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HomeMy WebLinkAbout0267 GLENEAGLE DRIVE a 0 I o m TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map f q Parcel 141 Application# Health Division Conservation Division Permit# s Tax Collector _ Date Issued 7 no Treasurer Application Fee Planning Dept. Permit Fee �j Date Definitive Plan Approved by Planning Board _ Historic-OKH Preservation/Hyannis Project Street Address 2 of C7l le bri v Village Cfn--erVI I I e Owner ka h feeler M. Roy C r®-F-F Address 2(07 Glen Eod e DyI VC- 'eh-le v-v, ( le) A 02 6 3 2_ Telephone �D8 - '7q O- 0-7 i 3 Permit Request lilew fc�.e-�/ l -00 A4 Ale to /fIlGw kom ! ,� Square feet: 1 st floor:existing f proposed 35A 2nd floor:existing proposed s Total new Zoning District Flood Plain Groundwater Overlay ZE w Project Valuation-40"4/0,r 060 00 Construction Type 001 Cn rQ3 w rn Lot Size �Jr e)56 5e1. Grandfathered: ❑Yes RN o If yes, attach supporting do umentation. Dwelling Type: Single Family ZTwo Family ❑ Multi-Family(#units) Age of Existing Structure C�o y6f Historic House: ❑Yes ©'No On Old King's Highway: ❑Yes Q o Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new f Half:existing new Number of Bedrooms: existing new 0 _ Total Room Count(not including baths):existing ro new First Floor Room Count Heat Type and Fuel: 61'Gas ❑Oil ❑ Electric ❑Other Central Air: ZYes ❑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:Er/existing ❑new size lY40 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization- ❑ Appeal# -- - —- - , - --Recorded❑ - - Commercial ❑Yes O No If yes, site plan review# Current Use Proposed Use fan 120yCro( f-f k/�m. (3 r i ILD�ER�INFORMATION Name T. Roo C.ro-f� Telephone Number .777_)y'`91 Address 65 F-bei) Sr ictin ROGLGL License# renk-_rV 1 �,t.P �� 026 32 Home Improvement Contractor# Worker's Compensation#-IAK, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -- :C3 SIGNATURE j DATE Jame Ss 3zr } FOR OFFICIAL USE ONLY !y[ r P>✓RIMIT NO. { DATE ISSUED MAP/PARCEL NO. �. ADDRESS, VILLAGE s OWNER DATE OF INSPECTION: 2 s FOUNDATION /t FRAME INSULATION 10 FIREPLACE l ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL i s ' FINAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. k t � Fej.�Mosp ��1 � Z�� Gt.r egGvc �Rt�c "1BP-V1LLC) / Ilk ' { AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMIR 5301.2.1.1)1 Q Check 1.1 SCOPE Compliance WindSpeed(3-sec.gust).................................................................. ................................................ 110 mph ✓' WindExposure Category.................................................................. .............................................................B 1.2 APPLICABILITY Number of Stories(a.roof which exceeds 8 in 12 slope shall be considered a story) stories <_2 stories RoofPitch ...........................................................................(Fig 2) ........................:.................._' 5 12:12 MeanRoof Height ..............................................................(Fig 2)............... .............................. 2 ft :533' BuildingWidth,W ...............................................................(Fig 3).................................................... ft <_80, t/ BuildingLength, L...............................................................(Fig 3).................................................-lUft 5 80' Building Aspect Ratio(L/W) .............................................. (Fig 4)................................................�s 3:1 ✓ Nominal Height of Tallest Openingz ...................................(Fig 4)................................................�-� 5 6'8"' 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)............................................................... _tom 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete....................................... r/ ConcreteMasonry.................................................................... ............................................................... 2.2 ANCHORAGE TO FOUNDATION"' 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only �' Bolt Spacing-general..........................................(Table 4)............................................ . -�in. 1/ Bolt Spacing from endfjoint of plate.............................(Fig 5).................................... in.5 6°-12" Bolt Embedment-concrete.........................................(Fig 5)...... ............................................-T in.>7" Bolt Embedment-masonry.........................................(Fig 5)............................................ 0 in.>15" ✓ PlateWasher................................................................(Fig 5).............................................._>3"x 3"x'/<" 3.1 FLOORS Floor framing member spans checked ....:..........................(per 780 CMR Chapter 55)..................... ............. t/ 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 Supporting Loadbearing Walls or Shearwall................(Fig 7)....................................................D ft _<d Maximum Cantilevered Floor Joists — Supporting Loadbearing Walls or Shearwall................(Fig 8)............... 5 d f FloorBracing at Endwalls....................................................(Fig 9)................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)................................... Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55).......................11±t in. Floor Sheathing Fastening................................... ..............(Table 2).. Zd nails at_(I_in edge/l2 in field 4.1 WALLS Wall Height Loadbearing walls..............................:`.........................(Fig 10 and Table 5)........................... ft 5 10, ✓ Non-Loadbearing walls..............................:.................(Fig 10 and Table 5)...................... .... ft 5 20' Wall Stud Spacing .................................(Fig 10 and Table 5):.................. in.5 24"o.c. Wall Story Offsets ........................................................(Figs 7&8)............................................Q ft 5 d ✓ i 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(Table 5)..............................2x ft in. ✓ Non-Loadbearing walls........................:.......................(Table 5).....:........................2x Co - ft in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10)................................................................. ✓ . WSPAttic Floor Length................................................(Fig 11)............................................. ft>_W/3 Gypsum Ceiling Length(if WSP not used)...................(Fig 11)..................................,......... I r ft>_0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. .. (Fig 11).............................................. .. ............... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays_ Double Top Plate .Splice Length ........................................................(Fig 13 and Table 6).................................... 4 ft !,/' Splice Connection(no.of 16d common nails)..............(Table 6).......................................................... !� AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Loadbearing Wall Connections Lateral(no.of 16d common nails)........:.......................(fables 7)..................................................... —IC Non-Loadbearing Wall Connections Lateral(no. of 16d common nails)..................:.............(Table 8)........................................ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)................................... 1 ft-(,.- in. 5 11' SillPlate Spans ........................................................(Table 9).................................. ft_j2-in.5 11, t/ 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) HeaderSpans.............................................................(Table 9).................................. S ft O in.512' Sill Plate Spans..........................................:................(Table 9)..................................�ft CD—, ft 512° t� Full Height Studs(no.of studs).........................:..........(Table 9)................... Exterior Wall Sheathing to Resist Uplift and Shear SimultaneousV Minimum Building Dimension,W t� Nominal Height of Tallest Opening2 ............................................................................. Sheathing Type......................................:.......(note 4).....................................................L2_ ✓� Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ 4 in. r/ Field Nail Spacing..................... ...... ...... ......(Table 10)................................................. Q_ in. 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).................... �f Maximum Building Dimension,L Nominal Height of Tallest Opening2...............................:................................. ...... <6'8° SheathingType..............................................(note 4)................................:.................... 14 Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................ in. ;/ Field Nail Spacing..........................................(Table 11).................................................—11 in. Shear Connection(no. of 16d common nails)(Table 11)....................................................... 3 ? Percent Full-Height Sheathing.......................(Table 11).....................:..............................1 % Wall Cladding 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).................... Rated for Wind Speed?......................:........................... ............. ................................... ...... 5.1 ROOFS Roof framing member spans checked?........................(For Rafters use AWC an Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19) ............. �T ft<_smaller of 2'or L13 r/r Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift.................................................(Table 12).............................................U=Z03 plf Lateral................................... .......(fable 12).............................................L=l6 plf Shear...............................................(Table 12)............................................S= 7 plf Ridge Strap Connections,if collar ties not used per page 21... (fable 13)...............................T=_plf Gable Rake Outlooker..........................................(Figure 20)............. Oft<_smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................ U=447 lb. Lateral(no.of 16d common nails)...(Table 14)............................. .........L=7.Q51b. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness..............................:............ . ...........................................I&in.>_7/16"WSP ./ Roof Sheathing Fastening............................................(Table 2).......................,................................. g _� Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. �� Cn©r-, /ZOO AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7so CAIR 5301.2.1.1)' 4. a. From Tables 10 and 1.1 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom'plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel: Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d . staggered at 3 inches on center per figures below Vertical and Horizontal Nailing for Panel Attachment a —=V*MTH s r&srsom • ttseadwkas - ,. AT6bs, - 1.1 '„ .11•` - '° id II it o n rl o PR r1 11 WLSPACM 11 ii • Mpgg„ U r Ir 1 II tl {r • PATi�t- _ d 4 See Detail on Next Page Vertical and Horizontal Nailing for Pane]Attachment . ��r - •JItG l�D/ll//C4IC/IH'!7(�� !J�.�1'�Q•iiQCflllaF.'Ccs o r? Board of Building Regulations and Standards a sE , ? Construction Supervisor License License: CS 83280 Birthdate: 11/29/1964 Expiration: 11/29/2010 Tr# 5313 Restriction: 00 SEAN J ROYCROFT 65 EBEN SMITH RD CENTERVILLE,MA 02632 Commissioner /ze �om/na�zwe¢l� 0�✓`2'adtac�zuae . Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 141225 Expiration:, 1/22/2010 Tr# 262207 Type: Private Corporation ROYCROFT&KUEHNE BUILDERS, INC. Sean Roycroft 65 Eben Smith Road Centerville,MA 02632 Administrator 4 Town of Barnstable ' HARN3TABLE, MASS. �� Regulatory Services �Fo a Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 12kaffi)e(fki K Rcc rc)-F-F- ,as Owner of the subject property hereby authorize �—�Ana n J, p oyc y-b to act on my behalf, in all matters relative to work authorized by this building permit application for: 2-7 Glen �c�c�le `Drive, C:enky—vile (Address of Job) 4qa Signature of O er Date Print Name Qlorms:buildingpennits/express + Revised 123107 f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations P 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r Please Print Legibly Name(Business/Organization/Individual): p n QycrgT+ y kLdd0hne_ a [&rs,�Y)�• eU-v� 3' I1.UyCrU �- Address: -=7 F ben 5rni+h Road City/State/Zip: ry i MA O 32 Phone#: -7-74- 9 3&-(0(02 Are you an employer?Check the appropriate box: Type of project(required): 1.[✓] I am a employer with 1— 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 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance. 9. Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have . employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1� Insurance Company Name: Gro n l f�- 3ta-)c ={jj(�rQY1 Cc cUmpon g Policy#or Self-ins.Lic.#:yy6 t 1+-7 -6 3- I q Expiration Date: 81r,12c)o� Job Site Address:2(ol r7 th �na)e_ DhVc City/State/Zip: �iO�r'Vi/le Nq 026 3 2 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 ce fy u der h ,Vn d penalties of perjury that the information provided above is true and correct Signature: -,/ Date: 1 Phone#: -7-7 4­ 9 moo- 2.4 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i REScheck Software Version,4.1.1 Compliance- Certificate_ Report Date:06/25/08 Data filename:C:1Program FileslCheddRESchecklbellerose.rck Energy Code: Massachusetts Energy Code Location:. Barnstable,Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 170/a Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor. 267 Gleneagle Drive John&Katie Bellerose Steven Cook Centerville,MA 02632 267 Gleneagle Drive Cotuit Bay Design,LLC centerville;MA 026$2 43 Brewster Road Mashpee,MA 02649 508-274-1166 steve@cotuitbaydesign.com - Compliance:4.8%Better Than Code Mabmum UA:84 Your UA:80 Ceiling 1:Cathedral Ceiling(no attic) 292 30.0 0.0 9 Skylight 1:Vinyl Frame:Double Pane with Low-E 16 0.410 7 Wall 1:Wood Frame,16"o.c. 522 19.0 0.0 26 Window 1:Vinyl Frame:Double Pane with Low-E 51' 0.330 17 Door 1:Glass 40 0.330 13 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 256 30.0 0.0 8 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.1.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected to heat or coal Me building shall b greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Name-Title Sign re Date Project Title: Page 1 of 4 Data filename:C:1Program FileslChecklRESchecklbellerose.rck Report date:06/25/08 y REScheck Software Version 4.1.1 Inspection Checklist Date:06/25/08 Ceilings: ;`5 ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30:0 cavity insulation • Comments: Above-Grade Walls: - ❑ Wall 1:Wood Frame,16"o.c.,R-19.0 eavrty insulation, Comments: Windows: t' ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor.0.330 - For windows without labeled U-factors,describe features: #Panes - Frame Type Thermal Break? _• Yes No Comments: Skylights: ❑ Skylight 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.410 #Panes Frame Type_ 'Thermal Break? Yes - No ' Comments: , Doors: ❑ Door 1:Glass,U-fa_ctor.0.330 -' Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation . Comments: Air Leakage: i ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. When installed in the building envelope,recessed lighting fbdures#meet one of the following requirements: ' 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or ^ gasketed to prevent air leakage into the unconditioned space, - 2• Type IC rated,in accordance with Standard ASTM E 283,with.no more than 2.0 cfm(bi944 Us)air movement from the the f conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 IbstU pressure difference and shall be labeled. Vapor Retarder: - Q Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors: (Materials ldentiflcation: ❑ 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 tieing insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: Project Title: Page.2 of 4 Data filename:C:\Program Files\Check\REScheck\bellerose.rek Report date:06/25/08 Ducts are insulated per Table J4.4.7.1. Duct Construction: All accessible joints,seams,and connections of supply and return ductwork located outside conditioned-space,including stud bays or joist cavitiestspaces used to transport air,are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. ' Cj The HVAC system provides a means for balancing air and water systems. Temperature Controls: Thermostats exist for.each separate HVAC system.A manual or automatic means to partially restrict or§hut'off the heating an&or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: C] Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections'780CMR , 1310 and J4.4. Jf _ Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. w Swimming Pools: All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletabie sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: _ 0 HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. a Project Title: Page 3 of 4 Data filename:C:1Program Fles\ChecldREScheck\bellerose.rck Report date:06/25= Table 1:Minimum Insulation Thickness for Circulating.Hot Water Pipes f. Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts ' Heated Water Temperature(°F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" - • 170-180 0.5 1.0 1.5 P 2.0 140160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. { ' Insulation Thickness In Inches by Pipe Sizes Piping System Types Range("F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressurerremperature 201-250 1.0 1.5' _ 1.5 `2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any f 1.0 1:0, 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and '40-55 0.5,-, r 0.5 0.75 -1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) ` i Project Title: 4 of Page 4 `.° Data filename:CAProgram FileslCheck\RESchecklbellerose.rck Report date:06 of 4 Y � GRANITE STATE INSURANCE COMPANY 71337-0000 WC 447-03-14 13102 ------------------- - -- 3-66-0807-0 PENNSYLVANIA ROYCROFT & KUEHNE BUILDERS INC. Member Companies of 65 EBEN SMITH ROAD p CENTERVI LLE, MA 02632-0000 American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.V. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA L1I#: a- SOUTHEASTERN INSURANCE AGENCY WORKERS COMPENSATION AND EMPLOYERS 641 MAIN ST LIABILITY POLICY INFORMATION PAGE HYANN I S, MA o26o 1-5403 INSURER) IS PREVIOUS POLICY NUMBER CORPORATION RENEWAL 004392269 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6io ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 08/06/07 TO 08/06/08 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3-A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A ITEM a The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Q ❑Remuneration $109 OF Re- Premium Annual 3 Year unrrat on X Annual 11 3 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $124 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $284 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $2,550 It indllcated below. interim adjustments of premium shall be made:I El _ Semi-Annually 11 Quarterly El Monthly DEPOSIT PREMIUM ENDORSEMENT$(FORM NUMBER) SEE ATTACHED FORM SCHEDULE -•WC990612 08/30/07 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Representillive INC 00 00 01 39967 ����''•"'<� ��"r-��; •�+�*"'�R.�f .�..•-1�"�y•..�li�k�`�-1�i'�:. rr.'.u"*+yi:ct�r�-;ip��'�y.'�;.i.i+w4'•4y5�✓+"4 1,'�"�'1'S�"•.^i1`... .,.ii.,,r :,'?3'.�#�'F ry`gs�;iai'`s'��+ we•. ... .. .o.<f•n s `orrtNe row�o� Town of B argstable ' Regulatory Services BARNSTABLE. - 9 MASS. - `� v639. Building Division ArFDMP�a .. 200 Main Street,-Hyannis;MA 02601 Office_: 508-862-4038 Fax: 508-7 0- 2 9 6 30 Inspection Correction Notice Type of Inspection I ►'— Location �- �� - �rG�Permit Number Owner Builder One notice to remain on job site, one notice on filedn Building Department. The following items need correcting: Ps-trot 9A(c- S u c - - I= 7 - Please call: 508=.862-4038 for re-inspection. Inspected by 1`I e6-1/v�, Date t Q' �' as / Assessor's map and lot number ..._.......... .................:.1.�,.-.'�,�- � � t- . �' • SEPTIC SYSTEM MUST BE 'NST Sewage Permit number ..... "�. "......................... !N COMPLIANCE WITH TITLE 5 �Q�OF7NEr��o TOWN OF BA " i l " E AND � lyS i BJHB$TADLE, i -' ,r M6 9 R UIIDING INSPECTOR .. .. APPLICATION FOR PERMIT TO .....��:.......:......... O!-`, .......l..o...,er1�.? '' 4 .5 j TYPE OF CONSTRUCTION .li✓D) ......5/../?".kn4....1..E..," ................ I . .......... j ....��.....................19. • "TO"THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......G ..... ��............................. 5./ .......... � 1.!� e........ ✓. .............`f/................................ Y ProposedUse .... It .��6., ......................................................................................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ...sca.CC z.�.y......... ...........Address Name of Builder '( ✓.:. -��/1t./� .......AKn.,.F,.5...........Address 2<90......1 4.5.. �n 7�..'.........T.P....1/..�a Name of Architect ......Address .................................................. .. 0 Number of Rooms .......... ................:....................................Foundation ... ........ ?Q.v. :.` `.......l.C•1 .......................... Exterior .... dca!//................................................................Roofing ......GCL/i7G!.5 ...... � �1.� ................... Floors .....efi.-. A.4...............................................................Interior .....15zll .:� :..... . Heating /�i�` C7e.S.................................... Plumbing 0.. ............................ ......................................................... ..... ....................................................... Fireplace yGS.......................................................................Approximate Cost ...�l�(s....1`���......................................... Definitive Plan Approved by Planning Board ________________________________19________- Area :777.4- ... ...1 • Diagram of Lot and Building with Dimensions Fee �Ct.............. ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 42- / �O � aa, • I / 31 3v 'mod I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 2 Name .... ..�!/. .... ............................... I ��SFA COLONY HO^IL'S Na .a.2.657... Permit for One Stor�' r' . .............. ........... r Single...Family... .... ................ '- Location ...L.o,.t.....#...2..5......2..5..7 ..G1�. 1�3�� s...>)r ' Centervil,l . ................. �. ............................... Sea Colon Hom ` Owner �':..........��...................... Type of Construction .F ,T;1je........................... ' ........... .�� ................................ .................... ;1 4 U' Plot- ....y .��................ Lot ................................ s Permit Granted ..... 19 80 Date of Inspection/. :7/` ......."19 Date C mplete 9 t S PERMIT REFUSED T ' rn ......o..v.....%.......................................... 19 .......�. . ........... rn ." .. . ��.. .................... . ...... r .................. 0�r. ............................. .............' ApproveX. ............................`. ............ 19 ........ ...... ................... . �? Assessor's map and lot number .............:........... .............!..... ' SewagePermit number .......................................................... Qy�*THE T��4 TOWN OF BARNSTABLE • BAHH9TADLE, i 9O�Y.ae�� BUILDING INSPECTOR f .. APPLICATION FOR PERMIT TO ..................................................................................................................:.......... TYPE OF CONSTRUCTION ..................... ..............r-,-. . . .... ` .s..!...:................................................... ..... ..............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... �:. .....:1 ........�S F i7.c . f'. /'°......... J�:....).! ..e.....':'...e -4) /f/................................ -J ProposedUse ........................... ....................................................................................................................I......................... ZoningDistrict ...............................................,..........................Fire District .............................................................................. 141 Name of Owner .....!.!°.:±.............................. ...........Address .........:_.....,........._........�.:. f Name of Builder .. '. :... !::��..:.:.:..........+ :.�. Address .�.�: :......�:..::..<. ....� �:...�' .................t ..... ..... Name of Architect fr .r, <............................................Address .......... ......... . .. . ......... ................. Number of Rooms ..........r�....................................................Foundation ...�!.........or.. :.., ........ ._ ............ ................................. Exterior I Roofing .......Floors n� �' .Interior . .........:........................................................................... .....:.............................................................................. 1 Heating . , .:.'..:......................................Plumbing .................................................................................. 61< ' �/ lq6 Fireplace ..: ..:...........................................................................A.pproximate Cost Definitive Plan Approved by Planning Board ________________________________19________. Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH S� t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. II i SEA COLONY HOMES 192-141 No ..?2657.. Permit fo ,..nny...St=Z , Single Family Dwelli g ............................. ........ .......... Location ,Lot #2.5 267 Glen a le Dr. Centerville " ............................................................................... Owner ......Sea Colony. Homes ' Type of Construction ...Frame ............................. ................................................tee............................. Plot. ............................ /Lot ................................ Permit Granted .. nvemhex...1.Q 19 80 Date of Inspection 19 .......... Date Completed ......... ................... 9 f PERMIT REFUSED .................................. .. 19 ........ ...... ... .............................................. . ... .. ........................ 1-1 ............. �. . ................ . ............... Approved ................................................ 19 ............................................................................... . ....................".......................................................... I` ti w r r ti .� r- �!. � "ajr�� �/1��'4 1rL:p ram`.r'S 'Y�'•il.:•P'��'✓�fk,:�. .1`. " `... TOWN,OF!BARNSTABLE 2657 r Per No. -BoildingInspector - ----- �= ' r OCCUPANCY , PERMIT'. Bond X_/ P `.`No building nor structure 'shall`be�;erected;in'd no'landi building or`etructure,shall.be` x,.. used for a new, different, changed, or enlarged. use -without'.a Building Permit,'therefor first having been obtained from the Building Inspector.*.No building.shall be 'oecupied until a * certificate of .occupancy has'been issued,by;thetBuilding Inspector:". ,., �► . Issued to Sea Colony HCMe8 Address' lot #25 - .•267 Glenej QP16 Drive: Centerville, Wiring Inspector y '' �/� t; Inspection date. Plumbin `ld_ f -Inspection date G . Gas Inspecto Inspection date ',. f;•' T Engineering Departmrent 'r /i" tilv�>. v% f✓ Inaction date THIS1iPERMIT WILL NOTe BE VALID, AND THE BUILDING .SHALL•.NOT BE 'OCCUPIED ;UNTIL' . SIGNED BY'THE BUILDING'. INSPECTOR-,UPON SATISFACTORY .COMPLIANCE:'WITH TOWN . REQUIREMENTS. ; ^............._.. ..� ......,• _. j / Building Inspector