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0203 EISENHOWER DRIVE
7hav TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION- ,- Ma Parcel IZ Application p pp Health Division Date Issued Conservation Division Applicatio ; Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis' Project Street Address 2 b 3 CIS oy (� . Village C&U IT. Owner P`-U 1 LO gU C-4 Address 31 S_ C4fi8Gf l W JQAA de- Telephone o Z O1 — 24 2A Wadffir 1A (a- VA 2b!1 Z Permit Request CA J S-?r au ur S W ELF � 14 --4 (6 Msm 9 Mpw n v� ICKIL Square feet: 1 st floor: existing 112r'proposed _2n our-existirnn3-- uposed Total new .2 Zoning District Flood Plain Groundwater Overlay N�H Project Valuation SU oA Construction Type Lot Size d 4 6 / c.yt rs Grandfathered: ❑Yes ZNo If yes, attach supporting documentation. Dwelling Type:' Single Family a Two Family ❑ Multi-Family �# units) A f Existing Structure Historic House: ❑Yes 1 o On Old Kin 's Highway: ❑Yes JNo Age s g g g y Basement Type: ❑ Full Krawl ❑Walkout ❑ Other T L Basement Finished Area,(sq.ft.) io Basement Unfinished Area (sq.ft) ZZ�! Number of Baths: Full: existing new AA Qw �H�ilf:�existing rj new Number of Bedrooms: 3 existing Q new1�C?,, Total Room Count (not in ding baths): existing 6 new , �� First Floor Room Count Heat Type and Fig I: Gas ❑Oil ❑ Electric ❑ Other _ Central Air: Yes ❑ No Fireplaces: Existing I New 6 o D size_ Attached garage: Yexisting ❑ new size Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use i`A IAJ u l Proposed Use R_fA m LAM a APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number aco Address 6 IA41,V f_ License # G G3 ay rj 02,6 31- Home Improvement Contractor# J1 1 Em C_pZutMrn� Urfy Gvhrj - C Worker's Compensation # IftC( vIl 1 .4q i ti R11) 6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C, Yh� �ryT�a S h�MuACAA-, SIGNATURE DATE U FOR OFFICIAL USE ONLY x APPLICATION # r DATE ISSUED t r i MAP/ PARCEL NO. r r ADDRESS VILLAGE t a OWNER 'DATE OF INSPECTION: FOUNDATION FRAME b INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ` GAS: ROUGH FINALtF ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. • 9 a r ` -77w Commornveakh of3&s-Yadruvetfs. Departmerxt of rfudusft id Accidads Off- we qf1m.wnVafiv= 600 Wrr&hWan a�treet -- Boston,MA 0211 '` t�+�vt�trxras�gF�fiiia Wmimrs' CampenmfimInsm-ance AfRdavi -BIDtdeI-dCun ractmMectdclan hers AppUcamt InformalFan Please•Print Le�[ily Nye Address: d a Ci€yfSfatel�ip PhaneJ b AT.•e}*a an employer?Checktheappropriatebom T of ro'ect(required): L I am a employer 4 ❑I am a general contractor and I 6. New caflsina eu�rloyees[fiall aoiifocpart-timed* Iia�ellired.Qie sir-caakrat-fos Remodeling 2.0 lam a wle prop rietor ar partner- Ttsfed on the attached gheefti 7.. ❑ These sub-contractors hwe slip and have no employees S_•❑D hfran wod-Ing fame is any capacity employees and bar,e wQLjwe 9. uildiIIg addifiun INN tzo&Ders' camp,insure ce: comp_Msu,ano--1 required-] 5. ❑.We are a iorporafifln and its 1a❑Eleefacal repairs or additions 3.❑Iamahomeovmff doing alimbsk , officers have•exercised their 1L❑Plundxiagrepairsoradditions right of exemption per MGL myself tivTo v�Faecs tamp. .• U-❑Raafrt_pairs . ihsura ce retluined j 1 c_152,§1(4)6 and we have no employees_IN•O wodoe& 13.E'Other comp.ias z=m requirAl •dayapp�i�t�atcbedsboa#l—stRImfiIlrn7t4hesecti=bdawshmdng3ie7mwn&es'cam —mtin�poIi�gi�aems`aua fi Sameva+aerswiw snbm&ffw eSdw9 ia&tdmg they Rm dmmg snwo*m4 tbenhae a• Wdeeaatmctnesamst %dk rig=CT.. fCa��+*��xtebec'I�ihFstraurmas[sttarhed�.addiiianalsheetsI�ouiagflrea�eoftl�snfi-c�rtcscAo-xs�dsf�evr}sethecarnat•rbaseeahiieshase ea31gayeas.Iftbem3h-c tuto sbareemgiaye?-%ffieymustpm-ide•thek wudma'•rnmp.paliyammben I aw an emplgr ffia ixpmfdhW warkexs'compewadmi himircHre for,my*empElyees. SelowislhepaM7 rrad jab site iTL�Otwrali0li. ' InsmMuce Company Name: 'Pol'icy,4*'or SeFf-itLs.Tic_ &VIZZEDnDate: Job Tite Address Zdj it� r aaa c�y�sta r p: c dye. � 40T Bch a copy of the workers'compensationpolicy-declaration page(showing the policy number and esph-ation date). Failure to secure covemga as requirednudar Se-cEiort 25A of MGL ci 1572 can lead to the impasitim of critn n I penalties of a fine up to$UDO Oa and,°ar one-yearimpdsonmeat,as w&as civil penalties iu the farm of a STt7P WORK ORDEAand a f of up to$250-00 a clap against the violsfur_ Be advised that a copy of this statement.snag be forwarded to the Office of 1mvestiigaffow of the DIA for insurance coverage'.wificatiaa " .Ida lterwtry cexqy njulgr tl p jzl*vfperjury th&the urf`arma6=m m dzd a Sorg is Gars and'arrrect Siffiatur� / I}ate: Phone it ; �� (T• D U 0, tcd rrse arrl�. Uo lint eFaita ia.tFi axaa,fir be�rrittgted bP ai�fuir-n n `rcial CW orT awn: Permiff&ensei# Issuing Anflwhy(mr a one).: L Board of Hi9th Ralf mg Deprarb nmt 3.City town Clerk 4.Electrical Inspector S.PFumbmg hupector 6.Other Conbct Person: Phone#: Wormmation an'd laS C .oxas M��cgr}rrzse s General Laws 152 rego�s all e�Ioy�`o PaME WDIIi comPensafon fur f trnr employees_ Pnrsa�to this sf��,as enplvye�is defined M,—everpPesdnin.�.e service of anot3�IIod�-my contact ofh , e3gress or j3�nplimt'oral or witf=f pa association,corporation or other'egg ey,or any�o or c �4n Mayer is defined as"an in�idnal, rfncxsh�, sen�ives of a dEceased employ,or of The foregoing a nggedin aJomt eufXprzse,and inclndmgfa legal xepre associafi or otlandegal entity,employing�FmYD- $OFPCver the recei4 ortinstesofasin�vidnal,parfaeaship, artmentsandwho resides iherem,ortheocc�tofthe- owner of a dwelling horse having not more three apartments dweaZ horse of aaoffiff who employs persons to do=dXtMaoce,C n-rcLUd on or repaQ woric on such dweIlmg house or on the grounds or bmldmg app. na thereto shaIlnotbecanse of sanh effiploymetbe deemed t o be am employer_" MGL cbapt cr 152,§25g6)also Stara ffid¢eVety!, or local Rcendmg agencg shaII wiffib.old$e issuance ar rmewaI of a$cease or permit to operate a busnae.s or to construct bwldings in the comm for any applic=twho has notprodnced acceptable addeum of compflance wiffi tbr-hmmrance.coveXage raguir� Additionally,MGM chapt�r 152,§25CU)states¢Nefiher the com=Wwcalft nor gY ofits political subdivisions shall enter into any conixact frnr the perms ancc ofpnblio wink u�I acceptable evidence of complian.cevrhb.the insurance.. rcTnremcnft of this duptEx have Been.presmatedto the contra .auiiiol�Cy." ,�gplicani� ' app to our enation if Please fill uut The wow'compmsaion affidavit compleinly,by chef g ih bD=ill heir y to 70 i=s)of necessary.�PPfSr sab-cont a or(s)miners), addresses)and phmr,nombes()along in essay Limited Liability Compmm�(IBC)or Lja i Liabi�ity P ps(LIB)withno euzployees other than the members or partners,ate not rid to eery woncc&compensat aEL mso�ce If 2n r r r or LLP does have employees,a policy isrequ>red Beadvisedthat this affday�maybe snbmii�din th,-Deparbneatof TndOStCW Accidents for confitmaiion of insurance coverage. Also ba sure to sign and date he a•6daVrt The affidavit should t The D epar(menf of baTr b med to$e city or town That the application for the'pemf or I=So is being regae�ed,no TnrTnaflial Acai� nouldyou have aay questions g•die law or ifyou are mquhed to obtain awoiio=- compensatiou policy,please caIL the Department at the number lisiEdbeloW. Self-ins�meanies should Meter tfieir Self icL u ce license amber on the app�Iine. City or Town Officials . r Pleases be sure that ti:o affidavit is complete and primed legiibly. TI het Department bas provided a space at the bottom of the affidavit for you to fill out in the event the Office oflnv � nT*� has in Contact youregardmg the applicant_ Pleas a be sru a in fill in the pe�it/Iicense mmiber whi ch will be used as a reference number. Iu addftion,an applicant t3iat must submit multiple PMMWhC use a0ht&MS m any given.year,need only submit one affidavit indi g cat policy fi for tcatian(rf n=s and under-Tob 5`ne Q_drll '°the appIica�should write�aR 1Dcaiiuns in ( 'or town).'A copy of ffie-�davitthathas bey officfaIlp stomped or mazked bythe city or town may be provided to the applicant as proofthat a valid affidavit is on file for futM penDits or licenses_ Anew affidavitmzrstbe fIled out ear�i EL of c�itnotrelatedto any business or commercial4�e year.There a home owner Or chiz=is obiammg P leb tf1I5 affidaVft (ie_a dug license orpcuaittobumlMVes etc.)saidperson is110T to camp The O$ce of In w°uldlzke to thaakyoum ad�ce foryour coaperatian and shouldgon have aay quesizons, please do nothesiiate to give us a c l The I?eparfinenfs adds,telephone and faxn=bm: + Thb CG=MwwItIE Of Massachxoe� Deparbnmt of II fttda AoDidauft ' oa Of 0> Radou.,1A Q I I I T(,-I<4 GI-1-7V-4900 cxt 4€6 ar 1-977 M &A Kevised424-07 Wdia- . r Client#: 38438% 2CENTRALCA' DATE(MMIDD/YYY`l ACORDTM CERTIFICATE OF LIABILITY INSURANCE" 05/15/2017 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(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C N AC NAME: Dowling&O'Neil Insurance Ag PHONE 508 775-1620 FA 5087781218 AIC No Ell: A/C No 973 lyannough Rd,PO Box 1990 E-MAIL Hyannis,MA 02601 - ADDRESS: 508 775-1620 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company 14788 INSURED INSURER B:Associated Employers Insurance 11104 Central Cape Construction Company,Inc. a - 820 Main Street wsuRERc: Cotuit,MA 02635 IbsuRER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS v LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY MP197640 11/14/2016 11/1412017 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY y PREMISES RENTED nce $500,000 CLAIMS-MADE F x1 OCCUR' MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: . PRODUCTS-COMP/OP AGG $2,000,000 POLICY PE 0 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO + BODILY INJURY(Per person) $ - ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED: " PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE, $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WCC50050091992017A 05/1412017 05/14/201 X TO AND EMPLOYERS'LIABILITY Y I N Y LIMIT OTH- , ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT s500,OOO OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) y E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-.POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Comp Information Voluntary Compensation Proprietors/Partners/Executive Officers/Members Excluded: Steve Devlin,Pres./Treas. (See Attached Descriptions). . CERTIFICATE HOLDER CANCELLATION % SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mashpee Commons LP THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box1530 -ACCORDANCE WITH-THE POLICY PROVISIONS. Mashpee,MA 02649 AUTHORIZED REPRESENTATIVE ' ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 .of 2 The ACORD name and logo are registered marks of ACORD #S190898/M190897 LS1 �J/ Q� a dw _ = Office of Consumer Affairs and Business Regulation - 10 Park Plaza- Suite 5170 Boston,'Massachusetts 02116 Home Improvement Coactor Registration Registration: 131841 Type: Private Corporation Expiration: 9/26/2018 .. Tr# 419291 CENTRAL CAPE CONSTRUCTIONCO 1 C. STEPHEN DEVLIN 820 MAIN ST. COTUIT, MA 02635 Update Address and return card.Mark reason for change. Address Renewal Employmint Lost Card SCA 120M.05/11 x !l�riri�ulatioG/a License or registration valid for individual use only Office of Consumer Affairs&Business Regulation • • n ate. If found return to: ? HOME IMPROVEMENT CONTRACTOR before the expiration d Office of Consumer Affairs and Business Regulation ! Registration'-\131841 Tyf� 10 Park Plaza-Suite 5170 Expiratiomottij91-2018 Private Corporation Boston,MA 02116 CENTRAL CAPE CTONSTRUCTIO.NCO.INC. STEPHEN DEVLIN ` n t <; 820 MAIN ST , � 4 :� x •. -, __' COTUIT,MA 02635 } Undersecretary i. x !•Fot;,.. d oat signature 1 - tiw �""- k fk •"fu x .. ` Massachusetts Depart►nent of P Board'of,'BW ding'Regulatlons and tan arc4s tice6jd7,CS-047993 � = Cflnstructlon 5up2rv�sc�r _* STEPHEN J DEVLIN � 820.tNAIN STREET'yx °� � � eaa �' COTUIT MA 02635 j .�, wAJ\ {� T5� EXp�EattC+tl w "` ° 02/0412018 _ �rritssionier 3 s �4 tF Ai.. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis,MA 02601. www.town.barnstable.ma.us ' Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must , Complete and Sign This Section If Using A Builder I, 0 LoyV C:t ,as Owner of the subject property liereby authorize 'R _A-fyi. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) - a/ �� 7 Signature:of Owner Date ` _ as b Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. ` C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Dutlook\L7U69LF2\EXPRESS(2).doc 01/25/17 2 09'. M- cCIv i-T, ass s AWiC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Ti Massachusetts Checklist for Compliance(7s0CMR5301.2.1.1)' Check_ Complian 1.1 SCOPE WindSpeed (3-sec.gust)...............................................................::....:...........................................:110 mph I'Wind Exposure Category.........................................................:....:........:.........................................:.............B' 1..2..APPLICABILITY - / Number of Stories(a roof which exceeds 8 in 12 slope'shall be considered a story) stories <2 stories \�/ ,! RoofPitch ..........................................................................(Fig 2)........................................... rl 512.12 0/ Mean Roof Height ...................................:..........................(Fig 2)..:........:.................................... 1' ft 5 33' BuildingWidth,W...............................................................(Fig 3)......................... ft s 80' .................... BuildingLength, L ..(Fig 3)................................................. ft <_80' 9t .............................................. Building Aspect Ratio(L.NV) ...............................................(Fig 4)......................:.......................... I.Z 5 3:1 Nominal Height of Tallest Open1ng2 ............(Fig 4)................................................ ! ' :s 6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements.of 780 CMR.5404.1 . Concrete.....,.........`................................................................................................................ Cormete"iGrsonry.................................................................................................................................... 2.2 ANCHORAGE TO FOUNDATION'3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an altemative in concrete only Bolt Spacing-general................................. ........(Table 4).......................................... 5..... '�i in; Bolt Spacing from endroint of plate ........................... (Fig 5)..................................... in. 6 12 Bolt Embedment-concrete........................................(Fig 5).......................:............�.-..P in.2:7" Belli-Embedmentry.........................................(Fig ):........................................... rer- Tr° PlateWasher...............................................................(Fig 5)...............................................z 3"x 3"x'/." 3.1 FLOORS Floor framing memberspans checked"...............................(per 780 CMR Chapter 55 .....:.............. V/1 Maximum Floor Opening Dimension.................. ..... ...... :................(Fig 6)............ . ... .. . ................�ft 512' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... V Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall.:..............(Fig 7).....................................................A ft 5 d Maximum Cantilevered Floor Joists / Supporting Loadbearing Walls or Shearwall. .............(Fig 8)................................................:. .� ft 5 d 1/ Floor Bracing at Endwalls.......................a...........................(Fig 9)..................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)..........:......................... Floor Sheathing Thickness ................................................(per 780 CMR Chapter 55)....................... in. Floor Sheathing Fastening....:......................... (Table 2)... d nails at in edge IC infield ' 4.1 .WALLS Wall Height Loadbearing walls............................... (Fig 10 and Table 5).........:........... 'e ft 51Y 1/ Non-Loadbearing walls..........................................:........(Fig 10 and Table 5).................... �3... ft 5 20' Wall Stud Spacing ...............I........................ ......... .(Fig 10 and Table 5)...... ..... ._U, in.5 24"o.c. �l Wall Story Offsets ............:..................::.........7.............(Figs 7&8)........................................... 6 ft 5 d 4.2 :EXTERIOR WALLS' Wood Studs Loadbearing walls.......... :. (Table 5) ........2x-1,- '7 ft in. Non-Loadbearing walls.................................................(Table 5)..............................2x-IL-i2-ft in. Gable End Wall Bracing r Full Height Endwall Studs........................ ................(Fig 10).... ..................... ........ ...................... WSP Attic Floor Length...............................................(Fig 11)......................: it— ... Gypsum Ceiling Length(if WSP not used)..................(Fig 11)...........:...........................' ft z 0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ..(Fig 11).... ..................... ...... ..................... -�-- or 1 x 3 ceiling furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays Double Top Plate Splice Length ..................................:...(Fig 13 and Table 6)...........:.........................--kL ft Splice Connection(no.of 16d common nails).............(Table 6)..........................................:...............-6L AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' 'r Loadbearing Wall Connections Lateral(no.of 16d common nails) ..............................(fables 7)................................................... 2-- Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Table 8)........................................................ 2-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans ........................................................(Table 9)...................................a ft 0 in.511' Sill Plate Spans .. able 9 .................................. ' ft 6 in.511' Full Height Studs (no.of studs)...................................(fable 9).................Z..k.AX.C.14...San4.............. Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9)..................................3--ft ® in.512' Sill Plate Spans.................... ...................................(Table 9)........................... ..:3—ft Q in.512" Full Height Studs(no.of studs)....................................(Table 9)...................Z...emit..4 c........._(I Exterior Wall Sheathing to Resist Uplift and Shear SimultaneousV Minimum Building Dimension,W Nominal Height of Tallest Opening2 ::r 6,80 Sheathing Type.............................................(note 4)...........................................:�/b°.. WJe Edge Nail Spacing.................................:.......(Table 10 or note 4 if less)....................... 6 in. Field Nail Spacing................. .......................(Table 10).................................................-J,?-in. —/ Shear Connection(no.of 16d common nails)(Table 10)........................................................� Percent Full-Height Sheathing.......................(Table 10).........:....:......................................�% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... �l�r Maximum Building Dimension,L . g2.............. ....................................... G 8 Nominal Height of Tallest Openin . :...... . Sheathing Type.............................................(note 4)......................................'��16 ..... Ws Edge Nail Spacing. ..........:............................(Table 11 or note 4 if less)....................... in. Field Nail Spacing.........................................(Table 11). ............................................. I Z in. Shear Connection(no.of 16d common nails)(Table 11)........................................................ a Percent Full-Height Sheathing. Z / ......................(Table 11)..................................................... , 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Wall Cladding / Ratedfor Wind Speed?...............................................................................................:............................. 1_ 0 t/ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19) .�_o ft<_smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12). .................................... ..U= 2a3 pif V/ Lateral.............................................(Table 12).............................................L=--Wplf Shear..............................................(fable 12)..............................................S= °�' plf Ridge Strap Connections,if collar ties not used per page 21... (Table 13) ..............................T= 13 0 pif Gable Rake Outlooker.........................................(Figure 20)..........:.. ft 5 smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors /1 Uplift....:...........................................(Table 14)............................................U=�1 ,lb. Lateral(no.of 16d common nails). .(fable 14).......................................L=alb. ✓_/i Roof Sheathing Type...................................................(per 780 CMR Chapters 58 an�59)............ ✓/ Roof Sheathing Thickness........................................... .............................................. .in.z 7/16"WSP / Roof Sheathing Fastening...........................................(Table 2).................6 .....�..6... Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. AII.Straps per Figure 17 e: Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. j y, AWC Guide to Wood Construction in High Wind Areas:11 D rnph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)t 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: {. Panels shall be installed with strength axis parallel to studs. i{. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,.panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top. plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:.Vertical and Horizontal Nailing for Panel Attachment WHEN THIS EDGE REM ON FRAMING USESd NAU. AT 6"" tl li 11 - 11 1 Y H tl 11 tl 1 11 II 11 I 11 11 r • 11 11 11 '.{c 1 .. 11 13 { (y 1 11 1 { 11 It N IL G 4 1 I a 1 1' 11 11 0 ii av i{ {I Z OD n fl Q - 1 Ir 13 {{ 11 1 yl tl 1J u • It � 11 it p 1 I 11 Ir Ut 1 . a u r.r 11 rr 1 W V i i it F, - 1 f�•r H 11 J I 1 r l 1-I1------r I ti r - •-A.� -,.111 1 1 r tIOUSLFCD arm -- t♦ MA1LSPACWG See Detail on Next Page Vertical and"Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in Sigh Wind Areas:110 mph Wind Zgne Massachusetts Checklist for Compliance(7so Cmx 5301.2.1.1)` ,t ► i 1- I I a I r�, r r o ` ► I � an ► r� ► FRAMING MEMBERS ' ' E M ER&AEDIATE I aw i r � r r _ ► --S_-i--------- -- ---- ----+- -+--- STAGGER® 3•MIN KA&PATrE PANEL PANEL EDGE DOUBLE NA L EDGE SPACING QI ML Detail Vertical and Horizontal Nailing for Panel Attachment Cs Barn 4.16.a5 Central Construction 1-21-16 lea BesmEngine 4.13.?.1 Materials Database 1527 203 E wftwer rd. 3:08pm Cotuit;MA I of I Member Data Description: Member Type:Beam Application:Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: U360 live,1-1240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight 40.0 PLF Filename:Central Cons Other Loads Type Trib. Other Dead (Description) Side Begin End Width start End start End Category Point(LBS) Top 111 0.W, 3795 2075 Live Replacement Uniform PS Top 0' 0.00" 22' 0.W' 13' 0.W' 30 15 Snow :::::,:<,�:::;.::::.-�.,:_,a::>:::,,---psi::::r'A•r_::.__..„. _..,,M_.._,. ........_..... ... — _ — — 2200 2200 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 a 0.000" Wall Steel 5.6w, NIA 8060# - r 2 22' 0.000" Wail Steel 5.500" NIA 8060# - _ -Maximum•Load-Case-Reactions- ,.-.:- _—.-----------.._.._.__...---._... - ......_..._..._.__...._.._._.__.._._._....- .._---- - Used for applying point loads(orline loads)to mnying members Live Snow Dead 1 18M 41409 3532# 2 1807# 41400 35M Design spans 21' 2.75V' Product: W_ 8 x 40 (50ksi) PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 55.84'k# 97.62'k# 57% 11' Total Load D+O. Shear 8.06" 59.40k# 13% 0' Total Load D+O. LL Deflection 0.5472" 0.7076' U465 11' Total Load 0.75 TL Deflection 0.9m, 1.0616' U262 11' Total Load D+O. Control: TL Deflection All product names are tm6emado of their rasDedive ewers Copyright(C)2016 by Simpson SboWTie Company incALL RIGHTS RESERVEa —Passing Isdefinodes when the member,doorfolsl,beam or ginfe5 shown on this dialling meets applimble design ofleda forl.osda,Loading Condhlons.and Spans listed an this sheet Th�a gn must be reviewed bya Qualified deaigaerordesWn omfeeeional as "hed forapprovel.Thisdesign asaumeopm uct installation eamoing to the momdadumes TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel,. Application 100 Health Division Date Issued , vv Conservation Division Application Fee Planning Dept. Permit Fee 1P D Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis, Project Street Address 2© 3 15 'u �YL Village CdIT =g+qq =l 4-g Owner 2 a a Address by t, CID Q) Telephone_ D — Z 2- Permit Request d1J ZZ. C/bve hQvh( ( " nJ w - IN� Square feet: 1 st floor: existing proposed 2nd floor: existinp—proposbd Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (00 W 0 Construction Type Lot Size 2-0 S Grandfathered: ❑Yes ❑ Ajhyes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family( units) Age of Existing Structure I �1 Historic House: ❑Yes ®'No On Old Kin 's Highway: ❑Y 9 9 ges LL]'No Basement Type: ❑ Full yawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing Z- new Half: existing 0 new Number of Bedrooms: existing D new Total Room Count (not including7il xisting new First Floor Room Count Heat Type and Fu ❑ Gas ❑ Electric ❑Other Central Air: es 0 No Fireplaces: Existing_L_New 0 Existing wood/coal stove: ❑Yes �Mo Detached garage:2isting' ting ❑ new size_Pool: ❑ existing ❑ new i Barn: ❑ existing ❑ new size_Attached garage: ❑ new size _Shed: ❑ existing LiAiApsize _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current.Use �: � I �'hl:!G�.� Proposed Use S APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l e_ �-,Az Telephone Number 76 Fq7 Address wl av� License # O L M Clct.3 qmtt Home Improvement Contractor# Worker's Compensation # 1CC�bb �l�ti 2oISg ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO —�°�C� SIGNATURE DATE I U t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED �r - MAP/PARCEL NO. ADDRESS VILLAGE OWNER ,4. DATE OF INSPECTION: _ FOUNDATION 6 NI 1 I FRAME 'C � I�9� ® (. i#- INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. J T / s J Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston; Massachusetts 02-116-1 Home Improvement Cont actor Registration Registration: 131841 Type: Private Corporation i �L Expiration:. 9/26/2016 Tr# 256305 CENTRAL CAPE C0NSTRUCTICNCQA.11Cr STEPHEN DEVLIN i ! 820 MAIN ST. - JJ COTUIT, MA 02635 Update Address and return card.Mark reason for change. f U Address I Renewal Employment Lost Card SCA 1 C. 2OM-05/11 ---- f�e�i�nrmcvrccclea�(�a�G'l�a:tr:ccr.�utc/l1 ' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: Nti SOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation BRegistration: 131841 Type: g �r _ 9/26/25 Private Corporation 10 Park Plaza-Suite 5170 Expiration 01 Boston,MA 02116 CENTRAL CAPE C6NS1-RUCTIONC0.INC. ; STEPHEN DEVLIN 820 MAIN ST COTUIT MA 02635 C Undersecreta No valid without signature ry t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supe.n�is.or License: C—"4793 1- r r.. STEPHEN J DEVY N 820 MAIN ST Wf At Cotuit MA 02635� i Expiration Commissioner 02/04/2016 i Client#:38438 2CENTRALCA DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 07/07/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.if SUBROGATION IS WAIVED,subject to. the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER " NAME: Dowling&O'Neil P"°NE 508 775-1620 FAX No: 5087781218 A/C No Ext Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC 9 Hyannis,MA 02601 INSURERA:National Grange Mutual Insuranc INSURED INSURER B:Associated Employers Insurance Central Cape Construction Company,Inc. INSURER C 820 Main Street Cotuit,MA 02635 INSURER D: INSURER E INSURER F:. COVERAGES. CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUB POLICY EFF POLICY EXP LIMITS LTR IN WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY MP19764Q, 1/14/2014 11/14/20'15 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PREMISES EaE. rence $500,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY JECOT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WCC50050091992015A 5/14I2015 05/14/201 X WC STLI ATU- OTH- AND EMPLOYERS'UABILnY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500 000 i DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Steven Devlin is excluded from coverage under the workers compensation policy. Certificate holder is named additional insured for general liability when required by written contract. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION. Mash pee Commons LP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE p THE EXPIRATION DATE THEREOF,' NOTICE WILL BE DELIVERED IN PO Box 1530 ACCORDANCE WITH THE POLICY;PROVISIONS. Mashpee, MA 02649 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S154066/M154065 LS1 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/Llectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): C i- d� Address: x d}t+a %S City/State/Zip: 07U t i kh n � 62 63 S Phone#: 6--6 CQ Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 6 4. I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling 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. insurance comp. insurance.: required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.] t e. 152, §1(4),and we have no employees. [No workers' 13. Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. II Insurance Company Name: c<ti"C d �VJA nLA Q _ Policy#or Self-ins.Lic.#: va, S:!6(0t6t)q Expiration Date: lt-I Job Site Address: 16K .&1St"► qLW C., . • City/State/Zip: ray j► , Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t ns and penalties o ' ry that the information provided above is true and correct Si ature: Date: Phone#: �7 �U Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: A WC Guide to Wood Construction,in High Wind Areas:110 mph Find Zone Massachusetts Checklist for Compliance(ego CMR 5301.2.1.1)1 0 Check Compliance. 1.1 SCOPE WindSpeed(3-sec.gust)....................................................:............. ................................................ 110 mph / WindExposure Category.................................................................. ................................................ ......... B 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story)_2 stories :52 stories t� RoofPitch ...........................................................................(Fig 2) ........................................... 5 12:12 MeanRoof Height .:..................................:.........................(Fig 2)..................................................Zd ft 5 33' BuildingWidth,W ' ....................... ...... ........... ................. .... .... ................ .. .. .. (Fig ).................... .. ..................eft s80 Building Length, L...................................... ..(Fig 3)...................... .... ?eft 5 8Y ....................... ....... Building Aspect Ratio(LNV) ...............................................(Fig 4).....................................- :5 5 3:1 Nominal Height of Tallest Opening2 .:.................................(Fig 4)..........................................I...... 6 8 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)............................................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete............................................ .....................................:........................................... ConcreteMasonry ................................................................... ............................................................... 2.2 ANCHORAGE TO FOUNDATION'3 5/8"Anchor Boles imbedded or 51W"Proprietary Mechanical Anchors as an aftemative in concrete only / Bolt Spacing—general...... .................................(fable 4)....................................... L in.�:..... Bolt Spacing from endpoint of plate.............................(Fig 5).................................... IV in.5 rl° 12" Bolt Embedment—concrete.........................................(Fig 5)..........................................�.!!_in.z 79 Bolt Embedment masonry.........................................(Fig 5)............................................ in.>_15" PlateWasher.....................................::.........................(Fig 5)..............................................z T x 3°X Y4. _Tz; _ 3.1 FLOORS Floor framing member spans checked (per 780 CMR Chapter 56)..................... . V............:.................. ............ Maximum Floor Opening Dimension...................................(Fig 6).................................................. ft 512' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor,Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7).................................................... Q ft s d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8 ..................................................... It 5 d N Floor Bracing at Endwalls....................................................(Fig 9)................... Floor Sheathing Type .:......................................................(Per 780 CMR Chapter 55)....................... / Floor ...............................................Sheathing Thickness ..(per 780 CMR Chapter 55)...................... in. Floor Sheathing Fastening................................................:.(Table 2).._J_d nails at in edge/ C in field 4.1 WALLS Wall Height Loadbearing,walls........................................................(Fig 10 and Table 5)......................... .—TL ft 51 a Non-Loadbearing walls.::.............................................(Fig 10*and'Table 5)............................�ft <_2U Wall Stud Spacing ..(Fig 10 and Table 5).................... in.s 24"o.c. Wall Story Offsets ........................................................(Figs 7&8)............................................ 0 It 5 d V 4.2 EXTERIOR WALLS' Wood Studs / Loadbearing walls.....................................................:..(Table 5)..............................2x 6 - I It in. V— Non-Loadbearing walls................................................(Table 5)..............:...............2x 6 - O in. (/ Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10)............................................... .. .............. WSP Attic Floor Length................................................(Fig 11)............................................. ft>_W/3 Gypsum Ceiling Length(if WSP not used)...................(Fig 11)...........................................eft i'0 9W / and 2 x4 Continuous Lateral Brace @ 6 It.o.c...(Fig 11)..................................I........................... / or 1 x 3 ceiling furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft.spacing in'end joist or truss bays L.- Double To Plate .......................................................... i l .� i = : P Splice Length (Fig 13 and Table 6)....................:.:............. ft V Splice Connection(no.of 16d common nails)..............(Fable 6),,....,.::::: o/ r.. .......... ............... AWC Guide to Wood Construction in High Wind Areas:110,mph Mind Zone Massachusetts Checklist for Compliance(78o CMR 5301.2.1.1)1 Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Fables 7)..................................................... Non-Loadbearing Wail Connections Lateral(no.of 16d common nails)................................(Table 8)....................................................... 2— Load Bearing Wall Openings(record largest opening but check ail openings for compliance to Table 9) Header Spans ........................................................(Table 9)..................................-6-ft 0 ''in.<-11' Sill Plate Spans ........................................................(Fable 9).................................. I ft O in. 11' Full Height Studs (no.of studs)....................................(Fable 9).........................................2-L-A:Btr_JE2 0 Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) / Header Spans.............................................................(Table 9)..................................-2 ft U in.g 12' Sill Plate Spans...........................................................(Table 9)..................................3_ft o in.512° Full Height Studs(no.of studs)....................................(fable 9)........................................J.. , SGn C- . Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension,W Nominal Height of Tallest Opening2 .......................................................................:.. ..Zr.6'8H ✓� Sheathing Type..............................................(note 4)....:.................................... 6W.is .....�� Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ in. �/ Field Nail Spacing...........................................(Table 10).................................................�in.. �V/f/ Shear Connection(no.of 16d common nails)(Table 10)........................................................ Percent Full-Height Sheathing.......................(Fable 10)....................................................a 51/6 Additional Sheathing for Wall with Opening>6W(Design Concepts).................... Maximum Building Dimension,L Pell Nominal Height of Tallest Opening2................................................................... i �6'8" Sheathing Type .........(note 4)..........................................:Z� dS R Edge Nail Spacing.........................................(Fable 11 or note 4 if less)........................ in. V Field Nail Spacing......:...................................(Fable 11)................................................. in. Shear Connection(no.of 16d common nails)(Fable 11)....................................................... to Percent Full-Height Sheathing .. able 11 .................................................. % 5%Additional Sheathing for Wall with Opening>6W(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?....................................................:......... ............................................................... D 5.1 ROOFS e � Roof framing member spans checked?........................(For Rafters use AWC Span Tool,see BBRS Website) I Roof Overhang ...................................................(Figure 19) ............. )ft<-smaller of 2'or L/3 J/ Truss or Rafter Connections at Loadbearing Walls Proprietary Connors Uplift.........:......................................(Fable 12)............................................U=Z�Zplf Lateral..............................4..............(Fable 12).............................................L=:EE plf V / Shear...............................................(Table 12)............................................S=°L'�1 Plf i/� Ridge Strap Connections;if collar ties not used per page 21... (Fable 13)........�.1 .��...C.J�'I =fie ,plf Gable Rake Outiooker..........................................(Figure 20)............. ft s smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls - Proprietary Connectors 4�1 Uplift................................................(Table 14)............................................U-_&L lb. Lateral(no.of 16d common nails)...(Fable 14).......................................L= N.0b. Roof Sheathing Type.. (per 780 CMR Chapters 58 a9j 59)..�i.Og a Roof Sheathing Thickness........................................... ............................................. Y in.z 7/16"WSP Roof Sheathing Fastening............................................(Table 2)................................ ...... ('' 6 C — Fe rn Notes: J 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. r j . 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(78o CMR 5301.2.1.1)' 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: L Panels shall be installed with strength a)as parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double. top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment tar•�r�s�r�rsoN � �alr u n 11 1/ .. 11 .. u u /1 n u !1 It 1/ 11 11 11 M N 11 11 11 It gg-� � F F tl 1112 IL °a� 11 Ir a 11 I F Q 1 .111 I f A 4 W u u {z� 11 ■1 Y Y I1 /1 N 11 11 M&SPACM 1 i PAMM See DeWlbn Next Page Vertical and Horizontal Nailing for Partel Attachment j; AWC Guide to Food Construction in Krgh Nfmd Areas:110 mph Wind Zone Massachusetts Check fist for Compliance('86 CM s'oi.z.l.1)' ' 1 t • T ! 1 a l l t ! 1 , 1 l l t 1 MEN ! , E E 11 /! l jl � x i 1 r _ STD r PAM EWDM � DOUM R MNL H7(>,fi SPACM DETAL Detail Vertical and Horizontal Nailing for Panel Attachment F 9 F 0 ® Y E® MEMBER REPORT ROOF,Ridge PASSED ■' 2 piece(s) 13/4"x 16" 2.0E Microllam® LA Overall Length:23' + + t) D _ y U 23' All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. Design Results ACbwl @ Location. Allmved Result LDF Load:Combination(Pattern) System:Roof Member Reaction(ibs) 5870 @ 4" 8181(5.50") Passed(72%) -- 1.0 D+1.0 S(All Spans) Member Type:Flush Beam Shear(lbs) 4956 @ 1'9 1/2" 12236 Passed(41%) 1.15 1.0 D+1.0 S(All Spans) Building Use:Residential Moment(Ft-lbs) 31826 @ 11'6" 35781 Passed(89%) 1.15 1.0 D+1.0 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.815 @ 11'6" 1.117 Passed(L/329) 1.0 D+1.0 S(All Spans) Design Methodology:ASD Total Load Defl.(in) 1.261 @ 11'6" 1.489 Passed(L/212) 1.0 D+1.0 S(All Spans) Member Pitch:0/12 Deflection criteria:LL(L/240)and TL(L/180). Bradng(Lu):All compression edges(top and bottom)must be braced at 3'2 13/16"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Bearing Length Loads to supports(Ibs) Supports Total Available Required Dead Snow Total Accessories 1-Stud wall-SPF 5.50" 5.50" 3.95" 2075 3795 5870 Bloddng 2-Beam-SPF 5.50" 5.50" 3.95" 2075 3795 5870 Blocldng •Bloddng Panels are assumed to carry no loads applied directly above them and the full bad is applied to the member being designed. Tributary Dead Snow Loads Location Width (0.90) (1.15) Comments 1-Uniform(PSF) 0 to 23' 11' 15.0 30.0 Mass default snow Weyerhaeuser Notes �SUSTAINABLE FORESTRY INITIATIVE Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for Installation details. (www.woodbywy.com)Accessories(Rim Board,Blocidng Panels and Squash Blocks)are not designed by this software.Use of this software is not Intended to circumvent the need for a design professional as determined by the authority having jurisdktion.The designer of record,builder or framer is responsible to assure that this calculation Is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software operator Job Notes'. 10/9/2015 10:50:51 AM Jeremy krauss Central Construction Forte v4.6,Design Engine:V6.1.1.5 fa mouth lumber 203 Eisenhower rd Central const 203 Eisenhower.4te (508)548-3227 Cotuit,MA jeremyk@falmouthlumber.com Page 1 of 1 CS Beam 4.16.0.5 kmBeamEng ne 4.13.7.1 Central Construction Matefials Database 15z7 203 Eisenhower rd, - ` �p 8:22am Cotuit,MA I of I Member Data Description: Member Type:Beam Application:Floor Top Lateral Bracing:Continuous . Bottom Lateral Bracing:Continuous Standard Load: Moisture Condition:Dry Building Code:SBC Live Load: 40 PLF Deflection Criteria: 1,660 live,LP240 total Dead Load: 10 PLF Deck Connection:Nailed Member Weight: 22.0 PLF Filename:Beami Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End - Start End Category Point(LBS) Top 11110.0011 3795 2075 Live Replacement Uniform PS To 0' 0.00" 22' 0.00" 13' 0,00" 30 15 Snow 22 00 2200 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 a 0.000" Wall Steel 5.500" N/A 7869# 2 22' 0.000" Wall Steel 5.500" WA 7869# Maximum Load Case Reactions Used for app10110 point loads(of hae loads)to mrMag members Live Snow Dead 1 1898# 4140# 3341# 2 1897# 4" 3341# Design spans 21' 2750" Product: W 12 x 22 (50ksi) PASSES DESIGN CHECKS Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 54.B2'k# 69.86k# 78% 11' Total Load D+O, Shear 7.87k# 63.96W 12% 0 Total Load D+O. LL Defkiction 0.5121" 0,7076' U497 11' Total Load 0.75 TL Deflection 0.8893" 1.0615" U286 11' Total Load D+O. Control: TL Deflection I An paduet names ere tredemorla of theffrostrective owners - CopAht&12015 by Simpson Stmng-Tfe Company Inc ALL MGM RESERVED. "Passing is defined aswhan the member,aoorlolm,beam orglideg shown on this drawing meet$applicable design aftede for Loads,Loading eoodigons,and Sparta a ed on Elie sheet The design must be reviewed by qualified designer or design pmfessionai as required forappmvai.This design assumes product imlaltati ao»� lO the menufecturefs specifications, a9 . f s* MEMBER REPORT ' Level,Floor.Drop Beam PASSED 3 piece(s) 2 x 10 Spruce-Pine-Fir No. 1 / No. 2 Overall Length:21' 0 0 s t .: L - 0 0 All locations are measured from the outside face of left support(or left cantilever end).AII dimensions are horizontal. Design•Results A,dual lA4;Local on Allowed Resuit ;t,. LDF� Laad Comtiination(pattern). System:Floor Member Reaction(Ibs) 4730 @ 14' 9563(5.00") Passed(49%) 1.0 D+1.0 L(Adj Spans) Member Type:Drop Beam Shear(Ibs) 1877 @ 14'11 3/4" 3746 Passed(50%) 1.00 1.0 D+1.0 L(Adj Spans) Building Use:Residential Moment(Ft-Ibs) -3125 @ 14' 5147 Passed(61%) 1.00 1.0 D+1.0 L(Adj Spans) Building Code:IBC Live Load Defl.(in) 0.040 @ 17'6 3/4" 0.228 Passed(L/999+) -- 1.0 D+1.0 L(Alt Spans) Design Methodology:ASD Total Load Defl.(in) 0.048 @ 177 5/16" 0.342 Passed(L/999+) -- 1.0 D+1.0 L(Alt Spans) Deflection criteria:LL(1-1360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 21'o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Applicable calculations are based on NDS. r Beanng:Length toads to Supports pbs) � Supports royal xavauable Required Floor, Dead Total Accessories " Lrve, 1-Pocket in masonry-concrete 4.00" 4.00" 1.50" 414 1161/ 1854/-161 None 2-Column Cap-steel 5.00" 5.00" 2.46" 1081 3631 4712 Blocking 3-Column Cap-steel 5.00" 5.00" 2.47" 1087 3643 4730 Blocking 4-Column Cap-steel 3.50" 1 3.50" 1.50" 411 1159/ 1839/-159 None •Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. Tributary Dead Floor live c. ...., ' ,LOads.r . Lacahon ��.,„• ^Width 4(0: 0) F(i oo} omments 0 z 1-Uniform(PSF) 0 to 21' 11' 12.0 40.0 Residential-Living Areas Wey2rhaeuser Notes SUSTAINABLE FORESTRY INITIAt1NE Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. �7 Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.wGodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC ES under technical reports ESR-1153 and ESR-1387 and/or tested in accordance with applicable ASTM standards. For current code evaluation reports refer to http://www.woodbywy.com/services/s_CodeReports.aspx. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator Forte Software Operator Job Notes 11 i 10/2015 9:38:47 AM Cc:,f,1c ea; 2a EISENHOWER ROAD I Forte v5,0;Design Engine:V3.4.0 4; Fein o.dh Lumb=r CCTUiT,MA Page 1 of 1 oF"'r • ■narrsrneU& • �a Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division } Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize S-1TPHC-,\)' QN LW to act on my behalf, in all matters relative to work authorized by this building permit application for: U 3 E/Jr-V {)LJ&L C)/L., C'.arlu c7' ZVR--OZC 3 (Address of Job) Signature of O Date / 4-Uc3 Print Name If Property Owner is.applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\lvticrosoft\Windows\Temporary Internet Files\Content.0utlook\2PIOIDHR\EXPRESS.doc Revised 040215 U oF � Town of Barnstable *Permit# Expires 6 months from issue date. Regulatory Services Fee —�T * saarasTws[E M"M i6;q. Richard V.Scali, Director ♦0 �ATEO MA'1 A f , Building Division Tom Perry.,CBO,Building Commissioner ; 200 Main Street,Hyannis,MA 02601.. www.town.bamstable.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 ( � a r Property Address '2_03 1E t 5ef' ) H ow eV,_ �_ �K L)I � residential. Value of Work$ - 00 Minimum fee of$35.00 for work under$6000.00. Owner's Name&Address�l 026 0 ci y '20Z2i S { ova v Contractor's Name?--T JAW �}- s© tv-S ,�'vC. c Telephone Number D U ' 6CJ ��7� Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) XWPRr 1 Z Norkman's Compensation Insurance R f Check one: . ❑ I am a sole proprietor OCT 1 2U14 I am the Homeowner . I have Worker's Compensation Insurance TOWN OF BAR NSTABLE Insurance Company Name Workman's Comp.Policy# V 1 2 E 6 o L Copy of Insurance Compliance Certificate must accompany each permit. Pest r..cquest(check box) CAUL p )( PP g g ) C� V® �' �� NA Re-roof`hurriear, ..ailed stri in old shin les All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof). ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: 5 ❑ Smoke/Carbon Monoxide detectors.4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. f *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. A co y of the Home Improvement Contractors License&Construction Supervisors License is -- — - - - ----__... SIGNATURE: Q:\WPFILESTORMS\buil g permit forms\EXP SS oc Revised 061313 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street , _ Boston,AM 0111 ~. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers .Applicant Information Please Print Legibly Name(Business/Organization/Individual): .l f�}G1` tv `} ' S6A) Address: City/State/Zip:_ IN✓4-t Phone#: � < ZF Are you an employer?Check the appropriate box:. Type of project(required), 1. I am a employer with 4. I am a general contractor and I ❑N employees(full and/or part-time).* have hired the sub-contractors 6. ew construction 2.❑ I am a sole proprietor or partner listed on the attached sheet. T 0 Remodeling ship and have no employees 4 These sub-contractors have g, Demolition employees and have workers' working,forme in,any capacity. P h' � 9.. ❑Build ing addition [No workers' comp.insurance comp. insurance. 10.❑Electrical repairs required.] 5. We are a corporation and its p ' or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions ; myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13El Other comp:insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information:. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. , $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy and job site information. Insurance Company Name: �M Policy#or Self ins.Lic,# So 16 Z C f 6 0 3 7 Expiration Date: Job Site Address: ` �'. 1 S�eN{�G 'e ��— City/State/Zip `. Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration'date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a`fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for'insurance coverage verification. I do hereby certify der t pains a d pe aloes of perju t the information provided above is true and correct Si ature: G Date: lo Phone#: ,< Q J 7� ®� ®� Z Official use only. 'Do not write in this area,to be completed by city or town official ...-_....... . ._ -._ tY..: _ _. .... - Ci or Town: - - -Permif/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector, 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee.is defined as"...every person in'the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including.the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be,an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency'shall withhold.the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have.been presented to.the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the. members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the.applicationfor the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly.,The Department has provided a space at the bottom of the affidavit for you.to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,.an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in {city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this.affidavit. The Office of Investigations would like to thank you in advance for your,cooperation and should you have any questions, please do not hesitate to give us a call.: . The Department's addiess,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 4-24-07 www.mass.gov/dia Aco CERTIFICATE OF LIABILITY INSURANCE DATE D5-05-2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES.BELOW. THIS CERTIFICATE OF INSURANCE.DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 1 IMPORTANT: If the certificate holder Is.an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED; subject to the terms and conditions of the pollcy,.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 - - - _ .r .NAME: GILMORE INSURANCE AGENCY INC PHONE FAX 27 ELM ST Aro No Ezl: A/C No): - -N ATTLEBORO, MA 02761 E-MAIL INSURER(S)AFFORDING COVERAGE NAIC a INSURER A:TRAVELERS PROPERTY CASUALTY COMPANY OF ... - AMERICA - INSURED - - INSURER B:- - JACK FLYNN& SONS INC INSURER C: 86 E BACON STREET I PLAINVILLE, MA 02762 INSURER D - INSURER E; _ r - 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. ILTR TYPE OF INSURANCE INSADDR_WB POLICY NUMBER MM/DPOLI1D/1YYY MM/DO/YY POLICY Y LIMITS I LTR I INSR NND ( ) LIMITS GENERAL LIABILITY EACH OCCURRENCE I S COMMERCIAL GENERAL LIABILITY: DAMAGE TO RENTED s- - _— - _I----) - PREMISES Ea occurrence. _ ;CLAIMS-MADE_I OCCUR MED EXP(Any one person) S PERSONAL&ADV INJURY S - ! - - GENERAL AGGREGATE S i I GEN'L AGGREGATE LIMIT APPLIES PER: - _ PRODUCTS-COMP/OP AGG j S PRO- POLICY JECT --i LOC ,_AUTOMOBILE LIABILITY MBINED SINGLE LIMIT S ANY AUTO a accident BODILY INJURY(Per person) S -- AUTOS OWNED. I-—_, AUTOS ALL SCHEDULED .r BODILY INJURY(Per accident), s HIRED AUTOS" NON-OWNED j30PERTY AMAGE S" - ._...._. AUTOS .. r - ( --� s I ".UMBRELLA LIAB I !OCCUR : - EACH OCCURRENCE EXCESS LIAB i i CLAIMS-MADE. AGGREGATE $ ! - I RETENTION 5 s ! I DEDI �'NORIKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N - _ TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE,,N/A E.L.EACH ACCIDENT $1,000,000 _ _ OFFICER/MEMBEREXCLUDED? - 7PJUB 05-01-2014 05-01-2016 I (Mandatory in NH) E.L.DISEASE EA EMPLOYEE $1,000,000 OF OPERATIONS below 2E160379 DF:SC RIPTIOIJ OF O II yes,bescribe E.L.DISEASE-POLICY LIMIT .$1;000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) THE INSURED'S MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN'MA IF THE INSURED HIRES,OR HAS HIRED EMPLOY EES.OUTSIDE OF MA. THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF -THE ..ABOVE DESCRIBED POLICIES BE I CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE. WITH THE POLICY PROVISIONS. - - - AUTHORIZED REPRESENTATIVE - - - - - - JOHN J.LUPICA,President - Q 1988 2010 A RD RP R TI N. All rights reserved.. ACORD 25(2010/05). The A.CORD name and logo are registered marks of ACORD dtin yv7 �, �,� i JACK FLYNN 86 E. BACON STREET JPLA€NVILLE, MA 02762 & SONSPHONE # 508-695-2272 PR©FESSIO.NAL ROOFING SYSTEMS FAX # 508-695-3308 High Quality Roofing Prop€ml 38 Nears experience Incorporated Since 1976 To: lair. &Mrs Bob Looney 9710-14° 203 Eisenhower Dr Cotuit Ma. job Same. Attn Bob . Phone r 1-703-201-2421 FAX 1-703-49071 54 The following proposal is herein stalxr fitted for Your review and approval.: Strip &reroof Main house-'& garage with Ceitainteed Pro Pewter w€iod. Max Definition Architechtual goofing shingles, . 1. Remove all old damaged existing layers of ahirlgles and dispose of off the premises.Cover all bushes and lay-tip areas with tarps. w 6e s ,arp Shingles �11 stripped directly into Dunapster 3�.her�e possible to minimize mess&dispose of off premises. Provide dumpster for all debris. 2. Renail all roof boards & Renail. Ply wood In. all. areas,Prepare root-surface for application. of neit4 roof, renailing any loose roof boards as needed.:to help insure a smooth roofing surface. Rutted roof boards would be replaced at an additional cost, (onlVif needed) 3.Install a new 8" aluminum drip edge o. al fascia edges: . On Chimney, Fascia & valleys install 2 sheets 72"wide sheet of Certainteed ice&water barrier on all valleys&gutter edges & Certainteed premium.As halt felt on balance of roof. Flash in all cheeks, Pipes, chimneys.To prevent further ice dams we are installing Additional.Ice& water barrier. 4.. Install,Certainteed Landmark Pro Pewter wood Max Definition. AR Lifetime Architechtual Fiberglass/Asphalt shingles o-xTer�;n re roof area.(Lifetime.) S.Install a Certainteed Continuous ridge vent system on Maim roof area. Install Certainteed Shadow ridge Cap on entire ridge of roof 6. Vented D► spedge,Soffit vents,Flashing metals,&step flashings +rill be Alu minum Provide for a High quality cleanup.' . . Clean up all roof related debris:Rake lawn areas with a magnetic rake to pickup any roofing nails: Dispbse of ail debris off premises. Clean all gutters. CM=ck.flynn & Soros i a certified Certainteed Roof ng installer. aterial-s& strip&R eroof Main house &garage .:...:.< ..... ............... ..$ 9,985.00 +permit Option 2 Materials# lahor to Strip &reroof front of main house & garage only.............$ 5,495.00 +permit Option 3 Materials &labor to Overlay Entire Maize house &garage ..<:. ............................$ 5,495.00+permit _.. ... _ , I i -ADDITIONS : 04 Install A vented Aluminum Dripedge Cut entire fascia &install................ ......... .$495.00 0 - 3" White,Soffit vents . Drill Moles&install ......— ........:. Permit cast is not included in all options � I includes,all Insurances,materials, High quality labor, Dumpster& disposal. Fully Insured for workmans comp& liability "A lifetime Certain teed Roofing Co. Manufacturers wrarrarrty will be issued on completion of project. "A 2 year Materials and labor warranty is included with call lack Ilynn &.Sons Qualify workmanship* `Fully insured with o�rkman!s Compensation&Liability insurance,Certificate upon request. Additions; N' -n ted in contract ayrnents: 1`/2 can start,balance due on'compietion Signed. �atc: Maul, ..Flynn, Pre�sid t Acceptance Of p os• �d pa , 'ent terms as rioted above; Si ned: 2 J — Z,U g Date: . _ Ua �l If this pro crsal is acc tec, please sib€a and return copy_ to above address. 23-24 .......... ..... i �ie. diwnaarz�aea�C�ioy a��ccclhca t�S Massachusetts',Depa,rtriientof Public Safety 0friceofCuasutaerAffairs&Business'Regn. .:.,t + Board of Building"Regulations and Standards Y :,.. .IMPROVEMENT CONTRACTOR ..1ilE IMPRO Construction Supervisor egistration: 108179 Tyl'P' Private Cor jb ,i License: CS-091208 • xpiration -:8/13/2016� > i a �- • � nJ� � I: PAUL J FLYNN JACK FLYNN.&SONS INCH ,G y 1,.. 269 WEST ST i - North""Attleboro 1V�A 02760 _ Paul Flynn �Ft I �.: 86 E,Bacon St 2762 " Undersecretary .. Plainville;.MA0 retary -"� Expiration 03/05/2015 Co�mmissionet _ „� f qll-7)Jq - �MC�ARTI Y � T6Nk RUC sid�#tial and Commercial Su�lder " .&' ka.;^ 3 EAT IZAT ON SPECIAL—VI aac 70� March 15, 2014 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry, , This affidavit is to certify that all work completed for permit application#201303559;Status A; Parcel 39124 at 203 Eisenhower Drive, Cotuit, MA; Permit Type RADD.and issued on 6/10/2013 has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction LOT 33 .......... ..... © ; L.O T aL 14 -b LOT o-3 io EX1%:T o.: tLij Lo 1 t ro z ti^ 3 t� 740z C1C3 4 - N iIA - ✓ , Y y0 WADE. - _ 0C,a rl OiV � ,BA_fZ�l S..T�.A1:.E �P'��4 5S• �. + .a. LAND C�?tJRT' PLARI 3C�f�i�& w. «�r; TN�1 7' THE EXi�T- 'Q�, �Q •" !NG FZ90AIDA 7,�ON G'OC-"4 T/OA/;!S CY7.eE?Et_ p� ` »4 SU{��t� / -' _ Tt-/E f3U✓LJiN't ��TC3AC.�',�EQUic��Mc�.�.5 OF 71-IL pht a C^ _ �I 4 -LI�1 I N AR 1 ' 43 7 � �� a ,PEG• L 4 C,0Oi.vELL 8 Gl//GGc7Gt/ST., r. r � b TOWN OF BARNSTABLE Permit No. Building Inspector Cash OCCUPANCY PERMIT Bond x No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Seminara Construction Corp Address Box 860 South Dennis, MA lot #22 124 Roosevelt Roado Cotuit Wiring Inspector 44496 -Zv Inspection date Plumbing �Inspector ? Inspection date Gas Inspector � l � � Inspection date ✓ Engineering Department a���// � Inspection dateV1_ THIS PERMIT WILL NOT BE VALID;At ND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. �/„ 3 0 191.�., , .............. .... ..............., ......... Building..Inspector.........._.............._._ C w Assessors map and lot number ` 0 f Sewage Permit number ......a......"..�..... '.... ....... .....r SEE'T IC SYSTEM M MU BE INSTALLED IN- �COMPLIANCE = MAUSTABLE, House number ` ...................................:. E II STATE '°o 6 SA� T ARTICLE as AIRY CRDE AND TOM oMFY ` TOWN OF BARMS." T9BLE BUILDING" .I:N"SPECTOR • �A ,yrp. . �^ i t APPLICATION FOR PERMIT'TO .., �$�.f.. 'drs�.3... .............................................:...............................:.......:.. ...................... TYPE OF CONSTRUCTION ........ O ..... ............................................................ ..............z..`..� /...�..19...Z...' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location0.........::P7. .. .6�1.d � . � .........(�..0.(. k. ................................................. . ... .... ProposedUse ..jee;f..................................................................................... .. Zoning District ... .. ................................................................Fire District ................ Name of Owner .. ...4/ � %.)-..r�4 ?:5?- �� Address "T" ...... ��...... .1�. ��i �...... Nameof Builder ....................................................................Address ......................... .......................................................... Name of Architect �r .OY!LQ...rr /�.f�/.*./T.........Address / C' �.r./-V. ---re,;;�"- Number of Rooms ............................................Foundation .. /�...... ........................................... ........ Exterior .........�✓� .:S ........................... Roofing ....... ,0..%41__r ........... � ! e�Floors ...........�r.��..............................................................Interior ..... ..... ..... .............................................. Heating .... oT W�l/��.........................................Plumbing C9,. ���. Fireplace .....�/0-of.......®„7`/ ��/ Pp "� ...... ....................................A Approximate Cost .... ......./..:..................✓?..3...�i.'..�v�. T Definitive Plan Approved by Planning Board -----------_-------------------19 Area /.... ... ................... • „ Diagram of Lot and Building with Dimensions Fee D SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarAing the above construction. Ne .... . ............. Seminara Construct, No Permit f&welldng........ .. .....V.- ...................................... Location `sen ........................................................ .... ... .......... CT-1 Owner ......ja=ijaara...Cons.t............................ Type of Construction ..Wzod-Snaine.................. A ............................ ............................... g. Plot .......M--39-1-32/4 Lot ................................ .-Permit Granted ........qul.y....3119 78 Date of Inspection ....�. ..........9 Date Completed '. ........... ................19 PERMIT REFUSED .... .................... .................... 19 . ............................... if........ .......... . .... . ..... ........I.................. . ........ ............... ................................................. • ........................................................................ ...... Approved ................................................... 19 - ............................................................................... ................................................... Assessor's map and lot number ......� '.... /:P -4{ �' ��r 3-7�" Sewage Permit number ............... f.......�7. ��Q� ♦� / Z SARNSTAXE, i House number .............. r.`..:... ........................................ y MU& �p 039. up"I TOWN OF BARNSTABLE i BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..,-V n�- C"" 5:�.............. ................. .................................................................. TYPE OF CONSTRUCTION ......................f..........:..A.I jo.'. .................................................................................. r ............................ ................. 19.. .: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location,: r?.. ......... .. ................................................S { -�7�" ..... I � 0. �!r .. .. ..... .. ........ .......... .... Proposed Use ... ZoningDistrict ..r?.!.... ........................................................Fire District ........................'............................................ Name of Owner��;�J ",d7i� a „i /'.e,v c �� Address f/ `.... G..4...... Name o `Bui`Idsr ... .. . .... . ......................r.....Address ....................................................... ................ .......................................................... I . .... Name of Architect !r✓ `�N''.L/. i'/�/7/��i .........Address .. ..srP::Q!�'' ..... ... Number of Rooms .......... .............................................Foundation ... ��drrr,rn �r7 Lei L, G ........................................ Exierior t=G ?�J...-.t <>i.5.i. e Roofing /1 � ?✓...�.. . ..................................................... ....... .......... ........................... .....�.......... Floors �Qi4'" .Interior ,091','7 4 ................................................................ Heating ...........................Plumbing .. 0.....................:................... Fireplace ......,-�......... 44A.f.. ...............................'......Approximate Cost ..' .`fI,- r.< .0..... , `1�............. I/ f..v ..;f. Definitive Plan Approved by Planning Board ________________________________19_______. Area .�.. ..... ........................ Diagram of Lot and Building with Dimensions Fee � ......:...................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............. `.' ' -.. /��' a~?': .^^ ............ � not �...12.4. Permit G ranted ........ Ij I Y\��a.................1978 � --_ of Inspection_ . ' Dote Completed . � / PERMIT RE, SED � � ................................................. — lV � ( � -- — .�� .................... / -�—�� � _--�~«�--�-------- .................... ..,_...---.----....---..,. .—.---.. � � ----^—'—'~^^^^—^—`---^'~—^^----- � � � � Approved ---------------- 19 ' -------'-----^`---'^~--'—^^--^' � ----^--`-------~'----''--^~—' r TOWN OF BARNSTABLE BUILDING PERMIT-APPLICATION Map Parcel Application S Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee . Date Definitive Plan Approved by Planning Board (:O(a /`oim Historic - OK _ Preservation / Hyannis P-r- Street- Address d ess3 �s�hh � Owner 7 ������- •'�T'- Address > �.Telephoriel �����gac mf173 Permit Request ��S �� �• �'w,.�+}-- Cc.fu-ti Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docume., tion. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) o Age of Existing Structure Historic House: ❑Yes ❑ No On Old i g's Highw LJ ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Others Basement Finished Area (sq.ft.) Basement Unfinished Area (siI.ft) "-1 Number of Baths: Full: existing new Half: existing 'Rew ; Number of Bedrooms: existing _new co Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing . ❑ new size_Pool: ❑ existing ❑ new. size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use,, Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name-- ,Telephone Nu bm er 0 Bow SZ Address-'l --License # West- ,.eonis, Cell (508)280-6964 Home.lmprovement_Contractor#CSL _58633 _ �.__ _ Worker s3G pensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -SIGNATURE- �Nzl DATE I��113 w--- P i FOR OFFICIAL USE ONLY APPLICATION# _ DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE i` OWNER , . Rom• Yaw � !`✓ .. 1 I, DATE OF INSPECTION: !! ? F d.UNDATION LAff3 E FRAME — - INSULATION, FIREPLACE ELECTRICAL: ROUGH FINAL . . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING' DATE CLOSED OUT ASSOCIATION'PLAN NO. ` The Commonwealth of Massachusetts Department p tment of Industrial Accidents Office of Investigations ' 600 Washington Street r, Boston,MA 02111 - www.mass.gov/dia - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Applicant Information Mike McCarthy gUestrueflamPlease Print Legibly Box S2� Name(Business/Organization/Individual): Q Cell Address: � �' City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors °6. ❑New construction employees(full and/or part-time). — 2.W I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' F � 9. ❑Building addition [No workers'comp.insurance comp. insurance. , required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13. Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: ('d+" r A4 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 leadto 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 D for insurance coverage verification. 4 I do hereby certify, e th ai and nalties ofperjury that the information provided above is true and correct. Signature: Date: 5 31 � Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r' Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and incl�udinsthe�.P&al -e esentatives of a deceased employer,or the receiver or trustee of an indii ';assfo�ca �n.o'other gat entity,employing employees. However the owner of a dwelling house having not more MV4 ai inents and who resides therein,or the occupant of the dwelling house of another who eiA�T�&#trA to�il�"hUiNAIARce onstruction or repair work on such dwelling house or on the grounds or building appurte ift khdMN-1 bJja&of such employment be deemed to be an employer." 9> •Y P MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia 5/26/2013 203 PM GMT-1 Frome J Kevin Fisher - To.s +1 508 568 1933 Page 2 of 2 14ZB41 OWNER AUTHORIZATION FORM g, b (Owners Rums) owner of the property located at , I r (Property Address) 9 (Property Address) 0 hereby authorize C ��} C (SubContracto r) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. 4pWn , _ ®ate _ F-11- C C0VR +_ a `►` .MAY 2 8 2013 F. r 0/7 ` Office of Consumer Affairs and Business Regulation - 10 Park Plaza - Suitei 5170' Boston, Massachusetts 02116 Home Improvement Contractor.Registration Registration: 169393 Type: Individual ` Expiration: .6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY 3 s ? P.O. BOX 52 : u a WEST DENNIS, MA'02670 - Y Qe s, = Update Address and return card.Mark reason for change.: " .Address Renewal Employment. Lost Card SCA 1 0 20M-05/11 - - ner�'k ffairs ecr usifiess Regulation License or re isiration valid for individul useonl �. Office of Consumer Affairs&-Busi ess Regulation g y OME IMPROVEMENT CONTRACTOR before the expiration date. If found return for registration 1'69393 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite.5170 ,i xpiration 6/16/2015. Individual Boston,MA 02116 MICHAEL MCCARTHY ; MICHAEL MCCARTHY = 6 RANGLEY LN. ' - g } SOUTH DENNIS,MA 02660 Undersecretary: .Not valid without signature Massachusetts Department of Public Safety t Board of Building Regulations.and Standards .Construction Supen isor License: CS-056633 ' MICHAEL J MCCARTHY Pei BOX 52 W DENNIS rAA 02670 • Expiration Commissioner 04/10/2014 7 77, PjROJEOT, 7' TLF4 F, VECTOIR ,� SMOKE E 38 ;...EVIEWED & mF A. ti7� N8T 7MV T�M"r. -AT R �OEPAR: , E id URES:ARtf EO.b'IRFD FOP�i ERMIT "BOTH'SIGN, AT 4 , . d TING 'd ........ APE- CONSTRUC WCO I�AINSTREE A, 02635.� - ... ........... F op 77 f`0 P7 IV io CHECK, DRAWN' P -'OJECT TITLE 20 b 4 4" ef 7� .0, d. A ......... P P ------------I Biwid -1 TI PPQJFCT 7 -E a e a w. 16 . . ....... q . .... . ..... 7x . .....I 77777:77P� - 04 W"* it .......... o0orl ::N IMAWN -1 T"LF PROJECI '0 'Adjj Lo Fl. Pz! �77 7 OF, 6 're, 4", tc t ..j UM 76.1' (q6' x 7' q P. .7 �7e 4-L 44 ;j�- tw< 'N7 -g IQ, "Alt" ----- ------- t: -AL REP -r 6�7 PREPM 40 's MT,lwW W a: Y 4�t 7t'- 4� wr -K X V tt��l 0 . ..... 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V ..ni 77 A=v q-01"zoo � 77 NA", _2 Zy "W" ow"AN.MrAw "A" 47 Woo nn JQ 3 ONE PROJECT TITLE 77 € s � 6n 10 - x c .. _ .n.. — _._.�...-"-__.... .. q ,r Al bb .. n ...7. . .. *� �`' J : .,� 2,4 ' � ,/�,. �'..V .'�'. 4f .43�:�•t.l') ,.,«.�t "`'+•��'�'ef��7Fa� «a�4�,,4R�!"/-._ '� - �f{¢ . g 4 v. tr �°� � •k f,�. �. t pt 14 y�0NY 04 g3 > 7 i L,d y ]l , , .. .. 3 - - � n + R� y' i PREPARED FOR of cowny, Inc. , r r: rr . s r- i "rhe Excb+e ent Is:tau g' 820 Main Street Cotuft,MA•Sty-420-1340 ,-, - � 8�-11'��i'GDd�'Lf�$&°.4tlQ�f49i�4L4hEt 1�19.Gt?1R1 S'AL OWG NO, T:a JOB NO SHEET OF !7 p . lo. .10 7,. ? .. ..... ... p, 7777�7 4f 4,- 7—ot, ,4 `V e7 7�7, F 77.-, . f�7 �'�l LL ........... D,� 4i .0-site; vv 66 j .M16 4 DATI —POW N 0', IECR RAWN" � qbl D JOB�N 44 Vill 4e oil NSA to!holf Ono 07 MOM 0 I&ON.no, it!.QUA%Auo T Ism Cox, rob 77 A Not too 1 n it, oval-�, JTf AMIN EV mv DW foci PRQJE(;�T 0 rwn too Am jymn KTAWW� Him 0 too' il MAN ........ vow).mg xv MIA witty 4510 fit may 4591101 too Iry oil but, fly one: oil ENE ME son too Nov list Ago lot Eli Ail& 01001 too 77= Wo oil All-zoo mig "oil 777:U wo %NOD son Won.4 MA WA R NO BSS LOT33 DESIGN a ENGINEERING k , OFA & SURVEYING N 16'05'18" E STK FND STK SET STK SET r THONAS A www.bssdesign.com 1 65.00' pp"� �PdeCflC:S�.N BUNKER m` UNO.3WIG BSS Design, Incorporated 164 Katharine Lee Bates Rd 1,500 GAL H10 H2O �1 Falmouth Massachusetts 02W SEPAC TANK D—BOX EX/STING 508.540.8805 FAX 508.548.8313 LE ACH/NG PIT ' Q ° O 0 16"OAK Q 20't STK SET ry 16`WHITE (TYP) 0 Z p o PINE _0 F- Q O PROPOSED w I—' > V) 0 RINSE ADD/AON - LOT 23 C141 F� _ STATION PA TIO 14 X16' UJ U X J M i LO PROPERTY LINE � 0 U r\ � O Q W38.ZO' EXISTING ( (n � o W (n STRUCTURES 3: � w EXISTING HOUSE O W Z o Q �1 #203 PROPOSED Ix a _ O STRUCTURES w a o W W 1B O 0 49.9 NOTES: I J �' m N 1. LOCUS IDENTIFICATION Q W Q ry HOUSE No. 203 EISENHOWER DRIVE Pr) ! ASSESSORS No. MAP 039 BLOCK 124 Z 0 LOT 22 PLAN LAND COURT PLAN 36608 C SHEET 2 Z N z 2. LOCUS IS WITHIN: ZONING DISTRICT: RF w <C PAVED N FLOOD ZONE: X U m DRIVE LOT 22 { v, WIND—BORNE DEBRIS REGION 20,491 SF BUILDING CODE WIND EXPOSURE CATEGORY B O 00 AP (AQUIFER PROTECTION) Co SALT WATER ESTUARY PROTECTION J ' RESOURCE PROTECTION OVERLAY \�S 3. LOT COVERAGE BY STRUCTURES:�2), EXISTING: 2,126 SF 10.38% scale PROPOSED: 2,350 SF 11.47% 1" = 20' �� 140.00, ' 4. SEPTIC SYSTEM DRAWN FROM AS—BUILT SKETCH AND date HAS NOT BEEN VERIFIED IN THE FIELD. S 16'05'1.8" W _L) ivy p;=P 5. THE CONTRACTOR MUST VERIFY EXISTING INVERTS OCT 30, 2017 STK"SET FOR INSTALLATION OF NEW SEPTIC SYSTEM drawn COMPONENTS FOR ADEQUATE FLOW. ENT 17 6. THE CONTRACTOR SHALL BE RESPONSIBLE FOR MRT OBTAINING A TRENCH PERMIT FROM LOCAL checked MUNICIPALITY IN WHICH THE WORK IS BEING _T(t�TOWN OF BARNSTABLE PERFORMED IF REQUIRED. 7. CONTRACTOR SHALL NOTIFY DIG—SAFE AT job number EISENHOWER DRIVE 1-800-3 4 AT LEAST 72 HOURS PRIOR 14178 TO ANY EXCAVATION. title 0' 20' 40' 60' IP FND drawing number P22-65 - s II I nT 33 I ENGINEERING ���HOFss & SURVEYING STK SET N 16'05'18 E STK FND i JEFF�REY ti - STK SET �o r 1 www.bssdesign.com- 185.00, R`�r`• R BSS Design, Incorporated 4 CD 164 Katharine Lee Bates Rd 1,500 GAL H10 H2O ' ° ,L Falmouth Massachusetts 02540 SEP77C TANK D—BOX ' EX/STING 508.540.8805 FAX 508,548.8313 LEACHING P/T TO S�QN.AL F Z tl / REMAIN ®e 0 O 16"OAK STK SET Q s m 16"WHITE 20 + 76:8' (TYP) _O PINE r i' o .. PROPOSED EXISAA'G SEP77C _W LOT 23 LEGEND . 0- � RINSE ADD/110N TANK AND - iv D ' STA 77ON PA 770 22:Y22' D—BO)(.,TO BE d REMOVE_ D PROPERTY LINE, �, > U / I W W Q � z'54.0 � EXISTING � o � W (!) Z 65.3' \ _ STRUCTURES 0 0 M• O W 0 0 w EXISTING HOUSE f , PROPOSED �. - #203 STRUCTURES Q_ w Z' af r O a- w W O J . _ ,i m• 49.9 NOTES: 0 ES. O - ``' � � N 1. LOCUS IDENTIFICATION � Q F— � - HOUSE No.. 203 EISENHOWER DRIVE � ASSESSORS No. MAP 039 BLOCK 124 0 . LOT 22 PLAN LAND COURT PLAN 36608 C' SHEET 2 J N 2. LOCUS IS WITHIN: ZONING DISTRICT: RF Q ` FLOOD ZONE: X m PAVED I WIND—BORNE DEBRIS REGION DRIVE LOT 22 - BUILDING COD WIND' EXPOSURE CATEGORY B 4 1 F AP A E 20, 9 S (AQUIFER PROTECTION) J io SALT WATER ESTUARY PROTECTION RESOURCE PROTECTION OVERLAY �— \\� 3. LOT COVERAGE BY STRUCTURES: \\ EXISTING: 1,642 SF 8.01% scale �s 2j. _ PROPOSED: 2,126 SF, 10.37% 1" = 20'. �O' 140.00' ' 4• SEPTIC SYSTEM DRAWN FROM AS-BUILT SKETCH date rAND HAS NOT BEEN IN THE FIELD. 5. THE CONTRACTOR MUSTRIFIED VERIFY EXISTING INVERTS NOV'6 ° 2015` S ' 1$'05'18"' W STK SET FOR INSTALLATION OF NEW SEPTIC SYSTEM COMPONENTS FOR ADEQUATE FLOW.EDGE OF drawn ' , PAVEMENT 6. THE CONTRACTOR SHALL BE RESPONSIBLE FOR EJP _ OBTAINING A TRENCH PERMIT FROM LOCAL chec ed MUNICIPALITY IN_ PERFORMED IF REQUIRED. RED. E WORK IS BEING . 7. 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