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0033 OAK HILL ROAD
33(��ll /Zoat�' --- PP r Town of Barnstable Regulatory Services Thomas F.Geiler,Director '"x"AS& ` Building Division �16.19. � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# <::)O FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less �4"V III 1 t(� Location of shed(address) Vi llag - _ 4 Q Property owner's name Telephone number r —� NJ V' Iox 3 Size of Shed Map/Parcel# qo . Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg \ �� REV:052813 J `oFtNE rtio� Town of Barnstable ' Regulatory Services BARNSTABLE. ' 9 MASS. 1639. �0 Building Division prFD MAy a. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 ; rt Inspection Correction Notice Type of Inspection Location 3 Soo k 14 A Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 3ea� V ✓ U � 1j u Ven+ RO� i/ jT4Iled 4 QL4T J 7 U I A� It1GSA 110C�"n� no`' "As7WJe-Q' ��rD DC.rlt� �TUo �ucv) a /w Please call: 508-//862-40038 for re-inspection. Inspected byl --- Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parc � Application #z©I ) Health'Division Date Issued 5 C7 Conservation Division Application Fr 5 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board t Historic _ OKH Preservation / Hyannis Project Street Address Village N Q h t-kt�-\i " Owner �L �- 'Q-�l`�1 J4 dh Address„`� dA Telephone S 646- -Iq --'t Ck Lklk i r Permit Request F A& ����� o-4'M e_d - Square feet: 1 st floor: existing A5kproposed 2nd floor: existing Qproposed ��Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 600 Construction Type Woo 0 '-rI^M� Lot Size X 510 oQ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family . 11, Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes *No On Old King's Highway: ❑Yes 10 No Basement Type: '.Full ❑ Crawl )k.Walkout ❑ Other Basement Finished Area(sq.ft.) C CD Basement Unfinished Area(sq.ft) Number of Baths: Full: existing_ new _ Half: existing a new C) Number of Bedrooms: existing Q_new Total Room Count (not including baths): existing _! • new _First Floor Room Count Heat Type and Fuel: )(Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ),No Fireplaces: Existing _New Existing wood/coal stove: ❑Yes `kNo 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 ❑ f,- CD Commercial ❑Yes ❑ No If yes, site plan review# "�' Current Use \� �\ -�- Proposed Use 5 APPLICANT INFORMATION ' �, rn (BUILDER OR HOMEOWNER) Name t L � �`� Telephone Number Address "� �^ License # (a d 3 M Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION EBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO QAZSeA^ i tL SIGNATURE DATE _ l l ^ FOR OFFICIAL USE ONLY + APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE- OWNER DATE OF INSPECTION: ># FOUNDATION a :r FRAME 06111118,W M (ph 0 �I �9Qo Ayf INSULATION (,Ilje')Io FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING { DATE CLOSED-OUT- ASSOCIATION PLAN NO. � a f �• Commonwealth o Massachusetts The Cotnrzzonw f .Department of Industrial Accidents 1 Office of Investigations 600 Washington Street t� f Boston, MA 02111 r y� www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information -Please Print Legibl3 Name (Business/Organization/Individual): �)4jv*Ale— Address: .�� \A City/State/Zip: C� Az.r \\ p )% A�5 Phone #: �iGfC® Are.you an employer? Check the appropriate box: Type of project(required): 1. 1 am a employer with 4. ❑ I am a general contractor and 1 6 ❑ New construction have hired the sub-contractors employees(full and/or part-time).* 2.ElI am a sole proprietor or partner listed on the attached sheet. 7. ❑ Remodeling These sub-contractors have g, ❑ Demolition ship and have no employees- loees and have workers' working for me in any capacity. empy 9 [J Building addition [No workers' comp. insurance comp. insurance.$_ required,] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additi 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additi 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 41 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. tContractors that check[his box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insrrance for my employees. Below is the policy and job site information. Insurance Company Name: �,� a-A \ Policy#or Self-ins, Lie.#: — ® Expiration Date: 8—�S\"\d O Pt ��� 'R, ty p� �t Job Site Address: '3'� �_ Ci /State/Zi �/r Attach a copy of the workers' compensation policy declaration page(showing the policy number and p�rafia f Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby under th n nd p nalties of perjury that the information provi d abo is true and correct Si nature: Date: s art pC.) Phone.#: SOW- 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 S. Plumbing Inspector .6. Other rantact Pers'on: Phone#: 1i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employeedefined is dened as "...every person in the service of another Linder 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 affidavi 11 t completely, by checking the boxes that apply to your situation and,.if necessary, supply sub-contractors)name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confimnation 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 pen-nit or license is being requested,not the Department of Industrial Accidents. 'Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(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 burn leaves etc.) said person is NOT required.to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia F � r T aw. of Barnstable' Regulatory Services Thomas K Geiler, Director .9, id.A.B.4. .. i 619Lm Fo A, Building ;Division Toni Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 wvww.to-wn.barnstable.mo.us Office: 508-862-4038 Fax: 508--7 e must Property O�arn :r� p � Complete and Sign This Section zf Usin ABuilde •� )'\�'.N`(` , as Owner of the subject.property .. hereby autho to act oa my 6ebA i.a all matters ielative to work authorized by this building permit application for � � rays A SM (Address of job) Signature of Owner ate Print Namc if property Owner is,applying for permit please complete the Homeowners License Exemption Form on the reverse "side. Town of Bar-ustable of THE r N� " Reg�xZatozy Services s�xx Thomas F. Geiler, Director sn'ac.e. Building Division EO,yN'1 h Tom Perry,Building Commissioner. 200 Maid-Streeii H annis, N.a 026.01 P�rY,,�y.town.barnstabie-ma.us. Office: 509-962-4038 Fax: 508-790-6230 HOl IEC)*V NER LICENSE EXEMTTION Plcase Print DATE: JOB LOCATION: village, number street --—HOM$OWNER": name work - one# home phone# I CURRENT MAILING ADDRESS: city/town state rip code i The current exemption for"homeowners" was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEkTNTTTON OF HOIYLEO'SVNEI2 pergon(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 bt responsible for all such work performed under the buildin>7 permit. (Section 109.1.1) Tht undcrsigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeoner"certifies that-he/sbc understands the Town of Baznstablc Bui•Iding Dcparttpcnt w minimum inspection procedures and requirements and that be/sbc will comply with said procedures and rcgtti emcuts. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic fcct or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOW7' R'S EXEMPTION The Code stales that "Any homeowner performing.work for which a building pemot is required shay be exempt from the provisions of this scction,(Scction 109.1.1 -Licensing of cc nstruction.Supervisors);provided that if the homcowner cngagcs a person(s)for hire to do such work that such Homeowner shall act as supervisor." Many hortieowncas who use this exemption arc unaware that they arc assuming[hc responsibilities of a supervisor(sec Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.1 S) This lack of awareness`often results in serious problems,particularly when the homeowner hires unlicensed pertons. In this ease,our Board cannoten proceed against the unlicsed person as it would with x licensed Supervisor. The homeowner acting as Superrisor is ultirnatr)y responstblc. To ensure that the homeowner is fully aware of hislhcr rcEponstbilitics,many communities require,as part of the permit application, thal the homcovrner ccrtify that helshe understands the respanstbi)i6cs of a Supervisor. On the last page of this issue is a,form cumrnlly used by several towns. 'You may care t amend and adopt such it forrr)ccrtification for use in your community. e '1'CS FY .. d' t v r f � k it -tr\\� \1�1 ti en t\n \ d ti Dcp �t�ons,u� \GenSe ., u�1 R� erv�s°r oacd°t B �Clon sup r B u Consts 00 .1 Restr`cteato: 51 AN�EY p R pEAN rp N ETA�N 359R����E,MP 111912012 lratio A � i GE EXP tom. 1233 � p Valr�iriyooz•ae� o� Board of Building Regulatiods and Sta` HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only � q before the expiration �`' � Registrat on: P n date.ate. If found return Board of Build' rn to: � Ex irat► m Re u P _ on 11�28�2010 g g lati30 and Standards Tr# 278pgg One Ashburton Place Rm 1301 r Type t)ONidual Boston i E ,Ma.02108 � 3 DEAN F. STANLEY DEAN STANLEY� 359 CAPT. LIJAH RD1'I CENTERVI LLE,MA 02832-�._ dministrator -- � ,xt_ ,I Not valid without si _ r AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 33 OAK HILL ROAD HYANNIS Q Check Compliance IX SCOPE WindSpeed(3-sec.gust)...................................................................................................................110 mph Q WindExposure Category................................................................................................................................B Q 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) ..... 1 stories <_2 stories Q RoofPitch ..........................................................................(Fig 2) ...................................................3 5 12:12 Q MeanRoof Height .....................................:...............................(Fig 2)..................................................15 ft 5 33' Q BuildingWidth,W .................................:............................(Fig 3)................................................. 24 It 5 80 Q Building Length, L ..............................................................(Fig 3)...:..............................................38 ft 5 80' Q Building Aspect Ratio (Fig 4 1.75 <_3:1 Q Nominal Height of Tallest Opening2 ..........................................(Fig 4).................................................6'-8"5 6'8" Q 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ Q 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. N/A ConcreteMasonry.................................................................................................................................... N/A 2.2 ANCHORAGE TO FOUNDATION"' 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ................................. ........(Table 4)....................................................... in. N/A Bolt Spacing from endfjoint of plate ............................(Fig 5)........................................12 in.5 6"—12" N/A Bolt Embedment—concrete........................................(Fig 5)..................................................7 in.>_7" N/A Bolt Embedment—masonry........................................(Fig 5)........................................... in.z 15" N/A Plate Washer...............................................................(Fig 5)..............................................z X x X x'/4" N/A 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Q Maximum Floor Opening Dimension...................................(Fig 6)........................................—12'-0"—ft 5 12' Q Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... N/A Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)...................................................—ft 5 d N/A Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)...................................................—ft <_d N/A Floor Bracing at Endwalls...................................................(Fig 9)................................................................... N/A Floor Sheathing Type .......................................................(per 780 CMR Chapter 55).................................... N/A Floor Sheathing Thickness ................................................(per 780 CMR Chapter 55)..........................314 in. . .. . N/A Floor Sheathing Fastening..........................:.......................(Table 2)............8 d nails at 6 in edge/12 in field N/A 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5).........................6'-6"ft <_ 10, Q Non-Loadbearing walls................................................(Fig 10 and Table 5)...............................8 ft <_20' Q Wall Stud Spacing ........................................................(Fig 10 and Table 5).....................16 in.s 24-O.C. Q Wall Story Offsets ........................................................(Figs 7&8)...........................................—ft 5 d N/A 6 e) -AWC Guide to Wood Construction in High Wind Areas: I10 mph Wind Zone Massachusetts Checklist for Compliance (780 CNtx 5301.2.1.1)1 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(Table 5)..........................................2x4-6 ft 6 in. Q Non-Loadbearing walls................................................(Table 5)........:.................................2x4-8 ft 0 in. Q Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10).................................................................. Q WSP Attic Floor Length...............................................(Fig 11).............................................. ft?_W/3 N/A Gypsum Ceiling Length(if WSP not used)..................(Fig 11)..............................................24 ft>_0.9W Q and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. .. (Fig 11).............................. ............................... N/A or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Q Double Top Plate Splice Length ........................................................(Fig 13 and Table 6).........................................8 ft Q Splice Connection(no.of 16d common nails).............(Table 6)..............................................................6 Q Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Tables 7)............................................................2 Q Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Table 8)..............................................................3 Q Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)..........................................6 ft 0 in. <_11' Q Sill Plate Spans ........................................................(fable 9)..........................................3 ft 0 in.<_11' Q Full Height Studs (no.of studs)...................................(Table 9)..............................................................3 Q Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9)..........................................8 ft 0 in.5 12' Q Sill Plate Spans...........................................................(Table 9).................................._ft_in.<_12" N/A Full Height Studs(no.of studs)...................................(Table 9)..............................................................3 Q Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 .........................................................................6'-8"5 6'8" Q SheathingType.............................................(note 4)..........................................................WSP Q Edge Nail Spacing.........................................(fable 10 or note 4 if less).............................3 in. Q Field Nail Spacing.........................................(Table 10).....................................................12 in. Q Shear Connection(no.of 16d common nails)(fable 10)............................................................4 Q Percent Full-Height Sheathing.......................(Table 10)....................................34%for one floor Q 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts) Q Maximum Building Dimension, L Nominal Height of Tallest Opening2.....................................................................6'-8"5 6'8" Q SheathingType.............................................(note 4)..........................................................WSP Q Edge Nail Spacing.........................................(fable 11 or note 4 if less).............................3 in. Q Field Nail Spacing.........................................(Table 11).....................................................12 in. Q Shear Connection(no.of 16d common nails)(Table 11)............................................................4 Q Percent Full-Height Sheathing.......................(Table 11)....................................13%for one floor Q 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... N/A Wall Cladding Rated for Wind Speed?....................................................................................... Q i 5.1 ROOFS AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Q Roof Overhang ...................................................(Figure 19)..............2/3 ft s smaller of 2'or U3 Q Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12).............:................................ U=236 pif Q Lateral.............................................(Table 12)...............................................L=176 pif Q Shear..............................................(Table 12).................................................S=77 pif Q Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T= plf N/A Gable Rake Outlooker.........................................(Figure 20)............._ft s smaller of 2'or U2 N/A Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. N/A Lateral(no.of 16d common nails)...(Table 14).......................................L= lb. N/A Roof Sheathing Type........ ....... ....................................(per 780 CMR Chapters 58 and 59) ............ Q Roof Sheathing Thickness........................................... ...............................................5/8 in.z 7/16"WSP Q Roof Sheathing Fastening...........................................(Table 2)............................................................8d Q 33 OAK HILL ROAD MEETS THIS CHECKLIST THEREFORE THE FOLLOWING NOTE APPLIES: Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment -A WC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7go CMx 5301.2.1.1)1 NGUMBdNAt AT6'�o.c. 11 11 • 11 11 �1 11 u Id 11 11 II 11 11 11 11 11 1 11 11 1 / 11 11 K6 11 11 11 I l 11 li 11 IF, 1 F is i i o Ed m h ii Q I 11 OF 1 17 /1 Q 11 11 � fl 1I 1 1 1. 1 IIU ii 11 g - 1 Z 71 I l O Q it II O� d 41 v 1 f 11 11 a Ir 11 W V u 11 F 11 11 3 N r 11 tl 11 it 11 i OOLIM EDGE --- -----NAILS'PACM i PANEL a j� See Detail on Next Page Vertical and Horizontal Mailing for Panel Attachment -A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)1 Q t i 1 1 1 1 � dCL 1 1 d �a kl I1 ' FRAMING MBNlBERS 1 ' EDM R /EMT£ t l i � � 1 k k 1 1 ` -L_ 1 1 ssA 3'Mrd. iWULPATTERN � P/WEL �PA1 :/ Z oo m-NAjL SPACM UETAL Detail Vertical and Horizontal Nailing for Panel Attachment v ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 cNm 61.00) Applicant Name: Site Address: print Town: Applicant Phone: Applicant Signature: Date of Application: NEW CONSTRUCTION: (choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAX' VH M MINIMUM El Option 1• Ceiling or Slab Basement Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth R-10 National Appliance Energy .35 R-38 R 19 R 19 R 10 Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or greater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. Option 2• REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energycodes.gov/rescheck/ ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall& Ceiling Area equals Formula: (100 x b=a) 0 SF — 100 x — 1 % of glazing (b) Glazing area equals SF b a If glazing is :5 40% use the chart below. If glazing is>40 % proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MINIMUM Fenestration Ceiling and Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth .39 R-37 a R-13 R-19 R-10 R-10,4 feet a -30 4eiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire teffidg area(i.e.not compressed over exterior walls,and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) �, � �{ r .,- � -4_ _ _. f {.. r. . 1 t` .. .. 1l T-..., k } _ , � -,. • z i • � � �. �. • - - ., t _ .. ,. '� From:Kathy'Geddis FaxID:NOrthWOOd Insurance Page 3 of 3 Date:9/23l2009 11:37 AM Page:3 of` 9/4/2C09 11:00:02 AM PST (GMT-8) FROM: insurancevisions.com-TO: 15083932955 Page: 3 of 3 AG4:>R0 CERTIFICATE WI)D1YYYYI OF LIABILITY INSURANCE 009 PRODUCER NORTHWOOD ESHBAUGH INS AGCY INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 540 MAIN STREET SUITE 9 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HYANNIS, MA 02601 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (508)540-1223 INSURERS AFFORDING COVERAGE NAIC# INSURED DEAN F STANLEY BUILDING CONTRACTOR INC INSURER A; LIBERTY MUTUAL 359 CAPT LIJAHS ROAD INSURERB: CENTERVILLE MA 02632 INSURERC: INSURER D: INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'L POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER FRS GENERAL LIABIIUI Y EACH OCCURRENCE $ A COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS MADE OCCUR ME EXP Any on person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS•COMPIOPAGG $ POLICY 7 PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE UABILTfY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC1-31 S-374314-019 8/31/2009 8131010 ,� 1 we STATU- OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECLITIVE E.L.EACH ACCIDENT $ 100000 OFFICER/M(Mandatory in H)EXCLUDED? ® E.L.DISEASE-EA EMPLOYE $ 100000 (Mandatary in NH) If yes,desrnbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The workers'compensation policy provides coverage only for the state of MA as noted in section 3A of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN OF YARMOUTH DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 7 DAYS WRITTEN 507 BUCK ISLAND RD NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL WEST YARMOUTH MA 02673 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATWE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- y Parcel Application # Health Division Date Issued Conservation Division Application Fee //7'sol Planning Dept. Permit Fee l� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address s d Iq Y,_ v Village \ r�, Owner_ UiA-4\k A. 8 Address Telephone _105 6S_`-c�`l Permit Request c7 CDO Square feet: 1st floor: existing proposed �� :12nd floor: existing( proposed �Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0.60 0 Construction Type �Jo Lot Size \®.000 Grandfathered: )Ct.Yes ❑ No If yes, attach supporting`documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) ' cr, L Age of Existing Structure Historic House: ❑Yes %IL No On Old King's ighway❑Yes No Basement Type: .Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)l QSNO Number of Baths: Full: existing 3 new Half: existing (f) new 0 Number of Bedrooms: existing new Total Room Count (not including baths): existing new n First Floor Room Count Heat Type and Fuel: O-Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes _4Mo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detachede: ❑ existing ❑ new size Pool: ❑ existing ❑ new size — Barn: ❑existing ❑ new size_ Attached garage: O existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes f/ No If yes, site plan review# Current Use Proposed Use �Q1 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ T Name, J -e Telephone Number a Address f� \ License# a �6_5;' 0 7��l Home Improvement Contractor# \Jz\�N°_ ` Worker's Compensation # - CAW` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S SIGNATURE DATE 5 FOR OFFICIAL USE ONLY APPLICATION# ,r f ' DATE ISSUED MAP/PARCEL N0. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME z INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL j GAS: ROUGH FINAL FINAL BUILDING 2� a s`t DATE CLOSED OUT ASSOCIATION PLAN NO. ` I . t The Commonwealth of Massachusetts Deparfinent of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia U9 . Workers' Compensation Insnrance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information _ Please Print Le 'bl Name (Business/Organization/individual): t _ Address: S� ' City/State/Zip: �QK 1����\�/`�\/� Phone.#: Are you an employer? Check the appropriate bog: Type of project(required): 1Tq-Lam a employer with '� _ 4• ❑ 1 am a general contractor and T 6. ❑New construction employees (full and/or part-time).* have hued the sub-contractors Remodeling 2.❑ I am a•sole proprietor or partner- li fed on the attached sheet 7• ❑ g ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp,insurance comp. insurance.t S. ❑. We are a corporation and its 10.0-Electrical repairs or additions required.] _ a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I myself. [No workers' comp. right of exemption per Iv1GL 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 arc doing all work and their hire outside;contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state wbether or not those entities have employees. If the sub-contractors have cmployces,they must providt their workers'comp.policy number. lam art employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: ��3e — Policy#or Self-ins.Lic.#: \ Expiration Date: � Job Site Address: A-�� � ��� City/State/Zip: t, �l t Go Attach a copy of the workers' compensation policy declaration page(showing the policy numb and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of rrimirial penalties of a fine rip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations o e bIA for' urance co era e verification. I do hereby under th ai -and enaltzes of perjury that the information provided above is true and correct. Si afore: Date: Phone#: O 40;L - -5 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/Toytm CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other -Contact Person: Phone#: Information and Inst °Uctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees, However the owner of a dwelling house having not more than three apartments and who resides therein, or the 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 form 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, i necessary, supply sub-contractors)name(s),address(cs) and phone number(s) along with their.ccrti.ficate(s) of insurance. Limited Liability Compannies(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 requited. Be.advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for.the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their, self-insurance license number ou the appropriate line. City or Towti 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/licensc 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 onF 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 oz 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_Whore a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitato to give us a call The Department's address,telephone-and fax number: The ebmm.ozzw th of Massarh=tts Department of Indust dO Accidents Office of Investigations 600 Washington Street Boston, ILIA 02111 Tel. # 617-727-490.0 ext 406 4r 1-M-MASSAFE Fax# 617-727-7749 Revised 11-22.06 www.mass.gov/dia r 1 , .y �oFYHEr°�L Town of Barnstable Regulatory Services � MAS& ' ; Thomas F. Geiler, Director a'pl�bNw�a�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsUble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property- Owner Must Complete and Sign. This Section. ff Using .A.. Builder as Owner of the subject property hereby authorize S� \e ' to act on my behalf, in all matters relative to work authorized by this building permit application. for: r (Address of Job) i Si ature of Owner Date 4�tis� Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �op•(He rq�� Regulatory Services w sARtvsTAatE r Thomas F. Geiler,Director fl MASS. %679. Building Division �TfQ �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis., MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street villagc "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,Provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures, A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on.a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under tt e building permit. (Section 109.L 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 Deparhnent minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor," Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor: The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. �'/ze -�om+mzo7uuea� o���aaaa�uaeCla " Board of Building Regulatio s and Standards License or registration valid for individul use only ' HOME IMPROVEMENT CONTRACTOR before the Expiration date. If found return to: Board of Building Regulations and Standards RegistrAttion;�132149 One Ashburton Place Rm 1301 \ Expiration 11/28/2010 . Tr# 278086. Boston,Ma.02108 i` ype I tlividual �ss 1 DEAN F.STANLEY - � � DEAN STANLEY ` 359 CAPT.LIJAH RD.; 4signa Not valid Y CENTERVILLE,MA 026321 Administrator 4 5 t i r Board of Building Regulations and Standards ;1 s k Construction Supervisor License h � f Af Lic6rrt e: CS 35037 I Exp(rati n 9/2010 Tr# 12342 8 i vKk -Y, - <n Restriction OOS Ei z DEAN F' STANLEY � 1 I �. - f s 359 CAPTAIN LIJAH: Df��- CENTERVILLE,MA 02632"' zm3 + Commissioner ro ;��? r 141. tar � 5 4. 4 h 7 t »A syt - ���. V' A;AW ; 'z a r c 'xv�3r a 8 9 , s t f d 0. 1 •}i ? �•h °a �w � _ _ OP r;t a31 ''4 "4 wt VHI ��� v $ # 'x, , }, }� r S•..hv 454 rt Z �Na h to z• r � :t S� F' SV\a n.\- 1A Mn 3� IQC . _ n gg� i er5 W aP'raCM� j _ a- � ' Gc10, 2(a ATM CERTIFICATE OF LIABILITY INSURANCE 09/02/zoo s.e508-398-6033 FAX 508-760-1667 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5rn Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 19 Station Ave HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. So Yarmouth MA 02664 Cynthia Jenks INSURERS AFFORDING COVERAGE NAIC# INSURED Dean Stanley INSURER A: St Paul Travelers 39357 359 Capt Li j ahs Road INSURER B: Centerville, MA 02632 INSURERC: INSURER D: - INSURER E: COVERAGES THE POLICIES'OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT-WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDT TYPE OF INSURANCE. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONJLTIL Asa DATE(MMIDDIYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $- CLAIMS MADE F-]OCCUR - MED EXP,(Any one person) $. PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ P PRO- LOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT. $ ANY AUTO (Ea accident) ALL OWNED AUTOS - BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $' ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 7PJUB7699814 08/31/2008 08/31/2009 1 WC STATU- OTH-CRY _ I FIR EMPLOYERS'LIABILITY ORIGINAL TO FOLLOW FROM - E.L.EACH ACCIDENT $ 100,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? CARRIER E.L.DISEASE-EA EMPLOYE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,600 OTHER Dean Stanley excluded for Workers Comp DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS vidence of. Insurance e 96' Hawser Bend 'CERTIFICATE HOLDER CANCELLATION SHOULD-ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER•WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE:HOLDER.NAMED TO THE LEFT; Town of Barnstable. BUT FAILURE TOWAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Building Dept OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Attn ':',Jen AUTHORIZED REPRESENTATIVE Cynthia J Jenks ACORD 25(2001/08) FAX (508)790-6230 ' ©ACORD CORPORATIONA988 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a Parcel ( Application# Db- � Health Division Conservation Division ��� Permit# Tax Collector Date Issued 3,a �� Treasurer Application Fee d'D Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ® �' 4. Village A.4 Cv4 rt Owner ���` �� Address 33 CW_ Lu oeo�l Al�r 100 AV Telephone Permit Request Ke— CQA4er CIg/ ` A9 (Ppu.� 7 0 eOn a(Ld op cu a.-/L 3' ©VA?-r pa-K- Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size e` `—a j Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 77 Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# = Current Use Proposed Used BUILDER INFORMATION c� / Name Sc �J��n �� Telephone Number (9 Address ` %J �� � License# CS 1 O '7 3 S akk (lug 6,�.(s 4 Home Improvement Contractor# W� b Worker's Compensation# v (9c L(r7 - ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C4pq= CPJ 4Cf 9t e 4, a,4,ej SIGNATURE 02- DATE `�c�- FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS -VILLAGE ~ OWNER DATE OF INSPECTION: FOUNDATION FRAME 1 INSULATION " FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. o. - A rrc {rVrr LrrLVlL/YGwLLlL vJ triwuu wL rL wu GLrN o� Department of Industrial Accidents r; Off ce of Investigations ' 600 Washington Street' Boston,MA 02111 w iiwww.mass.gov/dia ' Workers" Compensation Iaasursme Affidavit: Builders/Contractors/]Electricians/Plumbers A licaut Information tt Please Print Le ibl Name(Business/Orgmization/Individual): . �� �� C1�t!'�"o • O ' —�(lZn S ' •Address: hZ\ �y U�• rQ 1 Wc� City/State/Zip: ¢-�c eS-�-o�e VI/LCJL-�ac�PhE ne:#: e ou an employer? Check the'appropriate box: -Type of io'ect(requited):. 4. I am a general contractor and I p 1 I am a employer with � ❑ g 6..❑New construction . employees(fall and/or part time).* have hired the sub-contractors 2.j] I am&'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. []Demolition ' working for me in any capacity. employees and have workers' •�. . 9. []Building addition [No�vorkeis' comp.msurance comp,insurance. required-] 5. Vine are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing ill work officers have exercised their 11.El Plumbing repairs or additions myself [No workers'comp. right of exemption per exercised. 12.[]Roof r airs insurance required.]t c. 152,§1(4),and we,have no employees. [No workers' . 13:❑Oth � Y __rRip �-� - comp,insurance required.] j6 C,k v en *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ® ®0 • `it nr t Homeowners who submit this affidatiit indicating they are doing all work and then hire outside contractors m mit ust sub a new a davitindieating such. V J :Contractors that check this box must attached an additional sheet showing the name of the'sub-contractors and state whether ornot those entities have employees: If the sub-contractors have ernploy�es,they must providd their workers'comp.polidynumber. I qm an employer that is providing workers'compensation insurance for my employees. Below is.the pantry and jab site information. Insurance Company Name: A^-Cro CO-n Policy#or Self-ins.Lic•#: G,-LEI �� Expiration Date: 1 C�K G a`�� d` lob Site Address: �� S, City/State/Zip: ® c Attach a•copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required tmder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator, Be advised that a copy of this statement maybe forwarded to the Off ce of - - Investigations of the 1DIA•for insurance coverage verification. I do hereby Gerd under thepain ndpenalties of perjury that the inform.atianprovided above is true and.correct, Si &tare:. ( Date: Phone#: _ OL ®ff cial use only..Do not write.in this area, to be completea by city or town officiaL City or Town: Permit/License# Iss•,iing Authority(circle one), :1.hoard of Realth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other ContactPerson: Phone#: Information and Inn" t tuctions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of anther under any contract of hire, express or implied, oral or written." An ernployer 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 T eivPr nr trustee of�an individual,partnership,association or other legal entity, employ' -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." M(aL 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,Md.L chapter 152,.§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for they erformance of public work until•acceptable evidence•of eomplizriee 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-contiactor(s)name(s),addresses) and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies•(LLC)of 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. B.e advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or.license'is being requested,not the Department of Industrial Accidents;- Should you have any questions regarding the law-or-if you are require$to obtain a workers.' compensation policy,please call the Department at the number listed below. Self-insured companies should-enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact'you regarding the applicant Please be sure to fill in the pe:mit/license number which will be used as a reference number. In addition, an applicant. that must submit multiple permittlicense 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 io 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 f please do not hesitate to give us a can. The Department's address,telephone-and fax number:- �,,CQMMOIIWalth of Musaf,bus�tts ��g t of fal A.oeic�=ts' Office cif Inw-stigations 6GO Washington Strut Boston,MA€}:2.111 T6.#617-727-490.0 ext 406.ar 1-'Q77- ASSAFE Fax f 617-727-7749,. Revised 11-22-06 mass. ov/die I . . g °FTM ra 'Town of Barnstable Regulatory Services " MSrAB Thomas F.Geiler,Director � Mass. g �ATfD MA+p�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: G 1`' Estimated Cost Address of Work: ^n Owner's Name: r V` C,ytA- - - Date of Application: -l �'-� 6 I hereby certify that: Registration is not required for the following reason(s): FWork excluded by law [-]Job Under$1,000 OBuilding 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 WORD 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: - It- - () I _5eco Date Contractor Name Registration No. OR Date Owner's Name Qlorms:homeaffidav PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 11/03/06 TIME: 08:21 +te" -------------------TOTALS ----------------- PERMIT $ PAID 25.00 AMT TENDERED: 25.00 AMT CHANGEPLIED: 25.00 APPLICATION NUMBER: 20064380 T METH: CHECK REF: 6036 EN 6 r OR 2 "Mail ,lra sx k a � f Town of Barnstable A; L_ *Permit# 4AA`�`+ Expires 6 months from issue date r- Regulatory Services Fee I � Thomas F.Geller,Director Building Division I7' Tom Perry,CBO, Building Commissioner NOV ® 2 2006OU 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us TOWNF'� �A 3.3�BLE O { Office: 508-862-4038 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY l� Not Valid without Red X Press Imprint Map/parcel Number rN57 0-73 Properly Address Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Nam Telephone Number�fo 8�_( Home Improvement Contractor License#(if applicable) 4 3 t U Construction Supervisor's License#(if applicable) 035L 3 CS/Workman's Compensation Insurance t Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name /rdl/�t2 �✓�5 : Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) [S"Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Hom rovement Contractors License is required. I SIGNATURE: Q:Fortns:expmtrg Revise071405 'M Board eBu iI� uue�// �� ticfuael� n,,.RZ t.-Iations::u„S. a.:ards HOME I. OVEMENT CONTRACTOR e9�stratr32" �€pira ora �28/2006 pa _ 'dJ�`v�dual DEAN F.STA )e' DEAN STANLEY � 359 CAPT.LIJAH CENTERVILLE,MA 0263 A�Irniuisir.for - �auolssiwwo� .. - 177 Z£9Z0 dW 311IA421N30 i `2 / cl Idldt/0`6S£ yA31N. � S =1 Nb30 i 00 LStitib :ou'. 900Z/6f/l0 said - I 6 I•/6 V a# #JI'a L£09£0 S0 aagiunN NOSIAN3dnS NOI onNlSN066':asuao17 SNOIl\/ln93H EJNlaims jO awoe �avyrr%yo° �o �a x �a y . y C; i 4�g • i � r a LL M1 iky rt The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations k s!1'� `�_ 600 Washington Street Boston, MA 02111 V� www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):TZ V. Address: � C.� S City/State/Zip: Phone #: -1P A u an employer?Check the appropriate box: Type of project(required): 1.Are a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the*sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. g• ❑Building addition [No workers' comp:insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.Z-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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: (t Policy#or Self-ins.Lic.#:_ ��(J 13_-7b990/q—c d6 Expiration Date: r Job Site Address:•b��l �• City/State/Zip: 601fir1(51ffl#-dW0 Attach a copy of the workers' compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce tify er the pains andpenalties ofperjury that the information provided above is true and correct: Si ature: Date: Phone#: of Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �tMe rq� Town of Barnstable LlaNBTABLE, y MA89, ,$ Regulatory Services �F°tea Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ;;Lno W ra �� / , as Owner of the subject property hereby authorize . i� F to act on my behalf, y in all matters relative to work authorized by this building permit application for: (Address of Job) 443 0 Signature of Owner Date Print Name Q:Forms:expmtrg Revise071405 I I ®® I� ®® rn i I I I i�lli y � �!Illi i li.l m rn a ❑ I I '' � II A D ❑ � I ,, I ��I�; I I it o — Ilti 'Ij ®® i�iI� II I iI ( ®® D ( � ol � I o Ewa �im-1 DyC � N ZA� ;Alo EM s p m ®® II I I. 1�A ff i m a � ®® ®® I ' g ®® ' Qt�1 N - \ � ®® to A O 0 o Q P _ ®® I ®® 4'-01 ' ®® T-8 1/2° iA ail I I III ( Iilll i i b'-10°77 bp an DZ Fo O o PROJECT: AT m Z °1 m 33 OAK HILL ROAD, NYANNIS MA FINE L11V E AhGHITECTUIL DESIGN �n Yi 8 WEST BAY ROAD . OSTERVILLE, MA 02055 ELEVATION PHONE: 508-420-1206 ! 01/91/£ TL Mai 'd9 NM` Cl 1001 '9or N'd1d �001� QNOD2S n0—"L9 4 Jo Z 133HG 00—LI o0—.6 .0-,6Z u0—.1I TRMU W D r Z �1 _ -- ---- `" D Goa 14141414 — ;/ '�NI161x3 nZ/I L—i91 Z Jae z 'a j /� ------------------ U) _ Ili o � W a Na .�..-..�Z .,. 1J # WOONCOig # dgd3G e = c p uL/1 E—Im O � ' $Z a � • m N aZ —————— ——-- Ile IV uB—$ n9—i0l ur—.6 nL—Q n0—'s u9-il rr � n0—iL9 1 O � r„ 24'-0° ul 70 Irn • y N m o A N • o C V, tl s D � s r � y � 0 r 'o D z K . o 4_00 m i N O i O 22'-0° 20'-0° D rJ o PROJECT: T m z " M 33 OAK WILL ROAD, �IYANNIS MA FINE LIT E ARCHITECTURAL DESIGl�I ao � W u 0 8 WEST BAY ROAD OSTERVILLE, MA 02G55?, o PLAN PHONE: 508-420-12-OG U � l Z70 D � mr ' o i 0 A O t — D z b 4'_0' rL r 22'-0' 20'-0° Cy ° > �- PROJECT: D m Lo Z 33 OAK HILL ROAD, HYANNIS MA FINELINEARCHITECTUPALDESIGN W o 8 WEST BAY ROAD OSTERVILLE, MA 02G55 PLAN PHONE: 508-420-1236 3 - - -- - - o m O ZI z _9 D rn n AN A 3n `Z O° N S A I O 0 PROJECT: �T �T m m 33 OAK HILL ROAD, HYANNIS MA FINE L11.V E ARCHITECTURAL DE I m S GN W � o 8 WEST BAY ROAD OSTERVILLE, MA 02rG55 U 8 A DETAILS PHONE: 508-420-12gro mmctfilA TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR ELEV. _ ����� 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE (ASSUMED) CLEAN SAND CONCRETE COVERS LOAM AND SE 4" SCHEDULE 40 PVC PIPE MIN. PITCH 1/8" PER FT. �J6 MA 2 4 CAST IRON PIPE MAX. `fig,D (OR 'EQUAL) MINIMUM PITCH 1/4" PER FT. HZa FLOW LINE. 9_J"4wCTo2 ELEV. _ �z -FMN" . ❑ ❑ ❑ o© Oao ❑❑ c P v.M p ,coTZ ELEV: = 9 7i 1147 LEVEL °°°, / p Cam[ cr+T2 ELEV. _ SG GA5 9 O o° ❑ O ❑ ❑ ❑ ❑ ❑ ❑ C7 ❑ C BAFFLE ELEV. _ `T- 6" SUMP. ELEV. SS. 4ALIVZ)2,V DISTRIBUTION °° ❑ ❑ o ❑ ❑ ❑ ❑ o❑ ❑ � ELEV. - ° ° ° ❑ ❑ ❑ ❑ C3 ❑ ❑ O ❑ ❑ C LIQUID OUTLET J DEPTH TEE BOX, ° °° 4 FEET 14 INCHyE�ES (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED - 500 GALLON DRYIMELLS WI 5 FEET 19 INCF�ES IF MORE THAN ONE OUTLET STONE IN AN 6 FEET 24 INCHES 1500 GALLON 7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) 1.3�X 24'�X 2 TRENCH FC 8 FEET 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" CLEAN DOUBLE WASHED STONE SOIL "'"., SORPIIO FREE OF FINES & SILT SY5 7M (SAS) SEWAGE DISPOSAL SYSTEM PROFILE USGS PROBABLE WATER OBSERVED WATER TABLE ( / NOT TO SCALE BOTTOM OF TEST � 4 \ \ lz 0 �0 92.7 \ \L�,96.4 \ o SHED 9 .5 \ I■ 79.8 90.4\ 1 1. � l I �FtiT i SoJIv 2.3 / /� / 0 - 96.6. . . // D 1 / `R • 82.3 / 98.4 4 7 ECK' 98.5 X"�90.0 98.5 c'QCis\ �p 1 �T�C TC7i2 � � v c✓l,o F o 0.4 / sl EXIS77NG . w DWELLING CAL L,p72 iZ3 T'�j \ \ ?G S• � �v.v,a Tc� � --� - p 9' 99.3 99. 99.2 �NCA yq� % 9 . " 4.9 / 6.6 9.2 99.2 ■ 94.9 I /�� 99.1 96 J I 99.0 7';Q NA�- 98,9f S/.c/ . 2 � . 101.E e _. DATE OF SOSOIL 1 GIL TEST � Z_ , a/2T SOIL TEST DONE BY GZ ✓� z sN WITNESSED BY OBSERVATION HOLE 1 ELEv.=-1-Z_a PERCOLATION RATE 4 Z' MIN./INCH AT INCHES DEPTH HORIZ TEXTURE COLOR MOTT. OTHER OF /2" LEGEND: i 2 p TONE VENT EXISTING SPOT ELEVATION 00,0 `S "'1 98 REQUIRED EXISTING CONTOUR ----00---- ��Z FINAL:SPOT ELEVATION 00.0 31, FINAL CONTOUR 00 SOIL,TEST LOCATION 7-5 2 ,5"1 UTILITY POLE -0- ry TOWN WATER =W--�--W CATCHBASIN - GAS--LINE - CLEAN OUT L /M C CESSPOOL C.P. Ee2 . 26 ELEV. _ - 7,O 25 �c/6 WATER ENCOUNTERED AT ELEV. _ -� z �d, WELL N A ZONE_X_- ADJU _X DESIGN CALCULATIONS 3 M/�- ' � ADJUST. _ NUMBER OF BEDROOMS GARBAGE DISPOSAL UNIT do LEV. = TOTAL ESTIMATED FLOW LEV. _ _ 3 k//0 3�0 GAL./DAY LEV. = _�'7Aa a12 GAL. 102.9 REQUIRED SEPTIC TANK CAPACITY � GAL. ACTUAL SIZE OF SEPTIC TANK SOIL CLASSIFICATION DESIGN EFFLUENT ELOAAD NGORATE� o� GAL//DAY/S.F. / LEACHING AREA /3Xc'�t Z x 76 " +77 SQ. FT. -� 101.8 'GAL./DAY LEACHING CAPACITY (AREA X RATE) 477x.74 RESERVE LEACHING CAPACITY N GAL./DAY' NOTES: v 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. 3. ALL COMPONENTS.OF THE SANITARY SYSTEM SHALL BE CAPABLE OF O1 6 WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10•FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE 101.1 'USED UNDER OR. WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. ` WITH 5 NO DETERMINATION HAS BEEN MADE .AS TO COMPLIANCE ANTE IS 0 x 4.aa x= •w:'yE. �v.v .u .st�_.u,z: � ' DEEDED..'-0R ZONING REGULATIONS^OWNER �{5. .. -i ... ,- §•,- ... ,......<__.. ram. - ��._.�,..�- .�'", u-...', vi I{PPR�P.�..,f AUTHC.k.. ._.�.... 4 - OBTAIt Gioll UtTEF.Miivr, :. Fnv 6, UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR / IS TO CALL "DIG SAFE AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING.WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE'BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE C Z49 AS PARCEL 73 _._.:,.. 9, LOT IS SHOWN ON-ASSESSORS MAP THE SOIL ABSORPTION SYSTEM 10. ALL UNSUITABLE MATERIAL:;SHALL BE REMOVED FROM UNDER, AND FOR A MINIMUM OF 5 FEET FROM AROUND 100.5 AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255; (3) �� Of ` _ (EXISTING SEPTIC SYSTEM TODBEEPUMPED AND I FILLED WITH SAND SHELL CR;4lC, r NpF1I 11. ' �1 OR REMOVED sHOIgi' ykP y R BI N 100.2 .� X APPROVED: BOARD OF HEAL TH 31341 "' OQ �a/D DATE AGENT 7 g/ PROPOSED SEPTIC DESIGN FOR JOHN NESBIT LOC. LOT 4A q16 4 R v C SL EE V 33 OAK HILL R,D, CtiT� �-� T ,- C�G R SRORTR P.T rp, 508- 2 P. 0. BOX 1044 C 1Z o1Ss'i 67 398-831.1 SOUTH DENNIS, MASS. 02660 /« �� ,� n e v S l SCALE 1,� = 20' DATE Z REVISED JOB NO. ; - MAP REVISED OF 1 LOCATION - y -a 0. 2002 CRAIG R. SHORT; MUM SOIL TES 112171 20 FT. MINI FROM CELLAR DATE OF SOIL TEST TOP OF FOUNDATION /�o.� 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE SOIL TEST DONE BY ELEV. = CLEAN SAND WITNESSED BY ._v- R_a ZY 5 oN (ASSUMED) CONCRETE OBSERVATION HOLE 1 ELEV.=1�a COVERS 4" SCHEDULE 40 PVC PIPE LOAM AND SEED � � MIN. PITCH 1/8" PER FT. 2" LAYER OF PERCOLATION RATE MIN./INCH AT 3 -q'g INCHES DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 1/a~ To 1/2~ LEGEND: ~ MAX. 99 O WASHED STONE VENT EXiSTING SPOT ELEVATION 00.0 / 2 / 9 2� 4" CAST IRON PIPE �a (OR EQUAL) MINIMUM _ MI . 98 REQUIRED EXISTING �CONTOUR ----00---- c y/2 FINAL SPOT ELEVATION 0.0 �i w PITCH 1/4" PER FT. � � FINAL CONTOUR FLOW LINE. 9�,Oo o, SOIL TEST LOCATION I N STq(,L 10" UTILITY POLETOWN WATER W�-.� 2 ,5y ELEV. _ �J� ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ 9J"G'CTO2 MIN. ELEV. = c17• /7 2,0~ o 0 0 //20 0 0 0 CATCH BASIN lovMp Fall LEVEL , ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ GAS LINE GG CEL C i712 ELEV. _ s GAS ELEV. _ �s.7Q 6" SUMP ELEV, = 9S•So a o 0 0 CLEAN OUT C o BAFFLE o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 2� Io CESSPOOL C.P. O z3�rr�� G A v.va?ty DISTRIBUTION ELEV. 0 0 0 0 o i* C Z .�a,,d - LIQUID OUTLET 80X = 0 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 0 0 '0 ELEV. _ _ f /� � 93, zd' 4 FEET 14 INCI�}•ES DEPTH TEE (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED Z - 500 GALLON DRYWELLS WITH 5 FEET 19 INCHES IF MORE THAN ONE OUTLET STONE IN AN 6 FEET 24 INCHES 1500 GALL"ON � ' � /Ud WATER ENCOUNTERED AT _i_Z ELEV. _ _��_� 8 FEET 34 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) /.3 x 2�' x 2 TRENCH FORMATION z_ WELL N A 3/4" TO 1 1/2" CLEAN S01 ABSORPTION ' INDEX X ZONE X DOUBLE WASHED STONE y n ADJUST-X- FREE OF FINES do SILT SY7x �� (SAS) DESIGN CALCULATIONS .. . , NUMBER OF BEDROOMS 2 3 USGS PROBABLE WATER TABLE ELEV. = GARBAGE DISPOSAL UNIT /✓� SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ __ TOTAL ESTIMATED FLOW 33� NOT TO SCALE BOTTOM OF TEST•HOLE ELEV. _ a'7,0 \ 102.9 GAL./DAY REQUIRED SEPTIC TANK CAPACITY oa GAL. ACTUAL SIZE OF SEPTIC TANKS GAL. 65 SOIL CLASSIFICATION 1 DESIGN PERCOLATION RATE < MIN./IN. 4 r / EFFLUENT LOADING RATE a GAL./DAY/S.F. ' LEACHING AREA /3 x 2,�^ t Z .c 76 = +7 7 SO. FT. 8 101. 6 •92• ' �� �' LEACHING CAPACITY (AREA X RATE) 3S� GAL./DAY 77x.74 RESERVE LEACHING CAPACITY iLJ A GAL./DAY NOTES. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. _ TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. \ T L��96.4 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO 92 \ �o -� WITHIN 6" OF FINISHED GRADE. SHED 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF � 0/lE6 WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN \ 9 .5 } 01.1 10 FT. OF DRIVES OR PARKING AREAS, H-20 LOADING SHALL BE \ \ \ 113 USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH \ I I fl DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO / OBTAIN SUiii DtTEF.Miivr,,,�,, r,,VFvl ArrrZf3'r''•, A� AUTHr'?!TY. I 79 8 \ \ \ 861 `• 90.4 \ I I 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, E^CAVATION CONTRACTOR I ' l k bbb IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GPADES R�D ELEVAT!ONS AS AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION ` IS TO BE; BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. C I 8. PARCEL IS IN FLOOD ZONE _ " 80.7 l�� 2.3 ' 1 / . „ > :i , .. _ ti;� �; , ., .. • . F' � . ;' ., , � � i - ,- � � / / 9. LOT IS SHOWN ON ASSESSORS MAP �'� AS PARCEL 70 \ 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND �� / �'�6 96.6 /\ D 13 100.5 FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM, F AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) l / / �jc \mil �USHED SHELL ;° L« O '�p (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. 00.0 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND op g 3 / / ,� S�iGt�" �''.ir �p� OR REMOVED 98.4 o s \ �;=� q Cit1eL rg'. 2� RLBI s� I L� 98.5 100.2 t i�cz Z7�3 ,• /P 92. / DECK \`\Fg1`iiE ��; ,31341 APPROVED: BOARD OF HEALTH `90 0 \ j i / 98.5 c'Qli\ ' QVALsu EJL�C Tc�R \ -1/ (\pl / /l oy ExrsnNc �� ` �� ����' 99.? � 8I �'bl DATE AGENT � 90'4 / DWELLING 4;2 ,��T,�/ ��. v PROPOSED SEPTIC DESIGN F .4 U^_1Z 99.4 �v FOR 99.399. JOHN NESBIT --94-- 99.2 K'q� " 9 " 9 6.6 9.. x 99.2 0, Loc. LOT 4A f/5 _ 3 OAK HILL, RD, ~ 9 4.9 /2 (CO� A / 99.1 \ L I�VC .SL EEV.E � 96_ J I 99.0 S Z �,o A T CRAIG R. SHORT P.R I -/'N c A7rc h' T= 1//v1= �� jr -Tr T 235 GREAT WESTERN 'ROAD r-mM98.9 c�As�.cJ C JZ ors, ,v P. 0. BOX 1044 508- �o39g i < Q�r-- � .L J a,9� iyr« zD ,( �`, - 398-8311 SOUTH DENNIS, MASS. 02660 o v �r DATE SJZp /D 2 SCALE 1 ,� - 20' �x / • �8.8 REVISED F5FB N0. " 101.6 / LOCATION MAP REVISED [ SHEET 1 OF 1 0 2002 CRAIG R. SHORT, P.E.