Town of Barnstable Building Department minimum Inspection procedures and requirements and that be/she will comply with said procedures and requirements. I Signatiirc 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. HOMEOWNERIS 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.(Sccdcin 109,1.1 -Liccrtsing of construction Supcn�sors);provided that if the homcowncr engages a parson(s)for him to do such work, that s�uCch Homeowner shall act as supervisor." Many homeowners who use this rxcmpdon are unaware that they arc assurring the rcsponstbilitics of a supervisor(see Appendix Q, Rulcs&Regulations for Licensing Construction Supervisors,Section z.15) This lack of awareness often results in serious problems,particularly* when the homeowner hirrs 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 responsjb)c. To enure that the homwwncr is fully aware of his/ha-responsibilitics,many conununitics require,as part of the permit application, that the homcovrncr certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomn/ccrrification for use in your community, }tll�lG GeaNSTRaJLT1p�L! - 3$ �-1Q4s�t" la9�tl� ��7�-i/ILG� �—:1g_1{ �j�, aty�o . 1 N AGL New , W S x 13 51mm. ft*m oN �ctt�.J 'Sao D PoST'S fit:f2 �� 'ems. 8 &BATTEN IL314OFALL 4 fr TILE PER KIfCH FOR IN . RRING BONE PA I AE7CU9ZA DIMENBIONB EL3 CO POTTER ROOM om YYo0D - R! Up. THE SAME �. CATAtHED 4. 1° .41 T it LAYO DAA1IY1 �6 CREATE J W14 BALE WALL MATHRAL Q9IUN0Q Cd UM ABOVE AND, BUILT IN STAIR TO BE '1w 4N b 0 GLA888HOWiERPOOR ;FUND :- e YYIDEN ENTRY FLOORING TO WIDEN Fr -RUBBER OOIN ►- _a- �l�tl FLOATNG.FLOOR- BUILT•IN BEAOOBD aARAL3ee3aRLEN Ly1 . w1 hca Tv AR71ctJLATINo ' ' ' q O BA TO BE ADDED pB Sf4 OF VYA UNT BRAOKfT . '801�oi 16 BAT'1E11 4 WALLS 040 OETi41L F1J11;4dALL HE40Hf THIS WA LL ONLY DQ !N$T�'LL. NOW POST-5 TO P�+IL . BOARD a Wa W4 volt.. v vlrr - D(/t6c;(t � AN t�X/'ST/1�G HEIGHTWOW FLOORING �CLOWTB�`Bmm WOOD FLOORING pout A 1W) ��wL Wr>koo�il C3' Ax) Lye Ut COLtI 3 �R yN Oft ftf NAArt'laN5. ADD NW � � Pa5f3 611CA00 GewuMnl A-Nu 'rcoriNG` OF WAC.i• to' * $ Main Level.Play DRAWINGS:NOT FOR.PERMIr"NO scale: j it�tbB�s�esl�;; f - � C J JOB Y4N6 3$ U4& , -, c Iu8 STRUCTURES ENGINEERING 1020 Plain St. Suite 240 SHEET No. Z. OF MARSHFIELD, MA 02050 cn+cu► sr' 1- o0J�j one2-18 (781) 834-0085 t i Fax (701) 834-1357 CHEMM DAB ! 3 SCALE - -� <- -' ' , _ : .St _ i.._ I _...... BEAM L\O`!f'RS ! a 1 77 - BE .HA( D S Crk BASED QN.DIrAWjiGS PFQW.EA.B� 2. 'BEAM. MdST BE IAlST�1LLED, ACCORD. ►N E RPITH ALL;CGTRRENT,BUIf,DING•COI B,REQti ]TSa .3 BED MUST BE I�ATF:RAI.LY BRACED BX.FWQ4 FRAMING(SEE DETA)L) _ ............._.._....;..._._,..._._ ; 4 1 PROPE�LY AND A' QUA!TELY SUPF(1RT BEAU S AT EACH STEEL QOLUMI�TS aR WOOD POSTS _. .._.... (SOSI,ID 4x4 FllT. O. 4x4 I1;EVI L LIN ERSTR�iNi?I,S').) ARE TO;BE SE(:URED- O 3HE,BEM A]51D/(?R , yFFpuplgA3 ,_ - -- '- ! CA AB�#i.I'L'Y-( ' I S'T UG T[ .'.R• OU,...... !.'I�QI+i••I'O SITP R'I 'I Al?P 'I+4A S S E) I3E VE tIl D PRICIR Tb BEAM TA' ON' .RI?PA�RS OR NEW FOUNDATJONS ARE TO BE CONSTRUCTED . - - _ -- E - AS� 1 Rri"TO�SumymT Ai.L I.OgDS E _..__.i.G STRTJGu'UI ES�INEERIW-jS-01NLt RSSPC�NS�LE FOK 1W DES G OF BEANIS�. AEA 4T R�DWS AA7 .CQI!iQMONS fAM TIBE.I3�SP�DNSIBILilTY OF nlTf�ER$ � _i......._. - -. . : S•IU�STEEL�TUTES} s - - -- - . , i -! 1 :AL STEEI._SHAT�L-IE ITE STEEL, CXXNEQRMING..T(J T)EIE _A I S C_{SPiCIF1CA .IO.IS FOR DFSIGN, FABRICATIOlY;AND ERECTION OF STR[�CT(JRAL STEEi<. FOR BUILDING AI D A-S-T M GRADE 36 . , �_.._ . ..................... _ 2 ALI, STFET SHALL HAVE TVIkO 'OAFS OF RUST-RWIBTTI�E P�iIX �AI�PI TOUCH UP ALL WELL?S," -'SCg AT I AR.S P 4INT AI B I0I4 , :..,. 3.' AVHERE JOIST FR ►1�IE Ti!5 TIDE TOP OY BEAi�I U A X8 TOP_NA)LEi�i TBR1;7`I30LT>I� fi 1/2-INC'H 7.Dibt�u7' �_B.p .TS ST�GOERF;D..,tkT? INCrIL5' .41-Ci ERS II+1U I SDP�E ►M. J.ATG .�iC1IST A1tE ....... TO BE FASTE�NEDiTO':THES TOP NAILER W.11H SINIPSON Ii4;HLiRRiCANE OLiP,s. V�IIERE JOIStS FLUSH. .._____d.... FItAIU#'tCC�THE S�iES`OI:THE BEA;ICJ,'C7S`l;'F(JLT.rDFPI"Hi`V1►EB B1;OCICII �i I+I. TQ tHEIDBS�7FfiTE BEAM. ►Nl -.F IkST$N"V .� ] D.. ?IAAgE �t. l..B )!�T$.A 24..INCDBS 019 C 1VT R--STAG ER.D :... :... _.. TOP AND BOTtO1V� FR;AlA TIC JOISTS TO Ti�E BI,OCKII�G v�IT�JOIST I�ANiGERS(5`�fiE DET�ILa.: .........�._...._ ._ ....... ._. TET�IP�1ItA1ZY SHORI11fG i 1 THE C(NTRACTOR M[TST PRCIVIQE T1;MPQRARY STRUCTURAL SUPPORT OR.SHORING AS REQUIRED TO �ISTa1T,L-iceSTRUCT 3�(�RCA$-CALLZD�1R®N �3R�1 G� AI;I,I►�EAIaSACID- �'NOI]S'fO �.._.._. ACOONWLISH THERE#*AIR WORK IS T,HE GONTR�ACTOR'S Rla`SPQNSIBILt'I'Y _2 TH .TI♦i1SABY SFI( RIISiLIl�?EI?QNLY'TU SUPPORT THE EAMS.-] AND POSTS HAVE BE$N INSTALLED. •_.__._ .__ .._..._ _ .. • .... 3 .THE dON'I'Rt�CTYQR MUST ;PROVIDE; ADEQUATE LATERAIE B1tAC NG A1.L :SHORES IE�CUST BB...;_ ...._ "C01V`i 1UOUS THRO iH Tip 'Fl%(90R '1 i VIrL S AS' ittE ES tt'Y AND' TFLAO .ALL SHORES Mi�ST�BE OARRIEU DOWN TO FIRM$EARINQ MATERIAL AND T�LOAD MUST BE ADLQV;ATELY SPREAq. -- - - - 4 :AFC ER EXISTI JG iAMITTiG I SHOR�THE i~LObR YiDjSfS R AY BE CCU A1�D FLUS i FRAMED TIGHT TO q S'IEI?L.HRA11+ WTITI JpISI H�iNGERS;AS SHOWNI .._.. ,._w _ _ , ...._ _NImIM17�1•FIWU9sM$bbf�. ' - ..;.-. :, ,. Project: FkOda Location:King CoI Crosby Lane,Centerville-Second Floor Beam SE Uniformly Loaded Floor Beam 78 pm Intem de(AISC aMml Building Co 13th Ed ASD)] ,-o ` Este Classic Court or .Estero.FL 33928 A36 W&I3 x 13.75 FT Section Adequate By.36.4% Controlling Factor.Deflection StruCak:Version 8.0.100.0 211812011613:30 AM DEFLECTIONS Cantoi Live Load 0.25 IN L1655 Dead Load 0.17 in Total Load 0.42 IN 1-3911 Live Load Deflection Criteria:U480 Total Load Deflection Criteria:U240 I Live Load 2475 lb 2475 lb Dead Load 1671 lb 1671 lb Total Load 4146 lb 4146. lb, Bearing Length 0.56 in 0.56 in OF-AM Center Span length 13.75 ft Unbraoed -Top 0 ft STEEL PROPF�tTIES W8x13- FLOOR LOADING , Properties: Side 1 Side 2 Yield Stress: fy= 36 ksi Floor Live Load FLL= 30 p9f 30 psi Modulus of Elasticity: E_ 29000 ksi Floor Dead Load FDL= 15 psi 15 f Dom: d 7.99 in Floor Tributary Width FTW= 6, ft, 6 it Web Thickness. tw= 0..23 In Wag Load WALL= 50 plf Flange Width: bf. 4.ln, REM M LOADING Flange Thickness: ff 0.26 in Beam Total Live Load: wL= 360 plf Distance to Web Toe of Fillet k= 0.56 in Beam Total Dead Load: wD=,. 230 pff Moment of kwrba About X X Axis: Ix= 39.6 in4. Beam Self Weight: BSW.= 13 pif. Section Modulus About X-X Ards: Sx= 6.91 in3 Total Maximum Load: WT= 603 pff Plastic Section Modulus About X X Ards: Zx= 11.4 in3 Design Properties per AISC 13th Edition Steel Manual: Flange Budding Ratio: FBR 7.84 Allowable Flange Budding Ratio; AFBR_ 10.79 Web Budding Ratio: WBR= 29.91 Allowable Web Budding Ratio: AWBR 106.72 Controlling Unbraced Length: Lb= 0 ft Limiting Unbraced Length for lateral-torsional buckling: LP= 3.51 A. Nominal Flexural Strength wf safety factor: Mn= 20479 ft-lb. Controlling Equation: F2-1 Web height to thidmess ratio: h/tw= 29.91 Limiting height to thickness ratio for egn.G2:2:httuallmit=: 63.58 Cv Factor Cv= 1 Controlling Equation: G2,2 F Nominal Shear 9trangth.%W safety factor Vn 26463 lb �N OF MAS`�t� 9 o� JOHN W. tiG rtl Controlling Moment 14251 ft-lb QUEEN `�' ,t0i W. 6.875 ft from left support � OL�?. o STRUCTURAL —� Created by combining all dead and Hm loads. v 13TilftlCil,41. 28011 Controlling Shear. 4146 lb �� 2"xii At support. GIST 11 L .Created by combining all dead and INeJoads. F Comparisons with required sections: Read Provided t1L0 v Moment of Inertia(deflectfon): 29.04 In4 30.6 ln4 Moment 14251 tt4b. 20479 ft-lb 3'8 lI Shear -4146 Ib '26463 Rr �s jas ti t - 38 �Ro"S'�Y LhW.`, :CF. ER+►1 ltl.G . STRUCTURES ENGINEERING 1020 Plain St. Suite 240 r►,o of . MARSHFIELD,MA 02050 f, Qy 0-16 VA-W (781) 834-0085 cucxaArw r Fax (781) 834-1357 ado er one i ! Y I i "THOU QL j S FITD RING - , , ;;1DI�TT,Hf iGE1 � i I , if , �"• , , ,. fir- 2.�.. .�t ,' ! 1 i 1 I - 1 L 1BE.- M__4 - ! �A - TlY- I "gip — E } S'11 -1 —F� tA f I e NtIT T G .... i j i } i t i BEAM SI�PP RTt BLARING�T�PART PARTITION f — —' — — ••.•�11f e r - ET,PR EDLa -AfAIlaEF� - i ; AT OP: FL�INGE STET LINd OEM,. T}IRt ......_. OR RT{1 - 7 AITL IBOV E ; ' t WDI7# lf2 THRU BIXTS;@ R Q D,E , t D FLANGE 'b-'—� -.. ..... .._.... E a......-.. Y. ..e p:...._. t .. i _. _ i �� t _____ _ —__ oIsTs i i e : ? i • ---.._...j. .-�-'•:.ipIST-+i�1NGER•S�•- � .__t_�--�--� � - •:� 4 - t i I -- - i 1 I `STEM ;BEAM w1nBo]CIKI I l E ' a. pi ` TT T} T7 Ir t i BETA ,. . NpT�T SC , - ..__.J...... � ALE- � , —. _. �,jj L � t L THRl1 BI]LT ARE, D IBE tl/ 'Sb $ClI �'1S WITH - AS(iER S 'A D r _. 1 ....:., # }- U Tf EIY7�T T" Rrl`I)E:P T1 T 1r=0 T7 :_�TAGEI�EIT A1VI-[- C7i ; P_'__-WDLD-..B Q KI1dG•_,TO- I Y_...BEAE2_ITV BDT .OM EL.P�NG�D� '--- $EpM. PRUNIIlE DD TI�NAL BL[7CI�INC AS N CESSAf�Y ;NDfi TC EXCISED a.£L I$ p r i ! i PROV-11 E JOIST 14 ANttER3 A ` AL.L JI]IsT ON JECTI©IN Ft9-LA GEt. I]D6�rSi �A 1V £ A1F-�frfl-GL4EL BEAM --•-+ t �,---�Rt]'�!'IIIE•,_,Sf'l��i=-$�7''�JEF,.I��"l�Y�'tJQ�I F"CODRIN��_.?�i�ly • � E � , ' I _ 3Etr _ 1 - -', _.. } t. LL: ELM _ - ;-t r i- i . �...._ _E J - _ i v�Relal 1pll,bpAeNd7[.1 BalYY Project: Fiore S Location:King Corestr.-W Crosby Lane,.Centerville SE Column 7840 Classic Court or [2W9 International Building Code(2005 NDS)] V Estero,FL MM 3.5INx3.5INx8FT 1.3E Timbomtrand LSL-Level Trus Joist Section Adequate By:32.896 StruCalc Version'8.0.100 0 2J18120117:06:35 AM Live Load: Vert-LL-Rxn= 2475 lb Dead Load: Vert-DL-Rxn= 1695 lb Total Load: Vert-TL4bm= 4170 lb 8 COLUiMJ[N DATA Total Column Length: 8 ft Unbraced Length(XAxis)Ly: 0 ft. Unbraced Length(Y-Axis)Ly: 0 :ft Column End Condtion-K.(e): 1 Load Eccentricity(X AAs)-ex: 1 in Load Ecoentricity(Y-Axis)-ey: 1 in Axial Load Duration Factor 1.00 COLUMN 1.3E Timberstrand LSL-Level Trim Joist Base Valuas i d Compresstv+a Stress: Fc= 1400 psi Fd= 14000 sn Cd=1.00 Bending Stress pc X Axis): Fbx= 1700 psi Roe=`1904'psi Cd=1.00 CF-1.12 Bending Stress(Y-Y Axis): Fby= 170D psi Fbyl= 1904 psi Cd=1.00 CF!,-,,1.12 Modulus of Elasticity: E= 1300 ksl E= 1300 kill Column.Section(X X Axis): dx 3.5 in. Colurnn.Section(Y-YAps): icily 3.5 in Area: A F. 12.25 in2 Section Modulus(X X Axis): Sx= 7.15 in3 A: Section Modulus(Y-Y Axis): Sy= 7.15 in3 Slenderness Ratio: Lex/dx_ 0 Ley1dy p AXIAL LOADING Live Load: PL= 2475 lb: Column Calculations(Controlling Case Only): Dead Load: PD=. 16"lb Controlling Load Case:Axial Total Load Only(L+D) Column Self Weight: CSW= 31 lb Actual Compressive mess: Fc= 340 psi Total Load: PT= 4170 lb Allowable Compressive Stress: Fd= 1400 psi Eocentricit)r Moment(XX Axis): Mx-ex= 345 ft-lb Eccentricity Moment(Y-Y Axis): My-ey_ 345 ft-lb Moment Due to Lateral Loads(X X Axis): 1& 0 ft4b Moment Due to Lateral Loads(Y-Y Abs): My '0 ftab Bending Stress Lateral Loads Only(X-X Axis):Fbx= 0 psi Allowable Bending Stress(X-X Axis): FbX= 1904 psi Bending Stress Lateral Loads Only,(Y-Y Axis):Fby= A pill Allowable Bending Stress(Y-Y Axis): Fbi(= 1904 psi Combined Stress Factor: CSF o 0.67 NMU OF o� JOHN W. yG J"W. QUEEN o STRUCTURAL g11 j 2ao 11 �11 �0 3-9 Jr` Protect: Florida Location:King Constr.-36 Crosby Lane,Centerville SE Column i 7840 Classic Court [20091ntemational Building Code(20W NDS)] •« Estero,FL 33928 3.5 IN x 3.5 IN x&0 FT #2-Hem-Fir-Dry Use Section Adequate By:3.6% StruCall;Version 8.0.100.0 2118120117.08:15 AM D G -VERTICAL Bg&OONS Live Load: Vert LL-Rxn= 2475 lb Dead load: Vert DL-Wm= 1682. lb Total Load: Vert TL4bm= 4167 lb Total Column Length: 8 it Unbraoed Length(X-Axis)Ly: 0 it Unbreoed Length(Y-Ax1s)Ly: 0 it Column End Condtion-K(ey 1 Load Eccentricity,(X-AXIS)-ex 1 in Load Eccentricity(Y Axis)-ey 1 in AAsl Load Duration Factor 1.00 COLLNAN PROPERTIES 02-Hein-Fir am 49 Compressive Stress: Fc= 1300 psi .FC 1495 psi ee Cd=1.00 Cfh-1.15 Bending Stress(X-X Axis): Fbx= 850 psi Fbx!= 9275 psi Cd=1.00 CF-1.50 Bending Stress(Y-Y Axis): Fby= 850 psi Fby 1275.psi Cd=1.00 CF=1.50 Modulus of Elasticity: E= 1300 W E'_ 1300 k9i Min.Mod.of Elasticity: E min= 470 W .E_mirf_' 470 ksl' Column Section(X-X Axis): dx= 3.5 in , Column Section(Y-Y Axis): dy= 3.6 .in Area: A= .12.25 in2 ,A Section Modulus(X-X Axis): Sx 7.15 W. Section Modulus(Y-Y Axis): Sy '7,15 in$. Slenderness Ratio: Lex/dx=.. 0 AXIAL L N Ley/dy=- 10 Live Load: PL= 2475 lb Dead Load: PD= 1664 lb Column Calculations(Controlling Case Only): Column Self Weight CSIN 18 lb Controlling Load Case:Axial Total Load Only(L+D) Total Load: PT= 4157 lb Actual Compressive Stress: Fc 339 pal Allowable Compressive Stress;_ Fd= 14" psi Eccentdcly Moment(X-X Axis): Wax=, 345 ft Ib Eccerniicity Moment(Y Y Axis): My-ey= 345 ft4b Moment Due to Lateral Loads( -X Axis): Mx= 0 ft-lb Moment Due to Lateral Loads(Y-Y Axis): My=. 0 ft-lb Bending Stress Lateral Loads Only p(X Axis): Fbx .0 psi Atimable Banding Stress(X-X Axis): Fbx`.=: .1275 psi Bending Stress Lateral Loads Only(Y Y A)is)` Fby= 0 ,psf. Allowable Sending Stress(Y-Y Axis): Fby'_ 1276 psi. Combined Streea Factor. CSF= 0,96 ^;H OF Mast' JOHN W, q�y JyW QUEEN m Qum C) STRUCTURAL — Siitt,'GT.H AL 28011 � 7S6'11 � or G/STEM S/ A EN 2-1�'lt a CSL: 103202 MC: - 165785 Gregory King 26 Sunrise Ave. Plymouth,MA 02360 Ym 508-269-3057 rc ,ropnsUrt�fit;ntl t:enc�vti�ar ;gking3057@gmail.com Job Description Proposed work at: 38 Crosby Circle Centerville,MA Estimated Job Completion Time: 12-14 weeks Project Scope: Complete renovation of entire first floor with the addition of a finished existing basement. Only work to be done on'the second floor will be the refinishing of the hallway hardwood flooring, about 18 square feet. Existing Square Footage: First Floor:, 850' Second Floor: 440' Basement: 816' A , Area to be Renovated: First Floor: 850' Second Floor: 18' Basement: 340' First Floor Details:, Garage: - Replace (2)existing windows with(2).removed windows from house Electrician adding a heat detector R 1 - BB &Plaster(smooth) - - Trim—per plan Crown Molding; Colonial Casing;Base_ 8oand o Interior Doors(5-panel solid) - All electrical work per plan and to code - All plumbing/heating per plan and to code - Paint per plan - Tile floors and shower walls(Tile supplied by Homeowner) - Glass walls and doors for shower Second Floor Level: - Refinish hardwood flooring in hallway at top of the stairs (18 sq') s Basement Level: ; - _ Install New Footings and Lally Columns required by engineer v Frame per plan o 14' x 32' area w o Rebuild stairwell w/landing o Oak treads Insulate all walls - BB &Plaster(smooth walls&ceiling) w - Install new exterior doer(Jeld-Wen) Trim per plan Crown Molding, Colonial Casing,Base Board o Interior Doors (5-panel solid) - All electrical work per plan and to code - All plumbing/heating per plan and to code, including a new heat zone - Paint per plan - Tile Floor Exterior: - Replace siding on lower back section of house ' o 245 sq' o' Maibec shingle to match Replace all corresponding trim with Azak trim boards " Exterior trim for newly replaced windows and doors will be Azak trim boards Homeowner and designer have submitted design plans and schedules to King Construction&Renovation that includes all.fixtures- finishes colors etc; • • Y - tr% 4 o Same height continuing up stairwell ` E_xistip_g floor to be pgjgN-d 11W refinished All electrical work per plan and to code o Including 1 floor outlet All plumbing/heating per plan and to code o Including replacing a gas fireplace insert(supplied by homeowner) Paint per plan Powder Room: ; - Demo as necessary - Frame as necessary per new plan - Insulate as necessary - BB &plaster. f - - Trim per plan Crown Molding, Colonial Casing, Base Board o Interior Doors(5-panel solid) o Built-in shelf unit o Board&Batten 3/4 all walls - All electrical work per plan and to code - All plumbing/heating per plan and to code - Paint per plan Tile floor(tile supplied by Homeowner) o Herringbone pattern Master Bedroom: Demo as necessary Frame per plan o Install Engineered steel beam to carry load Install (4)New Anderson A-Series windows Insulate: Interior(for sound)&Exterior walls BB &Plaster - Trim per plan Crown Molding, Colonial Casing,Base Board o Interior Doors(5-pane}solid) o Closet Kits TBD - All electrical work per plan and to code - All plumbing/heating per plan and to code - Paint per plan - Hardwood Floors: o Patch/fix or Install new o- Refinish Master Bathroom: - Demo as necessary , - Frame per plan - Install (2)New Anderson A-Series windows - Insulate: Interior&Exterior walls 3 Dining Room: - Complete Demo to studs of entire room except floor - Create Cathedral Ceiling - Insulate walls(rl3)and ceiling(60 or r38) - Blue Board& Skim coat plaster - Widen entry into kitchen - Replace entry door w/new door - Install(2)Anderson A-Series windows - Install Trim: Crown Molding,Colonial Casing,Base Board o Interior Doors (5-panel solid) - Board&batten on walls 3/4 height - All electrical work per plan and to code - All plumbing/heating per plan and to code, including a new heat zone - Paint per plan Kitchen: - Demo as required - Widen opening between kitchen and living room with engineered steel beam - New exterior entry door o Anderson 400 Series Patio Door, Full Glass, screen door ' - New Anderson A-Series window per plan - Frame as necessary , - Insulate as necessary - BB &Plaster. - New hardwood flooring to match existing house flooring(Red Oak 2-1/4") - Install Kitchen Cabinets o Including tile backsplash per plan - Trirp per pin Crown Widip_g, Colepial Casipg;Base$oard __ o Interior Doors(5-panel solid) - Install Pebble/Tile floor mat in front of door, ' - All electrical work per plan and to code - All plumbing/heating per plan and to code - - . Paint per plan Living Room: - Demo as required " - Frame as necessary ` o Install blocking for TV bracket , - Install(3)new Anderson A-Series windows per plan , - New Front Entry Door(Jeld-Wen 3'-0") - Repair or Replace existing stairs, railing, balusters, posts - Insulate as necessary ; BB &Plaster Trim per plan Crown Molding, Colonial Casing, Base Board o Interior Doors(5-panel solid) o Including Board&Batten throughout room 4' high 2 f . r i t + E�aut.� Dt�p.aetmcnt ttt"�o#t1� _ . - �' Bi►�art�rlt �t►ittllti�;:�E��e[attcn�uartl '�t - i< O t7 tr t on gear 1I €' t :S ReStfletetl t0 tic,,. 'a r 5 * t Tgg •,,GREGORY KING`,;; � 26 SUNRISE AVENUE PLYIVIOUT ,;!'WA 02360 57 a, C'4)mill iimc Expiration: 6!3/2pt3 T: Office of Consumer Affairs and. usiness Regulation 10 Park Plaza - Smite 5170 w a Boston, Massachusetts 02116 Home Improvement Contractor.Registration �:=m:.- `M -rye'-T ' Registration:" 165785 ` I . Type: DBA Expiration: 3/25/2812 Tri 2§6646. KING CONSTRUCTION & RENOVAYTtON GREGORY KING 26 SUNRISE AVE. PLYMOUTH, MA 02360 }=J - " Update Address and return card.Mark reason for change. Y....: Address ❑ Renewal Employment Lost Card DPS-CA1 0 50M-04/04-G101216 Office�t o, um r"�t�tair� Ines ,"f oii License or registration valid for individul use only' }` HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: `"Registration ::165785 hype: 7 Office of Consumer-Affeif•§eHd Busines's Regulation Expiration 3/25l2012 DBA .10 Park Plaza-Suite'5170 ��,,�� Boston,MA 02116 KI G'CONSTRUCT[ON il<RENOVATION Y t ` GREGORY KING `26 SUNRISE AVE. � � PLYMOUTH,MA 02:60 Undersecretary slid without signature + - Town of Barnstable f �j"E'' ►. Regulatory Services _ Thomas F.Geiler,Director ' " d - 9hoh l r a sa IX ` Building DMiion Tom Perry,Building Commissioner . > 200 Main Street, Hyannis,MA 02601 www.town.ba rnsta ble.m a.us Office: 508-862-4038 Fax: 508-790-6230 f: PERMIT# ,I 16 FEE: $ , ,.SHED REGISTRATION 200 square feet or less , g cro6w CIrele; Location of shed(addres Village. ... C lrosb G i rc l e ReOA Y : r a ��5�uA Ie+re�u1'� :rR 00 5 Property o ner'sname „. ' . Telephone number r E a Size of Shed Map/Parcel# l i nat Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation'Commission(signature is required)ry-F j Sign off hours:for Conservation'8:00-0:30&3:30-4:30` PLEASE NOTE: IF•YOU ARE WITHIN THE JURISDICTION_OF'ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND'APPLICATION FEE. PLEASE'SEE THE APPROPRIATE COMMISSION FOR DETAILS. a k THIS FORM MUST. BE ACCOMPANIED BY A ` PLOT.PLAN . f , Q-forms-shedreg _ REV:042911 t ,i NO PROPOSED 5' x 1 2' m v °O°O' 5 f1 E D LU Q O U o m 0' LLJN _ 22 8 1 7 m 0 40.3, O r\ LOT 4 10000.8 5.F. °0.°°, w BUILDING LOCATION PLAN FOR 38 CROSBY CIRCLE CENTERVILLE, MA PREPARED FOR o ti DAVID MURPHY EN W.- SCALE: DATE: DRAWN BY: . . R MBA I " = 20' 09- 1 4-201 1 TMW .35791 JOB NUMBER: FEV15ION: SHEET NUMBER: 1 1 -034 CPP- I �p� 10NP� `gNosu WELLER * A550CIATE5 I G45 PALMOUTH RD., SUITE 4C -- P.O. BOX 4 17 CENTERVILLE, MA 02G32 2 WINDY WAY, #232 NANTUCKET, MA 02554 TELEPHONE � FAX: (508) 775-0735 EMAIL: trl5weller@comca5t.net REGISTERED LAND SURVEYORS ENVIROMENTAL CONSULTANTS Traverse PC ' Town of Barnstable *Permit# „y „��e � ExQ' s 6 months jrortt issue rare - .' `% Inheg Y ulator Services � �r�6�.� • ,�r� MAtas �RA, Thomas F. Geiler, Director tGg9- ,�� �trls �e4411C�l Building Division Tom Perry,,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address ] ��vs6� C try c ~Residential Value of Work ,, S-0, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address i�' ✓uGr Contractor's Name /�iG�,l/�� r'/_ l�ft�7 �/ Telephone Number 5D0) 774�7- 3703 Home Improvement Contractor License#(if applicable) 11 aq 77 Construction Supervisor's License#(if applicable) 3 3 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Db{,dl 116 Workman's Comp. Policy# 90(a ? 32,ol 2- o00 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re,-roof(not stripping. Going over existing layers of.roof) 2(e-side ❑ Replacement Windows. U-Value '(maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. H me Improverne Contractors License& Construct Supervisors License is required. SIGNATURE: Q:\WPFI.LES\FORMS\Express\EXPRESSPERMIT.WOC Revise06O4O9 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 Legibly Name(Business/Organization/Individual):M;aa2( J U0.11I1d0 d�Rewb I oc" Address: l K I+Wwsk a@ �n City/State/Zip:02� vj MR 014U Phone.#:( 56S) 7)5 - S70 k Are you an employer?Check the appropriate box: Type of project(required): 1.Z I am a employer with . 'j 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.instuance comp. insurance.$ required.] 5. ❑ We are a corporation and its '10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.�Other 5 i ide-Ak(I 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. xContractors 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. i Insurance Company Name: D601,14 4t P)n Pt Policy'#or Self-ins. Lic.#:500(07 3$0( ZUUq, Expiration Date: 12(1 q to Job Site Address: 316 Cyos?� C(r, Cenfey4e AM. City/State/Zip: n14 37- 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 tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Simafore: Date: V 12, Phone#: 'MY 71 S 37 F Official use only. Do not write in this area,to be completedby 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 Insttuctions ~ A Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work unto 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 E necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of l insurance. ,Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete"and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference 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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business of commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston, MA 02111 Tel. #617--727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia r oFjrorti Town of Barnstable Regulatory Services uexsresr..� v KAM $ Thomas F.Geiler,Director En;9. 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder A ur I, .}•i 01 d G , as Owner of the subject property hereby authorize)VI JW91 J. lM44 to act on my behalf, in all matters relative to work authorized by this building permit application for. '(Address of Joby ti Signatur Owne . ate - Tint Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. n.rnnin_nnnrr-n nannmm��.r tKE Town of Barnstable r�y� Regulatory Services • r Thomas F. Geiler,Director >ttwss . �bs�. �•� Building Division PrED Tom Perry,Building Commissioner www.town.barnstable-ma.us Office: 508-962-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION . Please Print DATE: JOB LOCATION: number street village "HOMF.o'JVNER II name home phone# work phone# CLjRREK7 MAILING ADDRESS: cityhown 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 OF HOMEOWNER 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 strictures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certifies that-he/she understands the Town of Barnstable,Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner h i � s Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption ate unaware that they an assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed perms,as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To-=re that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that helshe understands the respo=bilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonn/certification.for use in your community. Q:fon-ns:homcexempt i t ot °06441 r•Lsl�c�e a seBoar ucR "( u U `Su rvrso im cons 1 Tr# 13952 i Its f Expiration 112212010 �1�� ,§ ��� ��'Rest�rllction lG� • V4A 1 . EL J i Mp HORSESHOER ' _ComriIC isswner ��. CENTERVILLE,MA 02632 F7s' •^=. p /4GaJ�[zc/tu°riw i � ` ty F(, ``c 4"Ry t r S Ill'^LICE only �S.i 0 l s t v. ���,� x �� (Oa4� � � k � Y ; ra t\�7. � s`�,�1 ��•.vr^ � it'll t0 ., 4l 1 V Y Y iz-r 5-, , ;�Rcbulatl x z� � tir 041- WO Pi'Ice[tut l3 " x is ration ;112977 ' stoE? ,�Ia 02L03 Tr# 128790 B Ezplration 517/2009 ,l w l'l" Type Individual MICHAEL MICN)AEL 4NGEL0� �� L 1�rvalld Bout s►gn�ture or SSHOE LN uustrat 105 HOR pdm ,CENTERS t4 E,;.Mh 02632 . Client#: 3860 2DANGELOMI iDrM CERTIFICATE OF LIABILITY INSURANCE DATE (MMI Dmrn 01108/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR g y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance Company Michael J. Dangelo Building & INSURER B: Associated Employers Insurance Compa 105 Horseshoe Lane. INSURERC: Centerville, MA 02632 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRDATE fMM/DD[YY1 DATE(MM/DDIYY) A GENERAL LIABILITY 168084331-1175TCT09 01/04/69 01/04/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300 OOO CLAIMS MADE �OCCUR MED EXP(Any one person) $S 000 X PC Ded:500 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG s2,000,000 POLICY JE� LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY - (Per person) $ SCHEDULED AUTOS A HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ I DEDUCTIBLE - $ RETENTION $ $ AT�B WORKERS COMPENSATION AND WCC5006733012008 12/19/08 12/19/09 X WC STIM IR OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1 OO 000 ANY PROPRIETOR/PARTNER/EXECUTIVE .OFFICER/MEMBER EXCLUDED? YES E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Michael D'Angelo is excluded from coverage under the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained In the certificate of i insurance shall be deemed to have altered,waived,or extended the (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Encore Construction Co. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1_ DAYS WRITTEN 103 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Dennisport, MA 02642 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED!;PRESENTATIVE ACORD 25(2001/08) 1 of 3 #54995 LS1 © ACORD CORPORATION 1988 •1 SMOKO 09TECTORS REVIEWF-D Existing 1st Floor Plan a R 7 ILDIN DEPT, DATE 6U Scale: 1/4" = 1 Foot FIRE DEPARTMENT DATE BATH SIGNATURES ARE REQUIRED FOR PERMITTING \1611 . Kitchen VM \ Bed 1 2-6 6 ,91. ' I i ...... ;;:::::::::::::::>x::: T _ "sa .9 N LO N 6 .9 i m N 8 Den/Office ca Living RM u6 .E6 2-10" Z.6 Z-5 ►� King Construction&Renovation Job: 38 Crosby Circle Centerville, MA I �. 181 1 " 2' 8 93Z 01. .1.6 CO _ ao p N` � Dining Rm 14 14 191. Existing Garage Scale: 1/4" = 1 Foot Existing Basement Plan Scale: 1 4" _e / 1 foot 1-4 0, 216 '1 Z M , 200 amp-panel 7' Ceiling Height ` OP ad �8 Lally Column icy N Utility: Furnace rn CV i 'I t I New 1 st Floor Plan ovnv I _ 73' 6 Tile Flooring s a m. _.:_. .. . .. 9 196. . ,. mas ter Bath o. SO... n _........................ Glass Door ::.:• o --------- Kitchen = 5 i •- 4, , e Cy' ;. D - : c, 4. _ Tile Shower p .....Kitchen _. tacked - #? S W/D Bed RM .. 6 .0 ►� Hardwood :. to Master Flooring N 6 .91. n - Living FM a LA Hardwood Flooring N �: - - - - - - - - - - - CD_.. _. _ a .. ... to _. 9 �Z-I*-► : � 2� 6 - 9 3z .9- ►� FI ating F oor _ CV . . � Heat Detector... _ DiningRM 00 O Nmm _ . V IsO6ILL so _. � : 777! New Garage 1/4" = 1 Foot 7772'� Existing 2nd Floor.w/added New:Smokes 111 10 „ 2, � Bath 2 . Ln CA 4,. 2 ZNI Bath 2 O. io Bed 2 N Bed 1 .. �� 14' 10 11' 10 Scale: 1/4" =..1 foot - _ New Basement Plan::: Scale: 1/4" = 1 :foot ,5E 9:Z ►� 00 mp panel Rec RM O » O O O A O � U �\ 4 Lally Column: N Utility:A.G. Unit LJ 'New2x2x2 Footing &4° Lally UtilityFurnace .; ::. W/H Unfinished Utility RM Utility:Water Heater; TXT _ . Rec RM