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HomeMy WebLinkAbout0064 PHEASANT HILL CIRCLE NE Ito Town' of Barnstable Building Department - 200 Main Street BARNWABLE, * Hyannis, MA 02601 9 MASS 163 9�- A. (508) 862-4038 Certificate of Occupancy Application Number: 201302665 CO Number: 20130092 Parcel ID: 002002006 CO Issue Date: 08/26/13 Location: 64 PHEASANT HILL CIRCLE Zoning Classification: RESIDENCE F DISTRICT Proposed Use: POTENTIALLY DEVELOPABLE LAND Village: COTUIT Gen Contractor: BAYSIDE.BUILDING, INC Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature C� Date igned OF BARNSTABLE INEBTOWN ■ SU- ■.I i ng 201302665 BARNSTABLE, * Issue Date: 05/13/13 p e rm i t.�' 9 MASS. ` �ArFO 3 A� Applicant: BAYSIDE BUILDING,INC Permit Number: .B 20131056 Proposed Use: POTENTIALLY DEVELOPABLE LAND Expiration Date: 11/10/13 Location 64 PHEASANT HILL CIRCLE Zoning District RF Permit Type: NEW SINGLE FAMILY HOME t� t , Map Parcel 002002006 Permit Fee$ 918.00 Contractor BAYSIDE BUILDING,INC Village COTUIT App Fee$ 100.00 License Num 005645 Est Construction Cost$ 180,00u, Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 2 BEDROOM,2 BATHROOM RANCH STYLE HOME WITH AND ATT CH1rAI�CARD MUST BE KEPT POSTED UNTIL FINAL CAR GARAGE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: COTUIT EQUITABLE HOUSING LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 95 INSPECTION HAS BEEN MADE. CENTERVILLE,MA 02632 Application Entered by: JL Building Permit Issued By: THIS PERMT.r CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER T O ORARILY E N ..ENCROACHMENTS ON.PUBLIC PROPERTY;.NO. -. SPECIFICALLY PERMITTED UNDER,THE BUILDING CODE,MUST BEAPPROVED BY THE JURISDICTION STREET OR ALLEY GRADES'AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.7HE ISSUANCE-OFTHIS PERMIT DOES NOT.RELEASE;THE APPLICANT'FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION(: , P RESTRICTIONS .MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). .6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. r PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). f J CARD OTHAT ISNISIBLETROWTHE STIREEVT BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS P �rQ>M o 6I� 7 2 _ i� 2 /��� . ��ra l�Ir� 2� I, 3 3Fs,,! $ �3 1 Heating Inspection Approvals Engineering Dept S- r Fire ept 2, Board of Health �RW13 _. S Duct Leakage Test Form OF RAR Customer Information: Test Conditions?(,' 1"�t16 V� 2 L?s Name: Bayside Building Date: F; 7.25� 013 Address: 1645 Falmouth Road Bayberry square Time: City: Centerville Indoor Temperatu F): State/Zip: MA 02632 Outdoor Temper�a�l�iire t.t E1 Phone: (508)775-1040 Floor Area(ft2): 1476 Email: System Airflow(cfm): 1200 Cooling Size(tons): 3 Heating Size(btu): 60,000 Building Address:(if different from above) Primary Location of Street: 64 Pheasant Hill Circle Supply Ductwork: Basement City/State: Cotuit MA 02635 Primary Location of Return Ductwork: Basement Comments: System located in basement on one zone. Duct work in cold spaces insulated with r-8 foil faced insulation all others r-6. All joints seams and connections sealed with 1580 Venture mastik tape UL#181b-fx System tested after rough install with Minneapolis duct blaster. Total Leakage Test Depress Press Outside(Leakage Test Depress Press Test Pressure: (Pa) Test Pressure: (Pa) Baseline Duct Pressure(optional): (Pa) Duct Press. Flow Ring Fan Press Duct Press. Flow Ring Fan Press Flow(cfm) Flow(cfm) (Pa) Installed (Pa) (Pa) Installed (Pa) 25 3 71 Fan Model/SN: Results: _ Outside Leakage(cfm): Fan Model/SN: Outside Leakage as% System Airflow: Results: Outside Leakage as% Total Leakage(cfm): 71 Floor Area: Total Leakage as% System Airflow: Eric Whiteley Toal Leakage as% 11 „W _ r,l eric@wvwhiteley.com Floor Area: 4.8 INC. 28 Village Landing P.O.Box 1266 w W.Chatham,MA 02669 Plumbing, Heating T 508-945-1100 Air Conditioning F 508-945-5549 Since 1952 www.wvwhiteley.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 002-. Parcel oy2- Qy(P Application U Health Division Date Issued Conservation Division Applicatio ' Planning Dept. x Permit Fee Date Definitive Plan Approved by Planning Board p s113)13 Historic - OKH _ Preservation/Hyannis Project Street Address (0 oil] r y d e_ Village (o,o&1 T Owner o 7 _ &le4 ddress &x Telephone 1� Permit Request O Z ► e owl �2 d vv c� drya r Square feet: 1 st floor:existing proposed IYVP 2nd floor: existing proposed Total new Zoning District W-1 Flood Plain Groundwater Overlay Project Valuation ��,btT0 Construction Type I Lot Size Grandfathered: ❑Yes ANo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ANo On Old King's Highway: ❑Yes 23 No Basement Type: N(Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) f L 7� Number of Baths: Full: existing new Z Half: existing new Number of Bedrooms: existing 2-new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: XGas ❑ Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing 95 New Existing wood/coal stove: ❑Yes &No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ ing ❑ w �_e Attached garage: ❑ existing J4 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ , _77 Commercial `❑Yes � No If yes, site plan review# L.J Current Use �I 6-Cav► Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name >e_ Telephone Number L Address k ✓� �� License# 0(DS_61P5,_ �Z-- Home Improvement Contractor# Worker's Compensation # b0'-7 S 40(Q2Z7— ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_�Srl (lyr Ck t --u 4f, 61 i SIGNATURE DATE 4/ J 6 I I I� il j FOR OFFICIAL USE ONLY I ' '. APPLICATION# DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER f DATE OF INSPECTION: FOUNDATION r , i FRAME 15j+6 ,rww(,COO Ws 1:1A44- .�r i ° INSULATION FIREPLACE � 1 ELECTRICAL: ROUGH FINAL +� PLUMBING: ROUGH FINAL GAS: ROUGH FINAL I ' ' FINAL BUILDING �� ..gp?-�►`` DATE CLOSED OUT ASSOCIATION PLAN NO.' - - � ` Department of Industrial Accidents b Office of Investigations ' 600 Washington Street w� Boston,M4 02111 wwv.n7ass gov1dia Workers" Compensation Insurance Affidavit: Builders/Contractors/Electricians/Flumbers Applicant Information Pease Print Lezib Name (Business/Organization/ludividual): 1� A� - , E Address: • City/StatefZip:649V 1 1vile Phone#: Are you an employer?Check the-appropriate box-- Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. L New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheer; l � ❑ 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. ❑ 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 1LE] Plumbing repairs or additions myself [No workers' comp. C. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees.'[No uTorkers' 13.0 Other COMP.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who,submit Phis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. �Contraetors 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'compensation insurance for my employees. Below is dre policy and job site information Insurance Company Name: I� Policy#or Self-ins.Lie.#:_ 0c'7`214 O (2Z7__ _ Expiration Date:II Job Site Address: City/State/Zip: C� a�, /1�1a �� 35— Attach a copy of the workers' compensation poliey 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.crimivalpenalties 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. 3e advised that a copy of this statement may be forwarded to the Office of Investigations.of the DIA for insurance coverage verification. I der hereby certify under the pains and petalties of penury that the information provided above is true&nd correct_ Signature: Date: Phone#: — Oq6 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/TwAm Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. O-ther Contact Person: Phone#: Subcontractor's Insurance 2012 GL Policy GL Policy WC Policy WC Policy Sub Contractor Effective Date Expiration Effective Date Expiration All Cape Garage Door 508-398-2757 06/01/04. 10/07/12 06/01/04 06/01/13 Baxter Nye Engineering&Surveying 508-771-7622 08/11/05 09/29/12 08/20/04 08/20/13 Campbell,William 508-790-3517 08/26/014 08/26/12 07/13/04 07/13/13 Cape Cod Marble&Granite 508-771-2900 07/01/05 07/01/13 08/16/05 08/16/13 Cape Concrete Forms 508-922-1910 06/05/07 09/29/12 12/07/07 06/08/i13 Carpet Barn Inc 508-548.14.43 01/01/06 05/01/13 01/01/05 01/01/j13 Chaves, Robert 508-362-9929 08/13/04 08/13/12 12/17/04 12/17/13 Christopher Costa&Associates, Inc. 01/22/08 08/27/12 02/06/07 05/06/13 Coy's Brook, Inc 508-394-8442 04/24/04 04/24/13 09/21/04 10/01/13 Davids Building&Remodel 508-428-3214 01/01/07 01/01/13 06/14/04 06/14/13 . Hill Construction 508-888-8154 04/29/07 04/29/12 08/14/04 08/14/13 Jeffrey Lauder 508-221.1046: 12/09/06 04/05/12 DBA-N/A Kitchen Appliance Mart 508-771-2221 08/12/04 08/12/12 01/01/05 08/12/13 - MAP Insulation 508-888-3599 10/01/07 10/01/12 10/01/07 1.0/01/13 Northern Sealcoating': 508-398-9474 10/01/07 10/01/12 04/01/07 04/01/13 Pastore Excavation Inc. 06/05/08 06/05/12 10/12/08 12/12/13 Wood Floor Specialists 508-888-3958 02/03/08 02/03/13 02/03/08 06/03/13 .. 1 c Massachusetts-Department of Public Safety Board of Building Regutations and Standards s. Copstruction Su;penisur License:CS-005645 �FTTS 40 BRIAN T DACE PO BOX 95 +� CENTERVII,LE 632 MA 02 _ ^I 4 c Exptratt�n Commissioner I - 04/19/201.4 /r - tiof eke ro�-Y : Town of Barnstable. y Regulatory Ser.v�ices �$ '$ Thomas F.Geller,Director �AjfD 1r1P��,� BuRding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Tm,W-town.b arnstab le.ma.us Office: 508-862-403 8 Fax: 508=790-6230 Property Own( r Must Complete and Sign This Section If Using ABuilder T, • k� )-/t tl -6I? - , ds Owner of the subject property hereby authorize _ e, 1hr to act on my behalf, in all matters relative to.work authorized by this 15 ijd.ing permit application for: . b e — (Address of Job) "rE Sig e f Owner Date Print Name Q TOP-MS:OWNERPERMIS SION AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR5301.2.1.1)' HERRING RUN MODEL-COTUIT MEADOWS COTUIT, MA Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust).................................................................. .................................................110 mph Wind Exposure Category...::....:........::......................:....................... .....................:........ ..............................B 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story)...... 1 stories s 2 stories RoofPitch ..........................................................................(Fig 2) ....................................................9 512:12 Mean Roof Height ................... .................................................(Fig 2).............. ....................................15 ft <_33' BuildingWidth,W ............. .................................................(Fig 3).................................................. 45 ft s 80' Building Length, L ..............................................................(Fig 3)........................... ...:....................62 ft s 80' Building Aspect Ratio(L/W) ...............................................(Fig 4)....................................................1.5 5 3:1 Nominal Height of TallestOpening2 ..........................................(Fig 4)..................................................V-8"56'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete..................................................:........................................................................... [� Concrete Masonry.................................................................... ....: N/A 2.2 ANCHORAGE TO FOUNDATION1,3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ...........................................(Table 4)...................................................32 in. N/A Bolt Spacing from end/joint of plate ............................(Fig 5).........................................12 in.5 6"—12" Bolt Embedment—concrete.........................................(Fig 5)..................................................7 in. z 7" [� Bolt Embedment—masonry.........................................(Fig 5)................................:............ in.z 15" N/A Plate Washer.: ...:..... (Fig 5).... -.................................:....:z 3"x 3"x%d' 3.1 FLOORS Floor framing member spans checked...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)....................................................10 ft<_12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... [� Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall.....:..........(Fig 7).................................................... ft s d N/A Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)....................................................—ft <_d N/A Floor Bracing at Endwalls...........:.......................................(Fig 9)................................. ............................:;.... Floor Sheathing Type ...........................................(per 780 CMR Chapter 55) ........ [� Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)...........................3/4 in. Floor Sheathing Fastening.......:.:...........:............................(Table 2)...........8 d nails at 6 in edge/12 in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)...............................8 ft s 10' [� Non-Loadbearing walls................................................(Fig 10 and Table 5).............................12 ft :5 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5).....................16 in. 5 24"o.c. Wall StoryOffsets ........ (Figs 7&8 —ft 5 d N/A ..:............................... ( g )............................. . AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(7s0 CMR5301.2.1.1)1 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls...::...................................................(Table 5)..........................................2x6-8 ft 0 in. Non-Loadbearing walls................................................(Table 5)............................... ........2x6-16 ft 0 in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10).................................................................. WSP Attic Floor Length................................................(Fig 11)............................................. ft zW/3 N/A Gypsum Ceiling Length(if WSP not used)...................(Fig 11)..............................................26 ft z 0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11).............................................................. N/A or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4.blocking @ 4 ft.spacing in end joist or truss bays Double Top Plate Splice Length ........................................................(Fig 13 and Table 6 Splice Connection(no.of 16d common nails)..............(Table 6)....................... Loadbearing Wall Connections Lateral (no.of 16d common nails)................................(Tables 7)............................................................2 Non-Loadbearing Wall Connections Lateral(no.of 1.6d common nails)................................(Table 8)............................... .............................3 Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)..........................................3 ft 0 in. s 11' Sill Plate Spans ........................................................(Table 9)..........................................3 ft 0 in. 511: Full Height Studs (no. of studs)...................................(Table 9)......................................:...........:...........3 Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9)..........................................3 ft 0 in. s 12, Sill Plate Spans...........................................................(Table 9)..........................................3 ft 0 in. s 12" N/A Full Height Studs(no.of studs)....................................(Table 9)..............................................................3 Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 .........................................................................6'-8"5 6'8" Sheathing Type.........................a....................(note 4)......................................... ....:. ........WSP Edge Nail Spacing.........................................(Table 10 or note 4 if less)...,..........................3 in, Field Nail Spacing..........................................(Table 10).....................................................12 in. Shear Connection(no.of 16d common nails)(Table 10)............................................................4 0 Percent Full-Height Sheathing....:.......::.........(Table 10)......................................................30% 5%Additional Sheathing for Wall.with Opening >6'8"(Design Concepts)..................... Maximum Building Dimension, L Nominal Height of Tallest Opening2.............................:::......................................6'-8"5 6'8" SheathingType....:.........................................(note 4)................................. .......................WSP Edge Nail Spacing.........................................(Table 11 or note 4 if less)..............................3 in. Field Nail Spacing..........................................(Table 11)......................................I...............12 in. Shear Connection(no.of 16d common nails)(Table 11)............................................................4 Percent Full-Height Sheathing.......................(Table 11)......................................................15% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... N/A Wall Cladding Ratedfor Wind Speed?.............................................................. ...............................:................................ [� AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR5301.2.1.1)' 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19)...............2/3 ft s smaller of 2'or L/3 [� Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift............................................:...(Table 12)..............................................U=303 plf Lateral...........:.................................(Table 12)...............................................L=176 plf Shear...............................................(Table 12)................................................S=77 plf Ridge Strap Connections, if collar ties not used per page 21... (Table 13)................................T= plf N/A Gable Rake Outlooker.........................................(Figure 20).............. ft s smaller of 2'or U2 N/A Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)...................................:........U= lb. N/A Lateral(no.of 16d common nails)...(Table 14).......................................L= lb. N/A Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59)............ Roof Sheathing Thickness........................................... ...............................................518 in. z 7/16"WSP Roof Sheathing Fastening............................................(Table 2)...........................................................8d THE HERRING RUN MODEL-COTUIT MEADOWS COTUIT, MA MEETS THIS CHECKLIST IN IT'S ENTIRETY THEREFORE THE FOLLOWING NOTE APPLIES: Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception: Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists,and girders shall be a double row of 8d vi. staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment f AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts. Checklist for Compliance(7so CNIR 5301.2.1.1)' -MEN TM EDGE RESTS ON PHAh11NG LW Sd NAILS ATfib.c . 11 11 1 11 IL 1 11 1 1.1 1 !1 11 11 I t 11 11 11 1 L n n l4 u n ! O n 1r'F 1 IL Q 11 - IL 11 If 1 IL t 11 UF t 0 t1 II II Il 1 1 tl 1i IL IJ 1 1.t � V IL 11 � 11 11 n t 1 7i n la t �1 11 rl ll DWOLEEDGE _`--- NAILSPACWG t Y See Detail on Next Page Uedical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7ao cMR53o1.2.1.1)1 E UMn r � r ♦ r ��jry, , Q EOa kj Ii FAMAINGMEMSERS i i EDGE K ERhMEDIAT£ ! i r Li r yg. � � z WIT STAGGERED MMLPATFERN PANEL PAWL EDGE DOUBLE NAIL EDGE SPACNLG DETAL Detail Verboal and Horizontal Nailing for Panel Attachment REScheck Software Version 4.4.4 J/ Compliance Certificate Project Title: THE HERRING RUN MODEL Energy Code: 2009 IECC Location: Barnstable,Massachusetts Construction Type: Single Family Project Type: New Construction Conditioned Floor Area: 1,509 ft2 Glazing Area Percentage: 11% Heating Degree Days: 6137 Climate Zone: 5 Permit Date: Construction Site: Owner/Agent: Designer/Contractor: COTUIT MEADOWS BAYSIDE BUILDING,INC. COTUIT,MA Compliance: Passes using UA trade-off Compliance: 2.4%Better Than Code Maximum UA: 253 Your UA:247 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. .. .. .. Envelope Assemblies Gross Cavity Cont. Glazing Assembly Area or R-Value R-Value or Door UA Perimeter IU-Factor TOTAL CEILINGS:Flat Ceiling or Scissor Truss 1,509 38.0 0.0 45 TOTAL WALLS:Wood Frame,16"D.C. 1,622 21..0 0.0 80 TOTAL WINDOWS:Wood Frame:Double Pane with Low-E 136 0.340 46 SHGC:0.00 Door 1:Solid 42 0.280 12 Door 2:Glass 42 0.340 14 SHGC:0.00 TOTAL FLOOR:All-Wood Joist/Truss:Over Unconditioned Space 1,509 30.0 0.0 50 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck . Page 1 of 7 REScheck Software Version 4.4.4 CNJ/ Inspection Checklist Requirements: 0.0% were addressed directly in the REScheck software Text in the"Comments/Assumptions"column is provided by the user in the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception is being claimed.Where compliance is itemized in a separate table,a reference to that table is provided. 2009 IECC Pre-Inspection/Plan Review Plans Verified Field VerifiedValue Value Complies? Comments/Assumptions 103.2 ;Construction drawings and ❑Complies [PR1]l ;documentation demonstrate energy ❑Does Not Comply code compliance for the building ❑Not Observable ; envelope. IE]Not Applicable 103.2, Construction drawings and ❑Complies 403.7 i documentation demonstrate energy ❑Does Not Comply. [PR3]' ii code compliance for lighting and ❑Not Observable mechanical systems.Systems serving multiple dwelling units must []Not Applicable demonstrate compliance with the commercial code. 403.E Heating and cooling equipment is Heating: Heating: ;❑Complies [PR2]2 sized per ACCA Manual S based on Btu/hr Btu/hr :DDoes Not Comply loads per ACCA Manual J or other U Cooling: Cooling: :❑Not Observable approved methods. Btu/hr Btu/hr. ;❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 13 1 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck Page 2 of 7 r 2009 IECC Foundation Inspection Complies? Comments/Assumptions 303.2.1 ;A protective covering is installed to ;❑Complies [FO11]2 protect exposed exterior insulation ❑Does Not Comply and extends a minimum of 6 in.below:❑Not Observable ; ;grade. ;❑Not Applicable 403.8 Snow-and ice-melting system ;❑Complies [F012]2 :controls installed. ❑Does Not Comply v ; ;❑Not Observable ; ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck Page 3 of 7 2009 IECC Framing/Rough-In Inspection Plans Verified Field Verified Value Value Complies? Comments/Assumptions 402.1.1, ;Door U-factor. ; U ; U ;❑Complies ;See the Envelope Assemblies table for 402.3.4 :❑Does Not Comply:values. [FR1]1 ;❑Not Observable ❑Not Applicable 402.1.1, :Glazing U-factor(area-weighted ; U- ; U- ;❑Complies ;See the Envelope Assemblies table for 402.3.1, average). QDoes Not Comply:values. 402.3.3, 402.5 :❑Not Observable [FR2]1 ;❑Not Applicable r8j 303.1.3 ;U-factors of fenestration products are ❑Complies [FR4]1 :determined in accordance with the ❑Does Not Comply NFRC test procedure or taken from U :the default able. ❑Not Observable IE]Not Applicable 402.3.5 ;Sunrooms enclosing conditioned U_ U ;❑Complies [FR8]1 Ispace have a maximum fenestration :❑Does Not Comply J ;U-factor of 0.50 in Climate Zones 4-8. ; ;❑Not Observable :New glazing separating the sunroom ❑Not Applicable :from conditioned space must meet code requirements. 402.3.5 ;Sunrooms enclosing conditioned ; U- ; U- ;❑Complies [FR9]1 :space have a maximum skylight U- T❑Does Not Comply: ;factor of 0.75 in Climate Zones 4-8. ; ;❑Not Observable ' ❑Not Applicable 402.4.4 ;Fenestration that is not site built is ❑Complies [FR20]1 :listed and labeled as meeting ❑Does Not Comply ;AAMANVDMA/CSA101/I.S.2/A440 or ❑Not Observable has infiltration rates per NFRC 400 :that do not exceed code limits. []Not Applicable 402.4.5 IC-rated recessed lighting fixtures ❑Complies [FR16]1 sealed at housing/interior finish and []Does Not Comply labeled to indicate 2.0 cfm leakage at ❑Not Observable 75 Pa. ![]Not Applicable 403.2.1 ;Supply ducts in attics are insulated to R- ', R- ;❑Complies ; [FR12]1. :R-8.All other ducts in unconditioned R_ R ;❑Does Not Comply spaces or outside the building ;❑Not Observable ; envelope are insulated to R-6. ❑Not Applicable 403.2.2 :All joints and seams of air ducts,air ❑Complies [FR13]1 handlers,filter boxes,and building ❑Does Not Comply. (39 ;cavities used as return ducts are sealed. ![]Not Applicable le 403.2.3 Building cavities are not used for ❑Complies ; [FR15]3 _ 'supply ducts. ❑Does Not Comply: pj ❑Not Observable ❑Not Applicable 403.3 [HVAC piping conveying fluids above R- R- j❑Complies [FR17]2 '105 IF or chilled fluids below 55 OF : :❑Does Not Comply: are insulated to R-3. ❑Not Observable ; ❑Not Applicable 403.4 Circulating service hot water pipes are; R- R- ;❑Complies [FR18]2 insulated to R-2. :❑Does Not Comply �q) ; '[]Not Observable ; ❑Not Applicable 403.5 ;Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air intakes and ❑Does Not Comply exhausts. ❑Not Observable : M1 ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck Page 4,of 7 2009 IECC Insulation Inspection plans Verified Field Verified Value Value Complies? Comments/Assumptions 303.1 ;All installed insulation is labeled or the ❑Complies [IN13]2 :installed R-values provided. ❑Does Not Comply IE]Not Observable ❑Not Applicable 402.1.1, :Floor insulation R-value. ; R- R- ;❑Complies ;See the Envelope Assemblies table for 402.2.5, ;❑ Wood ;❑ Wood :❑Does Not Comply:values. 402.2.6 ❑ Steel ❑ Steel :❑Not Observable [IN1]1 ❑Not Applicable 303.2, 'Floor insulation installed per �❑Complies 402.2.6 manufacturer's instructions,and in ❑Does Not Comply [IN2]' substantial contact with the underside ❑Not Observable ' q} ;of the subfloor. ❑Not Applicable 402.1.1, :Wall insulation R-value.If this is a ; R- ; R- ;❑Complies ;See the Envelope Assemblies table for 402.2.4, mass wall with at least%of the wall ❑ Wood ;❑ Wood :❑Does Not Comply:values. 402.2.5 ;insulation on the wall exterior,the ❑ Mass ;❑ Mass :❑Not Observable ; [IN3]' ;exterior insulation requirement Bj applies. ❑ Steel ;❑ Steel ;❑Not Applicable ; 303.2 ;.Wall insulation is installed per ❑Complies [IN4]' manufacturer's instructions. ❑Does Not Comply V []Not Observable ; []Not Applicable 402.2.11 ;Sunroom wall insulation has a R- R- ❑Complies [IN8]' minimum R-value of R-13.New walls :❑Does Not Comply: separating the sunroom from ;❑Not Observable .conditioned space must meet code :❑Nof Applicable requirements. 303.2 ;Sunroom wall insulation installed per ❑Complies [IN9]' manufacturer's Instructions. ❑Does Not Comply ❑Not Observable IE]Not Applicable 402.2.11 ;Sunroom ceiling minimum insulation ; R- R- ;❑Complies [IN10]' i R-value of R-19 in Climate Zones 1-4, ;❑Does Not Comply and R-24 in Climate Zones 5-8. []Not Observable ; ❑Not Applicable 303.2 ;Sunroom ceiling insulation is installed ' i❑Complies ' [IN11]' per manufacturer's instructions. EDoes Not Comply V ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck Page 5 of 7 Plans Verified T Field Verified 2009 IECC Final Inspection Provisions Value Value Complies? Comments/Assumptions 402.1.1, ;Ceiling insulation R-value.Where>R R- ; R- ;❑Complies ;See the Envelope Assemblies table for 402.2.1, :30 is required,R-30 can be used if :❑ Wood ;❑ Wood :[]Does Not Comply:values. 402.2.2 ;insulation is not compressed at eaves.:'[—] Steel ❑ Steel :❑Not Observable [Fl1]1 ;R-30 maybe used for 500 ft2 or 20% :❑Not Applicable (whichever is less)where sufficient ; space is not available. 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions.Blown ❑Does Not Comply [FI2]1 j insulation marked every 300 ft2. ❑Not Observable 0 IE]Not Applicable 402.2.3 ;Attic access hatch and door insulation ; R- R- ;❑Complies [F13]1 R-value of the adjacent assembly. :❑Does Not Comply } ; ;❑Not Observable ❑Not Applicable 402.4.2, Building envelope tightness verified ; ACH 50= ACH 50= ;❑Complies 402.4.2.1 by blower door test result of<7 ACH :❑Does Not Comply [FI17]1 :at 50 Pa.This requirement may :❑Not Observable (4 ;instead be met via visual inspection, ; ❑Not Applicable in which case verification may need to ; occur during Insulation Inspection. 402.4.3 Wood-burning fireplaces have ❑Complies [F18]2 ;gasketed doors and outdoor t []Does Not Comply ;combustion air. Not Observable ; ENot Applicable 403.2.2 ;Post construction duct tightness test cfm cfm. ;❑Complies [FI4]1 .result of 8 cfm to outdoors,or 12 cfm :[]Does Not Comply ;across systems.Or,rough-in test ;❑Not Observable result of 6 cfm across systems or 4 ; cfm without air handler.Rough-in test ; ❑Not Applicable verification may need to occur during ; :Framing Inspection. 403.1.1 Programmable thermostats installed ❑Complies [F19]2 on forced air furnaces. ❑Does Not Comply l ❑Not Observable. ; ❑Not Applicable [F 10]* heat pumps ❑Do s thermostat installed on plies Not Comply 0 RNot Observable ; r❑Not Applicable 403.4 y Circulating service hot water systems ❑Complies ' [F111]2 have automatic or accessible manual t❑Does Not Comply controls. ❑Not Observable ; wE]Not Applicable 403.9.1 ;Readily accessible switch on heaters t❑Complies [FI12]3 :for swimming pools. ❑Does Not Comply gJ [-]Not Observable ❑Not Applicable 403.9.2 ;Timer switches on pool heaters and ❑Complies [FI19]3 pumps are present. ❑Does Not Comply []Not Observable. ; ❑Not Applicable 403.9.3 Heated swimming pools have a cover. J❑Complies [F120]3 :Covers on pools heated over 90 OF ❑Does Not Comply ;are insulated to R-12. $❑Not Observable ; k ❑Not Applicable 404.1 ;50%of lamps in permanent fixtures ❑Complies [FI6]1 :are high efficacy lamps. ❑Does Not Comply ❑Not Observable IE]Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck . . Page 6 of 7 2009 IECC Final Inspection Plans Verified Field Verified Provisions Value Value Complies? Comments/Assumptions 401.3 ,Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not Comply ❑Not Observable IE]Not Applicable 303.3 Manufacturer manuals for mechanical ❑Complies [FI18]3 :and water heating equipment have ❑Does Not Comply been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: i 1 JHigh Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: THE HERRING RUN MODEL Report date: 04/22/13 Data filename: Untitled.rck : Page 7 of 7 2009 IECC Energy Efficiency Certificate Insulation . Wall 21.00 Floor 30.00 Ceiling/Roof 38.00 Ductwork(unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.34 Door 0.28 Cooling - Heating& Heating System: Cooling System: Water Heater: Name: Date: Comments: V « SMOKE DETECTOR ED TOWN OF m �5APINSTABLE E• f.� t BUI ING D'cPT. .• ~ O Lo N13 AP ^b 3: t;? n O DATE h FIRE DEPARTM R PERk.ITTING J ENT _ - z J n BOTH SIGNATURES ARE REQUIRED FO - - TV 5_���_���v4���PF D:l.._,. 0 a o W � Jz _ � a4 � 0 m ow: o wan all 00 co ® ® 00 New -- 'Q o FRONT ELEVATION M SIL 9CALE�I/4' I'-p FY LEFT ELEVATION • scn�e.w^.1_p N 3 w p ' zW ,p .v p SNF- Lu El �U w El E171 ® ® ® N# O RIGHT ELEVATION REAR LELEVAo ION 9L Z 1/4'.V-0' SHEET Al HERRING RUN MODEL .roe: 1302 1476 50 FT DRAWN BY. KW DATE 4/12/13 9'd Z m c a am a e C IL MASTER W BATH ® s e ^ ar O U C Q I I b m Q: O A5TER �� w w'm,ro h n _ _ I a a aR � cb 0: 0 .II e.vaa as I M W I�gl I cl __ ,A•..�ve ZI LJii✓�I I M m I I I 00 r—� loe uiumnu cou I w..o iA n � 1 1 � � GREAT ROOM � 8 I L1 I :II CO j w.e„e O W Q ,w o.u.roon w,xnem I eas,.e• N B (T�ri"°� Z W ,o s 3 R c-a c-r no�-a FIRST FLOOR PLAN SHEET xA�.v,•.P-o• HERRING RUN MODEL JOB: 130 1476 50 F7 DRAWN BY: KIN DATE 4/12/13 >. Z O : La -- ---- "" Ul k I ; t l • M� O Q: O I" -_--- - 0 ( n -- - l y l a r L----- —BAo EFIBEpANCIb(�BOLTs i s,ri aY wrnmE•,D I I ` O i oL___________ I .1 I4.Y-- I I,IL TIM - b r_ Imo`I I yl r I•�I - I3 I.L----w,a°W°"°`'ae" 1 e l F Z W W "_____ LU ------------- �u 0 ' J 2-a a'-o• r-a SHEET 1 FOUNDATION PLAN SC I ALE:1. �I'-O' JOB. 1502 DRAWN BY: KW DATE: 4/12/13 U N z m O M O ' � J W. 0 Da a m r� z r../ U mm O W 0: O is a g FQY O n D- n w 1p - s s y�� v]cTY.N.MD �/�■ �1�1� O P bw T v1i ^ rI L 0 - LU .. � GREAT ROOFIm _ nm rni¢e w.w etn rcv�mrr . - b GARAGE m ' - �im 1 c Jrnsr Trv[R wwri w.c. J .1 9 vJ'4LLT CDunw a I BASEHENT �� • •V L vnroM1wuu t daP cwriwDw¢us F'�Wc N 3 _ n CROSS SECTION § IL O Z � r Q O J O J SHEET 32 ' JOB: I305 DRAWN BT: KW DATE 4/12/13 V N m O In < a aTap Hi a•p�r�I ii R,FTER.IA o.. ~ O O c QJ yW W . .uu aiw w Iw wNLe ���� `/j AYILY BmISON nsTAle CONNCCTOR - N].5.E•.R ^ ` •S o.c. -''�3� TO•s-EN 1acK 9ND m H[ADER - — ^� • p G[pce Aw np, _ T-I-T[ _ J u O - _ TNeTra STUps oVvi nw.TilLi aPSNiNG9 .. - m w O O RAFTER TO PLATE CONNECTION W c n moo.+W.0.ecru II 1l in . d m oee roI Iur `/+ m W M Z I NAR O a. BRACINGH Arm v N. i� �¢� t .. W- 16i OF EACH WALL RUN VERTKJ.L SHEATHING WRH FIL BG NAILS 9'EDGE/12'FIELD - (4)I!d NAILS PER FT BOiTon PLATE - L- M OF EACH WALL RUN t 8 T VERTICAL 5HEATHING ITN Bd NAILS 5'EDGFJI3'FIELD an.rnei b+cgs `Ch£; wro vmN IVrm Dx Tw Iur[ (4)l-NAILS PER FT BOlTQ1 PLATE I �� ANp r IN•m � �; ��9 V 31 w 8 r tt 3 ULL HEI S A —SIN R /1 U NTE H E E —n O Ilre 'f e J SHEET 33 . JOB: ISCEi DRAWN 57: KW DATES 4/12/13 00#avl D(V Commonwealth-of Massachusetts -713�13 Sheet AI► tal Permit Date: 13 Permit# O(0 coq/ Estimated Job Cost: JiD,n Q o Permit Fee: $ gj . Plans.Submitted: YES NO Plans Previewed: YES NO Business License ? (f)d -,Applicant License# a M Business Information: Property Owner/Job Location Information` Name: - UYl���1 `� Name: r S�YI,I Street: C g Vi J I'D P_ L")11 Street: I q r hoQr�a f" ' I I City/Town: W l.��tt�l City/Town: ecr�, Sop- �. o0 gy 1 ) Telephone: � Telephone: 1 31 Photo I_D_ required /Copy of Photo I.D. attached: "YES` NO " Staff lnit J-1 /M-1-unrestricted license J-2/M-2-restrictzd to dwellings 3-stories or less and commeicial up to 10,000 sq. ft.'./2-'stories or less Residential: 1-2 family ly Condo/Townhouses Other Commercial: Office Retail Industrial Educational } Institutional Other Z Square Footage: under 10,000 sq.ft./ over I0,000'sq. ft. Number of Stories,: I s Sheet metal work to be completed: New Work: Renovation: �? HVAC Metal watershed Roofing A Kitchen Exhaust Syst.,m f) rro Metal Chimney/Vents - Air Balancing Provide detailed description of work to be done: X. UN 2 4 2013 TOWN OF BARNSTABL E INSURANCE COVERAGE: have a current liabilitV insurance 'olic or i equivalent the re uir ' , nts of M. Ch.1 2 ` Ye 'is e ul a entwhich meets eme G.L 1 s No � P Y q .. q ❑ If you have checked Yes:indicate the type of coverage by checking the appropriate box below:' A liability insurance policy Other type of indemnity ❑ Bond ❑I i OWNER'S INSURANCE WAIVER: l.am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and,that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent Si gnatureof Owner or Owner's Agent. By checking this box',17;1 hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my.knowledge and that all sheet metal work and installations performed under the permit issued forthis application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection - - - D-It Type of License. t t t By El Mast& f Title ` '- Q Master-P.estricted • w City/Town ❑Journeyperson Signature of Licensee Permit# o�n� [.1Jo,u.rneyp rsoTi=Restricted ,.,, License Number: Fee$ = s Check atv"rvJ rnass.aov/dpl Ub Inspector Signature of Permit Approval r r Towu of Barnstable* Regulatory Services uciv+sra�at� TlioinaS.F. Seiler,Director I-IF�D Brxz d��ng Division Torn Perry,}3tuilLtip;(;omrrdssionei-, 200 hla:irz Sti-ctt,I-I-In i" MIA,02601 rsv�v.tow n,b e.ma,7:s Oft ce: 508-8,62 4039 Fax.- SO&-790�230 Pra u :t Compete arts- Sign 'ThIs Sect om 1f LTs� ABu' .d--r las Ow.e.r of tnr sabjea.Propert� aJ . .....---' Pl lienbya�.sr to acl on UCT beha f, all triziters rely i ve to w.rk auffiomi will by t1u cep wit applic tioA for: TIJ�iLtII Date P tin i IE Pl"o_ODez-LY O-Wner iS jpp Y'ng for r e ]. .case eom fete the k p Z ameo e s �L ease Ex-z p�ion T o.L->n ors the revetse side. r. ':COMMONWEALTH OF MASSACHUSETT � a o o •Ao o :o •a a ". ":,SHEET METAL WORKERS AS A BUSINESS 1SSUES THE ABOVE LICENSE TO: ER'IC T.,.WHITELEY W. .:1/ERNDN 41HITELEY PLBG AND 28` VILL.AGE LANDING ?� PO . BOX ..1266 W., CHATH:AM MA 02669=,000. ; :. "1'60 12/22/14 2926:29`- s o ---�-----'— .COMMONWEALTH OF MASSACHUSETTS .. e p sA a ••o a ❑, o- ':o::a s� SHEET METAL WORKERS `. AS A MASTER-UNRESTRICTED "- ISSUES THE ABOVE LICENSE TO: N. ::.E.RIC T WHITELEY m :..PO BOX 248 ...,:.WEST CHATHAM MA 02669-0248 2967 02/28/14 , 119423 • Fold,Then Detach Along All Perorations' =ems � ' A�CHIJSEdTT� � MUMB 'b �U-N7BFAI �!: V �`$ i t {,3 v 6Y � r• i 'fit 1{: �1Sj�MAINST f7 i4 �� f v n 1h ';W CHATFt M,MA � � �5 � 'r— -•c s� ,. '>-' I Y.41.1 s ly` u, ITS*{• ,�f}!, `.',{1���)'�, , } 1�. • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations z 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): Ve�. r) � H-e 1 n Le 7 n C, J Address: �,k 'y,�l A I�A,;� n 5 Po City/State/Zip: UJe GH A a 1 m Phone 9 9 ° (3 Are you an employer? Check the appropriate box: Type of project(required): l.Q I am a employer with 9 4. ❑ I am a general contractor and I have hired the sub-contractors 6. ❑New construction employees(full and/or part-time)_'* 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.t required_] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required-] c- 152, j 1(4),and we have no. employees. [No workers' 13.❑ Other comp. insurance required_] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees_ If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A z Ut "t 4 w�i A-C ,,,�u I.A n C_o Policy#or Self-ins.Lic.#: w C_L— Z I 1 - a o o �3 O ) ' _ Expiration Date: 1 o i d o 13 Job Site Address: V a a us City/State/Zip: btil 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 iu 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 insllrancoverage verification I do hereby certify under d? p a e o perjury that the information provided above is true and correct. Signature- Date: /d q Phone#: C b g> 9 — !1 0 0 Official rise only. Do not write in this area,to be mpleted by city or town official. City or Town: emit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk •.4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: j ' Client#:48736 VERNWHI ACORD„, CERTIFICATE OF LIABILITY INSURANCE DATE 101011201/20/YYYY) 12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies.may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Karen A.Walther, CISR Rogers & Gray Ins. HO No,Ext:508-760-4630 FAX No; 877-81612156 434 Route 134 E-MAIL SS, kwalther@rogersgray.com South Dennis, MA 02660-1601 ADDRE - INSURER(S)AFFORDING COVERAGE NAIC# 508 398-7980 INSURER A:Arbella Mutual Insurance Compan 117000 INSURED W.Vernon Whiteley Plumbing &Heating INSURERB:Wausau Underwriters Ins.Compan Arbella Protection Co I17000' INSURER C Company, Inc. &Chatham Sheetmetal, Inc I P. O. Box 1266 INSURER D �INSURER E West Chatham, MA 02669-1266 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDUSUBR; POLICY EFF POLICY EXP LTR TYPE OF INSURANCE (INSR IWVD 1 POLICY NUMBER MMIDD/YYYY MMIDDYYYY I LIMITS A GENERAL LIABILITY ' 18500052832 10/01/2012 10/01/2013;rI EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY i I uAPAAGE TO RENTED PRE 153OO,000MISES(Ea occurrence) I CLAIMS-MADE OCCUR I I MED EXP(Any one person) S 15,000 ,, PERSONAL&ADV INJURY 51,000,000 IGENERALAGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X I PRODUCTS-COMP/OPAGG 52,000,000 P POLICY E� n LOC S AUTOMOBILE LIABILITY 11020006346 10/0112012 10/01/2013(EaCOMBINEDaccident)SINGLE LIMIT IS 1,000,000 Ea ANY AUTO I 1 I BODILY INJURY(Per person) I S ALL OWNED SCHEDULED S AUTOS X AUTOS BODILY INJURY(Per accident) NON-OWNED ! PROPERTY DAMAGE XI HIRED AUTOS X I AUTOS - I(Per.c R-nq IS A X UMBRELLA LIAB j OCCUR I I 14600052833 10/01/2012 1110112013�EACH OCCURRENCE I s4 000,000 EXCESS LIAB 11 CLAIMS-MADE I I AGGREGATE s4,000,000 DED ( X RETENTION SO i I ( S WORKERS COMPENSATION WC STATU- OTH- B WCCZ11260053011 1110112012 10/01/201i X RY IT IER AND EMPLOYERS'LIABILITY Y/N, ANY PROPRIETOR/PARTNER/EXECUTIVE- i E.L.EACH ACCIDENT I s500,000 OFFICERJMEMBER EXCLUDED? u N 1 A (Mandatory in NH) I I E.L.DISEASE-EA EMPLOYEEI s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT I s500,000 I i DESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Plumbing, Heating, HVAC service& installation. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE . '1 /) o ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S880171M87928 TLH TempParcelEdit Page 1 of 1 r Logged In As: Wednesday,January 162008 Frank Schlegel New Parcel Application Center Road System Reports Road System The record has been added. New Parcel Detail New Mapparcel: 002 002 006 Street Number: 64 _.._ Unit: Dev Lot LOT 6 Road Name: PHEASANT HILL CIRCLE _.._ _._.._...�.... V T/R Sec. Road: T/R Villlage: 07 Cotuit ,. Part of M/P: MAP 002 PARCEL 002 Plan Ref: jPLBK 617/69-75 (APP 7-62) Date Added: Updated: "'N' ®ele Add Another http://issgl2/Intranet/Propdata/TempParcelEdit.aspx?ID=Add 1/16/2008 Foundation Certification in Barnstable, MA Prepared For : Lot 6 N #64 Pheasant Hill Circle Cotuit Meadows Subdivision of Barnstable Assessors Map: 002 Parcel 02 Baxter : Nye Engineering & Surveying Flood Zone C ® FIRM Community Panel Number No. 025551 0021 D OWNER: Cotuit Equitable Housing, LLC 0 Deed Book 21804 Page 41 Registered, Professional OPEN SPACE. Cotuit Meadows Homeowner's Association, Inc. ® Deed Engineers and Land Surveyors Book 23161 Page 59 78 North Street, 3rd, Floor Barnstable Zoning Board of Appeals No. 2005-082 ® Deed Book 21059 Page 158 Hyannis, MA 02601 Minor Modification No. 1 ® Deed Book 22249 Page 282 Phone — (508) 771-7502 Fax — (508)-771-7622 Job Number. 2005-214 Scale : 1 20 05-20-13 00 0 , Q Z V � LOT 7 _ ss9y s V 10' S J �J�' �AC" �NF �5rti T 0. 68 O 01 O , 4.o' ocq n°N�nroq °Sirs/3g 1Fn0N 9 1'4.. p w 3 h' . S° �• ^ s2 LOT 6 8,782f S.F. - \ 0.20t ACRES b ro• N69 39'Og� NE ACk LOT 5 � o ( ULO N Q o N - - v ..I v I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURE SHOWN HEREON IS IN N COMPLIANCE WITH FRONT, SIDE AND REAR SETBACK REQUIREMENTS (20'/10'/10') AS NOTED IN TOWN OF OF o BARNSTABLE ZONING BOARD OF APPEAL No. 2005-082 (DB 21059 Pg .158) IS LOCATED IN RELATION TO N MAsr9 PREIMETER MONUMENTS SHOWN PER EXHIBIT "A" (DB 21804 Pg 45) AND IS NOT LOCATED WITHIN A o� cti� z SHANE M. SPECIAL FLOOD HAZARD AREA. BRENNER o THIS PLAN IS N 0 RECORDED NOR IS IT TO BE USED TO ESTABLISH' PROPERTY LINES. No.45917 � / O U �FJ'�RFOISTol� 0 N REGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING. DATE NAL , a 0 0 0 0� fy' ' t GENERAL NOTES: 1. LOCUS PROPERTY IS SHOWN AS: ASSESSOR'S MAP 002 PARCEL 02 2. SETBACKS: FRONT = 20' SMH T, SIDE/REAR = 10' 3. UTILITY INFORMATION AS SHOWN ON PROPOSED SUBDIVISION IHOUTa9.99 CONSTRUCTION PLANS. 3 4. COMMUNITY PANEL NUMBER: 025551 0021 D THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C, AREA OF MINIMAL FLOODING. 5. ENVIRONMENTAL NOTES: SITE IS NOT WITHIN AN A.C.E.C. (AREA OF CRITICAL ENVIRONMENTAL aMo CONCERN). / c SITE IS NOT WITHIN AN AREA OF ESTIMATED HABITAT OF RARE ' '� / WILDLIFE PER NHESP MAP OCTOBER 1, 2006 "ESTIMATED Z HABITATS OF RARE WILDLIFE" FOR USE WITH THE MA WETLANDS PROTECTION ACT REGULATIONS (310 CMR 10)." SITE DOES NOT CONTAIN A CERTIFIED VERNAL POOL PER NHESP cj / • MAP OCTOBER 1, 2006 "CERTIFIED VERNAL POOLS." SITE IS NOT WITHIN A PRIORITY HABITAT PER NHESP MAP OCTOBER l cy 1, 2006 "PRIORITY HABITATS OF RARE SPECIES" FOR SPECIES UNDER THE MASSACHUSETTS ENDANGERED SPECIES ACT, REGULATIONS (321 CMR10) SITE IS WITHIN A STATE APPROVED ZONE it GROUND WATER r RECHARGE PROTECTION AREA r ' ! c /` CONSTRUCTION NOTES: / 1. ALL GENERAL CONSTRUCTION NOTES ON SHEET C-2 FROM THE SUBDIVISION CONSTRUCTION PLANS FOR COTUIT MEADOWS, DATED 6/25/07, SHALL HEREBY APPLY TO THIS SITE PLAN. c /, 2. ALL GRADING, DRAINAGE, AND UTILITY NOTES ON SHEET C-5 FROM THE SUBDIVISION CONSTRUCTION PLANS FOR COTUIT MEADOWS, DATED 6/25/07, SHALL HEREBY APPLY TO THIS SITE PLAN. / 3. SEWER BUILDING CONNECTIONS: - MIN. COVER SHALL BE 3 FT. ' - SET CLEANOUTS AND MAINTAIN CLEARANCE FROM OTHER UTILITIES AS REQUIRED BY BARNSTABLE DPW. MINIMUM SEWER SERVICE CONNECTION SLOPE SHALL BE 2A X 66.25 w r a � � GO \ / a '� LOT Cotult Meadows subdivision o" / LOT Cotult•Barnstable Massachusetts S 0)" ; / 8,782f S.F. L _ PREPARED FOR ko o• S£� COTUIT EQUITABLE HOUSING, LLC 6 .29 c� H�a J? qck 64.50 P. O. BOX 95 0 / Robb 6.25 65.0 ,'� Cwt@rW119 MA 02832 ;S INV, 58.41 / T 4S 6.2 OAR4� �' Ro site Plan .0' +b4 ?0 +e9 B� � .0 � D GEETARATED 12" Lot 6■ 64 Pheasant Hill Circle SMHIN 1 0� c S INV. x DEEP 63.50 INV IN A •59.36 �� GARDEN (125 INV OUT-58.09 / s SCURB TOP A p"0 P Ii TOP 610RAGE) _ .- A Ramos 84 eo, soTTOM•eo.o BAXTER NYE ENGINEERING & SURVEYING 66 1 7 ,3r' c +ee o q' o s6A W Registered Professional c x o �h 64.5 63.0 •0� >' .70 . ' , Engineers and Land Surveyors 78 North Street, 3rd Floor,Hyannis,MA 02601 / x Phone- 508 771-7502 Fax- 508 771-7622 ° MA tTFiE W. ED„ ,� N 64.5x �� ,6rs.0 _- - 20 0 20 40 -� o.43 830 VEGETATED 12" DEEP R(its � N�AOk SCALE IN FEET �•-.Y�EN C.F. STORAGE TOP•61.0 ) .- LOT" 5 SCALE: 1" _ 20' DATE: 04-22-13 � ' BOTTOM-60.0 I ,'PROVIDE (1) 6' DIA. x 6' DEEP. REV. DATE: REMARKS LEACHING BASIN W/ 1' STONE SURROUNDING (OR ALTERNATE LOT EQUIVALENT VOLUME OF 289 6 N CONNECT ALL ROOF DOWNSPOU CFI To LEACHING BASIN h DRAwm NUMBER 0: 2005 2005-214 CIVIL DESIGN 2005-214PBLOTS.dw z� 2005-214