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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION '
Map Parcel I Application # [6
Health Division Date Issued 5/ J
Conservation Division Application Fee
Planning Dept. Permit Fee '®
Date Definitive Plan Approved by Planning Board
Historic - OKH — Preservation/ Hyannis
Project Street Address i.Sose Air eA,
Village - Con
Owner I�� 1�IQ.1.,SL Address
Telephone C17- C2
Permit Request k- cc-�l.,��y�
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family a'� Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number 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
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
,j
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use ' 2
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER).
Name Mike McCarthy Construction Telephone Number
PO Box 52
Address West Dennis, MA 02670 License #
Cell (508) 280-6964
C-S 58633--1C 11�669-39-3 Home Improvement Contractor#
Email Worker' m s Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE 'Slls l>>
a.
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
4d MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
" DATE CLOSED OUT
4
ASSOCIATION PLAN NO.
1-7_Sal-G2`p
n.
OF' A Town.,of tar-nstable
Re atory services
wiz
RIchard'tr.Scaly Dire+;ior;: ,
h� .0
19uidal ' .
g�rsivu
Torn Perry,Bnildtng Commissioner
200 Main Streev Hyannis;MA 02601
wwv !d* barnstable-maids
Office: 508-862=4038 `,,_,' pax: 508-790-6230
.'Property Owner Must'- .
Qompleteatiid,Sagxa;'his Section
.�. •.r_ r .. -mow...w-.. -a. .. .tea.-»n r....M .. ......• r.-.-
'If Us g A; uilde�r
s as Owner of tlae"sub ect `ro eat
hereby auiho nz� C. •tf u � " to act o a'rnp beb' if '
in aU nniiers..relative:to',work'aiAonzed.by'thiss 6.u1 g permit application:for. ,
(Address o$;�:o�`fkbS�)p€�•- �*�
t
=►�J?oo ences,and:,:alarms are.rhe r�spo tittytof rh -.2pp i6ht.:Pod].S
are= to be kd or uzllt ed iefoitr fence i 'rins�.alled and all final`
c
ib pecuoms are:pexfc jm4 and.acce a.
' igna of,O ner Signat=.0fJ poUcant
prinr.Name.. -:Print Nan-k.
G:o_CEO%ICp
f D
Date
MAY 1 1 2Q15
;Q;FORMS:owr,- tRMiSslblarooIS; ry
r
1 y
Jj n
7 i
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Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License: CS-058633
MICHAEL J MCC
ARTHY <_.
PO BOX 52 s
W DENNIS MA 0267�
Expiration
Commissioner \ 04/10/2016
Office of Consumer Affa>rs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contfactor Registration
Registration: 169393
r Type: Individual
Expiration- _6/16/2017 Tr# 264961
MICHAEL MCCARTHY .- ._.v
MICHAEL MCCARTHY
P.O. BOX 52
WEST DENNIS, MA 02670
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
20M-05/11
f
L pry.
s The Commonwealth of Massach itsetts
Department of IndustrialAceirlents
I Congress Street,Suite 100
_ Boston,MA 021I4-2017
www.mass.go..v/dia
117orkers'Compensation Insurance Affidavit:Iluilders/Contractors/Electricians/Pliirribers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information I Pease Print Legibly
Mike McCarthy Cons tru Name(Business/Organization/Individual): o Bn:x 52
Address: West Dennis, MA 02670
e280-6964
City/State/Zip:. CS 8633 HIC-169393
Are yor an employer?Check the a propriate box: Type of project(required):
I. am a employer with employees(full and/or part-time).* 7. ❑New construction
2.0 1 am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling
any capacity.[No workers'comp.insurance required,]
9. El Demolition
J.❑1 am a homeowner doing all work myself.[No workers'comp.insurance required.]1
4.❑1 am a homeowner and will be hiring contractors to conduct all work-on my property. I will 10 Building addition
ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.❑I am a general contractor and 1 have hired the sub-contractors listed on The attached sheet.
These subcontractors have employees and have workers'comp,igsurance.l 13.❑Roof repairs
6. we are a corporation and its officers have exercised their right o 14.zo(her
❑ rp ng t f exemption per MGL c.
152,§1(4),and we have no employees.[No workers'comp.,insurance required.]
•Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating[hey are doing all work and then hire outside contractors must-submit a new affidavit indicating such.
tContractors that check this box must attached hn additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp:policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and Job site
Information.Insurance Company Name: ATM r / IJ4J, 'Trey. o, 12!thy
Policy#or Self-ins.Lie.#: -6oi -7CS-6-.,_1c)y 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 MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER•and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify 11117tl nl s nnr! a!tles rjrrry that the information provided above is true and correct.
J
Signature: Date., c )/N /1-5—
Phone#:
Official use only. Do not ivrite in dris 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 Cleric 4.Electrical inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATIMPAGE
A.I.M. Mutual Insurance Company
54 Third Avenue, Burlington, Massachusetts 01803-0970
(800) 876-2765 NCCI 140 26158
POLICY NO. I VWC-100-6017656-20146
PRIOR NO. VWC-100-6017656-2014A
ITEM
1. The Insured: Michael McCarthy Construction Inc `
DBA:
Mailing address: P 0 Box 52 FEIN:**-***3862
West Dennis, MA 02670
Legal Entity Type: Corporation
Other workplaces not shown above: See Location,
2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the
states listed here: MA'
B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.
The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000.each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 500,000 each employee
C. Other States.Insurance: Coverage Replaced by Endorsement WC 20 03 06 B
D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE
4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans.
All information required below is subject to verification and change by audit.
Classifications Premium Basis Rates
Code Estimated Per$100 Estimated
No. Total Annual Of Annual
Remuneration Remuneration Premium
INTEA 0712979
INTER SEE CLASS CODE SCHEDU E
Minimum Premium $550 Total Estimated Annual Premium $29,332
GOV GO V Deposit Premium $7,748
STATE CLASS
MA 5479 State Assessments/Surcharges.
$28,601.00 x 5.8000% $1,659
This policy, including all endorsements,is hereby countersigned by 12/15/2014
Authorized Signature Date
Service Office: Bryden&Sullivan Ins Agcy of Dennis Inc
54 Third Avenue PO Box 1497
Burlington MA 01803 So Dennis, MA 02660
WC 00 00 01 A(7-11)
Includes copyrighted material of the National Council on Compensation Insurance,
used with its permission.
. a
x
LL TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
f —(,L).(.0 ('0"Os
Map Parcel _ t Application #
Health Division Date Issued & r
Conservation Division Application Fee
Planning Dept. Permit Fee L '
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address WV
Village o
Owner � Address 4111/
Telephone
Permit Re uest
LyeAe& e S
Square feet: 1 st floor: existingAproposedrIE 2nd floor: existing3� proposed �otal new
Zoning District Flood Plain Groundwater Overlay
oject Valuation (lam Construction Type � OZ6 to00p in C�_
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family I" Two Family ❑ Multi-Family (# units)
a
Age of Existing Structure Historic House: ❑Yes Lr�o On �14� 's Highway: L ��es ulo
Basement Type: U(ull ❑ Craw! ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area ( ft) Oas '
Number of Baths: Full: existing %LIFO new a�"L� Half: existing v mew
Number of Bedrooms: existing4 new ,
Total Room Count (not including baths): existing new b First Floor Room Count
Heat Type and Fuel: II Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes VNo Fireplaces: Existing ✓ New Yes ❑ No
Detached garage: _ ew size _ Barn: ❑existing ❑ new size_
Attached garage:Q/existing ❑ new size size — Other:
,
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial. ❑Yes _RrNo If yes, site plan review # -- _
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ���� awo&"� Telephone Number
Address - License # z�
00 - /moo a2&Q Home Improvement Contractor 4 '& Lo
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THISjPROJECT WILL BE TAKEN TO�
SIGNATURE �T)ATE
I m` FOR OFFICIAL USE ONLY
( r i
µ APPLICATION#
f
DAi E ISSUED
i
.MAP/PARCEL NO.
a
p� ADDRESS VILLAGE
a OWNER r }
DATE OF INSPECTION:
3C, f•' �.Y , ', 'r ..
_FO.UNDATtON��. _a _�iY�• ' �� �'` • ��
F
FRAME ® — i5 —
V.
f' INSULATION
' .;
N FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING' R
r i
DATE CLOSED OUT + t
ASSOCIATION PLAN NO.
r ;t
Town of B=Stable ;
�v Regulatory Services
�xrrsraes Tb am as F. Geil er,Direztor
Banding Divisiob
Th onus Perry; CB 0,13 nil ding C anmissi o n Er
200 Main Street, Hyannis,MA:02601
• ... www.tnwn�harnstahlama.us .
ORklz: 508-862=4038 Fax 508-790-6230. '
-PLAN R EVEW
Owner: . MaplParcel: 9 3
Project Address (o S OXp Bonder•: bArVt
The following items were noted on reviewing:
t3E� `TL1 Q (ZCthav fl ►J �t-�eST' FL.(0 PEnJ
LJ I46t E'. 4(3US F- �: Yhokrc
LN 5U UNR-)o r3 2 Jb I ZXF-CC
O F It-J a2STS
Rryiewed by.
o COMUranIw- Useffs
aeparftamt aflaulusfx rd Accidents
-- - Cce v irzrtzgiatrs
606 Washington meet
• $astarr,,M1 02 -
wn�m massga ilia
' arlr�e:a-s' Compensatiux-lusuranceAffidavit:Buildersl,C-oniracfiors/Mec.friciansMu-tubers
Appli"ut. Information Please Priat bl
Name v r
Address: ` e ��AN�f r %/I YLI-%lLlN
City/State/Zip: G o r5 OW) P b-cneZ8'0 J -
&-e you an employer?Check.the appropriattImnageneralomftactcrandl
T , of project r
'A-_ ) pT l {���-I_El Iam a employer withti_ Nevi construe ion
employees full andlor lime. * have hireathe sub-mnbrad 3.
�' 1� �
I El am a sole proprietor or partner- listed on the attached sheet 7_ [< Remode�iag
slnp and hate no employees These suh 000tractars have g- ❑Demolit oa
r foe me in arl c ca en�playees and have rNoeis'
odang Y _ W$uilding addiiicn
PTO Workers' Comp:tsmCa4rFnre. Comp-insurance
5_❑ Vle are a corporationmd it Mo l=lectrical repairs c*r aj iums
3_❑ I am a homemmer doing all work officers hn-, exercised fneir I t_Q Plumbing rep cr F�<iiLcxs
myself o workers' right of eizemption.per hTGL 1 Roof repairs
`c-� �4 §l� andwebssenu -`�
employees_[Na caorkrss- l3_[]Qther
comp-insaranc-erequired,j
*Any snpti flat miens boa n=zt slso fli oa tip section below dwwi ag poi-sy
�Homeacarn�s vrlo submit tins a$dsvit inm csting tf�ey eiZ 3aing�scenic�tlea ltize bsiside co.Lacers um;s scabosrt a r�s;�d�it m2ir�:n,=-suc2
=Gbnhscmm tlst rf�k this bmc mgst stTaclxi au additinnsI sleet shuuind tbE nmme a+5iE ds caffr.zJr and 5ste uhetbec txnnt t ea e�uties fi��
�nP3uyees Ifthe suh<,atmctam h:c a employees,the}'must gimride ti�i[ wa€kers'comp.poley numb
.Jain an crfnpr i3trrtis prrnddtng t.t orders'cotrzperuatiot:utaatrcutce�ar t�^e,�rptirJ eea �elvrc is the policy artd):on rye
infor matiarr_
Insurance Company Name:
Policy fr or Self-ins-Lic-4 Expiration.Date:
Job Sits Address: citytstate! :
Attach a copy-of the workers'compensation policy dedtratio8 page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal PC--lli.es of a
fine up to$I,500_Qt}andior onL—yeariwprisonment,as well as civil penalties in fe form of a STOP WORT,ORDER and a
ofup to 5250-00 a day against the:violator_ Be advised that a copy of this statement may be forwarded to the Office of
Im estrgations of the DIl far c Overage vest cation
I dd hereby certify it s den s fj eJurp thatthe' tqfbrrr aI&n prcn ided aboue u true and cigrrect
— 1f O
���._ Bate:.
Rhone 9:
Q�jicial tree only. Da Trot tvri'm in ME area„to be campleted by ciij or town uf�4iinL
City or Town: Porn itUccuse# t
Issuin Authority(circle one):
1.Board of Health BmId'iug Department I Cityfratea(Jerk 4-Electrical£nspector S.Plumbing Tnsp-ctor
6.Other
ContaCt Person: Phone T_
6
Information and Instructions
MassIchusetjS Creneral Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursultto 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_" i
An employ is defined as"an individual,partnership,association,corpo 'on or other legal entity,or any two or more
of the forego' g engaged in a joint enterprise,and including the legal repre entatives of a deceased employer,or the
receiver or ee of an individual,partnership,association or other legal tity,employing employees. However the
owner of a dwe - g house having not more than three apartments and wh resides therein,or the occupant of the -
dwelling house another who employs persons to do maintenance,co ctioa or repair work on such dwelling house
or on the groun or building appurtenant thereto shall not because of su employment be deemed to lie an employer."
MGL chapter 152, 5C(6)also states that"every state or Iocal been g agency shall withhold the issuance or .
renewal of a license r permit to operate a business or to constrx L buildings in the coramonw--slth for aiay
applicant who has n produced acceptable evidence of compl.ia ce with the insurance.covey rge required."
?.,. 1�
Additionally, MGL ch ter 152, §25C(7)states "Neither the co nwealth nor any o"t its political subdivisions shall
enter into any contract f the performance of public work until a eptable evidence of compliance,,k,i��i the insurance
requirements of this chap r have been presented to the contracts g authority_"
Applicants
Please fill out the workers' co pensation affidavit comple _ly,by checkng the boxes that apply to situation and,if
necessary,supply sub-contraem s)name(s), addresses)- d pb.one number(s)along vv ith then ceri iiicate(s) of
insurance. Limited Liability Co allies(LLC)or Limit Liability Partnerships(LLP)v eriih no en.�rloyees other than the
members or parhiers,are not r d to carry workers' mpensatiou insurance. If an LL C or L LP does have
employees, a policy is required. Re-dvised thaf this a davit maybe submitted to the Depaxtuntnt of indu_tTial
Accidents for confirmation of" coverage. so be sure to sign and date the atidpv it '11e ar%davZt should
be returned to the city or town that the pplication f the permit or license is being requested.,not the Department of
Industrial Accidents. Should you have y questi regarding the law or if you are regi fired to obtain a workers'
compensation policy,please call the Dep mt the number Iistc-d',below. Sell insured companies should enter their
self-insurance license number oa the appro ria line.
City or Town Officials
Please be sure that the affidavit is comple and rioted legibly. 'the Department has provided a space at the bottom
of the affidavit for you to fill out in the eat the face of Investigations has to contact you regarding t_he applicant_
Please be sure to fill in the permit/lice e number ch v'viL be used as a reference number, In addi ticn,an.applicant
that must submit multiple permit/lice� e applicatio i any given year,need only submit one afEc avit indicating current
policy information (if necessary)an under"Job Site ddress-the applicant should write"all locatio=In. (city or
town)."A copy of the affidavit that as been officially ped or marked by the city or town may be provided to the
applicant as proof that a valid affi vit is on file for fit pt=ts or licenses. A new affidavit m'.?st be ]led out each
year.Where a home owner or ci ea is obtaining a license r permit not related to any business or commercial venture
(i.e.a dog license or permit to b leaves etc.)said person 1\7OT required to complete this afida,,it
The Office of Investigations w uld like to thank you in advan for your cooperation and should yDu have any questions,
please do not hesitate to give a call.
The Department's address,t _ephone and fax number
nt-, ComYza nWt,-21th of ICI achusets
Degaitaeut e�f Ind�xstrial its ants
Office of kvestiptiazz
GGG Wasbingtoa S�'et
Boston.- 02111
Tel,A 617-727-4-9-GU(�'?06 or I-&�� E
Revised 4-24-07 Fax:4 6I7-727-7749
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` s�f�r��h � �m� �'�u�v�l��%���[7DD �H��S3U���L/l/ ' '
Massachusetts `��~~==�^ ^~~ ~~~���� ` ' ''
. . .
1.1 SCOPE
' ~y
Wind Spped(3-oor-
Wind
� ' Category _---
� Wind-Exposure Cobogmry................Engineering Required For Entire Project........................................C
� . 1�� ���L���B�I�� _ . ' ' ^^
' Number afSbxdeshs roof which ex���� bnY2�opmahaUbe�mddmmad sb�n4 stories 2stodss p
' Roof Pitch..... _............
.......
.............. 2) .
Mean Roof Height �___-___'__'__'--'___�'_-� ^
� BuD�ngVVd�,VV _--'-�.-' ................................. ........_(FIu
Building LenQth,L ..............................................................(Fig
Building Aspect Ratio _--_-_----'-.-.--_(F� ............................
----'--'
' Nom�sdH�ghdc�l�Ues Dpen�g^...............................................
---__'-_---'...�--(�g4)_-_-'-----_.-----'---�-' v�� ���^
. .
1'3 FRAMING General
. ' *^
oompDancev�hh�m�gcmnne��ns_--_-__.(Tab�2)-__-----__-----~_---.__----
`
2.1 FOUNDATION
` FoundaUonYyaUs meeting requirements of7DOCMRS4O41
-_-------------.--'-'-----.--_------------'- ..................
Concrete Masonry--.'�______-_-_'--__-'---__---__--'-.--�-__'--'__,-�----`-'
. '
2-2 ANCH ts ' �
5/DAnchDrs as an alternative in concrete onl
' Bo�� . °
Bolt Sp"c'efrom endrjoint`" plate.............................(Fig `
Bolt Embedment-concrete...........................................(Fig ........................................:............7_-kn. 7-
Bolt Embedment 7 masonry..................t ..................(Fig --......./............................... in.2:1S^
' Plate VYashec�____-----__'___�-'_---(Fig 5)..............................................-5-3^x3^x�� /
. . /
lY FLOORS
.""^ framing member spans checked ... ..........................(per'""GMR+^ ap=" =v............"-=`...............
W1smbnupn Floor Opening Dimension (Fig O) ft�12.
. _-'_-----_---'_- --_--`--_-'�---.-.----_'`-_�
Full D�dsadF�orD�:n�Qak�s than 2'�,mE�tahorVVaU�FlgO)------�........................
M�WmUm Floor Joist Setbacks
' SuppoftngLoadbsaring Waft cvSheanvaU................Fig7)..........................ZY4i.................Z� ft :5d �
Maximum Cantilevered Floor Joists
3uppor1inb1oadbeadngWa/lsor3heanwa||................(Fig //
ROD�Bra�ngatEndvw�b---..----'-'..---_--.----- ��--
' Floor Sheathing Typo ---_---.-.-.---�_. CMR Chapter
F�ur T�ckncss_----'__^-_''-_-_�.-�
Floor Sheathing FqsbarfinQ_--.----'_�._'___,�-[7ab�2)'.���dn�� edgo//L.infim�
~ ` _
4.1 WALLS
' Wall Height
.........
' Loadbaa�ngvmu��_--^--_-_-_------'--'-- and Table . .
vaa@s�- ............. -_ Uaod
WallSb�d .........................................................' and Table 5) _' u� *'
' VVaUSto�'[�sa� --_.-_--'__-,----_--_---�-��s7&8)'_-'-�---.----- ftud.
.
4.2 OR-WALLS= ' `
Wood Studs . `
Loadb&ahngv�adls........................................................ �i).........................._ ft in.
Non-Loadbaahng walls_-',_-__'._---_,-'(7ab�S)------.__--'2x-T_- �� � � in.
| Gable End '` ' ' -
| .
Full . �
vvur"�oo Floor LenJm ` ' y'ig 11) ucW/u
P used) ' 9VV
and2x4 Loban ......................................................
' - - - ' �Bn��� 11 _.-_.------._.-_-__-'_-
or z3 ceiling hUningstrips @ 1G~spacing min.with 2x4 '@4 ft.spacing io end joist urtruss
Double Top Plate '
SoDceLemcth -......................................................' (Fig 13 and Table �
' . SoUceConnacUon/no of1Gdcommpn nails)__-.-_(Dsb�G)__'--_-'----'--._---_-_
' ,�
. .
'
|
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Massachusetts Checklist for C;ompharice (7so•c1.1Rs3ol.2.l.1)`
Loadbearing Wall Connections -
'�l +' ' Lateral no.of 16d common nails abler
Non-LDadbearing Wall Connections
Lateral(no_of 16d common nails).............................(Table 8)......................................................
� ✓
Load Bearing'Walf Openings(neord largest opening but check all openings for compliance to Table 9) l
Header Spans _.............•------._._..._........:............_.(fable 9)...................................S ft_L rn.<11' V
Sid Plate Spans .................._.....__........:.......-..........(Table 9)................................. 0 ft_in.<11'
Full Height Studs no,of'strids ............. able 9 ..--------
Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
Header Spans........................ ........................_.........(Table 9)................................... ft d in.5 TZ
Sill Plate Spans........................... able 9
Full Height Studs (no.of studs)_..._..................-_:..._....(Table 9)...............................................
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4
Minimum Building Dimension,W
Nominal Height of Tallest O penin 5 6`6'
SheathingType..............................................(note 4)_......._..__.._.__..........._......._..........._. W
Edge Nail Spacing.........................................(Table 10 or note 4 if less).........._•___•___...:. in-
Field Nail Spacing..........................................(Table 10)..............__...._......._...-................ in. y
Shear Connection(no,of 16d common nails)(Table 10)....................................................... Z
Percent Full-Height Sheathing........:..........:...(Table 10)........,............................................ D. -
5%Additional Sheathing for Wall with Opening>&W(Design Concepts).:.___.:_.
Maximum'Building Dimension, L $`
Nominal Height of Tallest Opening2.........................::.......................................:_...�
( ).............:................................._...._.cvovp
Sheathing Type........................................•---.. note 4
Edge Nail Spacing......:........................._.: (Table 11 or note 4 if less)..... in.---•-
Feld Nail Spacing.......................................t_ able 11
Shear Connection(no,of 16d common riails)'(Table 11)......
...:...:....
:..........
:__:_:.:::.:::.:........ ..
Percent Full-Height Sheathing........................(Table 11):..__..._..........::._...:..::::..:.._:::.::::_::_. yo
5%Additional Sheathing for Wall with'Opening>SW(Design Concepts)...:.....:.......:..
Wall Cladding /
Rated for Wind Speed?_..........................:.............
.................... ..................................:........................... ✓
5.1 ROOFS
Roof framing member spans checked?........................(For Rafters use WC Span Tool,see BSRS Website)
Roof Overhang ...................................................(Figure 19)..._ ...... ft 5 smaller of 2'or 1.13
Truss or Rafter Connections at Loadbearing Wails
Proprietary Connectors
Uplift....................................-• ---_.(Table 12)...................................._.......U= J-plf
Lateral............ .........................:....(Table 12)...................................... pif
Shear...........................:..................(Table 12).......................-....................S= plf• ��-
Ridge Strap Connections, if collar ties not used per page 21... (Table 13)...............................T=LLO plf y,
Gable Rake Outlooker..........................................(Figure 20)............. ft s smaller of 2'or L12
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift...................... ..............-........(Table 14)............................
Lateral(no. of 16d common nails)...(Table 14)......................................
.............. . .........L gWilb. .
Roof Sheathing Type.............................
._...........__.._...(per 780 CMR Chapters 5B an 59)
Roof Sheathing•Thickness................ ..................................................................... in.>Z/16,W B
Roof Sheathing Fastening............................................(Table 2)..................................
$._.....__.. r
Notes:
-1. • This checklist shall be met in its entirety,excluding the specific exception noted in 2, to comply with the requirements`of
780 CMR5301.2.1.1 Item 1. if the checkdst 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- 2b Gage Straps per.Figure 11
c. Uplift Straps per Figure 14
d_ All Straps per Figure 17
e. Comer Stud Hold Downs per Figure 1Ba and Figure 18b
2- Exception:Opening heights of up to 8 ft shall be permitted when 5% is added to the percent full-height sheathing
requirements shown in Tables 10 and 11.
3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2--grade.
a. From Tables A it and 11 and location of wall sheathing and Building Aspect Raiio,determine Percent Full-Height
Sheathing and Nail Spacing requirements
b. Wood Structural Panels shall be minimum thickness of 711 V and be installed as follows:
1. Panels shall be installed With strength axis parallel to studs.
_.. il. All horizontal joints shall occur over and be nailed to framing. .
Ill. On single story construction,panels shall be attached to bottom plates and top member of the double
top plate.
iv. On two story construction,upper panels shall be attached to the top member of the upper double top
plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist
and lower attachment made to lowest plate at first fi6or framing.
v. Horizontal nail spacing at double top plates, band joists,and girders shall be a double row of Bd
staggered at 3 Inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment
5. Glazing protection: a)new house or tiorizontai addition—required if project is 1 mile or closer to shore(generally,south of
Rte. 28 or north of Rte.6)
b)vertical addition—not required unless there is extensive renovation to the first floor
c)replacement wiridows—needs energy conservation compliance only(chap 93)
6.Wood Frame Construction Manual(WFCM)for 110 MPH, Exposure B may be obtained from the Arnericdn Wood Council
(AWC)website.
WHEN THE EDGE RESTS ON
FKWr[G USEEd W L.S
'AT6�
Jr
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- 11 II
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ii [1 C 1 1 t 1
p I I I I �- I '1 N � 3••bAr'L i t
u
Y .' STAG
}JAL S?ACR�G ' NAIL PATTSUJ :E PAREL
------P�`— — PANS EDGE DOUBLE RAIL®GE SPAGt 1G OETAL
See Dfktail on Next Page
Detall
Vertical and Horizontal Nailing Vertical and Horizontal Nailing
for Panel Attachment for Panel Attachment
41
-- t
Town of Barlltstable
0
Regulatory Services
g .Richard Y.Scali Interim Director
1
Buildin Divi<s�ion
g
Tom Perry,Building Commissioner
200 Main Street,Hyaffiis,MA 02601
www.town.barnstable.mams
Office: 508-862-403 8 Fax: 508-790-6230 .
Property Owner Must
Complete.and Siam This Section
If Using A Builder
as O�vnet of the subject property
hereby authorize AN CV ly to act on my bebatf,
in all mattets relative to work authorized by this building permit
(Address of Job)
Pool fences and alarms ate the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections ate perfotmed and accepted.
S' e of Owner, tore of Applicant
Print Name Print Name
-
0. l4-
_ Date
1 V VTJLL Vl -uax IN, aura.
Regulatory Services r :• -
j
Richard Y.S=Ii Interim Director. -
-� Building Division
} MOWS AZU Tom Perry,Building Commissioner
2U0 Main Street, Hyannis,MA 02601
www.town.barnstablema.us
ce: 508-862-4038 Fax: 508-750-623 0
HOMEOWNER LICENSE EXE1v=0X
_ - Please Print
JOB LOCATION= - -
er street nllage
"HOMEOWNER":
name . home phone# work phone$
CURRENT MAILING ADDRES
cityltnwn zip code
The current exemption for"homeo ers"was extended to include j1hice
c ied dwellin s of six units or less.and to allow
homeowners to engage an individual r hire who does not possess ,provided that the owner acts as supervisorDEFINITION OWNERPersons)who owns a parcel of land an ch he/she resides or inteside,on which there is,or is intended to be,a one or two_family dwelling, attached or detachedstruc es accessory to such rfarm structures. A person who constructs more than one
home in a twoyear period shall not be cons' ed a homeowner. •5meowner"shall submit to the Building Official ona form
anceptable to the Building Official,that he/she be re onsiblech work performed under the lsuildin etmit (Section
109.1.1) -
The undersigned"homeownef'assumes responsibility r co ce with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certi$es that he/she and the Town of B amstable Building Department minimum inspection
procedures and requirements and that he/she will comply s ' procedures and requirements.
Signature ofHomrowner
Approval of Bufldiag Official
Note: Three-family dwellings con 35,000 cubic feet or larger be required to comply with the State Budding Code
Section 127.0 Construction Control
HOMEOWNER'S EXIQKTTON
The Code states that. "Any.hom er performing work for which a b g permit is required shall be exempt
from the provisions of this section(Sectio 109.1.1-Licensing of constrndion Supe rs);provided that if the homeowner
engages a person(s)for hire to do such wo k,that such Homeowner shall act as supervis
Many homeowners who use this emption are unaware that they are assuming the esponsibiIities'of a superAsor
(see Appendix Q,RnIes&Regulations f Licensing Construction Supervisors,Section 2 Lack of awareness.often
results in serious problems,.particularly when the homeowner hires unlicensed persons., In this e,:our Board cannot
proceed against the unlicensed person it would with a licensed Supervisor. The homeowner a ' as Supervisor is
ultimately responsible.
To ensure that the homeowne is faliy aware of his/her responsibilities,many communities req e,as part of the
permit application,that the homeown certify that he/she understands the responsibilities of a Supervisor. On the last page
of this issue is a.farm currently used b several towns. You may care t amend and adopt such a form/certifi�ca "an for use in
your community
Q:`wP��O}�b��gpeS�ltfDiIl15�SS.dDC- .. • . .
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License: CS-002782
IDAVID G`dHALF,-N
53 Chandler 1Driv
South Dennis M,4 0269�!Vj
Expiration
Commissioners 10/15/2015
��lie �PanvnzoryecuealGli m�C�lcc�accclzccaeCifs ��
'Office of Consumer Affairs&Business Regulation
�1 *bME IMPROVEMENT CONTRACTOR �.
J egistiation 180040 Type:
.>7 Expiration 1g6/201-6 Corporation
DAVID'G.WHALED, `
DAVID WHALE
53 CHANDLER DR f�f
SO.DENNIS, MA 02660
t Undersecretary
1.
1
off.
�9,D
r
2D�
`5
0
LEY
O
THOMAS E.KELLEY CO.�
�7 ENGINEERS—SURVEY9ic3
346 LONG POND DRIW
SOUTH YARMOUTH,MASS.
02664.
CERTIFIED PLOT PLAN
WCATIorq
SCALE /. ..�,� DATE . . .
ev
� I CERTIFY THAT THE ON T r E GROUND
••
SHOWN ON THIS PLAN IS LOCATED H
AS SHOWN HEREON
1 DATE 1
1 '10HER:
EOISTERED LAND SURVE R
1
° MEMBER REPORT 2ND FLOOR BM AT EXIST.BEDRM,Floor.Flush Beam PASSED
9 F OR T E 3 piece(s) 1 3/4"x 11 7/8" 2.0E Microllam® LVL
Overall Length:14'7"
0 0
14•
a a
All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.;Drawing is Conceptual
..- _n
Design Results� Actual b Locapon Allowed k _ Result ' LDF; Load,Corit6mation(Pattern), '„" system;Floor
Member Reaction(Ibs) 4865 @ 2" 13781(3.50") Passed(35%) 1.0 D+1.0 L(All Spans) member Type:Hush Beam
Shear(Ibs) 4010 @ 1'3 3/8" 11845 Passed(34%) 1.00 1.0 D+1.0 L(All Spans) Building Use.:Residential
Moment(Ft-Ibs) 16936 @ 73 1/2" 26772 Passed(63%) 1.00 1.0 D+1.0 L(All Spans) Building Code:IBC
Live Load Defl.(in) 0.354 @ 7'3 1/2" 0.475 Passed(L/484) 1.0 D+1.0 L(Al Spans) Design Methodology:.ASD
Total Load Defl.(in) 0.454 @ 73 1/2" 0.712 Passed(L/377) 1.0 D+1.0 L(All Spans)
•Deflection criteria:LL(L/360)and TL(L/240). ..
Bracing(Lu):All compression edges(top and bottom)must be braced at 14'7"o/c unless detailed otherwise.Proper attachment and positioning of lateral _
bracing is required to achieve member stability.
a Bearing, Loads to Supports(Ibs) ,
Supports Total I "Available p Regwred Dead<; " Floor Total g A«essones
Live
1-Column-DF 3.50" 3.50" 1.50" 1073 3792 4865 None "- -
2-Column-DF 3.50" 3.50" 1.50" 1073 3792 4865 None
. .'• y ,Tributary $, : D ead�,� Floor Live - - -
n:
6a 1 Location 'Width ';x (0.90) . Comments
1-Uniform(PSF) 0 to 14'7" 13' 10.0 40.0 'Residential-Living. -
Areas
Weye rttat user Notes SUSTAINABLE FORESTRY INITIATIVE
Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. l
Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details.
(www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to
circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to
assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable
forestry standards.
The product application,input design loads,dimensions and support information have been provided by Forte Software Operator
Forte.Software Operator _ . .' ; Job,Notes " 11/3/2014 3:10:38 PM -
William Rubel DAVID WHELAN
Forte v4.6,Design Engine:V6.1.1.5
Mid-Cape Home Centers - : WEILAND ADDITION .. WHELAN-WEILAND.4fe
(508)398-6071 65 OXNER DRIVE
bRibel@midcape.net CENTERVILLE, MA Page 4 Of 4
9 FORT E c JOB SUMMARY REPORT
fd! i� WHELAN -WEILAND.4te
01:ADDITION 30IST
Member Name Results Current Solution :_ { '- a; Comments
Floor:Joist Failed 1 Piece(s)2 x 10 Spruce-Pine-Fir No.1/No.2 @ 12"OC
LVL as Floor:Joist Passed 1 Piece(s)1 3/4"x 9 1/2"2.0E Microllam@ LVL @ 16"OC
02:2ND FLOOR BM At EXIST.BEDRM _
Member Name Results ", Current Solution - .a , 1. Comments,;'
Floor:Flush Beam Passed 3 Piece(s)1 3/4"x 11 7/8"2.0E Microllam@ LVL
Forte Software Operator Job Notes 11/3/2014 3:10:38 PM
William Rubel DAVID WHELAN Forte V4.6,Design Engine:V6.1.1.5
Mid-Cape Home Centers W EILAND ADDITION WHELAN-WEILAND.4fe
(508)398-6071 65 OXNER DRIVE -
brnibel@midcape.net CENTERVILLE, MA Page 1 Of 4
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STATE BUILDING CODE REQUIRES THE UPGRADING OF
,P E�-A'-E BUILDING DEPT. DATE SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN
ONE OR MORE SLEEPING ARE4S ARE ADDED OR CREATED.
FIRE DEPARTMENT DATE NOTE: A SEPARATE PERMF IS REQUIRED FOR THE
B07H SIGNA7JRES ARE REQUIRED FOR PERMITTING PERMIT
OF SMOXE DETECTORS-THE ELECTRICAL.
PERMIT T SATISFY THIS REQUIREMENT.
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Town of Barnstable *Per"#Lvbw
kswdde
Regulatory Services � h�
KMW Ricbard V.Semi,Interim Director
Building Division
Tom Perry,CBO,Baiidieg CommMioner
' 200 Main Saes,Hyannis,MA 02601
N. www.tDwn.bamstabie ma us
Office: 508-862-4038 Pax.508-790-6230
FxPREss P PRESIDENML ONLY
Not VW wkkorrt Red X41rm Ian
MgVpawd Number Q
Property Address -�T ,
e�
Residential Value of Work$ V,?Z Wn mmm fee of MOO fa work Tder$6000.00
Owner's Natce&Address
s N�
Al #vAles6r d st
Contractor's Name( tJES Q UI A&wi TelephoneNumberlD - 7 6
Home Improvement Contractor License#(if applicable) l 73 245 Email:
Construction Supervisor's License#(if applicable) 0!J�/�-7
jgYV0",s
one:
Inuance APRESS PER H
0T
Check
❑ I am a sole proptieta J U N —
I am the Homeowner 20I4
I have Worker's Compensation Insurance
Insurance Company Name ,,�`Kna]r j jA0 C b- MA MI or-o e np. A
BLE
Workman's Comp.Policy# C.- e? 2
Copy of Insurasee Complfanm Certificate most amompany each permit.
Permit Request(cam box)
❑ Re-roof(hurricane sailed)(stripping old shingles) All constcvction d"s will be taken to
❑Re-roof(hurrkwe rolled)(not stripping. Going over existing layers of roof)
❑ Re-sick
pRepla=o t WbdowsldoorJshders.U-Value 30 (maxamwn.35)#of windo
#of doors:
❑ Smoke/Carbon Monoxide dcteetors.4 floor plans marked with red S and mspecdons required.
Separate Etectrkai&Fire Permits required.
-Wbm rwpnm& ISSO mm of fts pemut does not ampt comphnw w ah odt tnm dVabo nt iegubfims.Le.HtaWm C 98tt0®,am.
***Note: Property Owe most sign Property Owner Letter of Permmston.
A of the Home Improvement Contraders License&ConshvWon Supervisors License is
r'e!
r
SIGNATURE.
T.VCEVW_DM3udft C6aigeduDUM S
Revised 061313
R ,
r 24ay.19.2014 07:17 PAUL'c^,NBc3Y RENEWAL PVBER 81 -545 1293 PAG2. 8
Ren
hyAm al h'FATIE AL BY�L 7n •-3= r U.
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CUIMOMWUMOW AND DOOR RBMODEI.1A'OACMEE,NINI!
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rt Agrxnl Iamlun the attai1ed:TA-r-*f tdon+E�eek icellccri„ il�i€`:�enrrieclza" O CrCodth Q HOAF
'7etgi;bbAmourr _� b*rmed&%VnIftullc hleft4off9gmem tJ rJGzeh esanc�tid
peFe3RRsahraG .e _ � -•_ WGCi��
Credtcamis arc actmPud fee onir-mat0etuat if3 of der
Gahm at512nof job
lZl°`g.. pmpeeheetr_[ffemeg.ends ttens)ByhM,nesgdtis
Fvatsa e6tamFtcr Rut
amtxwY�• os"Inkl" 6nit a<Sattr.f�bznetee
Pdiaaof d . ��jfJ• cai� e�csanSu58ta iaCa ' ion D46arnatberamft�.credik
cud.nd m�6r 6e rnnde er i check ba,4 41edr air osh
Bayer(*) and understands that this.Agreement eonstitans the eatge oskderstandiag be , ..the patties,and that
theft we no VWWW aDiersta�iaga chaagfag eny of flee terms of Qua Agreginesu Bayer(m) fedges dm H
(1)has xm d Ibis Agreement,anderstauAs m,
the terms of dds Agreeme .a leas nd received a. ai �(A)
copy of tWwApvement,!*claAngthe tyro attached Nodc es of Cancellation,on the date first a�a"{2)was oral*
irbn'med of Bares C%ht tv cancel twa Agreement:DO NOT SIM111 IS CONTRACT 1F THERE .IJNY BIA.'+iK SPACES.
(RhodaWand Sales Only}3iodce to Bay m(1)Do ant tiger this Agr.•esrat w a ay of the spasm is edfar the ag:eed Ierrss
to the extent of rhea avalhrhle lnpbrmnugo arts tedihj@mh.(2)Yon mae eariHsd to s eopyof th64 at at the tYtne you Sian
it'(3)Yoet may at nay doze pay afT the f smapaId balance&*agodcr this Agreement,and in g you.maybe eneidea to
receive
reces a partial rebate of the Ewtace and insurance changes.(d)The feller has no right to dly eater hoots premises
or commit aety Imeich of the peace to tepossrsa goods punhased sander this Ag7reemeet.(5)You p cono*t slris Agfeemau .
if it hao not been.signed at the main office or a.branch of ern of the stligr,provided you eotif•y seller sat his or her maim
office orbranch office shown:in the Agreement byregistered or certified irmiil,.which*bail be not tester than addntght
of the thw eakndar day a6ar the day an which the buyer sups the Agurtomn4 mcladhis'SuMay any boaiday an which
eega]sr mail deflveries are not made.See the aecampa8ying notice of rsacen"oo form for sm eioo of bspr's arlgltw
Buxz(9j=cark-Athe4ulMUMCCO&A-.uit.n m.sreria4egartiir dl c^Rtusdc1314-md antr2ctoris9x&f !-,jaBc-.a (BAjgp
$LriCtsritt ivy a rae&hNew$agl=d. Be
. tore f us. !4L•r �r / Sgm�int `` Si�etatarr ,
� e �
Ptthdluut:atPruit=L%6nager — - PhntN70B)c PaintlVznx
YOt%THT BtnWAg3),MY CANCBI.TIII$'1'iRfl►'rlSACTTON AT ANY TIPS IMRIOIC TO MIA 7QHT OF TM TEIM
BUSIlsiM D.AY AI? =T=DATE OF T=TRANf8At;GM SRB T7M ATTACMD manals OF - C733iATIONl FORMS
F0RAX1MCP %MTiOA OFTHIS RIGHT
.ANCELIATIONt 7NOT 1 E
Darts of Transaction - ,You may eanttl 1 Date ofTrsuaaction Yau may cancel
this transaction.without any penalty or obiigatian,within this transaction,without any pe or obiloati ,within '
three business the above:date.If you cancel,any I three business d aneer
from the date.If c
property traded froth arty payments made by you under cho t property traded let,,;Lrty p t made by you under d*
Contrast or Sale,and any nepetiable instrument*=cuted I Contract or Safe.and arty neao' e 4mtrument executed
by you will he,returned within ten business days following I by you will be returned within _ husitx.ys. fHjfaM-
recellyt by the Seller of your tarttaelP.ation nadce� and any ' receipt by the-Seiler of your c eltation notice.and any
sectnrty interest arising Otte of flee nanstction MR be tearity interest prising out of transaction well_be
eancded Nyotr eeneet,�yroou must makearu7abfe a fire Seller' P esncelid.Of you zance%pau aru,st: o available to the Seller
at your residence,In t[alyasgoodcontrnlonaswhen i at your residence,Insubsnettfaliy good condition as when
red,my goods you under this Contract or I received,any goads tNtivered Lo u►►der this Contract or
Sate;or you no*if you with,,comely with the instructions of I Sale or you may,of you wish,a with Ow i nstn -ttons of
the Seller regarrBng the return skhpnwnt of the goods at th o the tiger regarding dw retssn alh eat of the goods aR tl4C
Sollor'i 0�p0 8nd risft;tf y0u de n'alre eke goods arallabre Seller's +wnse and risk.If yotr do' the Santis available
to the Se ferr and the S.Uar does not pick them up within to fglor and the WIw daps pick them up within
twa&ty days of the dam of cancetladon,you may retain or a twenty da at the date of can on,you m rstatn.or
ditpofs of the goods without any further obligation.If you i di....of flue goods without any "her obllgUFon..if you
fail to make else seeds aYailmbic ea else Seiler,or,d you agree I fail to snake the goods ztrailabte ter Seger,or,if
to return the goads to the Solkr and fail to do so,been you f to return dw coeds to the Seller fail to do so then you t•.
remokin titbit fur performance of all obl gart*ons under the rennin ilable for performance of I obllgatlons tender the
Cont+actTo cancel this transaction.mail or deliver a signed B Contract;To camel this tratpaetle mail or deliver a signed'
and dated copy of this-cancellation notice or any otherI .and dated copy of'this cancel n notice or any other :
writew nodco,orowdatelegmm toitettewslbyAnderienaf.I wnktennotice,orsondatals Renewal byAndersenof
Southern New Ere and at36Affion Road, 'n 1 t.R BbS. f Soutim m New Eh *red at 74Alb Road Uncotn,Rl CINS,
NOT LATER THAN MIDF41GHT OF "� '` I NOT LATER TI MIDNIGHT E
Data Mate)
: EREBY CANCEt..THISTRANSAt:TiON. f HERABT CANCELTHISTIM GTION.
sspiN'tBeaOnn l4itrlensa Darr Oarrt'yiyutW+ tttr.r anti
UA Ccp js YV ie,. tithyer Cosy.Ydtaw Buyer CoW.Ph a
- r
Southern New England Windows
d.b.a
Re
newal by Andersen of SNE
t n
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Comtruction Supen isor
License: CS-095707 =`
BRIAN D DENNISON . ---
7 LAMBS POND EIRit E s
Chariton MA 01507 -
Expiration
Commissioner 09/08/2014"' t
• ; ,,y n��B (��O.7J•L%/'ffJ%7.•C/JP.flll� Q��J../6`�CYJ1ff•�,llfli Office of Consumer Affairs!an usiness Regulation
10 Park Plaza-Suite 5170
Boston,Massachusetts 02116
Home Improvement Contractor Registration
. Registration: 173245
Type: Supplement Cord
SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9119=14
DENNISON BRIAN ----- ----_.— _
1137 PARK EAST DRIVE -
WOONSOCKET,RI 02895
' Update Address and rcto-card.Marl reason for eba lie.
su r o�ourvii LJ
—Address F Renewal '`j Employment El Lost Card
�.sllike omm—&Rein&Baines—RrgapOoa Lhense or regisleaden valid for IndNldul an only
E OMPROVEMENT CONTRACTOR before the expire
date.If found return to:
•Reglatretlon: t: 45 T Office of Consumer Affairs and Business Regulation -
L',; .f?" TOs: 10 Park Plaza-Su Be 5170
Expiration: WIW014 Supplement::ard Boston,MA 01176
SOUTHERN NEW ENGLAND WINDOWS LLC.
RENEWAL BY ANDERSON .
DENNISON BRIAN ,
f c
1137 PARK EAST DRIVE
WOONSOCKET.RI 02895 Uodrrerrrcury Not valid without signature - --�--
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www massgov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Aliplicant Information Please Print Leveiblv
Name(Business/Ormization/Individual): ft S Ue
Address: 9 O
City/State/Zip: /It/t�O IN , ./� �, =16,5 Phone $- ?VDO,
Are you an employer?Check the appropriate box: Type of project(required):
1.9I am a employer with AD 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner. listed on the attached sheet. 7. ❑Remodeling
ship and have no employees , These sub-contractors have 8. []Demolition
working for me in any capacity. employees and have workers'
[No workers'comp.insurance comp.insurance# 9 ❑Building addition
required.] 5. [3 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 LO Plumbing repairs or additions
myself.[No workers'comp. right of exemption per MGL 12.Q Roof repairs
insurance required.]t c.152,§1(4),and we have no
employees.[No workers' 13.01�Other &0=ti
comp.insurance required.]
•Airy applicant that checks box#1 must also fill out the section below showing their workers'compemaation policy rmation.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such
tContnrctors that check this box must attached an additional sheet showing the name of the sub-connectors and slate whether or not those entities have
employees. If the subcontractors have employees,they must provide their workers'comp.policy munber.
I ram an employer that is providing workers'compensation insurance for ney employees Below is the policy and job site
information.
Insurance Company Name: Shrew C. ' a,,v
Policy#or Self-ins.Lic.# I[ri ���dr J�3o� Expiration Date: o't
Job Site Address: City/Stateailp: wd
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form Of STOP WORK ORDER and a fine
of up to$250.00 a day against the violator.°Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification
I do hereby kerb under the pains and penalties of perjury that the informaahon provided above is an correct
Si store: Date: _
Phone o";L
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#:
o '
Client#:30124 SOUTNEW
ACORM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
8/06/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY,OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to
the terns and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER NONE: Anita Little
Willis of New Jersey,Inc. PHONE :856 914.4660
ac No: 856-914-1881
1015 Briggs Road,PO Box 5005 E40AILADDRE a: anita.little@willis.com
BOX SODS Mount
INSURERS AFFORDING COVERAGE NAIC d
Mount Laurel,NJ 08054 INSURER A:Selective Insurance Co of the S 39926
INSURED INSURER B:Argonaut Insurance Co.. 19801
Southern New England Windows LLC INSURER C:Beacon Mutual Ins.Co. 24017
D/B/A Renewal by Andersen
26 Albion Road INSURER o:
Lincoln,RI 02665 INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDLSUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MIDDIYYYY) (MMMQIYYM LIMITS
A GENERAL LIABILITY S202945900 8/10/2013 08110/2014
pEAACMH�OECTCURRENCE $1 000 000
X COMMERCIAL GENERAL LIABILITY PREMISES EaEo rD $1 OO OOO
CLAIMS-MADE a OCCUR MED EXP(Any one person) $1 O 000
PERSONAL&ADV INJURY $1 OOO 000
GENERAL AGGREGATE $3 000,000
i
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000
POLICY E LOC $
A AUTOMOBILE LIABILITY S202945900 8/10/2013 08/1012014 COMBINED SINGLE LIMIT
1,000,000
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNEDtX
SCHEDULED BODILY INJURY Per accident $
AUTOS AUTOS ( )
NON-OWNED PROPERTY DAMAGE
X HIRED AUTOS AUTOS Per accident $
A X UMBRELLA LUU) OCCUR S202945900 8/10/2013 08/10/2014 EACH OCCURRENCE $5 000 000
EXCESS LWB CLAIMS-MADE AGGREGATE $S OOO OOO
DED I I RETENTION Eg $
C WORKERS COMPENSATION 0000068028-RI 8/21/2013 08/21/201 X WCSTATLL OTH-
AND EMPLOYERS'LIABILITY YIN
Y
B ANY PROPRIETOR/PARTNER/EXECUTIVE❑ AIC927818352394 8/21/2013 08/21/201 E.L.EACH ACCIDENT $1 000 000
OFFICER/MEMBER EXCLUDED? N N I A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 000 000
If under
=OF3aTIO OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space Is required)
CERTIFICATE HOLDER CANCELLATION
Southern NE LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
26 Albion Road ACCORDANCE WITH THE POLICY PROVISIONS. '
Lincoln,RI 02865
AUTHORIZED REPRESENTATIVE
01988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) 1 of 1 'The ACORD name and logo are registered marks of ACORD
#S215109/M215088 - AXL
Assessor's map and lot number ...:.....
/a.6
........................... CF THE TO
• Sewage Permit number `..vv �. EDO BUST BF-
SEPTIC rSYST �'I.i 7Pfi. Z BAUSTADLE
i
House number .................1�......'4'r.......
NS............yamt�{{ '�'A� .. iWi 90 rasa
f6
�I T TITLE 5 qE } o�pYPY Or�9
: TOWN OF BgrA,RN`SfiABE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ............................ ........ ....
',�' . .....................................
TYPE OF CONSTRUCTION ................ r% ...: !P ". .:....:....:..................................................
....
t•
lJ..'.... ............19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the.following i formation:
Location ........I�Jo.Z •••.._)06..../.0........ .. .°........ . ...... ,..
ProposedUse ................./1'.�.!!%.... .� !"!" .................................................................. ...........................................
Zoning District ... .. ..................Fire District ................................. ........................................
Name of Owner ...4 !. J . �/............... Address ' .1�.�..� .1> ..... .. ... ..�� ....................
Name of Builder' ..:.................................................................Address "
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ........................................... oundation �¢ "t Lea
Exterior .... -�.... ......d:6.. t� oofing .............� ........... ...................................................
.. _
Floors . ' !'r........: :... ? 't �e"� ..................Interior ......... �J.... [. C1
�. .... .. .............
Heating .....r....... ..............�....:. .1.<.:h.. .Plumbing ........ag. ar..................................................
Fireplace ..........0....................................................................Approximate Cost ....... o"........................... . ....
Definitive Plan Approved by Planning Board ________________________________19_ . Area ..................�.d.......... ........
Diagram of Lot and Building`with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
�30" +!rc td y,6
r�
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 ....... .. ................................
STANLEY
25728 One .Story
-Po ................. Permit for ....................................
Single Family Dwelling
.................... ..........................................................
Location ..Lo.t...4.0......6.5...Q NXI.Q.r...RoAd.......
Centerville
............................................................
Owner ..0......F......S.ta.n.l.ey..............................
Type of Construction, ..EX.AiDe............................
............... ....................... ...................................
Plot . .......................... Lot ........... ....................
Permit Granted ..Novdmber...3 .......19 83
..................... .....
Dcite of. Inspection ....................................10
Date-C complete .19
1
WN OF
o• TO Building ARpNSToABLE ---- `-----
, "
Ins
, •. Permit No. ______________
} fiu�Tan Cash
...� - - —---- -
A,e�o
OCCUPANCY PERMIT Bond -----------
Issued to '. Stanley Address
Wiring Inspector / L Inspection date
Plumbing Inspector �. ,/ Inspection date
Gas Inspector Inspection date
Engineering Department .�� Inspection date
Board of Health Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTII.
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
Building Inspector
i
h ., k FROM
'OWN of BARNSTABI E
.BUILDING DEPARTMENT
mt. F c ,s Lahtsine 367 MAIN STREET , HYANNIS, MA 02601.
Tom clerk
-
'CviU,.�. Prone- 776-1120 .. ,
SUBJECT: ;
FOLD HERE -
DATE
Jtme ]a 19$4 MESSAGE
Meted wxler Pexmit #25?z , c �q � ; * a.
Please refea B€ d,
rap'..$�...e-+pr�..ew..axn.� .wA..- y-a+..,,as,r+v�saer4,r.e+sew.S•e.P�c%fi
SIGNE•
DATE , ...� ,
{ j)
REPLY G}/!
< . SIGNED .. r .
Ne7•gml RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY
• - PRINTED IN U.S.A.
SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT.
'1
O�- V
A
1 �
tN OF
0
80 LEY
su
\ THOMAS E.KELLEY CO.
f +J7-tT ENGINEERS-SURVEYORS
346 LONG POND DRIV9
- SOUTH YARMOUTH,MASS.
02664
CERTIFIED PLOT PLAN '
LOCATION
SCALE ./4a::5 �# . DATE
PLAN REFEREN .
I CERTIFY THAT THE
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
zlmei 6
AS SHOWN HEREON
DATE "f -
PETITIONER: . EGISTERED LAND SURVE R
r
i
A complete Javelin@ framing plan requires thelFramer's Pocket Guide e�
See the Framer's Pocket Guide for Product Tra .mark Information -
2 2 2 2 2 2
(98
Framing Connector Summary ,
7 PIotID Qty Manuf Product Design Method Face Nails Top Nails Member Nails Skew Slope Backer Blks Filler Web Stiff
H1 21 Simpson IU52.37/9.5 Designed 8-10d x 1-112 - - - - No No No
Products
PIotID Length Product Plies Net Qty 0
J18'- 18,0" 9 112"TJI®230 1 21 LU
I
Ml 22'0" 1 3/4"x 9 1/2"2.0E Microllam®LVL 1 1 �.
; TSCal 16'0" 1 1/4"x 9112"1.3E TimberStrand®LSL 1 4
co
00
Accessories Y v
i 00 00 00 0 00 00 00. 00 00 00 00 aD 00 00 00 00 00 a0 V PIotID Length Product Plies Net Qty o `U -
23/32"x48"x96"Weyerhaeuser Edge Gold Ponel(0/24)T6G SF 1 13
)— !�f7 i"J i'7 f'7 ti ti I"7 .. h ti....F7 h f'J ti h h .h I-7 h h F7 F7
f 0
m a
rw�?
o
I,I
ill I
,
i
TSCnl
A3. r
22' 0" LU
-
!/��t Main Floor Framing Plan LEVEL NOTES LU J o
1
�� Current Date: li/10/20 4 z � _
Scale: 1/4" = V 0 x LU File Name: WHALEN-WEILAND.jvl o Z
LU
®,(
p-� Level Name: First Floor 10 v A
TJ-Pro Rating(Weighted Average): 33
( Minimum Level TJ-Pro Rating&Joist: TJ-Pro rating=34,joist=J18'(i7O)
Maximum Level TJ-Pro Rating&Joist: TJ-Pro rating=34,joist=J18'(i70)
v u d
Building Code-Design Methodology: IBC 2006 U
FLOOR
Floor Container: FC1
Use/Occupancy: ResidentiolLivingAreas
Floor Area Loading is: 40.0 Ib/ft' Live Load&12.0 Ib/ft2 Dead Load
z
Maximum Allowed Deflection: L/480 Live Load&L/240 Total Load o
TJ Pro Rating Information LU o
WARNING
Weighted Average: 33Q
" un e," —��� Directly Applied Ceiling. None a a
aeon°rMWdm
Decking Attachment: Glue and Nail > w;., 0 3
I Frameworks Floor: No
Do,
NOT'". :1-ft °°NOT"i„-J.— ONOT '„�;: 3 �- � - i Decking Material: 23/32"x48"x96"Weyerhaeuser Edge Gold Panel(0/24)T&G 5F
w�unrmnraesuLr. pyv,.sr,u omb ow,`
p«mm a w
w<Rn,na"a a-- � Perpendicular Partition: No tt
Lent er proper emdnpLurin°"o don anrnutln verleu, u o
,ccldenh eurge qe to loxtep pulde lnn'
".�@ peen rtm"eemed xnlpme,n.em.,,.�m ,m,d�e. m�.e mpmymye.�. - - ti Strapping at max 8' o:e.: None E. s
Blocking at max 8' o.e.: No
ee mmpmW nudaamma y.d,ldneee.v eeevm,mwam,eepeadmn,aymn. -
a
P,wnn z�We,.m,M Poured Flooring: sheet:
A w.v�mm��ii ww rn�m em®e,,,l,mn,s.mclueb,rmnurs,meer r,.,r,bendrm,�e.u.r.. I of 1
rp nq ded,merlo MW"yamew"er Mt°]d,3 Weyemeeuwr RR Comreny Nr°bmurvM.
1.0
GENERAL PLAN NOTES WHERE DISCREPANCIES EXIST BETWEEN THE STANDARD
COMMENTS, NOTES FROM THE DESIGN PROFESSIONAL OR THE CODE, THE MOST S-BARS
RESTRICTIVE SHALL APPLY. ALL CONSTRUCTION SHALL COMPLY WITH TOWN OF ORLEANS g
° V-BARS: B-BARS: S-BARS:
A
AND MASSACHUSETTS STATE BUILDING CODE 1 SIZE - 1/2" SIZE - 1/2" SIZE - 3/8"
•�FOUNDATIONS/FOOTINGS/SLABS SPACING - 7" SPACING - 7" SPACING - 12"
�—�-F- � �'
1. CONCRETE SHALL BE AIR ENTRAINED WITH A MINIMUM COMPRESSIVE STRENGTH AT 28 DAYS OF: i : :.r. V-BARS
RETAINING WALLS - 31000 PSI
2. MINIMUM ASSUMED SOIL BEARING CAPACITY IS 2,000 PSF 6.0 T:; :' NOTE:
3. FOOTINGS SHALL EXTEND BELOW THE FROST LINE; MINIMUM DEPTH 48 INCHES BELOW GRADE. ..r A. # `. SPACING OF S-BARS IS APPROXIMATE.
4. FOOTINGS SHALL BE A MINIMUM OF 60 INCHES WIDE AND 10 INCHES DEEP. 1 '(-A-� USE TABULAR NUMBER OF BARS AND
5. RETAINING WALLS SHALL BE A MINIMUM 10 INCHES THICK- MAXIMUM WALL HEIGHT 8.9 FEET. ° j• SPACE EVENLY WITH 2" COVER
6. REINFORCEMENT SHALL LAP A MINIMUM OF 18 INCHES AT ENDS AND AROUND CORNERS. +�
7. 4 PERFORATED PIPE DAYLIGHTED SURROUNDED BY 12 OF 1 STONE AND FILTER FABRIC OR 2
WEEP HOLES NOT LESS THAN 12' O.C. . . '. GROUND URFACE
1.0
B-BARS FOOTING SHALL BE PLACED
5.0
SECTION ON COMPACTED SOIL
( AN BUTTRESS DETAIL
SCALE: NOT TO SCALE
Liz
2.0
4.0--
.0 PROPOSED
REINFORCED
CONCRETE
. BUTTRESS
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