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0030 HOLLY POINT ROAD
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'° •^�" : i' _ TOWN OF BARNSTABLE.,BUILDING PERMIT,APPLICATION:.,; Map Parcel ;Application Health Division "Date Issued Q 3 Conservation Division = Application Fee i Planning Dept Permit Fee Date Definitive Plan Approved by Planning Board Historic =OKH _ Preservation/ Hyannis Project Street Address WOG.t Y ®O//,/ Village Owner �1/ L/y /` Address SAC Telephone7 � Permit Request c' Li�iiCri ) p } Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District. Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,ig Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes UNo On Old King's Highway: ❑Yes 3kNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing fi ;new Number of Bedrooms: existing _new ^* { x3* Total Room Count (not including baths): existing new First Floor Ropm Couat Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑ Other o Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo /coal s Bve: Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: existing ❑ r,,,w 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name S 7�46IZ4 //Z5 Telephone Number Address 30 f/OLLy fD0/.it//� 0 .�' License # (LIV I—R 111�Z f /W/` D, 66 3 2-- Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE � ��s � DATE r FOR OFFICIAL USE ONLY -;!?PLICATION# UATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION L1 6/b FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING 1= lolly 67 6 1011461 i :I DATE CLOSED OUT' ASSOCIATION PLAN NO. l f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): Address: 30 HoL-Y eO IIY - City/State/Zip: 6e�✓Y7E R KII 1,65 Phone.#: 77 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 employees(full and/or part-time). * have hired the stub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or'partner- listed on the'attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have 8.'❑ Demolition working for me in any capacity. 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. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself o workers' co * right of exemption per MGL y � mP• 12.❑Roof repairs insurance required.)t C. 152, §1(4),and we have no employees. [No workers' 13.® Other (,m6es, comp.insurance required.] J. " P6f?P1IT_ A3 PEP, PLANS *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. iContractors 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 emplgyees,they must provide their workers'comp.policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below 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 MGL c. 152 can lead to the'imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day.against.the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investilrations of the DIA for insurance coverage verification. I do hereby certify um r the pains and penalties of perjury that the information provided above is true and correct Simafore: Date: Phone#: 7 If? Y 0,9 50 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. 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 gccupant 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 azth 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-conf actors)name(s),address(es)andphone 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 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(ifnecessary)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 maybe 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 (Le. 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 Dgparfznent of 3ndustnigi 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 11-22-06 . www.mass.gQvldia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- JN- TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: 4 fiZV1L 1S �f/YUG�177-5 Site Address: 30 10U Y e011✓1_" A& print . Town: Applicant Phone: "77y ff/ 0?6-0 Applicant Signature: Date of Application: 2L/ 91200 NEW CONSTRUCTION: choose ONE of the followin two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAXIMUM 'MINIMUM Ceiling or Slab Option O l: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER 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.- 1987 as amended,minimums or eater as applicable 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 CUR 6107.3.2 REScheck—Web which can be accessed at http://www.energycodes.goy/rescheck/ ADDITIONS:OR"ALTERATIONS.TO EXISTING BUILDINGS.OVER 5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % 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 glazing is<`40%.use the chart below. If glazing is> 40 % rgceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration .Ceiling and .Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R.-Value R-Value R-Value and Depth .39 R-37 a R-13 . R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be 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 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 Appendix 120.P Town of Barnstable `. of T r�TArs. . Regulatory Services r • s,utxsrtst a Thomas F.Geiler,Director � '� 6. Building Division PrED M1d Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA 02601.. www.town.barnstable.ma.us Office: 508-962-4038 Fax: 508-790-6230 HOMEOVNER LICENSE EXEMPTION Please Print DATE: JOB LOCAT7�D /y O L-L Sy 1401�1 number o�,,�/ �7 street village "HOMEOWNER": :�n y�LS� -::;0& ,41175 7 H ?9YQY 50 5�5D name V home phone# work phone# CURRENT MAILING ADDRESS: 30 )Wu.r PQ/Nj /rI ERVI t,C Ali9 DV6--3,Z city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling 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 HOMWW-.ER 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 shvctures 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 m;n;rnum inspection procedures and requirements and that he/she will comply.with said procedures and requiremen f ,&rgna ' 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 hip:to do such work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption are unaware that they am assuming the responsrbi}ities 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 GITMW 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 respo=bilities of a Supervisor. On the last page of this issue is a form currenay'bs6d by several towns. You may care t amend and adopt such a form/certification for use in your cDmmunity. Q:forrrrs:homccxempt , oxTa�ti Town of Barnstable ' Regulatory Services . � g Thomas F.Geiler,Director En;9. 16 Building Division ' Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, R /SsYU�AiT/S , as Owner of the subject property hereby authorize ,4sPMiffXS Z, / $�} to act on my behalf, in all matters relatiXrktlorized by this building permit application for.//V; k (Ad dre of Job) r 3 /9 �009 of Owner Date Z, 6,Pe7i V/L/S 1�74 ffU LI/ T)S "Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2-; 09 Parcel Application #,2n0Y05 4 b2-, Health Division Date Issued Conservation Division _ Application Fee Planning Dept. Permit Fee GJ�' Date Definitive Plan Approved by Planning Board Historic.- OKH Preservation/Hyannis Project Street Address 13 ® O L L / POINT F O A 4 Village G fffvT U L 1- - �rin Owner F-D CJ K a -Ay SP-A' 34w[Al HS Address I OIL Y Telephone Permit Request. ADD 1-11 io� , 4 I p4e-y-w . �,7ic.,�kekn �g*c o IM Square feet: 1 st floor: existing 151 f proposed (;�f3 2nd floor: existing proposed Total new I-7 6 3 Zoning District Flood Plain Groundwater Overlay Project Valuation (OZ000 Construction Type Lot Size Grandfathered: ❑Yes O No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-FaYNo (# units) Age of Existing Structure Historic House: ❑Yes On Old King Highway:'s Hi hwa : ❑Yes &No Basement Type: dFull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) 5-00 Basement Unfinished Area(sq.#) J� Number of Baths: Full: existing 2— r new Half: existing rsew Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor R® m Count Heat Type and Fuel: YGas ❑ Oil ❑ Electric ❑ Other c5 27 Central Air: ❑Yes Iy No Fireplaces: Existing I New Existing woo coal st®ve: O Yes No Detached garage: ®"existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existinc❑ r feW 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 APPLICANT INFORMATION -(BUILDER OR HOMEOWNER) Name �, '-1 5 Telephone Number 508 2-q 2, 2,�`' �l Address . \ tPCF—Lof License# CS 0`435 o o CQ (y 1 V)A P Q2(Q Home Improvement Contractor# !o 6 Worker's Compensation # W'c Soo a-32Zo k 2 D eg ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� `� FOR OFFICIAL USE ONLY �d APPLICATION# D "SE ISSUED ,I MAP/PARCEL N0. a ADDRESS VILLAGE OWNER ' a DATE OF INSPECTION: FOUNDATION FRAME t G aq `� gla9 INSULATION 6- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING u� 9W, 604to Ili DATE CLOSED OUT ASSOCIATION PLAN NO. I ,per The Commonwealth of Massachusetts- " Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El ectricianslPlumbers Applicant Information Please Print Legibly Name (BusinesslOrganizationllndividuaI): Q U 6L I y "�l OC� W K � ,v C Ad�zess: City/Sta&zip: (026 ?J Phone.##: J�'� • 2-4Z � A�rye,you an employer? Check the appropriate b= Type of project(required): I am a employer with 4• ❑ I am a general contractor and I 6 Kew constr_=t n employees (fun and/or part-time).* have hired the Sub-contractors 7. Remodeling listed on the attached sheet _ 2❑ Ism a sole proprietor or parbacr- These sub-contractors have ship and have no employees 8. ❑Demolition Crop and have workers' working for me in any capacity. 9. gBuildink addition [No workers' c rop.•?n_s ranee COMP.inerrra C-t- 5. We are a corporation and its 3. I am a 10_0 Electrical repairs or additions '. refit ] officers liave exercised their I Ln Plumbing repairs or additions [] a homeflwner doing all work myself[No workers' comp. light of exemption per MGL 12 ❑goof repairs re fi. c. 152, §1(4), and we havt no insurance e&] employees. [No workers' 13.E]Other comp.insuranecYegtm-ed.] *Any applirant that chmia box#1 must also fill out the section below showing their wark='corupmsahon Policy irdbm atiorL t Homeowners who subrmt this of davit indicating they arc doing all work and thrn hire outside cGntrart rr must subrmt a new affidavit indicafrog such. TCrmtractors that check this box must athmbcd an additional sbmt showing the name of the sub-ootracttna and state whether or not thosd entities have employees. If the sub--onirdctDrs have arIPloyces,tbey must PnTvi dt their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: Policy#or Sclf--ins. Lic.#: VvCC��� �© � Z.O $ Expiration Date: 0(0 I Q� 2©Q 0 `J �ru 1`1� Job Site Address: �O iA 0LL I �© 14j'1 �� City/State/Zip: C� 1 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 crirnirial penalties of a 5na tip to $1,500.00 and/or onn-year imprisonment, as well as civil penaltie fine s in the form of a STOP WORK ORDER and a of up to$250.00 a day against the violator. Be advised that a copy-of this statcmerit may be forwarded to the Office of InVC3tiK&tiMIS of the MA for ins rrancc coverer ,c verification. I do hereby certify under the paires•and penaalties cf^perjury rhat the information provided above is true and correct. ' Si attire u(" c `� Date: ©l 1i fl /0 U Phonc# Lf Official use only. Do not write in.this area, rb be completed by cIV or town offrciaL City or Town: Permit/License# Issuing Authority.(circle one): 1.Board of Health 2.Building Department 3, City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. pursuant to this statute, an encployee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" S ,, 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 rcprescntafives of a deceased employer, or the I,,ciVCr 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 Iocal 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 ohapter 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 compliznce R ith the insura-tee regnirem,r is 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, it necessary, supply rdb-eonfractor(s)name(s), address(cs) and phone numbei(s) along with their eerdfieatc(s)of insurance. Limited Liability Companies*(LLC) or Limited Liability Partnerships (LLP)with no-txnployees other than the =nibers or partncir, arc not required to carry workers' compensation insurance. If an LLC or L.LP does have :mployees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial kccidr,nts for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should )e returned to the city or town that the application for the permit or license is being requcstcA not the Department of ndustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' :orapcnsation policy,please call the Department at the number listed below. Self-insured companies should enter their ;cam;nsuranGe license number on the appropriate line. :ity or Towle Officials 'lease be sure that the affidavit is complete and printed Icgibly. The Department has provided a space at the bottom ,f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant - affidavit be sure to fill in the permitgicense number which will be used as a reference number. In addition, an,applicant eat must submit multiple pemmitlliccnse applications in any given year, need only submit onp affidavit indicating c=crLt olicy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or )wn)."A copy of the a$davit that has been officially stamped or marked by the city or town may be provided to the pplicant as proof that a valid affidavit is on file for fiiture permits or licenses. .A new affidavit rust be filled out each ear.Where a home owner or citizen is obtaininD a license or permit not related to any business or commercial venture .c. a dog license or permit to burn Icaves etc.) said persoii is NOT required to complete this affidavit he Office of Investigations would him to thank you in advance for your cooperation and should you have any questions, lease do not hesitate to give us a call. ie Department's address, telephone-and fax number. The C6mmonw-Wth of Massachusetts Department of Iadus-tdal Accidents Office of Iuvestigat ans 600 Wash&tGn Street Boston, MA. 02111 TeI. # 617-727-490.0 ext 4-06 or 1-V7-MASSAFE Fax# 617-727-7749' :d 11-22-06 www.a-ias.-,.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- ANM 'TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Narne: AQn(�� 5 � ( �( S� Site Address: D �L(,>E T-0)j►-j (� � Per,,, Town:. F-lJ-T P•Z Applicant Phone: . 0 201 Z . 25e9 Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE oft e followin two op tions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE, AND-TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Basement Slab ❑ -Option 1: Fenestration exposed Wall Floor Perimeter U-factor floors. R-Value R-Va.lue Wall R-Value AFUE T�SPF SBLR R-Value R-Value and Depth National ApplianccEncrgy 3 5 R-3 S R-19 R-19 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amendcd,minimums or rcatcr ns a llcahle Note: This form is not required if you choose either of the two versions of REScheek.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 c;:in be accessed at http://www,cnergycodcs.goy/reschecld ADpZTIOZVS<OX2 AZ,TERA TZOl�S :T0 LI IIN ..BU7I�DINGS:':OR 5:.XEARS OLD *Buildings under 5 years old must use option#1 or 42 in New Construction section above: :�omplete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_a) SF 100 x - _ % of glazing (b) Glazing area equals. SF b Q f lazing is-�;40% use.tfie chart below. If,glaziri .is>:40'.% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING 'LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter EOFenestration Exposed floors Wall Floor Basement Wall R-Value U-factor R-Value R-value R-Value R-Value th and De .39 R-37 a R-13 , R-19 R-10' R-10, 4 feet R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the'full R-value over the entire ceiling area(i.e.not com ressed over exterior�Yalls, and including any access openings).- ' ` SUNROOM-An addition or alteration to m existing buildinydwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall-and peiling area of the addition, Note:. Owner to fill out Consumer Information Form (found in Appendix 120.P) r 1 ` °FVE Town of Barnstable Regulatory Services Y * Y a MAS& Thomas F. Geiler, Director h1 pQ°p 1 6�9.AS9. �, TfoM -Btfilding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.tolvn.barnsto ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner-Must Complete and Sign This Section If Using A_ Buff der j ��RZ ILI ANULA'ITI� as Owner of the subject property , `G �oo ti�s 1 d C hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: cb&3 o 110ZLY 11,17 (Address of job) �6 a00� Signa of Owner L7ate ER�6WL/-S /77S Print Name If Property Owner is applying for permit please complete theIomeoamers License Exemption Form on the reverse side. Town of Barnstable 0�YHE r ye Regulatory Services ' 'Thomas F. Geller, Director j, MASS. q, 0fq. Building Division preo �n Tom ferry,Building Commissioner 200 Main Street, Hyannis, MA 02601 v-Yny.town.b2rnsiable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HO)ITOWNER LICENSE,EXEMPTION Please Print DATE: JOB LOCATION:___ number street village "HOMEOWNER": — name home phone# work phone# CURRENT MAILING ADDRESS: _ city/town state rip 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 faun struciures. A Person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "horireowner shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such workperfcrmed 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 minim m inspection procedures and requirements and that he/shc 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. ROMEOWNER'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 1o9.1,I -Licensing of construction Supervisors);provided that if the homeowner engages a pc-son(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption aic unaware that they arc assuming the responsibilidcs of a supervisor(sec 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 homcowncr is fully aware of his/her responsibilities, many communities require,as pal 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 fonn/certification for use in your community. Will !'I, " t iornvnzoouu �i BOARD OF BUILDING REGULATIONS a' License: CONSTRUCTION SUPERVISOR .t1 I i f t Number CS 093566_ r } d �Brrthtlat 02/20/1978 d I ON D J(420].0 Tr. no: 935661-0 i — R�esytnctedNOW OOj �k i ARMINAS DIMSA~ {, f I' POBOX 2373, NAPJTIJCKET, MA F- Cof'miss loner u_ 01 0011- Board o 11ng a ula/n g s and taTna4r Ps One A�hb urton Pe lac - Ro om om 1301 Boston, Massachusetts 02108 Home Improvemel t Cbntractor Registration Registration: 161601 Type: Private Corporation . QUALITY WOODWORKS INC. 117E � xpiration: 10i29/2010 Tr# 277006 ARMINAS DIMSA 17 PATIENCE LN � COTUIT, MA 0263 !�`, `� Update Address and return card.Mark reason for change DPS-CA1 a0 50M-07/07-PC8490 [] Address (� Renewal a Employment C Lost Card Oct 16 08.02:00p Habig Magoon 508-238-9020 p.1 ACORD CERTIFICATE OF LIABILITY INSURANCE »K o9rozro6 PRODUCER THIS CERTIFICATE IS ISSUED AS'A MATTER OF INFORMATION Habig&Magoon Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 95 Belmont Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Easton NA 02375 INSURERS AFFORDING COVERAGE NAIC N INSURED Quality Woodworks,Inc. INSURERA: TravelersindemnityCornlmny 17 Patience Lane INSURER»: AssocieWlEmployersinsCo Cotuit,MA 02635 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHISTANDWG 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 CONDMNS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. TNSR DD' ! POLICY NUMBER MEMO POLICY EIIPBiATION. UMTS I GENERALLUL8IUTY I EACHOCCLMNCE S 1,000,000 A ; X COMMERCUAL GENERAL UMILITY i MGO.4494M4OA4ND-OB 06/16/2008 0511 W2009 DAMAGE TO RENTED S CLAIMS MADE a OCCUR! MEO EXP ane wn s5,600 i PERSONAL&ADY?NAM S 1,000,000 I GENERALAGGREGATE S 2,000,000 I GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-CONIPIOPAGG S 2,000,OOa POLICY PRO-JECT LOC i AUTOMOBILE LIABILITY CONIBINlS7 SINGLE LIfAT S I ANY AUTO lEe awdent) If ALL OVNiEDAUTOS ! BODEYfNJURY S SCHEDULED AUTOS (Paf Pam +) HIREDAUTOS BODILY INJURY S NON4IAMC-D AUTOS (Per welch"? s PROPERTY DAMAGE S (Pet awid") GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHER THAN EA ACC S I I AUTO ONLY: AGG S i i EXCESSiUMBRELLALUBIUTY i EACH OCCURRENCE S 1 OCCUR FD CLAIMS MADE AGGREGATE S I S I DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND x tYC STATU I I DTH- 9 EMPLOYERS uaelLmr i WCC6007322012DOO 06/09/2008 OMN20N E.L EACH ACCIDENT S 100,000 ANY PROPRIETORVARTNERIEXECUTIVE OFRCERMIEMBER EXCLUDED? E.L.DISEASE,-EA ENFLOWE S 1001000 IT yes,desaibe unlar . SP IAL H)N E.L.DISEASE•POLICYLLIIT Ssao,00a OTHER . OESCWP7fON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT)SPECIAL PROVISION via fax#508-7904230 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING HISURER WILL ENDEAVOR TO MAIL 0 OAYS WRITTEN, ZOO Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REPRESENTATNES. AUTHORIZED REPRESENTATIVE <DC> ACORD 25(2001108) Q r�f _/_ � PORATION 1960 Daniel E Draman,PE 189 Harbor Point Road Cummaquid,MA 02637-0361 Phone(508)362-6016 September 9, 2008 Ken Sadler Kenneth Sadler Associates P.O. Box 1149, Hyannis, MA 02601 Project: 16408 Ed and Ausra Janulaitis Residence, 30 Holly Point Road, Centerville, MA At your request, I have reviewed the drawings for the above subject residence in regard to the structural members. I find that the structural members as shown are structurally sound and meet the requirements of the Massachusetts State Building Code. Daniel E. Bram `Z -q:b " r Daniel E Braman,PE + 189 Harbor Point Road Cummaquid,MA 02637-0361 Phone(508)362-6016 ' November 24, 2008 Ken Sadler Kenneth Sadler Associates P.O. box 1149 Hyannis, MA 02601 Project: 16408 Ed & Ausra Janulaitis Residence, 30 Holly Point Road, Centerville, MA F a-774 At your request, I have reviewed the drawings for the above subject residence in regard to the structural members.'This involves the: * W 12x22, 16'-6 span , * 2- 1 3/4 x 11 7/8 structural ridge, 12' long * New W 1Oxl9 beam under the ridge. I find that the structural members as shown are structurally.sound and meet the requirements of the Massachusetts State Building Code. Daniel E. Braman, P iN C' L H �+ 1 S? ®��s�Dull E � if for AASCMCWT Gp-t /BUG o S !�D e•..•-o'Peo-.1a...wa.fu.rWYwY a • - 1 ••!en t6•s•nl Mueur•...w.1.N�Lf. r '�- .. w/l.♦k.ywy � � 7 � I b � 1 s',s•Nu..w.,f,,.,ylt,,,wnl ,i - i-- --- --- -- — �:,. � < , i - '� !'-7 1/!' � I t6•re•/W..:vw feu. � � ii_IIILL 1 4.!I•..v..i ,fir 1 , I , !'Peu-•J wnw.l.Jur1 NP I �' •'.s•.1/♦'PWwe•A.rr 6.. 0 II '--------------' I � w/b nl.,rlp eetr.rLrrur. I - Stes.♦nJ e•F.nrtl,,l•/.rk. - - - �� 1 PY. wfeu.yl4n le ell W/fM I ; Ptn nfwfet•.J.l 1—le ell w/4— I I f.lo•r•Lr p•.r J.IW:./. I i New it rl.b•Y.�,. ; i ♦..t Pr.L.r ph-A,d jt.le I ell Mut4/4n.r.Jrwr.l Y.le n.w. I lwwlwi Yn 1t � '•4• 1 , , I , Tr' •1 , ell Wunl•1 Ln MIr•u•.J I..1•n•w. - /� II I �i111 n•W�•.f'•fi.r• 1 --7 � X I 'er.,.L,,,ti.,4lY.ff•y.el lrw.; —_— --_--, 1 - �` O I , v + bk II ➢- \ it r.tr.I•.nw.l.fe.l of I ' ,-. �-r I II�� ��; � ,'.. (^� w/s t/s'at•a..l en1••nw.1.- I I .,' ; � �. �.�._�._ II4 �. ,' t3eUn•w deny.•le..• - I I--- I w-- I . '. 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'-? 4�II b Wn7�0 OCMR fR�Otllt►ebre�M WNw elA�r•nr net ,a''� \ � w.« ,, �rrtrnorran•tns,'�erroim�.e��t�olnd�Dor�r�uae ■w�$����`■� f 0 NIrM.ar•••wA•t7•w.Ln.,,ti to hlrfotl•Hlflar tnf prpo•r o17lO GKR ff00•Mr coney ■o �E�p ._f Y•J.•'••rM•It'Y A..•rA!w...r (I�nW GOA WLNq�j,•f PeN•bn o1 l00 GNR l I OO tllN ff.00 ■{■■•� 7 0 � •Y K••eI•ew•MY 11rw - j��9��f 9 Jtagf101r Tts trf•Ion of nrl lift r.r'•l connct.r to tn•.N•tln f �) _I a L truclwtbn•nrr•o�tcL4itn•'tldtbn of•d•k w pftle vfto% I or••rtr J .l i Teo c•ttt aeauff t �f d 1�Q.+ f xreu� en 42010.3 sI ArANON MrGO.yy 0 r17 60 C f]O♦.td 4so♦ - lV IRY'�.•,.pS r...+• t.r'`='� ... t.�5..'9'i- 7tM 4w�OOf 11l�Ary NOf•JDIa/AttOur �E a' � h o-IuVC - ,o L i tom, A ' �t Town of Barnstable *Permit# ` Expires 6 mon s fro issue date PER E gulatory Services F _ rt BARNSTABLE,g APR mas F.Geiler,Director ` 1 �� 2008 Building Division Er- 05-168 rFp OF 8AIV Tom Perry,CBO, Building Commissioner �TAB Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number or-, (&� Property Address r 4 WResidential Value of Work ID Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1402LO �qtk v (A( �h T Contractor's Name • h4n ICU C Telephone Number j 7,Q Home Improvement Contractor License#(if applicable) (� CIE ,M,Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance f� Insurance Company Name Workman's Comp.Policy# ul Q Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) / CEkRe-roof(siripping old shingles) All construction debris will be taken to — ��e�tJ� ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum,4 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. a,��'wa SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 " � r a, 4: s _ - xIRa + agrd MW IL d 3 s z � i t� s O .L S. 3. 3 en�' �•pl O7 ' .`'� 1�6C�%r s+x�'G.:� p, 0 \• 1/i \ • i. p a$'�R d � x J t • �� ��.r. � z .v� � it 3y rd ar T� �Oaw1 etV�t a5 ✓�-.'" NO S afoS000a<taoaa< .. \\ ' ,t<at�ooaate 1005 aoa5 � / e o<<e�i<�t���eto�a��3�� \ \ ,- y�ceo5ethee<J�a�0�4ee4� befo< a of$ <too4 a $ostoo, e � o Jt 5��oatJ< ' AC ORD CERTIFICATE OF LIABILITY INSURANCE oP ID KS DATE(MWDD/YYYY) MONGE-1 04 08/08 PRODUCER - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bryden & Sullivan Ins Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Dennis Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 485 Route 134, PO Box 1497 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. So. Dennis MA 02660 Phone: 508-398-6060 Fax: 508-394-2267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER CNA Insurance Companies INSURER B: - Michael Mon eau INSURER C' 77 Traders Lane INSURER D: West Yarmouth MA 02673-3334 INSURER E. COVERAGES . 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID.CLAIMS. Sft POLICY EFFECTIVE POLICY EXPIRATION LTR NERD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ - COMMERCIAL GENERAL LIABILITY — 'PREMISES(Ea occurence) $. CLAIMS MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Perperson) - HIRED AUTOS - - - BODILYINJURY $ NON-OWNED AUTOS - - -. (Peraccldent) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY-EAACCIDENT $ ANY AUTO + O OTHER THAN EA ACC $- AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE - - - RETENTION $ $ WC STATU-' OTH- WORKERS COMPENSATION AND - TDRY LIMITS.. ER EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE 6S59UB48OX760908 03/04/08 03/04/09 E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE _::�$ 100.000- Ityes,descrlbe under - - SPECIAL PROVISIONS below E.L.DISEASE-POOCYLIMIT ,Q$ 500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - Michael.Mongeau included himself for Workers Compensation benefits under class code #8742 Sales CERTIFICATE HOLDER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable Building Dept; IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street REPRESENTATIVES. Hyannis MA 02601 AUT40RJZED REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 °F1HEr � Town of Barnstable Regulatory Services RARNSUBv t.e� Thomas F.Geiler,Director Build ingDivision Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: `508--790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, �(/SR.� ` �h/UL��T`� , as Owner of the subject property V. hereby authorize to act on my behalf, in altmatters relative to work.authorized by this building permit application for: 30 Mt y Poilvr kD 1/iZze' 0�3z (Address of Job) Signature of O VfIr to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �Oc 1HE tp�� Regulatory Services BARNSTAaLE, = Thomas F.Geiler,Director 9 MASS. Building Division Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 wvnv.town.barnsiable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ------------ HOMEOwNER LICENSE EXEMPTION �n Please Print DATE: M/ JOB LOCATION: 30 /LOLLY POIwr a (,r5 ly'7Z� number pp ��77 f street p -7 �7village �]� "HOMEOWNER": S tr /7 �A / �0 3/SO-OO � qo 771 � O name Vhome phone# work phone# CURRENT MAILING ADDRESS: S NW6 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. ; DEFINTTION..OF.HOMEOWNER , `t 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. rgnature of Ho wner 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 1o9.1_.I-Licensing of construction Supemsors);,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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l Please Print Le 'bl Name(Business/Organization/Individuan: ce cJ Address: teii City/State/Zip: Phone.#: 5 CD ' 7 q - Are ou an employer? Check the appropriate box: Type of project(required): 11I 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.El 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' P tY• $ 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 their 11.0 Plumbing repairs or additions myself:LNo workers' comp. right of exemption per MGL 12. 00f repairs insurance 1equired,]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 aD 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 subcontractors and state whether or not those entities have employees. If the sub-conhuatws have employees,they must pmvidb their workcrs'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: a &B 6 Expiration Date: Job Site Address: l l City/State/Zip: L�L�,-Ac Attach a copy of the workers'64ensation 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 tip 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 th 'olatm. Be advised that a copy of this statement may be forwarded to the Office of InVeStiRZtiMS of th ce covera a verification. I do hereby c nd the ins- nd penalties of perjury that the information provided above is true and correct Si a Date: Phone# f Official use only. Do not write in this area,to be completed by city or town official . City or Town: Permit/License# Issuing Authority.(cirde 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: 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 representative's 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 a#ployment 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 bas not pcoduced4cceptable�evidence of compliance with the insurancecoverage 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 Rzth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLQ 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 require, , 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 submif moltigle permitllicense applications in any given year,need only,submit,one affidavit indicating current policy information(if necessary)and under Job Sile Address 'the applicant should,wale -all'locations in (city or town);'A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call ti The Department's address,telephone-and fax number. The Commonwealth oflMassachusetts-~ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 TO. #617-727-4900 ext 406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www,masS.gov/dia -- Q Check Compliance 1.1 SCOPE WindSpeed(&sec.gust).......!,t........................._...........................--•--.._............_--.._._......._...._..:._...110 mph WindExposure Category.........................................................._...........................................___.._.......:._.......B — 1.2 APPLICABILITY Number of Stories-..............................................................(Fig 2)....._..._:.................�_stories.<_2-stories ' RoofPitch .........................................................................(Fig 2)............ jZ,s 12:12 Mean Roof Height (Fig 2)................................................Aftft s 33'�80,Building Width -- W--•---•- ---•-••-•-•••-•--••-------•--__--•-_--•-----•--•--__,(Fig 3).....................•---------••--------„---••Building Length,L (Fig 3)•........................_................_.. ft <-80, Building Aspect Ratio(LNV).-----------------------------------------------(Fig )•------•-••----•--••-•-•-----------••--- 3:1 Nominal Height of Tallest O i .(Fig 4)......................:.... l=8- Open in ...................... ..........._...... 6'8' 1.3 FRAMING CONNECTIONS General compliance with framing connections____________________ able 2 ---._.....-----• � 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete......... . ........•...---------......... ......-•---.........---......_........_..........-_--_.. _ ......._....._..__. ConcreteMasonry.................................................................................................................................... 2.2 ANCHORAGE TO FOUNDATION" 5/8-Anchor Botts imbedded or 5/8-Proprietary Mechanical Anchors as an alternative in concrete only -Bolt Spacing general........... .......•-..........---_.....Table 4).........-...................................... in_ Pa 9-9 --• Bolt Spacing from endJjoint of plate _...................... (Fig 5)......................................$in.<6--12- Bolt Embedment-concrete----------------------------- 5 .........................................-�Q in•>-7" y •-------- (Fig )...._ Bolt Embedment-masonry-----------------------------------------(Fig 5)............................................ in.a 15, PlateWasher................__...........................................(Fig 5)..__._...... ..........................._...>_3-x 3-x'/." 3.1 FLOORS V Floor framing member spans checked ...............................(per 780 CMR Chapter 55 ......................___.._._,___ Maximum Floor Opening Dimension...................................(Fig 6)........... ... ft s 17 or L/2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwad................(Fig 7)...................................................._ft s d 6Lt Maximum Canb7evered Floor Joists Supporting Loadbearing Walls or Shearwall_..............(Fig 8)....._........:;........_............ _..... � Floor Bracing at Endwalls...................................................( ig ).:...................._.........._.. ................,.:ft.. d F 9 Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)..........._......... Floor Sheathing Thickness .. (per 780 CW Chapter 55)-..___,_--_-_:,_-_.- , in. Floor Sheathing Fastening..................................................(Table 2)_t:5 d pads at min edge/,�2,in field 4.1 WALLS Wall Height Loadbearing walls................................................ (Fig 10 and Table 5)............,_.............Rft <-10' Non-Loadbearing walls................................................(Fig 10 and Table 5)............................ ft <-20' Wall Stud Spacing .................:.....................................(Fig 10 and Table 5)................... in.s 24"o.a Wall Story Offsets ..........................(Figs 7&8)....._..........................._._.._...Q ft <-d 4.2 EXTERIOR WALLe Wood Studs Loadbearing walls.......................................................(Table s)............................2x - ft_in. Non-Loadbearing walls.........._.._...................._.._.....(Table 5).............................2x - _m- Gable End Wall Bracing r FiFull Height Endwall Studs.............................................( g 10)•---........._....._............_......�.._._....:_...._-......... WSPAttic Floor Length....................--------------------------(Fig 11)........................................_. ft>_W/3. Gypsum Ceiling Length(d WSP not used):............:.....(Fig 11)..........,:................................_ft a 0.9W 2 x 4 Continuous Lateral Brace @ 6 fL o c...(Fig 11)............................................................ T _ ... .. .�..... ........ .....' ...... ........ �_ f AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)..............(Table 7)........................................................ Z, _ Non-Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)...............(Table 8)...............................................I.........� Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) v Header Spans (Table 9).................................. ft in.5 11' Sill Plate Spans ........................................................(Table 9).................................. ft in._11' Full Height Studs(no.of studs)...................................(Table 9)............._..........:............................. _%� 11 Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9)................................. ft .<_17 Sill Plate Spans...........................................................(Table 9)..................................�ft�min. Full Height Studs(no.of studs)....................................(Table 9)...............:....................................... . Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously" Minimum Building Dimension,W Nominal Height of Tallest Opening2 ..........................................................................tom 4w 6'8. SheathingType..............................................(note 4)......................................... ............�Sin. �r Edge Nail Spacingable 10 or note 4 if less........................ in. Field Nail Spacing..........................................(Table 10)................................................. Shear Connection(no.of 16d common nags)(Table 10)...................................................... \� Percent Fult-Height Sheathing......................:(Table 10)...............................................--; �70 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Maximum Building Dimension,L Nominal Height of Tallest Opening2................................................................ .. 5 6'8' SheathingType..............................................(note 4).......................................................T Edge Nail Spacing.........................................(Table 11 or note 4 if,less)........................kn. Field Nail Spacing..........................................(Table 11)................................................. n.Shear Connection(no.of 16d common nails)(fable 11)...............:.......................:......... _ Percent Full-Height Sheathing.......................(Table 11)_..................................................d'�n% 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... _ Wall Cladding \ Ratedfor Wind Speed?.............................................................................................................................. V 5.1 ROOFS Roof framing member spans checked?.....................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ............... (Figure 19).............._ft 5 smaller of 2'or U3 r ............ Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12).....:.....................................,U ff Lateral.............................................(Table 12).............................................L= ApIf �i/ Shear...............................................(Table 12).............................................S= pff Ridge �i— Strap Connections,if collar ties not used per page 21.....(Table 13)..............................Tf Gable Rake Outlooker.........................................(Figure 20)............... ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)..........:.................................U Ib. Lateral(no.of 16d common nails)...(Table 14).......................................L= Roof Sheathing Type...................................................(per 780 CMR Chapters 58?trd 59).................. Roof Sheathing Thickness........................�!.............................................................1.Z in.z 7/16"W P Roof Sheathing Fastening...........................................(Table 2)......................................... Notes: '/ 1. This checklist must 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 18a 2. Exception:Opening heights of up to 8 ft..shall be permitted when 50/6 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. AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliaince(7a0 CMR 5301.2.1.1)1 4. a. From Table 10 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing 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 dower 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 the Figure, Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in,High Wind Areas: 110 mph Wind Zone Massachusetts Checktist for Comptiance(7so CMR 5301.2.1.1)' WHEN THIS EDGE FUNM CM ROMMUSESd UP" ATt'ore. n 11 1 t1 1 It �1 u Ut 11 11 • R Ii 11 It 11 It ► M H 11 1► 11 11 It It � 4 ii ii 1 4. ► � n a► m =' lF rdG 1t r► p 11 It qi u r1 W i V it 3► t„ ' to ' tt u n 1 1 ►t ►1 hKll1OLIE E ------ +i MULSPACiNG + t PAitfa — v See Detail on'Next Page Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Arenas:I10 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)' ■ 0 1 r ■ N 1 } ■ w 1 r ■ r 1 j ■ r r ■1 �i r 1 ti 1 1 r rfid } i r 1} CL i i Q tI �i i } EDGE E�aIMMEMTE 1 1 / � 1 1 1 1 r r 1 STAGGEFED3�M nfi&PAT7EFiN PA . PAM EDGE DOUBLE MM EDGE WA(;WG DETAL Detail Vertical and Horizontal Nailing for Panel Attachment vi. REScheck Software Version 4.1.3 Compliance Certificate Project Title: Ed an Ausra Janulaitis Report Date:09/09/08 Data filename:Janulaitis.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: 11% Heating Degree Days: 6137 Construction Sfte: Owner/Agent: Designer/Contractor: 30 Holly Tree Road Ed Janulaitis Kenneth Sadler Centerville,MA 30 Holly Tree Road Kennetrh Sadler associates Centerville,MA P.O.Box 1149 Hyannis,MA 02601 508.790.3922 Compliance:13.0%Better Than Code Maximum UA:.69 Your UA:60 -. . w 04=9 Q?@ Ceiling 1:Cathedral Ceiling(no attic) 252 30.0 0.0 9 Wall 1:Wood Frame,16"o.c. 100 15.0 0.0 6 Window 1:Wood Frame:Double Pane with Low-E 17 0.340 6 Wall 2:Wood Frame,16"o.c. 209 15.0 0.0 15 Window 2:Wood Frame:Double Pane with Low-E 19 0.340 6 Wall 3:Wood Frame,16"o.c. 100 15.0 0.0 7 Door 1:Glass 10 0.340 3 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 252 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 4.1.3 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 coo he buildgig shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. U q 1b D Name-Title �S ign ure Date Project Notes: Calculation are for addition only CS#039020 D...:-. T:N... CA .... A—— 4 -4 A REScheck Software Version 4.1.3 Inspection Checklist Date:09/09/08 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-15.0 cavity insulation Comments: ❑ Wall 2:Wood Frame,16"o.c.,R-15.0 cavity insulation Comments: ❑ Wall 3:Wood Frame, 16"o.c.,R-15.0 cavity insulation Comments: Windows: Window 1:Wood Frame:Double Pane with Low-E U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Wood Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.340 Comments: Floors: ❑ Floor 1:All-Wood Joist/rruss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Air Leakage: ❑ 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 fixtures#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(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Insulation is installed according to manufacturers 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: Ll Ducts are insulated per Table J4.4.7.1. Duct-Construction: LI All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces 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. Ll The HVAC system provides a means for balancing air and water systems. Temperature Controls: Ll 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. Heating and Cooling Equipment Sizing: 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. Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. 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-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. o...:....�TS1..• C.1 .... A....... �......�..a:.. o---13 „s e Table 1:Animum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness In Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" Temperature(°F) 170-180 0.5 1.0 1.5 2.0 140-160 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 Rangeff) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" - Heating Systems Low Pressurelremperature 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 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) o...:....a T:H... MA .... A....... I......I..N:.. D...... A .S A r n Am MA MAN Wyk: r a s pyy s +i ✓ ,�:s $.` Y'(C 3 CA "'*� ; f' A y L IN VP .s, ks y E �7f � ;Of OilY , it pi- s A. a � , � � s t f 3 3 i �Y{ c' Y� � tw sty � `x,�n(r`�e. _ .'' +,•'> .�a. 1 u � �. NA` �,. r ilP%j4 _ r4 fJ. x t�te >'s t z -0r "m F•,.t _, MP lw >ao�y.:.�" �`: Tp'm`'a # n e x Y r. nett" 4{y '' sf. �, y, y v..�y �r e+ ?,�,,, ur A oil SIR � e`.J i� € � AT1NflxQti Fq �I^ r Y. 5 ti sf y ;z ti CAT 1 " TA s q ,F' r AN # ? ° OWN- 01, IP An MEN; p ; a .rt 3 r b l as _ ° � z Vi �X N-C awl �} 3 51 m - NMI >+s ` oil y r y x� 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE h - \ NOTES t CU tt c rws cam Gvr_ . Z ^4 4i(tg' qp I",1 b4.4(..4 In signing i gn g this form.the licensed construction supervisor,registered professional or homeowner(responsible party),as applicable attests to the fact that,to:the best of his/her knowledge,the work as described on the referenced permit number and associated plans and specifications has been executed in accordance with the provisions of the applicable.state building code(code)and reference standards. ff Name of Responsible Party Signature of Responsible Party Construction -`Home I p ovement Registered Registered Supervisor License Y Contractor Registration Professional Engineer Architect Number Expiration Date Number xpiration Date Number Expiration Date Number Expiration Date "- �� oZI(�tlo �1 t01` �a . . This form is submitted for the following project Permit. Number Property Address 200 m®�--L-Y YO(u 2�p�040 1026 780 CMR-Seventh Edition 3/23/07) (Effective 4/1/07) cl- f 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS APPENDICES Construction Checklist Single-&Two Family Dwellings ` If required by the building official,rthis form shall be submitted at the completion of the work,prior to the issuance of a certificate of F_ occupancy.or completion,by the licensed-construction supervisor,registered professional or homeowner(responsible party),as ° applicable,the municipal and/or state building official in verification that,to the best of his/her knowledge,the work has been executed in accordance with the provisions of the applicable state building code(code)and reference standards. The date shall indicate the date on which the responsible party viewed-the building activity to ensure compliance with the code and/or reference standards. This date may or may not cmrespond•to the'date on which the activity was inspected for compliance by the municipal and/or state building official. Note any deficiencies that were discovered(if any)and corrective action _ Activity Date taken to ensure compliance with the code and/or reference standards Foundation a. Locationlexcavationt i7�2 b. Preparation of bearing soil C. Placement of forms/reinforcing Q �g d. Placement of Concrete e. Setting weather protection methods f. Installation of water/dampproofing. Q fj g. Placement of backfill 9 ' p Structural Frame2 p a. Floor r b. Walls 01 c. Roof/ceilings Ol IZ , 9 d. Masonry or other structural system Energy Conservation a. Insulation/vapor and air infiltration barriers llY� b. NFRC rated window (Q ) c. HVAC equipment with proper efficiencies 'D31 2 +9� Fire Protection a. Smoke O� b. Heat ®3 04 c. Carbon Monoxide Q�I d. Other Special Construction a. Chimneys b. Retaining Walls j c. Other; i s If encountered in excavating for foundation placement,the responsible party shall report the presence of groundwater to the building official and shall submit a report detailing methods of remediation. 2. Frame shall include the installation of all joists,trusses and other structural members and sheathing materials to verify size,species and grad,spacing and attachment methods. The responsible party shall ensure that any cutting or -notching of structural members is performed in accordance with the requirements of this code. 3.The building official may require the responsible party to be present on site at other points during the construction, reconstruction,alteration,removal or demolition work as he/she deems appropriate. 3/23/07 (Effective 4/1/07) 780 CMR Seventh Edition t�25 Engiq.eering Dept."(3rd floor) Map,' o� Parcel Permit# S 3 House# . `�0 _ Date Issue* 2 t Board of Health(3rd flo4ry(8:15 -9:30/1:00-4:30). - O 7 Conservation Office 4th+floor 8:30'- 9:30/1:00- 2:00 U ,a Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SY UST BE c �� TALLE Definitive Plan Approved by Planning Board - ' � 19 CE WI • TOWN OF BARNSTABL:E , wIRoNM AND T®WM RE TIONS f Building Permit Application Project Street Address Village C; !1�61r '`1 ,". Owner Address 6P r Telephone — — ®G Permit Request , 51, WJ 1 "INIMIZU 9����l fS f�39�1� �i>>r/dn� �i�?�✓T�d y'a�2+ � 1��s92. ��4-C/,�4�] First Floor; square feet Second Floor square feet Construction Type Estimated Project Cost $ g�, &V0 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 UTo On Old King's Highway ❑Yes JarNo Basement Type: uorull ❑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 &6Io If yes, site plan review# - Current Use Proposed Use Builder Information Telephone Number Address /6 b &-tIV7VWW A,� Cl�i7 License# DrSr,9 03 Z �VWlew6WT ' ' Home Improvement Contractor# !Da 701',6 --Z 7-;-/ ,� 7 —tiy1i7 Worker's Compensation# 4,Yal IS a Z f2 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 - /DATE BUILDINalt QhQi, OWING REASON(S) 9 f3C� r FOR OFFICIAL USE ONLY ' PERMIT NO. DATE ISSUED - _ r _-F• 5 MAP/PARCEL NO. C ADDRESS VILLAGE •: - . • OWNER4 DATE OF INSPECTION: FOUNDATION to X,o , FRAME' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL'I - k PLUMBING: '. e ROUGH,;• FINAL .r rri— • s GAS: -ROUGH- # FINAL FINAL'BUILDIN_G- !f9 ' DATE CLOSED O ASSOCIATION PM O.C€ _ m ® - t , i ° UtA►r + w c t.a$N, D Z,05AC Ul J 1,00VW6 D v •�C� �'; pa O A e _ 2 06 T°TA�..�' O 0 1.02AG Q (L 3 OO r� \ � 3 � " >o a. 4e ;. 0,1 o 0 47. Oy 1 _ - - < - SHALLOW PO*p g •et oc %,pj,,�' ° y off• 2' > � ..x ° O' lV q44 00 _y a ; Al 5 ; k AO r 42 C � . �o • "7 :: r�is 94'p�,y i P 0�� , 1 •9 tiY 41 a 56 y - �`.. s ,,,0 FL4''. 40LIZoft .; E` s 10�aft This form was reproduced by United Systems Software Company I800)969-8727 �.>w- The Town of Barnstable BARMABM 9� M �0�' Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For.office use only ; Permit no. s Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ' MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: &fAgTL �i Est.Cost Address of Work: g,0 1Z pe-/ Owner's Name Date of Permit Application: y—/O 7 I hereby certify that: Registration is not required for the following reason(s):_ Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: rg7 /GO 7,00 Date -� Co ct r N m�.,_,4 Registration No. OR Date Owner's Name The Commonwealth of Massachusetts Department of Industrial Accidents ONCO oljnyestigaffm 600 Washington Street • Boston Mass. 02111 Workers' Compensation Insurance Affidavit It MitJif rofiTaffi 61i = .,:K' '� nam • cati ciry r✓d�!// .�� �2G5' phone', 9S/� I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 71 ti-.1 fit M• wCr" ��.+ �Qi•'+ �1`L 1 am an employer providing workers' compensation for my employees working on this job. comp anv name- address: city. phone# insurance co Zf / policy ri 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: cir phone#• insurance co 461icv if coml2anA, name: address: city phone insurance co Policy# ,Attach additional' hest if ne_cess_an Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition or criminal penalties of a lineup to s1So0.00 and/or one years'imprisonment as w ell as civil penalties in the form of a STOP N'ORK ORDER and a fine of S100.00 a da}-against me. T understand that a cope of this statement may be fon+arded to the Office orinvestigations of the DIA for coverage verification. 1 do hereby certrjv u pains a penalties ojperjury that the information provided above is true and correct Sienature 10Dare Print name /Vdb�7 ��—��� Phone orricial use only ~ do not-rite in this area to be completed by city or town official cin or town: permitNicense M rlBuilding Department C C]Licensing Board check if immediate response is required Selectmen's Office Health Department contact person: phone a: 0Other__.__ (,�.%uJ 1:0t P1A1 O( (A /tj y Y I 1 1 V r APPLICATION PREREQUISITE TEXT No new bedrooms authorized. Health Division records show a 2 and a 3 bedroom house . Assessors shows a 1 bedroom house . Septic off to opposite side of addition, shown asbuilt . Addition is a kitchen. Assessor's office(1st Floor): VEM W. Assessor's map and lot number SY C®fa `_ Conservation 4th Floor): Board of Health(3rd floor) CO, • Sewage Permit number �� �� ��� ;sesRu►ntc . Engineering Department(3rd floor): � ^�'=,',`ti`At U�'"��'� °o�i6}p.``�d° House numbero�sr Definitive Plan Approved by Planning Board 191 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR.PERMIT TO t L C mz 6!-po/�ZC TYPE OF CONSTRUCTION _ 00 0,C) it 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Y cf— Proposed Use \, A'a Zoning District r Fire District C Name of Owner �IQ Address Name of Builder Address-bO (#rMFz.1.r�J Name of Architect Address Number of Rooms Foundation CO W C K R 1� t _ V.as Exterior Roofing Nf)Q 1 Floors Coo L&[ fe— Interior Heating Plumbing Fireplace Approximate Cost Area M1 Diagram of Lot and Building with Dimensions Fee L� 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. Na Construction Supervisor's License LENA, JEFFREY 070 BUILD No _ Permit For GARAGE - Accessory to dwelling Location 30 Holly Point Road 4 Centerville r? Jeffrey Lena Owner Type of Construction Wood frame Plot Lot - *� Permit Granted September 7 19 94 Date of Inspection: f Frame to Insulation 19 r r Fireplace 19 Date Completed tb-3 1 y 19IN - r Centerville Sidney & Dia e H ....BA.R.NS.T.A.B.L.E.................... Rejonip'ng to......... Deed In Book._- .......page—L—... ...... —... ...2............. Court Cooffles"No. L4111_...in Back... P6.90-62. B.a.rn_stab.1.e_ .9istry.-Dist.r.ict....... ...... ....... In ...... Rc ........ ... Land Court Plan 20239 C f-iled with Cert- 20178 February 1953 Record"FUn........................................................................................................ Date of Plan .................................... Barnstable . - District, in ISO 118 Sheet 5 In ................................... Book...... ..........No_-....... Filod Plan No. ......................... MORTGAGE INSPECTION PLAN PATROIT BANK., - N.A. #60458 Laura & David Cohen 30 Holly Point Road, Centerville - Barnstable PIPC Z—,:>T- 69 70. V\ 41 HOLLY POINT ROAD Sept. 11,1986 3 7S '5 50137 JN C;ERTIFY THAT THIS PLAN WAS PREPARED IN ACCORDANCE WITH THE COKMONWEALTH ..z OF MASSACHVSETTS PROCEDURAL AND TECVNiCAL STANDARDS FOR THE PRACTICE '42 OF LAND SURVEY114C 250 CMR G.QS AND WITH THE SPECIFICATION SHEET ATTACHED HERETO. 0; KENNETH ANDUMN tft#*_31296 The Town of Barnstable BAR.ISr"LE. MASS, S, Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner 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 tip 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. CA7o� Type of Work. « Est.Cost 0cc7 Address of Work: 3 o (4o t, Owner Name: J j�i_Al 67-f)_,V �'I) ON Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S 1,000 Building not owner-occupied O I'mer 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: �-,, a z Date Contractor name Registration. No. OR Date Owner's name COMINI O NTWF A I TH OF NZASSACH USETTS D N-T OF ;�'D UST R LAL ACCIDENUS '�'Sli1�- CEAFFIDAVIT v.J �, S o(S ()4-I 6 I G (licensee/permincc) with a principal place of business/residenec at: (City/Suitt/Zip) do hereby eerzify, under the pains and penalties of perjury, than. j ] I am an cmplovcr providing the following workcrs' compensation coverage for my employees working on this job. Insurancc Company Policy Numbcr l am a sole proprictor and havc no onc working for mc. [ ] l am z sole proprictor, gcnc:v contmaor or homeowner (circle onc) and havc hired the contractors listed bclo,,v who havc the following workcrs' compcnsarion insurance politics: Namc of Contractor insurance Company/Policy Numbcr Namc of Contactor Insurancc Company/Policy Numbcr Namc of Contractor Insurancc_Comp any/Policy Numbcr Q ] am z homeov,•ncr performing all the work m}•self. NOTE, Plc�sc be :.,: e •,h v Dilc bomeowaers�+,o employ persons to do raaintenamcc.construction or repair work on dwelling of not more zLZZ three uniu in w�ich the LorncoWncr a}so resides or on Lc Froun6 appurtenant thereto arc not FcncrJly considered to be cr p?eyes �d_r the Worwcrs' Cor--pcns:tion Act (GL C. 152,sca. 1(5)), application by a boracowocr for a IICc DSC or permit m:y evidcccc &c 1cFJ st_:r,:s of:.: cmplovcr under the Workers'Corapcns:tion Act_ l understand t}:at :copy of trig st:Icmcnc will be forwaJdcd to the Dcpa:tment of In&:striJ Aeadenu'0fi-ree of lnsurancr for co-era=c .er.fuaior. aae th-: fa:!crc to seeurc eavc,—_�Cc Z, rcouircd ender Scetior,25A of MCL 152 e:n Ie:d to the imposition of 'in' J pen:ltics cor.:isc^�Cr: f,nc cf tc S l 5GX. ".00 zn&or imnrionmcnt cf u:) to onc yc : _nd c _' ;,Cndtics in the form of: Stop Work Ordcr and : fine of S l GG.GC' : me. Signed t i< day of , 19 t Licensee/PcrmirTcc Licensor/Pcrmitzor Assessor's office(1 st Floor): r7 5 o S'e SEPTIC SYSTIEIW Assessor's map and lot number oC. INST'ALLEC)'r4 C Conservation(4th Floor): _ WITH TI� -Board of Health(3rd floor): ' 1 �` - ENVIRONPa Sewage Permit number ` � _ r `" ✓� �+"� %4Zj ��4TA °ouvt3� Engineering Department(3rd floor):', House number Definitive Plan Approved by Planning Board 19 , APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN Of BARNSTABLE :BUILDING INSPECTOR APPLICATION FOR PERMIT TO 4ZQrv�U,� TYPE OF CONSTRUCTION 19t/� C> 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location y ,\ Proposed Use '1 4 (r 7C L4 t h Zoning District / , l Fire District C �� Name of Owner ,fie. e 4M A Address,30 Name of Builder_1 G l Lw Address �3 &`C ©A PAM, ®a 6 6 od a,16'1 7 G N Name of Architect Address t Number of Rooms Foundation r\A Exterior ✓ Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area V151_�fl Diagram of Lot and Building with Dimensions Fee j0 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 ` Construction Siipervisor's License 06 Is-� I LIMA, JEFFERY 1 No —3�`Permit For Remove Deck/ Replace w/Gazebo /Bar/ peck/ g; giP Family Dw. R Location 30 Holly, Point- RnaCI Centerville Owner Jeffrey Lima Type of Construction ' Frame f Plot Lot 4 Permit Granted August 25, 19 94 Date of Inspection: ; Frame - 19 Insulation 19 Fireplace 19 Date Completed [ 1 19 Y s I r ' o m�n�aaa 1� 1� I I ( I f I U I ro i i 310'CI l ]ON AS C13HVd3Hd _ .. _ _.: _ _ _ . . _. ,, 1 _. ' _ . �`•• m 7-3 FFell,14� lo i -- 4 axi Ac4de e P ISIWQ ed, 1 � turd v m p v bl A m A � e � �,, ! •i'• - Gam' �i W i✓ �• t' � 1 {�.Ta',�`.F����� ��"tf'l d ��l^'(�'��i Lt, l-.� ram." r • � t 'Q;'Q t4 f f 'd <+`t�.'.,.�{,. -+�7a., d�7®drs�i y. �,t•� �ic.� �,�.�,3•,,�,� � f r...� xt , �It ��• k 'S` u.x v"4��;' ,••a,� +cd c..� ra`. r1",^ JS� ..s.,.... -j ��'►'°•�.+��`Y� i L nrK C:.\ 1� i•. �;y - t �l -. ? ''9g r�- :'i.. y �r�'�s, ✓l' a a.y._t�x wI�s. r 1 dtz '�+�.. a�v �`a:. , .:t. t .r , i; 1 ` •.- t1AV a.7 1r a }1 .♦ x s ro • '' t+ ;�-j#'�,i7A'`/ � Pi r .s i 1 �t. .��-_ „ '�' fq`�S�r� v� hrf �• q� ���' ,i"i J � �• � ( #_ raj. �14't �" f •'��T�-- � , � 1' • i % fy ed off ,ARNgrABM The 'Town of Barnstable e Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner 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 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. T of Work: a ck l0e 1-ee. �e�u 6, 3'Ix /r .�� Est. Cost '�� U Address of Work:� �a�/t / 12J Owner Name:_ Je I-e y Date of Permit Application: FIdg 023 9'`f 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: (o SU(o Da a Ile Contractor name Registration No. OR Date Owner's name - J 7, JUN 14 ' 93 5: 40 FROM INTREPID PAGE . 005 LidI. BARNSTABLE Centerville.................................................. Sidney & Dian, H. ,fi Belonging to............ ................ .........�!L"n Deed in Book. Lmrkd Court Cortiflesft No.74732 i-Book 6K ....... in .,Barnstable Roi,ty District....... Reewi"]Pis"...Land Court Plan 20239 filed with Cert. 20178 Date of Plan ..February 1958 ...............- Barnstable District, in 150 118 Sheet 5 In........................Registry.......... ........................ Book.................No............ Fil" Plan No. ...,........._................._... MORTGAGE INSPECTION PLAN PATROIT BANK., - N.A. #60458 11.0"Me. Laura & Cavid Cohen 30 Holly Point Road, Barnstable Zo T- 69 V 70. kV ITO" .51 HOLLY - POINT ROAD Sept.' 11,1986 50137 JN I CERTIFY THAT THIS PLAN WAS PREPARED IN ACCORDANCE WITH THE COMMONWEALTH OF MASSACHUSETTS PROCEDURAL AND TECHNICAL STANDARDS FOR.THE PRACTICE OF LAND SURVEYING 250 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED HERETO. KEMNETH o B. AN C" No.31298 r Opuvv v . / \.Iy !E / I.ODUPLAND LG� f I•LT�� .31 WET � z_ \I.a \ IZ AC local_ U o r� �< N r• \ .\ m 1.31 ZS r - 1.09�PU.ND alga ° 50-Z brio e "l4 p1"T O I.oZ UP%-AKD WET yj 2A5 . BI - Z J I:po0 1•p b e� !0 1.02AC � <3 41D al (APP 4'IIIA) / (` LMsry) O 9��y1 le0 ( i 1 Lj J I O 1 O•4 O PI ID / 'I 0 47 O ry I Q ' O r 6g � 4 •yi.� I SHALLOW PONO I 46 R •67 � � I � i N'ti6) 45 y D ' Q 0 1, � I 44 VC, 050 �s A� � I I °J I 43 P CV1 `fig �.S ,7►� ; � I 1 r . `a oo. 6 J H•iSg,l f I r° 50. l 40 p, �V 690�Y its ... .._T 'S POI 15 -,6 I u o �- � ill /'l .Nor .Y G 78 79f� s $ >° REV. BY AV/S 1970 ORIGINAL ISSUE /96B .ye M't�t l S ,7L 50-3, 4 6 7 214 2.34 254 at 213 233 253 212 232 252 233. ___ Y - r'-b• r o'o° 0 9.. 0 m a P L 1 - �. o _— Naw lsiFNrn dN,on I No _ .. . o Fsm .xi..J hq Jubw d r it 9 Qy+ canvoJ}a fu0 J ik rho or -+' Md.r..n.G q .. 1A 42 ' 4Xq 7- �ol:l Lsrinr- {f I �' W r Lx!!9+I.dY4m.Jrw. - O 11 i 0 '114X4 To soli • _ � - i 6`' �.3 I R..may..xi�Firy non-b.d Y.arin4 - � 0 - wn '� I �� I t N.w A°ty 4alrus}ur�,lfb..giw - _' F . � o mn�for cov.r.d.nJry.N.w roof. ui _ 11 �A �- f ^ ruc4 A roof rW". __ i w/r! ourod cenar.J.fooJ e - - T r rixi.}{y Bonus}..nd Yrick..F.rs 06$ ' i. a n nP m,nan-1 ,eY.rrb, •. i w.,n.....xi.,Fin,.,F.' � ws0.l.aw rWy.yporJ po F •r_.............._i snd .Jcb Fo maJcl.. �i - '4 m_�,..o� N� ..._...-. P . 1 l_............ .-..._---.I . Jo.x,.JYu,roof r,dy -'"j U ' r 0. J - Haw •lxr afar h.ad.r ;; 1l. •. p-.pbc.sxi.}ny�l r.r� R•+flwsx,.+:nq Jd.r. ..1 And.—a NLGGV'pOA�l ld.r.. - - w//.nd.r�.eim NLpGOOriA�144r• ` _ �A `P--TPL00E-PLAN." 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' rm6 &W try 7 AGM eto Como.t f u[y whh the code(or new con traction wiles woclhc ow Poundrl•'lon Ply n g1110" ktrmgeopa�e► - - p10�/t1�p��xbtinpcorsponentsor Nst urasOfaocbtinptuildrlpoNch lntne oPedonof ike buiminp '_ officla,ars eanprous,uro afe,luleov6cemw or mmom�tr me dsoags or sl gdf k tl e eel rloration or wriOt Otnfwfso presentetivesi to the occupoeeWto tM pubdc safety ehatl be remsN stedin 66o df eodtn the 4p;;Hc we sections of too OMRs l 00 thru ItZO. + SHEET NUMBER: e ° OO g 9 g o �o 00, 2 R } s Eat .s:JIM ji m c, V- 6 z 3 A c' eA a 6 >, Pbor br.c for .n.l o n.<+'nn♦ I Pbor br.cin�•4'•O"e6. r I for ILonn.cJion� ° P.^4 btmr."or..LUC B h.n yr. t x r O Pbor jo i.J 0 f 4"0.4. I I I I I MJnch l.dyr bo.rd w/eaiwy.�ona I I 4OB'.<r.wr Jo.xi.J fr 11 G II� "p. n fl I u � - - - I I I 4oi�"ona LUbt Bhw.y.r�0 IG"o II p I _ - 4DGwls: 1/4"- 1'-0" 1{.1 tu - - la r.n.leonn«Hon. 4x4 R.Idy ruRorJ+o..ol id b..rhp --- f• i ------ ----- t.i a LmTA I b 0 r . - .. 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