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I I I �- '­�,' �, "I I I w I -1 I , :,, � I , - . � , I " e . ,e I � I 11 � , � , 7 n� �Y,�� � � ,;.��., � , ­_'�',��".�:,i , - - - ,I 1�1 I I ,�� 7, , �, �il , ,- , �, , :,. ­I .. _ �, I , , � : �. �,�I , I �'­: `,,�, � �',_ .._ �� ,�'I, , I 11 � �� I � - ,�,,-.�,�,� : I � � ,� ,_� � �, I 1, , � , , �� , , - , I 1 '' t, "I ��,I "', , ,, - ,, , � , -, , I I �� ", 11 - : , I I.: I � " i �� I I, ,� � � ,� ,: ,,,, , , ,� � I I I 1� ; �_ ' � 17,� 1 1 1 . , ''� . -, � , , , - - I - ,_� � I , � I , , -1 I , I.,I I ­ ­ , .1 I .1�" i. I , I 1�1 � - �:,, i - � - � � � I " , ",)­-, "! -r , ", � : , " ,�_ , __ ,; ­ . - .11 , I __ 1. 1 - : , I . M Liz: r � x# . r 5 i i 3t` 'X 013 611 1-5, r4 Town of Barnstable *Permit it Expires 6 months from issue date Regulatory Services FeeMAM ; 1ARNSI•ABLE, 6 9. Richard V.Scali,Director Building Division Tom Perry,CBO,Building Commissioner OCT 2 200 Main Street,Hyannis,MA 02601 TO�,n r 6 www.town.bamstable.ma.us U OF BA R Office: 508-862-4038 F` : . &CO-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Z U✓ h Property Address J ®1✓� G N [Residential Value of Work$ 2-0 D O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address F6 ( D 130 S' y Z 6(� S Contractor's Name � � �� ' . Telephone Number Home Improvement Contractor License#(if applicable) �6 W Email: Construction Supervisor's License#(if applicable) C� 0 `J w VWorkman's Compensation Insurance ' Ch k one: 9I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# _ 1p 5��U 6— q h� Copy of Insurance Compliance Certificate must accompany each permit. Permit Req st(check box) t (VRe-roof(hurricane nailed)(stripping old slimgles)•All construction debris will be taken to i ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum 32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requi SIGNATURE: QAWPFILESTORMS\building permit formsEXPRESS.doc Revised 040215 The Commonwealth of-Massachusetts , Department of rndustrial Accideras r==� Office ofInvestigations 600 Washingion Street` y Boston,M4 02111 (aver.ni assgovfdia Workers' Compensation.Insurance Affidavit:BnildersiContractars/EIectricianslPlu nbers Applicant Infarmatinu Please Print LembIY Name(Bus wssK)rg=iz&ittn d}_ SU410 1 GJ 0 Ob W,00_� t al c Address: Ljj . City/ [ate/ ip: ^ CCU 17 Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑I am a general contractor and I * have hired.the sub-contractors G. I+leuv consirucfion ,�,/�loyees(full anxlJ`or part-time). 7_ Remodeling 2.Ly 1 am a sale proprietor or partner- Iisted au tl�e attached sheet ❑ g ship and have no employees. These sub-contractors have g. ❑Demolition wading for me in any capacity. employees and have workers', 9- ❑Building addition [Na V,orkers'comp.insurance comp.insurances.$ ' 5. ET are a corporation and its 10.❑Electrical repaiis or additions required_] 3.❑ I am a homeowner doing all work officers have exercised their 11-❑Plumbingrepairs or'additions set€ o workers' right of exemption per MGL mY � �F- 1-27-❑Roof repairs . insurance required.]-s c.152,§1(4k and we have no ���� employees.[Nowodoas' 13.[ Other comp-insurance required-) *Any applicant dst chedcsbos P1 mast also filloutthe section below shavdng theirworkere compensation policy iafurmadan. ; I omeoarners who submit this af5datrif n c=_q they ara doing all watt and don hire outside contractors mast submits.new affidavit indicating ssicb- (Contractors-bat cbech this boar mast attached an sddiGanal sheet shaming the name of the sub-cantw m and state whether or not those entities bave employees.Ifthe sub-contactors have employees,they musrpmuide their sr<orken'romp.policy number. I arrt atr errtplo}�rr tltrrt is pro�zdirtg workers'cotrrp ertsrrtiort irtsrtrartea form}*etrrptoj es Betoov is the prrlicy rutd job site inforrnrrtion, � .. Insurance Company Name: Policy A or Self ins.Lic-9: /,., 2U — D 1 g 4 FF.xpiratiion Date: g' / 0 [9 1 Job Site Addn= 9J�' C-0 b.D1 iJ GTO ki City/Stafe/Zip: C 5 N ) 1 w� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date}. Failure to sew coverage as required.under Section 25A of MGL c- 152 can lead to the imposition of criminal penalties of a fine up to S 1,50a.00 and for one-year imprisonment,as well as civil penalties.in the form of a STOP WORK ORDER and a fine of up to O-00 a day against the violator. Be adtdsed that a copy of this statement maybe forwarded to the Office of Investigations of the DIA.for insurance:coverage verification— Ida her.e.&y certrfy�ttttd t e prams andpertalties ofper,jutya thatthe inforetatiort ptrot i&d abm a is[rare attd c.arrect a Signature: ' Date: Phone 97 509 2-01 L 2-5S If O aefal use only. Do not write in this area,to be cotnpTeted by city or tos-n offidat City or'romn: PermitUcense# Issuing Author€ty(drde one): 1.Board of Health 2.Building Department 3.Citylrown Clerk 4 Electrical Fnspeetor rr.Plumbing Inspector fa.Other Contact Person: Phone#: Information and Instructions �` T Massachusetts Geheaal Laws chapter 152 recurs all employers to provide workers'compensation for their empIoyees. p tD this she,aa.empIoyee is defined as"_.every person in the service of another under any contract of hie, express or implied,oral or wrfttea" An Moyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged is a Joint enterprise,and jar-hiding the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or othwlegal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant ofe - dwelling house of another who employs persons to do mai„tea ce,contraction or repair work on such dwelling house or on the grounds or building appurEenanf therm shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(5)also sites that"every state or local licensing agency shall withhold fTie 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 complian.ce.'Fvith the rsnrance.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 perfounance ofpubho wont until acceptable evidence of compliance with the ins rran c8._ rff T;r-Prrr eats of this chapter have been presented to the contracting auf aority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, l a anPPY sub-cont-actor(s)name(s), address(es)and phone number(s)along with their certifrcate(s)of h murance. Lmmited Liability Companies(LLC)or Limited Liability Parfnerships(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 aff davit may be submitted to the Department of Industrial Accidents for conf=ation of insurance coverage. Also he 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 „ ,ctrial A_ccid=s. Should you have any questions regarding the law or ifyou ace required to obtain a workers' compensation policy,please call the Deparment at the numb=listed below Self-insured companies should enter thee• e the lime. ce license number on self-mcrrran aPProPn� City or Town Officials t - Please be sui e that the affidavit is complete and pried legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigati ns has to contact you regarding the applicant Please be sure to fill is tine pemzit/license number which will be used as a reference narnber. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating cun:-ent policy inf6rmation.(if necessary)and under"Job Site Address"the applicant should write`-'locations II (may or town)_"A copy of the affidavit that has been officially stamped or masked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for f tir,pmrmi�s-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 vdutnre (Le. a dog license or permit to bum leaves etc.)said person is NOT regnied to complete this affidavit co eration and should you have any questions, The Office of Inves-bgzhons would like to thank you m advance for Your op . Please do not hesitate to give m a call. The Departmenf's address,telephone and fax ntanberr The Commmwmlth-of Massachmttts . DeparSnent cif 1nd�izial Aoci�.�nts �Q��ashingtQn t ' Bastoij�MA G2111 T(,-L 4 617 727-4900 Qo t 4€6 or 1--& MA S ,A Fax 617-727-7M Revised4-24-07 mae��QZr��JIa - r SA IMAJ3LE, - ,er Town of Barnsfable �rEoA Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building CommissioQer 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If_Using A Builder as Owner of the subject property hereby authorize yJ� N NKIJ' - to act on my behalf, in all matters relative to work authorized by this building permit application for: /J CTI� (Address.of Job) Signature of weer Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the ` reverse side. ,- QAWPFILES\FORMS\building Permit formsUTRESS.doc Revised 040215 Town of Barnstable F, Regulatory Services oF7HME r� Richard V.Scali,Director ' I Building Division a rt snxxsrestE Tom Perry,Building Commissioner v� 1639. ��� 200 Main Street, Hyannis,MA 02601 QED www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the . permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) / 0 10/15 2 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT FREDERICKS INS AGCY INC NAME:PHONE FAX 1046 MAIN ST (A/C,No,Ext): (A/C,No): E-MAIL ADDRESS: OSTERVILLE MA 02655 24 LMM INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:ACE AMERICAN INSURANCE COMPANY INSURED INSURER B. QUALITY WOODWORKS, INC. INSURERC: 17 PATIENCE LN COTUIT MA 02635 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES Ea occurrence_ $ CLAIMS-MADE OCCUR - MED EXP(Any oneperson) S PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG POLICY PROJECT LOC - S AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT Ea accident $ ANY AUTO SCHEDULED BODILY INJURY Per person) $ ALL OWNED AUTNON-OWNED BODILY INJURY Per accident S AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS Per accident $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ IDED1 IRETENTION $ S A WORKERS COMPENSATION WC STATU- - OTH- AND EMPLOYERS'LIABILITY (GSG2UB-5B97878-6-15) 04-19-15 04-19—16 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? YIN - E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) N NIA E.L.DISEASE—EA EMPLOYEE$ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE—POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) BROKER OF RECORD CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREFO,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. SG & D INSURANCE AGENCIES LLC AUTHORIPR IV 1046 MAIN ST. OSTERVILLE MA 02655 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD U. P . , ace group ACE GROUP P.O. BOX 3556 ORLANDO FL 32802-3556 SG & D INSURANCE AGENCIES LLC 1046 MAIN ST. OSTERVILLE MA 02655 I m=_ N� d� O� O O� m O n� a� ACORD CERTIFICATE OF 0 INSURANCE (On Reverse) 010458 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-093566 ARMINAS DIMSA,. - 17 PATIENCE LN. COTUIT MA 026:35 all 19 . -. • Expiration Commissioner ;a 02/20/2016 Unrestricted cone l _ .. Buildings or ess than 3 any use,......,.:. ... -- enclosed space S,OOp cubic feet�99,P Which f Failure to possess . State g a curr wilding ;� ent edition ' e is cause for reVocation of For DP of the S Licensing infor Massachusetts oration visit: this license ,Www-Mass.Gov/Dpg — -- c�1e a��ae�aorz�uecr,/G/o1, QAaddacXudef { I Office of Consumer Affairs&Business Regulation License or registration valid for individul use only . before the expiration date. If found return to: I OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation i egistration: ,-'161601 -Suite 5170 _ Type: 10 Park Plaza i Expiration. QUALITY. Private Corporation Boston,MA 02116 QUALITY,WOODWORKS ARMINAS DIMSA 17 PATIENCE COTUIT,MA.02635 Undersecretary Not.valid;without signature of THE Town.Of Barnstable *Permit# Expires 6 mo fro issue date O s Regulatory Services Fee tnnNscast.E, 9� MASS. Richard V.Scali,Director 1639. �EDMA'lA ., Building Division . Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma us Office: 508-862-4038 Fax: 5.08-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY / - v Not Valid without Red X-Press Imprint Map/parcel Number Property Address Ccy� ❑Residential Value of Work$ �,000 Minimum fee of$35.00 for work under$6000.01 Owner's Name&Address TO f Contractor's Name � � M Telephone.Number JO Z 2q Z 2578 Y Home Improvement Contractor License#(if applicable) �p I ( Email: Construction Supervisor's License#(if applicable) CS © "f [�Workman's Compensation Insurance o IT C ck one:M I am a sole proprietor OCT 15 2014 ([] I am the Homeowner TOWN OF BARNSTABLE 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(hurricane nailed)(stripping old shingles) All construction debris will be taken to Q�d" 11 S YwA w5 ❑Re-roof(hurricane nailed)(not stripping. Going over. existing layers of roof) [� Re-side [�Replacement Windows/doors/sliders.U-Value . 0-fD O (maximum.35)#of windows #of doors: 2-- ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic;Conservation;etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Im rovement Contractors License&Construction Supervisors License is required. SIGNATURE:: QAWPFILES\FORMS\building permit forms EXPRESS.doC Revised061313 1 - ,a �assuchuus> � �amtrxop� , eprrrl rex/t rr` uZ st Accideuts - - - t o Of 1 esiklatia2rs 6Of'Waykington Street Aastar MA 02 wrt;rv.rxsugaIdia Workers' Compensafiun Iusua-nca A fidavit BuildersiCantzactorsMectriciauMumberS Applicant Inf'mrniation. Please Print Legibly Name i ddr�ss t<�' U43 Gty �stat = c�v �� oZG ` Pam 5: 2� z g Are yon an employer?C6ecictheapFtropriatebox: _._._ --- - - -_. Tie o# olect(remred_. --- - 1._ElI am a employer with 4_ ❑ I am a i contractor and 1 6_ ❑New,=,Er oa employees{full and/or part-time)-* hay;a l the sub contmcfrns. �_El I am a sole proprietor or partner- listed on the attached sheetZ_ El Remodeling ship and have no employees These sob contractors 3iazre g_ ❑Demolition employees and have worker€' wo> forme in anycapacity_ SR_ ❑Building addition [go wokkP s'camp:ii rranre Comp_+*,mono&$ req-ired] 5- We are a corporaticnaud ifs lf}_Q Ilettrical repairs oradd�ions 3_❑ I am a h,omecrwn-er doing all work officers hatim exercised their 1 T_Q Plumbing repairs or additions myself[No workers'Comp_ right of exTmpfion per MGL l of repairs tom,,,�e r�nirEcl-]F c 154§1(4} and we hen a as nn employ? [No ems' 1 _ Odle �� QZ Ol od.2 S camp_msutance required_] "1��yapp nithat checks boafloastalsofllouttlesectimbelowshnwingihei vo&eemmpensatimp rMTinff3cmatian- #Homeowners vrha submit this athdsv F it mratn+g d3ey are doing sII wack and then hire outside.coetracrars mast sabmit anew atadnit ixur=tm sarh_ =C antractors that check this bux mast sdached sa addidnuA sheet shvccmg the name of Sic Ind stair ulietber grunt thaw emifles have zmpluyee5 Iftlre mh-coatmctars hate emgIoyees,they must provide their wor],ers'comp:policy atmbrr_ I nm an srnglrry�F t7iat is pra►�idiii�tvarkers'cam�itzniin.n inlztrarE�for to}*errr�I'�yc�tu .B�elvyr is the pr�iic}*and job srt� irrforrr�sli�r� r 4 . Insurance CompanyNa ne: .' Policy 41 tar set€ins UcAk Expuatiou l)a.te: Soh Sites A.ddirss: i� �P- / Aff2ch a copy of the wGrkers'compensation policy- er-Iar3tion page(showing the policy comber and txpaation date). Failure to secure-coverage as requiredvnder Section 25A o€LM]Uc. M can lead to the imposition of Fnmiaal pmatEies of a fine up to$1,500.00 andlor one-yearimprisamment,as well as civil penaT6 s in the form of a STOP WORK ORDER-and a fine ofup.to$230-00 a day against the.violator_ Be advised brat a copy of this statement may be forwarded to the Office of IM es@igations of the DIA for insm:,ce coverage verification- that the iqfbrmat6 tnprmidgdpr abtn a is hzta and correct SiEnatum: Date 2- z z�rg ti t Phone 4' � Zdal rrse only. Do not wr itir in this area,to bg completed by city pr tawn official - City or Town: Pernzitucense# Ensuing A tharity(circle one): 1.Board of Health 2.Buff-ding Departmmt I Cityll own Clerk 4.Electrical Inspector S.Plumbing,Inspector 6.Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an employee is defined as"-..every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee.of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit td 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 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 Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the ai$d2vit The affidavit should be retumed 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 ob t_il-r 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 ia.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 homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc-)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number Tbc CommaawcaTth of M&--sachusetts Depart me at cif In dustdal Accidc fit GffiQe of Iavesfigatxoas 6-Q0 W bk an StrQ:ff_t Bastw,MA 02111 Tel.A 617 727-49-00 i�-xt4-06 or 1-9 -MAS 'E Revised 4-24--07 Fax#617-727-7749 wry ma to 2:avJdia - OFF ri - Q� O * * lARNMBL.E. • - ��, �- ,m� Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnAable.ma.us. Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This. Section If Using A. Builder I, ��`� `� �` ��� , as Owner of the subject proP terry hereby authorize sJ i to act on ray behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) IVA, Signatute o Owner Date Print NaU, x If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFLLES\FORMS\building permit fonns\EXPRESS.doc Revised-06.013 Town of Barnstable Regulatory Services . . , 4oFztt�Tgcyy Richard V.ScaIi,Director Building Division anaxSrnsr-E. Tom Perry,Building Commissioner Mass. 1639. 200 Main Street, Hyannis,MA 02601 Alfas a www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION: Please Print. DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. - The undersigned"homeowner certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt . from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person,as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 i �' Cam%/e. �'an��zoiacoeaCC/z o�'P/I/�cutoccc/acureCGi- Office of Consumer Affairs&Business Regulation L�ce;ise or registration valid for individul use only WWII ME IMPROVEMENT CONTRACTOR befdi a the expiration date. If found return to: istration 1,61601 Type: Office of Consumer Affairs and Business Regulation iration 10/29/201.4 Private Corporatio: 10 Park PlazaSuite 5170 n Boston,MA 02116 :QUALITY WOODWORKS 1NC ARMINAS DIMSA 17 PATIENCE LN i 1J COTUIT, MA O2635 Undersecretary, o Valid without signature u Massachusetts Department of Public Safety Board of Buildin g Regulations and Standards Construction Supervisor License: CS-093566 ARrIINAS DIMM4-,`� _ 17 PATIENCE Lid COTUIT MA 02635 Ex piration i p ration Commissioner 0 2/2 0/20 1 6 q TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Map Parcel Application #Cw/oio3 Z Health Division Date Issued Z� / Conservation Division - Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 0 L112,41t) Historic - OKH _ Preservation/Hyannis Project Street Address 3 Village Owners . `� � �l�C u 1 Address Telephone Permit Request '�-� � `��\4 5 F ` ® ixCA/toovi IV) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuationb� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) r (� Number of Baths: Full: existing new Half: existing new v Number of Bedrooms: existing _new 3 � (41,�, 0 V� Total Room Count (not including baths): existing new First Floor Room o(" unt Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: , k =24 7 p> 2 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ° I Commercial ❑Yes ® No If yes, site plan review# c Current Use Proposed Use a a APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _ Telephone Number t-I.� Address � � License # CS Q) Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �'�` DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE Y .. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ®I DIM to a DATE CLOSED OUT ASSOCIATION PLAN NO. r The Comitforx-wearth ofmassdchusezts Department oflridustrtalAccidertts office.of rrivesdgatrons 600 WcrshinVon Street Z3ostoti, A- M 02111 • wtt�l-s�.m ass.gau/dia • Workers' Compensation Tmnrance davit: Buiiders/Contractors/Eiectriciarns/ -Iumberg A Licant Information Please Mut Le bl NaMe, (BusincsslOrganizadon/Individual): , Address: • -_ - _-C��'_�i`I - - � -�1��`� Phone.#. _-.���� z�'�-•2�0 �`1--: _: _ .' City/State/Zip: Are yon,an employer? Chec,'c the appropriate bor-. Type of project(required): 1.❑ I am a cmploycr with 4: ❑ Z a general contractor and I 6 0 Now construction e mploy ees (full and/or partaimc).* have bircd the svb-contractors listed on the attachcd,shect T ❑Remodeling 2.❑ I am a'sole proprietor or partner- These sub-contractors have ' ship and have no employees S, 0 Demolition employees and have workers' working for mein any capacity. 9. [] Building addition [No workr'n'.comp.•insarancc comp. insurance. 10 �' P ns. Electrical re airs or additio • required] 5• �We are a.corporation and its 3,❑ I am a homeowner doing.all work officers have cxcrcised their 1.0 Plumbing repairs,or additions right of exemption per MGL. II : Roof r airs myself. [No workers. comp. �• incnrancc required]f c. 152, §1(4), and we have no � employees. [No workers' 13. Other comp, insurance required.] *Amy applicant that checks libx#I roust also fill out the section below ghowing their workers' compensation policy information. t Homcowncrg who submit this affidavit indicating they arc doing all work and then hire outside contractors insist submit a 71m affidavit indiating such. XConlractnrs that check this box must attached an additional;bent showing the name of the sub-conk Actors and stain whether or not those entities have ampioyees, lfthc sub-contractors have errtployccs;they must provid6 their workers'comp. policy number. tarn an ernproyer tha.l is providingworkers'comperisayiDrt bsurance for my employees: ,BeCov is the porky andjob site information lwuzance Company game: Policy# ar ScLf--ins. Lic.#: Expiration hate: lob Sitc Address: City/Statc/Zip; �� �� ' Attach a copy of the workers" compensation policy declaration page (shoPving the policy number and expiration date). Failure to secure covcragc as required.undcr Section 25A ofMGL c' 152 can lead to-the imposition ofcr;rn;rial penalties Of fno up to 31,500,00 andlor ono-ycar imprisonment; as well as civil pcnalti•cg in the form of a STOP WORK ORDER and a fine of up to 5250.D0 a day against the violator. Be'advised that a copy of this statement maybe forwarded to the Offer, of Investigations of the DEA for insurance covera c verification. -I I do hereby cerkfy n er thepains•art naWes bfperjury tlt.at the information provided above rs.true and colreLt '. Date: ®� Z S i an a.turc, p Pbone#: 4111'2 Official use only. Do not write in this area, fo be co.;x Leted by city or town officiaC71n�pe City tir TDwn; ------------ Issuing Authority(circle one);1. Board of Health 2, Building Department 3. City/To?MClerk 4. Electrical Inspector 6. 0ther i a r ons usetts Gcncral Laws chapter 152 requires all employers to proiide workers' co pc drr a for o tra tmfhj[r, : Massach person in the service of another Pursuant to this statutc,.an errtpMyee is defined as"..,every P express or implied, oral or written." hi association, corporation or other legal entity, or any two or more An employer is defined as an individual,partncrs p of the forcgoing.cngagcd in a joint enterprise, and including the legal representatives of a dec casod emP1Hevcz the receiver or tnisteo of an individual, partaerslup, association or other legal entity, employing YLho owner of a dwelling house having not more than three, apartments and who resides therein, or the occupant cl in dwellinghouse of another who employs persons to do maintenance,construction or ent be deemed to beair-work on such dan e p�oyolr'c ep or on the grounds or bvtlding appurl:t:nant thereto shall not because of such empl yrn "eve strafe or local licensing agency shall.7Rithhold the issuance'ar 25 also states.thatrY MGL chapter 152, § �� in-the reuevt�al of a.license or permit to open . blebr to buildings �o rvid nce of compliance withtheinsuran e cYene age,required." applicant who has not produced•acerpta AdditionaIly, y of MGL ohapter 15z, §25C(7) states 'NeitherblOAtablctcvidc norncc of ompliznee RZth therincuzance entcr•into any contract for.the performance of public work p zcquircrncnts of this chapter havo been presented to the contracting authority. Applicants. Please fill oirt the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, iIf . necssazy, supply sub-contractors)namc(s), address(cs) and phone numb cr(s)along with their certployc (s)of insuranDo. Limited Liability Companics.(LLC) or Limited Liability Partnerships(L b)with��oroLLP doeschauc other than the members or partners, arc notxcquizedtocarrywozkcrs' compensationiusurance. Ifus d that this affidav ud omployees, a policy is required. Bq adviseit ma to sin and date the affida�t.ntThoOf afGdavitt should Accidents for confirmation of insurance coverage. Alsobe bo rctumod.to the city ar town that the•application for the p if ezznit or Jiccnse is IR-W oro are roquixed to obtain ang I-Equ ewoz�kcls' of Industrial Accidents. Should you have any n bons xt e A �cgtcd below. Self insuzed companies should enter their compensEitionp0Jlcy,p asc call the Dep self-insurance license number on the approppFan line. Cityor To-Tfla Officials Please be sure that the aff davit is complete and printed legibly. The,Department has pro e bOttDM tact o die aiding the applicant of the)affidavit for you to fill out in.the event the OfE which will be usnycstied d as as zef rononnumber. In addition, an applicant Phase bo sure to fill in the permioiccnsc number that must submit noultzplc permit/hcense applications in any given year, need only submit onp affidavit indicating current polidy,i�formation(if peccssary) and under' Site Ad��drre�ss" tho applicant should write"all r town may locations ro idcd to tho oz e r town),"A cbpy of'thc affidavit that has b c bfEcfIlC xallyrtsG -opr orits 0�]1cenSC S.�A Dow ity oaf6daYJt Lnustb��out each applicanS as proof that a valid affidavit is year.Whezo a home owner or citizen is obtaining a liccns c or permit not related to any busincss or commcreial vcntuze (i e. a dog license or•permit to bum leaves etc.) said persau is NOT required to complete this affidavit Tho Office of Investiga.dons would bIc to thank you in adyaace fox your cooperation and should you have any questions, please do not bcsitato fo giYc us a call Thc Department's address, tclephone•and fax number: Thb Commonwi�4th Of IAas nhusP*3 �rrlOtiAt Of�dlltt7 AGC1Cl�rlt5 QfficC 0f XT,1 e#ig-a.m-S 600 Wa-hi Wu Strut Boston, MA 02111 Tel; # 617-727-4900 cxt 4.06 Qr 1 4777 MASSAFE Fax 4 617-727-7749 Revised 11-22-06 www.rnass..go-v/dia I �0FTH.6 gown of B Arun able "Regulatory'Servzces . BA"STADLE Thomas . Geiler, Director ,� suss � • o m Building ]division Tom Perry, Building Commissioner { , 200 Main Street, Hyannis, MA 02601 wVvw.to7vn,barnstable.ma,us Officer 508-86-2=4039 - - Tax: 508-790-6230 l + -- • ---- - - - P r.0Perty OWnev Must Cb-7plete ai7d Sign This 5cctiof� a If Usilig A }3uilde ., X G110/I%61,5 Jz�'�/{��' as ow.ncr,of the subject pxopetty heteby authorize to act'on my behalf, in all matters telative to work authorized,by,this building permit applicatiotz'for: : C9DblA GgC)Qe ess of Job) Addt .. Signature of e'r" Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption porlTi on th•e reverse side. Town of Barnstable y�v OF YHE rp�y� RegulatorY Services Thomas F• Geiler, Director B 4RNS),13LX, _MASS. -�� �' Building Di-vision PrFa) a�n Tom Perry,Building.Cominissionet' 200 Main Street, Hyannis., MA 02601 -W3Y.to A,n.barnstable.ma-us Fax: 508-790-6230- Office: 508-862-4038 __ HOAZEOWNER LICENSE EXEAIPTrON Plcnse Print DATE: JOEI LOCATION: street village number "I-10MEOWNLR": home phone N work phone I name CURRENT MAILING ADDRESS: code city/town slate zip rliings of The current exemption for"homcdwric tit'as extended to in o�vner-oess a li'pce n e�vrovided that the owner acts to allow homeowners to engage an individual for hire who does not possess , supervisor• DEFINITION OF HOMEOWNER pcerson(s) who owns a parcel of land on'which he/she resides ors accessory toress to �sueh use and/or farm stluchtres, to be, a one or two-family dwelling, attached or detached s person Who constructs more than one home ffcial on aaformtaedcepfable to the Bu shall Dot be ilding Official,ered a that he/she he shall be "horneowner" shall submit-to the Building res onsible for all such wozl< crformed under the buildingermit: (Section 109,1,l) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other ' applicable codes, bylaws, rules and regulations. le mg Th•a undersigned "homeowner"certifies that he/she understands the mill Comown o]pwithts ad procedurres)and�ent minimum inspection procedures and requirements and that he/shecomply mquizements, Signature of Homeowner Approval of Building Official Note; Tbree-family dwellings containing 35,000 cubic feet or larger will be rcquired.to comply with the State Building Code Section 127.0 Construction Control. 1401ME0WNER'S EXEMPTION P P a crson s for•hirc to do such The Code s Cates that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1o9.1,1 -Licensing of construction Su crvisors rovidcd that 1f the homeowner engagesP () work, that such HD shall act as supervisor, are as the articularl Many homeowners who use this e exemption ar visorsr Sectioaware n 2t 1t5)yThis la k of gwarcnesooftcnlretsultsf in s noussproblemsppendix Q,y RuJcs &*Regulations for Licensing Con P when the homcownerTires unliceriscd 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 ultimatc)y responsible, art f th permit application, To ensure that the homeowner is fully aware of his/her responsibilitics, many communit cs require,asp o e i that the homeowner certify that he/she n dental ds hearespon ibiliities of cation fSups nsyourO otmmuanityagc of this issue is a form currently used by .,\ Niassachusctt�- Department of Public Snfar . <Tulations and 5tand<irds Board qt Buiidin`..1 Rel. < Supervisor License 'Construction. CS 93566 License: Restricted to:, 00 gRMINAS-DIMSq 17 PATIENCE.LN i `COTUIT MA02635,. pr Ex i ation: 212012012 rim- Tr#: 17177 a (•onuiiissiune:r _ Board o ui m e tula�iOns an tan g Me& z One Ashburton Place - Room .1301 Boston; Massehusetts 02108 Home Improvement`Contractor Registration - Registration: 161601 � �` Type: Private Corporation - —_ 1 Expiration: 10/29/2010 Tr# 27700673 ` QUALITY WOODWORKS INC. ARMINAS DIMSA 17 PATIENCE !N �` / ------ COTUIT, MA 02635 'art Jq.• _._._ ._ ___ ___ Update Address and return card.Mark reason for change. F„ DPs-cai 0 50M-07/07-PC9490 Address n Renewal Employment ❑ Lost Card - 2 7 £ LAU- - Tovfffff r F cc�-- r f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a Map Parcel V , Application #: 0q0_ 10 Health Division Date Issued Z Conservation Division Qt :DA - L Application Fee Planning Dept. Permit Fee QFTS .CJ0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation ! Hyannis U Project Street Address- CODD 6 ® Z�> Village Owner T-��� Di�I�S`(`�EN�c 0 2--C t'�AS Address ��o�� Telephone a 2 01 -4 _1 Permit Request �-a1 GQ Z )60- ode, CXV_ a 0 w, Oi JQ1 G�9 no 5 cLl& , \ \O Ca�,c rS r VAS a� , Q��e �2. US2 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed �_(o 0 Total new 1512 Zoning District Flood Plain I Groundwater Overlay Project Valuation ® Construction Type Lot Size R o Z Grandfathered: ❑Yes �9 No If yes, attach supporting documentation. Dwelling Type: Single Family e9 Two Family ❑ Multi-Family (# units) Age of Existing Structure 2�0 Historic House: ❑Yes O No On Old King's Highway: ❑Yes ® No Basement Type: ❑ Full ❑ Crawl ❑Walkout �410ther 6a'L0. Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new �- Half: existing new Number of Bedrooms: 3 existing I new y ;� Total Room Count (not ,i including baths): existing new IL First Floor Room Count Heat Type and Fuel: � Gas ❑Oil ❑ Electric ❑ Other Central Air: O Yes ❑ NoLew ireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing size—Pool: ❑ xi in g g ge sti g ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: n Zoning Board of Appeals uthorization ❑ Appeal # Recorded ❑ -n Commercial ❑Yes No If yes, site plan review# w, co i Current Use Proposed Use o. INFORMATION -- r (BUILDER OR HOMEOWNER) Name (w S l�S Telephone Number 09 ZOi Z 2-1;Y4 Address - l i(6WC� LJ-J License # . ©9 35-6 l Colo IT c �7 2 6 15- Home Improvement Contractor# d� Worker's Compensation # lA CC�0 0�-3z2_w_o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ( ( Ion M r a ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION y1e I /It/to FRAME "012rY1` LtI o INSULATIONr 53 0 31/7l0 FIREPLACE L ELECTRICAL: ROUGH FINAL y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING �� hi� o DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents > Office of Investigations I' '.00 Washington Street t F; Boston MA 02111 " �-,www.mass.gov1dia Workers' Compensation Ins u ran d,Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information o1 `` Please Print Legibly Name (Business/Organization/Individual): U �L[; W C' ��W 0 ZK C Address: City/State/Zip: G�)?J Phone #: qO Za 2— Are you an employer? Check the appropriate box: Type o project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I Lo Plumbing repairs or additions myself [No workers' comp.- right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who'submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ( Q Q + Insurance Company Name: TI �° Ci 46001\j- l h U e,4 tic Iz Policy#or Self-ins. Lie.#: W CC 5_001' 2 Z© Expiration Date: �p I �� 2'o I b Job Site Address: CC �� N 1�� �_V City/State/Zip:��0—pFe-J'L_� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under thepains and penalties ofperjury that the information provided above is true and correct Signature: 0�`' Date: �Phone M 5® v tQ 2q 2 �50 Q Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector`r 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." . Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit.. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. plicant. g Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof-that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia r ENERGY CONSERVAUON APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE; AND TWO-FAMILY DETACBED RESIDENTIAL'CONSTRUCTION (780 CMR 61.00) Applicant Nam'e*: GJ S _ �[ �� — Site Address: 31�- C0 D!0)PC9TC)/J t�> print Town: - C�IJ TI��VI t_LF Applicant Phone: 570 8 2R-2- 2L 9 `1 Applicant Signature: . Date of Application: NEW CONSTRUCTION: choose ONE of the followin two-options 790 CMR.TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA_ FOR NEW ONE-AND TWO-FAMILY BUILDINGS hCUIMUM MINIMUM Ceiling or Slab QOption 1: Basement Fenestration exposed Wall Floor me Periter U-factor floors R=Value R-Value wall R Value '� HSPF SEEF R-Value R-Value and Depth National Appliance•Energy .35 R-3 8 R 19 R 19 R-10 R 10, Conservation Act(NAECA)of 4 ft.- 1997 as mncndcd,minimums or cater as a licable Note: This form is not required if you choose either of the two versions of REScheck as listed below. Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at http-//www.energycodes.goy/rescheck/ ADDITIONS.OR:ALTERATXONS.TQ E,XrSTING OLD* *)Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b=- a) SF 100 x - _ % of glazing (b) Glazing area equals SF b a If 'laziia is<-40%.i4e the chart beloW: If glazing is> 40 % rgcc6d.to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM h�TOvf{JM Ceiling and Slab Perimeter ❑ Fenestration -Wall Floor Basement Wall U-factor Exposed floors R-Value R value R-Value R-Value andd Depth ept th .39 R-37 a R-13 • R-19 R-10 R710, 4 feet a R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total ET glazing area of said addition exceeds 40.% of,the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in A •endix 120.P r ATVC Guide to Wood Consti-uctiou in Hi;Ir I•Yind Ar-eas: 110 mph Wind Zone Massachusetts Checklist 61- Compliance (78o clvm 5301:2.1.1)' Check Compliance 1.1 SCOPE J WindSpeed (3-sec. gust)........................:....::................................... ................................................ 110 mph WindExposure Category.................................................................. .................................................I........... Wind Exposure Category................Engineering Required For Entire Project ..................:.......:............C 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) Z stories 5 2 stories _ Roof Pitch ...............................:............................................(Fig 2) .,...............I......... ........:....... � _ 2 <121 MeanRoof Height ....................................:..........................(Fig 2)................................................. O ft <_33' Building Width,W .................. 2ft <_80, _ .............................................(Fig 3}...................:............................ Building ...................(Fig 3)................................................. Z$ft 5 80' ✓ Building Aspgect Ratio(UW) .................................................................(Fig 4).................................................I r 17 5 3:1 Nominal Height of Tallest O enin ......'.............(Fig 4)................................................ jj:;�g 5 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 U Concrete.............................................................................................................................. ConcreteMasonry ....................................... ... ........................ ..............................................:................ 2.2 ANCHORAGE TO FOUNDATION"' 5_/8"Anchor Bolts<imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only'r5 / BoltSpacing-general ..........................................(Table 4)............................................... Y in. . V Bolt Spacing from end(oint of plate................:............(Fig 5).................................... S in. 5 6°-12" —t7 Bolt Embedment-concrete.........................................(Fig 5 ••• in•i 7"{ g )....................................... Bolt Embedment-mason .....................(Fig 5 in.>: 15" PlateWasher.......................................................:.........(Fig 5)..............................................>3"x 3"x 1W 3.1 FLOORS - Floor-framing member spans checked ...............................(per 780 CMR Chapter 55)................................... Maximum Floor Opening Dimension.................. . . (Fig 6 ft_12 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks 01 Supporting Loadbearing Wail's or Shearwall.................(Fig 7)................, . < Maximum Cantilevered Floor Joists _ Supporting Loadbearing Walls.or Shearwall..:....:........(Fig 8)...................................................._ft :5f�d /4 Floor Bracing at Endwails...................... ........................(Fig 9)................................................................... Floor Sheathing Type ............:.................(per 780 CMR Chapter 55)........:.. .......... ... Floor Sheathing Thickness ............................................:.....(per 780 CMR Chapter 55).......................W.in. Floor Sheathing Fastening..................................................(Table 2).. 9 d nails at in edge/ I'Lin field 4.1 WALLS Wall Height (UU l� Loadbearing walls..........:.............................................(Fig 10 and Table 5)...,..........,..........B T ft 10' Non-Loadbearing walls.....:..........................................(Fig 10 and Table 5)....................... ... ft s 20' Wall Stud Spacing ..............................:.............:...........(Fig 10 and Table 5)....................l in.:5 24'o.c. Wall Story Offsets .....................................................:..(Figs 7&8)..............I............................. ft s d, 4.2 EXTERIOR WALLS' ' Wood Studs Loadbearing walls.........:..............................................(Table 5).............................2x C� - d ft A in. Non-Loadbearing walls................................................(Table 5)..............................2x4- _8 ft._�J in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10).....................................I............................ ' WSP.Attic Floor Length..................:.............................:(Fig 11)............................................. ft>_W/3. 'Gypsum CeilingLength if WSP not used ....:............ (Fig11 Lft>-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 c r I` tt 1�, f 4Rf1 rnmmnn nailcl (TahIP F1 ANVC Guide f0 l-l%Od Constructim in High 141iru{Areas: 110 trrhlr Whld ZOne Massachusetts Checklist for COmpiiance (780Cilrz5301.2.1.1)' Loadbearing Wall Connections <� V Lateral(no.of 16d common nails)................................(Tables 7)..................................................... Non-Loadbearing Wall Connections 2- Lateral (no.of 16d common nails)................................(Table 8)....................................................... Load Bearing Wall Openings(record largest opening but check all openings for compliance Table 9) J Header Spans .....................(Table 9)................................... ft O in. <- 11' v SillPlate Spans ........................................................(Table 9).................................. ft 0 in. 51' 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......:................................................ ........(Table 9).................................. Oft G in. 5 12 Sill Plate Spans.... ..................:....................................(Table 9)..................................—ft—in. 5 12' -IT Full Height Studs(no. of studs)....................................(Table 9)....................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension, W t Nominal Height of Tallest Opening2 ........................................................................:... z'_ SheathingType..............................................(note 4)..................................................... 2 _ Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................_31n. _ Field Nail Spacing .................. . Table 10 ...............................I................. ( Z in. p n( o. . ..... .. . . ( ) Shear Connection(no, of 16d common nails)(Table 10)....................................................... 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 Opening2...................... . . �� `6'8" . . ............................................ SheathingType..............................................(note 4)..................................................... l P: Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................ 3 in. FieldNail Spacing.......................................:..(Table 11)................,..................................L2.jn. Shear Connection(no. of 16d common nails)(Table 11)........................................:............ .. Table 11 :....... 3 . Percent Full-Height Sheathing......................( )....... .................................... 5%Additional Sheathing for Wall with*Opening> 6'8'(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?.............................................................. ............................................................... 5.1 ROOFS Roof framing member spans checked?...................:....(For Rafters use AWC S 1 ft s smaller of 2'or U3 an Tool,see BBRS Website) Roof Overhang .................:.................................(Figure 19) ............. 8_ Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors _ Uplift................................................(Table 12)............................................U If Lateral....:........................................(Table 12).............................................L=Mplf Shear............................:..................(Table 12)............................................S=_jAft . �! Ridge Strap Connections, if collar ties not used per page 21... (Table 13)...............................T=�-plf Gable Rake Outlooker........................... ...............(Figure 20) .............Q ft-<smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors �'� Uplift................................................(Table 14)............................................U-- Ib. Lateral(no.of 16d common nails)...(Table 14).......................................L=L:V,,Ib. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59) ............. Roof Sheathing Thickness.....................................:...... ............................................. /?? in. 7/16'WSSPPt Roof Sheathing Fastening................... ......................... 2)................................5.........�.......(i.'s"" rl Notes: X 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR-5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are.not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 1 Ba 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 re uiren ents shown in Tables 10 and 11. q 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. I z r Taws' of B Arn-stable Regulatory Services Thomas F_ Geiler,Director, y �D; � Building Division Toni Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862--4039 Fait: 508-790-6231 Property awrier Must Complete and Sign This Section - If Using AA Builder I l `✓l�S lfZ�l�S'lS' , as Owner of the subject.property hereby authorize to act onnzybehaN, in all matters relative to work authorized by this building permit application for. M(L L . (Address of job) C-- L� Signature o Date Print Narne , If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable mop THE ray Regulatory Services swRxszwsLF- Thomas F. Geiler,Director MASS � 1e59. . ,�� Building Division PrFo Ma's'` Tom Perry,Building Commissioner 200 Maid-Street,.-Hyannis,MA 02601 www.town-barnstable-ma.us Office: 508-862-403 8 Fax: 509-790-6230 HOTH OWNER LICENSE EXEMPTION Pleare Print DATE: JOB LOCATION: _— number street village --"HOMP-OWNER": name home phone# work phase# CURRENT MAILING ADDRESS: cityhown stag zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow hQltneowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER c land on c h she resides ii intends to reside on which there is or is intended to- be, s who owns a parcel of which e/ r r , P ( ) P ' 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 i form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1-1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/sbe understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signatirrz of Homcowncr Approval of Building Official Note: Three-faunly 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 bomeowna performing work for which a building perTnit is required shall be exempt from the provisions of this scetion.(Section 109.1.1 -Licensing of construction Supervisors);provided that if the bomeorync engages a person(s)for hire to do such work that such Homeowner shall act as supervisor." Many hofncowncrs who use this cxcmptitm are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Rcgulatioms for Licensing Construction Supervisors,Section 2.15) This lack of awarrncss bftrn results in serious problems,particularly when the homeowner hires unlicensed pastor s. In this ease,our Board cannot proceed against the unlicrrnscd person as it would with a liccnscd Supervisor. The homeovmer acting as Supervisor is Otimatrly responsible. To ensure that the homeowner is fully aware of hiAc.T responsbilitics,many communities require,as part of the permit application, that the bomcownC.f certify that hc/she understands the responsbilitics of a Supervisor. On the last page of this issue is a,form currently used by several towns.'You may tarn t amend and adopt such a forrn/certification for use in your community. Q:forrns:homcczcmpt ; I kNte F Board oWui ing egula ons and tan ar s One Ashburton Place Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration R� Registration: 161601 . � = ,� Type: Private Corporation � s Expiration: 10/29/2010 Tr# 277006 QUALITY WOODWORKS INC., y ARMINAS DIMSA 17 PATIENCE LN COTUIT, MA 02635x. Update Address and return card.Mark reason for change. .,_.,. Address Renewal Employment ❑ Lost Card DPS-CA1 is 5OM-07/07-PC8490 r EGU1 ATIONS.•; �' BOARD OF BUILDING R CONSTRUCTION SUPERVISOR License. 93566 Numb CS, y "p2T2011978 -fr.no: 93566 ire! +�2010 s pOBOX'2373 ✓ 1 ' CKET, MA ,4 ,Commissioner I NANTU --- i I f - M f4 REScheck Software Version 4.2.2 Compliance Certificate Energy Code: 20061ECC location: BIk4i�5 4911OW Massachusetts Construction Type: Single Family Conditioned Floor Area: 810 ft2 Glazing Area Percentage: 15% Heating Degree Days: 6058 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 37 Coddington Road Ed 6 irene Uzgiris Steven Cook Centerville,MA 37 Coddington Road Cotuit Bay Design,LLC Centerville,MA 43 Brewster Road Mashpee,MA 02649 508-274-1166 steve@cotuitbaydesign.com M. Compliance:1.0%Better Than Code Maximum UA:152 Your UA:151 .i Ceiling 1:Flat Ceiling or Scissor Truss 810 30.0 0.0 28 Wall 1:Wood Frame,16"o.c. 872 19.0 0.0 42 Window 1:Vinyl Frame:Double Pane with Low-E 130 0.380 49 SHGC:0.33 Door 1:Solid 38 0.140 5 Floor 1:All-Wood Joist/Truss:Over Outside Air 810 30.0 0.0 27 Compliance Statement: The proposed building design described here is consismn,t with the building p s,specifications,and other calculations submitted with the permit application.The.proposed building has n designed to ee 2006 IECC requirements in REScheck Version 4.2.2 and to Avno)tst�etz comply with the mandatory requirements lis the RESch In on Checklist. 5`Br T Z Name-Title Signatt#6 Dat Project Title: Report date:09/02/09 Data filename:C:\Program Files\Check\REScheck\Uzgiris.rck Page 1 of 3 REScheck Software Version 4.2.2 Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑Window 1:Vinyl Frame:Double Pane with Low-E,U-factor.0.380 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break?—Yes_No Comments: Note:Up to 15 sq.ft.of glazed fenestration per dwelling is exempt from U-factor and SHGC requirements. Doors: ❑ Door 1:Solid,U-factor'0.140 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Outside Air,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are either 1)Type IC rated with enclosures sealed/gasketed against leaks to the ceiling,or 2)Type IC rated and ASTM E283 labeled,or 3)installed inside an air-tight assembly with a 0.5"clearance from combustible materials and a 3"clearance from insulation. 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: ❑ 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 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 dearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ❑ Ducts in unconditioned spaces or outside the building are insulated to at least R-8. ❑ Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R-6. Project Title: Report date:09/02/09 Data filename:C:\Program Files\Check\REScheck\Uzgiris.rck Page 2 of 3 I Project Title: Report date:09/02/09 Data filename:C:1Program Files\ChecklRESchecklUzgiris.rck Page 3 of 3 ti Duct Construction: Air handlers,filter boxes,and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and, mechanically fastened. All joints,seams,and connections are made substantially airtight with tapes,gasketing,mastics(adhesives)or other approved closure systems.Tapes and mastics are rated UL 181A or UL 181 B. Building framing cavities are not used as supply ducts. Lj Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. 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. NOTES TO FIELD:(Building Department Use Only) y. Y 2006 IECC Energy Efficiency Certificate Ceiling/Roof 30.00 Wall 19.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Window 0.38 0.33 Door 0.14 NA .3 .. . . Water Heater: Name: Date: Comments: r 1206 Viewmont Dr. Niskayuna,NY 12309 1 December 2009 Mr. Thomas Perry Building Commissioner Town of Barnstable 200 Main St. Hyannis, MA 02601 Ref.New Garage 37 Coddington Rd. Centerville Map/Parcel 186/ 059 Dear Mr. Perry, l oy This letter is in response to the discussions you had with our architect Steve Cook �N Cotuit Bay Designs) on November 30 regarding the above proposed new garage. From the discussion, Steve indicated that the plan of the garage as drawn up by him will meet with approval provided a letter of planed use is submitted to you by me and my wife the owners of 37 Coddington Rd property. Also an addendum to the plans will be provided by S. Cook to clarify some issues raised by the building department. No fundamental changes to the garage plans are needed according to the discussions that took place. We the owners plan to move permanently to the above property within the next year. To do this in a practical way we need a garage with ample storage space and a place where I (Egidijus Uzgiris) can have space for an art studio since I am an artist in addition to being a retired scientist. Hence we attest to the following intent for the new garage: 1) The space above the first floor will be used as an art studio and as a storage area. 2) We will not rent out the garage_ We hope that this,letter of inlen+wilessatisfactory and that our plans will meet with _ your approval. _ `- Sincerely airs, gidiju�,. z iris Irene Uzgiris� c) -1 77 00 JENNIFER M POTTER Notary Public C 10�fM�EALTH Of NA$$ACHUSan MY Commission Expires October 29,2015 TRADEMARK® RESERVE INSTALLATION INSTRUCTIONS fa , NIF f I ;,.g� ^tii•,,r L t*,�� '�.-M, yµ '� as"'s,4 .�- � 1 � � � . Read all instructions completely before starting any part of the installation. Each sub rail kit comes complete with all parts, hardware and installation guide to install one complete sub rail kit (EXCLUDING TOP RAIL, POSTS, SKIRTS AND CAPS) Sub rail kits have been pre-cut to 6'or 8'lengths. Check to ensure the kit is complete. SAFETY: Always wear goggles when cutting, drilling, and fastening materials. NOTE: Check local building code requirements prior to installation. . IMPORTANT NOTE: 51/Z Top Rail is sold separately and comes in 12 and 16-foot lengths.Use the Top Rail Connectors with all joints including Post, In-Line,450 and 22.5"to ensure a proper fit between parts. f ions r The 4'W"and 6"x6"ppost sleeves have been designed to - r slide easily over the Composatron rust proof coated , Tallboy.Follow the Surface Mount Bracket instructions for `¥ �� wood deck or concrete slab before installation of the Post = Sleeves.Pressure treated wood 4"x4"or 6"W'can also be '� used but is not recommended due to uncontrolled M ' swelling,cracking and twisting of the wood. IMPORTANT:DETERMINING POST HEIGHT - 4'W"CENTER POST: For 36"railing height,the post sleeve must be cut to 34". For 42"railing height,the post sleeve must be cut to 40". i l 6"W' MAIN POSTS: For other than column full height 6'W"post installations, cut the main 6"x6"Post Sleeve a minimum of 2"higher . than the desired rail height or 38"for a 36"rail or 44"for a 42"rail. Figure 1 . NOTE:If optional Post Skirt is to be used,install over Post 1 Sleeve prior to installation of sub rail or use our 2-piece post skirt. Rail Measuring and Cutting Measure between post sleeves,top and bottom,to obtain the rail length. Also check rail opening to 36•MIL-34' :. ensure the posts, newels or walls where the rail is to , 42'MIL-40' be mounted are plumb and square.To obtain proper ,�AC ES ORY;-6 TDP RAIL r. 04 POST SLEEVE baluster spacing,be sure to measure and cut retainer 6z6POST r and bottom rail an equal distance from the center. SLEEVE I I I I -) 36' (1)38(FOR 36') STEEL SURFACE I t, ) ( OR OR MOUNT BRACKET , ;�� I( ,I)� )�I I , 42• (2)44^(FOR 42•) TIPS: See our website www.composatron.com for: ` 1)Optional cut technique to equally divide rail kits, i.e.make 2 rail sections from one rail kit and 3"DECK SURFACE 1 YENTE 0.SU DPO RT / ca.oE uvn 2) How to cut and position railing on the Post Sleeve ; at a 450 angle. DECIL)O)ST S' 4 -I------'--6z6 WOOD POST------.-..- , Figure 2 il Bracket Installation Place the U shaped end of the bracket on the under side of the bottom rail and retainer just slightly inside t, 6. (1/16")the cut edge. Mark and drill pilot holes with a RETAINER 3/16" drill bit. Drill holes to proper size using a 3/8" BOTTOM RAIL 9yB. �-TOP OF POST SLEEVE - drill bit. � - / i BOTTOM OF Note: When drilling the bottom rail, drill through the -� �— / ;� "EF"TMER bottom wall only—do not drill through the top SUPPLIED ALLEN\--- _,I� ;, _—--------- -_ 1a'PAN NEAD 1P surface wall. WRENCH \-J ! f� `` F' BOLT Using the Allen Key supplied, screw the threaded TRRFADEU IN6ERT \ fl SII.PAINTED . insert into the 3/8" holes,from the bottom until flush. Be careful not to over tighten/torque: Fasten Brack- POST WALL E WALL 71 �-RAIL MOUNTING ets using the 1/4"x 20 pan head bolts to the under BRACKET side ofthe retainer and bottom rail. - STEEL SURFACE MOUNT BRACKET Figure 3 Assemble and Fasten Align the ends of the baluster with the predrilled t holes in the retainer(see fig.4). _> Using the#8 stainless steel wood screws,fasten the #8WOODSCREW (SUPLIED) ends of the baluster to the retainer first,through the I predrilled holes,then fasten the other ends of the B TOP RAIL PREBBEB balusters to the bottom rail (be careful not to over- ONTO-RETAINER tighten/torque the screws). �-PRE-DRILLED RETAINER(4 7)32 O.C.) - �- 1•SELF DRILLING SCREW(SUPPU.D) �---BALUSTER .. - (4-OPENING) PRE-DRILLED BOTTOM RAIL(5 7132 O.C.) Figure 4 s RAILINGTRADEMARK RailingCenter Support Attach the stainless steel center support bracket to the pre-cut center support using the 1 remaining#8 wood screw. Install the support assembly in the center of the underside of the bottom rail using the 1" screws supplied in the sub kit. . 5� x , Connection #6-1: 4 x4 Center Post, Corner Post and VW" Main.Posts Center the assembled rail sub section between thei post sleeves and position the bottom of the retainer aprox.1/16"above the top of the 4'W"center post. Mark the bracket hole locations and drill with a 3/16" drill bit. Fasten the section to the post using the #14 x 2"stainless steel painted'screws supplied with a#3 Philips or square driver. NOTE:For the 4"x4" center post and corner post,the bottom of the retain- er should sit at the top of the post to allow the top ' hand rail to pass over the 4"x4"center post. For ; F a center post corner application a 6"Top Rail Corner ` Connection Hardware Pack" is required. #6-2: 6"x6" Main Posts,45"Connection Follow the 450 Rail Installation Instructions or visit ' our website at www.composateon.com for details. A 450 Hardware Pack is required for this installation. .,< Install All Sections =� Before installing the top rail, ensure all sub rail sections are installed. - a x � L j• i K 14 TRADEMARK , 5. Install . Top 1 After all sub rail sections have been installed,_ I measure the length between the 6"x6"main posts 'P and cut the Top Rail. (NOTE:Use the System Connectors, sold separately, L at all joint connections to ensure proper fit).Place the cut Top Rail onto the retainer of the previously installed Sub Rails and over the 4"x4"center posts. (NOTE: If the Top Rail is tight over the 4"x4"Center Post, the retainers may be misaligned. To correct this problem, loosen the#14 x 2"stainless steel screws holding the top brackets, reinstall Top Rail and retighten the screws). #8-1:Install Corner 6"Top Rail over Center Post Follow the directions as per step#8. Cut Top Rails with corresponding 450 angles approximately 1/8" shorter than a piece for a tight fit to allow room for the joiner piece.Before installation of the Top Rail, insert both Top Rails into the joiner. Place the loose assembled Top Rail pieces onto the retainer,find the proper seating location and firmly press Top Rails onto the retainers.(NOTE:Caulking may be used to seal the joiner to the Top Rail if desired).A 4"x4" Over-Post Connection Hardware Pack is required for this application, NOTE:Over-Post Connections other than 900 are not possible with this rail system until our new 22.50 degree Post Sleeve and accessories become available.Please see separate Top Rail Connector printed installation instructions or visit our website 1 at www.composatron.com - ) Fasten The ,.. . Top il 1 Retainer Use the remaining 1" stainless steel screws supplied, fasten up through the retainer into the underside of the Top Rail to lock it in place: Space screws evenly. For a 2` a additional holding strength use caulking between the , Retainer and the Top Rail. „ TOP RAIL #14x2'Ss BRAOII=T SOREW TOP OF 4X4 POST SLEEVE ' ASSEMBLY OVER POST INSTALLATION OVER POST INSTALLATION (FRONT VIEW) (SIDE'A. '.. a CIMPIDSAIN Manufactured under Compos-A-tron Research&Development US Patent 6,702,259 B2,Cdn Patent 2,363,976 ` For more information call customer service at(416)335-6500 or visit www.composatron.com z Under Strandex Canadian Patent#215695 and Strandex U.S.Patent#5516742 Printed in Canada c( us '1 �r TRADEMARK RAILING SYSTEMS COMPOSANGN . ,' COMPOSITE TECHNOLOGY Railing Conversion for Stairs THESE INSTRUCTIONS APPLY TO BOTH RESERVE AND SELECT SYSTEMS The assembly and installation of stair rail is the same as for horizontal rail(see over)except for changes detailed below. Please read instructionsfor horizontal rail before attempting to assemble and convert to stair rail. 1.PREPARATION: Figure 7 First check the rise and run of the stairs to determine the proper stair rail angle. 3 (see Figure 7)Check the rail opening to ensure the sleeves,newels or walls 4 where the stair rail is to be installed are square and plum. Measure between the Post Sleeves to obtain the rail length. Be sure to measure between the j 2 ,Post Sleeves at both top and bottom..TIP.• Ensure the proper fit by cutting a_ test piece of wood to the previously determined length and angle and fit it into, the opening. Once the proper measurements have been confirmed,measure the handrail and retainer from the center of each part and trim an equal amount from each side to obtain the top length measured between the sleeves. 2.BALUSTERS I 4 Cut Balusters to proper angle,top and bottom. Keep length identical. \ 3.DRILLING HOLES RETAINER AND BOTTOM RAIL The Retainer and Bottom Rail have been factory drilled for'horizontal'rail i installations to assist with the assembly.For stair rail installation,the Retainer and Bottom rail holes will need to be re-drilled to match the required stair rail angle. From the center of the top holes,draw a line*the proper angle down the . side of the bottom rail to be used as a guide(see Figure 8)• Using a IA6th bit,drill through the top hole following the angled guideline,and through the bottom of 1.Stair Angle j the rail making sure to drill through as close to the center line as possible. j g I TIP: Use a drill guide to ensure accuracy and see our website for additional information. 4.MOUNTING BRACKETS Bend the brackets to the proper angle(Top of stair bend in,Bottom of stair bend Figure 8 out)or use the Stainless Steel Hinged Bracket available at your local dealer. S.ASSEMBLE AND INSTALL Assemble as per horizontal rail installation instructions Step#5. Note:-The 2W handrail is placed onto the retainer and secured using the 1"drill bit and Quick Screw supplied. 3 z 'H 20 TRADEMARK i_ SELECT A- Railing Installation Guide •• Please read all instructions completely before starting any part of the installation. - _ Each railing kit comes complete with all parts,hardware and installation guide to install ' one complete rail section(excluding posts.)Railing sections have been pre-cut to 6 ft or 8 ft lengths,Check to ensure that the kit is complete.Safe Alwa s wear goggles when � 9 P Safety: Y , 9 99 F „• / I handling,cutting,drilling and fastening materials.Note:Check local code requirements. , 1.POST SLEEVE INSTALLATIONS: I The Post Sleeve has been designed to slide easily over a nominal wood 4°x 4" ' (min.33h„x 33/6",max.39/ts'x 31A6")post after the deck sub-structure is complete and the deck board has been fastened.If the nominal wood 4"x4"post is twisted or oversized it will # s be necessary to shave the post Do not force the Post Sleeve as this may cause it to crack :- ors lit The 4"x4"wood post should extend down to the bottom of the rim'oisL For firmest I p p l b i attachment,completely"BOX IN"the 4"x4"wood post so there is support on all four sides. %_ Figure 1 (see Figure 1) The Post Sleeve is then slid over the wood post that has been mounted to the deck or a concrete slab using the"SURFACE MOUNT BRACKET". 116 For more information see our website. Note:If optional Post Skirt is to be used,install over Post Sleeve prior to installing railing.. gs 2.POST SLEEVE HEIGHT.CALCULATIONS ' minimum Calculate and cut Post Sleeve to required height(see Figure 2)• Slide Post Sleeve over 36, (1)38(For 361 q g 9 ' Or or wood post into position. For 36"rail cut Post Sleeve to a minimum of 39'. For 42"rail cut w. mmlmum Post Sleeve to a minimum of 44°. 0 42" (2)44"(For 42") 3.MEASUREMENTS AND CUTTING Measure between posts,top and bottom to obtain the rail length. Also check the rail r.�°e«losr opening to ensure the Post Sleeves,newels or walls where the rail is to be installed are GRADE LEVEL square and plumb. To obtain proper baluster spacing be sure to measure and cut retainer - , AIOO°,= and bottom rail equal distances from the center. Cut handrail to match retainer. T/PS. See our website for 1)Optional cut technique to equally divide rail kits,i.e.make figure 1 2-4 foot kits from an 8 foot kit and 2)How to cut and position railing on the Post Sleeve RETAINER AND BOTTOM RAIL � at a 45°angle. ` 4.RETAINERS AND BOTTOM RAIL BRACKET INSTALLATION(see figure 3) Place the"U"shaped end of the painted stainless steel bracket on the underside of the retainer and bottom rail. Be sure to place the bracket just slightly inside('/,6")the cut edge �J of the retainer and bottom rail. Mark and drill pilot holes with a 3/6"bit Drill out the two mounting holes,to1/e". Note:When drilling for the bottom rail,drill through bottom wall only—do not drill through Figure 3 the top surface. . Using the enclosed tool,screw the threaded inserts into the holes from the,bottom until flush. Be careful notto overtorque. Install inserts and fasten brackets with panhead bolts to the underside of the Retainer and Bottom Rail using the'/ x 20 panhead screws. 5.ASSEMBLE,FASTEN AND SLIDE Align the ends of each Baluster with the pre-drilled holes in the Retainer(see figure 4). ' Using the 13/<"#8 wood screws,fasten the Balusters to the Retainer first,through the pre-drilled holes. Do not over torque. Align the ends of the Balusters with the holes in the i Bottom Rail and fasten the Balusters to the Bottom Rail through the pre-drilled holes using �13 the 3"#8 wood screws. Place the partially assembled railing against a solid surface and slide the Handrail over the Retainer. Note: If the brackets cover any of the pre-drilled holes wocwor there is not enough room for the baluster to firmly attach to the retainer,notch the 1 ` baluster so that it fits around the bracket and screws. t Also see our website for additional TIPS. Seal any exposed holes with a silicone exterior-Figure 4 grade caulking.). Revised Dec.7,21M 22 TRADEMARK SELECT i� • ailing Installation Guide NOTE:LEVEL RAILING PRIOR❑ ❑ TO MARKING&DRILLING 13l4'WOOD SCREW p CENTER❑ - O SUPPORT❑ ~ j CENTER❑ BRACKET SUPPORTO L ' ---- X BLOCK MARK&DRIL❑ HOLES r Figure 5a I in'LAG BOLT rr BOTTOM RAIL BALUSTERS ,( ❑ Figure 6 CENTER SUPPORT SIZE ,. PRE-DRILLEDE� Tit R CENTER SUPPORT❑ - �� HOLES �� BRACKET US Select-Flat 4'/16D SELFUS -Select 4 5/a"*" DRILLING SCREWS CENTER SUPPORT US Reserve 41/8" BLOCK -:4 CENTER OF BOTTOM RAIL Figure 5b * indicates size supplied ` Chart 1 6.CENTER RAILING SUPPORT Fasten center support in center of railing using 1"self-tapping screws. 8•POST CAP APPLICATION (see Figure 5a&b)Check Chart 1 for the proper cut length for your ` ' Apply generous amount of construction grade adhesive to top edges style of rail. of Post Cap and press Post Cap firmly into place. 7.LEVEL AND ATTACH RAILING(see Figure 6) 9.FASTEN HANDRAIL TO RETAINER Level the assembled railing prior to making any markings or drilling. Take remaining self drilling screws that were used in Step 6 and install Place assembled railing between Posts and level. up through the retainer into the handrail to lock it in place. Mark holes. Space screws evenly over the span. Remove assembled railing. Drill pilot holes in the Posts with a73/4'drill bit For care and cleaning instructions Re-position assembled railing and using a#3 Phillips driver bit attach to visit our website. Posts with#14 x T stainless steel screws. LOT COMPOSACAI yNAwLAY Manufactured under Compos-A-tron Research&Development COMPOSITE TECHNOLOGY C OS "^ "" US Patent 6,702,259,82. For more information call customer service at(416)335-6500 or visit www.composatron.com Under Strandex Canadian Patent#2153659 and Strandex U.S.Patent#5516742 Printed in Canada Trademark Railings is a trademark of CCPINC. Town of Barnstable Permit# Expires 6 monUTs from issue date Regulatory Services Fee ;2 . y� LARNSTASLH, ' A � ��Thomas F. Geiler,Director SS PBuilding Division MAY v 2010 Tom Perry, CBO, Building Commissioner 200 Main Street; Hyannis,MA 02601 TOW OF BARNS1.)�B tivw-vv,torvn.barnstable.ma.us - Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT°APPLICATION - RESIDENTIAL ONLY Not Va1id without Red X-Press Imprini Map/parcel Number Property Address i Residential Value of Work SQL 0 Minimum fee of s25.00 for work.under S6000.00 - Owner's Name&Address Ck Z63l Contractor's Name �kl 113.K-S S '. TelephoneNumber Home Improvement Contractor License#(if applicable) l 0 ' Construction Supervisor's License# (if applicable) RAorkman's Compensation Insurance [ I am a sole proprietor. A,%PRESS PERMIT ❑ I am the Homeowner MAY9 �Q�O ❑ I have Worker's Compensation Insurance Insurance Company Name -TOWN OF ARNsTA L Workman's Comp.Policy# t 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 i Replacement Windows/doors/sliders:U-Value ��`�® (maximum .44)# of windows 3 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,ix.Historic,Conservation,etc. *° Note: Property Owner must sign Property Owner Letter of Permission. a A copy,of the Home Improvement Contractors License & Construction Supervisors License is required: nwealih o � The Cornmo Massachusetts f Department of Industrial Accidents, d Office of Investigations �,t j 600 YYashington Street Boston' NIA 02I1'I s' iUIvw.jnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information i 1 Please jPrint Legibly Name (Business/Organi2ation/Individual): Address: City/State/Zip: C��� I�f t M ;0 �� Phone #: Are you an employer? Check the appropriate box: Type of project(required):., ` 1.❑ 1 am a employer with 4. lam a general contractor and 1. 6 ew construction 2.�employees (full and/or part-time).* have hired the sub-contractors 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity, employees and have workers' 9 . Building addition [No workers' comp. insurance 7 comp. insurance.$ required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11:'❑Plumbing repairs or additions right of exemption per MGL ---myseIffNo Workers.'-cozl?p,. _.. 12:�-Roof.repairs insurance required.] re u t c. 152, §1(4), and we have no q ] employees. [No workers' 13.E] Other comp. insurance required] *Any applicant that checks box#1 must also fill out the section below showing their tivorkers'compensation policy information. t Homeowners who submit this affidavit indicating they.are doing all work and then hire outside contractors must submit a new affidavit indicating such., $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. r am'an employer that is providing workers'compensation insurance for my employees. Beloiv is the policy andjob site information. Insurance Company Name: Policy# or Self-ins. Lic.#: 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/ozone-year imprisonment,as well as civil penalties-in the form of a STOP WORK ORDER and a fine of up to$250.0.0 a day against the violator. Be advised that a copy of this statement may be.forwarded to the Office of Investigations of the D1A for insurance coverage verification. . I do hereby certify under the pains and enalties ofperjury that the information provided above is trite and correct. f Date: . � Signature: iv - Phone#: Fri 0 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 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, constriction or repair,work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth-nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their,certificate(s) of . insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to carry workers compensation insurance, If an LLC or P 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 fixture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 — - Revised 4-24-07 ,,,,,,,.,, rn iQQ anv/dia Town own of Barnstable e regulatory Services y BABNSTABLE Thomas F.'Geiler,Director v MAss 16,19-FD Building Division R µA'�p " Tom Perry,Building commissioner 200 Main Street,Hya.nriis,MA 02601 - vvww.town.b arnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section P . . If Using .A Builder - r Y� 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 f or: 3 Co WAG®rJ (Address of Job) Signature er Date °Print Name If Pro e Owner is applying for petiTiit please complete the Homeo.wners License Exemption Forth on the.reverse side. Town of,Barnstable �P��F TFtE Tp�O Regulatory Services " Thomas F. Geiler.,Director ' »rrxsrnsre, AASS $ i639. Building ]division p�ED �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street .village "HOMEOWNER": name home phone#1 work phone q CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended-to include owner-occupied dwellius 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/ shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0.Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assum ng 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 parl of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\wPFILES\FORM S\homeexempl.DOC J � Board o ui ingAVeplalons and tan ar si One Ashburton Place - Room 1301 Boston, MassFichusetts 02108 Home Improvemed-6ntractor Registration, K Registration: 101601 Type: Private Corporation" _f Expiration:" 10/29/2010 Tr# 277006 N� 4 ¢ QUALITY WOODWORKS INC. . - ARMINAS DIMSA AL 17 PATIENCE !.N --- COTUIT, MA 02635 -o --- --- -- -' Update Address and return card.Mark reason for chan e ` - L.Address Renewal F_� Employment Lost Card DPS-CA1 is 5OM-07/07-PC8490 r � l.5'S7('Ir►rti. B°,►rd of g►u7 D('I);) c►r ding rtnr Constrpc &C(911 r►1f 1'ubli Lic tion S ►tion`.; 11 c Sate t1. Restrict'eryse. CS 93568 d d to• 00 pRervisor Licen5eanda►•d,s. AR/W/NAS. 17 PTIE NC DIA4SA, _ -� COTE LN U/T '. ,yam MA 02635 �� - �� f' k ---------------------- .Expiration, T Z20/20j2 r#• 1 71�7 } MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:! L MA. Date — �tiPermit# Owners Name. —A Building Location Type of Occupancy: Commercial! .Educational Industrial Institutional .VResidential New: Alteration:Ej Renovation: Replacement:0 'Plans Submitted: Yes No FIXTURES z .z m o W --1 x I- W a. W Z IQ- Y o) 'J U uJ W m x a w r 1- W Z Nco v> O a x ; JO ? rn W o F- z z cn y t7 ij a LL 0 U. l- Q U m Q W o ` O p W y J J _z m .� Q Y x O a. o l- x z Q u- � a Y a x W W w v Q ¢ Q O F- > > O = Q .rr Q CO a Q H Q Q Q m m I] u_ O x Y >� N I- p SUB BSMT. BASEMENT 1 FLOOR t y0 2 FLOOR y 3 u FLOOR q 4 FLOOR. z 51HFLOOR (� WH FLOOR 7 FLOOR 8 .FLOOR Check One Only Certificate# Installing Company Name:--- .9- � �.. ET Corporation, i Address: l City/TownI� State: MA Partnership - Business Tel: Fax: f� Firm Company Name of Licensed Plumber: i�12 �k1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which+.meets the„require ments of MGL.Ch. 142 Yes If you have checked Yes, please indicate the type of coverage by checking the appropriate box below."' F A liability insurance policy j T-�_ Other type of indemnity Bond j OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachus General L d th t my signature on this permit application waives this requirement Check One Only ` Owner (� Agent Si na of Owner or Owner's A ent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all' Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. BY(. -- =_Y Type of License: Titlef f✓�.Plumber Signature of Licensed Plumber Master Cityffown A PROVED OFFICE USE ONLY Journeyman License Number: MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FI City/Town._3,%4� C_- F MA. + Date: O�//o/ ��7 r 0 Permit# VV J Building Location: Owners Name: (d2-Gr(N%S'T != r Type of Occupancy: Commercial ❑ Educational'❑ Industrial ❑ Institutional❑ Residential New: ( Alteration: ❑ Renovation: ❑. Replacement: ❑ Plans Sub 11 mitted: Yes❑. No❑ FIXTURES ca w W w I— W, rn U3 V 't ¢Iju W O m = 0 W. w cn H w w w w 0 z Q p w O Q O Z w U) w Co o O a uj z W w z � Iw- H 0 z . _j 0 u_ = I.- w w w w 0 . tY rn ¢ ¢ m to - 0 z O N Z F- _ v o o W 0 0 _ _ O n0 . > > p SUB BSMT. BASEMENT 1 FLOOR j 2 FLOOR Vu FLOOR 5� 4 FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR ` Check One Only Certificate#. . Installing Company Name: o�c9 "b , . Address: L ❑`Corporation . ;,�f 1'�ao/ �j� � City/Town 1{S State: " ❑Partnership Business Tel: ,,QK 775�-! SfC� Fax:- r 'Firm/Company. Name of Licensed Plumber/Gas Fitter: ( >b°11 v�k? INSURANCE COVERAGE: I have a current liability Insurance policy' or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes 2 No If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of Indemnity ❑; Bond'❑ . OWNER'S INSURANCE WAIVER: I am.aware that the licensee does not have the insurance coverage'required:by Chapter 142 of the Massachusetts General Laws,and that my signature on this,permit application waives this requirement Check'One Only i Owner ❑ Agent Signature of.Owner or Owner's A ent ' By checking this box❑,-I hereby certify that all of the details and information I have submitted(or entered)regarding,this application are true and accurate to the best of my Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be In compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws: Type of License: By El Plumber AAA, Tiile ❑ Gas Fitter Signature of Li ed Plumber/Gas Fitter ❑Master ; city/,rown ❑Journeyman License Number: APPROVED OFFICE USE ONLY ❑ LP Installer �C��IO�l ✓d 4 ,67 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING . City/Town:� n V-_ a MA. Date:I-�_��_—_� ermit# �i3� t?,-ffr BuildingLocation? Cc7 , I �.. C _.b. ! Owners Name: 02: 15.E .. t cuS - Type of Occupancy: Commercial 1 Educational LJ Industrial 0 Institutional ResidentialE] New: i� Alteration:; Renovation: Replacement: Plans Submitted: Yes No FIXTURES z z 0 Y U CO x 0 W co a. z Fa- Y N .j C.) W u a a co z S N O m L n. w CO >- Q co Y rn a .X or I� ? y o a w O o W z w cn .'z V �- FL Y = :5 O 0 F- x z a u_ o_ Y a x W W W I- U F- . O to F- > > O O O z Z 0E- F- x o Q O x J Q a a a F- 2 m m 0 u. O SUB Bs T, BASEME `f 1bl FLOOR ` yQ 2 FLOt - y yy/ 3 FLO 4 FLOOR ,51H FLOOR r z 6 TH FLOOR 7 1 H FLOOR 8TH.FLOOR Check One Only Certificate# Installing Company Name: P • . - - -�_— Corporation Address:j. m,�City/Town� State: MA 11 44 Partnership Business Tel: Fax: / Firm/Company Name of Licensed Plumber 1, �R.,.,. . -- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YestNo If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy j7 1 Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachus GeneraAL hd th t my signature on this permit application waives this requirement. Check:One Only - - Owner Lj Agent Lj S ig na cf Owner or Owner's Agent hereby certify.that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all Pertinent.provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Ai 41 By I //o/W Type of License: r �` wa tT Si nature of Licensed Plumber Titled i? ✓ . Plumber g --- — -- - `=1 Master 1 J E City/T01Nn1- OFFICE USE ONLY D,Journeyman (�g License Number: APPROVED �.- �1HE TOWN OF BARNSTABLE Building Application Ref: 200905410 ermr p BARNSTASLE, Issue Date: 12/14/09 Permit ■ • ■ ■`t y MASS �j 1639• Applicant: DIMSA ARMINAS Arlo IVIA�A Permit Number: B 20092422 Proposed Use: SINGLE FAMILY HOME Expiration Date: 06/13/10 Location 37 CODDINGTON ROAD Zoning District RD-1 Permit Type: GARAGE DETACHED RESIDENTIAL Map Parcel 186059 Permit Fee$ 255.00 Contractor DIMSA,ARMINAS Village CENTERVILLE App Fee$ 100.00 License Num 093566 Est Construction Cost$ 50,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 2 BAY DETACHED GARAGE- 1 BED, 1 BATH,NO KITCHEN,NO S THIS CARD MUST BE KEPT POSTED UNTIL FINAL NO CABINETS,NOT TO BE USED AS AN APARTMENT INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: UZGIRIS, EGIDIJU$ BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1206 VIEWMONT DRIVE INSPECTION HAS BEEN MADE. SCHENECTADY, NY 12309 Application Entered by: JL Building Permit Issued By: Lax THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR AN ART-THERE E TEMPORARILY-OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIF'ICALLY:PERMITTED'UNDER THE BUILD.ING'CO ;MUST BE APPROVED BY THE JURISDICTION STREET OR ALLY'GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE.OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS, THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS: WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 i 1 2 2 . . 2 3 l Heating Inspection Approvals Engineering Dept r" Fire Dept 2 Board of Health LOT 1 42-0ft It 49.1 LOT 2 ASSESSORS i.EXIS771VGriiiii y LOT 188-50 AREA=18B72fS.F. I II �'sssss;;;ssss' BORDERING c9 N 82`3214 A N VEGETATED-0 ,�'1 0 31 .8ft VL WETLANDS 64.28' Q N ov �441 40 , W �� 'PO - L 100'_ WETLANDS BUFFER �� � V 50' WETLANDS BUFFER NOTE: WETLANDS FLAGGED BY: VACCARO ENVIRONMENTAL CONSULTING FLOOD ZONE A10 GARAGE CERTIFICATION RES ZONE• RD-1 TOWN CENTERVILLE SCALE 1'=40' PL REF` 170=93 ELEV N/A SETBACKS 30'-10'-10' THE' GARAGE IS.SHOWN ON THE PLAN YANKEE LAND AS IT EXISTS ON,,THE GROUND ���a��;�CF 11� ®�® \bTcR 4cir SURVEY CO. INC. STEPHEN � �, J. � 40 INDUSTRY ROAD DOYLE > MARSTONS MILLS, MA 02648 ��37559 TEL• 508-428-0055 FAX 508-420-5553 s U ®® JOB 01- so,.l p DATE:0711912010 NUMBER 54540 DEC 16 2004 12:26 FR GE CORPORATE R-D 5137375604 TO 61508790623a P.a1/04 ljV So : 0 , R' 7 ..... , /z all _ : .. ..... ... . ......... i , : , ...... • _ : : I i : DEC 16 2004 12:t7 FR GE CORPORATE R-D 5193875604 TO 9153873OS230 P.04/04 DEC-1472004 21:55 FROM:HEHt_Y Monday,December 13,2004 0929 BC CALM 2003 DESIGN REPORT-US 00tibie1 314-x S 912" VERSA-LAW V100 SP 1=ile Name: ac CA LC Project:Il Dascriplion: Job Name: UsQieis Res. SpeefHer: aotwtlo Lumber Co.inc- Addrew 3T Coddington Rd. Designer: Cotuft 68y Oeswrl ",t3teis,Zip:Cent"Ile,Me. Company: Customer: Jim Healy, codo rw rs:•1080 5512,NER 028 �o ra ' t Syrvlmd igid-251 413 oQ+n Tft is Y 1125 be LL t3v 113e 1be OL 11251ba LL 1158 The OL Total+iert¢ental Lsngth Generrltt t3ata Load Summary Ref. start End TVPe value Trfb. Dur. Vey: t1S Imperial ID DasorIP00n Load Type 25 psi 05-00-00 11546 s Standard Loa Unf.Area Left Ofi-00-00 15-00-00 ad 15 psf 0s-00-00 90% MemberTypC Roof Seam 25 psi 01.00.00 190% Numbwrof SPens t 1 oeiNns toad, Un1.Arena Loft 00-0a-4o 1r00 00 ppad 10 psf 01.00_QQ 9D% Left Cantilever No 0 plf We 100% Rlgnt Cantilever No 2 layover roar loarUnf.Lin, Left 00-00-00 15 Ofl 00 d gp pif No 00% slope: 0112 an Location Tributary: CS-0f1•aD Controls 8uminary y,Allowable Duration Load Case Sp Control Type Value 53,111% 115% 3 1-tntemal Moment $500 R•lbs n/a 100% Nag,Moment 0 1111-403 27 696 115°6 3 1-Left Lire Load: 26 pet End Shear 2042 sl7s 89.3°k 3 1 Bead Load: 15 pe Total Load Defl, U760(0.003") Pamark Load, d pet.. Live Load Deft. . 1J527(0,347) Duration:" _ 't45. M"Defl, 0.893" Disclosure Notes The compieOanass end QwYMgV of pesign meets Code minimum(U180)We Iona deflectiontal load to c e criteria. the input must bo Vermad by anyone Design meets code minimum(LrAO) wAo would rely on the output as Design meets afbhrary(t'?Maximum load deflection criteria. wvidence of suNltb1INfor a Mlinimum bearing length for So Is 1-1R-- The output psrtltUlgre�ppftoptlon. Minimum beating length for Bt ie 1.112". abate 01 beam upon building Member Slope=0,consider dreinage- code,emptod dealpn PrOW196 Entered/D 50 yea Kortxontol Span Lon9b(Q}m Clear Span+112 min,end bearing t2(nterrnedlaDa beetirtp and analysFs methods. lnsbltebon of BOISE engineered wood Connection Diagram products must be In accordance Consult project design profacdenal of rocon!or BCISE technical representative for connsctio"design wins the Ciim4ntnsW� GooUdes Member has no side loads. a the e land ppuce ro.obtain on If»tellopon Guide or If Connectors ate:fed Sinker Nails you.have any g1llestions,please toff _d (80=3247P beldre,"ginntng' e M a• product in6tsifeliori., b,V1 b SC CALC D.60 FRAMERS,5010, d S 12" 9C RIM BOARD".f3C.088 RIM 80ARD7w.golee GLULAMI, C VE"AJ-UO;VERSA-RIMS, VERSA-RIM PWS®, VER8A,8TRAN0Tw. .— ...s VeRrASTJCW''ALLJO13 M and v Ajillin we trademarks of � Bosse Casoode Corporanan. 508-477-5315 PA5E.03 DEC 15 2004 09:46 :f:* TOTAL PAGE.[14 W DEC 16 2004 12:27 FR GE CORPORATE R-D 5183975604 TO 915037905230 P.03iO4 DEG14-2004 eD CAL04D1003 66SIGN kg"R-' - US Monday,December 13,2004 0929 Double 1 3/X' x.S 1/2"VERSA-LAMS 3100 SP Ple Name: 6C C,ALG Project:FE1101 Dsscrtption; Job Name: Utgida Res SPeclfi®r, Boletlo Lumber Co,Inc. Address' 37 CCddington Rd. Dee19nerf COW Bay Desten city State,ZIP:Cenon"14,Ma. " Company: cunt nw .lim,Healy. Misr.: Code report: ICBO SS12,NER 628 1 Smndard , toad-to I 1 .•....: .. .. ,. as Be 1 gaa to U- 1 ass Ibs LL 13811be pL 1361 lb*DL Total Nortm tel Leng4h-0"(1-00 Lload Summary Oenea"at Q4ta`,'; vewa Trib. our. verelen: WS Imperial 10 oeacriptfon Low Type Ref, Start End Type S Standard Load Unf Area Left 00-00.0o 09-00.W Live 4O pef 0/Ot1�00 10096 Meeribar Type: Floor Beam Deed 10 psf 01.0D-40 80% Number of 6pane: 1 1 roof toed- Un1.Area Left 00-00-00 09 00.00" Dead 2s per 01-0.08.00 100% Left Cantilever. No Rlght Gandlgvgr:" No 2 ceiling load. Unf.Area Lett 00 00.00 09-QO-00 Doaad 10 PSI 07 00-00 190% Slope: W12 3 layover root IoatUnf.Lin, Left 00 00 00 09-00.00 Cad 100 ptf nla 100% Tdbutrary: 01-00-00 controls Summary Control Typo value 36 Allovaetlio Duration Load Cana Span Location Live load: 40 pef Moment • 7309 ft-lbs 45,5% 1?5°i6 3 1-Internal Dead Load: .,,. ,1"O.pst Neg.Moment 01FIbe n/a 100% Mltl Pton Load;: 001' End Shear 2677 lbs 361% 1 t 5% 3 1-Left Duratlen: `"' Total Load Daft US07(D.2131 4713% 3 1 Live Load Deft, Lrl 2(0,1Z2► 40.S5b' 3 t' Disclosure Mier Den. 0 213° 21.3% 3 1 The aompi8teneas and accuracy of the lnput must be v6aad by anyone Nantes who would rely on the,output ag Design meets Code minimum(U240)Total load deflection crtterta. evidsnce of 9uftobility for a De"n meets Code minimum(Ll1160)Uve load deflactlon witede. pm*Ular application. The WOUt Design meets arbitrary(1')Mlatamum load dellectlon or feria, above la bawled upon building Minimum bearing length for 00151-1Pt° code-aceei0ed design 1111401116098 Minimum bearing length for 81 is 1-1f2". and anstyals M@4h*&. Installation gritwadogployed Notflontal 8pan•tength(s} Cleat Span+1n rnlrv.en"earing 1y2 irtletnnedtate beanr+g of 8016E engineered wood products must be In accordance Connection Diaprafn with the current Installaton OU140 Consult project deslgn profeaslonst of record or SOISE technical re0e6ent8Wsrfor eonnoetlon desfgn and the applicable bLiiding codes. Member has no side loads. To obtain sn,Install wGulds or if you hara•any 4u , f9ai.pieoae aall Conriorlors era:18d Sinker Nails prodaot2?fr8elion.� InrAng "w 2" d-- -7 b=3' go CALC®,BC FRAMERS,500, c=2-314" g 9C RIM 90ARDYm 50 088 RIM d w 12" • BOARD-,BOISE bUJLAM-, VLR8ALAW VERSA-tilMS, C VF-RBA-Rart PL.0 SO, VERSA-STRAND^', ve, OA4YTuOe,ALLJOISTO and AJS^'are tradamarb of a —..—a Beige Cegoade CorporeTon. DEC 15 2004 09:45 5F113-477-5315 PAGE.02 DEC 16 2004 12:27 FR GE CORPORATE R—D 5133E975604 TO 915097906230 P.02/04 16 December 15,2004 REF: Building Application for 657 SO.Maitl St.CZntETVilk,MA ATT'N:Mr.Jeff Lauzon Enclosed are the engineering specifications for the two LM1.beams.The shorter 9 foot beam is for the dining room wall and the longer is for the new kitchen addition. A rectangular louvre(app. Mot by 1.5 foot)will be put in the upper corner of the kitchen wall(north facing)for venting the new roof.'i'he other aspects of the venting are on the submitted plans. I can be reached daytime at 518 387 6408,Fax 518 38?5604. Home number in New York is 518 374 9067. Thank you, Ed Uzgiris �FZHE ro Town of Barnstable N Regulatory Services sAMSPABLE, Thomas F.Geiler,Director 9 MAW. g 1639. 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. // / 1 Type of Work: Ae d azz-/� `t khe-47 Estimated Cost Address of Work: S'7 s� �« ` ` Owner's Name: �101✓!/S' Z '1 �� Date of Application:_/� I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 ❑Building not owner-occupied g0wwner 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. 0 Date Own e Qhrms:homeaffidav RESIDENTIAL BUILDING PEPMT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE 1h square feet x$96/sq.foot= x.0041= plus from below(if applicable) Z-VG32— ��}•� ALTERATIONS/RENOVATIONS OF EXISTING SPACE _t square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $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.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck -__ __x$30.00= '36 1 o® (number) _ Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) q,g3 Permit Fee Proicost Rev:063004 oFWEr, Town of Barnstable Regulatory Services s�vszas1M4 . Thomas F.Geiler,Director � 6 9 ,0� Building Division ArEO MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �j Please Print DATE: rye 1 JOB LOCATION: 6 57 So , `22d w S/� number '` street C�� 7 village ..HOMEOWNER": �iZ�f®T✓(/5 UZC-,ay �l 3,Y1 L0S` 5y &92 name / home phone# work phone# CURRENT MAILING ADDRESS: If 14 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. l2 � Signature of Ho Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt f ENFERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J �S2 45�e 112ao27 Applicant Name: e!�;:640,Ij %7 De' Site Address: Applicant Address: 112d a P7— DR City/Town: Cemmzul u_e?, ��SllSe!`�4�U .fJY Use Group: Date of Application: Applicant Phone: Applicant Signature: ^ Compliance Path(check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.1b): Heating Degree Days(HDD65) from Table J5.2.1a: (For items d. through i.,fill in all values that apply from Table J5.2:1b:) a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing Area' sq.ft. g. Floor R-value R- c. Glazing%(100 x b-a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE . ❑ Component Performance: "Manual Trade-Off" (Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable] ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts ❑ Home Energy Rating System Evaluation Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher), ❑ Systems Analysis OR ❑ Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall+Ceiling Area 724 sq.ft. b.Glazing Area' 9 C) sq.ft. c.Glazing%(100 x b_a) ADDITION with with Glazing%(c.) up to 40%may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM U-value MINIMUM R-Values Fenestration' Ceiling' Wall Floor Basement Wall Slab Perimeter,Depth 0.39' R-37 R-13 R-19 R-10 R-10,4 ft I Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e.-not compressed over exterior walls,and including any access openings.) ❑ "SUNROOM" addition(greater than 40%glazing-to-wall and ceiling gross area) Attach"Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied' El, Date of Approval/Denial: Reason(s) for Denial: (provide additional details as needed on back side) r. I 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 bean 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. Please . supply company name, 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. ne 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 policy,please call the Deparment at the number listedbelow.. required to obtain a workers' compensation 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 size to fill in the permit/license number which will b'e used as.a reference number. The affidavits.maybe returned to the Department by nail or FAX-unless other arrangements have been rnade.: The Office of Investigations would hike to thank y'ou in.advance for you cooperation and should you have any questions, please do not hesitate to give us a call. WOMEN" The Deparhnmt's address,telephone and fax number The Commonwealth Of Massachusetts Department of Industrial Accidents MW of ImsfigauOns 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 The Commonwealth of Massachusetts Department of Industrial Accidents 600 T3'ashin;ton Street _ x Boston,Mass. 02111 ` Workers' Compensation Insurance Affidavit-General Businesses Ulu dress �.� Il r ®G OQI�r //4 ad state Y zip: 12309 Phone# J lL7 /��j�/J� mrwark, L address 6J�6 �le "i� a site location full am a sole proprietor and have no one Business Type: []Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Once El Sal ,including Real Estate,Autos etc.) ❑I am an em to er with eta 1 ees(full& art time). ❑Other / ��//%%���///%%/%%%/%/%/O//// �I am an employer providing-workers' compensation for my:employees worlQng on this job. 3'•' ''' com anv.n :,. _ f.,;,, "1• hone# ' city: 'h% %..;: i�: '.:/'..:.:;'. ...,:/ �] I am a sole proprietor and have hired the independent contractors listed below who:have the following workers' compensation polices: corn'"en name: address: • .. ,. '?• , .T '•4'' hone#! `' city:. , :a;=,.• ,;{' •,.. :i'ar:::' insurance co. . ;. _.. /l////////// ////// com'en. name: •. :. ' . .. .. . !� address: hone 9: :,• t:.. fo ins Fallure to secure coverage as required under section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or__ one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Fine of$10o.0o a day against me. I understand.that g copy of this statement may be forwarded to the Office of Investigations of the DlAfor coverage verification. I do hereby certify under th a lesof perjury that the information provide'd aje is true df orre� Data 6/Signature A Phone# S/ C� / 7 Print name REEL—,-,GIOf // n �75` Z06 l official we only de sot write in this area to be completed 00 MENby city or town official permitflicense# ❑Building Department city or town, ❑Licensing Board ❑Selectmen's Office [3 check if immediate response is required C]HcalthDepartment L: phone#; ❑Other g coataetperson: 'ynt (revaedScyL2003) - Moo .cam' 1 • , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 's ` ,:. M Permit# ��7$ Health Divisions 6 �D-t L� I(� 1��� Date Issued Conservation Division 0 Application Fee Tax Collector Permit Fee #MV.7's lwto Treasurer Planning Dept. EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO__g _#OF BEDROOMS • F Historic-OKH Preservation/Hyannis Project Street Address Village Owner �_Ap Addressµ VMWOVA1L4 Telephone 3>-*"06 72/9M0,F P // ' 3"7 Permit Request 1�' ®� -547%k. Square feet: 1 st floor: existing t 040 proposed 2nd floor: existing G 5 proposed 0 Total new a/ Zoning District Flood Plain Groundwater Overlay Project Valuation Jl -70 Construction Type Lot Size 0.0 oaa eg Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family e Two Family ❑ Multi-Family(#units) Age of Existing Structure 47 Historic House: Cl Yes 9'No On Old King's Highway: ❑Yes ❑ No Basement Type: 'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) © Basement L nfinished Area(sq.ft) �ZS Number of Baths: Full: existing 2w new —&15P Half:existing new Number of Bedrooms: existing_ new 4_r:1_T Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: IrOGOas ❑Oil ❑Electric ❑Other Central Air: ❑Yes & o Fireplaces: Existing New 4 Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use 'Proposed Use ` BUILDER INFORMATION Name L Telephone Number 9Ob7 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / /J� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ~ ` -r MAP%PARCEL NO. ADDRESS r~ VILLAGE " OWNER DATE OF INSPECTION: tf' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL._ PLUMBING: ROUGH FINAL, tr+ M GAS: ROUGH F-- FINAL - e n1 FINAL BUILDING F1 h t I. m 0 rr DATE CLOSED OUT ` rn ASSOCIATION PLAN NO. h y r , U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For lnsurance Company Use': Al. Building OwngLc Nam�e a, S Policy Number A2. Building Street Address(including Apt. Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number I ., , City � ,/ tate IP Cg� A3. Property Descripto I- and B ck Numbers, x Parcel Number,Lg al Description,etc.) A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory, A5. Latitude/Longitude:Lat. 3 (� Long. ? 1 a cp/„ Horizontal Datum: ❑NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain Food insurance. AT Building Diagram Number A8. For a building with a crawlspace or endosure(s): A9. For a b ' W1 - -dewhed garage: a) Square footage of crawispace or enclosure(s) 0 A sq ft a) Square footage of attached garage boo sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade G c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b W0D sq in d) Engineered flood openings? ❑Yes ❑No d) Engineered flood openings? %Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State ?---'A'a-#o I A- Goo® ► au.n�s B4.Map/Panel Numb r B5.Suffix B6.FIRM Index BT FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effe ve/Revised Date Zone(s) AO,use base flood depth) IV B10. Indicate the source of tth Base Flood Elevati (BFE)data or base flood dept entered in Item B9. ❑FIS Profile 1IZI.rIRM Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑NAVD 1988 ❑Other(Describe) Of B12. Is the building located in a C tal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ 'Yes No Designation Date wit ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings" ❑ Building Under Construction Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations—Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diayfamAspecified in Item AT Use the same datum as the BFE. ( Benchmark Utilized K—+'{ Z Vertical Datum 1 b Conversion/Comments I' Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) ' rL�Jf feet El meters(Puerto Rico only) b) Top of the next higher floor et ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) � ,❑�/feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) et ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building d .©'feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) '7 f) Lowest adjacent(finished)grade next to building(LAG) Q feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) S .4 Q feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including �eet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. l certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. -Of ❑Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �� licensed land surveyor? ' ❑Yes o O PdOf�E G JJJJ"'""`'���_ V LANDER,5,XAULEY i Certifier's Name h Numb�r� WY yk a ul�Y ��I`C/) 1 RA No.35101 Title lA9N � J offa Name .o CISTE� Address I �X C' �i5 4 ®z o e AL Signature Signature Date Telephone FEMA form 81-31; r 09 See reverse side for continuation. Rep aces all previous editions U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Efaergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Policy Number A2. Building Street Address(including Apt.,Unit,Sudee,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number City tat IP Code ire A3. Property Description(Lot alncIBlock Numbem,Tax Parcel Number,Legal Description,etc.) A4. Building Use(e.g.,Residential Onn-Res9dential,,Iddition,Accessory,et®.) A5. Latitude/Longitude:Lat. u,� (� Long. V _2J O(o Horizontal Datum: ❑NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number A8. For a building with a crawispace or enclosure(s): 4 A9. For a garage: a) Square footage of crawlspace or enclosure(s) 0 Ar sq ft a) Square footage arage sq ft b) No.of permanent flood openings in the crawispaoe or b) No.of permanent flood openings in the attachaz6garage enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? ❑Yes ❑No d) Engineered flood openings? -id Yes ❑No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State LGA u�- A B4.Map/Panel Number B5.Sufroc B6.FIRM Index B7.FIRM Pa el B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 25 � Z t� - Feu✓. ,hut_ 9 ® A B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth ente d in Item B9. ❑FIS Profile XFFIRM Community De ermined ❑Other(Describe) Bl 1. Indicate elevation datum used for BFE in Item B9 NGVD 1929 ❑NAVD 1988 Other(Describe) B12. Is the building located in a Coastal B rri r Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes No Designation Date ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings* ❑ Building Under Construction' Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,.AE,AH,A(with BFE),VE,V1430,V(with BFE);AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT Use the same datum as the BFE. �a s i Benchmark Utilized Vertical Datum Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) ®. CU❑feet ❑meters(Puerto Rico only) b) Top of the next higher floor � feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) ❑feet ❑meters(Puerto Rico only) d) AH garage(top of slab) L�(feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building ._j_[Rle'e4 ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) 0 Lowest adjacent(finished)grade next to building(LAG) ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) �� —. it ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including i. et ❑meters(Puerto Rico only) structural support T SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that anyfalse statement maybe punishable by fine or imprisonment under 18 U.S. Code,Section 1001. OF Check here if comments'are provided on back of form. Were latitude and longitude in Section A�, (No ided by a JOHN cyc licensed land surveyor? []Yes o LANDERu;G9ULEY CIVIL:_. Certfier's Name' License Nu ber y No.35101 Title om an Name �O�P . l_A-Aj �.�F FOISTERA Address C' o e ss/4NAL E��' 3 Signature Date Telephone IMPORTANT: Imthese spaces,copy the corresponding information from Section A- For Insurance Company.Use: Building Sfrrjeeet Address(including Apt.,Unit,Sul e,and/or Bldg.No.)or P.O.Route and Box No. Policy Number i City t to ZIP Code Company NAIL Number � � 2-- SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date Check here if attachments SECTI E-BUILDING EL VATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND Z E WITHOUT BFE) For Zones AO and A(without BFE), mplete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4,use natural grade,if available. Check the meas)ree,3*t used. In Puerto Ric only,enter meters. E1. Provide elevation information for the following and check the appropxes to show wheth the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosur _ ❑ et ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosur eet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided n_, Items and/or 9(see a es 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _ LJ to ❑above or below the HAG. E3. Attached garage(top of slab)is ❑feet❑meterbove o ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the buildin ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of th or eleva d in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official mustis informati in Section G. SECTION F-PROPERTY OWNER(OR OW(ER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes S,96ions A.B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,and E are ybrrect to the best of my k wledge. Property Owner's or Owner's Authorized Representative's Name Address State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY IN RMATION(OPTI AL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4-G9)is provi d for community floodplain manageme purposes. G4.Permit Number G5. Date Permit Is G6. ate Certificate Of Compliance/Occupancy Issued I _ G7. This permit has been issued for. ❑ New Construction t G8. Elevation of as-built lowest floor(including basement)of the�Wilding . ❑feet ❑meters(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site ❑feet ❑meters(PR) Datum G10.Community's design flood elevation ❑feet ❑meters(PR) Datum Local Official's Name Tit Community Name Telepho Signature Date Comments ❑Check here if attachments ,70 4� -- C`-�1 i E 1 3 S � . s V/ � s t , _......_-.. _,.._. ................. 7 i i • i -� NJ TOWN OF BARNS'�AB'LL BUILDING DEPARTMENT HOP OWNER LICENSE EXEMPTION Please print. DATE. Y JOB•.LOCATION �' �� G um er Street a ress Sections town 'WHOM.,OWNER" - (2' : . . ' ..a . .. ame,. ,• ome p one WOrFpTone • ;:icy:y.,t,. PRESENT MAILING 'ADDRESS i ty town:.. - tate i p c owe Tie`1 gent exemption for dwellings iomeowners" was extended to include own er-occued . of six uni.ts .or Tess an o allow such homeowners to engage an pn ivi ua,:.for hire. who.does .lot possess a license, provided that the owner acts' as, supervisor: (State Building Code Section , .DEFINITION OF HOMEOWNER: side, on which there is, or is intended to be, a one to six family Perso'n(s) who owns a parcel of land on which he/she resides or intends to re dwelling, attached or detached structires accessory to such use and/or farm structures. A person who constructs morc 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 3uilding Official , that he/she shall be responsible'- for all such work performed ender the building permi ec ion , The undersigned "homeowner" Issumes responsibility for compliance with the State Building Code and other applicable codes, by-laws ' rules and regulations. The undersigned "homeowner" certifies that he/she understands the Tow n of Barnstable Building Department 'minimum inspection 'procedures -and requirements' -and that he/she will comply ith said procedures and requirements: HOMEOWNER'S SIGNATURE ��---� APPROVAL OF.BUILDING OFFICI�-. Note: Three family dwelling; 35,000 cubic feet,. or lar to comply with State Buildin, Code Section 127.0 ger> will be required Construction Control 8 a 1 HOME OWNER 'S EXf_ _p,{_ pT I ON Ttie -_Code state that : Pe. mi t Is "Any Homo Owner performing work for which a e building required shall b CSectton 109.1 .1 exempt from the provisions of this section Home Owner — �.Icensing of Construction Supervisor engages a persons) for hire '.o do such w s) ; 'provided that If a ork shall act as supervlsor. 11 that such Home Owner Many._Home Owners, who the responslbil�ltlesUsoftaisupervpsoon are unaware for,, Llcensln that they are assuming, g Construction Supervisors, (Sectlone2tllg 0' they and Regulations . ofte'n`:r.esuIts In:serloos. ) . This . Iack of awareness .�.,.�.. Unlicensed problems particularly when . the Home Owner , uric Icensed persons, ' In this Person as It would wlthclicensed Sse our upPrtllsornnoThe Home Ow hires kas`t?supervisor Iseultimately res onslbte: proceed against ...the _. -- • p . Owner acting To ensure that the Home Owner Is full communities require` Yyawire of his/hor responsibilities m cartlf ' as part -of .the� permlt a Y that he/she understands the respo:)slb1IItl'esl'of �a Supervisor . any - last'i'page of this Issue_ ls a form that fha Home �`Ovtner care to amend and currently Used b pervisor . On the adoptt'such a form/certlr y Of towns. Icatlon You may for use In Your c y community. l SYSTEM mu's Assessor's office(1 st Floor): Q' a Assessor's map and:lot number / t r F y LLE®IN Corwr Board of Health(3rd'floor): WITH"nTL 0 Sewage Permit number r, � lO D '` �!E E�i9�'�L PP11 _G�4VW REGU�Q sT Engineering Department(3rd floor): ; i !�— „Sd House number- + 7'Y. O 163V• Definitive Plan Approved by Planning Board 119 ��r►r e� APPLICATIONS PROCESSED :30-9:30 A.M.and 1:00-2:00 P.M.only 1 AP;VR0VEDB , � . ast" le Conservation T iN O A R N S T A B L E igned I Date ILDI•NG INS[P CTOR APPLICATION FOR PERMIT To TYPE OFCONSTRUCTION Py��,� P/'�ezwvwx? !&7Af da 19. � F TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: G Location /U o /V iZ 0 Proposed Use 13 Cam/i L�% 7 A h2-� Zoning District /�I�!/ Fire District Name of Owner Address✓ I K) G u-,Gw7 @ /1 Sc f-r N F eT A`,P1k Al f s Name of BuildereZ1,4Gi�/1f 0-f AddressZS7 / z? P7 --R J' 7 .r. /.T oPToat/r� Name of Architect Address e/ Number of Rooms Foundation 1*9 Exterior "voy-119 Roofing a"/n Floors , ���m Interior `"` Heating Plumbing Fireplace Approximate Cost Area /►l o Xv GA QK, 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 regar ab GaRwuction. c \ c;.-lJ /r✓ s KG�i 4c lwS Name ,�I / Construction Supervisor's License 1 3-� VZGIRIS, E. "No A34086 Permit kor B 71d Addition Sin 1e-- Fami1 D 1°lin Location: 3• mad L r I 1 Centej�-v1.3 Zie t n r, r^ Owner t'E+.m V`L .,pr is - � ~ F r ire � •` - ^! t } ; � - s Type of Construction , Plot Lot Ct I wi ' f t z' � 1 Lt i � r•• 1 I � mIt Gr rated; •November 2 9, 119 go Per' .bat'e-of,Inspection 19 Date Completed 19 f r C _ Y 1 �,e TOWN OF BARNSTABLE Building Department - Foundation Permit Date Permit # oo �� Name ARmijCAJ t)3::M5A Location .3T7 C��DiL i�� ,fib �.� Insp. of BIdgs. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# � HeAbiKDivision 77­6 'NWT ✓ �61-50- �'" '4 Date Issued - 2 -7 Conservation Division F, sa r 6 Fee 2 8 Tax Collector 0 5� � �- Application Fee Treasurer /�- ✓�� O 'v­ ® _ �zU Planning Dept. �_ Checked in By Date Definitive Plan Approved by Planning Board "► ° Approved By rit? Historic-OKH Preservation/Hyannis Project Street Address 6 5 '7 Village Ci_�/lz ?/,&41e _ Owner z_- /.�>IGG.� �"Anc"W Address Telephone 6-140 &?,f- 906 .5CtY � 1Y V /,.2 0�7 Permit Request l/l� G Ae! C ? / " OOF Square feet: 1st floor: existing proposed_,f!:�1'2nd floor: existing proposed --------Total new Valuation V" �07J Z Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size 191 Grandfathered: ❑Yes qNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ANo On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout tg Other �1��� Basement Finished Area(sq.ft.) 42M ry Basement Unfinished Area(sq.ft) X9! Number of Baths: Full: existing new E--- Half:existing Number of Bedrooms: existing Z/ new Total Room Count(not including baths): existing 00 new First Floor Room Count .� Heat Type and Fuel: d(Gas Cl Oil ❑ Electric ❑Other Central Air: ❑Yes WNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 4f No Detached garage:❑existing ❑new size,-,--' Pool:❑existing ❑ne a Barn:❑existing ❑new size Attached garage:❑existing ❑new size �Shed: ❑existing ❑�neva-sip Other: C Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial-❑Yes 04No. If yes, site-plan review-#- -- -- -_---�r _ _ _L��i Current Use Proposed Use CG�T 3� BUILDER INFORMATION / Name Pi'C' -/ Telephone Number Address i� C/ License# <! /� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ATE 5- ' FOR OFFICIAL USE ONLY i i r PERMIT 1,90. i DATE ISSUED t ` MAP/PARCEL•NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ., . FIREPLACE ELECTRICAL: ROUGH FINAL! PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING G - f DATE CLOSED OUT ASSOCIATION PLAN NO. , f oFtNE�a,, Town of Barnstable Regulatory Services. a i MASS. Thomas F.Geiler,Director rf1 39. A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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 Wo k: Gb Estimated Cost Type Address of Wor h�� �2G7� ,��/Qy� 39 • ��j��'U/��e Owner's Name: ''/f�iJ�ll.( Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav , -= - The Commonwealth o ealth of Massachusetts -- Department of Industrial Accidents — Office of Investigations ' 600 Washington Street, a Floor Boston,Mass. 02111 fi Workers`Compensation Insurance Affidavit:Buildingr/Plumbing/Electrical Contractors �I7�"dni1�Q� a�i��- •far ^o���«.' i.�.- �.ly�„�.e• xl. ].. � name AEC /71-1 ' zz� address: /� 6� ' 10l/�i J//C1'//� J� city LG��V�11-.1//e state:' zip: 45V AIR z phone# work site location full address): I am a homeowner performing all work myself. Project Type: ❑New ConstructionARemodel I am a sole proprietor and have no one working:in any l k..fi`•,: , c .:akci ., �•.r:r:.. Bu~;il-dcirrs Addition r as r:,,.k`m �c,?j , r ] m an employer providing workers'compensation for my employees working on this job. company name: address:' city: phone#• insurance co. policy# Sx-�ia•v�ulo5�v$f4;.�%.lEit}��uimurS�.Z:b''fh kE.dry,1:��6•.:a:s°•'.`.'J,cs.'a"�tiFrr.cs.�." .s'� t.�.:S:. N::ti:•4`�' ':.�-•_d_;`{+�••r�w.:'.._.'.: �aa'.4r�rrca.�':ie::...�'' a`..+tss. :.`�:k,�`K..dd"' , �I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below,who have the following workers' compensation polices: company name- address:: -y / city: �l'/17 �o `/ phone M J! OOL % a 19/ insurance co. olic # .iiir�; ':�''r,yxs;:<'R;i°�'"3.'''is':�a:.hFi'Tij'-' `°�,`:i' y'. "7s. eyjr a= x •v.-;:^�4'';�'.+ ,F.x.:v. �x'`;i ',<o�b:).M <T� •:r. - uF��Re -i. :>'f'�•-''�'#} ....�a.4�•Nr...r,�:�"'�dt�%>"r.�..fi'ic i:::ds:•',4»'gMi..:�d..t.;�r,i.j'' ..:�.�`FBY.•>an.n..Y{T'.:� �:ar2�Y:l':f:i5''':"i'#'.:Jr� r`, �i.a'� 'company name: address: city, phone#• insurance co,. policy# 4k "C.,a'Y'fl�Yf7fij' Orla.,r ..Etil-UC�C,4$A, .ci F4 a. �• *.p:M� ti`:r .�:....p 3< 3°�t �s�y}r,.rn.- '•v,�.:._i�rr... .L. A., r #Sw M ItFRIM91. �a J +i r ' YXJ @ aL' r`� ` a''m�1'f 'r 3 ` Re Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to Sl,500.00 and/or one years'imprisonment as well as civil 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 maybe forwarded to the Office of Investigations of the DIA for coverage verification. ' I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct, Signature DateA'�� Print name l Phone# 5 official use only do not write in this area to be completed by city or town official city or town:• permitAicense# ❑Building Department ❑Licensing Board ❑check if immediate response Is required ❑Selectmen's Office contact person hone# ❑Health Department treviscd Sepc 2003) p ' ❑Other Information and Instructions Massachusetts General Laws chapter 1.52 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 writterl. . 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. jq�y pi w"ti . ;�'k 'M' '�t,�)1�Va> ".�`'�t� �x�n'fi. .�'�"Y:vrr, �;,? .'�,Ay�°y.'^t.Y vE��".',-� :'•�t�F.: '�`'.'r'�s.,�'�`�t�,� ,t` �.'�••:;,�+�T��.';' k ,:.'r�' :'..� Y{. .yC ¢..t. F} ' •''' :��.`.i:.1�., .',' •.[3•r;�u"' !sY).}r.N.o�Y�CM•`:�:.-'3'w.« 'GiR�,����',; _.''t�i'dl. � ..:�:�: .�`- �'. �'.' �Si :ca,,SVE •,aft n u+>:ttt.•�1' �.d. .4_e�'��g3.. x`..,. . Applicants Please fill in 'the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,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. Alsobe 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. `L, t �°�' '�'.. � 'P& t ter.. �. � :3°.��,�,3;,-.5 �:r• ... a{''r. •� >..;�"Y.,�t.r �cy_} ,�.�'SS. 2..��. 'r ,,t .q�." x9�, .•'�::;.,,. t, y t �' �¢ e,�yr �?��'�'"i ;rlx°�. ,�,:r°':. ,� �.y,+ •A t r 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 returned 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. 'btt.h��'.d -+�%'. •Ft: �T:. .+.•�.. !.'t.r _� __ _ :k.��..,a Yr rr. .� pia y�'�-ri'iw'�it'4i" s` .,aK.�'.y'.hr.;.F�Jv �.t r... .�Be ,lfirir� .�sr r4p'S:+r,:aa�b�'!,irs(}:. D.-.tF'a.�a4` i,�#3*at :..i'�,x. ..�r: r.� .:��x yy*��` 'TP;^4T; :6�,i:... �j���;.., 'wti:..-..yi.:fJr.�',• :i� .�$}�%t"5: PL J t a Sn•�'tl"r i a. ���..r,5* � v,� ' •�•n•�f' ,���ir��ka� �r,4,c�'"a� �i�>i X'd��r {�"�-e "'St•.f hi .t!'"1��� n�1„ra,�r,����� ��3� Y m$ .1� . -a"w+ fF 's'` r.��P'�,r�•°' Ltia,n .� i n ...fit a •ro t rr, a,•..r a �w� The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7u'Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 . I Town of.Barnstable R Regulatory Services BAMSTABL& Thomas F.Geiler,Director 6 ,�� Building Division ATFD��p Tom Perry,Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: __. number street r' village "HOMEOWNER"://'�z�lT�/� .32,� �G,' .S/--f 3, � name 9 / home phone ,#[ work phone# CURRENT MAILING ADDRESS: city/own 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 Rgnnit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and'regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require ents. Signature of Homeo Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in our community. Y t)' Q:forms:homeexempt ' i ! I ' ! i i ! ! I I i I I � ! I I I •' i ' I i I I � I i ', ' : I ' ; I : F , r I ; I : � t• I i I I I •, r. � � � i I I 1 i i I : ' S 1 I i I I I ; I : I : 1 , II I I 1 u ' i i 1 I I i ! , I i : I y i I .. R I : 1 I , • � .S/!I��. . .j_ .i�. i. ..., ._...i _. .. {_... _. _i .I � ......... ..__.-_i._ 1_.....` .1_..._ i _.. y I__._ �. I- .._ _. A. '_.. i _ _ .. i .i � I I + I III _ IL . AlIr SILL r ; Y i I . I , , i I , I I ' I I I I 1 i � r 1 fla-4 6 6 I I I I '• I ! � � _ L I 1 � i � i i 1 1 ! i I I I I I I j i ' I � I ' : , ..... _ � t , , , , , i a I: i Assessor's map and lot number ...... . L'-�...."'.. ................... �°F TH E Sewage Permit number .... ........................... Z 3AUSTAMLE, i House number ......................................................................... r Mae& Epp,1639. \00 > 'FI?MpY Ar• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............ ............................................................................................ TYPEOF CONSTRUCTION ................WSP.R....................................................................................................... ....... ..........1.03..............19. L. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. Location ............... 3J... ..►.? 4?la......,............. il. .....rf�................................................................... Proposed Use ...........4A,v t ....Ck11 �t.:........................................................ ... ........... .... .. t i ZoningDistrict .............................../......................................Fire District ........... ,.....................�.......................................... r Name of Owner '} .UL t .!. ................................Address )1P.G A/I e'.!'Arn.1PYJ.....Dd Nameof Builder Ctb?�.....................................Address........................... .................................................................................... Name of Architect ! �.. ............ ............. ......................................Address .................... ..:........................................................ T Number of Rooms ....... J c�� ►. ........Y.QA%.........Foundation ..........No...... �v4,cve.;e„..c... ! Exierior ...............4\ .1�9, ..:... 5.! ,��,................................Roofing) (" `a. ci .........s.�� ti�i�..J....................... Floors .....................UV...... . ....................................................Interior .................. f4+....W.&.16.......................................... Heating .................... .Plumbing ....... � ........................... .................. ................................ ........ ......... ................................ _ 11 oQo°� Fireplace ......................UO:.....................................................Approximate Cost ......... ............!............................................... >b Definitive Plan Approved by Planning Board ---------------____-----------19________. Area .............. a................. a Diagram of Lot and Building with Dimensions Fee .................. ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH a o43 ; 1 0 l� �nt5� CO.DD ►N6TON 3 ' 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 ......................... to Construction Supervisor's License � 've�- r-� 31319 Build Addition Single Family --'' / ' Location .... t_.. � Centerville � ----'---'------------------' le � � T � � � � ' � . ~ - ` ^ ' � - � � '*, 9 r r �`.,y .'r'• '.d 1 L'' s, ,,-J:�+',' s-x _,f,va�., ' 1 f y..,r ry.w"f` .'�r-+�'�•r<.w,Y'sa.��-aS..,fir„rn." Assessor's office(1 st Floor): Q�� 0�,. K -^ Assessor's map and lofnumber THE Tp Board of Health(3rd floor): Sewage Permit number k9I Engineering Department(3rd floor): }� �.� 1 12, House number �� "� �^` °o �939• \��' Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only '1 ` T WN OF BARNSTABLE /V4UILDIHG INSPECTOR . APPLICATION FOR PERMIT TO ; TYPE OF CONSTRUCTION 19 TO THE INSPECTOR O.F BUILDINGS: 1 t The undersigned hereby applies for a permit according to the following information: G Locations ! - - t AJi O/V 12 r6��df4�;eVJ Proposed Use ;/1 U ?Y/ ` / X l�( C ��i z�- 1 /rc ow Ftoa-p? Zoning District �1� 1 Fir e•District t ,j'-1 r+,d',4X l4Qo�� r Name of Owner g y 2 6 tie l S Address ✓ C IL/ /F 7 D ,Wr^ '``� Sc h /F/U �eT i�rar/!Q7u Name of Builder G�/1/ of l� �4 (Addre sQ�/ / ' Name of Architect Address s Number of Rooms � s -_.-F.oundation Exterior- "vw Roofing Floors (,�lD Q Interior Heating Plumbing Fireplace Approximate ost O 2 G tlJ " �ElAf-ea: �r 1LU t�If",l /uC. 7 �,.. Diagram of Lot and Building with Dimensions, Fee - OCCUPANCY PERMITS RE.QUIRED'FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regard'ng-the3ab�ovesconstruction. Ce I' (r ate 6�j S' Name. Construction Supervisor's License /a VZGIRIS, E. A=186-059 Y No 34086 Permit For Build Addition Single Family Dwelling co V i rria-1,r'L 3+, Location dd Centerville Owner. E.' Vzairis Type of Construction Frame Plot Lot Permit Granted November 29, 19 9 0 Date of Inspection 19 Date Completed 19 ; PERMIT COMPLETED 1/1/2.1- � � -I��" y � � � / �- 1 i .r�..Y- / Engineering Dept. (3rd Poor) Map 'G Parcel �rmit# .2— `t 'a l� House# ,3 Date Issued Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:30) Fees" Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) - Planning Dept. (1st floor/School Admin. Bldg.) fHE rq DgefiPIApproved by Planning Board 19 ' . . RARNVARLE, TOWN OF BARNSTABLE Building Permit Application Pdress Village Owner &WAI)D az a i rl;s (r_r e n�� Address Telephone �5-/k'/IT7—���/®g N.l_,3Lea tiA,,_A/U Permit Request of First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑. Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) r Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 1 0 p'zf_ �� . ��j,-0������,� Telephone Number Address p /). A License# Home Improvement Contractor# Worker's Compensation# 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 BE TAKEN TO SIGNATURE Pi . �� ��d�� DATE_T1 �97 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY _ - c - f PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. 1 ' • r r{ G u tn ADDRESS ' VILLAGE OWNER ; x DATE OF INSPECTION: , t FOUNDATION - FRAME INSULATION FIREPLACE 3 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH -. ' FINAL GAS: ROUGH y. FINAL FINAL BUILDING ' DATE CLOSED OUT a ASSOCIATION PLAN NO. } ' , r) '-Permit#Engineering Dept.(3rd floor) Map / Parcel / . � -f , House# ^'l �. _ Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee Aar I v-t; Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin.Bldg.) IKE rq Definitive P al n Approved by Planning Board 19 BARNSTABLE, ` ' MASS. �rFO�s• TOWN OF BARNSTABLE Building Permit Application ,�f j Project,Street Address--fir=� -7; ,, 7j—, `J-- ;?9 isr , j - �(,1 /dfi 14-141 C, Village _ Owner' �rJ/�aAn ���/a i`r �� (I r Pr: Address Telephone �.�;/ � 3 7�/� V/)R, N,.S rA wiwA Al U Permit Request n� / P/rhh 10(6,6 APDm n?amhrAj,,ee) First Floor square feet Second Floor square feet •Construction Type Estimated Project Cost $ y _ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ . Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basemeni Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half- Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals-Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name ,on1Y13r.Ya f, /r-/?/,1124l0�' Telephone Number `7 7,a'-% Address P License# A, Home Improvement Contractor# Worker's Compensation# 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 BE TAKEN TO alb SIGNATURE - DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/.PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - t FRAME INSULATION - - FIREPLACE - ELECTRICAL: ROUGH FINAL r _ PLUMBING: ROUGH FINAL j GAS: ROUGH FINAL _ FINAL BUILDING _ DATE CLOSED OUT ASSOCIATION PLAN NO. 1 ' � .=/f?� Vdl7w�!'LIY�i,fl1E'C7�LfL �aa I�GCZ6aG�C!'2�C1.6P�6 - i • ._ Boars 0 Poi ding Requlat.Tions andIstanda�cis One Ashburton Place -- Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR _ Registration 108918 Expiration 08/27/98 - - --- - --- ---- --- - € Type - D B A Tlrh� u i HOME IMPROVEMENT CONTRACTOR Registration 108918. THEODORE L . HITCHCOCK Type - DBA " THEODORE L - HITCHCOCK Expiration 08/27/98 E PO 'BOX 21.1/55 LISA LN j W BARNSTABLE MA. 02668 ` THEODORE L. HITCHCOCK F THEODORE L. HITCHCOCK �eP�Q„$OX 211/55 LISA LN s ADMINISTRATOR6ARNSTABLE MA 02668 f 4 3 �oFt►+e r� ' The Town of Barnstable S. Department of Health Safety and Environmental Services — P Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 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 pre-existing units owner occupied building containing r to o such residence dence or bui dwelling ld ng be done by registe ed contractors, with structures which are adjacent certain exceptions,along with other requirements. Type of Work: "'" —)nll St.Cost �, 10 0. O D 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 ROD E L T WORK DEAG WITH j O NOT HAVE CONTRACTORS FOR APPLICABLE HOME 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. -2 Registration No. Date Contractor Name OR �. The Commonwealth of Massachusetts • Department of Industrial Accidents Ofllceollorest/osde�ls 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Applicantt iin�torma6on: f?7easePRiN7"ledihier name: T!��/)✓!.1/!�_ �'n D�%��.i locatiL 3 7 / isnD44 1 a mA1 AmD f:tU ,phone q -39 7�il�/�/1 lam a homeowner performing all work myself. m a sole proprietor_:-,d ha%e no one working in any capacity I am an emplover pro%i din a workers' compensation for my employees working on this job. come name Theodore L. Hitchcock address: P.O. Box 211 city W. Barn§t-ahl a nhoneJY: ( 5081 775-77AI Travelers pol;c n 807K449-0-96 ��cur�nce co Y — - 1 am a sole proprietor. _eneral contractor,or homeowner(circle one) and have hired the contractors listed below who ha% the foho%%ing workers' compensation polices: { phone N: policy.J't la company name: saddresst phone No poRcy 1! insurance co- F Failure to secure coverage as required under Scctioo 25A of MGL 152 as lead to the impoaitioo of erimlaal peaaltia of a ftae up to S'40AO and one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fiat of SI00A0 a day gaioat me. I oadeistated the copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do-hereby c ijy under the pains and penalties of perjury that the information provided above Jis htte and eorrecL 9 Z114 Si rc / 8�+, Print name Theodore L. Hitchcock Phone ( 508) 775-7763 Cochectkifi do not write in this area to be completed by city or town officialpermitniccoae 0 -Building Department _ _ (3Uceosiog Board pSelectmeo's Office ediate response is required �Healtb Department _;� -Other phone p;_ ._ (revised JAS PJA) Parcel Detail Page 1 of 3 AMr +� m iyygy+i "s hL Logged In As: Parcel Detail Wednesday, November 4 2009 Parcel Lookup Parcel info Parcel ID86-059 .. __ ._ ._..,m....... _ m. ,_ . .-._.. I Developer LOT 2 Lot Location[37 CODDINGTON ROAD i) Pri Frontage 80 Sec Road jHAYWARD ROAD I Sec Frontage 1190 Village{CENTERVILLE Fire District,C-O-MM Sewer Acct�..-4___.,�.�...-.� Road Index 0331 Asbuilt Septic Scan: InteractiveI �fi`r.' 186059_1 Mapr �, � > Owner Info ...I.... .... .......... _ .......... ....... ........................ ..... .. ............ Owner IUZGIRIS, EGIDIJUS Co-Owner.IRENE UZGIRIS Streetl j1206 VIEWMONT DRIVE Street2 City SCHENECTADY state NY Zip 112309 Country USA _ Land Info Acres I0.42 use jSingle Fam MDL-01 ( Zoning RD-1 Nghbd -0110� Topography;Level I Road?Paved i Utilities Public Water,Gas,Septic Location Construction Info Building 1.of 1 Year Roof, Ext aKh s� Built 1957 _ struct Gable/Hip Wall iWood Shingle Effect I Roof€._ -... — -- AC }. ........... _ 1888 As h/F GIs/Cm None '' Area I Cover 1 p p Type Int i... _.. .......... Bed;.. ..:._.......... style 1Colonial Drywall ) ,4 Bedrooms Wall Rooms a _. _ Model iResidential I '" Bath!2 Full Floor f Rooms• y,v Grade Average Plus Type Hot Water 1 Rooms Total 18 Rooms Stories(1 3/S OrieS � Heat]Gas "� Found-;T iC81 Fuel= ation 1 yp Permit History Issue Date Purpose Permit# Amount Insp Date Comments http://issgl2/intranet/propdata/ParcelDetail.aspx?I0=12577 11/4/2009 Parcel Detail Page 2 of 3 05/27/2005 Repair Work 84458 $6,800 04/04/2006 00:00:00 01/05/2005 Addition 81578 $70,000 09/13/2007 00:00:00 11/01/1990 B34086 $3,100 01/15/1991 00:00:00 CE ADD'N 10/01/1987 B31319 $17,000 01/15/1989 00:00:00 CE ADD'N - Visit History Date Who Purpose 11/19/2008 00:00:00 Paul Talbot Cyclical Inspection 02/11/2008 00:00:00 John Greene In Office Review 09/13/2007 00:00:00 Paul Talbot Meas/Est 09/29/2001 00:00:00 Paul Talbot Meas/Listed-Interior Access 01/15/1989 00:00:00 IML Sales History Line Sale Date Owner Book/Page Sale Price 1 UZGIRIS, EGIDIJUS 12924/185 $0 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2009 $210,200 $2,600 $0 $361,500 $574,300 2 2008 $198,700 $0 $0 $369,100 $567,800 4 2007 $205,800 $0 $0 $369,100 $574,900 5 2006 $174,000 $0 $0 $351,200 $525,200 6 2005 $158,500 $0 $0 $315,600 $474,100 7 2004 $129,300 $0 $0 $561,000 $690,300 8 2003 $127,800 $0 $0 $134,300 $262,100 9 2002 $120,200 $0 $0 $134,300 $254,500 10 2001 $120,200 $0 $0 $134,300 $254,500 11 2000 $94,000 $0 $0 $70,300 $164,300 12 1999 $94,000 $0 $0 $70,300 $164,300 13 1998 $94,000 $0 $0 $70,300 $164,300 14 1997 $94,600 $0 $0 $70,300 $164,900 15 1996 $94,600 $0 $0 $70,300 $164,900 16 1995 $94,600 $0 $0 $70,300 $164,900 17 1994 $94,400 $0 $0 $70,300 $164,700 18 1993 $94,400 $0 $0 $70,300 $164,700 19 1992 $106,900 $0 $0 $78,100 $185,000 20 1991 $107,700 $0 $0 $93,700 $201,400 21 1990 $107,700 $0 $0 $93,700 $201,400 22 1989 $86,100 $0 $0 $93,700 $179,800 23 1988 $78,800 $0 $0 $48,800 $127,600 24 1987 $78,800 $0 $0 $48,800 $127,600 25 1 1986 1 $78,800 $0 $0 $48,800 $127,600 Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=12577 11/4/2009 I _ Parcel Detail Page 3 of 3 Aye �Q �u � t Af rtr r UI, k http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=12577 11/4/2009 Assessor's map and lot number ............................................ IN COMPLIAUC t �y � E roe♦ CF Sewage Permit number .... .....:.. ... . --?,,�L H 3ENTAL COS R�F"rf-) d BARN TABLE, i House number .........................:......:..............:.........:.......::.... ro roes. O i639. \0� i �D YP�tr• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............AM IN A U�1 I,N............................................................................................ TYPE OF CONSTRUCTION ............... Op ..................................................................................... ............ .:........�.J:............19B., TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................3 .......... aa.!�► I,dh. ..... ................................................................... Proposed Use ...........�.4 l hr .. ` ................................................... Zoning District ........ '/... .............. ........Fire District .........0........... .......................................... Name of Owner ........�......U2� ...................:............Address ..... ... QOW�-.. N Y Nameof Builder .................Sam...........er.....................................Address .................................................................................... Nameof Architect ......................`. .......................................Address ................................�+............................................. r- �� Number of Rooms 11Ai t) c l c d......r©0.h�f. �0......F�.W.44 :..... ? � C . oo� ► ,) ................... .........Foundation ......... (Jl'" Exterior ...............W.0;47:..SIN,, .................................Roofing ..............1As-?.1:R&....... ..,5 �....................... Floors ....................�.00.4.....................................................Interior ..................Ply....W.9%........................................... ,T�aa I)JO Heating ........Q.......................................................Plumbing ................................................................................:. Fireplace ......................T40......................................................Approximate Cost ....................I............................................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ............... o.. .............. -4e ®o Diagram of Lot and Building with Dimensions Fee .................... .. .. ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH w^, � 13 C r II Q How j C0DD INGTON OCCUPANCY PERMITS REQUIRED FOR NEW IELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I I Name .............. ............. . ............................... Construction Supervisor's License .................................... UZIGIRIS, G. No .31A!9.... Permit for ...Build...Addition Single Fam DweUing........... Single„ ..... Location ................................................................ Centerville ............................................................................... Owner .......G.......U z.g.-L.r.i s.....................:........... • Type of Construction . .......Frame................................... . ......................... Plot ............................ Lot ................................ October 20', 87 Permit Granted.........................................19 Date of Inspection ....................................19 Date Completed ............................;1V... 19 INE Town of Barnstable *Permit# s 3 3 Expires 6 moat from issue dare Regulatory Services Fee Thomas F.Geller;Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 X-PRESS " ° Office: 508-862-4038 Fax: 508-790-6230 J U L 8 - 2005 V` EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY Not varidwWwut1zedXPresslmprint TOWN ORBARNSTASLE apiparcel Number �"- opertyAddress 4�,p ,Jaa Q°CL'J mod`• ��h�j''U/��P Residential Value of Work .s PWT !?So Minimum fee of•$25.00 for work under$6000.00 wner's Name&Address 6/ ` ontractor_s_Name . Telephone Number ;ome Improvement Contractor License#(if applicable) onstraction Supervisor's License#(if applicable) ]Workmen's Compensation Insurance Check one: I am a sole proprietor am the Homeowner have Worker's Compensation Insurance asurance Company Name Vorkmaa's Conn.Polky# .opy of Insurance Compliance Certificate must be on file. 'ermitRequest(check box) ❑ Re roof(stripping old shingles) All construction debris will betaken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ) Replacement Windows. U Value (maximum.44). / ''Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,idonservation,etc,' ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. 4igaature 1 QForms:expmtrg Kevise063004 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations M 600 Washington Street Boston,MA 02111 ',M y www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: ���yol�Q Phone#: Are you an employer? Check the appropriate box:. Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ 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 10.❑ Electrical repairs or additions required.] officers have exercised their 3 I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. C. 152, §l(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit 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.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct h 0SiJMafore: Dater ® 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Mass 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 r 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 renew al 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 n 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 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 cant'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 f'ature permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia pF�1H5Eip� The Town of Barnstable RARNSTARLE,g! MA Department of Health Safety and Environmental Services SS. i ,59. ♦0 piE0 MAC" - Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location �� • (►n Permit Number �5 Owner Builder One notice to remain on job site,one notice on file in Building Department. The following item Seed correcting: GIL C" C.il. �� ��c J A n J -. _ V-fr �nC[� cA a_ n� r f LtZr, 1t l�?enr ra �v t r V 1 e v 0 Cc rV !rl G 0 L.,n J c V V L 0- L, r\ fN Please call: 50.8-862-40.38 for re-inspection, Inspected by Date -1- "u Qck Q -n7- ) n i �f i i V\ �2 Y� J -) ,I ' C TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# Health Division Conservation Division Permit# Tax Collector Date Issued c> o Treasurer Application Fee Planning Dept. Permit Fee - c�Y,5 =DU Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -37 �� �n/t ft►� ���� Village 04,-Vf � ,/ Owner ��f �� ��s Address 1Z06 i/6A11nV4 r )e- Alvjky!v of N.,V Telephone Permit Request -F 14er_ e i S' s®c 4/.,,,voDdwj w�` Xeev 14�'n bzf.ul AT 6(jenP471(- 1.-',7 .140 .Cep ®y.�� Square feet: 1 st floor:existing /30P proposed 2nd floor:existing 5� proposed t Total-new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting docurpentatio& r. 'ram Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: I Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing l new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count I Heat Type and Fuel: XGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes Alo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use _ .BUILDER INFORMATION Name- ie3 'V�L Telephone Number Address License# "�'9fTA Home Improvement Contractor# G y Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ✓v,yi SIGNATUR GB-,n$ DATE -X 7 FOR OFFICIAL USE ONLY PERM�T NO. DATE ISSUED d MAP/PARCEL NO. ADDRESS VILLAGE OWNER` r DATE OF INSPECTION: FOUNDATION FRAME s INSULATION 7 FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - ✓lie -�iarr�naruaea�Cl ���la�aac�lcaelta s Board of Building Regulations and Standards � HOME IMPROVEMENT CONTRACTOR. Registration: 115770 Expiration: 4/10/2008 T e In p vidual e: Y , JAMES P.HEALY JR . JAMES HEALYJR; p _...15 ANNAWON RD - ir`- MASHPEE,MA 02649 Administrator r Board f Building egulations and Standards . f t Cons truction Supervisor License € t � 1 L icen a CS 56765 1 Birtif ite�`4/24/1957 Expta ►on 4/�2009 Tr# 11598 s { Restnctton � n 1e 1GL: f JAMES P HEALY Q' 15 ANNAWON RD � . Commissioner i MASHPEE,MA 02649 i 3 [ 9 r �o I E r° Town of Barnstable Regulatory Services BARNSrABM ' Thomas F. Geiler,Director 9 MASS' i639' �0 •� p � BU.11d1T1DivisionD1v1S10 fvr�+ Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ����s I, , as Owner of the subject property hereby authorize Vlfn4e5 4WZY to act on my behalf, in all matters relative to work authorized by this building pertnit application for: 37 610i3/tiG-7ati �• (Address of Job) Signature of O er Date Print Name Q:FORM&OWNERPERMIS SION Regulatory Services SAx1vSTAMM Thomas F.Geiler,Director Fci9. ► Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town,barnstable.ma.us ace: 508-862-4038 Fax: 508-790-6230 Permit no. Date /V tZ 07 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 excep urns,along vszth other requirements. Type of Work: rj(��A�'°c+/ su°v'�' Estimated Cost, 6�°�� Address of Work:. 37 �oDt7i �✓ ��- �4r✓,,/4� Owner's Name: Date of Application: 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑'Job Under S 1,000 QBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: oWnRS 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 own ; Date Contr ctor tore Registration No. OR Date Owner's Signature Q:wpfRcs.for=:homeaffidav Rev: 060606 :::::::.....:...DATE MMIDD A c CORD :::.: :::: -:>: ::: :::. :::::.> ::: ::: : >: <:< :: :::::: :::: ::::: ::::»:<:<::>:: :......:_:>.....::::>::::>::.......... nn PROD .................................................... ...... 1 0/01/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PAYCHEX AGENCY INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1175 JO.HN STREETt ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, WEST HENRIETTA, NY 14586 COMPANIES AFFORDING COVERAGE COMPANY* ' A GUARDINSURANCE INSURED COMPANY � - - JAMES HEALY JR B 15 ANNAWON ROAD MASHPEE, MA 02649- COMCPANY COMPANY D .:::.:::.::::.:.:::::.::.::::::::::.:::..:....."......................:...::.::::::::::::............::::::.::.:::::.:.:::::::::::.:::::::...:::.:............................:.:.:._:._::::::::::.:::::::.:.::::::::::::::::.::::::::.:.:......:............. .: ......:::: ::.::::::::::::: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MWDONY) DATE(MWOONY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY LAIMS MADE[�DCCUR PRODUCTS.COMP/OP AGG S �OWNER'S&CONTRACTOR'S PROT PERSONAL 8 ADV INJURY S EACH OCCURRENCE S FIRE DAMAGE(Any one tire) S MED EXP(Any one person) S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY S (Per person) HIRED AUTOS S NON-OWNED AUTOS BODILY INJURY(Per.accident) _ PROPERTY DAMAGE S GARAGE LIABILITY , AUTO ONLY-EA ACCIDENT S EA ANY AUTO -- � OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM - � AGGREGATE S OTHER THAN UMBRELLA FORM - v• S WORKER'S COMPENSATION AND X WC sTATU- OTH- A EMPLOYERS'LIABILITY T Y i i EL EACH ACCIDENT S 100,000.00. THE PROPRIETOR! INCL PARTNERS/EXECUTIVE JAWC805606 06/30/07 06/30/08 EL DISEASE-POLICY.LIMIT S 500,000.00 OFFICERS ARE: ®EXCL EL DISEASE-EA EMPLOYEE S 1C0,000.00 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEMCLES/SPECIAL ITEMS JOB:645 WAQUOIT HWY,EAST SALMOUTH,MA -..........................................................................................................:.............................._..._.::..........-_...... ......._..:......:.:......:..:..:....::.......:. GEFITEF�GAIr1r> �IL1��f3:::;::......::>::::<: ..........._...... .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE = EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTOOPMED REPRESENTA IVE V' Gt2......2 5...195............................................................................................................. .................................................................. _"...{.... �- ._"......"_..............................................._.............. .."...................._ ........ }""�: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 M www.mass.gov/dia Wo 11 rkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: �sy� � a'Z64 Phone. #: Are you an employer?Check the appropriate box: Type of project(required): 1 PA I am a with employer 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- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers'. 9._❑Building addition [No workers comp.insurance comp. insurance,# required.] 5. ❑ We are a corporation and its 10❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised then 11.❑Plumbing repairs or addtrions myself. [No workers'comp. right of exeniption per MGL .12.❑Roof rep insurance required.)t c. 152,§1(4),and we have no employees. [No workers' 13. Other c omp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors_ must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,the must provide their workers co• ohc number. Y P mP•.P Y 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.#: Expiration Dater Job Site Address: 3 7 aD3 i'! ^� �� ' City/State/Zip: 6 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: o iZ&uo7 Phone# o 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#: 1 r - --.,,.._._.•_ r. . � r F._.. --.,.,•--'�---r-..-...Vie..--.,., »._�,,., � -Y.. i .._._;`..",i� o.+-..--._ __.. �..� 3 _.�.,,_ __-„c._ d :� �._".s'�.'...,.... - .. y.._._{.,."•so.-+--Y-�-- _ ,--•..-1 .._f»•.-mow--k. _ .._:.-._. .,_..-__,._.._.y.;..-. d "-".�-•�-r.,- P-.-•�;.yerc.�.e-��.cxv-am.m:..aac� .,,.�..._,,,.,....._...;<,... `, �.... � r i , ..-....,�-.....y...._. J + -,....;,r.+i._...__'_-i.�,_ ._ 4.,_.• ..J.-.... 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';-._. r..____�..-..... —.-t.,_....,»: ...> •_a.,._�...� 3s y ��r lv ....,....,.r.,.re.N ..3„. 1 ;. _�.. .,.,..,.:.,.._. s..:le F ,.---�-i ems,.+.•-. -'".--�.s..,...�,.._._(_�.,_t�z_.,_..w.�,-, ,n..__._..„-.,.,eL._,�', 1' w 1 ' r , 1 " ,l :7j t a ; �'j4 _. .. ... HE' ti Town of Barnstable BARNSTABLE,p• Regulatory Services 9 MASS. 0 s639. 01 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 -Fi',1S k L,t� i o N Location ? C i Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: LN5uILI 7 16,i iv67- Sr Cu2F()- PROPER I-Y �L `1SULL�-`lVry A10T 7,-05-1A"r--0 C o2RE C i LY ( ROLLEO UNDC-7✓L_. ��kVCt4 t�) Please call: 5n08-J8�62-40388 for re-inspection. Inspected by Date f Insulation Certificate 34- CFYD)wk C5t Number and Street city County Subdivision Lot Number Permit Number Description of Installation ROOF �nt ��,,AI p Product i d paSeb ©�w 'V 241-Look Lot Number Thickness (inches) + Thermal Resistance (R-Value) 123� CEILING Product Lot Number Thickness (inches) Thermal Resistance (R-Value) Loose Fill Type Brand Name Contractor's minimum installed wight/ft2_lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) EXTERIOR WALL Product ,c bca.�► ��O w Lot Number Thickness (inches) Thermal Resistance (R-Value) OR RAISED FLOOR Product Lot Number Thickness(inches) Thermal Resistance (R-Value) SLAB FLOOR Product Lot Number Thickness (inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Product Lot Number . Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards. L9 to Genera tractor(Builde License Number Signature and Title Date CQhe Ifoal 5br24 M Sub- ontracto-Insulation nstaller) _ License Number Signature and Title Date WiRs aa BDge. is a BioBased® Q�a{IFI6D Insulation Certified Dealer e Revised August 2008 m ®/NfSAfABUL USED = p} AT/ON � '� �ROAM ItA Insulation Certificate Ile Number and Street City County Subdivision Lot Number Permit Number Description of Installation ROOF ^mac Product Lot Number Thickness(inches) u Thermal Resistance (R-Value) CEILING ���� ' Product i5 Lot Number Thickness (inches) �( Thermal Resistance (R-Value) Loose Fill Type T Brand Name Contractor's minimum installed wight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) EXTERIOR WAL Product �U Lot Number Thickness (inches) ' Thermal Resistance (R-Value) RAISED FLOOR ` Product Lot Number Thickness(inches) Thermal Resistance (R-Value) SLAB FLOOR Product Lot Number Thickness(inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Product Lot Number Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards. Genera Builderl License Number Signature and Title Date Sub ontractor�(Insulation nstaller) License Number 3 Pe L5�D 3/a o/c� Signature and Title Date is a BioBased•Insulation Certified Dealer ° B/OBABEL� o Revised August 2008 °� iwiac.r rioOZ t 07 10 09:53a Quality Woodworks Inc 5086818960 p.1 �« L—Cj v 2— o r c� rn e�o I L-�D ;3v� 2-9 Z5 s .x Oct 07 10 09:53a Quality Woodworks Inc 5086818960 p.2 4� too � • • •• - � � Installation instructions CAD Drawings How it works: Flood Protection:The FLOOD VENT door is latched closed until flood water enters.Entering flood water lifts the patented internal floats which_unlatches and rotates the door open,This allows the flood water I to automatically enter and exit through the frame opening,relieving the pressure from your foundation. ii Model . 1540-570 I . ` Installation Type: Stud all 2 `: "14" Style: Insulated d o} Dimensions: 14'h"x 816' Rough Opening: 1431i"x 8 3A" Finish: Stainless Steel(Standard) Exterior Wall v Cross-Section:�f Available Powder Coal Colors For Special Order: i Use Fewer Vents Preserve the aesthetic beauty of a home by requiring 23 fewer vents. Each SMART VENT`protects 20D sq!'ft of enclosed area vs.60 sq/ft for non-compliant vents.. j While Wheat Gray Black Stainless Istandarc) Optional Accessories: j Fire Damper,Interior Trim Flange W�' ;";;_ ; e , Other Models Available:SMART VENT` Dual Function Ventilation I16"x 8' Flood Vent,Insulated 16"x 8" FLOOD VENT, Overhead Garage Door Model,Stacked and Quad Configurations, .r Models for Wood Studded Wall Applications and Pour in Place i Buck Systems. i There's more online at www.sinartvent.com Dealer Locator, Installer Locator,Cad Drawings.Installation In-. slrucllons,-Technical Specifications,Frequently Asked Questions, How does one SMARM'VENT'" fi Video,Testimonials,Resource Library Database,lnsurance Forms. provide so much coverage? € _ You may have heard that FEMA requires that flood openings provide one square inch of opening per one itbhft ii, square foot of enclosed area,referring to dimensions of the.opening in proportion to the space to be vented. This is only partially correct.FEMA's regulations and guidelines do state that a non-engineered flood vent solution must(among other requirements)provide one �f square inch of opening per square foot of enclosed i� area to be vented.However,all SMART VENT" i•' products are certified en gin openings.The hav 9V e >^ been designed,engineered,tested,rated,and certified Y to provide flood relief so efficiently that only one unit is ..,:. needed for 200 square leer of enclosed area.It would be our pleasure to contact your code official,surveyor,, or insurance agent if they require more information. www.smartvent.com •877-441-8368 Oct 07 10 09:53a Quality Woodworks Inc 5086818960 p.3 Ill tl� I � ;K I • �+ s F - �R s�ovva with inleaor. . tr6crryan e a High Efficiency Insulated Flood Vent 1CC Superior Automatic Flood Protection .Designed for Installation Between Studs . IMES Evaluated and One W z" x.8?/z"' vent is certified to cover 200 FEMA Accepted Foundation Flood Vents square feet of enclosed area for flood protection Potential savings on homeowner's NIFIP premiums The Wood Wall Flood Vent is designed to fit between studs. Preserves aesthetic beauty of a home by requiring s spaced on 16" centers.One vent covers 200 square feet of 213 less vents enclosed area,and it is an easy retrofit.This vent only comes in Each vent certified to protect 200 sq.ft. an insulated model. of your home Code Compliant FEMA accepted, IMES Evaluated :_. All Stainless Steel construction meets or exceeds flood and corrosion resistance:code requirements Patented automatic floats release bi-directionalET flood door www.smartvent.com 877A41-8368 12 Oct 07 10 09:54a Quality Woodworks Inc 5086818960 p.4 1� SERVICE' Most Widely Acc4t4d'andTeusted" IMES Evaluation Report ESR-2074 Reissued Fearuary 1; 2009 Thisreport is subject to re-examination in two years. vvvvw.icc-es.org 1 (800)423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council® DIVISION:10—SPECIALTIES unlatch, allowing the plate to rotate out of the way and Sectfon:10230—Vents allow flow. The water level stabilizes, equalizing the lateral forces. Each unit is fabricated from stainless steel, and REPORT HOLDER: each opening provides 76 square inches (49 032 mmz) of net free area for flood mitigation in the open position. The SMART VENT, INC. SmariVENTTM Stacking Model #1540-511 - and 450 ANDBRO DRIVE,SUITE 28 FloodVENTT" Stacking Model #1540-521 units each PITMAN, NEW JERSEY 08071 contain two vertically arranged openings per unit,providing (85ti)30T-14ti8 152 square inches (98 064 mm ) of net free area for flood www-smartver t.com mitigation in the open position. eval@smartvent.com . 3.2 Engineered Opening: EVALUATION SUBJECT: The AFFVs comply with the design principle noted in Section 2.6.2.2 of ASCE/SEI 24 for a maximum rate of rise SMART VENT"AUTOMATIC FOUNDATION FLOOD VENTS: and fall of 5.0 feet per hour (0.423 mm/s). In order 10 FLOODVENTTM MODEL #1540-M; FLOODVENT*°" comply with the engineered opening requirement of STACKING MODEL #1540-621; SMARTVEN" MODEL ASCE/SEI 24, Smart Vent AFFVs must be installed in '91540.610; SMARTVENTr" STACKING MODEL #1540-611; accordance with Section 4.0. WOOD WALL FLOOD MODEL #1540-570; WOOD WALL 3.3 Model Sizes: FLOOD OVERHEAD DOOR MODEL #1540-574; FLOODVENTrm .OVERHEAD DOOR MODEL #1540-524; The FloodVENTTM Model#1540-520, SmartVENTTM Model SMARTVENTrm OVERHEAD DOOR MODEL#1540-514 #1540-510, FloodVENTT*' Overhead Door Model #1540- 524, and SmartVENTIm Overhead Door Model#1540-514 1.0 EVALUATION SCOPE units measure 15314 inches wide by 73/4 inches h" h 400 Compliance with the following codes: . by 196,9 mm). The Wood Wall Flood. Mode 1540-570 and Woad Wall Flood Overhead Door Mode! 1540-574 ■ 2006 International Building Code®(IBC) units measure 14 inches wide by 83/4 inches high(355.6 by ;roperlies 2006 International Residential Code®(IRC) 222.25 mm). The SmartVENTT"' Stacking Model #1540- . 511 and FloodVENTTm Slacking Model #1540-521 units evaluated: measure 16 inches wide by 16 inches high (406.4 by 406.4 w Physical operation mm). ■ Water flow 3.4 Ventilation: 2.0 USES The SmartVENT® Model #1540-510 and SmartVENT° ® Overhead Door Model#1540-514 both have screen covers The Smart Vent units are automatic- foundation flood vents (AFFVs) employed to equalize hydrostatic pressure with '/4-inch-by- /4-inch (6.35 by 6235 mm) openings- on nonfire-resistance-rated foundation walls, rolling-type yielding 51 square inches (32 903 mm ) of riet free area to overhead doors and building walls subject to rising,or supply natural ventilation The SmartVENTTm Stacking Model#1540-511 consists of two Model#1540-510 units in falling flood waters. Certain models also allow natural one assembly, .and provides 102 square inches (65 806 ventilation in accordance with Section 1203 of the IBC or mm) of net free area to supply natural .ventilation. Other Section 408.1 of the IRC. AFFVs recognized in this report do not offer natural 3.0 DESCRIPTION ventilation. 3.1 General: 4.0 INSTALLATION When subjected to pressure from rising water, the Smart SmartVENT� and FloodVENT-m are designed to be Vento,AFFVs disengage, then pivot open to allow flow in installed into walls or overhead doors of existing or new either direction to equalize water level and hydrostatic construction from the exterior side..Installation of the vents pressure from one side of the foundation to the other.The must be in accordance with the manufacturer's AFFV pivoting door is normally held in the closed position : instructions,' the applicable code and this report. The by a buoyant release device. 'When subjected to rising mounting straps allow mounting in wood,.masonry and: water, the buoyant release device causes the unit to concrete walls up to 12 inches (305 mm) thick. In order to ICGF.S Evaluation Reports are nor ro be con trued as representing gestherics or anp other tatribures nor specificatl)'addressed,nor are they to be construed us an=10sement of the subjecr of the report or a recoanrttdation for itr use.There is w warranty by ICC Evaluation Sovice,Inc..rrpress or implied,ac to any finding or other matter in this report,or as to product covered by the report. Copyright®2CO9 Pagel of 2{ Oct 07 10 09:55a Quality Woodworks Inc 5086818960 p.5 vva --Y tea.�.cYcc�a.+v irwtcu - .�. ., rage G of e- comply with the engineered opening design principle noted 5.1 The Smart Vent® AFFVs must be installed in in Section 2.6.2.2 of ASCE/SEI 24,the Smart Vent AFFVs accordance with this report, the applicable code and must be installed as follows: the manufacturer's installation instructions. In the ■ With a minimum of two openings on different sides of event of a conflict, the instructions in this report each enclosed area govern. ■ With a minimum of one AFFV for every 200 square feet 5.2 The Smart Vent® AFFVs must :not be used in the (18.6 mz) of enclosed area, except that the place of "breakaway walls" in coastal high hazard . SmartVENTTA Stacking Model #1540-511 and areas, but are permitted for use in conjunction with FloodVENT'"' Stacking Model #1540-521 must be breakaway walls in other areas. installed with a minimum of one AFFV for every 400 6.0 EVIDENCE SUBMITTED square feet(37.2 mz)of enclosed area Data in accordance with the [CC-ES Acceptance Criteria ■ Below the base flood elevation for Automatic Foundation Flood Vents (AC364), dated ■ With the bottom of the AFFV located a maximum of 12 October 2007. inches(305.4 mm)above grade. 7.0 IDENTIFICATION 5.0 CONDITIONS OF USE The Smart VENT®,models recognized in this report must The Smart Vent® AFFVs described in this report comply be identified by a label bearing the manufacturer's name with, or are suitable alternatives to what is specified in, (Smart Vent, Inc.), the model number,and the evaluation those codes listed in Section 1.0 of this report, subject to report number(ESR-2074). the following conditions: Oct 07 10 09:55a Quality Woodworks Inc 5086818960 p.6 • U.S.Department of Homeland Security 500 C Street,SW Washington,DC 20472 FEMA Michael Graham NOV 21 A13 General Manager,SmartVENT 200 Warrick Avenue Glassboro,NJ 080208 Dear Mr. Graham_ I am writing in response to your letter of August 11, 2003 to Paul Tertell,an engineer on my staff. Your letter concerns the use of engineered openings in foundation walls in Special Flood Hazard Areas and the use the SmanVENT product.Your letter states that there is a lack of awareness that flood openings can be. engineered and certified. In addition,you make specific suggestions concerning: 1)the elevation certificate, 2)NFIP Insurance Agents Manual, and 3)a Broadcast Advisory to NFJP Stakeholders. Enclosed in your letter is an evaluation report,NER-624, that addresses the flood vents that your company manufactures_ With the transition to the International Building Codes, the International Code Council(ICC)Evaluation Services now issues evaluation reports. NER-624 is a legacy report from the transition from the National Evaluation Service to the ICC Evaluation Service. Concerning your suggestions about increasing the awareness of engineering openings,FEMA will consider your suggestions, but may determine that another course of action is more appropriate.We will keep you apprised as to our decision in this matter but please understand that we are prohibited from promoting or helping to market specific products. However,I would like to discuss the ittformation you have provided about the SmartVEN7 products. Evaluation reports are often used by building officials as evidence of the compliance of a specific product-or. material with the requirements of a model building code or standard. As with all evaluation reports,the local building official,or the authority having jurisdiction,makes the final determination as to the appropriateness and acceptability of using the material or product in a specific application. Communities that participate in the National Flood Insurance Program(NFIP) must adopt and enforce ordinances that meet or exceed requirements described in 44 CFR. The NFIP regulations require that all enclosures below the Base Flood Elevation (BFE) in A zones be designed to allow for the automatic equalization of hydrostatic forces during a'flood event. Section 60.3(c)(5)'of the NFII'regulations states that a community shall: Require,for all new construction and substantial improvements, that fully enclosed areas below the lowest floor that are used"solely for parking of vehicles, building access, or storage in an area other than a basement and which are subject to flooding shall be designed to automatically equalize hydrostatic flood forces on exterior walls by allowing for the entry and exit of floodwaters. Designs for meeting this requirement must either be.certified by a registered professional engineer or. architect or meet or exceed the following minimum criteria: A minimum of two openings having a total net area of not less than one square inch for every square foot of enclosed area subject to flooding shall be provided. The bottom of all openings shall be no higher than one foot above grade. Openings may be equipped with screens, louvers, valves, or other coverings or devices provided that they permit the automatic entry and exit of floodwaters. wvv .w.ferna.gov . Oct 07 10 09:56a Quality Woodworks Inc 5086818960 p.7 Marc detailed guidance on meeting this requirement is provided in FEMA NFIP Technical Bulletin 1-93, Openings in Foundation Walls. The Federal Emergency Management Agency(FEMA)has determined that this evaluation report,NER-624, is sufficient to demonstrate the following; If determined appropriate by the authority having jurisdiction and when used under the conditions of use described in NER-624, the two products,Model#1540-520 and#1540-510, meet-the minimum NFIPfloodplain management requirements(CFR 60.3 (c)(5))with respect to flood openingsfor enclosed areas for the purpose of equalizing hydrostatic pressure resulting front flooding. Specifically, the jurisdiction may use this report to determine that_the flood flow rate permits one vent to vent up to 200 square feet of enclosed area. This acceptance, on the part of FEMA in no way alters other conditions required for flood openings as called fore in the NFIP regulations, locale, floodplain ordinances and building codes, as well as applicable national.standards(such as ASCE 24-98), and model building codes,such as the International Code Council Building Code Series. These requirements include, but are not limited to, having at least two flood opening vents for every enclosed area and placing the bottom of such vents no more than 12 inches above grade. Thank you for sending us information concerning this new evaluation report and for your commitment to developing products intended to reduce future exposure to flood damage. Sincerely, Clifford Oliver Special Assistant to the Director Mitigation Division ` LEGEND CB (FND) ■ UTILITY POLE 3 HYDRANT X DDwcT01v CATH BASIN MAPLE TREE ! LoCus WETLAND- FLAG P EXIST. CONT. / > � 13 jA4 / 50 Egv�' oNG LOT 1 CENTERV= ASSASSORS , HARBOR v / 60 LOT 186- ' h r / I � I - LOCUS MAP / I /no .\s�dp )kl PLAN REF 170-93 - / — DEED REF 2924-185 AsslyssoRs ° ` / SETBACKS 30D10'-10' LOT 166-59 5.Oft FLDOD ZONE. A-10" AREA=19672fSF. �� / ; / BFE = II' cARORAPOc mPANEL NUMBER.• 250001 0016 D BORDERING / / I `� ��°. �/ �/ BENCHMARK DH IN CB DATED.'. 07-02-1992 WETLANDS / (� -8.91' � ELEVATION. 10.29' / L=19.0T � � , b DATUM: TOWN OF BARNSTABLE ►sMAPf 2& .......... SITE PLAN . LOCATED AT 37 CODDINGTON ROAD _5 _ _�� _ > � / CENTER VILLE, MA. 100' WETLANDS BUFFER y4i O� / PREPARED FOR.• k 50' WETLANDS BUFFER ` ....,,� IRENE UZGIRIS l • �- �;100 YEAR BASE AUGUST .4, 2009 . I � �moo`' r�`'- 'F.; 1�. FLOOD ELEVATION f ♦ STEMHEN ! CCC J. I DOYLE r w _ , REV V - - REV ....+'� REV NOTE: WETLANDS FLAGGED BY: VACCARO ENVIRONMENTAL CONSULTING o o l i GRAPHIC SCALE YANKEE SURVEY CONSULTANTS 40 0 20 40 80 UNIT 1, 40B INDUSTRY ROAD P. 0. BOX 265 MARSTONS MILLS, MASS. 02648 f TEL.' 428-0055 FAX 420-5553 1 inch = 40 ft. SHEET 1 OF 1 JOB;' 545T0 .,��' LEGEND CB (FND) ■ UTILITY POLE £ HYDRANT X C0 nDDvc7nw CATH BASIN go MAPLE TREE • LOCUS WETLAND FLAG P Lu EXIST. CONT. S� 8 c / 13 / 60 NG cQ LOT 1 ASSESSORS HARBOR LOT IBB-BO es a � LOCUS MAP � a 1B � � - PLAN REF 170-93 _9 // f � DEED REF 2924-185 LOT z � / ZONING. RD-1 lk ,k `_�— SETBACKS.- 30'10'-10' / 4 lk �Ass�ssoRs �o / 11 ! / f FLOOD ZONE.• "A-10" AREA=19B7zf3F. I PROPOSM) 7 / / aq*,;, PADS / // BFE = 11' / 1 GARAGE PANEL NUMBER.- 250001 0016 D 1 DATED. 07—02-1992 BORDERING / ! / / %% sAo, / / BENCHMARK: DH IN CB VEGETATED / / PROPOSED sr ELEVATION: 10.29' WETLANDS / L=19017 DRIVEIYA / DATUM: TOWN OF BARNSTABLE / Al , "s"ss"s"s"s"s,,,,,, = ¢a,� 64. l / SITE PLAN / _ - / v / > LOCATED AT i 37 5 CODDINGTON ROAD CENTER VILLE MA. At ' 100' WETLANDS BUFFER- �O ` ` O / pZ,AA ° / a�� PREPARED FOR.- 50' WETLANDS BUFFERSH n �; IRENE UZGIRIS ' PSG\ _�Fo c�`�v 100. YEAR BASE ® CDSTEJ. ® AUGUST 4, 2009 FLOOD ELEVATION ® DOYLE d :� REV NO VEMBER 11 2009 vv®� REV REV NOTE: WETLANDS FLAGGED BY: VACCARO ENVIRONMENTAL CONSULTING GRAPHIC SCALE YANKEE SURVEY CONSULTANTS UNIT 1, 40B INDUSTRY ROAD 0. BOX 265 20 80 P.MARSTONS MILLS, MASS. 02648 TEL 428-0055 FAX 420-5553 1 inch = 40 ft. SHEET 1 OF 1 JOB # 54540 JF J o a LEGEN D CB (FIND) ■ UTILITY POLEt HYDRANT X cODDWGTON CATH BASIN ® MAPLE TREE ! Locus D WETLAND FLAG_P �► EXIST. CONT. ` � G BEACB / 50 / C,� i LOT 1 CENTERVILLE AsslrssORs HARBOR / LOT 188-80' / I o I� LOCUS MAP �� 1�y PLAN REF.: 170-93 DEED REF. 2924-185 ZONING.- „RD-1 , aLOT 2 As�ssons SETBACKS- 30'-10�'-10' ARLOT 188-59 EA= 9872fS F. I l /�f •�CK ,"\ � / r FLOOD ZONE- BFE � lip PROPOSED 7 / 4-:-- / J� GARAGE / ---- ---- - 0 / • PANEL NUMBER.- 250001 0016 D ........; BORDERING / r / / �2s!°. (� BENCHMARK: DH IN CB DATED.' 07-02-1992 VEGETATED / / PROPOSED ..............�i - lr ELEVATION: 10.29' WETLANDS / I18 p�. DRIVEIPAv --�-- O� DATUM: TOWN OF BARNSTABLE / \ / / / Ss"s"s"s"s"s"sstiss% o n GIS MAP± - _NReW¢o- � - - `�'� SITE PLAN -- - / 84z8• LOCATED AT- Cv �y 3 7 CODDINGTON ROAD 6t -5 ` -= ���� - _ CENTER VILLE MA. 100' WETLANDS .BUFFER O / y�• A..4 �\ Nor-r I �� 44 PREPARED FOR' u5 50' WETLANDS BUFFER �\ v ��Q�G1 ST E4Fp9c�G g STEPHEN � IRENE UZGIRIS m' 100 YEAR BASE / � � . DOYLE ; A UG UST, 4, 2009 FLOOD ELEVATION a rq -o #37559 t • � P e REV NO VEMBER 11, 2009 REV REV NOTE: WETLANDS FLAGGED BY: VACCARO ENVIRONMENTAL CONSULTING GRAPHIC SCALE YANKEE SURVEY CONSULTANTS UNIT 1, 40B INDUSTRY ROAD 40 0 20 40 80 P. 0. BOX 265 MARSTONS MILLS, MASS. 02648 TEL 428-0055 FAX 420-5553 1 inch = 40 ft. SHEET 1 OF 1 JOB # 54540 JF CODDINC N LOCUS A LOT 1 0��� 13AC 0_ �R A,5SESS'ORS c��� -LOT 186-60 OF 10,18, CENTERVILLE ! ice P� o `�� HARBOR THE SEPTIC SYSTEM a sTEP'�Er� J. WAS DRAWN FROM THE . ® o DOYLE r ( �6. TOWN OF BARNSTABLE a g7 SEPTIC INSTALLERS CARD ® . O ®v®v� LOCUS ' fi•// - . , MAP , LOT 2 / 4 PLAN REF '170-93 ASSESSORS /// C� �` \ ASSESSOR'S MAR186-59 LOT 186-59 / �j� ZONING: RD-1: O 0� l SETBACKS. 30'-10'-10' AREA=19872�S.F. BULKHEAD j C^ TO BO MOVED / PROPOSED ,�� 7' ' .c � / PLOT PLAN OF LAND ADDITION °' "" ass LOCATED AT` 37 CODDINGTON ROAD CENTER VILLE MA. R=8_. 91 x , L=19. 07 PROPOSED' �� PREPARED FOR- DECK. IRENE UZGIRIS N8,2 3,2' 40 64 28' _ '' � �j� DECEMBER -02,• 2004 ,S•�4¢l ¢ Q' REV ' O' / REV REV.• . _ g31 YANKEE SURVEY CONSULTANTS L; O UNIT 1, 40B INDUSTRY ROAD 20 GRAPHIC SCALE 40 O�� P. O. BOX 265 AfARSTONS MILLS, MASS. 02648 TEL• 428-0055 FAX 420-5553 1 inch = 20 ft. SHEET I OF I JOB # 53801 JF • V a N 21'4, d>n., .-_ ,{- � "x � ..-n.. t!- a --_:.��.k� ra. a ",. �:.'r�.,.,. c•_ ,;ss,. ,,. - ",:: -�. t..: �c'; _ _- -.:. V <. — -- — — — — — ------- —77 rn . ... ,, .._>. : h ..:•a ��.:'.:_ ' ;..,. .� "�.,�. a.:. :.. I �� I".:, ::.��',:{tom y .-.��. � p: � Z7 7MZ I I' ------ --- OZ b a 4'8' i 6'-2" I� cn�maN . I I N. 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RULING THAT THE NEW ROOM ABOVE THE GARAGE WILL BE CONSIDERED 1/4" = F-O" A BEDROOM, BEDROOMS#3&4 IN THE MAIN HOUSE WILL BE COMBINED TO MAKE ONE BEDROOM. tHEREFORE, THE SEPTIC SYSTEM SIZE AND THE TOTAL DATE: BEDROOM COUNT WILL MATHC 9/1/2009 DRAWING NO.: l 7'-0' DD D D N G m O Z N N Z O n ®O O Jyn _Z m O m rO � Zc c mU'„ c I.,� 4 Om pmD Cf.) m z D p o o o° o m o� V^ m s•a' I K °m rr--OO A a --- G) () Z m O�1 m NO oo D N .. 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CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS KENZIE NI"cn `mx�:a «A .r ac &DIMENSIONS IN THE FIELD V -4 Q 2.)VERIFY ALL SMART VENTS DETAILS&SPECIFICATIONS PRI ANCHOR BOLT DETAIL ; Q TO INSTALLATION INTO WALLS 1p p O w ci SCALE: 1/2"=1'-U' O 3.)BOTTOM OF SMARTVENTS TO BE 2"ABOVE FINISHED �,�. FGI STERN I,�I" w Q TOP OF FOUNDATION Fs S/O t; G 13" INSTALL 5l8"ANCHOR BOLTS AT45'..MAX �,���:�� �zarvwmc [` 4.)FLOOD ELEVATION 11.0 FEET FEMA ZONE(A13) NAL _ \ WI SIMPSON BPS 518-3 BEARING PLATES . �w3vtMw z a'9�'' !T!d At_.JLN s. g• WIIT OM EACH q,•rnunm�ova wunmc �asnw wM of ama�mw 5.)ALL MECHANICAL&ELECTRICAL EQUIPMENT TO BE INSTALLED CORNER AND A a"MINIM SCALE: ON THE RAISED FLOOR AREA SHOWN ON THIS PLAN AS THE MECHANICAL ROOM AT EL.11.25 FEET OR SEALED TO MEET ALL FLOOD ZONE REQUIREMENTS I/4" = 1�-0" ro 1 6.)SMART VENT CALCULATIONS: " to O DATE: (1)SMART VENT COVERS 200 SQUARE FEET OF AREA -- 45"nc 9/4/2009 753 S.F.OF GARAGE AREA IN FLOOD ZONE i i s— (5)SMART VENTS REQUIRED WHICH EQUALS 1000 S.F.OF COVERAGE f 0 7 DRAWING NO.: 7.)SMART VENT MODEL#1540-521 INSULATED,COLOR:WHITE O.H. DOOR DETAIL SIDE ELEVATIONA6 ANCHOR BOLT DETAIL NO scAl>= W n, -+ Z A -DHC CDII j O2 Dm r� 9? '-`O 24'P zP �T r fTl (SHED DORMER) .� r� m0 -100 z =v w D 0 ;p T zin mcn z m rn;o0 m �S Z -+ — z T. 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MASHPEE:MA. 02649 PH.(508)274-1166: ka 37 CODDINGTON ROAD CENTERVILLE,`MA FAX(508)�-NO2 NAILING SCHEDULE a' 110 MPH EXPOSURE B WIND ZONE z s- 6-e r-a^ a-a z v JOINT DESCRIPTION NO OF COMMON NAILS NO.OF BOX NAILS NAIL SPACING le ROOF FRAMING' BLOCKING TO RAFTER(TOE HAILED) 2.ad 2-lad EACH END RIM BOARD TO RAFTER(END NAILED) 2.I6d 3-1Cd -EACH END WALL FRAMING 0 Q N N TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-IGC -5-16d AT JOINTS Q Lp.^) A ) 16d6d I6d 16'oc ALONG EDGES Q�� b STUD TO STUD FACE NAME HEADER TO HEADER(FACE HlA1tED DN v FLOOR FRAMING JOIST TO SILL TOP PLATE OR GIRDER ITOE NAILED) d.8d 040d PER JOIST BLOCKING TO JOISTS(TOE NAILED) 2.8d 2-10d EACH END BLOCKING TO SILL OR TOP PLATE OE NAILED 3.1 fd g (T ) 4.16d EACH BLOCK W^00 'I B E LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-/6d 4-16d EACHJOIST � W AS JOIST ON LEDGER TO BEAM(TOE TNILEO) }Bd 3.10d [� O AND JOIST TO JOIST(END NAILED) 3-16d 4-I6d PERJOIST 'I^m U)�x BAND JOIST TO SILL OR TOP PLATE(TOE HNILEDa 2-I6d 3-16d PER FOOT O Q y ROOF SHEATHING U d">E T, WOOD STRUCTURAL PANELS(PLYWOOD) RAFTERS OR TRUSSES SPACED UP TO 16'o c ad 10d 6-EDGE/G'FIELD 1 \3 x 4 Lo RAFTERS OR TRUSSES SPACED OVER 16'a c ad 10d 4'EDGE/4'FIELD GABLE END WALL RAKE OR RAKE TRUSS W/O OVERHANG ad 10d 6-EDGEl6'FIELD GABLE END WALL RAKE OR RAKE TRUSS 6d I0d 6'EDGEl6'FIELD W/STRUCTURALOUTLOOKERS ` I I BATH GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS ad 10d W EDGE/4'FIELD M CEILING SHEATHING - u GYPSUMWALLBOARD — STAIR N ` Sd COOLERS T EDGE/10'FIELD 77 WALL SHEATHING LIN b WOOD STRUCTURAL PANELS(PLYWOOD) 2S^z6'e^ O"%BR' - STUDS SPACED UP TO 24'a C. ad 10d 6'EDGE/1Z'FIELD —— 12'&2513Z"FIBERBOARD PANELS ad — X FDGEI6-FIELD C T 12'GYPSUM WALLBOARD Sd COOLERS -- TEDGEIIO-FIELD E / FLOORSHEATHING• C WOOD STRUCTURAL PANELS(PLYWOOD) ad 10d 6'EDGE/12'FIELD Y ON 1-OR LESS THCKNESS of GREATER THANI'THICKNESS 10d lad 6'EDGE/GFIELD W �g § p m HALF WALL - a - D N N .a C STUD AT EACH SIDE OF ALL ROUGH INSTALL TWO FULL HEIGHT STUDS&OPENI GCS BEDROOM #,4. C _ 3 WINDOW W 2 z 6 WALL ` N C 4%1" F \ �H QJ]JJ�'�✓������/) o `JACK STUD A i — (ROUGH OPENING) A5 STUD DETAIL (LOAD BEARING WALL) "a 2'-6, -`• __ - - INSTALL THREE FULL HEIGHT STUDS&TWO JACK W b 2 6 STUD AT EACH SIDE OF ALL ROUGH OPENINGS 2vffff-M Wfflopmly L� WINDOW o C C g 2 K 6 WALL ABOVE ON -,�.. GABLE w r � 3,-D' 10,8 ' 7.9^ 3'-3" (ROUGH OPENING) JACK STUD v STUD DETAIL NON-LOAD BEARING WALL <� t o 6 D' 2 0' - _(SHED DORMER) SEC ^ _ OND FLOOR . PLAN � C,6 Ion w � APPLY CAULK OR WINDOW SCHEDULE Q TAPE AT ALL SHEATHING W m . SEAMS AND THE TYVEK VAPOR BARRIER TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS A ANDERSEN TW 2446 2'-6 1/8"x 4'-9 1/4" STORMWATCH DOUBLEHUNG SCALE APPLY CAULK OR B " " A 21 2'-0 5/8"x 2'-0 518" STORMWATCH AWNING 1/4" = 1'_O„ APPLY CAULK IVEWHER ADHESIVE UNDER C TW 2442 2'-6 1/8"x 4'-5 1/4" STORMWATCH DOUBLEHUNG li ADHESIVE WHERE PLATE INDICATED - D TW 2432 2'-6 118"x 3'-5 1/4" STORMWATCH DOUBLEHUNG DATE: .I', DETAIL AT FLOOR/WALL E ;; A251 2'-4 7/8"x2'-0 5/8" STORMWATCH AWNING 9/4/2009 F CIR 20 2'-0 5/8"x 2'-0 5/8" STORMWATCH CIRCLE CUSTOM GRILLES NOTES: DRAWING NO-: 1-CONTRACTOR TO VERIFY ALL WINDOWS WITH OWNER AND ROUGH OPENINGS 1.SEAL ALL JOINTS,SEAMS,&PENETRATIONS IN THE WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS BUILDING ENVELOPE TO REDUCE AIR LEAKAGE 2.ANDERSEN 400 SERIES WINDOWS WHITE EXTERIOR&PERMANENT EXTERIOR GRILLES SEE SECTION 6106.3.3 IN THE STATE BUILDING CODE CLEAR VIEW SCREENS I x4TRIM W/KEYSTONES CONT RIDGEVENT U FOR CIRCLE WINDOW ^] AZEK 1 x 8 RAKE BOARDS TYPICAL ASPHALT Wl I x 3 DRIP BOARD ROOF SHINGLES U) GT (HIGH WIND) Q CROWN PEDIMENT W/ 12 0 CDCD 5/4 x 6 HEAD TRIM& mil/ -,73 �o 1 x 5 TRIM ON SIDES ¢ Q AZEK 1 x 8 FASCIA& m Z 1 x 6 FRIEZE SoARDS (y,v 00 TOP OF PLATE TOP OF PLATE JO 00 O i17 O m c�L�X NP AZEK 1x5/1 zfi CORNERBOARDS C 0 W C SHINGLE SIDIN IC 0 m 5"-TO WEATHER 9 n N N SECOND FLOOR SECOND FLOOR SUBFLOOR SUBFLOOR TOP OF PLATE TOP OF PLATE FM FH O FM my N = FIRST FLOOR TOP OF FOUND - SUBFLOOR- ELE_V 85' flip CARRIAGE SNLW/0 H DOORS W (VERIFY MFR&DETAILS Wl OWNERS) FRONT ELEVATION _ w E--". z 12 TOP OF PLATE 12 TOP OF PLATE r T, 20 w �a m� -w H N �N - 7 7 n m � m SECOND FLOOR SECOND FLOOR SUBFLOOR SUBFLOOR f^---� �K TOP OF PLATE TOP OF PLAT-S 0,6 O P T 6 x 6 POST WI 1x 911 10 '�' `•J C j AZEK CASING a a 7 QN SCALE: as n 1 J4" FIRST FLOOR SUBFLOOR- DATE TOP OF FOUND ELEV 65' 9J4/2009 RIGHT SIDE ELEVATION DRAWING NO.: 7'-S 12' 7'-B 12' N m (BB"STUDS) O c m (88 STUDS) 0 CA v WO 0 I o Zco 10 IAA Im 7)0 Im u m m r C r-a 12 'S UD O C.� (88"STUDS) T m (BB"STUDS) 0 .0 9 I T y I I O z yy I 7 IpA Im Ipa Dm 1rn c�i� NN r x p z m CZ vv N zz 0y m �- E191 Nx �11 m x x O J m N �➢ N N b m A m 10 O IM0 a ®® Immmc 15O Cm m ywo <O O �O O O 0 o m o m m8•4 12' T-B 12' HIT 1 o (96"STUDS) (BBSTUDS)®® m SOv V J T a M - - - -m OOv 2 ,O Ellfl M� C ®® z > z0 Z Z- T Z 1 • r � N O "1 T m i m z r ®® Nm D M mT m N 00 A➢ Q P O ®® Z C> mA m cz Oc�D 7n zv A:03 0= m� �A�p 2 mxx. O% ONOD m m0 NT mN Off' Iv I'V 0 NIm mAm .lmi0 N x O rW0 N O INO A O I� IAA 1 S o " 07 m 7'-812" (96"STUDS) (88"STUDS) y NEW GARAGE FOR: COTUIT BAY DESIGN, LLC I� 43 BREWSTER ROAD " `" ED & IRENE UZGIRIS MASH8)2 4-11 02649� o �- PH.(508)274-1166 FAX(5U8)539-94U2 37 CODDINGTON ROAD CENTERVILLE, MA U , TYP. ROOF CONST. --� -2 x 10 ROOF RAFTERS @ 16'o c CONT RIDGE VENT -5/9'COX PLYWOOD ROOF SHEATHING -ASPHALT ROOF SHINGLES -15LB FELT PAPER 2x6's@16"0c •8'HI-R BATT INSULATION C/) m @ SLOPED CEILINGS(R=30) __ _ w 0 -r -9'GATT INSULATION __ __ [� <CV @ FLAT CEILINGS(R=30) - O CD 4 •2 x 12 RIDGE BOARD / \ }" CL'O LSD (2)SIMPSON H 2.5 HURRICANE CLIPS / \ ¢AT ALL RAFTER ENDS -ICcn E/WATER SHIELD AT BOTTOM 72 / / \ `\ 'Z�T' 3'0"Of ROOF oo w N PROP-A VENT BETWEEN RAFTERS T / 2x 8's 16'o c \ w LA 00 O 00 / NEW 12"GYP.BOARD \ TOP OF PLATE 12 Q (n x ON/x 3 STRAPPING \\\ c Do U co 5 / @16'oc \ 20 CONT.ALUMINUM SOFFIT VENTS TYP.WALL CONST. -2x6STUOS@16"oc m N BEDROOM #4 \ \ -S"BPLYWOOD SHEATHING 6' GATT INSULATION(R=19) U 12"GYP BD SUBFLDORLGLUED 8 NAILED OOD \\ -W C SHINGLE SIDING -TYVEK HOUSE WRAP SECOND FLOOR SUBFLOOR 14"ENGINEERED JOISTS @ 16'o c TOP OF PLATE SB'FIRECODE GYP BD ON 1 x 3 STRAPPING @ IS' oc IN GARAGE l7 GARAGE �N m� (4-CONC SLAG ' SLOPE 2"TOWARDS DOOR) ELEV.8 S TOP OF FOUND I w TYP B"CONIC TYP. ROOF CONST. '. FOUND WALLS b i A SECTION @ GARAGE 2x6's@16'oc -TYP e•%,8" A5 CONC.FOOTINGS ,2 -- U T __ 2x8's 16'oc -- - t2 TOP OF PLATE T �n 20 `CONT ALUMINUM W SOFFIT VENTS / BEDROOM #4 \ \ TYP. WALL CONST. Z / \ BATH\ / \ SECOND FLOOR Z J SUBFLOOR 14-ENGINEERED JOISTS@16'oc W TOP OF PLATE Q 3-1 3!4"z 9 1/4"LVL BEAM �1 FASTEN W/SIMPSON EPC 66 BEAD BOARD ON 1 x 3 O STRAPPING @16'oc w N PT 6x6 PT POSTSW/ 'T y W 1 x 9/1 x 10CASING GARAGE Lo \`V 91C CORRECTOECK _J SCALE o�V eeMARK A. �t���`' 2xBPTJOISTS@16'oc —� 1/4" = F-0" MCK�-NZIE 3PT 2x10's 2x8PT JOISTS@16'oc ELEV 85' TOPOFFOUND FASTEN POST TO BEAM W/SIMPSON SC6 DATE: POST BASE IAc SAU-c�N A AW-07 TYP D WALLS 9/4/2009 f�; 1440e TPW�� FOUND WALLS FG(s T���. AS �NG\ ,p��(IC►..� DRAW[NG NO.: S/ONAL TYP 6'x16" Sic CONC FOOTINGS NEW 28'DIA"BIGFOOT'FOOTING UNDER IT DIE SONOTUBES AT SECTION a0 GARAGE PORCH 4'0'DEEP P T 2 x 10 LEDGER BOARD LAG BOLTED TO SOLID BLOCKING W/(2)LEOGERLOK BOLTS 16"o c W/JOISTS HANGERS AT BOTH ENDS A.'"J LEGEND CB (FND) ■ UTILITY POLE ):E HYDRANT !A CODDDVG JV CATH BASIN In MAPLE TREE LOCUS WETLAND FLAG P EXIST. CONT. — — S0 G BEpC can / LOT 1 / CEATMVff E' / S WOM HARBOR LOT 188-80 ' rar cam nay ffi p. LOCUS MAP ,� PLAN REF 170-93 / / •� _ / DEED REF• 2924-185 / LOT 2 / » „ / h ZONWG. RD— A 1 , / ,moo 1.1 SETBACKS 30 —10 —10 OAss�ssolzs � `—�`/— � / I BACK / FLOOD ZON » » aa¢�=:eerzfsr: l / f E. A-10 PA0JV= 7 / PAD / // / 11 GARAGE BFE/ ....... ........... PANEL NUMBER. 250001 0016 D BORDERING loll 07—02-1992 ?*.o• / (� // ~BENCHMARK: DH IN CS DATED. VEGETATED / L ' %%" "'%%""""""' �+ ELEVATION: 10.29' WETLANDS W e.e1• P�e0 ; ss>,.,.,.'s'ss. / Q� DATUM: TOWN OF BARNSTABLE• ............... GIS MAP± _ �o• 4 iloll / / SITE PLAN `' Q LOCATED AT _ 1 37 CODDINGTON ROAD -5 CENTER VILLE; MA. 100' WETLANDS BUFFER PREPARED FOR.'50' WETLANDS BUFFER IRENE UZGIRIS 100 YEAR BASE c` FLOOD ELEVATION AUGUST 4, 2009 REV NO VEMBER 11, 2009 REV 11 1Z NOTE: WETLANDS FLAGGED BY: VACCARO ENVIRONMENTAL CONSULTING I REV GRAPHICYANAE' SURVEY CONSULTANTS SCALE UNIT 1, 4OB INDUSTRY ROAD 20 '� �° P. O. BOX 265 MARSTONS MILLS, MASS. 02648 TEL 428-0055 FAX 420-5553 1 inch = 40 ft SHEET 1 OF 1 JOB # 54540 .TF' NAILING SCHEDULE s 5.4• 5'.4 e•e 110 MPH EXPOSURE B IMND ZONE I.6. JOINT DESCRIPTION NO OF COMMON NAILS NO,OF BOX NAILS NAIL SPACING z ROOF FRAMING' U S•a BLOCKING TORAFTER(TOE INILEq T•T! 2•iGd EA.DHEND RIM BOARD TO RAFTER LEND NAEEq 2.100 ltOd EACH END WALL FRALING Q ¢N TOP PLATES AT INTERSECTIONS(FAQ NAILED) - LIA S180 AT JOINT9 O C7 STUD TO STUD(FACE NAAE01 b led . b ON N HEAOERTOHEAQR(FACEIMILLq tBd T't8d glee L3: Vim' led IB•oe ALCHGECGES Q �. FLOOR FRAMNG L JJOIST 4T TO SILLTOP LATE pl GIREq(TOEKE PO NAq a.Bd e.lOd PER JOIST WC— :LOCKING TO JOISTS ROE PAP ED) 2.8d 2.100 EACH ENO L- N LLB N.•-.B EK. B BLOCKINO TO SILL OR TOP RATE ROE NAKEOI }1 W a-16d LEDGER STgIP TO BEAM OR GIRDER(FACE NAK.f0) SIQd a-lGd EAG�t JI`OI " L4 O� AS JOIST ON LEDGER TO BEAM ROE t) 1Bd 110d PER JOIST E Ct l v y SAND JOIST TO JOIST To PLATE S10d d-180 PER Jp3T . '• b B BAND JOIST TO SILL ON TOP PLATE ROE tWLEDO 2.180 S•l e PER FOOT m X " ROOF St1EATT1NO vim•5 0�.,G¢."6 WOOD STAU L)CTLAAL PANELS(PLYWOM. y d' RAFTERS OR TRUSSES SPACED LA TO tB'e e BA lod RAFTERS OR TRUSSES SPACED OVER 18'e o ad IGd e'EDGe1C FIELD e•EDGE/!•FIELD..GABLE EIID WALL RAKE OR RAKE TRUSS—OVERHAtKT 8d .100 4*EDGEN•FIELD. b - -•S �. _ / GABLE E!O WALL RAKE OR RAKE TRUST Bd 10d 8•EOGEIB'FIELD W/STRLK:TURAL OLJTLOOKERS GABLE E/ID WALL RAKE OR PUKE TRUSS Wt LOOKOUT BLOCKS ad IlW 1'EDGlN•FIELD BATH cEIUNG SHEATHING ' PTA ROOhVN GYPSUM WALLBOARD -ULL Sd COCLER3 — TEDGC/tP FIELD b - I I .ta•B' LIN Ao WALL SrM 1ao - _ - 2Sk6B' WOOD STRUCTIRAL PANELS at.YWDDDI •. N L _� STUOS SPACEOUP T.... 'ad tod I e'EDGE/tiFIELD t C Q'G ERBOARD PAb EL3 Be 3'EDGE.a FIELD q'GYPSUM FIBA WALLBOARD Sd COOLERS — T EDGE/10'FIELD . FLOOR SHEATHING- ON WOOD STRUCTURAL PANELS(PLYNOOq '^ GREATER THAN I'TIHCKNESS Sd tOd TEDGE/1TFIELO IGd 18d 8'EDGE/G FIELD 4 4 ^ - S 1 `��..�O © HALF wAII b § - N 4 INSTALL TWO FULL HEIGHT STUDS&TWO JACK _ STUD AT EACH SIDE OF ALL ROUGH OPENINGS (o ; WINDOW LL W b � 2.6 WALL C d•.I• ._•e � b A5 (ROUGH OPENING) JACK STUD tl STUD DETAIL (LOAD BEARING INSTALL THREE FULL HEIGHT STUDS 6 TWO JACK 2'•� D - STUD AT EACH SIDE OF ALL ROUGH OPENINGS. C C WINDOW ABOVE ON - B 2 T_6 WALL a GABLE AS O 3'-(r IaS 7-7 34-3• (ROUGH OPENING) \ JACKSTUD STUD DETAIL NON=LOAD BEARING WALL <� �./ [0 • . (SHED DORMER) 2s•4 z z SECOND FLOOR PLAN Q C'6 o WINDOW SCHEDULE w o APPLY CAULK OR TAPE AT ALL SHEATHING M SEAMS AND THE T1NEK VAPOR BARRIER TYPO MANUFACTURER'S UNIT TROUGH. A PENI REMARKS ANDERSEN TW2446 14 STORMWATCH DOUBLEHUNG SCALE: APPLY CAUtJLOR B A 21 2'-0 5/8"x 2'•0 5/8" STORMWATCH AWNING I/4" _ ( —Q" APPLY CAULK OR ADHESIVE UNDER VELVHERE PLATE �� CD TW 2442 2'-6 1/8"x 4'-5 INDICATED 1/4" STORMWATCH DOUBLEHUNG wotcn TW 2432 2'-6 1/8"x 3'-5 1/4" STORMWATCH DOUBLEHUNG DATE: DETAI L.AT FLOORMALL E " A 251 2'-4 7/8"x 2'-0 5/8" STORMWATCH AWNING 9/4/2009 1 F CIR 20 2'-0 5/8"x 2'-0 5/8" STORMWATCH CIRCLE CUSTOM GRILLES NOTES: 1 CONTRACTOR TO VERIFY ALL WINDOWS WITH OWNER AND ROUGH OPENINGS DRAS�'ING NO.: 1. SEAL ALL JOINTS,SEAMS• 8 PENETRATIONS THE WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS BUILDING ENVELOPE TO REDUCE AIR LEAKAGE WI 2.ANDERSEN 400 SERIES WINDOWS WHITE EXTERIOR 8 PERMANENT EXTERIOR GRILLES SEE SECTION 6106.3.3 IN THE STATE BUILDING CODE CLEAR VIEW SCREENSA2 zao- 6❑ � ���� � „� , 2'-7 (SHED DORMER) ,Y O� 2.8 RAFTERS @ 16 o c B TO BE BUILT OAR MAIN + ` �7/� �. CA A5 ROOF SYSTEM. 5(�.l 1 O (0 C'�,LO N� iV b CO [� X � � L SOLID 10 LEDGER BOARD LAG BOLTEDLOK BOLTS I 16'o c W1 JOISTS HANGERS AT BOTH ENDS l� 9%6" ! J ,PJ�` I THROUGH BOLT P T.6 x 6 ( POSTS INTO DOUBLE w +� 4 0\ P T 2 x 8 END BEAMS o / I I I I T s?$' 4 4 0 1 _ P�'�e 1v c I I I I I I O1w 2x 12 RIDG=_BOARD S 1 1 1 1 1 1 I� B A5 01 m W N ~ I A5 I i I 1 3/4'x 14"LVL B 11. o SOLID 2 z B BLOCKING IN THE OUTSIDE, tL o F -TWO RAFTER&CEILING JOIST BAYS - ° A 49^o c ALLOW SPACE FOR AIR W O - FLOW ON THE UNDERSIDE OF ROOF 6'-0" '� SHEATHING (SHED DORMER) +r w Z ' 24'47 ROOF FRAMING PLAN NOTES: 1.) ALL ROOF RAFTERS TO BE 2 x 10's 6 �— UNLESS OTHERWISE NOTED 2.) USE SIMPSON H 2.5 HURRICANE CLIPS --/ Q AT ALL RAFTERS ENDS A I b O 3)W/OVERIWNERS FY ER TYPE/LAYOUT ROOFHIGHVSHING EST AS O� 2 x 10 RAFTERS `\\�\ -5/8"COX PLYWOOD SHEATHING _ w /� ��+ 154 FELT PAPER 7 r�T,( �V s9Cti 2x 8 BLOCKING TO ` (2)SIMPSON H 2 5 HURRICANE CUPS - tA o f-1 �V cn O= MARK A (/�� PREVENT WIND __ _ - p l�Vl R WASHING �� �3'0-WIDE ICENJATER SHIELD __ __ __ _ A5 g IY1CK�•NZt� �i ALUMINUM DRIP EDGE 3-1 314'x.11 7/8'CONT LVL HEADER B SCALE: SIMPSON LSTA24 STRAP 1 z 3 STRAPPING W/ - 1 x 8 FASCIA BOARD PERFORM NO APAWOOD POR AL WALL A5 1/4' = 1'-0" 112"GYPSUM BOARD FRAMING 3-1 3/4'x 9 i/4'LVL BEAM SOLID BLOCKING SIh1PSON LSTA24 STRAP i x 4 SOFFIT BOARD FASTEN P-T 6 x 6 POST TO O b IN THE FIRST TWO CONT.VINYL SOFFIT VENT - JOIST BAYS PER FORM NO TT-1000 BEAM W!SIMPSON EPC66 DATE: CCG+I S T e \�1 777 �_ 1 x 3 SOFFIT BOARD 48^o c @ - APAWOOD PORTAL WALL POST CAP F TYP 2z6WALL5 1 314-CROWN FRAMING , 9/4/2009 SS%ONAL ���� —1 x6 FRIEZE BOARD DRAWING NO.: DETAILAT WALL CONSTRUCT GARAGE END WALLS 24'O USING THE DPORTAL WALL SECOND FLOOR FRAMING. PLAN SCALE:112"=T-O° FRAMING FOR ENGINEERED APPLICATIONS WI HOLD DOWNSWNS PER PER FORM NO TT-100C (SEE ENCLOSED DETAIL SHEET) A7 ! - (EXISTING) (EXISTING) Lo 30 cj�pto EXIST EXIST - O m Q In ,.s�• T'< 1 7 EXIST. BEDROOM#3 � 1 ROOF DECK . X N Ito - + - EXIST - b EXIST. oN x b in N � EXIST HALL �X W LIN. O EXIST. BEDROOM#2 W � - � w :D EXIST.. Z BATH W . L _ EXIST EXIST r (EXISTING) .. (EXISTING) O HOUSE SECOND FLOOR PLAN o LEGEND: W Z EXISTING WALLS W Q --, CONSTRUCTION TO BE REMOVEDME _ Q L--J O NEW CONSTRUCTION THE EXISTING HOUSE CONTAINS 4 BEDROOMS WHICH THE SEPTIC SYSTEM . w 06 IS RATED FOR. WERE IS A BEDROOM ON THE FIRST FLOOR AND THREE SCALE: BEDROOMS ON THE SECOND FLOOR. IJUE TO THE tOWN OF BARNSTABLE B.O.H.RULING THAT THE NEW ROOM ABOVE THE GARAGE WILL BE CONSIDERED 1/4" = F-0" A BEDROOM, BEDROOMS#3&4 IN THE MAIN HOUSE WILL BE COMBINED TO MAKE ONE BEDROOM" tHEREFORE, THE SEPTIC SYSTEM SIZE AND THE TOTAL DATE: BEDROOM COUNT WILL MATHC 9/1/2009 I ! DRAWING NO.: j TYP. ROOF CONST. PLAN CHANGES PER TOWN OF BARNSTABLE BUILDING -2 x 10 ROOF RAFTERS @ 16'o.c. CONT, RIDGE VENT -5/8"CDX PLYWOOD ROOF SHEATHING DEPARTMENT REQUEST. CHANGES CAN SECTION -ASPHALT ROOF SHINGLES -15L6. FELT PAPER 2 x 6's 16 o.c. SHOWN A S CIRCLED-8"HI-R BATT INSULATION @ SLOPED CEILINGS(R=30) _ _ w �o -9" BATT INSULATION -- -- N FLAT CEILINGS(R=30) NO -2 x 12 RIDGE BOARD -(2)SIMPSON H 2.5 HURRICANE CLIPS / AT ALL RAFTER ENDS w , m -ICE/WATER SHIELD AT BOTTOM 12 / / \ \ �+ "r Lo 3'0"OF ROOF - -PROP-A VENT BETWEEN RAFTERS 7 2 x 8's @ 16"o.c. w N 0^O � wp" o� \ TOP OF PLATE Lo NEW 1/2"GYP.BOARD � O / ON 1 x 3 STRAPPING \ \ 12 20 CONT.ALUMINUM SOFFIT VENTS TYP. WALL CONST. a -2 x 6 STUDS @ 16"o.c. -12" PLYWOOD BEDROOM #4 \ \ _6'BATT NSULA ION(R1119 0OD 0 / 314"T&G PLYWOOD \ -1/2"GYP.BD. SUBFLOOR-GLUED&NAILED -W.C,SHNG G / -TYV OUSE WRAP COND FLOOR SU OOR 14" GINEERED JOISTS @ 15'o.c• TOP OF TE \-5/8"FIRECODE GYP.BD. TYP. WALL CONST, ON 1 x 3 STRAPPING @ 16' FOR GARAGE o.c. IN GARAGE CEILING &WALLS -P.T.2 x 6 STUDS @ 15'o.c. - 1/2" P.T. PLYWOOD SHEATHING p -5/8" DUROCK INSIDE FOR LOWER 47 GARAGE -50 FIRECODE GYP.BD.ABOVE `r FLOOD ZONE A-10 ELEV.11.0' -W.C. SHINGLE SIDING — _ — — — — — — — — -TYVEK HOUSE WRAP s (4"CONC.SLAB SLOPE 2"TOWARDS DOOR) ELEV.8. TOP OF FOUND, jw TYP.&'CONC. FOUND.WALLS z ru, — A SECTION @ GARAGE TYP.8"x 18' r T 1 A5 _ CONC. FOOTINGS } v " ol MAX. O AZEK WHITE PVC �y ,. RAILING SYSTEM z FORMERLY TRADEMARK g N = RAILING P.T.4 x 4 POSTS BOLTED = INTO PLATFORM FRAME r as O V P.T.2 x 12 STRINGERS 9 1/4'(MIN.) / Wcn MAX. SHPERE DIAMETER TO BE SCALE : 5 3/$" PER SECTION 5312 1/4 if _ 11-0 n EGRESS STAIR DETAIL DATE : 12/2/2009 NOTES: 1. FOLLOW ALL MANUFACTURER'S INSTALLATION INSTRUCTIONS DRAWING NO. FOR THE AZEK RAILING SYSTEM 2. FOLLOW ALL STATE OF MASSACHUSETTS SEVENTH EDITION CODE REQUIREMENTS FOR STAIR & RAILING CONSTRUCTION PER 5311.5 & 5312 3. SEE FRAMING DETAILS FOR PLATFORM CONSTRUCTION ON SHEET A7 A8