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0608 SKUNKNET ROAD
��.. , � .4 �� ,�,.'� ,,:�:. yeti° 'd t� y.: •�-' r t a i t f 0 T l 4 u 0 0 4 I 1 ® 4- ,41 / d Cow ig ' �d� 7 14 1 1 ' Ili I� ALi, a `ma x, Town o Barnstable Building f r Post,This CaRA rd So That it is Visible From'the Street Approved Plans Must tse Retair'�ed on Job and this Card Must be`Kept i MASS -. :�s a� ,d " `�, e s6tq- Posted Until Final Inspection Has Been Made r.w ,, -.: .. : . w._ ,v x �. � p yam ° Where a Certificate of Occupancy is Required 'such Building shall N ot be'Occupied until a;Final Inspectionhas been made 1 �j ijjlt Permit No. B-18-561 Applicant Name: BRIAN WOODILL Approvals Date Issued: 03/09/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 09/09/2018 Foundation: Location: 608 SKUNKNET ROAD,CENTERVILLE Map/Lot 169 015-015 Zoning District: RC Sheathing o Owner on Record: SULLIVAN,ADAM D&SHANNON L y Contractor Name::., BRIAN WOODILL Framing: Address: 608 SKUNKNET ROADContractor License 178388._ 2 CENTERVILLE, MA 02632 $60,000.00e Chimney: Description: Adding a 20x20 Family room and 1/2 bath on the kitchen rI- Permit-Fee: y„ M1 $356.00 Insulation`/��i� Project Review Req: Fee Paid: $356.00 ' Final: �� Date 3/9/2018 �' ,� �1 ✓ Plumbing/Gas "• �� ? Rough Plumbing: --: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorised by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application 4and the-approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures`shall.be in compliance with the local zoning by-laws and codes. Final Gas. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for-public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing t " Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT oI' lication NumberTOWN !. .-� ..�. OF �ARNSTABL ` � , V ............... ... "'...©. .....Other Fee........................ i63�. , b zoEe 6 A PermitFee.... 4. p TotalFee Paid...`r............................................ .. ...... ...... Vt., TOWN OF BARNSTABLE '� �0 Permit�,ral by......... on... . .�! BUILDING PERMIT Map............................... ..Pared............................................. APPLICATION Section 1 — Owner's Information and Project Location Project Address - .0 17e Village vet �r Owners Name Give c.\O h, q�� ol ,t4 Owners Legal Address C ti o y s city �(/f State , d''Y/4 Zip Owners Cell# /P�Og e I Ste- 33�E-mail Section 2—Use of Structare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory" Structure ❑ Change of use ❑ Demo/(entire structure) ❑ 'Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment. ® Sprinkler System Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description aa X T Act imdated 2/9/201 S I Application Number.................................................... Section 5—Detail Cost of Proposed Construction P10, zoo Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist WFCM Checklist ❑ Design Section 6—Project Specifics i Wiring ❑ Oil Tank Storage ® Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression ® Heating System ❑ Masonry Chimney ❑Add/relocate bedroom 1 ❑Water Supply � Public Private _ Sewage Disposal ❑ Municipal ® On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility '�1 � � I am using a crane ❑ Yes El No � Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section S—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated:2/9/2018 LOT 15 q 23,326 ,SQ. FT. + CB/DH 0,54' ACRES ± < FND) 887.23 PERIMETER _ A 77-58,429 � ry 17017; C—� 0 27.46' 23.17' 14.20' o I P(FND) a s o ti BEHIND UP Iv SHED cis 3 -- ^' p N GAS` 1. 99:98 LoIsoo ti ru Lo ti 34.84' " PROPOSED 2O' X, 20' o S 78 8'02 S 78'48�02' E - v� 3 ADDIT.I❑N 00 4 1 S0.00% 325,82, m°' ti �' CB/DH co o ( FND) OJ 0 o N Id o w LOT 15 h i e CB/DH (FND) CERTIFIED PLOT, PLAN OF LAND IN CENTER,VILLE, MASS. AS PREPARED FOR ADA1Vl & SHANNON S ULLI VAN PLAN REFERENCE— TO: ADAM & S PL.BK.339: PG_ .49 HANNON SULLIVAN ;NOF"IAs, ON THE BASIS OF MY KNOWLEDGE & (LOT 15) o`' PAU INFORMATION, I FIND, THAT AS. "A RESULT OF A SURVEY MADE ON THE SvjqTs GROUND TO THE NORMAL STANDARD PLAN SCALE— U, N 5044� OF CARE OF PROFESSIONAL LAND 1"=50' SURVEYORS PRACTICING IN THE COMMONWEALTH OF MASSACHUSETTS, DATE DRAWN— THE LOCATION OF DWELLING 12/17/1.7 IS AS SHOW REON._ FILE:' 2311-00 PAUL E. SWEETSER R . 12 17 17 � F.B.: EFB PROF: LAND SURVEYOR NOTES P.O. BOX 1146 DATE PROFESSIONAL LAND SURVEYOR REV'. DATE" DENNISPORT, 'MA 02639 ' � o BUILDING DEp7- I, FEe 20 Tows OF: 2018 r BARNSTAgLE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www..mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciang/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C1 0 Address: �2 � � ICAV,N'L City/State/Zip: ✓-e �Me—phone Are you an employer?Check the appropriate bog: - ,, , Type of project(required): 1.911 am a employer with Z 4. []'1 am a general contractor and I employees(full and/or part-time).* have hired the.sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition worlds for me in an capacity. employees and have workers' g Y aP tY• 9. M Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10:❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their. 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152, §1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state vyhether 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: S t (✓ C�F1/�' Policy#or Self-ins.Lie.#: 0c e— <Vo 11450 I(o X Expiration Date: Z-70 Job Site Address: �� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a co y of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificatio I do hereby c u ai an enalties ' ry that the information provided ove is ue and correct Si a e• Date: Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2•Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to thus statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds,or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-;ns,rarice license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete.this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number- The Commonwealth of Massaohusetts Department of hidustrial Acddents Office of Investigations 600 Washington Sheet Roston,MA 021 It Tel.#617-727-4900 ext 406 or 1-877-MASSAM . Fax#617-727-7749 Revised 4-24-07 w .mass,gav/dia Commonwealth of-Massachusetts Division of Professional Licetisure Board of-Building Regulations and Standards Constr. rll bpe,rvisor Etpires: 07/05/20 CS-079685 19 BRIAN WOODILL PO BOX 1538i BREWSTER Mpv02631 _I0 AN ' Gbmmissioner Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause,for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl 1 - Application Number........................................... Section 9—.Construction Supervisor Name Ozod; j j Telephone Number Address 7 L -ta K- City �n State Zip Q Z License Number 629 1License Type�n t ts�v�Expiration Date 7-5---- z6 lgj Contractors Email (� oC0i✓� Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re 80 CMR and the own of B .Attach a copy of your license. Si Date G /g Section 10 —Home Improvement Contractor Name "k n Te ep o e Number Address lau Ir 9 1 ity State Zip (976VY Registration Number iration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I umderstan a construction inspection procedures,specific inspections and docunientation by 780 CMR ano the Town le.Attach a copy of your H.I.C... Site Date !L Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or.Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Site Date APPLICANT IGNATURE Signature Date ;f/ Z " Print Name J I A '► Telephone Number E-mail permit to: 6 apcwt, -D. o J' I f corms T M in mm o 1 1 Section 12 —Department Sign-Offs Health Department © Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation "' For commercial work,please take your plans directly to the fwe department for approval Section 13—Owner's Authorization I, A S�\\\Q W , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) 2 12 F� Signature of Owner Ate,,, Print Name i a Last undated:2/9/2018 iTarinHuntington FaAD: Page 1 of 2 Date:226/2018 09:12 AM Page:1 of 2 TOWN0 BARNSTABtE Phone: ( - Fax: (508) 790-1414 2018 FAR 26 . H g: 28 Fax From: Tarin Huntington To: Lindsay Parvin Pages: 2 Fax: (508) 79076230 Date: 2/26/2018 09:12:30 AM Phone: Subject: Brian Woodill Confidential Note: Information in this facsimile is confidential and intended for use by the individual or entity named If you received this telecopy in error, please immediately telephone us and return the original via U.S. Postal Message: see certificate-Thanks! =rom:Tarin Huntington FaXID: Page 2 of 2 Date:2/26/2018 09:12 AM Page:2 of 2 WOODB-1 OP ID, TH ACORO' DATE(MMIDDIYYYY) CERTIFICATE OF-LIABILITY INSURANCE TE(MMI DfYY 018 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 pol(cy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER 508-775-6060 COMEACT Hyannis Office Bryden &Sullivan Ins Agency PHONE 508-775-6060 FAX 508-790.1414 88 Falmouth Road (AIC,No,Ext): (AIC,No): Hyannis,MA 02601 EMAIL Hyannis Office ADDREss: INSURERS AFFORDING COVERAGE NAIC INSURERA:NGM Insurance Company 14788 INSURED Brian Woodill DBA INsURERB:Associated Employers Insurance BW Construction 22 Laurel Lane INSURER C: Forestdale,MA 02644 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD MMID M ID IYVYY A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE occuR- MPT1990G 10/22/2017 10/22/2018 oAMAGES( RENTED pric $ 500,000 X Business Owners MED EXP An one'arson 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ja LOC PRODUCTS-COMP/OP AG 2,000,000 POLICY El OTHER: ° $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTNNOSSyyyy pp BODILY INJURY Per accident $ AUTO ONLY AUTOS ONt Y PP.r.c cl DAMAGE $ H $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC) RETENTION$ $ B WORKERS COMPENSATION X PER T OTH- AND EMPLOYERS'LIABILITY Y I N CC50050114502017A 10/22/2017 10/22/2018 500,000 ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMg�R EXCLUDED? N❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE O DER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Barnstable Lindsay Parvin 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ti Map Parcel 0 1 5 �- ®` � Application - Health Division �� - Date Issued Conservation Division BUILDING DEPT. Application Fee 01 Planning Dept. MAY 19 Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis Project Street Address (0® Sku N r- N Village Ce.�-T-er-V ��2 Owner U f�o4 Address 5sa<•.C, Telephone `50 9, —731 Permit Request jpr`c`m��L ; A O i S'f On p Square feet: 1 st floor: existing clZI proposed SO^e-2nd floor: existing 9 L"1 proposed fir'-dotal new Zoning District Flood Plain W i t" Groundwater Overlay Project Valuation 4 100 V Construction Type VS Lot Size 2,115 22 Grandfathered: ❑Yes 51rNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes R(No On Old King's Highway: ❑Yes C"No Basement Type: UfFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) lo0e) Basement Unfinished Area (sq.ft) 100 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 2, existing new Total Room Count (not including baths): existing �O new First Floor Room Count Heat Type and Fuel: NdGas ❑ Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing New _ Existing wood/coal stove: ❑Yes YNo Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes U/No If yes, site plan review# Current Use Proposed Use S ; c,wvra APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - -- -- -- Name A do(,N S \i Telephone Number 50 `j 73?7 Address (0f S1e-un i'-v License # T " • Home Improvement Contractor# Email 0 �'�'en a w S rn�•°� ,C��" Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ..•► � ���P SIGNATURE i DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE r r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL M J _ GAS: ROUGH FINAL { FINAL BUILDING L� r DATE CLOSED OUT ASSOCIATION PLAN NO. ,4 �'' �= 11.t � i.�}r..�4.;'� �- (Z�"�'�-, �(Z�(�!�.-r:� :A`S ►��-�w.�u�-�"ram r s' s c , } - e r , M p / /}; ,�,.--� '��,'�otf� � r/��.n9{��1:.�1= ✓':__-`;, f��_�''w�.t�,� ..,�. 1�>e -1 ` 1�� 5TV l — I (`f•�"1/ e, c7 fTop x � lid `'�, - ry✓' � s f 6s 1 s i f pp , y� I / �0 �j donne `� 1c V� r £= v� G._; '`t -� r ' J 5TV tom, — l ✓ '�' r .. , �.'—��r4 t.. rn.,, Za� . ZL 101, -1 0 Town of Barnstable Regulatory Services of r�y� Richard V.Sca.li,Director Building Division t smear ��R Tom Perry,Building Commissioner , MA SS p$pr 2.61F 1a$ 200 MakiStvot Hyannis,MA 02601 .www town.barnstable.ma..us Office: 508-862-4038 Fax: 508-790-6230 2 (l 7 HONMOWNM raCEVM E zON Plcase Print DATE:. ` JOB r.00ATrorr (0 O'�> \Lk)N�L N C i erU I I F nnmbcr shut _ village -HOMEowN� name home phone# wmic phone# CURRENT MAlI-JNGr ADDRESS: SRM C citylfnvrct sfafe rip code The current exemption for`homeowners"was extended to include owner-occupied dwtI inu 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_ DEMiITION OR HOMEOwNM 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 oa a form acceptable to the Building Official,that he/she shall be responsible for all such work performed tinder the buildin 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_ - .a. '- The undersigned"homeowner"certifies that he/she understands the Town ofBamstable Buildiag Department minimum inspection procedures and requirements,and that he/she will comply with said procedures and requirements: • Sigaahuz ofHomcowna - ' Approval of Building Official Note: Three-family dwellings conlaining 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Conslivcdon Control HONMOWrlEk S�TiON The Code states that: "Any homeowner performing work for which a building permit is reqE'dired shall be exempt from the provisio ns of tTiis sec on(Section 091SZicensmg oT co�cfion u�rvisors);provi3 tTiat ithe homeowner engages a persons)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,partienlarly 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 My 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 Iast page of this issue is a form currentIy used by several towns. You may care t amend,and adopt such a form/cer>fication for use in your community. Q'lWPFII-ESIFOR ffibm1dmgpermitfonasl=RESS:doc Revised 061313 ,l Town of Barnstable Regulatory Services g, Richard V.Scal4 Director -s639 �� 659 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyamus,MA 02601 www.townbarnstabIema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must .Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized.before fence is installed and all final inspections are perfomsed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date . Q:FORMS:OWNERP aMISSIONPOOIS . .77ie Commornrreakh 46f_Mrassat hrtsetfs ` 'f 1�F�?L�F't1FfP1'Tt(l��7�fllfsfJZtI��GQCIelB�, Qre ofirm.wtigations { 00 Was:�ar�gta>i,street `Baston,MA 02111 , li`FVrk'.7itEIS£gftVIdI[I t Workers' Campensafittn Insurance Affidavit Builders/Contracturs/_Electr cianslPiumbers A.np�icantIufar>inatian Please PrinfFe.zrIly .• Nam�3vs[uess�3rganmtionFEn_�r�l� �J�`�1 A tj Address: (0 09 S V-j r IC-N C--Z city/stetelZip cv)- rV i 11 F M A 0 7,D3Z PhcnD-' ©� Are you an employer?Checkthe appropriate box: T . of -a ect r 4: I am a general contractor and I yl p J ( eq�d) I.❑ I am a euzplover uith ❑ 6..❑New comttucfioa Io ees.full.and(or art-time * ' ° have hired.the sub'-contractors m y C P � .. ,. 2.❑ I am a sole proprietor or partner-"-,� listed on tine attached sheet:. 7- ❑Remodeling ship and haze no employees Thesef sub-confractors have 8-,❑Demolition 1Vnr1�for ypn-many capacity. employees and have wodcm' [No rti�ers' comp.insurance comp-msurant $ 9. ❑Building addifiosF required-] 5- ❑.Fte are a corporation and its 14❑Electrical repairs or additions 3. I am a homeouMer doing aU A Ork ofscers have esercised their' 11-❑Plumbingrepairs or additions o work_ess tight of esempfian per MGL . z'�`1£� ' -•, 1?_❑Roofrepairs mcrr�aricerequuad]1 c.152,§1(4�and we have no employees-[Ls1'o workers' 13-0 Other . � cansp:insurance required_] .� . w .a *Any appEicantffatcheticsbax rl nms#aLsa filloutSe section below showing i6rirwoaexe compensafiaupalicyirfornrauna ` 1 Homeo nien who mbmit dms.afiidat=s iuffc frog they are doing off wat and.6mhire outside coutnrctomnmst submit anew affidavit kdiczfm-.sucb- rC'antractors ibat ehea this boot mmt a#tached=additional sheet showing the name of the sdb-cantrscmm and state whether.of not those entities liar enrp3a3=ees.If the suirtant xctmshave employees,they mustpxov-ide their nvrkere comp.poRU nmnber. I alit an ezztpLaJVer tltrrt is prat dr'rtg�uarkers'ce►r�rzsrrtiart ir�rcrartca form}*entplay�es BeFa�v,is flier paTic}'ruzd jQb site tnformadom Insurance Company Name: _ Policy;IfL or Self-ins.Y.ic- Expiratiou Date: Job Site Addres Cityl5tate� .tp; Attach a copy of the tsvrlrers camliensationpolicy dedaration page(showing the poUry number and expiration date). Failmm to secure coverage as requiredunder Section 25A of MGL c� 57 1 can lead to the imposition of rrimrnal penalties of a fine up to SUOD 00 andfor one yearimp isoumeuk as well as civil penalties.in the foan of a STOP WORK ORDER and a lime of up to$250-00 a day apiust the violattir. Be adiiised drat a caP'r of this statem_eivt raay.be forwarded to fly Office of I»est patrons of the DIA for insumnee coy era a terfrcatia L Ida hereby calify uitdtder�tlie pains andpetiaUL-s afl7cr fui y fltatflte in Parma iattptm,*Tzd abk m g fs bars wid correct Sit3zature: /��/` bate- D tP Phone p Ofifeial use only. D47 not o-Frzte in this area,to be cirinpleted by tdiy at'totrn officiet City or Town- Pern6lUcense if Issuing Anthor€ty(ca tie one): I.Strand oMeaItii Z.$urT Ing Department 3.CitsfrosQn Clem 4.Electrical inspector Sr.Plumbing rTspector G.Other Contact Person: Phone it: aformafian and Ins&uefions r hfasSarh=cts Geheral Laws chaptr-a 152 reggaes all empIayers to provide workers'compensation for their employees., parS0[M3ttn this statrt,an a r4d*ae is defined as-- -.every persdn in the service of another under any contract ofl>ae, egpress or iiMP: liecf,Oral ar WEfttt." An ernplayer is defined as"an individnaL partamslilp,association,corporation or other Iegal entity,or any two or more of the foregoing engaged k a Joint enfergr" and including the legal sepreserr-atives of a deceased employe,or the receiver or trustee of an mdividnal,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dweIling house of another who employs persons to do maintenance;construction or repair wail on such dwelling house or on the grounds or building appurtenanttiiereto shall notbecanse,of such employment be,deemed to be au employer." M_ C3L chapter 152, §25C(6)also sides that"every state or local licensing agency shall Withhold fhe issuance or renewal of a license or permit to operate a bTFM" ess or to construct buRdiags in the commorrwe-alth for any a-PP licautwho has not produced acceptable evidence ofeompliancm with th m e harzncn cove-rageregnaed:' Additionally,MGL chapter 152,§25co states Neither the commonwealth nor any ofits political subdivisions shalt enter io:to any con$act for theperfonaance ofpublic workuna acceptable evidence of compliancevlith tb-e fiLS xnCe6% regtm ements of this chapter have been presented to.bier contracting authority" - Applicants - Please fill oi-± the workers'compensation affidavit completely,by chff_- r�u the boxes that apply to your situation and,if necessary,supply sol�ontra-etor(s)name(s), addresses)and phone numbers) along with their cert[f cate(s) of ; nu-aa ca. Limited Liability Companies CLLC) or L=trdLiabdity Partnerships(LIT)with no employees other than the members or partacrs,are not reqused to carry worirers' compensation i sm-ance. If an LLC or LLP does haYe employees,a policy is rego>red. B e advised that this a$dayt may be submitf_.d try.the Department of Industrial Accidents for confirmation of in romc ane coverage. Also be sure to sign.and date the afr=tdavit The affidavit should be refrrmed to the,city or town tip the application fur the permit or license is being requester not the Department of n , A_ccid=f 3. Should you have any questions regarding the law or if you are reqcrired to obtain a workers' compensation policy,please call the Department at the number listed.below. Self-insin-ed companies should enter their self-iosTrance Hceaase noniber on the appropriate lira City or Town Offircials t Please be sure that the affidavit is complete and prhAnd 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 regardiDg the applicant. Please b e sure to fill in the pens itllicrose number which will.be used as a reference number. Ina addition, an applicant that mast submit multiple permit/license applications in any given year,need only submit one affidavit mdicafmg rTnTP nt policy bfornatiou(if necessary)and ceder"Job Site Add-r-ess"the applicant should Mite"all locations n (ciy or town,)--A copy of the•affidavit that has been officially,stamped or marked by the city or town maybe provided to th-e ' applicant as proof that a valid affidavit is on frZe far fotar permits or licenses" A new af5 avit must be filled of t each year.Mere a home owner or citizen is obtaining a license or permit not related to any business or commercial veltzlm (i.e_ a dog license or permit to bum leaves etc_)said person is NOT reqaireff to completa this affidavit The Of of Investigations would Em to thank you in advance for your cooperation and should you have any questions, - lease=do not-fi =in =knit- - ------ — - --- ------ ---- - - -- -- - ---The I?epartmenfs address,telephone and fax number. T ha CG.=,aaw� Sth�of Mamaah ' f I3ag` tmmt of 1 iduftial Aackdent4 J j o- • EQQ.��shin�tQn et TeL 4 61T-727-4M cxt 406 ar 1-4M-MASgAM Fax#617-` 27 '749 Revised4-24-07 W W 7-Mass-gavvc a • Y � 1 � 1 -�2�� IdPG�e�oE o� S1r'►ok� ' DETEc.-raeS t�E�D� 6D r s Pl�2 2 rLTo� t " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel � CC Permit# �.�L� J Health Divisio "_- 2 Date IssuedA�l Conservation Division f_ � �s �� �� Fee Tax Collector GQg/I"l�o� (.UI r Treasurer �� 1 EPTI S STEM EE INSTALLED IN COMPLIANCE _Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AKD TOWN REGULA°�ICN Historic-OKH Preservation/Hyannis Project Street Address (p 0_ �tc.y�c v►_F.�' I Village C Owner'.%p g4+ 11.uT ?QAIt a Address Telephone - N b " ' S Permit Request Urko0`L_ Lfuig^iJco Square feet: 1st floor: existing_ proposed 2nd floor: existing proposed Total new Valuation oning District Flood Plain Groundwater Overlay Construction Type WMD Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family N/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Z® Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: Cl/Full ❑Crawl ❑Walkout ❑Other -10asement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0N,umber of Baths: Full: existing r new 1 Half: existing new Number of Bedrooms: existing o°� new _ Total Room Count(not including baths): existing 4 new Jf First Floor Room Count Heat Type and Fuel: ❑Gas O10il ❑ 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:M/existing ❑new size Other: - Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes IN If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name �' Telephone Number 1-71 -s-L"7 Address 201 A IL-0 License# 1 30 q Ir Home Improvement Contractor# /all 30 41 Worker's Compensation# fo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ( it�sel4 'L�� SIGNATUR �.,. DATE �1-G i FOR OFFICIAL USE ONLY = TERMIT.NO. t DATE ISSUED } MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - i FRAME y - INSULATION — FIREPLACE _ ELECTRICAL: ROUGH FINAL 3 PLUMBING: R0VGH FINAL - GAS: R013GH FINAL I: FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLANeNO. r :r The Town of Barnstable ' BnsxsraszE. • > g Regulatory Services ► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �j Please Print DATE:— V JOB LOCATION: 6 l���i� �Zaz numb street /village "HOMEOWNER": �' tom^ name P home hone# 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, opr vided 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' ction procedures and requirements and that he/she will comply with said procedures and ents. a jf6aturc of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a . person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communtnes 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:FGAMS:EXEMPTN y1. 1 a � "Oo/ ti i _./. .� _ ' �� -�. -- �� - 1 �� _ - L' --- . 1. ` _ _ b �.- ___- J) 0.w.. `'"�. � 1 `•t � may\ , �. __�_ �. �� .. �� � �� ti... _ . �. �y e.r '�. 4. .. �� 5 r �, � � � t'e ' ....- :��,s'y ,,y _ ' �' _., ;'� `awl ��-�- �_. _.. - ,.- RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET LIVING SPACE - `T- ffe plus fro �if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE -; - —square feet x$64/sq.foot= Z Z Z x.0031= 0 ( T plus from below(if applicable) 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) 4 - 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) a Permit Fee proj cost - ��� The Commonwealth of Massachusetts Department of Industrial Accidents force 011HY8511989AHS 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit XX name '��i7 h r1Aa 1 s eS i 2�1 location. 1,0 6-0 fv c hC i►. I Z• hone# -_?0 2.0-N 2?1 I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one working in any ca acity I am an employerroviding workers' compensation for my employees working,on this job. ::.:..:::.::::.. comaanv name X. address.. one a llisurance co:: .. am a sole proprietor,general contractor, omeowner- ' cle one)and have hired the contractors listed below who have following workers' co ensation polices: , the g :::... .............:. ..:............................................ . cum an name. " .>;.;;:.:;.. , <,", -R .. att fires s >> a lwx . ... :>.< ; ro C1tY' ;..` :;:: < ::::: anv name:... ..::::.:........... x. nNu X. _.. ::.::... ........:............... addre3s. `city" D ii on .................. ::::::::................................................................. ..........................-............................ asnraac j Faflms to seems coverage as required wider Seaton ISA of MGL 152 can lead to the imrpositlon of criminal penalties of a fine up to s1,S00.00 andlor one years'imprlsorunmt as weII au ctvfi pensitta in the form 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 O>Rce of Investigations of the DIA for coverage verifit ation. I do hereby certify under the pants and ptata o perjury that the information provided above is tutu.and coned Date Signature �t / Print name Phone# (/ l� official use only do not write in this area to be completed by city or town ofiidal city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkitimmediate response is required ❑Selectmen's Office ❑Health Department contact person. phone#; ❑Other Quvaed 9/95 PIA) nk Information and Instructions 'No `Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensationa foor their contractny er employees. As quoted from the "law", an employee is defined as every person in the service of another of hire, express or implied, oral or written. An ernP lover is defined as an individual. Partnership, association, corporation or other legal entity, or any o o or more of c_ the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of or another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews or permit too operate a business or to construct buildings in the commonwealth for any applicant who has ' ense P of a he P Additionally,neither the not produced acceptable evidence of compliance with the insurance coverage required. Addrti Y, commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavFt completely,by checking the box that applies to your situation and supplying company names,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 ou have an questions regarding the"law"or if you being requested, not the Department of Industrial Accidents.please call the Department at the member listed below. are required to obtain a workers' compensation.policy,pia City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bo=m f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be s to fill in the permit/license member which will be used as a referen ure ce number. The affidavits may be retilaned to the Department b mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advancefor you cooperation and should you have any questions- please do not hesitate to give us a call. ent's address,telephone and fax number. � 'Ihe Departm The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lmlesugations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 l 1 .. - ti � `. _ ... "� �:.. �"w �+H�6�me�a�ti.ae.00„�.wrr.�..�..,..i..�...:._.._......�. ...rdw+5..:+�!, =r9�ii'l�*`+i9i19'�al�tlf'2h%3m'M3i�laR4ir3bivame�,a � .... _ _._mf�i+wt�ti�i "^ "W'C�.�e..ar�� a .. ill _ y i i �� / * �/ {} i Jai( I / ��p ,�, r.. � . _ r,. � � � . . .. +�, ., r r. ,.�� /` . f . i t , � i � j ! o. ---_ ' � � y ` S . J , i �'` i r i i ---------- } 2�PfAl .............. �j - 7 /V • �� _ • S ICE D ETECT®RS O.K. ARNSTABLE BUIL DING DEPT. Poo X .. ?A IP2 1 3 �x T1N�w,a o� y 216 , s I 710 CMR Appwmft J Table JSZIb(amduued) pmMpttre Padugn for One and Two-FMK4 Resideatfal Buddlap Sated with Fad Fueta ' �cP,dae MAXIMUM M179MUM Glazing Glazing Ceiling Wall Floor Basement Mab Heating/Cooling Area'(%) U-value= R value' R•vaiue' R valueJ Wall perim= Equipment EfEdmcY' package R value' &value' 5701 to 6500 Hating Degree Dew Q 12% 0.40 38 13 19 10 6 i Normal R 12% 0.52 30 19 19 10 6 Normal 9 12% 0.50 38 13 19 t0 6 85 AFUE T 15% 036 38 13 25 NIA NIA Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 NIA WA 85 AFUE W 15% 0.32 30 19 19 10 6 85 AFUE X 18% 032 38 13 23 N/A NIA Normal Y 18% 0.42 38 19 23 NIA NIA Normal Z 18% 0.42 38 13 19 10 6 90 AnM AA 19% 0.50 1 30 19 19 10 6 90 AFVE 1. ADDRESS OF PROPERTY: �e�X 5'(1u1 muri-C fQ c tKc�vz��Lc��c� ,61.E 012.L 32. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: RIB 3. SQUARE FOOTAGE OF ALL GLAZING: 0 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J A_ Footnotes to Table J5.2.1 b: ` ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall ed as a percentage. U to 1%of the total lazing area may be excluded from the U-value requirement. area, express p g p g For example,3 fl of decorative glass may be excluded from a building design with 300 W of glazing area. , =After January 1, 1999, glazing U-values must be tested and documented.by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are for .whole units:center-of-glass U-values cannot be used. The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full v the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation thickness over p Y insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. •Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding,structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. '.The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. Tine entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br:cements must be included with the other glazing. Basement doors must meet the door U-value requirement d.scribed in Note b. 7 The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes eleetric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package- For Heating Degree Day requirements of the closest city or town see Table J51.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wail,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). r; _ 43 GTE rBoard ofBuileing Regulations and Standards HOMC IMPPOVEMENT CONTRACTOR Regl;trn;jaa { ii7304 c.,Pl�iion i0/03/2002 Yam:'.Y DIVIDUAL MiGHAEk 1.SAd.,rH I►IM� AdIC Ei„ aAi mh � � I The Town of Barnstable 9snxrMAM rsreet.e.� Regulatory Services �'�fo;p�►�� Thomas F. Geiler, Director Building Division _ Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 1 Office: 508-862-4038 Fax: 508-790-6230 Permit no. 2GD� 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: '&aQ n� 1' ��CA rK S Estimated Cost Address of Work: b�f� S�LtTwl L wc�"t Owner's Name: %jlS Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. (A/C) .............. Dat Owner's Name q:forms:Affidav:rev-070601 r . i Assessor'sx rnap?:and lot number . ........ . PyOf?N E T��I Sewage Permit number ....:. :. ........................... ,fJ BJHB4TAILE, i House number ........................................................ ..... rasa 9 1639.a�0� G YFY .. TOWN OF BARNSTABLE , x BUILDING INSPECTOR CA APPLICATION FOR PERMIT TO r U`� +�. ....................... ... � TYPE OF CONSTRUCTION �J.Qn. ......�V .M ........................................................... ... ........... ac .. ................19 �.. TO THE INSPECTOR OF BUILDINGS: The undersigned>hereby applies for a permit according to the following information: Location 's 5 � .......... ... ?.............� ............................................ ProposedUse .......S.,.(.\. P...,•........ A ........................................................... . ..................................................... Zoning District ..... ............................Fire District CPA\.....0S.)t Name of Owner ... MP ..... .....5.m '�..........AddressC���1 `> ................ ............-.. ... ........................... .Name of Builder uM�..... :.....S.4.Y.1�..\n........Address ................. ... n �" `-¢—............... ...................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................ .Foundation ....... <. t��r. .................. ......... . Exterior ...t. .,? .......aC..... �\\............ Roofing ............fit .. N*.zC&.............................................. .. ............ \ Y� C�iJ:)O �. ........................Interior ............ . C�X/� Floors .................................................... - Heating ........... 6 .......'......0A�................................Plumbing ..............1.... ?.....1h.............................................. . ............ Fireplace ........Q n ..............................................................Approximate Cost ..A 9Q............................................. Definitive Plan Approved by Planning Board ---------------------_----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ;�-A NIL3� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ,Name .....` .a. °... ;. Sfh�. ........................ U < �' SMITH, JAMES K. /71615�15 No ...23590 Permit for OSingle Family D .. Location ..Lot #15„ 6 0 8 . Centerville Owner ....James K. S.m.i.t.h.......................... Type of Construction' ....F.. anti......................... ........................................../................................... Plot ............................ Lot ................................ Permit Granted 040ber 26 , 19 81 Date of Inspection ../...............................19 Date Completed ... .................................19 P RMIT REFUSED ........................ ................................... 19 ...................... ...................................................... .................... ...................................................... Approved ................................................ 19 '............................................................................... ............................................................................... TOWN-OF BARNSTABLE BUILDING PERMIT'APPLICATION Map Parcel Permit# Health Division - Date Issued Conservation Division Fee �(1 Tax Collector Treasurer Planning Dep - Date Definitive Plan Approved by Planning Board ; Historic-OKH Preservation/Hyannis Project Street Address o 3 S k L iJ t! Village C2 Mac-, N V 1, Owner U'R e.r Address k,-)nJ - -Telephone 4 Z�— -7-7 YL( Permit Request `� [ZP (L&Ltd•h ems,-(_ L) -I_kaui s ak j Sc CA. -t •_� -���t �-_. rn�.��-- � � s-�u vl.�ram.(_ Square feet: 1 st floor: existing proposed 2nd floor: existing' proposed Total new Estimated Project Cost S, SOU Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family C Two Family ❑ Multi-Family(#units)) Age of Existing Structure Historic House: ,❑Yes ' O'No On Old King's Highway: ❑Yes ❑No Basement Type: •0 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: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No ' Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal#T Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use - BUILDER INFORMATION Name Cg;A-V,iP(o•.J ujc,-Lc�_ Telephone Number � �1 t t. Address iv- License# �l -�{ 01 �ov\, mA- OZ-3 ZZ-- Home Improvement Contractor# Z �� Worker's Compensation# LvA ero,, ALL CONSTRUCTION DEBRIS R ULTING FROM THIS PROJECT WILL BETAKEN TO 1 S+0C, SIGNATURE DATE - ( � FOR OFFICIAL USE ONLY s PERMIT NO. DATE ISSUED t MAP/PARCEL NO. a - ADDRESS _ VILLAGE , OWNER. '�•. - = • .- , c • DATE OF INSPECTION: FOUNDATION v FRAME ' INSULATION - F FIREPLACE ELECTRICAL: ROUGH FINAL r - PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL E ' FINAL BUILDING _ DA TE CLOSED OUT ASSOCIATION PLAN NO. _ , r` TOWN OF BARNSTABLE Permit No. _________ _-______ ( Building Inspector 11WfTAU Cash 7 ■NL _Y OCCUPANCY PERMIT Bond _______ No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to J-Im p—q K . Smith. Address -iarng4 a!').te Wiring Inspector j l=: `L�� / f Inspection date Plumbing Inspector ,* Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building Inspector "IAR ' T I /..7:.-./�1-..Z THE r ssessor's map and lot number . .... Sewage Permit number .....Q!`.` 1. ..'.........................' ,SEM SY$ ► ��T �' �v � v _ t INSTALLED IN CCMR Basal RILE, � � JY .IOD.� ii� House number :............'............................:.....:.........:.......:,..... j ro �� 1fM61�1 � � pYpY NVI ® E ALCODEAND k� ,.. TOWN OF BAIRN A-D 20HIS :i UU.ILDIRG' . IMPtCT.OR f .,r APPLICATION FOR PERMIT TO .. ...... .............................. .V?. ... . ............. TYPE OFF CONSTRUCTION �4 ao ..... atY1 ..................... Ck,* .r� ................198t.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....\"V!'J:k......v............. ....�......................K....9A............ VA...�XA. ......................................... Proposed Use ��, n e.........�.;iF -m. ...... Zoning District .... ............................ District ' Q.S..... ........ .... ....................................... curl s Name of Owner ...�.�m.�.....�......5.rY. .7\4...........:..Address . Name of Builder ..... :.... :.......Address J1tl ................. ...... .......... ............................................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms- ................. Foundation � n CJ�- . . ..... Exlerior ...u*.A ..... �....�ii� ..Roofing .. Floors ........ .4. e?. ...Q...........................................Interior ""' .:.............................................. Heating ...........�.�ASN.......:........0A................................Plumbing i Fireplace ..:..... .............................................................Approximate Cost ... .`....®:..................:. ............ .,.....� Definitive Plan Approved by Planning Board -------------------_-------____19________. Area .......Q.../.. ...... S. ...........2 Diagram of Lot and Building with Dimensions Fee. ................. ..... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... 0.X SL°...P.......S-101.1AAn........................ S24ITH, JAMES K. 23590 • One 1/2 Story = " No ................. Permit for .................................... . ........S.ixl91.e...F.ami.lit...Dwel.1lag.............. 7 Location ..Lot...1#15...p.Q.$....Skla�l�.li�t,..�s�ad ....................... ....... Owner e...James.. ......5mi.tkl...... �, -J .1 „ Type of: Construction. ..... x alIla........................ ............ ................................................. IlkPlot ............................. Lot' .:'.......Y................... 1 r� Permit Granted 2October 26a3.....:79 �l .................. Date of Inspection ......................... ..:1,9 n c Date Completed ... ........... _ ............... 9 :. PERMIT REFUSED - 19 G y . t � ............... .... ...................................................... , .'.......................................................... Q . a Approved ............................................................................... ............. ;'prs t6kl -DATA St'NGt.E P-AMIL-f 3 SEDZD04AS Av,6 tPA,t uY PLO.0 a 3 x t i o = 490 irwPt> ♦ `�r 5ei-rlc -r-A,jV = 33o )c IZo 495 &Po u '* A- tZd+48�1•08)(2•S) - l94 G.Pv 'Bo T-rom APc--A �t2'x2d.��t.o� _ 2$8 �r.p.D. 1.3 • , �� � t TOTAL -Si GN d82 6 Kv- PE-�•2GotJ�.'�t o►J tZAT� l'i ru 2 MrrJ• 02 t_f�,. '� " ` . : • � . - 00 r 7 0 i I 24 vir �2� i CZ- f Fes( 'ru XT" Tt-I� r-UU IA'C>N7 to AZT'-t �CD T S�IuWi.1 uE.�Z�ohl GoM RY5 kiITU THE �o WOK,,, •�.�• f �tpEu►-1E. ANn 5�T'F3�c-iL- 2Eflu«EM�'fS G'�= 'fl , -ratE -rowu oF3P�RN T Lca `�' �5 S 1ZfuNKNE.T- oo V-c.5 Z 3 1 tz�• �u� �.�t �,. �e�cT�rz. � uy'��iuc.. S p`;to `ul- .. 41 t � pi le i b1a o.o o 4=45' ,�t Y�i�a 7 c 9 8 . - r kvt-�- St/z 9Y BI . A ' I, 8etX3R a (M-• qG LOAM ". t►N tuV• t000 Iv2V uIJ dNi7 ^N. Go4l., Rt.b 4c.4 Sot 9t.L ' G c019R,5d 17 TAu IUV• 94-,O ram. .•r.i�- �. K. q,544 W(TW A:of 3/4 ro Ilc we5►1sa sy,v ;1st f . 4TOUL- OLD AIz WQT>. 2• of PL".AIT01jG- 04 Tar W&Tsay- tA-- 8 c o -.,. BGfO no sccla Town of Barnstable _emit: - --.- Regulatory Services t ate:' "1NE 1p - os Thomas F.Geiler,Director Z-vd sARNSTASLE, * Building Division 9 MASS. 1639• Peter F.DiMatteo Building Commissioner 4i'°lEnr A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT 4(9D Owner: �i�G' Phone: O Install at: Village: Map/Parcel: /,6 ��,�,� Date:_TC Stove #. A. New U rS) B. Type: adia /Circulati g C. Manufac Sri Lab. No. ---4�aO— AD. Model No.: o<f r ' Xhhnney A. New/Existing (If existing,please note date of last cleaning) B: Flue Size r C. Are other appliances attached to Flue? D. Pre-fab Type and Majigfacturer E. Masonry: ine nlined Hearth A. Materials: B. Sub Floor Construction: Installer Name: Address; Phone: Location of Installation: APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev122801 -- Town of Barnstable emit: OFZHE 1p� Regulatory Servicesbate: � Thomas F.Geiler,Director '+ sAxivsTASLe, Building Division 9 MASS. 1639. Peter F.DiMatteo Building Commissioner AIFo �p 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 i TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Z�C Owner: Ire eff /f�P lei Phone: Install at: � (� � Village: VWap/Parcel: t�.6 ��„�,� Date: ' �C f 1 stove . New U Type: adia /Circulati g 3. Manufac Sri Lab: No. . onao— Model No.: ff- himney . .New/Existing (If existing,please note date of last cleaning) W Flue Size Are other appliances attached to Flue? Pre-fab Type and Manufacturer- Masonry: ine mined arth ;Materials: oe 1Sub Floor Construction: 1-y .aller Address: ro ae: 3� ttion of Installation: .APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev122801 i ay I ° 71. #- --- - SMOKE DETECTORS REVIEWED �l►&l/6 A BUILDING DEPT. DATE FIRE DEPARTMENT.: DATE r� BOTH SIGNATURES ARE REQUIRED FOR PERMITTING s Q R I : -1 n a o I 1 U o 8 -:5tu' n e ItV 'L- 4a ar) C ►� v, 11-f. c h--e f) _A7 L V✓QN Ile 1 _ - V 1 2- t I 1 2— a _ Ulf SSA ryi-t,,L4 C SA-d-I r s - GD w 216 ryu (1 oo 36 Gi �\ -.-�. ..... ..:.M..:�,;.::�<M.-w;�.s:::h�r�:z,��w ao,-,..:t:.e ....� _ _ .. _. ..N,.M......xti��r•b:P-.�-:�:icvm�>i;cti+*c�,��a.> : a.Ya,m...:.,e..r.,_____ _�...�..,_.,�_....a.;..^+� �fi&a�':� '1:�'�i+rea,Cz.�. SMOKE DETECTORS REVIEWED WTAILE BUILDING DEPT. DATE FIRE DEPARTMENT D E BOTH SIGNATURES ARE REQUIRED FOR PEPITTING --. f i . ' � � � .:..-.-::�,.:�:IF+�,�t.�rfya.,,r;,�2;...>,car,«.r�,.,x.,.o»,.�..-,_,-......::..,�..._..�.._......-,.«.,...,.-�+av; Ff:�?:a+�.c.*2h,14sa-a-r�.�"" -.- - ____,....�.___...�._.�..-.a:h..wcer�nt-n[�c-"-"amuss9Fce" fir"? ;, �•. •� ,��� i ' i � t . � i � � � - E i p - 4 _ .tea -A� x - _ ._ —___— - - E s _ _ . . .. i KE DETE�r® S o. . - / ARNSTABLE BUILDING 111LD1�C- DEFT. . �Do M sn-t d r— t P i 6b The Commonwealth of Massachusetts Department of Indtairial Accidents - �^ - -- Office 81IMS08908S — 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: hone# itv c❑ I a homeowner performing all work myself~ ❑ I a sole etor and have no one in ailv //,, "i, / ////////////////%//%///%//%/////%%/%O%////%/%/%/%%/�i, //%%%/%%%//%%%/%/�/,%// women on this job. 1 workers easatloa for my ........::.::::$.:::::::::::::., ..:: ::::::.:.::::...:::::.:::::.::::::.:..:.::..:::::,.:..:.::..,.:.,. e �g co .........Y:....,::•:t•..: •::.:.:,•.Y.....::::......::......... .... amI. an :......... ::::::::......................................... . 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Failure to segue coverage as reQoired order Seetlast 2AA of MQ.1S2 dot Ind bo of erimiad pendtin of a Sae up to S1,S00.00 andlor one years'imprisonment as weal as dvn peadties in the form of a STOP WOES ORDER and a Sae of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMW of Iavealigxd=of the DIA for coverage verlflcation. I do hereby fy under the p • and pmalties ofpc!►�'that the information provided about is duo and correct Date Signature . (7 W P��fK� �`� Phone# ���— 5� �a Print name_._.� MOMI ofncW use only do not write in this area to be eompletied by city or town official permif/Iicense# QBudding Department city or town: ❑Licensing Board ❑selectmen's Office ❑che&if immediate response is regtdred ❑Health Department phone#• ❑Other contact person: orrued 9/95 F1A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to Provide workers' compensation for their ated from the'la*",an employee is defined as every Person in the service of another under any contract employees. As qu . of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, Corporation or other.legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of or another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in for any a in the applicant who not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall eater into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contractmg authority. / Applicants Please fin in the workers' compensation affidavit completely,by checking the box that applies to your situation and suPP1Ying company names, P� address and numbers along with a certificate of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confi Ation 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 not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, are required to obtain a workers' compensation Po1mY,Please call the Department at the number listed below. City or Towns Department has provided aspace.at the bottom of the Please be sure that the affidavit is complete and printed le�lY. The eP P affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the aplicant. Please be sure to fill in the pa mit4iceose number which will be used as a reference number. The affidavits maybe returned io the Department by mail or FAX unless other have been made. The Office of Investigations would lam.to thank you is advance for you cooperation and should you have any questions- please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Olflce of lugestlgatlons 600 Washington Street Boston,Ma. 02111, fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 EVE A The Town of Barnstable & KAMM � Department of Health Safety. and Environmental Services �6 79.�► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERWr 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: 2P �� c,e�^ � w ,t �)(Al& Estimated Cost S , 5 0 Address of Work: 6 5 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 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply a permit as the ent of the owner Date Contractor Name Registration No. OR Date Owner's Name q:fb ms:Affidav i — / WMQDOW&,•,G0tWG/ / ,;PA*10-,AOOMS .. i OEPARINENI OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nuiber. Expires: ., Restricted To: IG OYAYNE C ORAGG00 5511 SPRING CORNER Ro ■VINYL REPLACEMENT WINDOWS ........... - i„ _; I11PEOVEIMF r nN i Pa ■ STORM DOORS A - . WINDOWS PRIVATE. (�1pDIiFIS1�I�' rlmmM,IOH 'al"wnw , L Arlalr n,nr„� _00 F a r ,Is ' ■ PAL104ENiRYDDORs E;IA�1S1 (rLE, i!I aiIAQ I,I t f V'NY 1.`.>IDINC AND rRI.S1 • e ., .s _ _ ■ PAM)ROOMS S PORCIi ENCLOSURES •, ' -, .* .. - o 75 SfOCKWELL DR. _,■.AVON, MA 02322 ' PH: 503-580-3119 877-946-3699 FX: 508-580-6064 ' .1�-'i VA I:t'::V f is::UA TT OATE(MMIO vROGutER (513)421-6515 FAX (513)421-0130 THIS CERTIFICATE IS ISSUED AS A MATTER OF INF O4/O ral ter P. Dol l e Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ION 312 Walnut Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 3200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cincinnati, OH 45202 COMPANIES AFFORDING COVERAGE Attu: Robert B. Barnett COMPANY Lumbermen s Underwriting Ext 214 A INSURED �� ' ...................................... Champion Window Co. of Boston South, LLC COMPANY 75 Stockwell Drive ' B < ... ....... Unit #7 COMPANY Avon, MA 02322 ...., ....... . ..... - COMPANY° 0 THIS IS TO CERTIFY THAT THE :..:::.:::.:.:.:::................ P,0UCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE•POUCY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR)NAY 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. TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION ... ....... LTR POUCY NUMBER DATE(MMJOCIYY) DATE(MMMO/YY) LIMITS.,, GENERAL LJABIUTY COMMERCIAL GENERAL L1ASVTY GENERAL AGGREGATE 1 ... ...... CLAIMS MADE i :OCCUR PRCOUC'rS•COMPf('P AGO �• r w.: c PERSONAL 6 AOV NJURY s OWNER'S&CONTRACTOR'S PROT' ... ........ EACH OCCURRENCE i ....... ................................................. FIRE OAMACE(Any OM A(e) f. . ......:. ......,. MEO EXP(Any one porwn) ; AUTOMOBILE LtA81UTY r CMBIN LE LIMIT ANY AUTO C EO SJNG MIT f ALL OWNED AUTOS SCHECULED AUTOS SICILY INJURY f HIRED AUTOS •• NCN•L'WNEO AUTCS. - BMLY IN,;URY _ PRCPERTY DAMAGE $ ' GARAGE Lu81UTY AU,a CNLY-EA ACCICENT f ANY AUTO .,.... _ .. .. .... .... ... .,... .: R NLY GTHE THAN AUTO C , EACH ACC:CENT S .EXCESS 1L181UTY AGGREGATE S UMBRELLA FORM -,.� EACH OCCURRENCE $ OTHER THAN UMBRELLA FIRM a AGGREGATE .. AGGR f WORKERS COMPENSATION AND EMPLOYERS'L"IUTY " X. TORY LIMIT ER 12/O1/1 A THE PROPRIETOR/ "•' 275086 - - r ^ EL EACH AGGCENT 1 SOD,000 INCL-, 999 : 12/O1/2000 .... AFIC ERSIOcECUT1yE ° EL CISEASE-POLCY LIMB S 500,QQQ OFFICERS ARE. EXCL' s OTHER e•" EL CISEASE-EA EMPLOYEE S SQQ QQQ DESCRIPTION OF OPERATION3ILOCAT)ONSIVEHIClES13PECUL REM3" +t CERTIFICATE HGtDE...... SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE 133UIN0 COMPANY WILL ENDEAVOR TO MAIL I 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIOAnCN OR UASIUTY 0/ANY KING UPON THE COMPANY rT!AOENT3 OR REPRESENTA TO WHOM IT MAY,CONCERN AUTHCRID REPRESENTATIVE ACORD 26:8 VIM):...:. ... —:. ...... ...... CACORD COMWATiON 10 CERTiFICQTE C7F LIABILITY INSURANCE r DATE MMIDINYY;.,;..::.;:.;.:;.;.::..:,.. 1 PRooucER 12/06/1999 (513)421-6515 FAX (513)421-0130 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION al ter P. Dol l e Insurance Agency, Inc.' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 312 Walnut Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 3200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cincinnati, OH 45202 COMPANIES AFFORDING COVERAGE Attn: Robert B. Barnett COMPANY Fireman's Fund Ext: 214 °, A . INSURED ... «,", . • • .. ' Champion Window Co. of Boston South, LLC. COMPANY " . 75 Stockwell Drive 9 Unit #7 COMPANY Avon, MA 02322 C `. COMPANY - s _i• - ..................... tnA.+ D IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED•ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING•ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR'MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE Of INSURANCE POLICY EFFECTIVE:POLICY EXPIRATION - POLICY NUMBER . CATE(MM/CCM) ? DATE(MW CC/YY) LIMITS GENERAL LIABILITY - GENERAL AGGREGATE j COMMERCIAL GENERAL LIABILITY i P .... COUCTS•CCMPIC AGG` j CLAIMS MACE ;OCCUR.` PERSONAL&ACV INJURY j CVVNER'S d CCNTRACTCR S PROT: ...: ................ EACH OCCURRENCE j ... ... - FIRE CAMACE(Any on*lie) f MEO EXP(Any on*Peron) f: AUTOMOBILE W841TY - _ ANY AUTO CCM81NE0 SIpiGLE LIMIT S ALL OWNED AUTOS SCHECULED AUTOS BCCILY IN.URY s (Pa Dentin) HIRED AUTOS NCN-OWNED AUTC$ SCCILY INJURY f .. PWCPERTY CAMACES I OARAOE LIABILITY ANY AUTO AUTO CNLY•EA ACCICENT j CTti,ER n.AN AU,0ONLY EACH ACCICENT S , AGGREGA;- j, EXCESS LUB4ITY EACH OCCURRENCE f, 15,.000,000 i A X uMeRELUFORM XYZ00096219456 12/.O1/1999 12/01/2000 AccR c�;1 E 'E S 1"5.,000,000 ' OTHER THAN UMBRELLA FORM - - � � -� - 1 f M/CAKERS COMPENSATION AND I EMPLOYERS'LUIBIUTY TCRY"LIMITS ER THE PRCPRIETCR/ EL EACH ACCICENT. f INCL OFFICE RSEXECUTIVE EL CISEASE-PCUCY LIMB S OFFICERS ARE. EXCL' OTHER n EL CISEASE•EA EMPLOYEE j ',I DESCRIPTION Of OPERATIONSLOCATION3/VEHICL!SISPECIAL ITEMS CERTIFICATE H�R SHCULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE 133UING COMPANY WILL ENCEAVCR TO MAIL, 30 DAYS WRITTEN NOTICE TO THE CBRTIfICATE MOLDER NAMED TO THE LEFT t BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR WBIUTY Of ANY KIND UPON TH!COMPANY,ITS AO T3 OR REPRE3! IVE3. TO WHOM IT MAY CONCERN AUTHOR=REPREUNTATIVe 42 ACORO 2`.d : CACORD CORPORATION 1 -'J ndri1F1on ?11ii G':J r:i y, i jiJ J O »Gi»i r2L• 1J y� 1.:lJ=sli Page 2/8 NFRt Product Certification Authorization Report(U-Factor) . Menufacbrrar Intorrnation IA Identifier: A 356, Champion Window Mfg. 11750 Commons Onve Page. 1 Cincinnati,OH 45246 Product Information seriesimodel: 860 DOUBLE HUNG Product Type: Vertical Slider NFRC Product 10: 356-A-006 • Cert.Authorization Expiration Date: 11/17/2002 Delete Code: Laboratory Information Simulation Report Issued By SETC Simulation Repor,Date: 10/28/58 Simulation Report Number: 034-5719 0-510.0 Product Infonriabon Prod Del Ras NcnRes Frame Sash Glazing Low'E'Data Film Spacer Gap No U-Value U-Value Type Type Layers Emissivity 1.2.3(Surface) (Surface) Gap Width Type God Fill 001 06 0.32 0.31 VF VF 2 0.03(3) 0.562 Al 8 ARG 002 0.34 033 VF VF 2 0.15(3) 0 570 S4 9 ARG 003 0.34 0.33 VF VF 2 0.15(3) 0 514 S•1 9 ARG Baseline Information Te9t Thermal Tested Standard Thermal Test Lao Test Oats . Test Sizes U-Value U-Value Report Nume-er TETC 11/17/98 38 x 80 34 .35 034-5741 0-510 0 TETC x I hereby certify that the above informatio s true to the best of my knowledge I also certify that all requirements for certlficalicn authorization under the NFRC PCP hav ,been met. Authorized IA Signature: J/�l,/c.� Date Approved: 11/17,98 Revised Date: 12'07/98 s NFRC Product Certification Authorization Report(U-Factor) Manufacturer Information IA Identifier: A 368, Champion Window Mfg, 11750 Commons Orrve Page. 1 Cincinnati,OH A5246 Product Information Senes/Model: 800 HORIZONTAL SLIOER Product Type: Horizontal Slider NFRC Product to: 358-A-0o5 Cert.Authorization Expiration Date: 11/1&2002 Delete Code: Laboratory Information Simulation Report Issued By: SETC Simulation Report Oate 1028/98 Simulation Report Number. OU-5720.0-510.0 Product Information Prod Del Res NonRes Frame Sash Glazing Low'E'Oata Film Spacer Gap No U-Value U-Value Type Type Layers Emissivity 1.2.3(Surface) (Surface) Gap Width Type Grid Fill CO1 06 0.33 0.31 VF VF 2 0.03(3) 0.5e2 Al 8 ARG 002 0.34 0.33 VF VF 2 0,15(3) 0.570 S4 B ARG 002 0.34 0.33 VF VF 2 0.15(3) 0 514 S4 B ARG Baaellne Information Test Thermal Tested StanC2rd Thermal Test Lab Test Date Tast Sizes U-Value U-Value Repot,Number TETC 11/18198 80 x 38 31 31 034-5742.0-510.0 TETC x I hereby certify that the aoove informabo is true to the best of m knc ledge I also certify that all requirements fcr certification authorization under the NFRC PCP hav een met Authorized IA Signature: Data Approved: 11/12/92 Revig al Date 12/07/98 Cram 1cn -,u1r clv d,Ir P g �13 iac ao1a; Fao- 10 11 :03. LI; F—Ige ale NFRC Product Certification Authorization Report(U-Factor) Manufacturer Information IA Identifier. A 366. Champion Window Mfg. 11750 Commons Drive Paga 1 Cincinnati.OH 45246 Product Information Series/Model: 700 PICTURE Product Type. Fixed NFRC Product 10: 35d-A-004 Cart.Authonzation Expiration Date: 11/8l2002 0 ete Code: Laboratory Information , Simulation Report Issued By: SETC Simulation Report Date: 1012819e Simulation Recort Number. 034-5710.0-510.0 Product Information Prod Del Res NonRes Frame Sash Glazing Low'E'Data Film Spacer Gap No U-Value U•Value Type Type Layers Emissivity 1.2.2(Surface) (Suffice) Gap Width Type Gnd Fiji 001 0.32 032 VF 2 0.15(3) 0.570 S+ 8 ARG 002 0.32 031 VF 2 0.15(3) 0 514 &1 g ARG Sasellne Information Test Thermal Tested StardarC Thermal Test Lab Test Date Test Sizes U-Value U-Value P-sport Nurr.t:er T_TC 1 t/5r9t) ae:ae .29 29 034-5732.0-510.0 TETC x I hereby certify that the above informati is true to the test of my knowledge. I also cerliPj that all requirements for certification authorization under the NFRC PCP ha been met Authorized IA Signature: id,�. Date Approved. 11/06/98 Revised Date 12/06/98 J o rd� 1U 1 0 Ja •. �f ..r1dm�,iGn .'1_ii:va � .. �iJ- �i � �'� 1 ' . NFRC Product Certification Authorization Report (U-Factor) Manufacturer Information IA Identifier. A 366. Champion Window Mfg. 11750 Commons Drive Page: t Cincinnati,OH 45246 Product Information Series/Model: 700 AWNING Product Type: Projected NFRC Product 10: 356-A.003 Cart.Authorization Expiration Date: 9/18/2002 Delete Code: Laboratory Information Simulation Report Issued By: SETC Simulation Report Date: 10/28198 Simulation Report Number 034-5709.0-510.0 Product Information Prod Del Res NonRes Frame Sash Glazing Lew'E'Date Film Spacer Gap No U-Value U•Value Type, Type Layers Emlaslvity 1,2,3(Surface) (Surface) Gap Width Type Grid Fill 001 0.32 032 VF VF 2 0:15(3) 0 570 S-+ B ARG 002 0.32 032 VF VF 2 0..15(3) i 0 514 S4 B ARG 13asaline Information Test Thermal Tasted Standard Thermal Tcst Lab Test Date Test Sizes U-Value U-Value Report Number x x I hereby certify that the above infcrmadon Uue to the best of my knowledge. I also certify that all requirements for certification authorization under the NFRC PCP have en met._J(�/ \ Authorized IA Signature: (7�JJ Gate Appccved 09112 9E Revi3ed Date:, 17-1 6,96 Pip 4RC Product Certification Authorization Report (U-Factor). Manufacturer Information 368, Champion Window Mfg. IA Identifier: A 11750 Commons Drive Page: 1 Cincinnati.OH 4524E Product Information SarlearModel: 700 CASEMENT Product Type: Casement NFRC Product 10: 356-A-002 Cert.Authorization Expiration Date. 9118/2002 Delete Code: Laboratory Information Simulation Report Issued By: SETC Simulation Report Date: 1012a198 Simulation Report Numt;er. 034-5709.0-510.0 Product Information Prod Del Res NenRes Frame Sash Glazing Low'E'Data Fikn Space( Gap No U-Value U-Value Type Type Layers Emissivity 1.2,3(Surface) (Surface) Gap Width Type Grid Fill 001 0.22 0.32 VF VF 2 0.15(3) 0.570 S4 8 ARC 002 0.32 0.32 VF VF 2 0.15(3) 0.514 S4 8 ARG Baseline Information Test Thermal Tested Standard TRerrnj1 Test Lab Test Date Test Sizes U-Value U-Value Report Numt:er TETC 9/18198 30 x 60 .34 .34 034-5'31.0-510.0 TETC x 1 hereby Certify that the above information s true to the best of my knowledge. I also certify that all requirements for certification authorization under the NFRC PCP have een met. 6LAuthorized IA Signature: Date Approvec 019/12/98 Revised Date 12/C6/58 i �j i:n amp ion P1111CCYJ ,bif ; 3z1J3- 3 c]' ; pec 10 __ l i .C-11.',i page il8 NFAC Product Certification Authorization Report(U-Factor), Manufacturer Information IA Identifies: A 384, Champion Window Mfg. 11750 Commons Orive P3g.. 1 Cincinnati.ON 45246 Product Information SeriewMadel: 3100 PATIO DOOR Product Type: SGd1119 G1033 Dcor NFRC Product ID: 35t}A-001 CerL Authorization Expiration Date: 10/5/2002 Delete Code: Laboratory Information Simulation Report issued By: SETC Simulation Report Date: 10/28/98 Simulation Report Number: 034-5718.0-510.0 Product Information Prod Del Ras NcnRes Frame Sash Glazing Lcvv'E'Data Film Spacer Gap No U-Value U-Value Type, Type Layers Ern siviry 1,2,3(Surface) (Surface) Gap width Type. Grid Fill 001 0.35 0.36 VP VA 2 0.15(3) 0.750 S4 8 ARG Baseline Information Test Thermal Tested Star.Card Therrmal Test Lab Test Date Test Sizes U-Value U-Valve R4-. rt Numter TETC 10/5/98 71 x 79 .40 .33 034-5740.0-5tC.0 TETC r I hereby certify that the above Infcrmatl n is true Vtbest cf my knowledge. I alsc certify that all requirements for certificationauthorization under the NFRC PCP ha a been m Authorized IA Signature: Date Approved 10/05198 Revised Date 12/06/98 r oy. Cnampion '`l1nGC':1 ?,i y• S1 }•J». Oi- rc iC' __ ' ^,I' , - rage d/d - National Fenestration Rating Council,Inc. -CertlHed Products Dlrectorl Page: W1 Product Description Gluing Doscriptlon 'Energy Ratings' Individ. Manufacturer Number of Glazing Layers;Spacer Type; Gap U-Facor U-Factor Product Product Code Low'E'(Emissivity 1,2,3)(Surface);IF-Internal Film(Emirs)(Surf.); Wldth(s) RES NON-RES Number Primary Insulating Glass Gap Fill and Grids(T,Y,or 8). (Air Spaces 1.2-3) Size Size Manufacturer: Champion Window Mfg. Manuf. 10: 356. CHW IA: A Product Line: 356-A-001 Product Type: Sliding G1333 Door Frame Type: VP 3100 PATIO DOOR 001 2 SA 0.15(3) ARG (B) 0.750 0.35 0.35 Manufacturer. Champion Wlndow Mfg. 6Aanuf.ID: 356, CHW IA: A Product Line: 3%-A-002 Product Type: Casement Frame Type: VF 700 CASEMENT 001 2 S4 0.15(3) ARG (8) 0,570 0.32 0.32 002 2 S4 0.15(3) ARG (B) 0.514 0.32 0.32 Manufacturer. Champion Window Mfg. Manuf.10: 364, CHW IA: A Product Line: 356-A-003 Product Type: Projected Framo Type: VF 700 AWNING 0111 2 Ss 0,15(3) ARG .(6) 0 570 0 32 0 32 CC2 2 S4 0 15 (3) ARG (6) 0 514 0 32 0 32 Manufacturer. Champion Window Nlfg. Manuf. 10: 35n. CHW IA: A Product Line: 356-A-OC4 Product Type: Fixed Frame Typo: VF 700 PICTURE C01 2 S4 0.15(3) ARG (5) 0.570 032 0.32 CC2 2 S4 0.15(3) ARG (8) C.514 0 32 0.31 Manufacturer: Champion WIr.Ccw Mfg. Manuf. 10: 356, CHW W: A Product Line: 356-A-005 Product Typo: Horizontal Slicer Frame Typo: VF 800 HORIZONTAL SLIDER CO2 2 Ss 0.15(3) ARG (6) 0 570 0.34 0.33 G03 2 S4 0.15(3) ARG (B) 0 51A 0.34 0.33 Manufacturer. Champion Window Mfg. Manuf.10: 366, CHW )A: A Product Line: 358-A-OC6 Product Type: Vertical Slider Frame Type: VF 800 DOUBLE HUNG CO2 2 S4 0.15(3) ARG (13) O.S70 034 0.33 GM 2 S4 0 15(3) ARG (8) 0 514 0 2A 033 (EXI5TING) (ADDITION) 00 Lo 0 00 Lo W W p Q EX15T. A5 0 DECK Q o QZ/v+ p /- .NEW _ - - - ►fF..rV _ r�}I. DECK V `- EX15T. _ ExIff. EXIST: EX15T. a i d cy) MARVIN cy) N MD INTEGRITY 1 ISFD 8065 � w EX15 � BATH 00 .. 00 Q 0 o EX15T. EX15T. X O II II TV ROOM KITCHEN EXI II II o p w I ' o LIN � � II ! I 5'-10" Q N Il fl _ FWT EX15T. //JJ i I I I I L I B W cn x F� O HALL +I z O L15T. NEW 0 caz DN. °A O �' ----- ' ; LI f I I I � `� 02 N _ -- ROOM N W 0 I I L..--BEAM5 1 ! (VAULTED I I g Q co II ABOVE II CEILING) II VERIFY ! ! w/OWNER - EXI I F T. I I -- 11 112 i I 4'-11 112I I 5-3 12° EX15T. CL oEX15T. VL O W DINING ! UP s .. EXI T. ' MR, =yl��/`! -"�'`il � .' �' '.1/ry.,.y9vr' ..;W � o I� EX15T. EX15T. EX15T EX15T. N O NV506 5'-8 8'-2 (EXI5TING) (ADDITION) ^ 00r l W �I !\ST fLOORFLAN GENERAL INOTE NOTE: I :) CONTRACTOR 15 TO VERIFY EXISTING CONDITIONS AND 5.) ANY DISCREPANCIES, ERRORS AND/OR OMISSIONS IN THE NOTES, THE PIAN5 5HOWN ARE LEGEND DIMEN5ION5 IN THE FIELD PRIOR TO THE START OF WORK DIMENSIONS, AND/OR DRAWINGS CONTAINED ON THESE DOCUMENTS THE 50LE PROPERTY Of THE DE5IGNER AND CAN 2.) CONTRACTOR TO REMOVE EXISTING DOORS, WINDOWS; SHALL BE BROUGHT TO THE ATTENTION OF THE DE51GNFR PRIOR TO NOT BE COPIED, EXISTING WALL CONSTRUCTION TO REMAIN WALLS; * ROOFING AS REQUIRED FOR NEW CONSTRUCTION. COMMENCEMENT OF CONSTRUCTION. PROCEEDING WITH CONSTRUCTION REPRODUCED AND/OR NEW WALL CONSTRUCTION CONSTITUTES ACCEPTANCE OF THESE DOCUMENTS AND ANY DISCREPANCIES, ALTERED WITHOUT THE 3,) ALL NEW CONSTRUCTION TO MATCH EXISTING IN MATERIAL, E A EXPREsS WRITTEN ERRORS AND/OR OMIS 5 ONS BECOME THE / RESPONSIBILITY C_ OF THE EXISTING WALL CONSTRUCTION TO BE REMOVED DETAIL; AND FINISH. BUILDING CONTRACTOR. CON5ENTOFTHE DE51GNER QS NEW/ EXIST. 5MOKE/CARBON MONOXIDE DETECTORS 4.) ALL WORK SHALL CONFORM TO THE MAS5ACHU5ETT5 STATE BUILDING CODE (LATEST EDITION) AND ALL OTHER SCALE : APPLICABLE LOCAL CODES , � 1/411 = 11-011 i DATE WINDOW 5CHEDULE 5 z 2/14/2018 TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS : PROD. NO. A MARVIN INTEGRITY ITDH 3046 2'-G 172" x 4'-0 I/4" DOUBLEHUNG 1 2017-8012 B �� �� lTDH 3260 2'-8 1/2" x 5-0 1/4" DOUBLEHUNG C IRT36-2W DH 6'_0" x 3'-0" HALF ROUND STAMP: DWG. NO.: p IAWN 2523 2'- 1 " x I '- 1 15/8" AWNING L :6 WI" 9Z b I=J NOTE # I :CONTRACTOR TO VERIFY ALL QUANTITIES AND SIZES OF NEW WINDOWS WITH OWNER AND ROUGH OPENINGS WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS 0 5 10 ;12 N C I I -U120 COPYRIGHT 2018 NOTE #2: CONTRACTOR TO CONTACT PAM DIVENUTI AT MID CAPE HOME CENTERS (774-21 2-G958) >;,, f QBYTHOMAS A. MOORE DESIGN CO: TO REVIEW WINDOW SCHEDULE AND DETAILS OF WINDOWS. ,. V4 rATJ. I J 00 t Z o Z Z `L0 w W ' O NEW ROOF SHINGLES E Q 0 TO MATCH EXISTING - co NEW FA5CIA* FRIEZE BOARDS O CEILING HEIGHT TO MATCH EXISTING � p Z cn FM F0 lUi 1 J_I00 ch 1I_l1.IL L1.f. I ! I QQ Q Q 00 n W x lt.(��L �.1L1 Z1.� w LW...)1._. I NEW BOXED-OUT 1l1L1L1L11 ' 1 i WINDOW Q LAE U� I I I �I li I I !I !�! t , i � O � 11_1L l i_ I I I ! f I11 51UBFLOOR FLOOR i i 11 ! 1 1 }_llJ1 1L1L11 1 11 I1 L11 t I I1 I a l 1LLL1{ NEW CORNER BOARDS ll 111ill ill Hi IllTO MATCH EXISTING Q CV W - Z a NEW WHITE CEDAR MATCH 51DING TO w O f ISO N T E L E V AT 10 N A CH EXISTING Q a 341_411+ 20' 0" (EXISTING) (ADDITION) r—+ A ►-� A5 +r 0 Q IST7 QEXI5T� 15KI LT.1 I - EXIST. 15KI LTa �► i s s: BATH 1 1 p EXIST. s I � 0 BEDROOM O _STS NEW FEXI EX157: ►.. w EXIST. S GREAT DOOM '` HALL 13ELOVif r� +i z 15T. z 00 c NOTE: 0 x THE PLANS SHOWN ARE EXIST. THE SOLE PROPERTY OF MASTER THE DE5IGNERAND CAN ,.. , p NOT BE COPIED, BEDI\OOM O ' REPRODUCED AND/OR r ALTERED WITHOUT THE EXIST. . _ O �1� �'�'a,_.� ,:. EXPRESS WRITTEN w BEDROOM \ CLS. P s, ~� CONSENT OF THE DE5IGNER t SCALE 1/4„ _ 1,-0„ J DATE N 2/14/2018 A PROD. NO. - 10, 34'-4°+ A5 2017-8012 20'-0" (EXISTING) (ADDITION) STAMP: DWG. NO.: SECOND f:L00KPLAN (S) NEW/ EXIST. SMOKE/CARBON MONOXIDE DETECTORS 0 5 i O 15 20 CA2 )COPYRIGHT 2018 l BY THOMAS A. MOOKE DESIGN CO. �t: 00 Lo Lo w _._ 0 w O NEW ROOF SHINGLES Q Q; TO MATCH EXISTING —�- �+ Q 0 �D Z NEW FASCIA * FRIEZE BOARDS Q TO MATCH EXISTING - CEILING HEIGHT _ Z NEW CORNER BOARDS Imo fli. 1 . 11_L1__11L-1� L1 ( LLL �, O� TO MATCH EXISTING WL l .. (� 00 NEW WHITE CEDAR W Q oO SHINGLE SIDING TO ! w p MATCH EXISTING } I I Z i l._ FIRST FLOOR L� € Ef 5UBFLOOR N Q Q N r ca LQ REAR ELEVATION w ° ooe o � o cf) Q NEW RAKE DRIP BOARDS I i TO MATCH EXISTING Aoo w ►...a } rti M W W ADDITION I � � CEILING HEIGHT I ( I€ i I , ••� ~"� I} 0t, o_LLimAi �+ UA } } CEILING HEIGHT (L1 I 15 �11ll�1L1lLLh Q � oW o ll I� 1J :l-LL111hJ1? - 0 1111 I LL!9L1a 11 ° NEW CORNER BOARDS NOTE: TO MATCH EXi5TING .1.1� THE PLANS-SHOWN ARE Q Hill 11 if THE 50LE PROPERTY OF z I ( I I 1 NEW WHITE CEDAR THE DESIGNER AND CAN } I I SHINGLE SIDING TO NOT BE COPIED, w I MATCH EXISTING REPRODUCED AND/OR ALTERED WITHOUT THE 1 I 1 EXPRESS WRITTEN LULILIUL111 J u1LL CONSENT OF THE FIRST FLOORIEIHM DE5IGNER 5UBFLOOR E ii l II SCALE l I __I. Ili i i i Sli�-1 I (CLf_I i!I tl [i it 1 I i( 11 F-0° DATE 2/14/2018 RIGHT 51DE ELEVATION-LEf 51DE ELE V ATIOPROD. NO. 2017-8012 STAMP: DWG. NO.: 0 5 10 15 20A3 O - COPYRIGHT 2018 BY THOMA5 A. MOOKE DE51GN CO. V 00 Z o LO W W � 34'-411-±- 20'-0" (EXISTING) (ADDITION) 70, w 0 E- 0 I-- - - - - - - - - - - - - - - - - - — — � E- I I � G-2" (NEW DEC C,> (� CD cn I IY.A A � W � EXIS► 1T. I 1 2" DIA. 50NOTUBES T3- .. w00 DECKTO 4'0" DEPTH00 �3- P.T. 2 x 8's P.T. 2 x 8'5 P.T. 2 x 8 DECK J015TS @ 16' o.c: " = a Q N ! ° > a � z Q N w +I I W N Z I T. EXIST 1 - c UTILITY EX15T. UTI LITY NOTE: SAW CUT EXIST. WALL ! AS REQUIRED FOR ACCESS NEW ( 'BASEMENT TO NEW CRAWL SPACE N W .. CRAWL 5>'ACE I I EXIST.LAUNDRY (z" CONC. SLAB> I I COpICAL NC FOOTINGOS X 1211 TEEL TYIL ALALLY COLD NS I +► 1ST. z ►-� o ---- EX15T. }- -2 x loG►RT I -1 o Q TYPICAL ! No Q ..ROOM F1 13EAM ----- 2 x 10 FLOOR J0I5T5 I G" O.C. POCKET ' W 06 16A5EMENT ►—� EXI5T. i WINDOW 5TORAGE i IUlw UP DRILL# PIN NEW FOUNDATION TO EXIST. FOUNDATION WALL ^ (f� O TOP * BOTTOM — — — — — I--d 00 IST. - - i- - - - - - - - -- - - - - — Q w N BASEMENT — � u N WINDOW TYPICAL I O"x 20" CONCRETE FOOTINGS NOTE: W/345 BARS THE PLANS 5HOWN ARE NOTE: DROP TOP OF NEW FOUNDATION v "-4" FROM BOTTOM THE SOLE PROPERTY OF TO MATCH NEW 5U5FLOOR W/THE A N TYPICAL 8" CONC. THE DESIGNER AND CAN EXISTING SUBFLOOR,(VERIFY IN FIELD Arj FOUNDATION WALL NOT BE COPIED, W/ 244 BARS AT TOP REPRODUCED AND/OR IF REQUIRED). AND BOTTOM ALTERED WITHOUT THE EXPRE55 WRITTEN CONSENT OF THE i 0'-0" DESIGNER 'ss 3 z t SCALE 34-4n-+ 20'-0" "* 1/4°, = 1°-O,° . - t , (EXISTING) (ADDITION) zi Nol 4 DATE : NOTE: .. MENT 2/14/2018 15ASIE f LOOK FLAN FOUNDATION CONTRACTOR TO PROVIDE 5/8" DIA. ANCHOR BOLTS AT 48 o.c. WITH MINIMUM EMBEDMENT OF 7 PROJ. NO. INTO CONCRETE. ALL 5(LL PLATE5 TO BE CONNECTED U51NG S� NEW/EX15T. 5MOKE/CARBON MONOXIDE DETECTOR5 3" "x3x 1/4" SQUARE PLATE WASHERS. 2017-8012 - STAMP: DWG. NO.: 0 5 10 15 20 A4 ©COPYRIGHT 2018 1 BY THOMA5 A. MOORE DE51GN CO_ 1, ..7/77 2x4 TIE EACHRAFTER PAIR _ _ -IOd NAILSw/EACH END f2 1'�' �0� LONST, 0C C° �. MATCH alltDfE TO WOOD . Cr; EXIST. - 2 x 10 ROOF RAFTERS @ 10 o.c. 2_1 - f/2" CDX PLYWOOD ROOF SHEATHING 110 M IP tit EXPOSURE 0 w 1 r4 Z O U F LVL ROOF BREAK BEAM A5PHALT ROOF 5HINGLE5 (5EE ROOF FRAMING PLAN) '* - 1 5LB. FELT PAPER Z Lj - 8" MIN. SPRAY FOAM INSULATION Table 2. General N.trtrng Schedule --- �, 2 x 8'so.c. @ ROOF RAFTERS (R=49) 1 12 - RIDGEBEAM (5EE ROOF FRAMING PLAN) Z ¢ a? MATCH a : EXIST. 1/2" GYP. 8D. ON `: , Root Framing I x 3 5TRAPPING @ I G" o-c. SIMPSON H2.5 'r i Flocking to Rafter !Toe-rule � ? 8d 2-10d earn end HURRICANE CLIPS BOXED BEAMS `� --51MP50N H2.5 Rtm Board to Rafter +End-r,a�4ed; 2-16d 3-16d each erg: -� - HURRICANE CLIPS VERIFY w/OWNER - --- _-__- ;✓ t< ap Framing {f f ? TOP OF P Top Plates at Intersections :,Fare-nailed) 4-16d 5-16d atoints LAT Stud to Stud ;Face-nailed 2-16d 2-16d 24" o.c- ^� 1 t I . WALL Header to Header (Face-natled) 16d 16d 16"o.c.along edges ;--. �C N E W 1 p n CONST. �' �- 1\>_A� z Joist to Sill Top Plate or Girder (Toe-nailed) (Fig. 14 4-8d 4-1Od =� H g ? per ioist KOOM 2 x G 5TUD5 @ I G"O.C. Blocking to•foist (Toe-nailed) 2-8d 2-1Od each end - !I2" PLYWOOD 5HEATHWG = , Sill or-Top Plate ,T.->e-nailed} 3-16d 4-16d each block z �- _--- BIockrng h - G BAIT INSULATION (R=2 1) -. - 112" GYP. BD. Q .edger Strip to Beam or Girder iFace-nailedi 3-16d 4 16d each joist W, C_ SHINGLE 51DING Jost on t_eager to Bearn ;Toe-nailed) 3-8d 3-1Gd per;o,st '! i---� 3/4" T G PLYWOOD - 'TYVEK' Sand .Joist to Joist End-nailed) ;Ftg 141 3-16d 4-1fid ` SUBFLOOR- GLUED NAILED FIRST FLOOR { y Far}Dist _ _SUBFL00_R Sand -Joist to Silt or Top Plate ;Toe-nailed) (Fig. 14i 2-16d 3-16d ;per toot ^ CC; 2 x 10'5 @. !6" o.c. 2 x 10'5 @ I G" 0-46677 518" DIA. ANCHORBOLTS AT 48"o.c. Root Sheathing 3-2 x 10 GIRT Wood Structural Panels rafters or trusses spaced up to 16"o.c. 8d 1 Od 6" edge/6" field TYP. 3- 1/2" DIA. -TY BA r,,rl �vT PICAL 8" CONC. STEEL LALLY COLUMNS I FOUNDATION WALL rafters or trusses spaced over 16" o.c. 8d 10d 4" edge/4" field - 1 w/ 244 BARS AT TOP 2* CONC. SLAB ; AND BOTTOM gable endwati rake or rake truss w/o gable overhang 8d 10d 6" edge/6" field gable endwall rake or rake truss w: structural lid 10d 6" edge/6" field -TYPICAL 10"x 20" outlookers _'---TYPICAL 30" x 30"x !2" ' ' ' - - CONCRETE FOOTINGS ante en:ty al; rake or rake truss «r:' lookout blocks 8d 10d 4° edge/4" field ^ L CONC. FOOTINGS W/345 BAR5 g g "-4" FROM BOTTOM Ceiling Sheathing 3 U I L D I N G 5 1-CTI L.,./ 1 V �..�' N E V Y GREAT R V I . Gypsum 4WailGoard 5d coolers 7" adge ; 10" t,eid-- _ WAN Sheathing Wood Structural Panels ' studs spaced tip to 24" o.c- lid 10d 6" edge ' 12" field 1.;2" and 25!32" Fiberboard Panels 8d 3" edge/6" field 20'-0" y -+- (ADDITION; t%2'' Gypsums, Wallboarri 5d coolers 7" edge 1 10' field '-- � r r Floor Sheathing :-•-. J I Wood Structural =`:ainels i 1" or less 8d 10d 6"edge/ 12" field - -t greater Irian I" 10d 16d 6" edge/6" field -��-- � Corrosion resistant?? 7a;=roofing Waits and yg gage staples are perfmtlQd,check it3C for additional requirernent; ^• ! —:, Ie ,. I ! I 1Vati< Unless otherwise staters, sizes given for nails are common wire sizes. Box and pneumatic nails o4 equivalent ,�` F � ;,,�, diameter and equal or greater length to the snecified common nails may be substituted unless otherwise pronibited. 2-1 /4 x - T F 15 AK rXlSTING RI TO REMAIN __ _�— - _ -_ 2 I `/4" x 14" 'vL OGE EAM _ Q 1 , Z' THE PLHtJS SHOVsly' AK a +. I J THE SOLE PROPERTY OF THE DE5fGNER AND CAN NOT BE COPIED, REPRODUCED AND/OR of ALTERED WITHOUT THE { — I T EXPRESS WRITTEN EXfSTING ROOF RAFTERS ,O REMAIN CONSENT OF TF _ NN t � f �� �� ©�'Jk_ lam'r D�51Cf' k', 38962 , 1 /4" 1 -0 UA1E : 2/ 14/201 � - --- --- - -- -- ----- ROOF fKAMING FLAN 201 i-8012 20`-O" ii ( _ - - --- (ADDITION) - - ---- --- - -- -,f ,� 1 . 'v1 P: d G, :ti O-: "DOTE 1 : ALL ROOF RAFTE�--',5 TO BE NOTE 2: ALL DOORIWINDOW HEADERS TO BE 3-2 x G 2 x 10'5 @ I G" o.c. UNLE55 UNLESS 0ThERW15WE NOTED OTHERWISE NOTED NOTE 3: ALL CEILING JO15T5 2 x 8 1 G" ox. A 5 20 t )COPYRIGHT 2018 '� - -- -- �� --� -- — - BY THOMAS A. MOORE DE51GN CO. �-�--T`.-.e�..-.p.-,-„�....'... IFS" �__�..,_.,,.-�_.�..._,.-.,...•._�,_._-__,.,.,,_ ......,...,�..—�,��--�_,_.._. -,. —. •_ - --- ---. --- : . - _. . - _ -- - - ,. DRAWN BY j , -� �� ----�._ _...�... .— 1. � ta- �2,�,.,s=-� w��r•.r�-ru_ �+ • t-' Fw� / IF 111 1 `4 � M••^ 5 • . t _ �_ '•-• - -rwa,.r_www+ ..» ' �. ; ` �. .} ! k:Y�. 1 v't.4V'..MJ'\�� .�1 lA- � •'L_�w i f f r E L - t��+Fu yy}i ' V i : i ,. �._L+ii:?�4'li.. �Le3 %�.i � 44„_°"�y-�'�""c ',4"1•�:, •S,� � � f � L.1. 4,�� A� P01, ° CLASSIC COLUMNS, 10" X 101 FLITTED _ TUSCAN CAP&ATTIC BASF: �+', -,ti �:!«- =�.3 �"-"'{.. a'��.., '�""?"gs:':ck.•C.,,"`;''?t a t:r:. ;� � 'Tel` k 6, i tj Ic G.'�•y q""/.. �1!'l 1 �s lye!' � k � Y� ,[T� �✓ �! r r p } ' ` ,� ,. SANCTUARY FLOOR PLAN "1 L'� '�.._''•Ac.�'4 r•�C _ ''•L�+i..�L.J�•.'s��,`y 11�' '�.r� ..��`i _ '�•"4:i.J" � � -��. I �.. � _ � 3 '"�rz .,.tom- cf"( __ --_T...�.._ _..__._..__._.__._.. � 1 � _.•_--f". �t.CC jL tlb +�.r�: � _.cr .,..t � 4 � G—u r Ll • i �' a v `_ `` �` � _____ ..�..- .....�_ -„�-.•,. .�,:,1.....! 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