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0395 MARINER CIRCLE
�9� �jarrner' �ir,$ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �' Parcel. , Permit# Health Divisioni 9111-h:3 �� I O# I '`' L I�'�.�VA 3 L E Date Issued Conservation Division `P c s S EM PAUST kation Fee Tax Collector INSTALLED IN COMPL.IPMEFee o .Treasurer Ef+t ift&ANTAL CODE AND Planning Dept. TOWN REGULr,'.IONS ING ENGINEER MUST SUP Date Definitive Plan Approved by Planning Board INSTA WRITING THE SYS INS TA iVrSTRICT Historic-OKH Preservation/Hyannis AP019DANCE TO PLAN. Project Street Address 3 '57 10,qr►1.4Pr Village Owner (7"le g /71 eln Le-yo�iL� Address Seen e Telephone •S ark' q2 t ®l 71 Permit Request h-S� Y 14�0_Z® ���►�� .��i?7 Od�» r Jn-r � �h sa liXel Square feet: 1 st floor: existing proposed .3 0 2nd floor: existing proposed Total new 301a Zoning District Flood Plain Groundwater Overlay (� Project Valuation l 9 �� Construction Type LL1 Lot Size 12 S X l 7-2 Grandfathered: ❑Yes o If yes, attach supporting documentation. i Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structu e iq 9/ Historic House: ❑Yes SAo On Old King's Highway: ❑Yes Jd/No Basement Type: 51 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: O 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:-2(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 BUILDER INFORMATION Name Pwilpe kl'I d/'"/Telephone Number. S 31%f Address 7 s90 L�! c►re G/ �✓'. License# _C S 971 - en Af fl a32 2 Home Improvement Contractor# 12 717f Worker's Compensation# 1414Da9 �Z2;7 ALL CONSTRUCTION DEBRIS SULTIN FROM THIS PROJECT WILL BE T IN TO n-4 Irr Z� J/U C ll�LdI ! , � - �e / h�l ski,�1 G SIGNATURE DATE I6 3 F FOR OFFICIAL USE ONLY ` ryl PERMIT NO. DATE ISSUED -' MAP l PARGEL NO. ADDRESS' VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION QK FRAME " r< INSULATION FIREPLACE : r ELECTRICAL: Rg QH • ,S? 7 ; FINAL FINAL PLUMBING: � ILil� t __. -; ? GAS: AROUGH; FINAL t.7 Li fJ FINAL BUILDING DATE CLOSED OUT 3� - • ASSOCIATION PLAN NO. CIVSL t PANEL SPAN ALUMINUM HANIGM . ASSWBLy CONNECTED TO WALL STUDS EPS FOAM SANDWICH O 16'cc PANEL WITH AL 6063-T6 ALUMINUM I-BEAM AT 4'-()'Cc ! 2 PIECE HEADER BEAM \, ALUMINLJM SIDING DOOR OR WINDOW PROVIDE 4 P-CO;dTROL SCREWS Q AT EACH END OF Q ANC FM PANELS UNDER 16' LONG R-CONTROL PAN E I SEE TABLE Q 7.7&7-8). MIN 3 2' BEARING ENTIRE PANEL WIDTH, BOTH END (--PLYWOOD SHEATHING ON a FRAME (SEE TABLE 7.2) GIST HANGER 77MBER .JOIST (SEE TABLE 7.3) BOTTOM OF FOO77NG SHALL BEAR ON A FIRM STABLE SOIL ' _I�l.1NN_ G A S-- $ _ CAPACITY OF oPS-r�iG TUBE EXTENDING TO BE:LoW THED TllE s FROST LINE '�FTC ' LEDGER AT i ACHED TO EXISTING STRUCTURE i ` 'ICAO CiRos C 'Its 71TLE-- cHAMPION ENCLOSURES' 1 PATIO RCOM 7. FLOOR DECK y�/� TD ry r� ,� # FIG is V_�L� /.�G � ET+IG-97-2i3—OH DAIE. DRAWN 5Y: 3-3-99 SCALE: .fLC NONE "---B Rl C TESTfNG 3502 SCOTIS Imo' D A ��.T? ceL'lAms, Ric. I'F3L�. . 19129 , (215) 438-15M - _ _: iL .� �.•",,b'fi + ..fie' I FOR PANEL SIZE SEE TABLE 7.7 3` 1 7/16` R—CONTROL- � O—ALL=PLY� � CON i3Nu6us L L LI ALL OUBLE 2x SPLINE 8d NAILS O i2`cc Two ROw, STAGGERED R—CONTROL PANEL R—CONTROL DO—ALL—PLY RAC ROL�DO—ALL—PLY 8c BOTTOM OPTIONAL FACTORY ELECTRICAL CH ASE ---------------------- LLLLLL �- --------- -- --- F'STEN WTH '8d NAILS OR 807H 1 1/2" STAPLES �p $"cC NOTE: VAPOR RETARDER ON BOT}i SiDES OF PANEL JOINT OR WARM SIDE OF PANS EQUIVALENT TYP_ EACH SIDE —L SHOULD BE UTILIZED WI731 DOUBLE 2x SPLINES i WLE i 2 HAA PJON ENCLOSURES ' R—CONTROL DECK SPLINE CONNEC i1ON DETAIL (DOUBLE 2x + JOB : ) f1(r�1RE 7 4 ENG-97-213—OH 3-3-99 DRAWN BY: I _ dLC SCAT-E. A MBRI c & NONE e 3502 sCc�s � ENG�RMG AssOCIATES, INC. I A 19129 (215) 428—IW f -�� rJ yydc 5C7 P (4)-R—CON7ROL C,,Z EWS ACROSS%.CANEL FOR �,atY, PANELS '16'OR LESS LLLLLLLLLLL L LLLLLL R—CONTROL DO—ALL—PLY OF R—CONTROL PANE PR01rIDE MIN OF PANEL BEARING ENTIRE WID7i1 STRUCTURAL SUPPORT GIRDED GIRDER BEARING (4)—R—CONTROL SCREW ACROSS PANEL AT GEARING OR PANELS T S' OR LESS ------------------------ -- 99LLLLLLLi LJLL --- ---------- L L L L L --- ----------- R=C{jN SANE:PROVIDE MIN---- OF PANEL BEARING ENTIRE WIDTH R—CONTROL DO—ALL—PLY STRUCTURAL BOLTED TO SUPPORT LEDGER 1U+ALL MIN 1 1/2'WIDTH LEDGER BEARING TMZ CHAMPION ENCLOSURES R—CONTROL DECK END BEARING JOB :ENG-97-213—pH DATE: fyG &E 7 _ 3-3-99 DRAWN BY: dLC SCARF: BRIE�S'T:.IN NONE 3502 SCOTTS LIME, PA 1912D pN�G ASS©CiAgES INC. (215) 4U-18M k�, •"• C' lk ,. xa 3�bofi;J DOUBLE 2x SPLINE SEE FIGURE 7.4 r' •'•;y�6137���•° 1 FOR SPLINE CONNECTION FOR �� �'f' •"; �� SPLINE CONNECTION FASTENING INFO R—CONTROL. PAtJEL SEE LOAD DESIGN TABLES 7.7 do 7.6 FOR PANEL LOAD CAPACITY 2x LUM EDGE PLATING MATERIAL I I N0 if .04 Sep° NOTE: A YAPOR RETARDE ON WARM SIDE OF PANEL SHOULD BE ISOM TRTC UTILIZED VdTH DOUBLE 2xl SPLINES I . TITLE: CHAMgION ENCLOSURES ' AMB RI C TESTING & ENGINEERING ASSOCIATES, INC. R--CO�TROL DECK .F[GUI E` 6 3602 SCOTI� LANE, PHR A., PA 10121) 11 (216) ,tie—leoa J09 ENG-;�7-213-0H DRA►�N 8�': JLH SCALE: NONE, FAX (21a) 438-7110 PATE: 3-3-- 9 t, ------------ 9-147NO11 ENCLOSURES ,'ABLL- 7.7: ALLOWABLE LOADS FOR R-CONTROL PANEL DECK USING DIMENSION LUMBER BEA1%4: LOAD DESIGN CHART (DIMENSION LUMBER BEAM) PSF TIivIBE EPS CORE. ;'. °DEFL. PANEL SPAN JOIST. `I HICKNES S FLOOR SIZE' 10+ 12' 14' PANELS 16 .MAX.-SPAN L/360 100 68 43 28 2 . 2 X 6" 5 1/2" L/240 100 100 64 43 12 FT. L/180 100 100 86 57 L/3 60 100 100 67 46 2 - 2XV 71/4" L/240 100 100 100 68 14 FT. L/180 100 100 100 82 L/3 60 100 100 100 70 2 . 2 X 10" 9 1/4" L/240 100 100 100 98 16 FT. L/180 100 100 100 100 FLOOR PANEL SPANS USING PANELS MANUFACTURED TO AFM STANDARDS AND INSTALLED IN ACCORDANCE WITH DETAIL FIG. 7.6 USING MIN. 7/16 IN. APA RATED 24/16 SHEATHING TOP AND BOTTOM. FRAME WITH CONTINUOUS DOUBLE 2X'S 4-0" O.C. AND SINGLE 2X'S AS PANEL PERIMETER BLOCKING USING MIN. 92 SPF (EXCEPT WHERE NOTED), OR PRE-ENGINEERED EQUIVALENT. TOP SKIN THICKNESS FOR FLOOR PANELS SHOULD BE 3/4" MIN. OPTIONAL: MIN. 7/16" TOP SKIN OVERLAYED WITH A MIN. 7/16 FINISH FLOORING PERPENDICULAR TO THE PANELS, THIS WILL PROVIDE ADEQUATE RESISTANCE TO IMPACT AND POINT LOADING. AMBRIC Testing& Engineering Associates, Inc. 3502 Scotts Lane, Philadelphia, PA 19129 �v --•�a• �s};'-_ March 9, 1999 DORA WE:SEL, U MIR- ;<' w - LL ro �IoER.A �k- ► i i. C I I S 0 n1G lool Soljo • i . 1 g" �t5 F AAs _ - — - - .51j N � i I . i o RN e LSo'f0 .� r- IN i Lj - r The Commonwealth of Massachusetts _ Department of Industrial Accidents _ Office 81/nuesti9atiens 600 Washington Street J� Boston,Mass. 02111 Workers' Compensation-Insurance Affidavit d name: 'nafRn is location: 1 �i' r city AX ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compens tton for my employees working on this fob � � T'�`v��✓f-�< .n.� ��. �ism'k JYtr„'i� �" � � r � r s�'v „ z3,S� t� rrc a yi,. `�A„ ' �`x �Sr°'X�'s7�bs�' *•�.,'�.���"'t-s�r��"�L°r � l�i rcom an �oe:me jip'.,g""�'v x f-.r ra -a a v r r jr¢ .x;: 1-.r 4F 'C,&., z s F'y`a +'�3"" k� ;-,'y� s..,PR sv +��,f.w. >" s• 3 ...er-gr- 2�^,.,r+ £... `�'"� # s. x k-. g Y<..K4 ra`5' £Y`✓ 3rf3 rs,k�1,°�' �s' �• s` "� •"b.S. s :r � vk• t L Sr'` r ni ,f ds8 r 1 its+ i p,4 -'�': � r .a� address �^ s # .•.+. 3n na'ti:47� r �^mm-u 0C1 : .str 3 Sr X N x T sc rs ��E' �.L^E':�3'�..�' �x;,-'�. '�� "`,k 3�sw,�_�'c �.xe�; v`� ��.r..��' S�xA�� c �.� •�'�; �5 �.��, k��[k w3�`,�,a.'"Y�„�sTi,�e.'^�4�t.�T>�}3� � �as" ` �"`• aka ���.� ,� £ ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices 'a- z d r S �- 5 -.t,k1§ �t 4: i� ex .i s ar, _,x. x"(os.SW•p�' x'""Eti »�`�` ��''��. '"',/+°' 3� .s." s' '.`�* -.•rN�' �'�*af 3�r(a X�,. � ;s,�in �-''Yri ,sr � , .� ham' � r L ' r,� ,�r�'M�Y�2;,�'^.�� §�`�4i��Z�yF�s.,x,�,�y��. .�*w�`��. -; � x�.Gi k �% �` � "x §�5'.`r".,,�,� .r�axa �� ��� `�.£ �'. .� 'X" +,4. �y r�• s +' '�� f '+z ,��' .��;i-`v, e�: eX�c t�� � �� ��.f���.�.�4 Syr 5' 'w v a�'.r, -„{ axe� Sx} sz � .ti ?xY"rq }d �'�-9'n i`�+•+3'fr �-�.'i"'�'u„�"x �4 r�'S'`�,k'��'+'��,h .�. c's: address t a Fkz s d k .�..�Y ,��E -. �s33 w Y' a'Y 3✓.� sP ^�r..�97s�q+: f '. lk a-r,', dYuy 3 2• R4 �' ... N �.'� x g� `� F�'Sa i, d<�^„ -.fs t ¢ '' r i �yb r #°r.$G t R�'rTt� :§r tzv s,�'rxA f 2 a:_ -rr q r`x €s b r zyrar r EInSUranCeCOFsNs¢ro+�.i "rr :,rr cDOIIC>Y,`:'�# .'°a o s .:x MDX�•. ..,,�r .e.�. Sr.�_.�. F %�' 1x< x ` '� x'°r: x i+ ,34(F< t v ,Sa t s ' "'�� B�.� rsarj,�sn r� �^ :�"� •s` xr'�z„fias` "v ':?kn ��`�"'���3'. •'` rx'kt'� �,s CORI an wnanivyi�r XA r s r qt§ x rs rt2y:y^va"ir' t"[r5'sy aw,ez",j5� Pr��'yr'�xs 1 J, t •, s J-. k 5 s a k. < s 'as y: '�� , � �� � � `r r r' c y r t taddres9"�`�� ��������� .� �`�3ax � "� • � ra s s � � a• a� t � r�r tra''8�' t-�''r � �� �': §L �., rh€ c.-. r-a g ::. ,�a r'. 3 x 4 ti F r �, c y e•'s N•Y r Citl� � of s �t � r 4 phone># § E 'f ,aa+,°,3°, .,�sX 0 `3 r=� t'✓:,'a i'`i 1q 3 a ky a�¢.z r,s a ze t.s? V e t 4r k `ez �Xp ..s�°�� �� ���7.ffina"`'se5..,¢ '� 4 .72"✓:- � - § a. -9 r` 'r t^�:� hF! �.�,. � +F�r ,r,k , -, �✓ya, �`;L4r...cy�y .�.+ Failure to secure coverage as re ed under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as as��jivil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement be fo 5rded to the Office of Investigations of the DIA for coverage verification. I do hereby cerd under e p ins and penalties of perjury that the information provided above is true a d correct. Signature Date �Vjaf Pri Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# MBuilding Department []Licensing Board check if immediate response is required ❑Selectmen's Office Health Department contact person: phone#; nOther (revised 9195 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to.be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 °pISE rqs� Town of Barnstable Regulatory Services $ saxxsrABLr. Thomas F.Geiler,Director ass. 9`�prfo;p.�04, Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508462-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. P011M Type.of Work: '04 f/, Estimated Cost V� a ' Address of Work:—�4 �_ A�t��r/1� Owner's Name 06 f- /t Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME UYIPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: I �V4���L A J4 fl at C tractor Name Registration No. OR Date Owner's Name RESIDENTIAL BUILDING PERAUT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKS ET NEW LIVING SPACE —�---square feet x$96/sq.foot= la x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) , Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee (� -'so- 7 M" t•t'w-PTA 5. _ _•{, y��,s' y .. ,gw.t 3. � �'� :� c� 4' �• yt�+sa�' F '+ _ .s 2 :•��T t�'4•; r :� i W�.• z�.iK��S .. y `Z - .K 'w x,.^�' �i .� I r i "' 't? '�-` .r•R" V.R a � �.c o..��.•. �F'E F:}.: ::? - ' 'Z'y ry4-9V 1 4. .o• Y ..� � 7 - �,•',-/.:i� Lt.C �'f J _ Y i� �y -Y• ?. -' 'Y r--; '' -'�s`"'b:' T2 + ..a; T ,aJ - ?^'ya`•15�-•3 �, °.. i ?. _ FOUNDA '10 %j f! r in MASM r li P •o � i! PI r;%I \may �lI , w� I• .. 1 !1' r j m, ;:1 r , f r- it OIYA'SD 8 Y SCALE: / "=Sa' DATE= �9vG• /� t 9�j/ r t 1 1 4 rry NORMAM GROSSWAN------ HEGISTERED LA SURVEYOR I PEP.Eby CERTIFY THAT THIS FOUN04TIO.N IS LOCATEDON rlE LOT AS SHOWN AND COMFORUS TO THE T(''r'!K ;t� "� � <1 rF P:•rlNSTABLE ZONING R`GULATIQNS REGARDI"+G STREET LI":£S t- "O LOT LI 1ES '!•\ \t v.�� • , � Tlie T�omvrreovaurea�� a�il/�acliciael2a 1 BOARD OF BUILDING REGULATIONS License CONSTRUCTION SUPERVISOR " Number:.CS 072489 r , x tau , "i 1�xplrep:-1.1/0612003 Tr.no: 10694 Restricted:. 1 G DWAYNE C DRAG GO"O. 3 COUNTRY CLUB WAY NORTON, MA 02766 Administrator Board of Building Regulations and Standards License or registration valid for indis"idul use onh HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 127179. Board of Building Regulations and Standards Expiration: 9/15/2004 One,-Ashburton Place Rtn 1301 Type: Ltd Liability Corporation Boston, Nla. 0210$.. - CHAMPION WINDOW&PATIO R 75 STOCiiWELL DR. 4VON, MA 02322 �••,:ni.r�•..,,, Nor%slid %%ith0l1t cionnrure r r FACTORY DIRECT Q) SINCE 1953 4e � I` ! a WINDOWS • SIDING . ' PATIO ROOMS a�li J i �I ' I I !' AFFIDAVIT I/We hereby certify that I/We are the owner on record and have authorized the work described with this application and further authorize •VINYL REPLACEMENT Champion Window, Siding and Patio Rooms, and its personnel, to act as WINDOWS my agents in matters concerning this project. I/We further certify under the pains and penalties of perjury that all statements made herein are true and accurate. Property Owner's Signature(s) Date L{ p 3 M.STORM DOORS& 7 WINDOWS Property Owner's Name(s)(print)_,,-1,-0,.,1-- Address of Property �j��j ��� ✓�i(/�YL ( /fie �7�y1 T J A PATIO&ENTRY DOORS � •� QuincyOnly ■VINYL SIDING AND TRIM Exemption from Sewerage Rehabilitation Fund City Council order Number 36 of 1990 I hereby certify that the subject property is a one, two, or three family and I will live here for at least one year from date of completion of this project. If the e PATIO ROOMS& foregoing is found not to be true I hereby agree to pay the Sewer Rehabilitation Fee PORCH ENCLOSURES within thirty (30) days of receipt of a due notice Signed: Date: l� ". W.a�-. 75 STOCKWELL DRIVE ■ AVON, MA 02322 PH: 508-580-3119 ■ 877-946-3699 ■ FX: 508-580-6064 n......—+uanL2a.a.:.v.. ..i CW:'a.w..� Y.... w�.-."y'E-'"-'+��� 'r ,_'��.:1 Y.M1`J:'1'�J -xa uL {•"4 y"g . I ;; CONSZJMEREINFORMATIOlFORM ,m..Y,�:-. -. MR. 15%Iassac use State ail g Code(780 JCS chop J11.21 • The Massachusetts State Building Code (780 CMR) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration,orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings Way create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a"sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation-Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner (not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and ener co ervation. atu a of Actual B uildQ Owner Date Prin ame Address of Permitted Project (/ Owner Address(if different than project location) Owner's telephone number ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIM 01/22/2003 PRODUCER (S13)421-651S FAX (513)421-0130 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wal teO P. Dol l e Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 201 E. Fifth Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 1000 ' INSURERS AFFORDING COVERAGE Cincinnati, OH 45202 INSURED Champion Window Co. of Boston South, LLC INSURER A: Liberty Mutual Ins Company 75 Stockwell Drive INSURERB: Fireman's Fund Unit #7 INSURERC: St Paul Fire & Marine Avon, MA 02322 INSURER Chubb & Son Insurance INSURER 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMIDDrirn DATE(MMtDDrfY) LIMITS GENERAL LIABILITY 7-541-434194-012 12/01/2002 12/01/2003 EACH OCCURRENCE $ 1,000,000. X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 2509000 CLAIMS MADE FX�OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL 3 ADV INJURY $ 1,000.00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY PE Q LOC AUTOMOBILE LIABILITY 1-541-434162-012 12/01/2002 12/01/2003 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY XYZ9679653 12/01/2002 12/01/2003 EACH OCCURRENCE $ 5,000,000 X OCCUR ❑CLAIMS MADE AGGREGATE $ 5,000,000 B $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND A0205278 12/01/2002 12/01/2003 TORY LIMITS I I ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 1,000,00C C E.L.DISEASE-EA EMPLOYEE $ 1,000,00( E.L.DISEASE-POLICY LIMIT $ 1,000,00( THER 79815100 12/01/2002 12/01/2003 $10,000,000 Limit D xcess Liability DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE . EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS ACZENTS OR REPRESENIATIVES. TO WHOM IT MAY CONCERN AUTHORIZED REPRESENTATIVE ACORD 26S(7197) ` OACORD CORPORATION 1988 FACTORY DIRECT SINCE IVA CHAMPION WINDOW CO.OF BOSTON SOUTH L.L.C. '75 Stockwell Drive•Avon, MA 02322 WINDOWS SIDI Q PATIO ROOMS ® 0) 508-580-3119. 1-877-946-3699 WINDOWS _ _ HA.C. 127179 M.N.04-3450124 To -, O e%.� Le%r�,��� Date �^©3 .CIS Aoik ez CiQ /� County/THmshp �42 Home Phone ��—'� ���0/ 7& City !r-� State AM** Zip -()Rv _:?X� Business Phone(Mr./Mrs.) �;illP k� Replacement Windows•Storm Windows&Doors•Vinyl Siding,'Trim&Shutters•Glass&Screen Patio Rooms•Entry&Patio Doors WHOLESALE & RETAIL PATIO ROOM CONTRACT CHAMPION TO MEASURE,MANUFACTURE,FURNISH AND INSTALL-THE FOLLOWING CUSTOM MADE PRODUCTS FOR THE AMOUNT STIPULATED BELOW: Champion To Build A Patio Room With Outside Dimensions Of Approximately_A:_ X B: X C:.� t Champion To Build A Screen Room From 2'Components With Outside Dimensions Of Approximately A:__ X B: X C: DECK OR SLAB YES NO YES NO $ut -n O Under Customer s Existing Roof J�',— Q Room Dedc Approximately (�X Material . %� O I-On Customer's Existing Concrete Slab '�� 19J�'Open Deck, Approximately X Material- ❑ N<On Customer's Existing Deck J 13 Steps^WcdK.Concrete ❑`Approx.Number Of Risers--Ope�Closed O O p�(Tear Out Existing:Slab O Deck ❑ ❑ �Railing Approximately Material ❑ A ooters For Existing Slab ❑ Skirting Approximately Material O UR Tear Out Existing:Walls❑ Screens❑ Roof O Rails O O Pour New Open Concrete Slab Without Footers Approximately X 0�A Tongue&Groove Sub Flo ❑ ` ' Pour New Concrete Slab With Footers Approximately X <!WALLS All Champion Patio Room wall systems consist of a series of sliding aluminum windows on top of an approximately 16'tall knee walls and/or full view sliding doors(see layout).Windows and doors include duel locking system,anodized aluminum threshold,synchlock interlocks,stainless steel wheels and sliding screens.Champion to determine exact size of units at final field measure.All glass is tempered safety glass,and all walls include build-out and leveling system as necessary. YES NO f O 'Super Frame,_Wing-&Trim"Color jWhfig Tan O Bronze O��Y-4—i Z/_ / Z/ H❑ 3/16'Triple Strength Non Insulated Glass �Lll � �< �� .. ❑ � Double Pane Insulated Glass _ E O Low•Elnsulated Glassy %Qi2ar�i0N Fixed Glass Knee Walls 'Location: A O B O C❑ 0 IW Knee Wall w/Aluminum Skin(R-19):White 0 Tan 0 Bronze 0 ❑ (Kne—e WaltwNinyl Skin_(R 19 Whit'e)d Tan O A 0 -4 Build Up O Build Down t] location: A O B O C❑ �`L •� � 1,_��_� O Fixed Transom Glass Location: A❑ B O C❑ ✓ ',/ O Locking-Screens 0 fib Cap Existing Posts LAYOUT SKETCH OK �ie1(� ❑f Key L_odcJ X=ACTIVE 0=FIXED 0 ;W..Sliding Screen Room System(No Glass) =FULL VIEW 2�' =KNEEWALL ROOF Champion's superfoam roof system is a nominal 4'(R-19)or 6'(R-30)expanded poly-styrene insulated foam with an embossed laminated aluminum skin and thermally broken I-Beams. YES NO YES NO O oq Studs Roof System Color. VVtitte❑ Tan❑ 4'❑ 6'O W�O Gurier_&=Down-Spottt To Grade CAK7 O Gable Roof System_Color.Whitef�Tan O 4 f 6'O Shing eslesi (]o-Match As Gloss As Possible) og� El Gable GIa ❑ Quantity:s�B(wng Glass 0 Numbei Of Pieces; O Skylights:Vented O Non•Vented ,�D ❑ Gable Tie iriiri(IncludesShingles On Saddle Only And"Vertical Vinyl Fill On Inside Of addle)--7 DOORS YES NO O A< Storm: Outswing Color Style Left Hinge 0 Right Hinge❑ OSLI O t<Entry:Inswing❑ Outswing 0 Color Style Left Hinge O Right Hinge❑ OSLI OTHER YES NO' YES NO 0 Heat/Cool Unit O Aarpet X_ Color Cut To Fit Loose Laid O bo Blinds: Color Style Height Location:.A O B O C 0 O Electrical-P_adcage_(Induding 3.Wall_Sockets,__ Wall Switches) Hook Ups Of Customer Provided_Ceiling-Fan-With Wire-Mold) COMMENTS h� Interior Roof Slo s To p ozs ft. Attaches To House:Wall O Gutter Board Cl Fascia Board❑ / ��' • --- Champion Is rble For Ex'sling Foundations,Structures.Or Existingu niin. A; BUYE 'S RIGHT TO CANCEL Total sale price $ .0 BUYER MAY CANCEL THIS CONTRACT BY DELIVERING WRITTEN NOTICE TO Less down payment v#� �f $ /off 017 Initial balance $ __�Q q 6�0g THE SELLER AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS Less partial payment $ ill a - p len of room structure PRIOR to DAY AFTER THE DATE OF THIS TRANSACTION.BUYER MAY USE THIS lostallatlon ol�Custcomom Glass,Carpet Electric,Blinds) CONTRACT AS THAT NOTICE BY WRITING"I HEREBY CANCEL'AT THE FINAL BALANCE $ O OO O i0 O BOTTOM AND ADDING BUYER'S NAME AND ADDRESS.THE NOTICE MUST (00e in full following t00%completion of project) - — ❑Bank Financed 1 C I BE DELIVERED TO THE SELLER AT THE ADDRESS SHOWN ABOVE. � Payments of$` ash on Completion "r---per-Month All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices.This contract is valid only with proper signatures. Champion shall not be responsible for time and material delays,strikes,acts of God or any other matters beyond its control.Buyer and Owner agree-that-the.@ in this property is security for this contract. Since this contract calls forma - "order-goods,itis�not subject to cancellation except as stated above.Start installation on or about 0-'. ' eeks from above date.Estimated date of substantial completion is7 All charges-listed above.Champion to remove and haul away all job related debris.All sales and discounts allotted.All contractors and subcontractors must be registered by the oard of Building Regulations and Standards and any inquiries relating to registration should be directed to this agency. Champion shall obtain any and all necessary permits as the Owner's agent unless otherwise directed by Buyer.If Buyer secures permits,he o:she may be excluded from the guaranty fund provision of G.L.c.142A. M Champion must pursue Buyer for collection of amounts past due,Buyer will be liable for Champion's reasonable fees and costs,including attorney's fees.A FINANCE CHARGE calculated at the rate of 1-1/2 percent per month(18%ANNUAL PERCENTAGE RATE)will be added to delinquent accounts. All Installation and completion dates are approximate and subject to change without notice. Verbal promises can cause misunderstandings,therefore this contract constitutes the entire understanding of the parties,and no other understanding, collateral,verbal or otherwise,shall be binding,unless signed by both parties.Thank you for your order.Do not Sign this c tract if there are any blanks spaces. 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Y 3.07" �D o 1:222 0 1 1.62 3 0.220 1.543 clifO.81 —0.080 N P� of - . o i vr 0:095 4298 5A5i INSERT I 4 oo v: .08" 0 0080' Z o 3 ¢ ` Z W O a�:Q ALUMINUM CENTER MILLION © ALUMINUM ROOF PANEL FASCIA 7O ALUMINUM LEAPING WALL HEADER® ALUMINUM FEARER for`7J ^ <v,o INTER 6.00' s 00' LOCK IN ERT U Q U q c u 3.64' �� 0.52" ,�� 3.64' —,� 0.52" -#' 1.48' .� I y aTe rte moz ,�7� scve m {WXALD DOOR/ WINDOW FRAME 3 VVINYLO1C?ItW WINDOW FRAME VINN.DOOR/YJILWW_ DAVIO 5 2 VENf INTERLOCK DEADLtfE INTERLOCK E--7 NEISEL L 3560 delxxM+ 71LYo'.' Assessor's map and lot number ..' y.. THE Sewage Permit number ......: 3.'75....................... SEPTic SYST'M 9 Q INSTALLED IN (;ONA117'. t. BARNSTABLE,1:6 i H9use number ... 9 .,4................................................. ' 'Ay u Te r. r ae 4 EWIR NMEN A TOWN OF 'BARNST I � BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................ —al...............:........................... ........................................ TYPE OF CONSTRUCTION .........(/v®©� 'ref�..... (•Uf /! z ............... .�...- ................ TO THE INSPECTOR OF BUILDINGS: The undersi ned hereby applies for a. permit accoew ding to the following inform.,aation: Locatiori .�.�( /...........�,m/. ,e...... ..........:��ll ......:�:.:`.... ................................... ProposedUse ... .z1---�//v......................................J...................:................................................I......................... 9 Zoning District F .......................Fire District . ....... Name of Owner �. �� ..........Address ............. ...........J ....... ....................... l�.E'/7'7®LC�/t Name of Builder ...S14C.1;�./p ......Address ....................................... Nameof Architect ..................................................................Address .................................................................................... u /�,, 'y.E � Number of Rooms ................. ............................................Foundation ( 5�� 4 Exterior 1�� /7/dV l� ..Roofing ..... . S �Q /� .. ................... Floors � GlJ �� .........Interior ......�/@ GG)14 .......... .... .. .4/0054--, !........1. r / Heatinglf... ..... ........................Plumbing .......................,/....................................................... Fireplace .........................1........................................... .............Approximate Cost 000........................................ Definitive Plan Approved by Planning ,Board ____ �_ 1__ 19��_. Area ..... ......... ...... Diagram of Lot and Building with Dimensio Fee l............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 150M0 1� C i Al 46- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r arding the above construction. Name. . . . ....... ... . . ....... ............ .................. THEO CONSTRUCTION CO. y NO" .,............... Permit for ....QXl ..stOz ......... ...D.wel ling. ............ ` r e Location ,Q ... k.11...395...Marine ••Circlp Cotuit ' ............................................................................... M f Owner .,Theo••ConstruC� Ql�...C.Q.........." Frame Type of Constr.Uction .......... i yam- r Plot ........ Lot ............:................... • August, 12, _ 81 ' Permit Granted ........................19 ` 't Date of Inspection ........ ...........................19 { f Date Completed �s :.. 19......: f t� PERMIT REFUSED w.sIrv ......... : .fir". ... . . .............................. ... 19 f ............................. / ,• r ..................................................... r .................................................................. ` ......... 1 - r Approved ................................................ 19 .........................................:..................................... ................ ..........................................................::. %.. / -Assessor's map and lot number ...... ..�............. y C,*?NE l0 Sew$ge Permit number ........ �......................................... fl Z EARNSTADLE. i ') ff Hq(USe number .... e rA ..... a 0o FAO 9� Ar TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TOf 1 .............................:.................................................................................................. TYPE OF CONSTRUCTION ........./��''�0ty/...... �'•?e1C` f!`�........!... :r -U ' �!s�o f.. ............................... ..................7......'J ...........I9.�. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Al'.1-4 �, Location .%................/.,�................................................�............ .,.......................................:....................................... ProposedUse ......................../ / ! /!/�`�................................................................................................................. ................... 7 ...../ Zoning District ........... ..../7.:..............................................Fire District o< ;,/....../.................... ....................................... Name of Owner ...................................................t Y , tt` .:. j............Address ............ t'?....... �............... Name of Builder .....:..� ,4%h �II�G /`�c� �.l. Address ............... ........................ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .................5 ..............................................Foundation ........................................................: .................... Exterior ....,-.,........... ........................ ............Roofing f f� ftf if� ������-�.... .. ...... ... .......�................1../.......:.....!.....�,............................. Floors :.......:.................:...........:...........................................Interior ...... ! }rt:.. l_t .................................................................. 4j s R Heating �r { t f .�`.. ..........................Plumbing ........................��r:............................................... Fireplace .....Approximate Cost 4 00 Definitive Plan Approved by Planning Board _____4_____ ____ 9 Area' ' _. -� =- :...........�............ Diagram of Lot and Building with Dimension'/ / Fee ��................:........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH . r 41 — r i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .................................................. "*.CONSTRUCTION Co. =24-69 ,/No• 2 3 3.6,2'. Permit for ....One..Story........ . Single Family...Dwelling.............. Location , Lot #11 395 Mariner C��rc1e ......................................... Cotuit ............................................................................... Owner .....The Construction ................................................... Type of Construction ....Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted .......A.ugu-st••••12-y.......19 81 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED // .. .... ... �9 �.Q .........� ...........I I.............. Y mil., r Approved ................................................ 19 .....................................................0......................... ............................................................................... •-Ca T�' �T Z-0 T� -22 zg 3 r_S ,Ld7- /A 0 3 kl -J t. `o 44 6A U L m $ � PLAN SHOWING ' i tz� 11 D F.OUNDATIO.N LOCATIONqc T r, Mai " G C O T U1 T, MASSACHUSE T T S D, R! r • .� OWNED BY T/ Ea CcN�S'T,t� Gp ,, � �n fl,r`x° SCALE : DATE: 4uG• 3 NORMAN GROSSINAN----- - REGISTERED LAND SURVEYOR C C 3 I HEREBY CERTIFY THAT THIS FOUNDATION. IS LOCATED �- ON TINE LOT AS SHOWN AND CONFORMS TO THE TOWN rf� �ar" �.\ OF BARNSTABLE ZONING REGULATIONS REGARDING `gyp "AN N'�, • D n 0 10 14 534WAN ��'j � r- Q � t SETBACKS FROM STREET LINES AND LOT LINES . �`�, t i ft�r ` � (� - in NORMAN GROSSMAN R.L. S. DATE P"- °`yam TOWN OF BARNSTABLE Permit No. --__-________-__ qVAUSTA� s Building Inspector Cash ---------—----- -- aI MY•` OCCUPANCY PERMIT Bond Is.;ued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19......»..» .............................................................................................................»... Building Inspector