The URL can be used to link to this page

Home My WebLink About0581 OLD POST ROAD 1 U�� 1POST �� J l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION (9-57L! o 1 -4-- Map Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address :5 Village f' Owner S,��ti � �o v�emu�Z Pos t- ,L'Ad)ress L,c�r' 3 o r.�y �-c 5 f-; Telephone SbS - �,�®`�1 Permit Request i wSf-.X��-r1�+r• tr� �o'��` 1' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation J 7-3, 1)�. Construction Type Lot Size 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: ❑ 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_ �. =T CD 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 1\G> W,� +►a Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C I-FAW ) �t��d, Telephone Number L98-s'6 f� Address I OA+<- License # 9SIPLV/LLB V26sS Home Improvement Contractor# �q y Worker's Compensation # \(W C o 14 14 00 z-OI 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Avl�.Ist 4le- �✓�•�-�� SIGNATURE FOR OFFICIAL USE ONLY APPLICATION# P DATE ISSUED 1 MAP/PARCEL NO. I ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE S ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING j t DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ' s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): n e� Address: City/State/Zip: % (� �rO Phone#: JOg O� 1 Are ou an employer?Check the appropriate box: Type of project(required): 1.M I am a employer with' -1 4. E] I am a general contractor and I employees(full and/or pat't-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. (] Demolition workingfor me in an capacity. employees and have workers' Y p t}'• 9. ❑ Building addition [No workers'comp.insurance comp• insurance.$ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 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 Other 13.[ N employees.[No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information.. Insurance Company Name: ACT—, 0). rnL//+wd Policy#or Self-ins.Lic.#: �l�c(O Y'f (� D�� Expiration Date: /p� 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 tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do Hereby certify under the pains and penalti of perjury that the information provided above is true and correct SimAture: —Date: 13 i�J/( 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#: Office of Consumer Affairs and usiness Regulation 10 Park Pl aza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 149094 Type: Individual Expiration: 11/22/2011 Tt# 290946 CLEAN ENERGY DESIGN THOMAS WINEMAN - 11 OAK LANE OSTERVILLE, MA 02655 - Update Address and return card.Mark reason for change. Address [] Renewal r Employment ❑ Lost Card IS-CA1 is 50M-04iO4-G101216 _ License or registration valid for individul use only otTrce of AHsas&Busiom g $nO0 before the expiration date. If found return to: HOME 3WROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation � - r Rego .149094 10 Park Plaza-Suite 5170 _ Expia T[# 290946 .. Boston,MA 02116 11t2212011 Type CLEAN ENERGY-DEStGlJ:f.. THOMAS WNEMlAN i i OAK LANE OSTERVILLE,MA 02665. Undersecretary l Not valid without signatare 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Industries of Massachusetts Mutual Insurance Company 54 Third Avenue,Burlington,Massachusetts 01803 (800)876-2765 NCCI NO 26158 POLICY NO. I VWC 6014140012010 PRIOR NO. I NEW BUSINESS ITEM 1. The insured Clean Energy Design LLC Mail Address: P O Box 1954 North Falmouth MA 02556 Street No. Town or City County State Zip Code FEIN 02-0742710 [Individual ❑Partnership ❑Corporation ❑Joint Venture ❑Association ®Other Limited Liability Co Other workplaces not shown above: 2. The policy period is from 12/21/2010 to 12/21/2011 12 01 a.m.standard fimte at the insured's mailing address. 3. A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the states listed here; MA B. Employers Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident$ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance:Coverage Replaced By Endorsement WC 20 03 06A D. This policy includes these endorsements and schedules:SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 098452 SEE (TENSION OF INFORMATIC N PAGE Minimum premium$ 500.00 Total Estimated Annual Premium $ 1,091.00 As indicated interim adjustments of premium shall be made: Deposit Premium $ 1,145.00 ® Annually ❑ Semi Annually ❑ Quarterly ❑ Monthly MA Assessment Chg. $789.45 x 6.8000% $54.00 This policy,including all endorsements,is hereby countersigned by 01/04/2011 Authorized Signature Date GOV GOV KIND PLACING CLAIM NAME SAFETY Leonard Insurance Agency Inc STATE CLASS AUDIT OFFICE OFFICE CHECK GROUP P O Box 494 MA 5645 2 604 OMervllle,MA 02655 WC ,0 00 01 A(11-88) Indudes copyrighted material of the National Counal on Compensation Insurance, usedwith its permission. MAR-16-2011 08:53 FROM:SARA AND DON 508 785 2732 T0:18884248824 P.1/1 Mar 25 11 UH:U3a tam Wlneman ! ULU bUH-4ZU-U3'/U p. 1 • • Town of Barnstable s , ' Reguiationy Servxs Than=P.QeUer,Director Building Division Tom Perry,SntldtAS Commissioner 200 Mam Street,Hyumia,MA 02601 www,towm,buutab1e,m4.as Met: 509-UZ-4039 Pax: 508-790-6230 Property OwmrMust Complete and Sign "his Section Yf j sing ABufldcr I, Sara _�meaux .as-Owner of the subjea pmpeny hmbyatrrhorize to act on mybehA in all maam mkat v e to wusk mWwrked c6is buffing pewit applicarion fora CMdrm of Job) s o Prcu acne If Proper Qzmr is applying for pcnnit please complete the Homeowners License Exemption Form on the reverse side. �.Foarwts:aov�r�ssstoaa . 6 YA 1 } roSS",SC C_j t r )i S � S A e, I ...( i(> y� •cwtii w..:( I� i It 1 .,, � •� > i. .�� l:: t ,� ` ti Ir t' I .. � r. 11,( �� ' y "¢¢a} ;�� ►. �.�,u�� ti. ��``{�+�� I j �, ',� � � I �(�- ' '�,��j I I:'''�� , ;��) 1;?,.t s;l f .::i i �� .;a„� �t,,::.�� .�t �� I � �;• !� Ali � , I, ii�_,f ,-{, �'� rl I�, li r_..} , i,l.,.^I , 1; • _ 11{ •�.: S�I��4 ��.��I�. �vl,� ,�zd~� � I�'. , .� ;-7tlt,��i�. �_��t" t L�Ir �'rk9t an¢ .. ��,' r ,._.,;� iD.,;;f;4t i' }I • , '.�...'..._._:.T'.. ._ :. ._. �.'r•__:. .:... '�' � �.w'tx@lb,r`}.. ..—. ...1':�.r�.•�� ! V•O.-. II I i., _.._ _. : ;� '�i D 1,IWP:>I o M�SapPn.c,Nt R�nvNTloj �..•..'�l�f rx'i* l�-f bt ±•,1�. .. T 1 , c :.•.. .. ... �.,.a _. 1 i . . .•_,• ... �....e a .:�2x .G:,_.a ,Y .a -.T. i � ►J'. • a•� Iln.,, 0 z' 41 G R M C'a u r. A zi 4 T I , B .i.i'ii ......,.:.: s a'l k t 1" `I �3S R + I, . r.M1\,L vr.f+,\ fw,r• v «r Mb."+».w,�. ( i y `Jnv .. R'l� . �..�+..«w -r.i- r.«....r•...:r n� xa.x 1y .«.(, .+wr x..M: •.�w ..Inw. .wwm`7 � 4 \ � �R .1\• T' ., �... .• v wfw� „ \xw.gx.rw.,ws .� - .. .C.I�wf� .o•.. 7 ``a.F*�'�_ � w++ol;►w!a.w+ir*�, r«rw•1 «fiya tv,Nr w,•.ip,gl�q 1 '� .. y.M«.'.� �\, ',�}••ii ' wcv r• rw1H TrY'rw. . .. •w 1 �.,' ?cy,. •,www w�rwM v.+W'/y`N'y,K �Zj -rb. i U LA-'V.'�`"/!lr't. �! �`� 1 C..�'°--(.. Ar x f«`l wrr" a.r .+.I.w' Y ':� .•' / .J� 'b , L !1 S1r1V ''I /� f -''G r \ i, is '• S • , r,.svwww.r av wW •Vw'++«!r.e+ 4.+wrF'.YrrVC ••\ \ r •..^ ' '' 1 ` s.rowlwwvwrwM+•Awwr,r .. ' ' � '� %nr.w,w,�w:...wn• v\yw•. ..M.....-.a.n 1 :i • � •. '. v< w..r',�..w1�.:.:n.r,._a,:,x.. ,ww .yc w•rw+•,vrrni*rw,.. • .. � +/'+««n✓n:Yw.�wr ..ri A,x a•M1n.P Pt,,:N« ..�t w .:..4... � p[ �ev.+v. «.uw�..rrww• ..•,!+v �a.wer.+v� ' .. S•�' uww.w•IeW.�»•.J w«wd'•+wwfr•w+..vxy,x.(w„.. A �l }+� i w � � i�. «y.�,• 'Yi" yww.. ..s�Ftww-,.^I•rai w`.xwny:w«w p/r�g�r� l+ 't.! „Y,� r •tx6 r ., i n,vwww+..w•P.+,vr.,•www.w. 4L V,., .w. � f E:...... .. .. i u•�e �,,1'4Sd'.e��.-.�Y yry�;:.: �»+,.w�+..c .b - .:�.�.i.. �1. �+�,,�w�.».,.L�:�i'r,...a...w..r,;.,.,.w:x.....A,.,..�,v...,.... «..� ,r..r, ..u,,...... «.;. M��,± •::. ,.:: «.r« ,-:. �:r� `�:':.r;•^•..,e.»^":r.:«...,M'�^•F,••.'••��tir«A.:.«.....ti N.». .?'!.:' xS'".:.wa"A`r'"wiw..• •"'v', ��w� �;.'•;+r.:.+.�."("•?C� �r..w:ow.��:�A�.`.:;.,++..�`t�.:.''��n:w ar. .�t..•..fwly�,••?j `i,�,�Y."•'rS�`VRY,'519:';T.T.RF•yL'Xt',LY"u1':'��7"'!'r�v?f!•+'f�E3'SsnS,s«r,i1fi.::'ri.Y�.M(rs,RwNc.a. 'tt14GL�ti.��+",if"�r ,L. :�«wwo...r:r:w= -q..v�•.«r.row. .�-.w,y •«vw«....x..f«..,w•or .:�•.w,,..w. .w.:r.f.«•..K .�W� .ry. ,h,.r.,,.,. -. _- :.,.w...,.n•�* :..hr<w.�rt�n.,+. w+.+�v..�n � ',,t ;' r?n..w+.+.•,«N,..ww�..wr. ,yrw `:.t;��:..q.�p�,:�,3,•�:�'w+'."'"wran?w...rwr: r ,�"'•�, •�`."",—.Y�"'�'�'.''w`•:G:':i:�.i6;:"a :\..:9ti;:; :".'.'.�.;f".0 =?`,l. .�..xNn•.w....:w«.r,.,a,w...:wx..:.. d„ ...�......«...:.....n.........-...v....,:r,-..l«,.,-ya.... .....r�-•. ...1«•',r..,,.-,«....,,. ., s..,..'w,,.r:.w.. ...,.,n.w.,«wc....:..r,,.......,...,« .. ..a.,�.... gin, .... _ •w, t(,.:.,..«:. ,.7 Y!! CHIMNEY LOCATION 12112 PITCH ROOF LINE OF CHANGE IN SLOPE AROVR T)ORMRR 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 225 BLK 3/12 PITCH DORMER kOOP 1 PV Judge,Skelton,Smitb SGALQ;LAYOUT Architects 16,Joy Snzt•Boston•Massachusetts-02114.617.227.9061 Pmjau: Shcs,Tdle LAW GUEST HOSE SE PV LAYOUT sstaaPoetaeee OPTION CuAa )wachmus Done: $heft NA 08.05.2010 SD-3 A Aown DY Sealc: S.W.S S U N POWE R__ r . _ $ Sv " r �anesare fnPw { he mast r ti. t effic{ert41, #phatovolta1c re x market#cd�ry -:1116 �.w Y 2 s r fOtlf agl Unrque desrgn co€nbrnes hrgh me MCI . arf er slkfr bl0cl, appe(irc€nc #cblr:rd tT of an#I with the roIN of e9 Y fU(or�;Power = s the sctme;amoun1 of spare- up to more ihan conventronal`destgnS and x - rreare#hari tlrin fart sour pines , s Rett�sle a� Robust Dtstcrl k N 4 .^ V^W�. Tf to SelnP "`"225 Sala Pcmei provcdes a revalufeonary comlifiiation' f f Proven materrals; tempered franf Mass:, and a sturdy anodrzed`frame alEow '� of higis efficiency and attractive,sleefc cppearance.Utilizing 72 bade panel to operate reliably in muftrpler ` r contact solar cells�and.a black bocksheet,the Sun Power 225 blends,, mFounting'configurations ✓ '.} s elegantly with the roof 6nd delivers a total panel conversion efficiency , v f of 18`.T° The panel" reduced voltage coeffic"rent-arid � yF i exceptional low,41aht performance attributes provide outstanding;energy f i f 5 z � delivery per peak power waft. 3 F L Z : .. a f `. y. SUnPaYvel's f tigl EHicienry Advantage.Up ro Twice the Power k y� l Thln Flfm Conventional SunPower Peak Waft/Ron of b A 7t3 225 t •dR('". S'� ' EHjclerTry 0 4 Q% 13 % f 18 + : Peak.Watts/ 8(90)s- .12(1301 17(1811, f k lUaouf SaaarPowe f S x . T s.;-¢i�,: ,...'?..?'s .Ain ...''...xir' '1n+kC ,:.•'... Cw Fi^aw ",.'xua 6:-`=s r .{... � _ _ SuaPower designs,manufacCures aiid`delive�'shTgh-performance ; solar electric technology worldwide.-Our high-efficiency solar cells " f generate up to 5Q'/o more power than,conventional solar cells. ' 4 i ` .:k 1 Our high-performance solar panels, roof tiles and trackers deliver " significantly more energy than competing systems ' i r 225 SOLAR 'rr ®rDW E - }r y < Eledrtcat:'.Data I V Curve f :; � -; slaauoed ats^.ardiHdfoaCandnm:(SFCJ'rnaAaKeaEtoo6wlrta-�tfiA is mdcet ..aTs°- , 1 Peak Power(+/5%) Pmax 225 W 7,0 ._ 1000 W/n�at 50 c t i i Rated Voltage Vmpp` 41 0 V - — - Rated Current Pmpp 5.49 A I : 50 Open Current Voltage Va 48 5 V 4,0 _.,.._-- _.. _. t �. Short Circuit Current f 5.87A 3,0 2,0 Maximum System Voltage Ul 600 V t 10 Temperature Coefficients ? ? 200 W/mz, 010 Power -0 38%/K _ 0 10 20 30 40 50 60 3 E v Voltage(Val 132 5mV/K ! Voltage(V) irs r ' r M1 Current(lc) 3 SmA/K Current/voltage characteristics with dependence on irradiance and module temperature. �NOCT 46 C+/2 C 77- _,____-----. ._.___ .. _..__ ._ —------- __ - TeiSfed Operating Conditions: ' _ . _ t Series Fuse Rating 20 A t 1 Temperature -40'F to+1 BY F(-40'C to+85'C) � 1 4 1 9 - eC�tantCA(Data - 113 sf 550k /m2 5400 P front a snow; ` Mox load P 9 ( al g # l Solar Cells 72 SunPower 4back contact monocrystalline ' 50 psf 245kg/m2(2400 Pa)front and back a g.wind _.,. _-.,_-_-._..-----_-_ - _ ._. __ t Front Glass high transmission tempered glass Impact Resistance Hail I in(25 mm)at 52mph(23 m/s) Junction Box IP•65 rated with 3 bypass diodes arran Wfies End Certifications t dimensions:32 x 155 x 12$(mm) ! € t1 Output Cables t 000mm length cables/MultiContad(MC4)connectors ` Warranties 25 year limited power warranty Frame Anodized aluminum alloy type 6063(black) 10 year limited product warranty F ' Weight 33.1 Ibs.(15 0 kg) ° Certificatwns Tested to U!1703 Class C Fire Rating7. _ 1 rife 5 DI offs t 2X 1200 g 14i.?.411 i g tNM - - Y [7ss)+`1 I 1 i066<5 �• 4� i70i) - # ` ` '2X 't0 2., 571 8 04.2 t`'+ 4X { }'a j (22.70 [vv } s 2 y. 11.0 Tao 7.5 t . ax .-r [31 d2) 2X kp4_2 129.69 l 1 a I t,i71 ) 1 p k "Ct I Iy 1 lssy i cs i ax ;22 I 2X n 2r. 19 s z y [ 1.as] "1 [1.a1 t �;2. ]t-� �i�;) l 4X 12 _X 15'5 y CAUTION: READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. Visit sunpowercorp.com for details R �- SUIVOWER a,d 4*SUNPOWER logo ore mdemarts or regisM.md aadxmub of Su ower C.orparmio, _ su n powercorp,com 3 r ;. 0 2oM March&,&.ereapern rao_All,irks resenad.Specdiccibm inck&d in this dabd�ser ace sd*d b d=W wdout maw. Dacuamni s00id2I88 RavB/CiR EN [ # t -Roof Mount Estimator-Empneening Report httpJ/www-imirac-comtestimator/part/estimator/detail/solar/6/ Roof Mount Estimator - Engineering Report Customer Information Project Information Company Clean Energy Design, LLC Name Molyneaux -- Guest Contact First Tom House Name address 581 Old Post Road Contact Last Wineman City, State, Zip Cotuit, MA 02635 Name Solution Contact Category Roof Mount Email tom@deanenergydesi,gncom. Racking Type Sunframe Phone 508-292-4583 Engineering Variables Description Variable Value Units Building Height h 25 ft Roof Angle > 7 to 27 degrees Wind Exposure B Importance Factor 1 Wind Speed V 120 mph Effective Wind Area 100 ft2 Roof Zone 3 Design Wind Load Calculation Description Variable Value Units Net Design Wind Pressure (ljplift) -47.9 psf (Uplift) Net Design Wind Pressure (Downforce) Pnef3o (Downforce) 10.5 psf Adjustment Factor for Height 1 and Exposure Category Importance Factor I 1 Design Wind Load (Uplift) Pnet (Uplift,) -47.9 psf Design Wind Load (Downforce)Pnet (Downforee). 10.5 psf Load Combinations Calculations 1 of 3 3/16/2011 12:49 PM -Roof Mount Estimator-EmpmnrigReport htip://www_unirac.comlestimator/parttestimator/detail/solar/6/ Description Variable Downforce Uplift Units Dead Load D 5 5 psf Total Design Wind Load Pnet 10.5 -47.9 psf Snow Load S 25 Total Load Combination'll D + 0.75Pnet + 0.75S 31.625 psf Total Load Combination 2 D + Pnet 15.5 psf Total Load Combination 3 D + S 30 psf Total Load Combination 4 0.61) + Pnet -44.9 psf Max Absolute Value Load 44.9 psf Distributed Load Calculation Description Variable Value Units Maximum Absolute Value of P 44.9 psf Load Combinations Module Length Perpendicular B 2.62 ft to Rails Distributed Load (Uplift) w 117.56 plf Distributed Load (Downforce) w 82.80 plf Rail Span Information Description Variable Value Units Racking Attachment Type Single L Racking Attachment L-Foot Rail preference Revised Rail Span L 3.33 ft Allowable Spans Single L Foot SF 4.5 ft Double L Foot SF 4.5 ft __._-. -_ -_____-__ ..._-_ Point Load Calculations (per Code, these are based,on maximum allowable spans as shown in chart above) Description Variable Downforce Uplift Units Single Sunframe Point Load R 372.6 -529.0 lbs Force 2 of 3 3/16/2011 12:49 PM -Roof Mtiurt Estimator-FjV=rivgReport bnpJ/www.unirac.corWestinator/parVesfimtor/detail/solar/6/ Point Load Calculations for your span are: Rail preference Revised Rail Span L 3.33 ft Sunframe Point Load Force R 275.7 -391.5 lbs This engineering report is to be evaluated to Unirac SolarMount Code Compliant Installation Manual 227 which references International Building Code 2003, International Building Code 2006, and ASCE 7-05, ASCE 7-02 and California Building 'Code 2007. The installation of products related to this engineering report is subject requirements in the above mentioned installation manual. 3 of 3 3/16/2011 12:49 PM S r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map V_ Parcel'~ 017 Application #AP/r67/ Health Division . Date Issued Conservation Division Application Fee = Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis (v " Project Street Address ! Village Owner � � Address Ch117,7 Telephone I Cz3 �p1 Permit Request r � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio G Construction Type . Lot Size 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: ❑ 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 .a Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other ' Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood%coal stove:''L]Yes❑ No . , CID Detached garage: ❑existing ❑ new size_Pool: Elexisting ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new. size _Shed: ❑ existing ❑ new size _ Other: _ rn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 17� w Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - M Name Telephone Number Address License # Home Improvement Contractor# 6;202 7,, Worker's Compensation # �AVL74 ALL CONSTRUCTION DEB RESULTING F OM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE lD FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r OWNER DATE OF INSPECTION: FOUNDATION PO FRAME INSULATION ,r ` FIREPLACE ELECTRICAL: ROUGH FINAL =� PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT a ASSOCIATION PLAN NO. i - ,,L OF'T/yF * COTUIT + �leX Bryartment * REDISTRICT vao 1926 ,9,A 4300 FALMOUTH ROAD, P.O. BOX 451 'FD JULV* COTUIT, MASS. 02635 PHONE 508-428-2687 FAX 508-428-7517 April 30, 2010 Mr. Don Law 36 Baystate Rd. Cambridge, MA 02138 RE: 581 Old Post Road Dear Mr. Law, The water has been turned off at the street and the meter has been disconnected in the garage for the service that supplies town water to 581 Old Post Road. A private water line runs from the garage to the house. Sincerely, Chris Wiseman Superintendent APR-27-2010 19:18 NationalGrid P.02 10"q fpL APR 4 GG national rid February 4,2010 To:Diane Snow Re: 581 Old Post Road,Cotuit,Ma This letter is to notify you that after our investigation,it has been determined there is no gas being supplied to 581 Old Post Road, Cotuit,Ma 02635, If you have any questions please feel free to contact us at 781-907.2930 Sincerely, Dine L. Stevenin Customer Driven Construction diana.atevenin®us.ngHd.com ' 781-907-2930 - 781-522-1066 fax 40 Sy lvan Iv n Road E-2 y Waltham, Ma 02451 I TOTAL P.02 The Commonwealth of Massachusetts -Department o Industrial Accidents Office of Investigations + 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information P ease Print LeLyffil Name(Business/Organization/Individual): / Address: ��(v City/Stat ip: f Phone.#:_ag� -Z�_X a Are u an employer? Check t ppropriate 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 stab-contractors 2.0 I am a soleproprietor or'partner-' listed on the-attached sheet. 7.. 0 Remodeling ship and have no employees These sub-contractors have g, '❑Demolition workingfor me in an capacity. employees and have workers' • Y P tY• $ 9. ❑Building addition [No workers'•comp.�insurance comp.insurance. required.] - S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §l(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state 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: V- Policy#or Self-ins.Lic.#: we, Ed 6 Expiration Date: p2 ` . Job Site Address: City/State/Zip: OO�G7S Attach a copy of the workers' compensation policy d daration 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 crimirial penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the ' lator. Be advised that a copy of this statement may be forwarded to the'Office of Investigations of the DIA for' coverage V91ificatiom I do hereby certify under e and na s f rjury that the information provided above is true nd correct Si afore: Date: D/ _ Phone#: b Official use only. Do not write in this area, to be completed by city or town offlciaL .City or Town: Permit/License# Issuing Authority(circle one): ' 1.Board of Health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector ,6. Other Contact Person: Phone#: 1 Information and Insttucti®ns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more engaged in a joint ente 'rise,and including the legal representatives of a deceased employer,or the of the foregoingJ rp receiver or tiustee 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 aintenance, construction or repair work on such dwelling house m or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or ate a business or to construct buildings in the commonwealth for any renewal of a license or permit to operate g applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, it necessary,supply sub-contiactor(s)name(s),-address(es)and.phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on.the.appropriate line. City or Town Offictals Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple perm.t/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town),".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts -, Departtnent of lndustrial Accidents Office of InvestigatiQns. 600 Washington Street Bo stun, NIA 02111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 . www.mass.govldia �tHe ra,, Town of Barnstable Regulatory Services " BARNSTABLF, ' Thomas F.Geiler,Director Mass. 9q'°r16 39. a � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usina A Builder 1 as Owner of the subject property hereby authorize c ' ( i , to act on my behalf, in all matters relative to work authorized by this building permit application for: E) te- (Address of Job) Signature of Owner ate A-) 4Z�--4�-0--i Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O W N ERP ERM IS S ION Town of ]Barnstable OF THE Tp� Regulatory Services xsznsLE Thomas F. Geiler,Director Building Division plE� �A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 __----------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "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, tha t he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109,1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed . Supervisor. The homeowner acting as Supervisor is ultimately responsible, To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor, On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC 74 Massachusetts- Department of Public Safeti Board of Buildinly Regulations and Standards Construction Supervisor License License: CS 16161 Restricted.to 00 • is �. � t` - ROBERT F HAYDEN' 60 CHEOH ROAD COTU IT, MA 02635 n- -- - Expiration: 9�19[201 Commis Ion k-i Tr#: 4275 � �. ,p� •Bo��P�nr}daeg�wa�s+ffL�Q�Id�t�:s� HOME IMPROVEMENT CONTRACTOR, Registration: 106207r ExpiratV N7/22/2010 Tr# m, ype�Private Corporation Fr; HAYDEN BLDG HORS=INCr Robert Hayden PO BOX 496f COTUIT Mills, MA 02fi3 Administrator • - DOE"_ .<.� l 04/30/2010 15:29 5084204474. PAL.UMBO INS COTUIT PAGE 01 DATE(MMIODryYYY) Lb CERTIFICATE OF LIABILITY INSURANCE 4/30/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER (508)428-1943 FAX: (506) 420-4474 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Aiill:am kalumbo Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4527 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: C _ Cotuit MA 02635 _INSURERS AFFORDING.COVERAGE— _ - NAI _. —_.. ----- 5t--a-t® .I-n s..uzance INSURERA INSURED Co - -•-- •-- - Hayden Building Movers Inc. I INSURER Bt,_—. --- — p 0 BO]c 496 INSURER C_ INSURER D;---- -- - - -- - --- -- -- -- Cotuit MA 02635 INSURER E: COVERAGES THE TH POLICIES OF INSURANCE ORLISTED COND CONDITION OF HAVE AM'CONTRACT OR OTHER DOCUMENT NAMED VNTH RESPECT TOPWH CH THIS S CERpIFICATE MAY eIEHSSUED OR REQUIREMENT.TER 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, _.-... .- -. ••-•-- - - - - ` POLICY EFFECTIVE POLICY EXPIRATIONLIMITS [ANY R DID IN9URAN POLICY NUM9ER DJ RI(RRLLY.-.n �a , EACH OCCURRENCE GENERAL UASIUTY EN 6 I. -- A�E'PO R - COMMERCIAL GENERAL LIABILITY PREMIBES oncel_(Ee oeculr �-. r OCCUR I M_DP( y EXAn arm p_rs-) $ _�CLAIMS MA � I DE I --_ �__.. LPERSONAL A ADV INJURY $_ --- - - - -- "-I GENERAL AGGREGATE. - -:_�.. -- -/OP.. - AGG --- — --• PRO9UCT9 COMP $ GEN'LAGGREGATE LIMIT APPLIES PER - POLICY -- PR - LOC AUTOMOBILE LIABILITY - I COMBINED SINGLE LIMIT 6 ' ANY AUTO - - EODILYINJ—.URY �S ALL OWNED AUTOS (Per perncn)_ •--- --. -. — SCHEDULED-I AUTOS BODILY INJURY S HIRED AUTOS I (Per accident) .- - --- -- NON-OWNED AUTOS -' PROPERTY DAMAGE (Par accident) $ AUTO ONLY-EA ACCIDENT S _ GARAGE LIABIUP( EA ACC- $ THAN - I ANY AUTO I I �[OTTjMFR TO ONLY. AOG�a -- -- _EXCES31 UMBRELLA LIABIUTY _ Ih EACH OCCURRENCE I S_ AGGREGATE S —,OCCUR --I CLAIMS MADE I S _.__ -• -— DEDUCTIBLE RETENTION $ I WC STATU- IOTH- A WORK ER30OMPENSATION _—ITORY_LIMI7SJ ERAND EMPLOYERS'UAE{LI?Y I E L.EACH ACCIDF_NT AS __ZO,O ANY PROPRIETORIPARTNERID(ECUTIVE Y I N I IM •— T .IOFFlCFRIMEMBER EXCLUGED? - I- -•--- (Mandatary In NM) baC6608263 2/6/2010 2/6/2011 E.L.DISE/18E-F.AE_MPLOYEE S lOD�000 If yyeea d'sP,q undor E.L.DISEASE-POLICY LIMIT I$ 500 000 gpEdIAL PROVISIONS Delow OTHER I ' I' I. DE L DESCRIPTION OF OPERATIONS LOCATIONB I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION (S08)790-6230 SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BECANCELLIED FORETNEEXPIRATION Town of Ba nstable DATE TMEREOF,THE ISSUING INSURER.WILL ENDEAVOR To MAIL 10 DAYS WRITTEN 260 .it an St NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIAHILITY OF ANY KIND UPON THE INSURER IT3 AGENTS OR REPRESENTATIVES. AUTHORIZED REPR!!3ENTATrVEJa+- 11 Willia-,% Pa].urtbo/ABE ®1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009I01) INS026 wneoi), The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ZQ 5o3Zy 4 Map Parcel oil M . Application # U'7,;),49 Health Division 1 Date Issued Conservation Division 4.1.Apphcatioln Fee TT V Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address 00 ?251� W)#"P Village Owner ?QqjF TI)ND U .4 —Address Telephone Permit Request Square feet: 1 st floor: existing Q 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 Structure 's Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: LTFull ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 120® Number of Baths: Full: existing , new Half: existing new "— Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing new � First Floor Room Count Heat Type and Fuel: eGas ❑Oil ❑ Electric ❑ Other Central Air: CS' es ❑ No Fireplaces: Existing 7— New Existing wood/coal stove: ❑Yes ❑ No Detached garageAlexisting ❑ 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) --- - R--_ Name �a.�u s �iA ct ,,, �c c-f { Telephone Number 9 _9 T-7 -7 Foo Address db '�'� S'; License# l t� n �z L Home Improvement Contractor# /6/ 9!':K A Worker's Compensation # Id C Z Q YDA J ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGN.,. DATE Co U l O FOR OFFICIAL USE ONLY APPLICATION# ` DATE:ISSUED N9AP/PARCEL_NO.NO.. i ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: f"FOUNDATION FRAME ro LL•5t'. INSULATION. �!o ra [ a� k 9 woks FIREPLACE ' ELECTRICAL: ROUGH FINAL t , I • PLUMBING: ROUGH FINAL ' y AS: ROUGH FINAL is FINAL BUILDING ► z _ _ " O /Z�h� _,DATE CLOSED.OUT "� ASSOCIATION PLAN NO. - The Commonwealth of Massachusetts ,Depa1**He-nt of industrial Accidents _ Office of Investigations' 600 Washington Street Boston, MA 02111 '� �, `y wwlt�.mass.gav/dia Workers' ensation Xnsurance Affidavit: Builders/Contractots/Ele ctricians/Plumbers Comp Applicant fnformation Please Print Legibly Warne (Business/Organiza.6onffndividual): �� y� ��- t — Address:__City/state/zip: 11t � Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I ® ❑ N construction 1. a employer with�— 6. ❑ employees (full and/or part-tim.e).* have hired the sLtb-contractors listed on the'attached sheet. 7.. euiodeling .2.❑ I am a soleproprietor or'partrter Theso sub-contractors have ship and have no employees S. ❑Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition (No workers I.comp.•insurance comp insurance. required) 5, �] We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 I.❑Plumbing repairs or additions myself. [No.workers' comp. right of exemption per MGL 12.0 Roof repairs c. 152, §1(4), and we have no insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.) *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ng the name of the sub contractors and state whether or not those entities have tConiractors that check this box must attached an additional sheet showi employees. If the sub-contractors have employers,they must provide their workers'comp.policy number. I am an employer that 1s providing workers' compensation insurance for my employees. Below is the policy and job site info rm ation. Insurance Company Name: _ Policy#or Self-ins. Lic.#: �l Expiration Date: Job Site Address: T�I r tom, City/State/Zip: 4�ffm q Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure fo secure co�erage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirial penalties of a fine up to$I,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 16 hereb rtfy under the pains and pena ies of p rjury that the information provided above is true and correct Si a Date: Phone OffWal use only. Do not write in this area, tb be completed by city or town official City or Town: Permit/License # Issuing Authority(circle one): h.Board of Health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector e 6. Other i informationand st�rct ®ems Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as ...every person in the service of another under any contract of hire, ckpress 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 ti'v or stee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelltiag 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 of on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every'state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." applicant Additionally,twMGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public wont until acceptable evidence of compliznce ith the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if number(s) along with their certificates)of necessary, supply sub-contiactor(s)name(s),-addresses)and.phone t insurance. Limited Liability Companies.(LLC) or Limited Liability Partnerships(LLP)with no employees other than the quired to carry workers' compensation insurance. If an LLC or LLP does have members or partners,are not re employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the auntber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or,Town Officials i Please be sure that the affidavit is complete'and printed legibly. The,Department has provided a space at the bottom estigations has to you regarding the applicant. of the affidavit for you to fill out in the event the Office of Inv contact • lease be sure to fill in the permiYHGcnse number which will be used as a reference number. In addition, an applicant P that must submit multiple perrnit4icense applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under`Job Site Address the applicant should write"all locations in (city or town):".A copy of the affidavit.that has been officially stamped or marked by,the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would ar,to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: The Commonwealth of Massachusctts . Department of lad Accidents Office al'layestigatbus. 600 Washington Street Boston, MA 02111 TeI. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-22-06 vAvw.mass.gov/dia 07/15/2010 THU 11: 00 FAX 12002/002 Client#:33693 PERFBUI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(M 2010 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 t IBELOW.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 19 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- Rogers&Gray Ins. Plymouth P ME: 341 Court Street Arc No, c Ext:508 398-7980 C.No): L P.O.BOX 3700 ADDRESS: PRODUCER Plymouth,MA 02361-3700 CUSTOMERID* INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURERA:Peerless Insurance Performance Building Company,Inc. INSURER B:ACE Property&Casualty Ins.Co 50 Tanner Street 4 Lowell,MA 01852-4419 INSURERC: INSURER D: INSURER E: ' INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE DL UBR - POLICY EFF POLICY EXP POLICY NUMBER MM DD LIMITS A GENERAL LIABILITY CBP8051843 7103/2010 07/03/2011 EACH OCCURRENCE $1 ODO DOD X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY P X LOG AUTOMOBILE LIABILITY BABO59234 7/03/2010 07/03/2011 COMBINED SINGLE LIMIT ANY AUTO (Ee $dent) 11000,000 ALL OWNED AUTOS BODILY INJURY(Per person) $ - � ' X SCHEDULED AUTOS BODILY INJURY(Per accident) S X HIRED AUTOS PROPERTYDAMAGE - (Per accident) - $ - X NON•OWNEDAUTOS $ $ A UMBRELLA LIAB IV I OCCUR CU8056854 7/03/2010 07/03/2011 EACH OCCURRENCE $10 000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10 00O 000 DEDUCTIBLE „ RETENTION $ B WORKERS COMPENSATION 1 WC293D838 7IO6/2O1D O7/O6/ZO11 X WC STATU• OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVEY/N EL.EACH $1,ODO,000:_, OFFICERIMEMBER EXCLUDEDp F NIA _ (Mandatory in NH) NO EXCIUSIOnS E.L.DISEASE EA EMPLOYEE $1�000,OOD4 tt ASCRIPTION under - — DESCRIPTION OF OPERATIONS below E.L.DISEASE-;POLICY LIMIT $1-000 000-_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Comp Information:Included Officers or Proprietors. t' CERTIFICATE HOLDER CANCELLATION 30 Days for Non-Pa ment ` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. ywy AUTHORIZED REPRESENTATIVE 0198 ,2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S53831/M53821 DAC tts!iaehaa�c:ttti- Department of Public Saf'ets lIourd of Building Regulations and Sta ndatrda Construction Supervisor license License; CS 16060 Restricted to, 00 . JAiUlES W MCCLUTCHY 50 TANNER.ST LOWELL, MA 01852. -`•.. Expkation: 4/19/2012 CE mmissit)ner Tr#8: 23482 ------------ I Y Sara Molyneaux 7 Wilsondale Street Dover MA 02030 Tel. 617 519-0891 Number of pages sent Message: r r' �IHE Town of Barnstable Regulatory Services ` r � BARNSTABLE, Thomas F. Geiler,Dfrector 039. �,�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town,barnstable.ma.us Office: 508-862-4038 Fax: 508-790-62 Property Owner Must Complete and Sign This Section If Using A Builder , , as Owner of the subject property hereby authonze 1 mow\ �. �ct on mY behalf, Elk in all matters relative to work authorized by this building permit application for. OLP (Address of job) Signature of Owner Date Print Name ff Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Town of Barnstable Regulatory Services Thomas F. Geiler,Director sA_axsrxst.E, M"_q& Building Division Arlo ' a Tom Perry,Building Commissioner 200 Main.Street, Hyannis,MA 02601 www,town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 - HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: village number street "HOMEOWNER': phone name home phone# workp CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellin>s of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forrrr/certification for use in your community. c. 07/06/2010 TUE 14: 35 FAX 0002/002 r � ✓die CT *�#IVBoVuiTmgeguns an . .tan ands One Ashburton Place - Room 1301 Boston, Mas'SaChusetts 02108 Home Improveme tractor Registration Reiaistrallon: 161993 Type: Private Corporation z i d Expiration: 12/22/2010 Tr#•279132 PERFORMANCE BUILDING CO w JAMES MCCLUCHY - 50 TANNER ST �- LOWELL, MA 01852 a Update Address and return card.Mark reason for change. 0 Address Q Renewal ❑ Employment J Lost Card 1 0 5OM-07107-PC8490 �i�e �aaosws��✓�araac%a� . Board of Building Regulations and StandardsHOM ? Req ROVEIYIENT CONTRACTOR U�0�or registration valid for individul use only before the expiration date, If found return to: 161993 Board of Building Regulations and Standards 010 Tr# 279132 One Ashburton PlaceRm 13ol R e Corporation - Boston,Ma.02108 PERFORMANC C JAMES iNCCLU 50 TANNER St LOWELL,MA 01852 -.t..•1Ci.e'W� _ Adaiiaistrator----- Not valid --- — ; ' IS . f - i i i i i i PROJECT NAME: A�OI Irv" /` r ADDRESS:J 7/ &7- k—XI PERMIT#A�!! PERMIT DATE:��p/T�r/!� M/P: — O� LARGE ROLLED PLANS ARE IN: BOA SLOT- Data entered in MAPS program on: BY: �� _. � a/wnfiles/archive yoFIHE Town of Barnstable Regulatory Services BARNSTABLE 9 MASS. Building Division prEO MAC a, i 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 F Fax: 508-790-6230 Inspection Correction Notice Type of Inspection �gx Location ��l �IcQ /owllZ"cQ C Permit Number j { Owner. ' Builder One notice to remain on job site, one notice on file"in Building Department. d" + The following items need correcting: L2 { n, ti i 74-f - - Please call: 508--862-46M for re-inspection. Inspected by lea Date , f IMPORTANT Schematic Design Bid Drawings ANY CONSTRUCTION THAT INCREASES LIVING SPACE EEYONO 1200 SO.FT PER LEVEL MAY REQUIRE THE Aril 9, 2010 I f INSTALLATI p ON OF ADDITIONAL SMOKE DETECTORS.v'Yi - - NOTE:A SEPARATE PERMIT IS PERMIT INSTALLATION OF SMOKE DETECTORS-THE ELEFCTRICAL PERlAIi c N 7 SATISFY iH15 REQUIREMENT LAW G U ES T HOUSE 581 ON Post Road - .Cotuit, Massachusetts DRAWING LIST CS-Cover Sheet SI-Site Plan A-1.1-First and Second Floor Plans A-1.2-Basement Level Plan A-2.1-Elevations A-2.2-Elevations A-5.1-Second Floor Bath Plan and Elevations E-1.1-First and Second Floor Electrical Plans E-1.2-Basement Level Electrical Plan S1-00-Structural Sl-01—Structural Judge.Skehon.Smith . 4b�fm0®-�m.�®.miw-ulvfmY - UWCIlEST HoU Cmv�m -.2010 CS DRAWINGS IN TEBS SET ARE NOT TO BE USED FOR CONSTRUCTION AND ARE FOR INFORMATION ONLY [9-V olarsaro - .� mmav sv aHLVTnswaeot�rmrdsveaNv�u.Lv•srnm- wna HTermaoHavwaNr��o He oL sa�vla:aHldrsAHNvmoiTv ®vuHxHe oaTv�nLtTHTa aNtumTrv- - m^xP�SW�^ HSf10x Ll3fLd/A� - aH10Nx63H 3e QLHSaOx i0Y0M3L1T- m01�Otldee Ol�IA1id6'IVOalLT3fd JNYndW0JH00JHLY00HaV- Outalx nl mwhYi w nyV� mOmNSY®YIdiHHe OLPaHLa00/d m1WOx[a13a TlY- 'a'd13dAL P73LSA6•aHTiY15N13801wHLSA6DH1LY�iNHN- 1[JIWS'UOJ j _. w TL3ddOJ 39Od S3tUl ATddfIST1Y 1Lidd00aH aVSlwm0NU1s l OR,moms a00MM3N ILIlAt mJYma.Ol Aww Now He01m.,TiOS TIV-m0tl'M HH OL ONIH dT1Y- I madm AvtAz NI ONILsw N"QL-am sx00a-moma00M TIY- AxYSSdJ3HSY aHHOdVd 3e aNYNIVWHx013SY S�ISUUf HOU[HLUDtULSLCa- - sxaunnls aoo�e woLHlualevxdao nsHx HnmHe oasmaawnTrv- 'Hsioaa .W7H ' - He aTIm sNOLL1aN000NLLSOCd a NY mO vvaNd:4umsHDNVd3xOS1aANY- J WHSLYLd dOUVOOO WVYdwOWHA( H �Ol SKiLWHS ONY SNOaNLtl tV011.000p LOIlLd113"il'/- MR AO M-SNO15Nd OT N « 3S1,Z _ H ..-..... T f l --------------------- ------------------------ AYMHa311H i Tr° O AxONf1VT ' �ay.®.a�meun I aO - AllIN.i aww.unwme.m Y� ❑❑ __________________ nmo ,mo mw II .0 Tlvx • i SNdLLOH '. O I l ._ xTNTLM I whom lvw Iw00Sme >.� Q i H1Y Q -------- w00e0N1An woDaaNlNla cwaoxme iwooaade O xMod Nns ----------------------------------- • l a fil$ # T� s y r � " R #A $ F --- -------- ----- it it IN"I-AMI, J I 114, r ri Y e M NOTES: . -ALLDA S10NSTOBEF VEBBBiO 'a. •. - r, - .t— ._- -nu eAserwENrwNDowoPENNGs ro ee ceNtseLv .. ^ - .. - -. ' Judge:Skelton.Smith ' BEIAW WBn10WSONOROUNDLEVFL ' _ ., x. - - Archimv " .. 1OBASEM Wm00WSABETOBEI.OGAIED .r _' •. i4bsen.e®-umemm.miu au ONFBOWFAOADEOFROUSE - - '- a r • r: .. ': a -�- ...� ,. rp - LAW GUEST NOUSE Bamvm 1.l •Phn NAMO - -. �uiNmtr slum COTU � T =-_-" S8 *041 1 39.48 (TIE COURSE) ATE COURSE) -H N 00 c-- 4A o w z TOp C� O LOT 1 A E— V) X TOP OF BANK w LOT 1 B -H o� S85'08'48'E 0.41 a 66.8 04 I� N EXIST M � HOUSE NO. 561 v 1 EXIST. 28.5 N TO BE MOVED � /F BLAUVELT G. CHRISTOPHER & BARRI M. No s5 I 17.1 BK. 12721 PG. 204 \ ADDN. i �2.7 f \ 9.3 17.8 'O -8.0 30.0 N 2,152 S.F. PARCEL 8cd Q 00 EXIST I B SEPT] PRQP. f i AWN.. I .,,�O y 1 R � o13.7 0 � -0 N N 25.0 24.6 _ 1 EXIST DRIVE / 6.3 HOUSE /I \ N NO. 581 PROP. LOCATION N v � LY N .0 17.6 y 8.8 w ', 56.3 5.3 —5.3 o I tl-: r o 8. L CD 2,152 S.F. PARCEL A 3 N. r�,I N 00 in 00 N I 1 I PROP. DRIVE � I S8b'08'48'E �30.41 �o 4� % o' W iD o� 37.7 EXIST GAR. n \ EXIST EXIST I L DRIVE CARRIAGE HOUSE 38.2 I � � jrO o - s 0 co 56g1�� O OP \ oS �0 0 �, � BAY COTUIT ------------------------------ --------- .. ................ ---------- ------------------------------ 39.48 ) ------- ----------------- ----- r- / 6 '� C4 Lo ', i O _ 0 702 X ---- TOP OF BANK= - - go r '---------704__ I 66.8 /^\ ' ow _ `\ Ixw. 17.0 '1 '°K"°rm Q 1', N/F RODGERS, CHARLES S. & RODGERS, FRANCENE SUSSNER mm N/F BLAUVELT G. CHRISTOPHER & BARRI M. No eas �� 17.1 �\ BK. 9709 PG. 215 BK. 12721 PG. 204 9.3 14.7 \\ \ 45,718 S.F. f ZONING DISTRICT 2\ RF — WITHIN RESOURCE (TO TOP OF BANK) ,�� PROTECTION OVERLAY DISTRICT _ REQUIRED HSE NO. HSE NO. HSE NO. 595 581 581 PROP. LOC. FRONTAGE 150' 103.51' 152.90' 152.90' to _ FRONT S.B. 30' 281.9' 245.0' 147.9' 013.7 o SIDE S.B. 15' 9,3' 14.7' 25.0' s - , N ' e) - REAR S.B. 15' 100.2- 112.0- 198.1- 24_6 1 _ 25.0 POST , I '_ 1-1 \\ PLAN REFERENCES r'i \� PLAN BOOK 459 PAGE 81 10- T.B.M. s 102.35 PRw• �L TIOM N I PLAN BOOK 37 PAGE 121 CUT NAIL:IN 24' OAK i tj �� PLAN BOOK 21 PAGE 111 04 �, 1 .0 to 17.6 8.8 ---- 56.3 5.3.`� \ DEED REFERENCES _ - I � ' `\ BOOK 22633 PAGE 9 to 8� / �` �\ BOOK 24391 PAGE 198 o i " BOOK 24391 PAGE 198 - LOT 1 ; - 37.189 S.F. (TO TOP OF BANK) I , 'O+ ORIVE � 37.7 EXIST GAR. \\\ EXIST EXIST ' CARRIAGE \ DRIVE,r ----------------- MOUSE r 38.2 3 , , 1�0 / h ' P ' TOPOGRAPHY SHOWN IS BASED OW AN AN ON THE GROUND INSTRUMENT SURVEY \'O - Ov ' NO DETERMINATION AS TO COMPLIANCE WITH ZONING IS MADE OR INTENDED REBY CERTIFY THAT THE PROPERTY LINES ESHOWN ON THE PLA ARE THE LINES \\ A 4. 3 DIVIDING EXISTING OWNERSHIPS, AND THE LINES OF THE STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED, AND THAT NO NEW LINES FOR DIVISION OF EXISTING OWNERSHIP OR FOR NEW WAYS ARE SHOWN. i CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS. PLOT PLAN OF LAND `"or '�' REGIS ED A1qDSURVEYOR J. SWONEW ' N .e #47581 _ e tss\ p� SURD f I CU Re,50urce,5 , Inc . 5 n 81 & 595 OLD POST RD. r COTU I T, M A. COTUIT FIRE DISTRICT _ LAND s U RVEYORs GROUNDWATER PROTECTION ZONE:AP APRIL 21ST 2010 ADD T.B.M. D.M.S FLOOD ZONE V11 (EL. 9) & C APRIL 16TH 2O10 ADD NOTES M.O.D. ZONING:RF — WITHIN RESOURCE APRIL 14TH 2O10 REVISED RELOCATION OF NO. 581 M.O.D. - = PROTECTION OVERLAY DISTRICT P.O. BOX 324 281 CHESTNUT ST. ASSESSOR'S MAP: 054 DATE - DESCRIPTION BY AUBURN, MA NEEDHAM, MA. PREPARED FOR: PARCELS:016 & 017 508 832 4332 781 444 5936 0 10 20 30 40 60 80 fieldresources@hotmail.com DONALD LAW NOT A RECORDABLE PLAN SCALE:1"-20' J.N. 73-08 073-08 20SC ANR