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HomeMy WebLinkAbout0031 OLD SHORE ROAD f, 0 Town of Barnstable Regulatory Services �'ME t� Thomas F.Geiler,Director Building Division BAEWSfABI.E. : Tom Perry,Building Commissioner v amass 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 January 31, 2014 Michael Deluga 568 Santuit Road Cotuit, MA. 02635 RE: 31 Old Shore Rd., Cotuit, Map: 035 Parcel: 073 Dear Mr. Deluga: As you may recall, on or about March 21, 2011 this office issued you a building permit to construct two shed dormers at the above referenced address. Our records show that there has been no final building inspection, no final electric inspection, and no final plumbing inspection. Please contact this office to arrange for the required inspections or explain your lack of progress. Thank you for your immediate attention in this matter. Respectfully, rvL Lauzon Local Inspector 'e1 ffrey.lauzongtown.bamstable.ma.us (508) 862-4034 a Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR: 1�- JOB SITE ADDRESS: 3� l�IG��L '� �� ao/u4- .W-� DATE: , ,� Zd AREA THICKNESS R-VALUE Ceiling Cathedral Ceiling Garage Ceiling Basement Ceiling Slopes Exterior Wall ss% Garage Hse. Wall W alkout W all Cathedral W all B lockers I O v e r h a n g Stair/Risers All R-values and thickness measurements are deemed to be accurate by the following installers: TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM' i i z 'Arnmrrane ThermalGuard CC2 TECHNICAL DATA SHEET . I PRODUCT NAME I PHYSICAL CHARACTERISTICS Property Value Test Method ® �,e� ��� Density.(nominal): 2.0 lb/ft3,., ASTM D-1622 R-value; 7/inch ASTM C-5I9\ ThermalGuard CC2 Compressive Strength: 35 PSI ASTM D1621-94 I " Tensile Strength: 70 PSI ASTM D1623-78 PRODUCT DESCRIPTION I Dimensional Stability: <40/oA ASTM D 2126 Closed Cell Content: 96% ASTM D 2856 ThermalGuard CC2 is a fast set,closed Air Permeability: .002 L/sm2(@ 75 Pa @ 1") ASTM E283 celled,245fa-blown spray polyurethane Vapor Permeability: .8 Perms @ 2" ASTM E96 , foam(SPF)insulation designed for use Fungus Growth: None ASTM G21 in residential&commercial structures, Service Temperature: 250°F(120°C)* exterior foundation or perimeter ;Service temperatures will vary depending on application. Contact yourArnthane Technical Representattv�or iIISU1at10n,below grade applications, recommendations and limitations.Always-test ThermalGuard CC2 for,suitability for yourparticular application in exterior tank/pipe insulation and etc. a safe manner. ThermalGuard CC2 is applied as a -LIQUID PROPERTIES liquid and expands 25x in seconds to fill Property Value Test Method' and seal building cavities of any shape Viscosity(A) 200-250 CPS ASTM D-2196 and size. It exhibits superior thermal , P ',,Viscosity(B) 1100-1300 CPS . ASTM D-2196 insulation,air-barrier,and sound Weight Per Gallon(A) 10.25 lbs/gal ASTM D-1475 (; attenuation properties compared to. Weight Per Gallon(B) 9.4 lbs/gal ASTM D4475 conventional insulation materials. REACTIVITY PROFILE Once fully cured ThermalGuard CC2 property Value remains rigid maintaining significant Cream Time: 2-3 seconds @ 25.°C(77 T) structural strength and thermal 'Rise Time: 12-16 seconds @ 25°C(77°F): f insulation properties in adverse conditions across a wide variety of COMBUSTION PROPERTIES " applications. Property Value Test Method - Flame Spread Index: S25 ASTM E-84 MANUFACTURER Smoke Development: <450 ASTME-84 ThermalGuard CC2 is manufactured PACKAGING&STORAGE exclusively by Drum Weight(A) 551 lbs Drum Weight(B) 5001bs i Arnthane Inc. Total Set Weight 1051 lbs 1002 West Main Street Storage Temperature Range(STR) 60—80 IF. Richmond,MO 64085 Shelf Life at STR 6 months P.816.776.3015 " F.816.776.3215 *Do not allow material to freeze. Do not pre-heat or recirculate(B)material as it will causefrothing and loss of www.arnthane.com blowing agent. Storage at temperatures above or below STR may shorten shelf life and cause degradation or loss of blowing agent. Cold material will develop higher viscosity which Can cause during processing Such as.pump cavitation and poor mixture of(A)and(B)components.For best processing performance during application(A). CORROSION and(B)drum temperatures should be between 60 7—80 F ThermalGuard CC2 is chemically& PROCESSING PARAMETERS . physically compatible with all common Processing Pressure Range: 900-1400 PSI* building materials including electrical Processing Temperature Range: 115-145 OF*. wiring,wood,metal,concrete,plastic Substrate Temperature Range: 35—105 OF (PVC),copper,vinyl,and glass. Ambient Temperature: 35—105 OF Substrate Moisture Content: <19% INSTALLATION Yield: 3800-5000 Board Feet Per Set* Maximum Lift Thickness:`. 4 inches** ThermalGuard CC2 must be spray applied using approved equipment.Use *P'ocessingparameters&yields cari`vary widely depending on substrate temperature,type&condition,ambient 1'1'ratio proportioning system that can temperature,elevation,humidity,equipment and other factors. During installation.the applicator must observe the quality and characteristics of the foam and adjust equipment temperature&prffs'u're settings as needed to achieve the Specified temperature and accommodate these variables in order to ensure optimum yield proper adhesion,proper cell structure,and pressure requirements. performance ofthefoam. **ALWAYS test ThermalGuard CC2 at desired thickness in a safe manner prior to insulating structure to ensure that it can be safely tnstalled at the desired 1i thickness without risk of charring or combustion.It is the exclusive responsibility of the applicator to achieve proper 1i thickness for safe application. Safe lift thickness may vary from application to application. t tt r/' thane Thermalftard CC2. TECHNI CAI L.DATA SHEET appropriate PPE as required by OSHA, „intended for use by nonprofessional ThermalGuard CC2 demonstrates NIOSH,and state/local safety. applicators,or those who do not excellent adhesion to various substrates regulatory agencies. purchase or utilize this product in the when installed according to normal course of their business.The. manufacturer specifications. It is the applicator's responsibility to potential user must perform any, comply with all job site safety ;. pertinent tests in order to determine the ThermalGuard CC2 resin(B)does not requirements set forth by OSHA,. product's performance and suitability in require agitation. Do not pre-heat or NIOSH,and state/local safety the intended application,since final recirculate resin(B)as doing so will regulatory agencies. determination of fitness of the product result in the"boiling off'of the 245fa for any particular use is the blowing agent which will result in poor LIMIATATIONS responsibility of the buyer. yield and poor foam performance. ThermalGuard CC2 should not be left. All guarantees and warranties as to the ThermalGuard CC2 should be installed exposed to sunlight,as UV light will products supplied by Amthane shall at a maximum thickness of 4 inches per rapidly degrade foam. Do not use near have only those guarantees and pass with a minimum of 30 minutes high heat or open flame. warranties expressed by the between passes. 'It is the applicator's manufacturer. The buyer's sole remedy responsibility to test lift thickness for a ThermalGuard CC2 must be covered as to the material claims will be against particular application prior to with an approved 15-minute thermal the manufacturer of the product. The commencing installation to ensure that barrier when used as insulation for aforementioned data on this product is the product can be installed safely at the residential or commercial buildings.- to be used as a guide and is subject to desired thickness. Installation must comply with all change without notice. The information applicable building codes. herein is believed to be reliable,but SAFETY&ENVIRONMENT unknown risks may be present. Do not install ThermalGuard CC2 at a ThermalGuard CC2 is installed by thickness exceeding 3 inches per pass NO WARRANTIES,-EXPRESSED OR independent SPF contractors. It is 'and do not apply subsequent passes IMPLIED,INCLUDING PATENT recommended that building owners within 30 minutes of the previous pass. WARRANTIES'OR WARRANTIES verify that the SPF insulation contractor In rare cases doing so may cause OF MERCHANTABILITY OR maintains proper credentials;insurance, charring and combustion., FITNESS FOR USE,ARE MADE BY and licenses and is properly trained to ARNTHANE INC.WITH RESPECT safely install SPF,insulation products. It is the applicator's responsibility to TO PRODUCTS OR INFORMATION a; test lift thickness for a particular, SET FORTH HEREIN. ThermalGuard CC2 achieves a Class I application prior to commencing Fire retardancy rating and meets or installation to ensure that the product Nothing contained herein shall exceeds minimum building code can be installed safely at the desired constitute a permit or recommendation_. requirements for fire safety. thickness. to practice any invention covered bya patent without a license form the owner ThehnalGuard CC2 has low odor during Please contact your technical sales of the patent. Accordingly,buyer application and produces no toxic representative for recommended assumes all risks whatsoever as to the vapors after application. equipment configurations and for use of these materials,and buyer's recommendations for your particular exclusive remedy as to any breach of Always read and follow all-Material application. warranty,negligence,or other claim Safety Data Sheets provided with all shall be limited to the purchase price of shipments.Additional copies are DISPOSAL&CLEAN UP the materials. Failure to adhere to any available upon request from Amthane recommended procedures shall relieve Inc.or your technical sales Cured/reacted product may be disposed Amthane Inc.,and the manufacturer of representative. of without restriction.Excess liquid'A' all liability with respect to the materials and'B'material should be mixed and their use thereof. Basic PPE safety equipment is required together and allowed to cure,then for personal protection including,but disposed of in the normal manner. not limited to:long-sleeve chemically Product containers that are"drip free" resistant overalls,rubber,nitrile,or may be disposed of according to local; latex gloves,splash shield or safety state and federal laws glasses with splash guards,rubber or leather boots w/covers,full-face air- WARRANTY&DISCLAIMER purifying respiratory(APR)with Arn thane appropriate cartridges or full l-face The data presented herein is subject to supplied-air-respirator(SAR),and other change without notice and is not 1pAmthane Inc. 1002 W Main Street Richmond,MO 64085 - P 816.776.3015 F 816.776.3215 www.amthane.com 1002 W Main Street Richmond,MO 64085 P 816.776.3015.32 r F 816.77615 ® www.amthane.com Arn ane .l. . Spray Foam Insulation Products t Y g s r Z" s� r ThermalGuard ThermalGuard ThermalGuard CC OC 1 OC.5 & OC.5R Nominal Density: 2.0 IMP Nominal Density: 1.0'Ib/ft3 Nominal Density. .5 Ib W CC2 R-value: 7.Olin R-value: 5.24/in OC.5 R-value:3.8/in Compressive Strength:45 PSI Compressive Strength: 7 PSI OC.5R R-value:4.3fin Vapor Permeability: 0.8 Penns @ 2" Vapor Permeability:3.6 Perms @ T Compressive Strength: 0.6 PSI Vapor Permeability: 4.2 Perms @ 2" Product Description Product Description Product.Description ThermalGuard CC2 is a semi-rigid,fast set, ThermalGuard OC1 is a soft, fast-set, ThermalGuard OC.5 & OC.5R are soft, closed-celled, spray polyurethane foam open-celled, 100% water-blown.• spray low-density,open,celled,100%water-blown spray (SPF)insulation system designed for use as polyurethane foam (SPF) insulation system .: polyurethane foam (SPF) insulation systems designed for use in residential & commercial designed for use in residential&commercial wall, a high.performance thermal insulation. g wall,attic,and roof-deck applications. attic, and roof deck applications. Both products 'can reduce_ energy consumption by up to 50%and ThermalGuard CC2 is a spray-applied insulate &ThermalGuard OC1 can reduce energy air-seal the structure in a single step. System suitable.for a variety of insulation ThermalGuard OUR is a bio-renewable product applications including in-plant,. tank & consumption in structures by up to 50"/o that exhibits superior fire-resistance properties and pipeline, residential & commercial compared,to conventional insulation systems increased R-value. ThermalGuard OC.5 can be because it insulates&air-seals in a single step. optimized for installation in cold temperatures construction, foundation and.below grade down to 15°F. applications where compressive strength or ThermalGuard OC1 is applied as a liquid and impact resistance are desired. expands over 40x in approximately 8 seconds to ThermalGuard OC.5 &-005R are applied as a fill and seal building cavities of any shape and liquid and expand over 100x in approximately 4 ThermalGuard CC2 is applied as a liquid size. It exhibits superior thermal insulation, seconds to fill and seal building cavities of any and expand 25x in a approximately 12 air-barrier, and sound attenuation properties shape or size. They deliver.superior thermal seconds to form a smooth,durable surface' over conventional insulation materials and has insulation, air-barrier, and sound attenuation been proven to improve indoor air quality & properties compared to conventional insulation perfect for the application of primers or comfort. materials and contribute to a healthy indoor, and finish coatings. )utdoorenvironment. a.: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION { r Map 03c Parcel 073 Application # t✓' ��� 1 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee S3 ° Gt� Date Definitive Plan Approved by Planning Board � 11u,1�3 Historic - OKH _ Preservation/ Hyannis Project Street Address .3 ` 0611 6�xOyrc Village CCA,v% ,/� gg Owner 1 e-® C,Id 11 PN� � iNl i al Address ZO Qe_Yv-Ao�V L.&% 6A• Lc,: AAO Telephone St LA I eQ 1_1 i Permit Request c_\� w;I.JC111)5 coll-k env S )IL-1 e-zc � Z Wd Le ",0 �-w YCDVY ti., a4` irQ C�- ✓'c d-t..i._ ,� ��e. v., r.Q r✓i` _ �r�..e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new 0 Zoning District ?QF Flood Plain CIL Groundwater Overlay AL)C:) Project Valuation O 000 Construction Type�(tA,9 '�14^ Lot Size 700 5� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 2--' Two Family ❑ Multi-Family (# units) _ Age of Existing Structure Y5 Historic House: ❑Yes &< On Old King's Highway: ❑Yes 9-P< Basement Type: ❑ Full yawl ❑Walkout ❑ Other A Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(s ft Number of Baths: Full: existing new O Half: existing / € nevi c� Number of Bedrooms: -3 existing®new Total Room Count (not including bathe): existing _ new First Floor Roo Count � rn Heat Type and Fuel: alUas ❑ Oil ❑ Electric ❑ Other -- Central Air: 3'Yes ❑ No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes U- U Detached garage: ❑/�existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: Slexisting ❑ new size L 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 -- ,�Yw(BUILDER OR HOMEOWNER) Name A q.o. obd•ti_ Telephone Number 6 Address 753 Z3 /4 License # S 4 tJ Pcdw toj{-,., OZ,S�6 Home Improvement Contractor# Worker's Compensation # Wwc 35,6,2,t! ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO cT J�1 y e_ t3ca °( SIGNATURE DATE FOR OFFICIAL USE ONLY ` APPLICATION# -DATE ISSUED y MAP/PARCEL NO. ADDRESS VILLAGE F OWNER DATE OF INSPECTION: ti FOUNDATION FRAME o INSULATION e FIREPLACE ELECTRICAL: ROUGH r a FINAL — PLUMBING: ROUGH ' FINAL GAS: ROUGH FINAL . :y FINAL BUILDING �131! DATE CLOSED OUT ASSOCIATION PLAN NO. r J r 1 y i P i `Y ?'he Commonwealth of Massachusetts Department of Industrial Accidents O lice of Investigations 600 Washington yS`ireet Boston,MA 02111 w►rrwv.mass.govldia Workers' Compensation Insurance affidavit: Builders/Contractors/Electrici:an&Oumbers Applicant Information Please Print Legibly Name akwws mTanizatiw&dividwt): `��a1 In�i w & S o y% .TA c Address: City/StateJZip:K"Fa(ygw4A, Al A e9g-5S6 Phone#_ 008 SGS 3-3 R 6 Are you an employer?Check the appropriate boa: ,. / I am a 1 contractor and I Type of project(re dred)- 1.R I am a employer with � . 4. ❑ .6. ❑New won employees(fin and/orparwim ).* have hired the sins-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet,. 7. [�odeling strip and have no employees These sub-contractors have g_ ❑Demolition w for mein a capacity. employees and have workers' working any apa ty. Y 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its. 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers.have exercised their 11.❑Plumbing repairs or additions myself;.[No workers'comp- right of exemption.per MGL 12.❑Roof repairs insurance required]l c. 152, §1(4),and we have no employees.[Now' 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 mast also fill out the section Below showing their workers'compensation policy information- T Hameoamers who submit this dfidavit indicating they are doing all walk and duen hire outside contractors mast submit a new affidavit indicating sach- tContractors that check this boar must attached an additional sheet showing the name of the sun-eomnac;oars and state whether or not those entities bave employees. If the subcontractors have employees,they must provide ffieir workers'tromp.polity mmiber. I a►rt art employer that is providing t Porkers''corttperrswtion i►im ran ce for my etxpfoyees. .Belo wis the pokey and job site informatiom Insurance Company Name:VRC.1 vA sj�y-a.e..g. G tp,4 Policy#or Self--ins.Uc.#: e'!CW IL S S G Zl I Expiration Date: 1 7 A Job Site Address:_ lc� 6 ►- - City1StatelZip:�+�- M ®Lfo3,5— Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c_ 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year impaisonment,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 Offrce'of Investigations of the DIA for insurance coverage verification. I do hereby cej j Fy a pains andpenalties vfpeduty that the inforinafian provided above is bue and correct P" tire: Date: // 7 Phone#: 22./ S'3 41�;- F fficial use enly. Do not write in fhis area,to be completed by city or town o{fi'ctiaL ty or Town: PertmitUcense# nning 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#: 6 MCLAU-1 OP ID: KG CERTIFICATE OF LIABILITY INSURANCE DATE 08105/20/YY) 08/05f2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). CONTACT PRODUCER Phone:508-771-1632 NAME: Northwood Ins.Agencyy,Inc. Fax:50893 PHONE FAX 540 Main Street,Suite 9 -2955 C No E : AfC No): Hyannis,MA 02601 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC B INSURER A:Travelers Insurance Company INSURED McLaughlin&Son,Inc. INSURERB:PMC Insurance Group 56 Sandwich Road INSURER C: Bourne, MA 02532 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. ILTR TYPE OF INSURANCE INS INSR POLICY NUMBER MMIDD MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY 6804537C47A 04M 8/2013 04/18/2014 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 CLAIMS-MADE J OCCUR MED EXP(Any one person) $ 5,00 X Business Owners PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY JECT F1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY I Iis ER B ANY PROPRIETORIPARTNEWEXECUTIVE Y 1 N MCWC356211 01/07/2013 01/07/2014 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? ❑ NIA - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Leo and Randy Schmid ACCORDANCE WITH THE POLICY PROVISIONS. 131 Old Shore Road COtUIt,MA 02635 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS 6 55 4 UGHIy PATRICK W MCIA i 753 RT 28A/PO BOX U N FALMOUTH NIA Expiration 11/09/2015 Commissioner -Badings of any use group Which contain 1han 3-5,000 cubic feet(99 im3)of enclosed = a current edition of the Massachusetts. Failure to possess for revocation of this license,. state Building Cede is cause For ors tsc � angrtion v , .Nass Gaul DP5 erm /zecne:tr.«r�cealfl . Office of Consumer Affairs&Busraess Regnia€�o-� Mg-IMPROVEMENT CONTRACTOR gistration: 132486 Type: ,9xpiration: _�f124314:._, PrivateCorporatior � v _ MCLAUGHLIN&SON INN- PATRICK MCLAUGHLIN' 753,RTE 28A .N_FALMPUTH,MA 0556 - Ui tlersecretary = ra"Jor mdiddul use only Lecenseor'regis °a beforethe agiirotia>g dam- If-foand return:to: :. .: :{ice of Consumer.Affairs and' usmess Re;',u ou 10 PwtPlaza-Suite-5170 1 oston,MA 021-16 y � - Net rraled'w►t�out stignu . snstvsrasLe Town-ofl Barnstabk Regulatory Services Richard V.Scab,Interim Director Building DIVIS1011r. Thomas PerrCBO Building Commissioner 200,Main Street; Hyannis;MA 02601 : . wvnvA6wn►harnstahle.ma.nc Office: -508-862-4038 Fa*t 508-,790-6230 P Property Owner Must Complete andSign This Section If Using A Builder LEO c I y ,as Owner.of the subject:property hereby authorize T2i� � ,bcdHGr�' v � N act on my behalf,` , in all matters relative to:work authorized by this building permit o P'p llcation for: .. (Address of Job) 'Ww a,,, j I Signature of Owner Date, Print Name If Property Owner is applying co for permit,please mplete Ho the me'owners-License Exemption Form on the ` reverse side. TAKEVIN D\Building ChangesWMRESS PERMMEXPRESS doa Revised 061313 i � 'H M I P D E N.GEE-,...ecR.. ..t�I_ 2oAD. 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PLa�N._ -�FiATI�IGE �, P>V N!%G Iz A-IZLN I-rEGTu.Iz E , IG��nT}tq•�IWE LEE 6A�TE5 �D� r�U-tavT)-I, Nlst alf4o ,-feL. 538� 54o G5�3' �{r7Fi_�. Orr.T•clgE-1�.30'/ ..2.013 - TOWN OF BARNSTABLE 2013 Nov 18 AEI O: 41 `-;I() ELI y, WIP PAWL- tJ b PAn*. yHtNGr1.�i ✓ �GHMID 12E�IDENGE PROJEC � 1 �/ ::• :.. i. NAME: �2�, ADDRESS: I- -PERIYIIT DATE: 3 t - LARGE ROLLED PLANS ARE IN: =. BOX D . SLOT t Data entered in MAPS program on: L3 BY: 1 q/wpfiles/forms/archive � � �,�a S �O% uh,proT�"' G� `•' _ � ire" �� a_ � �*I sf.. � f � .y t . y . . _' �t F c= 1 �y .. _,�� i t nt (�y h� ! t ' d t,` +� Since 1955 E GAco WEsTERN Insulation Certificate Date installation completed 6r, DGl Building address r o� 5ostre� City/State/Zip ee&Tv W M �� .�,usTl��e�i Application Contractor(company name) Avow Address City/State/Zip �i��ASfc'Z1 Phone 5yo �-z 3 Areas Insulated Exterior stud Average thickness XV/ "1 R-Value Z& - A&vim P44 Ceiling Average thickness R-Value S8 Roof deck Average thickness . R-Value Crawl space/basement Average thickness % R-Value Additional areas insulated tilAel r A.�:,Q 6f Vg�, d. I(print name) as an independent contractor,certify that the'GacoWestern insulation installed on this project was applied in accordance with7the GacoWestern recommendations and specifications as stated on the product data sheet and the Gaco pp ica io ecifications in the amount as indicated on this certification. (signed) Date wb Gacofttern Aged R-Value Chart` Dimensional Lum.. 1" 2- 3" 4�, 5" . 6" 1aa 8a, GacoGreen 4.2' 8 r` 12 16 20 24 28 32 36 14 22 z 29 Gacoflrestop 3.7 1 11 15 19 22 26 30 33 <13 20 Z7 183 6.4 `13 21 33 - . .40 41 53 60 >23 31 48 6.1:. 13 20 21 34 40 41 54 60 24 31 . 49 193 6.2 13 20 21 ' 34 41. 41 `54 61 24,. `31 49 'Based in fndial measured K-values.. , GacoWalaFoam SPRAY POLYURETHANE FOAM INSULATION www.gacowal foamxom I 800.456.4226 PRODUT A Gaw Waffoam Gaco Western WallFoam 183M is an HFC-blown(zero ozone-depleting)liquid spray system that cures to a medium-density rigid polyurethane insulation material.Gaco WaIIFoam 183M contains polgols derived.from naturally renewable oils,post-consumer recycled plasticsi and pre:consumer recycled materials.Gaco WallFoam 183M does not contain CFCs, HCFC's or other gases harmful to the environment:This system can be sprayed on clean,dry substrates down to 35°F(21).Gaco Wall Foam 183M is a class I fire rated foam that meets the requirements of IMES AC377 Acceptance Criteria for Foam Plastic Insulation.Gaco Wa11FDam183M meets the requirements of AC377 Appendix X for use in attic and crawl spaces without an additior al ignition barrier.. INFORMATION ,ensureoptimum 1' 1 pass thickness 13/4" recommended with the maximum not I exceed per pass.For typical1 IConsult1 Western's Ga(oFoam Spray Guid' PROPERTY TEST TEMPERATURE ASTM TEST UNIT VALUE- Nommai Density(Sprayed'In Place) u '?17°F(25"() ` } D 1612 03 s<< s Ibs/ft' ,..�..L} s 18=2 2 4 T R Value'See (518x R 6 4 at 1 € t Compressive Strength(Parallel to Rlse)rty ��,�77°f(25°Q -< D 1621 04a> .,•�� psI � r 3Z =� � '' ' �•�^r �• '�'%P�.s ° ° 'i.'r' 'I`�-F•.�e,..a � i e�+s � .. :t r _ t-. Tensile Strength 3 f� 77 f(25-C) r q D 1613 } si 64s a rr 5e r ¢a ' p s x a ° Water Absorption C)Ar f s� % i 0 45 t WateryaporTransmission ' 'F1 77°F(25°Q� , tsE 96'05 x airperm m w 112 , ` Dimensional Stabtllty(7 Days 158°F(10°O(95%RHOS D 2126 99 x' %linear change ,L 6% W 5% T 3% Recommended Service Tempeature Range k 77°F(25°C),i' �F ' °F/°C d 406F to 200°F(40°C to 93°C) ' s F s Closed(ell Content s � h 77°F(15°q �� D 6226 Nr Permeance 75Pa(Infiltration/Eiiflitratlon) 11°F(25°(j r 1 @ F y,k E 283 04 a L/s/mzr 0 000(0 000(@ 1 thickness) NOIEsFedeT1TradefITe131s tilthefederffiIlz.l6tAt 460 A d_ rvar t ass CrTfg 'w � r ;Y _ � testiBgt� fwmOHTRu$9ea�lic�ODa�dsaa�sata°75°F � m�ntesttemperatureFaikire`toaomp(y�auresuBin (Also known1 SYSTEM THICKNESS FLAME SPREAD INDEX SMOKE DEVELOPED INDEX WaIlFoam 183M 4 (10 2 cm) x t0 `r 400 r.«.. ..Ss,4... r _...>,..,!^«._..�Fu.t x...,.,.a_..k...S.•4�.�. ._. .. .... xi..ai..3,fx.a...r r..ua IIt tl 1 IRE TESTING NFPA Appendix LOCATION FOAM THICKNESS J. ,° wq•+ . K -,s r La.0 v^a ,r x i i x.£` .. Walls �f txa .�a 3x =4 p Up tD 9 5 (1413cm) s r S 35.. ,�.- -•y^ T -^� ,+•a :cx :, -r>- { arc ^s K 'z •r rn . 9 r p to 11"(2194 cm) `#[eilin >i��r,� U JYPI(AL LIQUID PROPERTIES 'A"(omponent containspolymeric isocyanate; Component 1 polyol, d blowing1' PROPERTY TEST TEMPERATURE ASTM TEST UNIT VALUE Sgecihc Gravity `A Compomnt L�, 77°F(25"C)s} 1638 70S Speiific Gravity B Component Weight/Gallon A Component 'V77°F(25°C) r < Weight/Gallon B Component h a v ¢ Mixing Ratio At& B Component 17°F(25°C) Y � Y`,' By volume 11 Stability When Stored at 50°Fb 70°F � F �" y' Months A 3.(omponent 1 year Component 6 months EQUIPMENT ,Itl ,; 1 SETTINU VALUE CHARACTERISTIC VALUE im Pre Heat lso(A) ` nY, 115°f 130°F(461°C- 54 4°C) f�Cream Tlme ` fi "r` r 0 t sec M Pre Heat Poly'(B) it °F(4 54'4°() %3 735 sec Hase Neat { �di 115°F 130°F(4 R; 54 4°() Tack free Time " 3 5 sec tr Recommended Spray PressureAt 800 00 psi(dynamic) fore Time fi` �n hours .,. .,r.M .,10 r.The infamullon herein Is believed to be reliable but unimm.n lids may be Present ALLWARRAIMES OF ANY KIND,EXPRESSED OR IMPLIED,INCLUDING WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE AND THAT GOODS ARE OF MERCHANTABLE QUALITY,ARE SPECIFICALLY DISCLAIMED.See Oaco Westem forinfomra0an conumlog its limited wamnbj aid its availabiNty. J: >,C^K,c"?c�;�`,�`t� ?a.5�'"�e!".�•a_�iFr,�'�4�A;-k•�nUb"r'�t��1a,� i�.?, y;'a�*+� ',y"'' v���.�"'n443"y,Yr �'^� .. ICc } r s� 4^^`�f f YOII i :: LIL�CD W E'Mill V F ENEflGY STAfl t 1 IDcnpo h.;md&,&.j—%,14f—MM m�o..xe�66m6o.d r M.{� PAIiTNEfl rL'aa W_A.Jos C—dvubi—ri.`-,-.. -HIM Toll-Free:677499-4226 www,.gaco.com Produd#GWFDS1 OZ/12 7� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Hipp ication # Health.Division Date Issued rl 3 Conservation Division S P sb�y P �G �'�� � Application Fee ' o � .31�21Zo1� Planning Dept. Permit Feel Date Definitive Plan Approved by Planning Board oK.� Z7 13� Historic - OKH Preservation / Hyannis Project Street Address i OLD 5 H6 2-e- J2bA 0 Village Co-ro 1-i- Owner z> w NN c. 4.0 Address I 01-v Si46gE 00AD Telephone ­5 i d GRI - 17( -1 / 7/-5. �_t L£e-mold Permit Request 6 D D'+ /!2 ti '1 D �46e)!5.6 —r. L6 o a ' Square feet: 1 st floor: existing proposed 2nd floor: existing l proposed *A Total new 3'4a Zoning District Flood Plain Groundwater Overlay JVQ Project Valuatio X,000- 'Construction Type Lot Size g 700 a Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family I/ Two Family ❑ Multi-Family (# units) Age of Existing Structure 850 Historic House: ❑Yes UNo On Old King's Highway: ❑Yes 4KNo Basement Type: ❑ Full dcrawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) PIA Basement Unfinished Area(sq.ft) N'Q Number of Baths: Full: existing new Half: existing new Number of Bedrooms: - .o existing 0, new Total Room Count (not including baths): existing 7 new First Floor Room Count Heat Type and Fuel: S/Gas ❑ Oil ❑ Electric ❑ Other Central Air: 1�(Yes ❑ No Fireplaces: Existing New 4 Existing wood al stove]Y4 U/No Detached garage: ❑ xisting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑e�tsting "ew�ize_ Attached garage: existing ❑ new size 2 Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization Appeal # Recorded,! CO Commercial ❑Yes I No If yes, site plan review # , Current Use Proposed Use APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) y_ Name , cC � �� 5,1J 1P Telephone Number Address P. l to P6 Q i'P' RA OX eu 4° License # Home Improvement Contractor# /SCE Worker's Compensation #,AC, LVC% '39' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 2�04_pir_ 1-5 Lo SIGNATURE �/�[ DATE � � F FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. f' ADDRESS VILLAGE OWNER t r: DATE OF INSPECTION: N'FOUNDATION.__.�-<• t FRAME 141A 1 INSULATION V ' r FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT i It ASSOCIATION PLAN NO. r, The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): K044-.;Ce t4!i#J 0 ,V 0/ Address: To &V- I A 7,!,;1 94 9E 2J4 City/State/Zip: �b�A�R Wit— U�<6 Phone#: Tc, s ��► '" s 4, Are you an employer?Check the appropriate b : Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• 0 Demplition workingfor me in an capacity. employees and have workers' Y P t}'• � 9. uilding addition [No workers' comp.insurance comp. insurance. required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:,P ( `�'* VLS UY`X,,,LC_ Policy#or Self-ins.Lic.#: W �� t ( Expiration Date: 1 � �®� A Job Site Address: ?:>t City/State/Zip:Cok"i rT Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50-0.00 and/or one-year imprisonment,asmell 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' ce coverage verification. I do hereby ce nder a pains and penalties of perjury that the information provided above is true and correct e Signature: Date: Phone#: -,7-2 / S q 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs`persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also.,states that:`every state or local Iicensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance-coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials s 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 multiplepermit/license applications in any given year,need only sub mit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.,Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts `3 - Department of Industrial Accidents Office of Investigations 640 Washington Street Boston,MA 02111 Tel,#617-727-4900 ext 406 or 1-877-MASWE Revised 4-24-07 Fax# 617-727-7749 WWW.mass_gov/dia The Commonwealth ofMassachusetts Department of Industrial Accidents x Office of Investigations 600 Washington Street Boston,MA 02111 �s www.mass gov1dia ` Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ,4 w✓ /, m 4,- Address: k c:z-- City/State/Zip: (A-F^ E.7- vlA A c z s 3-i Phone M %—M-3 G o- i t 1 Are you an employer?Check the appropriate box: 4 I general Type of project(required): 1.El . am a contractor and I I am a employer with $ 6. ❑New construction employees(full and/or part-time).' have hired the sub-contractors 2.Erl am a.sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition ,_.. working'for me in any capacity. employees and have workers? - [No workers'comp.insurance comp.insurance. 9. Building addition$ required•] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L[]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152,§1(4),and we have no employees.[No workers' U❑Other comp.insurance required-] *Any applicant that checks box##1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance formy employees. Below is dmpokcy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: Qf 7cial use only. Do not write in this area,to be completed by city or town ofJiciaL City or Town: PermitlLicense# 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#: 08-06-'13 12:44 FROM-G. H.Dunn Ins. B.B. 508-759-7177 T-853 P0001/0001 F-187 Aebp r CERTIFICATE OF LIABILITY • INSURANCE DATE IMxuDDnwr, 14—� oS106 013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate doss not confer rights to the certificats holder In lieu of such endor9ement(s). PRODUCCR Phone: (SOS)75"132 Far: 508-759-7177 CONTAICT Toni E.Davies G H DUNN INSURANCE AGENCY,INC. P+,oN (500)295.0006 er"�c N 500-295-0360 P 0 BOX 330- EMAIL tonl@ghdunn.com 215 MAIN STREET ADORE,". BUZZARDS BAY MA 02532. INSURER(S)AFFORDING COVERAGE NAIC a INSURER : ARSELLA PROTECTION INSURANCE COMPANY 41360 INSURED GARDNER CONCRETE CONSTRUCTION INeuAeRa : ARBELLA PROTECTION INSURANCE COMPANY 41360 .. GARD C/O ANGEL KING INSURER PO.BOX 3203.._...._.._..- - -...---- - ----- ----.... ..... .._..-- - — INSURER 0 _ ...-...._ BOURNE MA 02632 ursoaER e tNSUAlIA P COVERAGES CERTIFICATE NUMBER: 20417 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. IrNrSSR 'TYPE OF INSURANCE ADOL 8U0R POLICY NUMBER POLICYEFP POLICY eXP LIMITS B GENERAL LIABILITY $500040631 041101/13 04/01114 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To RENTEo 100,000 PREMISEBOEoaauronae $ r CLAIM34MOE OCCUR MED.EXP(Any orm person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL ADORWATE S. 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG f 2,000,000 POLCY PAD LOC f AUYOMOBI►e LIABILITY COMBINED SINGLE LIMIT (Ea almWer") f ANYAUTO BODILY INJURY(Per perm) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAVTOS NON-OWNED PROP R OHMAGE 6 AUYO& +roadr f UMBRELLA LIARI . OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS•MADE AGGREGATE S DED RETENTION S $ Wr A WORKERS COMPENSATION 9115070410 04101R3 04101114 YORVUMIYS fR f AND eMPLOYERV LIABILITY ANY PROPRIETORIPARTNERMI)ECLnIVE YIN E.L.EACH ACCIDENT $ 500,000 0PFIc1!AWMftR EXCLUOED7 I 1 I NIA tNMadelo/yIn NH) J E.L.DISEASE-EA EMPLOYEE 6 500,000 IIye-dauanbe under E.L.DISEASE-POLICY LIMIT f 600 000 OLSCA07i0N OF oPFAAPoNs below I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarfts Schedule,R more space IB required) Angel King is excluded from workers comp CERTIFICATE HOLDER CANCELLATION MCLAUGHLIN AND SONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 31 OLD SHORE RAO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CATUIT MA ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIRP REPAESEMATIVE Attention: $08-743-5025 /U IB` ACORD 25(2010/05) 1886.2010°CORD CORPORATION rights reserved. The ACORD name and logo are registered marks of ACORD 'acC>RH CERTIFICATE OF F,,'ATE(MM,DDNVYY) LIA�ILiTY INSURANCE /1„2012 fws' CEwrtricxlTE 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 y LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED 1;1/2ESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. iMPfiRTANT: If he certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the I;?rrns and coitditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the cer t:icate holder in lieu of such endorsements). PRODUi;r-R CONTACT NAME: Courtney Finigan, CIC, CRM Murr;iy & MacDonald Insurance Services, Inc. PHONE -(S08)540-2400 FAX 550 I3acArthur Blvd. rc N ;(soa)zas-alit EMAa cfinigan@tnmisi,com INSURERS AFFORDING COVERAGE NAIC9 Bouz:ILe _ MA 02532 INSURERA:Arbella Protection Insurance 41360 INSURE'I '—'---- — ____ INSURER B:Travelers WC Co1cJ.Iy Insul�:tion Inc. — ---�-- --- .—_ INSURER C 28 Jemathan Bourne Road — INSURER D: Poca;€set MA 02559 WSURER E - -- -- -' COVET AGES CERTIFICATE NUMBER:12-13 Master GI, REVISION NUMBER: THIS is TO CERTIF"THAT 'THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDIGATED. NOTVOTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CER`i=1CATE MAY 3E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCt_ISIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.INSR AOD'L b -S LTR TYPE OF INSURANCE POLICY NUMBER. POLICY EFF POLICY EXP �` (30FERAL LIABILITY M DD/yYYY MM/DD/YYYY LIMITS EACH OCCURRENCE g 11000,000 X 'COMMERCIAL C ENERAL LIABILITY DAMAGE"0 RENTED A PRI MISES _d axurtence) $ 100,000 _��CLAIM5k1ADE ❑X occur'? B500028928 /18/2012 8/1B/'1013 —`—" MED EXP(Any one person) $ 51000 `— PERSONAL&ADV INJURY S 11000,000 GENERAL AGGREGATE S 2,000,000 GE':L AGGREGATE LIMIT APPLIES PF_R: PRODUCTS-COMP/OP qGG $ 2,000,000 X PUUCY I°RU- --' LOC AU r-)MOBILE UABILI TY _ COMBINED SINGLI LIMIT Ea accident $ 1,000,000 A ANL OWNED BODILY INJURY(Per person) S X SCHEDULED 9692400002 8/18/2012 B/18/2013 j AU"rOS AUTOS BODILY INJURY(Per ac:citlenp $ X lilRf:D AUTOS X NUN-0VVNED PROPERTY DAMAGE AUTOS $ � Per accident — --- X dMSRELLA LIAR Underinsured rnotonst of s lit $ 20 000 OCCUR :EXCESS LIAR EACH OCCURRENCE g 3,000,000 A _ CLAIMS-MADE AGGREGA"I'E )EU X RETI'NTION$ 10,00 4600028929 8/18/2012 /19/2023 — -- B WO:�AERS COMPENSATION $ ANC.s?MPLOYERS'LIABILITY WC S'fA'1"U- OTIi- j ANY :'ROPRIETORIPAF'I'NER/EXECLIrIVE Y I N OFF-ER/MEMBER EXC:LUDEW ❑ N/A E.L EACH ACCIDENT $ SOD,OOO (Maia-atoryinNH) 4" /18/2012 B/18/2013 If ye;,descrlt.*under y' _ �l E.L.DISEASE-EA EMPLOYE'- $ 500,000 DF_S':{tIPTION OF OPERATION$below -- '— E.L.DISEASE-POLICY LIMIT $ 500,000 i er DESCRIPTI1. OF OPERATIONS/LOCA'nONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,11 moro space is required) CERTIFY ATE HOLDER �� •' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN M::!Laughl in & Son Inc ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 11$ N,arth Falmouth, MA 02556 AUTHORIZED REPRESENTATIVE -r C Firigan, CIC, CRM/A ACORD�:' (2010/05) INS025(2C1)0S)01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOO fj NolixiIISNI 1W0`I00 LTT9V95BO9 YVA LT:9T 9109/90/90 MCLAU-1 OP ID: KG CERTIFICATE OF LIABILITY INSURANCE DATE 1 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). NTACT PRODUCER Phone:508-771-1632 NAME: Northwood Ins.Agency,Inc. Fax:508-393-2955 PHONE X 540 Main Street,Suite 9 AIC No FA Ext: AIC No Hyannis,MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC t INSURER A:Travelers Insurance Company INSURED McLaughlin&Son,Inc. INSURERB:PMC Insurance Group 56 Sandwich Road Bourne, MA 02532 INSURER c 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. ILTR TYPE OF INSURANCE POLICY EFF 0 EXP INSR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY 6804537C47A 04/18/2013 04/18/2014 pREM sES Ea occur ence $ 300,00 CLAIMSMADE ®OCCUR MED EXP(Any one person) $ 5,000 X Business Owners PERSONAL E ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO- AUTOMOBILE JECT LOC $ AUTOMOBILE LIABILITY O aBI ED SINGLE LIMIT(Ea ff ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION.$ - $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY TOIR LI IT R B ANY PROPRIETORIPARTNEWEXECUTIVE YIN MCWC356211 01/07/2013 01/07/2014 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMEER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 Ifyes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,.Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES'BE CANCELLED BEFORE Leo and Rand Schmid THE EXPIRATION DATE THEREOF, NOTICE WILL�.BE DELIVERED IN y 131 Old Shore Road ACCORDANCE WITH THE POLICY PROVISIONS. COtult,MA 02635 AUTHORIZED REPRESENTATIVE ©1988-2010-ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD * ■nelvsTna�. • MUM Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division . r Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6236 f Property Owner Must Complete and Sign This Section If Using A Builder I, s Owner of the subject property ti hereby authorize \N�LA )� Na tL S� rtr,G to act on my behalf, . in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date LeIA Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\8R76BDVA\EXPRESS.doe Revised 061313 PHILBROOK ENGINEERING & 107 BEACH STREET CONSTRUCTION DENNIS, MA 02638 1-508-385-8682 ENGINEERING DESIGN • CONSTRUCTION INSPECTIONS • BUILDING, ALTERATIONS & RENOVATIONS BtIMNNG ADDITIONS&ALTERATION Date: 10 June 2013 To: Mr.Thomas Perry Building Commissioner—Town of Barnstable From: T.Vamum Philbrook,P.E. RE: SCHMID Residence, 31 Old Shore Road,Cotuit,MA Dear Mr. Perry; I am providing you some back-up information on the design approach I took in approaching this job for Beatrice A. Bunker Architecture. For the new rear addition and connector to the garage I used the WFCM 1&2 Family manual—specifically Clip.3 Prescriptive Method w/the Exposure C modifications. I applied,Engineered Design for the MicroLam®LVLs,garage beam reinforcement and the solid posts as i allowed.by Para.R301.1.3 8 h ed. IRC 2009. All of this work remains below the ridge and constitutes i` N single story construction to an existing 2nd story. The new extension was checked for lateral(shearwall) ,art l and connection(uplift)loads. I contniue with the narrative format in hopes it helps with your understanding of this particular the job. As always.thank you and please call me w/any questions or comments you might have. Respectfully, T.VARNUM PHILBROOK,P.E. OF T. VAR NUM ; PHILBROOK �+ 1 encl;Design Submittal Packet MECHANICAL No. 30890 ISTER�� tvp 1 ILI I, 31fce°xb =:License or registration valid..for mdividul use only M 111Y�CO , r y Ore thm e .piration date. If found return to: gist ret on ry3i5�2486 "• Tyde t Office of4Consumer AffafYs and Bu siness Regulation xpiration r91 21)14 PNate C orati, r 1p Park€Plaza-,Suite 5170 a f tOn;' 02`I�16 MCIAIIGHLIN&SWdNC ti PATRICK MCLAUGHLIN i 75a.RTE 28A P pt�ALM UTH MA 5-6 + - ersec�etr�2 ( Not valid without signature Massachusetts-Department of Public Safety, "Board of Building.Regulations and Standards Cunstiructiun Supen"iso r License: CS-016554 . , PATRICK W M&AU&MIN�i xk. 753 RT 28AAM6]BO 1ff8 5: I qua Ss l( N FALMOU-MA 02556 ssioner Cox irate Commi ; . 11,1)9f?� PHILBROOK ENGINEERING FIELD REPORTIWORKSHEET Project No: �� •3� }� ion e�cN srneFr V��} NO: �+ of - I, GENERAL DESCRIPTION Beatrice Bunker, AIA 508-540-6577 - Cq�h ed. P10-39- Narrative: 1st.Floor Dining/Kitchen Addition to Existing cw610 ---------- 1-1/2 Story Houe w/ Attached 2 Car Garage Location: SCHMID, 31 Old Shore Road, Cotuit, MA. ; ° Construction: 2"x 41"/6" @ 16" o.c. Platform Frame w/ Concrete ------------- Foundation and Stick-built Wood Framed Floors/Roof SPECIAL CONSIDERATIONS Pip .31 Use Group(s) : R-3 (1 & 2 Family Residences) ------------- OF Construction_Type_ V-B (unprotected) see separation below Misc or Comments: o Site Inspections, Plan Review - Sizing & Layouts . T•'VARNUM coo PHILBROOK N^ ----------------- o Design Reviews - Roofs, Beams, Headers & N. 30690 MHANICAL o MEMO w/ Construction, Shearwalls & Certification Q yno DESIGN CONSIDERATIONS E1 S's � r� Soil Data: - Site Plan or Boring Log available: NO fQHAI «� ---------- Preparer of plan or log: -- - Direct Observation: YES, P95-46 (Haseck) 1 L� from CC Atlas Qmp; Gravelly-Sand, Pebbles Description: ' USCS = SP SBC Class = _-8-_ 2 Specifics: Br(allow) = 2,400 lb/sq ft w/ 20% allowable width increase Fire Data: GWB Separation'between garage & residence IAW Tbl.' R302.6 ---------- Loads SBC Location #/sq ft ' Dur Note/Code . 1st Floor 40 1.0 Tbl' 5301.5 2nd Floor 30 1.0 Tbl. 5301.5 Attic - non Expansion 10 1.0 Non-Storage Partitions: 2x4/6 12 1.0 . Bear/Non-Bear iWFCM 1&2 Family -_Chp 3; Prescr_iptive Method for now i Snow m 3.25/12 (150) 301.1..15 Tbl. R301.2(5) (MA) WFCM 162 Y _ Famil Ch 3.;_ Prescri tive Method for C&C and MWFRSUON� Wind - Speed 110 MPH EXPp= C. Tbl. R30112(5){) Height & Exposure Coef. 1.21 Tbl. R30 42(4) (MA) Roof Pitch > 10' to 30' Mrh = 12 ft Dormer - 2 Tbl. R301.2(2) Ref Pres (Horiz) Zone 4 = -25 MWFRS Tbl. R301.2(2) Ref Pres (Horiz) Zone 5 = -34 C&C Ref Pres (Vert) Zone 1 - -22 MWFRS Tbl. R301.2(2) s Ref Pres (Vert) Zone 3 =45 CSC A Tbl. R301.2(2) 3 i Loadings I• 1st Floor 2nd Floor -Attic Roof Deck -------- ---------- ------------ ---------- -------- -------=----------- LIVE LOAD 1 40. 30 10 30 60 ---------- ----------- --=------- -----'--- ---=--- -=------------- DEAD LOADS 1 12 . 12 7 8 7 " - Misc: 1 2"x 8" Joists, LVL Beams & 2"x611/8" Rafters DESIGN TOTAL 1 55 45 20 40 70 : w/ round 1 w/ 5% on DL Tbl. A-3.4 NET UPLIFT = (10' to 30") - .6(Rf+Cl) _ lb/sq ft -350 per fin ft W/ C&C - low slope (-45) - .6 x (20) = -33 lb/sq ft -396 per fin It for MWFRS (-22) - .6 x (15) = -13 lb/sq ft -169 per linft 2 : P82-FRW-7 I GENERAL DESCRIPTION Beatrice Bunker, AIA 508-540-6577 8th ed. +; P10-39 Narrative: 1st Floor Dining/Kitchen Addition to Ekisting ---------- 1-1/2 Story Houe w/ Attached 2 Car Garage Location: SCHMID, 31 Old Shore Road, Cotuit, MA DESIGN ANALYSIS: _ - -- -_— a--.- --C — --- — P - --- `-" -04 --F-—.---� Wood Frame Const. Manual. l-2 Family hp 3; Prescri tive Method w/ EXP C Rafters; 211x 8" KD SPF @ 16" o/c w/ Roof Beam Tbl. 3.26C & Footnotes 6 EXP C Adjustments _ (1716+1519")/2 x .98 = Span of 1613" > 1610 , OK by Table Ceiling Joist; 211x 8" KD SPF @ 16" o/c w/ Strongback Tbl. 3.25E for Attics w/ Storage ' = 1613" > Spans of 61611, 1116" & 1610" OK by Table , Rafter Uplift; 21'x 10" @ 16" o/c @ Rear Wall (Tbl. A-3.4 >8 ft to corner) _ -396 lb & @ 49 lb/toenail Nn = 8 nails NG not enough room Therefore add Simpson H2.5A Clips OK by Mfg. Table Rafter Uplift; 2"x 8" @ 16" o/c @ Ridge Beam (Tbl. A-3.4 <8' ft to corner)- -246 lb & @ 49 lb/toenail Nn = 5 nails OK for Nailing Therefore add Simpson H2.5A Clips. OK by Mfg. Table Rafter/Ceiling Joist Lap; m = 3.5/12 (Tbl. 3.9A) ' 10 ea 16d Cmn x 1.2 = 12 ea 16d Box nails OK by Table or 5 ea 311. Timber-Lok screws OK by Mfg. Outside Corner Shearwalls; Sides of Wing - W & L'eff = 1610" Tbl. A-3.17A & B (Ekp ,C) for Wind Perp & Parallel to Ridge KEY Elevation (Exposure Face) & Level (Location) Wind to Ridge Orientation; Parallel .or.Perpendicular A End Wall'; Width (W ft) or Length (L ft) B EFFECTIVE Full Height Sheathing (WFCM 1&2 Tbls. A-3.17A or B) C Wall Height Adjustment (H/8)' D Wall Height E Effective Sheathing Panel Length (H/3.5) F WFCM Tbl. 3.17D Adjustment for Types of Construction G Adjusted Minimum Required Length of Full Height Sheathing H Available Length of Effective Full Height Sheathing KEY Wing-Side Wall(Roof,Cell 81 Fir). KEY Wing-Rear Wall(Roof,Cell 81 Fir) Wind Parallel to Main Ridge Wind Perpendicular to Ridge A End Wall(W) 16.0 ft Side Wall(L). 16.0 ft B Min.Eff Len. 6.1 ft (from Tbl A-3.1713) Min.Eff Len. 8.1 ft (from Tbl A-3.17A) C Wall Adj 1.06 H18 Wall Adj 1.06 H/8 D Wall Height 8.5 ft Wall Height 8.5 ft E Eff.Panel 29.1 in Eff.Panel 29.1 in F Tbl.3-170 Adj[ 0.74) (from Tbl 3.17D)' Tbl.3-17D Adj�00 none G Adj.Eff Len 4.8 ft Adj.Eff Len 8.6 ft H Avail Eff Len 5.0 ft Avail Eff Len 10.5 ft Notes: Stanarr-h arwall; 1/2" CDX w/ 8d ring-shank @ 6" o/c and solid blocked seams w/ 1/2" GWB/plasterboard on 'inside . SW-2 Increased Shearwall; 1/2" CDX w/ 8d ring-shank @ 4" o/c on and solid blocked seams w/ GWB/plasterboard on inside T. VARNUMPLBROOK G� MECHANICAL v+ No. 30690 zvut, 'zo 3 GENERAL DESCRIPTION Beatrice Bunker; AIA 508-540-6577 8th ed] P10-39. Narrative: 1st Floor Dining/Kitchen Addition to Existing ---------- 1-1/2 Story Houe w/ Attached 2 Car Garage Location: SCHMID, 31 Old Shore Road, Cotuit;'MA DESIGN ANALYSIS: ; ;Engineered Design (IAW Para 5301.1.3) for Ridge Beams & Floor Joists Flush Roof Paired Beams -`2 ea 1.75"x 14" 1.9E MicroLam LVL ~ Wul = (30+10+10)x 16.5'/2 + 20 = 435 lb/lf ' 1 Span; 15'6" Wul(—ax) = 698 lbs, •,_ ' DEFinax = .68" (w/ 85%) DEFact .5111e OK by i-Level® Tbl. Flush Wall Header - Applied 1.75"x 14" 1.9E MicroLam LVL Wul = (40+15)x 12.51/2 + 120 + 10 = 485 lb/lf 1 Span; 81611 Wul(mmax). = ,968 lbs' " DEFinax = .38". (w/ 85%). DEFact _ .27" '.OK by i-Level® FORTE Columns;' 4"x 4" #2 D-Fir w/ Fc(ll) = 1,725 PSI;'-E'= 1.6x 10(6)~PSI Pend @ Post = 3,480 lbs- Leff = 8101' `w/o blocking " f'c(ll)req = 286 PSI L/d = 27.4 :. - old NDS Zone'III F'c(ll)allow = 638 PSI, @ Cd = 1.0 OK by design Garage Built-up Beam Assembly; 8WF17 (5th ed.). & WT4xl2 bottom welded Wul = (30+15)x 23!/2 + 25 = 545 lb/lf '_ 1 Span; 25'0" Mmax = 42,580 ft-lb Sreq = 23.5 in^3 & Savail -= 23.8 in^3 using F'b ='21.7 ksi DEFinax 1.04" (w/ 85%)' DEFact = .91" down '' OK EnerCalcv ECO.ts Columns; 4"x 4" #2 D-Fir w/ Fc(11)° = 1,725 PSI; E = 1.6x 10(6) PSI Pend @ Post = 6,815 lbs Leff = 8'0" w/o blocking f'c(ll)req'= 556 PSI, ; L/d 27.4 old NDS Zone III• F'c(ll)allow = 638 PSI @ Cd 1.0 ' .,. •OK by design 5/8"x 16" Anchor Bolts paired w/ 1/2"x 811; New Construction. -Use Tbls. A-3.2B & C for guidelines. OK for combined 48" o/c maximum spacing w/ dedicated corner bolts t OK by Tables: ` T. VA 'NUM ' PHILBAOOK _ vMECHANICAL No. 30690 . SSIONAI E z . •Svu� z.� 3 r T.Vannum Philbrook, P.E. Title: SCHMID Addition/Alterations Job#P10-39 Philbrook Engineering Dsgnr: Date: 9:14AM, 7 JUN 13 107 Beach Street,Dennis,MA Description:Existing Garage Beam Remove Post 8 Reinforce 508-385-8682(o) 508-364-1301 (c) r Scope: Existing 8WF17 w/T4x9 Project No: P welded to bottom Rev: 580006 User:KW-0600325,Ver 5.8.0,1-Dec-2003 Built-Up Sectiori Properties Page 1. (C)1983-2003 ENERCALC Engineering Software multi9.em:General Jobs Description P10-39: SCHMID Garage Beam Steel Shapes #1: Name WF8x17 Angle 0 deg Depth. 8.0000 in bo( 56.4000 in4 Location of Centroid from Datum Width 5.2500 in lyy 6.7200 in4 Xcg 0.000 in Ycg 0.000 in a Area 5.0000 in2 Xbar 2.625 in Ybar„ 4.000 in #2: Name WT4x12 Angle 180 deg Depth 3.9700 in, 1xx 3.5300 in4 Location of Centroid from Datum Width 6.5000 lyy 9.1400 in4 Xcg 0.000 in Ycg -7.175 in Area 3.5400 in2 Xbar 3.250 in Ybar 3.275 in Summary Total Area 8.5400 in2 Ixx 166.629 in4 ' r xx 4.4172 in lyy, 15.860 in4 r yy 1.3628 in X cg Dist. 0.0000 in Edge Distances from CG... Y cg Dist. 2.9742 in +X 13.2500 in S left 4.8800 in3 -X 3.2500 in S right 4.8800 in3 +Y 6.9742 in _ S top 23.8922 in3 -Y :4.8958 in S bottom• 34.0349 in3 f Philbrook Eng.&Const. Datum 107 Beach Street Center of Gravity Dennis,MA 02638 atum Datum JL enter of Gravity Center of Gravity Y . S1AGCM V3��b X \hrr 4 12' 4y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,a. .. ./�11 O' WO Map Parcel Application# v l Health Division Date Issued Conservation Division I Application Fee Planning Dept. 'Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis P �' Project Street Address Village sy Owner ISCA 121 ef Address Telephone Permit Request Square feet: 1st floor: existing�__-.,-_proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �J 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 594 • �� Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: l/ct Full 8/crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 12, new Half: existing new Number of Bedrooms: existing �ew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ®'Gas ❑Oil ❑ Electric ❑ Other Central Air: OlKs ❑ No Fireplaces: Existing Je -New Existing wood/coal stove: ❑Yes 12 No Detached garage4existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: Vxisting. ❑ new size _Shed: ❑ existing ❑ new size — Other: cry Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use Co i-n APPLICANT INFORMATION (BUILDER OR HOMEOWNER) /b,b Name Telephone Number27 n Address License� . o # a*,1 l� Home Improvement Contractor# /���`y Worker's Compensation # cif f 0 ALL CONSTRUCTION DEBRIS ESU TING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ��' F 1 ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED 'T r ..MAP/PARCEL NO. ._. 's ADDRESS VILLAGE' OWNER DATE OF INSPECTION: .-FOUNDATION' FRAME �_� ��°/c c Xarti � INSULATION...] FIREPLACE ELECTRICAL: ROUGH FINAL ti PLUMBING: ROUGH FINAL GAS x `' - ROUGH QC S - =''' FINAL w td :FINAL BUILDING '*4. _DATE CLOSED OUT . ' ASSOCIATION PLAN NO. 4 The Commonwealth of Massachusetts ^( I Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Bus iness/0 rganizatio n/Indiv i dual): l ) / Address: Ito tt City/State/Zip: ��L� � Phone #: ®' Z' AVI u an employer? Check the appropriate box: Type of project(required): 1. m a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2. El am a sole.proprietor or partner- listed on the attached sheet. # 7, ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp, insurance' 5. El We are a corporation and its required.) officers have exercised their 10,❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp,insurance required.] 13,❑Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensa 'on insurance for my employees. Below is the policy and job site ,information. Id. V M Insurance Company Name: A � Policy#..or Self-ins. Lie'. #: �� �� Expiration Date: / Jbb Site Address:. — City/State/Zip: Attach a copy of the workers' compensation policy declaration,page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c: 152 can lead to the imposition of criminal penalties of a fine up to$.1,500.06 and/or one-year imprisonment, as well as civil penalties in the form of 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 Elie at. and za. s of perjury that the information provided above y' true ynd correct. Signature: Date ` Phone M 7-V Offlcial use only. Do not write in this area, to be completed by city or town official City or Town:. Permit/L.icense# Issuing Authority(circle one): 1. Board of Health 2. Building Department�3. City/Town Clerk 4..Electrical Inspector 5, Plumbing Inspector 6. Other Infoarmation and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as "an individual, partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." t MGL chapter,,152, §25C(6)also states that every state or local licensing agency shall withhold he issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptabla,evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,-by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications, in any given year, need only submit one affidavit indicating current policy information (if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a calla The Department's address, telephone and fax number: ' The Commonwealth of Massachusetts Department of Industrial Accidents' Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 r-- WORKERS COMPENSATIQN AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company Burlington, Massachusetts Nccl NO ao95s (800) 876-2765 POLICY NO. I WCC 5006114UI2010 ITEM PRIOR NO. I WCC 5006114012009 1. The Insured Michael Deluga dba Village Craft Building&Remodeling Mailing Address: 568 Santuit Road Cotuit MA 02635 (No. Street Town or City County State Zip Code ® Individual ❑ Partnership ❑ Corporation ❑ Other FEIN 04-3182146 Other workplaces not shown above: 2. The policy period is froml2/23/2010 to 12/23/2011 12:01 a.m.standard time 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 $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 10 0,000. each employee C. Other States Insurance: COVERAGE REPLACED BY ENDORSEMENT WC 20 0306 A 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$too Estimated No. Total Annual of Annual Remuneration Remuneration Premium INTRA ' 355380 SEE EXTENSION OF INFORMATION PAGE Minimum premium$ 500.00 Total Estimated Annual Premium $ 2,924.00 As indicated,interim adjustments of premium shall be made: Deposit Premium $ 3,099.00 ® Annually ❑ Semi Annually ❑ Quarterly . ❑ Monthly MA Assessment Chg. $2,577.35 x 6.8000% $175.00 This policy,including all endorsements,is hereby countersigned by 10/25/2010 Authorized Signature Date GOV GOV KIND PLACINGI CLAIM I NAME ISAFETY STATE CLASS AUDIT OFFICE I OFFICE_I CHECK I GROUP Malcolm&Parsons Insurance MA 5645 7 504. Agency Inc g Y WC 00 00 01 A(11-88) 6 Freeman Street-P O Box 527 Includes copyrighted material of the National Council on Compensation Insurance, Stoughton,MA 02072 used with its permission. r T r ti Town of Barnstable Regulatory Services t LLH.NSrAST E Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 Prop'erty Owner Must Complete and Sign This Section If Using A Builder I L �� • as Owner of the subject.property hereb authorize r Y ,i l.� to act on my behalf, m all matters relative to work authorized by this building permit application for old (Address of rob) Signature of Owner D L& M{ Tat Name If Property Owner is applying for permit pleas e complete the Home owners'License Exemption Form on the reverse side. Town of Barnstable j-rt ray Regulatory Services Thomas F. Geiler,Director . � ' Building Division PrAFD 'i a Tom Perry, Building Commissioner 200 Mairi.Street,_Hyanais, MA 02601 Rwuv.t o w n.b a r ns to b I e_m a.us Office: 508-862-403 8 Fax: 508-790-6230 I30AEOWNER LICEi\'SE EXEMPTION Please Print DATE: JOB LOCATION: . number strcct 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 dwellinZs 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. DEk71<MON OF WteMOwNER Persons)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 constrgcts more than one home in a two-year period shall not be considered a botneowar-r. Such w"homeoner"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/sbe understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. SignatLrc of Homcowncr.- Approval of Building Official Note: Thrce-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOhsEO WNER'S EXEMPTION .The Code states that "Any bomcowner performing work for which a building permit is required shay be exempt from the provisions Of this section.(Section 109.1.1 -Licensing of construction Supcntisors);provided tha t if the homeowner engages a pason(s)for hirz to do such wofk, that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they art zuurning the responsibilities of a supervisor(see Appendix Q, Rules&Rc6ladons for Licensing Construction Supervisors,Section 2.15) This lack of awarmcss 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 Supervisar. The homeowner acting as Superrisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her rtsponsibilitics,many communities require,as part of the permit application, that the homeowner certify that hclshe understands the responnbilitics of a Supervisor. On the last page of this issue is a form currcnt)y used by several towns. You may cart t amend and adopt such a fonn/ccrtifieation for use in your community: r � ` PHILBROOK ENGINEERING & 107 BEACH STREET ., CONSTRUCTION + DENNIS, MA 02638 . . . CO NS 1T R U C 1T I O N 1-508-385-8682 ENGINEERING DESIGN • CONSTRUCTION INSPECTIONS • BUILDING, ALTERATIONS & RENOVATIONS BUILDING REMODHJNG Date: 26 February 2011 To: Mr.Paul Roma Building Inspector—Town of Barnstable From: T.Varnum Philbrook,P.E. RE: SCHMID Residence, 31 Old Shore Road,Cotuit,MA Dear Paul: I am providing you some back-up information on the design approach I took in tackling this job. For the dormer roofs and support components I used the WFCM 1&2 Family manual—specifically Clip.3 by Prescriptive. Method w/the Exposure C modifications. I applied Engineered Design to the Versa-Lam Ls.and solid posts as allowed by Para. 5301.1.3. All of this work is 2"d VL story construction w/in an i existmg:2".d story. There were no changes to the lateral frame resistance and no changes to the height or width(aspect)rations. Vertically the new dormers remain below the overall height and projections . .� g P J z l remain unchanged. 1 r I am continuing w/this narrative format in hopes it helps w/understanding a particular the job. As always µ tharil�you"andrplease call me w/any questions or comments you might have. Respectfiilly, VARN PHILBROOK,P.E. d; j� 0f4R:v,�,r 1 encl;Design Submittal Packet w/SK-I extract T,. VAR`, tvp 1 PHILBROOK f ENGINEERING FIELD REPORTIWORKSHEET ! Project No: lf Q)0 3y 107 BEACH STREET t C I, fit. DENNIS.-M1102B38_. - I.__......JhG et _N Oe.-.. ._..__.-__.—� -___ .. - — —1•SOB38S8802 GENERAL DESCRIPTION Beatrice Bunker, AIA 508-540-6577 P10=39 Narrative: Upsize/Add Dormers to Existing 2nd Floor for ------ 1-1/2 Story Houe Remodel w/in Existing. Dimensions Location: SCHMID, 31 Old Shore Road, Cotuit, MA Construction: 21'x 411/611 @ 1611 o.c. Platform Frame w/ Concrete ------------- Foundation and Stick-built Wood Framed Floors/Roof SPECIAL CONSIDERATIONS Of AM Use Group(s) : R-4 (1 Family Residence) /CyG6' NUM in Construction Type: 5B (unprotected) see separation below P, VAB� ROOK ------------------ o MECHANICAL u'I "cov Misc or Comments: o Plan Review, -Note Sizing & Check Site Layouts " No 30690 ------------------ r FSSIONAL DESIGN CONSIDERATION, Soil Data: - Site Plan or Boring Log,available: •.NO ---------- Preparer of plan or log: Direct Observation: YES, P95-46 (Haseck) �. from CC Atlas - Qmp; Gravelly-Sand, Pebbles 4� Description: - z USCS = SP SBC Class = _-8-_ Specifics: Br(allow) _2,400 lb/sq ft —w/ 20% allowable width increase Fire Data: 1 hr Separations between Private Garage and Residence ------ including walls & ceiling Loads SBC Location #/sq ft Dur Note/Code 1st Floor 40 1.0 Tbl. 5301.5 2nd Floor 30 1.0 Tbl. 5301.5 Attic 10 1.0 Non-Storage Partitions: 2x4/6 12 1.0 Bear/Non-Bear WFCM 1&2 Family - Chp 3;�Prescriptive Method for Snow Snow - m = 1.5/12 30 1.15 Tbl. 5301.2(5) WFCM 1&2 Family Chp_3; Prescriptive Method for'C&C and MWFR_S_UON _ Wind= - Speed = 110 MPH EXP = C �Tbl: 5301.2(4) Height & Exposure Coef. = 1.24 Tb1. 5301.2(3), Roof Pitch > 0" to 10 Mrh = 17 ft Dormer - 2 Story Ref Pres (Horiz) Zone 4 = -25 MWFRS Tbl. 5301.2(2) Ref Pres (Horiz) Zone 5 = -35 ' C&C Tbl. 5301.2(2) Ref Pres (Vert) Zone 1 = -25 MWFRS Tbl. 5301.2(2) Ref Pres (Vert) Zone 3 = -50 C&C Tbl. 5301.2(2) Loadings I lst Floor 2nd Floor Attic Roof Deck LIVE LOAD ► 40 30 10 30 60 DEAD LOADS I 12 12 7 8 7 Misc: 121'x 811 Joists, 21lx6"/811-or LSL Rafters DESIGN TOTAL I 55 45 20 40 70 w/ round I w/ .5% on DI. Thl. A-3.4 NET UPLIFT-= (10' to 30".) - .6(Rf+Cl) = lb/sq ft -273 per fin ft w/ C&C for slopes (-50) .6 x (15) 41 lb/sq ft -300 per linft for MWFRS (-25) - .6 x (15) -16 lb/sq ft -117 per lin ft P82-FRW-7 ' PHILBROOK _ Pit) :31 I ENGINEERING ),' FIELD REPORTMORKSHEET Project No i, ,ol6EACHSTREET Of oEr,Nis.ruoze3e !GENERAL DESCRIPTION Beatrice Bunker, AIA 508-540-6577 �7th ed P10-39 Narrative: Upsize/Add Dormers to Existing 2nd Floor for ---------- 1-1/2 Story Houe Remodel w/in Existing.Dimensions - '" Location: SCHMID, 31 Old Shore Road, Cotuit, MA DESIGN ANALYSIS: OF a0q - - . —.. Wood Fram-e Const.- - Manual 1-_2 Family Chp 3; Prescriptive Method w/ EXP C _�-T.,VARNUM _ g PHILBROOK Rafters; 211x 6" KD SPF @ 16" o/c w/ Roof Beam v MECHANICA Tbl. 3.26C & Footnotes & EXP C Adjustments No. 30E90 u = 111311 x .87 x .80 = 71911 = Span of 71911 OK by Table .off, �Nc Ceiling Joist; 211x 6" KD SPF @ 16" o/c w/ 'Roof Beam D `s NAL E� �r^ Tbl. 3.25A for Attics w/o Storage f� trr 16'11" > Span of 7'9" OK by ,Table Z� T�.V?z Rafter Uplift; 2"x 6" @ 16" o/c @ O/S Wall (Tb1. A-3.4.<8 ft to corner) -300 lb & @ 31 lb/toenail Nn = 9 nails NG not enough room Y,. Therefore add Simpson H2.5A Clips OK by Mfg. Table Rafter Uplift; 211x 8" @ 16" o/c @ Ridge Beam (Tbl. A-3.4 <8 ft to, corner) '�a = -382 lb & @ 31 lb/toenail Nn = 13 nails NG not enough room 5 Hang w/ Simpson LUS28 face mount hangers OK by Mfg. Table z Jack Studs; none, headers run continuous end.to end' of dormers King Studs; 211x 4" KD SPF (Tbl. 3.23C note 1) PER side For 510" Opening 2 ea w/ Tbl. 3.23D x 2 sides OK by Mfg. Table- Dormer Shearwalls; Sides of New Windows - Sidewall'Length = 13.5' Tbl. A-3.17B (EXP C) for Wind Parallel to Ridge Roof & Ceiling; Min. L = 3.5 .ft w/ note 2, H = 61.10" & weff = 2311 Provided Length = 3.7 ft OK by Table Engineered Design ,(IAW Para. 5301.1.3) for Ridge Beams & Floor Joists Headers; 2 ea 1.7511x 5.5" 1.9E Micro-Lam or 2.0E Versa-Lam LVLs . Wul = (40+20)x 81/2 + 10 = 250 lb/lf Openings to 510" opening WOK by Mfg: Table Headers; 2/211x 8" w/ 1/2" CDX. Fb = 930 PSI & E 1.0x 10(6) 'PSI Wul = 85 lb/lf & Pts = 51/2 x 250 = 625 lb @ 2.0' & 7.0' 1 Span; 910" Mmax , 1,835 ft-lb DEFinax = .32" w/ 85% DEFact = .27" OK by, EnerCalc®; Long Ridge Beams; 2 ea 1.7511x 16" 1.9E Micro-Lam or 2.0E Versa-Lam LVLs Wul = (35+15)x 221/2 + 15 = 565 lb/lf 1 Span; 2210" c-c Mmax = 34,185 ft-lb - DEFinax = 1.1" w/o 85% DEFact = 1.26" NG, add break post Columns; 411x 4" #2 Doug-Fir w/ Fc(ll) 1,555 PSI; E = 1.2x 10(6) PSI Pend @ Post = 7,460 lbs Leff = 710" w/o blocking f'c(ll)req = 610 PSI L/d = 24.0 old NDS Zone III F'c(ll)allow = 719 PSI @ Cd 1.15 OK by design DESIGN NOTES - Referenced to Plans (separate cover) & SK-1 (attached) : #1 Attach truncated 211x 8" rafters w/ Simpson LUS28 face mount hanger. Cut 1-1/2" seat cut into bottoms of rafters #2 Attach 3.511x 16" ZVL ridge beam to post points w/ pairs of Simpson LSTA15 strap ties #3 Install solid wall blocking between studs to provide toe-nailing support for truncated 211x 8" rafters P82-FRW-7 I : Philbrook Eng. &Const. 107 Beach Street Dennis, MA 02636 t�10-3� 5K• - EN R21?-I'!.E�i-To..1'(ATati._EX,,,QPP�6IDE•' � �� � S � Lo.NT•R.VOBE�BOOF IN 6r.9YJ,TEM1,..�VF.i; - �" � 5/$GDX..T4G'PI�IwO:n..6,Hs�iNe�OVEe - 2xG yqM bIHPSO►I }42.6 lA•I%@I(ovOG iFT ,. � 4 6•X7,WALL.`#'Lk9260 H6A'PSILAEpI'�.' xsj." 9L la �r w Z. O 7�6 cl4 Jols`re l4'ep T G1lf�5TAgLTgN..5x 2elh NEW f- T.s.Fit.DB QQyy � a KA,&E J `W(ZIMPSoM� :GO�i :J O ,$?b FITS.INSTALL 'a SI HPSON JAI Sr F•' O n°`o - 6hGk4 GERM;.Cy r 3�12"x1!o LVL,cut roFIT, 'fa NEW HHAD _I. 2. ? i ENTiIZfi NtPTH OF HMI (zoj f -1o,:ITN 4XA•#1 FI/Z m 3. 3, �[?OST9 AT ENV.SOLID B{:OGIA'f0 SATE 9�ELOVJ, Cosap cgu.SMWf-IN PL�cE IN5ULA-r^j \\ EX15TG DORhem p 9 LU m , Z: \ ,i - � {(3.�I''/}"c S/z"LVL-GOM'. H6oaElE END OF .�\ _ 12. l po¢ne�ro rsNn voµr Ea TErI° EX15T fr 6F1�Ro0N — � � ! .3�17.'GLOZED LOLL SPDAY IN PI.A!£INSULh'71eN• S 1" —96,x14TGr 2x8'S C 14.'0:4• � `� -4r- � d Zx6 Ilz"YL. hvjVp#EOVE-Ex,.. 2 j 5 0 P>GLOOR 1 6 AP-W--TO EXTe LWr4- z N'AU- &N u 111 boTH-Gvn-n "n .. E1(15T'& R✓F/(LOOP R-F-WND _ 1 ul to QL lu- _Exlht'G_�I TGH EIJ � S � ENO GfiA.N6rEh� (NO GFtANyEg) `� Z O ro.M,?ON,9WTS 6ND 64 N...D1T.10'NS II G �r;: vERIFI.Eo. wr STwc-rukAl. eN&we;E2.,AND 1- S A9ClHI-rP-61- UPON Ple.LD IN6,F5CTION SEEIN6t m — A-A -A-3. pj(Ih•1'l.N6r GONDIT�ONS• qs. y Z 4 H S T.Varrlum Philbrook, P.E. Title: Job# PHILBROOK Engineering Dsgnr. Date: 1:46PM, 26 FEB 11 107 Beach Street Description Dennis, MA 02638 Scope 1-508-385-8682 Rev: 580004 User:Kw-0600325,Ver5.8.0,1-Dec-2003 General Timber Beam Page 1 (c)1983-2003 ENERCALC Engineering Software Description P10-39; Floor Level Header Beams Ger,*al Information Code Ref: 1997/2001 NDS,2000/2003 IBC,2003 NFPA 5000. Base allowables are user defined Section Name 2-2x8 Center Span 9.00 ft . . . .Lu 0.00 ft Beam Width 3.000 in Left Cantilever ft . . . ::Lu 0.00 ft Beam Depth 7.250 in Right Cantilever ft . . . . .Lu 0.00 ft Member Type Sawn Spruce-Pine-Fir(South), No.2 Fb Base Allow 775.0 psi Load Dur.Factor 1.150 Fv Allow 135.0 psi Beam End Fixity Pin-Pin Fc Allow 335.0 psi E 1,100.0 ksi Full Length Uniform Loads Center DL 85.00#/ft LL #/ft Left Cantilever DL #/ft. LL #/ft Right Cantilever DL #/ft LL #/ft Point Loads Dead Load 200.0 Ibs 200.0 Ibs Ibs Ibs Ibs Ibs Ibs Live Load 425.0 Ibs 425.0 Ibs Ibs Ibs Ibs Ibs Ibs ...distance 2.000 ft 7.000 ft 0.000 ft 0.000 ft 0.000 ft 0.000 ft 0.000ft Summary Beam Design OK Span=9.00ft,Beam Width=3.000in x Depth=7.25in,Ends are Pin-Pin Max Stress Ratio 0.901 Maximum Moment 2.1 k-n Maximum Shear* 1.5 1.4 k Allowable 2.3 k-ft Allowable 3.4 k. Max. Positive Moment 2.11 k-ft at 4.500 ft Shear: @ Left 1.01 k Max. Negative Moment 0.00 k-ft at 9.000 ft @ Right 1.01 k Max @ Left Support 0.00 k=ft Camber: @ Left 0.000 in Max @ Right Support 0.00 k-ft @ Center 0.273 in Max.Mallow 2.34 Reactions... @ Right 0.000in fb 963.71 psi fv 66.11 psi Left DL 0.58 k Max 1.01 k Fb 1,069.50 psi Fv 155.25 psi Right DL 0.58 k Max 1.01 k Deflections Center Span... Dead Load Total Load Left Cantilever... Dead Load Total Load Deflection -0.182 in -0.315 in Deflection 0.000 in 0.000 in ...Location 4.500 ft . 4.500 ft ...Length/Deft 0.0 0.0 ...Length/Deft 593.0 343.21 Right Cantilever... Camber(using 1.5*D.L.DO)_ Deflection 0.000 in 0.000 in @ Center 0.273 in .,.Length/Deft 0.0 0.0 @ Left 0.000 in @ Right 0.000 in i r T.Vprnum Philbrook, P.E. Title Job# PHILBROOK Engineering Dsgnr: Date: 2:OOPM, 26 FEB 11 107 Beach Street Description Dennis, MA 02638 Scope 1-508-385-8682 Rev: 580004 User:KW-0600325,Ver5.8.0,1-Dec-2003 . General Timber Beam Page 1 (c)1983-2003 ENERCALC Engineering Software Description 1310-39; Long Ridge Beam General Information Code Ref: 1997/2001 NDS,20W20013 IBC,2003 NFPA 5000. Base allowables are user defined Section Name VersaLam1.75x16 Center Span 22.00 ft . . . .Lu 0.06 ft Beam Width 3.500 in Left Cantilever ft . . .Lu 0.00 ft Beam Depth 16.000 in Right Cantilever- ft 1 . . . .Lu 0.00 it Member Type Manuf/So.Pine Boise Cascade,Versa Lam 2800 Fb Fb Base Allow 2,800.0 psi Load Dur.Factor 1.150 Fv Allow 190.0 psi Beam End Fixity Pin-Pin Fc Allow 900.0 psi E 2,000.0 ksi Full Length Uniform Loads Center DL 180.00#/ft LL 385.00 #/ft Left Cantilever DL #/ft LL #/ft Right Cantilever DL #/ft, LL #/ft Summary Beam Design OK Span=22.00ft,Beam Width=3.500in x Depth=16.in,Ends are Pin-Pin Max Stress Ratio 0.853 ; 1 Maximum Moment 34.2 k-ft Maximum Shear* 1.5 8.2 k Allowable 40.1 k-ft Allowable. 12.2 k Max.Positive Moment 34.18 k-ft at 11.000 ft Shear: @ Left 6.21 k Max.Negative Moment 0.00k-ft at 0.000 ft @ Right 6.21 k Max @ Left Support 0.00 k-ft Camber: @ Left 0.000 in Max @ Right Support 0.00 k-ft @ Center 0.596 in Max.M allow 40.07 Reactions... @ Right 0.000 in fb 2,746.81 psi fv 146.50 psi Left DL 1.98 k Max 6.21 k Fb 3,220.00 psi Fv 218.50 psi Right DL 1.98 k Max 6.21 k Deflections Center Span... Dead Load ' Total Load Left Cantilever... Dead Load Total Load Deflection -0.397 in -1.246 in Deflection . 0.000 in 0.000 in ...Location 11.000 ft`. 11.000 ft ...Length/Deft 0.0 0.0 ...Length/Deft 664.9 211.82 Right Cantilever... Camber(using 1.5"D.L.Defl) Deflection 0.000 in 0.000 in @ Center 0.596 in ...Length/Deft 0.0 0.0 @ Left 0.000 in @ Right 0.000 in Stress Calcs Bending Analysis Ck 20.212 Le 0.000 ft Sxx 149.333 in3 Area 56.000 in2 Cf 1.000 Rb 0.000 Cl 0.000 Max Moment Sxx Read Allowable fb @ Center 34.18 k-ft 127.39 in3 3,220.06 psi @Left Support 0.00 k-ft 0.00 in3 3,220.00 psi i @ Right Support 0:00 k-ft 0.00 in3 3,220.00 psi Shear Analysis @ Left Support @ Right Support Design Shear 8.20 k 8.20 k Area Required 37.546 in2 37.546 in2 Fv:Allowable 218.50 psi 218.50 psi Bearing @ Supports Max.Left Reaction 6.21 k Bearing Length Req'd 1.973 in ' Max. Right Reaction 6.21 k. Bearing Length Req'd 1.973 in N6 woow I21 k'I v.IJ. exl07li 441 k1 Pot ro5r t5e1,f,W calm HEADER• BeAN• Q (2�5Ikesom USIA IE V4,; ET Nl cvL Hf NA ED DWIL Y i D - - _ _. � � Moe�o°'•wsncw�s.ra I Doolt LAKoUT o HAToti FaclS'I(. � o I D T G Poo. tT o INSTALL.-A•tuusrAeLe 7 1 � EMDVE EJC16 SL (� 1 ..�.K PA NRER - .-I- ExIsr0. owe� Ex.Pxlt I ..i•FIEWINCn .oP Tb BOTrprL, ,. 1�I `I BATH .N - N6NILOGATfoN....... I Q q r{ d yl I Fwnew. 1 FxoVIDE NEW PRAYS - I — �, •i �I ,al'. """P� u) teEv>w+ N FliL WIDEK WALL DeM.- 6 — N H>B!.,4EP ecAn .� NY -I FI4Y to Whu3 CFoRrrte 6UII.D LR•ILIGb.( 1 1 1. I I ' SYN INNNE6 Dook.Loewrto NS. " (oVftflZAnt):' I I I I I I i•llll\ 9�1' 1 1 m FI A»ove �\ ` .q.pu, HEW cL05ET/: I p I. I 1 le \. I3 GReh51t-* RH• XX ui tx14T,&Roof - I __�I_ _ 1 ��•.F.Rn0µ 9LD an.) i _ . W.INP00 6�H.e�uLE ; z BBL°W 1 - ,' Ex JRPocY•�f Coos.txnrsir -ro -- (R iL dRIu.E LAYocrr sore ELEV) Q D0os1•. WOP bA1010E15 _ V Q. MAI?VIN°.Woot, r-F-AY!E� a. Z .d. 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X1hTIGc .FoYGR EXIh.1Gi �17GHEN - s � (NO G1iANf,Eh� (No GHA1,14SI.) _ i �wlr F_t V + • Z 3 '� •. ,• �5T¢LtvFNRRL.GoMPON EWTS ¢ END GdNDITiPNs „ st - '(f �E..VEWIFiED 13Y STRNI�fuRAl FN60NBE2 A'N7 ' ARaHI'rEG'f UPON PIELD IN5PE6TION. SECING U_ \ � .' EXIh•rl-N6r CONDITIONS• -. . _ , * - - - - S u1 I `' Town of Barnstable *Permit# EZpira 6 r nas f Lnue NAMl � : Regulatory Services Fee %63 $ Tbomas F.Geller Director Building Division PRESS PERMIT Tom Perry, Building Commissioner X- 200 Main Street,.Hyannis,MA 02601 S E P 2 1 2005 Office: 508-862-4038 Fax, 508-790-6230 TOWN OF BARNSTABLB l EXPRESS PERMIT APPLICATION: - RESIDENTIAL ONLY NotYand w1awUf Red X Press rmpnnt -. apfparcel Number 03 073 operty Address Residential Value ofWo*rk �j. �0'b • Minimum fee of•$25.00 for work under$6000.00 wner's.Name&Address ,Zrzh le /i ontractor's_Na a JOLT GOwd'T r�L� e�A g_Tel Number ;ome:Improvemcnt.Contractor License#(if applicable) �nstruc#on ervisor's License# if applicable) 3Worian&s Compensation Insurance Check one: •. 0 I am a sole proprietor PIhe Homeownerhave Worker's Comp ensationn Insurance esurance Company Naane y Y/ /�&1/ . VorkmaWs Cori Policy# 69 C74 ad VI?re '4V e Y ®V "opy of Insurance Compliance Certificate must be on file. )ermit Request(check box) El"Re-roof(stripping old sbmgles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44)- *Where required: Issuance of this,perrdt does not exempt compliance with other town department regulations,i.e.Historic,C-b servation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ome Improy Contractors License is required. r Signature QForsns:expmtrg Revise063004 g ti r B7. oard of.Buildiug Regulatioua and(Standards µ ,- License or reg�sirahon lid fou tndrist >ytsoghy H011AE WM ,.k tMENT CONTRACTOR before the'expiration date.'J T otin:d return to r Re tstrutto tbard of Re ulations and'Standards 9 � 134286 g . xpira�on j�2z/2005 One Ashburton Place Rm 1301 . ' B stop Ma.02108' ye �P RLT CONST.IN&`4 6j, USONi SIDING&ROOFIN RONNIE TAYLO �tf9 Fi 8°JANSEBAS7IAN #4' h SANDWICH,;IZA 02653 p t �. :. Admm�stratdr : otvaltc ;w�tkoutsi ature f Island Siding and Roofing 10 43 h a dkvisiomof RL7Conantction,Inc. f September 6, 2005 Steven J. Bishopric ` 1112 Main St. . Osterville, Ma. 02655 We are pleased to submit the following specifications and estimates for reroofing: Strip existing asphalt shingles and flashings. Inspect and re-nail sheathing and trim as needed. Install new copper drip edge, valley flashing, and pipe flashings. Install 3 ft. ice and water barrier to eaves, valleys, and interwoven with flashing on skylites and chimneys. Install Typar 30 roof underlayment to remaining roof. Install 18"red cedar perfections (Pressure Treated)using only stainless steel fasteners. Install 1X6 red cedar ridge caps to all ridges. Clean up and haul away all debris to landfill. We hereby propose to furnish materials and labor—complete in accordance with the above specification, for the sum of. f V f" FOURTEEN THOUSAND NINE HUNDRED DOLLARS $44,4*.00 Payment to be made as follows. Payment in full due upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control. Owners to carry fire,wind damage and other necessary insurance. RLT Construction,Inc.carries General Liability and Workers Compensation Insurance. Certificates of Insurance provided upon request. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work ecified. Payment will be made as outlined above. Date of Acceptance: —/ �Q g' Signature {, Start Date: Signature :r n 8 jan Sebastian Drive, Unit 14 •Sandwich, Massachusetts 02563 Telephone 508.42a5243 and 508.833.5249 • Fax 508.833.0098 • Emi[caperoofer@caperoofer.com oFtMEr� Town of Barnstable Expires 6 months from js ale �T Regulatory Services Fee BARtvsTAst.e, : Thomas F.Geiler,Director 9 MASS. 1659. Building Division TFO Ir1A't A Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508462-4038 Fax: 508-790-62 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY w Not Valid without Red X-Press Imprint Map/parcel Number � � �� Q 11�• Property Address j� (/id :5 46i-e— F-1 Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address >j 1 '� �%_"bi'�� t✓ "• Contractor's Name M1 � �i�Rt Telephone Number U Home Improvement Contractor License#(if applicable) _ Y pp=ss PERMIT ❑Workman's Compensation Insurance Check one: 0EC _. 7 200.9 ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BA RNSTA�L� have Worker's Compensation Insurance f Insurance Company Name ,11�556z'j � r. Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) �] Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re- ide Ile V Replacement Windows/door slider Value L;/A (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:bu ildingpermits/express Revise112807 . The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street t - Boston MA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl a Name (Business/Organization/Individual): AA — _41,, - �J r Address: � � 1-2 1 .V City/St /Zip: C�%/ ✓ �� Phone #: al AVI an employer? Check th appropriate box: Type of project(required): 1. am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l LE] Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp, insurance required.] 1 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:'} 'v 'fit✓ v Policy# or Self-ins.Lic.#: Expiration Date: Job Site Address: N4 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ins and pe s of perjury that the'information provided above is trice and orrect. Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: - r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition,an applicant that must-submit multiple permit/license applications in any given year, need only.submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia �OFIME, y Town of Barnstable. Regulatory Services • BARNSTA$LE, r MASS. $ Thomas F.Geller,.Director 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 r Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the P subject property . J P , rtY hereby authorize to act on my behalf, in all.matters relative to.work authorized by this building permit application for: , (/ �O� l�l V Y'e,- Address of Job) Signa e of Own r Date Leo 5 ► Print Name Q:FORMS:OWNERPERMISSION } , b� (Massachusetts- Depar-iment of Public Safety. . Board of Building Regulations and Standards Co nstruction,Supervisor License License: CS 50234 Restric ed t4 00� h ! MICHAEL`DELUGAf F 568 SANTl IT AD COTUIT, MA,02635 :3 Expiration: 7/9/2010 C:'onuiiissiuncr Tr#: 30003 92. Board of Building Regulal.lnns and Standai'ils HOR1 IMPROVEMENT CONTRACTOR Registration: 105548 ^EiXp ration'=7j17/2010 Tr# 27197J.,' Type DBA' VILLAGE CRAFT 1,U, fL¢ING ODELIi G � $5ANTUITRD. CQ�UIT, MA02G35 Administrator. Licctise orrregistration valid for indn►dul use only,-'.. bcCo a the expiration date.' If foul d returnrto a N t - C Board of Building Regulations and Standards I One Ashburton Place Rm 1301 Boston,Ala.02108 -------------- Not valid without signature $�;urn cgis do t 11 d for wd►�', ulVC-only c the crpu atiodate?'tPfourid retur Board of.BuildingyRe.gulations and Standards °'e Onc'AsIb ton`Place"R n,1301 r ;. bstou,Nh.02108 _._..,Not valid�,i,!4out signahurc �ACORP. CERTIFICATE OF, LIABILITY INSURANCE DATE(M1WCDtYYYY)-o2/i4/zoos Fk^.DUrER (781)344-3200 FAX (7 B1)344-1425 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Malcolm & Parsons Ins. Agcy. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6 Freeman St. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box S27 Stoughton, MA 02072 INSURERS AFFORDING COVERAGE NAIC q nisuRw Mic`ciae'T( Deluga INSURERA! Associated Eneployer.s Insurance }I-- DBA: Village Craft Ruilding & Remodeling INSURER B: 568 Santuit Road INSURFRc Cotuit, MA 02635 INSURERD: ---i—'------'-- -----' INSURER E: COVERAGES THE POLICES OF INSURANCE USTEC BELOW HA',-BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNDICAT_D.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANti CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFOR]ED BY TH:POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LPAITS SHOW J ilAY HAVE dEEN REDUCED BY PAIDCLAIMS. ItISR �' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION" LIMITS TR _�1JTE: I GENERAL LIAB.LITY EAOG OCCURRENCE 5 001AMERCI.AL GENERAL LIABILITY DAWA.3E TO RENTED ` S ! CLAIMS MADE OC:UP. - MEG EXP(Arq one persenl S I - PERSOrSAL&AD'✓INJURY ------------ GENERAL AGGREGATE S GEN L AGGREGATE L'I^I'AFPL.I_S 'ER PPCDJCTS-Z;0l4P/0P.A.Gr .5PRO _ dECT AUTOIA66iLE UADLITY COta3iN[-IFiIP13LcLIMIT S AN'(ALTO (Ea accidnrit) I —_- ALL OW NEC AUTOS - - ' EODILYIhiJUP.Y SCHEDULED M_TOS (Per peg wn) F:iRE j AUTCS BOpLY IN.IURY S I NON-O✓✓NEC A;.TOS (Per uc dent; I - - _ ?ROPERTY CAMAGF. S - - per aeedeh) GARAGE LIABILITY AJTOOWI'-EA4CCIDE?IT S EA ACC 8 OTHER THAN --_ AIJTOOALr AGG S FXC9S8fU1l FRELLA LIAEILIT� EACH OCCURRENCE S j I OCCUR r7 CLAIMS PA..DE � AGGREGATE--- S —,--_ . 5 DEDuCTSLE — > -- RETENTION S .. -----"--- $ - — WORKERSCOMPENSATIONAND 1h_C500611401-2008 12/23/2009 12/23/2009 w YTATUIAT• "c'' EM2LOYFR3'LIA51Ur`Y - — — — — E L EA' -AC:DENT S 100 100 /S, I gyvFHC•PRIETGR/PARTtiER,'EXECUT;'dE � _ -- _ -..._ 7 OFF EWNENBEP,EXCLUDE07 F. DISEASE-EA EMPLOYEE S 1001000 :t Yca cewice under S-ECIAL PROVISIONS re�w _ E.L D1,=ASE.PO!n'Y Li N'!T 5 SOU OQO OTHEF? - i "DESCRIPTION QF OPERATIONS I LOCATIONS I VEHICLES I EX(WSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - 'Residential cort:actrjr- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN N0110E TO THE CERTIFICATE HOLDER NAMED TOTHE LEF* B:;T FAILURE TO MAIL SUCH NOTCE SHALL IMPOSE NO OBLIGATION OR LIABILITY Insured's Copy OFAN�KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Evidence of Insurance AJTHCRIZ=DREPRESENTATIVE Irving Parsons ACORD 26(2001108) OACORD CORPORATION 1888 X-PRE_SS PERMIT ' �Il�T� EC 2 2008 Town of Barnstable *Permit# '_6021 Expirr F BARNSTABi.ERegulatory Services Fee 6.nior Osfrom issue date BARNsrABLE, : Thomas F. Geiler,Director 9 MASS. 039• A,� Building Division rED MP't Tom Perry,CBO, BWlding Commissioner 200 Main Street,Hyannis,MA 02601 www..town.barnstabl8.ma.us Office: 508-862-4038 Fax: 508-790=6230 EXPRESS PERMIT APPLICATION -—RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address c [Residential Value of Work , Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address kr_ Contractor's Name /`!�. y Telephone Number Home Improvement Contractor License#(if applicable) V "I ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name. IAi ziK vi r� Workman's Comp.Policy# �✓t--C �� l� �� Copy of Insurance Compliance Certificate must be on file. Permit Request(check boxy , [�rRe-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping: Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. r SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 4.i Board lding Itc9ulal.011s and Standards 1 UY . . License or registration valid for individul:use only \} HOM�IMPROVEMENT CONTRACTOR ! ,�t before the expiration date. If found return to: Registration;. 105548 _ Board of Building Regulations gand Standards: Expiration 7/l7j2010 Tr# 271g7.J. One Ashburton 'Place Rm 1301 4 FT, DBA` - Boston,Ma.02109- VILLAGE,CRAFT18UILbING&RyIODELING - MPSael D°1uga ' � J/ `68 SANTUIT COT UIT;`NIA 02635 Administrator Not valid without signature j '� iYla�sachusettx- Dep:u-tment of Public Safcrh Board of 136ildin, Rc:rulati()ns Arid Standards . Constructiorl Supervisor License License: CS 50234 Restricted to: 00 MICHAEL.DELUGA 568 SANTUIT RD - COTUIT, MA 02635 Expiration.- 7/9/2010 - ('ununissiuner Board of Building Rc uhtinns , and g Standards HOMIMROVEMENT CONTRACTOR License-or registration valid for individul use only Registration a before the expiration date.,If found return to: y 105548 Board of Building f Expi�a o 7J17/2010 Tr# 27197Ji Regulations and Standards One Ashburton Place Rm 1301 t^� Ma.0210$ rl- Ype DBA Boston PILLAGE CRAFTt3UILb NGa&R {ODELIl`[; - M ael ANT .�u a - . ��. UIT RD. ` I COUIT,MA 02fi35 =� Administrator ---- -- _ Not valid without signature — c Restricted to: .00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current-'edition of the Massachusetts_State Building Code is cause for revocation of this license., Refer to:,. WWW.Mass.Gov/DPS 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + 600 Washington Street ' Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information P ease Print Legibly Name(Business/Organization/Individual): IZ& Address: S Y!414 rrll i City/State/Zip: I- Phone.#: �� —a`74�9 Aru an employer?Check he appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. New construction 2:❑ I am a sole proprietor or partner- listed on the attached sheet. 7. .❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp..insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.Y�Koof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] 'Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their worker;'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: i / � ✓' dv e 1� Policy#or Self-ins.Lic. #: Expiration Date: / 0 ` C Job Site Address: 61 �� y ��e City/State/Zip: 44 A Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveraLye verification. I do hereby certify under th pa' and pen lt'es perjury that the information provided above is t ue and rrect. Si afore: Date: Phone#: /aS Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r, Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more ---ofthe-foregoing-e— ng�-m—a-joint enteipifse;and=uic-lu-dag--the leg al=representgtive--of�dec ased�mpio�er,-or_the _.::. receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-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 Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address„telephone and fax number: The:Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass_gov/dia SHEr, Town of Barnstable • r Regulatory Services a F BARNSfARM r MASS. g, Thomas F.Geiler,Director E16;.. 16 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 Using ABuilder as Owner of the subject property J hereby authorize ) to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) f Signature of Owner Date Leo S6 M1 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION Town of Barnstable �OpTHE! � Regulatory Services t BA SrAB Thomas F.Geiler,Director MAss. Building Division lEn►u.�t Tom Perry,Building Commissioner vrwvv.town.barnstabie.ma.us Office: 508-862-4038 Fax: 508-790-6230 HO)EOWNER 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,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 responsf 3ilities 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 fonn/certifi cation.for use in your community. Q:forms:homcexempt tbEC_0_.2007(THl!%-14.12----b_IALCOIM & NRSIDNS•-INSURANCE (FAXi17813441925. - P:-00?/008 - :- ACO-RDT,,_CERTIFICATE OF LIABILITY INSURANCE t • D4TE(MWDDIYYYY) } 12%20/2007 t PRgDuc:a (7S1}3441-3200 FAX (7 B1)344-1425 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION _ Malcolm & Parsons Ins. Agcy. Inc. ONLYAN1)CON FERS NO RIGHTS UPON THE CERTIFICATE, T 6 Freeman St. HOLDER,THIS CERTIFICATE DOES NOT AMEND, EXTEND OR •_ P.:O. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Box 527 T,Y Stoughton, M4 02072 INSURERS AFFORDING COVERAGE NSUAED MTc ae Ue u a Enplo ers NAIC�. ��• g - �� ' � INSURER.At ASSOCIated y Insurances DBA: Village Craft Building & Remodeling INSURER B: r S68 Santuit Road -- ---- � ' ___—•—___ INSURES C' Cotuit, MA 02635 +NsukEaD — --_-- - — -r---_ -. INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HA1?BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD!NDICATzo.NOTWITHSTANDING ANY REOUMEMENT,TERM OR CONDITION OF ANN CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFOROcD BY TH:POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH f POLICIES.AGGREGATE LIMTS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. _ II+SR TYPE OF INSURANCE - POLICY EFFECTIVE POLICY EXPIRATION - LIMITS - ? ROLICY NUMBER _ . GENERAL LIAB!UTV EAQ4,C CURRENCE 5. COMMERCIAL GENERAL LABILITY DANAGETCRENTED S j ) — C VIAIS MA.D_ D OCC'JP, M1IEO EXP(Ar,7 one yenunl 5 4' i _ - 4 -- - PERSONAL a ACV INJURY S. i --_ GENERALAOGREGATE 5 ' I GENLA3GSEGh TE I!IAI AP7,I:S Pi R' � - - PRO - PFLDJC'TS•GOMPIOP AGO 5 � POLICY!� •- .I AUTOMOSILE LAABILITV - + �N'f AUTO CONEANF)SINGLE LWIT (Ea - - — ALL OWNED AUTOS •- SCHEDULED A'.TOS Pepy sanjU P,Y - a - HIRED AUTCS _ Nw-OWNED AUTOS- - - BODILY INJURY - . Per act deN) - PFCPERTY DAMAGE (PeracGdcN) S 'k, 4:r GARA.GE LIABILITY a AUT00`ILY•EA aC.ICENT S s ; � ( AN r aJT o --.. _ OTHER THAN EA ncc A.:0 011;Y: EXCESSNIIBRELL4LIABILITY - - - - EA0kQC.CURRE4CE. 5 - ' OCCUR CLAIMS MADE � - AGGREGATE .. WORKERS COMPENSATIO14 AND wX5OO611401-2007 12/23/2007 12/23/2008 IT'ZY�'T I'UT s r<- �7��TATV• - I etAPLCYERS'UABIUTY , Q I aN`'PRCPRIETGRPARTNER'EF.'cCUT1VE E.L.EACF ACCC£NT S IOO,OOO c iFICEWrAEMBER EXCLUDED? l yea *5C6t&onde. - - -.L.D'SEASE•EA EMPLD'YE S 1OO,-00 y S✓ECdAL PROVISIONS belo,, OTHER E L.DGEA.SE-POLICY UNIT 5 $OO,OO " CESCRpTIOtI QF UP BRaT10N51 LOCATIONS I VEHICLES I EX(:USIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS es i d e n t 1•,�;�-•.con t ractnr• d e F° CERTIFICATE HG!_DER CANCEL ATI ------------------------- SHOULD,ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BF.FURE THE' .h EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL ' DAYS WRITTEN NOTICE"TO THE CERTIFICATE HOLDER NAMED TO THE LEFT 'a •aUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY . YnSUred'S Copy OF ANC'KIVD'JPON THE I��SURER.ITS AGENTSORREPRF.SENTATIVES.' a ` - Evidence Of insurance �AVTHORLZ;�DREPRE5ENTATvin Parsons " ACORD 25(2001J08) (DACORD CORPORATION.1988 - d :. y l , '^Assessor's office(1st Floor): r� SEFnC SYSTEM M L1 M" Assessor's map and lot number � INSbALLED IN CC-MK�_ o�' To a �` Board of Health(3rd floor): r o Sewage Permit number f C( ® WITH MTLE e _ E �U'AONMEIPJ AL C _ BARS 1 Engineering Department(3rd floor): 3 rasa House number � `SOWN REGULd il .�... ,639. ®� Definitive Plan Approved by Planning Board 19 'fp YPY d` APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR ; } APPLICATION FOR PERMIT TO /,,=iV Aw4 co rC TYPE OF CONSTRUCTION. 11r ZiE�� . 19 '9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 3 f�1 a cS' lak v�'� �� l �r�c V,,4 Proposed Use 9-i'i /.47 vr+ 4?-4-el V^e - Zoning District l Fire District L:/ al / Name of Owner�'7: ��®.y �ait/;zfLL Address /� /3c% - i Name of Builder .A. Address �J �irrlr% - � Name of Architect Address Number of Rooms Foundation "o' e.rie-.? y`e Exterior ¢/.� _ Roofing . 6��'�2 A/ Floors Interior Ake Heating &a:v e Plumbing Fireplace /V®Ne Approximate Cost 4-d er U 0 i Area 7-2 Diagram of Lot and Building with Dimensions Fee 43-01 j • jos ,^ f1 f k. f ' i �a o p v�ed �cic�i To�v .j r ' R OCCUPANCTPERMITS REQUIRED FOR NEW DWELLINGS Y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg the above construction ` 1 _ Name i Construction Sloervisor's License ds�a S MORRILL, H. LEIGHTON t ' tNo 33528 'Permit For Build Add t— on Single Family Dwelling , t Location 31 Old Shore Road Cotuit Owner H. Leighton Morri 1 1 Type of Construction Frame Plot Lot Permit Granted February 23 , 19 90 Date of Inspection /"' 19 _ Date Completed G f 19 ITIC 4 �a 1 t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 : Parcel073 Application#' Health Division Date Issued r Conservation Division Application Fee Tax Collector Permit Fee f e Treasurer j Planning.Dept. . Date Definitive Plan Approved by Planning Board CA Ci Historic-OKH Preservation/Hyannis Project Street Address n M IM Village Owner s � ;s Z I c r d Address Telephone 0 ) 9 7/ Permit Request an �} r' 3(2 Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation go d Construction Type wmg( Lot Size Grandfathered: U Yes 0 No If yes, attach supporting documentation. J Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure ;yY e Historic House: ❑Yes L(No On Old King's Highway: ❑Yes i No fi Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) IN. of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing - new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑.existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use _ — Proposed Use BUILDER INFORMATION Name ) Telephone Number Yd Address 4r� License# 000,�3 &�aJ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION D RIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ' FOR OFFICIAL USE ONLY AP"PLICATION4 DATE1SSUED � MAP/PARCEL N0. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION k FRAME INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 'FINAL GAS: ROUGH FINAL FINAL BUILDING Flu! '} DATE CLOSED OUT ASSOCIATION PLAN NO. i s The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 .� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information RleaseFrint Legibly Name(Business/Organization/Individual): _ Address: City/State/Zip: Phone ir,�- 5 4 LZ =_r Are an employer?Check the appropriate box: Type of projec(required): 1. I am a employer with 4. ❑ I am a general contractor and I — * have hired the sub-contractors 6. ❑New cons ction -- employees(full and/or part-tim.e). listed on the attached sheet. 7. ❑ Remodelin na F 2.El am a sole proprietor or partner- M 7i ship and have no employees These sub-contractors have g, ❑ Demolitio working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL -12:❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees'. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state 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'compensatiop insurance for my employees. Below is the policy and job site information. .0401 r Insurance Company Name: ° fie Policy#or Self-ins.Lic. #: t��' Expiration Date: Job Site Address: 31 ��1 �� . City/State/Zip: . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the i nd pe i of perjury that the information provided above is rue and r4o,rrect Si afore: 7 Date:, Phone#: ��— ���� Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector' 6.Other Contact Person: Phone#: + r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. -In addition,an applicant that must submit multiple permitflicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address",the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: 4 The Commonwealth of Massachusetts . Department of Industrial Accidents. Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-72.7-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/dia oFtMEr Town of Barnstable t Regulatory Services + BARNSTABLE, y MASS. $ Thomas F.Geiler,Director �p 16;9• rFo •�" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 50$ 790-6230 00 tr Property Owner-Must Complete and Sign This Section , If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 3f Yf 1V Signature of Uwner Date A'3 � 1 Print Name '. If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION Town of Barnstable SHE 1p� Regulatory Services y BARNSTABI.E, Thomas F.Geiler�Director * + 9 MASS. qp 1639• p,0 Building Division lfn � 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, that he/she shall be responsible for all such work performed under the:building permit. (Section 109.1.1) r 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 1 requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt I� LV� SG�/ ..J kb fi tr3 t t {11 { iS1 14 P 11 ;6 9 .� JI� t6r� ,bJ SZ1 �i� - 3 a 57 �th 5 ma- I � f 7 K y Lev 5�.1�►� � ._ 5 �3I ojd s�6*,� d� � 573 17/3 9/1-o7759 ,�, ty) ki DEC-20- 007(THU) 14: 12 MALCOIM ,&. PARSONS INSURANCE (FAX) 17813441425 P. 007/008 �----._...-- -'---- DATE(MMiDDIY'fYY) - C, ERT',IFICATE OF LIABILITY INSURANCE ' 12/20/2007 PRODUCER (78,1)344'-3200 FAX (7 B1)344-1425 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Malcolm & Parsons' Ins': Agcy. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ' d. Freetiian St. HOLDER,THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 527 Stoughton, MA 02072 INSURERS AFFORDING COVERAGE NAIL# INSURED MIChaef Ue uga� INSURER A: Associated Employers Insurance DBA-: Village Craft Building & Remodeling INSURERS. 568 Santuit Road INSURES C' ----� — -- —---- « Cotuit, MA 02635. INsuREFo- ^----------- —�.- INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HA1 :BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD!NDICATED.NOTWITHSTANDING ANY REOUIREMENT,'TERM OR CONDITION OF ANti CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY TH:POLICIES DESCRIBED HERJN IS SUBJECT TOALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH. - POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY?AID CLAIMS. IfISR CD'' TYPE OF INSURANCE - POLIC'Y NUMBER - POLICY EFFECTIVE POLICY EXPIRATY N LIMITS GENERAL':LIABIL:TY� ,g -- ' EnCr OCCURREP,CE $ 1. xPAMERClS'_GE`JERAL L-4BILITY DAiJA.;E TC RENTED S PaFbncFc p",.r ,a i _ — OLAINIS MADEC� h1ED EXP(Ar;one;ersCrii $ ----- . PERSONAL 8 AC'a INJURv S - __�-- GENERAL AGGREGATE S - GEN L AGGREGATE LIMI-APPLIES PER -- ---' -- - - PRO PRCCJC'TS- AGO, S - j POLICY .ECT ElLCC - •_ - — -� '- . AUTOMOBILE LIABILITY -- ANY AUT7 -. !Ea acc dent ..- ALL OWNED AUTOS SCHEOULcDALTOS ,'Perpersen; ----...._ .—.----- ----- --— - I j NIREO A:J-CS � ----... ._— I BODILY INJURY�-- I:)OV-OWNED wl,T��5 t?e,accdw) - PROPERTY DAMAGE S - I ... (PeracetieraJ _ GARAGE LIABILITY AU7001LY-EA ACCIDENT $ THAN EA ACC S_ ---.-- EXCESSfUMBRELLA LIABILITY ?T EACH pG..I,1RR_NCc OCCUR CLAIMS MACE :M j Rc crgl ON _------�_..--- $ a i WORKERS COMPENSATIO14 AND N':C500611401-2DO7 12/23/2007 12/23/2008 V.,C3ATU. JT,,. - ENIPI CYERS'LIABILITY _ Y:JIVI I ;: --- - ,Q "i"PRCPRIETOPoPA.RTNERt-XECI'TiVE .. E.l.E'ACI-ACC CENT S -- 100,000 I C*,I-cR'NEN'It EP,EXCLUDEC? E.L.DuEA5t-.A EMPLOYEE 100,000 If Yes oescrite u,,,ie' �( vEC;IAL PRCVSICr;S below 1( - E.L.DSEASE POLICY 1-WIT S 500,00 - OTHER 4 [CESCRIPTIOrt 9F OPERATIONS I LOCATIONS I VEHICLES I EX(!USIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.-THE ISSUING INSURER WILL ENDEAVOR TO MAIL - DAYS WRITTEN NOTICE TO THE-,EP.TIFICATE HOLDER NAMED TOTHE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Insured's Copy OFANYKIVD'JPONTHEINSUREF.ITS.43ENT_SORREPRF,SENTATIVES. Evidence of Insurance f AUTHOR2=DREPRESENTATIVE Irving Parsons ACORO 25(2001108) ( ACORD CORPORATION 1989 c BOAIQ�BUILDIN '1tEGUI�ATfONS k license .GQN9�RUCTIO ;SURfSOR dr + )NUmberS� 050234 r' 81, h a== 09 62 a r 7 .Tr no 29204 e MICHAEL ZELUG � 568 SANTUIT,RD. oo ;' Commissiorior' N;, Y Expiration 11 /2008.., 'T, ! �.. �,�-E CR AFT ��I R G&R-�i� DEL(NG yga f= TOWN OF BARNSTABLE �17rr }tiitig Board of Appeals �,_ �' Z, c� rr7 Henry L. Deed duly recorded in the Property O«•ner r� C Same County Registry of Deeds in WIQIC .._.O __.........._._......_.........._....__..._.............__...___... ._._.............. __._ Page __._........_.....-, Petitioner District of the Land Court Certificate No. ............ l ( .. ..... Book _ =f rage.'-7- -appeal No. _.....198:9:-93........... FACTS and DECISION Henry L. MorriZZ Petitioner .._..---._.........__. ---------------------- --- filed petition on .august 20�:_. 1J4 requesting a variance-permit for premises at __..31 OZd Shore Road in the village . . ................._....._.._.__.._._ (street) Cotuit of ..._.._..___.......------___---------_._-----�___-, adjoining prcnuses of .........._ (see attached list) Locus under consideration: Barnstable Assessor's Afap no. _., 5..._._._.-.._.........._ _� lot no. _73 Petition for Special.Permit ❑ Application for Variance: . ❑ made under Sec. ................................................_.........__ ,of the Town of. Barnstable Zoning by-laws and Sec. ._.._. __.-._-_..........._..........................................__._..._.......... Chapter,40 A., Mass. Gen. Laws for the purpose of _._kddition of—Lj� ! bedrvot» .!i� ��!_��,:�'h_(.n�` 'G n �n 10 guest house. Locusis presently zoned in......._._._._............._..............................................__................................... ......_.�_._...._.._... -...__.__._....-- Notice of this hearing was given by mail, hostage prepaid, to all persons deemed affected and by publishing inB(u"'nstable Patriot newspape,r published in Toxvn of Barnstable a copy of wbich is attached to the record of these proceedings filed with Town Clerk. 4 A public bearing by the Board of Appeals of the Town of Barnstable ..was lield at the Town Office Building, Hyannis, Mass., at. __..-s:00i\i. I'.iii,_S _.? ,.r- 6' 191,9 upon said petition under Zoning by-laws, Present,at the hearing were the following menthem: w. Richard L. Boy Lake P. Lo l l.r Chairman Dexter BZi.ss Rrnt rT�,»:=;:; 1.1__--•-_._..._._ ->sx.Y. "''a 1..s�"`. .+easN,._..::'g.=�� 'xVdiv7�"'.'e'-'•,,4'Yi1av�.W�i.w'a�:i:-:.lPun;:au:s>Wax.v-ur.�amwwuwunrced« _ ..�......�.-,-,......»....._ — __ �._..___. - PARTIES IN INTIEREST September 6, 1984 . 1984-93 HENRY L. MORRILL GLORIA M. TUR\IER 61 St. Clair Ave. , Apt 608, ribronto, Ontario, Canada M4V 2Y8 C[-IARLES D. RADDEN 111 Forbes Rd. , Westwood 02090 DORO= A. STOOKEY 32 Godair Pk Box G, Hinsdale, Ill 60521 JOHN M. GRANT, Jr.. 15 Old Shore Rd. , Cotuit GENIO R. ARCIPRETE Springfield'Inst. for Savings Box 3034, Springfield 01100 HENRY C. CHURBUCK 854 Main St. , Cotuit FEDERATED CHURCH PARSONAGE Main Street, Hyannis FRANK E. SULLIVAN 17 Ramsey Drive, Surmit, N.J. 07901 MARION SAWYER c/o RAYMOND H. GOODAL.E P.O. Box 32, Cotuit RAYIAM H. GOODALE P.O. Box 32, Cotuit MAMON SAWYER P.O. Box 277, Cotuit. DIANE E. GEYSER Box 287 756 Main St. , Cotuit - TOWN OF BARNSTABLE BOARD OF APPEALS NOTICE OF PUBLIC HEARING UNDER ZONING BY-LAWS To all persons deemed interested or affected by the Board of Appeals, under j Sec. 11 of Chap. 40A of General Laws of the Commonwealth of Massachusetts and all amendments thereto,you are hereby notified that: APPEALNO. 1984.91 STEVEN WHITE 7:30 PM Steven White has appealed a decision of the Building Inspector and petitions for a Special Permit to allow a family apartment at 36 Hallett's Ln., Marston Mills in an RF zoning district. A PUBLIC HEARING WILL BE HELD ON THIS PETITION AT 7:30 PM APPEAL NO.1984-92 ROBERT BYRNE 7:45 PM Robert B)Tne has appealed to the Zoning Board of Appeals and petitions for a Special Permit to construct a 25 X 30 addition, plus a two-car garage at 2956 Falmouth Rd., Osterville in an RF zoning district. A PUBLIC HEARING WILL BE HELD ON THIS PL:1'ITION AT 7AS PM APPEAL NO. 1984-83 HENRY L.MORRILL 8:00 PM Henry L. Morrill has appealed a decision of the Building Inspector and petI- tions for a Special Pcrmit to construct two bedrooms and a 3' wide deck to an existing boathouse/guest house at 31 Old Shore Road, Cotuit in an RF zoning district. A PUBLIC HEARING WILL BE HELD ON THIS PETITION AT 8:00 PM APPEAL NO.19S4-95 EDWARD&CAROLYN CONNOLLY 8:15 PM Edward&Carolyn Connolly have appealed a decision of the Building Inspec- --tor and petition for a:Variance to allow sn.undersized lot to be utilized as a buildable lot at 15 Sturbridge Drive,Ostenille in an RC zoning district. A PUBLIC HEARING WILL BE HELD ON THIS PETITION AT 8:15 PM i APPEAL NO. 1984-97 THE 429 SOUTH ST.ASSOCIATION 8:30 PM The 429 South St., Association has appealed a decision of the Building In- spector and petitions for a Comprehensive Pcrmit to allow the razing of the ex. isting Visiting Nurse's Building and construction of one 24-unit structure at 429 South St., Hyannis in an RB zoning district. A PUBLIC HEARING WILL BE HELD ON THIS PETITION AT 8:30 PM These hearings will be held in the HEARING ROOM, TOWN HALL,367 MAIN STREET, HYANNIS on THURSDAY EVENING, September 6, 1984. You are invited to be present. By order of the Zoning Board of Appcals. RICHARD L. BOY Chairman Barnstable Patriot August 23, 30, 1984 Y At the coo-Insion of the hearing, the Board took said petition unifier advisement. A -%•icw of the us was made by the Beard. , LJ 1984-93 Appeal 1\'0. __...__ .__...._.._.........._.._ Page of September 13,. On __...._ _�._�..___._._...._ ___..._...---............___._................ 19 8............_. The Board of Appeals found Attorney John Alger represented the petitioner who is seeking a Special Permit to allow the construction of an addition of 22 x 23'6" plus a 3' L shaped deck to a boathouse/guest cottage to accommodate fumi.Zy members only, Zoeated .at 31 Old Shore Road, Cotuit in an NF zoning district. Said parcel is 2.25 acres. The petitioner acquired the property in 1963 a??d in 1971 he was granted a building permit to construct; the boathouse/guest cottage on the premises. Since 1971,. this has been consistently used by members of the fcnniZy. The addition will be comprised of two bedroonz5and a deck, as shown on the plans submitted at the filing. A Notice of Intent has been f'i Zcd with the Conservation Commission, a copy of which is submitted with the filing. This addition is mereZy an extension of the non-conforming use - would not change the area. This would be an accessory residence use to the principal residence. The Board voted unanimously to grant the Special Permit with the restriction that it never be rented,to be for the petitioner's fcvniZy use only. To grant this application would fulfill the spirit and intent of the by-Zaws without substantial detriment to the public good and without detriment to the neighborhood. _ . a. Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify- that tivent.y (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled pe.tit.ion and that. no appeal of said decision has been filed in the office of the Town Clerk. Sinned and Sealed this day of ................0<T.:O-W-.vZ................ 19 ��.__.�_ under the pains and penalties of perjury. Distribution:— Property Owner ............. ............... ............._....___._.___ Town Clerk L'oard of Appeals Applicant Town of Barnstable Persons interested Building Inspector Public Information By Board of Appeals Chairman 4� x > W ^ o z ` o rb En la O ' w �G G ���'-EMcVrL�• �c�r � O ^'i '� � D Z3 + s7 arc p i 2,3 o rrl En �\ N 5• 22. 3 -® .. ., • f-��it/ 5��.�- � � M,a ifs ' ,,���• -- :d r - i, ,a::.^r.��,dt-.:5�""EI"-v.•.'M*:.!'t :..f�✓+n�".'F3.-4P"'k,�ir". Gar'�,cis `#.d;;3r1r-:IG��-Mv� {;�::e1gs 'hrt'yv�7'�d"'AY?'°�.tia'X'��Yr"t'.+""..,s'r,aL�.$'� �^�,?�•Mvi^'a4'�7j+.Fw't:`!`�..y" ..„�t.f .- .��'t� � 'Assessor's office(1st Floor): , •��� rj �aUl .Assessor's map and lot number ©--�� / i , o`TNe lob♦� Board of Health 3rd floor): • w � Sewage Permit number Engineering Department(3rd floor): . �J� ' rwea House number , �� XYf �' y °o,�+a}9.a\®�' Definitive Plan Approved by Planning Board 19 o rAY APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-:00 P.M.only - 'TOWN OF - BARNSTABLE BULLDING ` INSPECTOR - APPLICATION FOR PERMIT TO wit/!%>4 A,ra r TYPE OF CONSTRUCTION19 � r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the,following information: Location �' 41 n 5' a�a,� / �� / .4,11 Proposed Use Se, A7 *.I- r Af 46 a,4e e- Zoning District / Fire District �117 h Name of Owner ��'/ r, � a.c� j�/�1,5'/�! Address C7/ .a i4 R r�rl�. 5i�L n Name of Builder dC', +F"-a ra Address Name of Architect — AAddress Number of Rooms �' Foundation Exterior /. �. ., / � : ,q Roofing Floors nterior ' Heating ✓c rt:_- Plumbing /tee" Fireplace /Y,0 N?- Approximate Cost 4 - (rj 0 Area Diagram of Lot and Building with Dimensions , FeeIv t / j 317 I ,R o p 0 5 read Jd, /i, OCCUPANCY'PERMITS REQUIRED FOR NEW DWELLINGS ' r , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rega.ding the above ve construction.) r Name _ Construction Supervisor's License ,MORRILL, H. LEIGHTON A=035-073 _. 73 r No 33528 Permit For Build Addition Single. Family Dwelling Location 31 Old Shore Road Cotuit Owner H. Leighton Morrill Type of Construction Frame Plot Lot Permit Granted February 23 , 19 90 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/11 L aka . _ s Assessors map and lot number" ....... ...... THE;R.. toy Sewage Permit number Z BA"STADLE, i House number ° NAG& �p 1639 9� i. �0 MPY a TOWN OF BARNSTABLE , BUILDING HSPECTOR x APPLICATION FOR PERMIT TO I ... a.' 1.s4?.r [. /. ................................................... .....�. . TYPE OF CONSTRUCTION ....0/!:!�. ....... ............................................................................. Jul 123, 1984 , ......................19.w TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ,permit according to the following information: Location ... lX ?�(?� �� � 7 ...3 r s Propoed Use ......BOti hqLis.................................................................................................................................................. Zoning District .... : ' ......Fire District 0..€.1'.1.z t.................................................. ................. ........./................. 917 South Warson Road. ................... Name of Owner �'!/r'✓ t/..... ......../. ...0 ......Address .o.. T' 9 '�4.?.,. n.!( .a• ��?? ............................. 131 Old Post Road Name of Builder 2'.1......� Z...... .®Z'j�.........::..............Address r?C1tE'x! . .,Ay...hlf¢ac !. ..................................... 22 Depot Street Name of Architect ............................Address T1.).!X..b1a.1.'y-,... as.s,......G,2,33. ............... Number of Rooms ...2............... ..Foundation . P6..can IQ".,CAXl.cT:plo...U,e,ma.......... Exterior ......WOod...Shi.r�g e. ............................................Roofing .......AA!.halt...k?.'1�n.gr.1:eq.............................. . .... Floors Ponderes'a Pine..........................................Interior ........Dyn t!z li....................................................:. F Heating Fertr .........................................................Plumbing .....I.?©11 Fireplace ...None....................................................................Approximate. Cost .... 'aT.�,. .n.n.�?...,............ .................. --_19-----___. Area , 506SF Definitive Plan Approved by Planning Board __________'__________________ . ....�...............�........ Diagram of Lot and Buildingwith Dimensions . Fee ..... :� ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH • r' r . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .............. Construction Supervisor's License _ A=35-U73 MIBR]U, HENRY L. 27074 ADD BOATHOUSE No .............. Permit for ------------ Accessory to Dwelling . -----_--,'=--,--_-.—.—=------.- . r ' - - Location .....3I.{1Ld..Shore.'Jbad..................... . . ----.--{lzbut.---.-----------.. . ' Owner ....leO��.Ii. ..Mrrill.......................... ^ ' Irarrm . Type of Construction --------------' ^ -----.—.—.----.-------.—.----- . . . Plot ............................ Lot ................................ ' ' ^ ' October 10, 84 ' Permit Granted -------------.lA - Date of|nnpecion ------------l9 ' ' Dote Completed ...................................... / ~ Z:5 ' , . ` ~ . ^u ^ ^ - ^ ^ . . � , ^ ' ,. ° � .. � . ' . 117 3S- 073 SVsTrm MUST BE Assessor's map,and lot number: ...:....:........ 1 AtUtg._ AULED �n�y � Cr. �OF TH E r0� Sewage Permit:. number ........................ ....... ..... .... .. • . l�r-e TITLE �,� re °� • � „ ig9rS 1 j uBF�§a BAHBSTADLE, i House number ................................................. ........ ...... ` I`.� 1)t + ` *ooM63e 0 MIR h� TOWN OF BARNSTABLE BUILDING " HSPECTOR APPLICATION FOR PERMIT TO ..................?.Z.................................................... TYPE OF CONSTRUCTION ....!( l-/192 d?. :.:../..: h's rrt.. ............................................................................ Ju1�. 12a 1984 ...... ...... ............19 r l .F TO THE INSPECTOR OF BUILDINGS: } The undersigned hereby applies for a permit according to the following information: v r Location ...... . ..... &a,.., 1..Q1d...Share..Fi.d.«.. o.tu3.t.,...Adass.. Proposed Use ....:.Bo8 hpus.e................... Zoning District ....RF''..............................................................Fire District ............CCLtult...:..;..:........................................ 917 South Warson--Road Name of Ownerel�L/'.1 .....:., ,......�L��..C!^.r..,l/......Address St....sc31�3.se. Ada.....fi31`.L4............................ p� Jr��p� 131 Old Post Rmad Name of Builder The...54T0 4Y..G.Q.rP......7,/�••-•-..Adcfress C.entervilla,,...mass.....:..........:..................... 22 Depot Street Name of Architect .Q.mbbrll/smi.th...........................Address Duxbu . . Alaas. :02332• t Number of Rooms Foundation ..QTO6..07 10 t.... ..........�i.Q C.>'l3 t.G...P1Q.x'. ......:........................................................... Wood Shin les .Roofing ....:..K.spk al';...5hinglez.................. Floors Ponderosa Pine .' ......................................................................Interior ........D2';STW&11..........:............................................... ` :� None Heating 'i' .Q.G. x°�C.........................................................Plumbing .................................................................................. Fireplace None .......:.............................................:.Approximate. Cost .... 35.,I1�Q..OA.. .... . . ....................... Definitive Plan ' 3'Approved by Planning Boar! __ __________________________19________ Area (506SF.............)........ Diagram of Lot and Building with Dimensions Fee' ....., .... .. ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH • t - x t_ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabie'regarding the above construction. • q =... . ,Name ... ..... ..... , .... ............................... Construction Supervisor's License .... , n MORRILL i HENRY L. .. z No 27074.... Permit for .. csssax-y- ..................... K Location ......31 Old Shore Road; ^ ^^^"""^" "^^^^^ c may J �c .......................... ., , C" 1. G. - ,`�.J ''� �• _ . otuit _ v1 i v Ly - ............................................. ................................. Le v c L'- r C Hdnry L. Morr ll Owner ..... .... ..... ................. Type of Construction Frame .......,. Plot ............................ Lot ....................1-' ... e Pe�mif Granted ,_,.October 10I �.19 84 4 �4 Date-of. Inspection ; ° Date Completed . '�1-9. ' U 0 1 C, ? '-- to _,,- . „ i: G', %t3 � >. _ .�.•• _ ` r,- ' THE OLD HOUSE INC. - -TTk'TE RI ORS -' 696 Main Street OSTERVILLE, MASSACHUSETTS 02655 ^ , i <� I Al— T �^u�r b 1 � ?3 3 G \ V .3 Z- J /j C': i / � J r noR ADDI-r i oN �a "7- S`�M,M`N■1eR fRes�{v�je•••ace, Qk I Oa 35 i _ I i -►_ I _ ; i It r _ , , I � I s Ej. _ - I - - -- _. -J I , - I —1- __ - - ,�, e.� e COL --HO_ SE I 0 - ! _ - _... - - - -- - - 9I6 M t� - - - - -° _._.. R I L -11r1A AC. VS Ti _ 2�5 .{_ f _ - - - I illl I � illl ! il ! I � i II i III III � i I � i i � i I ! 310 CMR 10.99 `Form 2 SIG NO. DA—9 0 0 0 5 44- OF tll E Barnstable Commonwealth CityiTown 9ARISTAn • of Massachusetts ,o r�ae �� Applicant Morrill p %6;q. `� 17V;✓ '°�oaAck 01/22/90 Date Request Fled Determination of Applicability Massachusetts Wetlands Protection Act, G.L. c. 131, §40 TOWN OF BARNSTABLE BY—LAW, ARTICLE XXVII From_ Barnstable Conservation Commission __ Issuing Authority u Same (Name of person making request) (Name of property owner) 31 Old Shore Road Address Co to it, MA. 02635. Address Same This determination is issued and delivered as follows: ❑ by hand delivery to person making request on (date) by certified mail,return receipt requested on February 14 , 1990 (date) Pursuant to the authority of G.L.c. 131, §40,the Barnstable conservation r-nTmI 1;_Q7 nn has considered your request for a Determination of Applicability and its supporting documentation,,and has made the following determination(check whichever is applicable): Location:Street Address 31 Old Shore Road, Cotuit, b1A. 02635. Lot Number: 73 Map Number- 35 1. ❑ The area described below,which includes all/part of the area described in your request, is an Area Subject to Protection Under the Act.Therefore,any removing,filling, dredging or altering of that area requires the filing of a Notice of Intent. 2. C The work described below,which includes all/part of the work described in your request,is within an Area Subject to Protection Under the Act and will remove,fill,dredge or alter that area.There- fore,said work requires the filing of a Notice of Intent. Effective 11/10/89 2-1 SPECIAL CONDITIONS - NEGATIVE DETERMINATION - DA-90005 H. Leighton Morrill. 31 Old Shore Road, Cotuit, MA. 02635 Assessor's Map #35, Parcel #73 1 . ) All work on this project shall proceed by hand. 2. ) Staked haybales shall be set at the work limit to be established 5 feet to the east (marsh side) of the proposed addition, . ` 401 arzzs di -4-�ur.bed construction shall be revenetated immediately following completion of work at the site. No areas shall be left unvegetated 'or unmulched for more than 30 days. 4. ) No tree removal to accomodate the proposed addition is sanctioned by this Negative determination. 5. ) The Conservation Commission, its employees, and its agents shall have a right of entry to inspect for compliance with the provisions of this Negative Determination. � 4 3. p The work described below,which includes all/part of the work described in your request,is within the Buffer Zone as defined in the regulations,and will alter an Area Subject to Protection Under the Act.Therefore,said work requires the filing of a Notice of Intent. This Determination is negative: 1. O The area described in your request is not an Area Subject to Protection Under the Act. 2.. p The work described in your request is within an Area Subject to Protection Under the Act,but will not remove,fill,dredge,or alter that area.Therefore,said work does not require the filing of a Notice of Intent. 3. The work described in your request is within the Buffer Zone,as defined in the regulations,but will not alter an Area Subject to Protection Under the Act.Therefore,said work does not require the filing of a Notice of Intent. (SEE SPECIAL CONDITIONS) 4. O The area described in your request is Subject to Protection Under the Act,but since the work described therein meets the requirements for the following exemption,as specified in the Act and the regulations,no Notice of Intent is required: Issued by Barnstable Conservation Commission Signature(s) c3�—�— oe" This Determination must be signed by a majority of the Conservation Commission. On this 14 th day of February 19 90 ,before me personally appeared Douglas Bruce McHenry ,to me known to be the person described in,and who executed,the foregoing instrument,and acknowledged that he!she executed t e me as I /her free act and d d. October 28, 1994 . No ry Pu i My commission expires This Determination does not relieve the applicant from Complying with all other applicable federal.state or local slatuies.ordinances. by-laws or regulations.This Determination shall be valid for three years form the date of issuance. The applicant,the owner.any person aggrieved by this Determination,any owner of land abutting the land upon which the proposed work is to be cone,or any ten resioents of the city or town in which such land is located,are hereby notified of their right to reouest the Department of Environmental Protection to issue a Superseding Determination of Applicability,providing the reouest is made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form as provided in 310 CMR 10.03(7)within ten Gays from the date of issuance of this Determination.A copy of the reouest shall at the same time be sent by cenif ied mail or nand delivery to the Conservation Commission and the applicant. 2.2A L 9 D E S I G N , _ s J � Q EN GINEERING '.1 & SURVEYING N z- W U G Q 0 y www.bssdesi9 n.com, _ cHooL C Site Cotuit Design,. . e BSS D Incorporated . 8 Y'P Bay 164 Katharine Lee Bates Rd _ ' Falmouth Massachusetts 0254( Bo Y X. 5 I - 5 8 540 8805 FAX 08.548 831.. CB FND _ CB FND LOCUS MAP ' BOAT RAMP :EDGE OF BERM OLD SHORE ROAD EDGE OF BERM E y �. 79-20 30 E - CB FND r 1- f— < Z 0 _ _W _ o — 0 I r0- NC. Q 0 9xco J Q c1oVRR 0 AL AL AL 2 _ 0. 2 U v ti AL Q CONC. c� L COVER O W i SAT MARSH tiAL LL. 0 AL : UJ LEGEND.:.. o s ,� � _ a ,� W J_ PROPERTY LINE W , _ o AL a J p . BSS a F ` FLOOD ZONE W —1 . � _ m - O N o ,� O O TOP OF .COASTAL BANK � LL Q O � � N ` T MARSH�� SAL f— O � � t:n S q� I`7 ti C Z o W N � - F d J s _ Q F G D U _ O m PARCEL 74 .� O r 9 , EXISTING � � O s sEPTIc � O TANK -9� SALT MARSH Q N \ � ' W <y O alllc 3 0, y AL to 00 —` N T s�Ot Go 0pp EXISTING . ONE to F •�. _V1 STRUCTURES _N �— 258.8' . . coo � oq ZONE 15) s - , V1 1 . g w cal AL 1 — 20 LOT D date 98,700 si= EXISTING" SEPT 19 2013 HOUSE 2.26 ACRES FF—,4s6 drawn ABOVE HIGH WATER _ AL TJB EJP _ SALT MARSH NOTES: checked AL AL 1. LOCUS IDENTIFICATION: HOUSE No. 31 OLD SHORE ROAD �- job number EXISTING ''� ASSESSORS No. MAP 035 PARCEL 073 0 1 : CESSPOOLS LOT D LAND COURT PLAN 19606 A ., 13013 � 2. LOCUS, S WITHIN: revisions AL ZONING DISTRICT. RF FLOOD ZONES: V17 ELEV 15 V11 (El 9 Al ELEV` 12) & C PAVED._... � � �. � �• ..DRIVE BUILDING' CODE WIND EXPOSURE CATEGORY: B_ AL — RI REGION AL ,� , WIND—BORNE DEBRIS I DISTRICT AQUIFER ..PROTECTION OVERLAY S DOCK &..PIER OVERLAY DISTRICT 99 RESOURCE PROTECTION OVERLAY DISTRICT 20 3.3.3 � SALTWATER ESTUARY PROTECTION - m 3. OCUS IS NOT WITHIN: WATER SUPPLY 3 ONE II OF A PUBLIC W i LLHEAD` PROTECTION OVERLAY DISTRICT. - x s, ,,� ROU DWATER PROTECTION OVERLAY DISTRICT, o N M N EMI � HABITAT SAND ENDANGERED SPECIES HA _ OUNDATI �n o 4. LOT COVERAGE BY STRUCTURES.; N POLE . M FLA - :. 4 27 SF 4.58% .- EXISTING... 5 o _ m . 5. ELEVATIONS ARE BASED ON NGVD, BENCH MARK: M28 SA. z S TE S ENCH MARK: TOP OF HYDRANT ELE V _ 17.86 M WAS. DRAWN AS OUR INTERPRETATION OF 6. SFP +I� SYSTEM :.. ..EXISTING 20' .. y AND FIELD LOCATIONS . . HOU _ � IV��TALLER S SKETCH. A s SE r SAL MARS FF 28.3f co ' AL AL 13RICK A. TI PA CI m " AL AL Cf I O N I • CB FND BRICK I CERTIFY THAT THE STRUC tURE.S P TIO �. � - t3F =: ARE LOCATED ON LOT D AS . SALT MARSH • ' ' SHOWN. THOU"` � N 81 06 30. ..E 402'f ,,nc�s�a W Jr .., DISC FND O O.O PARCEL 7$ v z r+•I P FESSIONAL AND. SURVEYOR O n O g Z o r� � g DATE:: f c� 0 N M. r a GRAPHIC SCALE r- m 20 0 10 20 40 e0: y z drawing. number. ( III FEET ) a 1 inch 20 ft. B1'7-72