HomeMy WebLinkAbout0027 CENTER LANE eV
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o�o . LOT AREA ;
CONCRETE 21,000f SO. FT. , '
FOUNDATION
EXISTING , f
DWELLING
SHED
FOUNDATION PLOT-PLAN DCE #04 227. .
PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT- FOR ANY OTHER USE
LOCATION 27 CENTER LANE
. PREPARED FOR:
CENTERVILLE, MASS. '
SCALE : 1' 40' ,. DATE : ❑CT❑BER, 28, .2010 JOHN LOPES.
REFERENCE. ASSESS. MAP 251 PCL 62 ,
PLAN,BK 177'PG 97 ' ASHOFMq
ss
I HEREBY CERTIFY THAT THE STRUCTURE DANIEL 9cti�
SHOWN ON THIS PLAN IS LOCATED ON THE �� A •
GROUND AS SHOWN HEREON o
OJALA
off 508-362-4541 No•.40980
fox 508 362-9880
P
down cape engineering, in c, ® U
Cl ulL ENGINEERS
LAND SURVEYORS
DATE. REG. LAND
939 Moin Sheet.. - YARMourHaoRr, MASS. ' SURVEYOR
�
TOWN OF BARNSTABLE BUILDING
.PERMIT APPLICATION
Health Division Date Issued DL7)
Planning Dept. Permit Fee
Date Definitive Plan Approved bv Planning Board
Historic OKH Preservation / Hyannis
Project Street Address �
Village
�
Owner Address.
Square feet: 1st floor: - 2mdfk}0r existing—proposed O8vv _______
Zoning District Flood Plain GroundwaterOv8r8y ________ �
Project Vadu8UOO Construction Type ~°71r er� �
Lot Size Grandfath0red: 0Yes JN0 If yes, attach supporting documentation.
Dwelling Type: Single Family LJ Two Family Ll Multi-Family (# units)
________
Age of Existing Structure Historic House: 0Yes 0NO On Old King'GHighway: 0Yes LlNO
Basement Type: 0FuU Ll Crawl 0Walkout LJ Other
B8G9rn8Dt Finished Area/Gq.ft.\ B8G8rO9nt Unfinished Area hsq.fA
Number 0fBaths: Full: 8xi8tiOg new Half: existing n8vv____________ �
Number 0fBedrooms: ` existing __new
Total Room Count (not including b81h8): existing new First Floor Room Count
Heat Type and Fuel: LJG8G LJ (li| LJE|8CtriC Ll [th8r___________
Central Air: L3YpG CJ NO Fin8p|8C8G: Existing New Existing VV0Od/CO8| stove: LlYe8 L3 NO
Detached garage: LJ existing Li new size—Pool: LJ existing U navv size B8rn: LJ 0xiGtiOg U O8vv size___
Attached garage: LJ8xiGting UD8vv size —Shed: Ll8xiGting 0n8w size Other:
Zoning Board Of Appeals Authorization LJ 4»p88 # R8COnd8dLJ
CODlDl8rCi8| Ll Yes LJ No If yes, site p|GO review #
Current Use Proposed Use
'
. ' `
APPLICANT INFORMATION
OR
N808 Telephone Number
*uuneuu uC8n8R # 10ZXJA,1,aA,`4 JX �
Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
� ~.~.....~..~- .~-...-
~ |
� F
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED '
MAP/PARCEL NO.
7
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
C "
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
r
06/06/2012 12:34 FAX Q002
OWNER AUTHORIZATION FORM
(Ovine Name)
owner of the property located at
Z 7 CeH � h
(Property Address)
4!�eNf
(Property Address)
L
hereby authorize GQ,17� C-0 d 10--T�1 0
(Sub ntractor)
t an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building
permit and to perform work on my property.
Ai-%
Date
D
god
JUN 6 2012
- v1C a
> �
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 153567
f
Type: Private Corporation
Expiration: 12/15/2012 Tr# 206433
CAPE COD INSULATION, INC4� r
HENRY CASSIDY
455 YARMOUTH RD. _ _rt +ftl
HYANNIS, MA 02601 �� ` -1 i --
_ ;Update Address and return card.Mark reason for change.
4 '� Address Renewal 0 Employment ❑ Lost Card
t _
0PS-CA1 0 5OM-04/04-0101216
Office o mer Affairs us ne ReguI Lion License or registration valid for individu!use en!y
HOM S ZA before the expiration date. If found return to:
Registration: 153567. Type: Off-ice of Consumer Affairs and Business Regulation
Expiration: 1.2/15/2012 Private Corporation 10 Park Plaza-Suite 5170
'" Boston,MA 02116
OD
V INSULATIO:[J;'IN'C__,
HENRY CASSIDY
455 YARMOUTH RD=�
HYANNIS,MA 0260,1 � Undersecretar At
tune
:._ y
achusetts-:Department of Public Safeh
Board of Wilding Regulations and Standards`
i Qonstruction Supervisor License
License: CS 100988
HENRY CASSIDY A �'
8 SHED ROW. ''f
WEST I�ARMOUTH MA 02673 � •,y`
Expiration: 11/11/2013
(bnmiksioner Tr#: 7620
The.Common i-t,iilch of Massachusetts
Department o .Industrial Accidents
W Office vJ'l a vestigations
600 tiVos/-iington Street
F
D
w4 BOsi.t.)"1., HA 02111
-�° WWII,.ltarss.gov/dia
Worker's compensation Insurance Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name.(Bi.isiciess/Organization/Individual)
Phone#: 50979
Are you an employer? Check the appropriate box:
Type of project(required):
t. I ant a employer with4.❑ I am a gc net d contractor and I have 6. ❑ New construction
etttployees (full and/or part-time).* hired the sub-contractors listed on 7. ❑ Remodeling
the attached sheet.$
2. 1 atn a sole proprietor or partnership These sub c-ittractors have 8. ❑ Demolition
and I'lave no employees working for employees:md have workers' comp. 9. ❑ Building addition
the in any capacity. [No workers' insurance.:1: 10. ❑ Electrical repairs of additions
comp insurance required.] 5. ❑ We are tt rot 1toration and its
officers It,tt C exercised their right of- 11. ❑ Plumbing repairs or additions
3. ❑ t am a homeowner doing all work exemption het MGL c. .152§(4),and 12. Roof repairs
tnyself. [No workers' comp. we have nti c,.niployees. [No workers' 13. Ocher
insurance required..l t comp. insucnice required.]
s
Any applicant that checks box#1 must also fill out the section below showirt�ih��u workers'compensation policy information.
t lhoown tr
crs who submit this affidavit indicating they are doing all work-uid then hire outside conactors must submit a new affidavit indicating such.
tCoutruntctors that check this box must attach an additional sheet showing dtc name of the sub-contractors and state whether or not those entities have employees.if
ttw sub-couu'actors have employees,they must provide their workers'comp.policy number,
l am an employer that is providing workers'eornpensation.i,rnwrance for my employees. Below is the policy and job site
injorntation.
Insurance Company Name: I � (�►I '�..1 " �'
Poticy 9 or Self-ins. 1,ic. #: Z� 0 20 � C (`
1 Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the worlters' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c: l i3 cut lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one-year iutprisontnent,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 lnaXje forwarded to the Office of Investigauons of the DIA for insurance coverage verification.
here c i under the ins and penalties ofpetyury that the information provided above is true and correct.
771do
aDate:
Phon (�
FF, " . Do not write in this area,to be completed by city or town official
t'ermit/License#
ty (circle one):
lth 2.Building Department 3.City/'Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
Othet
ntact Person: Phone#:
Jul. 2. 2012 3: 11PM No. 1605 P. 1
Client#:4597 CCINSUL
ACORM, CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY)
07/02/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWI`E14 THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed,if SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsemenl(s),
PRODUCER CONTACY NAME: Mar aret Young
Rogers&Gray Ins.-So.Dennis PHONE 508-760 4602 F 877-816-2156
434 Route 134 ac E-MAILExI: Arc No
IL -
South Dennis,MA 02660-1601
508 398-7980 INSURERS)AFFORDING COVERAGE NAIC N
INSURrRA:Peerless Insurance 18333
INSURED `. INSURERB:Evanston Insurance Company
Cape Cod Insulation Inc Atlantic Charter Insurance
455 Yarmouth Road INSURERC:
Hyannis,MA 02601 INSURER:Commerce Insurance Company 34754
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE FISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 11Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IV TYPEOFINSURANCE ADDIP45R W D POLWYNl1MBER PVOILIDY<YYW MMIICDY`_EXY LIMITS
A GENERALLIA61LI7Y CBP8263063 4/01/2012 04/01/201 EACH OCCURRENCE $1 000000
X COMMERCIAL GENERAL LIABILITY PREMISES a accTurrDence
CLAIMS-MADE �OCCUR MEO EXP(Anyone Oereon) $5 000
PER$OmiA &ADVINJURY s11,000,00
GENERALAOOREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMPIOP AGG s2,000,000
POLICY PRO' M LOC $
p AUTOMoeIL1EuABILITY 12MMBCKVMK 4/0112012 04101/201 EoMBFNEDSINGLELIMIT 1000000
ANY AUTO - BODILY INJURY(PerPerson) $
ALL OWNED X SCHEDULED -
_AUTOS AUTOS BODILY INJURY(Per accident) S
X HIRED AUTOS X AUTOS NON-OWNED PROPERTY S
(per accideau-
B X UMBRELLA LIAB OCCUR XONJ453512 0410112012 04/01/2013 EACH OCCURRENCE $1 OOO OOO
E)(0%ULIAB CLAIMS-MADE AGGREGATE $1000000
DED X RETENTION 10000 $
C WORKERS COMPENSATION WCA00525902 6/3OI2012 0613OI201 X WCSTATU. OTH•
AND EMPLOYERS'LIABILITY y(R YLT
ANY PROPRIE70�pgg7NE yFCUTIVE E.L.EACH ACCIDENT 1 OOD DDD
OFFICERIMEMBEI�EXCLU09 N I A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1000000
II yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE,POLICY LIMIT 1$1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101,Addlllonal Remarks Sphedul9,I(Irlore space Is required)
"Workers Comp Information
Included Officers or Proprietors
Certificate Holder is Included as an additional insured under General Liability when required by written
contract or agreement.
CERTIFICATE HOLDER CANCELLATION
Cape Cod Insulation,lnc SHOULD ANY OF THEABOVE CESCRIBIED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL 6E DELIVERED IN
ACCORDANCE WITH THE POLICY PROVIsIoNs.
AUTHORIZED REPRESENTATIVE
®198 -201 D ACORD CORPORATION,All rights reserved.
ACORD 25(2010/05) 1 of 1 The ACORD name and logo aro registered marks of ACORD
#583849/M83848 MEY
o Dk, T12-31/Z � k
J
CAPECOD
INSUL 'AT10N
NB[R OLASS 5eA--55. SPRATIOAM SYSPENOEO -
BATfi 4UT1'FNY INSOLATION CRILINOS -
1-800- 96-6611:
Town of Barnstable
Regulatory Services
Building Division r
200 Main St
Hyannis, MA 0260.1
Date: 00/1 �--
Dear Building Inspector
Please accept this Affidavit as.docuinentation that Cape Cod Insulation, Inc. performed &
completed the insulation and weatherizdtion,work at the property listed below. Cape.Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected by a certified Building Performance Institute
(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements: `
Property Owner Property Address Village
Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted
Ceilings
Slopes
Floors ) ( ) ( ) ( ) ( )
Walls
` 5ea1 t✓t
Sincerely
He y E Ca sidy r, President
Ca e Cod sulation, Inc.
P`�ptHETp The Town of Barnstable..
BA
Department of Health Safety and Environmental Services MASS.
Ti 0
a 039. .m
"rEOMa� Building Division
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection r--raMe
Location �7 L.2r� Lh Permit Number d201(�0�388
Owner Builder
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting: (�
Yl�g� ( �m Was eh �c4.c-rie+r �1e�el Cx tao-` e-y- - cAor yla1'S
12 p4c
cTIVt_ 010.C e r p 1 UL 4n
Zn --u co c
�► y � (
C
l$l3 ° 1+C4 l"S C. Y1eeSe� C, rm c 1. o T OL iM
` C -", S
9-I
403y
Please call: 508-862-44M for re-inspection.
Inspected by
Date 3W I
OFtHE Tp� The Town of Barnstable
BARNSTABLE. ' Department of Health Safety and Environmental Services
T MASS. 0 �
fEOMpi° Building Division
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection �-ro m e-
Location )r7 C 2.Ae-r L. , Permit Number
Owner Builder
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting:
WC'
-Ce r `�� �,� c� ?UC. , e�
vJ \ ` \
z�! �Gra�c� Ce�e� 0T C' n� Co to • `� IeS
i 4 CA -q, L t"L k �s
5 1 ( �.
nk��S � Vc+�� i rcc� UIw�S�.�e
I
yo3�j
Please call: 508-862-40M for re-inspection.
Inspected by
Date 3)3 Jl
-� ins! � vn':
c,� D
3 _5
Al
r
�� ►� S he'd
J
..........
C�
`r �5"tA- p i rh
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map S Parcel (/ �,� Application
08
Health Division Date Issued
Conservation Division ',Application Fee
Planning Dept. , '.a Permit Fee,
Date Definitive Plan Approved by Planning Board 0127//�///��//�L/
Historic - OKH Preservation / Hyannis
Project Street Address -n-, L�4 rz ll P
Village
Owner 6" S)C1no O Y2 Address lie—
Telephone
Permit Request 4a
By
Square feet: 1 st floor: existing proposed 2nd floor: existing r- proposed Total newer
Zoning District Flood Plain Groundwater Overlay
Project Valuation 20 Construction TypeAeU620
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family. :Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes W�No On Old King's Highway: ❑Yes A No
Basement Type: JA Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ��
Number of Baths: Full: existing_ new Half: existing O new
Number of Bedrooms: existing 10 new
Total Room Count (not including baths): existing knew First Floor Room Count
Heat Type and-Fuel: dd Gas ❑ Oil ❑ Electric ❑ Other TTTT
Central Air: ❑Yes 64 No Fireplaces: Existing/New Existing wood/coal stove: A Yes ❑ No
Detached garage: Ulf existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing W new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes a No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name n 4_: Telephone Number
Address , l eo bF11 La License#
1'
�i16�,I'1 I�P/( ( � G1 • 6 Home Improvement Contractor#
Worker's Compensation #
ALL ONSTRUCTION DEBRI RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE ��
FOR OFFICIAL USE ONLY
APPLICATION#
'. _-PATE ISSUED
r
_ MAP/PARCEL NO.
ADDRESS !/" - n l , r !f VILLAGE
OWNER-%
j DATE OF INSPECTION:
FOUNDATION.'
FRAME
...INSULATION,+� . 3I18�3:_Polti
FIREPLACE . . _
ELECTRICAL: ROUGH = FINAL 4'
O
PLUMBING: ROUGH '? FINAL ,
GAS `.- ROUGH ,; FINAL
Q«F;INAL_BUILD.ING !:_ -W :1
;:. .DATE CLOSED:OUT-
ASSOCIATION PLAN NO. f`" -
� rt
of1NF> y Town of Barnstable
°-� Regulatory Services
BARNSTAHLF t Thomas F. Geiler, Director
p MASS.
ED ,�"`� Building Division
Thomas Perry, CBO,Building Commissioner
200 Main Street, Hyannis,W 02601
www.town.barnstable.ma.us
Office: 508-862=403 8 Fax: 50 8-790-623 0
PLAN REVIEW
Owner: L0 n2;5 MAP/Parcel: e2S 1 OGI
Project Addresso29 Builder: 0 u)ne.c=
The following items were noted on review'
ing:
fLl
Z e��' r a�-`� �i h e�e��' �,�ti�e�s w�e�e �o ut e red.o ne, '� •
As
3 ;�,�• p ov. 4� -;n mow^ n-t�'`�dq,�t� + L�r l�ww�s a or+�
r
Reviewed by: SQok>� �oWOE q�Iy)io
'Date:
. ,
Q:Forms:Plnrvw
s The Commonwealth of Massachusetts
Department of Industrial Accidents
i xl Office of Investigations
600 Washington Street
U. = Boston, MA 02111
t www.mass.gov/dia
Workers' Compensation Insurance.Affidavit: Builders%Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): "
Address: . .
' 0
City/State/Zip: �Phone #:`
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ 1 am a employer with 4. ®-I am a general contractor and I
6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- ,.aisted 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 area corporation and its 10.-❑ Electrical repairs or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work' right of exemption per MGL I LE] Plumbing repairs or additions
myself. [No workers' comp. K c.`152, §1(4),and we 1have no 12.❑ Roof repairs'
insurance required.] t employees.[No workers' -; ]3:❑ Other
comp. msurance;required.]
*Any applicant that checks box#1 must also fill out the section below showing their.workers'compensation policy information.
?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 thepolicy and job.site
information.
_ - m
Insurance Company Name: A
Policy#or Self-ins. Lic.#: r Expiration Date:' ' 1
r
Job Site Address:22 C a City/State/Zip: �,,V-Vt1-e �,0,02632
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'violato'r: Be advised that a copy of,this statement may,be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby Gerd a er the in d penalties of perjury that the information provided above
>is true and correct.
Signature: Date:
Phone
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#: .
r
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or"other legal entity, or any two or more
of the foregoing engaged iri 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."
i � i.
MGL chapter 152,,§25C(6)also'states that"every state or local licensing agency shall'withhold`the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance.of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking'the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be'submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is`being requested, not the Department of'
Industrial Accidents. Should you have any questions regarding the-law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. "Self:insured companies should enter their
self-insurance license number on the appropriate line:
City or Town Officials ;; a L&.
Please be sure that the affidavit is complete and printed legibly. The Department=has provided a space at the bottom
of the affidavit for you to fill out in the event the Office.of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number.,In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call. z
The Department's address,telephone'and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents.
Office of Investigations
600 Washington Street
x Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax# 617-727-7749
www.mass.gov/dia
s,
Comp.
7
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10/15/2010 09:23 5087753821. OLDE CAPE COD. INS PAGE 01/01
Oct-11-10 , 04 aRm Fram- T-040 P.0011002 F-010
TOWN OF BARNSTABL'E
CERTIFIC �bAN 1 AqQCE 10MV20110
HIS CERTIFICATE IS ISSUED-AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED
BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
HE ISSUING INSURERS ,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT: If the Certificate holder is an°ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATION
IS WAIVED, subject to the teams and conditions of the policy,,oertain policies may-require and endorsement, A Statement
n this certlflcata does not confer ri hts to the certificate holder in lieu of such endorsement.
PRODUCER
Olde Cape Cod Insurance Agency,
296 Winter S!
Hyannis,MA 02601
COMPARRS AFFORDING JNSURANCE
COMPANY A ` , - GRANITE STATE INSURANCE COMPANY
INSURED
John Lopes
27 Center Lane
Centerville.,MA 02632
COVERAGES
THIS 1.S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVi BEEN ISSUED TO THE INSURED NAMED ABOVE FOR
THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY.REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER
DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE
POLICIES DESCRI290 HEREIN IS SUBJECT,TO ALL THE TERMS,EXCLUSIONS AND CONDITI'ONs OF SUCH POLICIES.LIMITS SHOWN :'
MAY HAVE BEEN REDUCED 91Y PAID CLAIMS.
TR TYPE. SURANCI? POLICY NU M11 POLICY GFFECTTVr DATP. POLICY rXPIRATION PATPi
ORKER C MPENSATION
AND VAPLOYERS'LIABILITY LIMITS
HE PRCPrPJVOR/
PARTN15RS/EXECUTN@
DFPICDR$ARC: -
INCL 0 PxCL q ®5291 j > , 0/02/201 C 10/02/2011 STATUTORY
LIMITS
OTHER -
CavomBe ApMiae to NiA OPEMIOMn Only, - -
EACH ACCIDENT
100,000
DisEmm POLICY Lima S 500,000
DISEASEGACN EMPLOYEE $ 100 000
DESCRIPTION OF OP TION9NEHIGLES/SPECIAL ITEMS
RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE_FOR JOHN LOPES,
CERTIFICATE HOLDER CANCELLATION
TOWN OF BARNSTABLE SHOULD ANYOFTHEABOVS CEACRIBED POLICIES BE 0ANC5LLED 6EFOAE THE
BLDG DEPT EXPIRATION DATHTHERCOP.NOTICE WILL BE DELIVERED IN ACCORDAnIde
200 MAIN ST WHTETHC POLICY PROVI 00,
HYANNIS,MA 02601
AUTHORIZED REPRESENTATIVE
The Commonwealth of Massachusetts
Department of industrial Accidents
Office of liivestigations
600 Washington Street
t f r Boston, MA 02111
yy www•rnass.gov%dia
Workers' Compensation Insurance Affidavit: Builders/Contra ctors/Electrici anslPlumbers
Applicant.Information please Print`Legibly
Name (Business/Organization/Individual):
Address:
City/State/Zip, Phone.#: —
Are you an employer? Check the appropriate-box: Type of project(required):
1.❑ I am a employer with 4• [�'I am a generahcontractor7andl 6 New construction
have'hired the sub-contr _ _
employees (fiill and/or part-time}.
2-❑ I am a sole proprietor-or partner
-listed.on the attached sheet. 7. /� Remodeling
ship and have no employees These sub-contractors have S. Demolition
employees and have workers'
working for me in any capacity. 9. ® Building addition
[No workers',comp. insurance ,` comp. insurance.$
5. We are a corporation and its 10.( Electrical repairs or additions
required.] '
3. I am a honeowner.doing all work officers have exercised their. 1 l.� Plumbing repairs or additions
myself. [No workers comp.
right of exemption per MGL 12�Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees.[No workers' 13.[I Other t
comp.insurance required.] ti
*Any applicant that checks box#1 must also fill out the section below showing theirworkcrs'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have '
employees. If the sut--contractors have employees,they must provide their workers'comp.policy number. "
I am an employer that is providing workers'•compensation insurance for my:employe es. Below is the policy and job site
information
Insurance Company Name: -
Policy# or Self-ins.Lic.#: a 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 MOL 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 e D A for insur e coverage verification:
I do hereby cer a der th ,pai and penalties of perjury that the information provided above is trice an4eorrect.
S i nature:
Date:
Phone#:
i' Official use only. Do not write in this area, to be completed by city or town'official -
City or Town: Perinit/License#.
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and fnsfiructiOES
lo
oye
Massachusetts General Laws chapter 152 requires all employers Prlhe'sdervioce workers,
ano oth P under oany contrac on for their �lh fees.
Pursuant to this statute, an employee is defined as ".,.every person in
express or implied, oral or written.
legal An employer is defined as "an individual, partnership, association, ccorporaatio t Lives of adeceased employer, oo ore
Lbe
of the foregoing engaged In a Joint enterprise, and including the legal p
receiver or trustee of an individual, partnership, association ments or other legal entity, employing employees. However the
ccupant of the
oner of a dwelling house.having not more than th do anlenance,ncdoostniclion who eorhepair work on the o
w such dwelling house
dwelling house of another who employs Persons
o
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 lice se or permit to operate a business or to construct buildings in the commonwealth for any
1. tproduced acceptable evidence of compliance with the insurance coverage required,"
applieantwho has no
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
cote f into any contract for the performance of public work until acceptable evidence of compliance with the insttranee
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 sihration and, if
necessary,supply sub-contzactor(s)name(s), addresses) and phone numbers)along with their certificates) 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 he affidavit nt of The affidaviilshould
Accidents for confirmation.of insurance coverage, Also be sure to sign
be returned to the city or town [hat the application for the pennit'or license is.being requested,not the Department of
Industrial Accidents. Should you have any questions regarding required to obtain 8,,wD-fklrs'
the Jaw to rf ys i are f-insu ed compa ics should enter their
compensation policy,please call the Department at the number listed be w .
self-insurance license number on the appropriate line,
t
City or Town Officials
Please be sure that the affidavit is complete and printed legibly, tT e Departos entLo has t ovideYOLl.r a spa g the ce at he bottom
of the affidavit.for you to fill out in the event the Offiee of lnves g
Please be sure to fill in thc.permit/license number which will be used as a.reference number. In addition, is applicant
that muss submit multiple permiVlicense applications in any given year, need only submit one affidavit indicating current
or
policy information (if necessary)and under"Job Site Address" the applicant should write"all locations in
stamped or marked by the c)ty or town may be provided to the
town)."'A copy of the affidavit that has been officially
applicant as proof that a valid affidavit is on file for future permits or licenses.. A nan busiiness or commercdavit must be ial F 1 venlu7
year. Where a home owner or citizen is obtaining a license or permit not related to y
(i,e. a dog license or permit to burn leaves etc.) said-person is NOT required to complete this affidavit.
The Office of lnvestigalions would li e la Chyoti in-advanc-e for—you-r-co.op-eration 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 02.111
Tel # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax 9 617-727-7749
Revised 4-24-07 www.mass.gov/dia
AWC Guide to llwor! Cnrrstrcr.ctioir r.'rr flii;li IY�rrrl;(r�crs: IX0'fra lr {V�nrlloirc
Massachusetts Checklist fol- C01iap.hanCP- (780 GIN' 53()1:3.1.1)'
Check
Compliance
1.1 Wind S
Wind Speed (3-sec. gust).............................. ..
............... ....:. .. . .::: .. ..... ......:: ... .... 110 mph
Wind Exposure Category .:a . ...... .... B
...............................
Wind Exposure Category. r. Engineering Required For Entire P,,rofecf... .... .:.. ... C
1.2 APPLICABILITY `" -
Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story) stories s 2 stogies
Roof Pitch ........................ (Fig 2) `12:12
Mean Roof Height- r ..(Fig 2) ..........................
ft _< 33'
Building Width, W .. ..... . . ...(Fig 3) .�tQft 5 80'
Building Length, L ................................ ..(Fig 3) ft s 80'
Building Aspect Ralio(L/W) .......... ..(Fig 4) . !: 5 3:1
Nominal Height of Tallest Opening Z ... (Fig 4) .......: .. ....:....................... s 6,8, -!
1.3 FRAMING CONNECTIONS I
General.compliance with framing connections.................. (Table"2) .,.. .. .
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concc
rete........ :., ., :;'
Concrete Masonry .......... ..• ,.: ,: .... ... .... .. ...
2.2 ANCHORAGE TO FOUNDATION1'3
5/8'Anchor Bolts:imbedded or 5/8"Proprietary Mechanical Anchors as an alternative.in concrete only
Bolt Spacing—general (Table 4) n.
i
Bolt Spacing from end/joint of plate ........................ ..(Fig 5):. ... .. in. 5.6"—12",
Bolt Embedment concrete............... in. > 7
. g . .....,. .,.
.. ........ "
Bolt Embedment—masonry .. ....:... ...... (Fig 5):.
. .::...... in. > 15"
Plate Washer..... .............. . :... ..... ,..........,.. . ...(Fig 5).. .,:.... .....:........:..,.... >3xxIWI
3.1 FLOORS g (per Floor framin member spans checked (p 780 CMR Chapter 55) .... • •• _6z
ft<12'
Maximum Floor Opening Dimension (Fig 6).., .......,,................
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wail (Fig 6) .. ,.. ...... .. _
Maximum Floor Joist Setbacks
... .eft 5 d'
Supporting Loadbearing Walls or Shearwall: ... ...:.....(Fig.7).......... . : ..... �
Maximum Cantilevered Floor Joists
Supporting Loadbearing Walls 9r Sheanvail..`.,.: ....::.(Fig 8)... ..... .. ....: ft 's d
Floor.Bracing at Endwalls....•. (Fig 9).... . ... ......
Floor Sheathing Type (per 780 CMR Chapter 55) ...... ..
Floor Sheathing Thickness ... .. (per 780 C Chapter 55 �in. �
Table :. * d nails at, in edge/Irfn'field .
Floor Sheathing Fastening.... ......:: ....... .. ...... ( 2) ;
i
s
4.1 .WALLS - 1
Wall Height_ r �t ;
Loadbearin ,walls......................: .` .... (Fig 10 and Table 5) `` l ' Ift
ft <.10
.
••••••••••(Fig 10 and Table 5). ..... �'�'*..... s20' �C
Wall Stud Spacing ......... ... .(Fig 10 a_nd Table 5) .' in s 24 .o,c.
............. ....,.......,.....(Figs 7& 8) ...... .. ...... ft 5 d
Wall Story Offsets :`. —
4.2 EXTERIOR WALLS'
Wood Studs
Loadbearing v✓alls.. ... . ... ,. ..(Table 5),, .....:; ... . � � -r—
Non-Loadbearing walls.................. .....: .....................(Table 5).: :,: ....2x -�'ft in:
3
Gable End Wall Bracing
Full Height Endwall Studs.................. .... (Fig 10)....:
.. ... ................
WSP Attic Floor Length:......:..:......:..............................(Fig 11).............................:............... ft zW/3 �
Gypsum Ceiling Length (if WSP not used),....,.I...... ....(Fig 11)................................I..........._ft?0.9W
and 2.x 4 Continuous Lateral Brace.@ 6 ft. o.c. .. (Fig 11).................................:...........................
or 1 x 3 ceiling furring strips @ 16 spacing min. with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays_
Double Top Plate
Splice Length :...................:.............:....(Fig 13 and Table 6)....................................._ft
Splice Connection (no. of 16d common.nails).......:......(Table 6).......,:....,,...,........,...........,,:..............._
ATVC Guide /0 Iflood Coflvlr[iction ill Hi,{l/l M/h1d,d1'erzs; 110 fflj�lr. Wind Zone
Nliass,,iclillsetts .cllc�c.l(.list fiber C0111jAi1 ,'111C(', (790 Ci1tf2'5301.2,I.1)i
Loadbearing Wall Connections
Lateral(no. of 16d common nails)..........................:...,.(Tables 7).....................................,,..............
Non-Load bearing Wall Connections
Lateral (no. of 1.6d common nails)...........:. ( )................... Table 8 ....................................................... 1�
Load,Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9)
Header Spans ................................................(Table 9).................................. ft_in. < 11'
SillPlate Spans .........................................................(Table 9).................................. ft,—in. 5 11'
.Full Height Studs (no. of studs)....:................................(Table 9)........................I.......................
,:,..:.
Non-Load Bearing Wall Openings (record largest opening but check.all openings for compliance to Table 9)
',Header Spans,...... r .....:.......... ......................(Table 9),................................. ft_in. 5 12'
SillPlate Spans.... . ` , ................ ................,.....(Table 9)............:..................... ft in, 5 12"
Full Height Studs (no.,o1studs).......................:............(Table 9).........:......:......................,...............
Exterior Wall Sheathing to`Resist Uplift and Shear Simultaneously4
Minimum Building Dimension, W
Nominal Height of Talh�st QpeningZ 5.......::...................................................................... 6'8"
Sheathing Type........1! ....%\y.....:...............(note 4).....................................................
Edge Nail Spacing.........................:................(Table 10 or note 4 if less)........................__(��_in.
Field Nail Spacing..............:........:... :.............(Table 10)..................:..............................�-L in.
Shear Connection (no. of 16d common nails)(Table 10)................,...,....................I.............
Percent Full-Height Sheathing...................:...(Table 10).......,............................................_%
5% Additional Sheathing for Wall with Opening > 6'8"(Design Concepts)....................
Maximum Building Dimension, L
Nominal Height of Tallest O enin
Sheathing Type.................:�`........................:.(note 4)....:....................................I.........
.
Edge Nail Spacing.........................................(Table 11 or note 4 if less)................,.......in.
Field Nail Spacing.......................................:..(Table 11)................................................... ( iin,
't Shear Connection (no, of 16d common nails)(Table 11)........................................................—
Percent Full-Height Sheathin ..... Table 11
5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).............
Wall Cladding
Rated for Wind Speed?,......
5.1 ROOFS
ROD framing member spans checked?.......:................(For Rafters use AWC Spin Tool, see BBRS Website)
Roof Overhang ................. ..... ..............:.....,.(Figure 19) .............q[, ft s smaller of 2'or L/3 t/
Truss or Rafter Connections at Loadbearing Walls
Proprietary.Connectors
Uplift .....,:(Table 12)......:.....................................U= plf
Lateral:......................:.......:..............(Table 12)... ............I.......................L= plf
`N Shear....................................,..........(Table.12)...................................,........S= plf-1 .
Ridge Strap Connections, if collar ties not used per page 21... (Table 13)........I....I...............I.T= plf
Gable•Rake Outlooker::::.......................................(Figure 20) .............to ft 5 smaller of 2'or L/2. —�
Truss or Rafter Connections at,Non-Loadbearing Walls -+
Proprietary Connectors
Uplift.............................................. .(Table 14).......................I. =
Lateral (no..of;16d cot�}�on nails�.(Table 14).....:..:,..:................ ...:.....L= . lb.
Roof Sheathing Type..... . ..,Q..!. "!4?.YY (per 780 CMR Chapters 58 and 59) ............ _sue
;. x
Roof Sheathing Thickness....... ......1�..... ...A......;.... '.............:..............................._)in. >_7/16"WSP �G
Roof-Sheathing F-as#erring................ ..... C.....:......�Tabl �e ).....:.
.............. ...................................
Notes:
1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of i
780 CMR-5301:2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not
required per the.WFCM 110 mph Guide:
a. Steel Straps per Figure 5 N .
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..
THE r `Town of Barnstable
Regulatory-Services
swxtvsrwsLe Thomas F. Geiler,Director
Building Division
PIfD µp'l A x ' •`
Tom Perry,Building Commissioner 1
200 Maiti.Street Hyannis,MA 02601
_..
www.town,barnstable.ma.us
Office: 508-862-4038 '` Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION P.
Please Print
DATE:
JOB LOCATION: �2
number Q street
,� village
"HOMEOWNER': _,Zy y" li D��
name home phone# 4L__work phone#
CURRENT MAILING ADDRESS:2-7
city town a state zip code
The current exemption for `homeowners was extended to include owner occupied'dwellings.of six.,units,oroless and
fo allow homeowners to engage an individual for hire who does not possess a lic6nse,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
f person who constrgcts more than one home in a two-year period shall not be considered a horneowner,` 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`imd'er'tlie liuildint?permit.s(Sectioii.;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,Depa.=cn
,„in;rr,um' ecdon procedur and requirements and that he/she will comply with said procedures and
afore of Homeowner•
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control. -
HOMMO WNER'S EXEMPTION ti"
.The Code states that "Any homeowner performing work for which a building perinii 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:. x
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption an unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Ueeasing 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 corhmunities require,as,part of the permit application., .
that the homeowner certify that hdshe understands the responsrbili6c's 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 fomJcertification for use in your cormnunity.';
Q:forms:homcexempt
V
• THE rocs Town of Barnstable
Regulatory Services
r r
• a
BARNSTABL.E,
y suss. $ Thomas F. Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
k Property bier Must �.
Complete and`Sign This Seci-ion
If Using'A'Builde
p
, J
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
nature of Date
Print Name ---- -- -
If Property Owner is applying for permit please complete.the
Homeowners License Exemption Form on the reverse side.
Q:F0RMS:0 WNERPERMISS)0N
From•.A&enne Frazee FaYJD: Page 2 of 5 tXft:W1 ImUl u()1:5W I-M Page:l of 0
9/ 15/2010 2 : 20 : 46 PM 8935 ® 03/03
DATB MMDM'*
CERTIFICATE OF LIABILITY INSURANCE 0111010
THIS CERTIFICATE is IssOEO As a NmTTER or IsroAmlor ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE BOLDER. THIS CEBTIMATS
DOSS NOT AMMIATIVELY OR NEBATIVEL4 ARM, EXTEND OR ALTER TES COVERAGE APrORDED NY THE POLICIES EELOV. TNIe CSRTIPICATE OF
INSURANCE DOES NOT CONSTITTTE A CONTRACT SET 11 TEE DOING INSORER(G), ADTNORTSSD IMPRESMAIM OR PRODUCER, AND TEE
cicwnrICATS soma.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(fes) must be endorsed. If SUBROGATION IS VAIM, subject
to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not
confer rights to the certificate holder in lieu of such endoreemaot(s).
rroaum COMMIT
Northeast Insurance Agency Inc rum Mar
294 Worcester Ct (Ale.So.bd)-
Falmouth, ba 02540
raOucM
Amu=ADD.
nnaamcci arrmm coomm Dues
7981mm Iman a<A.I I.M. Mutual Insurance Co
Lawrence Reich MISOM a;
P 0 Box 1223 IDAPDaI!:
Sandwich, MR 02563 D:
1111MUM P1
COVERAGES CERTIFICATE N0M8ER: REVISION NUMER:
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CERTIFICATE BOLDER CAN('LLLATION
JOHN LOPES
SWW MT or'DM<.Jam DENCam=POLICINs NN CUCNLL®AS, THE
21 CENTER LANE s:Y'Ie02011 mm Tancor, -no WZm Be aEumm IN mommeh IS plan SEE
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�P4�N 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS 27CTl2 f
.rTliE MASSACHUSETTS STATE BUILDING CODE
ct,talLo -
0 No.3TUR P 1 j A WC Guide to Wood Construction in High Wind Areas;110 mph Wind Zone pF
0 S7RUCTuF"' Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' `T
s orva,E " `, Check
Compliance
1.1 SCOPE
Wind Speed(3-sec.gust) .. ................ ............. . .. . .......:....:. 110 mph
Wind Exposure Category. .. .................... .......... . ....:.............. B —
1.2 APPLICABILITY
Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a ssgry)
L stones s 2 stories _
Roof Pitch ....... . ........... . .... ...... (Fig 2) ... . ... .... ........it
h 12:12
Mean Roof Height ... . ........ ......... ... (Fig 2) . ..... .... . .... .... ft s 33'Building Width,W ...... ..... ............ (Fig 3) ....... .... . .. . ..... ft s 80'
Building Length.L ... ..... .. .... ... ...... (Fig 3) ... . ... .. .. ..... .... ft s 80'
Building Aspect Ratio(L(W) ......... ...... (Fig 4) . ... .... ..... ....,; s 3:l . —
Nominal Height of Tallest Opening= .... ... ... (Fig 4) - ti "
1.3 FRAMING CONNECTIONS
General compliance with framing connections... (Table 2) ........ .. ........ ..... .......
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concrete .....
Concrete Masonry ..:........... ... .. ......... ........... . ....::.:........ . .... —
2.2 ANCHORAGE TO FOUNDATION'.' `
Anchor Bolts imbedded or%"Proprietary Mechanical Anchors as an alternative in oncrete only 5(M�
Bolt Spacing-general...........•.....• (Table 4) (,a �j!t��i 2 in. � 1�
_-� A � /L-
Bolt Spacing from end/joint of plate ...... (Fig 5) ......•..`...... �in. s 6"-12" .(G - �p P
Bolt Embedment-concrete........... (Fig 5)......................... ..-Z in.i 7"
Bolt Embedment-masonry.............. (Fig 5) — in.z 15"
Plate Washer ......................... (Fig 5) .... ............... z 3"-x 3"x 1/4"
3.1 FLOORS —
Floor framing member spans checked ......... (per 780 CMR 55.00) °..............:...
Maximum Floor Opening Dimension.......,. (Fig 6) ..................... 12'
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)
Maximum Floor Joist Setbacks —
Supporting Loadbe-aring Walls or Shearwall . (Fig 7) ft s d
Maximum Cantilevered Floor Joists
Supporting LoWbearing Walls or Shearwall . (Fig 8) ....................... =ft s d
Floor Bracing at End Wails .................. (Fig 9) ...... ... ................
Floor Sheathing Type . ......... (per 780 CMR 55.00) ...............
Floor.Sheathing Thickness ................. (per 780 CMR 55.00) .. ........ in.
Floor Sheathing Fastening ... ...........•. (Table 2)&.d nails at_Vin edge./,�in field
4.1 WALLS
Wall Height, . ..
Loadbeadtig walls ......... (Fig 10 and Table 5) ..........feb ft 10'
Non-loadbearin walls
8 ....... .. (Fig 10 and Table 5) .. ft s 20'
Will Stud Spacing . .......... .. ....... (Fig 10 and Table 5)..... . .in s 24' o•c.
Wall Story Offsets......................... (Figs 7&8) .. -ft s d _
4.2 EXTERIOR-
WALLS'
wood Studs
Loadbearing walls : (Table 5) 2x ft b ;in.
Non-Loadbearing walls ........:. ( )
Table 5 2x `
Gable End Watl �Bracing'.
Full Height Endwsll Studs........... (Fig 10) ' ........ _
WSP Attic Floor Length :. ........... (Fig 11) ..... ft z W/3
"G �m-Ce;L'� ..
and 2 x 4 Continuous Lateral Brace®6 ft.o.c...(Fig 11)........:.....................
or I x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 f.spacing in end —
joist or truss bays
(Fig 1.. . ... .. . ..:..t,
Double Top Plate e
Splice Length. :.,. .. ... .. .`... 3 and Table 6) .
Splice Connection(no.of.16d common nails)(Table 6). . ..... ... ... •. _ -
1054 780 CMR-Seventh Edition 12/28/07 (Effective 1/1/08)
OF ASS 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
•(N
gOtiG APPENDICES
2 M1cHELE sm Loadbearing Will Connections
CUDtL04 Lateral(no.of 16d common nails
0 No.3477 Non-Loadbearing Wall Connections ) (Tables 7) . . ...,.• 2 0 UCTuaAL —
STR Lateral(no.of 16d common nails) ......... (Table 8) rL
Load Bearing Wa110penings(record largest opening but check all openings for c pliance to Table 9)—
REGIS�
Header Spans. ...................... (Table 9)
$ill Plate Spans .................. ••. ft�D in.
(Table 9)
Full Height Studs(no.of studs) ft,Q in. s I P
........... (Table 9) '2—
Non-Load Bearing Wall Openings(record largest opening but check all openings for mpliance to Table 9)
Sill Plate Spans.... . ft in. s 12'
(Table 9)
„......(Table 9)
Header Spans.,.... ;....•............ .. (Table 9)
• """"" ". . co
••••....•.
Full Height Studs(no.of studs) .... '''''•'• '•'••• ft in. s 12"
• . � —
Exterior Wall Sheathing to Resist U�and Shear Simultaneously.. •... . .. . .. . ..` . .. ..
Minimum Building Dimension
Nominal Height of Tallest Opening'
Sheathing Ts 6'8" _
Edge Nail Spacing -
Field Nail Spacing �1�
•••••• (Table 10 or note 4 if less) .. ....... in,
m (Table 10)......... ..... . . .. .... i
g
Shear Connection(no.of 16d common nails)(Table 10) —`
Percent Full-Height Sheathing ).. .
(Table 10 .. . ..
............. _
5%Additional Sheathing fo Wall with Openin >6'8"(Design .. .... ..✓r_%Concepts)..........
Maximum Building Dimensio<1 —
Nominal Height of Tallest Opening
Sheathing Type ....... .. . ...... `s 6'8" —
..... . (note 4)........ .... . ... • . .. -/
Edge Nail Spacing • • • YV lP
••••••••••••••••... (Tablellornote4ifless) . .. . .... —
Field Nail Spacing �_in,
.........:.. (Table l l).......... ............ •�Z in
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 —
Truss or Rafter Connections at Loadbearing Walls ) '' —ft s smaller of 2'or L3 _
Proprietary Connectors
Uplift (Table 12).
Lateral ............................ (Table 12).,............. U
Shear. . ... . L=
(Table 12). S=�
Ridge Strap Connections,if o 1 tt
Gable Rake Outlooker not se r page 21(Table 13)............. T=
................ .... 20 plf —
(Figure ) ....•�_•(•,.ft s smaller of 2'or L/2
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift ....... ....•............ (Table 14)......
Lateral(no.of 16d common nails) ''' '''''''''' U lb. —
Roof Sheathing T (Table 14)................ .... L=—lb. _
YPe ...••••••••........:... (per 780 CMR 58.00 and 59.00)............Roof Sheathing Thickness . . ..,
Roof Sheathing Fastening / in. 2:7/16"WSP _
. (Table 2) e��.fP. . ;a4,q!Notes:
1.. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the
requirements of 780 CMR 5301.2.1.1.Item 1.If the checklist is met in its entirety then the following metal straps
and hold downs are not required per the WFCM 110 mph Guide:
a. Steel Straps per Figure 5
b. 20 Gage Strips per Figure 11
c. Uplift Straps per Figure 14
d. All Strips per Figure 17
e. Comer 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]Oared 11.
3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade.
4. a. From Tables 10 and I 1 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height
Sheathing and Nail Spacing requirements
12/28/07 (Effective 1/1/08) 780 CMR-Seventh Edition
1055
Cy
AWC GWde to Wood Consiructio►t in High Wind Arens: 110 ►►tph Jfind Zone
Massachusetts Checklist for Compliance (780 CMR s;ol.i.l.t)'e-.
-:3- OF+
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
•-MME'N TINS EDGE MS18 ON
FPA~118E 8d NAU
ATBb&_
- .-----
11 11
11 /1
Y H
1 11
1� 11
11 11
M N
11 11
1/ 11
11 /1
11 1/,F
I/ Y1
/1 11 $ J
t'1� it it
16 n iti
oil
F■{Ji/� Il 1l
a U u
U 1/
11 11
11 11
11 11
W
11 11
1 tll
rw ♦�
DOW M�i; - ------ `
NAIISPACM
See Detail on Next Page
Vertical and Horizontal Nailing
for Panel Attachment
CM
II'C Grride to IVonrl Cmrslruclion irr High Wind Areas: 110 mph IVirrd Zone
Massachusetts Checklist for Compliance (780 cn912 S3u1.2.1.1)'
a ,
EDW
1
.V 1
1
I, is
s
� ' FAAMIN 1AElABEiMS _� �
, LL
1 f 1 1
3*14IN 9
MAIL PATIEFIN PANEL
PASS E0M MR LF.NAIL GrA SPACNO'MAL
Detail
Vertical and Horizontal Nailing
for Panel Attachment
GENERAL NOTES AND MATERIAL SPECIFICATIONS:
FOUNDATIONS
1. All workmanship to conform to the requirements of the Massachusetts State Building Code, latest edition.
2. For site location and grading information,see Site Plan,by others.
3. Assumed net allowable soil bearing capacity,q=3000 psf,for a medium sand/gravel composition. Other soils encountered,
contact the Engineer of Record.
4. Concrete: Minimum 28 day strength,fc=3000 psi,3/4"aggregate,designed per American Concrete Institute Code,latest
issue,maximum slump=4".
a.) Anchor bolts ASTM A307 galvanized,min. 5/8"diameter, 12"long,w/2-1/2"hook spaced 4' o/c,QQr in concrete piers w/
Simpson ABU-series base; SPACED 2'o/c for slab-on-grade construction(i.e.Garage). Vo ti,
FRAMING
1. All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition.
2. Structural Design Loads:
Dead Loads:Actual Weight of Building Components
Live Loads: Snow Load =30 psf(plus drift)with applicable reduction
ATTIC Storage=20 psf
Living Floor=40 psf
Sleeping Floor=30 psf
Decks and Balconies=60 psf
Wind Load: Criteria used for 110 MPH Exposure B.
3. Structural Steel: (as required)
a. ASTM A572 Grade 50;shop paint with rust inhibitive paint.Thru-Bolts: ASTM A307, 1/2"diameter;punched holes:
9/16"diameter.
b. Welds: Shop weld cap and base plates to columns;shop weld bearing plates to beams;use E70xx electrodes.
Alternatively, field weld by certified welders.
c. Deflection Criteria: L/360 total load deflection.
4.Timber Framing:
a.All new timber framing:Spruce-Pine-Fir No.2 with Fb=1000psi,E=1,300,000 psi,or better.
b. Pressure treated timber(P.T.):Southern Pine with Fb=1300 psi,E=1,600,000 psi,or better.
c. Laminated Veneer Lumber: All L.V.L.shall be 1.9E L.V.L.with Fb=2925 psi,E=1,900 ksi,Fv=285 psi,Fc_per=750 psi,
Fc_par=3035 psi. Parallam(PSI.):All PSL shall be min. 1.9E ES with Fb=2900 psi,E=1,900 ksi,Fv=285 psi.Fc_per-750 psi.
Fc_par2900 psi. Note that Microllam and Parallam may be used interchangeably.
1. Deflection Criteria: L/480 Live Load,L/360 Total Load
2. Optional: Provide shop drawing submittal of engineered lumber systems for approval prior to materials purchasing.
5. Metal Connectors:
As manufactured by Simpson Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail
holes filled,with the size nail as specified by mfgr.or herein.
a. Rafter to Ridge Beam: Simpson LSSU-series,or Simpson Straps over top of plywood,spaced 48"o/c;
Rafter to Ridge Plate: Collar ties min. Ix6@ 48"o/c at top or Simpson Straps over top of plywood spaced 48"o/c
b. Rafter ends to top plate: Simpson H2.5A
c. Band Joist: Simpson straps at 48"o/c
6.Bolts:
Bolts in wood framing shall be standard machine bolts unless noted otherwise.Bolt holes in wood shall be 1/32" larger than
bolt diameter.Bolt heads and nuts shall bear on standard malleable iron washers,or square plate washers.All nuts shall be
retightened at completion of job.
7. Blocking.
a. Blocking shall be solid blocking,2x minimum,and full depth of member.
b. Stud Walls:provide blocking at 8'-0"o/c,maximum height. Comers to be blocked at 48"o/c with plywood edge nailing
to this blocking for the first 48"of these building comers.
c.Nailing Schedule:
Solid Blocking to Bearing 2-8d toenails ea.side
Blocking Between Studs 2-I0d toenails ea.end,or 2-16d end-nails ea.End
d. New Framingi Provide 2x blocking for 2 joist/rafter bays and spaced 48"o/c in joist andrafter plane at all edge
plywood edges to this blocking or Mass
8.Nailing Schedule: "��y
All nailing shall be.in accordance with Appendix 120.Q,unless noted herein specifically. C) MICHELE
Multiple Studs 16d @ 12"staggered Z 0001LO -A
a:All nails shall be common wire nails. o No.34774 `n
b. Sub-bore where;nails tend to split wood. TURAL
9. Headers less than 4'-0",use 2-2x6;all others per MA State Building Code Table 5 l,)," O. STRUC o ��
E
.MIGHE�E CU� L6� P• SSIpNRt_GN
Consulting ,:Structu�nl Ertnir�aar
123 Cottonwood Lane, Centerville, Massachusetts 02632
S Drawn By; MC Date: 08 / Z) Drawing
�Z --7,! 6eq'J Ttn--'". .
��,s^�i4a Scale* AS NOTED Rev. 0
�'�►F n-J���� 1'"(A File Name: LofIE5,� Project No.: �
7
.. . IU "cu vvI In %, Ury I IIVUUUJ VVUUU b I KUL;I UKAL NANtL JHtAI HI
OUTSIDE ELEVATION SIDE ELEVATION
•- - - Extent of header two braced wall segments)
- - - Extent of header (one braced wall segment) ----J
i
Pony ry .- Min. 1,000 lb
wall Braced wall segmentk
(�' r ` per IRC Table R602.10.4 '` t•' tension stra
k, „; p
height". S j Strap shall
centered at
be
:; • • f • t 3{ 'y# t, ;�i 5� t tti�nth 4 , � 7 , ':.J�t -i • • • • ,•
MIDIa1 , ��;w f bottom of
•i • • .. n r, t "k�. ,, zit , • 1..'.l..
t�',t L4 �stl �y t 1 • • • • ,• + header.
I• c,,l� 'i\., 4 "Cxn 3 1L�t }\n'\,�,.` thb.; Q�Y hl\tea !� • • :• • ;•
•» +. `' - 2 to 18' (finished� opening width) 16d sinker
2 j•, • ; Fasten sheathing to header with 8d common i nails (0.148'
Ix. ;;"„ nails (0.131" x 2-1/2") in 3" grid pattern as shown x 3 1/4'') in
•
of `o; ;I "• 2 rows
j j,i ` and 3" o.c. in all framing (studs and sills) typ. ,t
1 .;. @ 3" o.c.
ill " Header shall be fastened to the king stud
]htwith 6-16d sinker nails (0.148" x 3-1/4') W
ood struc-
•;• ;•;: rf �,;,� .=.r, turol panel
Minimum 1,000 lb strap shall be - 1,;,� r.
10` centered at bottom of header and installed �� `� �' must be
1 .. ,n I
'• 1• .,, t.,,x � @,tt �f da ' ;, continuous
max77
. r ! on backside as shown on side elevations �`� t- '
•1 CTY ,
height I•i• 1i, TR, i ti ti •' 3 �'r--- _ from top of
.1. --- )e ee p p For a panel slice (if needed),
ti _._-- I•,i wall to bottor
• ;1•I• panel edges shall be blocked and of wall or
occur within middle 24 of wall height from top of
wall to
i•�• �•,•i Wood structural panel strength axis1 permitted
•. t 1�, tA� i` i i i.i Splice area
.,.� Min. number of studs shoshown:" a\�= ���fyl t (•;•; ;•;• ;
- Min. length based on 6:1 aspect ratio. �44 "y � �•1•;
- 7/16" min.
}�` «•, For example:l b" min. for 8' height. thickness
wood
structure
,
- ---1---; --------=-- ___ panel
--- Anchor bolt per IRC Table R403.1 .6 typ sheathing
Min. 2"x2"x3/16" plate washer No. of jack studs per
re: IRC Table R502.5(l&2)
See Table 1
- Not to scab
OVER CONCRETE OR MASONRY BLOCK FOUNDATION
Form No. J740 ■ C 2008 APA - The Engineered Wood Association • www
--- --- --------- -— --- _ ..... _._.—.....- ...... _.---
= _ s MICHELE CUDILO, P.E.
/gyp L._S Consulting Structural Engineer
p y a o tones ane, en emue, assac use 6 3�
Drawn By: MC Date: pg /3t 0
-Drawing a in
`Z-7 -r��i�'GJ'(_YL- tz�: Scalier AS NOTED Rev. 0 cjj
(`-` -}✓�t..L.l_. � File Nome: p ZOO— ►J K"—
Project No..
■
2b GAR
by Weyerhaeuser 4 Pcs of 1 3/4" x 16" 1.9E Microllam@ LVL .�. (�� Yf "TJ-Beam®6.35 Serial Number:7005107030
User:2 8/31/201010:59:21 AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
Page t Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED
�— 23'2318"
Product Diagram is Conceptual
LOADS:
Analysis is for a Drop Beam Member. Tributary Load Width: 13'
Primary Load Group-Residential-Living Areas(psf):40.0 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" 2.76" 6032/2168/0/8200 L1: Blocking 1 Ply 1 3/4"x 16"1.9E Microllam®LVL
2 Stud wall 3.50" 2.76" 6032/2168/0/8200 L1: Blocking 1 Ply 1 3/4"x 16"1.9E Microllam®LVL
-See iLevel®Specifier's/Builder's Guide for detail(s): L1: Blocking
DESIGN CONTROLS:
Maximum Design Control Result Location
Shear(Ibs) 8083 -7052 21280 Passed(33%) Rt.end Span 1 under Floor loading
Moment(Ft-Lbs) 46206 46206 62228 Passed(74%) MID Span 1 under Floor loading
Live Load Defl(in) 0.741 0.762 Passed(U370) MID Span 1 under Floor loading
Total Load Defl(in) 1.008 1.143 Passed(U272) MID Span 1 under Floor loading
-Deflection Criteria: HIGH(LL:U360,TL:U240).
-Bracing(Lu):All compression edges(top and bottom)must be braced at 12'7'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.
\f 0F"1r
PROJECT INFORMATION: OPERATOR INFORMATION: MICHELE
CUDILO
LOPES,JOHN Michele Cudilo o No.34774
' Michele Cudilo,P.E. " gTRUCTUR?,'. ,
27 CENTER LANE,CENTERVILLE 123 Cottonwood Lane
Centerville,MA 02632-1979
Phone:5087717601
Fax :5087717163 r
mcudilo@comcast.net
Copyright O l 2009 by iLeve , Federal Way, WA.
Microllamfi& is a registered trademark of il,evelJ.
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I `55s3chusetts State Bullding Code Latest Edition requirements.
- �etds to be E70xx electrodes, Shop weld cap and base plates to �yzHor�1ss'
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u N0.34774
STRUCTURAL y
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I A� A/ Consulting Structuroi- Engineer t
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!S/co 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
h of M THE MASSACHUSETTS STATE BUILDING 7 LI�L
ILDIN 2 G CODE �-��= K., r
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t�ICt1.ELE y�;a' AWC Guide to Wood Construction in High Wind Areas;110 mph Wind Zone
CUDl10 OF
�, Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 `T
No.34774 s
STFUCTURAL. /
Check
.1 SCOPE Compliance
Wind Speed(3-sec.gust) .. .. .......................... . ........ ........... I10 mph
Wind Exposure Categoryy .. ..... ......... B
1.2 APPLICABILITY
Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a )Sr stories s 2 stories _
Roof Pitch . . . . . .. .... .... .
.. (Fig 2) .. . .... .... .. . _ ' k 12:12
Mean Roof Height .... .... ..... .. ... (Fig 2) .. . .. ..... . ft s 33' —
Building Width,W ... ... ..... .... .. ...... (Fig 3) ft s 80'
Building Length,L .. . ..... ... .... .. ...... (Fig3) ... . ... ... . ........4 ,
Building Aspect Ratio(L/W) .... .. ... ...... (Fig 4) . ft s 80' _
S� s 80 _
Nominal Height of Tallest Opening....• ... . .• (Fig 4) .I�w$$1s 6'8" _
1.3 FRAMING CONNECTIONS
General compliance with framing connections. .. (Table 2) .... ... .'.
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concrete
Concrete Masonry . .. . . ........ ...... ... ..... .. —
2.2 ANCHORAGE TO FOUNDATION'.3
%"Anchor Bolts imbedded or% Proprietary Mechanical Anchors as an alternative in conc to only
Bolt Spacing=general.... .......... ... (Table 4) lam :, /�tg1D� „
Bolt Spacing from end/joint of plate ....... (Fig 5) ...... ..`•..... 4 in. s 6"-12"
Bolt Embedment-concrete....:......... (Fig 5)...... ................. .Z in. k 7,.
Bolt Embedment`-masonry............ (Fig 5) in.i 15"
Plate Washer_. ........ ............ (Fig 5) .. ................. �t'3"x 3.,x t/i,
3.1 FLOORS
Floor framing member spans:checked ......... (per 780 CMR 55.00) .......... ...:.:..
Maximum Floor Opening Dill enslon ......, .. (Fig:6) ........ .. L
Full Height Wall Studs at Floor Openings less than 2'from ExteriorWall(Fig 6)
Maximum Floor Joist Setbacks'> -
supporting Loadbearing Walls or Shearwall (Fig 7) ....• _ ft's d
Maximum;Cantileveredfloor Joists
Supporting Loadbearing Walls or Shearwall :(Fig 8) =ft s d
Floor Bracing at Endwalls ...:............::(Fig 9)
Floor Sheathing Type (per 780 CMR 55:00) —
Floor Sheathing Thickness `'(per CMR 55.00) .. 3 in,
Floor Sheathing Fastening (Table 2)_&d nails at in edge/ in field _
%4.1 .WALLS
Wall Height
Loadbearing walls; .:. ...... (Fig 10 and Table 5) tr8 ft s 10'
Non-Loadbeanrig walls .. (Fg l0 and Table 5) Ib ft t 20
Wall Stud Spacing : Fi 10 and Table 5
Wall Story:Offsets (Fig ) in. s 24"o,c.
(Figs 7&8) .. ..... .. =ft s d
4.2 EXTERIOR WALLS'
Wood Studs.
Loadbearing walls .................... (Table 5) ...:.:. .....2x = ft b--Min.,.
Non-Loadbearingmalls ............
:. (Table 5) ............2x
Gable End Wail Bracingft
Full Height F.ndwall Studs . .... .... (Fig 20) ..
WSP Attic Floor Length .:, (Fig 1-1) ft a W/3
ew wsp
and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c...(Fig 11)................. . _
or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking 4 ft.spacing in end
joist or truss bays
1... ..............Double Top Plate
Splice Length.... ..... .... . ..... .. .... (Fig 13 and Table 6)P4. .
Splice Connection(no.of 16d common nails)(Table 6). ...... ....... ..
1054 rim �{
780 CMR-Seventh Edition 12/28/07 (Effective 1/l/08)
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o� RAICh1ELE .:
oCUDILO
V No.34774 APPENDICES m
STRUCTURAL J,
Loadbearing Wall Connections
Lateral(no.of 16d common nails)qF� ......... (Tables 7 2 gEo% ) . .. ...... . .... .. . ......... _ —
_`.�� Non-Loadbearing Wall Connections
Lateral(no.of 16d common nails ......... (Table 8) .......... . ... . .. ...... .. 12,
Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)-
1 Header Spans.......... ............... (Table 9) !D
. .�ft in.
Sill Plate Spans .... . .. ................ (Table 9) ft O in.s III
Full Height Studs(no.of studs) ........... (Table 9) . I _—
V\/. Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
Header Spans...... .... .......:......... Table 9
Sill Plate Spans.... . . .... .... .... (Table 9) ... .. ft 12"
Full Height Studs(no.of studs) �, !. (Table 9) 12-
. .. _
Exterior Wall Sheathing to Resist U an Shear Simultaneously'
Minimum Building Dimension
Nominal Height of Tallest Opening' ......... ..... :. . ... ..
... t �t
. s 6'8"
Sheathing Type ..... .. . . . . ... ... ..... (note 4). . .. . ... . .. . . . . .. . .. _
Edge Nail Spacing . . . .... .. .......... (Table 10 or note 4 if less) . . ....... in.
Field Nail Spacing ................... (Table 10)...... ... . .... . . .. . ... �� —
Shear Connection(no.of 16d common nails)(Table 10) —
Percent Full-Height Sheathing .. . ....... (Table 10)... .......... . . ... ..... .. 90 _ _ �� 0 L-dtJ I Fri
5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)...........
Maximum Building Dimensiot,'L —
Nominal Height of Tallest Opening' t
Sheathing Type ...... . ....... ... ..... note 4 —
. ..... ........ . . _
Edge Nail Spacing . .. . .... . .......... (Table 1 I or note 4 if less) . . ....... in. _
Field Nail Spacing . .. . .. . ..:. .... .... (Table 11)......... .. .......... . Z in
Shear Connection(no.of 16d common nails)(Table 11) . ....... .. _
Percent Full-Height Sheathing ......... (Table 11)...... . ... . ... ..........2' _= 13, 3 Lw•Fr
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) ...... _,.,ft s smaller of 2'or U3-
Truss or Rafter Connections at Loadbearing Walls; lam' Z7 71!
Proprietary Connectors 1
Uplift (Table 12) SlM
Lateral l"I able 12)
Shear. ..(Table.]2) ............. 5= t�
�:.2151 t
Ridge Strap Connections tf o l ti not se page 2i.(Tabie 13)....... .. .T==plf
Gable Rake Outlooker .... ...: ,,..: (Figure 20)N/...:U ft I smaller of 2'or U2
Truss or Rafter Connections at Non Loadbearing Walls Q
Proprietary Connectors
Uplift .. (Table 14).... U—
Lateral(no.of 16d common nails) c (Table 14)...
.... L 1b.
Roof Sheathing Type . ....... (per 780 CMR 58.00 and 59.00)..... .....
Roof Sheathing Thickness '7#in.i 7/16"WSP
Roof Sheathing Fastening ............ (Table 2)
Notes:
I. 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 l.If the checklist is met in its entirety then the following metal straps
and hold downs are not required per the WFCM 110 mph Guide:
w Steel Straps;per Figure S
b 20 Gage Straps per Figure 11
c. Uplift Straps perFiguro'14
Al!Straps per Figure 17
& Conner Stud Hold Downs'perFigure 18a and Figure 18b
Exception:Opening heights of up to 8 ft.shall be permitted when 546 is added to the percent full-height sheathin¢
regUineYnMta clnun+.iw Tnbl�.]o..,,a)1. -
s. -rne bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated lit-grade.
4. a. From Tables 10 and I land location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height
Sheathing and Nail Spacing requirements
12/28/07 (Effective 1/1/08) 780 CMR-Seventh Edition
I055
ELSEP
�;f/i6REC'D I
s Cotes�p�,'s
A WC Grride to Wood Construcliorr hi High fti ind Arens:'l l U ►rrph Wald Zon s-7 C �
Massachusetts Checklist for Compliance 780 CMR 5301.2.1.1> E&431'eL
F. -3 v, 4-
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
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See Detail on Next Page
Vertical "and Horizontal Nailing
for;Panel Attachment
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,A WC Guide to 61%od Conslruelion in High bVind Areas: 110 mph fl ind Zolle,,,'7 66 1M I
Massachusetts Checklist for Compliance (780 CMII S3111.2.1.1)' (.*J115 /IW
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LPSE
6 RECT
,� ' ►.o Town of Barnstable *Permit# ?7.24 3
` Expires 6 monMs from issue
. : Regulatory Services Fee
Thomas F.Geiler,Director
Building Division X-PRESS. PERMIT
Tom Perry, Building Commissioner S E P 9 200 Main Street, Hyannis,MA 02601 2004
Office: 508-8624038
Fax: 508-790-6230 TOWN OF BARNSTABLE
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint .
.apfparcel Numbed' 6Z
'operty Address �l �t�n � fo Y�'JG} � •
3 Residential Value of Work_ Ar��/'Q Minimum fee of-$25.00 for work under$6000.00
wner's Name&Address T-C U
. l
Inal
ontractor's Name Telephone Number
ome Improvement Contractor License#(if applicable) /
mst iltion Supervisor's License#(if applicable)
]Workman's Compensation Insurance
Check one:
El I am a sole proprietor
("'I am the Homeowner
❑ I have Worker's Compensation Insurance
surance Company Name
orkman's Comp.Policy#
)py of Insurance Compliance Certificate'must be on file.
amit Request(check box)
5T Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of root) ,
VRe-side
❑ Replacement Windows. U Value (mum.44)
'Where required: Issuance of this.pemut does not exempt compliance with other town depmtnent regulations,i.e.Historic,Conservation, ,
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
Mature
'orms:expmtrg
ise063004
/ Notes:
• � """ 1.All work to be performed in accordance with Massachusetts State Building Code
780 CMR,seventh Edition,or as directed by authorities having local jurisdiction.
2.Contractor to secure all permits,and to arrange for all required inspections on
3 site.
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3.All debris to be disposed of legally off site.Completed work to be in usable and
clean condition.
LOCATION MAP NITS •
4.Patch and repair all areas of the existing building where affected by new work.
ASSESSORS MAP 251 PARCEL 62 - Replace all components where temporarily removed during work.Refinish areas as
ASSUMED DATUM required to match existing.
l
• 5.Contractor to coordinate his work with utility companies and other third parties
\ which may need to become involved in the completion of the worlL
/ 47.
/ tl,kz 6.Cost of all permits and utility company back charges to be by the Owner,unless
/ \ + 0, otherwise specified in the Owner-Contractor agreement.
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SMOKE DETECTORS REVIEWED
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+47.1 +47.8 Wil LDIN'GYa P-T DATE
' 47.9 EXIST.DWELL.
47 +46.6 7.87.3`\\ 6 FIRE DEPARTMENT DATE
+45.8 +46.1 0 + BOTH SIGNATURES ARE REQUIRED FOR PERMITTING
BENCN a--aN
q +45.7 � CaNGM P 6. 47.6
+453 +45A - +47.1
45 7
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<4 44.e - . SITE PLAN
SHOWING PROPOSED GARAGE ADDITION !!
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}433 CENTERVILLE List of Drawings:
PREPARED FOR
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1ev sae-36z-9esoJOHN LOPES Site 1- Site Plan
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YARMOUTHPORT MA 02675 u ri /1 0 10 20 30 ao 50 FEET AS Sections and Details
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raming Plans
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Andrejs R- STOMS
Architect
a4 River Yew lane,'tC: lervaia M4sa4chiSeui t17632. •Telephone(509I 7904A7F 1
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STRUCTURAL
Andrejs R. Strikis
Architect
85 River Yew Lane, Cen4rv81e,Mo..ht utb OW2 •7&phone(588)790-m
Foundation Plan A
W t /` Addition to 27 Center Lane A6
yQ� Centerville,MA 02632 —
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Elevations
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