HomeMy WebLinkAbout0453 SHOOTFLYING HILL RD Alf Ah"
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UPDATE PERMIT RECORDS: ADD CHANGE DELETE PRINT FEES HELP END i
CHANGE RECORDS IN PERMIT TABLE
PENTAMATION----------------------------------------------------------- 12/10/0.4
PERMIT NO. 76964
PARCEL ID _ 213. 005 453 SHOOTFLYING HILL RD
PERMIT TYPE BADDI BUILDING PERMIT ADDITION
DESCRIPTION ADD 2ND FL DORMER/FRONT PORCH/REMODEL EXIST
STATUS C COMPLETED
APPLICATION DATE 06/01/2004 DATE ISSUED 06/01/2004
EXPIRATION DATE DATE COMPLETED
MASTER PERMIT VARIANCE
VALUATION 157056 . 00 BOND 0 . 00
CONSTRUCTION TYPE 434 GROUP TYPE 1
CONTRACTORS OWNER PROPERTY OWNER
ARCHITECTS/
ENGINEERS/OTHERS
ENTER Y IF ALL ARE CORRECT OR N TO REENTER
LEAVE BLANK FOR NON-PROPERTY RELATED PERMIT. CTRL-I FOR HELP.
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�a. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
t
Map Parcel GC,_!r_ Permit# 7.416 4
Health Division S; ,\ Date Issued 611 hq
k '
Conservation Division 0 Application Fee r
Tax Collector a pb3 Pkwd SYSTEM M • o I
Treasurer �� INSTALLED IN COMPLIANCE
Planning Dept. WATH TITLE 5
ENVIRONMENTAL CODE AND
Date Definitive Plan Approved by Planning Board T"REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address
�
Village C:
Owner lJ� G Address
Telephone
Permit Request
AeX f Slat!/;t C,�'�-•` cs�� k fV�;r-3
Square feet: 1st floor: existing,LLt) Proposed 'y -✓re2nd floor: existing proposed dotal new YO s
Zoning District Flood Plain Groundwater Overlay
Project Valuation �� Construction Type
Lot Size ,7y /Va-a- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family R/ Two
Family ❑ Multi-Family(#units)
Age of Existing Structure y Historic House: ❑Yes O'er On Old King's Highway: ❑Yes @- o
Basement Type: U I' ull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
GOUL 6W11&f3w /-,
Number of Baths: Full: existing new,(?/3f�in ✓s � Half:existing_ new
hci• rr�ouc,d �
Number of Bedrooms: existing 3 newts bra.? ✓ .ccxvt✓� ✓, uc
Total Room Count(not including baths): existing new 7 First Floor Rooms Count� _
Heat Type and Fuel: QGas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes Fireplaces: Existing _� New Existing wood/co stove: Yeses &<o
• co
Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑ex ting w Fqe
Attached garage:2 eAsting ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes Cl No If yes,site plan review#
Current-Use Proposed Use
BUILDER INFORMATION
Name /701Mt0Whu— Telephone Number � ����
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
4
FOR OFFICIAL USE ONLY
...PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
i
ADDRESS VILLAGE
OWNER
- s
DATE OF INSPECTION:
FOUNDATION / /
FRAME '(�1 �S�l�d y Q'g/u L/
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH )FINAL
� m i
GAS: R ( 61�i� 9. FINAL
�. FINAL BUILDING
F— ca
m0F= �
DATE`CLOSED'OUT m m o ,
- . c� � 00
y ASSOCIATION PLA I'NO
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x'he achusetts
• _ _= Department of Industrial Aeeidents' .
. . 600'Washington Street _
�` '• Boston;Mass..bZIX
'? Workers',.C mslii ensation,'Usurance Affidavit-General Businestses
,., ry -•" •tR ram, .ti v ' I
a mom
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state: .
t; fu11 address :' ' ' [] etail❑RestaurantBaFlJ✓atYrig kstablishm s e .
work site loca roprietor and have no onb ' $usuiess e ffice[�Sa' including Rt:a1' Antos etc.)'
[] X ato:a 8010P ' ' . [] '
working any capacity. . .. }her
' e
em to er with: esn to ees hill& art .
////%//H�/�/%//��%///%/%%//��/ on this job.,
/% � //////� to ees worJsng .. t;.. '•.;
leers'cbmDmsation for mY, .�' ;. r ,•,„ :+ ,•.1 :r�'
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~ri:��4'' •. F'.s F't t+%is.• N • ::'r '1
'b:{ifs, ;;;t""k. .ti::a'• a to$1 00.00anor
insur$2ie-•£ J27
osition of crimfna111e����of a fin sg? zs
Failure to secure coveeaasa ell u ea in a I��inn?�A of MGL 152 can lead to the imp r
the foYm of a STOP
WORK ORDER and a fine of�100,00 s'day against me, I undera t 1<
ris onm a verii'ication.
Oise: imp be forprarded to the Office Of of the DTAfor coverag !
copy or this statement ply '
J or the pains and psn bf p erjury that •e Worm anon provided above is frue and or•.0
I do hereby a Date ,
5�ignature t hone#
print namB '
do not'R'J'ite in this area to be completed by city or town offici4 ❑Building Department
official we only
• permf t/license# []Licensing Board
city or town: ❑selectmen's Office
[]Health Dcp9rb=nt
[}•oheckif�ediata response is regiliz ed []Other
phone#;
contact person:
(revised sept 2003) I "
• ' , Information and Zns bruction�
f General Laws cfiapter 152 section 25 requires all employers to provide workers'compens tioa fcr thejr.
Massach',' e f`law", an employe is.defined as every person m the service of another under any contract
�,1�,�; As quoted'from
xpre�s or
irr�?l�,ed; oral or written.
of hire,e .
An emp
Z er is defiiaed as an individual,p�ers4, association, corporation or other legal entity, ' any{wo or rngre of
the foregoing engaged-in a•joint enterprise,and including the legal zepresentatives of a deeeased,employheer, or the Ofreceiver or
artuershi association or other legal,entity, employing tmployees. 'However.the owner of a
.trustee of an individual,p P� .
dwelling house having•hot'i sore than three apartments and who resid�•s therein, or fhe,occupantto the dwelling house bf
ti n or r ' air work on such dwelling fioue me on the grounds or
c constr4ic b cp
' another who.�'1o�'Spersbns to do,main'ke� e, ,
errant thereto shall not becaus a pf such
;employment be deemed to be ail,employer, ,.,
'building.app
dha tom.i52 5ectibn 25 also''siates that'every state or legal licensing agency shall withhold the Ssuaneb or renewal
Mom' p t to operate a business or to construct buildings fn the.6n nnonwealth for any applicant who has
n a license or cerjable•eviaence'orco game with the Insurance coverage requiz'ed: A.ilditionally,'neithbr'the• .
not produced nor of its political subdivisions shall enter into any contract for the performance of public work until
cozrao�wealthnar.any P ,
acceptable evidence of compliance with the assurance requirements of this chapter have beenpxesentetT to the contracting
. _..... ,
authority: .
Applicants •, .. e box that a Lies to our 5ituatian.,Please
Please the WOrICeCS'.eo ensatimt afaLvit completely,by checlang the ,pp :., ,, Y,
supply company name, address anAphone numbers along with a certificate of insurance as all affidavits maybe submitted
to the Depamtrnent'of Industnal Accidents-for cMETmation of insurance coverage. Also be sure to sign and date the
affidavit. The davit should be returnedto the city or town that the application for the permit or license is being
ailment 6�l dustdll Accidents• Should you have any questions regar&J the''°IaV or if you are
requested,not the pep .
requiredto�o:�tain a•wo��5•'•compensationpQlicy,please call theI?epar(znent at the niwmber liste�,below.
a � .
22,
City or Towns . , • '
leasebe sure that:the affidavit is c lete and Tinted legibly. The D artn=thas rovided a space at thdbottorn of the
P � peP p�. .
affidavit for you to:fill o�Yt in-the event the Office of Investigations has to contact you regarding the applicant Please -
e to fib- the perrmthicense,number which w�l be used as a reference number. The.affidavits rnay.be xetuzned tq•
be;sur ernmts havebeenmade,• .:
theDeparfineutb�. orFAX,unlessothez':ar'rang , . , •. . . .•. .
The Office of Investigations would lie to thank y'ou in advance for you cooperation and sl onla you have aay questions,
. •• '
please do nothesiter,to.give us a•call.•
The p� ent's address,tel and fax number: . '
• The Commonwealth Of Mv.Lssachusetts-
Department.of Industrial Accidents
eNIce td We SUP&nd
600 Washington Street
Boston,Ma. OZIII
fax#; (61.7)717-7749
r
qiA QriFG ApP�� G°ti���J
rj jbTA.iS Z.11i( gafcd trf�gc3�tf(F`uelx
pres°rlptlYe F'uk=K�far aan sad'Cwa•l:taill}'Ar�ldentisl Huildia&�
� hffl`(1M� Slab •H�attr,g/Coaling�
14iAXMtltng Wdl Floor F3s Gat ppntcnt F-Tien
Glazing �, �� A yxl�° c R Ytluar
Aft('/�} u.Yaltt F3,•YaI l;.yulua
' gEskas�o 3701 to 6S0d gr�ttiag Aim�x1Y' � j;orauci
13 l g 10 8 Nnrttts�l
0.¢0 33 1g LQ 10 IS AFVB
Q IZ'h 0S2 30 tg 10 Namsal
ti t7'/. O.Sd 33 13 T N
21 NIA 6
13 Norsk
ISVIL d3fi it 19 tg 10 IVA fSAFUB
151/9 0.44 13 29 NIA ' fS Al•{7E
Y151/4 0.44 30 tg 19 10 'N1A Nomsal
1S% Q.SZ 25 NIA lq=4
1g'!� 032 3 13
t 19 C 21 NIA N1A g0AF
YWK 0,4x 13
0.4Z 19
19 10 6 g0•AFU
10
18l• 30 1g
x
0.30 j
1tiA '
ADDRESS OF PROPERTY:
'� RxOR BALLS; � i
SQUARE FOOTAGE OF ALL EXTE
tJARE FOOTAGE OP ALL GLAZI�tGs
3. 5Q
4. %GLAZING AREA(03 DIVIDED BY
s sDLECT PAC�.AGE{Q
AA.see chart abav6):
G�RG�REQU�MENTS
O�RMoRE it�[VoLV'ED METKoD��a
jOT ARE kVAjLABLL', ASY,US FORTHT �
•
�DI1�G INSPgCTOR Al'PROV�L;
B V0,
1
gdorm�•fl$0303s
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings;Additions $50.00 S�
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
yG square feet x$96/sq.foot='M/ O x.0031= �p��. �►3
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
14 R square feet x$64/sq.foot=1 j 06a72.. x.0031= fb
34
plus from below(if applicable)
GARAGES(attached&detached)
square feet x$32/sq.ft.= x.0031=
ACCESSORY STRUCTURE>120 sq.ft.
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00 I `
>750 sf- 1000 sf 75.00
>1000 sf- 1500 sf 100.00
>1500 sf-Same as new building permit:
square feet x$96/sq.foot= x.0031=
STAND ALONE PERMITS ,!
Open Porch �_x$30.00= / 30.bb
(number) �d
YP
Deck x$30.00=
(number)
Fireplace/Chimney x$25.00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable)
Permit Fee
4SI 6, "F?
pTOJCOSt
i
pF1HE?0{� Town of Barnstable
Regulatory Services
'"ar' E
MASS.
i Thomas F.Geiler,Director
1639.
Building Division i
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601 .
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
i
Date
i
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements. 1
Type of Work: 4/47"'- Estimated Cost
Address of Work:
i.
Owner's Name: 1
Date of Application:
I hereby certify that:
i
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.
i
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No: .
O I
c5 c3 O eu
Date Owner's ame
Q:forms:homeaffidav
p�
I
ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION and AMMONS
780 CMR Appendix J (effective 3/1198)
Applicant Name: a2A App Site Address:
Applicant Address: City/Town_
Use Group: ',
/j Do2 Date of Application:
Applicant Phone: n/o S, Applicant Signature:
ALTERNATIVE FOR ADDITIONS ONLY:
a. Gross Wall +Ceiling Area 3--rsq.R.(D-Gj g Area' aQ - sq-& c. Glaring%(too x b T a)
J- ., I
[j ADDITION with Gla�ng %(c.) up to 40% nmy use 780 CMR Table 11.1.2.3.1 below:
MAXIMUM MINIMUM
Fenestration Ceiling Wall Floor Basement Wall Slab Perimeter
U-value R-Value R-Value R 4alue R 4alue R 4alue and Depth
0.39 R-37' R43 R49 Rao R40, 4 ft
'R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-
value over the entire ceding area(iie. -not compressed over exterior walls,and including -
any access openings.)
Q "5UNR00M7 addition. (greater than 40% gL=hWto-wsH and ceiiieg grass area)
Ate"Consumer Infarnation Farm"from 780 CMR Appendix B.
Of'rMai's name: OPficiati's Signature:
Application Approved Denied Q Date of ApprovaYDeaial:
Reason(s) for Denial: (pmide additional details as needed on back side)
e. w
a
i
' Glazing Area may be eidw Rough"Opening,oc Unit diaaensicns, seats odtz,�4
r
oFIKE Town of Barnstable
Regulatory Services
anxtvsTaB Thomas F.Geiler,Director
MASS.
1639 ••� Building Division
Ten r�u►+"
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstabkAna.us
Office: 508-862-4038 - Fax:.508-790-6230
HOMEOWNER LICENSE EXEMPTION
u Please Print
DATE: (, c3 ►�lSZO T
JOB LOCATION: �C�V /"/ /7/��
street -
village
"HOMEOWNER": �7 J S U el G/0/2" ;7
name / home phone# work phone#
CURRENT MAU-ING ADDRESS: c J�a C s -- -
�c vi�lc 11174
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwelling of six units or less and 'w
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs.more than one home in a two-year period shall not be considered a homeowner. Such - -
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit (Section 109.1.1) _
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The.undersigned`homeowner",.certifies that he/she understands.the Town of Barnstable Building Department a'
minimum inspection_proc dures and requirements and that he/she will comply with said procedures and
reqffft
ents.
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'l-27.0 Construction Control. .
HOMEOWNER'S EXEMPTION
_ The Code sta!es."t `Any,homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such H
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible. —
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt `
i
Buking Sketch(Page - 1)
orrower/Client MacDonald Paul B.$Michele L.
Property Address 453 ShootHyina Hill Rd
City Centerville County Barnstable State MA Zip Code 02632
Lender Plymouth Savings Bank
66.0'
--� Workshop area
Bedroom o Dining Kitchen
m Area
i
Living Room
Bat
r�//�� h
1 1 2 car garage 29.0'
Walk-in
$ I Dining Room Closet
Master
Bedroom Bedroom Balh
14.0'
6.0'
Porch _..........__._._...._._._........._...._._._.'.
_....._.......................18.0' 34.0' 22.0'
I
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s
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O
SHEPLEY WOOD PRODUCTS, INC.
216 Thornton Drive,Hyannis,Massachusetts 02601
www.shepleywood.com
Joe Madera
Engineered Wood Toll Free:800-227-7969
Direct:508-862-6217 Mobile:508367-8108
Email:jmadera@shepleywood.com r_ Facsimile:508-862-6007
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BoisE BC CALC® 2003 DESIGN REPORT - US Wednesday, May 12,2004 10:39
Double 1 3/4" x 11 7/8" VERSA-LAM® 3100 SP File Name: Paul Macdonald.BCC : FB01
Job Name: Paul MacDonald Description: LVL defining stair opening
Address: 453 Shoot Flying Hill.Rd Specifier:
City, State,Zip: Barnstable, Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
1
Standard Load-20 psf 110 psf Tributary 05-00-00
AL-_ —
a fir;x
BO B1
517 Ibs LL 517 Ibs LL
629 Ibs DL 629 Ibs DL
Total Horizontal Length-10-04-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur.
S Standard Load Unf.Area Left 00-00-00 10-04-00 Live 20 psf 05-00-00 100%
Member Type: Floor Beam Dead 10 psf 05-00-00 90%
Number of Spans: 1 1 wall Unf. Lin. Left 00-00-00 10-04-00 Live 0 plf n/a 90%
Left Cantilever: No Dead 60 plf n/a 90%
Right Cantilever: No
Controls Summary
Slope: 0/12 Control Type Value % Allowable Duration Load Case Span Location
Tributary: 05-00-00 Moment 2959 ft-Ibs 13.9% 100% 2 1 -Internal
Neg. Moment 0 ft-Ibs n/a 100%
End Shear 926 Ibs 11.5% 100% 2 1 -Left
Total Load Defl. U2130(0.058") 11.3% 2 1
Live Load: 20 psf Live Load Defl. L/4722(0.026") 7.6% 2 1
Dead Load: 10 psf Max Defl. 0.058" 5.8% 2 1
Partition Load: 0 psf
Duration: 100 Notes
Disclosure Design meets Code minimum(L/240)Total load deflection criteria.
Design meets Code minimum(L/360)Live load deflection criteria.
The completeness and accuracy of Design meets arbitrary(1")Maximum load deflection criteria.
the input must be verified by anyone Minimum bearing length for BO is 1-1/2".
who would rely on the output as Minimum bearing length for B1 is 1-1/2".
evidence of suitability for a Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
particular application. The output
above is based upon building Connection Diagram
code-accepted design properties Member has no side loads.
and analysis methods. Installation
of BOISE engineered wood Connectors are: 16d Sinker Nails
products must be in accordance
with the current Installation Guide a=2" +
and the applicable building codes. b_3„ b-I d
To obtain an Installation Guide or if
you have any questions, please call c'7-7/8 a
(800)232-0788 before beginning d- 12
product installation.
C
BC CALC®, BC FRAMER®, BCI®,
BC RIM BOARD TM, BC OSB RIM
BOARD TM, BOISE GLULAMTM
VERSA-lAM®,VERSA-RIM®,
VERSA-RIM PLUS®,
VERSA-STRAND TM,
VERSA-STUD®,ALLJOIST®and
AJSTm are trademarks of
Boise Cascade Corporation.
Page 1 of 1
BOjSEn
BC CALL®2003 DESIGN REPORT - US Wednesday,May 12,2004 10:41
Triple 1 3/4" x 11 7/8" VERSA-LAM® 3100 SP File Name: Paul Macdonald.BCC: FB02
Job Name: Paul MacDonald Description:2nd fl LVL carring addition
Address: 453 Shoot Flying Hill Rd Specifier:
City,State,Zip: Barnstable,Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
1
3 11 1 1
W
EPP I 2 5
y Standard Load-40 psf{10 psf Tributary 01-00-00
vet -
16-00-00 12-08-00
BO B1 B2
3373 Ibs LL 6365 Ibs LL 348 Ibs LL
2406 Ibs DL 4680 Ibs DL -232 Ibs DL
Total Horizontal Length-28-08-00'
General Data Load.Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur.
S Standard Load Unf.Area Left 00-00-00 28-08-00 Live 40 psf 01-00-00 100%
Member Type: Floor Beam Dead 10 psf 01-00-00 90%
Number of Spans: 2 1 exterior wall Unf. Lin. Left 00-00-00 16-00-00 Live 0 plf n/a 90%
Left Cantilever: No Dead 80 plf n/a 90%
Right Cantilever: No 2 attic Unf.Area Left 00-00-00 16-00-00 Live 20 psf 10-00-00 100%
Dead 10 psf 10-00-00 90%
Slope: 0/12 3 Roof Unf.Area Left 00-00-00 16-00-00 Live 25 psf 10-00-00 100%
Tributary: 01-00-00 Dead 15 psf 10-00-00 90%
4 FB01 point load Conc. Pt. Left 19-00-00 19-00-00 Live 517 Ibs n/a 100%
Dead 629lbs n/a 90%
5 stair Unf.Area Left 16-00-00 19-00-00 Live 30 psf 05-02-00 100%
Live Load: 40 psf Dead 10 psf 05-02-00 90%
Dead Load: 10 psf
Partition Load: 0 psf Controls Summary
Duration: 100 Control Type Value %Allowable Duration Load Case Span Location
Moment 19702 ft-Ibs 61.7% 100% 4 1 -Internal
Disclosure Neg. Moment -17077 ft-Ibs 53.5% 100% 2 1 Right
The completeness and accuracy of End Shear 4940 Ibs 41.0% 100% 4 1 -Left
the input must be verified by anyone Cont.Shear 7009 Ibs 58.2% 100% 2 1 -Right
who would rely on the output as Uplift 923 Ibs n/a 4 2-Right
evidence of suitability for a Total Load Defl. U347(0.554") 69.3% 4 1
particular application. The output Live Load Defl. U582(0.33") 61.8% 4 1
above is based upon building . Total Neg. Defl. -0.163" 32.5% 4 2
code-accepted design properties Max Defl. 0.554" 55.4% 4 1.
and analysis methods. Installation
of BOISE engineered wood Cautions
products must be in accordance Uplift of 923 Ibs found at span 2-Right.
with the current Installation Guide
and the applicable building codes. Notes
To obtain an Installation Guide or if Design meets Code minimum(U240)Total load deflection criteria.
you have any questions;please call Design meets Code minimum(U360)Live load deflection criteria.
(800)232-0788 before beginning Design meets arbitrary(1")Maximum load deflection criteria. ,
product installation. Minimum bearing length for BO is 1-1/2".
BC CALCO, BC FRAMER®, BCIO, Minimum bearing length for B1 is 3".
BC RIM BOARD- BC OSB RIM Minimum bearing length for B2 is 1-1/2".
BOARD-, BOISE GLULAMM, Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
VERSA-LAMB,VERSA-RIM®,
VERSA-RIM PLUS®,
VERSA-STRANDTm,
VERSA-STUD®,ALLJOIST®and
AJSTm are trademarks of
Boise Cascade Corporation.
Page I,of 2
BOiSE-
BC CALCO 2003 DESIGN REPORT.- US Wednesday, May 12,2004 10:41
Triple 1 3/4" x 11 7/8" VERSA-LAM@ 3100 SP File Name: Paul Macdonald.BCC: FB02
Job Name: Paul MacDonald Description:2nd fl LVL carring addition
Address: 453 Shoot Flying Hilt Rd Specifier:
City,State,Zip: Barnstable,Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products 4
Code reports: ICBO 5512, NER 629 Misc:
Connection Diagram
Nailing schedule applies to both sides of the member.
Member has no side loads.
Concentrated loads are not considered in side load analysis.
Connectors are: 16d Sinker Nails
a=2" d
b=3
c=7-7/8" a /\
d= 12°
e 3". 0 I o
C
r • •
e o 0 0 j.
�II
i .
f
Page 2 of 2
BOISE,
BC CALCO 2003 DESIGN REPORT - US Wednesday, May 12,2004 10:42
Double 1 3/4" x 11 7/8" VERSA-LAM@ 3100 SP File Name: Paul Macdonald.BCC: FB03
Job Name: Paul MacDonald Description: Beam defining left side of stairs
Address: 453 Shoot Flying Hill Rd Specifier:
City State,Zip: Barnstable,Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
Standard Load-40 psf l 10 psf Tributary 01-00-00
N �• �,. mow: � �� .,�, ��
BO
648 Ibs LL
617 Ibs DL 376 Ibs LL
286 Ibs DL
Total Horizontal Length-12-08-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. 'Start End Type Value Trib. Dur.
S Standard Load Unf.Area Left 00-00-00 12708-00 Live 40 psf 01-00-00 100%
Member Type: Floor Beam Dead 10 psf 01-00 00 90%
Number of Spans: 1 1 FB01 PT load Conc. Pt. Left 03-00-00 03-00-00 Live 517 Ibs n/a 100%
Left Cantilever: No Dead 629 Ibs n/a 90%
Right Cantilever: No
Controls.Summary
Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location
Tributary: 01-00-00 Moment 3515 ft-Ibs 16.5% 100% 2 1 -Internal
Neg. Moment 0 ft-Ibs n/a 100%
End Shear 1204 Ibs 15.0% 100% 2 1 -Left
Total Load Defl. U1624(0.094") 14.8% 2 1
Live Load: 40 psf Live Load Defl. U3078(0.049") 11.7% 2 1
Dead Load: 10 psf Max Defl 0.094" 9.4% 2 1
Partition Load: 0 psf
Duration: 100 Notes
Disclosure Design meets Code minimum(U240)Total load deflection criteria.
Design meets Code minimum(U360)Live load deflection criteria.
The completeness and accuracy of Design meets arbitrary(1")Maximum load deflection criteria.
the input must be verified by anyone Minimum bearing length for BO is 1-1/2".
who would rely on the output as Minimum bearing length for B1 is 1-1/2".
evidence of suitability for a Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
particular application. The output
above is based upon building Connection Diagram
code-accepted design properties Member has no side loads.
and analysis methods. Installation of BOISE engineered wood Concentrated loads are not considered in side load analysis.
products must.be in accordance Connectors are: 16d Sinker Nails
with the current Installation Guide
and the applicable building codes. a=2„
To obtain an Installation Guide or if b -d
you have any questions,please call b=3"
(800)232-0788 before beginning c- 8
12" \
product installation. d=12
-i-
BC CALCO, BC FRAMER®, BCI®, C
BC RIM BOARDTM OSB RIM -�
BOARD TM BOISE GLULAMTM,
VERSA-LAM®,VERSA-RIM®, "
VERSA-RIM PLUS®, j
VERSA-STRAND-,
VERSA-STUD®,ALLJOISTO and
AJSTm are trademarks of
Boise Cascade Corporation.
Page 1 of 1
BOiSETM
BC CALC®2003 DESIGN REPORT - US Wednesday,May 12,2004 11:10
Double 1 3/4" x 11 7/8" VERSA-LAM® 3100 SP File Name: Paul Macdonald.BCC: FB04
Job Name: Paul MacDonald Description:2nd fl beam defining stair opening
Address: 453 Shoot Flying Hill-Rd Specifier:
City,State,Zip: Barnstable,Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
n
3
Standard Load-20 psf 110 psf Tributary 08-00-06
INE
2,At
BO B1
1747 Ibs LL 1185 Ibs LL
1489 Ibs DL 1094 Ibs DL
Total Horizontal Length-11-06-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur.
S Standard Load Unf.Area Left 00-00-00 11-06-00 Live 20 psf 08-00-06 100%
Member Type: Floor Beam Dead 10 psf 08-00-00 90%
Number of Spans: 1 1 attic load to baclUnf.Area Left 00-00-00 03-06-00 Live 20 psf 06-04-00 100%
Left Cantilever: No Dead 10 psf 06-04-00 90%
Right Cantilever: No 2 FB03 pt load Conc. Pt. Left 03-06-00 03-06-00 Live 648 Ibs n/a 100%
Dead 617lbs n/a 90%
Slope: Oil 3 wall Unf. Lin. Left 00-00-00 11-06-00 Live 0 plf n/a 90%
Tributary: 08-00-00 Dead 60 plf n/a 90%
Controls Summary
Control Type Value %Allowable Duration Load Case Span Location
Live Load: 20 psf Moment 1 1 8327 ft-Ibs 39.1% 100% 2 1 -Internal
Dead Load: 10 psf Neg. Moment 0 ft-Ibs n/a 100%
Partition Load: 0 psf End Shear 2740 Ibs 34.1% 100% 2 1 -Left
Duration: 100 Total Load Defl. U695(0.199") 34.5% 2 1
Live Load Defl. U1322(0.104") 27.2% 2 1
Disclosure Max Defl. 0.199" 19.9% 2 1 j
The completeness and accuracy of
the input must be verified by anyone Notes 1
who would rely on the output as Design meets Code minimum(L/240)Total load deflection criteria.
evidence of suitability for a Design meets Code minimum(U360)Live load deflection criteria. I
particular application. The output Design meets arbitrary(1")Maximum load deflection criteria.
above is based upon building Minimum bearing length for BO is 1-1/2".
code-accepted design properties Minimum bearing length for B1 is 1-1/2".
and analysis methods. Installation Entered/Displayed Horizontal Span Lengths)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
of BOISE engineered wood
products must be in accordance Connection Diagram
with the current Installation Guide Member has no side loads.
and the applicable building codes.To obtain an Installation Guide or if Concentrated loads are not considered in side load analysis.
`
you have any questions,please call Connectors are: 16d Sinker Nails
(800)232-0788 before beginning F
product installation. a=2„ b d
BC CALC®, BC FRAMER®, BCI®, b=3"
BC RIM BOARDT"' BC OSB RIM c-7-7/8 a
BOARD- BOISE GLULAMT , d=12" �• •
VERSA-LAM®,VERSA-RIM®,
VERSA-RIM PLUS®, C
VERSA-STRANDM
VERSA-STUD®,ALLJOISTO and "
AJSTm are trademarks of • •
Boise Cascade Corporation. i
i ,•
Page 1 of 1 j
-
BOiSEM
BC CALC® 2003 DESIGN REPORT - US Wednesday,May 12,2004 11:11
Single 9 1/2" AJSTM 10 APG File Name: Paul Macdonald.BCC:J01
Job Name: Paul MacDonald Description: attic joist
Address: 453 Shoot Flying Hill Rd Specifier:
City,State,Zip: Barnstable, Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: BOCA 22-09,SBCCI 9707D, ICBO PFC-5504 Misc:
Standard Load-20.psf 110 psf OC Spacing 12"
mE�
BO, 1-1/2"
2 B1, 1-1/2"
00lbs LL
200 Ibs LL
100 Ibs DL 100 Ibs DL
Total Horizontal Length-20-00-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value OCS Dur.
S Standard Load Unf.Area Left 00-00-00 20-00-00 Live 20 psf 12" 100%
Member Type: Joist Dead 10 psf 12" 90%
Number of Spans: 1
Left Cantilever: No Controls Summary
Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location
Moment 1500 ft-Ibs 54.8% 100% 2 1 -Internal
Slope: 0/12 Neg. Moment 0 ft-Ibs n/a 100%
OC Spacing: 12" End Reaction 300 Ibs 26.2% 100% 2 1 -Right
Repetitive: Yes Total Load Defl. U529(0.454") 45.4% 2 1
Construction Type:Glued Live Load Defl. U793(0.303") 60.5% 2 1
Max Defl. 0.454" 45.4% 2 1
Live Load: 20 psf Span/Depth 25.3 n/a 1
Dead Load: 10 psf
Partition Load: 0 psf Notes.
Duration: 100 Design meets Code minimum(U240)Total load deflection criteria.
Disclosure Design meets User specified(U480)Live load deflection criteria.
Design meets arbitrary(1")Maximum load deflection criteria.
The completeness and accuracy of Minimum bearing length for BO is 1-1/2".
the input must be verified by anyone Minimum bearing length for B1 is 1-1/2".
who would rely on the output as Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
evidence of suitability for a -
particular application. The output
above is based upon building
code-accepted design properties "
and analysis methods. Installation
of BOISE engineered wood
products must be in accordance
with the current Installation Guide
and the applicable building codes:
To obtain an Installation Guide or if
you have any questions,please call
(800)232-0788 before beginning
product installation:
BC CALC®, BC FRAMER®, BCI®,
BC RIM BOARD-, BC OSB RIM
BOARD-, BOISE GLULAMT ,
VERSA-LAM®,VERSA-RIM®,
VERSA-RIM PLUS®,
VERSA-STRANDT"'
VERSA-STUDS,ALLJOIST®and
AJSTm are trademarks of
Boise Cascade Corporation.
Page 1 of 1
BOISE-
. BC CALL® 2003 DESIGN REPORT US Wednesday, May 12,2004.10:23
Single 1 3/4" x 11 7/8" VERSA-LAM® 3100 SP File Name: Paul Macdonald.BCC:J02
Job Name: Paul MacDonald Description:2nd fl joist under master bedroom
Address: 453 Shoot Flying Hill,Rd Specifier:
City,State,Zip: Barnstable, Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: ICBO 5512, NER 629 Misc:
Standard Load-40 psf 110 psf OC Spacing 24"
AhL
BO, 1-3/4" B1, 1-3/4"
640 Ibs LL 640 Ibs LL
207 Ibs DL ' 207 Ibs DL
Total Horizontal Length-16-00-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value OCS Dur.
S Standard Load Unf.Area Left 00-00-00 16-00-00 Live 40 psf 24" 100%
Member Type: Joist Dead 10 psf 24" 90%
Number of Spans: 1
Left Cantilever: No Controls Summary
Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location
Moment 3387 ft-Ibs 30.6% 100% 2 1 -Internal
Slope: 0/12 Neg. Moment 0 ft-Ibs n/a 100%'
OC Spacing: 24" End Shear 742 Ibs 18.5% 100% 2 1 -Left
Repetitive: Yes Total Load Defl. U601 (0.32") 39.9% 2 1
Construction Type:Glued Live Load Deft. U795(0.242") 60.4% 2 1
Max Defl. 0.32" 32.0% 2 1
Live Load: 40 psf Span/Depth 16.2 n/a 1
Dead Load: 10 psf
Partition Load: 0 psf Notes
Duration: 100 Design meets Code minimum(U240)Total load deflection criteria.
Disclosure Design meets User specified(U480)Live load deflection criteria.
Design meets arbitrary(1")Maximum load deflection criteria.
The completeness and accuracy of Minimum bearing length for BO is 1-1/2".
the input must be verified by anyone Minimum bearing length for 131 is 1-1/2".
who would rely on the output as Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
evidence of suitability for a
particular application. The output
above is based upon building
code-accepted design properties
and analysis methods. Installation
of BOISE engineered wood
products must be in accordance
with the current Installation Guide
and the applicable building codes.
To obtain an Installation Guide or if
you have any questions,please call
(800)232-0788 before beginning
product installation.
BC CALCO, BC FRAMER®, BCI®,
BC RIM BOARD-, BC OSB RIM
BOARD-, BOISE GLULAM-,
VERSA-LAM®,VERSA-RIM®,
VERSA-RIM PLUS®,
VERSA-STRAND TM,
VERSA-STUD®,ALLJOISTS and
AJSTm are trademarks of
Boise Cascade Corporation.
Page 1 of 1
s01$ETM BC CALCO 2003 DESIGN REPORT - US Wednesday,May 12,2004 11:15
Single 11 7/8" AJSTM 10 APG File Name: Paul Macdonald.BCC:J03
Job Name: Paul MacDonald Description:alternate joist for attic
Address: 453 Shoot Flying Hill Rd Specifier: i
City,State,Zip: Barnstable,Ma Designer: Bill Campbell
Customer: Company: Shepley Wood Products
Code reports: BOCA 22-09,SBCCI 9707D, ICBO PFC-5504 Misc:
I
Standard Load-20 psf 110 psf OC Spacing 1-
BO, 1-1/2" B1 1-1/2"
267 Ibs LL 267 Ibs LL
133 Ibs DL 133 Ibs DL
Total Horizontal Length-20-00-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value OCS Dur.
S Standard Load Unf.Area Left 00-00-00 20-00-00 Live 20 psf 16" 100%
Member Type: Joist Dead 10 psf 16" . 90%
Number of Spans: 1
Left Cantilever: No Controls Summary
Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location
Moment 2000 ft-Ibs 54.6% 100% 2 1 -Internal
Slope:, 0/12 Neg.Moment 0 ft-Ibs n/a 100%
OC Spacing: 16" End Reaction .400 Ibs 35.0% 100% 2 1 -Left
Repetitive: Yes Total Load Defl. U670(0.358") 35.8% 2 1
Construction Type:Glued Live Load Defl. U1005(0.239") 47.8% 2 1
Max Defl. 0.358" 35.8% 2 1
Live Load: 20 psf Span/Depth 20.2 n/a 1
Dead Load: 10 psf r
Partition Load` 0 psf Notes
Duration: 100 Design meets Code minimum(U240)Total load deflection criteria.
Disclosure Design meets User specified(U480)Live load deflection criteria. j
Design meets arbitrary.(1")Maximum load deflection criteria.
The completeness and accuracy of Minimum bearing length for BO is 1-1/2".
the input must be verified by anyone Minimum bearing length for B1 is 1-1/2".
who would rely on the output as Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
evidence of suitability for a }
particular application. The output
above is based upon building
code-accepted design properties
and analysis methods. Installation
of BOISE engineered wood
products must be in accordance
with the current Installation Guide
and the applicable building codes. i
To obtain an Installation Guide or if
you have any questions,please call
(800)232-0788 before beginning
product installation.
BC CALCO, BC FRAMER@, BCIO,
BC RIM BOARD-, BC OSB RIM.
BOARD-, BOISE GLULAMTM
VERSA-UaMO,VERSA-RIM(&,
VERSA-RIM PLUS@, I
VERSA-STRAND TM,
VERSA-STUDO,ALWOISTO and
AJSTM are trademarks of
Boise Cascade Corporation.
1
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I certify that this property is
located in Flood Hazard Zone C (out-
side- the 500 year flood) as identified
by the Department of Housing and Urban
Development (HUD) .
Date_foy CERTIFIED PLOT PLAN
E R LOCATION tg�ge!vsT� cr<C�,�,r?crzuccE�
SCALE . ........... .... DATE 26D¢
Reg. ndo e, PLAN REFERENCE .
• . ,fir/j�, .GoT�9, ..Sh�D�NN..ON. . .. .. .
I certify to Plymouth Saving Bank THE LOCATION OF THE ORIGINAL DWELLING
that there are no visible encroachments SHOWN HEREON ,EITHER WAS IN COMPLIANCE
or easements except as shown and that this WITH THE LOCAL APPLICABLE ZONING BYLAWS
IN EFFECT WHEN CONSTRUCTED (WITH
plan was prepared under my immediate RESPECT TO HORIZONTAL DIMENSIONAL
supervision. REQUIREMENTS ONLY),OR EXEMPT FROM
VIOLATION ENFORCEMENT ACTION UNDER M.G.L.
TITLE VII ,CHAPTER 40A,-SECTION T,U'NLESS
OTHERWISE NOTED OR SHOWN HEREON.
f'
The Town of Barnstable
8ARNSTARLL Department of Health Safety and Environmental Services i
MASS a
Building Division
367 Main Street,Hyannis,MA 02601
508-862-4038
508.790.6230
PLANIEVIEw
• i
Owner: QO��A.1 mc; o>rt � Map/Parcel:5 n8s
Project Address: oe tJ�I+q Builder:_O W 1J R � • • - --�---- ----
H•,11 �a J
The following items were noted on reviewing:
i
" I
• l
I
I
Reviewed by:
f
Date: �� '
UPDATE PERMIT RECORDS : ADD CHANGE DELETE PRINT FEES HELP END
CHANGE RECORDS IN PERMIT TABLE
PENTAMATION----------------------------------------------------------- 12/10/04
PERMIT NO. 77735
PARCEL ID 213 005 453 SHOOTFLYING HILL RD
PERMIT TYPE BREMOD RESIDENTIAL ALT/CONY
DESCRIPTION EXTEND SECOND FL ROOF PERMIT #76964
STATUS C COMPLETED
APPLICATION DATE 07/08/2004 DATE ISSUED 07/08/2004
EXPIRATION DATE DATE COMPLETED
MASTER PERMIT VARIANCE
VALUATION 23040 . 00 BOND 0 . 00
CONSTRUCTION TYPE 434 GROUP TYPE 1
CONTRACTORS OWNER PROPERTY OWNER
ARCHITECTS/
ENGINEERS/OTHERS
ENTER Y IF ALL ARE CORRECT OR N TO REENTER
LEAVE BLANK FOR NON-PROPERTY RELATED PERMIT. CTRL-I FOR HELP.
i
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel (�'�S� Permit# rM 3 5
Health Division Date Issued 77[VIO y
.� Conservation Division 141— a � ®� Application Fee �®
Tax Collector (�?(22v Permit Fee 1 �-
Treasurer �� < < L /C-A 3 9
/ SEPTIC SYSTEM MUST BF
Planning Dept. INSTALLED IN COMPLIANCE
Date Definitive Plan Approved by Planning Board WITH TITLE 5
ENVIRONMENTAL CODE AND
Historic-OKH Preservation/Hyannis TOWN REGULATIONS
j
Project Street Address VrYJ7 ' .,✓c
Village 4
Owner 4 ; Address :� v
Telephone .: .
Permit Request i T/D - w
•� t
Square feet: 1 st floor: existing proposed 2nd floor: existing c v proposed c,2`�v Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type ,
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting-documentaWn. car
o` �.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) �
Age of Existing Structure v Historic House: ❑Yes 9-N-6 On Old King's Hig way: ❑LYes R Mo
Basement Type: a-Full ❑Crawl ❑Wal out ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) CD
Number of Baths: Full: existing C-12— new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing 7 new First Floor Room Count
J
Heat Type and Fuel: Gas ElOil ❑Electric ❑Other
Central Air: es ❑ Fireplaces: Existing New Existing wood/coal stove: ❑Yes 31q;
Detached garage:
g gZing
t g ❑new size Pool:El existing El new size Barn:❑existing ❑new size
Attached garage: ❑new size Shed:❑existin 0 new size Other:
g 9 9
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial-❑Yes--...UIN- -_,...,.If_yes,site plan.review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
r
FOR OFFICIAL USE ONLY
PERMIT NO.
' DATE ISSUED
° MAP/PARCEL NO.
ADDRESS_ VILLAGE
OWNER
DATE OF'INSPECTION:
FOUNDATION
FRAME �Gf�l�.y '► av �K
INSULATION !
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH„ � FINAL
mr
FINAL BUILDING Q;jA
o m rt
co
5.
DATE CLOSED OUT' C)
cr 0
;.,. ASSOCIATION PLAN NO. n .=!
a
'r
oFIHE, • Town of Barnstable
Regulatory Services
BARNSTABLE, Thomas F.Geiler,Director
9`bArE a``� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: Estimated Cost
Address of Work:
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
OBuilding not owner-occupied
§40wner pulling own permit
Notice is hereby given that:.
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR
Date Owner's Name
Q:forms:homeaffidav
_ The Commonwealth of Massachusetts
Department of Industrial Accidents
- 600 Washington Street
- Boston,Mass. 02111 .
Work/%Gers' Com ensation.•Insurance Affidavit-General Businesses
address:
0 state: Zip: phone#
work site location(full address/• ,
❑ I am a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBarBatYng Establishment
working in any capacity. ❑office❑ Sales(including.Real Estate,Autos etc.)'
❑I am an em to er with einlo ees(full& art time): ❑Other
I am an employer providing viorkers' compensation for my employees working on this job..
ctim"ari '•name•
asLLresS: a t *.i•r..': r.,,. ._x...-'st:i''.• .}.
...:... . .' ... ,.'• •' �"
phone
y tj
r.insurance.cos':...�•.:.,:..!�..:,�. ..... .. . .. ;•::.::.:..,.-.'.: •:.,. ... ..•,} .... . ,
1 am a sole proprietor and have hired the independent contractors listed below who have the following workers' .;
.compensation polices: ' , • . :•'
en' 'nime
co'm '
insurance co. - '
�y:�'<1.1;[. '{.. i71•' - '�' ,.59:.�:,:u ::.�fir:':-r`.:
1'. .4•i't'. •.ti \. 'fit•.; .� r•: ,
e•eai
coin'en. II _
cif' :p otiE#s
insurance�sb:'+� -
///i
Fatlure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties In the fsiim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certi nder the pains and enalties o erjury that the information provided above is true and rrecL
Signature s� . Date
Print name Phone# . .
official use only do not write in this area to be completed by city or town official
city or town: permittlicense# ❑Building Department .
A ❑Licensing Board
❑check if immediate response is required ❑selectmen's Office
❑Health Department
A contact person: Phone#; ❑Other
(revised Sept 2003)
�a
Information and Instructions
Massachusetts General Laws ch4 pter�152 section 25.requires all employers to provide workers' compensation for their.
employee&: As quoted from the"law", an employee is.defined as every person in the service'of another under airy 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 mare of
the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased,employer, or the receiver or
partnership,.association or other legal entity, employing employees. However the owner of a
trustee of an individual,
dwelling house having not more than three apartments and who resides therein, or the.occupant:of the dwelling house of
another who employsperson's to do.maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such.employmmt.be deemed to be an employer,
MGL chapter 152 section 25 also*staies 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.commonweaIth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor.any
.of its political subdivisions shall enter into any contract for the performance of public work until
with the insurance requirements of this chapter have been presented to the contracting .
acceptable evidence of compliance
authority.
Applicants
mpensation affidavit completely,by checking the box that applies to your situation.. Please
Please fill in the workers' co
supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted
to the Department-of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the
affidavit. 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
sation policy,please call the Department at the number listed below.
required to obtain a.workers'.compen _
City or Towns .
Please be sure that the affidavit is complete and.printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to Min the permit/license number which will be used as a reference number. The.affidavits:may be.returned to
the Department by mail or FAX.unless other'arrangements have been made
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call
The DeP artn=t's address,telephone and fax number: .
The Commonwealth Of Massachusetts
Department of Industrial Accidents
WIN of fi msngafiens
600 Washington Street
Boston,Ma. 02111
fax#: (617)727-7749
phone M (617) 727-4900 ext:406
f
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p,,DDRBSS OF PROPERTY;
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�. SQUARE FOOTAGE OF ALL EX'FEP•z0R .
3. SgUARE FOoTA4E OF ALL GLAZING:
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MORE WIC)LVED METHODS OF DE Rma fit
HER ErtER
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ARE AVAILAa ASS t15 FOR'I'HIS INFO
B�,DI�G I�tSPECTOR APPROV AL:
`fps;
q•facm='fl80303s ,
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings,Additions $50.00
Alterations/Renovations $25.00 �_
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE y
� � iv d
"square feet x$96/sq.foot= �` KD x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot= x.0031=
plus from below(if applicable)
GARAGES(attached&detached)
square feet x$32/sq.ft.= x.0031=
ACCESSORY STRUCTURE>120 sq.ft.
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf- 1500 sf 100.00
>1500 sf-Same as new building permit;
square feet x$96/sq.foot= x.0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
Deck x$30.00=
(number)
Fireplace/Chimney x$25.00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable)
- Permit Fee
projcost
Town of Barnstable
yoF�►,E Teti -
a„ Regulatory Services
. ..�
tAENSTABLE Thomas F.Geiler,Director
9Q, MASS. Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
�/ Please Print
DATE: 4 cC� o/
JOB LOCATION:
Z
street village
"HOMEOWNER!:7 Z10a
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility-for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection proc dares and requirements and that he/she will comply with said procedures and
equ ments.
ig-iture of Homeowner
f
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
�,. several towns.,You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
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NEW SMOKEEVEN THE ADDITION OF A
ARE NOW LAW
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