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0960 MAIN STREET (COTUIT)
� o �� o � � �. �� ,�_ �-� oF'THE Town of Barnstable ��EcoPMfror 1% Planning & Development Department 9 Barnstable Historical Commission * BARNSTABLE, * 200 Main Street, Hyannis, Massachusetts 02661 9 MASS. L.•-�'' 1639. (508)862-4787 Fax(508)862-4784 'OrFD Mp`t A erin.logan@town.barnstable.ma.us EP " Commission Members n r,.-t;r I t. f BUII-DING ® Nancy Clark,Chair Nancy Shoemaker,Vice Chair Marilyn Fifield,Clerk •�'`�''�''`�''TABL` I"'14N i��'='``I' J n ry 202� George Jessop,AIA Cheryl Powell Frances Parks Jack Kay,Alternate TOWN STABLE DECISION 2020 DED,2-1 PN Summary: Demolition Delay Not Imposed Pursuant to Chapter 112 Historic Properties, Section 112-3 F Applicant/Property Owner: Daniel Pozen and Heather Garni Subject Property: 960 Main Street,Cotuit Assessor's Map/Parcel: 035/095/000 Hearing Date: December 15,2020 Pursuant to the Barnstable Historical Commission receiving your notice of intent on November 18, 2020, a duly advertised and noticed public hearing was held on December 15, 2020 to determine whether the significant structure identified as a single family structure on this property is a preferably preserved significant building and whether a demolition delay would be imposed for the partial demolition of this structure on the parcel addressed as 960 Main Street,Cotuit. After review and consideration of public testimony, application and record file, the Commission, by a unanimous vote in favor, found that the actions proposed do not constitute a substantial alteration and would not jeopardize the historic structure's status as a contributing structure in a National Register Historic as defined in§3 of the Cape Cod Commission Development of Regional Impact Review Threshold. In addition,after further review and consideration of public testimony,application,and record file accordance with Chapter 112F, the Commission found, by a unanimous vote in favor, the partial demolition of the single family structure is not a preferably preserved significant building. In accordance with Chapter 112-3 F, the Commission determined by a unanimous vote in favor that the partial demolition of the single family structure would not be detrimental to the historical, cultural or architectural heritage or resources of the Town. This decision applies only to the demolition described in the notice of intent submitted on November 18, 2020. No future demolition shall be permitted without application and approval from the Barnstable Historical Commission. Present and voting on this application were: Nancy Clark, Nancy Shoemaker, Marilyn Fifield, Fran Parks, Cheryl Powell. Nancy Clark,Chair Date cc: Brian Florence,Building Commissioner Ann Quirk,Town Clerk Planning&Development Department-Elizabeth Jenkins,Director I r i� a ` k PROJECTED PERFORM11z RESNET Certified Home Energy Rating Services ` y° BLOWER DOOR TEST.HERS IECC 2015, IECC 2012 Test Location Customer Information IQ 960 tMain Street � Picard Construction Cotuit, MA 02.635 255 Turnpike Road a Southborough, MA 01772 Bill Picardi (508) 380-1370 Bill@Picardiconstrucion.com Test Conditions Date: 2 / 12 /2018 Relative Humidity: 92 % Time: 9:45 am Base Pressure: 1.8 pa Temperature: 42 F Range: 1.8 pa / 1.6 pa Wind. Speed: 6 mph Comments: Test Equipment Fan Model: Retrotec 5000 Volume: 53,228 cu/ft Serial Number: 100402 Test Pressure: i 50 pa Fan Flow Ring: 3 B8 -Ring Test Criteria: 3.00 ACH Fan Flow Rate: 1176 CFM (Air Changes Per Hour) Test Results: 1.33 ACH Pass i Test Performed by: Peter Ruiz Jr BPI Certified # 5059457 Resnet Certified # 4746349 Address: 141 Maple St, Douglas, MA 01516 Phone: 508-269-5394 Email: Pete@Projected2Perform.com. _ wN w.ProjectedVerform.com "Home Energy Rating Services" FA B TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Quern 0� r�U� Map Parcel J Application # kj Health Division Date Issued Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 8011 61A0 ► Historic - OKH _ Preservation / Hyannis AU6 U 72A117 Project Street Address qGQ CAI l OI/U;m Village Owner uS:' Address Telephone �� • n�• � Permit Request 1 --� 0 -�b4tc)oz (zA01,1 )J ceQ-1 c aW "&MA Ak c C.023 1mbycL-.C; a s V—CIX Square feet: 1 st f oor: existing. proposedJOftC 2nd floor: existing�3� proposed �" " Total new SAS Zoning District S —Flood Plain Groundwater Overlay Project Valuatio/nn Constructio Type Lot.Size I 0 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type:***Q Full \Ql Crawl r"*9 Walkout ❑Other Basement Finished Area (sq.ft.) 60, Basement Unfinished Area (sq.ft) CA()j rm Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing5 new Total Room Count (not including baths): existing new��First Floor Room Count Heat Type and Fuel:ArGas ❑Oil ❑ Electric ❑ Other Central Air: 4Yes ❑ 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 Y1J Proposed Use A\m — - =- - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name "Telephone NumberG- Address S License# - 01 14 v b v Home Improvement Contractor# ,l l G0ij�Aluci6'�orce)r's Email l 1 C,k Compensation # AW C y007 02 ALL CONSTRUCTION DEBRIS RESULTING O THIS PROJECT ILL BE TAKEN TO 2�I V y U� 7� C - SIGNATURE DATE A7 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION G FRAME q J " Fg, ArrA e INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL -ti FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. --O---------------------------- — I I I I I � I ,rnTrn 29'-0° Ills1 1 1 1 loll 1 1 1 1 - 1LL11J I ------------ I I I 0 0 vl Exercise Room V74 �. Play Room Crawlspace to °' ' i a Laundry 9e Bath _ o v t (� = Storage Equipment Rm. n=== ® Go C o O N a'-o° s'-o v NANI I z a 32'-0" M L----� I m rn M Czo m -� O D I a I I rn Cn n Proposed Basement Plan o U 1/8"= V-O" M D M ` M M N � O 4 I� .. b v A Open Deck Screen Porch 31'-01/2" w w o Kitchen/Family Room Den 0 i i ® Playroom N 4an �- _ -- uWEntryjq, - � N N L �14 4' �31-2' 9'-3 112" CO 'Q K IN Guest Room 14-0" G7 01 N n O D Proposed First Floor Plan i � D N N O V 22'-0" Master Bedroom 1 W C V U. 8'-0" 1T 21/2" closet � �I co 0112-10 N = � ® Bedroom 3 Bedroom 2 Bedroom 4 -O 19'-2" 1T-2" o O N CD n � � O C D n Proposed Second Floor Plan 1/8"= 1'-O" 8 o D'-1 N w O V r� I 11� I I I t I�1 ". I t I I LIT I I.•�I�"!.III j sl l�l L'I I I.I 1111 1 I 'I I�I J I I I_l. I tlf (I :t I II CI111 I.tl IL.I I I II !is III IfI.I.JI ILIA I.:,i��L I. IIII ' I III I !•IIII I: I 1 li�l1. lItl II_I.. 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II-Lf 11 Ll.:ll! 11' ill. 111 t.11.l ..tl f;;.t 111li.Ll1r1 _["1! LL .I I.L.LIiI L .11.4fi ILI t.11111;1.1 L11 t111. I Ilil t_ ' �. .x _k .<X .� II .i:L( II LUf I I!II i:l 1l -.III! L I IJ! I 1.!ll L ll il.l:! I-ll I il!I l t !LI1! ILI L L!I I i:.ill l l il..ltl If I( LIt I tl f'! L�t!,,..d u.ti,-,Ll la4:.1. �!1� I,! .. 1�1 f,xl _I ILL,f11.L_1.I1.aJ..l �!' Iti' �� .�._' ,.a.,11n. .-_a-!.I. I I I .Il.i Proposed Right Elevation Pozen A6 960 Main St-Cotuit, MA July 10,2017 � I ii i'I it I"L' - �/. i � Li 41, I'I I J L..L I I L I-' I I \\• IIII 1 rl 1 jjIrllU IIIIa :1! \\ II I I LI I l l IILI I IIII I \ I I l I I I I. 1 ill I I I I I Irf'I I I� tIJLI JJI II� I I It't I-:I rI II I'1 II l l�l.. \ I.I LtLi II rlfl I t ILIA 111(_1 - II — I — I[�li Ali it I i!I\ IrrI I 1 1 IIII, I. L ' 1' L If tlr 'Ifl Jiy I lLl IttJ. �I_i..II I IC:Lfi II IL1 I I III II L(r. I;I L,J" I11 II!..I 11111 Irll l:it IIr IL. II, 3 III 11.1I 1'i l.: fell I IJ I...I.l IL- .LL I I1.. I .III I IIIII I .0 II I Il I,I.I ll ifI .�II 1111f ttII i.L.tllll ILI I:I I t f IC.I III IIII I I Ir I IIIli 11 11 1LI� I:I I�LI_J I.t7111 II I'I IIII Ll:rl Il ll! CIIIIrI IIII r� - 411 III�LIJJ tII I,I r,ll I I II,111 If�l',I.IIII IIII I,I Il�ll;�fl l�I I I II'LI IIL ll I �- TTI 1-f Proposed Rear Elevation Pozen A7 960 Main St-Cotuit, MA July 10,2017 ' t + r _ t b ! �i��its�r��n«o:r�7ru,'aG �c'��mlati7rs�ra�& gilics of Consumer Affairs&BuSiLess kegkilslion r k i1OMLa IMPROVEMENT CONTRAGTsOR r ReglstratloW N076501, TYpe. ' Eacpira!iI. r 5 pilvate GvrPoratipn PICAFRDl CONSTF�," wIlliam PlCarcli 7 fr 25$T'.trnpNe Road �:',s f i V ;°[•::r:�;=rF�- _.,_ --.._. Soulhbaruugn,IVIA- 017r7 ;c UTSerseeretary ., 12 yr "i #�t�t�•/� ��d_. '' 'h(�' •F7v�' K t�.c 'tt+�%l'(9§' j'd9i'r"�m� ' "��. 4Ys_� ` J��'^l��p,�71 ,���,''`��(r],V•f .� rr.Y A� f�r `1a,ny'�. b NR�`�' M�Ssarh,4 oats �parlrn �1 nl public 2W ,� •5u,�r�l•t���.u4lriSng l`{,�p�:�atio.ns�n�t.'S�ridlant�s W. ILU-AM J-ICiAkbl' f" 755 TURNPIKE RD FfJti +? .4� �t§�te�ts5�c�tseT ,r��2fA8,20'{8 ! `�•�� � rtiS r{+ �'�`Jy�ir 1"+��"4 off,7�.'vx��ref4Y@�� )edr;r�}l,el� �. �'� 4 ^'W'4&t �°b 1•p,4,���Aa"f kh'�t�'h �7 �'"Ytri,�'y;�'/J 7�, S� t '�.�,(d{ i,�c�55N`4i�,'r 11;f,,�d`1�As�> `�' ^,itt 7•if 'ktE�il f� • a Y✓Fa� LFY 251( ry t siy�,Soe�§,14i{d��,, Pr'§ti,'ra r��� �a�t,�F��� ��ra;t�� '�' 4;. r Jr' i. �"E Town of Barnstable Regulatory Services KAB& Richard V.Scab,Director Building Division, Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 - Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ,. a I j L►� ,as er of the subject property hereby authorize - to act on my behalf in all matters relative to Work authorized by this building permit application for. (Addy s of Job) **Pool fences and alarms are the responsibility of the applicant.Pools are not to be filled or utilized before fence is installed and all final ections are performed ted. S tore of Owner Signature of A licant 1} ✓ �A � L Print Name Print Name at _ Q:FORMS:OWNERPERMSSIONPOOLS r r L t J Town of Barnstable Regulatory Service_s ox Richard V.Scali,Director Building Division t &4F2aFrA1= Paul Roma,Building Commissioner i639. &A 200 Main Street, Hyannis,MA 02601 Fp www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village ` 5 ' "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor DEFINITION 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. r 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 YheCommonivealth of Massachusetts Depar'trrferrt aflndasft ia:[Accidents O re ofrnmstigadem . 600 Wizdiington Street Basteon,MA 02HI kkwgv.axtasygorldia NWar•Isers' Cumpensaf an Insurance Affidavit:$mldersICnntractGrslEIecfricians/Pl¢mbers A Iicantluf mn,atian Please Print 'Ill Name�USSID2 nni�aEit�FLnd n�j� �C ryO 1V Address: R� ` City/s atel ig Are you an employer?Cheak the appropriate bo=- ' Type of project(require4- �19 I am a employer with 4 ❑I am a general confractor and I G_ ❑New construction; employees(full andlor part-lime)-* have hired the sub-contractors 2.❑' I am a sole proprietor orpartner- listed authe attached sheet: 7- ❑Remodeling These sub-confrac#ors have slop and have no employees. $_,❑Demalitiaa w Q far a in atrY capacity- employees and have wo&ers' °�� car+f�`- 9. El Building addition�INo s' camp.insurance comp_rnsurarrv_-# - 5. ❑ We are a corporation.and its. 10❑Electrical repairs or additions requLMd j officas have exercised their 3.❑ E am a hameau*uer doing all work I❑Plumbing repairs or additions self o workers' right of exemption per MGI. �5' � - 13-❑Rflofrepairs. . fimzancerequiredj i c.Lit,§l(4�andweh&veno employees.[No worms' 13.❑Other ' comp_insurance mquired_j •AmyappBamt that chedksbo%91IDnst also fMoodthesecctionbeiaarshm4 gthe¢waaerecompensat! upenuifbrmauon_ ffomeovuners who submit tlsis dRdavu=&rating they are dung sll wa l mad tfiffi hire aut mAe camhactors amst submit a new affidavk indicRdmg such-' fC'antmctms irizt check this bcc.must attached=additional sheet showing the nam.,e of the sub-caatksctors and staff whether or not these eaddes have empimyeas.If the solrcantactatskwe employee-%theymustpmvide their markers'comp.policy number. I alrz an empL4,er tfzat Setoiv it tfiepoUcy and jah site trzz5rmatibm Insurance Company.Nt anm: �701ZA I 71-n-5 policy'or self ins.Tic_t AW C 0 O 2.,0 tJM s` Job Site Address ,o�>n ity/State/2tp: C Attach acopy of the workers compensationpolicy ded'aration page showing the policy number and expiration ate). Failure to secure coverage as required.under Section 25A of MGL c 1572 can lead to-the imposition of criminal penalties of a f=e up to$1,50D OD and lGr one-yearimprisouuteuf,as well as civil peuahies.in the fazm of a STOP WORK ORDERand s frme of up to$250-00 a clay against the violator_ Be adcased that a copy of this statement maybe Envarded is the Office of Iuve of a>1c ca y�fr�i� I do hereby cetVfj r a. 'is art zaWes o et�zrz}�thattfze uzfbrirzatiorzprozirf€dabot�` bars lzd correct Sit3rattue: Date: Phone ilk OffleiaL use an[. Do not write in this area;to be crrinp£eted by city ortopr u officiair City or Tam•n.: Pernriff 1cense ff. Issuing Anthor€ty(cirde one): 1.Board of Health 1 Building Department 3.f itrjlrovm a lerts 4.Electrical Inspector 5.Phum-bing•Inspector b.Other Can-tact Person: Phone#. } ormation and Instructions Massar<husetts GES,=al Laws car I52 regre-s all=ployers to provide-WDIk='compersation for their employees. P=MTart-tn this sty,an�Ioyee is deed as_¢-_everpperson m the service of anothmr under any cox�rar aflihe, w„ express or imiplitA oral or write" An mTky n-is defined as an individual,partnership,association,corporation or other Iegal entity,or any two or more of the-foregoing engaged m a Joint muterprise,and including the Iegal Fepresesda&es of a deceased employer,or the receiver or tmstee of as mdiyidnal,partnership;associa I. or other legal entity,enhployittg employees. However the owner of a dwelling house having not more than tbree apaltmeats and who resides therein,or tide occupant of thhe _ dwelling house of another who maploys persons to do maIh tm ce,construction or repair waik on such dwDI ing house tam Ihereto shallnotbecanse of such e aploymentbe deemedto be an employer." or on.the.grounds or bm�app MGL cbapt--r 152,§25C(6)also stains that"every sftz or local lhcensmg agency shall withhold ffie issuance or _ renewal of a Iicrose or permit to operate a buskess or to construct hurZdmgs zn the commonwealth for any applicantwho has not produced acceptable evidence of compHanm with the ffiii-�r:ce cov6ragerequired_ Additionally,MGL chapter 152,§25dM states- Neither tie ca-.guweaIa nor any of.its political subdivisions shall enter min any c0=trad fnrfh-e performance ofpublio�oiicux�Z aneepf�Ie evidence of compliancewith:tlie mi ce. teahave been enlndto the co 3t7ar1��a�iMitt " regr�enie�of thus.chap Prey �,- Please fill obf the wormer'compensation affidavit completely,by cherlozhg ffie boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone numbers)along with their certificatt.(s)of mnm ance. Limited Liability-Companies(LLC)or Limited Li.ability-Partnerships(LU)with no employees Other than the members or partners,are not rNQi]md to carry workers' compensafron instn-�ce. If anL LC or LLP does have e To ees a policy is B e advised tbaf thus affidavit may submi�d to the Department of Industrial mP- Y , P Y - Accidents for confirmation of fi s n7ance coverage_ Also be sure to sign and date the affidd,n The affidavit should 9 be reinmed to the city or town that the application for the permit or license is being req'uestec�not ihle Depar1c of I�strial Accidents. Shouldyon have.any gaesfhons regarding the law or ifyon are regolred to obtain a workers' compensation p"orrcy,Please call t�.e Department at the number listed below. Self-fimued companies should enter ijieir Self—insurance license number on the appropriate Ime. City or Town Officials e b ottom . Please be sore that the affidavit is complete and prim '1 primed legibly. 7he Depariinenthas proaided a sPace .atti of the affidavit for you to fl out in the event the Office oflnvestigations has to con -tyouregardingthe,applicant Pleas e be sin c to fill in tihe p= iVIicrose number which:wffi be used as a iefmrence number. In addition,an applicant that must sabmil m-ubipIopmnitll c=D applitafi=;a any gtvenyear,new only;sobmit ane�affidavit iadirafmg cm 'nt policy bIfb nation(if neces`azy)and under"Job Site A ds�ress"the:applic�t should write"aII locate ns n (cfiY oz town)-"A copy of th-,off dav:t that has beea officially stamped or maimed by the city or town"may.be provided to.the applicant as proof that a valid affidavit is on file for fatm: .-P zmits or Iieanses. Anew affidavit must be filled oat each year.Where a home owner or citizen is obtaining a license or permit not related to;any business or`commercial vez e (ie_ a dog license orpennit to bum leaves etc.)said person is NOTto comg�lete this affidavit The Office of Investigations would like to thank you in. tv a -mce for your cooperation and should you have any qu estrous, please do not hesitate to give us a call. The Deparfinent's address,fiElephone and fax 1 IIm er Thtcanrtt of c1� t#s • � '�, 14� I�ega��nfi t�f Iztd�:ia1 A�ci�-�n� - ^� p _ BaszuzM4 Q111 Tf,-L 4 617 7-4900 Qxt 406 Qr 14M-MAS� Fax 9 617-727 7749 xevisr-a 4-24-07 p snas �Q�*fdia ? G-07-2017 !r 11 11 4�9- AM P. OIJ1 . r CERTIFICATE OF LIA ILI"TY INSURANCE' DATE(MNUDD.YYYYj 04118/2017 THIS CERT[FICATE tS 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 IiIY THE POLICIES BELOW. THIS CERTIFICATE.' OF IN$UkANCE DOES Ndf CONSTITUTE A CON-TRACT BETWEEN THE ISSUING INSURER(S), AUTHORi2E0 RE-PRESENTATIVE OR PRODUCFR,AND THE CERTIFICATE HOLDEN. _ IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(tes) must be endorsed, If SUBROGATION 19 WAIVED,subject to the terms and conditions of the policy,certain polloies may.require an endorsement. A statement on this certificate dogs not confer.rights to the certificate holder in lieu of such endorsament(s). PRODUCER Sharon Greenwood NORTHSTAR INSURANCE SERVICES INC PHONE WAIL LOREss: sgreeawood@nsins.corn 300 FIRSTF,VENUE SUITE 300 INSURER(C AFFORDINGCCVERAeE___—__ wUc+1 N[E_DHAM —� MA 1212484 IASLIRERA! AIM MUTUAL INS CO ri^ 33755 INSURED � '- — INSURER Bar - PICARD[CONSTRUCTION CO INC REMODELING CESIGN SHOWROOM INC AND INsunI:R e PIC,ARDI CONSTRUCTION CO INC SEE SCHEDULE INbURER1D- _ � --- 255 TURNPIKE ROAD INSURER EE— SOUTHBOROUGH MA 01772 INSUREst F: COVERAGES CERTIFICATE NUMBER. 144719 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTEh®FLOW HAVE BEEN ISSUED TO T'HE INSURED NANIEO ABOVE FOR THE POLICY PERIOD INDtC;A.TED. NOTWITHSTANDING ANY REQUIRE'KiENT,TERM OR CONDITION OF ANY C40NTR4C'T OR OTHER DOClrMENT"W17H RESPECT TO WHICH THIS OERTIFICA?E MAY 6E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI..THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS. NSR ADD L SUBR. POCY SFF POLIO EXP --� LT't LI TYPE OF INSURANCE PO CY WUM©s,R umloo/YYYY MIND71YYYY - -- LIMITS L'OMME;RCIAI.G£AERAL LIABILITY WCH UCCIJRR£NCE i ,LAiM8-MADJ; ��OCCUR I DAMAG"ET6R=NTED ' --- _ PRE-MISES1F8 paw rent _-- --• t I MED�E:<P An anc anon $�. .,r ®_ __--_ —_ ` N/A PERBOhIAI iS AC7V INJURY $ OENL.AOGREGAT£UM7AP?I_IEa PER: 143ENERAL.AGGREGATE 6 POLICY Ej JECT LOL' PRODUCTS COMPrOPAGG $ y' _ OTHER: r S AUTONOBILBLIABILITY COMBINED SINGLE LIMIT 3 r5cciden1l _ A Y AUTO ROCtLY INJURY(Per pa'arn) S ^ u1.`�USiNcU �1��UT�ULEG --- ----- i�l/A BODILY INJURY(Per 90:ideni) S tllkEt?AUTOS SN008wnlio PPAPER-YDAM.AZE b AUTOS U>HBMLLA6LNU L� OCCUR - ------FFA CGURR6NCk, S F1CF.SsuAB I OLAIMSAIADE 141A A30REOATE $ --Ip--�EO RrzTF-NTIQNs � $ I wilRKERS COMPENSATION —� P "T•r�TI+ i AND£MItLOYERS'LIAMUTY Y!rI X r. ANYPROPRIETORIPAR7JZ-,KFXECUTIVE I E,I„FACHh(',CIDENT' 5 5t10,0pG A OFFICERIMEMBERExCLLDED7 N1A NIA NIA AWC4007020$$>32017A 03115/2017 i 03115/2018 -- -- t�es dascfte:uno€ j r.L.01L A3E-EAEMRLOY $ 504,0UU I)LBORIPTIINtOPOFOPEFWTIONBtsiaw A 1 E.LGISEASE-PCIICYLIMIT It 600,000 N/A 0 DCIUPTION OF OPERATIONS t j OC,A'FIONS r VEKICLES(ACORD 101,Additional Redraeka Sohtfid1b,Mqy he Atta0aal 11 morn epeae 1a required) Workers'Compensation benefits will he paid to Massachusatts amployeas only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states other Than Masswc h+Jsetts if the•Insursd litres,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy In force on the date thstthls certificate was iaeued(unless the expiration date on the above pr icy precedes the Issue date of this certificate of insuranca). The status of thls coverage ran be Irlanitored daily by ac.essing the Proof of Coverage-Coverage Veriflceton Search ool at vnww.mass.gcnitNdlwortcsrs-contpensetlonRnveat)gations;. CER11FIC.ATE HOLDER—--- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POOCiES BE CANCELLI9D BEFORE THE EXPIRATION DATE THEREOF, Narice WILL DE DELIVERED IN Picardi Construction Inc- RedWood Deck Co IT1G ACCOI�RANCI WITH THE POLICYPROY19lONS. 255 Turnpike Road ------�— kUTNORIZLL kEI'RESFN'rAT+YE Southrouoh MA 01772 Y Llarr;al tJt.CrdW CaCU,Vice President—FtF,sidua!Market—WCFJBPAR 1988.2014 ACORD CORPORATION.. All rights reserved. ACORD 25(2014/01) The ACORD name and Ingo are registorad marki of ACORD G-i1 r-2.i 1 , P'q'1� 11 'r r; CERTIFICATE OF LIABILITY INSURANCE DAviciMMiochW'r) T THIS CERTIFICATE IS ISSUED AS A MAI-ER 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 DDES NOT CONSTITUTE A CONTRACT BETVVEEN THE ISSUING iNSURER(S), AUTHORIZED REPRIESENTATIVE OR PRODUCER,AND THE CERTIFICATE MOLDER. IMPORTANT, If the certificate holder la tan ADDITIONAL INSURED,the poltoy(fes)must be endorsed, If SUBROGATION IS WAIVED,8"bjact to the terms and conditions of the pollcy,cartafn policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lig�u of such endorsement(s). PRODUCER NAME: Sharon Greenwood _ NORTHSTAR iNSURANCE SERVICES INC iAaN6 781)431,2500 fa _— �DREss: sgrean►vood�nsins_rom --J` 300 FIRST AVENUE SUITE 300 _ Itasu slAFPORDIH caHr RA�e- -----�-- Irnacs NEEDHAM MA 02494 tI4WRsaA: AIV.MUTUAL INS CO 33768 INSURM INSURERS: REDWOOD DECK CC INC. 255 TURNPIKE ROAD INSURER ---i-- 5OUTHBOROUGH MA 01772 Iffiqur<ERF; COVERAGES CERTIFICATE NUMBER; 144716 REVISION 14UMBER: THIS Is-in CERTIFY THAT YHE POLVES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWiTHETANDINC ANY RE-QJIREMENT,TERM OR CONSITiON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BF= ISSUED OR MAY PERTAfN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EX LUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS s?iOVVM MAY HAVE BEEN REDUCED BY PAID CLAIMS, LNBRR —:TYFEOF[N3UP.ANCE — NDLICYNUMBEFI PQLlCYFPF POLIC P �— LIMITS — COt9NIERCIALGENERALLIAeILitY EACH OCCURRENCE $ CLAIMS•AAAD6 O OCCUP, MTL$ �u D���$ ^" �ME,D EE%P kny we Person) —I$$ -- _ NJA I Fl RaraNAL S ADV INJURY $ GRN'LAGGRE9ATE'_IMIT APPLIES aCR; GENERAL AGGREGATE t;w POLICY PRO. I i LOG J6(:T L� PROp11CT&-GOMPIOP ACIA3 $ OTHER: _ S AJTomdRIU UASLL15'Y COMBINED SINGLE LIMIT $ ANYAOTC BODILY ROURY(Per pereon) 5 ALL OWNED i I SCHEDULED AU`7GS L_AUTOS WA i j BODILY INJURY(Pcr mo uldcnk) $� I NON-OWNED I-PROPFStT1'DAMAGE HflEbAUTC$ —J AUKS I fPnreucldrntl____ _ UMBRELLA LL48 f EACH OCCURRENCE $-` EXCESSLIAe CL4IMS,AAAD£ N/A AGGRE�GA.TE �- $ --- OED I RETENTION 5�„��� WOg0RACONIPENSATION FER oT1i, AND EMPLOYERS'LIABILITY !STATUTE I _ A �AtJYPROPRIETORiPARTNr-R F-XKLITIVr Y/N E.L.EACH ACCIDENT s 500,DD0 UFFii%ER;'MEMdERE,MGLUVFQ? NIA NaA N1A pVirC4pG7Ad,�b6t32Q't7A 03/1 12017 03/151d{718 — I Wandatory In NH) E,L.CISE{1SE- 1 EMI'�L�Y $ 500,000 DDN ,t,daget1be u'lLer RIPTION OIL OPCPERFTIO AS 41:cnv _— E,L.DlBFA"E-POLICY LIMIT . 500,000 I NIA DESMRlPTtON OP OPERATIONS r WrATIONs;VDW1V..Le,s(AGORD 161,Adulttonel Renlerke schedule,tray b6 AUAched If more apace le inquired) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 03 B,no authorization is given to pay 019)m3 for benefits to employees in states other than Massachusetts If tho Insured hires,Or na.S hired those Amployea6 outside of Massachusetts. This ceriifcate of insurance shows the policy In force on.tho date that this certificate was issued(unless the expiration date an the above policy precedes the issue date of this certificate of insur€anos). The status of thls coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwdtworkers•compensotlonJinvastigeWnel. CERTIFICATE HOLDER A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL.48D 0F.FoRE THE FXPIRATiON DATE THrREOF, NOTICE WILL SE DELIVERED IN Picardi Construction Inc- Pedwcicd Deck Co Inc ACCORDANCE WITH THE POLICYPROVir,*Ng 1,55 Turnplk.e Road AUT MORK15O RE PR E BE N TATI VE �a so Jtnbornugh MA 01772 D JI M.Crq y;CPCU,Vice President,-Residu21 Market-WCRIBMA G 1988•b014 ACORO CORPORATION, All rights reserved. ACL]RD 23(201410'1) The ACORO name and logo are registered marks of ACORD r DATE: September 2i 2017 FoaM 9nsula#ion P ► Owner/Contractor STTF ADDRESS Bill Picard! ;960 Main 5i3 CotUlt MA Clare out letter for the-project Closed Cell GC® Western Aged R value 7.2 Per Inch Thermal Paint Paint to protect DC-315 Open Cell Lappola Foam Loc 500 Aged R Value 3.9 Per Inch INSTALLATION OF SPRAY FOB INSULATION IN,'6 HE-FOLLOWING AREAS LAREA OF APPLICATION Foarn V Approximat - - — - Derr! a R-Far First and Second floor exterior To Code walls Open Cell Greater than der inch Roofline _ _ Open cell R,-40 Thermal paint to exposed spray Paint to µ, do-315 foam basement space rgt-e t_ Foam Insulatlon P.O.Box 2582,Westwood,MAM-2S8-1001 Fax781-320-1177 f T n J17 :,.0 _i� _'1 M�U� on T " A"iniTHR m ot# DATE: September 21, 2017 Foam Insulation � � I Owner/Contractor SrTE ADDRESS Bill Picard Cotugt hole,, MA .ATTIC: AM Green Star Poam Is pleased to provide you with a spray foam 411sulation quotation based on the requirements determined at the site address listed above. SUPPLY AND INSTALLATION OF SPRAY FOAM INSULATION IN THE FOLLOWING AREAS: j AREA OF APPLICATION i Foam S�tl.�,^ -Approx. PRICE— As Discuses At Site Walkv Oensit _ R.-Factor _.__._------ na floor Roofline — Open cell 1914 :�.11„38 $6,567.00 21d floor aVralls?.X6 +i3 a cell 300 _ R-21 �52 .00 Ana 0+or walls 2x4 __- �- --Open-call 313 R16i $363.00 Fiat floor roof I Open cell 335 First 7Plp0g walls ,p. (B n cell 1466 To cods $1,913.00 __-- Sound ceiling flr!t floor ----------- batt 19o0 1300,04 Sound walls bathrooms bate _ 275 _A2TP.0 Basement walls Classed cell 1449 R14 — 3 614.00 Basement Ibloclters — — -- -Closed call R21 Thermal point where needed in the basment � � j 3k Terms and Conditioraaa 1. payment Is due In full upon completion of spray foam insulation application. 2. unless stated above,windows and ignition; barrier may not be included in the price. 3. Pricing listed above Inciudes taxes, 4. Ail mechanical/electrical work to be completed and Inspected prior to spray foam application. S. The material will have high and low spots, however the R-factor is averaged throughout the application. 6. Owner/bulider to ensure that other trades remain clear of area during installation. 7. A building permit is necessary on some jobs there will be an additional charge to obtain one, 8. Owner/builder to ensure that area to be sprayed Is free and clear of all obstructions. 9. Owner/builder to ensure that Green Star is afforded truck access to the site address. 10. Any additionsjdeductions or extra charges must be approved in writing by Green star,and the miner/builder. M The area/home sprayed must be dear for.24 hours in order to let the area air out per the spray foam i.1i erlbuilder shall discharge and save Green Star harmless of any liens or encumbrances against land, chattels in eonnecdon with the goods and services supplied within this quotation. i t indicating your ac mptance of the pricing, terms, and conditions of this qwi Cation. Foam Insulation PA Box 2982,Westnood,MA 02090 (781)810-055 AM 505 Deer Ridge Lane Ara,El,VA 24C53 aRnDeer Ridge Consulting, Inc. Ofica:M-755-91i]12 .;-61)c U -441-*54 hate, January 23,2017 Subject, Altecnati,,e ignition Banner Assombliei DC315 Fireprocrf Paint., Lnternational Fireproof Technology,Ir,.c. TO WHOM IT MAY CQNCE)RN, The purpose of this letter is to clarify the use of DC315 F.�.-F.pzoof Paint as a coating over SPF (sprey pollwiret'hane foarn)to qualify and recognize that FSSOIftibly as an Alternative Ignition Barrier Assembly. 1. IFTI(Internatioaal Fireproof Technology,Inc,)currently has a CCRR(Cods Compliance Rewai-cl-, Report)issued by Intertek and desipated as CCRR-1076, 2. CCRR-1076 iecogijizes tl,,e use o-,F'DC315 as a;;ouiponur inAlternate Thermal Barrier Assemblies as required under AC?77 (.April 2016) isad under AC4-56 ('October 2015). Assemblies recupized undm-these two criteria maybe found ire CCRR-10 76 or the SPF manufacturer's individual evalustior. report, Recognition in either location is,valid and fully compl;=t. 3, AJterna4ve(gnition BiLyrier Assemblies are not included in CCRR-1 076,The reason is that AC3 7') does not require fire-protective coatings used as a. component in Alternative Igmtion Barrier As=-zbhes to be compliant with.AC4.56. 4. To verify that Alternative lgnition Barrier Assemblies DC315 as a component are valid and tecogri�ized, refer to the individual SPF manufactuter's evaluation reports. Those SPF evaluation reports provide specific information regarding UrWtations as to SPF tNichwss,DC315 thickuess and DC315 applicat:ion rates. AR Alternative Thermal Baxyier Assemblies and AlteTratilkle.Ignition Barrier Assernbhes 1-ecognized in evaluation reports employing DC315 as a coniponenthave been tested via bvildbag-code compliant ful].scale test protocols. 6. For additional information regarding igsifioa barriers and thetaial barriers; refer` to SPFA-1126 Therrned Barriers and)gnffiort Barriers for the qprc.y Polyurethane Foam IndiatrY available at Respectfidly suboijitted, Deer Ridr.Consulting,Inc, Roger V.Morrison,PE,RRC Presidont A66 xis 9co FOAM-LOW 500 F0AMM11.6$1r Open-Cell Spraylnsulation SPRAY FOAM INSULATION ICC ESR-2847 Product Use and Design Physical Properties FOAM-LOK-500 is an Open-Cell spray applied foam,which when installed Test Method/ following application guidelines,adheres tenaciously to framing members Properties Requirements Value and substrates. FOAM-LOK— 500 provides superior energy economy and durability while significantly reducing unmanaged moisture and air Aged"R"Value ASTMC518 3.9 per inch infiltration. f Core Density ASTM Di 622 .4-.61bsJft3 FOAM-LOK"500 forms a completely sealed air barrier in wall cavities and Open-Cell Content ASTM D2856 >94% can be used to fill 2"x 6"stud wall construction in a single application.Its Tensile Strength ASTM D1623 3 psi performance is superior to commonly used fiber-glass batt or blown-in Air Permeance ASTM E283-04 <0.02L/s/M Z at 4.5 inches insulation. It adheres well to most building materials and will provide a continuous barrier against air infiltration for the life of the building. As a Dimensional ASTM D2126 3% component of a"systems"approach to proper building envelope construction Stability:28 days at 15%max by in both residential and commercial construction,FOAM-LOK—500 provides 160°F,100%RH volume change exceptional performance in reducing heat transfer. ASTM E413-2004 Sound Transmission Class 41 Recommended Product Applications Sound Transmission ASTM El332-90 Indoor-Outdoor Transmission Class 30 •Walls •Attics •Floors •Crawl Spaces ASTM C423-02a Noise Reduction Coefficient 0.10 •Ceilings •Vaulted or Cathedral Ceilings Moisture Vapor ASTM E-96 1"-22 Perms Transmission 2"-15 Perms Recommended Processing Parameters Flammability ASTM E970/ .19 .rocessi >0.12 ng Designation Regular Ambient Temperature 20"F-120"F Flammability NFPA 259 1812 BTU/ftz 20.6MJ/mz Optimum hose pressure and temperature may vary as a function of the type of Credentials/Certifications equipment,ambient and substrate conditions,and the specific application.It .ICC ESR-2847 is the responsibility of theapplicator to properly interpret equipment tec hnica I literature, particularly information that relates acceptable combinations of FOAM-LOK"500 is a Class I formulation,as Tested per ASTM E84,and gun chamber size,proportioner output,and material pressures. possess the flammability characteristics shown:(UL 723,NFPA 255,UBC 8-1) Processing Des ASTM Method E84 Class I Equipment Dynamic Pressure 1,100-1,500 psi Flame Spread <25 Preheat Temperature 110-135°F ,. Smoke Development <450 Hose Heat Temperature JT6-135 F x R �H ASTM E-1354 PASSED .,P Drum Storage Temperature�6 65 85°F ASTM E-119 1 Hour Non Load Bearing Wall-Wood or Steel (18-29°C)i ,.7 Hour Non Load Bearing Wall-Wood Shelf Life: 6 months when stored properly. l ; 1 Room,torner Fire Testing* 51 -r *NFPA286 2:1 transfer pumps are recommended for matenal transfer from contarner � may, m-�r- - ti Location r rckness ttSPFThi to the proportioner. Wall and Ceilings ;L 'k Up to 1 Z in(3t)5 mm)t a -CAUTION Extreme care must:be Aaken _ wa removgadesa ll rAPa vesdrfied NOT toreverse_the AdBcmponents NFPA6 drum transfer pumps soas e ndixX �!&4�arA�`3;i Walls `" t13 [Uplo Up toS'SO inches Donotcirculateormixothersuppliers A or"B cornponentmtoFOAM-LOK" Ceilings 1150mches contain is _ E ) i 4' 3 4Wetmils/3 Drymils FIRE LOK/DC31S.Regwred The lural coin Went prop rtioner must be ca able of su m each i p po P Po P pplY 9 t component within+2So of the desired 1 1'mixmg ratio by volume. ;."T ESE VALUES REFER;TO TIE TOTAL THICKNESS OF THE PRODUCT �' 1 TESTED, 'NOT THE MAXIMUM THICKNESS', ALLOWED PER PASS OR _ 3td � ) ) f r APPLICATION.THIS FOAM MUST NOT BE APPLIED IN `El(CESS OF 6 INCHES PER APPLICATION THE:fOAM SHOULD BE ALLOWED TO{OOL Lapolla Industries, Inc. 1 15402 Vantage Parkway East, Suite 322 Houston, Texas 77032 1 (888) 4-1-apolla 1 lapolla.com M nN FOAM-LOIN 500 FOAMm[L(DIX Open-Cell Spray Insulation SPRAY FOAM INSULATION ICC ESR-2847 Rev.Date 01123120V FOR 10 TO 20 MINUTES OR UNTIL THE SURFACE TEMPERATURE In Case of Spills or Leaks HAS RETURNED TO AMBIENT BEFORE ADDITIONAL APPLICATIONS Utilize appropriate personal protective equipment OF FOAM ARE ATTEMPTED. FOAM APPLIED IN EXCESS OF 6 INCHES OR WITHOUT ALLOWING FOR COOLING MAY RESULT IN,BUT IS NOT Ventilate area to remove vapors LIMITED TO EXCESS HEAT BUILD-UP AND COULD RESULT IN FIRE OR Contain and cover spilled material with a loose,absorbent THE GENERATION OF OFFENSIVE ODORS THAT MAY NOT DISSIPATE material such as oil-dry,vermiculite,sawdust or Fuller's earth WITH TIME. Shovel absorbent waste material into waste containers proper • Wash the contaminated areas thoroughly with hot,soapy water Thermal Barrier Report sizeable spills to proper environmental agencies IRC and IBC codes require that SPF be separated from the interior of a building by an approved fifteen(15) minute thermal barrier,such as 1/2"gypsum In Case of Fire wall board or equivalent, installed per manufacturer's instructions and corresponding code requirements.There are exceptions to the thermal Extinguishing Media: Dry chemical extinguishers such as mono ammonium barrier requirement: (1) Code authorities may approve coverings based phosphate, potassium sulfate, and potassium chloride. Additionally, carbon on fire tests specific to the SPF application.For example,covering systems dioxide, high expansion (proteinic)chemical foam, or water spray for large fires. that successfully pass large scale tests may be approved by code authorities in lieu of a thermal barrier;(2)SPF protected by 1"thick masonry does not Positive pressure ventilation of the work area is recommended to need a thermal barrier.Certain materials that offer protection from ignition; minimize the accumulation of vapors in the work area during the called"ignition barriers,may not be considered as thermal barrier alternatives application.Improper application techniques of this foam system must be unless they comply with NFPA 286 or other similar full scale tests.Applicators avoided. This includes excessive thickness,• off ratio material, and should request test data and code body approvals or other written indications spraying into rising foam. The potential results of improperly applied of acceptability under the code to be sure that the product selected offers materials may include but is not limited to excessive heat build-up,and code-compliant protection. may result in a fire or offensive odors which may not dissipate with time and/or poor product performance due to improper density of the applied Safety and Handling material. Large masses of sprayed materials should be avoided.When large Respiratory protection is MANDATORY! Lapolla requires that supplied air masses are generated they should be removed from the area,cut into small and a full face mask be used during the application of any spray applied pieces and allowed to cool before disposal. Failure to follow this foam system.Contact Lapolla Industries for a copy of the Model Respiratory recommendation may result in a fire. It is recommended that a fire Protection Program developed by CPI or visit their web site at www. extinguisher be located in an easily accessible portion of the work area. polyurethane.org. Persons with known respiratory allergies should avoid exposure to the "A" component. The "A" component contains reactive DISCLAIMER isocyanate groups.The materials must be handled and used with adequate The data presented herein is not intended for use by non-professional ventilation.The vapors must not exceed the TLV (0.02 parts per million) applicators, or those persons who do not purchase or utilize this product in for isocyanates. Avoid breathing vapors. Wear a NIOSH approved respirator. the normal course of their business. The potential user must perform any If inhalation of vapors occur, remove victim from contaminated area and pertinent tests in order to determine the product's performance and suitability in administer oxygen If breathing is difficult. Call a physician immediately.Avoid the intended application,since final determination of fitness of the product contact with skin,eyes,and clothing.Open containers carefully;allowing any._, for any particular use is the responsibility of the buyer. pressure to be relieved slowly and safely._Wear chemical safety goggles and rubber gloves when handling or%working with,these materials lnta'se of All guarantees and warranties as to products supplied by Lapolla F ' Industries shall have only those guarantees and warranties expressed in eye contact, immediate) flush with lar e^amounts of water for at least Y 9 p fifteen minutes.Consult a physiciar%.immedfately an case of skin contact,xj writing by the manufacturer.The buyer's sole remedy as to any material wash area withs?Wp and-water.Wash clothes before,reuse. claims will be against the applicator of the product.The aforementioned data on this prooducWs,.to be used as a guide and is subject to change S x Applicators should ensure the safety of the jobsite and construction personnel without tnotleThe mfoaonherein is believed to be reliable, but b posting appropriate si ns wamin that all"hot work such as welding, unknown, risks maysbe present NO WARRANTIES, EXPRESSED,OR�, Y P 99 9 9 soldering, and cutting with torches should take place no less than 35 feet._ IMPLIED; INCLUDINGtPATENT4WARRANTIES OR ,WARRANTIfES� OF from any exposed foam. If "hot work must be performed all spray.. _ of MERCHANTABILITY ORFITNESS FOR USE;'ARE MADE BY LAPOL�LAA WITH urethane foam'-should'`be c overed with%an appropriate fire or welder s..- ,fRESPECT TO OUR PRODUCTS Oft INFORMATION SET FORLH HEREIN. blanket,and a fire watch should beprovided r � ICC icj rt J i. �..� T016 best of ow knowledge the technical data contained herein is trua and accurate at the dete ofissuance and is subject to charW withoufprw notice.Uselmust contact Lapolla Industries,Inc.to Verily correclrress before.specdying orordenn IHo guarantee ofaccuracy i5 given or implied.We guarantee ourproduds to conform to Lapolla tndushies,Inc'st7uaidy corltiol pe W+e assume no responslbilAy fob covera9o, Prmarl eoor iyuries res_tAng from X Copyright®2016 Lapolla Indusfias bi It fights reserved.Lapolla®and Foam-LOK—are trademarks of Lapolla Industries,Inc.in the US and other countries. • Lapolla Industries, Inc. 1 15402 Vantage Parkway East, Suite 322 Houston, Texas 77032 1 (888) 4-Lapolla 'I lapolla.com WidelyMost ICC EVALUATION • i - i and Trusted c SERVICE ICC-ES Report . 4 This report is subject to renewal 09/2017. DIVISION:07 00 00—THERMAL AND MOISTURE PROTECTION SECTION 07 2100-THERMAL INSULATION REPORT HOLDER. LAPOLLA INDUSTRIES, INC. 15402'VANTAGE PARKWAY E HOUSTON,TEXAS 77032 EVALUATION:SUBJECT: FOAM-LOK FL500 (ALSO�`KNOWN AS AIRTIGHT OC, GUARDFOAM 55-OC OR OPEN CELL RETROFIT FOAM) SPR�►Y FOAM INSULATION ICC ICC C PM G LISTED Look for the trusted marks of Conformity! �h� "2014 Recipient.of Prestigious Western States Seismic Policy Council ���� WSSPC Award in Excellence" �ptERxanuNn� � A Subsidiary of CODE�IIMpC ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not 9FA specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a I 'r recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as to any finding or other matter in this report,or as to any product covered by the report. PROMCERMNUM Copyright 0 2015 ICC Evaluation Service, LLC All rights reserved. FICC NS 1 / i'SERVICE WidelyMost IMES Evaluation Report ESR-2847 Reissued September 2015 This report is subject to renewal September 2017 www.icc-es.org 1 (800)423-6587 ( (562)699-0543 A Subsidiary of the International Code Council® DIVISION:07 00 00—THERMAL AND MOISTURE rated wall assemblies when constructed in accordance PROTECTION with Section 4.5 of this report. Section:07 21 00—Thermal Insulation 3.0 DESCRIPTION REPORT HOLDER: 3.1 Foam-LOK FL500: Foam-LOK FL500 spray foam insulation is a low-density, LAPOLIA INDUSTRIES,INC, cellular polyurethane foam plastic that is installed as a 15402 VANTAGE PARKWAY EAST,SUITE 322 nonstructural component of floor/ceiling and wall HOUSTON,TEXAS 77032 assemblies. The material is a two-component, open-cell, (281)219-4100 one-to-one-by-volume spray foam with a nominal density www.lai)olla.com of 0.5 pcf. The polyutherane foam is produced in the field by combining an isocyanate "A" component and a EVALUATION SUBJECT: polymeric resin "B" Component. The components have a shelf life of six months when stored in factory-sealed FOAM-LOK FL500 (ALSO KNOWN AS AirTight OC, containers at temperatures between 50°F and 80°F GUARDFOAM 55 OC OR OPEN CELL RETROFIT FOAM) (10"C and 27°C). The insulation liquid components are SPRAY FOAM INSULATION supplied in nominally 55-gallon drums. 1.0 EVALUATION SCOPE 3.2 Surface-burning Characteristics: Compliance with the following codes: The insulation at a maximum thickness of 5.6 inches (142 mm) and a nominal density of 0.5 pcf, has a flame- s 2012 and 2009 International Building Code®(IBC) spread index of 25 or less and smoke-developed index of ■ 2012 and 2009 International Residential Code®(IRC) 450 or less when tested in accordance with ASTM E84. ■ 2012 and 2009 International Energy Conservation 3.3 Thermal Resistance(R-values): Code®(IECC) The insulation has thermal resistance (9values), at a ■ 2013 Abu Dhabi International Building Code(ADIBC)t mean temperature of 75°F(24"C),as shown in Table 1. 'The ADIBC is based on the 2009 IBC.2009 IBC code sections referenced 3.4 Air Permeability: in this report are the same sections in the ADIBC. ? Foam-LOK FL500 spray foam insulation at a minimum ■ Other Codes(see Section 8.0) thickness of 41/2 inches (114 mm) is considered Properties evaluated: air-impermeable in accordance with IRC Section R806.4, based on testing in accordance with ASTM E283., ■ Surface-burning characteristics 3.5 FIRE-LOK/DC 315 Fireproof Paint for Foam: ■ Physical properties FIRE-LOK / DC 315, manufactured by International ■ Thermal resistance(R-values) Fireproof Technology , Inc., is a water-based coating ■ Air permeability supplied in 5-gallon (19 L) pails and 55-gallon (208 L) ■ Attic and crawl space installation drums and has a shelf life of twenty four months when stored in a factory-sealed container at temperatures ■ Fire-resistance-rated construction between 50"F and 80°F(10"C and 26.7"C). 2.0 USES 4.0 INSTALLATION Foam-LOK FL500 (also known as AirTight OC, 4.1 General: GUARDFOAM 55 OC or Open Cell Retrofit Foam) spray Foam-LOK FL500 spray foam insulation must be installed foam insulation is used as a nonstructural thermal in accordance with the manufacturer's published insulating material in buildings of Type V construction installation instructions,the applicable code and this report. under the IBC and dwellings under the IRC. The insulation A copy of the manufacturer's published installation is for use in wall cavities, floor assemblies or ceiling instructions must be available at all times on the jobsite assemblies and in attic and crawl space applications as during installation. described in Section 4.4. Foam.-LOK FL500 spray foam insulation may be used as an air-impermeable insulation. 4.2 Application: Foam-LOK FL500 may also be used in fire-resistance- The insulation is spray-applied on the jobsite using a ICGES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use.There is no warranty by ICC Evaluation Service,LLC,express or implied,as to any finding or other matter in this report,or as to any product covered by the report. M Copyright®2015 ICC Evaluation Service,LLC. All rights reserved. Page 1 of 4 r ESR-2847 I Most Widely Accepted and Trusted Page 2 of 4 volumetric positive displacement pump as identified in the following conditions: LAPOLLA application instructions. The Foam-LOK FL500 a. Entry to the attic or crawl space is only to service resin B" component must be stored at temperatures between 50°F (10°C) and 80°F (27°C). The insulation is utilities,and no storage is permitted. used in areas where the maximum ambient temperature is b. There are no interconnected attic or crawl space areas. equal to or less than 180°F (82°C). The foam plastic must c. Air in the attic or crawl space is not circulated to other not be used in electrical outlet or junction boxes or in parts of the building. contact with water. The foam plastic must not be sprayed d. Attic ventilation is provided when required by IBC onto a substrate that is wet, or covered with frost or ice, loose scales, rust, oil, or grease. The insulation must be Section 1203.2 or IRC Section R806, as applicable, protected from the weather during and after application. except when air-impermeable insulation is permitted in The Foam-LOK FL500 insulation may be spray-applied in unvented attics in accordance with Section R806.4 of one pass up to the maximum thicknesses specified in the IRC. Under-floor (crawl space) ventilation is Section 4.3. provided when required by IBC Section 1203.3 or IRC 4.3 Thermal Barrier Section R408.1,as applicable. . e. Combustion air is provided in accordance with IMC 4.3.1 Application with a Prescriptive Thermal Barrier. (International Mechanical Code)Section 701. The Foam-LOK FL500 spray foam insulation must be separated from the interior of the building by an approved In attics, the insulation may be spray-applied to the thermal barrier of '/z-inch-thick (12.7 mm) gypsum underside of roof sheathing or roof rafters, and/or to wallboard or an equivalent 15-minute thermal barrier vertical surfaces; and in crawl spaces, the insulation may complying with, and installed in accordance with, IBC be spray-applied to the underside of floors and/or vertical Section 2603.4 or IRC Section R316.4, as applicable. surfaces. The thickness of the foam plastic, applied to the Thicknesses of up to 12 inches (305 mm) for ceiling underside of the top of the space, must not exceed cavities and 12 inches (305 mm) for wall cavities are 11 /2 inches (292 mm).The thickness of the foam plastic applied to vertical surfaces must not exceed '/ recognized based on room corner fire testing in PP 5 z inches accordance with NFPA 286,when the insulation is covered (140 mm). The foam plastic must be covered on all with minimum '/z-inch-thick (12.7 mm) gypsum wallboard exposed surfaces with the FIRE-LOK / DC 315 coating, or an equivalent 15-minute thermal barrier complying with, described in Section 3.5, at a minimum wet film thickness and installed in accordance with,the applicable code. of 4 mils(0.10 mm) (dry film thickness of 3 mils(0.08 mm) or 1 gallon (3.8 L) per 400 square feet (37.1 m)). The 4.3.2 Application without a Prescriptive Thermal FIRE-LOK / DC 315 coating must be applied over the Barrier The prescriptive 15-minute thermal barrier may be Foam-LOK FL 500 insulation in accordance .with the omitted when installation is in accordance with this section. coating manufacturer's instructions and this report. The insulation and FIRE-LOK/DC 315 coating, described Surfaces to be coated must bed , clean and free of dirt ry, , , in Section 3.5, may be spray-applied to the interior facing loose debris and any other substances that could interfere of walls, the underside of roof sheathing, and in crawl with adhesion of the coating. The coating must be applied spaces, and may be left exposed as an interior finish when ambient and substrate temperatures are a minimum without the prescribed 15-minute thermal barrier. The of 50°F time. The assembly described in this section may thickness of the foam applied to the underside of roof be installed in unvented attics in accordance with IRC sheathing must not exceed 111/4 inches (286 mm). The Section R806.4, when the foam plastic'is applied to a thickness of the foam applied to vertical wall surfaces must minimum depth of 41/2 inches(114 mm). not exceed 5/4 inches(133 mm).The foam plastic must be covered on all exposed-surfaces with the FIRE-LOK/ DC 4.4.3 Use on Attic Floors: Foam-LOK FL500 315 coating at a minimum wet film thickness of 20-mil (also known as AirTight OC, GUARDFOAM 55 OC or (0.51 mm) [dry film thickness of 13 mils (0.33 mm) or Open Cell Retrofit Foam)spray-applied polyurethane foam 1 gallon ( 3.8 L) per 80 square feet z insulation may be installed at a maximum thickness of 51/2. q (7.4 m)e The FIRE- inches 140 mm between the LOK/DC 315 coating must be applied over the Foam-LOK ( ) joists in an attic floor. The FL 500 insulation in accordance with the coating insulation must be covered with FIRE-LOK / DC 315 manufacturer's instructions and this report. Surfaces to be coating applied as described in Section 4.4.2. The from the interior must be se coated must be dry, clean, and free of dirt, loose debris insulationP nor of the and any other substances that could interfere with building by an approved thermal barrier. adhesion of the coating. 4.5 One-hour Fire-resistance-rated • Exterior Wall 4.4 Use in Attics and Crawl Spaces: Assemblies(Non-load-bearing): 4.4.1 Application with a Prescriptive Ignition Barrier. Foam-LOK FL500 insulation may be used as a component When the spray-applied insulation is installed within attics of one-hour fire-resistance-rated, non-load-bearing wall and crawl spaces, where entry is made only to service assemblies as described in Section 4.5.1 or 4.5.2. utilities, an ignition barrier must be installed in accordance 4.5.1 One-hour Wood-framed Wall Assembly: with IBC Section 2603.4.1.6 or IRC Sections R316.5.3 and 4.5.1.1 Interior and Exterior Face: One layer of 5/8-inch- R316.5.4, as applicable. The ignition barrier must be thick (15.9 mm), Type X gypsum board, complying with consistent with the requirements for the type of ASTM C36 or ASTM C1396, installed with the long edge construction required by the applicable code, and must be parallel to the studs on both sides of nominal 2-inch by installed in a manner so that the foam plastic insulation is 6-inch wood, No. 2 Grade, Southern Yellow Pine, studs not exposed. spaced 16 inches�406 mm)on center. The gypsum board 4.4.2 Application without a Prescriptive Ignition is secured with 1 /4-inch-long (32 mm) Type W drywall Barrier. Foam-LOK FL500 spray-applied polyurethane screws spaced 8 inches (203 mm) on center along the foam insulation may be installed in attics and crawl spaces perimeter and in the field. Gypsum board joints must be as described in Sections 4.4.2 and 4.4.3 without the taped and joints and fastener heads treated with joint ignition barriers described in IBC Section 2603.4.1.6 and compound to Level 2 finish in accordance with ASTM C840 IRC Sections R316.5.3 and R316.5.4, subject to the or GA-216. ESR-2847 I Most Widely Accepted and Trusted Page 3 of 4 4.5.1.2 Stud Cavity: Nominally 51/2-inch-thick FL500 .5.10 A vapor retarder must be installed as required by the foam insulation is,spray-applied in all stud cavities. applicable code. 4.5.2 One-hour Steel-framed Wall Assembly: 5.11 The components of the insulation are roduced _ p 4.5.2.1 Interior and Exterior Face: Two layers of 5/8- in Houston, Texas, under a quality control program inch-thick 15.9 mm , Type X with inspections by ICC-ES. ( ) yp gypsum board, complying with ASTM C36 or ASTM C1396, is installed on both sides 6.0 EVIDENCE SUBMITTED of 35/8-inch-deep (92 mm), No. 20 gage, galvanized steel 6.1 Data in accordance with the ICC-ES Acceptance studs spaced 24 inches (610 mm) on center. The base Criteria for ,Spray-applied Foam Plastic Insulation layer of the gypsum board is installed with the long edge (AC377), dated November 2012, including tests in parallel to the studs and secured with No. 6 by accordance with Appendix X of AC377. 1 /4-inch-long (32 mm),self-drilling drywall screws 8 inches (203 mm) on center along the perimeter and 12 inches 6.2 Reports of air leakage tests in accordance with ASTM (305 mm) on center in the field of the wallboard. The E283. - face layer of the wallboard is secured with No. 6 by 6.3 Reports of room comer fire testing in accordance with 1 /a-inch-long (48 mm),self-drilling drywall screws 8 inches (203 mm) on center along the perimeter and in the field of NFPA 286. the wallboard. The joints must be staggered from the base 6.4 Reports of testing in accordance with ASTM E970. layer the face layer and from interior to exterior face of the 6.5 Reports of testing in accordance with ASTM El19. assembly. Gypsum board joints must be taped and joints and fastener heads treated with joint compound to Level 2 7.0 IDENTIFICATION finish in accordance with ASTM C840 or GA-216. Components for Foam-LOK FL500 spray foam 4.5.3 Stud Cavity: Nominally 35/a-inch-thick Foam-LOK insulation are identified with the manufacturers name FL500 foam insulation is spray-applied in all stud cavities. (LAPOLLA Industries, Inc.), address and telephone 5.0 CONDITIONS OF USE number, the product name (Foam-LOK FL500/AirTight OC/GUARDFOAM 55 OC/Open Cell Retrofit Foam); The Foam-LOK FL500 (also known as AirTight OC, mixing instructions; the density; the flame-spread and GUARDFOAM 55 OC or Open Cell Retrofit Foam) spray smoke-development indices; the shelf life and production foam insulation described in this report complies with, or is date or the expiration date; and the evaluation report a suitable alternative to'what is specified in, those codes number(ESR-2847). listed in Section 1.0 of this report, subject to the following FIRE-LOK / DC 315 coating is identified with the conditions: manufacturers name (Intemational Fireproof Technology, 5.1 This evaluation report and the manufacturers Inc.) and address, the product trade name and use published installation instructions, when required by instructions. the code official, must be submitted at the time of 8.0 OTHER CODES permit application. In addition to the codes referenced in Section 1.0, the 5.2 The Foam-LOK FL500 spray foam insulation must be products described in this report were evaluated for installed in accordance with the manufacturer's compliance with the requirements of the following codes: published installation instructions, this evaluation report and the applicable code. If there are conflicts ■ 2006 International Building Code®(2006 IBC) between this report and the manufacturers' published ■ 2006 International Residential Code®(2006 IRC) installation instructions,this report governs. ■ 2006 International Energy Conservation Code® 5.3 The insulation must be separated from the interior of (2006 IECC) the building by an approved 15-minute thermal barrier, except when installation is as described in The products comply with the above-mentioned codes as Section 4.3.2 or4.4.2. described in Sections 2.0 through 7.0 of this report, with the revisions noted below. 5.4 The insulation must not exceed the nominal density 0 Application with a Prescriptive Thermal Barrier. See and thicknesses noted in Sections 3.2, 4.3, 4.4, and 4.5. Section 4.3.1, except the approved thermal barrier must be installed in accordance with Section R314.4 of the 5.6 The insulation must be protected from the weather 2006 IRC. during and after application. ■ Application with a Prescriptive Ignition Barrier. See 5.6 The insulation must be applied by contractors certified Section 4.4.1 except attics must be vented in by LAPOLLA Industries, Inc. accordance with Section 1203.2 of the 2006 IBC, and 5.7 Use of the insulation in areas where the probability of crawl space ventilation must be in accordance with terrriite infestation is "very heavy" must be in Section 1203.3 of the 2006 IBC or 2006 IRC Section accordance with IRC Section R318.4 or IBC Section R408, as applicable. Additionally, an ignition barrier 2603.8,as applicable. must be installed in accordance with.Sections R314.5.3 or R314.5.4 of the 2006 IRC,as applicable. 5.8 The insulation has been evaluated only for use in 0 Application without a Prescriptive Ignition Barrier Type V construction under the IBC and in dwellings under the IRC. See Section 4.4.2, except attics must be vented in accordance with Section 1203.2 of the 2006 IBC, and 5.9 Jobsite certification and labeling of the insulation must crawl space ventilation must be in accordance comply with IRC Sections N1101.4 and N1101.4.1, with Section 1203.3 of the 2006 IBC or 2006 IRC 2012 IECC Sections C303.1.1, C303.1.2, R303.1.1, Section R408, as applicable. Combustion air is provided R303.1.2 and IECC Sections 102.1.1, and 102.1.11 as in accordance with Sections 701 and 703 of the applicable. 2006 IECC. I ESR-2847 I Most Widely Accepted and Trusted Page 4 of 4 ■ Protection against Tefmites: See Section 5.7, except except jobsite certification and labeling must comply use of the insulation in areas where the probability of with Sections 102.1.1 and 102.1.11, as applicable, of termite infestation is "very heavy", must be in the 2006 IECC. accordance with Section C< n R320.5 of the 2006 IRC. ■ Jobsite Certification and Labeling: See Section 5.9, TABLE 1—THERMAL RESISTANCE(R-VALUES) THICKNESS(inches) R VALUE ff ft2.h/BtU) 1 3.8 2 7.6 3 11.3 3.5 13.2 4 15.0 5 18 6 21.8 7 25.5 8 29 9 32.8 10 36.4 11 40 12 t 43.7 For SI:1 inch=25.4 mm;1°F.f.hBtu=0.176 110°K.m2Ml. '9values are calculated based on tested K-values at 1-and 4-inch thicknesses. I r ICC EVALUATION lz�� SERVICE Most Widely Accepted . IMES Evaluation Report ESR-2847 FSC Supplement Reissued September 2015 This report is subject to renewal September 2017. www.icc-es.orta 1 (800)423-6587 1 (562)699-0543 A Subsidiary of the International Code Council® DIVISION:07 00 00—THERMAL AND MOISTURE PROTECTION Section:07 21 00—Thermal Insulation REPORT HOLDER: LAPOLLA INDUSTRIES,INC. 15402 VANTAGE PARKWAY EAST,SUITE 322 HOUSTON,TEXAS 77032 (281)219-4100 www.laoolia.com EVALUATION SUBJECT: FOAM-LOK FL500(ALSO KNOWN AS AirTight OC,GUARDFOAM 55 OC OR OPEN CELL RETROFIT FOAM)SPRAY FOAM INSULATION 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that Foam-Lok FL500 (also known as AirTight OC, GUARDFOAM 55 OC or Open Cell Retrofit Foam) spray foam insulation, recognized in ICC-ES master report ESR-2847, has also been evaluated for compliance with the codes noted below. Applicable code editions: ■ 2010 Florida Building Code—Building ■ 2010 Florida Building Code—Residential 2.0 CONCLUSIONS The Foam-Lok FL500(also known as AirTight OC,GUARDFOAM 55 OC or Open Cell Retrofit Foam)spray foam insulation, described in Sections 2.0 through 7.0 of the master evaluation report ESR-2847, complies with the 2010 Florida Building Code—Building and the 2010 Florida Building Code—Residential, provided the design and installation are in accordance with the International Building Code®provisions noted in the master report. Use of the Foam-Lok FL500 (also known as AirTight OC, GUARDFOAM 55 OC or Open Cell Retrofit Foam)spray foam insulation for compliance with the High-Velocity Hurricane Zone provisions of the 2010 Florida Building Code—Building and the 2010 Florida Building Code—Residendal has not been evaluated,and is outside the scope of this evaluation report. For products falling under Florida Rule 9N-3,verification that the report holder's quality assurance program is audited by a quality assurance entity approved by the Florida Building Commission for the type of inspections being conducted is the responsibility of an approved validation entity(or the code official when the report holder does not possess an approval by the Commission). This supplement expires concurrently with the master report, reissued September 2015. ]CC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use.There is no warranty by ICC Evaluation Service;LLC,express or implied,as to any finding or other matter in this report or as to any product covered by the report Copyright m 2015 ICC Evaluation Service,LLC. All rights reserved. Page 1 of 1 I I Get Outlook for iOS ---------- Forwarded message---------- From:"Sol Cohen" <iaketdO-aim.com> Date: Fri, Jun 30, 2017 at 7:13 AM -0400 To: <bill(@pica rd icon st ru ct ion.com> Hi Bill. This is the information for the ICC building code. Hope your weekend is nice and safe Sol J I I f Get Outlook for iOS ---------- Forwarded message---------- From:"Sol Cohen" <jaketdCabaim.com> Date: Fri, Jun 30, 2017 at 7:30 AM -0400 , Subject:one more To: <billOpica rd icon st ru ct ion.com> This article has some more info for your reading. click on the link below for more on the fire resistance. httpsJ/www.sbcmag.inib/news/2017/may/la polla-introduces-improved-foa m-lok-500-high-yield-spray-foa m Sol I i 7/5/2017 Workspace Webmail::Print .,t :� Print I Close Window Subject:,one more From: Sol Cohen<jaketd@aim.com> Date: Fri,Jun 30,2017 7:30 am To: bill@picardiconstruction.com This article has some more info for your reading. click on the link below for more on the fire resistance. https://www.sbcmag.info/news/2017/may4apolia-introduces-improved-foam-lok-500-high-yield-spray-foam Sol Copyright©2003-2017.All rights reserved. https://emai102.godaddy.com/view_print multi.php?uidArray=274851INBOX&aEmlPart=O 1/1 7/5/2017 Lapolla Introduces Improved FOAM-LOK 500 High Yield Spray Foam I SBC Magazine I :/Aapolla Introduces Improved FOAM-LOK 500 High Yield Spray Foam Originally published by the following source:Lanolla(httas://www.laoolla.com/)—May 2,2017 Unless otherwise noted,the content below has not been altered by SBCMagazine. Lapolla Industries,Inc.,the global supplier and manufacturer of high performance,energy efficient building products,today announced the new and improved FOAM-LOK6 500 Spray Polyurethane Foam Insulation.The open-cell insulation is a high performance product designed to seal the building envelope and greatly enhance energy conservation and energy savings in the structure.Ideal for application in residential and commercial buildings of all types,FOAM-LOK 500 is low density and provides high-yield benefits. "FOAM-LOK 500 is an insulation solution which provides homeowners and building 41 owners up to 50%energy cost savings over the life of the structure,"said Doug Kramer, w f / president and CEO of Lapolla Industries." ® < FOAM-LOK 500 is ideal for a variety of building envelope applications including use in w ,a y 1 walls,floors,ceilings(including vaulted and cathedral style)and attics.The material y/ works by forming a completely sealed air barrier in wall cavities and can be utilized to fill 2"x 6"stud wall construction in a single application.FOAM-LOK 500 adheres tenaciously to most building materials and framing members and provides exceptional performance in the reduction of heat transfer. �� The improved insulation has passed the AC 377 End Use Configuration Criteria and l r meets the building code requirements for use with no additional ignition barrier required. Additional benefits of FOAM-LOK 500 Spray Polyurethane Foam Insulation are substantial and include noise attenuation and significant reduction in unmanaged moisture.Additionally,the product's ability to superbly seal the envelope improves indoor air quality while reducing temperature fluctuations and the presence of hot and cold pockets inside,greatly enhancing the indoor comfort of inhabitants. FOAM-LOK 500 is a spray applied product with no mixing requirements.The insulation material is a water-blown technology with non-emissive catalysts in an added benefit to the environment. "The benefits of FOAM-LOK 500 to contractors,builders,homeowners and building owners are far reaching,"added Kramer."This improved insulation not only provides indoor comfort,but is earth-friendly in so many ways.It's a great addition to Lapolla's family of products." POSTED ON MAY 8,2017 IN BUILDING SCIENCE(/NEWS/INDUSTRY-NEWS/BUILDING-SCIENCE),ENERGY EFFICIENCY(/NEWS/INDUSTRY-NEWS/ENERGY- EFFICIENCY) r 1 , C Han&IS.wiZ ® , (/ad/click/9369/dl2aO7a2f201487a169d32bc3762efdOd54945d6712adObOd925c9358928bb61) • . r f NEW EQUIPMENT Non 11110 d Umiar c ut•oft 0®� 9�vsp�acssb.,y. - , (/ad/click/10690/a5e41a93bal Od2ll792b6ee6a2c7cc3e6f6c79bcde9e3f23f3f27548f8dc5c2f) hftps://www.sbcmag.info/news/2017/may/lapolla-introduces-improved-foam-lok-500-high-yield-spray-foam 1/3 1 ' ?? TOWN OF-BARNSTABLE BUILDING PERMIT APPLICATION Q- JeA ` Map O Parcel Application # �VZ Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 3 S CA rah '+ 1 U' 3 S Date Definitive Plan Approved by Planning Board 0 �� Historic - OKH _ Preservation/ Hyannis r , Project Street Address Village - 1 Address O o" Telephone Permit Request AAA ia ►V►C�oc ; �eYnou+g ? bcoRr�. �� *tc Ab�J �o , Jb5AI R 0\1 14,1 s !1�►I) p 4mr-) 11 t w Square feet: 1 st floor: existing proposed S 2nd floor: existing i�J$ proposed S Total news Zoning District _ Flood Plain Groundwater Overlay kllkam V On� Pro�t` da"fion onstruction Types��-�QorLy Lot Size + a '1'� �O Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: 0 Yes ❑ No On Old King's Highway: ❑Yes A No Basement Type:"*'411 Full "*'I Crawl -"4 Walkout ❑ Other Basement Finished Area(sq.ft.) ` � Basement Unfinished Area(sq.ft) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existingSnew Total Room Count (not including baths): existing new First Floor Room Count Heat Type andFuel: `® Gas ❑Oil ❑ Electric ❑Other Central Air: ©Yes ❑ No Fireplaces: Existing e New p g _ Existing wood/coal stove: ❑Yes.*No >etached garage: ❑ existing .❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ ached garage: ❑existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use I ro Proposed Use 1 APPLICANT INFORMATION ---- (BUILDER OR HOMEOWNER) Name a Telephone Number Address UQn 0,62QLicense# c 1,I cM ><1 Home Improvement Contractor# C, 0 Email a 1 C'KSiC II\ l A� �W�U)n Worker's Compensation # /A UJ C H 00 r7 My$� 1�► ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,c�a c�rin. c2 SIGNATURE DATE I� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - a FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r l V'V 21Yw- 00 I 1 r � I i 6)61 Y41 I +%nn on, 'Pm � y„ Picardi Construction it 255 T mpike Rd SouRlbomugh MA LInI�nI ,. JI n .:III ,R I I I 1 1 1'I'111'.I ❑ ❑ ,1'f 41 1 I I l l l t,�., ❑ I11 IIII I I I'il,I I I ❑ I r 11'Il V II '1 Il:! I1 I1111', 141,1 141tr'Illn1 Ifllll II 1) l I I I ,.11n l I I In l Il 4 111'll 1'I1 Itl I I I, I I I i 3c� I'I 71'1'I Iyl Irl il!r1'1'I'I iI I'l ll I,I11I II,i I;I, 11 5,I r.,11111'. 1 'r'I'1'IT ',+ II I+5 I.I I II it I,141 II I' 1 !I 4.1,Iillll I 11 ,I,I f Ii1,1lI I! '1141 I I .l 1'Irll I'I!' 1 ,4 :1�4111 ,I 71 II,1 1111!ISlll - 11,4' I. 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U111 II,III:L,,1,4, A. 9° 00 O n Front Elevetlon �' -° Picardi Construction 255 Turnpike Rd Sadhbomugh MA M1 II 1'I I,!I, IIII :I 171 I;,I'I ii411 II '�� II1111.1.1 Il,ll l l it „ I l lllrl.r . 9m I I tl n i. ❑ ❑ I I 1 I I I I I I I t I I ,I I III, 111r,14r I I II}'I1111 'I$I I'+$;1'I111 , ,ll I�II11'1 r4114r1'1IIII , , rl"111111 'Ir,,l'1'srl'rirs,,lr'i, i,ls l'I :IIII r'I 111 II1,Ir IU1" lfll'III Ir 11111'1'r'r 1,it I IJJrI. , Il.r 11 ! IIII 114 III l r 14 '1 ll 1l,1 I,siil l�,Il �'"'„ � I;i',ll l',ll,l' 1 I .rl'1, Il.11 l' I'11I,':l U, l'11J I'I I,,I�r',Illlr II ITI,'IIII - , if r'•11.f. � �.I',1'" ',!I,II, - � ' IIII✓'L,.i'111. 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I'1.1,An r' IIII C 1T, O LLl ,I I„lrl.rl II11111$1') rll ❑ r LL �i - 9 l III fl,n ' 11';II'11,4,'I'r. 11,11,11!r,,IIII ll Ilr,l' Ills I i fill II.I I ,y!111'„IIII ,'III 1,41,I,.I ri II I I 11 1}11 i"+i; 1�I IIr14il'r lll'll Ir llll,,r!. ,,r�1,11 I111 Ills.,ill�,ll Ir' 141I 1 I,11 'r III 11,1 „Ill 11 I I 'r,l l 1] yll I II. , irll ll lii Ifl. It I I .,ill,f I 1. 1 14,.1 1 ll 41 1„I.111 , Ir LIIIi I_I" '14, L111 , nil 4r11.I ,1, 1.1 .1 , III I rl I l,s rll IIIII , I„1 IIII, .I,.I '1� i l'111,111, I'.11 I 11117 , IJ ,117 111., rllll 1 I: � .Ilu I11,11 LI,J.Irl1•,� I,1 4; ral,ll,l,l.,na 1, J I,IJ'11..1.: I1.,1-II ,.:,ill, 1'1,.LI,,,I I' 1! J,1111' r ,1. Itl 'ir A Li r, �•� t ear Elevadon IP•P r•eIn• 1S-e• C0'•4 J T Picardi ------------ Construction ----------- 255 Turn Pike Rd Soudibamugi,MA -------------------------------- 6 _ i 1 ` ❑ I I i r_____________.i i ------------- I I 0 i I �- ----------------- •N I1 1 C� o x a w I I I I 1 1 , L------- .. Y4 — 5 el'•P � l� K. w'•l tlr Picerdi Construction —--- 255 Turnpike Rd _ -- Southborough MA • i _ i i a W ' I ------------- DD 3� If- 1 y V t PIc8Td1 t,? Conduction 235 Turnpike Rd 2r•9 Mr Southborough MA ik DD c K .......... a x ^rz'k R B•9 11'•10" a rr. .r b 0 W.9mr �_ -- !•' Q .x w ce N m (30 s Pe�4 . ]1'•8 im 8 !q .r•B• t .fB Y � Generated by REScheck-Web Software Compliance Certificate Project Pozen Energy Code: 2015 IECC Location: Barnstable, Massachusetts Construction Type: Single-family Project Type: Alteration Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 960 Main st Dan Pozen William Picardi Barnstable, Massachusetts Picardi Construction 255 Turnpike rd Southboro,Massachusetts 01772 5083801370 bill@picardiconstruction.com Envelope Assemblies Gross Area Cavity Cont. Assembly or U-Factor UA Perimeter Ceiling: Cathedral 2,426 38.0 38.0 0.013 32 Wall: Wood Frame, 16in.o.c. 2,936 14.0 14.0 0.036 81 Window:Other 246 0.290 71 Door: Glass 446 0.300 134 Basement: Solid Concrete or Masonry 420 21.0 21.0 0.022 9 Wall height:8.0' Depth below grade:8.0' Insulation depth:8.0' Crawl: Solid Concrete or Masonry 252 21.0 21.0 0.025 3 Wall height:4.0' Depth below grade:4.0' Insulation depth:4.0' Mechanical Equipment Description .- Efficiency Other(Except Gas-Fired Steam) 95 AFUE Project Title: Pozen Report date: 03/02/17 Data filename: Page 1 of10 Compliance Statement. The proposed building desi W describe ere is con with the building plans,specifications,and other calculations submitted with the permit application.The p building has been c78s' ned to meet the 2015 IECC requirements in REScheck V on 5.5.0 and to c I with the mandatory requir s lis RES ck Inspection Checklist. Name-Title Signature Date QlA-Ynt Project Title: Pozen Report date: 03/02/17 Data filename: Page 2 of10 �(JREScheck Software Version 5.5.0 Inspection Checklist Energy Code: 2015 IECC Requirements: 100.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section ,:. $ 3,: Plans VertfiedjFleld*Verified µ , o # Pre Inspection/Plan Review- _ complies? cmments/Asums tions & Req.ID ValueNalue p 103.1, ;Construction drawings and , xp �.ft ❑Complies ;Requirement will be met. 103.2 documentation demonstrate 4 [PRl]1 energy.code compliance for the "❑Does Not building envelope.Thermal ` ��' []Not Observable { � '� °'; envelope represented on x _-- -�F ❑Not Applicable ;construction documents. 103 1; ;Construction drawings and ❑Complies ;Requirement will be met. 103.2, !documentation demonstrate �i ❑Does Not 403.7 ;energy code compliance for *. [PR3]1 "lighting and mechanical systems - ` []Not Observable :Systems serving multiple ° ❑Not Applicable ;dwelling units must demonstrate vau ; :compliance with the IECC W ,Commercial Provisions. 302`:1 Heating and cooling equipment is; Heating:. ; Heating:. ;❑Complies ;Requirement will be met. 401.7 sized per ACCA Manual S based ; Btu/hr 1 Btu/hr :ODoes Not [PR2]2 on loads calculated per ACCA Manual J or other methods ; Cooling: Cooling: ,❑Not Observable ; 3 approved by the code official. ; Btu/hr Btu/hr .[]Not Applicable ; of ; , ; Additional Comments/Assumptions: 1 High Impact(Tier 1) 3;: Medium Impact(Tier 2) 3;'Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 3 of10 Section , r . Plans Vered "Field Verified '# Foundation lnspect!on . Value Value ' Complies? Comments/Assumptions. & Req.ID .. .f . p.' 402.1.1 ;Conditioned basement wall ; R- R- ;❑Complies ;See the Envelope Assemblies [F04]1 :insulation R-value.Where interior; ,R_ _ R_ -]Does-Not table for values. insulation is used,verification may need to occur during ; :❑Not Observable Insulation Inspection. Not ;❑Not Applicable required in warm-humid locations in Climate Zone 3. 303.2 ;Conditioned basement wall F 4 ❑Complies ;Requirement will be met. [F05]1 insulation installed per ❑ ; ;manufacturer's instructions. ' Does Not ' []Not Observable ; ❑Not Applicable 402.2.9 ;Conditioned basement wall ft ft ;❑Complies ;See the Envelope Assemblies [F0611 insulation depth of burial or ❑Does Not ;table for values. distance from top of wall. ; ❑Not Observable ❑Not Applicable 402.2.11 ;Unvented crawl space wall R- R- []Complies ;See the Envelope Assemblies [F07]1 "insulation R-value. R_ R_ ❑Does Not ;table for values. i i ;❑Not Observable ❑Not Applicable 303.2 Unvented crawl space wall ;,, �P. qj ❑Complies ;Requirement will be met. [FO8]1 insulation installed per 7 - ❑Does Not ;manufacturer's instructions. &g ❑Not Observable ; I `Ir a ..x ❑Not Applicable 402.2.11 ,_Unvented,crawl space continuous ❑Complies ;Requirement will be met. [F0911 vapor retarder installed over F, ❑Does Not exposed earth,joints overlapped by 6 in.and sealed, extending at i;._ - 'a ❑Not Observable ; {least 6 in. up and attached to the ❑Not Applicable ; ;wall. 402.2.11 Unvented crawl space wall ; in. in. ;❑Complies ;See the Envelope Assemblies [FO10]1 "insulation depth of burial or T❑Does Not ;table for values. distance from top of wall. I ;❑Not Observable ❑Not Applicable 303.2.1. A protective covering is installed T. []Complies ,Requirement will be met. [FOl1]2 ,Ito protect exposed exterior v} ❑Does Not j insulation and extends a, minimum of 6 in. below grade. (k r� 4 []Not Observable []No t Applicable 4039 Snow-and ice-melting system r b ' ❑Complies ;Exception: Requirement is [F012pcontrols installed. " -]Does Not not applicable. QW." ❑Not Observable , wa E. ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) :3 Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 4 of10 4-Section - x•- } Pa $.t ns Verlf�ed F�elld yerifledt.; , # - Framing/Rough In Inspection {., ;. £ Comphes. Comments/Assumptions' - Value Value v . 402.1.1, :Glazing U-factor(area-weighted U- ; U- ;❑Complies ;See the Envelope Assemblies 402.3.1, :average). ;❑Does•Not- ;table for values. 402.3. , 402.3.6, ; ;❑Not Observable ; ; ; 402.5 ;❑Not Applicable [FR2]1 303.1.3 ;U-factors of fenestration products ❑Com lies :Requirement will be met. x x ,� x P q [FR4]1 are determined in accordance + ; with the NFRC test procedure or ❑Does Not taken from the default table. ❑Not Observable ; :" ❑Not Applicable 402.4.1.1 :Air barrier and thermal barrier ` ❑Complies ;Requirement will be met. [FR23]1 installed per manufacturer's ❑Does Not instructions. _ F, t " ❑Not Observable ; �. ❑Not A licable 402.4.3 ;Fenestration that is not site built ❑Complies ;Requirement will be met. [FR20]1 :is.listed and labeled as meeting Does Not AAMA/WDMA/CSA 101/I.S.2/A440 i or has infiltration rates per NFRC ❑Not Observable :400 that do not exceed coder ° []Not Applicable j ;limits. 402.4 5 IC-rated recessed lighting fixtures � ,❑Complies ;Requirement will be met. [FR'16]2 sealed at housing/interior finish v t . []Does Not :and labeled to indicate<_2.0 cfm ' leakage at 75 Pa. []Not Observable ❑Not Applicable 403.2.1 ;Supply and return ducts in attics ❑Complies ;Exception: Ducts located [FR12]1 insulated>= R-8 where duct is ❑Does Not :completely inside the >=3 inches in diameter and >_ j ;building envelope. ❑Not Observable R-6 where<3 inches.Supply and 9. � ' , :return ducts in other portions of ❑Not Applicable ; ;the building insulated >= R-6 for :diameter>=3 inches and R-4.2 _ :for<3 inches in diameter. ' 403.3 3 5 Building cavities are not used as � � ❑Complies ;Requirement will be met. [FR15]3 ducts or plenums. ;" � ��, ❑Does Not •" ❑Not Observable -" ❑Not Applicable 403.4 HVAC piping conveying fluids R- R- ;❑Complies :Requirement will be met. [FR11]z above 105 QF or chilled fluids '❑Does Not i below 55 QF are insulated to>_R- 3 ,❑Not Observable ❑Not Applicable 403.4.1 Protection of insulation on HVAC , � � , � °❑Complies ;Requirement will be met. [FR24]1 piping ❑Does Not . •. []Not Observable * ,❑Not Applicable 403.5 3 Hot water pipes are insulated to ; R- R- ;❑Complies ;Requirement will be met. [FR18]z �>_R-3. {❑Does Not :0Not Observable ❑Not Applicable ; 403.6 , Automatic or gravity dampers are ❑Complies :Requirement will be met. [FR19]z installed on all outdoor air " ❑Does Not intakes and exhausts. ❑Not Observable ; ❑Not Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 5 of10 1 High Impact(Tier 1) 2: Medium Impact(Tier 2) 3 s Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 6 of10 Section g Plans Verified AV.Field Verified 'men � x # Insulation lnspectronv .Coin lies Comssum Mons "Ile ID .. Value Value ,p p q• _ g 303.1 ZAII installed insulation islabeled '�r� �'; ❑Complies Requirement will be met. [IN13] or the installed R-values m ❑Does Not provided. y ❑Not Observable ❑Not Applicable 402.1.1, ;Wall insulation R-value.If this is a: R- R- ;❑Complies ;See the Envelope Assemblies 402.2.5, i mass wall with at least 1/2 of the ❑ Wood ;❑ Wood ;❑Does Not :table for values. 402.2.6 :wall insulation on the wall [IN3]1 exterior,the exterior insulation j❑ Mass ❑ Mass :[]Not Observable I requirement applies(FR10). ;❑ Steel ❑ Steel ;❑Not Applicable 303.2 ;Wall insulation is installed per ' ° � ` E ❑Complies ;Requirement will be met. [IN4]1 manufacturer's instructions. ,w " " - ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2' Medium Impact(Tier 2) 3'` Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 7 of10 Section _ # Final Inspection Prov�s�ons Plans Verified' Field Verified:? p � *Value` Value�' ' �Comphes.F Comments/Assumptions' de;Req.ID 4- R _ 402.1.1, "Ceiling insulation R-value. R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ;❑.Wood ;E.Wood ;❑Does Not ;table for values. 402.2.2, Steel [] Steel 402.2.6 � ❑ � :❑Not Observable ` [FI1]1 ; ;❑Not Applicable i 303.1.1.1,;Ceiling insulation installed per ' " `' r' " ❑Complies ;Requirement will be met. 303.2 I manufacturer's instructions. ❑Does Not [FI2]1 ;Blown insulation marked every i 300 ft'. ❑Not Observable ; ❑Not Applicable 402:2 3 -'Vented attics with air permeable ¢' .° €" " ❑Complies ;Exception• Requirement is [FI22]2 jinsulation include baffle adjacent t ❑Does Not not applicable. to soffit and eave vents that a extends over insulation. Fes. " < ❑Not Observable ; ❑Not Applicable 402.2.4 ;Attic access hatch and door ; R- R- ;❑Complies ;Requirement will be met. [FI3]1 'insulation>_R-value of the ;❑Does Not adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ; ACH 50= ; ACH 50= ;❑Complies :Requirement will be met. [FI17]1 ach in Climate Zones 1-2,and ;❑Does Not <=3 ach in Climate Zones 3-8. ; ❑Not Observable ; :,[]Not Applicable 403,2.3 ;Duct tightness test result of<=4 ; cfm/100 cfm/100 ;❑Complies ;Exception:All ducts and air [FI4]1 cfm/100ft2 across the system or ftz ft2 E❑Does Not handlers are located within <=3 cfm/100 ft2 without air ❑Not Observable conditioned space. handler @ 25 Pa. For rough-in ; :tests,verification may need to ; ;❑Not Applicable ; occur during Framing Inspection. 403.3.2 ;Ducts are pressure tested to cfm/100 cfm/100 ;❑Complies ;Exception:All ducts and air [F127]1 .'determine air leakage with ftz ft2 ;❑Does Not :handlers are located within either: Rough-in test:Total conditioned space. leakage measured with a ,❑Not Observable ; pressure differential of 0.1 inch ;❑Not Applicable w.g. across the system including ; !the manufacturer's air handler ; enclosure if installed at time of ; :test.Postconstruction test:Total leakage measured with a ; pressure differential of 0.1 inch ; w.g.across the entire system ; including the manufacturer's air handler enclosure. 403.3.2.1 Air handler leakage designated ❑Complies ;Requirement will be met. [FI24]1 'by manufacturer at<=2%of. n ❑Does Not design air flow. ❑Not Observable 0 ❑Not Applicable 403.1 1 Programmable thermostats n.: Complies ;Requirement will be met. [FI9]2 installed for control of primary a � , �� ❑Does Not q heating and;cooling systems and initially set by manufacturer to i ❑Not Observable ; code specifications. '� �" �., '' ❑Not Applicable 4031 2 Heat pump thermostat installed ❑Complies ;Exception: Requirement is [FI10]2 on heat pumps. ❑Does Not not applicable. ` ❑Not Observable ; ❑Not Applicable 4035 1 Circulating service hot water 04 ❑Complies ;Requirement will be met. [Flit systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ❑NotApplicable ; 1 High Impact(Tier 1) 2, Medium Impact(Tier 2) : ,'Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 8 of10 -,=Sectioh, s ,�.'- •%.;.•` ,�• r .w �... -. tea > t -= ' # Final'Jnspec#ion Provisions{� Plans Verfied Field Verlfied Complies? Comments/Assumptions Req.lD ;. F ValueValue - :. u. 403,6.1Atl mechanical ventilation system ❑Complies ;Requirement will be met. [F125]2 Mans not part of tested and listed ❑Does.Not HVAC equipment meet efficacy $V � j and air flow limits. �� ❑Not Observable ; " ❑Not Applicable ; 403.2 Hot water boilers supplying heat , � ��; • ❑Complies ;Requirement will be met. s ' [FI26J through one-or two-pipe heating ❑Does Not ; systems have outdoor setbacks ❑Not Observable control to lower boiler water _', temperature based on outdoor ❑Not Applicable ; temperature. , a . 403.521.1': Heated water circulation systems += :; ❑Complies ;Requirement will be met. [FI28J have a circulation pump.The ❑Does Not r system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable ; pipe.Gravity and thermos- _ ❑ pplicable ; syphon circulation systems are = . not present.Controls for circulating hot water system ; pumps start the pump with signal for hot water demand within the • i Control occupancy. s , automatically turn off the pump • ;; '. when water is in circulation loop < - is at set-point temperature and Z 4,, - r no demand for hot water exists. f ' 403'5 1 2 Electric heat trace systems k []Complies :Exception: Requirement is [F129]z }comply with IEEE 515.1 or UL .ram ❑Does Not not applicable. 515.Controls automatically ; adjust the energy input to the „� ❑Not Observable ; heat tracing to maintain the P" � '� ❑Not Applicable desired water temperature in the Q ,_ piping 403i5 2 ::;Water distributions stems that Y r' ❑Complies !Requirement will be met. [FI30]2 have recirculation pumps that ❑Does Not pump water from a heated water supply pipe-back-to the heated. m5 ❑ Not Observable water source through a cold ' .$ h ❑Not Applicable ; water supply pipe have a 4 4 d demand recirculation water `system.Pumps Pumps have controls that manage operation of the J pump and limit the temperature - „ of the water entering the cold ;water piping to 1049F. °• �: 4015 4 Drain water heat-recovery units ` `" ❑Com lies ;Exception: Requirement is [FI31] tested in accordance with CSA A []Does Not :not applicable. B55.1. Potable water-side pressure loss of drain water heat []Not Observable I recovery units<3 psi for ❑Not Applicable individual units connected to one i or two showers.Potable water- . 4 � I side pressure loss of drain water I heat recovery units< 2 psi for . ; :'• individual units connected to ,three or more showers. s° 404.1 '.75%u of lamps in permanent to� '� � ❑Com lies :Requirement uirement will be met. 1 0 A P q (FI6] Mixtures or 75/o of permanent _ t .• ❑Does Not ;fixtures have high efficacy lamps k 5 s i Does not apply to low-voltage ° ❑Not Observable alighting. �, n ❑Not Applicable 404.1 1 .Fuel gas lighting systems have ,; []Complies ;Requirement will be met. [F12' no continuous pilot light. * ❑Does Not ' 4" ' ❑Not Observable . I » _;❑Not Applicable j 1 High Impact(Tier 1) 2_-I Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 9 of10 section Plans Verified Field Verified # Final Inspection Provisions Complies? �3Comments/Assumptions �. r Value'. Value 401.3 'Compliance certificate posted. p �A ❑Complies :Requirement will be meta [F17] ❑Does Not 8 j ❑Not Observable "L []Not Applicable 303.3 y Manufacturer manuals for '_ F` 't 'i ❑Complies :Requirement will be met. [FI18]3 mechanical and water heating '. ❑Does Not systems have been provided. , ❑Not Observable []Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) ,:2; Medium Impact(Tier 2) 3`"' Low Impact(Tier 3) Project Title: Pozen Report date: 03/02/17 Data filename: Page 10 of10 r 2015 IECC Energy Efficiency Certificate Above-Grade Wall 28.00 Below-Grade Wall 42.00 Floor 0.00 Ceiling/Roof 76.00 Ductwork(unconditioned spaces): Window 0.29 Door 0.30 Other(Except Gas-Fired Steam) 95 AFUE Cooling System• Water Heater• Name: Date• Comments PHILBROOK. Pl6" ENGINEERING :' FIELD. REPOAT/WORKSHEET Project No Sheet... NO—. ! of— . -saesdseee2. . GENERAL DESCRIPTION Builder,, Bill Picardi 508 ol-292-9/360-1370 8'th ed P16-48: Narrative: 1 Family 2-1/2 Story Colonial style Hip Roof House cs5265 4i/ Rear Florida Room. & Open Decks bn:Miked.Foundation `. • i pLocation: DOZEN, 060 Main Street, Gotuit.,, MA (NQFM Constructiion. 211x 4'^/6" Rough Stud Platform €rams w/ stone fi Bi- T VARNUM --- wall Foundations vy Stick built Wood. Framing PHflDRO4K y { -=---- Hea MECHANiCAt a SPECIAL CONSIDERATIONS Q � q.30$90 i Use" Group-(s) : A-3 (1 Family Residence) l ------------- Construction.Type-. V-B (unprotected):: see. separation. kielow t --'- --ts o, Site Checks 6 Plan/Layout Reviews Misc or Commen -------- - o: Design Review LVL/Steel Beams 4 Supports o.MEMO w/ Plan Notes & Certification s DESIGN CONSIDERATIONS - I Soil Data: Site Plan or Boring hog available: NO --- -- Preparer of plan. or log:. } - Direct Observations YES - P07-08 Bearing - Coarse-medium Sand w/. some Gravel USCS. =_SP(SM)_ SBC Class _8 Specifics: Br{allowy _' 2,.A00 lb/sg_fts j i w/ 20 allowable' width-increase i Fire IIata: Standard.rl/2'! (M or Old: Plaster inside, None £or cuts :d® ; Road s. - - s, SBC-Iocation. #./sq ft Dur. Note ---- -- -- -- - - - -- - - - . 10t Floor 40. 1 0 Tbl:: R301:5 2nd Floor 40 1- 0 Tbl,: R3'l Attic. 0 1..0: Tbi;. R301.5. t t Decks (use 50 for ,open decks.) 4"0 1 0. Tbl:. R301.5 t Partitions: 2x4/6. 12 1..0 Bear/Non-Bear: Snow m - -7+/12 .( 31.1") 30 1.15 Tbl.: R301,_2(5)-(MA) i Wind - Speed.- 110 MPH EXP 8 1.0 Tbl. R301:.2(4).(MA) Roof: Pitch: = 30° to 45" Mean Roof-Height = 25-V ft f: Re£ .PraO (Horiz) Zone. 4:._ 20' MWFRS Tbl: R301.2•(2) Ref Prey: (Vert) 'Zone°3 2!,- C&C Tbl.. R301,.2"(2`) ( Loadings. t !at Floor 2nd Floor Attic Roofs Decks: } t. LIVE LOAD ) 401 40 0 -30 50 DEAD LOADS 12s 13 $ 9 16 Mist I' EWP Floor, 2"x: 8"/10" Decks 'Stick Roof' DESIGN TOTAL I 55• 5S lU 40 80' w/' round 1 w/ 5% on DL r Wood Frame Coo t Manual-1.=2 FamLly�-.'Chg 2;�Engne�ered Method � NQ changes to lateral restraints or pro?ected exterior: areas: k CHECK Floor &' Dectc'Loads for Dropped `Steel/wood Beam Conde bons: P82 P'RV1ti7 POZEN - CAPE 1310-00 PHILBROOKt Ne ENGINEERING. FIELD REPOATM A SHEET Pfoiect No GENERAL DESCRIPTION Buildsr; .Bill Picardi 5'08 481.-2929/38G=1370 8th ed. P16.-48 Narrative;:'. 1 Family 2-1/2 Story Colonial' Style. H p Roof House - c 5 ---- -- W/ Rear Florida Room 6 Open Decks on:Mixed,Foundation �tHt3Ft�� a-Location;. POZEN, 960 Main Street, Cotua.t :.:MA f VARNIJM y� - -- -- RHILHROOK DESIGN ANALYSIS_t: Z8. .3Ay' trill'] %o.�I A06 00 and Engineered Des g(IAW Para t2301 1 3.) for Joists,�Headers 6 Support" ONAIE��'i pp 29.Ox: 10(6j PSI Simple Spz. #:1 = Dro ed.Beam; W2x50 (W]8x55j ASTM.Grade:.:992 /. E - -. Wul(roof S Wall) _ 22`'"/2x (30+20:j' - 1,:,280 lb/lf full- width Wul(2nd flr) =: 41'/2x (40+20) + 60 = "550 lb/lf { Wul(sum) - 1.,.830 lb/lf full length: Span, 32'"0" o.-o } DELmax 1.34" (@ 85:.%)'. AELact.= 1::23" for W2ix50 End.Pts 29,300 lb Ok by Ener Cale V6 A7 ;1 1 42 - Dropped Beam; W18x46. (W16x50) TM`Grade. 992 m/ E 29.Qx :10"(6) FSI" Simple Spa" 1 Wul(xoof wall) = 120 lb/lf + '50 lb/lf 1170 lb/lf:'full Width. v4 Wul(2nd flr 6 rear deck) = .19'/2x (40+2O) + 24'/2x; (40+25) - ;1.,35.6 lb/If Wul(sum): - 1,}520 lb/lf full.length Span = 29:'-0" .o-0: ! DELmax 1.110 .(@ 8S$r). DELact 1. 18" for 1Wl8x46 f i End, Pts = 22,,000, 1b OK by Ener rale� v6 1.7:1 43 Deck' Joists; 14" TJI 360. Series' @ 1.6" o/c Wul: _ (40t20)x 'I.33 F.,SQ lb/lf Span 241.0" OK by T7''6rteC) 45 2_ End Point = 745 lb/if (Note. - reduced to 1;2" o/c: fof Rim Beam below) 1 y 4 = Shared Dormer Su rt Joists; 2"x 1:2" Rough + 2 ea; 1:75"x:;16" MieraLam:LYLs Ppo g 1 { Wul(2nd 'fir dormer) =. 28'/2x {30+15) + 80- + 20 = 820 lb/lf. .. 1 -. 4 NOTE:. Toads :shared between ex�stincj :and sistor LVL-a Will(sum): - 820 lb/l'f fd11 length Span...- 18'°6" o-o Separate Loads: ;Balance by EI 547 2 9 2,270 Ful(LVL) It/If. W121;.(2ic12) 140 lti/3f OK by Eaef Calm v6.17,1- DELmax" = 1.34" (@ 85 `) DELact =. :7.1" for Assemblg 5 - :Flush: Rim Beam {supports Declr, Joistsy ; 1:75"x'.14" MicroLam LVL WU 745. lb/lb, i Spans 7'3^ o/o for: over '4 spans OK'by TJ'FortelN` v5,2 t #6 - _Flush: Rim:beam (supports Deck Jois,tsj ; 2 ;ea 117510x 2:1,875" M croLam LVLs., i Wul = 11';/2 x' 00+20) + 25+ 100'c= 455: lb/lf, Pts''from' #5 3"', 7';Q;; 7'1,31% 713T:.S 11011 i By i-i6pection. DELact.« DELmax OK.by TJ:Forteg v5 2'.' #7 - Columns, 5!'x5"xVs HSS. or 511' dia. ;Stnd Steel Pipe ' . Pmax 29:,000 lbs: Leff 1010!' maximum':@ steel; « "wood frame Pallow > 100 kips. OK`b" A3SC�Tables s 6,OQ0: lhs 8 Corner: Post Bearing @ Pier = ' Base Area:'Cylznder = :24" din. Bearing 'Area 3 14 sg £t or :about 7,'544,lbs QK.,by:Dsszgrt: #9.'Hi h Load Din W i=a a .is,v_f=5,500 lbs .� g _ p � _.. �. V(mall) (Roof, Ceiling Floor) x (Width)/2 x E7C0 B (Mrh 26i') Tbl: 2 5B 125 x, I .; / lx . '/2' 5,502 lb outsidenersV 7 > and thss_ ss shared over 2 ;panels Wj 4".0' of high-strength construcion v(wall high strength} - V(high strength)/Leff 4,820. 1bj4.0' ='1,37.6 lb/lf Dse�APA Rated 5/8" w/ 2 rows of lOd nails of 4" o% all edges an BO'►'p S*aQa OK to 'I,720 'PLF _ Double All Bounda� Membera i Sn 7 d R7nack All 7 Sinarn Ox-- APA F3 gh-Load :D� � 1 111r✓/Ivv1♦ ENGINEERING FIELD REPORTMORKSHEET Project No. tO7 BEM N M. EP t: No � 3 of DESIGN NOTES:• Note Please verify dimensions; scaled.from plans to existing t Provide uplift connections All wood foists to beams; flush :or:dropped a SK-1, #1 r Dropped Beam; W2.1x50 (W18xS5). A3TM Grade 992 - Simple Span',.. provide SK-2. 11/16" dia:.. holes for a3l ;holting of ledgers 4 :bear n_g plates &: SK-3 #2 - 'Dropped Beam; W18x46 (W16x50) ASTM Grade 002, Simple Span.. Provide 11/16" dia:;. holes for all bolting of ledgers &_bearing plates 1 #3 - Deck Joists.; 14" TJI 360 Series @: 16" o_ /c wl Simpson IUS237/14 face.mour #4 - Shared Dormer Sup port Joists 2"x I2" :Rough. + 2 .ea 1.7511x 1511MicroLam: LVLs, Fasten to 211x 12" w/ 3 rows of: Trus-lok screws @ 15" o/c.. Provide 7 Simpson LS series single side end connector clips to beam ledgers ' #5 - Flush Deck Rim.Beam. (supports.Deck Joists).; 1.3.5"..x l4l MicroLam LVh.s #:6 - Flush Floor Beam (supports Deck Joi"sts);; 2 ea 1.7511x 114 50-MiqroLam. f s: LVLs . Carry thru loads, bola to and plates and are supported at their center points w/ 5 25" square 1.8E PSL posts #2 Columns;: 51'x5'Ix3/811 ASS' or 5" dia Stnd Steel Pipe.; Columns w/ base. i plates and :top caps support steel beams and outside corner of deck and 1' Florida room Provide. baseplate bolting to foundation points t #67 Corner Post Piers 2411 dia. ADS pipe or Sono-Tubes. Piers to rest on ( excavated in material,: throughly Wetted and:compacted. OK .to add . supplemental 811+ of gravel pack #9HighLoad DiaphragmTWalls_ 'Provide double boundary members to receive 5/8" CDX on both 'the inside :and outside - stand vertical and limit the: butt joint to middle third. Nail boundary w/ 2 rows of 10d nails spaced ' 2" o/c staggered Fasten plywood to�steel tube w/ IdILTI screws-:the same: Oaf ty 7 VARNISH f'tiil8Rl7QK �" met,AHICAt rtr. STD S!©NALt��,� f 1 � _ 1 j 3 j## � i } P82-FRW 7 f i Philbmak Eng.Z Const. 107;aea streak . Den4lc MA 6906 �'tb • Li@ 4, Existing Second 'it_f Fioot } T? _4°12 y� tm Y 3 c. r..�....�• `n 'Existing First Floor`` �� � w P! n 1 A„ t: OI tb ff t 0„ Confirm Exst!Cofumns Y ' 7)1 Section 6 1` 1e 1' 0" Pozen 9M M Phiii nok tngfl Goose. 107 Bcach stisetAgr -SK 2 00, U ., n G. $ p_, rn co 00 -_ Q }_ 60o C GO CD- 11 6 r i i• + J � ppR 1 t k... 1 1 4L ! } k.., { ,. + \-11" . A-/ ok Eng.1k Gorist;.. �a py+yl��Q7 pc�h atgrPtle, e^^egq4pp r , Plb S i vi -714 : 4QQ a A t � f A. E F � i • dl y� If � 1 s PHILBROOK ENGINEERING. Nei Title POZEN'<Plcardi:Construdon Project ID. P1:6 d8 T_`Vamum Philbrook,P"E. Engineer. 107,Beach Street Protect Descr Primary 2nd Story Clear Seams Dennis,MA 02636 508-385.8682(o) 508-364-1301(c) Tvamphil@Verizon.Net a: s, ar2uat;t l r1 Molt# l@.!#f#1pl@ 8 8ttt FMi EWS-e'mA VBMD^ 11PHI;1 PHhDOCUME- LBR 30ERCA 2PIU8-1,EC6 - _ ENERGALC,INQ,'1983 2U17,8Uild 6.1.7;1.1i Ver.6.17at`.18 Description; Tall,Slender Beam Ample Headroom Keep:Side Loads Close to Centermeb Steel;Beam Design Main D1rnng/Kitchen Al perlllSC 360-1Q t8t:2D1z;'CBC 2o1s,ASCE 7 STEEL Section "W21x50, Fully Braced _ UsingAltowable Strength Design with ASCE 7-10 Load Combinations,.Mator Ax1s Bending., Fy= 50.0.kst E= 29,000.0 ksi Applied Loads Beam self wel0t.calculated and added to loads Unif Load:D=0,020, L=0.040 k1ft,Tnb=20:5t1 ft Unif Load: 0=0.020, S=0,030 klfl;TrI6=11.0 ff 'Design Summarl � _ Max fb/Fb Ratio. = 0 719:1 t4: Mu:Applied 197 445 k-ft aV16,000.11 in Span i#"1 Mn/Omega:Allow 274,451.k ft 224 ;ato: pt Load Comb. +D+O.75OL+,:4.150S+H. _ T Max fv/FvRabo 0166:1. — x_ _ µ Vu:;Applied 24.681.k ' at b,bbb ft in Span#1 :32.Oft vn 1 Omega Allow 158.080 k a Load.Comb:'; +046.75OL+0.75OS+11 Max ReacEions (k) ra fir :. v+t; E H. Max Deflections �. .: ,.. Left Support 10,88 13:12 5.78 Downward L+Lr+S 0.682 in Downward Total 1.282:in;. Right Support 10.86 :13.12 5:28. Upward L+Lr+s 4,000,in Upward Total 0.000 in.' Live load Deft Ratio: 563 Tatai;pefl Ratio. 2gg Steel"Beam`DeSO Rear pming/Srttrng Area _ Calcutadons perAISC 360-10.IBC 20A2;CBC'2013,ASCE 7 10 % STEEL Section: W1646, Fully Braced Using;Allowabte Strength Des ignwith-ASCE7=1o:Loa9CbMbinat66P ,MajdeAxis"Bending Fy= 50.0.Itsi E:= 29,000"Oksi: Abblied Loads Beam self wetght.calculate land added to loads.. Unif Load: D=0 02t7,`L_0,040 0 Tdb=9,6b ft UngLoad D=0.0250,.L=0040kit,Tn7b=1204 Unif Load D=4.12d kltt,Ttitr-•4.O ft Design Summary Max po 0 Ratio = 704:1 1 Mu: :Appllied 159 365 k-ft at 14.5 00 ft in Span#1 i Mn/Omega Allow 226.297 k-ft i Load Comb +fl+L+H ` Max fv/FvRatlo:= 0.16f3 `1 Vu:App{red 21..981 k` at 0.000 Itin Span.#1 H 29.o ft Vn/Omega;;Allow 130.320 k Load:Corrrb: +D+L+H Max Reac,iOnS {k) o L ti S. 1N' E K Max Deflectors Left Support 9.51 12.g7 Downward L+Lr+S 4:666 in Downward Total 1.175in' Right;Support 9,51 12.47 Upward L+Lr+S 0.000 in Upward Total 0.000 n Live Load Den.Ratio '522 Total:Defl Ratio, 296 MEMBER.REPORT level,F.Dr..4bbt PASSED 1 piece(s).14"T710 360 @ 16".00 Overall Length-24 0 0 a ' T 2400 L'J Q -All locatioris aie measured from the outside fac e O let su pport(or left:ontllever end):All:8lmeri9on5.are:horizofttai,. Design Resifts %''Acdiat®iccatann. Atloved .= Rewtt s V oeeMember Reardon(Ibs) 937'@ 0 3 8 10.80(1.75" Passed(SZ96) +1.0 L(All Spans) Member Type WstShear(lbs) 9379038 1955 passed(48%) +.`1.OL(AH S ) Bigid$g Lise Revdr�inai. Moment(Ft-lb5) i 5483 @-12 0.0 .7335.. Passed(75%) +_1,OL(Ail Spans):lJve load Defl.(in)i 0.557@ 12 0 0 0 781 t�as5ed(U504) +1.0 L(A(I' nS t>�dgn ckdmdology abTotal toad Defll(16) 0.836 @12 0 0 1.171 Passed(U336) +a.0 L(Ali:Spans .. TJ-Pnui".Raung 39 -_ .35 Passed •DdlecOon cAterw:Les{U36D)aritl7l(U240), Top Edge Bracing(Lu).Top compressl-edge must be bracedat 4 3"0 oft unless detaged othendse.. 866m.Edge Bredng"(W):Bottom mm scion edge mud be tuaaed at23 5 0 o/c:unie5s de4fled att vise: A sbrktural analysis of the do&.has not been perforrt edr Deflection anafysis.is based on composjte action wfth.a single ayer.Of 23/32"Wey2!h u *e-Panes{24"Span:Rating)that is gJuW and rtaikd down: AdditlorW conmdera for theTJ-Pt—Ra u*g ingt�e:,1/2"Gypwm:ceJfing,1z4:Rat sCappin9,:perpendiMar parb"tiotts, - Bearing tangM `- ,.Wads tD:SOFp�tom) e , SN(1p0£tS - _ Total-_ A.aita�e Required Qead. .. .Total,„f Ao�saicv. �) 1-Hanger on 14'M-bearn -3.50" Hanger+ o: / a_ 320.._. 690. 960 'See'-itote 2-taiger on 14"ISi-tteam 3;50" Hanger" 1.75"7 : 3H 646 960 See Hate, { .'•.At harger supports the Total.B,eMng dimension is:egt�l-tD the width,of the materfal:that ls,su;*Mng the hartw •s.See'Connedurgrlii'ttddwtoi:a�tiotialinformatlon'aiM/orregtiiiemtiits: 1 Required BearingLength/Requited Beadng:_Leto witiiwebStiffene s Connector.'-Sim n Stron -Te Gontnectafs „ # Support`::` - MadeY-" _ SeaRtett9et ` „-.T<pMails _ ;.:,,FaaeHailS: , .'t+�mber.fla0s Am�sortes.-. " 1-Face:MourrENarger -.. IUS2:37/i4 2.00" J N/A..._.. 12-10dx1-1/2..,'' .. N/A: 2-FaceJolotmuli .W. ,. I(�Zf37f14•. z.00"- N/A. 124od x 14 NJX_ Dealt a.t I01*LYYe LAWS Lo®tlon(�de) .; 5pacirtg~' dB.Qgj {360) i t3n to[m(PSF� 0 0 Q,m 24"0 D 16" 20.0 4o.o. Res",*" U�� s Rear Ope Deck - Weyerhael�eCN01es r s SUSTAihiA&tfFORESjRriNIMSh/E weyertmeer warrard5 ttrot Cte slang of its pioducts wilf be In accordance with weyal>aeuser product design Mteria artd publi�ted design values: Weye:haeirser e>Q?!esstY drsdalms airy otttt wartandes related to the soRware Refer tb cturerrt Weyerhaeuser Iitrrature for rsmilatlon detatls, (www.woodbywy com)pcceswries(Rim Bodirl„Bioddn9 Panels and Squash Buda)are rgFdeslgned by dtfs sofhrare Use of arts software is not tilt sided w drcumrertc the need far a design profeasiortat aa.debermirted lty the authority travlrg jurisdlMon.The deOww of rep i builder or framer is responsible m. assure ftiat fhls raiculatlon)s mmpplible widt the overa0 ptojea Roducts mamdadured at weyer.hawser fadiitfes are Bitrd-party owdred to susta)iiabte- forestry star�rds.WeyeAtae W-Enowered'Uim1w Products haw been evaluated by IOC ES under bechntcal rep"ESR-ii53 and ESR 1307 and/or lh acwrdarce witlt app8cable.ASCPt star>dards:;Far current Ede exaltation r refer ro ttttp:/lwrww,wouCtiyywy corN s_Co Reports aspii:. -tie P applicatldri,hrput d0stiyt loam,Gi(RenKianS:::arid supportinformatlon have bit proviQed by f6rbe Software Operator Fartu9swareUpuratar tai3.totes F 1#25f2f}i71yJ47.5$f FOtle 4,2,Deg' n En ine V6.6 0 24' .>_) T-',fsmute:,Phdtutfpk' Pi3$F# � � ( P+MBROQK Et4GINKRfNG- 990 Main Strao P02en.4te i (5m)M345 i8•t CAUxt.MA - + nt7irii' VtaTxt)R —,--.-----•.-- }ege t or fi 0 III: I ME�76EIt RmRT L:eve�Rim Flush Bean; Phi i piece{s)1.3/4"x 147 2.0E MicrolIAMI&LNL Overall Length;:`:29 0 0' . ----••-----�-� ter-.-.�..--.,�,.�.—..�;-,�� 73`0__ 730.. 730 .. 730:.. �( o All locations are measuredfrrom the:outsidelfaoe.of left support.(or left cantilever,erd).Ajl dimensions are h6dwritaL,. DeSignResults, achwt�lmahm+ :Atlowed tiesutt tDF tgad:CotnMnaUon,('taWem) ',, .<sx."' systeni: taoor. Memb&Readjon.(lbs). 6324'@ 73 6 6668',(6.60") .Passed(9S%) —.: 1.0 D+1.6 L(Ad1.5pans)' Member Type:Rmhtwin Shear(Ills}:. 2159,@.5 10:0 4655 Passed(460A) 1.00 1.0 0,+(1.0 L(Ad)Spans)'. Su(lding Use Residential Momait:(FC 1bs) �4313:@ 7 3 0: 12129 Passed(36%) 1 00: 2.0 D+1.0 t(AdJ:Spans), avatd?n9 coee taC?ao4 Uve Lwd Defl.(In). 0.037.@ 111, 0.173 Passed tJ999+ - 1.0.D:+1.0 L(PJt Spars) De r b4Y:aSO' Total lead Deft.(in). Q.053';@l 3 610 '11:34fi Passed(t1994+) -.:. 1.0 0+1:O:L-.(At65pans) Deffecpon&Mria:LL.(V480)arje7t(t/240). Top Oradrg(W).7op.compeessian edge'must tie Draeed at16`10 0 o/cume§5 detafleii olAertvise. 8omom Edge Brairg(Lu):,Bodom,compresslon edge must be braced at 12 3 0 atc`unless detalkb'oUi�w a Bearing length toads bo Supports{!bs) .up Total `Available ';ftequ( Uve red bead Tatat Acaessori�'.,` _i 1-Stud wait-LA. 550"- 3.75' 2.13' 623 i657J 2475J-128 1:3/4"RW Board ' _ .128 Z:-I Stud waft:-t5t 21$6 : .,-4138 ne_..6324• No 3-Stud wa8-t5L 6.00 6:00" SS25' Iti72 3967 : 5839' Norte: . :.: 4-SWwaif-Ida 6:00'.. _6 00 ..;5.6r. 2186 _..4138 .:6324 None. . . ._ .. ... 5-S1ud:waA 15C,: 5.50� 3:75" 213" 823 16S2/- 2475/-128 1;3/4"Rtrtc6oard •ftlm Board is assuriigd tarry all:loadsappfled dir6W*a4*tt bypassing the d ember bring desk 'd Triwi head Floor Live Lo d9 ' Location(Sure) Widfh', .,. L0.91)) (I:DD) t ammenb 0-Setr weight(PLF)` o I li to 28 I0'4 rota 7t2 0 0 o to 29 0 o Residermai-;clang t-Untiorm(PSF) a'D'0 265:D 480:0 s W�wwrants:tteat the sizing of its pro Wr8.t7e'in accordance.w4h Weyerfianuw product dj?MPn criteria and Mr RaWd design*elUes.: ° .. ..F Y SUSTFi1NA8lEfORE5TR1'fFi(1iAriV Weyelfrae�rser urns*LdWatms ant other Waranft rdai)W tp the WtVwa .R�to-ctarent Wemba—0#3awm for in�liallon de4ft Y (wwiv.vroodbywy.com)•Aocessories.{Rrm Baa'rd;:Bloddrxl Panels and Sq sh Bloat)are not design d by tl>is software,tS of this MftWaie rs notiMended to; arcumvent%die need fora design pnifesdbnal as Cefiermined.tiy the auU my having)iirt;dictlon,The designer of MCord,bultder or trarnerJsto assure ttiat tidi caktiilatiar is w t�pwp(tti@ mpatitite with itre overa8:project Produixs rtianufaGCired at weyehaeuser taalldes are third-pa W cerlified m�fnabfe forestry Stdards.tNey�haeuse-,&-!eered lumber Prodrids trove been'evatuated by ICC ES MKIM tedtNag reports E�t1153 and�t 1387:arai/or 4ahed in abooiva Wtth appUrahle ASTr?slandard5: fbrpuratoo eyaluauorr reporls.n m htlp:/wwW.Woodhywy.wmJservicesJs CcdeRepwts arc Tire product appttca8or%lnput destgn'lo s,diarenslorts ark support W*natiorf lima beei WovtQW by ante Software Opivator i iorlaSa�rru®f>Erdrator- ,Iabtdot�s 1/��J2(39T 1�42:29PA±3' T.varrxxi-f�hifurook:'� - - �+c<5.ai - - P>}tte;u5:2,flea4n EfigrOc�;V6,8.£k:.`(4. pH1tHRC]Dit,i;NGitVFERlN:GL :�o too sveP4 P0266416 Om 385- m Colma,MA "f vnrnpixlil�Y?rsmn.nei t'age tot i I , �`O ''P MEMBER REPOPS Lever Fbor.Hush Besm PASSED I 2,piece(s)l 31.4"x;117/8" 2.0E Microllam®;LVL: Overall Lengths 29 0'0 4 930 1080_ 930 q o a o a All.lotations are measured,from,the outside face.of lAti support(or Wcantllever end).All dlmenslons are horizontal. Cesi nResuli CcmDFnatlo":{Pattern) Member Reactiom(ihs) 44452 @ 93 0 14438(5.W) Passed(100%) 1.0 D+4.0 L(Ad)Spans).. Ptember Type"Flush Beam. Shear,(lbs) 8066:@ 20 il_10.. 7897. Passed(102%) .1.00 1.0'D+1.0 L(Adj Spans).. aujiding Use:eesii:11in it Moment(R-Ibs) 13993`@ 93 0 17848... Passed;(78%) .?r1:00 .3A D+1.0 L(AQJ-Spans) &nlding:Code IBC 2009- Uve<Load De&(in) 0.155 9143,0 0.350 Passed(1!812) 1.0 D+1.0 L(Ak,Spal s: Crril9n o0 ,asD Total.LOad Defi:(in) 0.205 @ 14,3 0; Oi525: Pawed(L/614) 1.0.D -:1Al(Alt-Spa r'.,: _:_ ..... { dettettitln cr{brla:ll:(V360):Bnd Tl(L/240). ToDttige 6radfg:(0):Top comAtzlon edge must to braced at 113;0 o/c unless detailed altierwlse Bottom Edge Bradng:(W):Bottom com 'presort edge must be braced at 8 4 O,o/c_unless dHail otherwise tl�eing tel�gtb: lA'3d4'l0 SUpports'(Ibs) $1lFlw P�QP3S Total Availati{e Raquinxd ;Oead, Tofai Aacessorles'. i-Hance on 117/8':PSL.beam .. 3.50'.. Hargal 4,50" ..1969 .3392 5361 -See noW 1. .. `. '. 5.50e 5:50" 5:51" 5635 6817,. 14452 ` Node al 31 Column-of .siso- 5.50" 5.43"' -5557 8707 44264 .:None 4-Hanger on 1171W"PSt beam 330" Hangerr 3:50" It38B 3220 5308 Seerwie'i •At hanger wpporis;the Total BeaAng dimension tr equal_to the wtdlfiaf tl1e material that is supporting the ttargef: •t SeeCnnedor grill below for.additionaf:informationarrd/or require-ts. _, s Canne�al:.Sim n 5tron 1ie;Connectots. �` �• . �. _ _ Supp wt tdodel', Seat Lertyth. ;'.; fop ttalis:' Pace i�is Mer"ber`NaOs, Adcessauies 24:SUS se{fErMIng 16-SDS self-drilling 1-face Mount Hanger CA3 63(H1=-9.25). 450° N/A wood screw:o.242-dia. wood sneer 0442 dia. ...-.- .. .. . m 4 .. -:. 24-SDS se f_.wMfV �16•sos sdf-0ii42lfing 4-Face-t4ount Hanger .01GLLl 63(1i1=9.25) k5. .242d N1A: wood sgpw 0W' .wood mr ;0:2 dia 7. ,Tfibli ry,.; d loads`{ -' {o®tiun(s{de) Width (a.90) - ( 90) ewnntertts_ A -; 0-SeH.Weght(PLf),. 038 to2888 N/A. 12.1 0 0:0 to 29 00 Residentlal>.:pving 1-tlnifomf(PSF) too 235.0 220.0 A ren 2 Poi 03W(F gt(ib). ... .. rontj NXA 823 1652:. 3-Pomt:(jb).. ....-.•.. 7 DiO(frwH):. N/A 21t36. 4138r" 4-P.oint(ib)_ ..._ _ 143-6(Rait) ..N/A .1872 ;3967 5-Point.(lb). 2L6:0(front) H1A.... .2t86 4138... . . ' 8-Pont(Ib). 2899(rokj NIA sm: 1652 Mtinber Nottes 7 1�Flour'--florlda ttoom PLUS Detir,Loads from Above FcstO 5attware[lpozstos lob Naies 11261201111.12 0 PM T vaaw Phgtxii4k. l clsa rl FDfte y .2 D sig t Engfne?V6&0.1;4 . S''titt 04t4(1K f NGiMEEt?NG 96Ct main 8iieat Pozen oe 15m)W58fi82 Town of Barnstable N Regulatory Services "m'� ` Richard V. Scab,Director °r�; •`� 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 O ner Must Complete and Sign This Section If Using A Builder Ck I , as of the subject property hereby authorize C �Zt.A VIA L to act on my behalf, in,all matters relative to work authorized byL building permit application for. tJ� V (Address f Job) **Pool fences and alatrns-are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S' e-of Owner ;' ` Signature o Applicant Print Name Print Name *, Date QTORM&OWNERPERMLSSIONPOOLS Town of Barnstable . Regulatory Services j o� Richard V.Scab, Director Building Division . = Paul Roma,Building Commissioner M 5 M. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to.include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached 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 wifh the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "A ny homeowner performing work for which a building P required permit is r wired 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 to amend and adopt such a form/certification for use in your community. .t The Commonwealth of Massachusetts -� Department of Industrial Accidents Office-of Investigations - I Congress Street, Suite 100 Boston, MA 02I14-2017 �" Sv www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Picardi Construction, Inc. Address:255 Turnpike Road City/State/Zip: Southborough, MA 01772 Phone#:508-481-2929 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with_� 4. ❑ I am a general contractor and I 6. New construction employees (full and/or part-time).* have hired the sub-contractors. 2.❑ 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' [No workers' comp. insurance comp. insurance.* 9. ❑Building addition required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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:KI.M Policy#or Self-ins. Lic. 4:AWC40070208882016A Expiration Date:03/15/2017 Job Site Address: 41,4 City/State/Zip: 1 1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiratio 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 Investi he DIA for insurance cover erification. I do hereby certify and a ena per that the information provided above is true and correct. Si ature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ."� PICAR-3 OP ID:SG CERTIFICATE OF-LIABILITY INSURANCE DATE 03115/20/YY) 03/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NorthStar Ins.Services,Inc. NAME: Fax 300 First Ave,Suite 100 A/c Ne E>R:781-431-2500 Alc me):781-431-6134 Needham,MA 02494 E4I1AIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company INSURED Picardi Construction,Inc. INSURERS: Redwood Deck Co,Inc. INSURER C: c/o William J.Picardi 255 Turnpike Rd(Route 9) INSURER0: Southborough,MA 01772 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 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. ILTRR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POIDD/YYYY MIS/DD/YYYY LIMA GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BOA5087296 03/15/2016 03115/2017 DAMAGE TO RENTED PREMISES Ea oxurtence $ 50,00 CLAIMS-MADE Fx�OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY JECTPRO LGC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccident $ 1,000,00 A ANY AUTO MAA5087299 03/15/2016 03115/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS Ix AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOSNON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE CUA5087300 03/1512016 03/15/2017 AGGREGATE $ 1,000,00 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N T RY L M TS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION PROOFOF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD r, - ..�►co CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) `.� 1 03/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 NTACT NAME: Sharon Greenwood NORTHSTAR INSURANCE SERVICES, INC. IPA_NE M Ext: (781)431-2500 ac No): E-MAIL -ADDRESS: g Sreenwood@ nsins.com 300 FIRST AVENUE,SUITE 300 INSURERS AFFORDING COVERAGE NAIL# NEEDHAM MA 02494 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B PICARDI CONSTRUCTION CO INC REMODELING DESIGN SHOWROOM INC AND INSURER C: PICARDI CONSTRUCTION CO INC SEE SCHEDULE INSURER0: 255 TURNPIKE ROAD INSURER E: SOUTHBOROUGH MA 01772 INSURERF: COVERAGES CERTIFICATE NUMBER: 37132 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, INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGES(RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY E JECTPRO ❑LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ - HIRED AUTOS AUTOS - Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X I STATUTE ER" AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? NIA NIA NIA AWC40070208882016A 03/15/2016 03/15/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 y N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation 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 states 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.govAwd/workers-compensationAnvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plcardl Construction Inc- Redwood Deck CO Inc ACCORDANCE WITH THE POLICY PROVISIONS. 255 Trunpike Road AUTHORIZED REPRESENTATIVE Southborough MA 01772 Del M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD p VIVMassachuset#'s Department of Pubic Safety ; i Board i'n R ulations and Standards �. License CS-014878 ® \ _ U- COnstrUCtiOn SUpeNiSpf', � �;� --� "g OLLIAM J PICARDI4 255 TURNPIKE RR. l� S,gUTHBORO Mk;bf � am i°. s11 IS Rl- • .. Commissioner � UZ/08/20'18 ��- 14 ps� z {S �UNf � IO ` may dielanasaaPafl ZbLW vw`U6nojogy;noS peoa 9)1idwn155Z ISNOb IaHVOld uopijodlo0 a;enud 8 OZiS O1��ld :odf(1 �59G0 =� uo.4 slBas s SO.LDVHINOO IN3 W3 n021d W 13 W OH aoyeln�ag ssamsng�g sneu aamnsno3;o 43W � f f A . 1 , AAC 'Me cc -- in �g YAll ACW -!�Oonlr- s �Gl1 i I i d o •�S S i e oom .0 6 a of o V-ao C7 { i AWC Guide to Wood Construction in High Wind Areas:110'mph.Wind Zone Massachusetts CheckUst for Compliance(790 CAIR 5301.2.I.I)1 = Q Check C �c 1.1 SCOPE omp WindSpeed(3-sec.gust).................... ............ ..................................................................110 mph Wind Exposure Caiegory..._.._........ . ................................................ .........._...:B 1.2 APPLICABILITY t Number of Stories ................._..........:.....-._._.. 2)................_......... �stories 52 stories RoofPitch ......................_............................ ......... .(Fig 2) ...................... .....b 512:12 Mean Roof Height »................................._.........................(Fig 2)_:......._...._........ Ift _<33' BuildingWidth,W.........................................._............ (Fig 3)........................_......_....... . ft 5 so, Building Length,L .:......::.........._.... ..........._........:.:.._ ._.(Fig 8)............._........_......:............:!aft s 80, Building Aspect Ratio(UM (Fig4 < — Nominal Height of Tallest Openine .................__...... __:_.(Fig4 ...... 5 BIB, f G CQNNECTIONS 1.3 GeRneraNcompliance with"fiamin .................... .• / g connections ............................. J.. ..(Table 2}....... ................._....... 2-1 FOUNDATION Foundation Walls meeting requirements of780 CMR 5404.1 Concrete................... ....................... .... ..........._.......:........_......: .......... Concrete:Masonry............................................_........_.......................................:.........._.............._.... .. 2.2 ANCHORAGETO FOUNDATION1'3 5/8'Anchor Bolts imbedded or 5/8 Proprietary Mechanical Anchors as an alternative in concrete only SoltSpacing-general.................I.:......................(Table 4).........................-----_.. ....... in. _ Bolt Spacing from endpoint of plate ......_...(Fig 5)........... in.s 6'-12" _ ............... Bolt Embedment-concrete....... ............. (Fig 5)..............................................._in.>_7" Bolt Embedment-mason ...(Fig 5)...................... in.z 15' PlateWasher...............................:.................................(Fig 5)..............................................2:3'x 3'x'/4' 3.1 FLOORS Floor framing member spans checked ....:_.......:... . . Maximum Floor Opening Dimension (per 780 CMR Chapter 55):.._.............:....:..........:ion_.................. —(Fig 6)........................_.._ft 512'or L/2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from E)derior Wail(Fig fi)......:.:........................._.._. Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)................................................... ft s d Maximum Cantilevered Floor Joists — — Supporting Loadbearing Walls or Sheanuall................(Fig 8)........::.'...........-_.................:....:.._ft 5 d FloorBracing at Endwalls................................................:..(Fig 9)..........................._........................................ Floor Sheathing Type .........................................................(per T80 CMR Chapter 55)................... ---- -------- .... Floor Sheathing Thickness.................._. '.. ...(per 780 CMR Chapter 55) . Floor Sheathing Fastening.................................................(Table 2).._d nails at in edge/ in field 4.1 WALLS Wall Height Loadbearihg walls.......... (Fig 10 and Table , Non-Loadbearin walls ....( g 5)............••.._.._.... ft 510 g Fr 10 and Table 5 .... Wall Stud Spacing ..........(Fig 10 and Table 5)................. __.in.5 24"O.C. - Wall Story Offsets ......... .......................(Figs 7&8)....................................... ft 5 d 42 EXTERIOR WALLS-' Wood Studs Loadbearing walls ........... ......................................(fable 5)...................... a—--ft - in. Non-Loadbearing walls able 5 Gable End Wall Bracing Full Height Endwall Studs...... ....................(Fig 10)................. WSP Attic Floor Length..._ ......................................(Fig 11)......................... "ft>W/3 Gypsum Ceiling Length pf WSP not used)....:............(Fig 11)........................... • ft Z 0.9W 2 x 4 Continuous Lateral Brace C 6 ff.o.c...(Fig 11).....I.......I................................_.._..._:_.. Double Top Plate Splice Length .....................(Fig 13 and Table 6)__......:.........------ _--- ..._.. ft _ Splice Connection(no.of 16d common naifs).............. _ .(Table 6).._..............._.......... _............_...._... f .r AWC Guide to Wood ConstrucKion in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7s0 c1MR 5301.2.1.1)1 Loadbearmg Wall Connections Lateral(no.of endnalled 16d common nails)..._.........(Table 7)-.------_............................................. Non-Loadbearing Wall Connections Lateral(no.ofendnaiTed 16d common nails).._..........(Table 8).............._................................... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ......_......... ...............................(Table 9)........_........................ Sill Plate Spans — Full Height Shads(no.of studs)..............................(Table 9)...................................._................ — Non-Load Bearing Waii Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.....................................................__..:.(Table 9)...................-............_ft in.512' Sill Plate Spans. .... ......:.........................._........(Table 9)........... ............... ft_in.512" — Full Height Studs(no.of studs)............_......................(Cable 9)......................................._........._.... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously{ Minimum Building Dimension,W Nominal Height of Tallest Opening2 ......... ......_..._............ _............ .................._...... Sheathing Type........._....._...._......................(note 4)................................................. :.._. _ Edge Nail Spacing..................... (Table 10 or note 4 if less)......................_—in. _ Field Nall Spacing...........................................(Table 10)................................... ..---........ in. _ Shear Connection(no.-of 16d common nails)(Table 10).............................. ................:....._ _ Percent Full-Height Sheathing................._....(Table10)_.....:........................................... _% _ 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)........._.......... Maximum Building Dimension,L Nominal Height of Tallest Openine......................................................................_5 618" _ SheathingType......................................._(note 4)................._.............................I...... — Edge Nail Spacing................... ...(Table 11 or note 4 If less)....................._. in. _ Feld Nail Spacing........................................(Table 11)..............................._................ in. _ Shear Connection(no.of 15d common nails)(Table 11).......................................I................ • _ Percent Full-Height Sheathing.......................(Table 11)..._.._._...._................................._°/a — 5%Additional Sheathing for Wail with Opening>6'8'(Design Concepts)..................... — Wall Cladding Ratedfor Wind Speed?.............__.. .................................................._..._......................__.._......I....._.... — 5.1 ROOFS Roof framing member spans checked?......-......._......(For Rafters use AWC Span Tool,sea BBRS Website) _ Roof Overhang .................................................. (Figure 19).............._ft 5 smaller of 2'or L/3 — Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)..............................._._._.....U= ptf Lateral ........ able 1 Z — Shear..... ................................(Table 12). .__.....................................S= pif — Ridge Strap Connections,If collar ties not used per page 21.....(Table 13)..............................T= plf _ Gable Rake Outiooker....................................... (Figure 20).......... _ft s smaller of 2'or L 2 — Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift_................_............................(Table 14)........-...............................U= i6. _ Lateral(no.of 16d common nails)_.(Table 14)................................�_..:.:L= Ib. _ Roof Sheathing Type......__........................................(per 780 CMR Chapters 58 and 59)............ . Roof Sheathing Thickness...................................... Y............................................_in.a 7/16'WSP Roof Sheathing Fastening..........................._............(Table.2)........._................._............... _.._..._ — Notes: 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 530121.1 Item 1.if the checklist Is met in its entrety 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.. 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. ' ; � �FFrt�Grricfe fa ft`�ad Corrrh-irctiart iir.£�i��Fr�uzdttreds_•fID rrt��r f�'rud�a�re ' Massa chusetts .Ch ecUigt for CompH mco gaff CAM sinr2LI_1)` 4. - - a From Tables ID and 11 and Iacafinn of vralf sluing and Bulldtng AspectRaflnr del�rmine Fet�rtt FuII-Height' _ Sheaff ing and Mal Spacing regcfirwT=ft b. load Staid nai Panels shall be n*t<mnn Nckness❑f7116'and be bstalled as falloff . . L . Panels shall be uts dad W5 sfmngIh azis parallel fn sh& I X hnrlmtdal jdrtis shall D=ir aver and be nailed to kanimg . tit_ Dn single staPy mnstntafion,panels shal be ached to b0tinm plates and iap.inember of the double -- -.— — P _ .. _ ..__.. a - - ---- -- .-- - - —-- ---- ----1t Dn fvmsiwy F-onsln Dn,?��akshallhe inAhelop member of fha-upper double top------ plate and to band joist at botbm of panel UpperaffachTent of tourer panel sh be made in band joist and Io�veraitadhmertt made to lowest pfafe at fast fioarframing. ' v_ Hor¢mnfal rrJ spacing at dotbfe top Pb6er,, bMd lnisls,and gin=shall-be a double nova of 6d - staggered 9 3 Inches on center per figrm betDw:VmIcal.and Horizontal Nartng for panel Affmchment , 5. Glazing ptatec5ont a)*new house Dr hDrimnfaf adMon-requirad ff prnjertis i rNle Dr cioser'tn shore(generaliSr■south of - Rb-- Z8 or north of Rfa-6) b)verfical addman-nat reqLff6d uiless them Is e�rz renovation b ihafast-ffon_r ' c)reptat zlnent"v,Ridtrrrs-needs EnMW mnm vafinn mmpltarnc�-only(chap.93) ' 6.W6Dd Frame C.:artsfru ciao Manual OWCMI for 110 MPH,Exp sum B maybe obtained from the Americ ti Vdaod 4:ounctl (AWb)wabkffi. ttssEr�F� • - u 11 - ■. Il 1 - u _ • u n t tr11 (. r L ec iirr it t m rx xD t r tr t li Rr - tElTm{lT7liPTC 1 ,1 Li • til ii it t - tt. • u ar rst i t - 3lfit u t�� i l •� zk. �- t .. _ •S It Il kl L t a•E. .. r is t 1Ii JI Z _ _ t •� r t t rl = , ti • fi���_ �� - Z,U4LPi42'rH�l+t - � pl.T.lR See Da1E�on N,=d Page _ V-=Ecal and Hwiznn{al NarTng Dew - ' for Panel Aftat VFaI Htr�I Nailing - . fnF Panel Aii�rtr� - - . 'k4novcc+, 3 zcz qzj SMOKE DETECTORS REVIEWED a` BARNSTABLE BUILDING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING do --- i (l i�J:.IY ; !I IMPORTANT- UPGRADE REQUIRED ��.. STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. i !h�r i il4r�!�I' rl ,' +I "' ;" " t O "' .tit;�' r.,'+ NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE 1 i Ir.;„ II„ -,li rit. ,a1 I�ii 'I''1 it '' 14iII' i'rIi ' Ci ' I I 1111.�1.1 ill 1 '.II' Ili�1''i�l�� I �1 1 III I:�A.11,.1 Y •U,il µ INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. /2/1 r ' - __- —--- a J✓ � ��� , 'lI FFFFF'''" I 1 f I, IMPORTANT .; It.i} 'I I l'f t-i1 ill',t!� 11,1'i - 't'.r I;+i? ';�;',I .i i','i• ! ,t I i I' I 1, I.I II"11' I I1'' -1'I •. I II 11 7'I'll -I I+Ir t ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SO. FT. PER LEVEL MAY REQUIRE THE - I INSTALLATION OF ADDITIONAL SMOKE DETECTORS:.` 1J7I NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE F INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL ' Proposed Front Elevation PERMIT DOES NOT SATISFY THIS REQUIREMENT. 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I.li I,. i •.: I 1 I.I'J�.111',1"I+1 I1 I.'1!il 1 1.�1 :1 r 1: 00 1 Propose d Left Side Elevation Pozen A2.2 960 Main St- Cotuit, MA Jan 25 2017 t,,,; ®I - , 17T II1�111 I I II I'I'Ii 111,1 III•:�f•I I.1� 1 1 t '' t- �Il, `I�'1 t' ,rJf I Illtti I.t• 111 trl 1 11 II I IS III II. I: I loll i 11II I II1.11'I r 11 I. IIIII1111i-'I II IJ l nn II'1 III ,I' 1 I I 11.1'll �'�I"1l till :I I J I I ) I t 11 ' � i 11'r' I11 1111 1 'll� I' II111 � III ll 'I I,,J!I.II,II:I I.I "^ 111J1 I-.1 iilrl f II -I lnl �I!i tl ' i l'l 1 1 1t 111. 1 1'I�1 r l ll l� J1111 1" �k' � 1`I�r'I'11 II , 1 III it 1.,11 IJIIII IIII- It'I"1 �'�-- �� �� 11• 11:Ill.,r..ti-I L 1, 71r, :,I,I'1,11 1 ! III, - II I I,I,1J.11 1 1."1 1 fll l l illl I I I I l:�i ' illl ', I 11,1 !I I1, II i ll ., 11 'I,�I I' I' , 11 - 1.1,! - •>''r.:. ,t ,I ,!( , �/.,1 111,. ,1 , 1 , I — -- -- t ,1 I , 1-I• , \ .y�*v�'Y• �.X ly: 11 '••I-III, 'Il f1L.l 1'11111 II ilr'11lJllllr rill ! '1 llr rli II'ii 1.. I .�ll II. 1. .'1 ' I'i�, 11 .Y ♦ I�1 „y \THY �!4� ✓-�� rI I. , ! YII )11 I I ! •� II 1'I, SII IIII 1,11.1 :1 II" 11. "i,: IIII' I I liI 1, t�l I' Y Y„)�il+;;�Y� �I 11, �,�11 11•,: 11 r!'1!,Ir lllr IllrI IIIJ, Ili IIII I.-Ir 1�,' 111-'.11111J'•1� 'll � :l:�l:, I i, '1�V Ul Ij �. `i�` >.�14 ' ' )J'�Y1 ��(.Y`:,11 t II I 1 '% Y �` LrI.111!111':Illfl if r. 11!'(il 1. 11,f1•full'll"Il.l,l 'II'1�� 'Iilil'i111111'tl'��1111'l1J 'll�S.111�1'llri II'1'll 1'I 'e,.'r 11 11;IIII!.!1 �!:.. Proposed Right Side Elevation Pozen A2.3 960 Main St-Cotuit, MA Jan 25 2017 1 M ' $w,�J !•�!'r'i'r'rSi I: Il llr 1 II 4 11 III.1J.(.1 �:. LIII I I��i I./ IIl'I I i 111 r 11 I I'I.I 1 1111'I I 1'• III III IiI '.1 ( 11 1.1 1 rll I ' I I I III.J I rl Ilr I I l'li i�'IS,' f t I•Ill 1 l-�1 i I I Ir.l l'"'1 1 .'ll 1 1 1 l�y 1}II Ill I'II'F I (III 11� 11 � 'l.l � ♦ � IIIIJ llr:1 III 1 rl "I'll I; �11 J'I I I f Ill .Ill 11 I I 1llll nl )L - glll 111r III , li J 'II���yyyt'�''`77T'�777f}�IIr'�7II''I¶III�;{f1'II�;�1��������7�y7y�{��������������I�'IIIIII� 11¶¶Q1ppI�� �- I I t i , �i•� - �lW1�I11IlYJ1J.l.l.11�ll� '1 li'i.II I11 .I 11 r I 1111 ,.1 `I�+ II'l il'I,1 II ilIII�I,'1.1�. __.___..__ __._..___ 115�•'r�IIIJI I �i'II�!! { ��1 � I I'I! I I I li hill'.l i 1111 11 'II '�Y'`.:'� `y�/ >..� �/1 \ yy�.•I .,r> BSc WX�X x??,_ X.� I % Y` d �LUI � � I n Proposed Rear Elevation Pozen A2.4 960 Main St-Cotuit, MA Jan 25 2017 LI a� m a N 0 V Fr- N 0 I I I I I I I I I 60 cctti y � 0 � a ` O C CO — C O 14'-0" o CL 10'-0" 41'-6" 2 a r- Pozen A1.0 *—Blo5r yv)ilt _ 960 Main St- Jan 25 2017 _ Cotuit, MA 14'- 8 1/2" 13'- 8 1/2" 011 . I ------- __ --------- ' men LO 14, ._._.....-- --.__...--------- -----...----- -- --- - 4 o �Q c All ___- C3- ------ -------- -- o — co: - ------ ----- t -- ---------- s m a, 41 .......... __-----_ - _ "PO 00 _— — 33'- 101/2" 8'-0" 8'-0" Pozen 960 Main St - Cotuit, f EI o _ N T �tik _) T I S T a iD o on — ---- ---- O CV (_ — 12'- 0" 5' — 11 1/211ol .N _l E- L—Z \^lln�Il T v el . co _ ® g co 8' - 5" 10'-9" 10'-9" - 1 Pozen — - 960 Main St - Cotuit, ' 10-14- f(v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION >M A A Map 03 Parcel -L Application.# s V Health Division ol Date Issued � a Conservation Division ���® Application Fee /l Planning Dept. g ��� Permit Fee l ?V Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyann .niN. Project Street Address r0c) tin Village I , Owner e +A t9Q9M I AddressCJ�s iNinwiceIA- Telephone Permit Request wy lAok S o M141E Square feet: 1 st floor: existin2ooroposed"4 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Ca Project Valuation bo- Construction Type t)be%Q `��Oryvv Lot Size �'� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -V Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes X No On Old King's Highway: ❑Yes ,ZNo Basement Type: XF0 4 ;ff Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 1100 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing S new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing q t-) new First Floor Room Count Heat Type and Fuel: '�-Q Gas ❑ Oil ❑ Electric ❑ Other Central AirNII 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 �►{l I+AyY� 1C�A4(Q1 Telephone Number F 3 o ' b p � Address 7M iZ License # Y g-vl8 � ide)t,)(�^ 'VIA f� TM IV -2.z Home Improvement Contractor# l(7�65' 0 Email I �� c, c� C�3" &oC�ton+ C5 orker's Compensation #�`iQC q oo ! ON082 ' ALL CO TRUCTION EB I RES NG FROM THIS PROJECT WILL BETAKEN TO �,. SIGNATURE DATE \0 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ' ADDRESS VILLAGE ,OWNER n DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL -PLUMBING: ROUGH FINAL GAS: ROUGH FINAL F FINAL BUILDING t 1 DATE CLOSED OUT ASSOCIATION PLAN NO. i . r i 8LOZ/80/Zo Jauolsslwwo0 :uol;ejldx3 w--� y t dZ[LLo vw oaosHlnos 021 3NIdN2lf1199Z IONVO1d r WV17111M JoslnaadnS uol;bni;suoO SLMO-so :asua0l-1 spiepue;S Put? suol;eln6ab 6ulplln9;o pi A;a;eS ollgnd'.lo;uawpedaa sBasnyoesselN � aan;cu2l noq;!m pgeA;ON Sac;aiaasaapnn ;,: N ZLLI,0 VW'46naog4lnoS peo-d a�llduwnj-99Z - ip�eo!d.wellllM NI NO11O0-8.LSNO0 1(RNVOld,Ono vw'uo;soc[ OLIS a;mS-ezeld 3facd Of uol;ejodjoO a;enlid f3LOZ/5/8 wol;ealdx3 uol c n8a ssoulsn put s uv aawnsuo o aar :ad�(1 �059LOI, uol;ea;sl6aa l R g p �� �3 O 2101OV211NOO 1N3W3kNdW1 3WOH :o;uan;aa punoj jj •a;cp uol;v gdxa ay;aaojaq• aoyeln2ag ssauisna ig s nej3d aamnsuoO;o 33330 ,Sluo asn lvnPlAlPul.ao3 P!IZA uol;ca;sl2a.a ao asuaalrj r aC�na Ducar a� vamaioacaacto a� , liear�vnwoicueci Waodac�uaeCY Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 107650 Type: Office of Consumer Affairs and Business Regulation xpiration:.--8/5/201.6--- Private Corporatio=i 10 Park Plaza-Suite 5170 s Boston,MA 02116 PICARDI CONSTRUCTION INC i William Picardi 255 Turnpike Road g %fir Southborough, MA 01772' Undersecretary Not valid w out signature l The Commonwealth of Massachusetts Department of IndustrialAccidents, Office of Investigations I Congress Street, Suite 100 Y Boston,MA 02114-2017 s� Y www mass.gov/dia Workers' Compensation Insurance'Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Hanle (Business/Organization/Individual): Picardi Construction Co. Address:255 Turnpike Road City/State/Zip:Southborough, MA 01772 Phone #:508-481-2929 Are you an employer? Check the appropriate box: Type of project(required): 1.0 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' [No workers' comp. insurance comp. insurance.: 9. Building addition 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 I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' 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:A. I. M. , Policy#or Self-ins. Lic.#:AWC40070208882016A Expiration Date:03/15/2017 Job Site Address: 960 Main Street City/State/Zip:Cocuit, MA 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 he DIA for insurance coveragTVZffiQtion. I do hereby certify under the a perju at the information provided above is true and correct Si ature: Date:10/17/16 Phone#. 508-380-137 Official use only. Do not write in this area,to be completed by city or town official. 1 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#: PICAR-3 OP ID:SG CERTIFICATE OF LIABILITY INSURANCE 1 D03 /2 11.512 Y016 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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 endomement(s). PRODUCER CONTACT NAME: NorthStar Ins.Services,Inc. PHONE 781-431-2500 AR No):781-431-6134 300 First Ave,Suite 100 A/c No Ext Needham,MA 02494 EamAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company INSURED Picardi Construction,Inc. INSURER B: Redwood Deck Co,Inc. c/o William J.Picardi INsuRERc: 255 Turnpike Rd(Route 9) INSURER D: Southborough,MA 01772 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 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. ILOLICY EXP TR TYPE OF INSURANCE NR ADDL SUB POLICY NUMBER PM/DD/YYYY LICY EFF PM DDrfYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BOA5087296 03/15/2016 03/15/2017 DAMAGE ( ENTED PREMISESS Ea occurrence) $ 50,00 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 19000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY EOMaBBIINdEDtSINGLE LIMIT $ 1,000,00 A ANY AUTO MAA5087299 03/15/2016 03/15/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per acadent) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT $ X UMBRELLA LIAAB X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE CUA5087300 03/15/2016 03115/2017 AGGREGATE $ 1,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITSER ANY PROPRIETORIPARTNER/EXECUTNE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ _F DESCRIPTION OF OPERATIONS./LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION PROOFOF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Proof Of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA71VE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ,4co CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder.is an ADDITIONAL INSURED,the policy(ies)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 CONTACT NAME: Sharon Greenwood AX NORTHSTAR INSURANCE SERVICES, INC. AC.N Ext: (781)431-2500 F'C No): ADDRESS: sgreenwood@nsins.com 300 FIRST AVENUE,SUITE 300 INSURERS AFFORDING COVERAGE NAIL i NEEDHAM MA 02494 INSURER A: AIM MUTUAL INS CO 33758 INSURED - - INSURER B PICARDI CONSTRUCTION CO INC REMODELING DESIGN SHOWROOM INC AND INSURERC: PICARDI CONSTRUCTION CO INC SEE SCHEDULE INSURERD: 255 TURNPIKE ROAD INSURER E: SOUTHBOROUGH MA 01772 INSURERF: COVERAGES CERTIFICATE NUMBER: 37132 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. INSR LTR TYPE OF INSURANCE ADDL SUER WVD POLICY NUMBER POLICY EFF POLICY MMIDD EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE PREMISESRENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: r $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A _ BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per acxiZ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE NIA AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION X1 SPER TATUTE ERH AND EMPLOYERS'LIABIUTY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? WA NIA NIA AWC40070208882016A 03/15/2016 03/15/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached Of more space is required) Workers'Compensation 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 states 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.govAwd/workers-compensationAnvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Picardi Construction Inc- Redwood Deck Co Inc ACCORDANCE WITH THE POLICY PROVISIONS. 255 Trunpike Road AUTHORIZED REPRESENTATIVE Cp Southborough MA 01772 n Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD f Barnstable .� Town o 6 s • Regulatory Services ` BANNSTAIUX Richard V.Scali,Director 6 •` Building Division / Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 ,- www.town.barnstable.ma.us Office: 508-862-403 8 Fax::508-790-6230 Property Owner Must , Complete and.Sign This Section If Using A Builder v � �ZQA I ;as Owner of the subject property to act on m be o A � hereby authorize �1 Y in all matters relative to wow authorized by this budding permit application,for: Ain G2 c- 4, V (Addres of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Si Owner Signature'o gnature of f App 'cant Print Name . Print Name a G Dat Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable •Regulatory Services s 'THE Richard V.Scali, Director Building Division MASS Paul Roma,Building Commissioner 1639. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: / JOB LOCATION: number street / village "HOMEOWNER": name home phoneelg work phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFWITION 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 buildinIZ Dermit. (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 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." Man homeowners who use this exemp tion are Y unaware that the r p y a e 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 to amend and adopt such a form/certification for use in your community. • W-v' S-512' 1T-B• Deal IZ Picardi Construction • -- --- 255 Turnpike Rd Soud:bomugh MA ------------ a r7b _— a • 7 * --- 7 --------------- -- 4:0 m U) b Q 00 ---------------------------------- t----------------- ------- X a w i v �. O .. 3§ IL C= er-e• - 4 S-6IM i 'is.• . � 3 I N t a ® e gN ., PEV71 4T-a Ilk r,ltng Second Floor - t 1,4 �6.�a,5.• Pozen sy ro N 960 Main St-CaNd,MA o �r Existing Conditions TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued' 6 BUILDING DEPT. - Conservation Division Application Planning Dept. AUG 02 2016 Permit Fee Date Definitive Plan Approved by Planning BodrrdsWN OF BARNSTARI F Historic - OKH _ Preservation/ Hyannis EI^� Project Street Address l` t A-7 S7— Village C8 rL,i T- Owner o A/ Address !1 4 Dr- Telephone f 3 a 6 S a Permit Request R 2ai v tl�e, �,—/L-o� Fl o et-ioti� x' /�S Qe e�+777 v-`+J 1 a 7 &-X:IV ie, Le TG r-lAe_ to - 'fie — A) ?'/t-ucru ®vim 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 documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing r g s g Structure Historic House: ❑Yes ❑ No On Old Kmg s Highway: ❑Yes ❑ No Basement Type: .❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 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 ❑ 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 R LGH A-e.-P 4-flu 2 14 Telephone Number :7 6 y -7 7 Address l L E A-k 17 2 License # S r—A d, / 7 9 y tt,4" 03-31 P Home Improvement Contractor# n q :1 7 Email 14"u9,1 A a(-7 CQ JY S A), CO AI'J Worker's Compensation # f-02 W G 7l .X 03 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C-" Sy'n"cr/b N 13 K�"1 P Sre2 D oy 5'17-e SIGNATURE DATE �� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: j FOUNDATION 1 J FRAME Y° INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 0 r . d MULTI-STATE RESTORATION, INC. FIRE* FLOOD*WIND* SMOKE*HURRICANE*VANDALISM Fed ID#050515889 CONTRACTORS REGISTRATION#140427 AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT '� 1 U -✓� ,herein referred to as "Customer",authorizes MULTI-STATE RESTORATION,INC.,herein referred to as"MULTI-STATE",to perform any and all necessary cleaning and construction services on Customers'property at: to D ��vt t" 6L & i t 6 2 G Telephone: a l � and with respect to items that need to be cleaned at a remote location,to remove and clean such items as necessary. Customer authorizes /7�` Insurance Company,herein referred to as "Insurance Company",to directly and solely pay MULTI-STATE. If for any reason the check should come to be or be made payable to the Customer, Customer then agrees to pay MULTI-STATE immediately upon receipt of the check from the insurance company. In order to expedite payment to MULTI-STATE, Customer hereby appoints MULTI-STATE as attorney-in-fact,authorizing MULTI- STATE,to endorse Customers'name,and to deposit Insurance Company checks or drafts for MULTI-STATE services.Customer agrees to pay Customers deductible in the amount of$ ` that applies to this claim. If the loss is not covered by insurance,Customer agrees t the total amount to MULTI-STATE upon receipt of the invoice. Sign tute er It is my understanding that the services to be performed by MULTI-STATE will be limited to those,which are authorized by my Insurance ,, Company. C/W�b Insurance Company Name / y`( q� Y� Policy Number Customer agrees that MULTI-STATE is working for the Customer and not the Insurance Company or agent/adjuster. Additional.remarks: I have read this document and completely understand and agree to same. /Z 1�c Sig'ha � Date CL Printed Name P.O. BOX 2210•MASHPEE, MA 02649 .866-921-9111 •FAX 774-238-4422 0 _. " i TIm qfManizdiusetty DeentqfLzd=ftdAcdd-enisr 600 Washuigf=&reef Boam,MA OW wrPMmass gos/dra Warms' Camp ensafsonInsarce Af RdaviL ltaflde7JQm *�� ns�Ph�hers AppEcantTIformatiauPlease E . IL S7-0 2,t77 oN Ad&e= 6'b IV Ir o Le,,r-rA `S W-- A / Citg/Sw,n(Z*- A'S Pw 0 d-6q i Phone 7 7- 3 3 33 Are you au=gADger?Cbeckthe appropriate bam Type of project(rued)_ I.&I am a employer w 4 4. ❑I am a gexiia l confractur and I 6_ ❑New amstrmtion employees(full an&br pact-fime�* ' I=e hin dffse sub 2.❑ I am a sole prgdetmr orpartuer- fisted onthe atUthed sheet y- ❑ReffiadeHng ship and have no employees.. These sub-coatractas have 9- R Demolition woxidng fnrme is any capacity_ wvloyees and have wadoere 9. ❑BaUdnag Odifrou IN4 WO&M&0010P-irISITMn 5 COMP.k1su arur -� 5. ❑ We are a coaporafioa amf its 1'L❑meal repair,or ad&ions officers have exeressed fi r 3_❑ I am.a bame�r doing all w�c 11-❑Plumbingrepaiss or addihaas O • zbt of effiempfion Per litfts�L ❑ MyselfF- 13 F.00f ;;nou,n=r d-]Y c.I52,¢1(4).and we lave mo emplo9mm[N0 WodOM& 13_❑'fatmer c=qL msucanme mgdred.] Anyspp6a�t9,4c�,eazvosin— elwlMomitbesechoubeiaars�&erwa&e3t-�p�aspo�gin�aML ;Any leos�ataiso sabot dtis sf5dam�ing are3oiag s]Fwa¢�andBiea7nae o-�,ieecanmst su7smitsnewsffidreyt m3i 5crh fCantwdnsAaebecBtidsbmcmasta3tad�aasd stsineeisSoazagtLensmeofthe �rlstatew7tdh�camrtthnsee l?a� • emp3Qyees.Iftbesvb-c�a*��,�,�5�e empTafers,BmeYmastpanvide f� 'a►mP•p[alicF a�bez . lam mi euigsr fliQtis prauidiag cvQrkers'aaatps=resrdiort irisureser a carplaf Sdoev is ilex pa�cp ar�d jolr she ifff0 aatlae5 . - Insurance campany Name l7 IA"` 1-9 S CO •Po-ficy 4.1 or Self-ins_Iio_ �.a w C 7 i a,d 3 0emanate b -�7 ` Jib Addre 6 o Ifl't T- q S ram- �T kA c4istawzip: Co7—ctt7 Attach a copy of the work ere;'comzpeasationpolicy declaration page(shoving the poficy member and expiration date). Failure to secure coverage as reguir�nmder Sew 25A of MCE[ m 1572 can lead to&e imposftina of crimha1 penalties of a fine up to$L50a QQ andlor one-yewimpdsonmemk as will as dvrl peuslge in the fbrm of a STOP WARS ORDEltand a fine of up to$250M a clay against the violafflr. Be adzdsed that a copy of tins sta tee s map be forwarded-fry th e Office of Imre s of tine DIA for insures co vecage oa- Fria her*ceift t�epaizn.,and peaatifas ofFerjsLty thatflie igfbrma€fvapraei&�diabars ig tree and correct SiMmItIlre: Date, Pipe Irr ��`1 z tad nse only. 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I - •• ■• •:FYI■:■ I• •J• ■1- r: I :1 age a■1 -.w ■- �•••la- _It■ Y. allltl. �•i■..1 tot ■ i .Q9i.9t•. ' :'■ t` off .IC■311 • +•. tit ►:• to 11M. • ACO. CERTIFICATE OF LIABILITY" INSURANCE OdiT�;Mrt Ql}YYYY, tar:'219!Z 16 THIS CERTIFICATE IS tSSUED.AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLgER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREI (S), AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER, IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, It SUBR-OGATION IS WAIVED,subject to the terms and conditions of the policy,Certain policies may r>equka an endorsement. A statement on this cortiftate don Trot confer rights to the cortifitme Wder in lieu of such endomemeat O. F'xocwcs Fa r.A �. ° tsld Ilulrn>� STARKWEATHE€Z r SHEPLEY INSURANCE BROKERAGE INC. ""°"a tlt; 35 moo to r raa. =rt k�lAIL 2 . PD87 I.:1i-1# aI11rIm84)SIa heti£'['Ym . GO CATr MORE 84-VD. - .. .m,13J5t;<R£" rs4 f r#itIC:A EAST PROVIDENCE Ri 02g14 ,2?5 S AIGt1Rfl FrS sJJf2ffe`dClr CO _ 3235f1 INSLME0 MULTISTATE RESTORATION CAPE COD DIVISION INC h°uUTICFC : PO BOX 2216rNS�E.x t F1A;aHPEE MA 02549 te�uJieatF. COVERAGES. CERTIFICATE NUMBER. 13188 REVISION NUMBER: MIS aS t' `. 13p PlAr tic;.-K LK:ILS C,I• t.VS o1A1tf.-LISILO E,'_LCM fAV,_i.'LLIJ !S&'YL.) TO 1 7PdS#t J NAI'A'_D AI;OV FOR l SIC; : l: �i)T"t'§JI§jIA.:3$CtiJC ANY st:-uji ,:rrl„V? 'I�'v^.1 3�: Gn�1»fli::`" O, !AS& -1.J C Chit( W :'f11H �, vP° Cl JCl":Fli4:t§ In1' f: •{FIkiCAH UAI Eit I:,itF: C,°° Ri;.v ?::2'J.AIV, r11 .J L1J4 -tA,1JC;_ Ak',0,4j* i UY Ili: ?Ct.1 iL'a JL°.aC diai::U 114 S.Ff3.;r_C] TO ic(L tll_ N::RFAS, X L.JaIC`+N7 A`D C;O%3i IO,%J 0+SUCH POLtC IZS L OT,1 8ii 01 N fIlr'ry flAV 13_-AJ {_ It i tf/»Ad<5 VLAIP.9IS. ..... ItY91{`� ... ...... ....... ..._. .. AAi71 9)iBN' .._....` W:1'L>t.'Y kFF � raA1.�Y�.xv , YY- ;cc7err•�r>�rAt.r�rrs�,slptpa�stsr'i ![r�,��cx�1°tura�:f s E:€�:&l fs F 4,4 t 4 1 t7i1F f�i2r Wir-`31t:,r'<rats1r I 5...._.... .............. -- _._....___.......... _...............__.... kIf L F J 1(erg �u fxs sc 1 5 I c N-F 1=:t:`.C75N 'I.1 4.FAT %Fkr .S`r F' fl ?(4,N'R+l AM&2MATF S 3 ... ;F zr� ;UX .F'F24,a.f.3t.t�-i:i:JhW'.'�'tl'N.{>Ez S AtiTIVA05ittz L>A,64VTY ....... ,.c. .......... ........... ._..._.. ,e€M ;,€rt W Fna,2W.?J 3tt fJh..r „ ar t; w;arow:I :. f ...... .S ............_._.___ i Trl'd�NtL.LA L7AYr F:.i'Fi @Z:t:rJliP.. l ; x V �5 LzuF2 Q'Ams WLLT: NIA F�{;€aKFk CvSYF 5 AMeLAq:1•'14Y�frS'UA$rf1:19Y i.,; ."s1 y> R'R 1#l,F ..... I►J F2 urr� wf I 1;�aFitsa� xr^a:Tfr Ft EAHAZCtN;Nf '}tgr,.tla:A4E.�J F+Fh!'&t3Tt£Y? fdfA-:k:A IAA R2WC7�1203B 07ilf612a'i r, t)7?'r t5i2(Y1 r ..... ,-.. .. sAtanE rfuy in KH) ................ ... .. .... C;; C.".3.ASL PCA,I.v Li,3I 5 a 0t).0U0 . NfA (S�9CitJW I"tr3t2CYR�?J°kI{.dIKrN9l 1�C:I1Tt4N3;YkTrIC.1.0S(.�4>mlrl iG6,Ael�utiaint xCaw,rtriM SYh�Ju¢A,rsiroYlai hlL+r,Fwtg ff trout�s>Nosw fa ret�ifraU) ��� tr`orkef C rrYr, nsaUCr,benefils it be paid to Massa btrska3Es esnt ust pfoyees urily.Pursctt tlJ Erse6r2rts§aT�ssfq@ We 2L no G3 88 8, aumoricabon is gfvan to gamy a�9 Mfl for:bi)P�61z,s)i)rl'�Plcfye e,in States 01hat thaT'r wl�esxsl�rl>s�llti:t the,!1 ,-0d Nres.&thus Forsd thj&e e mobyeas outside of trtr,"dlusens Tt133 rz rtefi 4'lez r,f Ft',f ?ar Lxx rltaax @f*gxlticy,in forw of:Me&Ow 1b.'at ttu:.,<+drtifa a@es.vku6 fssu'ed(unfwiw,, Ilk)oxtaral.a'w&trite on the abovo s)aicy pft. -odds Out ssa�e tIstar tal#}1ae r TLric:a1a raf iT€Ifur gip. 'Tfvs status or tht&c average rAo bemonitored duly by agxiozsirfg tl,�a Prj',of crf Cov6r1i,Ire-Coleerag€r VwiFicabeFi SOAMh 100140 c�v,ev.rrs Fr t.�iv,i»tl.Yl�rker?claT)t3orss7FtacrJrTvas�tig7tiasie +RE 96'Mail Street Cotuit MA 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION'' DATE THEREOF. t:IOTME WILL BE {;fEl.IVERED IN Town of Barnstable ACCORDANCE WITIi THE POLICY PROVISIONS. 267 Man Strem - AirTNCk'ir2EQF�PR1;'SENTAYt+Ak's HyAmilfi IvfA ()Coll', Danie M.Cr1N.uley. CPCLI.'V ce F4esidertt- Ressduaj i~:t iAet VVCR18MA 0)1 II.2814 ACi3:RO 00RPORATtON, All rights reserved. ACORD 25(2014t07) The ACORD name and logo are registered marks of ACORD _4 . 1 ® DATE(MM/DD/YYYY)AC� �i CERTIFICATE OF LIABILITY INSURANCE 7/29/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 CONTACT Beth Deschene NAME: Cross Insurance, Inc.- RI ONE A/C No Ell): (401)431-9200 A/C, /C No:(401)431-9201 376 Newport Avenue AIL ADDRESS:bdeschene@crossagency.com P. O. BOX 4830 INSURERS AFFORDING COVERAGE NAIC# East Providence RI 02916 INSURERA:Selective Insurance Co. of SC 19259 INSURED INSURER B MULTI-STATE RESTORATION CAPE COD DIV, INC. INSURERC: 68 NICOLLETTES WAY INSURERD: INSURER E: MASHPEE MA 02649 INSURERF: COVERAGES CERTIFICATE NUMBER CL1651772535 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WV0 POLICY NUMBER MM/DD/YYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR _ DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ S 2139645 1/2/2016 1/2/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICYJECTPRO ❑LOC PRODUCTS-COMP/OP AGG $ 3,000,000 X OTHER: F $ 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 HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N - STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE d $ It yes,describe under _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 960 Main St., Cotuit, MA 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Beth Deschene/BDX .1-OkA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Massachusetts -Department of Public Safety x Board of Building Regulations and Standards . ^--- -- r""---= - o r-- �o ' �,uu�u uuuni JUYGI VIM i cx� rauuiv License: CSFA-051784 RICHARD D LAU 'ter.TA 1 LEAH DR t Rockland MA 02370 IV Expiration Commissioner 04/01/2017; o��vrraa�acaea��b��i�Gaaoac�cueC . Uoegistration- e of Consumer Affairs&Business Regulation t .. E IMPROVEME-'NT CONT License or registration valid for individul use only RACTOR before the expiration date. If found reira . 1tur 4042# Office of Consumer Affairs and Busin ss in Regulation o Expiration07151 Type' f 2037 Su 10 Pal lc Plaza-Suite 5170 MULTI-STATE RESTORATION iNC pplement C.4-6 Boston,MA 02116 C APE COD' RICHARD LAURIA 1ti i i 21 PEQUOT RD. MASPHE ,MA 02649 i ✓ Undersecretary Il J NO alid t ut signature 5 2 g 9 L,v,^'a r r � � r 0- Itro St'�t Pk `7 DEN 0-0o F-tov� 9�e 4-7w s� � rZ, r al essor's offioe (1st floor): THE T essor's map and lot number ........ `3q DESIGNING ENGINEER MU A INSTALLATION AND CERTI I Board of Health (3rd floor): T Sewage Pe?;nit number I ..�M THE SYSTEM WAS INSTAL 9 .. .. ....... .... Engineering Department (3rd floor): ACCORDANCE TO PLAN. *oo _ ,,N & House number } `e o�aY APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P•M. only• Symm mu$T BB A P P R o v E D "STALLED t OMPLI : � $ ns ble Conservation m sW N .O F BARN LE 5 rTAyLDIHG INSPE C Gu� CODE� , igned ptp a� . '. APPLICATION FOR PERMIT TO ..;.. .r� ..I.. ,��:::���........................................................ 1 TYPE OF CONSTRUCTION ............ ..---.......A0.i-:?-q)............ .......19-!`J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ` q. ....1C,. 4.1P.....<4�: r 0-rQ.i-V........................................................................................................ Location ........ . .. ...T............ ProposedUse ... ....................................................................................................................................... r Zoning District .... .. .:.t .......................................................Fire District ....... ► ?=v` .................................................... Name of Owner ..P. --... .. �? � !�+ .......Address .....q,. ?...... :...: ..�rCCv.4"�.................... Name of Builder ... ....................Address .... 0... 09. ..i.�.:.Q-u...onl ..��x► x-ft C, Name of Architect 'W`4T A.CA4Y...FR.L.�.��'►G�►MO............Address ...Rq7 4T2 ` '�niJ C. .................... ..( . .........f 1�:�..........�.......off•?;...u tNumber of Rooms .......�p....................................................Foundation ....P.4.,-Q—�!......C2k9 ........................ Exlerfor ...W.c�ojo...... .!! .� ........................................Roofin g ..... K 1. %� .. ........................................................ Floors .... .�1� ...�.�.A:�: T...........................................Interior ..... .1:�QK� ................................................. Heating .... ... �.Ar...W.•......�.. ...5.....................................Plumbing ....G ���� Fireplace ....`t � �:2'A( ..-.. ti$Ta!J .............................Approximate Cost .......A, 00.9 Definitive Plan Approved_by Planning Board _____________________________19________ . Area ..... J........ Diagram of Lot and Building with Dimensions Fee '— SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ;i Name ... ... .. .! ...... 1 �. Construction Supervisor's License ...00324............... EVANS, PETER & DOREEN r ,No ... Permit `for .... .emode-4............. S.i p.g.1P-..Faml:ly...D.,� ellj-ng........... .� Location•...9.60...Maixi...S.treet S.tr.eet..................... yl ,71 C.otua t................ C) 4 Ril Nt -w Owner ...Pe.tpax'...&..Baz'ehn...auan.S........... 4_. Q. Type of Construction ........................ ez `N.................... .C...... �`-� < Fi ZZ Plot .......:.................... Lot ................................ ) . � _. I n 4 ,. a 3 Permit_Granted .......JwXUa C.y....2.2.,..: 19 8 8 J Date of , J Inspection"��..��..� .....�..�.19 ., Date Completed ................... :..............t�%19 co Co. - f� ss J 7v �' sSNIr MNCO a COIr -1 7 ID M _ -= cr. Assessor's offioe (1st floor):, o THE o Assessors map and lot number ............ / T... .................... .. Board of Health (3rd floor): _ fO�Q o� Sewage Permit number t� ..' �.. �M -+ """""' Z BARESTADLE. Engineering Department (3rd floor): 9� L YA9 House number o s6} • `00 r........,.............. ... ..... O MA,I APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00_ P.M. only ' TOWN OF BARNSTABLE -•. , ,�/�BUILDING IN-SPECTOR APPLICATION FOR PERMIT TO ..... ......�... 1 ... 2..1. ....................................................... TYPE OF CONSTRUCTION ............ ��eC �J"n.tA. ..I�.. ? :................................................................... ............. ............... TO THE INSPECTOR OF BUILDINGS: i The undersigned hereby applies for a permit according to the following information: n � Location ......`A. ..... .Alk,t ....... ....}......E. l�.l." ...:.................................................................................................... Proposed Use T ....................Fire District .......C.UTY%N Zoning District ................................................................ .... ............................................... Name of Owner .......Address ..... .....IMNNP.SCC:....�... vl�.................... Name of Builder ...Ic..: .. p "1M (L,....................Address ....\4. 0...... �.0.t.q., ?....'Q!�-1.��-eE Name of Architect .0-1N4TXX-oPy...F -WAA. . M4............Address ...1tot TI' ....�A.......... / ►JOIr?,i,C.t� ............. Number of Rooms ...... ..a ....................................................Foundation ....1"'[a.,,k4--A.... �............................................... Exterior34go.C)......;lA. ^.?.� ................. .......................Roofing ...... Alt v........................................................ Floors ...;.(0.0.0 1.0...VCA ..........................................Interior ...... ................................................. r Heating ... a �a,.. ,y.....�. s............ ............. . ; - � ...........Plumbin ... - .�.. Fireplace .... .............................Approximate Cost ........, V.AO ................................... 4 AV Definitive Plan Approved by Planning 'Board --------------------------------19-------- . Area �....../�............. Diagram of Lot and Building with Dimensions Fee -__ ........ ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .............w.................................................... Construction Supervisor's License .... d . r EVANS, PETER` & DOREEN A=035-095 No ... Permit for ...ReaQdel.............. Single Family Dwelling Location ....,960 Main Street ................................................... h Cotuit Owner .......Peter & Doreen Evans ................................................ Type of Construction .Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ......January. . . . ....22.. ..,. 19 88 .. .. .... .. .... . . Date of Inspection ....................................19 Date Completed ......................................19 ,.l °F IHE, The Town of Barnstable e 9� , ; 10�' Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 15, 2000 PETER W&DOREEN W EVANS PO BOX 1510 COTUIT, MA 02635 Re: Certificate of Inspection Multi-family Dwelling(5-year Certificate) 960 MAIN STREET, COTUIT 035 095 Dear Property Owner: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 3 Units - $ 81.00 The fee has been established by the State (Table 106) and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn j990428e - J Town of Barnstable Regulatory Services ` TsaMASS T; Thomas F.Geiler,Director 9`bArEp;p.�a``� Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM DATE: TO: File REGARDING: COI Multi-Family Use Re: Certificate of Inspection is not required for this property--does not consist of 3 or more units within a single structure. Notes: O! t__0 01 EVE Tp,._ The Town of Barnstable = E►arrsrnHLa '� � Department of Health, Safety and Environmental Services 'OriroNa�° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner CERTIFICATE OF INSPECTION CAPACITY INSPECTION MULTI-FAMILY DBA M&P LOCATION OWNER ADDRESS ZeV A —_/O ZONING NO. OF UNITS/FEE lJ GLORIA URENAS / APPROVAL DATE 9/9 INSPECTOR DATE OF INSPECTION J980309A Town of Barnstable Permit# Expires 6 m the from issue date . Regulatory Services Fee Thomas F.Geiler,Director Building Division ^ Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �2 n.r Not Valid without Red X-Press Imprint Map/parcel Number VJS �1 J Property Address /kO /t/d,in V r-ee eo&I ["Residential. Value of WorkA&000 Minimum fee of S25, 0 for work under$6000.00 Owner's Name&Address S Stf U7t Contractor's Name L�J d AY,--T7 M(X t & I f!-&Z, ZA&Telephone Number Home Improvement Contractor License#(if applicable) �Q Q Construction Supervisor's:License#{if applicable) V R�V'orkman's.Compensation-Insurance Check one: APR 16 2008 ❑ I am a sole proprietor . TOWN OF BARNSTA�LE ❑ I am the Homeowner E�-I have Workers Compensation Insurance Insurance Company Name: ' Workman's Comp.Policy# 5700 7 ZO I c2©Q Copy of Insurance.Compliance Certificate must be on file. Permit Request(check box) [I�Re-roof(stripping old shingles) -All construction debris will be taken to ❑Re-roof(not stripping. 'Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders. U-Value *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conserv`�tion;-etc. ***Note: Property.Owner must sign Property Owner Letter of Permissi'Ari A copy of the Home Improvement Contractors License is required i jkJ SIGNATURE: Q:Forms:expmtrg Revise061306 - ji I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organ tion/Individual): E:J J 'n/t 1�_p 2/f.f Lb& Z AX Address: City/State/Zip: gV /tj/S, 02,!�O/ Phone:#: � � I1-7g ' g (I Are you an employer?Check the appropriate box: Type of project(required):. 4. I am a general contractor and I 1.❑ I am a employer with 6. 0.New construction . employees(full and/or part-time).* have hired the sub=contractors 2.El.I am a sole proprietor or partner- listed on the attached sheet 7. [ emodeiing ship and have no employees These sub-contractors have g Q Demolition workingca employees and have workers' ' .for me in any capacity.n'• t . 9. �Building addition [No workers' comp.insurance comp.insurance. 5. [] We are a corporation and its 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised.their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]]t c. 152, §1(4),and we have no employees. [No workers' 13.0 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. p^ r Insurance Company Name: 't= Policy#or Self-ins.Lic.#: 0 d G 7 a 0( o y Expiration Date: ` LO Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date): Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. .I do hereby cer ' r the pains and penalties of perjury that the information provided above 's true and correct. Si afore: Date: _ Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk'4.Electrical'Inspector 5.Plumbing inspector 6.Other' Contact Person:. Phone#: Board of Building Regula ions. and Standards One Ashburton Place Room 1301 Boston. Massachusetts. 02108. Home.Improvement,t tractor:Registration r.. . Registration. 110609 Type: Private Corporation " '• �� �� a ' � .. ;.Expiration. ,11/3/2008 Tr# 124739 E J JAXTIMER, BUILDER; INC::" _ ' c ERNEST JAXTIMER _ - 48 ROSARY LNy HYANNIS MA 02601 = a >— - — -- Update Address'and`return card. Mark reason for change. _; Address Renewal Employment. Lost Card:. DPS-CA1 s,r 50M-05/06-PC8490 9 I - � 1 a �6 9 i j i" �(it 7S�: ✓� U/0717iI720�7.111 � dP.�6 �.; - _ 7 Boa . . .�: i f.Bwldmg;Regulahons and Standards s p l , Co�nst�uctfon Supervisgr l lcense al � t v Li dense °C3 3251 ,' ;r! ;. x�rratioti 1/14/2010" Tr# 13629 � Ili �s ;I�es. i n 0 f I t ERNEST J'UAXTI 48 RO,SARYiANEl � _ I}� 4 HYANNIS MA 02601 3 r r Comm�ssfoner r� e , reb, 19. 2008 3:20PM No. 4623 P. 3 +� Town of$amstable .` Regulatory Services , MM : Thomas X CrWer,Director Building Division Toth Perry,BuWng Commissioner 200 Maly street;Hyannis,MA 02601 wwwAown.barastablejmus Office: 508-862AO38 Fax: 508-790-6230 Property Owner Must Complete and Sign This Sect © If Using ABuilde I, Eva n S as Owner of tbe'subjecx property herebyai thorize—P j. JaX:1 M e'y, T)u 1 Je V. lw to act en mybehalf, in aU meters relative to wozk authorized by this 6 9ding Pank Wkali=fon-- at S a (Address of Jab) ka 0 - 5' Of Owner Date Pant Name If Property QR r'is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QS0PAQS:0WN$RPMMISMI0N s Client#:2093 2JAXTIMEREJ ACORD- CERTIFICATE OF LIABILITY INSURANCE 0DATE 3/17/8D ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. � 973 lyanough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURER A.- Acadia Insurance E.J.Jaxtimer Builder, Inc. INSURER B: Ernest J.&Marie T.Jaxtimer - INSURER C: 48 Rosary Lane INSURER D: Hyannis,MA 02601 INSURER E: I 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. INSRrD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MMIDD DATE MMfDD A GENERAL LIABILITY CPA010264814 01/01/08 01/01/09 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY -. - _ DAMAGE TO RENTED $250 OOO CLAIMS MADE 51 OCCUR _ - - - - MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICY jERPT IOC AUTOMOBILE LIABILITY - COMBINED SINGLE LIMB $ ANY AUTO (Es accident) ALL OWNED AUTOS - BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED ALTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY _ .AUTO ONLY-EA ACCIDENT $ " ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESSRIMBRELLA LIABILITY CUA01026491.4 01/01/08 01/01/09 EAC►+OCCURRENCE $2 000 000 X OCCUR CLAIMS MADE AGGREGATE s2,000,000 HDEDUCTIBLE -:. '. ,. `, . "- .. . "$ . RETENTION $O $ TUjA WORKERS COMPENSATION AND - WC�A020455011 01/01108 01/01/09 WCSTMIT OTH- EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUrIVE ' EL EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? NO - E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under _ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER ... DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. E.J.and Marie Jaxtimer are included under the workers compensation policy. CERTIFICATE HOLDER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #51277 LS1 0 ACORD CORPORATION 1988 Parcel Detail Page 1 of 3 T ty� PA ,�y.��-_..ram.. .N'SrAML ze, Logged In As: Parcel Detail Wednesday, Ap Parcel Lookup Parcel Info _ Parcel ID 035-095 Developer Lot'PARCEL 1 Location?960 MAIN STREET (C0TUIT) Pri Frontage 75 Sec Roads I Seci Frontage Village COTUIT Fire District COTUIT Sewer Acct' 1 Road Index 0951 Asbuilt Septic Scan: Interactive x` , 035095_1 Map ,( Owner Info owner',.EVANS, PETER W& DOREEN W TRS Co-owner t EVANS REALTY TRUST Streeti P 0 BOX 1510 I Street2 City ;COTUIT + State AMA zip�02635 Country I Land Info Acres,0.46 use lThree Fam zoning {RF Ngnbd *F10 Topography Level I Road !Paved Utilities[Public Water,Gas,Septic I Location Waterfront,Excel View Construction Info Building 1 of 1 Year'1890 _ I Roof Ext 1W Built - Struct-Gable/Hip ood Shinle g Wall 1 I Effect"`_ _.__..., _.___�..__. _ Roof; _�__ �_ __ _.__ AC l Area 13871 I Cover JAsph/F GIs/Cmp Typee INone Style!Conventional I Int',Drywall . ._ __ �'� Bed 15 Bedrooms Wall Rooms --- -Floor ,..�._._w._...._._..m»»�.. ... Bath Rooms model,Residential i Hardwood5 Full + 1 H -- Totalf- Typ Water 1 Heat Rooms,10 Rooms } http://issgl2/Intranet/propdata/ParcelDetail.aspx?ID=2293 4/16/2008 Parcel Detail Page 2 of 3 G Heat _�_ _ Found- .._ ... Stories '2 Stories Gas Stone Walls ! f Fuel ation r 7 Permit History ------------ Issue Date Purpose Permit# Amount Insp Date Comm( 1/1/1988 B31560 $150,000 1/15/1989 12:00:00 AM CO REI - Visit History Date , Who Purpose 6/9/2005 12:00:00 AM Paul Talbot Meas/Est 5/3/2000 12:00:00 AM Paul Talbot Meas/Listed 1/15/1989 12:00:00 AM Lloyd Kurtz - Sales History ......... Line Sale Date Owner Book/Page Sale P 1 11/29/2000 EVANS, PETER W& DOREEN W TRS 13391/323 2 5/15/1982 EVANS, PETER W& DOREEN W 3481/167 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2008 $450,600 $7,200 $0 $1,506,100 $1 3 2007 $448,900 $7,200 $0 $1,506,100 $1 4 2006 $446,800 $7,200 $0 $1,415,100 $1 5 2005 $340,500 $6,400 $0 $1,414,000 $1 6 2004 $287,200 $6,400 $0 $1,285,400 $1 7 2003 $170,200 $6,400 $0 $1,027,600 $1 8 2002 $170,200 $6,400 $0 $1,027,600 $1 9 2001 $170,200 $6,600 $0 $1,027,600 $1 10 2000 $150,800 $6,000 $0 $436,100 ; 11 1999 $150,800 $6,000 $0 $436,100 ; 12 1998 $150,800 $6,900 $0 $436,100 ; 13 1997 $217,900 $0 $0 $436,100 14 1996 $217,900 $0 $0 $436,100 ; 15 1995 $217,900 $0 $0 $436,100 http:Hissgl2/intranet/propdata/ParcelDetail.aspx?ID=2293 4/16/2008 Parcel Detail Page 3 of 3 16 1994 $190,100 $0 $0 $425,200 17 1993 $190,100 $0 $0 $425,200 18 1992 $216,700 $0 $0 $472,400 19 1991 $240,400 $0 $0 $545,100 20 1990 $240,400 $0 $0 $545,100 21 1989 $202,400 $0 $0 $545,100 22 1988 $140,900 $0 $0 $302,200 23 1987 $95,000 $0 $0 $302,200 ; 24 1986 $95,000 $0 $0 $302,200 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=2293 4/16/2008 THE The Town of Barnstable • saexsrA SM • ` Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner CERTIFICATE OF INSPECTION CAPACITY INSPECTION MULTI-FAMILY DBA M&P LOCATION �U� 19 OWNER ���ti 9-1, ADDRESS Zee2 f dl",;2 i.S+/D 7 ZONING NO. O F , UNITS/FEE 1 � 7s� �,;7,z- GLORIA URENAS APPROVAL U �'�� DATE - 9/9 INSPECTOR DATE OF INSPECTION J980309A [ ] [R035 095 . ] • LOC10960 MAIN STRE COTUIT CTY101 TDS] 200 CT KEY] 21318 ----MAILING ADDRESS------- PCA] 1051 PCS] 00 YR] 00 PARENT] 0 EVANS, PETER W & DOREEN W MAP] AREA107WA JV1273224 MTG12001 PO BOX 1510 SPl] SP21 SP31 UT11 UT21 .46 SQ FT] 3318 COTUIT MA 02635 AYB] 1890 EYB] 1980 OBS] CONST] 0000 LAND 436100 IMP 217900 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 654000 REA CLASSIFIED #LAND 1 436, 100 ASD LND 436100 ASD IMP 217900 ASD OTH #BLDG (S) -CARD-1 1 217, 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 960 MAIN ST COT TAX EXEMPT #DL LOT PARC 1 RESIDENT'L 654000 654000 654000 #RR 0951 0075 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE105/82 PRICE] 240000 ORB13481/167 AFD] I LAST ACTIVITY] 09/07/89 PCR] Y lyT � R035 095 . P P R A I S A L D A T , KEY 21318 EVANS, PETER W & DOREEN 0 LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 436 , 100 217, 900 1 A-COST 654 , 000 B-MKT 443 , 100 BY 00/ BY LK 1/89 C-INCOME PCA=1051 PCS=00 SIZE= 3318 JUST-VAL 654, 000 LEV=200 CONST-C 0 ----COMPARISON TO CONTROL AREA 07WA -- TREND EXCEEDS STANDARD NEIGHBORHOOD 07WA COTUIT PARCEL CONTROL AREA TREND STANDARD 151 15 LAND-TYPE 4361001 LAND-MEAN +0% 6540001 462400 IMPROVED-MEAN -5301 25% ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] i{ R035 095 . • P E R M I T [PMT] AC* [R] CARD [000] KEY 21318 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT [B31560] [01] [88] [AD] A 1500001 [LK] [01] [89] [100] [NEW ] [CO REMOD'L] [ ] [ ] [ ] [ ] ] [ ] [ ] [ ] [ ] [ ] [ ] [?] RESIDENTIAL PROPERTY rNO. LOT NO. FIRE DISTRICT SUMMARY 5 95 STREET 960 Main St• Cotuit C o LAND BLDGS. 5 !o O O OWNER TOTAL l07 PSO LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. O1 -1026._. 240 B TOTAL LAND M Morgans., Rhoda L. 5/10/71. 1509 658 .l�6a BLDGS. 0-0 6 12-29-76 2448 141 Tax De Ferra I TOTAL LAND / BLDGS. TOTAL LAND BLDGS. I TOTAL CY- / ox4;Aq y, LAND 0 BLDGS. TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: BLDGS. �.� 01 _ _. n.' ....c'\. TOTAL DATE: —IS 2�,> LAND ACREAGE COMPUTATIONS a BLDGS. owD TYPE OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE 2-o O 6 O 0 S-0 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. ' WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND ! 6 u O) BLDGS. _ LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT,PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND J ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND LAND COST tone.Wells Fin.Bsmt.Area Bath Room Base EILDG. COST Cone.Blk.Walls Bsmt.Rec. Room St. Shower Bath Bsmt. ((It'.1 '. ATE onc.Slab Bsmt.Garage St. Shower Ext. Walls PORCH.PORCH. PRICE Brick Walls Attic Ff.&Stairs Toilet Room Roof RENT tons Wells Fin.At Two Fixt.Bath Floors /Q s �'i• iers INTERIOR FINISH Lavatory Extra TEZ �•smt. F 1 2 3 Sink • r/ Plaster Water Clo. Extra Attic 32 S EXTERIOR WALLS Knotty Pine Water OnlyF�77,71<' ouble Siding Plywood No Plumbing Bsmt.Fin. Ingle Siding Plasterboard Int. Fin. Shingles TILING I, ,- pftf onc.Blk. G .F P Bath Ff. Heat ace Brk.On Int.Layout / Bath Fl.&Wains. Auto Ht.Unit / Veneer Int.Cond. Bath Ff. &Walls Fireplace om.Brk.On HEATING Toilet Rm.FL Plumbing' olid Com.Brk. Hot Air Toilet Rm.FI.&Wains. 4= I / Tiling Steam Toilet Rm.Ff.&Walls lanket Ins. U V Hot Water / i St. Shower oof Ins. Air Cond. Tub Area M Total Floor Furn. ROOFING 3ZOA,a3 COMPUTATIONS ' sph.Shingle Pipeless Furn. S.F. . ood Shingle No Heat S.F. �. D sbs. Shingle Oil Burner pow /♦ S. F. •p OD late Coal Stoker S.F. sJ' ile Gas S.F. OUTBUILDINGS ROOF TYPE Electric able Flat S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 71 8 9 10 MEASURED ip Mansard FIREPLACES S.F. Pier Found. Floor n� r ambrel Fireplace Stack Wall Found. 0.H.Door ' LISTED --- FLOIDRS Fireplace Sgle.Sdg. Roll Roofing onc. LIGHTING _ Dble.Sdg. Shingle Itoof arth No Elect. DATE ine Shingle Walls Plumbing - ardwoodw,rX 7 ROOMS Cement Blk. Electric sph.Tile Bsmt. 1st -r TOTAL Brick Int.Finish D ingle 2nd �,� 3rd FACTOR REPLACEMENT - OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. - PHYS. VALUE Funct.Dep. ACTUAL VAL. W LG./ CA' ed 0J � i /� Z 911,5--7 .2 s- 2 3 4 5 . 6 7 t3 9 10 TOTAL Property Location: 960 MAIN ST COT MAP ID: 035/095/ Vision ID: 2293 Other ID: Bldg#: 1 Card 1 of 1 Print Date.09/14/1999 �; € , Imo;,>. .3 �, \ ',- Description o e jAppraisedValue AssessedValue O BOX 1510 RESIDNTL 1050 156,80C 156,80C 801 OTUIT,MA 02635 E DATA-Barnstable, ccounPlan Ret. Tax Dist. 200 Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT_PARC Notes: DL 2 1, GIS ID: I o a , 4. ' - �L�.'.�'.`.�, � �-�3• �,..a•:,y;.. #. ::�•- .`.�...ss: .... a• �,; .,,: ...: s ,.�.. � :� a<. &.... �: >.,� ,.ate- ;,, a y .�,••. �. . r. Code Assessed Value n o e ssesse a ue r. o e ssesse value > > , OUI 199 1050 156,80 199 1050 157,70 oa. I oa. oa. , w ; ,w is signature acknowledges a visit y a ata o ector or Assessor Year lypelvescription Amount Code Description Ivumber Amount Gomm.Int. VAL Appraised Bldg.Value(Card) 150,800 Appraised XF(B)Value(Bldg) 6,000 Appraised OB(L)Value(Bldg) 0 °° Appraised ra Land Value a (Bldg)soul ..�,. : t , .� . _� .: y,. Special Land Value Total Appraised Card Value 592,90 Total Appraised Parcel Value 592,90 Valuation Method: Cost/Market Valuatio Net TotalAppraised Parcel Value 592,9UU Mw -, Permit ID Issue Date Iype Description Amount Insp. Date No Comp. Date G omp. Comments Date ID Ud. Purpose/Result f na. ' x r Use Code Description one D Prontage Depth Units Unt Price 1.Pactor actor Nbhd. Adj. otes-Aqjl3peciat Pricing Adj. nit rice and Value ree am o es: , o a an Untilo a an a u , Property Location: 960 MAIN ST COT AL4P ID: 035/095/// Vision ID:2293 Other ID: Bldg 1 Card 1 of 1 Print Date:09/14/1999 Y" Element Description Contmercial Data Elements Style/ lype )6 Conventional Element Cd. Ch. Description Model )i Residential Heat&AC dAb 28 Grade )B B Frame Type UBM Stories Z 2 Stories Baths/Plumbing 10 10 28 ccupancy 0 CeilingfWall BAS 32 Rooms/Prtns AT Exterior Wall 1 14 Wood Shingle %Common Wall UBM 1 U 2 all Height Roof Structure 03 Gable/Hip 13 Roof Cover 03 Asph/F GIs/Cmp 42 C HUML VATA- U 42 JS r Interior Wall 1 05 Drywall 2 Element Code Description flactor BAS Interior Floor 1 14 Carpet Complex UBM 2 Floor Adj Unit Location eating Fuel 2 it Heating Type 5 Hot Water Number of Units 27 27 AC Type 1 one Number of Levels %Ownership Bedrooms 5 5 Bedrooms Bathrooms 4 Bathrooms LVA1 10, 0 Full Unad).Base Rate 48.00 W-Vi AS Zj Total Rooms 12 12 Rooms Size Adj.Factor 0.88931 42 Grade(Q)Index 1.42 ath Type dj.Base Rate 60.62 8 Kitchen Style Bldg.Value New 239,328 Year Built 1890 Eff.Year Built 1980 15 Niml Physcl Dep 17 FuncnI Obsinc 0 con Obsinc 25 A • all'Specl.Cond.Code da pec I Cond% 5 Coae Description Percen!aff Overall%Cond. 63 100 Inrecram luu Deprec.Bldg Value 150,800 Wif Code Description LIB Units Unit Price Yr. Dp Rt YoUnd Apr. Value ]JUAR Bsmt Garage IT-------I-------4WM FPL2 Firepl-1/2 Sty B 1 3,200.01] 1980 1 100 2,70C 41 A B qpvgy,CC;o e Description Living Area Cyross Area Lff.Area Un t Cost undeprec. Value --BWS---F—irsTFIoor 2'1& 2-,W, FAT Attic,Finished 24f 49( 242 30.3 15,03z FUS Upper Story,Finished 1,134 19134 1,13 60.6: 68,74- UBM Basement,Unfinished 1,91( 38, 12.1: 23,151, I M Gio'ss L&ILease Area 239,32 s NOTES: I. CAST IRON INLET CASTING SHALL BE LIGHT DUTY GRATE A ' O CD FOUR INCH HIGH FRAME OF THE APPROXIMATE DIMENSIONS SHOWN. O O I 2. ALL CONCRETE BLOCK SHALL BE STANDARD 8'X 8' X 18'CD O O O I NOM. CEMENT CONCRETE BLOCK. USE SOLID UNITS OR OR HOLLOW CORE UNITS WITH CORES FILLED WITH MORTAR O O O O DURING CONSTRUCTION. O O O O I 3. ALL BLOCKS, BRICK ADJUSTING COURSE AND CASTING TO O O O BE SET IN FULL BED OF MORTAR. PLASTER THE INTERIOR OF THE COMPLETED STRUCTURE WITH 1/4' OF MORTAR. 4. OIL ABSORBENT PILLOW SHALL BE WESO CORP. 18'LONG X 8' DIA. 'SORBENT SWAB' OR EQUAL SUSPENDED ON ROPE SO AS NOT TO FALL BELOW THE OUTLET TRAP. PLAN B SET IN FULL BED OF MORTAR 4" :. OIL ABSORBENT PILLOW TO BE FIXED TO EYEBOLT 22't1' AT CASTING LEVEL WITH 1/4' NYLON ROPE 90'EL - 8. _ 5,-8. MIN. 2'-0' 8' 22'.1' 8' OUTLET PIPE STANDARD 8' SECTION A—A SECTION B—B CONCRETE BLOCK DROP INLET 0 1 2 3 4 5 6 7 8 9 10 FEET SOURCE: ELLIS & THULIN. INC. DATE: SEPT. 15, 1987 478 RT. 6A. EAST SANDWICH, MA 02537 INSERT SCALE: 0.04166 SIZE ® 1/2"=1': 7.0" X 7.0" F207 - 01 - 1 ----- ----- --- -- .- - I . 11 I I . 1. I I I I I .. . I I ,� I I 11 . I � � .11 . -, I 11 .1 I'll 11 I I I I I � I . .. I � I I . I 1, . . .1 . I I I � � I I I I . . _' I I � . 1. 11 . , . . I I I � I . I . I I � . I I I � 11 I I . I .11 .. .. I .1 I J . . . � � ,. - I I . I I . . I '' . I . 11 I � . . . 11 I , . I . 1. . 11 ., I .1 � I . . I 1, . I I � . I I I I I . I I I I I I ... � I I . I . . I I : I I I .- I � � 1, I . 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TOP OF TATE A CO STAL'BANK Z : , .� . , POSSIB E`SMALL:AREA:OF E cP - _ s '� \ (n . v o \ O \ `TOWN COASTAL BANK. - 0 0 \ H � O o I- P_ � SLOE EXCEEDS D, 2 18� F . F o o ; AB VE FL OD ZONE BUT I. N \ 1. PROP05£ I'tt! II II EMO D F R VF W `:: FARMERS \ k..: IS LANDWARD DF LAWN STEP � , :', \ AND PAVED DR W "1 . IVE AY. PRCH \ 4 < , Z \- 0 1 1 \ \ r .. :SLOPE:<18�6 BEACH GRASS r . , 8 r o ,�y 3 , r GE` ._ � G RA ._A Q N c' �. 4 STATE DEP CO ro 2, 2B t ASTAL BANK _ 3 o \ O.r \ \ FOLLOWS 0 FLO D ZONE LINE: I- . ._ . �. -_ \, CROS ' Q \ -. \ A S SITE SLOPE'DOES - 2 \ \ \ U. tJ : S .. : GRASS n ti. \ s- \- � - � -� _ -_ NOT.EXCEED 2596 DIRECTLY c9 ` \ �, 4 h� � � 1 cP i � \ ABOVE FLOOD ZONE" \ : ) : . \ ,� \ 1 \ \: \ . \ \ n (� Q : \ \ H \ \ �, \ :SLOPE..... 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I\I�L\I,-II N A..�II.'-:�I...�< I-1_I.II�II.(�I1I 1l�.-eI 1.I�.I.1��'I,I..II:.:�..I.III�I ,I I-_'.I�..t 1�II1I.�I1,:.�I I1�l I�II I.�I�I.rII.1�II�..�II�.1..II�I�I I�1.�III,.II I.�.II Ir.I.1 I1I.I�I\I II I I,1.��II.II,-�II�1&%..I I�I I I�1I I.\I I.I,.N..,.I 1I 1 II.-.I 1 I�II�,.,�I I I.�.I,I1.,I I.II I.I.�I�I\I..1 I I..��.I�11I I.I�\..I..1��1.�I I:�.1I�I I I.I�I.,I�.�1I I _ \ _ ., . �, \ - F_ _M _ Q'J T ___. Q \ _ _.s.. \ \ c�\\ ECK \, - Z s \ \ z An PAVED 9 \ ls5 \ 4. * \ \ \� LEACH \ \ -f a \ \ 70 U r \ r 12 \ . IT \ 56 J \7 7 - \ \ . O I o \ \ 1- ': \ '. \ :. \ \ \ \ \ / \ ,� \ . \ - . LEACH. \ \ _ r� ? \ \ � I WALL \ � , \ \ so PIT 2 �--. \ o w 1 • , d� > -4 , w 1 T (T . '� N \ PAVED DRIVEWAY \ ; S o I \ I- w \ \ _ 1 \ O ? \ 6 ; CB FNp' ,; 241.71 TO-CB 1 , \ . HED CH tilt Q . . U f' y - r .CONCRETE WALL - 295 t r.. :.. S 49 23 20 I E _I ce FND 5 \ G. z BENCKMARK TOP �+ - : . , • OF`CONCRETE BARNSTABLE COASTAL ' A N LEVATIO B NK >18 ABOVE . gg,, 2 . 36.53 NAVO FLOOD ZONE . . F . sC , , PARCEL 2 ate .', . . . ff- . F . . 1 1 _ 2p ., D - . date . FE B . 8 2017 . . drawn GEND - . . EJP PROPERTY LINE " . . -. checked TES: ...--- . N0 _: CB . : p CONCRETE BOUND C E TIFICATION. (�,, - 1. LO US D N '�J o. 960 MAI OHW OVER HEAD WIRES `:HOUSE N N .STREET J ob number ASSESSORS No. 035 _095 . S FENCE Or . . 16210 't H M A :PARCEL 1 PLAN BOOK 111 PAGE` 97 ., 4, - s - , 11 �, - C ., re .. , 2. LOCUS IS WITHIN. �r - _ visions EDGE 'OF LAWN O: ri ZONING DISTRICT. RF : TH01�1AS. m. CHANGED SIZE OF PROPOSED POR CH MARC 6 0 JP JACK50N EUNKER. .. H . Z 17 E OO ZONE. VE ELEV 4 X - - _ FL D 1 & N .. 2 3•. Od65 ND-BORNE DEBRIS EGO WI R I N + . ADDED COASTAL BANK 24 20 SPOT ELEVATION BUILDING CODE WIND EXPOSURE CATEGORY. C M RCH 7 2017 TJe ccG t3TE UIF R C O . AQ . ..E PROTE TI N OVERLAY DISTRICT - , 3. LOCUS IS WITHIN. . ,, �4I t F ZONE I q A PUBLIC WATER SUPPLY . EXISTING STRUC ENDANGERED SPECIES HABITAT TURES . VATIONS RE FROM 4. ELE A ON-THE-GROUND SURVEY BASED ON NAVD BENCH . K•' OP 0 MAR T F CONCRETE BOUND ELEVATION 36.5 A 3 , SEPTIC SYSTEM WAS R 5, E DAWN AS OUR INTERPRETATION OF AS BUILT . N FL SKETCH 0 I E WITH THE BARNSTABLE HEALTH DEPT. :. PROPOSED STRUCTURES 0 20 40 60 dr in aw g number , lin . - . 110 $24-108 TBM - TOP SB/DH DESIGN DATA: ELEV. = 35.22' MSL REF USC&GS MONUMENT M28SC STRUCTURE: n 1 TOP OF COASTAL BANK SINGLE FAMILY RESIDENCE ' PER I.E.P. 9/25/87 ELEV. 22.0 MSL °j DESIGN FLOW: FIVE BEDROOM — NO GARBAGE GRINDER 5 X 110GPD/BDRM = 550GPD .� N/F CRAWFORD SEPTIC TANK: moo, p 1 .5 X 550 = 825GPD USE 1500 GALLON SEPTIC TANK �h ^ qa'`r 13 SLOPE COMP LINE 8'/14' X 150 = 86' LEACHING RATES: Q i8.a ° EXISTING b �a, ssti N SIDE AREA 2.5 GPD/SF r; :. .9• EXIST. 4" SEPTIC SYSTEM PIPING BOTTOM AREA 1,0 GPD SF TWO—STORY WOOD FRAME ?? T9'F PROPOSED CATCH BASIN (SEE DET.) / DWELLING EXIST. CATCH BASIN - 4' INV OUT 24.09 TO BE RELOCATED TO STRUCTURE: ry 2 — 6'0 X 6' LP's W/1' STONE EXIST. CESSPOOL CONVERTED TO SEPTIC TANK INV. 25.5f TO BE ABANDONED SIDE AREA: 2(8 X PI X 6) = 301 SF BOT. AREA: 2(8 X 8 X PI 4) 100 SF 9 100 YEAR FLOOD CAPACITY: 25,, 19 ELEV 11.0 MSL ((301 X 2.5) + (100 X 1 .0)] = 852 GPD r PROP. DB EXIST. LEACHPIT' S' lo. ADDITIONAL CAPACITY AVAILABLE IN EXISTING LP WHICH WILL BE CONNECTED TO NEW DIST. BOX j�7_ pou Fuc PROP. 4"ADS DRAIN / PLAN REFERENCE: ADDITIONS o I S 8 9' o S°r' 'MT. wA L " BARNSTABLE REGISTRY BK 111 PG 97 PROPOSED CONC. RET. WALL R O' �F 4Hwi 3.12 PROP. SEPTIC TANK 4+ST0 ASSESSORS LOT NO: \o MAP 35 PCL 95 v� •'� PROP. LEACH PIT SOIL OBSERVATIONS: ^hh�� 3�, INST. AUG., 1S85 RnFEpr�01TOWN 'OT B^ARNSyTABLIC'E� B.O.H RECORDS ?O.w ' CB/DH (FND) PARCEL NO. 2 NOTE: N 1 . ALL MATERIALS AND CONSTRUCTION METHODS Pu TO CONFORM WITH COMM. OF MASSACHUSETTS PLAN A � ENVIRONMENTAL CODE TITLE V. 2. ALL SEPTIC SYSTEM PIPING TO BE 4 0 SCH40 1" = 20 PVC EXIST. GRADE = PROPOSED t 80T. WAIL " MMW* 3. WATER SUPPLY FOR THIS LOT IS TOWN WATER Ns sso CONNECTED AT THE STREET SIDE OF THE BUILDING 30 SS92ow 4. LOT AREA = 0.48 ACf w 5. THE RELOCATED CATCH BASIN SHOWN IS TO BE ' CAST IRON COVERS (H20) AT GRADE ' CONSTRUCTED OF CONCRETE BLOCK AND RENDERED WATERTIGHT BY PARGETTING INSIDE AND OUT WITH H.D. PRECAST CONC RISER COMP. LINE CEMENT MORTAR. THE BASIN WILL BE CONNECTED 25 TO THE EXISTING DRAIN WITH JOINTLESS ADS PLASTIC PIPE AT A DISTANCE OF 25' FROM LEACH PITS. PROPOSED 6'0 X 6' LP W/1 STONE 6. THE PROPOSED LEACH PIT DOES NOT HAVE THE REQUIRED SLOPE SETBACK AND WILL REQUIRE A 4"'SCH40 PVC TYP. VARIANCE FROM 310CMR 15.03 20.6 20 . . . . . . . . . . . . . . . . . . . . . { NOTE: F, I CONNECT DISTRIBUTION BOX TO TWO PROPOSED 1500 GAL M20 EXISTING LEACH PITS AT ELEVATION SEPTIC TANK (. OF EXISTING INLET INVERTS. A TWO FOOT LEVEL-PIPE SECTION IS REQUIRED 15 . . . . . • • . • • . • • 14F.6 AT. THE OUTLET OF THE.DISTRIBUTION . PROPOSED DIST BOX 960 MAIN S T R E E T COTUIT, MA. FOR PETER AND DOREEN EVANS — OWNERS 29.7 11.0 8.5 16..8 F�f�_ ELLIS 8c THULIN Inc . 10 i�N INVERT , to 0 N o o Mo w N >jy — Go z 478 ROUTE 6A P.O. BOX 159 ELEV. N N N N N N 9:. .." ;i % EAST SANDWICH, MASSACHUSETTS 02537 _ two, -�- SEPTIC SYSTEM RENOVATION SECTION THRU SEPTIC SYSTEM 1"=10' HORIZONTAL 1"=5' VERTICAL ��IL /�� DRAWN BY DCT SEPT. 23, 1987 87 — 040 CHECKED BY JRE DWG.NO. PPP01 TSM - TOP SB/DH ELEV. = 35.22' MSL EXISTING SEPTIC SYSTEM w REF USC&GS MONUMENT M28SC 3 STRUCTURE: / y THREE APARTMENTS TOP OF COASTAL BANK PER I.E.P. 9/25/87 r ELEV. 22.0 MSL DESIGN FLOW: FIVE BEDROOM — NO GARBAGE GRINDER r 5 X 11OGPD/BDRM = 550GPD N/F CRAWFORD SEPTIC TANK: µ �,4, •" y p 5'' X 4.5' BELOW INV. 3150. pq 5 X 5' X PI/4 X 4.5 X7.5 GAL/CF = 662 GAL. ^� 16.97 >1 LEACHING RATES: I IN a see• N SIDE AREA 2.5 GPD/SF ?i ' 0 38• EXIST. 4' SEPTIC SYSTEM PIPING a, TWO—STORY WOOD FRAME . ? '9'F BOTTOM AREA 1.0 GPD/SF 3aJ DWELLING EXIST. CATCH BASIN - 4" INV OUT 24.09 LEACHING STRUCTURE: W, 6.r ! 2 — 6'' X 6' LP"s W 1' STONE EXIST. CESSPOOL CONVERTED TO SEPTIC TANK / INV. 25.5t ,. SIDE AREA 2(8 X PI X 6) = 301 SF 3'`' � BOT AREA 2 8 X 8 X PI 4 = 100 SF 100 Y EAR FLOOD CAPACITY: je ELEV 11.0 MSL [(301 X 2.5) 100 X 1.0 = 852 GPD r ` EXIST. LEACHPITl5' ID. FL t Z Z> p lit T1Y v. -�� PLAN REFERENCE: Tw 33.5 9• - `' ""� ` BARNSTABLE REGISTRY BK 111 PG 97 PROPOSED ADDITIONS off. MH*l lj� - CONC. RET.� WALL Tv n 3 4 4' ASSESSORS LOT NO: M MAP 35 PCL 95 7.97 s� X 6, ,,., %�pR o tYb SOIL OBSERVATIONS: k �''�►� ''6? INST. AUG., 19$5 REFER TO TOWN OF BARNSTABLE B.O.H RECORDS .:..:.__,_. :. . .ry ?0,w ��. � � FOR REPAIR PERMIT, AUGUST 1985 CB/DH (FND) NOTE PARCEL NO. 2 A P0. WALL mk It ,� �,,� 1. ESTIMATE OF LEACHING CAPACITY BASED ON PLAN 1$ ^ FIELD OBSERVATIONS SEPT. 9, 1987. EXISTING LEACH PITS ARE CONNECTED IN SERIES AND ARE 1 1" ' 20' �' NOT SEPARATED BY ADEQUATE DISTANCE TO CONFORM WITH 310CMR 15.12 2. LEACH PITS DO NOT CONFORM WITH 310CMR 15.03 ss WITH RESPECT TO SLOPE SETBACKS AND DISTANCE FROM CATCH BASIN AND DRAIN. 3. NO EVIDENCE OF UNDER CAPACITY, BREAKOUT, OR OTHER SYSTEM FAILURE IS VISIBLE ON SITE UNDER EXISTING CONDITIONS. ' - COMP. LINE 4. PARCEL AREA (TO COMPUTATION LINE) IS 20,870 SFt 0.48 ACt 5. EXISTING BUILDING LOCATION AND OFFSETS TO WOODEN SIDING: LOCATION DATE 6/19/87 000 MAIN STREET " ' COTUIT, MA. FOR PETER AND DOREEN EVANS — OWNERS JO W t ELLIS & THULIN. Inc. 2�a7 r�:. ;, ; 478 ROUTE 6 A P.O. BOX 159 9F EAST SANDWICH, MASSACHUSETTS 02537 t . EXISTING SEPTIC SYSTEM DRAWN BY DCT SEPT. 23, 1987 amid CHECKED BY JRE DWG.NO. PPP02 87 - 040