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1783 SANTUIT-NEWTOWN ROAD
S�� 1 C� l�-N�'Cv j Oc.�.lx1 �� '- �.I I d', 1. fi "� li' x. _ , ,r .xx �h.• � x: r :. � ,. n 1. a.. ,U 1'� , �� ••�� . .. +y� ,a ,l. I .1 .i. rY , ., . U .rr " f ., 1'. ,fit �• �I � �Y I�`� • + .: � ,r l ih,dx r s� � rw ,. •� I. �, r �er a. 4` -� .� � �. .. � :.. ". . :. 'Ci-"Xt 1=d.' :.t rler h a:rr,.r• � � ,. r.�.L,��° �. .r ` 1 '.' r.- ♦. ., f al .. r. a,_...,.,`.-«�._a..... '.u..t^Frt}.+l:l w1a Xl...� i �r . ,�. „ '�: �i .. ,. N ..! ^ r Y I � i ,i [ � � � �. ' � � .. �S, ' � � fl _ IT .� .] •" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION oaf Map Pare �� � ( '_.Application #0_0 Health Division ,. Date Issued b e1Ca; Conservation Division Application Fe' Planning Dept. Permit Fee' Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address 7 3 5e�,i i o/7 1 o o PI-0 1,0 Village Co Tro t`� /9- 3S Owner 1(:, real Address Telephone S o E Loa I h Permit Request hOl t D l bf I q. 5l %3�r-)&o a o/�110�tl, /� yCii l N ��l laecs k?M r`A)a rZ4 f h �G�y ", /��'�✓��aA A 99 aA I7a eOde le-,- t4Np f90 aeck i Lw-,P46A. Square feet: 1st floor: existing 70 proposed 2nd floor: existing 26proposed Total newv Zoning District Flood Plain 1,fd1W NA-zA R.s7 Groundwater Overlay Project Valuation 16a.6-mc'- Construction Type Lot Size 2T 7LOV- SsF Grandfathered: ❑Yes ❑ No If yes, attach suppWing�ocumentation. o z Dwelling Type: Single Family 2" Two Family ❑ Multi-Family (# units) o Age of Existing Structure ` Historic House: ❑Yes U° No On Old King's HigbiaycU Yes 1I o Basement Type: Full ❑ Crawl ❑Walkout 010ther 13t)1, '/4e41 D 0 Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) w Number of Baths: Full: existing 4Z new Half: existing Y e\Vn Number of Bedrooms: 3 existing® new Total Room Count (not including baths): existing _7new�First Floor Room Count Heat Type and Fuel: dGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ® No Fireplaces: Existing New Existing wood/coal stove: k Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: U"existing ❑ new size !f�arn: 8/existing ❑ new size"o Attached garage: ❑ existing ❑ new size _Shed: LY existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 2 No If yes, site plan review# Current Use ter (,kg Endni Ly Proposed Use ' lW 6Le APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Malm S I SFjFieMAeJ Telephone Number SDF 757-70 10 Address V 0 747 9 444 6,1,1 License # K f 32�?3 Home Improvement Contractor# Worker's Compensation #/7l_2-3/6"-V9-0,9K, -0CC� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f b A.) d F (1 A) JA15� DATE SIGNATUR y s \ FOR OFFICIAL USE ONLY APPLICATION# SAT_E ISSUED S ADDRESS, :` VILLAGE OWNER Ir ' DATE OF INSPECTION: `K "':,FOUNDATIONBA4P FRAME ro / lVit.AMoK (o I-n INSULATION!; ox'k.e-, FIREPLACE ti ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL { t GAS,-. ;ifi%—R! ROUGH FINAL :FINALBUI'LDING :`X% .o w 00 !7(( pow :- DATE CLOSED.OUT v<; - ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Y Department of Xndustria[Accidents . Office of I'll vestigations 600 Washingfon Street . t Boston, MA 02111 yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le>7ibly Name (Business/Organization/Individual): 5 7 /(A A) (3 UQLO,e Address: 3e)ct 767 City/State/Zip: /k�AlUht�scJ� P3r ��D�Shonc #: 13g���`� b.5C7 Are you an employer?-Check the appropriate b x: Type of project (required): 1. ❑ I am a employer with 4. . am a general contractor and I 6. ❑ Nev%construction * have'hZred the sub-contractors.. employees'(full and/or gait-time). 2.❑ I am a sole proprietor.or partner- listed ora the attached sheet. 7. [ Remodeling ship.and have no employees These 96b-contractors have g, Demolition working for me in any capacity. employees and have workers' 9 tuilding addition [No workers' comp. insurance comp. insura.nce.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 1 I. Plumbing repairs or additions myself. (No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.) t c. 152, §l(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "Any applicant that checks box#) must also fill out the section below showing their workcrs'compensation policy information. t Horncowners who submit this affidavit indicating they arc doing all work and Lbcn hire outside contractors must submit a new affidavit indicating such. #Contractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and state whether or.not[host cnlitics have employees. If the sub-contractors havc employees,they must provide their workcrs'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: Policy# or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' comp ensa.tion 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 1250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Off ee of Investigations of the DIA for insurance coverage verification. I do hereby eert� tinder the p in a d pe allies ofperjury that the information provided above is true and correct. Si ature;rr c -� • Phone # d B d �? Official ase 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 S: Plumbing Inspector 6. Other Contact Person: Phone#: Information and bstructzoxls " Massachusetts General Laws chapter 152 requires all employers to provide workers' cornpe.nsalion fo 'their employees.. l of hire, Pursuant to this statule, an employee is defined as "...every person in (he service of another under any conlrac express or implied, oral or written."' An employer is defined as "an individual, partnership; association, corporation or other legal cbti(y, or any two or more of the foregoing engaged in a joint enterprise, and including the legal rep resenlaLives of a deceased employer, or the receiver or trustee of a❑ individual, partnership, associalion or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides (herein, or the occupant of the dwelling house of another who employs persons to do maintenance, constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be decmcd to be an employer.' MGL chapter 152, §25C(6) also slates 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}yho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) stales "Neither the commonwealth nor any ofits political subdivisions shall ente into any contract for theperfonnance ofpublic-Work until acceptable evidence ofcompliancc with the insuuancc r requirements of this chapterhave beenpresentcd to the contracting authority." Applicants mpletely, by checking the boxes that apply to your situation and, if Please fill out the workers' compensation affidavit co necessary, supply sub-contraclor(s) name(s), addresses)and phone number(s)along with their cerhficate(s) of insurance, Limited Liability Compa�ies (LLC)or Limited Liability Partnerships(LLP) With no employers other than the members or partners, are not required to carry workers.' compensation insurance. If an LLC orLLP dots have employees a policy is required.'Be advised that this affidavit may be submitted to the Deparmmeni of Industrial Accidents for confirmation ofinsurance coverage. Also be sure to sign and date th-e iffrdaM, The affidavit should be returned to the city or lown that-the application for thepennit or license is,being requested,not theDcpartment of Industrial Accidents. Should you have any questions regarding the Jaw or if you are required.to obtain e,workers' compensation policy,please call the Department al the number listed beloW. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Pease be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom of the a�dayil 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 permiUlicense number which will be used as a,reference number, In'addition an applicant that must submit multiepl permit/license applications in any given year, need only submit one affidavit indicating current ity or policy information(ifnccessary)and under"Job Site Address"the applicantshould write"all ]dcatrons in__(c town)."'A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the be filled otr t each applicanf as proof that a valid affidavit is on file for future permits or licenses. A new affidev{trust year, Where a home owner or citizen is obtaining a license orpermit not relaled to any bUsiDesSof commerci a] venture (i,e. a dog license of pCTMI to bum leaves etc.) said person is NOT required to complete this af6davil. The Office of Invesliga Lion s WD.Ldd Me o h-�ky>so�n�d r ri Pratinn and should shave any questions, please do not besitate to give us a call. The Department's'address, telephone and fax number; The Commonwealth of Massachusetts Department of Industrial Accidents Offiee of Investigat-jons 600 Washington Street B oston, MA 021 l l Tc). + 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 1-24-07 www.mass.gov/dia . I The Commonwealth. o Massachusetts Page 2 . of Massachusetts of Industrial Accidents Office of.Investigations 600 Washington Street Boston, MA 02111 Www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses ApNicant Informyti®n ]Please Print Le Pbly Name• 6LDE Z/mu �/ 7 Address: / ,/ (' / //1 // a�City /� 01-1UUal, i ci3�C/�-.. State A�1 Zip: /.r��5 Phone Work site location full address) CompanyMM i 5=.ti' t _ � �^ e�.� eT r__2•�t b <cye°'p:^ r5iz ? -< r name: 1 - . � //�� L Excavation Address- V STSOq city Phone -�• 737- Insurance Co lI GZ6111qdu/ l /�/ `/ Policy Company name: C Foundation Address: L� Ci / Phone Insurance Co. P01ic # O NO nn �, Company name: i ] 14k✓ C �f(//�Y[.,J Frame Address:20 6/3 Cit 44-1 -� Phone. Insurance Co (✓l��Li I I Polic #ER,H �[ �;. rtr « r C COmoany name: !VY YOU i E 'a� T ? �] Insulation Addresss� city Phone 'f� Insurance Co. f% �' U° '' �' Policy# (If IN213 cw/ - Com an name: z 0 , Drywall Address: � City `iJ Phone Insurance Co: P01ic # Wiz---� .<--•--�- -F--�� .- �s p- Coman name: Finish �; Address: City f � Phone Insurance Co' Pohcv# I. �W e--.Ok _5 ib iar C-� •"� � ''.�g�. �:�A.B i i� i f � ��w i f��� � (sCl?i, B 1 AWC Guide to Food Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance.(780 CMR 5301.2.1.1)1 0 Check Compliance' 1.1 SCOPE WindSpeed(3-sec.gust)....... ......... ...................... . ................... .....,.......................................... 110 ,mph WindExposure Category...... ......... ......... ........................::...... ..............................................................B a/ 1.2 APPLICABILITY / Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story)�_stories 2 stories RoofPitch ................ ......... ......... ......... ..................(Fig 2) ........................................... S <_ 12:12 Mean Roof Height .:. (Fig 2)-.-. _ ............. II Z ft <33' Building Width W .:. .........(Fig 3)..... gi ft 5 80' Building Length, L...: (Fig 3)...: _ - Q ft _5 80' Building.Aspect Ratio(L/VV) . ......... (Fig 4).... . 3:1 Nominal Height of Tallest Opening2 ...............(Fig 4).... ......... ......... ...........4,.. -vi' .5.6'8" — 1.3 FRAMING CONNECTIONS / General compliance with framing.connections ...................(Table 2)................. :....... V 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.4 Concrete.......... .....:... :........ ......... ..............:...... ....... ......... .......:. ......... ......... ----....... Concrete Masonry ........................................................ .. .. 2.2 ANCHORAGE TO FOUNDATION1'3 5/8"Anchor Bolts imbedded or5/8 Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general .. ........ .. .... (Table 4)............................................... in. Bolt Spacing from endfJoint of plate {Fig 5)._............. .......& in.: 6"-12 v� Bolt Embedment—.concrete.........................................(Fig 5)............... ...-...........................�in.>7" Bolt Embedment masonry :...................(Fig 5)..:......................... in.>_15° Plate Washer..... ......... ..........................................(Fig 5).................................. .........>_3°x 3"x'/ 3.1 FLOORS / Floor framing member spans checked ................................(per 780 CMR Chapter 55).................:.................. Maximum Floor Opening Dimension.,....................................(Fig 6)......-.........-...-...................-.......... ft:5 12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................: k ................. Maximum:Floor Joist Setbacks ` Supporting Loadbearing Walls or.Shearwall...... .........(Fig 7).... ........: .........::....................._.ft <_d y4 Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... ft _:5 d 1C Floor Bracing at Endwalls ..........(Fig.9)................ ...................... .. 1 Floor Sheathing Type ........................................................(per 780 CMR Chapter 55) ........... Floor Sheathing Thickness .. (per 780 CMR Chapter 55)........................V4 in. Floor Sheathing Fastening... ......... ......... .... :......... .:..(fable 2).. 11d nails at in edge/ I Z in field 4.1 WALLS Wall Height Loadbearing walls :.: (Fig 10 and Table 5).:......:...:.----- $ ft :5 10' ✓ .......... . Non-Loadbearing walls........................................... (Fig 10 and Table 5) .:. ....... ft 5 20' Wall Stud Spacing ........ ...............................................(Fig:10 and.Table 5).:.... ... ...:..1( in.:5 24°o.c. Wall Story Offsets ........................................................(Figs 7&8):....... :.._............................ ft <d �C 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls.........................................................(Table 5) ........... ....._..2x A -6-ft 6 in: Non-Loadbearing walls.................................................(Table 5)............ .......--....2x A-f-ft jL in. Gable End Wall Bracing'. Full Height Endwall Studs ....::... ........ ........... .........(Fig 10)...:.......... .................................. ........... ✓ . WSP Attic Floor Length................................................(Fig 11)............................................. ft_>W/3 ........... Gypsum Ceiling Length(rf WSP,riot used) .... (Fig:11)................. .,3.5�>_0.9W and 2 x`4 Continuous Lateral Brace@ 6 ft.o.c...(Fig 11)... ... .... ......... ........... �C 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 P 9 ......... ......... .:....... ....:... .......:(Fig 13 and Table 6):..... .....,....................... ft +� Splice Connection(no.of 16d common nails)..:: ....._.(Table 6) ....... r;e AWC Guide to Wood Construction in Hula Wind flreas 110 mph'Wind Zone Massachusetts Checklist,for Compliance('780 CMR, 5301.2.1.,1)1 Loadbearing Wall Connections .Lateral (no.of 16d common nails) .....:...........(Tables 7) ........ ...::.... '....:.._...:.. � Non-Loadbearing Wall Connections / Lateral(no.of 16d common nails).......:........................(Table 8) ........ ......... ........ ..............._� •✓ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ............ (Table 9) ft U in: <_11' _ Sill Plate Spans :.... (Table 9) ft in. <_11' Full Height Studs (no.of studs).. .... :.........................(Table 9) . .....:. ......... .... ...: :..:.:........: Non-Load Bearing Wall Openings(record largest opening but check all openings for.compliance to Table 9) Header Spans..: ........ (fable 9) ft pin._<12' Sill Plate Spans.. :... ...._...(Table 9) .._...... ft Full Height Studs(no.of studs)......................................(Table 9)...........:........,.... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 .;. ..:.....: . ..:::.::. `e�<6'8" Sheathing Type .. (note 4).. ......:................................... Edge Nail Spacing'...: ::.... _...... (Table 10 or note 4 if less) ........: —in. Field Nail Spacing..................... ........ ........(Table 10) �in. Shear Connection(no.of16d common nails)(Table 10 .... <:. Percent Full-Height Sheathing.. ......... .......(Table 10) .::._. ::....... ..� 5%Additional Sheathing for Wall with Opening>6'8°(Design Concepts)...........:......... AC Maximum Building Dimension, L Nominal Height of Tallest Opening2...... (.-$ <6'8" Sheathing Type (note 4):. ....:. Gd' pS� Edge Nail Spacing ...... ......... ........ (Table 11 or note 4 if less)........................3 in: Field Nail Spacing ...:.: :... :...........(fable 11) Lin. —LL Shear Connection(no.of 16d common nails)(Table 11) Percent Full-Height Sheathing.. ........ .....:.(Table 11).................... 5%Additional Sheathing for Wall with Opening>6'8°(Design Concepts).- ................... _ Wall Cladding Rated for Wind Speed?:. 5.1 ROOFS Roof:framing member spans checked?........................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ............ ......... .... ....(Figure 19) .. ....:.tLL.ft_<smaller of 2'or U3 Truss or Rafter Connections at Loadbearing.Walls Proprietary Connectors Uplift. ........ .:..:...:..........:..........(Table 12)........... U If Lateral......:...:. .....::.. :....:.........,(Table 12) ..........................L= Plf. Shear. ......... ....... ....... .. ..:(fable 12) ..:.... S '71 ?.pif Ridge Strap Connections if collar ties not used,per page 21.:. (Table 13) ........ ................T-LfQ plf Gable Rake Outlooker ...(Figure 20)_...... .. ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls ' Proprietary Connectors / Uplift.. ......................... .................(Table 14) U=4)bb. Lateral(no:of 16d common nails)...(Table 14) ... ......... ... :.,.. ...L=b&klb. / Roof Sheathing Type.....................................................(per 780 CMR Chapters 58 and 59) .......:..., �G Roof Sheathing Thickness ........ in >7/16"WSP Roof Sheathing Fastening ..... ......... .......: .......(Table 2). .... ........ ........: ...... 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 1 VFCM 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. i AWC Guide to Food Construction in High Wind Areas:I10 mph Find Zone Massachuseffs Checlfist for Compliance(780 CMR 5301.2.1.1)' 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 staggered at 3 inches on center,per figures below:Vertical and Horizontal Nailing for Panel Attachment -MEN THIS EDGE REM DN FRAMING(MIE W WAp_q AT 6b.G I B11 fl- 11 u 1 .. I, 11 Q 1 41 Q . 14 1 11 1'1 1 r rl .14-------!1 If DOl19LE CDGE ------ MAILSPAGING i See Detail on Next Page .-Vertical and Horizontal Nailing for Panes Attachment AWC Guide to Wood Construction in Nigh Wind Areas: 110 MP Wired Zone Massachusetts Checklist for Compliance (7sa CMR 5301.2.1.1)' ¢Za • � . � is � �r I� f11 � Q FRRh01NG MEMBERS f„ � EOGERdiFJZMEdIAT£ � f� �' ,i S!9' `.i 3"MIN. -STAGGERED 3'Mrl UVL PATTERN PANS. OIAWL EDGE DOUBLE NAIL EDGE SPAC84G DML Detail Vertical and Horizontal Nailing for Panel Attachment 2b liy rm` by weyernaea er 4 Pcs of 1 3/41 z 9 1/2" 1. E Microllam@ LVL Ti-Beam®6.36 Serial Number:7005107030 User:2 1015/2010 9:24:35 AM MEMBER IS I SUFFI!IT DUE TO LOAD Page 1 Engine Version:6.35.0 a. ,o b q7 Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 12' Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other 71 Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 1.50" 3060/1380 10 1 444 A3: Rim Board 1 Ply 1 1/4"x 9 1/2"0.8E TJ-Strand Rim Board@ 2 Stud wall 3.50" 1.50" 3060/1380/ 44 A3: Rim Board 1 Ply 1 1/4"x 9 1/2"0.8E TJ-Strand Rim Board® -See iLevel@ Specifiers/Builder's Guide for detail(5): : im Board DESIGN CONTROLS: Maximum Design Control Result Location Shear(Ibs) 4353 -3874 12635 Passed(31%) Rt.end Span 1 under Floor loading Moment(Ft-Lbs) 18138 18138 23550 Passed(77%) MID Span 1 under Floor loading Live Load Defl(in) 0.681 0.417 Failed(U294) MID Span 1 under Floor loading Total Load Defl(in) 0.987 0.833 Failed(U203) MID Span 1 under Floor loading ' -Deflection Criteria: HIGH(LLU480,TL:U240). Bracing(Lu):All compression edges(top and bottom)must be braced at 17'o/c unless detailed otherwise.•Proper attachment and.positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel@. iLevel®warrants the sizing of its products by this software will be accomplished in accordance with iLevel@ product design criteria and code accepted design values. The specific product application, input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by an iLevel®Associate. -Not all products are readily available. Check with your supplier or iLevel@ technical representative for product availability. -THIS ANALYSIS FOR iLevel@ PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel@ Distribution product listed above. -Note:See iLevel®Specifier's/Builder's.Guide for multiple ply connection. i PROJECT INFORMATION: OPERATOR INFORMATION: ro� PJIlCHLE for: LANCASTER Michele Cudilo $ t .2 'CUDILO � 1783 SANTUIT-NEWTOWN RD.-,COTUIT Michele Cudilo, P.E. ° No•34774 �'• 123 Cottonwood Lane STRUCTURALCenterville,MA 02632-0263, -_ ¢7 Phone: 50877176019FcrsrE�E� Fax :5087717163 mcudilo@comcast.net e r Copyright 0 2009 by iLevel@, Federal way, WA. Microllamt9 is a registered trademark of iLevel:. v Ir header by Weyerhaeuser 2 Pcs of 1 3/4'1 x 91/4" 1.9E Microllam® LVL TJ-Beam®6.36 Serial Number:7005107030 User 2 10/5/2010 9:36:00 AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Pagel Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED �r r� b 6. Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width:2' Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(plf) Floor(1.00) 0.0 140.0 0 To 6'6" Adds To ext wall Point(lbs) Floor(1.00) 3060 1380 3'3" SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 2.00" 1725/1252/0/2977 Al: Blocking 1 Ply 1 3/4"x 9 1/4"1.9E Microllam®LVL 2 Stud wall 3.50" 2.00" 1725/1252/0/2977 Al: Blocking 1 Ply 1 3/4"x 9 1/4"1.9E Microllam®LVL -See iLevel®Specifier's/Builder's Guide for detail(s):Al:Blocking DESIGN CONTROLS: Maximum Design Control Result Location Shear(Ibs) 2938 -2730 6151 Passed(44%) Rt.end Span 1 under Floor loading Moment(Ft-Lbs) 7952 7952 11204 Passed(71%) MID Span 1 under Floor loading: Live Load Defl(in) 0.082 0.154 Passed(L/901) MID Span 1 under Floor loading Total Load DOI(in) 0.138 0.308 Passed(L/558) MID Span 1 under Floor loading -Deflection Criteria: HIGH(LL:L/480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 6'6"o/c unless detailed otherwise.. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel®..iLevel®warrants the sizing of its products by this software will be accomplished in accordance with iLevel®product design criteria and code accepted design values. The specific product application, input design loads,and stated dimensions,have been provided by the software.user. This output has not been reviewed by an iLevel®Associate. -Not all products are readily available;. Check with your supplier or iLevel®technical representative for product availability. -THIS ANALYSIS FOR iLevel®PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for.Building Code IBC analyzing the iLevel®Distribution product listed above. Note:See iLevel®Specifiers/Builder's Guide for multiple ply connection. zN of r.1gs, gyp`' MICHELE A � ..PROJECT INFORMATION: OPERATOR"INFORMATION: CU DILO for: LANCASTER Michele Cudilo ° No.34774, . �. 1783 SANTUIT-NEWTOWN RD.,.COTUIT Michele Cudilo,:P.E. _. STRUCTURAL 123 Cottonwood Lane Centerville,MA 02632-0263 Phone:5087717601 c;r,r•.i. Fax :5087717163 mcudilo@comcast.net Copyright O 2009 by iLevel&, Federal Way, WA, Microllam& is a registered trademark of iLevel&. ll/5r)✓� C:\Program Files\Tres Joist\Job Files\2010-LANCASTER2Bkitch.sms / /� �. Z. 26 kitch by Weyerhaeuser 2 Pcs of 1 3/4" x 18" 1.9E Microllam@LVL - - TJ-BeamO6.36 Serial Number:7005107030 User:2 10/5/2010 9:33:53 AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 1 Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED ❑, , r e 76.srr ; Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 10' o Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(plf) Floor(1.00) 0.0 80.0 0 To 16 6" Adds To ext wall Uniform(plf) Snow(1.15) 360.0 240.0 0 To 16'6" Adds To t=12 SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 6.20" 5445/3774/0/9219 Al: Blocking 1 Ply 1 1/4"x 18"1.3E TimberS,trand®LSL' 2 Stud wall 3.50" 6.20" 5445/3774/0/9219 Al: Blocking 1 Ply 1 1/4"x 18"1.3E TimberStrand®LSL -See iLevel®Specifier's/Builder's Guide for detail(s):All: Blocking -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: Maximum Design Control Result Location Shear(Ibs) 9032 -7217 13,766 Passed(52%) Rt.end Span 1 under Snow loading Moment(Ft-Lbs) 36506 36506 44566 Passed(82%) MID Span 1 under Snow loading Live Load DOI(in) 0.355 0.404 Passed(U546) MID Span 1 under Snow loading Total Load Defl(in) 0.602 . 0.808 Passed(U322) MID Span 1 under Snow loading I -Deflection Criteria: HIGH(LL:L/480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 3'6"o/c unless detailed otherwise.. Proper attachment and positioning of lateral bracing is,required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is 66tput from software developed by iLevel®. iLevel®warrants the sizing of its products by this software will be accomplished in accordance with iLevel®;product design,criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by an iLevel®Associate. -Not all products are readily available. Check:with your supplier or•iLevel®technical representative for product availability. -THIS ANALYSIS FOR iLevel®PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.. > . -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel®Distribution producf)isted above. -Note:See iLevel®Specifier's/Builder's Guide.for multiple ply connection. PROJECT INFORMATION: OPERATORINFORMATION:. for: LANCASTER Michele Cudilo. i. 1783 SANTUIT-NEWTOWN`RD.,COTUIT Michele Cudilo;P.E. gHOF.rfl 123 Cottonwood Lane y �� Centerville,MA 02.SS2-02637 O� MICHELE G Phone: 5087717601 CUDILO r, Fax :5087717163 0 No.347"4 u mcudilo@comcast.net STRUCTURAL t� Copyright O 2009 by iLevel, Federal way, WA, M;crollam© is a registered trademark of iLevel©. C:\Program Files\Trus Joist\Job Files\2010-LANCABTER2Bly.sms l��5r1Z 2b kitch by.yerhae::se, 2 Pes of 1 3/4" x 18" 1.9E Mierollam@ LVL TJ-BeamO6.36 Serial Number.7005107030 User:2 10/5/2010 9:33:53 AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Page 1 Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED El Product Diagram is Conceptual LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 10' Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live., Dead Location Application Comment Uniform(plf) Floor(1.00) 0.0 80.0 0 To 16'6" Adds To ext wall Uniform(plf) Snow(1.15) 360.0 240.0 0 To 16 6" Adds To t=12 SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 6.20" 5445/3774/0/9219 Al:Blocking 1 Ply 1 1/4"x 18"1.3E TimberStrandO LSL 2 Stud wall 3.50" 6.20" 5445/3774/0/9219 Al:Blocking 1 Ply 1 1/4"x 18"1.3E TimberStrand®LSL -See iLevel®Specifier's/Builder's Guide for detail(s):Al:Blocking -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: Maximum Design .Control Result Location Shear,(Ibs) 9032 -7217 . 13766 Passed(52%) Rt.end Span 1 under Snow loading Moment(Ft-Lbs) 36506 36506 44566 Passed(82%) MID Span 1 under Snow loading Live Load Defl(in) 0.355 0.404 Passed(U546) MID Span 1 under Snow loading Total Load Defl.(in)(in) 0:602 0.808 Passed(L/322) MID Span 1 under Snow loading . -Deflection Criteria:HIGH(LL:L/480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 3'6"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from.software developed by iLevel®. iLevel®warrants the sizing of its products by.this software will be accomplished in accordance with iLevel®..product design criteria and code accepted design values. The specific product application;input design loads,and stated dimensions have been provided by the.software.user. This output has not been reviewed by an iLeveIV Associate. -Not all products are readily available. Check with your supplier or iLevel®technical representative for product availability: -THIS ANALYSIS FOR iLevel@ PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. Allowable Stress Design methodology,was used for Building Code IBC analyzing the iLevel®Distribution product listed above, -Note:See iLevel®Specifiees/Buikler's Guide for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: for: LANCASTER Michele Cudilo 1783 SANTUIT-NEWTOWN RD.,COTUI.T Michele CUdilo,,P.E: 123 Cottonwood Lane s e� Centerville,MA 02632-0263' O� RflICHELE �` t Phone:5087717601 �� CUDILO aj Fax :5087717163 ° No.34774 mcudilo@comcast.net STRUCTURAL Copyright 2009 by LevekJ, Federal Hay, WA. <lcrollazry is a registered trademark of Uevel . - C' C:\Procra Files\Trus Joist\Job Files\2010-LANCASTERMv.sms 0 J, I Ir header by 4Ycycrhaeusc' 2 Pcs of 1 3/4" x 91/4" 1.9E Microllam® LVL Ti-Beam@)6.36 Serial Number:7005107030 User:2 1015n0109:36:00AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Paget Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED Eiji L d s.s.. Product Diagram is Conceptuai. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width:2' Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(pif) Floor(1.00) 0.0 140.0 0 To 6 6" Adds To ext wall Point(lbs) Floor(1.00) 3060 1380 3'3" - SUPPORTS: Input Bearing Vertical Reactions jibs) . Detail Other Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 2.00" 1725/1252/0/2977 Al:Blocking 1 Ply 1 3/4"x 9 1/4"1.9E Microllam®LVL 2 Stud wall 3.50" 2.00" 17251125210/2977 Al:Blocking 1 Ply 1 3/4"x 9 1/4"1.9E Microllam®LVL -See iLevei®Specter's/Builder's Guide for detail(s):Al:Blocking DESIGN CONTROLS: Maximum Design Control Result Location Shear(lbs) 2938 -2730 6151 Passed(446/6) Rt.end Span 1 under Floor loading Moment(Ft-Lbs) 7952 7952 11204 Passed(71%) MID Span 1 under Floor loading Live Load Defl(in) 0.082 0.154 Passed(U901) MID Span 1 under Floor loading Total Load Defl(in) 0.133 0.308 Passed(U558) MID Span 1 under Floor loading -Deflection Criteria:HIGH(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and.bottom)must be braced at 6'6"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel®. iLevel®warrants the'sizing of its products by this soflware.will be accomplished in accordance with iLevel®product design criteria and code accepted design values.. The specific product application,input design loads,and stated dimensions have been provided by the software user.:This output has not been reviewed by an iLevelO Associate. -Not all products,are readily available. Check with.your supplier or iLevelt technical representative for product availability- -THIS ANALYSIS FOR il-evel®.PRODUCTS.ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel®Distribution product listed above. -Note:See iLevel®Specifiers/Builders Guide for multiple ply connection. J�q PROJECT INFORMATION: OPERATOR INFORMATION: l+JflCHELE (,-% . for: LANCASTER { CUDILO Michele Cudilo ° Plo.34774 1783 SANTUIT-NEWTOWN RD.,COTUIT. Michele Cudilo,P.E. STRUCTURAL 123 Cottonwood Lane Q Centerville,MA 02632-0263 R��GrL Phone:5087717601 r..l_�NG� Fax :6087717163 mcudilo@comcast.net a Copyright c: 20 by see Federal clay, vicrollam✓� is a registterredd trademark of i.LeveveiN. C:\Program Files\Tres doisc\3ob Files\2010-LA.uCASTER26kitch.sms -p ` • 2b lid ue, 4 Pcs of 1 3/4"''x 91/2" 1. E Microllam® LVL TJ-Beam®6.36 Serial Number.7005107030 user 1 Engine 0s24:35AM MEMBER IS INSUFFIGIE : 'DUE TO LOAD Page 1 Engine Version:6.35.0 C a q�■ Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 12' Primary Load Group-Residential-Sleeping Areas(psf):30.0 Live at 100%duration, 12.0 Dead SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/Uplift/Total 1 Stud wall 3.50" 1.50" 3060/1380/0/444 A3: Rim Board 1 Ply 1 1/4"x 91/2"0.8E TJ-Strand Rim Boards 2 Stud wall 3.50" 1.50" 3060/1380/ �0 A3:Rim Board 1 Ply 1 1/4"x 9 1/2"0.8E TJ-Strand Rim Boards -See iLeve*Specifier's/Builder's Guide for detail(s): im Board DESIGN,CONTROLS: Maximum Design Control Result Location Shear(Ibs) 4363 -3874 12635 Passed(31%) Rt.end Span 1 under Floor loading Moment(Ft-Lbs) 18138 18138 23550 Passed(77%) MID Span 1 under Floor loading Live Load Defl(in) 0.681 0.417 Failed(U294) MID Span 1 under Floor loading Total Load Defl(in) 0.987 0.833 Failed(U203) MID Span 1 under Floor loading -Deflection Criteria: HIGH(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 17'o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES -IMPORTANT! The analysis presented is output from software developed by it eveND. iLevel@ warrants the sizing of its products by this software will be accomplished in accordance with iLevele'product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software.user..This output has not been reviewed by an il-eveiS Associate. -Not all products are readily available.-Check with your-supplier or iLevel@ technical representative for product availability. -THIS ANALYSIS FOR iLevel@ PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevelS Distribution product listed above. -Note:See iLevel®Specifier's/Builder's Guide for multiple ply connection. tN 4F M4S, " 3 ��^ PROJECT INFORMATION: _ OPERATOR INFORMATION: o� R/i1CHELE G�.. for: LANCASTER Michele Cudilo , CUDILO 1783 SANTUIT-NEWTOWN RD_,COTUIT. Michele Cudilo,.P.E. D No.34Z7d s 123 Cottonwood Lane ' STRUCTURAL Centerville,MA 62632-0263 o Q Phone:5087717601 9FGrSTca ��� Fax :5087717163 mcud!lo@comcast.net r� �Az Copyright 2009 5y iLevel , Federal Way, WA. M'crollamg is a registered trademark of iLevel,^. 1 � - A MICHELE CUDILO, P.E. • Consulting Structural Engineer 123 Cottonwood Lane•Centerville,Massachusetts 02632-1979•(508)771-7601 •Fax(508)771-7163 mcudilo@comcast.riet October 5,2010 Mark Lancaster MA Cotuit RE: STRUCTURAL MODIFICATIONS 50 View Crest Dr.,W.Falmouth,MA PROFESSIONAL SERVICES RENDERED Telecon w/Client,re: obtain as-built information;Engineering analysis;structural calculations;3 beams,plan markups,stamped; TOTAL DUE _$320 Thank you in advance. r /2010 I r i✓ REScheck Software Version 4.3.1 Compliance Certificate Project Title: Sederman Builder Energy Code: 2009 IECC Location: Cotuit,Massachusetts Construction Type: Single Family Building Orientation: Bldg.faces 90 deg.from North Glazing Area Percentage: 20% Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Lancaster Residence Sederman Builder Colony Insulation,Inc. 1783 Santuit-Newtown Road PO BOX 767 28 Jonathan Bourne Drive Cotuit,MA Monument Beach,MA 02553 Pocasset,MA 02559 508-221-6886 508-563-6049 • • • • Elm - Compliance:5.7%Better Than Code Maximum UA:105 Your UA:99 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. • Ceiling 1:Flat Ceiling or Scissor Truss 460 38.0 0.0 14 Wall 1:Wood Frame, 16"o.c. 288 21.0 0.0 14 Orientation:Back Window 1:Wood Frame:Double Pane with Low-E 43 0.300 13 SHGC:0.45 Orientation:Back Wall 2:Wood Frame,16"o.c. 128 21.0 0.0 7 Orientation:Right Side Wall 3:Wood Frame, 16"o.c. 256 21.0 0.0 9 Orientation:Left Side Window 2:Wood Frame:Double Pane with Low-E 9 0.300 3 SHGC:0.45 Orientation:Left Side Door 1:Glass 21 0.290 6 SHGC:0.45 Orientation:Left Side Door 2:Glass 64 0.290 19 SHGC:0.45 Orientation:Left Side Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 430 30.0 0.0 14 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 4.3.1 and to comply with the mandatory requirements fisted in the REScheck ln§Rection Checklist. �P _ (3R- 0-/0 Name-Tit igna re Date i Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 1 of 4 f. REScheck Software Version 4.3.1 Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: ❑ Wall 2:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: ❑ Wall 3:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Wood Frarrie:Double Pane with Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.290 Comments: ❑ Door 2:Glass,U-factor:0.290 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs and framing. Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 2 of 4 r (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls: Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (0 Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: 0 Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: Cj Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: (] Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: ❑ Building framing cavities are not used as supply ducts. Lj All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 34.4 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 51.6 cfm(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 25.8 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 17.2 cfm(4 cfm per 100 ft2 of conditioned floor area). Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. Lj For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Lj Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 3 of 4 Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Cj Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. ❑ Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: ❑ A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage<=15 (d)50 lumens per watt for lamp wattage> 15 and<=40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: O Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 4 of 4 I _ h Energy Efficiency Certificate Ceiling/Roof 38.00 Wall 21.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Window 0.30 0.45 Door 0.29 0.45 ow .. Heating System: Cooling System: Water Heater: Name: Date: Comments: F L I REScheck Software Version 4.3.1 �( Compliance Certificate Project Title: Sederman Builder Energy Code: 2009 IECC Location: Cotuit, Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Building Orientation: Bldg.faces 90 deg.from North Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Lancaster Residence Sederman Builder Colony Insulation,Inc 1783 Santuit-Newtown Road PO BOX 767 28 Jonathan Bourne Drive Cotuit,MA Monument Beach,MA 02553 Pocasset,MA 02559 508-221-6886 508-563-6049 Compliance:12.8%Better Than Code Maximum UA:47 Your UA:41 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. • Ceiling 1:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Wall 1:Wood Frame, 16"D.C. ___ ___ Exemption:Framing cavity filled with insulation. Window 1:Wood Frame:Double Pane with Low-E 43 0.300 13 SHGC:0.45 Orientation:Back Wall 2:Wood Frame, 16"D.C. ___ ___ ___ __- --- Exemption:Framing cavity filled with insulation. Wall 3:Wood Frame, 16"D.C. ___ ___ ___ _ Exemption:Framing cavity filled with insulation. Window 2:Wood Frame:Double Pane with Low-E 9 0.300 3 SHGC:0.45 Orientation:Left Side Door 1:Glass 21 0.290 6 SHGC:0.45 Orientation:Left Side Door 2:Glass 64 0.290 19 SHGC:0.45 Orientation:Left Side Floor 1:All-Wood Joist/Truss:Over Unconditioned Space --- --- Exemption:Framing cavity filled with insulation. 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 4.3.1 and to comply with the mandatory req ' list in the RESc - spection Checklist. i 62 OBI--lO Name- Itle &gnatulrf Date Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 1 of 4 J • • REScheck Software Version 4.3.1 Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c. Exemption:Framing cavity filled with insulation. Comments: ❑ Wall 2:Wood Frame, 16"o.c. Exemption:Framing cavity filled with insulation. Comments: ❑ Wall 3:Wood Frame, 16"o.c. Exemption:Framing cavity filled with insulation. Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Wood Frame:Double Pane with Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.290 Comments: ❑ Door 2:Glass,U-factor:0.290 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space Exemption:Framing cavity filled with insulation. Comments: Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 2 of 4 Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: El Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: Lj Materials and equipment are installed in accordance with the manufacturer's installation instructions. O Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Lj Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: El Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically, fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 34.4 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 51.6 cfm(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 25.8 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 17.2 cfm(4 cfm per 100 ft2 of conditioned floor area). Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. Lj For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Project Title: Sederman Builder Report date: 09/07/10 Data filename:C:\Documents and Settings\JUNE.colony\My' Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 3 of 4 i Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. ❑ Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: Ej A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage<=15 (d)50 lumens per watt for lamp wattage>15 and<=40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: ❑ Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Sederman Builder Report date: 09/07/10 'Data filename:C:\Documents and Settings\JUNE.colony\My Documents\REScheck\SedermanBldr-9-1-10-1783Santuit-NwTwnRd-Cot.rck Page 4 of 4 U.� Efficiency Certificate Ceiling/Roof 0.00 Wall 0.00 Floor 1 Foundation 0.00 Ductwork(unconditioned spaces): Window 0.30 0.45 Door 0.29 0.45 Heating System: Cooling System: Water Heater: MMEMMEMMEM Name: Date: Comments: Town of Barnstable Regulatory Services ` RA NSTA$L.F F MAE3 $ Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Strect, Hyannis, MA 02601 www.to wri.b arnstab l e.ma.u s Office: 508-962-403 9 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Owner of the subject property hereby authorize't/�nut�j . lj�el)FI'Qlj'I4 Aol to act on my behalf, in all matters relative to work authorized by this building permit application for. —I (Address of Job) Sign of er Date Print � If Property Owner is applying for permit please complete. the Homeowners License Exemption Form on the reverse side. Q:F0RM5:0 WNERPERM1SS10N Town of Barnstable ' . . �P o Regulatory Services Thomas F. Geiler,Director 'ABEL Building Division �PrED '� Tom Perry, Building Commissioner 200 Main Stree�_Hyannis, MA.02601 WWW.town.barnstab1e_ma.us Office: 508-862-4039 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Plearc Print DATE: JOB LOCATION: number street village "HOMEOWNER": name homophone# work phone# CURRENT MAILING ADDRESS: city/town state ap wdc Ilse current exemption for"homeowners"was extended to include owner-occupied dwelIinF_s of six units or less and to allow homeowners to engage an individual for hire wbo does not possess a license,provided that the owner acts as supervisor. DEMI"rION OF BOMEOW ER Persons)who owns a parcel of land on which he/sbe 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 hD=0'V;mer. 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 rmdcrsigned "homeowner" certifies that.he/sbc understands the Town of Barnstable Building Dcparlmcnt rr;n; lim inspection procedures and requirements and that be/she will comply with said procedures and rcquircmcnts. Signatiirc of HomrOwner 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 homcowncr performing work for which a building permit is rcquirrd shall be exempt from the provisions of this SCC6Dn•(Srcticrn 1D9.1.1 -Lic raring of construction Supervisors);provided that if the hDMrOF/ncr cogages a person(s)for hire to do such work~that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unawzrc that they arc assuming the responsibilities of a supervisor(sec Appendix Q, Ru)cs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the home es owner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Superv-isor. The homcowncr acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/hcT responsibilities, many communities rmquire, as part of the permit application., that the homeowner certify that he/she under=tsnds the mspannbilitirs of a Supervisor. On the last page of this issue is it form currently used by several 1DAmt, You may care t amend and adopt such a forrr✓ccrtification for use in your community, Q:f orTT-s:h omccx crap t i t� j >- Massachusetts Dcpartmcut of Puhlic Safct� Board of Building Regulations and Standards . Construction Supervisor License License: CS 64323 Restricted to: 00 THOMAS J SEDERMAN , . ,, PO.BOX 767 MONUMENT BEACH, MA 02553 c— Expiration: 12/1/2010:_ ('uqunissiuni ' : Tr#: 7764 License or,registration valid for individul use only ( Bo before ing egu awo ;Au j t.indards �I efore the expiration date. if found return to' B b HOME IMPROVEMENT CONTRACTOR. J �! Board of Building Regulations and Standards Registration:�128112 One Ashburton Place Rm 1301 Expirrat on 2124/2011 Tr# 27970'1 Boston,Ma.02108 I t" TYPe DOA 1 SEDERMAN BUILDERS g r- j C THOMAS SEDERMAN ir_{ (;; + Not vali without signs ure 4 f PO BOX 7671405 SHORE,RD f; Administrator 1; . MONUMENT BEACH,MA:02553 44 AR WCIP Liberty ISSUING OFFICE 181 Mutual Workers Compensation and INFORMATION PAGE Employers Liability Policy ACCOUNT NO. SUB ACCT NO. Liberty Mutual Irmwance Group/Boston 1-328088 0000 LIBERTY MUTUAL FIRE INSURANCE CO. 16W POLICY NO. TD/CD SALES OFFICE CODE SALES CODE N/R 1ST WC2-31S-328088-010 XX X WESTON 102 REPRESENTATIVE 3000 2 YEAR ASSIGNED 2001 Item 1.Name of THOMAS J SEDERMAN Insured DBA SEDERMAN BUILDERS FEIN 01-7588024 Address PO BOX 767 RISK ID 000251552 MONUMENT BEACH,MA 02553 Status 01 -INDIVIDUAL Other workplaces not shown above: SEE ITEM 4 Mo.Day Year Mo.Day Year Item 2.Policy Period:From 05-30-2010 to 05-30-2011 12.01 AM standard time at the address of the insured as stated herein. Item 3.Coverage 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 3A. 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 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states,if any,listed here: SEE END WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE Item 4.Premium- 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. Premium Basis Rates LINE 110 Per$100 Estimated Code Estimated of RE- Annual Classifications No. Total Annual Premiums muneration Premiums SEE EXTENSION OF INFORMATION PAGE Minimum Premium $ 500 ( MA ) Total Estimated Annual Premium $ 500 Interim adjustment of premium shall be made: ANNUAL This policy,including all endorsements issued therewith,is hereby countersigned by Authorized Representative Date 06-07-10 Loc.Code Term. Oper. Audit Basis Periodic Payment Rating Basis Pot.H.G. Home State Dividend RENEWAL OF: 06-07-10 NR MA WC2-31S-328088-019 GPO 4030 R1 Copyright 1987 National Council on Compensation Insurance WC 00 00 01 A Insured copy I Show Header Print Hide Envelope From: Nancy Lancaster Add to Address Book To: ssederman@marketpluslic.com + Date: Thursday,September 30, 2010 10:48:08 AM Subject: FW:Gastro Nurse Feedback CPO 1 10( °F T Town of Barnstable *permit FIt?TCL. k �F� w ss Expires nt/i ron date Regulatory Services Fee HARNSTABLE 9 ,bE �� Thomas F. Geiler,Director i Building Division 0 Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02661 www.town.barns tab le,ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY - - Not Valid without Red X-Press Imprint Map/parcel Number n s 5� /7�� c r'Property Address ��� �� ���oe Residential Value Value of Work 15 0 42 Minimum fee of$35.00 for work under$6000:00 Owner's Name & Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: L El m a sole proprietor, X ' I am the Homeowner.' ` ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy#. , Copy of Insurance Compliance Certificate must accompany each permit. 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-side #of doors Replacement Windows/doors/sliders. U-Value I ,ttLKS (maximum ;44)# of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i,e.Historic,Conservation,etc. ***Note: Prope Owner must sign Property Owner Letter of Permission. A co of the Ho a Improvement Contractors License& Construction Supervisors License is e fired. ;IGNATURE: ���of Yite rory Town of Barnstable o Regulatory Services uIRrST,B Thomas F. Geiler,.Director buss i63q. Building Division _ Tom Perry, Building Commissioner 200 Main.Street, Hyannis,MA 02601 T wlv.town.barnstable.Ma.us Office: 509-862•-4038 . Fax: 508-790-6230 ETOA EOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number�. �' strectJ�� 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,umta.or less and to allow homeowners to engage an individual for hire who does not possess%a licc'nseN,provided that the owner acts as . supervisor. DEk7NITIOWOF HOIvMOW ERA-�- 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 constrycts more than one home in a two-year period shall not be considered a bomeoamer, 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 btiildir'g peimit..(Section,109,1`1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,r6les and regulations. The undersigned ` eowner"certifies that.he/she understands'the Town of Barnstable Building Department. nim mium eG .o roved and requirements and that he/she will comply with said procedures and re -. e ts. t Sign r of Horn wncr r Approval of Building Official Note: Three-family dwellings containing35,000 cubic feet of larger will be required to comply with the State Building Code Section 127.0 Construction Control,- HOMEOWNER'S EXEMPTION .The Code states that: "Any.homeowncr perforrrung work for which a building pcmait is required shall be exempt from the provisions . Of this scctioq(Scetion 109.1.1 -Licensing of construction Supervisors);provided that if the homcowncr engages.a person(s)for hire to do such wofk,that such Homcownca shall act as sup-Visor.7' Many homeowners who use this exemption am unaware that they are assurrung the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing construction Superyisors,Section 2.15) This lack ofawarcness often results in serious problems;particularly when the homcowna hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would ould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is frilly aware of his/hcrresponsibilitics,many communities require,as part of the permit application, that the homeowner certify that Wshe understands the responsibilities of a Supervisor. Od the last page of this issue is a.form currently used by several towns. You may care t amend and adopt such a fom✓certification for use in your community, -- r Town of Barnstable Regulatory Services sUaxsrABLF— vQ M.tse. Thomas F. Geiler,Director (7 s634. `m Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us i Office: 508-862-403 8 Fax: 508-790-6230 ` 'Property Owner Must Complete and Sigh This Section .If Using- A Builder as er of the subject.property hereby authorize � S� L`� '✓� to act on my behalf, in all matters relative to -w authorized b/6bisb g permit application for. (Ad dre of Job). fI V=e wner Date i. R14L �- Print Name E If Prop eIV Owner is applying forpern-tplease complete. the Homeowners License Exemption Form on the reverse side. The Commonwealth of Massachusetts f Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.g ov/dia . Workers' Compensation Insurance Affidavit: Builder/G'ontractors/Electricians/Plumbers Applicant Information Please Print LejZibly Name (Business/Organization/Individual):= MI Address: 17&3 1)EO-704)AJ ,. City/State/Zip:l-C'//tA-�j/�/ Cl9� Phone #: '� � 7-7 `Sz7 Are you an employer?Check the appropriate box: Type of projegL(required): 1.01 am a employer with . 4. ❑ I am a general contractor and I 6. n New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.,$ 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 r uired.] officers have exercised their IO;E Electrical repairs oradditions - 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, §](4),and we have no 12.❑ Roof repairs insurance required.] t employees.. [No workers' comp.insurance required.] 13.0 Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. f 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.. Insurance Company Name: Policy#or Self-ins. Lic. 4: 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-maybe forwarded to the Office-of Investigations of the DIA for insurance coverage verification. I do hereby Gerd under he pains an enalties of perjury that the information provided,above is tr a and correct. Si ature: "k-4 Date: 01 Phone#: �7 / 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 5.1 Plumbing Inspector 6.Other 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'chap'ter 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 f Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom i 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. jThe 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 i 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 Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR:Sed4e ewn JOB SITE ADDRESS: )-4 {e, DATE: AREA THICKNESS R-VALUE Ceiling Cathedral Ceiling — Garage Ceiling Basement Ceiling Slopes Exterior Wall Garage H se. Wall W alkout Wall Cathedral W all B lock.ers 3" Overhang Stair/Risers All R-values and thickness measurements are deemed to be accurate by the following installers: R TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM ,t. I ThermoSeal 2000—Product Specification ASTM D2856 >=90% ViscOSfty& Weights ASTM D2196 Viscosity A Side ISO @ 700 F 215±35 B Side Resin @ 700 F 700±100 k ASTM D1475 Weight/Gallon Spr ers A Side ISO @ 77°F 10.2lbs B Side Resin @ 77°F 9.81bs PO Box 1 182 New Canaan, CT. 06840 Mixing Ratio By Volume Phone & Fax: 800.853.1577 ThermoSeal 2000 is a standard 1:1 mix http:///www.SprayFoamPolymers.com product. Slightly off ratio can produce slightly heavier odors and foam characteristics.Typically a heavier A ratio will produce a crunchier foam result,and a heavier B Side ratio will produce a spongier result. Electrical Wiring ThermoSeal 2000 is chemically compatible Suggested Preparation&Use with all 14/3, 12/2 and other similarly ThermoSeal 2000 will perform best when coated electrical wirings.For knob and tube . gradually climate controlled to 77°F the wiring please seek the approval of your night before application.While local building inspector. recirculation of ThermoSeal 2000 without Product Storage heat prior to each days spraying is Component A-550 lbs of Isocynate stored suggested,recirculation of ThermoSeal in a a 55 gallon container outlined above. Bacterial and Fungal Evaluation 2000 in order to rapidly heat the product is Component`A' must be protected from ThermoSea12000 is not a source of food not is not suggested and may result in a freezing or deemed useless. for mold,insects or rodents.It has no decrease in catalyst count and product nutritional value.ThermoSeal 2000 reduces yield. We suggest starting with a Component B-500 lbs of ThermoSeal 2000 the introduction of moisture,food,and temperature of 125°F and a working proprietary formulated resin Component mold spores into the building envelope pressure of 1000 psi. `B' must be stored between 55°F and 80°F significantly more than traditional never exceeding either extreme. insulation such as fiberglass,cellulose and other non-sealants which do not provide an Both components temperatures should be at air barrier. Product Availability 75°F prior to mixing and use. Contact Spray Foam Polymers at Environment/Health/Safety 1.800.853.1577 for sales and availability WARRANTY When installed properly be a Spray Foam ThermoSeal 2000 contains no CFC's options. HCFC's,formaldehyde,or volatile organic Polymers authorized representative who has compounds.Following installation there Packa in2 completed all training offered by SFP,SFP will be a 24-48 hour occupancy window Products are shipped in 55 gallon open to warrants that the product will meet all before the odors,emissions and asses have pp g p P product specifications outlined in this g steel drums.At the customers request the dissipated to a habitable level for specification document. products may be shipped in 55 gallons open individuals highly sensitive to the materials top semi-clear plastic resin drums. , installed. ThermoSeal 2000 is is not to be installed . within 2"of heat emitting surfaces where heat dissipated exceeds 1857. DISCLAIMER:Information contained herein is,true and accurate,but all recommendations or suggestions are made without guarantee.Spray Foam Polymers,LLC(SFP)products are intended for sale to industrial and commercial customers.Since SFP exercises no control over its customers appreciation or use of the product manufactured by SFP and since materials used with the products may vary,it is understood that SFP can warrant only that our products will meet our written specifications.Nothing herein shall constitute any warranty of merchantability or fitness,nor is protection from any law or patent to be inferred.ThermoSeal must be installed in accordance with all applicable building codes and a building inspector's approval should be requested prior to installation.All patent rights are reserved.SFP requests that customers inspect and test our products before use,and satisfy themselves as to contents and suitability.The exclusive remedy for all proven claims is replacement of our materials and in no event shall SFP be liable for any consequential,incidental,indirect,or special damages resulting in any manner from the furnishing of the material. r ThermoSeaC 2000—Product Specification Air Permeance/Air Barrier ThermoSeal 2000 fills any shape cavity Burn Characteristics ' including all voids,cracks,and crevices ThermoSeal 2000 will be consumed by $pr. ers adhering to multiple substrates such as flame but will not sustain flame upon wood,metal,and concrete creating a removal of the flame source.ThermoSeal `rhe7-Mo$eaC2000 system with very little air permeance.With 2000 will not melt or drip.ThermoSeal Product Specification ThermoSeal 2000 no additional interior or 2000 must be installed in accordance with exterior air infiltration protection is all applicable building codes and a building Product Name required. inspectors approval should be requested ThermoSeal 2000 is the registered ASTM E283 Air Leakage prior to installation. trademark of SprayFoamPolymers.com for Zero(0) ft3/s.ft2 @ 75Pa(25mph wind) ASTM E84 Surface Burning Properties its 2.Olb high density,closed cell foam Sustained Wind Load insulation. Flame Spread @5" <=25 60 minutes@1000 Pa(90mph wind) Smoke Developed @ 5" <=450 Class 1 rating Product Description TBD Fuel Contribution none ThermoSeal 2000 is a semi-rigid,partially ASTM 2863 Oxygen Index TBD% water blown,2.Olb high density Gust Wind Load Test polyurethane foam insulation system blown @3000 Pa(160 mph wind)D VOC TESTING by Enovate®blowing agent and water TB CAN/ULC-S774 Pass which simultaneously insulates and air- SASKATCHEWAN RESEARCH seals your building structure. ThermoSeal ThermoSealTM 2.0 qualifies as an air barrier COUNCIL 2000 is designed to make homes more as defined by ICC. energy efficient,stronger,healthier,quieter ThermoSeal 2000 must be covered by an and more comfortable.ThermoSeal 2000 is Water Vapor Permeance approved 15 minute thermal barrier or applied as a liquid spray which expands ThermoSeal 2000 is water vapor permeable ignition barrier, approximately 15 times its initial mass and and will allow structural moisture to escape. cures within seconds into a semi-rigid mass. For situations requiring a vapor barrier the A These flame-spread ratings are not ThermoSeal 2000 fills all building cavities use of low vapor permeable paint on the intended to reflect hazards presented by this completely sealing all cracks,crevices,and interior of drywall is an option. or any other material under actual fire voids where air loss and infiltration are conditions. most common. Water Vapor Transmission Properties: ASTM E96 data Compressive and Tensile Strength Technical Data 1.11@ 1" ThermoSeal 2000 has favorable compressive and Tensile strength properties Thermal Performance Water Absorption for high density foam. Thermal resistance(aged 180 days)R/in. ThermoSeal 2000 is water repellent,will ASTM C518: R6.62hr.ft2 OF/BTU not wick,and does not exhibit capillary ASTM D1623 Tensile Strength 80 psi properties.Water cannot be forced into the ASTM D1621 Compressive Strength 35 psi Average insulation contribution in stud foam under pressure because of its high wall: degree of closed cell structure Physical Characteristics 2"x4"=R23 2"x6"=R36 DIMENSIONAL STABILITY Acoustical Properties ThermoSeal 2000 provides greater R value Performance in a 2"x 6"wood stud wall. ASTM D—2126 performance than other equivalent R value 1580 F 100% Relative Humidity,7 days insulation materials which are air ASTM E413 STC Sound Transmission permeable such as fiberglass.ThermoSeal TBD Volume Change <8% 2000 does not lose R value due to wind, ageing,convection,air infiltration or ASTM E 90 Class 33 Closed Cell Content moisture.An.R value fact sheet is available ThermoSeal 2000 is considered closed cell . upon request. Fungi Resistance foam insulation: • . ASTM G—21 ZERO RATING DISCLAIMER:Information contained herein is,true and accurate,but all recommendations or suggestions are made without guarantee.Spray Foam Polymers,LLC(SFP)products are intended for sale to industrial and commercial customers.Since SFP exercises no control over its customers appreciation or use of the product manufactured by SFP and since materials used with the products may vary,it is understood that SFP can warrant only that our products will meet our written specifications.Nothing herein shall constitute any warranty of merchantability or fitness,nor is protection from any law or patent to be inferred.ThermoSeal must be installed in accordance withal]applicable building codes and a building inspector's approval should be requested prior to installation.All patent rights are reserved.SFP requests that customers inspect and test our products before use,and satisfy themselves as to contents and suitability.The exclusive remedy for all proven claims is replacement ofour materials and in no event shall SFP be liable for any consequential,incidental,indirect,or special damages resulting in any manner from the furnishing of the material. 1'nOJECT..n f�"• NAME: �� ADDRESS: PER 4,IT# Z d t C> (�5 3 p 9 PERMIT:DATE: O 1 M/P: LARGE BODED PLANS ARE IN: BOX- SLOT 4 -' 1 Data entered r� 1V1A1'S p�ogranl on: 10 -�-o to -BY: — V �a. { ` II 3/2 VslALL, 4t�IZ'- ¢x x 6.5 Ll LIT Rff r2\1Pz 61 P, -T►+R�U'60l.T5` 4 IA Ihl� x 7u 5-n $� R � ``p1 .1. Tif{12 tJ�Y o�- /44 41i s (� ��IL PASH OF,&I S o� IWICtiCtE CUDIL0 ° No.34774 STRUCTURAL _ _ _ u , - MICHELE CUDILO'. P.E. ConsultingStructural Engineer Centerville, Massachusetts 02632 508 771-7601 Drawn By: MC Date: �� b--Drawing Scale: AS NOTED Rev. File me: M Project No: 0� rR=833.40' L=18.89' N 16.2' 2s.6" 24,70�± S.F. 0.57t ;AC. ,� Y 15.0' " ' Gar. o i% !� o Exist. N Qn ` Dw 8.0 #1783 I (�i� Exist. 71.4' w Fdn. ' O a Z `` 16 O rt , � � 1 61.6' Ln 67.8' '' "" 68 15.0 S 68 STREET ADDRESS. #1783 SAN7TIIT-NEWTOWN ROAD ASSESSORS' MAP 230 PARCEL 65-1 OWNER. MARK & NANCY LANCAS7ER DEED REF.: BK. 13044 PG 156 PLAN REF.: PL. BK.446 PG. 95 TOWN OF BARNSTABLE ZONING BY-LAW ZONE RF I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL SETBACKS : . KNOWLEDGE, INFORMATION AND BELIEF THE FOUNDA71ON FRONT = 30' SHOWN HEREON CONFORMS TO THE HORIZONTAL SE7BACKS SIDE = 15' OF THE ZONING BY—LAW FOR THE TOWN OF BARNSTABLE. REAR = 15' PROPERTY LINES SHOWN HEREON �jNOFMgSs, WERE COMPILED FROM AVAILABLE ��P qcy PLANS OF RECORD AND VERIFIED TERRY ON THE GROUND. WARNER N A No.38721 "AS—BOIL. T" THE FOUNDA77ON DEPICTED ON THIS ��N� �� PLOT PLAN PLAN WAS LOCA7ED ON THE GROUND IN BY TAPE SURVEY ON OCT. 29, 2010 AND 1 BARNSTABLE, MASS. EXISTS AS SHOWN AS OF 7HE DATE OF LOCA770N. f SCALE. 1"=40' NOV. 1, 2010 7HIS PLAN IS FOR PLOT PLAN 7ERRY A. WARNER, P.L.S. PURPOSES ONLY. 22 LONG ROAD HARWICH, MA. 02645 (508) 432-8309 THIS PLAN IS VOID IF NOT STAMPED AND SIGNED IN RED. 0 20 40 80 PROJECT NO. 10-189AS r� r T0w.n. 0f Barnstable . Regulatory Services r 7iLsNgrABm =' Tb:omas Geiler, Dixector KA S, , Building Dxzsiori rEp µx• , Thomas Perry, CBO,Budding Commssioner 200 Main street, Hyanms,M, 02601 ww)VAO.Wn.barns.2 ble.ma.us Fax:•508-790-6230 'Office( 508-862--4038': ' PLAN REVIEW -t�z a r a C>.-,5 30 9 . Owner: Map/Parcel: f" Project Address /1dO �,r+vTiiti'/ oliG/� Builder: �►eeP�r/nran Gz ` The following itetxas were noted on reviewing: - 3 N r /� /St ZC�F d by: /'Glf�� A Revie'' e O pate :x ' lV �— 1 - ,$ltu,.•�i;: u.._.�.J s..,.•.v�e3 .. o-1 .,6.r ", t . ..a.., rhF,. BUILDER INFORMATION Name Telephone Number Address /7� License# �n71n`T l/G, r9 6a( Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE fill TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION iw. Niap 0 02 3X Parcel ®try Q0l Permit# 4 45�� _3 Health Division 50 �-1�'D2 -ifZbW-7,7_G C31 V-rm o"ly� Date Issued ib /� "d 2 Conservation Division Application Fee 50 Tax Collector o" Permit Fee �- Treasurer L �7' .� SEPTIC SYSTEM MUST BE INSTAIJ.EDNC0MKAANCES�// Planning Dept. WM IE i Date Definitive Plan Approved by Planning Board ENVIROINTAL CODE ANG WN REGL U I.ONI ...�' Historic-OKH Preservat• /Hyannis Project Street Ad ress Village Owner l ,�y Address V (Z"/, -y r Telephone �9 % �/q Permit Request IL 12 7y, D 4 Wit`-0A1 Square feet: 1 st floor: existing proposed 90 2nd floor:existing So proposed 11J A Total new_/� Zoning District Flood Plain Groundwater Overlay O6 C7' Project Valuation CO Cit'a Construction Type Lot Size ?,`I, cl 5 r S' Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure -3D 05. Historic House: ❑Yes ONo On Old King's Highway: ❑Yes kNo Basement Type: dFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) A/A Basement Unfinished Area(sq.ft) O Number of Baths: Full: existing 62 new Half: existing ,a new Number of Bedrooms: existing_5 new 0 Total Room Count(not including baths): existing new_Z First Floor Room Count Heat Type and Fuel: 'a Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes 0"No Fireplaces: Existing New _ Existing wood/coal stove: if Yes ❑No Detached garage:❑existing ❑new size Pool:d existing ❑new size Barn:&(existing ❑new size c Attached garage:❑existing ❑new size Shed:Uexisting ❑new size7k Z Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ __Commercial._❑Yes._ ®_No _ If-yes, site,plan review#_ Current Use Proposed Use BUILDER INFORMATION Name MOAWS Telephone Number ��' ��" 3 �� Address License# AA w^P—A-IF Home Improve ontractor# /02 ZZ19 5, sation# ALL CONSTRUCTION DEBRIS RESULTING FRO PROJECT WILL BE TAKEN TO �41 SIGNATURE DATE 5;4PI—eAg l' b FOR OFFICIAL USE ONLY dd >- 1 PERMIT NO. DATEJ,SSUED MAP%PRCBL=`NO. . ADI)IS = VILLAGE" -f . t DATE 0 ECTION: FOUNDATION , FRAME''` INSULATION FIREPLACE" 3 ELECTRICAL: ROUGH FINAL,• F PLUMBING: ROU.GH:Z FINAL . t GAS: R OUG'H ij FINAL 0 , * - FINAL BUILDING k DATE CLOSED OUT ASSOCIATION PLAN NO C) ' t T RESIDENTIAL BUILDING PEPMT FEES . APPLICATION FEE ` New Buildings,Additions, $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 - FEE VALUE WORKSHEET NEW LIVING SPACE ! J square feet x$96/sq.foot= (0 4 U x.0031= . 2 plus from below(if applicable) { ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. >120 sf-500 sf S 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf .100.00 - >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00 (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool .$60.00 Above Ground Swimming Pool $25.00 Y Relocation/Moving $150.00 (plus above if applicable) / Permit Fee projcost 114E Toff Town of Barnstable y °* Regulatory Services '* BAMBxs1'As . ' Thomas F.Geiler,Director 9`�ATf :�a`�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: IX/U 100d TD7N/�A Estimated Cost _?�419. 101d Address of Work: /�� f��lfiL �� �'nZ7/� Owner's Name: V lJL2,41F'i 4 4�46 4QDvV-0_f/ Date of Application: �/:210 = I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied �wner pulling own permit r Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. oe Date Owner's Name IQAmis:homeaffidav ...... The Commonwealth of Massachusetts ri Department of Industrial Accidents -- = Ofllce oi/nsestigat�ees 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit iINSi name• location: hone#CitV I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one workin in capacity %% /%%////�//////------///%/%%%% I am an em 1 roviding workers' compensation for my employees working on this job. P stldtss...::.. ;. Q .::::... . .... . ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have e followin workers'compensation polices: g....................:..:.::.::::.::::........:.:.::..............:.::.::::::::..:::::::::..........::::::::::::::::::::.::.::..........:.:..:.:.::. ::::.:::::::::.:::::::::::::.:...............:::::•::::::::::::::::::.:::::::. an name: :. ::<:>::::>:<:>::>:::<:::;>:«:»:: cn :::::.....:.: .. .....:..::.::>:: .:::.::: ..........:.:::::..: :.;:.:::::::::: dress.•. •i:it::::.;. X. fj :��:}::::: y'h : -::;:;:;:+:::::.:......ii: ?' �i:�i:::i:::+:}:�n�::'i:"::i:'':;;(:! ') !"' :{'rh �::::::.�::::::::viii:4:t4i}ii::i:::r::•n-:is iiiii>iiiiii}iii:<viiii:<y::i.iiiiii::.:::::::::v::....•..:::::............... ............ .:;;;,�::::::::v;:::::::::v.�::::::::::::::i:4ii`i:?y ii:•iiiii'iiiiiii i:• ii::'iiii:•i iiii::•ii:^i::i�ii i iii:>ioi:iiiii iiii ....................... ii i:<ii ii iiii: t:i;:ii:'tY: .........................:.....:...........................n.:::::::::::::.:w::::v:n.......v v:::.�w:::::: {.i:^ii 'oi"`:'Cl►'.<::�'::�:;:: :;�?':`::<;::::�:::;�::;:::::;::>::"?:;:;;:{;::::::::::i.ii.�:�;;::::::::;:�<isi':;:i::`;:�:::-<.:::is;;:i:;::;'•:i;5i:::;::;::�:�.i: :>:>;i i::si:<r::i.:;.;:.;>;i:;.r.>:>.:>::ii::: `•�r' f� <: ; ::`'': ���:2?t::.'::?:<':::s:; ::y:::::+::::>: : : i i:::::::::ir;::<:: ::::2:<:;:;i::::::<:::>:z::::::i::i:<:;';z:::.i^:i::i�::::;•i:.i:.:.i:•>tt•:i::;::><:->:::::_;ci�i:::;i:'.::i.:.;:.>:�:::>::::;: c sn:n .. ....................................... \.4•....... sdtEress. ..t.ii:•:•i;:.i:•;:•:::.i:t.;:.;:::.ii:.:;:.::::::.::::: ism: :. )idn......::i::::::::::::::.:........... :::i: � "��`''1M'"��`�' ? i 'jt� >`>%Y>`� t'a > 2` <' ? ,.,.i;>::•;::.ii;i>i::>•t.;:.;:::;,::i.:- ll Fafime to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years,imprisonment as wen a,dvfi penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage veriflwflon I do hereby certify under the pains and pen • of perjury that the information provided above is true mid correct Signature Date �^ Print name - L i? ;/ Phone# lJ 9 ���'/� official use only do not write in this area to be completed by city or town official city or town: permit/iicense# ❑Building Department ❑Licensing Board ❑check if Immediate response is required ❑Selectrnen's Office ❑Health Department contact person: phone#; -- ❑Other (devised 9195 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Flo Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company naives, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernut/license number which will be used as a reference number. The affidavits may be retinned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Otflce of Invesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 • Table,I,S.Z.Ih( � moud Fads for daa I'd Twe'4smOr Rm'descW Bs"OD Et wrti�Ertel p�seriptfre Pielrs� . • 11�YiMUM ,-Q��,Rg MAxiM11M �� oar Ssaemasc Gig . GLdag Celliq Flow � F1lidra�7� Asses'(•/.) U-ti alua2 A-vs u, R-values Rrvattm' R RA%'D Padca?e 5"1 ie 6500 Heatta>s Degrss Da7� 6 Noses 19 10 . N � M:� Z!'. 0.40 ]E 13 6 30 19 19 10 t3 AFZ7E 12% M2 10 619 OS0 ]E 13 ZS .NIA WA 1S'/. 0.76 31 10 6 Nomw ISY• 0.46 3E 19. 19 =SAFUE U . l3 2S NIA WA v 13'/5 0.4.4 3E 6 !<S AFVE 30 19 19 10 Nonaal N 15% 03Z NIA 13 25 TVA X .18% 0.3Z . ]E u Ii/A EEFN===z1 y 1E'/. 0.42 3i 19 0ARM 3i 13 19 10 0 AFUE y 1EY. 0:42' 6 AA 30 19 19 . 10 1, ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING' ' 4, %GLAZING AREA(#3 DIVIDED BY#2): S: SELECT PACKAGE(Q—AA-see chart above):: THER MORE INVOLVED NOTE: O METHODS OF DETERMINING ENERGY•REQUMEMENT§ ARE,4yAILAHLE. ASK US FORTIES INFORMATION. BUILDING INSPECTOR APPROVAL: YES: N0: 4:forms-f9&0303 a r I Footnotes to Table J5.2.Ib: • Glazing area is.the ratio of the area of the glazing assemblies (including sliding-glass degree skylights, d basement windows if located in walls that enclose conditioned ipace,but excluding opaque doors) thegro ss ll area. expressed as a percentage. Up to 1% of the total glazing area may be eexcluded.fr•om the U-value requirement. For example;3 ft3 of decorative glass may be excluded from a building deli with.300 ftz of hang 2 After January 1, 1999, glazing U-values-must be tested and documented by the maaufaccursr in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken'from Table 11.5.3a. U-values are for whole units:'center-of--?lass U-values cannot be used. '.The ceiling R-values do not assume a raised ar oversized true cbnstruetion. If the insulation achieves the full insulation thickness over the exterior walls without campressiont R-30 insulation, tray be substituted for R--8 insulation and R-38 insulation may be substituted for R=49 insulation- Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if.used). For.ventilated ceilings.iasulatm8 sheathing-must be placed between the conditioned space and,the ventilated portion of the roof. Do not include 'Wall R-values represent the sum of the wall. cavity.insulation.plus insulating g (• used). exterior siding, structural$heathing, and iaterior'drywalL For example,an R-19 requirement could be met EITHER by R-19 cavity insulation•OR R-13'cavity insulation plus R-6 insulaimg' sttearhinP& Wail requirements apply to wood=frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-'frame construction. The floor•rcquirements apply to floors'over unconditioned spaces(such as unconditioned erawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements- TFeentire opaque portion of any individual basement wall with as avcrage depth less than 50%below grade must mc_t the same R-value requirement as above-grade walls. Windows and sliding glass-doors of conditioned br..,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. The R-value requirements are for unheated slabs,Add an additional R 2 far heated slabs. ! If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece.of heating equipment or.more-than one piece of cooling equipment, the equipment with the lowest' efficiency must meet or exceed the efficiency required by the selected package' 'For Heating Degree Day requiremcats of the closest city or town set Table 35.2.1a. NOTES: a) Glazing areas and U-values are maximum acceptable-levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components, ested b) Opaque doors in the building envelope must bane a th the e R greater than o Doke from uthe door es mustU-value and documented by the manufacturer in.accordance with the NFRC test procedure ' in Table 11.5.3b. If a door contains glaze and as aggregate U-value rating far that door is not available, include the U-value to determine compliance of the door. glass area of the door with your windows and use the opaque door ' One door may be excluded from this requirement'(Le.,may have a U-value greater than 0.35). c) if a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the e ,component complies if the area-weighted avrage R value is greater than or equal to the R-value requirement for that component. GIazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0,35 far doors). . ' 43 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: (71 r� �Q �'/� n JOB LOCATION: l�1�'�j� CAI!O(�JYI JIS/L'iC�C ""T f,711 Jnu—�mber /street / J village + "HOMEOWNER!": r koe - 7(�/ �� `l' ��o `f" ff / name Sq0 rv,, _ • home phone# work phone# CURRENT MAILING ADDRESS: I � , �Y 1 z::1 %xit A 9 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 rocedures and requirements and that he/she will comply with said procedures and requirements. ^ Signa a of Homp6wner 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 formicertification for use in your community. O:FORMS:EXEMPTN s - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION- J Map Parcel oGs; Do/ , Permit# Health Division ' � � Date Issued •a Conservation Division ,1/� Fee S _ Tax Collector 2 ;II �°ALLE® IN Treasurer �' - ® NCE WITH TITLE 6 ` Planning Dept. ENVIRorgMENTAL CODE Towrq REGUL�TIG6�S; •N® Date Definitive Plan Approved by Planning Board , ` Historic-OKH Preservation/Hyannis Project Street Address %7 R 3 'A • Village Owner Wrh9 AID _oeg }v Address 56M Telephone S d�3 • �� 7 t �, i Permit Request_�;o SI'Al 1,2d sh1•►.v%c j ar RQ S��n;,.,��j s�/-��e;- I(Atd,57 ea Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 4aSDD Zoning District Flood Plain Groundwater Overlay Construction Type 1 •d` Lot Size Grandfathered: ❑Yes ❑No ,If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) 'Age of Existing Structure Historic House: ❑Yes. ❑No `, .On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout 0 Other Basement Finished Area(sq.ft.) •Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new ,r Total Room Count(not including'baths): existing • new First Floor Room Count Heat Type and Fuel: 0 Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ` ❑No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new, size Attached garage:❑existing O new. size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑'Yes ❑No If yes,site plan review#. d2 Current Use Proposed Use BUILDER INFORMATION Name --o44 Obeezln--;oen Telephone Number . S-V8 -- -y7 ?,y?/ Address 3S W,90hbWAW ✓7'vC- License# as y- YY—8aa, 60•,% � /�l.� oab 73 Home Improvement Contractor# ,/a 70A? 7 ` Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ���d � DATE -79 FOR OFFICIAL USE ONLY, _ - • ' PERMIT NO. .' � _ + - ;' _' ... • � _ • ,- .!` , DATE ISSUED vt X _; - 1 MAP/PARCEL NO. ADDRESS t VILLAGE OWNER DATE OF INSPECTION". 4 1. FOUNDATION FRAME. INSULATION FIREPLACE ELECTRICAL: ROUGH"'3 "' FINAL PLUMBING: - ROUGH" " •+ FINAL � GAS: ROUGH "� FINALE t r -FINAL BUILDING DATE CLOSED,OUT - - ASSOCIATION PLAN NO.. T =r 1 t The Commonwealth of Massachusetts Department of Industrial Accidents - �==_��_ � Office of/ntlrestigaUgns `� � �. r . 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit name: 0.6ert/rrtit)e Vz location: ) 93 /lJecv tUe,.w RD cltV Si9Nft/ir t i'l�✓� phone# SOR -- 4/aR'9a3''7 ❑ I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any ca acity ❑ I am an employer providing workers compensation for my employees working on this job. company name: 0.�10n,YJ•ef 60' —um. ele-/IetiJ address: 3S' &4-► 3,444&n. �'wE city: (/V ®;;i 6 73 phone#: 3—OB insurance co. P01icV# ❑ 1 am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follovOng workers' compensation polices: companv name* address- city: phone#: - insurance co. oiicv# company name: - address: - city: phone#: . insurance co, olicv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a flee up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veritication. Ida hereby certify under the /airnssand penalties of perjury that the information provided above is trap and correct. Signature s� �v Date Print name Phone#• S OR - 7 2A -- ?Y"7/ official use only do not write in this area to be completed by city or town ofIIcial city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Offlce ❑Health Department contact person: phone#; ❑Other ::.• • : (revued W95 P)A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contr..c-, 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 receive:c: trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be re riiid io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Imlesugatlons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 . . °: The Town of Barnstable 9KAM&659. ,0�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost /'S-00 Address of Work: /7R3 IVAt., J1n S79N1ti�r /��t Owner's Name: r Date of Application: ?L,9 99 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ;)JaI ) 99 JJ '�nR� Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav 2 . + _ - --__—_— - ✓JLC U/07Y1/I�ZOILCl/2CtI.LI/ Q�1.'l/CG7�WCLCftU.J�C-C-J v DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION°SUPERVISOR LICENSE Number Expires: Restricted:To. AA JOHN E M.'-08ERLANDER y' 35 WASHINGTON AVE W YARMOUTH, MA 02673 ✓/ee i�omma�u�l�o�✓�avoac%u„e!L HOME IMPROVEMENT CONTRACTOR Registration 127087 Type - INDIVIDUAL Expiration 09/02/00 JOHN OBERLANDER OHS E. OBERLANDER ADMINISTRATOR WASHINGTON AVE W. YARMOUTH MA 02601 } TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O O J Parcel Application # .Zoi y Health Division Date Issued 2L,4� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservatio hiyaQnis r/Tv i- Project Street Address a Village 00 iv.•'i— Owner Address Telephone Permit Request Tq4d44 RC OA& 0 � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 'roject Valuation ��'� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure /9 7/ Historic House: ❑Yes /CNo On Old King's Highway: ❑Yes ❑ No Basement Type: (Full ❑ Crawl ❑Walkout ❑ Other _ Basement Finished Area (sq.ft.) Basement Unfinished Area (sgft) 32-0 sq E Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing irnew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: gGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes KN 0 Fireplaces: Existing New Existing wood/coal stove: LI es ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn" ED existing'...,0 new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: R� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# w 4 Current Use Proposed Use APPLICANT INFORMATION - (BUILDER OR-HOMEOWNER)_ n' e �� Telephone Number At ��3 ������ ( License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE � DATE Ll i -, FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. .' ADDRESS ` " VILLAGE OWNER ' r DATE OF INSPECTION: FOUNDATION 3 ` FRAME all t { INSULATION Af-SgD / FIREPLACE / ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING IMMJ r'eo a !N F DATE CLOSED.OUT ASSOCIATION PLAN NO. °F,HE rti Town of Barnstable BARNSTABLE. Regulatory Services . 9 MASS. �o i639. a, Building Division prfD MA'S 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection 3 1A) 1.;� • , .J V Location > S*-r66P7'/V �28ZJ,�T Permit Number Owner �14?(IGA ��-fL_. Builder !S"Z'Af0� One notice to remain on job site, one notice on file in Building Department. The following items need correcting: APM L -r �� m f— AA#VS ro 7 l 6W�7 W Cr6l-. a Please call: 508-862-493-Kfor r -ins ection. Inspected by `'✓ Date ho b I . x oF��E rti Town of Barnstable BARNSTABLE. Regulatory Services 7 MASS. g i6a9• �0 Building Division prFD MA'S a. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection r/ Location / 73-3 SA-V-rZGT NrJ MZcA) Permit Number Owner Builder !S"6" 4J One notice to remain on job site, one notice on file in Building Department. The following items need correcting: Y 6 p -7� L Please call: 508-862-483.9 for re-inspection. Inspected by t P Date f r The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations �k �� j i _600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): L4 r J 7 Address: WA) City/State/Zip: j ' hone #: �—T7 '" -77 Are you an employer? Check the appropriate box: Type of project(required):. I.❑ I am a employer with 4. ❑Tama general contractor and I 6 00 New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t. ❑ 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 '~ - officers have exercised their 10:❑ Electrical repairs or additions 3. .required.]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.❑ Poof repairs t employees. No workers' �� insurance required.} [ 13. Other t�Nl�� 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. 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'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie. #: 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 ' surance coverage verification. I do hereby certif u der a pains and tes of perjury that the information provided above is it and correct. Signature: ' Date: I �.d�i Phone#: —4/ '=� 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 Xontact Person: Phone M 3 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"...eve person in the ice"...every p e serve 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 apaitmerits 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 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. Anew 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 5-26-05 www.mass..gov/dia Town of Barnstable woe Yt+e ray Regulatory Services Thomas F. Geiler,Director r.rwss. Building Division Pr fo a Tom Perry,Building Commissioner 200 Mai .Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:- 508-790-6230 . HOMEOWNER LICENSE EXEMPTION s Please Print DATE: 57 �!` — JOB LOCATION: /e " '"e�0)� J number street villagd "HOMEOWNER '"� —4T�l.�l , �f '`[Ql� name ' home phone# work phone# CURRENT MATLING ADDRESS- / �3«- A ��—�-1-Vkj city/town state zip code Tlhe 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 superyiSOI. DEFINMON OF HOMEOWNER Persons) who owns a parcel of land on which be/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 constrrgcts more than one home in a two-year period shall not be considered a bomeowner. 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` meowner"certifies'that;he/she understands the Town of Barnstable Building.Departmrnt minimum inspec ' n or es and requirements and that be/sbe will comply with said procedures and. require Signa re f Ho eowncr APprdval 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 pcmvt is required shall be exempt from the provisions ' of this scction.(Sectidn 1D9:1.1 -Licensing of construction Supervisors);prowidcd that if the homdowncr engages a persons)for hire to do such work,that such Homeowner shall act as supervisor," Many homeowners who use this exemption are unaware that they arc assuring the responsibilities of a supervisor(sec Appendix Q, Ruics&Regulations for Licensing Construction Supervisors,Scction 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 homcowna acting as Supervisor is ultimately responsible. To ensure that the homcowna 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 formhcrtification for use in your corrvnunity. Q.forms:homccxcmpt . VEr°�ti Town of Barnstable ` Regulatory Services t LlRNSTASLE. � v MASS. g Thomas F. Geiler,Director '`�� BuiIding 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 aiid.S,ign,This Sectiono 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 rob) " Signature of Owner Date . Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORM S:O WNERPERMISS]ON w , m Y Zoo hk3 of Lit ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS. NOTE; A SEPARATE PERMIT iS REQUIRED FOR THE CARBON MONOXIDE ALARMS INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL MUST BE INSTALLED PER PERMIT DOES NOT SATISFY THIS REQUIREMENT. MASSACHUSETTS BUILDING CODE eA- � t lor �bt r �OJA r " t r b 4, ���,✓R c.c� �6 0� g f I Z- tza - ta'.s• te'a IF -0 1YB �a " PRIVACY PENCE -E4e2 ASt AWN ZCA2 UP Li Li QCQ (SPfpI DOOR ON NO77U8 P + POOL �� 4•-0' m a SHOWER j"MMASTER 033 BEDROOM 0 _ow_'j...... DECK . ,- � �rs• r.r Ear ®®,o Aft"ITCHEN ,f a ON 6-0' • S•-0•. i - i ..... NEW DECK / ""E" WINDOW i S E• REP a E I �,•�,s I 13 BUH N tL� BATH O HST NIUDROOM 010� ram• Q ❑ EXISTING DINING IB'-0• 1T-0' tow LIVING ROOM uP / __ '. IRST FLOOfi -N Fi� �- � • - NEW WINDOW - ® El -lit PRIVACY FENCE Y' REAR ELEVATION Nil 11 11 11 11 11 11 RIGHT ELEVATION U. Oil lilt lilt LEFT ELEVATION Assessor's office Ost floor): f] 3�dLS- R.,17 $E�C, e at OFTNETo Assessor's map and lot number IN COMPLIANCE Board of Health Ord floor): q,_� r('a } t M TIC TITLE 6 Qy ♦ Sewage Permit number I BASasTSDLE . ` � 1PiENTAL CODE AND'Engineering Department (3rd floor): ���`' �° rasa House number . ...t?..�.. .....TOWN REGULIITION$ °"�010 d`e Definitive Plan Approved by Planning Board ----__--------------------------19---------- % APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2i00:P.M • only TOWN OF �BARNSTABLE BUILD.IHG I'NSPECTOR ; e L eS 67 r APPLICATION FOR PERMIT ,TO 1 ..�� / �� /��'G TYPE OF CONSTRUCTION.............. .. Ul,?1/ '1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....II f/4F...../.Il. �OCJ/J....�-�..:. 4-Q/.CJ/%.......................................` 0.2 ? . ...... Proposed Use ... ....Oe�G ................. ......... ......... Zoning District L/1 ......... ....::......:..... .........Fire Name of Owner .,1 .!¢y LC_........�./ C�. ! .......... .:.Address .. Q. ...:/,✓. (Nll/llJ ................................... ' ....t... Y .Name of Builder Address ......... � . /161„4J.. A 9e./lam Name of Architect .......�r. . ..... ....................... .. ...... ........Address ....N ..... ... .................. . .......... Number of Rooms ,d ..... .................: .......Foundation I........................................................................ Exlefor A/ .... .......Roofing ...................................... Floors '...:!.Y�......................................... ..."Interior AAL........ Heating /,V. .. ............:. j.:...,.. Plumbing -- eG Fireplace Approximate Cost .l'�/..oUO:..� ....... V, Area �.�. 1. ............. Dia ram.'of tot and Building with Dimensions /�q 9 R g Fee ........SO,.`."�.................. /6 x cod. 1�6$0 DIL � r OCCUPANCY,PERMITS REQUIRED FOR ,NEW DWELLINGS I hereby.. agree to conform' to all the Rules and Regulations of the Towmof Barnstable regarding the above. construction. Name ... Construction. Superv.is'or's License ........ JORDAN, WAYNE r Swimmin Pool No .31:8.3.�... Permit for .. ..................g fAccessor'y, to. .��, e.1.],�ng................ Location 1 $. ...Xeww.t>07tda..Ro,ad................ ' . _- F �• n :...M ..,.A. ..... z� ' Owner ..Wayne...JQTdxl......... ....: _ Type of Construction ..V,yn.al... ........................................................... _ Plot ........:...................:. Lot ............ ......... ......... • • Permit Granted Apr 1.1 . 2 7.� 19 8 8...... ....... Date of Inspection ... .. .... .. .1.9 M � Date Completfed 1 _ - • }_ 4 - cr n) 0 00 Assessor's map and lot number ... J. �7 :/f tl K AA � y r/ � .SLi�r �u -5Gl� ?H E=�i/`/G .wage Permit number ,5�............................................... 7 d Z BABBSTABLE, i House number .........................................................a.............. 9� Maea pow 1639. \00 'Fp YFY a• TOWN IOF BARNSTABLE BUILDI G INSPECTOR APPLICATION FOR PERMIT .TO ... ....... . . . ............................... ............ ........................................................ TYPE OF CONSTRUCTION ............d..7. i d �..s�Y L . .lV.... ;.................19.01 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........� /..!..�o �( <!✓.. 1 �1 .:.....cp.211(11( f.�!/.. ASS...... ..................................... ProposedUse .........� f c 11.�f. ..... ....................................................................................................................... ZoningDistrict .......... ...........s.................................................Fire District ............ ................................................ -�- .................................. Name of Owner e:d .. ..... / '•�J % ....�1 ��� Address ........................................................... . ...... ... Name of Builder ..........................Address .. ?`:........... O:CSS...7.. %SS.... Nameof Architect .... ......................Address .................................................................................... Number of Rooms ..................................................................Foundation ...... �'O`/'7C'� eJc . .............. Exterior T/C.7..U�.......15 r.. . ..................Roofing ........7 4,-7�F,&................................................ Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ...................................................................... . ........Approximate Cost ........:�s.®......... ............. ... ^ v Definitive Plan Approved by Planning Board --------------------------------19--------. Area ....fit. `'..-�.�......:....... Diagram of Lot and Building with Dimensions Fee tsr... SUBJECT TO APPROVAL OF BOARD OF HEALTH _ 1 eol 1 � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding e above construction. Name !U..fa ?!� ,�. .. .... I................... i JORDAN, BONNIE FERRIS No 23066 permit for Build Storage Shed Single Family Dwelling 1783 --Newton� RoadE ` ........ .... Location ... .. Mo <= Owner Bonnie Ferris Jordan ............ . ..................... ... ...... ...... - Type of Construction Frame Plot .......................::... Lot L -f May 4,; 31 Permit Granted ................... .....19 Date of Inspection ....................................19 f Date Completed .................... ...�'`�.....19 PERMIT REFUSED .............................................................. 19 ................................. .i................. ......................... , ..................... ...f...................... ........ ............. r Approved. ............. ..................... 19 ............................................................................... ,hwvq«— •,� i �a,,t t, . . Y s,; •i < . �'i.,�a:.6t`�-fh�xsr,;;:';.ec,... , Assessor's office(1st Floor): Assessor's map and lot number a�- o oa Board of Health(3rd floor): Sewage Permit number ' ' Z DMUSTADLL i Engineering Department(3rd floor): �° NAsa House number ° i639- Definitive Plan Approved by Planning Board 19 �Fo MAY d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only �- TOWN OF BARNSTABLE t'T1 BUILDING. INSPECTOR ' APPLICATION FOR PERMIT TO !1J POO iC 06&,AL rc X /Si j (j! TYPE OF CONSTRUCTION 19 i i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies/for a permit according to the following information: /Location MG V V ric�%l�G�/U- RO A f.f CC)/ G1,,2— Proposed Use Zoning District Fire District r t1 - 1 Name of Owner . i �AQN 6 I �OWJ/ 'IRC/Ad Address A 5 Name of Builder Address t Name of Architect Address Number of Rooms 1 Foundation ,^ Exterior yVQG�©� �`' Roofing1��/��T Floors 040 Interior Heating r Plumbing -Fireplace Approximate Cost R.� Area !VdA-A rr C `r—O 00 Diagram of Lot and Building with Dimensions Fee "a OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I Y agree,hereb a to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 9 +�. Name Construction Supervisor's Licenser-�� JO ZDAN, WAYNE & BONNE f, A==023._.065 . 002 . , tc3'(.YoS•0d1 No 33707 permit For Enclose Dec'c Single . Family Dwelling Location 1783 Newtown Road ma,� ,605 lls Owner. Wayne & Bonne Jordan Type of Construction Frame _. r Plot Lot _..—. Permit Granted May 1 , 19 ^J Date of Inspection 19 Date Completed 19 ' r PERMIT COMPLETED 1/1/-1-1 Assessors map and lot number ........ dQ�.. THE tOfr Sewage Permit number Sj�C/�............. .J�� y ('-al Gtoi�s��� , ��, ♦� Z 33AWSTAXLE, i House number ........................................................................ 9� MA86 0� p 039. \00 MAY a' TOWN OF BARNSTABLE k i 4 BUILDI,NG INSPECTOR ; t ' APPLICATION FOR PERMIT TO ................... .............................. ............................................::......... TYPE OF CONSTRUCTION /.4..?�r✓`+d ..?li'1.�J..�. '-... .................. a ..........................................:......... .....��.r.� .. ?.................,9.of TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........�r� / ..° /,.7G�/!//J�.. / :.... .�Q. /�/.. .����1�1��r......0 c��t� J��. ............................... ProposedUse ........... 2� .�' ..................................................................................................................................... ZoninDistrict �i�.........................................................Fire District ..... .1LU•. .f................................................. g Name of Owner7�7/,��,,/,, '�f' �5.....✓.r�/2j�' Address .................................................................................... Name of Builder /. .��...................t.....Address :. J�.... CJC'a's-S�'7L '� .... Name of Architect ...�/�� P.r..T .��.P�......................Address .................................................................................... Number of Rooms ..........................:.......................................Foundation ......51...Qf ....... .�cre,� ............. Exterior .ep...... ...Roofing ........ ..,/ �........... Floors ......................................................................................Interior .................................................................................... HeatingPlumbing .................................................................................. Fireplace ...................................................................... ........Approximate Cost ......... s.®d:.. .0................ �... Definitive Plan Approved by Planning Board ________________________________19-------- . Area Ss`1,.!�����`...1......:....... Diagram of Lot and Building with Dimensions Fee .........K..... .... ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH M 4 � I A �ve7'(1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regg�nvbove construction. Name JORDAN, BONNIE FERRIS (:A:=�2311�65) .... ----------- Location l783..Nevvt��...Road ____.___ ^ . ............. {Jvyno, ��..Ferris.. '___.. .. �� � ',p= of Construction, � ' ' - - ....................................... . ................... - . Plot ' ~ � ' '='" Granted "' "= ` I ' � � Date Completed ........../..........................19 K PERMIT REFUSED -----' lV . � - ..................`~~--�r .......... — —~-- ............. ----^---------------------'' - -------~---^—'---^--^^'--`^--'' � � � - . ---------.-----------..----..� � / � . Approved ................................................ lg ---------------'--^--------' � ---------------------~'---- ` | � ,. __. -_.._-,_. ,.. _. :,.•y.� �.y. 17:�..�e;{aFx...:.{.•K�r ,e .:.. :�r _ �r. ,.,, arc::�.'2.a��.,.FS:;rey_a�.,n�'n��r.«t .... _ . + .:.i... r. ."r.5.:.a.n. .... .�... �.� t Assessor's office (1st floor): o�TNETo Assessor's map and lot number .............. ............................. Board of Health (3rd floor): Sewage Permit nu... .. r... !� -...... ........ .......t..�.:................. Z PAUSTADLE. i Engineering Department (3rd floor): '"'1 0, !Fj , , oo SAO& House number / 0 ........... a� Definitive Plan Approved by Planning Board _____________________________19________ . 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 ... .. .`... .....`"� . ...(,(�/�11 ...................................................................................... TYPE-OF CONSTRUCTION .............,�7.'.tfJ/ � F _ ........................................................... a7 ••...............19--...._. TO THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to the following information: Location .....>s' t �JGJN �11 G/ /7��`� G7 �f.... ........ ................................. �".��.. ..........................."...................�~ ............................. ProposedUse ...`.....�``��/'.1'/l 4Q '....................................................................................................................... ZoningDistrict ...............�. ....................................................Fire District ..... .................................................... Name of Owner lit/�': '/(/� ..............Address .. .... .! .�G�/�/ltJ�... ....................... -� , ............uaY Name of Builder �-•...... ................ .............................Address .............�'................ �_- Y�. Nameof Architect ..IY' .......................................................Address ....4rT.l......................................................................... Numberof Rooms .� .........................................................Foundation AW...................................................................... Exley ior ./NIi............................................................................Roofing Floors ..........!.............................................................................Interior ... ......................................................................... N ................... ..........................Plumbin ................................... Fireplace ..: ..........................................................................Approximate Cost OOo ...................�...........✓............... Area ......:�?../ ....................{ . Diagram of Lot and Building with Dimensions Fee ........ /6 x 3a ' �o ' jlk 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 ... .... ... /f � ~�................ ....i.t.`J.. .. .. r l r Construction Supervisor's License ..... s JORDAN, WAYNt A=023-0651 No 31837 Permit for ...Swimming Pool ................. AccessoryYto Dwelling Location ......1.7.8.3....N.ewto. . w. ... n Road. . .............. . .. . .. ....... .. .. .... .. ..................-c©tom- --fl,Aar3�`zn�S./t i�(f Owner .......WaXne Jordan ..................................I...... Type of Construction ....Vynal Plot ............................ Lot ................................ Permit Granted .....Apr.7..1,...2.7.,.............19 88 Date of Inspection ....................................19 Date Completed ......................................19 ��� �� �� ���� � ��w� �� � �. j � � � f ; . . ; The Town of Barnstable • snRrrsresi.E. • 16¢ ,0�' Department of Health Safety and Environmentaf Services Eo�r► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION Location of shed(address) O2 J / Property wner's name Telephone number FX/ Size of Shed r Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? N Conservation Commission(signature required) 2 AI d THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg 20 2.7 es showy props 'Y iin ►ng purp os asseas �actual, are ,go not represob _ ' / vel'cit .3 8 J I7+rl 7 `,. I r'I rIJ�/ j 18 ----- • I a x Y 1 \ /64.817 67. / r }'9 36.1 ' S5_2 / l \ 60 1 ' \/68.8 41 X 69.1 I }�66.3 64. 67.5 67.6 — - ------ - �', X p riEngineering Dept. (3rd floor) Map ( � Parcel �� Permit#House# j`7 2Date Iss eddard of Health3rd floor 8:15 -a9:30/1:00-4:30 c (, )( ) Fee - Conservation Office(4th floor)(00-9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) ? tMf►p;- Definitive Plan Approved by Planning Board - 19 BARNSTABLE. MASS TOWN OF BARNSTABLE - �fCMA��`� -- Building Permit Application Project Street Ad �Z93 ,/0w7VU4,, .en . Village d'Q as- Owner Address Telephone • r Permit Request Re •- /eek,f�,2 First Floor square feet Second Floor r �/17 square feet Construction Type G 000, FRr9mc Estimated Project Cost $ Zoning District st ' t Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure Qr 30,` ? Historic House ❑Yes ®No On Old King's Highway ❑ •Yes 0 No Basement Type: 01 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing�_ New jo' _ Half: Existing New No.of Bedrooms: Existing 3 New pl Total Room Count(not including baths): Existing New _i2r First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New _jO'- Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) /J?x-7a r. ❑Attached(size) ❑Barn(size) /0 qr A q J4 None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes A(No If yes, site plan review# Current Use Proposed Use Builder Information Name Fn�. � Obin/ ,,� Telephone Number Sb8d;39.j 0:?,P© Address _ /r? ST License# Q726 De�.�;ti-,Danz- YP70 00i6 2 j Home Improvement Contractor# &3,3,R'7 Worker's Compensation# /r/q NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Z4-vAAi/f ,+ SIGNATURE �"cr1 6�„�.�r„� DATE BUILDING PERMIT DENI F &LOWING REASON(S) z FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS ,1 VILLAGE' ¢r OWNER -------------- y. r r f • E , ' ` V } +k d ' DATE OF•INSPECTION: FOUNDATION FRAME 1 INSULATION t - FIREPLACE f ELECTRICAL: ROUGH FINAL — PLUMBING: ROUGH - FINAL r GAS: ROUGH %- FINAL �3. FINAL BUILDING DATE CLOSED OUT, ASSOCIATION PLAN NO. J�f , s T111.• C11111111o1rI1'Calth of 3tassachusctts -- %rr1 Deparlinelrt of Industrial Accidents _, 600lf'usfrhigrurrStreet Bmwim Mass. 0111 Workem" Compensation insurance AMdavit �PPii�tnt informatir►n - --.- - — Plcns'e PR(NT'le;iiily"�'^1�—�-�--�_—.-- _ Inc Linn- /✓Veev� Cite.�7G/�;'l f�14 nl,nne 7a�'—lath I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in anv capaciry I am an empiover providing workers' compensation for m% employees working on this job. emmi rni n tm( C OL47 44*247 WeO7h4LvPW De,--•-lYZ,�r Winne 0- p38a incnr-inrc m Pic LOP+i —7,q ;-, o, ,e nniict•to I am a sole proprie:or ;!'Hera! contractor or homeowner(circle otre) and have hired the contractors listed below who the :ollowing workers compensation police-: , comnnn,• n1(nc• lcirlrrcc• __ cir— nhnne&' inc„r^nrr rn nMir%-0 emmninv na(nc- ;t(irlrrcc• ri1P phone 0' incur^rice rn nnIICP f1 �� _ Attach additional sheet if necessary F. ,_.., __,;..:......, _.. .. .•.,...._�......... :., _.,�....�.,. :;-- ;�u.�-:,;. Fa0ure to secure cot•cracc as required unuer�cctton:_°A of AIGL 152 ran lead to the imposition of criminal penalties of a line up to 51.500.uo anurur uric cars' imprisonment:t. 1ccll :ts ci,•il penalties in the form of a STOP WORK ORDER and a fine of S100.00 a dag against me. I understand that a cope of Uti%..uttcnicut ma, be funmr—ded to(he Office of lnrestigntions of the DIA for coverare verification. [do hererrr cerri{t-tinier the pains and penalties 0f perjun•that the information prorided above is true and correct. Si^nature Odle .� �� 1�`�1 Date Print narnc L�Owr� t�J �s9rvUc°r Phone>r 39Y 0 3�Z, official �c only do not„•rite in this area to be complete�bycity�®rlown oRciai - cit%-or tn„n• permitilicense t3 riBuildin_Department c ❑UcCnsin;: Board [_ t Selectmen s orrice checl;if immediate response is required ❑ t 011caith Department con(act person: phone tt• nUther___�— Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' etiiiiprns:ttian far "la��'". an cnrplaree is dcf incd as every person in the service of :ttic)tlier under uin employees. As quoted from the :..,.; coflumct of hire. express or implied. ornl or written. An emplurcr is defined as an individual. partnership.association. corporation or other legal entit}. or any two or :. the foregoing cn�_n__ed in a joint enterprise. and including,the leap l representatives of a deceased employer. or the receiver or trustee of an individual . partnership. associatibn-or other legal entity, employing employees. Ho«'e'.•e- owner of a dwelling_ house having not more than three apartments and who resides therein. or the occupant of the d\\cllin�_ boost of another who employs persons to do maintenance;construction or repair work on such dwellinc or out the :_rounds or building appurtenant thereto shall not because of such employment be deemed to be an emp:c. MGL chapter 152 section 25 also states that eti•en•state br local licensing agency shall withliold the issuance or of a license or permit to opernte a business or to construct buildings in the commom,=1111 for any icnitt who iias not produced acceptable evidence of compliance with the insurance coverage required. AdL;.:ionallv.. neither the commonwealth nor anyof its political subdivisions shall enter into any contract for the pertorniz:ice of public \vork until acceptable evidence of compliance with the insurance requirements of this chap-.. been prese:ned to the contracting authority. Applicants Please Fill in the workers compensation affidavit completely, by checking the box that applies to your situation anz suepivin:= compazty names. address and phone numbers as all affidavits may be submitted to the Department of industrial �ccidettts for contirtnation of insurance coverage. Also be sure to sign and date the atCdavit• The should be returned to the cin• or town that the application for the permit or license is being requested. A ate Department of�Industrial ccidents. Should you have any questions regarding the "law"or if you are req.::-. rl :o obtai►t a workers' compensation policy. please call the Department at the number listed below. _._ City or l owns Plea-e be sure that the affidavit is complete and printed legibly. Tite Department has provided a space at the bottom; the a—"-davit for you to fill out in the event the Office of Investigations has to contact you regarding tite applicant. P: be _ = to fill in the permit./license number which will be used as a reference number. The affidavits may be returner -:ie Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questi please do not hesitate to _give us a call. Tire Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents -• Office of Investigations 600 'Washington Street Boston,Ma. 02111 fax n: (61 i) 727-7749 ' nilonc 617) 727--1900 c%r. 406. 409 or J .A .r4;;J� . .. i • . • I• •I •• ' V THE A The Town of Barnstable Department of Health Safety and Environmental Services `�°r�,�, • Building Division 367 Main Street,Hyannis MA 01601 Office: 508-790-6227 Ralph Cr0ssen Fax: 508-790-6130 Building Conuaiss: For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation,, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any preexisting owner occupied building containing at least one but not more than four dwelling units or to , structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Woric• Est.Cost c Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the Owner. Date Contractor Name Registration No. Assessor's office(1 st Floor): SIM, ^ Assessor's map and lot number oC9 3 C�6J Q y �=�_. '. �-THE ro Board of Health(3rd floor): Tom " � � TTU J '�Q ♦w Sewage Permit number3f .' Engineering Department(3rd floor): ' Q �u ob L House number c 7 Definitive Plan Ap roved by Planning Board 19 �o rw d APPLICATIONSROCESSED 8:30-9:30 A.M..and 1:00-2:00 P.M.only P^� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 060oC Q&C/L Aj TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: AVC Location Z ZO 3 ��2 l6J A.) Cl)e®A C' -7U� Proposed Use Zoning District �- Fire District Name of Owner Ca/U 20)ume- opG/w Address Name of Builder Address Name of Architect Address Number of Rooms Foundation "044 Exterior 4 £ Roofing 4solz,41-7— !gIllya &Y Floors Wo Interior Heating Plumbing Fireplace �— Approximate Cost Area o e C Diagram of Lot and Building with Dimensions Fee 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 71, ddh�= Construction Supervisor's License e7d y— . JORDAN,, WAYNE & BONNE �t No 33707. Permit For Enclose Deck t S incrle : Family DwellingPam: Location 1783 Newtown Road . Cotuit Owner Wayne & Bonne Jordan Type of Construction Frame i Plot Lot Permit Granted May 1 , '19 90 Date of,inspection f'19 Date Completed r' 19 I{ P _ _ L. "i v4 4 or Rye . tp ► � oa � a Ili - - - .. �- + - • a top \1 Is V � . Li y � L Cp .� r I U 4 ~a -. `p N�,a • i 5 t I k - fps 1,4-1\lit 1 yyg lit, fgp at t {[ 5 t EEE c 1',yy tt�� tS 7 1 ._4�� RAIU \ r e �� Gf C 1 j' f r f E r c� _ �_ N 70009'39"E 212.23' PO z " 0 wo SHED PROPOSED 60 o ADDITION.10'_X 9' N \p coo BARN -. PROPOSED N 67°50'31"E 94.45' �' ��DECK 10'x T ►� y 0 0 o EXISTING a y DWELLING "-Q' ' z HSE.NO.1 /03 I.EORCH. ,, 24.36' 5s' o �' 39,951 SF. j j � O w II II > I i POOL b • II I I I II I I LJ ----� N 68053'46"E 289.18' '7certifythattbedwellingshownon PLOT PLAN OF LAND this plan is as it actually exists on the LOCATED IN ground and that it conforms to the town of COTUIT,MASS. `AN OF 4f Barnstable zoning regulations regarding r,a`3 s yard setbacks." PREPARED FOR / DAVID q�yG - - - - - MARK & NANCY LANCASTER CHARGES f- ANI I - C R.L.S. DATE:SEPT. 11 ,2002 SCALE: 1"=30' 2 5 date.5=11,2002 CAPE & ISLANDS ENGINEERING Fs cISHR, flood zone cfnonhazard] MASHPEE,MASS. a°"AL LAND Sant-newtrd1783 LEGEND " 3 -EXISTING CONTOUR - 2O - '- oG ul e ce x 20.12 . EXISTING SPOT GRADE ^�ov� R° Locus 10o PROPOSED CONTOUR �°a. —W— EXISTING WATER SERVICE elef�` e< —0.H.W- OVERHEAD WIRES s �' P(2 9S TEST PIT j pee l° 1023� o SA BENCHMARK Tj �/ LOCUS MAP / V NOT TO SCALE AIFWAOw \ 10 Edge �_of 3 �I ROAD 1 k Pavement 100' II 102,38 1 ,gg t i 9�5 k 'J �8 4 A00' � � k S1051,05„ E rn , 100. tone Drive, .1 124.67' 3 24,702t S F. 0.57t A � ,'' Q Map 3 ko Parcel 657 c�_ :01\� CO o i , i 94 --- _Stockade_ Fence_ EXIS 1 sI7NG `. t HOUSE(#1783)/ ui ' 2 g' T6F=100.80/ I Apron I i -(Block). F' OPOSED \ DECK � III 9a 49 4 iIN-GROUNDICU° Q O k , PROP SE D i SWIMMING__P0OL �. ' p 03 l 1.g ADDI ON _ 50.1 .i i (p n - Deck Exists I �'1 -_ J o) q- ' Z 16.2,i Porch J cc Barn 0 _ `CFrain`Tnk fence 10 a1 'EXISTING PORCH 6 N l ` �� fJ Ylz BE REMOVED' . r0' O SE NK ` O 'oo -- -- EXISTIN--S.A� . TRENCH i EXISTING S."A.S '3 ___ --� TO BE ABANDONED ,130� EXISTING' SEPTIC TANK 2F .-BEEC . k �JLTP-2 4> i 1: o TO BE REMOVED 5� `� _ I 0 0 Vq U) 12 �`..\ �k 1•. DTP=1' I _PRDP�S_A.S t 4 10� 13 �3 x `` Sandbox 0 -- 25_�__ 14, �., k 1 GN 04 10 00 Shed ...........2 k k 1 1 BEEGH 0 aA o . CB/DH/FND 02 P ow 145.53 102.65 N 17°15'00" W --/04 ti0��0 k 1 - of 'k4Ss9� Benchmark Sef Top of Conc. Bound EL.=102.65 Assumed o PETER T., G� McENTEE CD CIVIL " No. 351os PROPOSED SEPTIC SYSTEM - UPGRADE PLAN A R£GISZE��`� �� FF E 1783 SANTUIT-NEWTOWN ROAD, COTO MA 2�1 IU Prepared for: Mark Lancaster, 1783 Santuit-Newtown Rd, Cotuit, MA 02635 Engineering by: Surveyinging by: SCALE DRAWN JOB. NO. r FF 1GATI ZONE RF FLOOD PLAIN DATA Engineering Works,Inc WARNER SURVEYING 1"=20' P.T.M. 206-10. ON: 1 12 West Crossfield Road 20 Long Road 4 `NT YARD=30' NON HAZARD Forestdale, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET N0. /REAR YARD=15' 9 24 10 HEIGHT = 30' WIND EXPOSURE CATAGORY: Exposure B (508) 477-5313 (508) 432-8309 P.T.M. 1 of 2