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0727 MAIN STREET (COTUIT)
R ' tKE Application nurn a .........�..................... Qti Fee ..................... /s2.... ►....... ESQ Building Inspectors Initials... Hasa. g P .. ..... , •`'' JUL 12 2019 11- t Date Issued........................ ...ZE .................... .. TOWN 0j BAHNSMBLE ......2 .. ....................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/S IDING/WINDO W S/DOORS/TENTS/S TOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ?2,7 1119,al 5-z— NUMBER STREET VILLAGE Owner's Name: L��1L���r7 a?�/1,11�_� Phone Numbe �-,3� Email Address: Cell Phone Number Project cost$ 6"OHO Check one Residential I/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize .7"y,/9 &�,g to make application for a building permit in accordance with 780 CMR Owner Signature: 60 t Dater I TYPE OF WORK ❑ Siding ❑ Windows(no header change)# Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review EfRoof(not applying more than I layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name WV/,D 4'du Home Improvement Contractors Registration(if applicable)# IM4&-7-7- (attach copy) Construction Supervisor's License# `' (attach copy) Email of Contractor J ,CQ Phone number cl ' ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER.................................................�.. *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No ' (If yes please attach floor plan with exits marked) Dimensions of each Tent X. X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes' No location Flame Spread Sheet of each tent must be attached. Provide a site plan with the at ion(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's,Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. ' COnxllonW(!.eRn PI MaSSaC11USeU5 - r:%/n Yiv"rrrrruvrrr,nrr///4/-^If r.fa�r. �in/IJ Division of Professional Licensure Office of consumer Affairs BusinessReguiatian Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Construction Supervisor TYPE:Corooration Registration E._px iralion i0M97 :: 03/24/2020 CS-063537 Expires: 10/15/2019 DAVID COX,INC. DAVID R COX y PO BOX 401 DAVID R.COX /�� SOUTH YARMOUTH MA 02664 � 19 LAVENDER LN C-1 W.YARMOUTH,MA 02673 UndersecretarY I / Commissioner s i The Commonwealth of Massachusetts Department of Industrial Accidents — -- Office of Investigations 600 Washington Street - Boston',MA 02111 www.mass.gov/dia _ Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbly Name(Business/Organization/Indivi dual): `, =�yv �) &6 Address: &Z M 4A7 City/State/Zip: -Y vZ /?71XQ Phone#: Se�Y q6,P_S� Are you an employer?Check the appropriate bog: Type of project(required): 1:U I am a employer with--�— 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 g, ❑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 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. .tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state wbother 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: Z4& zql=.g ' Policy#or Self-ins.Lic. Expiration Date: =ZJZ zo Job Site Address:. 7Z7;;'� 17WXO� : 1- 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 under the pains and penalties of perjury that the information provided above is true and correct Sip-nature: .f�// �,� Date: :;2z__0zL9 Phone#: Of use only. Do not write in this area,to be completed by city or town of City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector.,, 6.Other Contact Person: Phone#: _ .Information and Instructions Massachusetts General'Laws'chapter 152 requires all employers to provide workers' compensation for their employees.. j. Pursuant.to this statute;,an employee is defined as"...every person in the service of another under any contract of hire, :lexpress 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 havingynot more than three apartments and who resides therein,or the occupant of the dwelling house of'an6tBer 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 application for the permit,or license is being requested,not the Department of .,,�� nA,_-_1:„__,L,j-�.........a�};f.r.,,r a dmg he law or if you are,rem- irPd to obtain a workers' industrial ticc1dlenit . ,>u iiU JvV —11j �uw :v. :e5y= -n_.. •-.. "---' a—' 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 homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us,a call. The Department's address,telephone and fax number: The CoMmGnwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Bostan.,MA 0211.1 Tel,#617-727-4900 ext 406 or 1-$77-MASSAFD Fax#617-727-7749 Revised 4-24-07 w.mass,gov/d1a DATE(MAMDDIYYYY) AC40R" CERTIFICATE OF LIABILITY INSURANCE 07112,2018 ��. 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 INSUREA(S), AUTHORIZED REPRESE%'T ATM?%)R PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poilcypes)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies tray require an endorsement. A statement on this certificate does not confer rights.to the certificate holder In lieu of such endorsement(as). PRODUCER NA Mary Connor PHONE SULLIVAN GARRITY&DONNELLY INSURANCE AGENCY INC 508} 53-2586 Kathleen.gieddir.0s0ins.com 10INSTITUTE RD INSURERS AFFORDING COVERAGE NAW WORCESTER .`- ._._ MA 01609 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA �25666 NSURED 1NSUPER a: T DAVIT COX INC 114BURERc INSURER D I PO BOX 401 INSURER E --- 5 YARMOUTH MA 02664 INSURER F COVERAGES CERTIFICATE NUMBER: 290563 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, TYPE OF INSURANCE 0��POLICY iVUMt3ER ICY YVV ICY I LIMf7e' COMMERCIAL GENERAL LIABILITY I j I I EACH OCCURRENCE $ II CLAIM"ADE OCCUR $ _ _ ! MED EXP(Arty one erson $ N/A 1 PERSONAL&ADV INJURY 11 ! I OEN'L AGGREGATE LIMIT APPLIES PER J GENERAL AGGREGATE S POLICY D,JECT 1 LOC II i PRODUCTS•COMPiOP AGG $ OTH•R: AUTOMOBILE LIABILITY i � NLMAIT + I(EeLB;,cidenlS $ ANV AUTO BODILY INJURY(Per Peraonl 7�ALL OWNEO SCHEDUL@0 AUTOS AUTOS N/A I BODILY INJURY(Per dccidenly $ i �j P OPER Ah G HIRED AUTOS l AUTOS AU I UYBRELLALIAO OCCUR I EACH OCCURRENCE I$ EXCESS UAs HI CLAIMS-MADE I j N/A t— D 51JEU1ION I $ 'WORKERS COMPENSATION I t iANDEMPLOYERV LIABILITY Y 1 N { 8Tt1TE R _ ANVPROPRIETORtPART*46PJEXECUTiVE { tc.L.EACH ACCIDENT 'g 100,000 A �uFFICERnslernaeRexctuar=m N/A N/A I NIA OMUB91OX742218 07/16/2018 07/16/2019 (pta tdetory In NMI j E.L.DISEASE-EA_EMPLOVEE $ 100,000 II yea.desa+be u ider DESCRIp7tpN OF OPERATIONS Oelow E.L.DISEASE-POLICY LIMIT ,$ 500.000 I i N/a, i DESCRIPTION OF OPBRAT10N8/LOCATIONS/VEHICLES(ACORO 101,Additional Remarks Schedule,aney be eMsehed it more apace is required) Workers'Compensallon benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees In status other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of Insurance). The status of this coverage can be.monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www,mass.govhwdlworker6-cogmnsationlinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWfI Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 021301 l7aniei M.Crg4y y,CPCU,Vice President—Res{duai Market—WCRIBMA 0198E-2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks.of ACORD c>� t (,9 oFINKET Town of Barnstable *Permit# C� FVires 6 months from issue date 'Regulatory Services Fee_ S snitxsrABr.E.MAM Thomas F.Geiler,Director. PER iOrED 11AA'l Building Division „E`.: Tom Perry,CBO, Building Commissioner `- 200 Main Street,Hyannis, MA 02601 1 ovvi� i7, >= SARNSTABLE www.town.barnstable.ma.us ` Office: 508-862-4038 Fax: 508-790-6230 . EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY // RR,�� Not Valid without Red X-Press Imprint Map/parcel Number 03So (.J(J Property Address �� esidential Value of Work _��D� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ��`/�j��// � ��o S• —5 Contractor's Name, Telephone Number �j �(y Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable)_ �✓' - �orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I a Homeowner have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# y�, " .a—U ��1� Copy of Insurance Compliance Certificate must accompany each permit: Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over'C existing layers of roof) ❑ Re-side #of doors l Re la.cement Windows/doors/sliders. U-Value (maximum .44)#of windows / . *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 copy of the Home Improvement Contractors License&Construction Supervisors License is r red. . SIGNATURE: ------------- QAWPFILES\FORMS\building permit formslEXPRESS.doc Revised 070110 The Com ornlveat'h of Massachusetts Depivhnent of Iudastrial Accid 0,Qzce.€rf Investigadons 600 Washington Street Boston,MA 02111 n�r c*w.a ntrs&go v1'dur Workers' Compensation Insurance Affidavit: Builders/ContractorslElectiit:i-ans/Plnmbers Apiplicant Information Please Print Leeiblv Name tinny: Address: City/State/Zip: Phone# Are ga employer?Check the appropriate box: Type of project(required): 4. I am a contractor and 1 1. I am a employer with � ❑ 6._❑ employees(full andkacpar�noe).* have riredthe sub-contractors New construction�,�� 2_El am a sole proprietor orpartner- listed on the attached sheet 7. L' odeling ship.and have no employees These sob-contractors have 8. ❑Demolition wod ng for mein any capacity_ employees and have wt s' �To wodmrs'camp.insurance comp-jw=ncr 1 4. ❑Building addition 5, ❑ We area corporation.and its 10.❑Electrical repairs or additions . regos ] officers"Have"exercised 1wir 3.❑ I am a a homeowner doing all wrack i l_❑Plumbing repairs or additions myself [No workers'comp. right of ew=pti m per MGL 12.❑Roof repairs . insurance required.]r c. 152,§1(4),and we have no employees.[No worlmrs' 13.❑Other, comp.insurance,required.] ;Any appli aw that checks boa:#1:mnst also fill out the section belm shawm'their worker'compeasat M policy iaf�az Homeowners who submit this affidavit iadicadng they We damp aQ wed Rud dim bke outside conuactms mast submit a new affidavit indicating sorb: kznr=tms that check this boor must atUrbed am addition, sheet dwwbg the mane:of the vAb c�and stave whether ar not those eames hose employees. If the sub<natmaws have employees,dW must provide&w warkers'camp.palmy number. I um an employer that is pemiaYng workers'congwismion insurimcae for my ernpta w-% Bduw is thepoZicy Md job sr'te informadem Insurance Company Name: Policy#or Self-ins-Lic.#: `II L12�� Expiration Date: �Z Job Site Address:�i � �ti✓�J'f, «1Ty� i�° Oity/Stat&'Zip:- �i 7 Attach a copy of the workers'compensation policy declaration page(showing the policy number and espirstian date). Failure to secure coverage as required under Seeticn.25A of MGL c. 152.can lead to the itmapmidicn of criminal penalties of a fine up to S 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 farwarded to the Office of Investigations of the.DIA for insurance coverage veriftatiar7_ ' I do hareby,ccrdfy under paials aayndahies a irry than the informidiorn provided about is true and correct Date: l Phone#: Offidal lase only. Do not write in tills area,to be compleW by city or tel"i officiat City or Town: PermitUcense# Issuing Authority(circle fine): 1.Board:of Health 3.Building Deparhawnt 3.City/T.own Clerk 4.Electrical inspector 5.Plumbing Inspector b.Other Contact Person: Phone#: 6 ofTHEr Town of Barnstable ti . �. Regulatory'Services + HAMSTASLE 9 MASS. -Thomas F.Geiler,Director i639 ' . Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us 4 Office: 508-862-4038 Fax: 508-790-6230 'Property� � . .,:.: Owner Must Complete and Sign This Section -, If Using A Builder t I, f , as Owner of the subject property: hereby authorize (/ to act on my behalf,:. in all matters relative to work authorized by this building permit application for. A&t/ ` (Address of Job) S*nature of Owner /ate Print Name If Property Owner is applying for permit please complete�the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION T, f P�oF try r�� Town of Barnstable Regulatory Services BAMSTABLE, : Thomas F.Geiler,Director ME MASS. �A 1639• .0 A Building Division rE0 MA't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /-;21A�Ae , JOB LOCATION: number —,.- treet village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: r r r ' city/town state zip code The current exemption for"homeowners"was extended to inc We owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a�license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she re sides_or to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_pern t. (Section 109.11) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Bamstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger,will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt ACORN' CERTIFICATE OF LIARILITY;INSURANCE DATE(PoI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.Tf CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIEC_THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT'BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the olic p y(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms an 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 en _. PRODUCER CONTACT "'a• :-- NAME: t PHONE — Agplied Risk Insurance Services, Inc. (A/C,No,Ext):- (822)234_4420 I(ac,No):�877)234 4 t� 10825 Old Mill Rd E-MAID Omaha, NE 68154 ADDRESS: PRODUCER CUSTOME ID# . (877)234-4420 1 1NSURER(S)AFFORDING COVERAGE INSURED ------ — — — ' INSURER A: I {w, Continental—Indemn:Lty__Co^ —T Grover, Carey INSURER B: dba Grover Building and Remodeling INSURER C: PO BOX lOBO INSURER D: T -- Cotuit,, MA 02635-1080 INSURER E: CTL 1273 579907 I ------- --- --- --- 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 1 PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPI ; WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECS` , THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF I POLICY EXP k LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER I MM/DD/YYY MWDD/YYY LIMITS GENERAL LIABILITY ❑ { L ;, .[, _ tiu., EACH OCCURRENCE nCOMMERCIAL GENERAL LIABILITY i DAMAGE TO RENTED- CLAIMS I PRE AR, is �` MADE OCCUR -- -- { i MED EXP(Any oneperson) -S_ t' -- PERSONAL&ADV INJURY IS- �GEN'LAi,——GATE LIIAiI APPLIES PER, I GENERAL AGGREGATE i5-- j POLICY PROJECT PRODUCTS-COMP/OPAGG IS LOC =1 i • � — ----LS AUTOMOBILE LIABILITY I is ❑ I COMBINED SINGLE LIMIT ! > ANY AUTO (Ea accident) -- is ¢f ALL OWNED AUTOS BODILY INJURY(Per person) !S -s SCHEDULEDAUTOS I I BODILY INJURY(Per.cc1d.n: IS HIRED AUTOS I -- PROPERTY DAMAGE I ¢?' _ (Per accident) Is NON-OWNED AUTOS i I i UMBRELLA LIAB (OCCUR I I I EACH OCCURRENCE _ 15 f 1 EXCESS LIAR CLAIMS-MADE I i AGGREGATE DEDUCTIBLE I f s RETENTION t $ WORKERS COMPENSATION I II� WC STATU- OTH-1 AND EMPLOYERS'LIABILITY Y/N L T RY LIMITS ER I ANY PROPRIETOR/PARTNER/ - ,. ti EXECUTIVE OFFICER/MEMBER !��,'�� N/A E.L.EACH ACCIDENT $ SGRo + A EXCLUDED? 1b 46-805700-01-04 08/31%20 1 OS/31/2012. _ — t" (Mandatory in NH) E tr)ISEASE-EA EMPLOYEE S t 3. w If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY OMIT S i S S,. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach Acord 101,Additional Remarks Schedule,if more space is required) wz CERTIFICATE HOLDER —=L CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR PO BCI 1080 1T1g 8n3."`�•`^"0+++4! EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE PO Bmt: ZOBO THE POLICY PROVISIONS. QOtUit, NA 02635-1080 > AUTHORIZED REPRESENTATIVE iAe Attn: PrOjeCt b1mager �^ ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ©1 2009 ACORD CORPORATION All r4 :r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #a 0 09 l Health Division 61 br — 0e/ Date Issued 1 Conservation Division Application F:4 Planning Dept. Permit Fee P30 Date Definitive Plan Approved by Planning Board ' Historic - OKH Preservation/ Hyannis Project Street Address Village Owner �� Address 710 20 Telephone Permit Request cn Square feet: 1 st floor: existing ropos 2nd floor: existing proposed Total,eew 5 v ZoningDistrict Flood Plain— AV Groundwater Overlay Project Valuation Construction Type ' 6 Lot Size ® Grandfathered: : es ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family•.- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes Basement Type: ❑ Full r®'C awl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) (✓ Basement Unfinished Area (sq.ft) Z164- / Number of Baths: Full: existing = new I P--R~ 4,o Half: existing new Number of Bedrooms: existing'Onew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ®'Gases ❑ Oil .❑ Electric ❑ Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 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 Number � 1 Address R` �0, License # Home Improvement Contrac r# Worker's Compensation# 4;5— C/S,S?C-51C3 ALL CONSTRUCTION CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKENO SIGNATURE DATE rt - FOR OFFICIAL USE ONLY APPLICATION# , DATE-ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE OWNER t � . t DATE OF INSPECTION: i FOUNDATION FRAME o o to �-'Y�R- &4wcl INSULATION O FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING 0 lm DATE CLOSED OUT ASSOCIATION PLAN NO. C The Commonwealth of Massachusetts ` `. Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 4A _l y� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): L/% Address: c'/�©� City/State/Zip: �'`�Fhon �� � Are yo employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ 1 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,1 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions 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' 13.0 Other y 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. tContractors 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 andjob site information. Insurance Company Name: . Policy#or Self-ins. Lic.#: (a '?��-�c> Expiration Date: 3 /(j , Job Site Address: i�-��/ / / �17 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 and a pains a lti perjury that the information provided above is true and correct. Signature: Date: Phone#: e:;7 , 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 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 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 ATE AC®f�®,M CERTIFICATE OE LIABILITY INSURANCE Dab/`17/zDD9' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Applied Risk Insurance Services, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 10825 Old Mill Rd AFFORDED BY THE POLICIES BELOW. Omaha, NE 68154-0646 (8 7 7)2 3 4-4 4 2 0 INSURERS AFFORDING_COVERAGE NAIC# INSURER A: Continental Indemnity Co. 128258 INSURED _ —`-- I}— Grover, Carey INSURER B: dba Grover Building and Remodeling PO BOX 1080 INSURER C: Cotuit, MA 02635-1080 INSURERD:_ CTL 1273 470114 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDNY DATE MM/DDNY GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S CLAIMS MADE D OCCUR MED EXP(Any one person) S PERSONAL 8 ADV INJURY S _ GENERAL AGGREGATE S GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG S PRO POLICY JECT LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident), S ALL OWNED AUTOS _ BODILY INJURY I SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) S - � PROPERTY DAMAGE S (Per accident) ' GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: A__--- AGGIS EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE —1 OCCUR ❑CLAIMS MADE J AGGREGATE is DEDUCTIBLE - I RETENTION S I WORKERS COMPENSATION AND WC S IATU- OTH- -I EMPLOYERS'LIABILITY X. TORY LIMITS ER�, A ANY PROPRIETORlPARTNER/EXECUTIVE 46-805700-01-02 0 8/31/09 I 08/31/10 E.L.EACH ACCIDENT S 500, 000 OFFICER/MEMBER EXCLUDED? I t E.L.DISEASE-EA EMPLOY" S- 5 It yes,describe under 0 0, 0 0 0 SPECIAL PROVISIONS below E.L.DISEASE POLICY LIMIT f 5 OTHER I. - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - i I , CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Grover- Building and Remodeling ' EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAIL._3-p__ PO Box 1 0 8 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON Cotu i t, MA 0 2 6 3 5-1 0 8 0 THE INSURER,ITS AGENTS OR REPRESENTATIVES. - AUTHORIZED REPRESE E Attn: Project Manager 1783118 ACORD 25(2001/08) ©ACORD.CORPORATION 1988 REScheck Software Version 4.2.1 Compliance Certificate Project Title: Jarvis Residence Energy Code: 2006 IECC Location: Cotuit, Massachusetts Construction Type: Single Family Building Orientation: Bldg.faces 180 deg.from North Conditioned Floor Area: 568 ft2 Glazing Area Percentage: 7% Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 727 Main Street Timothy Luff Cotuit,MA 02635 Archi-Tech Associates,Inc. 6 School Street Cotuit,MA 02635 508-420-5335 Compliance:4.7%Better Than Code or Door, Ceiling 2:Flat Ceiling or Scissor Truss 551 30.0 0.0 19 Ceiling 3:Cathedral Ceiling(no attic) 22 30.0 0.0 1 Wall 1:Wood Frame,16"o.c. 325 13.0 0.0 24 Orientation:Front Window 6:Wood Frame:Double Pane with Low-E 36 0.340 12 SHGC:0.49 Orientation:Front Wall 2:Wood Frame,16"o.c. 220 13.0 0.0 18 Orientation:Right Side Wall 3:Wood Frame,16"o.c. 325 13.0 0.0 27 Orientation:Back Wall 4:Wood Frame, 16"o.c. 220 13.0 0.0 14 Orientation:Left Side Window 4:Wood Frame:Double Pane with Low-E 38 0.340 13 SHGC:0.49 Orientation:Left Side Window 5:Wood Frame:Double Pane with Low-E 6 0.340 2 SHGC:0.49 Orientation:Left Side Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 568 1.9.0 0.0 27 Furnace 1:Forced Hot Air 93 AFUE Air Conditioner 1:Electric Central Air 18 SEER . Compliance Statement: The proposed building design desc%ull o sis ent with the building plans,specifications,and other calculations submitted with the permit application.The propa b designed to meet the 2006 IECC requirements in REScheck Version 4.2.1 and to comply with the mandato ist a REScheck Inspection Checklist. Name-Title Signatur Date Project Title: Jarvis Residence Report date: 10/08/09 Data filename: C:\Program Files\Check\REScheck\jarvis,rck Page 1 of 1 t I AMPDesign Engineering& Co., Inc. P.O. Box 649-Middleborough, MA 02346 508-946-3561 -Fax 508-946-1653 I DATE FILE SHEET , ._ .__.,.. ------ SUBJECT . 1 . f 1 f _ I ! G} { } j } I __- ( _ -I 1 1 dt 1 t 1 1 i i � > - I � f 1 1 t 1 i 1 _ _ AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)1 ASAPDesign Engineering & Co., Inc. Jarvis Residence Project No.2009-220 727 Main Street Cotuit,MA 02635 (Addition) Q Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust).................................................................. ................................................ 110 mph Q Wind Exposure Category... ............................................................... .............................................................C Q 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) .......... 1 story<_2 stories Q RoofPitch ...........................................................................(Fig 2) ........................................... 10:12 5 12:12 Q MeanRoof Height ..............................................................(Fig 2)..............,................................... 14 ft 5 33' Q BuildingWidth,W ...............................................................(Fig 3 ................ 22 ft <_80' Q Building.Length, L...............................................................(Fig 3)...................................................28 ft <_80' Q Building Aspect Ratio(L/W) ...............................................(Fig 4)...................................................1.27 5 3:1 Q Nominal Height of Tallest Openingz ...................................(Fig 4)....................................................6'8"5 68" Q 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)............................................................... Q 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete ........................................................................................:..................................... Q 2.2 ANCHORAGE TO FOUNDATION'3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ........................... House... (Table 4)...................................................Rio: Q Bolt Spacing from endfjoint of plate.............................(Fig 5).......................................... 12 in._6"—12" Q Bolt Embedment—concrete.........................................(Fig 5)................................................... .7 in.>_7" Q Plate Washer................................................................(Fig 5).........................3"x 3"x'/4" z 3"x 3"x%" Q 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55)................................... Q Maximum Floor Opening Dimension...................................(Fig 6).....................................................N/A 5 12' Q 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)...........................................8"Maximum 5 d Q Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)..........................................8"Maximum 5 d- Q Floor Bracing at Endwalls..........:.........................................(Fig 9).................................(First 2 Bays 4ft O.C.) Q Floor Sheathing Type ..........................................................(per 780 CMR Chapter 55)...................T&G WSP Q Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)..........................%"in. Q Floor Sheathing Fastening..................................................(Table 2).............8d nails at 6 in edge/12 in field Q f AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (7s0 CMR 5301.2.1.1)1 d d D Engineering & Design Co., Inc. 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)...............:.......9'ft 4"in<_10' Q Non-Loadbearing walls................................................(Fig 10 and Table 5).......................9'ft 4"in:5 20' Q Wall Stud Spacing ........................................................(Fig 10 and Table 5).....................16 in.<_24"o.c. Q Wall Story Offsets ........................................................(Figs 7&8)................................. 8"Maximum<_d Q 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls........................................................(Table 5).............................................2x4-9 ft 4 in. Q Non-Loadbearing walls................................................(Table 5)............................................2x4-9 ft 4in. Q Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10)................................................................. Q WSP Attic Floor Length................................................(Fig 11)...........................................................N/A Q Gypsum Ceiling Length(if WSP not used)...........................(Fig 11).............:..................Full Ceiling ft>_0.9W Q and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ... (Fig 11)........................................................... Q or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays Q Double Top Plate Splice Length ........................................................(Fig 13 and Table 6).........................................Eft Q Splice Connection(no.of 16d common nails)..............(Table 6)........................................................... 10 Q Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Tables 7).............................................2 Per Stud Q Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)...............................................2 Per Stud Q Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)......................................... 3 ft 0 in.:5 11' Q Sill Plate Spans ........................................................(Table 9)..........................................3 ft 0 in.:5 11' Q Full Height Studs (no.of studs)....................................(Table 9)................................. ................ ............2 Q Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9)......................................... 5 ft 0 in.:5 12' Q Sill Plate Spans...........................................................(Table 9).........................................5 ft 0 in.:5 12" Q Full Height Studs(no.of studs)....................................(Table 9)..............................................:..............3 Q Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 .........................................................................68%6'8" Q Sheathing Type..............................................(note 4)................ ............................CDX/WSP Q Edge Nail Spacing.........................................(Table 10 or note 4 if less)..............................4 in. Q Field Nail Spacing ......... able 10 .....................................................12 in. Q Shear Connection(no.of 16d common nails)(Table 10).............................................3 Per Foot Q Percent Full-Height Sheathing.......... Left... (Table 10)......... (31%Required)(65%Available) Q Percent Full-Height Sheathing......... Rear.... (Table 10)..........(31%Required)(40%Available) Q AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (7s0 CMR 5301.2.1.1)1 d d �9 Engineering & Design Co., Inc. Maximum Building Dimension,L Nominal Height of Tallest Opening2.................................................................. 6'8" <_6'8° Q Sheathing Type..............................................(note 4)...............................................CDX/WSP Q Edge Nail Spacing.........................................(Table 11 or note 4 if less)..............................4 in. Q Field Nail Spacing..........................................(Table 11).....................................................12 in. Q Shear Connection(no.of 16d common nails)(Table 11).............................................3 Per Foot Q Percent Full-Height Sheathing............Left...(Table 11)..........(21%Required)(59%Available) Q Percent Full-Height Sheathing............Right.(Table 11)...........(21% Required)(80%Available) Q Wall Cladding Rated for Wind Speed?.............................................................. .....................:.......................... 110 MPH Q 5.1 ROOFS Roof framing member spans checked?........'................(For Rafters use AWC Span Tool,see BBRS Website) Q Roof Overhang ...................................................(Figure 19) .....1ft or Less<_smaller of 2'or U3 Q Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)...............................................U=265pif Q Lateral.............................................(Table 12)...............................................L=203 plf Q Shear...............................................(Table 12)................................................S=89 plf Q. Ridge Strap Connections,if collar ties not used per page 21... (Table 13).................................T=150 plf Q Gable Rake Outlooker...........................................(Figure 20) ..... 1 ft or Less_smaller of 2'or U2 Q Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14).............................................U=480lb.' Q Lateral(no.of 16d common nails)...(Table 14)........................................L=203 lb. Q Roof Sheathing Type......................(per 780 CMR Chapters 58 and 59) .......................CDX/WSP Q Roof Sheathing Thickness........................................... ..............................................5/8 in.>_7/16"WSP Q Roof Sheathing Fastening............................................(Table 2)...............................8d(6"Edge 6"Field) Q AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Engineering Design .Co,.Inc. The compliance checklist is typically used for the prescriptive design method for high wind construction and applies to structures located with in exposure B.When a structure is located in exposure zone C,the checklist is used as reference guide to help determine the areas of a structure that need further structural evaluation, as a result of the structure being located in exposure zone C. The forces that have been provided on the checklist have been calculated for this particular structure located within exposure zone C. Notes: a. 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. 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. 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: i. Panels shall be installed with strength axis parallel to studs. J. 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 AWC Guide to Good Construction in High Wind Areas: 110 nigh Yrind Zone Massachusetts Checklist for C®mpllauce (780,CMR5301.2.4.1)' Engineering & _ Design Co., Inc_ MEN THIS EDGE R NIS ON RRltMING USE 8d MAU AT6b� ' 11 11 1 11 11 1 ' M 11 11 1 11 rl 11 11 11 11 11 11 1 11 11 G r 11 tl N 11 Q !1 it m r 00 n 11 4 1 11 If 1 II � II 11 II 11 1! 0 11 If I 11 11 W i I 71 r r W 1 a It v I1 71 Q It it t It n W 11 V II 11 � 1 WAILSPACM M 11 11 11 rl r 1 f See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment AWC,Guide to Wood Construction in High WindArettse 110 niph Wind Zone Massachusetts Checklist for Compliance (780 CMR-5301.z.1.1)' Engineering _ Design Co. Inc. 1 a 1 i Y 1 za 1 , .i i R O4 it li r 1 EDGE FNTFQ TE 7 —•"I II 1 1 1 ♦� 1 , � 1 I '2r 1■y ` 1 1 STAGGERED XNL PATTERN r2 PANEL PANV EDGE '5 DOUBLE NAIL EDGE SPAMG DETALDE MLLI Detail Vertical and Horizontal Nailing for Panel Attachment f am@ go MEE@ Gampmomm 0M al MM)OM20 �] • {- ,{ P 110 MPH EXPOSURE B WIND ZONE Table 2. General Mailing Schedule Roof Framings r rz r z Blocking to Rafter(Toe nailed) 2-8d 2-10d each end M Rim Board to Rafter(End-nailed) 2-16d 3-16d each end Z M L.W Framing. a Top Pla#es at Infers pa ions (Face nailed) 4 16d 5 16d atjomts r Stud to Stud ,(Face nailed) 2-1.6d, 2`1'6tl 24 o.c Header... o Header(Face nailed) 16d 16d 16"o c.;along'etlges y Floor Framing_ , Joist to Sill,Top Plate"or Girder(Toe nailed),(Fig 14) 4 Sd 4 10d -.per joist y ,:.Blocking to Joist (Toe-nailed) 2 8d'- 2 fOd each end p Bocking'to Sill or Top Plate (Toe nailed) 3 16d 4 16d = each bloek Z 6 Ledger-Strip to Beam or Girder(Face-nailed) 3 16d, � : 4-16d reach joist y Joist'on Ledger to Beam (Toe-nailed) f 3 8d 3 1.0d per joist Band Joist to Joist(End-nailed) (Fig 14) 3 16d 4-16d :^per joist l Band Joist to Sill or Top Plate'(Toe=nailed) {Fig 14) 2 16d f'':_ 3'1:6d ` per foot Roof Sheathing .xY aae . I Wood Structural__Panels.. rafters or trusses spaced up to 16' o c 8d 10d 6" edge/6. field rafters;or trusses spaced over, o>c 8d 10d 4° edge/4'`field gable endwall rake or'rake truss w/o;gable overhang 8d 10d 6' edge/6"field gable endwall rake or rake truss w/structural 8d 10d 6 edge/6"field outlookers gable endwall rake or`:rake' Jruss w/lookout blocks P :8d 10d 4" edge/4'`field` Celling`Sheathng f Gypsum Wallboartl 5d coolers 7 edge/10 field - Wall Sheathin77 g Wood StructuralPanels -: studs spaced up to 24 o c 8d 10,d 6 :edge/-12 field:. t 1/2" and 25/32" Fiberboard Panels t 8dt 3° edgefield ; 1/2° Gypsum,Wallboard' 5d coolers j 7° edge%1U"field :; Floor Sheathing Wood Structural;Panels 1" or less 8d 10d 6".edge/12"field greater'.than 1; 3 10d 16d 6.,edge/6, field -' .__.pa er. ..�____�_ r 1 Corrosion resistant 11 gage roofing nails and 16 gage staples are permitted, check IBC for additional requirements. Nails.Unless otherwise stated,sizes given for nails are common wire sizes.Box and pneumatic nails of equivalent diameter and equal or greater length to the specified common nails may be substituted unless otherwise prohibited. AMERICAN FOREST& PAPER ASSOCIATION i I ivi u. Othpi r e* {I � eo 0-6 �} F � r } TOO TO k � � I ,� - � ice_• � :. � �? �f 1 � - i t_ r Nrir `� � t x k.cgwiFy ""T t wn % -)-T fat cosy ; $ Baf'4wimeffogiN45'-ziYfQ`gt 4ffiaP�'` HOME IMPROVEMENT CONTRACTOR • f Registration: 144322 Exp i'atiot: g%2312010 Tr# 27 409C ` Type:: C)BA {. GROVER BUll-b J6+.REMODELI.G 1 CAREY GROVER ' 56 BOWDOIN RD MASHPEE,MA 02649 Administrator 07-7 ! Bohr ft0 y. Construction Supervisor License License: CS 77754 Ezpiri 9n 111222009 Tr# 6877 Restnctaon= 1G:•� CAREY C GROVER t. PO BOX 1080 t �. , '0- - COTU IT,MA 02635 Commissioner Town of Barnstable RARm` Regulatory Services wit aaB $, Thomas F_ Geiler,Director to a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: S08-790-6230 Property Owner Must Complete and. Sign This Section If Using A Builder as Owner of the subject.property hereby authorize to act on my behalf, in all matters relative to work au orized. by this building permit application for. - (Address of Job) 6. S' e of er Date s�L - J � S P c t Name If Propertyy Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. of Tree 'own of Barnstable H ray „�L 0 Regulatory Services RASTABLF- Thomas F. Geiler,Director RN Building Division PrEo�y a Tom Perry,Building Commissioner 200 Maid-Street,._Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOl\'EEOWWER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village """HOMEOWNER": name home phone# work..pbonc# CURRENT MAILING ADDRESS: i city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwel nos of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that_he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this sectign.(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responnbilitirs,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsnbilitics of a Supervisor. On the last page of this issue is a.form currently used by several towns. 'You may care t amend and adopt such a formn/ccmtiftcation for use in your community. Q:forms:homccxcmpt 'g R BERT M ;> . IERS .f No f6770 - y �F70XAL Et\fi1� 51RUCTURAL DESIGN CRITERIA I _ MM c a.....,..., I. -FIRST FLOOR P5F LL 15 W m I IS P5F DLpq m _______ - ., _ -5EGOND FLOOR D P 5F IYI -ATTIC/STO. O P55F H^Y u-ROOF s PPSF I"d - -EM.WALLS 75 P5F DL �. INT.WALLS 50 P5F DL t -pEGK5/P0RGHE5 10 P�5F me .............. r-f �. f t. ! a -ROOF DEOKS 60 P5F - _---_ I ...f.. • O P5F i c s I K1L REOUIRED SOLID BLOCKING" (APPLIED TO ROOFS,GEILINGS AND FLOORS) EAVE DETAIL AT COERD EMRY � '°° {r i j - OCKING AND CONNECTIONS SHALL BE PROVIDED AT PANEL E06E5 PERPENDICULAR ' TO FLOOR AND ROOF FRAMING MEMBERS 3 I I IN THE FIRST.TWO BAYS OF THE FLOOR. - AND CEILING JOISTS AND RAFTERS THE BLOCKING HDU2 - ! SHALL BE SPACED AT A MAX OF 4-0 Gi FIRST FLOOR FRAMING NOTES'�t;1r''-x e c - .. -'AL L P05TS®ENDS OF,BEAMS TO BE B W 2X45 UNLESS -ALL WINDOW!EXTERIOR DOOR #° C cu - NEADER5 TO BE(2)2X65 W/1/2",; O rn .r. ..a m _ .. o*� mw n PLYWOOD UNLE55:NOTED tl�K�� x,v E _ bENERAL NOTES N C�R -AND TYPIGA D TAILS FOR HDU2 REOUIREMENPS t'•�� •5,n N f S o WOOD POST DOWN ''.1i +. fC r'� . p _WOOD P05TUP. _ acrY`u".01raorn. -- FIR 5 T FLOOR .F R A M I N 6 PLAN - - X HOOP ppST UP S HOL.DOWN DETAIL•EXT.WALL CORNER .. -3 fm �V.-OF,,j • _ - y> P� ROOF FRAMING NOTES ROOF ASSEMBLY . STRUCTURAL DE516N CRITERIA - O� ROBERT M ,p _ D R _ -ALL POSTS®ENDS OF BEAMS TO BE +RAFTER TO PLATE CONNECTION qq -FIRST FLOOR 15 PSF ILL Jo 36770 (2)2X4'5/(2)2X65,UNLESS NOTED T30 0 -INSTALL SIMPSON"M5 "HURRICANE _ IS PSF OIL - ^i STRAP AT EACH RAFTER TO PLATE -SECOND FLOOR - 30 P5F P o `� �., -ALL WINDOW HEADERS TO BE(2)2X6'5 CONNECTION TO RESIST UPLIFT FORGES , IO P5F �i• FGYSTER .c W/1/2'PLYWOOD,UNLE55 NOTED y .Fs(1Me: .. -ATTIC/5T0. '� 20 P5F - � _ ��Pi `� ' ALL RIDGES OVER 20'-O'LONG "RAFTER TO RIDGE CONNECTIONto P5F 8 -ROOF 35 P5F - ��I rf�Q+� TO BE(U 3/4'X 1/0' RAFADDITIONAL FASTENING 5RS MAY BE 1 REO BUT UIRED 0 15 P5F r _ -PROVIDE 2AO LEDGER BOARD (REFER TO DETAIL 2) -EXT.WALL5 15 PSF DIL _ °..m.,"v ®OVERLAY FRAMING FOR RAFTER -.___.------_-_ _------_------ -_-_ OPTION A:APPLY SIMP50N L5TA STRAP ,e 3 -INT.WALLS 50 PSF DL _. _.___ BEARING/SUPPORT ACROSS THE TOP OF THE RIDGE -DEGKS/PORGHES _10 P5F _ - _ (UNLESS NOTEE D R BE 6X80 .F. OPTION B:2X65 RIDGE LOCK BLOCK _. ..---------._.._..- FZ. _ - rn ROOF DECKS -` 60 PSF - -- - - -------- OF 51X(b) OD RING SHANK NAILS -------- _-. 0 P5F m 0.20 rn AGROS THE RAFTERS DIATELY BELOI•T�H�IDRA6FE�ND�ATMNIN� ................. THEM 7 RAFTERS N I i H r _ ' / k.•"' �.w• �i/I a .- i iI V � s I I�. MO I. / MEMMIF �. a. .moo "*'IXP- L� . ^ I B by ROOF PLAN ROOF FRAMING PLAN I A -{ ��T � •�°AioV�n�wpm " LL TYP.EXT.SHEAR WALL - O RAFTER.ITIRL155 HURRICANE TIE DETAIL O TYPICAL RIDGE 5TRAP DETAIL OPTIONS O Fr4VE DETAIL AT COVERED ENTRY A •E HOLDOWN DETAIL A- " """44 ` ISSUER),MWJ ON w: ♦ of 4 TOWN 4r' DA UN T , LE O*IHE tp� Town of Barnstable , tip ; 1� 2 0 �°1 3. 2 Barnstable Historical Cdii r ission * STABLE, 200 Main Street, Hyannis, Massachusetts 02601, y btA88. g (508) 862-4786 Fax(508) 862-4725 �A 1639• www.town.barnstable.ma.us - .. Dit���;a_�$� y • `,0 .> _ tV Linda Hutchenrider, Town Clerk Q 367 Main Street , R C^Thomas Perry, Building Commissioner �3 _ 200 Main Street ,� G Hyannis, MA 02601 William&Nancy Jarvis 727 Main Street Cotuit, MA 02635 Re: DECISION of the Barnstable Historical Commission,pursuant to the Code of the f Town of Barnstable ss 112-1 through ss 112-7 APPROVING the application for 'PARTIAL DEMOLITION(Rear Ell) of property as follows: Location: 727 Main Street, Cotuit Assessors map and parcel: 036008 p Owner/applicant: William&Nancy Jarvis During the Barnstable Historical Commission's Meeting July 21, 2009,.the Commission held an Initial Review of the application of William and Nancy Jarvis to demolish rear ell of the house referenced above, and construct anew addition. The house is individually listed on the National Register of Historic places and in the Cotuit Historic District: Based upon a review of plans, the Commission found that the plans drawn by Archi-Tech Associates, Inc;dated and received July 15, 2009,_were appropriate and did not constitute a . significant alteration of the historic architectural style of the house at 727 Main Street, Cotuit. Based upon this finding, the Commission approved the partial demolition of the rear ell at 727 Main Street subject to the plans received July 15, 2009. Sincerely _ Barbara Flinn, Chairman date: / August 2009 Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION da J t' 'd' Map � � Parcel CI0 INSTALLED IN OOFOPLIAI��Fit# 3q j 7 ( Health Division ��^ l 1. N ,� WITH TITLE 5 Date Issued 7 ENVIRONFMNTAL CODE AND Conservation Division f� �t9 Fee ���' to, Tax Collector Treasurer Date Definitive Plan Approved by Planning Board Masteite-=AKH PxesawafiaWRyamr is' } .Project Street Address 9 n)6 lV S7- Village Owner TAl1&J 5 Address S07 t� Slit C,s-h, Telephone 3�0 .Permit Request VIA w S A-b SAEb s _W S t6t+T4 I L-U I k1 6 `7"D MD C ~lq v TlL,-'10 c/ f=rAJ r S tfE.6 I7i*e_j,6' 4 ) Square feet: 1 st floor:existing proposed 2nd floor:existing proposed /7`Cv" Total new 7, Estimated Project Cost �_Zoning District Flood Plain Groundwater Overlay onstruction Type Lot Size Grandfathered: ❑Yes M NNo If yes, attach supporting documentation. Dwelling Type: Single Family EY' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes OdNo On Old King's Highway: ❑Yes t4 No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft), Number of Baths: Full:existing new- Half:existing .new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes XNo 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 QPNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name C�/Z_ Hbyr_- Telephone Number Address (o ff ,l e ,i ytw License# 7 / l'0"7,LlY. V}'1 6,26o35 Home Improvement Contractor# Worker's Compensation# Z2 Y-2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �(' zz SIGNATURE I � T DATE a FOR OFFICIAL USE•ONLY r r• , 4' ' -�-PERMIT{NO. • 4. r- _ _ �' - x , . -... r _ T - : _t DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION FOUNDATION FRAME t -�'" ; j Iq g INSULATION- FIREPLACE, � �• ,. ^� �,_ .f t- `` � p .w -`, - . , M ELECTRICAL•' r, ROUGH FINAL 1 ' PLUMBING: ROUGH FINAL -`� r GAS: R - ROUGH FINALS - � - ':' FINAL BUILDING, DATE CLOSED OUT t ,• - �� ' „^ ASSOCIATION PLAN NO. r I, The Commonwealth of Massachusetts • � =ice ��/"T ' Department of Indtistrid Accidents 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit / .�y • 4,/ n � ,.,.�. ., �!"����// / r name: ocation ' c2 + city / �l��t"t�-�� ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and L-we no one woikin in any rd achy am an employer providing workers'compensation for my employees working on this job. kaw eompan u,v name: l!A"/ I � =M�/ yes WL�If address: Ateitn 3/d AI 0 . city: 4 n[T 40Ato.3-T phone#: �Og) - Olt insurance CO. fI0IICV# //////,ll(///lll/'✓(i//.CQ///.(///,lu/// ////////////s/!/,lU/.%/i/a/ ��lG/// u/lti. ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the folloning workers' compensation polices: eompanv name: addre-5s• tile: phone :. :... ....>::::... . .. :. #: insurance ca. Company name: :. ...: ... ...:.....::.:. address. phone#: FaIIure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a 6ne up to 51.500.00 and/or one,years,imprisonment as well ss civil penalties in the form of a STOP WORK ORDER and a ane of 3100.00 a day against me. I emderstaod that a copy of this statement may be forwarded to the Ottice of Investigations of the DIA for coverage verincation. r do hereby terrify wider the pains anddppenalties perjury[hat the information provided Above is tra,an eor115ct re SigilBm� �" Date / k Print name rX CO FrieK V. RA S C k_IIL 9 S oindal use only do not write in this area to be completed by city or town olIIdal city or town: persudt/iicense 0 ❑Building Department 0Llcensiag Board (]dteck if iutmedlate reponae b requnred ------- ----- Sdeeaaen s OtOce--_--- ❑Health Department contact person: phone#-, Other (rewaa 9,95 P1A1 The Town of Barnstable 9 ' �e� Department of Health Safety and Environmental Services `6►9- • Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508.790-6227 Building Commissioner Fax: 508-790-623 0 For office use only Permit no. , Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, r construction of an addition to any pre-existing conversion, improvement, removal, demolition, o owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Shed h ne/SEst.Cost Type of Work: �® Address of Work: Owners Name � S Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE OGZ�,M OR GUARANTY FUND UNDER MGLO 142A ACCESS TO THE Al- SIGNED SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: -7l6Zfitolnt� °°7 N Date n a Name Registration No. OR Hers iYame ✓1e La„r,»ZG�:.uealC� G/',. llaunc/u�ea ,,:_,L +)EFA�: RENT -- 6,E. Number. �T pp CS 9075 ✓/ee foomnnonu�ea/�e o�/uaaoac/rutella Res trie.ed T0: 8; HOME IMPROVEMENT CONTRACTOR x d:H°aI„ CAPI_:I Registration 100740 i66S NEWTOWN' :H Type - PRIVATE CORPORATION TUiT. Expiration 06/23/00 CAPIZZI HOME IMPROVEMENT, INC as Capizzi, Sr. ADMINISTRATOR 1b45 Newton Rd. Cotuit MA 02635 ^- --- ✓�ie �a,no�aa�au,e�zl� G�:.llav�ac%ri�eCC DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE , Number: Expires: Restricted To: 00 THOMAS X CAPIZZI JR 280 PERCIVAL OR • �_ __�- -___._-_W BARNSTABLE,- MA 02668 ���� .�..w ^� -✓1lC l�10),i777G72IL�elLI.C� G/a,-l'G(IuJ(J.C/7CLJe�u E DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: -xpires: � Restricted To: 00 FREDERICK V RASCH' iI -"'1060 BOURNE RO PIYMOUTH, 4A 0'_360 tT � t _LJ / -T- IT I L i �AiE y. MT 72- 7 /Y)/g7Aj S7 . C672ca✓ ' own: 4.�aa 9 •pn�o OII�W WO NYM . -.t�Z_G'1P:I7i_Llr..ic. •�P 'a - _—lojai Fy . .t 1.8 I.y KAXr. A50/IAL7 QOoF ( Dc i t[O/J7 SCTTI-r L•'a NT ' ALUM 0.11c9f+ 5POu,� FXO.T OnLIJ - CGUL �T n+A,I LknUt tx•yl/NL. GUTTErt c/.7 rgvC T) - aLU IKI.'? klDlaE /A/ OOIC ALff _. .. >, dXlo KfiF1'tK� E."•.CIC PI•NCu� or71o1-I��� . 12 A,<LJ !x Y icy C/.a-SoFil r— FVez'c C 3'$ IY N. � /�u' J ��� ' • � daxS N@ADEKS Q 4-/0%+_ .. .�. _— ..__ (NO 1/.:5U L�171C�) VNTI n+l ylli� IJT6KIC,R 3� l 1>< IAS L 9D� i ;O�C Si1rNGl6J 5'T7•LIL�- /1MUW Iwr OVt,x ;a"r e,x Pcy - r �c�rz //:u �a• r— i N , DO E.2 f to � I IJi LctV SHE DU L'E wiloir ,i/NyL CIA,) IAT�+—'Y. _-_.._.._....._..—_.._.__1 y._G7•.� 'd„*— ''t`�— s I A/yMO[(Z �G — G1A f [./7'E o7Nt C • �ARJ� )oF.1 yo`7"Eros° TOWN OF BARNSTABLE BARNSTADLE. i "b DUILDI.NG INSPECTOR APPLICATION FOR PERMIT TO Apartments TYPE OF CONSTRUCTION ..........: °xame...�...?!-.-�...Boca Code ............. ........................................... March 15 73 ................................................19........ N TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according o the following information: 717 Main St•..,... Osterwille� Mass.. Location ... .......... ................................................................... .............................. ProposedUse ..AP!rkR t7 M8 s..................... ................................................. . ..............I............ . ................................. Zoning District Buisness A. ,,,,Fire District Osterville- Centervill.e ................. Wianno Trust John J. Gallagher Sr. Name of Owner JA.ha...J.....G.allaghex'...Jr..................Address .................................................................................... Trustees 1 Maln St. Osterville Nameof Builder OWn.e.rs....................................................Address 7...7............................................................................ Name of Architect Fr.4knk...Pt „L3qn sh......,,,•,.•,••,,,.•,,,,Address 12 Dimmock St. Quincy, Mass . ................................................................ Number of Rooms .��i...U11itS .......................Foundation Concrete..................................................:....... ............................. Shin les Cla' Boards & Brick Asphalt Exterior ...........�.........z...........P...............................................Roofing .................................................................................... Floors Oak Interior Dry B all ......... ; . ....................... 'Electric g Copper Heating ..................................................................................Plumbin ................... Fireplace v..............T.TOz1e.........................................................Approximate Cost ..110.000.00.:........ ............................ •1 Definitive Plan Approved by Planning Board -----------_________________:T9 a✓ Diagram of Lot and Building with Dimensions Plans filed with Building Dept, SUBJECT TO APPROVAL OF BOARD OF HEALTH 'NSTALLED M Co CE. TOWN �' w1TH ICI-E 11 STATE ART SANITARY CODE AND l•� pEGULA[10NS• F � 7 2- -1 a We I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Wianno Trust Name - Trustee _ rustee Wiarmo Trust No ..16o54.. . Permit for .........14 un.i.t apartmeit ........... ..... .............. . ........... . ...... ..... building ................... .................. ........................................ Location .. _7arr Main St. ........................................................ Osterville ............................................................................... Vkanno Trust Owner .................................................................. frame Type of Construction ........................................... y iv ................................................................................. Plot ............................ Lot ................................ 7 Z7(27-2- April 2 -AP 73 Permit Granted ....... .....19 j Date o�ns n ....................19 C) -Date Completed ......................................19 PERMIT REFUSED . .......................... ...................................... 19 ............................................................................... -7 /.... .........-...1-........ ........................................... ............................................................................... Id t ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... {• PVAN OF M,a� R RT nr. ( g D SI R " =' ! 36770 -� c, c„ i UCTUN.Al FOUNDATION 6ENSRAL NOTES, .:: U�VjOPoA •�:�� ` « Wip9 CONLRBTE FROST WALLS TO BE 10'THICK - � �}- 6 01174'%17(IMLE79 NO1ED1 CONTIRM CONC.fO0TIN6 W KEY(fFE16HT OF MALL TO BASED ON SHADE CONDITIONS 4'•O" a- MIN.FROM FIR GRADE TO BOTTOM O�FOOTING) i SILLS TO BE(U]xB(AR59M TREATED)W 5/6'912• f\{ GALVANIZED STEeL ANCHOR BOL15e•24_:OL:.MRL'AND�,) m IZ'FROM LOfd1ER9.BOLTS SHALL&;6 O HOTIi- PLATES AND BE FASTENED W 5119"PLATE WASHERS THERE SHALL BE A MIR OF]BOLTS FUR SILL.WASHER TO SIT ON V-M SLL @x 5TIN6FWNDATION M4LL5 AT D �T IB 8,DAYS E STRENGTH MIN F'&•SCoO PSI , `••°'f C •, �• `J -ALL P ItdS5 TO 12'TRICK UNREINPOR&ED - I� �'.,�.•� •(/� DRILL 14 REBNI 4"INTO EX CONL, 9p0O PSI GONLRETE 01"' TWON.PLRO.FEO�TTI]"NIN.INTCNEW OONG. -pRpyl F TC$BOrroM .d : ��I LOCAnoNy 1NB RYP./J.I.oTll� /OXI7 7�aP GmLNM9 I j�m 1 v Ex1STMG B'-R 1/4' R'-0'N- Isµ' ° • - {,A �.[ IF sia^x T NJM1 va•L u — — _ - u .. I'44 I' . � _• OJT OPENING IN ENS AL EQUAL EOJAL EQUAL. A WALL TO LEVEL OF - \ $ MSTC*v?R r e Inw 1 I \\ T NP�TRx@60BL1�LL a-0xD• j � 'i I�� ¢ KITCHEN -� I-y` �'• _� OL.NIN.(y PHY SILL�D" ' D f �, - I � . FROM LOTBIER9 TTPIGALI L�-` NIN.h1 BOLPS Pea 51u 4' ' : ————'—T —�—�—'-'d' - of RIDGE- PYI2929(ABOvE) - 9T•A A2 I li^i � ' - , - . �IP'.tipg , AEG ALI6NWA11 a'-0• 5-0' .� " MSTR: DROOM I �j •.0 .� WE%511N6 IX u�i X BEPOW GEI IIN� --- - I- - - v r ----- T r r b i --- x ; ----- SEAT - __ . w.l.G. -f /-i ' I '° ISOQOr•9 ER r_ III ASC4A]I99 B/" B'A 9 r Y 1 - M 'STR.BA RM s xAni I 3- Q E. A2 A2 I" DRILL A4 REBAR 4'INTO EX CON&. WALL C FOOTING m IS'OL.VERi. jl RRg y f`i L ¢a 'gFrF J g N ALLURFEOpW INS bP L.RE04R I. a $ y°T� �p• A? Tm�LATIOf6) W6211YP A40 R�• / < CC _ -. �' d •F - N - Q 2 a 009TIN6 RDUIIDATION WALLA AT AMA - 6ENER4L PLAN NOTES MAINfAgINRg4p'B-0'7�MIN. _ - Op'IEW Tp BOTTT06H Of NOTING 0.1LL.P8B N A R pg9nN6 ppU��'�N yy�LLq A-I - 9lPORT lark NOr M 2'LB' 9'•10 In' 14'-I'1/- T'-6' - •WINDOW9'f0 BE PB,Lq 9'-0 9/4' Z'A 9/a' T-0 In'./- 7'-0 In'./- B'-T In' 9'-10 I/2' fO- PMPACT-RCT-RE ISARCHITECT MEVI - ' - - WITH IMPACT-RESISTANT OF MRE915TANf 6LD&MLETIN6 _ _ / -ITN ED.OF NASA.STATE OR&LOGE PTI,'ELEVATIONS FOR 6F+IlLB 9'-l0 In' I4'-I'./- T!• A �'L• -I R TO ELEVATIONSABOVESI FOR W)NDOW RD,O.F E16M9 PPWE suBFLooR LL O X •�^ �a ^ pp C - WALL/DEMO WALLS AND ITEMS TO - 0 RBAOJm Aim MALLS TOREM b y job no. : OBIT - w MMI IEM WALLS. OBOB 19 A40U9T 2009 F O U N D A T I O N P L A N I DEMO NOTES FIR 5 T FLOOR PLAN Ex15TIN6 NO °2z 50.PT. sdB A9 NOTED eX19TINb 9CRE2N PORCRO H=904 90.PT. SCALE, 1/4' 1'-0' SCALE, 114" v 1'-O" PROPOSED ADDI71ON•15550.PT. drar)n KMW TO BE DA91ED WIId70W6 1 W4L45 - TOTAL.2,514 90.PT. TO BE RE R REP ACE PATCHED . - NEEDS OR REPLACED AS NOTED. fBV. y nN. m A- 1 m ISSUED CONSTRUCTION Bnt: t of m FOR 4 iL � CAP TO MATCH E%IPtI1H6 qR Rppp SH ,1 10 0F'V VVV LTOWMATLH FJ(16TIIb� NEIA ADDITION EXISTING HOUSE As V� P3 Az ALIGN R[POW OBERT \ C7 Bxl 1 g I RO � g MAIL B%ISTIN6 - ---- -- ro I G. 770 Cry - x NO �� 5TFUCTUP.A! N6 g�p xp I�qp� �x"�LIn6 G�� � �y$yp/g6 OpX q,y�p0 JPfEI LA51M5 - A2 10 4 �0�� Q•/ 7xb'8 IOL Y) E%IBT. 17 f•� `'•.. _ _ I I FASCIA AT ppyypp M TO MATCH E%19nN6 /OlYI4 i L/J ALIGN W EXIST. /g TOP OF DEL.PLATE 405 pµ�IpsrLI E�LRgF�ryS TO w: IINSi5 0 1 5T1AicH \ -- _= 8 � I bo I oN MSTR. �o SEDRM. - - 8cugspr�oM r an ro e' r'aE AA SHI SLE-6 (ON MOO PLYW000 - -- - NFL ,'"� i- h /IE OL C 1RIM AND).0rv4 IX BAND - -- _y 1SIED R-19 Pb.IN911L. CXI9TiN5 7%FLOOR 3//4g"pTLie PPLYWOOD QI —_ O gTGHFF� —.—.—. _ - yJy015yT�9 OLpI,e,oz. SYSTEM - A.19 FA.INSULATION r M� rT' '� •1IR6T FLOOR—. - —. - •!( O PIRSf-PCOOF� W-!�^ CRA T (2)1 514•x T 1/4. F _ P.r.2xp SILL PU � _ gg//56xx��77 9 IA'VIA 51L. ` ' a BOLTISL�4 oL. Ht.190 WIT _ COL.ON Clow. ' �4 LEFT ELEVAT 1 ON RRYYP POO N6 11 SCALE. 1/4" • 1'-O M V rASTIN6 HOUSE NEH ADDITION qR R�p6E y�N� 10'LONLw:1E Fi1G5T w O - TO MATCH PXI9PW9 C fMALL ALLLLtON PCOTI Nb 5 E G T 1 O N LEpgR Rppp 5 ry6yg A a cntj . - p G fT0 MATG4i E%15TIN61 SCALE. 1/4" I-O" . A2 A2 —R"TDD6evercAPover /—RIeRcAPavIDa wED6eM`v5e""rbcEAPova !� T'4 I/2' T'-0 If3" �) 9/4'X 4 I/4'RILE (I)19�4" BOARD MON9TRULTI BOAF�OGN•STRWTJ. BOARD INON�TRILTJ i I�p%�/�xbryryRR6s��..��TTfppf ON I% C/ - 1 PIT H qT T.ME - qqR�Q - Lp�q LLL���AAARRR pppFFF - �- BAY 77Appry6gLEEp 00:12h1•) - NSLEsIGE 1 12 5WH1 ALES .' 1 ag �INED ON 61617E Ng ry8 T.ME y�yqgpN9 1t �D/(� ND:R•)-)D 5M'00%P �LD% WOOD 1X9 /. Ole 7xB •Ib'0 '0 O I6 OL. ^ JAMB OA51M0 - r PLrvnov Aa Aa sre'PLYPeOD 12 -5- TO TLH Fjc�g H6 &�,L,' pp p5L ]XI LL6..b19TII SOA �Wq SECOND FLOOR —. —. TI 1 16 TION R-90 PG. TION Z / aJO yFpb.IHBp�IIiApTION (ATTIC/ - �Y \ Ix9 d INS VVz2 Nroo Pi.YwovD 1 rlNe FOU�✓D. MSTR. R � M5TR. -- - loN stuns)va'1x - SEDRM ' vo- $ BATHR n cD Pt�»zD T* ; 1'AM s { EAR 7%qg� yLprovD SEDRM. L TRIM AND k6469 BAND s b.N51L �?� -19 Pb 1QN51� WIS PB.I ItV9V.� '�r 8� ,8'g p�5 9y/4'r06 F Z 9/4'TIe PL OD O 75//44,Tie FLY`= r OYSTIN57X FLWR �y��P/pp�177669y2%�p .LI�N.I1 ' yy M 101yy��(gLpp0Cp1p6N'TO.pGH = 9l�f,ppR Rao TION j fi-I� b. TIOH - R-I9P®.IN'JA.4TION � •� O 1„ 0 PIP9T-BOOR a PIRSY N a� F�.Rm _� 7 $e 99 tq ®PIR3Y PC o 10.4Y�PCOOC-.- CRAWL (z)15/a k r Va CRAWL (2)1 5/4'x T 1/a' € � P.T.2X6 SILL PV �� P.T.0X6 SILL yy P.T.2X6 51LL W ggg buy 2•�ryLREfE gJgT s In D1A.wn- 85�p9.7%Igr A1�G�7R qg 58/0p xIT ANCNp11 y�- X 98/0�xu•A4_ R t- q$+ 'S 8 p� LOVER(9000PBV COL.ON.LdVL. (7Yf•ICAU 4 OL.4 f 2' R re UT (1TPICAU4W'OL p i _ Z (7•fPI0AL4 O L COy�W9T e i0 3 REAR ELEVAT 1 ON �^ Y Y � ��ey.�69� I ; SCALE, 1/4' • I' O" �________. •' 10"LONCR FROST . AALL LO N 24' 12" _ 10'LONClow-fell! 12' EtE YNLL ON 24"%12' . - - GONCAtElE F{OTNB CONLRET°FOOTIHs 0ONCR FOOTM KEY ay way SECTION ' j 5EG7I0N `V C SECTI ON •o - - - SCALE. 1/4" • I'-O' i SCALE: 1/4' • P-O" _.. - SCALE. 1/4" 1'-O' V AC A` � CEDAR ROOF SHINS LE9 CEDAR ROOF SHINGLES - S OMAR ROOF SHINGLES _ W i•+ TO MATCH E%19TIN6 TO MATCH E%ISTINe ON TO MATCH EXISTING M C _ON ICE 1 AVER NEMBRA`E rAO LAYERS OF ICE PA q� Atb 5/61 CEOX PLYWOOD CA%PLYW700 1� - �' p / (At bl7 ROOF ONLY) IRPMEJ 5/b'LDx PLYWOOD 1-12�' •c� yy2yyY6 RAPTE.5R9INO5UI�bp'O.L. ]N/XARR�gAFTEER�SS 0 166'T�0 2 2X6 RAFTERS O I6"OL. - SI-•� (� IxS 91�RAFf'P(IV6 ANDn IXTi STRAPPINS ANO ' 2xq�L6 Jp�g79 �9 N I/2"6TP,BOARD ----- I/]'GYP.BOAFm R-90 Pb.IIBLIA�OH OL.� 4 •Z N= W . NO VwP EObe w•AD. ND DRIP EOSE REaD, I Hv DRP EDGE Reap.D m __ _ 8004 abova Nc6Rrn pNw�� '1., IBIMM.IN6 777 h UOR%B PA9NA a 00/I0 FASCIA :]d A9ISdJIRED k IUmo,�,no: : O&T ALIGN V�Ypx IS7jN0 j - W^ ASuA�cPs>D ....... - O a Ix omrr-- a m data 19 AUOU5T 200Y Ix SOFFIT Pv C'OANT. IN, 'IV CONE I 01 VB�.T(B1 YAR-A-VEN� �LL VBTD2_ OP�.AI GK 71p' � �N 4� 8Wl8 A9 NORD } 7 i o 01 e�m"«7o1Na ` drawn KmA S.. 3 j K It e' p rev. 40015 )BM@p�UpF1NR6� g Rp6NO�1�6fE�Pg D1Ne I§ p� m �1 I/1'G0X IDLY. IX tlLOLRINb (a HEAD � a m OEAVE DETAIL (TYP) EAVE DETAIL AT W.I.G. �I 5 EAVE DETAIL AT MSTR. SEDRM. SAY A-2 SCALE,1 I/2".I'-O' - O SCALE. 1/2"•P-O" rl O SCALE:1 1/2'.I'-O" i ISSUED FOR 0000N sla: 2 Of 5 1