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3667 MAIN ST./RTE 6A(BARN.)
u a711117 M1. 1 ff=Z oa6 ' i R. 1. 7, J ' i• � 9 F. �`lyy r� ,� a .. � � .. � re - ., � .'y � ., }'11.%• _ u F ax tl 1 , - z > a o' „ c Date: February 23, 2018 To: Building File RE: Complaint: Pool Discharge Address: 3667 Main St, Barn Originator: Tim Friary(508-362-3573) Contact: Complaint: Saltwater Pool Discharge killing crops Enforcement Process Steps D1. Initiate local investigation: Assigned to Bob McKechnie D1 2. Document/enter into system Yes 13 3. Contact Tim Friary (508-362-3573) ® 4. Contact/owner 5. Seek access to subject property LLJJ 6. Seek administrative warrant (if necessary) NA 7. Notify state authorities of findings NA 13 8. Document conclusion ® 9. Referred No Property Property is developed with a 2 bedroom 1 bath dwelling circa 1820 on 1.41 acres. Background A permit (8-2014-03316) for a gunite pool was issued on 6/2/2014. 02/23/2018 Complaint received from Tim Friary(508-362-3573) concerning discharge and run-off generated from the Bagshaw's saltwater pool. Mr. Friary claims the discharge has ruined his crops and he wants to have this matter addressed before planting/growing season. i �TOW1N OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3a 0 Parcel BUDDING DEpT Application # 33 Health Division FEB 17 2016 Date Issued `J"Z—lee pioc Conservation Division Application Fee TOW 5 Planning Dept. N OF B4RNS74gLE Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address j'>��-,►�' �� Village ���¢, _ Owner Address Telephone Permit Requester Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ZFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name r___044j -�ri_ 1LMy e n64v? Telephone Number Address &&6A License # Home Improvement Contractor# Email ILw cs,Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE J FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION.PLAN NO. Complete Home Group Service Starts Here 770 B1 Main Street 508428-2828 Phone Osterville,MA 02655 508428-1974 Fax Town of Barnstable Regulatory Services Building Division Mr.Thomas Perry, Building Commissioner 200 Main Street Hyannis, MA 02601 February 16,2016 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY I,Adam Hostetter,Construction Supervisor's License#094302 and owner of Complete Home Group LLC, herby certify that Brian Powers Construction Supervisor's License#079418, a full time employee of Complete Home Group, LLC, will assume responsibility as project supervisor for the following project: Brian Powers-#079418 3667 Main Street—Basement Gym AdakTfostetter,License Holder Date t LMG 4/8/2015 B-41:33 AM PAGE 3/008 Fax Server �c Rt7� CERTIFICATE OF LIABILITY INSURANCE 4,3'20 15 THIS CERTIFICATE IS ISSUED AS A MATTER!OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFRRMATIVELY 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 CERTiFIGATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(tes)must be endorsed if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,gain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s 7 MARK SYLVIA INSURANCE AGENCY 404 MAIN STREET 1 JFW CENTERVILLE,MA 02632 ! ohm I AFFiTiti WCONEHA[f NAICg MMMMA: Liberty Mutual Fire Insurance 23035 NSURED COMPLETE HOME GROUP LLC I utsc�l B: 770 B1 MAIN STREET oaimc: OSTERVILLE MA 02655 i RORERD: RBURER E: i COVERAGES CERTIFICATE NUMBER: 24136425 REVISION NUMBER: THIS IS TO CEI:MFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE POLICY PERIOD INDICATED. NDTVIATHSTANDING ANY REQUIRENBNT,TERM OR CONDIIICN OF ANY CONTRACT OR OTHER DOCUNENr WITH RESPECT TO VNCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN1'rHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERfJfS, DCCUsaw AND CONDITIONS OF SUCH FOumk umT5 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEOFINSJRANCE wvh POLICY NUMBER dwilm UMrrs COMMERCIAL GENERALUABIUTY DCHOCCURRENCE $ CLAws mE❑cacm I. aaarraca $ NED EXP ota $ PER901WI_&ADVINIURY $ GENLAGORWATELWAPPUESPEFt t GENERALAGGFWArE $ POUCYaM ❑LOC I PRODLXT5.00uPIOPAC $ 4 ortm $ MAUM 1LEUMUN $ ANYAUrO ecoiLYINuuRY(Ierpma,) $ firm I BODILYINJURY(Peracdd$t) $ I NFEDAUMOS ALfriOS am $ $ UVEFUR.I.AUM OWLS EACHO0CUW4?, E $ EXCESSLIM HClA1N6 IDS f A[9GGREGAM $ DED I I RETWON$ $ A �00�BAD I WC2-31S-602832-M 3/23/2615 3/23/2016 ANY PROPRIE NPARTNE IEXECUMNE Y/N f ELEACHACCIDHVr $ 100000 OFRCER&EkSEREXCLUDED? Y N/A (MmwbtmvinNH) EL DISEASE-EAENP $ 1000000 MPEPA-na,abdtm EL DISE0.5E-POULYUNR $ 100000 i l DI ItONOFOPERATKMILOCAT1M/VEHCUB(AfAR)101,AddAlmer Schadtkneyl mamrih dffmwespecet;required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. i i j CERTIFICATE HOLDER I CANCELLATION E TOWN OF BARNSTABLE SHOULD ANY OFTHEABOVE DESCRIBED POLICIES�CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VOLL BE DELIVERED IN BUILDING DEPARTMENT I ACCORDANCEWITHTHE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA 02601 AU H0FVW TAMrVE -/4 *�- Liberty Mutual Fire Insurance [ 019W2014 ACORD CORPORATION. All rights reserved. t ACORD 25(2014/01) The ACORD name and logo are registered marks at ACORD NO.: 241.36425 CLIENT CODE: 1759552 Anne 4/3/2015 3:13:56 FM IEDf) Page 1 of 1 I s i The Commonwealth ofMassachms&lYs Dep=tzamt n;�'.i�ardsfrirl Accidents -- - wlice_ojc_r& rtr�t[oru ' 600 W,5sIj&zgton -ee-t ersta ( UI nrr'-w rraossgOilin Warkx-& CampensatfianLisarance Affidavit:Builders/Corti-actorsfElecfrkianMumbers ApWkant Information Please Prat bly N`ame($irsiges316rganizatint>/��r��I)= Gray/StateMp: O' >& / Phased Ar-e y an employer?Check the appropriate bo,: T of o ett r 4. ❑ I gm a dal contractor aad I 3 I e - L LJ t am a employer wiff� 6- ❑Near o�osfrisc#o� employees{fizllancVorpatt-imeT* have hired.the sub-contractors 2-❑ I am a sole proprietor or partner- lidded on the attached sheet; 7_ ❑Retvadeling ship and,have no employees These sub-contra r%have g- ❑DemolitiDa working far me in airy capacity employees and have wo'ers' p_ ❑Buildir_g ad&tic;z PTO workrTs comp_ire ,trance comp_iosumml 5-❑ We are a corporation and its 10_.0 Electrical repairs or ad�Ei Otis rectuirea:-I _ _❑ am a bameouner doing all work offrrers have exercised filar 11�_.0 Plumbing rep�rs or a•diii , myseS€ [No workers'oonzp- r hd of e�rmptiosz per IvfcL 12-0 IZnof repa-'s in m=-n re regntred-j l c-152,§1t4} and we hwe;nu employees_LNG errs' 13-0 Qther comp_insuranm required-1 *Any sapUcmt that cbecks boa f1=st also 51l out the sectiva below durwing ibeir warY¢s�cot©e�atiog Po F infuti T Hnmeo wners who submit this afhdv id in'r C>they are doing ZR—W $c and,thee lure oabsiae co tMc vrs nmst seal ft a s dsc it such- �h tnrs dw check this bo=nest sitadwd za=dditi m,rt sheet dww-mg t3se nme off&e Edo--mks and sty crheLmr Dinar tI�sE >i c emplayees_ Ifft1=e sty contmcto shim envloyees,dheymust gmuide thew wa&Rrs'c:GnT policyn=ber_ -lam arc errmpLayer thatisprcnid&ig workers'congwnsalioa irrztcranc-a for nzy LnTwLoyees. He&w is thepoH raid job stars igf°ornrr Mgm Insurance CompanyName: lt,,14L. //� �I Facy�nr Self ins Li,-:k:h.! DOz 029' Expiration Date: i foh Site Ajl ess: e'll ? /��'�/� �/ City}Stat&zip: Al. Attach a copy of the Nmrkers'compensation policy de-daratiou page(shoving the poles naruber•and expiration date). Failure to secure coverage as required under Section.25A ofMGL c M can lead tothe imposition ofcrimival pmalti.es of s fine up to$1,500_DD and/or one-ye-arirnpris�,as well as civil pemIRess in the form of a STOP WORK ORDER-and a fne of up to,$250-00 a.day against the violator_ Be advised that a copy of this statement maybe fonAarded to tale office of Iuriestigations of the DIES far irpwrance coverage vetificatiorL I iid hgreb-p certify rcrrtler t TS3 all Bs rrf rLty thatthe in forxccc an orat2de�£�zbus�e is 6zcs a-tfd correct Sit3tature: Dec- A6. )�1ttJnL i#: OgZcial use only. Da not write fir this area,to ba compieted by ci(p or town officiaL City-or Towa: rtrF1ftuceme iv Esc g Authority(drde one): 1.Board of Hedlth 2.Building Department GiiFJToYerc Qerk 4_Electrical Ensprxtor .Plumbing Ea r cto r 6.Other contact person: Phone u: 6 Information and Instructions Massachusetts Creneral Laws chapter 152 requires all employers to provides workers'compensation for their employees. Pursuant-to this sta-turte, 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 ivro or more of the foregoing engaged in a joint enterprise,and inclu tg the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,assoc nor other legal entity,employing employees. However the owner o dwellsng house having not more than three apfrtEaants and who resides therein,or the occupant of the - dwelling ouse of another who employs persons to do mpntemaucc, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall t because of such employment be deemed to bean employer." 4 MGL chapter 152, §25C(6)also states that"every state r Iocal licensing agency shall withhold the issuance or renewal of a license or`permit to operate a business to construct buildings in the commonwealth for. auy applicant who has not produced acceptable evident of compliance with the insurance cove:age required-" Additionally, MUL chapter 1\52, §25C()states"Neith the commonwealth nor any of its political s.rbdivisions shall enter into any contract for they erfozmance of public rk until acceptable evidence of compliance wri`h the insurance requirements of this chapter have been presented to th contracting anihoriry" Applicants Please fill out the workers' compensation ffidavit c pletely,by checking the boxes that apply to your situation and,if necessary,supply sub-contrzctor(s)name(s), ddress s)and phone numbers)along)With heir cer�r c tc(s) of insurance. Limited Liability Companies(LLC) • Li ed Liability Paz taershiips(L LP)with no employees other than the members or partners,are not required to cant'wore ' compensation inc�trance_ if an LLC or LL?does have employees, a policy is required Be advised that his aavit may be submitted to the Depar�?ent ei lzrduscrial Accidents for confirmation of insurance coverage_ Is be sure to sign and date the au�daSt 11;e a;;�dav7t should be returned to the city or town that the application f r the emit or license is being requested,not the Depart neat of Industrial Accidents. Should you have any questio regar g the 1a,,r or if you are required to obtain a workers' compensation policy,please call the Department at e 3am b listed below. Self-insured companies should enter their self-insurance license number on the appropriate ' e- City or Town Officials Please be sure that the al$davit is complete and p tad legibly_ The De ent has provided a space at the bottom of the affidavit for you to fill out in the event the cc of Investigations h• to contact you regarding the applicant Please be sure to fill is the permit/license number rhich will]be used as a refe nce number. In add i n iion,a applicant that must submit multiple pernrit(license applicatlops rn any given year,need o submit one affidavit indicating currentpolicy information (if necessary)and under"Job Sfe Address''the applicant shoal write"all locations is (city or town)."A copy of the affidavit that has been officially stamped or marked by the city town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew ar davit must ba Elled out each year_Where a home owner or citizen is obtaining a license or permit not related to any buss ess or co-inmercial venture (i.e.a dog license or permit to bum leaves etc.)said�persou is NOT required to complete ibis- des•; t- The Office of Investigations would like to thank you'in advance for your cooperation and shouldy a have any questions, please do not hesitate to give us a tail. I The Department's address,telephone and fax numbeA �h commohwealth of Massachusetts Degartm e� of Industrial Accidents Q�ee of Iuvt�fga,�ax�.s GGG W . JJ gtaa S7 t BGSU .1AA 02111 Tel.4 617 727-49-QO Q)%t&06 or 1-&7 I ASSAFE Revised 4-24-07 Fax- 617-7727-7-149 -wrww=S.5-go.vl&:'a . � y Town of Barnstable 0 ' Regulatory Services )rues. .Richard V.Scala,Interim Director Building Division Tom Perry,Building Commissioner 200 Mum Street Hyaffiis,MA 02601 www.town.barnstable_ma.us Office: 508-862-403 8 Fag: 508-790-6230 Property ONner Must. Complete.and Sign This Section If Using A Builder f � -Ck I J ,as Ownet of the subject ptope ty hereby authorize c..0�/1,` ('� /4c)y"&-- �(?�V,,O to act on my behalf, in 0=ttets relative to work auffiorized by this building p eitnit (Addtess of,Job) **Pool fences and alarms ate the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. Sb a±=e of Owner Signature o Applicant Print Name Paint Nzne . • _ 2- .1� - 20 I � • - - . : . . . . _ Date 1 V"J& V.L "aA AJa7 LL4Ll1tr - Regulatory Services.' pTr Richard V.Sc dl Interim Director. °-� Building Division - t - Tom Perry,Bniiding Commissioner MASM- 165 h 200 Main Street, Hyannis,MA 02601 1 • QED wwW.tovPn.barnstable.ma.ns Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOVRO R LI EX7 TTOhI PIease riot DATE: ` JDBI.00AT Cft . Cr street n7lage "HOMEOWNER": name home phone# work phone CURRENT MAM ING ADDRESS tyltnwn stale' zip code The current exemption for"homeowners"was extended to iIh owner-occupied dv✓eIlirg s of six units or less.and to allow homeowners to engage an individual for\hire who does not ps a license,provided that the owner acts as supervisor. DEFIIYTIFHQMEOWIZER Persons)who owns a parcel of land on which he/she residestends to reside,on which there is,or is'intended to be,a one or two- family dwelling, attached or detached structta s.accessory tQuse and/or farm structure,..A-person who constructs more than one home in a two-year period shall not be consider`` a homeowSuch'"homeowner"shall submit to the Building Official on.a form acceptable to the Building Official,that he/she sh be re o for all such work erformed under the buildin ermit (Section 109.1.1) , The undersigned"homeQwnet"assumes responsibility for mpliance with the State Building Code and other applicable codes, bylaws,rules and regulations. ~�.. The undersigned"homeowner" certifies that he/she ui d ds' Town ofBainstable.Building Departme�±minimum inspection procedm-es and requirements and that he/she will comply sad d ocedures and requirements. Signature of Hnmcowncc y AppiovaI of Building Official Note: Three-family dwellings containing 35;0 0 cubic feet or larger wyl b`re to comply with the State Building Code Section 127.0 Construction ControL HO?MOWN]KR'S EXMMT I ox\; The Cdde states that: "Any homeowner perTorming work for which a building pe is required shall be exempt from the provisions of this section(Section 109.1.1-_T icensing of construction Supery nrs);'pro ed 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 responsib' es of a supervisor _ (see Appendix Q,Rules&Regulations for Ucensin d-onstruction Supervisors,Section 2:55).I' is-.lam of bareness often - results in serious problems,.particularly when the ho eowner hires unlicensed persons.,_Iu this ese,:our a Board cannot proceed against the unlicensed person as it world with a licensed Supervisor. The•homeo�o.er acting as Supervispr is ultimately responsible. �' To ensure that the homeowner is fully aware o his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that hels a understands the responsibilities of a Supdrvisor. On the last page of this issue is a.form currently used by several towns. n may care t amend and adopt-such a form/cerlifiication for use in your community Q:1wPFILx51FORlvi51hm1dingpeffirtfoffis1E�RF�s doo- 8 , FbI OI'iiee ol'CpusnmerAffnirs�C f3nsiucss Regnlnlioo Liccuse or registration valid for individul use only "-HOME IMPROVEMENT CONTRACTOR before the expiration date, if found return to: egistration: 178455 Type: Office of Consumer Affairs' Business Regulation g .L,Expiration: 4/16/2016 LLC 10 Park Plaza-Suite 5170 '' Boston,MA 0211 COMPLETE HOME,GROUP LLC. AD AM HOSTETTER 770 ALMAIN ST OSTERVILLE,MA 02655 Nulcrsccret;uy Not valid without sil;unture j -� - -o —'- - _ _ _ _ _ _ _ _ o- �' , vi TOP OF WALL J.` RETURNS TO TYPICAL HE16H7. ,1 I it,ACCESS LA- frn OPENING EMENT O ...... - - — — — --- ---- -----� '" ---M— — --- — —---------� — .� — -- PLATE ATTACHMENT TO WALL: 5/8"DIA.ANCHOR BOLTS -Y I M EMBEDDED'1"INTO WALL 12"FROM CORNERS WASHERS 9"XWX1/4" .'i BASEMENT 5LABA96EMBLY I Ir1 I I 10 MIL.VAPOR RETARDER VnLIry __ i i i I CRUSHED STONE LALLY COLUMN,TYP. I VAMP-FROOF BELOW b E ' I 90"x 90"X 12" j FOOTM6,TYP. I .• i----2'X7'REMF.GONG FOOTING,TYP o. 71 �- DROPPED BEAM 1 I ABOVE,TYP. ..._.____..10"50N01VbE.._.._.__._�._.__ •'1_I_. ..i_ -.. .. �� ! .....__.,_...__.,..._____.. .... .__._..-.,..,._....___.._.Y_.__ BI6POOT 2H v—~ SY�•cin-1 BEAM POCKET, A. ' 6AUV(N6r I I r I "•p•� I I .�i I AccEss — — cRML.VAP OPENIN6 I 2"GONG 5L •r• � -_ 10 MIL.VAF CRUSHED 9 ��. ;•p;' :,.. .:•I'. ICI 11':I :[.>: :t �- .� - 3�67MRiNsr t- - - - - - — — — — — — — — — - - - - - - ::, : B�tlJSTkgLE,Mk I_ 'TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �/� Parcel Application # Health Division Date IssuedArl Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 442 eJ41 O 67— Village /f4 Owner Address Telephone ` G 17 — cy6 9-- /Z2 Z Permit Request L•J %5T,7_L 1142 ZV-4 y x7e- A0 Poo/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 45� 5 Oo O Construction Type 6 K^' Lot Size q3 ; 540 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 •• I 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/c al stove: ❑Yes ❑ No e p' I I2Ix2y2;�j Detached garage: ❑ existing ❑ new size_Pool: ❑ existing Il ew size _ Barn: O`&e 'isting O�ew,size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: -3 r a Zoning Board of Appeals Authorization 1❑ Appeal # Recorded ❑ "' Commercial ❑Yes ❑ No If yes, site plan review # ,0 10 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name' elephone Number j Address ZOZ 4Vka*4 A-MyCE- 64,6 License # .✓ 1� 1714 OZo 41 Home Improvement Contractor# ZY 0 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE y� 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE f ELECTRICAL: ROUGH FINAL r . PLUMBING: ROUGH FINAL _ GAS: ROUGH FINAL•' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. -� The Commonwealth of Massachusetis Department of Industrial Accidentr Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass gov1&a Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly' Name(Business/organ=afionaudividual): dwa-rj Address: IVYV45- City/Statc/Zip:—Ak LLJ Phone#: Are an employer? Check the appropriate box: Type of project(requu aired): 1. am a employer with 4. ❑I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed an the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g_ []Demolition working for me in any capacity. employees and have workers' [No workers'comp, insurance comp.ins urancC. 9. Building addition requir•ed-] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L❑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.❑ O il ie r :CU G comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing then'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 whether or not those entities have employees. If the sub-contractors have employees,they mast provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. ,Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic. LJC20'& Expiration Date: 2 f lob 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 miminal 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 certify under the and pen ofperjury that the information provided abov r' trae correct Signature: �j Date: fj /J Phone Official use only. Do not write in this area, to be completed by city or town oo'icial 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.Ofher Contact Person: Phone#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as"...every person in the s "'cc of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corpo` 'on 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 leg entity,employing employees. However the owner of a dwelling}house having more than three'apartments'and�who resides therein,or the occupant of the - dwelling house of anoth who employs persons to do maintenance`construction or repair work on such dwelling house or on the grounds or buildin\_sa ant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, §25C(t7that"every state or IocaI " ensing agency shall withhold the issuance or renewal of a license or perto a business or to co ct buildings in the commonwealth for any applicant who has not proep ble evidence of com ` ante with the insurance.coverage required."Additionally,MGL chapter (7) es"Neither the co�amonwealth nor auy of it's political subdivisions shall enter into any contract for tance of blic work unti acceptable evidence of compliance with the insurance. requirements of this chapter presented the con ting authority." Applicants Please fill out the workers' compensation affidavit comple by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) d pho number(s) along with their certificate(s)of ins rn cc. Limited Liability Companies(LLC)or Li - Liability erships (LLP)with no employees other than the members or partners,are not required to carry workers' c pensation' cc. If an LLC or LLP does have employees, a`policy is required. Be advised that this affi vit maybe sub -tted,to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign an ate the affidavit. The affidavit should be returned to the city or town that the application for th permit or license is be g • este, ,not the Deparmmem of Industrial Accidents. Should you have any questions re ding the Iaw or if you - r ed to obtain a workers' compensation policy,please call the Department at the umber listed below. Self-- companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and p i ed legibly.,The Department has provid a ace at the bottom of the affidavit'for you to fill out in the event the cc of Investigations has to contact you re ar g the applicant_ Please be sure to fill in the permiVlicense number hich will be used as a reference number. In ddidtion,an applicant that must submiemuAtiple permitilicense applica ons in any given year,need.only submit one vit sndicating current policy information(if necessary)and under"Jo Site Address"the applicant should write"all Iota ions m (city or town)."A copy of the affidavit that has been o cially stamped or marked by the city or town may be�provided to the applicant as proof that avalid affidavit is on e for future permits or licenses. A new affidavit must be JHQ out each year.Where a home owner or citizen is ob g a license or permit not related to any business or commercfal venture (i.e. a dog license or permit to burn leaves c.)said person is NOT required to complete this affidavit N\1 The Office of Investigations would like t thank you in.advance for your cooperation and should you have any'goestions, Please do not hesitate to give us a call. Vi,`•. `�*a, The Department's address,telephone d fax number.,. N, V e . Th CQmmc�n tt�weal of Massachusetts Dapartment of Industrial Accidents Office of favestigatio.As �4f1�asbin�tan Street BastGn,MA 02111 TO, #617-727-490-0 ext 406 or 1-8.77-MASSAFE Fax 4 617-727-7749 Revised 4-24-07 - www mass_gov/dia CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD�Y) 5/21/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the 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 - CONTACT - NAME: Rogers&Gray Ins. Bennis Branch PHONE _ _ � No):877-816-2156 434 Rte 134 E-MAIL South Dennis MA 02660 ADDREss: INSURERS AFFORDING COVERAGE NAIC# INSURER A-.ARBELLA PROTECTI N41360 - INSURED SHORPOO-01 INSURER B.We co Insurance Company - Shoreline Pools Inc INSURERC: 202 Queen Anne Road Realty Trust INSURER D 202 Queen Anne Road Harwich MA 02645 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1846370815 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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 - rypE OF INSURANCE ADDL BR POLICY EFF POLICY EXP - LTR INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD .LIMITS A GENERAL LIABILITY B500052096 /26/2013 /26/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY- _ -PREMISES Ea occurrence $100,000 CLAIMS-MADE IT]OCCUR MEDEXP(Any oneperson) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:- PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO-JUIT LOC $ A AUTOMOBILE LIABILITYCOMBINED 1020013830 19/2014 9/2015 Ea accident"NGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED -X SCHEDULED - BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS - Peraccident $ $ A X UMBRELLA LU\B X OCCUR 4600052138 /26/2013 /26/2014 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 - DED X. I RETENTION$10000 $ B WORKERS COMPENSATION WWC3080077 10/2014 /10/2015 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N YLIMITS - ANY PROPRIETOR/PARTNER/EXECUTIVE NIA A - E.L.EACH ACCIDENT $1,000,000_ OFFICER/MEMBER EXCLUDED? FN - - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) - - Additional Insured status is included under the General Liability Coverage when required by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN Robert Bagshaw ACCORDANCE WITH THE POLICY PROVISIONS. 3667 Main Street .Barnstable MA 02630 AUTHORIZED REPRESENTATIVE - - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 161240 }7 Type: Private Corporation Expiration: 10/7/2014 Tr# 232266 ' SHORELINE POOLS INC CHRISTIAN DITTRICH � {v 202 QUEEN ANNE RD HARWICH, MA 02645 rt �' if Update Address and return card.Mark reason for change P g , - ' Address Renewal FlEmployment Lost Card DPS-CA1,0 50M-04/04-G101216 �O'r"j'tO"u`e ° dQa License or registration valid for individul use only Office of Consumer Affairs&Bu iness Regulation g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: -:161240 Type: Office of Consumer Affairs and Business Regulation Expiration: 401712014 Private Corporation 10 Park Plaza-Suite 5170 == Boston,MA 02116 S LINE POOLS'INC- -` CHRISTIAN DITTRIC K-1,, "! 202 QUEEN ANNE RD' Ty e = — HARWICH,MA 02645,,, Undersecretary w.- o v d with t signature - Town of Barnstable ° Regulatory Services BARNSTABM Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,kk 02601 wwwaown.barnstable.ma.us '' .- Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 248 ��G'ST�►`� ,as Owner of the subject property hereby authorize 11!2 S .{a=r-J.-ew/uIXG �. mA :C4 act on my,behalf, in all matters relative to work authorized by this building permit 3 G 7 i �W- o�a1- (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 performed and accepted. Ayi;ture of Owner Signa e of Applicant r Print Name Print Name Date Q:FORMS:OWNERPEFMISSIONPOOLS 62012 r Town of Barnstable Regulatory Services sAzuvsras Thomas F.`Geer,Director BUMS,. 1619. . Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-86 -4038 Fax; 508-790-6230 HOMEOWNER LICENSE EXEMPTIO Please Print DATE: JOB LOCATION: nu ffiber street. village "HOMEOWNER": name +`\ home phone# work phone# CURRENT MAILING ADDRESS: 1 X city/town state zip code The current exemption for"homeowners"was extended to ' lode owner-occupied dwellings of six units or less and to allow homeowners to engage individual for.hire who es not possess a license,provided that the owner acts as supervisor. DEFINITION O HOMEOWNER` Person(s)who owns a parcel of Ian on which he/she resi es or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,atta hed or detached s ctures accessory to such use and/or farm structures. A person who constructs more than one me in a two-ye period shall not be considered a homeowner. Such "homeowner"shall submit to the Buil Official on form acceptable to the Building Official,that he/she shall be _ responsible for all such work Performed der the b ermit. (Secti6n=109.1.1) The undersigned"homeowner"assumes res nsibili for compliance with the State Building Code and other applicable`codes,bylaws,rules and regulatio The undersigned"homeowner"certifies that he/s understands the Town of Barnstable Building Department minimum inspection procedures and requirement d that he/she will comply with said procedures and requirements. Signature of Homeowner r Approval of Building Official Note: Three-family dwellings containing 35,000 cubic f t or.larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTI The Code states that "Any homeowner performing work for which a building t is required shall be exempt from the provisions of this section(Section 709.1.1-Licensing of construction Supervisors);provided that if the orneowner engages a persons)for hire to do such work,that such Homeowner shall act as super t sor." Many homeowners who use this exemption are unaware that they are assuming the resp•nsibilities 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 undhrstands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by t several towns. You may care t amend andoadopt such a form/certification for use in your community. Q:forms:homeexempt Top POLL MACNA LATCH'Safety Cate Latches we a - revolutionary breakthrough in latching security for gates around swimming pools,homes and child safety areas. Powered.by super-strong-Permanent Magnets". c . which never lose power these quality latches incur _no mechanical interference to closure and sou unprecedented reliability,safety and child 2 resistance. . -- ' OINTIUI MI rent I •� ¢, The popular"Top Pull"model is designed ."PIT UTfa°wall) - especially for swimming pool gates but can be 4� ;: s - k fitted to any gate where child safety is important. The shorter"Venieal Pull"model is recommended for gates at(cast 5'(1.5m)tall.This model is also a known as the"Pet Latch",as it provides security -for pet safety timer-. MI►UU All latches adapt readily to most new or esicunggates Y-- gates and any pate material.Two models are key- lockable for added safety. F -The latest"Series 2-latches can he adjusted r ,znicnl/r owl horizmnallr to ensure safe,reliable latching at any time during or alter installation. Vertical adiustmenl is quick and easy ticcause the AUCHA+UfOl has bw J go latch booty slides up and down dovetail-style.tacks tetledh rest rMn for easier sturdier installation, 400,000rywn,(ail Ilorizonial adwstmcnt is achieved by adjusting a swilalaiaApWbarriar ; strew within the"Striker Body"so that the striker (odes(apaAayatas to be can be adjusted across gupstuaginhfrom a"-Oh." WNDS4 aid tep4MV.INkrthbw (9-37mm): beendasigWandaidoadeatfyt Wto The"Series 2"models provide extra impact awl dri t ionumt7gwisalycodes c resistance and durability on larger gates and also against heavy pedestrian traffic. r 1 y The"R,nuai R»t A4.ptm The ka iue W.od.Mx M�AG@iA��ATtH .tit-.,. pi,..l Lit t.r - Ixa.kei.andshims..inMsi xnmm..;hlagtu.UtO —on chnnlmk and nihng_ Pet SetUl'ify •'R.p Pull-.r"ecru.) ts, d—mm. •� Pull"lamhe.to ga,ss and /'r Gate Lotth fe.nwnh.ro.dp u. t� i MAGNA•LATCH is �also suitable for house a� and garden gates where pet security and pet access control are t. important. Aeraal!(a#barnexopingsadkae� ► Ptnldi.,aeters i :%41 u)uun fMhm) "„"17)mmi demsafa f,wl.mtl) 2`Ns samm) •truer: wny,,.,ts�•w..r:�,�.>hdt�M.,,ti',-:• Quirk and easy installation 117,13 -dw f a<.t"*�eFMafke•Ith GwNr- W. C jl I w b t W Ir ON Saw r. > - INSTALLATION REOUIREMSNTS SAFETY NOTE (Yap Pill tt Yertw Pug erndels) _ �t Ater inuaEft edam on far ssrimming pool and other tied solely pawner do e'ti Ihea �tes most gar rieWas mid Sim" i i rsspomit�ly h evert end spedty the following reps'tatantc ado my gonr t°hows'a •The pool gate taus)epm ontwnrd i �" ` i and Mp,,Id rsf t away tray the pool,so the Will WSt 1 I so lfmt d» rentNunm be fitted to the*00&of the pad gate .3 efhA very sell e d •The Idth release knob Is to he as least Geer p ' seM�atdt 60'0 S00aan)above fbwdw ground ' J •Few Mot to be Widmann 40° sba>) wad � � t �' nn e/ewreOMb i 11200mm)above fbd f Ahroys confirm those rowemams with the { opera lord pod a safaty ot9wits in f your am,as regulations may vary.1raW dw Lower I W in otowdmae with W fenro/bmter dorud 1 I rogdatimn, wud k1 t fa k. Vrrm AAaardissltWtefttrsfarr�mlatEmenwAd � � i ,f sN-1'/u'r�.v.r�d.rFmio�ewnller , Hil 'tYwlPNnaw�m80a'VP'e1'/a'pwot , � r . r111 " VkRi(CAL c I f'Z fatka hom the l haslOpm�daaimw tr Vertird PsN model Selecting the correct size Specifications and H-Series heater: Dimensions: For Your Swimming Pool Universal H-Series Heater Determine your pool's surface area in square feet: 11 1 1 1 1 1 1 1 1 1 1 1 1 1 ? 400,000 1 350,000 300,000 250,000 200,000 1150,000 AL B R L 83% 83% 82.7% 83% 83% 82.7% - -. ' 36" I 33" 30" 1 28" j 25" 21" 1 29Y2" 29Yz 29Yz" 29Yz" 29Yz" 29 " Area=(A+B)x L x.45 Area=R x R x 3.14 Area=L x W Z 24" 24" 24' 24" 1 24" 1 24" '4 2"x 2Yz" j 2"x 2Yz 2"x 2Yz 2"x 2Yz' ' 2"x 2Yz" 1 2"x 2Yz" 1 1 , In this table,locate the surface area that '`'. Cupro Cupro Cupro Cupro upro upro is equal to,or just greater than,the pool's §•` Nickel i Nickel 1 Nickel Nickel Nickel Nickel H400 1,200 surface area.To the left of this number is the 1 8' i 8' H350 8 6 6" 6" ( 1,050 appropriate H-Series model that will fit the ; H300 900 selected area. 160 11 158 145 134 123 110 H250 I 750 For indoor pool installations,divide the pool's ° } H2O0 600 surface area by 3. " T I a �a a a/ ( a/ Table is based on a 30°Ftem temperature rise,314 mph averse H-Series heaters are available in a comprehensive range of BTU sizes for natural or propane � g PP H150 I 450 Wind velocity and elevation of up to 2,000 feet above sea level. gas.All units are certified by the Canadian Standards Association and carry the exclusive Hayward®warranty. For Your Spa or Hot Tub Millivolt Heaters Determine your spa capacity in gallons(surface area x average depth x 736). °`' 210,000 The reference table lists the time required in minutes to raise the temperature of the "' 27" spa/hot tub by 30°F.In the table below,locate the column with the spa/tub size in gallons 27Yz" j that is closest to yours.Select the desired time to raise the spa/hot tub temperature 30°F, ,, 28Yz" read to the left and select the appropriate H-Series model. This guide can be adjusted for other temperature rises.For example,if you desire a 15T ^° } { ° 1 Yz' x 2 increase in temperature,simply divide the time for 30'F rise by the ratio of 30/15,or 2. ; _ Cupro Nickel i - . ion 1 7" Note:Heat lost and/or heat absorbed by spa walls or other objects will add to the time it takes the spa to heat up. _ 17Ya" Spa sizing is based on an insulated and covered spa.Always cover your spa or hot tub 144 t <i when not in use to minimize heat loss and evaporation. r, a/4" r. B ,rye . 'NAM" ti H350 11 16 21 I 27 I 32 37 43 48 54 _� H300 i 12 I -19 1 25 I 31 37 I 44 1 50 I 56 i 62 H250 ! 15 22 30 i 37 1 45 52 60 j 67 ! 75 ~ H2O0 19 I 28 I -37 47 56 66 75 1 84 i 94 H150 25 I 37 i 50 I 62 75 i 87 1 100 112 125 Efficiency. Performance. Innovation. Whether you want to extend your swimming season or swim year-round,Universal H-Series ® O gives you comfort with efficiency.It's the perfect addition to your.Totally Hayward®System. R , ` To take a closer look at Universal H-Series Heaters or other Hayward products,go to www.hayward.com or call 1-888-HAYWARD HAYWARIY 620 Division Street I Elizabeth, NJ 07201 ilu A Hayward,Hayward Energy solutions,Totally Hayward and HreTile are registered trademarks of Hayward Industries,Inc.02013 Hayward Industries,Inc. LmiS13 Manual Air Relief Combination Pressure and Cleaning- is a high capacity,.rapid release Cycle-Indicator Gauge . manual air relief valve that bleeds air gives visual indication when cartridge with a quick quarter turn of the lever. filter elements need cleaning. Top Manifold Quad-Cluster Cartridge Elements provides industry's best energy saving hydraulic provide 225,325,425,525 or industry's largest performance and utilizes the entire cartridge !' I 700 ftz of filter area and extra dirt-holding capacity surface area to maximize time between cleaning t for long filter cycles.Precision-engineered core Heavy-Duty,Tamper-Proof,One-Piece Clamp provides extra strength and superior flow. securely fastens tank top and bottom together . ' Self Aligned Tank Top and Bottom and allows quick access to all internal make access to servicing Quad- components without disturbing piping or Cluster cartridge elements quick connections. IIy and easy. High-Strength Filter Tank is made from durable,glass reinforced �I co-polymer to meet the demands of the ;; ICI CPUC Union Coupling Connection toughest applications and environmental - — ;:' provides plumbing options of 2" conditions,including in-floor cleaning systems. or 2Y2"plumbing with 2"full flow internal plumbing for maximum Uniform Low-Profile Tank Base Design z hydraulic performance. makes removal of cartridge' elements fast and simple. " Noryl"Bulkhead Fittings Full-Size 1 Y2"Integral Drain for extra strength and heat resistance. provides fast clean-out and flushing. m= v SPECIFICATIONS r• 1 rl CARTRIDGE s.� FALTER TYPE Quad-Cluster cartridge elements: 225,325,425,525 and 700 ft total(20.9,30.2,39.5,48.8 and 65.0 m) ". _"'�' Y .F S`��` � 4'a*e,� cm•v...r�.,,: •-,dye : S x,.r FILTER TANK m Infection molded glass reinforced co polymer fix, an X FILTER ELEMENTS Reinforced Polyester PERFORMANCE RANGE ��'?/?to 3 HP,�(3O to��5O GPM 7_to 2 24�kW(114 fo 568 LPM)���� � f,�t C2O30—23"W x 32 Y2"H(58 cm x 81 cm) C3O30—23"W x 34 Y?H(58 cm x 87 cm) DIMENSIONS C4O30—23"W x 40 Y?H(58 cm x 102 cm) C503O—23"W x 46 Y?H(58 cm x 117 cm) 4 C7O30—23"W x 52 Y?H(58 cm x 134 cm) CPVC Union Connections PERFORMANCEDATA •._.. C2030 225 20.9 84 318 40,320 50,400 153 191 C3O30 325> '-30 2> i1 2 R.462583560t73,2OO. 277� a` C403O 425 39.5 150" t 568 72,000 90,000 273 341 C5O3O 525; 48 8` 15O��. 568F 72 00000 71 273 341 m .mot. C703O 700 65.0 150 568 72,000 90,000 273 341 Pressure and Cleaning Gauge Based on NSF recommended rate for commercial use at X5 GPM/ft.2 "Determined by pump size and piping system hydraulics;2"piping is recommended for flow rates equal to or greater than 90 GPM(341 LPM).Hayward doesn't recommend flow rates above 150 GPM. NSF To take a closer look at Hayward Filters or other Hayward Products,go to www.hayward.com or call 1-888-HAYWARD 1 0. HAYWAR10" ®• 620 Division Street I Elizabeth,NJ 07201 Hayward and Hayward Energy Solutions are registered trademarks and A Swlm Clear and Noryl are trademarks of Hayward Industries,Inc. ®2013 Hayward Industries,Inc. LfrswC13 TriStar Pumps � ° a Technology incorporated into TriStar creates a new benchmark in residential pool pumps and its higher 4 eA hw A flow rates can allow for stepping down in pump horsepower.Overall,TriStars feature the most energy efficient hydraulics and are the simplest pumps to install,retrofit and service. Features SINGLE SPEED TOTALI VOLTS PORT SIZE MODELS HP HIP FACTOR • Save up to 70%on your energy costs with the SP3205EE j 0.99 Yz 1.98 1 115/208-230 I 2"/2Yz" I 135/a" combination of an advanced hydraulic design and SP3207EE 1.39 ' 3/4 1.85 115/208-230 2"/231" 13%" proven two-speed technology. 3 SP3210EE 1.85 j 1 1.85 115/208-230 1 2"/21h I 14/e„ • Higher flow rates can allow for stepping down in SP3215EE 2.40 131 1.60 115/208-230 i 2"/2h" ; 14'/e" pump horsepower for even lower COSt and SP3220EE 2.70 I 2 j 1.35 208-230 1 2"/2Y2" I 14'/e" energy consumption SP3230EE 3.60 3 1.20 208-230 2"/21h" I 17Ye" • Heavy-duty motor with dynamic airflow designed for SP320363EE' 3.60 1 3 1.20 1 208/230-460 I 2"/2Yz" I 17Ys" greater dependability and longer life SP3250EE I 5.0 1 5 j 1.00 1 208-230 j 2"/2Y2" ( 17'/e". • 2"x 2 Y2"CPVC union connections make installation SPEED TOTAL �LTS � DIMENSION FIT and servicing fast and easy MODELS HP HP FACTOR • No-rib basket design insures easy debris removal. SP32102EE I 1.85 ! 1 1 i.85 208-230 2"/2'h" 14Ye" Extra-leaf-holding-capacity basket extends time SP32152EE 2.40 1 1 h 1.60 208-230 2"/2Ys" ; 14Ya" between cleanin s g SP32202EE i 2.70 2 1.35 208-230 1 2"l 2h" I 14% • Tri-Lock cam and ramp strainer cover design seals 'Three Phase with less than a quarter turn 120 • Crystal clear strainer cover lets you see when the E basket needs cleaning LU 100 • Pressure testable to 50 psi maximum LL 80 • Second base included to align TriStar with other 0 P325oEE models for easy retrofit installations 0 so 0 • Self-priming(suction lift up to 10'above water level) = 40 SP323003EE Q SP322 ,EE(Low Spread) P3215EE SP3220EE ~O 20 -� SP32102EE(Low Spa SP32 EE 0 SP2152EE(L�w Speed) SP3IWEE 1133 10.18 0.0 20.0 40.0 60.0 60.0 100.0 120.0 140.0 160.0 180.0 200.0 FLOW(GPM) O13d1 r ,IAYWMIC 8.16 TRISTAR" 2-SPEED (0-S"INGS TO `70% 1- -- To take a closer look at Hayward Pumps,go to ON YOUR ENERGY COSTS www.haywardpool.com or call 1-888-HAYWARD. CO. HAYWAR Hayward,Hayward Energy solutions, 620 Division Street I Elizabeth,NJ 07201 V and TdStar are registered trademarks of Hayward Industries,Inc. ©2011 Hayward Industries,Inc. UffSFR11 h lip+. AWL -4 .� dt - iruMa,:i$Ys',ytg'ti?X`-. s ,1 F r The pool cover that's so "Green" it's FREE.* Because an automatic safety Monthly Cost Savings cover is so easy to use,your With A Cover* pool can always be covered when it's not in use. That means you save big money on heating,electricity,water and Monthly Cost v Financing A Cover** pool chemicals. In fact,your cover can completely pay for itself in just a few years. You can save'more money than the cover actually costs! That means you gain the benefits of a safer and cleaner pool—for FREE. p Based on energy savings calcu- —Based on cost of financing + lations by the U.S.Department $10,000 @ 601.for 10 years. of Energy-RESPEC Program Cover system cost varies by size and complexity. S PROJECT �� I NAME: ✓►-� �,.-� ADDRESS: PERMIT# 1 C O 3 3 L P PERMIT DATE: �O M/P: 2 t -1 039 LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS program on: y BY: q/wpfiles/forms/archive �+ ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 3I Application # p Health Division Date Issued7"«�/ f/ Conservation Division Application Fee / Planning Dept. Permit Fee Je ' 1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 6S i Ji'C- 1� �� Village &YNS-m64� Owner LAn CAT61 -+XeUN 9. /✓E-yAr- U 7-9- Address 1Jl C1~--JPpi✓ PfgF_SE_r1 Telephone ) -�- m6- / ate VA-T-4-i-o , 1-4 94,6/0 Permit Request A# IIZeu7c4T-iF 6-4r1 e 6,rJ 7iLyPeo-Y, r--ix vp L✓1xLGS N � 4 ,J b 5.L� t �rZz- C_ �Square feet: 1 st floor: existing, [p"roposed 2nd floor: existing O proposeTA nevD�Zoning District Flood Plain Groundwater OverlayProject Valuation dB6.OD Construction Type � aLot Size Grandfathered: ❑Yes ❑ No If yes,:attachg cfocurWntation. M Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) # �n // Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ZYes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other !! OAK Basement Finished Area(sq.ft.) 0 Basement Unfinished Area (sq.ft) j') 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: CYexisting ❑ 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 ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION )(BUILDER OR HOMEOWNER) Name n/l 4VP tL(-Telephone Number Address - g =!� S ccT License # L S �� `� 9 �- 046tvatr_ OL6 5,15 Home Improvement Contractor# Email Q�M i n ko S+C t ra r- .>Me5 , CuM Worker's Compensation # Q y-V ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP/PARCELNO. c ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION F FIREPLACE ELECTRICAL: ROUGH FINAL ' /4I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commons h of-Massachusetts Department offm1w l Accidents Office of inve s4aiions 600 MasshingfonStreet Boston,MA 02HI wnnv masmgaWdia .' Workers' CampensatianInsumuce Affidavit:Builders/ContractorsfFJectricianslPlvmbers Applicant Information Please Print Le>=ibly Namo(> wI0rganimfioa&dividna) &A17W9T& �A e &O-r Lt& _ Address:- 2769 +city/Stat&zip_ mwpw M 0)tSs Pb�.47 'CO q�'; aka ——Are_ u-an-employer?deck the appropriate boz:_ ___.T of o'ect r Hire 4. I arrr s contractor and I � Pr. 3 (r e q d}:---_—------------- I-IJ I am a employer with ❑ 6- ❑=deling New employees{full and/or part-time)-* have hired the sub-contractom 2-❑ I am a sole proprie for or partner- listed on the attached sheet: 7- drip mid have no employees These salt-contractors have g_ ❑Demolition w for mein an capacity- employees and have workers' orking y t 9_ ❑Building addition [No workers'comp_insurance comp-insurana& � regarred] 5-❑ We area corporation and its 10.F]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers hoes exercised their 11_.Q Plumbing repairs or additions myself [No werkers'camp. right of eimmption per MGL 12_.0 hoof repairs H and wa52 1. ,§1(4},at:have at} 13-❑O V TM er��nce required.]t c52employoes.( workers' th I�,1 �l t�c?.CLI7Cef .. comp-insurance requir r-I *A�ry aPP t dirt ched:s bout*1 umst also fill out e section below shavring their waffteis m'compensation parley nfwmz& �Sameowners who submit this sfidavu in&rs.g they are doing aII vrcxk and then hue outside contractors Est snbffiit a new affidavit IDrfrcating sack tractors that check this bwL must attached sa additinno sheet shouting the nsme of tie sets ors and staff whether arnot those mtifim have Employees- If the sub-coatraeturs bare employees,they nnrst provide their walkers'comp.policy atunber_ I am an Bdow is the poTi y a .d job site ter,fntxrtaliat:e. �f _ Insurance Company Name: t ltafq cM ins �L�� NS Pblicy:fforSelf-ins.Lic. ��- o Expiration Fate: 3 5 Job Site Adds=: 36R wr-A J 1 lWAs A-9te City/'State/Zip- / D, Attach a copy of the workers'compensation policy dedaration page(showing the policy number and expiation date). Failure to secure coy erage as required undm Section 25A of MGL c 152 can lead to the imposition of"crnninal penalties of a tine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the.fowl of a STOP WORK ORDER and a fine of up to$r250.00 a day against the violater- Be advised that a copy of this statement may be forwarded to the Office of Im--estigations of the DIA for insuzrance coverage v cation- I do Feereby eerltfy nder tltapains andpenalties ofperdury thattlea informatianprotzded a fs and correct S.iPnature: pate: I Phone 9: s� �� ac a 01ta-ial use only. Da not write in f ifs area,to be completed by do or town official City-or Town: Perudt/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plarnhing Inspector 6.Other Contact Person: Phone#: 6 Information and Instructions V' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuantto this ,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, o or written." An employer is defined as' individual,parbatrship,association,corporation or other legal entity,or any two or more of the foregoing engaged in a j ' t enterprise,and including the legal representatives-o/(• a deceased employer;or the receiver or trustee of an individ artnership,association or other legal entity,emp;oying employees. However the owner of a dwelling house having no ore than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs ersons to do maintenance,construction lair work on such dwelling house or on the grounds or building appurtenant reto shall not because of such emplo ent be deemed to bean employer." MGL chapter 152, §25C(6)also states that"eve tate or Iocal licensing age)ry shall withhold the issuance or renewal of a license or permit to operate a busin or to construct build' gs in the commonwealth for alay applicant who has not produced acceptable evidence f compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)slates"Neither conumonwealthnor any of its political subdivisions shall enter into any contract for the performance of public work acceptabl evidence of compliance with the insurance requirements of this chapter have been presented to the co ' g autho ty." Applicants Please fill out the workers' compensation affidavit completely,by g eckia the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses)and pho /mm�ber( along with their ceraficate(s)of insurance.ance. Limited Liability Companies(LLC)or Limited Liab' ty Partnership (LLP)with no employees other than the members or partners,are not required to carry workers' comp on inc�trance. an LLC or LLP does have employees,a policy is required. Be advised that this affida ' may be submitted to e Department of Industrial Accidents for confirmation of insurance Coverage. Also b sure to sign and date th affidavit 'lie affidavit should be returned to the city or town that the application forth ermit or license is being re . ested,not the Department of Industrial Accidents. Should you have any questions r ding the law or if you are req ed to obtain a workers' compensation policy,please call the Deparrtment at th number listed below. Self iuusured ompanies should enter their self-insurance license number on the appropriate lin . City or Town Officials Please be sure that the affidavit is complete an printed legibly. The Department has provided a lace at the bottom of the affidavit for you to fill out in the event e Office of Investigations has to contact you regarg the applicant. Please be sure to fill in the permitllicense n ber which will be used as a reference number. In addd��on,an applicant that must submit multiple permitllicense plications in any given year,need only submit one affidavit indicating current policy information(if necessary)and er"Job Site Address"the applicant should write"all locations (city or town)."A copy of the affidavit that h been officially stamped or marked by the city or town may be pr 'ded to the applicant as proof that a valid affida t is on file for fixture permits or licenses. Anew affidavit must he filled out each year.Where a home owner or ci n is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to b leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations ould like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to gi e us a call. The Department's ad s,telephone and fax number: The Gommanwealth of Massachuse#;& Department of Industdal Accidents Office ce ofjavestigatFans 600 washingtaa Street Boston,NIA.Gal 11 Tel.#617-727-4M W 406 or 1-977-MAS S Revised 4-24-07 Fax#617-727-7749 - V1 .mass;gov1dia 5/22/2014 6:28:08 AM PST (GMT-8) FROM: 100005-TO: 15084281974 Page: 3 of 3 CERTIFICATE OF LIABILITY INSURANCE °ATE`MMI°°"'"Y' 5/22/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the 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 MARK SYLVIA INSURANCE AGENCY NCOCT AME 404 MAIN STREET PHONE I FAX CENTERVILLE, MA 02632 VC.No: E�uIAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 9 INSURERA: UbertV Mutual Fire Insurance 23035 INSURED INSURERS: COMPLETE HOME GROUP LLC 770 A MAIN STREET 04SURERC: OSTERVILLE MA 02655 INSURERD: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 20268820 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. LTR TYPE OF INSURANCE j SD SWVD UER POUCYEFPOLICY NUMBER MMIDDIYYY MMIDDIYYYCY Y LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _$ DAMAGE CLAWSWADE OCCUR TO RENT _ PREMISS Meoccurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JC LOG PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY CO B 1 $ Ea accident ANY AUTO - - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION WC2-31S-602832-024 3/23/2014 3/23/2015 STATUTE ER- AND EMPLOYERS'LIABILITY YIN N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ ,. t000000 OFFICERIMEMBER EXCLUDED? y NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000000 If yes,describe under - DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be allached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate Cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA 02601 _ AUTHORIZED REPRESENTATIVE UCLA Liberty Mutual Fire Insurance 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20268820 CLIENT CODE: 1759552 Anne Chandler 5/22/2014 9:21:20 AM (EDT) Page 1 of 1 a� i Massachusetts - Department of Public Safety Board of Building,Regulations and Standards ConslrurlirIn 5rrlri'rjnur' License: CS-094302 ADAM HOSTETTgR 770 SUITE A MAbN OSTERVILLE NfA 02� Expiration fill Commissioner 12/,2/2015 r License or re Officc of Consumer Affairs&Rusiness Regulation registration valid for individul use only `' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: � t egistration: ..178455 Type: j Office of Consumer Affairs and Business Regulation Z\ expiration: 4/16/2016 LLC 10 Park Plaza-Suite 5170 " '' ! Boston,MA 0211 COMPLETE HOME QROUP LLC ADAM HOSTETTER 770 ALMAIN ST gr � OSTERVILLE,MA 02655 Underscci'etary Not valid without signature ' F r kk�" �TME rti Town of Barnstable Regulatory Services RARNSTABBUSS.tE� Richard V.Scali,Director �ArE1 39. A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 12 as Owner of the subject property hereby authorize "y`' 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 performed and accepted. Signature of Owner Signature of Applicant } Print Name Print Name Date :FORM&OWNERPERMISSI NP Q O OOLS I c Town of Barnstable Regulatory Services ��°Fce TOicyy Richard V.Scali,Director ' Building Division Tom Perry,Building Commissioner MASS. 1639- .�� 200 Main Street, Hyannis,MA 02601 RFD MA'I� www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street ` village "HOMEOWNER": r name home phone# work phone# CURRENT MAILING ADDRFSS: -------------- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection 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 wiU,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 abuilding 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 shal Ic't as supervisor," y 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 formlcertification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 PROJECT NAME: ADDRESS: JCoCo r' �!lch S PERMIT# l o Al �1 1 PERMIT DATE: 1 LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS program on: Z BY: 1 a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 170 71 Parcel pplicationI# o Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ���� RSA Village Ge n Owner Zc,�5Tyk" ,re-ic^j d>✓ A,�REJTS4 7_04dress_114 C Arh,� odttUr,-J Telephone Permit Request Ard� .Sr,^JLl 7-6 d-e1f- C— b7,7 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning"District Flood Plain Groundwater Overlay Project Valuation S��y�a 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting a9curtati6n. CP 21 Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) ' Age of Existing Structure Historic House: ❑Yes ❑ No On Old KingsMighway Ye© ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)l Number of Baths: Full: existing new Half: existing ne=_ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name e0A4111tO41* �ye W Telephone Number S� �oD Address 36G� /l�/ QvY,� Spa 1 License # ® ( O);�- Home Improvement Contractor# J70�S Email rd 1 e — �/qcs �b lvi Worker's Compensation # V"C r> s 6)� I ALL CONSTRUCTION DEBRIS ESULTING FROM THIS PRO ECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ( Please Print Legibly Name(Business/Organization/Individuai): (6A 6w -- Address: S`I t6T- City/State/Zip: DS Ill V5U 6 Phone#: �- ,A, an employer?Check the appropriate box: Type of project(required): 1.1aam a employer with _ 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6: ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have $. Demolition workingfor me in an capacity. employees and have workers' Y P t1'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.�'umbing 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.El 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 whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. r— Insurance Company Name: Policy#or Self ins. Lic.#: W�a 3 J�'daq Expiration Date: 3 Job Site Address: J �6 r� S1 City/State/Zip: n�s 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 ag ' t the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DJA f r insurance coverage verification. I do hereby certify e the ins and penalties of perjury that the information provided abf ve . true and correct Signature: Date: Phone &)L 0 Official use only. Do not write in this area,to be completed by city or town offcciaL 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#: 5/22/2014 6:28:08 AM PST (GMT-8) FROM: 100005-TO: 15084281974 Page: 3 of 3 CERTIFICATE OF LIABILITY INSURANCE DAT5122/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the 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 MARK SYLVIA INSURANCE AGENCY NAME: 404 MAIN STREET PHONE FAX Arc "°:CENTERVILLE, MA 02632 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC S INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: COMPLETE HOME GROUP LLC 770 A MAIN STREET INSURERC: OSTERVILLE MA 02655 14SURERD: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 20268820 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. POLICY EXP �TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDY EFF (MM/DDfYYYYI LIMITS COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ DAMAGEO NTEO CLAIMS-MADE OCCUR PR SESoccurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- ❑ JE CT LOC PRODUCTS-COMP/OP AGG $OTHER: $ AUTOMOBILE LIABILITY C D E $ Ea a '.dent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Peracddent $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION WC2-31 S-602832-024 3/23/2014 3/23/2015 PSET R- ER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $ .1000000 OFFICERIMEMBER EXCLUDED? Y] E.L.NIA - (Mandatory in NH) DISEASE-EA EMPLOYE $ 1000000 If yes,dawrbe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,maybe attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE ' Liberty Mutual Fire Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20268820 CLIENT CODE: 1759552 Anne Chandler 5/22/2014 9:21:20 AH (EDT) Page 1 of 1 i Massachusetts - Department of Public Safety Board of Building.Regulations and Standards ('nn�lrurli�rn tiuper�r.nr License: CS-094302 ADAM HOSTETTO 770 SUITE A MAIN OSTERVILLE M5A p2� ' y� Expiration Commissioner 12/?2/2015 r t I i Z„ C;��r.. rpnurrirnir�ucri���c/�•�(.c7.lJnr,�riJr./�J ! ... .� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration: .178455 Type: Office of Consumer Affairs and.Business Regulation - jExpiration: 4/16/2016 LLC 10 ParkPlaza-Suite 5170 y: Boston,MA 0211 COMPLETE HOME,�ROUP LLC ADAM HOSTETTER 770 ALMAIN ST OSTERVILLE,MA 02655 Underscei'eta,•y Not valid without signature 4 f, Twn OFNot N Ar 1,1DIVIsICi I .............. SS v t,t r / t t� r J t t, to i� i a .,a u ..?;_.- x .. yr .. ,.s. .; say.n,;r, A , .. .,..roSW� S;,ax,„.,.,:-gym,rv.-. ,.�;.. ..G.w tie. �.,,.... ,r. ;�. ..t„.: �Yh ai?:..:,7#'... ,�,, a..4.t �• �rn'- :��. �.: .sr;t�'�� ,; .; : ,r:w - ,• y.,:. �k E 2,.,v" ,.t ,��rr•4A „�o .... ,, v x '"-•., � `��" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applicatif�rS Health Division Date Issued /t�'�3 f9p iv 0Conservation Division Application Fee Planning Dept. Permit Fee �-�- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street ,Ad"dress ��6� / T� 5 f )z I &A (KAF-A) Village -rs1�V'►3��� Owner 9 W WCA5TCe i Y yTt-J k1JEvPrT$A rt_�ddress (faFE-Jt o J Crz�5 7T-c�4R'1��11��C FOW �stm�(,rf'&q -I- Telephone ?D- Permit Request EkChvA'j-C &A-d- P0,n1 �v�•,-dk ��N �� Ne4' c(�f�'1�av Square feet: 1 st floor: existing�cb proposed ) 2nd floor: existing '40 6 proposed 0 Total new Zoning District Flood Plain N/A Groundwater Overlay Project Valuation t Lt'-01`'J 0Construction Type W "Frw--.e Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. / Dwelling Type: Single Family 2 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King",. ghway: Yes ❑ No con c'� Basement Type: U�Full ❑Crawl ❑Walkout ❑ Other_e/ITF Basement Finished Area (sq.ft.) a Basement Unfinished Area (sq. ft' r, Number of Baths: Full: existing new Half: existing 6 ne - Number of Bedrooms: existing _L new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 016as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing �' New Existing wood/coal stove: ❑Yes UrKlo Detached garage: 3 e'xisting ❑ 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 ❑ No If yes, site plan review # Current Use SAC LE _rArn rZ-Y to C- Proposed Use S.t-N 6ac �-.�M�F-L It- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r. :Name— n�C )�S*TFT'TC�fZ-- Telephone Number s�S ya4S a �Sa�f "Address /"V-0/ S T DSO t✓,r—L /Lt+ License# Home Improvement Contractor# l Sa I a Ll -- �, Worker's Compensation # �3- �15`6aS14 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 SIGNATURE DATE to b31 �3 1 1 FOR OFFICIAL USE ONLY - APPLICATION# DATE ISSUED -MAP./PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FRAME INSULATION. A. ..u.,`LA FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL.BUILDING, DATE CLOSED OUT 4 u1 ASSOCIATION PLAN NO. t ?7ze Commonwealth of Ma5sachJuSetts f Department of Indits&'al Accidarts Office of Investigations - 600 Washbigtori Street Boston,MA 02111 www.Trras&goWdia ctricianMumbers Workers' Compensation Insurance Affidavit"$> ildersJCol�tratvtnr I please print Legibly licanit�formaticin. Nams(Busmess�Organ�anPlndiv'dnal�' WPI�' � Address: d - tat�el'Zi : �i(v � t� Phone#: d CztylS P pp' P Type of project(required). ire you an employer?Check the s ra: to box: ti_ F] I am a general contractor and I 6. ❑New a mstruction i_❑ I am a employer with have hired the sub-camtractars employees(full amdloryar#-time)-* listed on the attached sheet_ ❑Remodeling 2_❑ I am a sole Proprietor-or partner Thesesub-contractors have g_ Demolition ship and have no employees employees and have wodoess' 9. g��g addition working for me m any capacity- cep insurance.: INo Workers,comp.insurance 5 We area corporation and its 10_D Electrical repairs or additions required-] officers have exercised their 1_E]plumbing Sepairs or additions 3.❑ I am a homeowner doing all work 1AGL right.of exemption per 12_(]Roof repasts myself[No workers MIMP. c.152,§1(4),and we-have no 13 Other insurance required.]i � workers' comp- camp_insurance required.]: applkaW that checks box� •Any 1 nmst also fin out the sectionbelow showing their workers'compensation policy information. are cuing all wc&and then hie outside contactors mast submit a new BMdavid irXa- --h Homeowners who submit this affidavit indicating tLey the name of&e sub-camtracWrs Knd state whether or not those entities hoes rCantractors that check this bins must attached an additional sheet shovFiug off number. 1 theynatstptn dde their workers'comp•policy emplo}recs. if the sulr{aatractorshase emP ogees, f ? rpl"Dy � T a>zd.ob sitO lain art employer that is providing it�orke.rs'conipertsation insurance or rri*en ees. Below is the lick i irrformatiom Insurance Company Name: LILSUt-r Expiratiaal}ate: Policy#or Self-ins.Lic.#: � City/Stateizip: ' ,)r—M tfi 4t(td� Job Site Address: ��� 'c nation date). Attach copy of the workers'compensation policy declaration page(showing the Poo another and eap' Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the impasitifm of-criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the frnm of a STOP WORK ORDER and a� of uF to$250.00 a day against the violator. Be advised that a copy of this statement maybe fatwarded��Office of. Investigations of the D insurance coverage verification g _. . ... ... ........ rect I do hereby c¢rhfy a der he ns andpenalties of p�edur that the injorrriufiaar p�o,,j&d al 3 d a orBat . Si tune: �: _ - 0fficiaLarse+unf},. Do not write in illis area,to be wmple ted by city or town+ffici at FermitUcense# City or Town: Issuing Authority{circle oae): ector S.plumbing)Inspector 1.Board of Health 2.Building Department 3.CitglTown Clerk 4.Electrical In- Phone6.Other Plane#- 6 Contact Person:. a �R�• CERT IFICATE OF LIABILITY INSURANCE DATE`MM MOT" FCOMIRCRI9 IFICATE 19.ISSUED AS A MATTER OF IRfORMATION ONLY AND CONFERS NO RIOHTB UPON THE CERTIFICATE HO DER 1TH19. TE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIpES THIS CERTIFICATE OF INSURANCE DOER NOT CONST171lTts A'CONTRACT BE7WEE�1 TTtE ISSUING INt3URERIS), AUTHORIZED TATIVE OR PRODUCER,AND THE CERTIFICATE HOLDtR IMPORTANT.T: If the ceAMeale holder Is an ADDITIONAL INSURED,the polLyrpes)must be endorse4 It SUBROOAT1oN IS WAIVED,subject ID the nd conditions of tt»pdtey,coRaIn policies may require an endorsement A atatemerWt on this certificate does not confer rights to the older In 0eu of suM aldorsemen s. PRODUCER Mark Sylvia Insurance Agency,LLC NAME: Debbie 404 Main Street MUM 508 957•?125 is roe:508 57-2781 CenteMle, MA 02632 l: ra mark vls surence Com TS!WR S_ t 1 ARORDING COVERAGE MAIC a IN SVRED LLWLmeA:Montpeler US Ins Cc - west BOY Menegwed Trust IN>eLIRERO:Treaders Insurance Co ' 770A Main Street INeAIRERC: OsterWle.MA 02655 II [RD: INSURER E: COVERAGES. 1NmuRER r CERTIFICATE NUMBER: REVISION NUMBER: THIS.IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED..NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. WR TYPE OFiWSIIRANR E POLICY NUMBER M 011 A OENBQILL IIABn.nY LIMITS MP000W01012633 1 IM2 12 T 4/y01tPER ENCE s 1.000,000 X COMMERCItiOt:NERHIILraBIL1TV; CLAWS-MADE u OCCUR 0OLLmx+ne.) f 100.000 nne enpn) f 5,000 CV INJURY f 1.000,000 y REGATE 1 2.000,000 OENL AGGRFGATE LIMIT APPLIES PE?•X POLICY lotMPIOP AGG 1_ 2,000 000 AUTOMOaILE L"Ln Y f ANY AUTO' a eado� N IIMI'I SCMePl4ED BODILY NJURY rof person) f AU7ED fqN-0M1VEt aODILY INJURY rw seddenl) I HIRED AUTOS AUTOS (Per ec Den f f UMBRELLA.UA6. OCCwJR EXCES3LIAB EACHOCCU"ENCE f CLAIAASMA06 AGGREGATE _ DME D RErENT*N B WORKERS COMPMArON UB-781580 A f ANDEMPLOYEN�LUBaITY YIN 3/23/3013 -!=- 014 T s>,rus X o ►� - . I(AW�ERiMEI.IpjECUTIvE❑ NIA E.L.EACH ACCIDENT f SOO.000 OMend"In.NH) .. •r- 5 07rCfbe veer E.L.DISEASE-t A ENPLOr : 500,000 CmPrIoN OF OPERATIONe N•Iow E L.DISEASE.POLICY limn f ..'::.. :. 500,000 DEt.YJ11P1YDN OF OPERArON9I LOCATIONS I VEMCLES(Arbon ACORD 101,Aediso"R.ev, Ben Wine,rpm specs to re4Wed) Resider'IW Carpentry CERTIFICATE HOLDER CANCELLATION t (508)790.6230 eHONLD ANY OF THE ABOVE DESCRIBED PoucIEB"BE CANCELUM BEFORE TownCtBernetebie BulCingDopartmenl 1HC 1MRATION OATU THEREOF. NOTWCE vrILL BE DELIVERED IN 200 Mfin Street ACCORDANCE WITH THE Polley PROVIBION6. Hyannis.MA 02601 AUTHONZW NTATM f 1888-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are regiatered marks of ACORD t Massuchusctts-Depa►-tmcnt of Public $afet� 86ard of Buiidin!ir Re-UlatiOns and Standimds " Construction Supervisor License License: CS 94302 ADAM HOSTETTER. 770 SUITE A MAIN ST OSTERVILLE, MA 02655 C, ,yam Expiration: 12/22/2013 Tr##: 7378 ('ununissioner L l ., Licensc or registration valid for indivldul use only ]r._\ Office of Consumer Affairs& Business Regulation before the expiration date. If found return to: _ OME IMPROVEMENT CONTRACTOR Office of Consumer A(feln and Business Regulation eglstratlon: 152124 Tye' 10 Perk Plaza -Suite 5170 xplratlon: 8/2/2014 DBA Boston,MA 02116 eyv WEST BAY MANAGEMENT TRUST ADAM HOSTETTER 770 A MAIN ST. - OSTERVILLE, MA 02655 Undersecretary Not valid without signature v_ - BAR1'$rABLE, Town of Barnstable �ts3Q `eg Regulatory Services Thomas F. Geiler, Director Building Division Thomas I err',C130 Building Commissioner 200 Main Street. Hyannis. M.A 02601 "Hw.to"n.barnstable.ma.us Off ice: 508-862-4018 Fax: 508-790-6210 Property Owner Must Complete and Sign This Section If Using A Builder },��G�e�I,T�/E2��' as Owner OF the sub1 cct property hcrcl)v authorize''' �s(tf! to act on rn behalf, in all marrcrs relative to work aurhorizcd by this building; hermit application for: (Address of fob) �� L o"nartirc of O,,%'ncr Darr a Pn'nr Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. C+l,sets,Jerul!ik1:\ppl)atu.L,xul',�1 cmwfl'.11'inJu��s',I'rm Internet FIICS1.Cuntent()utl,xiVQRFUL:I ME\PRESS dcxc Revised 05 1012 it Robert W. Dennis Jr. Register Structural Engineer License #13834 P.O. Box 534 - East Bridgewater, MA 02333 508-326-2464 Structural Evaluation 3667 Main St. Barnstable MA On October 22, 20131 1 inspected the property at 3667 Main St. Barnstable, MA with Project Manager Brian Powers from Hostetter Homes. The property consists of a classic Cape Cod house built around 1750 retaining much of the original construction. The fact the house still stands after 270 years speaks well of its fundamental structural integrity, however, as with many very old houses, it is evident that most of the original sills on the exterior of the house have completely deteriorated. All of the interior floors slope several inches towards the exterior walls of the house. Some of the original interior beams and ceiling joists have deteriorated or show excessive deflection. The owners intend to construct a large addition attached to the rear wall of the original house. They also wish to retain as much of the original house as possible. The front of the house has recently been jacked and a new 4ft. concrete wall has been constructed across the front of the house. It is my recommendation the two side walls and the rear wall of the original house be jacked and new exterior sills be installed. This will at least provide a relatively level starting point for the exterior of the building. For ease of construction, support for the new sills is probably best done using Sonotubes rather than.temporarily holding up the building while attempting to excavate under the existing walls and pouring a new concreter footing and foundation wall. In the interior of the house, I recommend removing and replacing those beams and/or ceiling joists that show significant damage or deteriorati s W. MMMIS.JR. .9 S13834 /O7 A a 23(i3 The new addition is to be constructed on a new concrete footing and foundation wall. I recommend the new foundation wall be extended across the back of the original house. This will allow for separate independent support of the rear of the original house and the new addition where they abut each other. or ram '°s W. 4iSNNIS,JR. 601 -� ,per 13B3i wp.L�� c �, OIIAI.�� n 23l �3 1� V .r I I I I I I o i 1 i i i I i eo I I Q I I - I o- -- y I _,-0 W �a h 28 ,._._................. -———— -_.__ Twain r N ___._._.__-_._._.__._ ._._._.T.-. y J I I Z F ti o-_ --,- -.-- .r--- --- --- -- -- ------ - t IS bZA�SFACF FULL HEIGHT L i—————— --I.J J"- I •'(. i yw ;N Txm— w �a emma roro�r 1^)� L•l i I I I I � I I ae�mera¢ I I I I I vuruw« I I I W h , an�e�ar I I I v»..was anaawu rem«e ————— -_ ----- -------- - ------- - - - -----------I A I -------- � i I �,��.., I i W yin II y I — g - '1---._.-------'----._.-.-._.-.-.-.---- ._--'r'-'--'-----.-._._._---'-'---- _ y FGRAWLSPAGE i i i .. i : Revrseo:lazz-zols I _ o- 12 -�._._._.-.-.-.-._-_._ -.-._._,-.---.-.-.- .-._._.___.- _.__.--._-.-.-._.-._ SCFO:MATIC DESIGN - _ CONSTRUCTION I - I FOUNDATION or PLAN b " �s� b y iu 1`t' ti f i'a Jl 0 FW AA ON PLAN 52.0 el G I I 1 I i i 1 j i i i i I I I I I I i I I I I 1 I I I I I p0 I.-.-- I I I F-1 N m--, -------------; ---------,---- ---------- ------------------- _ ;-----0 N j i i i i H �. j I I I I I I IT, .___._._._.-.____._._.__._.__I � � j I I 1 `// 1�1 y��•� I II 1 I I 11 � F I l I 1-.1 W NN -----.-------._._._.__ l l i O o I li i I o �_._ -_---- , I 6 . 1 I I i U N i w o--a------ -'--'-'--------'--------'- - b........re,... i j I n rn. AU ---------------------------- I mnrwae wrs �. I I I I I - I P0.0JER/ 13E: 10-I8-2013 Ff . REVISED: I I I I I I I I I I I I I I I I I 1- 12 -_ _._.-._._._._._.__._-._.___._._.__._._._.__._I_.__._.-._._.__._._._._._._._.__._._._._�._._._.-_ -_._._._._.-._._._._. _.__.__._._._._._. __1__._—-. 12 SCHEMATIC DESIGN NOTFOR CONMUMON I I I I I sr FLOOR FRAMING PLAN !:�F ?OR FRAMING C2. 1 Q Q Q Q Q QQ Q I I i i 1 I i I i i I I E i i i i i i m I i I i i i i o----- ------------ ---------------- ---------- -- --------- - 1 I I W rq `I 1 C I i a----- - - -- --------- ---- -------------- ,- ---------------------- i____-0 nn i i i � i i a aoae I I El s h m I I I i I I I i W a--------——---------—----'—----'----- j - I I ( ertorecry I I ! u,vE las-zou - 1 i I i I I I i I i I I 1 ----------------------------i---------------------- ---------- __._._._.___._._._._-. --__ ___-_ �-:-._._—_. ,2 SCHEM—00 ION .. CONMUCnON 2ND FL00R FRAMING PLAN 2nd FLOOR FRAMING c2.2 i is ------ i ---------- — _ -0 a- --T--------'-----r--'------'---'T'----- - -'-I--;---------------'-- ----'--- II 1 ' I Iiil o IIII i i 1 i i i 2 ----'-----'---- -----------------i-------- --------------- - ----------------------- -----0 c _ ' I ------'-- ---'i------------ - I�.---f-------------------.-.-.T.-._.__.--0 �1 = L--------------------'------ a L I r I III II i .li _._._._ _._._._._._._._._._. \ I II _ i 6 6 !I I I U M1 L=4A - -- - - _ W U i - i rn - ------ -----------�- s --'-------------------------'r�------- � --�- �-�-�--._._._._ .. � as - i I ! TIlT1 ill: IIII I: PROIECl/ ;--Ii I I-i Ii __..--_-. t.__.I ___ _ DATE: i418-2013 MT I III REVISPA: 1 - I-11 II. or 11 r .1-1 1 I 1 ICI I_ IlI I' 11 ! -_� TI iTl I - 12 ---1.-._._._._._._._.___._._._---._.,__._._._.__._I_._._.__._.-._.__.__.__._._,__.-._.,_._ _.-._.-__._._.__._._._._._._._._ _ �.:...` _._.__._.__._._._.-._._._._._I_._._-._. 12 S�C DESIGN NOTFO j j I NOTFOR I I I I 1 j CONSRNClION I I I ROOF FRAMING PLAN ROOF FRAMING S2.3 ,> Q Q Q 4 Q Q4 4 I I i i I I i 1 1 i i i o0 1 i i i i i �1-j� �•� I-_.-_-_._._---_._._�_._._- _._._- __._._._- I /p�� Fy N o-- - --------- -------- I---------------------I -� o- + -- ---------------------- I I I I a Q I j I j I I W F= O I 1 Fa. I I I I 1 ^W I I mF a_._.—_._._._-._._._._-.-._._._._._._.-._._._._.__._.r._.__._._._.__.__._.__-_.-.--__._._._._ I I � I I I I PROTECT 1 I I I I I I i DATE: 10.18-2013 I I. I REVISED: I I I I 1 I I I I I I I I � 11 �. ---------------------------i-------------------------�--------------------- _._._.__._._._.-._._._. __._._I__—._. 12 SCI$MAi1FDDESiGN i CONOTFOR,ON - - - I ROOF PLAN ROOF A2.3 v 1 I -._.____.__-_-.._._,_I___._ __.___ __ ___._ -�______ ___._._y_.__-_.__._____I___.____.____ __________.y_-____- _ 1 I � I I I mru.inro I I I I I 1 I I I I 1 � I �eaax.inra.w 0 I I I 1 I I. ® ® vrere ro r~h�rh-I 0 I �y U ..poi oen --- I .o. - ❑ `mow. I�1 W fsl �aa roues _ F�1 Lt1 N F T N� 0O h o I I I 1 I G �\ SECTION y��a � SECTION 1 W WA -----1-----'--'----'---------I----------- I I � m I I DATE: 10.18-2017 ------------ SaMtAAnC DF GN NOTFOR _-_ - ----'------- CONSTRUCTION I I I I BUILDING SECTIONS SECTION A4. 1 BRUCE MILLER ,1RCl1H,Cf I J%VALTHAMSMEET:'15 OFFICE BO5T0\.MA W I18 617.33S 3933 DEN. ...` _ LAUNDRY .. _. ".."._.._._.-. ...... _� � ... .. SCREEN \ PORCH Pu_BATH .1.t W frl Vx_ ) BEDROOM PANTRY /) KEEPING ROOM ENTRY pI ` p W [T]W U i 36 - I ~ E-I c I Z / \ KITCHEN I DINING 1 ' LIVING AREA TERRACE H 1 / I l H p; p c/) - V) � CLOSET - MASTER ' BEDROOM MASTER BATHROOM DATE: sn. OFEDDA-ci - 9-21-13 SCHEMATIC DESIGN: FIRST FLOOR PLAN FIRST FLOOR PLAN Owner:Robert E Bagshaw;Jr. �J Address:366Z Maln Sit.BarnsFable;MA 02630 Map/parcel:3.17039, `` = cl c a U n!r'i01 BRUCE MILLER _ AREA �- /. --___. - 16 WAL ON.MAOVI:21i BOi7O%.MA 02119 i ,—_---__ EXISTING �. BUNK ROOM SNED RODE - BAT EZ w ( 1 ( 1 x \ I I Lof .. R I D-G E I , t ( ( W - DATE: 9-21-13 SCHEMATIC DESIGN: SECOND FLOOR PLAN ��J ua•=,•-o• Owner: Robert E.Bagshaw,Jr. �_� Address:3667 Main St.Barnstable,MA 02630 Map/parcel:317039 i BRUCE MILLER A CHrr- q WALTHAMSMEET:215 . - 80STON NA091b _ 61].l J8.J9J1 V 14 ie Q V cn 0; V)� z � -- ----------------.--_ U. Tj o � V) o Q -- - -- --- SCHMATIC DESIGN: NORTH ELEVATION DATE: 9-21-13 Owner:Robert E. Bagshaw,Jr. �_� Address:3667 Main St.Barnstable,MA 02630 Map/parcel:317039 BRUCE MILLS ARCHU cr 96 MLMA1I STREET:25 RMO\.NA 0211E 617.33S.3933 U V) 19 w W � H _ Q v —_ K .. ... .. _ - O r� SCHEMATIC DESIGN:WEST ELEVATION DATE: 9-21-13 Owner:Robert E. Bagshaw,Jr. �_� Address:3667 Main St.Barnstable,MA 02630 Map/parcel:317039 BRUCE MILLER - I AREHTTEQ . 161YALTHA.\I STREET:215 617.338,3933 12 r _ W LLIJJ Li ,iEl ji w m ❑, i I ,❑ I Q❑ Q I❑ o ❑`: V) El El Ell: Ei M C) Pq SCHEMATIC DESIGN:SOUTH ELEVATION ve•=r-a• DATE: 9-21-13 Owner:Robert E.Bagshaw,Jr. Address:3667 Main St. Barnstable,MA 02630 A-5 Map/parcel 317039. BRUCE MIL R AXCHffER . M WALTHAM MEEE:215 BOSTON.MA 021IY ' 617.338.3908 19 - - _ a U < W GWra U a a U ' Q! Q;4:1j. cn <1 _ Q. ;EDI as (—I1 SCHEMATIC DESIGN: EAST ELEVATION DATE: 9-21-13 Owner:Robert E. Bagshaw,Jr. �_� Address:3667 Main St.Barnstable,MA 02630 Map/parcel:317039 o� s nor@ y9 A��o to orb ls3 If,- `o^' 21p�'�`�66j Ox�Sf���Pef �9 00 3.75' 4S6• � .6• R=27.48' a L=31.12 EXISTING CONCRETE ♦ 1 FOUNDATION 7g9 ♦O cap L R> LOT 1 61,240 SF 0 DCE #13-143 " u11NDATION PLOT PLAN PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE LOCATION 3667 MAIN STREET BARNSTABLE, MA SCALE : 1" = 40' DATE : JANUARY 2, 2014 PREPARED FOR: REFERENCE : ASSESSOR'S MAP 317 PARCEL 39 ROBER ' BAGSHAW REGISTRY REF: LOT 1 LCP 21798B I HEREBY CERTIFY THAT THE STRUCTURE ��t�Qg�•rq;S., SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. ARNE N o H. off 508-362-4541 " OJALA v fax 508 362-9880 880 1 0 2 8( down cape engineering, inc. CIVIL ENGINEERS LAND SURVEYORS - DATE REG. "�--------- 939 main st. yarmouth, ma N'D SURVEYOR _ . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued/l/�f Conservation Divisions Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 3bCj Wr1i S_T_ i Village BA7,J 51*9 G6 M4 Owner_4,/Tj L"Jewret & /J€✓rzzT5A 7ES Address 11l� &4?F-JD®r./ a€5&0— 044*b,CA Telephone � r ffcsm Permit Request F61.46n6t JS(046 VP eUSTI?A HavS'c R`bl) fth>±rptJ NEB F-r-i!�EP64-CC-5 /4✓,46 l)&PA7 kk *PN.GJ6 Live, Krrc o S -1-14 LAv^r�( 1 .�5 Square feet: 1 st floor: existing IN ,T roposed 2nd floor: existing9," proposed ,;�� Total new Zoning District Flood Plain Groundwater Overlay Project Valuation AeTConstruction Type WOM Lot Size ��1, -�y ve he/ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family CY Two Family ❑ Multi-Family (# units) Age of Existing Structure TqO Historic House: CKes ❑ No On Old King's Highway: a es ❑ No Basement Type: W Full LA/Crawl ❑Walkout ❑ Other 60C- (on /No ie Basement Finished Area (sq.ft.) 0 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 69- Existing w coal staff: ❑des afq'o Detached garage: J existing ❑ new sizA_WPool: ❑ existing ❑ new size _ Barn.]l existing5 new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 14 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ='a ..r= Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � �Srn- e `� Agmr 'T003i Telephone Number `� tO-c a �a� Address T?O M4%e1 S�` 05MOA.LE /-44 License # �i) Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 5�A +—�5) N SIGNATURE DATE i� !' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. r ADDRESS VILLAGE r OWNER DATE OF INSPECTION: r FRAME L +INSULATION:,JL FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING:Z DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Building Department - 200 Main Street ST"Iz, Hyannis, MA' 02601 9 MASS 16 639- a� (508) 862-4038 D MA'i Certificate of Occupancy Application Number: 201309119 CO Number: 20140151 Parcel ID: 317039 CO Issue Date: 11/14/14 Location: 3667 MAIN STATE 6A(BARN.) Zoning Classification: RESIDENCE F-2 DISTRICT Proposed Use: SINGLE FAMILY HOME Village: BARNSTABLE Gen Contractor: HOSTETTER,ADAM Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed TOWN OF BARNSTABLE Building- uI'd'n : . . �: 201309119 AS& Issue Date: 01/09/14 Permit M �* lIABt;. � 039' Applicant: HOSTETTER,ADAM Permit Number: B 20140025 Proposed Use: SINGLE FAMILY HOME Expiration Date: 07/09/14 Location 3667 MAIN ST.IRTE 6A(BARN.) Zoning District RF-2 Permit Type: RESIDENTIAL ADDITION/ALTERATIO . Map Parcel 317039 Permit Fee$ 255.00 Contractor HOSTETTER,ADAM Village BARNSTABLE App Fee$ 50.00 License Num 152124 Est Construction Cost$ 50,000 r Remy APPROVED PLANS MUST BE RETAINED ON JOB AND REMODEL/SURE UP EXISTING HOUSE,ADD ADDITION,NEW FIREI LAM&CARD MUST BE KEPT POSTED UNTIL FINAL HVAC-1 BED,DIN,LIV,KITCHEN,BATH,LAUNDRY INSPECTION°HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: LANCASTER,KEVIN&NEURITSA TRS BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1118 CLARENDON CRESENT INSPECTION HAS BEEN MADE. OAKLAND,CA 9"10 ,�n Application Enured by: PF Building Permit Issued By: �LLJ!/�— THIS PERMIT CONVEYS NO RIOHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,FUDEeRR TWOORARII Y OR PERMANENTLY.-PNCROACtA4'NI8 ON LIC PROPERTY. TrMCALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION- STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBIC SEWERS MAY BS '' «t OBTAL�IED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PER Wr DOES NOT RELEASE THE APPLCANT FROM THE CONDITIONS OF ANY ApPLCABLB SUBDMSION ".a.7tES7RIcnoxs. .;.MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: °I:.FOUNDATION OR FOOTINGS. 2.'SHEATHING INSPECTION 3 ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. d.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 'b:INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS- 1VORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. 14ERNIIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF •DATE THE PERT IS ISSUED AS NOTED ABOVE. ; PERMIT CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(asset forth in MGL c.142A). POST THIS CARD SO THAT IS VISIBLE FROMTHE STREET +~ BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS y 2 �r ✓ �i1-t 3' 1 Heating Inspection Approvals Engineering Dept Fire Dept � 2-JF- .n - Boa H t - 1 6 3.a�1`i G� Generated by CamScanner from intsig.com 17te Coniniomsrealth of_Massachusetts Department of Industrial Accidents rig- Office of Investigations ilt �-a 600 Washington Street Boston M4 02111 J �r� trs�rr.ntass.gm/din Workers' Compensation Insurance Mfidasit: Builders/Conh-actors/Electiicians(Plumbers Applicant Information ( ,,/ Please Print Legibh Name(Business.Chganizadon;Inditidual): AV>AM �`»iEITC ✓1/l 1C!5% Jam`/ /"'loN1T �12ySi Address: Mir J ST City./Statelzip: va-&o 1 Phone#: �<-o ce", Are you an employer Check the appropriate box. Type of project(required): 1.L1 1 am a employer unth � 4• ❑ I am a general contractor and I employees(full and-or part-time).* have hired the sub-contractors 6. Jeu construction ''.❑'I am a sole proprietor or partner- listed on the attached sheet. 7. [�odeling ship and have no employees These sub-contractors have g_ ❑ Demolition working for me in any capacity. employees and have workers' � �'- - 9. EJ Building addition [-No workers' comp.insurance comp.insurance.- required.] 5. ❑ We are a corporation and its 10.0 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 1 2.❑ Roof repairs insurance required.]` c. 153, §1(4).and we have no employees.[No workers' 13:0 Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy informattoa 'Homeowners who submit this affidae•it indicating they are doing aLl work and then hue ouUide contractors must submit a Lew affidavit indicating such_ -Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have emplrn•ees.they must provide their workers'comp.policy number. I ant air employer that is providing PtIorkers'compensation insurance for it{v employees. Below is the policy and job site infornration 1,�,,, Insurance Company Name: l L � C ILA/►Y4 Policy"or Self-ins.Lic.»: W-TK[S#S0 SA Egpifarion Date: kZ3 /L Job Site Address: • 6&1- r"►q y S f CityStatelZip: Attach a copy of the workers'compensation policy declaration page(shoeing the policy number and expiration date). Failure to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 17500.00 and or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250M a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DL-k for insurance coverage verification. I do hereby cerrifi-under the pains and penalties of pedun-that the information provided above is true and correct. Signature: Date: Phone--: Official rise arch•. Do not write in this area,to be completed bY cin-or rown offiiciaL City or Toren: PermidLicense 9 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. Cir_<iTorn Clerk J.Electrical Inspector Plumbing Inspector 6.Other Contact Person: Phone 9: 6 Aco , ;CERTIFICATE OF LIABILITY INSURANCE DATE Y) `'�"'� 12/032/03/2013 2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES. BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A"statement onkthis certificate does-not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTA NAME: Sarah Mark Sylvia Insurance Agency,LLC PHONE 508 957-2125 FAX 404 Main Street E-MAIL A/c No: 508 957-2781 ADDRESS:mark marks (viainsurance.com Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC# p INSURER A:Montpelier US Ins Co INSURED West Bay Management Trust INSURER B:Travelers Insurance CO. , 770A Main Street INSURER C: Osterville,MA 02655 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY"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 ADDL SUBR EXP LTR TYPE OF INSURANCE POLICY NUMBER MOMIDDY EFF M POLICY LIMITS A GENERAL LIABILITY MP0006001012633 12/4/2013 12/4/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JECTPRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E ao ident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS .,Pera cident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ JECESS LIAB HCLAIMS-MADE AGGREGATE $ D RETENTION$ $ B, WORKERS COMPENSATION UB-71315805A 3/23/2013 3/23/2014 7 WCSTATU- OTH- AND EMPLOYERS'LIABILITY YIN X ER ANY PROPRIETOR/PARTNER/EXEC.,I E OFFICER/MEMBER EXCLUDED? N I A E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Residential Carpentry CERTIFICATE HOLDER. CANCELLATION (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Bamstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 k AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 ADDITION 3667 MAIN ST. BARNSTABLE MA Q Check Compliance 1.1 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) ..... 2 stories _<2 stories Q RoofPitch ..........................................................................(Fig 2) ...................................................8 5 12:12 Q MeanRoof Height .....................................................................(Fig 2) ..................................................16 ft 5 33' Building Width,W ..............................................................(Fig 3)................................................. 60 ft _<80, Q Building Length, L ..............................................................(Fig 3)..................................................80 ft <_80' Q Building Aspect Ratio (Fig 4 1.5 <_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.............................................................................................................................. Q ConcreteMasonry.................................................................................................................................... N/A 2.2 ANCHORAGE TO FOUNDATION1,3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ................................. ........(Table 4)................................................... 32 in. Q Bolt Spacing from end/joint of plate ............................(Fig 5)........................................12 in.5 6"—12" Q Bolt Embedment—concrete........................................(Fig 5)..................................................7 in. >_7" Q Bolt Embedment—masonry........................................(Fig 5)........................................... in.a 15" N/A PlateWasher...............................................................(Fig 5)..............................................a 3"x 3"x%" Q 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Q Maximum Floor Opening Dimension...................................(Fig 6)................................................._ft<_ 12' N/A 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 FloorBracing at Endwalls...................................................(Fig 9)................................................................... Q Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................................... Q Floor Sheathing Thickness ................................................(per 780 CMR Chapter 55)..........................3/4 in. Q Floor Sheathing Fastening..................................................(Table 2)............8 d nails at 6 in edge/12 in field Q 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)...............................8 ft <_ 10' Q Non-Loadbearing walls................................................(Fig 10 and Table 5).............................18 ft 5 20' Q Wall Stud Spacing ........................................................(Fig 10 and Table 5).....................16 in.5 24"o.c. Q Wall Story Offsets ........................................................(Figs 7&8)...........................................—ft 5 d N/A AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(Table 5)..........................................2x6-8 ft 0 in. Q Non-Loadbearing walls................................................(Table 5)........................................2x6-18 ft 0 in. Q Gable End Wall Bracing' FullHeight Endwall Studs............................................(Fig 10).................................................................. Q WSP Attic Floor Length...............................................(Fig 11).............................................. ft zW/3 N/A Gypsum Ceiling Length(if WSP not used)..................(Fig 11)..............................................26 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 ........................................................(Table 9)..........................................3 ft 0 in.5 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) HeaderSpans.............................................................(Table 9)..........................................8 ft 0 in. <_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)(Table 10)....................... Percent Full-Height Sheathing.......................(Table 10).......................................................59% 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.........................................(Table 11 or note 4 if less).............................3 in. Q Field Nail Spacing.........................................(Table 11).....................................................12 in. Q Shear Connection(no.of 16d common nails)(fable 11)............................................................4 Q Percent Full-Height Sheathing.......................(Table 11).......................................................31% Q 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... N/A Wall Cladding Ratedfor Wind Speed?.............................................................................................................................. Q AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 5.1 ROOFS 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 plf Q Lateral.............................................(Table 12)...............................................L=176 plf Q Shear..............................................(Table 12).................................................S=77 plf Q Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T= plf N/A Gable or O Connections at Non-Loadbearing Wall s (Figure 20)............._ft s smaller of 2'or U2 N/A T Proprietary Connectors Uplift................................................(fable 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 DI)ITIO. 3667 IN 3T.NARNSTABIM 19EETS THE CHECKLISTIN ITS ENTIRETY, TH OLLOWING 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. Comer 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 AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(78o CNm 5301.2.1.1)1 �-WEN THIS EDGE RESTS ON F4IAMING USE ad NAILS AT6b c 11 11 1 11 11 1 71 11 II 1 u 1-I it 11 11 /1 11 11 11 11 11 11 11 11 11 1 N II 1 1 11 It I � 11 1I 7 I.cC 11 I. 1 ii 1 Y 11 O Il � 11 11 Q 1 e m n idIL .1 RIM 1 1l1 it {1 t li ii 1 ,I 1,1 1 40 I t •Q� 1 It Z 11 ii I.j 1 11 IL 11 Ir 1IIUUU 1 IL it 114 1 r I ii ii i I II tl l 1 11 LI 1} ��Iy�I�����,,—CC S�ys—�yJ��1 WUSIX t rrAlr� `-- - NAILSPACIN _ --_ L PAfVEi_ d � See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)1 Q Za ; � 1 1 1 ' / 1 a ' F_rI MEMBERS 6i ' i . EDG 1 1 1 1 L. ----- STAGGERED WAIL PATTERN PANEL PAWL EDGE DOUBLE NAIL EDGE SPAMG DETAL Detail Vertical and Horizontal Nailing for Panel Attachment REScheck Software Version 4.5.0 C�J( Compliance Certificate Project RENOVATION Energy Code: 2009 1ECC Location: Barnstable, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 3,016 ft2 Glazing Area 10% Climate Zone: 5 Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 3667 MAIN ST. HOSTETTER HOMES BARNSTABLE, MA Compliance: 0.8%Better Than Code Maximum UA: 616 Your UA: 611 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Ceiling 1: Flat Ceiling or Scissor Truss 1,516 38.0 0.0 0.030 45 Ceiling 2: Cathedral Ceiling 1,500 30.0 0.0 0.034 51 NEW WALLS: Wood Frame, 16" o.c. 3,490 21.0 0.0 0.057 174 ~ Window 1:Wood Frame:Double Pane with Low-E 282 0.340 96 Door 1: Glass 120 0.340 41 Door 2: Solid 42 0.280 12 Wall 2:Wood Frame, 16" o.c. 1,091 21.0 0.0 0.057 56 Window 2:Wood Frame:Double Pane with Low-E 72 0.340 24 Door 3: Solid 42 0.280 12 TOTAL FLOOR:All-Wood joist/Truss:Over Unconditioned Space 3,016 30.0 0.0 0.033 100 Compliance Statement. The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 1 of 8 r CREScheck Software !Version 4.5.0 �J( Inspection Checklist Energy Code: 2009 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table.is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.2 ;Construction drawings and ❑Complies 1 [PR1)1 documentation demonstrate ❑Does Not energy code compliance for the ; :building envelope. ❑Not Observable ❑Not Applicable 103.2, Construction drawings and ❑Complies ; 403.7 :documentation demonstrate ❑Does Not [PR3)1 energy code compliance for lighting and mechanical systems. ❑Not Observable Systems serving multiple []Not Applicable ,:dwelling units must demonstrate :compliance with the commercial ; code. 403.6 Heating and cooling equipment is; Heating: Heating: ;❑Complies ; [PR2]2 sized per ACCA Manual S based Btu/hr Btu/hr ;❑Does Not Ion loads per ACCA Manual J or ; ; Cooling: Cooling: I❑Not Observable other approved methods. Btu/hr Btu/hr ;❑Not Applicable , Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 2 of 8 2009 IECC Foundation Inspection 7 Complies? Comments/Assumptions 303.2.1 A protective covering is installed to ;❑Complies [F011]2 protect exposed exterior insulation :❑Does Not and extends a minimum of 6 in.below grade. Z❑Not Observable j❑Not Applicable 403.8 Snow-and ice-melting system controls;❑Complies ; [FO12]2 installed. ;❑Does Not J '❑Not Observable; ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 3 of 8 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions &Req.ID 402.1.1, :DoorU-factor. ; U- ; U- ;❑Complies ;See the Envelope Assemblies 402.3.4 ;❑Does Not table for values. [FRl]1 ; ❑Not Observable :.[]Not Applicable 402.1.1, ;Glazing U-factor(area-weighted ; U- ; U- ;❑Complies ;See the Envelope Assemblies 402.3.1, average). ❑Does Not ;table for values. 402.3.3, '❑Not Observable 402.5 [FR2]1 ; ;❑Not Applicable 303.1.3 ;U-factors of fenestration products ❑Complies ; [FR4]1 ;are determined in accordance ❑Does Not ;with the NFRC test procedure or ;taken from the default table. ❑Not Observable ❑Not Applicable 402.3.5 Sunrooms enclosing conditioned U- U- UComplies [FR8]1 !space have a maximum T❑Does Not !fenestration U-factor of 0.50 in Climate Zones 4-8.New glazing []Not Observable I ;separating the sunroom from ;❑Not Applicable conditioned space must meet code requirements. 402.3.5 ;Sunrooms enclosing conditioned U- U- ;❑Complies ; [FR9I1 !space have a maximum skylight ;❑Does Not U-factor of 0.75 in Climate Zones 4-8 ;❑Not Observable ❑Not Applicable 402.4.4 1 Fenestration that is not site built ❑Complies ; [FR20]1 !is listed and labeled as meeting ❑Does Not ce ;AAMA/WDMA/CSA 101/I.S.2/A440 I or has infiltration rates per NFRC [--]Not Observable 400 that do not exceed code ❑Not Applicable limits. 402.4.5 JIC-rated recessed lighting fixtures ❑Complies ; [FR16]2 I sealed at housing/interior finish ❑Does Not 00 !leakage labeled to indicate s2.0 cfm ❑Not Observable ' leakage at 75 Pa. ❑Not Applicable 403.2.1 Supply ducts in attics are R- R- ;❑Complies [FR12]1 !insulated to>_R-8.All other ducts : R_ R_ :[]Does Not m unconditioned spaces or outside the building envelope are: :❑Not Observable insulated to>R-6. ; ;❑Not Applicable 403.2.2 :All joints and seams of air ducts, ❑Complies [FR13]1 !air handlers,filter boxes,and ❑Does Not S ;building cavities used as return ;ducts are sealed. ❑Not Observable ❑Not Applicable 403.2.3 Building cavities are not used for ❑Complies ; [FR15]3 supply ducts. IE]Does Not ❑Not Observable ' ❑Not Applicable 403.3 HVAC piping conveying fluids R- R- ;❑Complies ; [FR17]2 above 105 QF or chilled fluids ;❑Does Not below 55°F are insulated to a:R- ; ;❑Not Observable 3. ❑Not Applicable 403.4 Circulating service hot water R- R- ;❑Complies ; [FR18]2 pipes are insulated to R-2. ;❑Does Not ;❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 4 of 8 Section Plans Verified Field Verified # Framing/ Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 403.5 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 5 of 8 Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 JAII installed insulation is labeled ❑Complies [IN13]2 or the installed R-values ❑Does Not 3 provided. ❑Not Observable 3 ❑Not Applicable 402.1.1, ;Floor insulation R-value. R- R- ;❑Complies ;See the Envelope assemblies 402.2.5, ❑ Wood ❑ Wood ;❑Does Not ;table for values. [IN1]1 6 ;ElSteel ❑ Steel ;❑Not Observable ❑Not Applicable ; 303.2, ;Floor insulation installed per ❑Complies 402.2.6 !manufacturer's instructions,and ❑Does Not [IN2]1 iin substantial contact with the underside of the subfloor. []Not Observable ❑Not Applicable 402.1.1, ;Wall insulation R-value.If this is a: R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.4, mass wall with at least 1/z of the ❑ Wood ;❑ Wood ;❑Does Not ;table for values. 402.2.5 ;wall insulation on the wall ;❑ Mass ❑ Mass ;❑Not Observable ; [IN3]1 :exterior,the exterior insulation ❑ Steel ; Steel ❑Not Applicable licable !requirement applies. ; 303.2 I Wall insulation is installed per ❑Complies (IN4]1 !manufacturer's instructions. ❑Does Not ❑Not Observable ❑Nat Applicable 402.2.11 Sunroom wall insulation has a R- R- ;❑Complies [IN8]1 minimum R-value of R-13. New ;❑Does Not walls separating the sunroom ;from conditioned space must :❑Not Observable !meet code requirements. ; ;❑Not Applicable ; 303.2 ;Sunroom wall insulation installed ❑Complies [IN9]1 per manufacturer's Instructions. ❑Does Not ❑Not Observable ❑Not Applicable 402.2.11 ;Sunroom ceiling minimum R- R- ;❑Complies ; [IN10]1 :insulation R-value of R-19 in ;❑Does Not Climate Zones 1-4,and R-24 in ❑Not Observable ;Climate Zones 5-8. '' ❑Not Applicable 303.2 ;Sunroom ceiling insulation is ❑Complies ; [IN11]1 !installed per manufacturer's ❑Does Not instructions. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 6 of 8 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, :Ceiling insulation R-value.Where R- R- ;❑Complies ;See the Envelope Assemblies 402.2.1, 1> R-30 is required, R-30 can be Wood ;❑ Wood ;❑Does Not ;table for values. 402.2.2 ;used if insulation is not Steel ❑ Steel :oNot Observable [FI1]1 ;compressed at eaves. R-30 may ; be used for 500 ft2 or 20% ;❑Not Applicable ; (whichever is less)where :sufficient space is not available. : I 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 I manufacturer's instructions. ❑Does Not [FI2]1 :Blown insulation marked every 300 ft2. []Not Observable ❑Not Applicable ; 402.2.3 ;Attic access hatch and door R- R- :[]Complies [FI3]1 insulation >_R-value of the !❑Does Not adjacent assembly. ; ;❑Not Observable j❑Not Applicable 402.4.2, Building envelope tightness ACH 50 = ACH 50= ;❑Complies 402.4.2.1 :verified by blower door test result: :❑Does Not [F[17]1 of<7 ACH at 50 Pa.This requirement may instead be met ; ❑Not Observable :via visual inspection,in which ;❑Not Applicable case verification may need to occur during Insulation : ;Inspection. 402.4.3 Wood-burning fireplaces have ❑Complies [FI8]2 gasketed doors and outdoor ❑Does Not combustion air. ❑Not Observable ❑Not Applicable 403.2.2 ;Post construction duct tightness cfm cfm UComplies [FI4]1 test result of 58 cfm to outdoors, ;❑Does Not or<12 cfm across systems.Or, rough-in test result of:56 cfm ❑Not Observable across systems or<4 cfm : : ;❑Not Applicable ; without air handier. Rough-in test verification may need to occur during Framing Inspection. 403.1.1 Programmable thermostats ❑Complies ; (FI9]2 installed on forced air furnaces. ❑Does Not ❑Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 'on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403.4 Circulating service hot water ❑Complies [FI11]2 systems have automatic or ❑Does Not accessible manual controls. []Not Observable ❑Not Applicable 403.9.1 Readily accessible switch on ❑Complies [FI12]3 heaters for swimming pools. ❑Does Not a ❑Not Observable ❑Not Applicable 403.9.2 Timer switches on pool heaters ❑Complies [FI19]3 and pumps are present. ❑Does Not ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3.1 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Design\Documents\REScheck\BAGSHAW.rck Page 7 of 8 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions &Req.ID 403.9.3 Heated swimming pools have a ❑Complies [F120]3 cover.Covers on pools heated []Does Not over 90 QF are insulated to R-12. ❑Not Observable ' ❑Not Applicable 404.1 ;50%of lamps in permanent ❑Complies [FI6]1 !fixtures are high efficacy lamps. ❑Does Not IE]Not Observable ; ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies [F17]2 ❑Does Not i []Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies ; [FI18]3 mechanical and water heating []Does Not equipment have been provided. ❑Not Observable , ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: RENOVATION Report date: 11/27/1 Data filename: C:\Users\Fine Line Des!gn\Documents\REScheck\BAGSHAW.rck Page 8 of 8 �( 2009 �ECC [energy , Efficlency Cerfificate h=MtM=Q cam Wall 21.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): p ... Gj L Window 0.34 Door 0.34 Heating System: Cooling System: Water Heater: Name: Date: Comments c� r•/IIIII(.//IIM!/III f/n II II JJ!/('II11('II1 \ Office of Consumer Affairs di BYfletas Regulation License or registration valid for indivldul use only OME IMPROVEMENT CONTRACTOR ., before the expiration date. If found return to: egistratlon: 152124. Type: Off-ice of Consumer Affairs and [Business Itcgulatlon xplratlon: 8f2/2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 WEST BAY MANAGEMENT TRUST ADAM HOSTETTER 770 A MAIN ST. OSTERVILLE,MA 02655 Uodersccrctary Not valid without signature oF� EAPXWA 3M � 659- Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas 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, 7AG-OFAO ,as Owner of the subject property hereby authorizei-irara 9mc5)LJe5-F BA`) Am I IZv51 to act on my behalf, in all matters relative to work authorized by this building permit application for: M S— r4erJ5'-1AKtE1/44 (Address of Job) swnature 01,6w e bate Print Name If Property Owner is applying for hermit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN_D\Building Changes\EXPRESS PERMEREXPRESS.doc Revised 061313 iVlutisuchusetts- Department of Puhli� Safety Board of Buildin!-Regulations and 5t.uular(Is Construction Supervisor License i License: CS 94302 ADAM HOSTETTER 770 SUITE A MAIN ST OSTERVILLE,'MA 02655 Expiration: 12/22/2013 C',rmmissiu��er Tr#: 7378 L f 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel_ v ;:APca ti n I Health Division Date Issued 7 g 3 Conservation Division Application Fee v Planning Dept. Permit Fee U O Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address -366 --?-- p+. 6 A Village �A�JSr7R�L� Owner:�SncL Ly,,sWAuJ Address 5?eyJ6FrELh Telephone 9 as S ram rv►6� b a .Permit Request � �EBvP n v�'ryfTrn� �� �i2a� ��o� S1�E or h{os-F, s��'dDlZi� L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '�'000 Construction Type o ���✓f Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U-_ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: l�d'1'es ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ✓VaN E Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new a Half: existing new Number of Bedrooms: 3 existing O new Total Room Count (not including bath:): existing new 0 First Floor Room Count �7 Heat Type and Fuel: Ull Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing 2—New 0 Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 01&isting ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Ln Commercial ❑Yes 0 No If yes, site plan review# R L Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name &M 5 1e-1Tc-e- Telephone Number Address aS f;5-f0,71 i License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO oP nJS �S_ STD-✓ SIGNATURE DATE D �� i r" t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER E DATE OF INSPECTION: _ FOUNDATION: FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Alassachusetts Departtnetu of Ltditstrial Accidetrts Office of Ltrestigation-s 600 TVashinglon Street Boston, AL4 02111 . , : st•,t•tr.ntass.gor-dia Workers' Coinpensatiou Iusuc-ance Affida-tit: BuildersiC:ontractors./Electticians,Plumbers Applicant Information Please Print Leaibb, N2ane(Business OreanizadonIndiv dual): AD40AW CSr UJ 1 Address: : '10 A� Mif JST2L -I City 'StatelZip: 71u� e S Phone�: S0� —°'�a —a a� AWI u an employer" Check the appropriate box: Type of project(required): 1. am a enlplo,'er with 4. ❑ I am a general contractor and I employees(full and or part-time).*. have hired the sub-contractors 6. ❑Nest constnutron _.❑ I am a sole proprietor or partner- listed on the attached sheet ['�emodeliue . ship and have no employees These sub-contractors have g_ ❑Demolition .corking for me in an capacity employees and have workers' 9_ ❑Building addition [.No xverkers• comp.insurance comp.insurance.- required.] 5. ❑ R'e are a corporation and its 10.❑Electrical repairs or additions q ) ❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions tw.,wlf.[No:corkers' comp. right of exemption per MGL 12.❑Roof repair insurance required.]- c. 152,y 1(4),and we hare no employees_[No workers* 13.0 Other comp. insurance required.] •.day ap ;cant ttu:checks Sox al mtt;t also fill out the sec:os below shooing their workers'compensation policy infortnaum. Homeowuen who;ubuia this affidavit indicating they are doing all work and then hire outride ccuumc:on mtw submit a new afEdava indicating such.. -Cennac:ors:hat check th:s box trust attached an addinoaai sheet showtns the name of the sub-cortmctors and state whether or not those encres have employees. Ie the sub-contraaon have etnplavees.they must provide their workers'comp.policy number. I am art ererplot•er drat is pros•iditi n•orkers'conrpeirsatiott irrsrrrarrce for act•enrplot•ees. Below is ritepolict•cord job site irrfornra►iott. l� Insurance Compare Name; C---� K ✓�L yj 1 a( V w 6-F, &FJz � Policy 9 or.Seif-ins.Lic.r: 1(3— IS(;/a SA Expiration Date: 3 a0 Job Site Address: City°:State Zip: Attach a copy of the n orkers' compensation polio-declaration pave(shon-ing the policy number and expiration date). Farhre 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 S 1.500.00 and cr one-year imprisonment,as well as civil penalties in the form of a STOP%VORK ORDER and a fine of up to S-50.00 a day against the violator. Be advised that a cope of this statement may be forwarded to the Office of Investigations of the DU for insurance ccverage verification. I do Iterebt'cerrif&it it the pains and penalties of perjnrt•that rite i►rfornration prot•ided above i true and correct. Sienauue Date: Phcne 74)L Official nse ottlt•. Do not,rrite in this area, to be contpleted bt'ciry or towit official. C•iry or Town: PermioLicense 9 Issuing Authority•(circle one): 1.Board of Health 2. Building Department 3. Cit} Tonn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 6 CERTIFICATE OF LIABILITY INSURANCE NCE DATE(MMrOD/YYVY) THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.01THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A•CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(tes)must be endorsed, If SUBROGAT70N IS WAIVED,subject In the terms and cendRtons of the Polley,certain Policies may requtre an endorsement A statement on Ihls certiecals does not confer rights to the certlHCate holder In Ileu of such ondorsefienl s, PRODUCER Mark Sylvia Insurance Agency,LLC NAME: Debbie 404 Main Street PNONE 508 957 Z125 ° ..�,(arC•Ne) 508 957.2761 Centerville, MA 02S32 AR➢BEfle,:mark rr�th vie nsurance com INSURER S� )AFFORDING COVERAGE _ NAIC INSURED LN—Swi R A;MOntpeler US Ins CO west Bay Management Trust iN9uRERe:Trevelers Insurance Co 770A Mein Street INSURERC: OstBrville.MA D2655 INSURER D: INSURER e: COVERAGES IIVBtNIER F CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL 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 MAYHAVE BEEN REDUCED E!Y PAID CLAIMS. OR TYPE OFINSURANCE POLICY NUMBER OLI NY A cENMALUABILITY MP000600TOT2633 1 /42012 1 4/2p1 LIMITS E 1,00 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 0,000 �� PREMISE' Es ooLvn+mrs) E OL/JM�MADE l•�I OCCUR 100.0 MEO EXP tMv°ne wson) 5 5,00000 PERSONAL g ADV INJURY g 1,000,000 GEN,F,RALAGGREGATE L 2.000,000 GENL AGGRFGP?E LIMIT APPLIES PER- !ALL OLICY PRO- LOC PRODUCTS-Co P/OP AGG S_ 2000000 OBILE LIABILITY ¢ CDM tDSNGL LIMIT NY AUTO Ee eBIN 5 o0SV�MSCHEDULED 60DILYIN•NPY(r-eroerzon) s NOtT40-01MVET, aDO1LY AIJURY(Peteald°N) 9 R M AUTOS - AUTOS Perec 1ienDAMA 3 UMBRELLA UAB d OCCUR EXCESS LIAB - - EACHnnyJRRENCE S CLAIMS-MADE EACH S DED RETENTION B WORKEROCOMP-MA71ON AND EMPL.OVERS'LIABILITY UB-7B15t105A 323/2014 i 3/?3/2013 T C Aru ° I+ ANY PROPRIETORMARTNERIEYECUTN,YIN� OFFICERIMEMBEREXCLUDED? Q s s X NIA E.L.EACH ACCIDENT S 500.000 IMmdetery 1n NH) I►yns descrlDe vtwar E.L.DISEASE•EAEMPLOYEC $ 500.000 DESCRIPTION OF OPERATIONS Oelew E L.DISEASE-POLICY LIMB I S 500.000 DESCRIPTION OF OPERATIONS I LOCATIONSY VEHICLE9(Atbeh ACORD 101,Addleeno RvrnaM@ Schedule,if mom 2we in nq Wed) Residential Carpentry CERTIFICATE HOLDER CANCELLATION ' (508)790.6230 SHOULD ANY OF THE ABOVE DESCRIBED POLJClae 13C CANCELLED BEFORE Town OrBernsteble Building0cpartment THE "PIRATION OATU THEREOF, NOTICE WILL ®E DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis.MA 02601 AUTHOn1ZE0 REPRE>FNTATINE ACORD 25(2010/t15) QD INO-2010ACORDCORPORATION. All rights reserved. The ACORD name and logo are registered Marks of ACORD oFTME MUMSrnB s ice. 059. � Town of Barnstable p�l Regulatory Services Thomas F.Geiler,Director Building Division Thomas 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 as Owner of the subject property hereby authorize l NS/� to act on my behalf, in all matters relative to work authorized by this building permit application for: ?&6- 6A (Address of Job) l Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the ` reverse side C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 �4 M r rt7Z. r/6%(rN.Jnr•/"Nc/6 . �L\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: eglstratlon: 152124 Type: Office of Consumer Affairs and Business Regulation xpiration: 802014 DBA 10 Park Plaza-Suite 5170 i Boston,MA 02116 i WEST BAY.MANAGEMENT TRUST ADAM HOSTETTER 770 A MAIN ST. OSTERVILLE• MA 02655 Undersecretary Not valid without signature 't May.-eachusetty- Department of Public Safet% Board of Building Regulations and Standards Constructlon Supervisor License ' License: CS OM2 ADAM HOSTETTER ; 770 SUITE'A:MAIN ST. OSTERVILLE;.MXM' 55': Expiration: 12/22/2013 (' nuul�aluner.' Tr#: 7378 0. MD. zz0.00 STAO 44 R QNSEX s ��Lp 9.5 I 23 000 STAG+ 7.966 R.01 BEANSET rid STONE V DRIVE �s� 4209 C� s> � 93 \ 2 921 0' 801 SMSPKSET CHE O 0)K 42.17 STA 74.88 02 BEA SET S TOP F D �� \ EL=45.33' \ 3h F��S Sf�ee to TOP FND. 1`112 - 18 CB.N. 25 0.00 A1+08 R0.. LP 9 8E0 pp / �(32 BEANSET V . $ 5kK5ET pp ro 0 23.75' p > 87 58 20- W 36 _ R=27.48' C� 0.00 STA1+ .459 EA y/ L=31.12' ri n } r r \\ .00 , +9TA0+26.664 R2.02BEANSET_OU VO - +64.1 L0.028 ET j �3 9" n o / p o/ Ur) r) s :01 +0 0 GARB 32 P 032 STAG+51.794 L0.018EANSET V r�J 4 N l Q�3g .4-0 DARB SPA0+63.087 RO.01 BEANSET ®® 75 mGE1A a8R 07 31 75 GBRUSH 88 XMIM SH 818 1 ELA QBRUSH IBRUSH �RUS 36.22 RU 815� VJ t36.3 Iw EDGE4AWNCBRUSH I K f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map:' ` Parcel Applicationo�Z6. Health Division Date Issued l co, Conservation Division ��� Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address :�400_ n M` 4 0- Aid H FA Village Zgy5 -xTgtC— Owner:&wc 19A6r-,,5ffAv✓ Address SFN6Mb S i Telephone —� —��� Permit Request lV�S �� sf�JGT J 1, .CJ T�6 2LT`-( /4-�D (�f� � S T & L) 71fC— &6rdreE WOOOD (,_rvc— To 5FE 1�0 44c- SS 0 Square feet: 1 st floor: existing 06 proposed 2nd floor: existing �d proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation d®, ®C) Construction Type Lot Sizes e— Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family af Two Family ❑ Multi-Family (# units) Age of Existing Structure lea S Historic House: Q__Yes ❑ No On Old King's Highway: ❑'Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Otherk� Basement Finished Area (sq.ft.) D Basement Unfinished Area (sq ft)! S'6 Number of Baths: Full: existing new Half: existing ,.knew Number of Bedrooms: 3 existing new Total Room Count (not including baths): existing new 0 First Floor Ro m Counf ' Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other CD Central Air: ❑Yes o Fireplaces: Existing47—New Existing wood/coal stove: ❑Yes ❑ No Detached garage: existing ❑ new size—Pool: 2 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 ❑ No If yes, site plan review # Current Use "x Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �6eL�� �/� Telephone Number A01-U Address ��� l��i OS �� License # Home Improvement Contractor# Worker's Compensation # H 3q( :76�A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 "kul algal`�✓ SIGNATURE DATE ds 4 F FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. f ADDRESS VILLAGE OWNER s k: DATE OF INSPECTION: x �L FOUNDATION _. r FRAME ,f INSULATION FIREPLACE _ ELECTRICAL: ROUGH FINAL 5 Lq r' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ti. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Oro niza ion/Individual): Address: AMP) ,�f City/State/Zip: o?r. Phone#: Are you an employer?Check t)ie a propriate boz: Type of project(required): 1.DI am a employer with cV� 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El 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 working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 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 whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ��� N ark (� Policy#or Self-ins.Lie.#: �� 19 650 SA Expiration Date: 3 1 Job Site Address: 62 g1 �k $ City/State/Zip: Jfll2i✓SV R&e 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$1,50.0.00 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 D 01 insurance coverage ve ' cation. I do hereby certify un r t e pai and es of perjury that the information provided above is true and correct Si Mature: Date: L 7 Phone#: Official use only. Do not write in this area,to be completed by city or town of zciaL City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the 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 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 confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitilicense 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 Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 TeL#617-727-4900 w 446 or 1-977-MASWE Revised 4-24-07 Fax# 617-727-7749 www.mass_gov/dia A CERTIFICATE F DATEIMMMO1YYYY) O LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT$UPON THE CERTIFICATE HOLDER. 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 cGRITIcate holder Is an ADDITIONAL INSURED,the Poltcy(tes)must be endorsed, if SUBROGATION 13 WAIVED,subject ID the terms and conditions of the Policy,certain Policies may require an endorsement. A statement on this certificate does n ceRlRCate holder In lieu of such endorsements. ot confer rights to the PRODUCER Mark S)6vla Insurance Agency,LLC NAME: Debbie 404 Main Street PHONE 508 957-21 ° 25 ArC.No):508 57-2761 Centerville, MA 02632 BRGBEBe.:mark mark via Insurance,Corn INSUgE-E S- )AFFORDING COVCPAGE NAIC 0 INsuRED INSURER AMOntpefer US Ins Co - West Bey Management Trust 1N8UReRe:Tr&Qers Insurance Co 770A Mein Stmet INSURERC: OsteNtle.MA D2655 INMER 0; INBL%M e: COVERAGES INSURER F CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREBY IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID C LAIMS. INS LTR TYPE OFINSURANCE SUER POLICY NLareER Iy OLI A GENERAL LIABILITY MR M2 LIMITS MP0006007012633 1 4/2012 T 41201 EACH OCCURRENCE > 1,000,0p0 X COMMERCIAL GENERAL.L LABILITY PREMISIrr $ 100.000 _� CLAIMS-MADE �OCCUR MED EXP Any one arson) S 5,000 PERSONAL 8 ADV INJURY ; 1,000,020 GENERAL AGGREGATE j 2.000,0()0 GENL AGGR@GATE LIMIT APPLIES PER• X POLICY LOG PRO- PRODUCTS-Co Plop AGG S 2 000 000 auromoeaE LIABILITY COIN kD se�GL uMn ANY AUTO Ea.dant �OORWNED SCHEDULED BODILY IINJUPY(Perouron) $ AUTOS I r OAMA 80DILY INJURY(Per e*eWenl) j HIREDAUT08 NON-OmEr. - AUTOS Peres dent 6 UMaRELLA UA6 DCQJR _ - ; ExCESSLIAI CLAIMS-MADE EACFIOCWCURRENCE AGGREGATE { DED RETENTION WORKeRB ANDEMPe VERS'L9BILIT YIN JUB-7B15805A 3/2312013 323/2014 T Cs Arus X o H j AND EMPLOYERS'LIABILITY ANY PROPRIErORIPARTNERIEYECUTIV, . ER OFF10ERIMEMBERFKCLUDED? �� NIA E.I.EACH ACCIDENT $ 500.000 (Mandatory In riml 11yes describe undar E.L.DISEASE•EA EMPLOYE• $ 500,000 DESCRIPTION OF OPERATIONb betgw E L.DISEASE-POLICY LIMB ; 500,000 9 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AtlsCn ACORD ter,Addldoml R•mnka SChedule,a mgrg apau III ngVIradl Residentiel Carpentry CERTIFICATE HOLDER CANCELLATION (508)790.6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town 01Barnstable BUBdingDcpartment THC EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVI61ONG. Hyannis.MA 02601 AM0rJZW REPRF.SEWATIV_E /° any_ ,.��•./'" � 0 IM-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010f05) The ACORD name and logo are registered marks of ACORD Town of Barnstable { °± Regulatory Services MASS. g Thomas F.Geiler,Director 'qEo 59. 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I o �ksm(-\J - as=Owner of the subject property hereby authorize Aw KA`� AigoiFA 124i to act on my bebalf, in all matters relative to work authorized by this building permit f5 A (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 performed and accepte . _ V w Signature of b/97v� I�S� -Gnu Print Naine — LoN/ ���., nt Name co'V{41M� s)V-.wI4e Date QIORM&OWNERPERMISSIONPOOLS 6/2012 THE Town of Barnstable Regulatory ervices KA� Thomas F.Geller Director 63 `�� Building D' 'sion n� a <Tom Perry,Building ommissioner 200 Main Street, Hyaw is,MA 02601 wv,,w.town.barnst Lble.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER UCEN EXEMPTION Please Prin DATE: i JOB LOCATION:_ number street village "HOMEOWNER"_ name home phone# work phone# CURRENT MAILING ADDRESS: city/town fair zip code The current exemption for"homeowners"was extended to include owndr-occupied dwellings of ix units or less and to allow homeowners to engage an individual for hire who does not possess a li 'nse,provided that the owrier_ cts as supervisor_ DEFINITION OF HOOWNER Person(s)who o-was 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 usepnd/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 Buildm' g Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work erformed under the buildingejii t_ (Section 109.1.1) !` The undersigned"homeowner"assumes responsibility for complian with the State Building Code and other applic\bdes,. bylaws,rules and regulations. �! The undersigned"homeowner"certifies that he/she understands the, of Barnstable Building Department minim procedures and requirements and that he/she will comply with said 'rocedures and requirements. Signature of Homeowner Approval of Building Official " Note: Three-family dwellings containing 35,000 cubic feel or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER' EXEMPTION The Code states that: "Any homeowner performing wo k 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 Homeown r shall act as supervisor." Many homeowners who use this exemption are unaware th 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. C:\Users\decolliklAppDatalUr--l\MicrosoR\Windows\Temporary Internet Files\ContEntOutlook\QRE6ZUBN=RESS.doc Revised 053012 l eo License or registration valid for individul use only . Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: iME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation istraUon: 152124 Type: 10 Park Plaza-Suite 5170 eg xpiration: 8/2/2014 OBA Boston,MA 02116 WEST BAY MANAGEMENT TRUST I ADAM HOSTETTER 770 A MAIN ST, OSTERVILLE,MA 02655 Undersecretary Not valid without signature I . . Massachusetts- Department of Public Safet% Board of Building Regulations and Standards ConstruCtion Supervisor License License: CS 94302 J ADAM HOSTETfER ` 770 SUITE''Ar..MA N.ST. OSTERVII-1 MA?Q2655" Expiration: 12/22/2013 (•onunhdunrK Tr#: 7375 ' of Town of Barnstable *Permit# 7 a 6 Expires 6 months front issue date Regulatory Services Fee Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 ®PRESS F. ' Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY s E P 1 '5 2004 �jNot Valid without Red X-Press Imprint TOWN OF BARNSTABLE tp/parcel Number 3 ' /r-� 3 / )perry Address &((Q7 Y�1 P� S 1 !V Residential Value of Work 44 6) Minimum fee of$25.00 for work under$6000.00 vner's Name&Address �M G- . 6e-j : I �/`Ln1�A- o�os - �urvi/ �o -L 3 ,3 intractor's Name j(i iAS Pefc 9t.�LYS�.S�S�n 1/l0�•Telephone Number 50$ )me Improvement Contractor License#(if applicable) you�6 >nstruction Supervisor's License#(if applicable) 1 J cc;L5 ' (Workman's Compensation Insurance Check one: ❑ I am a sole proprietor � I am the Homeowner C I have Worker's Compensation Insurance -trance Company Name orkman's Comp.Policy# 6 ' .S7d`�T@ Zi (�)s )py of insurance Compliance Certificate'must be on file. emit Request(check box) VRe-roof(stripping old shingles) All construction debris will be taken to & ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value maximum.44 ` ❑ eP ( ) '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. Home Improvement Contractors License is required. €nature Forms:expmtrg vise063004 OWMW roag- Board of Building Regulations and Standards One Ashburton Place - Room 1301 ` = Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 142463 Type: Private Corporation Expiration: 4/5/2006 SUNSPACE CONSTRCUTION INC. ANDREW DIONNE 39 SIASCONSET DR. SAGAMOREBEACH, MA 02562 Update Address and return card.Mark reason for change. Address n Renewal ❑ Employment Lost Card ;, ✓fe 't�aizvnzo�zu�e¢l!l• o�✓�l.¢J:ucc�raJe�'!'.J Board of Building Regulations and Standards License or registration valid for individul use only before the expiration date. If found return to: 1=_�'•�t;:. HOME IMPROVEMENT CONTRACTOR P Board of Building Regulations and Standards qt{ Registration: 142463 One Ashburton Place Rm 1301 Expiration: 4/5/2006 Boston,Ma.02108 Type: Private Corporation SUNSPACE CONSTRCUTION INC. ANDREW DIONNE 39 SIASCONSET DR. SAGAMOREBEACH,MA 02562 Administrator Not valid without signature /re�oazL�nanrueall� a��-�G�aaurcla�d BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR i Number: CS • 081325 Birthdate: 06/15/1970 F Expires:06/15/2005 Tr.no: 81325 Restricted: 00 ANDREW C DIONNE �� 39 SIAS CONSET DR ���,...ax SAGAMORE BEACH, MA 02562 — Administrator pfTNEt Town of Barnstable ~ Regulatory Services MASS. Thomas F.Geiler,Director rFo N,p+p Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I. 0 E2, pdL2V4(,e,, as Owner of the subject property hereby authorize Y05PPS CN,roL�crrar'S TdC. to act on my behalf, in all matters relative to work authorized by this building pemnit application for: (Address of Job) Si ature of Owner Date Print Name Q:FORMS:OWNERPERMBSION �j THE The Town of Barnstable WAMW Department of Health Safety and Environmental Services "9. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissions For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: 1 Est. Cost 0 �0-0 Address of Work: l 13a4'4z..4 � ox& Owner's Name p Date of Permit 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. ZZ&zq,?—� Dale o ractor Name Registration No. OR +` Tht• Cuntmonwealth of Massachusetts Dc ptrrtnrctrt of hnlustrial,4cctrlcnts � 1 Y � t _ off iceollnvestfgatlnns 600If'a.0hi, nStrec�t - W; ' Bosto». Ma-my. 02111 Workers' Compensation Insurance Affidavit Alinlic.int information': Please PRINT lebi 6jy_ n a m c: R k- e;-,4EZ--- location I am a homeowner performing all wo • myself. 1 am a sole proprietor and have no one working in any capacity • .•. -.s-. ..... ..�.r rsr.r.s+�sr+:a+�ww+/.7►!r.'�;.:I.�i.•'ww...w..IRTI��..•�...�.��.w�.w......*._+ �.+w•q•'......._ ...w+...._....__.....:. I am an emplover providing workers' compensation for my employees working on this,jobs corn umv name: city: [!hone#• 72 insurance co. Polio•# wc,1 ®C/ f d ! 7 O [) 1 am a sole proprietor, beneral contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnan• name: address: phone#: incurnncc rn. noliev# 1 .i-,..- -.. V..... _ _ r•Y...._:...•.. _ -- -�r�!�::�^lt iT"I1�w:s �Tr._.__ - ...w.ti _.�...._..._.Y. cmmnany name: addresc- cite phone#• insurance co. nnlicy 4 Attach additional sheet if n .- �- •-,-�--� —^ =' '--' ......, .....' ..,.�::._�ter,.,.; Failure to secure cucerace:is required under section 25A of 111GL 152 can lead to the imposition of criminal penalties of a lineup to 51.500.00 andiur one scars' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of5100.00 a day against me. I understand that a cope of this statement mac be forwarded to the office of Investigations of the DIA for coverage verification. 1 do herein•cerrift•under the pains and penalties of perjure-that the information provided above is true and correct. Si=nature r Date T/9 d Print name )-T;1 up L-• • Z2o 1 r,-, 0 rt-- Phone# 3 4 ' Z l 7 '�oflicini use univ do not write in this area to be completed by city or town official sin•or tncn: permit/license# riBuilding Department OLicensing 1luard tt 0 check if immediate response is required OSeleetmen's Office t t` Oticaith Department contact person: phone#• rj0ther !% r IJ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation for the 'employees. As quoted from the "la��". an enrpinree is defined as every person in the service of another under ally contract of hir express or implied, oral or Nvritten. An enrplurer is defined as an individual. partnership, association. co oration or other legal entity. or anv two or inc.- the foregoing en�.:a�La�ed in a•joint enterprise, and including the legal r presentatives of a dcccasctl'employer, or the receiver or trustee of an individual , partnership, association or oth legal entity,,employing employees. However owner of a dwelling_ h use having not more than three apartments nd who resides the or the occupant of the dwclling house of anoth -r who employs persons to do maintenane , construction or repair work on such dwelling_ !tc or on the ;,,rounds or buil 'ng appurtenant thereto shall not becau of such employment be deemed to be an empio.ve MGL chapter 152 section ' Iso states that every state or local icensing a;cncy small witlihold the issuance or renewal of a license or permt�io operate a business or to con truct buildings in the commonm-ealth for any applicant vs-ho has not produce acceptable evidence of com fiance with the insurance coverage required. Additionally. ncither,the commoi,i ealth nor any of its political ubdivisions_shall,enter into any contract for the performance of public work until ac eptable evidence.ofcomp ante with the insurance requirements of this chapter been presented to the contracting auth rity. Applicants Please fill in the %vorkers' compensation affidavit omplet y, by checking the box that applies to your situation and supplying_ company names. address and phone numb s as. I1 affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance cove e. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the a ication for the papnit or license is being requested. not the Department of Industrial Accidents. Should you hav am= questions regarding the "law-' or if you are requirez to obtain a workers compensation policy. please call the Depa . ent at the number listed below. City nr rowns i Please be sure that the affidavit is complete and printed legibly. The D artment has provided a space at the bottom c the affidavit for you to fill out in the event the Offic4 of Irrvestigations Ila o contact you regarding the applicant. Pie. be sure to fill in the permit/license number which wall be used as a reference umber. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. i Tlie Office of Investi=ations would like to thank you in advance for you cooperation d should you have any questio: please do not hesitate,to.give.us a call. f ...�... .-..._ �_ �. .••��-w�..•.+�.••r � t _ _. ..ter .. _ .. :`T.•. ..:F'- The Departments address. telephone and fax number: The Comm Lwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 . (,<1 n 7�7-ionn ...•r - 409 or D E71 nanu�ea o�✓�aaaac%uaetGr , OEPAJJNENT OF PUBLIC SAFETY CONSTRU1�PilN.,SUPERVISOR LICENSE Nuaber Expires: "�" , .' • )testy ct�d-�� 88 r +lX �ARTN.IIR'Lv'h0l66FF 19 NCCURMICK OR W BARNSTABLE, NA 02668 t �eN` HOME IMPROVEMENT CONTRACT Registration 7104499;' TYPe PRIVATE CORPORATI ExP1ration �a"/14/00 .;. x,`�*P �1�„ors r t �• x CART DOL60FF BUILDIN6/REMODELI, SADMINISTRATOR 4MCCOralc� f�..,' q Barnstable KA 02668 ,il { Engineering Dept. (3rd floor) Map 31 7 Parcel :63 9 Permit#', House# ,��lp Date Issued r r- :15 -9:30/1:00-4:30) - Fee'a r ��a—y :30-9:30/1:00-2:00) - Pi dmin. Bldg.) �t►,E, e mi g Board 19 N- pe Pt4c �'NS w . Imo, f'�;5-1-. ..,5 • RJR 9. ��ED MIr p` TOWN OF BA STABLE Building Permit plication F Project Street Address 3 7 �.� Village Owner —G� �`,�MJ Address t Telephone _Permit Request > First Floor square feet Second Floor square feet -Construction Type t Estimated Project Cost $ o'o G Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other ` Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# 'Current Use Proposed Use Builder Information Name Telephone Number 5-0 3 4 2 Address �" License# _�n / a7 6 '` r`�'•��we..,.Q� Home Improvement Contractor# l O 4/ t/ 9 9 Worker's Compensation# 46, C ll e/O J ;2 / 7 ,k NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN T SIGNATURE p� l DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) r ure�� �C . + y4 FOR OFFICIAL USE ONLY ARMIT NO. ! DATE ISSUED F ,� MAP/PARCEL NO. #' ADDRESS r VILLAGE , OWNER DATE OF INSPECTION: FOUNDATION FRAME 4. INSULATION FIREPLACE ! ELECTRICAL: ROUGH FINAL.' ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING DATE CLOSED OUT. - ASSOCIATION PLAN NO. s D We E V _ U h � 'b e12ro C W ® �C FE 1711 � LU L JEI N --- - I� 0000 — — — —— —— — — ---------- 0 h ti O .b a SOUTH ELEVATION SCALE: 1/4" V-0" A fy y imFTTI ® ----_- - - - -® --- --- -------- ® ---- -- -- PROJECT#1302 DATE: 10.22-2013 REVISION: 11-21-2013 1 CARBON MONOXIDE ALARMS MUST S OKE DETECTORS REVIEWED SACHUETS BUILDPEC MASSACHUSETiS BUILDING CODE -------- ------ ELEVATIONS BARNSTABLE BUIL ING DEPT. . DATE EAST ELEVATION i SCALE: 1/4" = r-o�� - FIRE DEPARTMENT DATE BOTH SIGNATURESARE REQUIRED FOR PEWITING Al • 9b ..r 12 h A x° _- �g HE ME 00 a o� 1n 00 00 a NORTH ELEVATION SCALE: 114" a I'-0" W y FM W y PRO1F,Cf#1302 DATE: 10-22-2013 ---- ® - --------- ® - - - - REVMON:11-21-2013 ELEVATIONS NEST ELEVATION SCALE: 114" - 1'-0" A2 III'-5" 28'-0" 10'-0° 14'-6° 12'-11" 21'_7• 3'-0' 21'-5" W-O' S'-0' 1'-8' 10'-5 I/2' '-4 1/2 4'-O° 3'-2° 4'-7° 17'-O" II'-10° 9'-7' pQ P Q a 0p O mpm A !-K F OC - 41I rA 5 �b TW m 20310 . RO 266I/I/B"x 7/8" TW 20310 OFFICE RO 26 1/5 40 7/8 3 - 0� L v LITE I H - A A 2B - A 251 RO 20 7/5"x24 5/11" N N. r , DEN z= ml < x El w coo m LAUNDRY ml g o .� _ I ❑ t� -1 � N - t�v - cmi a ��l tr l N lV yy� U LL'I f ULL' Q K Q K lV - 00 I..y REF. 2L - O SCREEN 1✓� N TW 20310 -- 6'-6" PORCH o C RO 26 1/8 48 7/8' ,DR j _ (V iv B NDN _ .o P.R. I C/� 00 I f � n � h � ROOM 24 - - DN PANTRY Q C TW 20310 GL05 UP RO 26 I/B 40 7/8' �1 6'-6" I 3'-4 1/2u 3' 7 1/2° 3'-3 1/4' 26 26 --- a 5'-8 IV4' 1 H BATH 24 I Q al I iiI o f TW 2462 " KEEPING ROOM I e I iiI " i i RO 3o ve^x76 7/B° - 1113 31 I iiI I 4 D ----------------------------- r - SQ W/T NSOM v Y 36 rn m O O I I 1 1 m c u m m TW 2031 I REF. n n R n Ro z6 v Q 4 Ci I-K V-K '^ 3p I I v I I KITCHEN iiI o DINING �_ i LMNG AREA FWG 10000-4 LITE �Z - ` 1 RO 117 3/4°x%' Nj • � � i i i 1 1 C � i i TERRACE O I m PORCH W 2032 b I �_ o o O 26 1/8"x40 7/0' I Ii 1 _ �(~ . mm rtm� __ __________________ o NN I ___ __________________ LL' o ❑ 3 K F K ❑ II'_9^ 1 1 a I2'-8' 1 1 i TW 2462 Q' M 1 1 1 RO 30 1/0"x76 7/8' FM 2Yi_2. 1 in i l x I O I I 11 1 1 Y.rc m SLIDING BARN DOOR 2& I In m - STAD-, CLOS PROIECP#1302 8 mpp g m & DATE: 10-22-2013 N N O N 2 z=m x " Q REVISION:11-21-2013 I I LL rc LL rc LL rc CLOSET ZD W-4 3/4" " 6'-I 3/4" I o W 2032 2fi 0 2� MASTER o RO 26 1/5"x40 7/6" BEDROOM - 2'Q 2 13,TW 2452 v N - Ro 30 1/8°x64 /° aw 4 - - LINEN W 2032 ] MASTER in . RO 26 I/8°x40 7/5" BAT 3 5'- 3/4" v 6'-4 1/2/2" - 3/4" 0 2J2 FIRST FLOOR PLAN W.c SH. m m FMT . SCALE: 1/4" 1'-0" m x '^ FLOOR V PLAN m N N h 6'-1 1/2° 14'-II° W-10 1/2' 4'-4" 6'-10' 7'-5" 5'-5' I5'-0° 6'_3' 3'-9' 17'-II° 24'-0" 24'-3" 35 2° A3 4° 2B-1' 4'_I' 20'-0" 3'-0 1/2" li_Ba 4-B' m r` " o m_ N O �rc I _ I ' 1 / N E -------------- TW 20310 r~ O o V 1 � I , I I I I .X •� I I _ I I - C 225 LR RO 48 I/2°x20 7/e' � BUNK 31 E RiX 0 I N N N _ W � N I I r m I I I I v BATH w I I 2�I O 00 -------------- 4'HIGH KN WALL El .. EE _E______________ ______ _______ 1 I q ___________________ ________________ G E � • ( � l ( I 1 I I II - I I I I \ I I TWT 2427 l i RO 30 1/8"x33 7/0" r l m I I I I 1 1 'HIGH KNEE WAL CRICKET - I I ------ m w ------------LOFT------- ---� 3---- R D G E Ro 3o5re o y ------ - -I ---- -----------------_ EA "x64 7/0° -------_ ______ 12'-8" - a - C � I TWT 2427 RO 30 1/8"x33 7/8" o g � TFM- N pN C N � R F 0 PROJECT#1302 DATE: 10.22-2013 REVISION: 11-21-2013 W-0 1/2' 3'-II" 7'-0" 3'-11' SECOND FLOOR PLAN _ SCALE: 1/4" a I'-0" SECOND FLOOR PLAN A4, i ,2O• ,�-0' I I CATNRED . . . . —.— .—.— —.— —.—.—.— — — — — —. 2%BCOLLAR TIE5ES.16'0.6.—.— —.—.—.—.— — _ _ — — — — —,_ —.—.— —.—._.—.—.— — — — —.—.— —.—.—.—.—._.— —.—.—.—.-- —._.—.—.—.—.—.— — R-BB NSULATION 1/2'Cl�ON STRAPPIN6 12 - TYPIC ROOF GONSTUGTION, R x PMFR 5/5"8'CAX PLYI'm. / 2X10 D.G RAPIERS 1R/-90 2'2'6M ON STRAPPIN6 LOPED GEILIN65 �{ , SMPSGN H2.s FAST81FR5 p I /// ft W S EAON TOP PLATE t RAFTER, / PLATE PLATE lmlcA EXTERIOR WALL CON5TUCTION yyg�HO E : T YREP:P� N I 1 m 1/2"FLYWD 51HEATHIN6 5�5uunoN AND TEM FJ O POST BEAM SYS F-1 R 91T9 ON R ARMED 5ARNYGUD SFP 1/2 6Y@ P PLATE ` B� S T.O. TYPICAL FLOOR CONSTUCTION: J1 I B/4'PLYWY`♦<J SUBFLOOR U i A 2X10 D.L.NWLA . 1/7 FG INS SL P w LFH 6 STRAP ING(WHERE APPLICAB I j 1/Y WB ON c LE) TO SUBFLR, �� :Il • SPA'.ED 32"O C. W� l ' 12"FROM CORNERS � 1�1 5EE STRUCTURAL _ WA5HER5 B"XB'X1/4" I 110 FRAMING PLANS FOR h BEAM AND COWMN I S1ZMG � 1 r r f f , O O. c) T SLAB I I I I I p I I I I I i ' SECTION ! i i SECTION 1 SCALE,/4" _ ,:-D' __— U � z W - - - - - -- -'- - -- - - -'- -- - - - - - ---'- -- l.• u< ` 1,06E 6N5 PLI W/R06E �OORMC-R w 12 I 1 MwM / W in i RAPIER SITS ON DOUBLC-PLATE THIS secnaN PROJECT H DATE: 10-18-2013 REVISED: 1:10-22-2013 2:11-14-2013 - - 3:11-21-2013 FY"HOFW. � 808E8f DENNISIR T . - STRUCTURAL y, Na 13834 gsS/DNAL 1ti t CONSTRUCTION SET II I BUILDING i SECTIONS ��SECTION A4..l Q 4 Q 4 Q Q Q Q i I I i i j i i i i i `J T - - - - - - - - - --- - - r - - - - - - - - -- - T --- - - - - - -- - - -- --- - - ---j- - —j - - --- - - - - - -- - -j- ---- �t I I I I I I th I I I I I f U I I N —.—._ .._._ _._ i.—. ._._ — — — _._ _ _ _ _ _ _ _ _ _ _I I i I i . HATCHING 5HO 11 ORANGE IN TOP OF WALL HEIGHT: ^ WALL DROPS FROM'fYPICAL HEIGHT. 7 1 0 — TOP OF I RETURNS TO TYPICAL HB6HT. r Is I i_ �. i 5 I — — — — — — — --- — — — — — L� ND I— I a: W dN�RAWLSPAGE 3X3' FULL HEIGHT — — — — — — � i OPENING BASEMENT N I o r4 iL EX15TM6 PLATE ATTACH ENT TO NLALL: FIREPLACE �' 5/a"DV\ANCHOR BOLT5 FOUNDATION - I EMBEDDED I"INTO WALL �� SPACED 32"O.L. 7 13"FROM CORNERS 1\�/� WASHERS 3-X NERS f1 I BASEMENT SLAB ASSEMBLY M SLAB -J C*MIL.IL,VAPOR RETARDER - I cRUeHED STONE t •I BPSEMENT - I LOLLY COWMN,Tl'P. I ( VAM F OOF BELOW 6RA0E U E'M VEI:TLL.AnON Ey WMPOW I I FOOTING, 2XT REINF.CONC FOOTN6, n A wx i I un - g ----- -------- — ------- — —�— ----------- I C%I, G" N I I �ABP/E,TYP�M I I Y y'1-'�] un 10"SONOTUBE I BEAM POCKET.TYP. P;I 616FOOT 28 I I r3 W. No I 10'-10" 10'-10, I I EN1.0 I I ]oN�c sALPB5t14L Y Vl M J L CRUSHED 5TONRETARDER I :; H IL — — s — t—— — — — — — — —— — - — — — —— ——— — — -- -.r.- - - ...... — — — I� GRANL5PAGE 10 - I PROJECT# a-0 e'-�" I DATE: 10-18-2013 REVISED: 1:10-22-2013 S. I 2:11-14.2013 o3.11 21 2013 -------- — — ----------I ------ — ---------1 I I I I I I OF AN TTl IE oN I dr ROB ERI W'.DENNISA wSt� Sft13URAL m— — — — :: I � qa 13834 -- 11 �93/ONALE�G I I I � - - - = - - J ?:: in 1 Z .r. — — — - - - - -- — — — — — — — — — — — — -- — — -- — — -- — — ............... -- — — — — — ...... — — — — — — — —._.—._.—.—.- — — — — — — — 12 CONSTRUCTION I — — — — — — SET 16-6" I FOUNDATION I j i i j i PLAN FOUNDATION PLAN S2.0 G I � � �. .—._._. _._._._._._._._._.T.-.-._._.-.-.-.-._._. r - - - --- - - - - T- - - - - - - - - - -'- - - - - -- - -j--'-j - -- - - - - - -'-'- - - - - - - - - -j- - -- j I I I I I I I I I I I I I I o I I I I I I I I I I I I I I I I ,�•1 -� _.—.—..._ _.—.—..._ —,-- — — --'-- — — — -- —�-- — — — —'— -- — — — --- — — — — — .— — I — — —'— - — — —'— — — — --I— — -- — i i I I I W v I HEADER:(2)4 1/4' - _ - - _ _ - _ - - - _ _ W ^�^-�� cis�. . . . . . . . . . . . r _� O I../ I - I DOUBLE J015T BELOW I OF OB TE LOCATION L JOISTS FIREPLACE MA55 ABOVE. W = W-ORONA WITH FIREPLACE 5FF .(BY OMER) _ ' (25 4 1/4"LV BELOW _ - -._.-.- - -.-.-.-._._ - - - - - - - -.�.-.- -.- -.-.-._ -.-.-.-.-.-.- -.-.J-._.-.—. q I..� Cn i - I[�[rr'�' SLEEPER 5Y5TEM AND LOW'MR ROOF a 3 I I AT FLOOR OF SCREEN PORCH BY GG [7� ....... ..... _ — 5 W Oo " (41 0-- - -- - - - — _ - - _ — _ _II- - — -- - - — --- - -- - --- --- — cn00 '(2)41/4-LVL W I O � I I j I I I DOUBLE JOIST BELOW Q 7 -.{—.-._._._.-.-.-.-.- -.-._.-.-.-.-.-.-.-.--------.—. ', FIREPLACE MASS ABODE. GO-ORDNATE LOCATION OF DBL JOeT i IWTH FIREPLACE SPEC.(BY OWNER) �+ I I i I VH� FF» TYP. -.-.-.-.-.-.-.-.-.-.-._._._._.-.- _ ()914-LVL W U 2x6 P.T.PUTE,TYP. r00 u 4X4 POST UP 2%10 RM J015T yy V) - 2XH Pr FRAMING®DECK 4X4 PT POST 4X4 PT POST VI II Q - -i- - - - - -- - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - -- - -- - - - -- ---- - - - ---- -i_-- PQ i j PROJECT# I I DATE: 10-18-2013 REVISED: L 10-22-2013 2:11-14-2011 3:11-21-2013 r2) 1/4'LVL ELO _ - j H OF FF(s I I j oaf ROSWw dOs j DENNIS JR ✓' STRUCNRRL SSroNAL E ` 12 _._1.-.-._.- -.-.-.-.-.-.-.-.-.-.-._.- - - - - - - - _ -1- - - - - - - - -- - -- -'-'- -- - ---- --- - - - - -- - - -'-'- - -- - - --'- -- - - -'- - -'-I- - -- - 12 CONSTRUCTION SET I I I I I j 1ST FLOOR i i i i j FRAMING PLAN j1st FLOOR FRAMING S2 . 1 IT — ---- — — — — —T — --'— — — — -- — — --'-- -- --'—j— — j — — — -- -- -- — —'— — —'— — — i—'— —— — J • I I I I I I I 0 0A I v1 'm I �C14 as U i A � _.—_. _ _ -- --'- - - - - - - - - - -- - - - - - -'- - - - - -'- - - - - w Qv2 c O � U i w ¢ c i 1n 2)9/a'LVL B 1 CA —-_-_-_._._ _-_._ _-_._._-_-_-_.—._.—. ._._. ._-_._._._._._.—._.—._._.—._._.—._._.— - -� 4 (�5 � 00It a ~ W r4 — - — — _ _ _ —._ __ _ _ _ _ _ _ _ _ __ _._ s w (A00 01 I I I y H axa PO T DOM I I i i W i i U H TYP. (3)9 LVL F x FWBH RMnED [�w7] I I axa Posr Dora+ ! lg � � � I I I I I I Ql, r z p4 I I I I I I d I I I PROJECT# I I DATE: 10-18-2013 I I ! REVISED: -tr 10-22-2013 ! 2:11-14-2013 3:11-21-2013 I � I ASH OF 1Ws. aosmTW.W`s I 1 I ! yF DENNISIR MRAL Na lum • I I 1 �ossPoNAlL 13 12 '--rt - - - - - - --'- - - -- - - - - - - ----- -- -I- - -- - --'- - - -- --'- -- - - - - --I-- --- - - - -- -- -- - - - --- - ------- - - -- -- -- - -I- - -- - 12 CONSTRUCTION I I I I I I SET 2.,D FLOOR FRAMING 0.1 r, PLAN 2nd FLOOR FRAMING S2.2. SCALE:1/4'. = 1 0 S � I RAFTER®16" O.C. T 0 v � own ca H2.5 0 EA. RAFTER . A � TOP PLATE d mW RAFTER TO PLATE CONNECTION W O SCALE:N.T.S. 00 I•� N O Vi N a .a° DOUBLE ROW W STAGGER NAILIN INTO BOTH PLATES 2x6 DBL TOP PLATE ._ VERTICAL = �1U w . STRUCTURAL PANEL W !� NAILED Bd COMMON [•��r Y 3"O.C. EDGE Ra tCMJ • AND 12' IN FIELD /Wy a �a JOINT DESCRIPTION NUMBER OF NUMBER OF NAIL SPACING VERTICAL e COMMON NAILS BOX NAILS DOUBLE ROW STRUCTURAL PANELS __ Fy STAGGER NAILIN BREAK ON SECOND FLOOR INTO BOTH PLATES RIM JOIST ROOF FRAMING 2x6 DBL TOP PLATE BLOCKING TO RAFTER(TOE NAILED) 2-Sd 2-IOd EACH END I RIM BOARD TO RAFTER(END NAILED 2-I6d 3-I6d EACH END WALL FRAMING — TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-I6d 5-I6d AT JOINTS _ _ _ _ _ STUD TO STUD(FACE NAILED) 2-I6d 2-I6d 24'O.C. SECOND FLOOR HEADER TO HEADER(FACE NAILED) I6d 16d 24,O.C. ALONG EDGES - _ _ RIM JOIST VERTICAL - VERTICAL STRUCTURAL PANEL - - STRUCTURAL PANEL PROIECC#1302 FLOOR FRAMING NAILED 6d COMMON NAILED ad COMMON •3'O.C.EDGE - •3'O.C. EDGE - DATE: 10@2-2013 JOIST TO SILL, TOP PLATE OR GIRDER(TOE NAILED) 4-Bd 4-10d PER JOIST AND 12"IN FIELD - - AND 12" IN FIELD a BLOCKING TO J015T(TOE NAILED) 2-Bd 2-IOd EACH END - BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-I6d 4-I6d EACH BLOCKRSVLSION: 11-21-2013 LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-I6d 4-I6d EACH JOIST _ _ - JOIST ON LEDGER TO BEAM(TOE NAILED) 3-Bd 3-I0d PER JOIST a. BAND JOIST TO JOIST(END NAILED) 3-I6d 4-I6d PER JOIST- BAND JOIST TO SILL OR TOP PLATE(TOE NAILED) 2-16D 3-I6d PER FOOT ROOF SHEATHING DOUBLE ROW DOUBLE ROW WOOD STRUCTURAL PANELS STAGGER NAILIN STAGGER NAILI INTO BOX AND BILL INTO BOX AND SILL RAFTERS OR TRUSSES SPACED UP TO 16'O.C, _ 5d IOd 6" EDGE/6"FIELD RAFTERS OR TRUSSES SPACED OVER 16.O.C. Sd IOd 4"EDGE/6"FIELD - 1I II GABLE ENDWALL RAKE OR RAKE TRUSS w/o GABLE OVERHANG Sd IOd 6'EDGE/6'FIELD GABLE ENDWALL RAKE OR RAKE TRUSS w/STRUCTURAL Sd 10d 6" EDGE/6'FIELD O7TLOOKERS GABLE ENDWALL RAKE OR RAKE TRUSS w/LOOKOUT BLOCKS Bd IOd 4'EDGE/4'FIELD CEILING SHEATHING 'A,u a GYPSUM WALLBOARD 5d COOLERS - 7"EDGE/IO' FIELD 11 11 WALL SHEATHING F7�RAIVIIWO • WOOD STRUCTURAL PANELS _. - DETAIIS STUDS SPACED UP TO 24"O.C. Bd IOd 6"EDGE/12'FIELD JjYj'AND-' FIBERBOARD PANELS Sd - 3"EDGE/6'FIELD GYPSUM WALLBOARD 5d COOLERS - 7'EDGE/10' FIELD - FLOOR SHEATHING WOOD STRUCTURAL PANELS OFULL HEIGHT SHEATHING —SINGLE FLOOR 3OFULL HEIGHT SHEATHING —MULTI FLOOR I'OR LESS Bel 6"EDGE/1"FIELD SCALE:N.T.5. SCALE:N.T.S. GREATER THAN I" IOd I6d6d 6' EDGE/6"FIELD ' -� - NEW TRIMMERS AND HEADER.Fi TO ALLOW FOR NEW DORMERS. SEE ROOF PLAN AND ELEVATIONS. E%I5TN6 ROOF FRAMM6 ----'- -'--- - -. I - - - - I I I I I I I I O I I I I I I � •� I I I in _._ _.---. .-._._._._._._._._._._._I_._ _._._._._._.-._._._._._._._._._._ _ _._. _ _ — p C j I I I I -� �� . I GATHREDAL CEILN6 w 2X COLLAR TIES AT 32".O.c. - Vl 75 � W Q i I i i i Q � � •� j : li i U CIO H i o I i i I� n—_ --- - - - - - - - __ - El - - - - - - --- - - - - - - ---- ---- - - -0 w 0Gn0 i I YW 2X8 COLLAR TIES AT ib"O.G. I I I I I I U F I I I I I I R bE �RD:2X,�2 I I I I � FZrq I � _.4- - - _._ __ _ _._ _ _ __ _ --- _._ - 2xe D.L.O PORLN ROOF FRAMIN6 ! M ca SIMFSON H2.5 FASTENERS — { EN'H TOP PLATE t RAFTER, - - - - PROJECT# DATE: 10-18-2013 TRAY CEILINGREVISED: I:10-22-2013 2x5 CEILING J06T5 2:11-14-2013 RIDGE EO D:2X12 ®Ib-O.G. I I 1 TYp I I I IO'-O-GEWNG 3:i1-21-2013 _ HEIGHT-VERIFY - - T — OF I T P DP AGEMENT oaa1t$W IIIIIIIIIIIIII HEI64T TO ALLOW $ I I FOR TRANSOM — — — WNDOW AND CASING 9N0.1304 SSOfNpt. ,�� 12 - �Y'-- -"-"-'- - -"- -"--'- -"- - -"- - - -- - --"-1-"-"- - ------ -"- - - -- I--'---- -"-"---- ----- - -'- -"- - -"- --"-" ......--"- -- -- CONSTRUCTION I I I I SET ROOF FRAMING PLA N ROOF FRAMING S2 . 3 1'0" SYSTEM PROFILE ALL SYSIEAI COMPCNENTS SHALL BE .. 11ARIDD LE APE OR WLiETC T RE Go.-LEIE MFANS FOR FUTURE lOG1KXH. LEGEND SYSTEM DESIGN: NO 05CNE NOTES terns Harbor ACCESS twins TOwmIIN e•of FIN ORAOE coruaETE cO.TRs To wmHN s'TRADE 2•PFASTOHE OR CEOTEXIRE 1.DATUM IS-ASSUMED GARBAGE DISPOSER IS NOT ALLOWED TOP FOUND.EL 45.33' FILTER fABRM DYER BONE 2.MUNICIPAL WATER IS AVAILABLE --99- EXISTING CONTOUR_ 38.0'YMIwY.TS'OF COVER OVER PR CASE - E.SLOPE REODUiFD OVER SYSTd 36.5 X"' EXIST.SPOT EUN. DESIGN FLOW: 4 BEDROOMS 0 110 GPD= 440 GPD B Ks aR WATERTESf O'BOX FOR VIEVElNE55 PREGST RISERS 3.MINIMUM PIPE PITCH TO BE 1/8'PER FOOT. xoro n*J-� PROPOSED CONTOUR USE A 440 GPD DESIGN FLOW T ,�, 4•FscNto PVC - NP`5 LEVEL 15f 2' �uPON INVERT TO BE AASHO HNG22FOR $ (98.4 PROPOSED SPOT EL ( ) ,• ENDS ROES 33.5 - ] SEPTIC TANK: 550 GPD 2 = 1100 •• •� - l- � ALL PROPOSED PRECAST UNITS s -IN 32.5' '^ THI 38.76'° 10,1500 GL N-20,4• M - $'C _ 9 USE A 1500 GAL.H-20 SEPTIC TANK _ - TEST HOLE 36.3' TEE SET+Iit TANK TEE 5. 5.PIPE JOINTS TO BE MADE WATERTIGHT. �S SLOPE Of GROUND fu °••- ��� ��� 6. CMR 15.0 (TITLE 5,)TO BE IN ACCORDANCE N1TH ` LEACHING: 33.05' 0 67' .. 310 CZAR 15.ODo(TITLE 5. 4'W,IFVR EEp1K . UTILGY POLE SIDES:2(47.5+ 10.5)2(.74)= 172.5 GPD 7.THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO �F 3/1•-1-1/2.OWBLE WASHED STONE!WN. X-10 50o GUI ILLHINL CIMYBFRS BY ACME PRECAST ORE BE USED FOi LOT TINE STAKING OR ANY O7HER BOTTOM 47.5 x 10.8(.74)= 379.6 GPD -'-"-'° � PRECAST (5)uNn REo01RED PURPOSE. [OCT7 2� FIRE NTpRANI b 6•CRMSNED STONE OR MEGNW ,OVERALL OMFRSDNS TO OUTSDE OF STONE 25A0'%12.R3' 1100:xor Au alms 1WF AHRtw M TOTAL: 746 S.F. 552.1 GPD L- COMPALTpN(1-1[2U - PIPE FOR SEPTIC SYSTEM TO SCH.40-4•PVC. 9.COMPONENTS NOT TO 8E BACKFILED OR CONCEALED pond USE(5) 500 GAL. H-10 LEACHING CHAMBERS(ACME OR EQUAL) (8 x-m (4 x-M L_2_x SUIPE, WITHOUT INSPECTION BY BOARD OF HEALTH AND - WITH 2.5 STONE AT ENDS AND 3' AT SIDES LEACHING PERMISSION OBTAINED FROM BOARD OF HEALTH. -THE INSTALLER SHALL VERIFY THE FOUNDATION- 31' -SEPTIC TANK- 75' 0'BOX 21' t9.o•eoTrou TN-t LOCATIONS OF ALL UTILITIES AND ALL FACILITY NO GROUMMATER FOUND 10.CONTRACTOR SHALL BE RESPONSIBLE FOR CALUNG LOCUS MAP DIGSAFE(1-888-344-7233)AND VERIFYING THE OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY LOCATION OF ALL UNDERGROUND k OVERHEAD UTILITIES NOT TO SCALE BUILDING SEWER PRIOR TO COMMENCEMENT OF WORK. PORTION OF SEPTIC SYSTEM 11.ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 317 PARCEL 39 REMOVED 5'BENEATH AND AROUND THE PROPOSED TEST HOLE LOGS TNT FACILITY.LEACHING 1 E7IED O LEACHING AND FIU.LITY SHALL ED NTH C M SA AND ENGINEER: DANIEL E. GONSALVES. SE#13587 13 YID ADDITIONP LOCATION PER CAD PLAN FROM DONNA MIORANDI, RS I-I ELEV. ELEV. ELEV. ELEV. ITEcT. - D WITNESS: 4 4 4 4 - DATE: 8/2/13 0' 37.0' Q 36.0' � 37.0' 2 38.0' - < 2 MIN/INCH A A A A 11 _ PERC. RATE LS LS LS � LS CLASS I SOILS p# 14089 10YR 4/2 10YR 3/1 10YR 3/2 TOMB 3/1 12" 17" 15" 12" 8 B B B ZONING SUMMARY LS LS LS LS ZONING DISTRICT: RF-2 RESIDENTIAL DISTRICT 26" TOMB 5/4 34 8' 27^ TOMB 5/6 33.8' 30" 10YR 5/4 34.5' 30^ TOMB 4/1 35.5' MIN. LOT SIZE 43.560 S.F. CG G C, - MIN. LOT FRONTAGE 20' PERO FS PEac FS FS SiL - - - MIN. FRONT SETBACK 30' MIN. SIDE SETBACK 10' 114" 1OYR 5/6 27.5' 96" 2.5Y 6/3 28.0' 102" 2.5Y 6/3 28.5' 96• 2.5Y 6/3 30.0, MIN. REAR SETBACK 10' C - r2 _ SITE IS LOCATED WITHIN AQUIFER PROTECTION OVERLAY DISTRICT SiL C2 C2 FS - 204" 2.5Y 6/3 20.0' SiL SiL 144^ 10YR 6/4 26.0' - C3 - 2.5Y 6/4 2.5Y 6/4 C3 - M/CS M/CS _ � 1 216" 1GYR 6/4 1,9.0, 132" 25.0' 132" 26.0' 196'1 2.5Y 6/4 21.7' NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED - O 1; O _ / N 28'43'00"E 193.81' 75.68' N 28'41'43"E \ 4 TOSTNc .1 To BE oE3NOusHEO C .3 2 EXISTING=GE/ ? Lot 1 fl OBE RdOfdFD - 40.0] `___' 9EPTC TANKS g�'I Area=61,240± Sq. Ft. �w �q' I I[3.5'9� FA,1 5 NCODE Or n I o 1.41± Acres I \ f I _� i ;O II L-y>yI ,a21 I ti CIO X 0 \1 �.i''��'- �, °°°Ro-BE TA°A --_aS�� I•��,, a bOL TITLE 5 SITE PLAN \. \ \ PROPOSED `\ / i , 7 .� I y' ti. OF d '� '�\ � (38'�/I � `� �^ , ', �� ^:� .�b I C� 3667 MAIN STREET EDGE LAWNCBRv13.o7 I 1 BARNSTABLE, MA 1 R v / \_ FIELD 1 z _ STONE � RETAINING WALL � I PREPARED FOR �I , p.03 CK MESH s 4'HIGH BU >L w u+ a s �1 -W P�ooTM a oSNCC GATES 5 g32'00 °;N� o � I . ROBERT BAGSHAW DATE: SEPTEMBER 10, 2013 \ 16.00' I BENCNMARK S.W.:1"=20' 169.30 S 3173'00" W I EL. 4228'OUND 1.L' / /fig//8, //�_ /per G IO 20 30 n0 50 FEET S jg21'40" Y / Fi®9/Y. Rock WORoad � AOFy oR SOB-50 FEET TNOF� &� DANIEL I d 508-J.com 0 tlOwncape.tom DANI6_A O.Q38 down cape eeline01141,ine. OJAU c NP.40380 . - CIVIL 'm a s,"osuav ` 0 4F V civil .engineers s_ � land surveyors s TEW 939 Moin Street (Rte 6A) DICE #13-14.3 DATE DANIEL A. OJALA,P.E., P.L.S. YARMOUTHPORT MA 02675 1 1}-14}BACSHAW.OVIC SYSTEM PROFILE " 4SLMGDMPpLNSSN B[ -'----1 LE END SYSTEM DESIGN' *` Mwa®NM tTG TAP[ • '� tNn m sun FaIPARAMl1 Mws rw rvnAE 1nuTlw. NOTES '_ i Blzrnswbk Harbs7r. ACC[35 CV>QS to Wmw a•.o,nN OR.>JE - _ IbHCAER CO>QS TO wmN r pAo[ - - Ex sTmc cw:Iw3 I GARBAGE DISPOSER IS NOT ALLOWED _•rtwroN[w uonxnt `1.DA nM K ASawED TOv Fp1ND.EL.as.J3' _ ;I n+[x I-o.2a s w . .- .. J6.0'I IRr,._,,..» PR - - x SiDPE R[aIARD Girt SYSTd J6.5 L MUNICIPAL WATER IS AVAILA3LE I{drs`rl qY'r `\.\ M r ExK' SPDT ELE. _ a CORDI ,/ DESIGN FLOW: 4 BEDROOMS O 110 GPO = 440 CPD _ _WATERI6T D'BOA FOR tMLwss- �aKt J MINIMUM TGE PITCH TO BE 1/!•PER FOOT. 1 .CCA51 2YA5 PRGPCSEO GOH"TWR - - •�>••1 -USE A 440 GPO DESIGN F_Cw . �^>'>5f}.b P.C. wom.R AAutL a DE A LOADING FOR ALL PROPOSED PRECAST UNITS i' '� - + :..D.CL ST 3 JwuIIS INVERT IN 32_5 TO BE AASHO H-2p, vRCPOSED zPo-EL SEPTIC TANK 550 GPO (2) - 7100 L ` Egos 0`°'7 sloEs 33.5 i-I USE A 150C GAL. H-20 SEPTIC TANK 36 78'• o•1l0o u N_p S nqq �� _ _ 5.PPE JpNTS TO BE MADE WAIENTOHi. �, tt3' `r•\ 'EST HOLE - - ` 36.3' tEF XPTIC•iANx TEE C ee qg 1 :I �.. �' .I ' . �g� C�g ggtl A �� A.CONSTRUCTON DETAILS TO BE-N ACCO,RDANCE.WITH-. 1< SLOPE or GRC.M; - - 7 _ .•. 1 •6 I r>,- I A A e P6 J10 CMR 1SDro(TITLE 5.) I z �.i- I T iL_A CH;NG: Up ttv. W[DUN 33 JS J27' '� ].THIS RIIH K FOR PROPOSED WORK ONLY ANp NOT T0. _I urslr,PaE SIDES:2 (t]S + 10 8) 2 (74) - 772.5 CPO „• _. _ _ c H-10 Sm r.H1\LCi•NG CHu6O¢T.c.[*Rc>t:a E BE USED FOR LOT LINE 6TAxNG OR ANY 01HER /A i - .:: U"-I-In'oalu..v.io Ira•c.'-wN (s)wr:z flEwaD- vv11PHUE. rro�HrDRAwT BOTTOM a7.5 x 10.8 (.7� - 379.E GPD - NL.AGu•o PPE:tsT macnA¢z - - {. - Ae - -. - 1 -duSrfD 4dt M MCCN>Nr gsvx�o:4,KCK n DUZ°E ar rY�E:n�D•r ix.y' e'PPE FOR SEPTIC SYSTEM TO SCH.a0-a'PVG. -y I MWro c I..ms..•..•[ - TOTAL:' 746 S.F.- 552.1 CPD mwPAcaN Oiaal(TD .. "- 9.COMPONENTS NOT TO BE BACxFIL!ED OR CCHCEALED USE 5 ..00 GAL. H-iC LEACHING CHAMBERS (ACME OR EQUAL) (=i AaK) ('-s L.,�'s_YIDC) ' - WITHOUT wSPECnCN BY BOAR°OF HEALTH AND - vATr.(2.)5' STONE AT ENDS AND 3' AT SID;:S ( LEACHING PERM590N OBTAINED FROM BOAR°OF HEALTH. - FOUNDATION- 31' SEPTIC TANK 75' D' BOA "21' - - .o.4-OH-I •T.HE INSTALLER SHALL V-RIFY THE - _:.,y - FACILITY w rAmwrwnrtll_rH}M - 10.CONTRACTOR SHALL BE RESPONSIBLE FOR CALUNG . LOCATICNS OF Ail UTILITIES AND ALL - - - ._ ' - - DIOSAFE(1-�-3as-T23.3)AND VERIFYWO THE LOCUS MAP . BUILDING SEWER, OUTLETS AND - - _ - LOC.LnON OF ALL UNCERCROUND A OVC1tHEAO UTILITIES PRIOR TO COMMENCEMENT OF WORK NOT TO SCALEELEVA PORTION O PRIOR TO INSTALLING ANY _ ` - - n.ANY t.NSIATABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 317 PARCEL 39 PORTION Of SE?TIC SYSTEM ... ' - - - - - REACMiM S'BENEATH AND AROUND THE PROPOSED . TEST HOLE LOGS - 4 „ - : - 12 DaSTINO LEACHING FACILTY SHALL BE PUMPEO AND REMOVED OR PUMPED AND FILLED WIN CLEM SA1O. .. ENGINEER: DANIEL E. OONSALVES. BE 113587 - - - - - _ ELEV. ELEv. S ELEv. t ELEV. - Y 13�TEVRECT. ADDITION LDCATION PER CAD PLAN FRpI WITNESS: DONNA MIORANOI, RS - 1 DATE. 8/2/13 .2 37.0' 2 A J6.0' Q 4 37.0• Q Q 3B.o• - - A A A A _. . PERC. RATE < 2 MIN/INCH LS LS Ls LS CUSS I SOILS Pj "M9- - 1GYR t/2 IOYR 3/1 1GYR 3/2 IoYR 3/1 12' 1 T 1 Y 12' e e B e ZONING SUMMARY Ls Ls - LS Ls - - ZONING DISTRICT: RF72 RESIDENTIAL DISTRICT 26• IOYR 5/4. 34.8' 27' 1OYR 5/6 33.8' 30' 1OYR 5/4 34.5' 30. 1OYR 4/1 35.5' - - MIN. LOT SIZE 20'560 S.F. ' .. - � � - � - MIN.LOT FRONTAGE 20' - G, G G G i. - _ MIN. FRONT SETBACK 30' Pwc FS raK FS FS SiL - L MIN. 510E SETBACK 10' 114' 1OYR 5/6 27.5' 96" 2.5Y 6/3 MID, 102" 2.5Y 6/3 28.5• 96• 2.5Y 6/3 30.0' MIN. REAR SETBACK t0' _ SITE IS LOCATED WITHINAOUIFER C2. CI - - PROTECTION OVERLAY DISTRICT- - - SIL - C2 CI FS - 204- 2.5Y 6/3 20.0' SiL SiL - 144" 10YR 6/4 26.0' - CI. 2.5Y 6/4: 2.5Y 6/4 CI M/CS M/CS - - - 2167 10YR 6/4 19.0- 132" 25.0' 132' 26.0- 196- 2.5Y 6/4 -21.7'NO GROUNDWATER ENCOUNTERED NO-GROUNDWATER ENCOUNTERED - - N 28 43 00" E 193.8'1" 75.68' . . - N 28.41'43"F '=11 PaA' Q�`. .TO BE DEW'USNED to BEREI.OVRO \ �.[SOLO[ SEP Tula 1 Qu 7- Lot Area=61,240 t ��. I. - .. Or _ PWooM�u aTTO Es Ll 1.41-t Acres �H, I� ���le v) I 13� - o 000 27,2� PpppOSED .ADO, D c= - PATIO TITLE 5 SITE PLAN D s L -- � JA of 3667 MAIN STREET. EDP L_ D _) BARNSTABLE, MA ;.. \,LIL.J 173 07' f 1 cx - 0.. W �z (� 516'S8'2 I � - a - - -. - � .__ '':\ ARMr°.cE A �, _ I • _,' •-_ PREP RFG FOR,' .. nELDsr WALL /* A .HIGH BLAa MEVI x a m4M �U k a xll� c 12 32'00 /I aoo SLITSL ro mo�A Es' ° I ^I. !: 1 o ROBER.T BAGSHAW r GA- 5 PTEvBER ;0.-2013 6 CON EE 8- -F/int Rock Road I B'2 i ` re _ ;'»7 I p s°o3e »2 s3ea V x tt - cvDe_ O downre�iair .141 14C. _ -•E _ - - : - _\ ss °>,P ',. civil l`engineers land surveyors t ' _ .. .� ' ..... t - � Lw "•� o ,.9J9 N Sr•eer (Rre 6A) - D^c u.13-14n - - DATE - ,DANIEL A. O..A_A..D.E.. P.L.S. YARM011 1NPOR7 AIA -.02675 L.G 1r J - r _ ±r C t R. y . s Y� 1 L: 5 t J { txISI1N� BIZ r V1 LX15 (lni(> 1-To P/ZJNT w x cOn �- O 0 w ua Nr w NL w y' TnJs7— r z Lij�, jvui7ni(, �, �"" tiollQ z � p �VfjL TA 3�Tr1 Srn�S rim �' V zF C� 4 1)0- T e4p tNOFU4S. 71 ac MICHELE "k CUOILO o S7RUGTURAL I r �+Tp � No 34774 / sl -0�SIA1� A9 9FG�STEP���c�'Q li 011' OE .iii � L .,.,�, N.T.S. '--- z C. I��:, ---i U/J r s C B H NMOJI� S/"?7/13 SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE E G E N SYSTEM DESIGN. (NOT TO SCALE) MARKED WITH MAGNETIC TAPE OR COMPARABLE MEANS FOR FUTURE LOCATION. NOTES Barnstable Harbor ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 1. DATUM IS ASSUMED - 99 - EXISTING CONTOUR GARBAGE DISPOSER IS NOT ALLOWED \ TOP FOUND. EL. 45.33' FILTER FABRIC OVER STONE 4 2. MUNICIPAL WATER IS AVAILABLE X 99•1 EXIST. SPOT ELEV. 38.0 MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM �> 5 DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 44D GPD BLOCKS OR " PER PRECAST H-10 3. MINIMUM PIPE PITCH TO BE 1 8 FOOT. 99 PROPOSED CONTOUR USE A 440 GPD DESIGN FLOW �' WATERTEST D BOX FOR LEVELNESS / RISERS (TYP.) PRECAST RISERS 2'm 4"OSCH40 PVC MORTAR ALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS [98.4 PROPOSED SPOT EL. PIPES LEVEL 1ST 2' COMPONENTS INVERT IN 32.5' z 1 SEPTIC TANK: 550 GPD (2) = 11!00 '' 4' (n p) 4' TO BE AASHO H-ZQ a 38 78' ENDS SIDES 33.5 c o z TH 1 * 1500 GAL H-20 ➢;;• ;_; o USE A 1500 GAL. H-20 SEPTIC TANK ; : 10" 14' °o°oo° ®®_ 000000Qo` 5. PIPE JOINTS TO BE MADE WATERTIGHT. oo ao 0 0 I TEST HOLE 36.3 TEE SEPTIC TANK TEE 36.05' ' ®® ®' ®® YYY ° ° ° ° °o°o°o °°°°°°°°° °° ®�®®® ;000°goon 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH o� a 2°1 SLOPE OF GROUND GAS BAFFLE +40,°000 0°,0� ;og0000 ®® ° LEACHING: °°°°°°°° 111p��ill, ®®�®®®®® :0 000 oo 310 CMR 15.000 (TITLE 5.) I ;` 4' LIQ. LEVEL (ACME OR EQUAL).; 33.05' 32.88' °oeo°o°o 30.67 fe 64 / •r• + 1 .8 2 .74 172.5 GPD 7: THIS PLAN Is FOR P �47.5 0 PROPOSED WORK ON SIDES: 2 -ONLY AND NOT TO ° y \ �� UTILITY POLE l ) ( „°°oe°o,00e,°,o;o,°°°000°,0000000;o;o;°,o°;o� a '0 .0 °°°°°°°°°°°°°°°°°° ° ° ° ° ° ° ° ° BE USED FOR LOT LINE STAKING OR ANY OTHER a �� ,o o�o_o_ _o_+.o o ° ° o 0 o'n'o°..�o?nP°°°°• H-10 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL C FIRE HYDRANT BOTTOM 47.5 x 10.8 (.74) = 379.6 GPD 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (5) UNITS REQUIRED PURPOSE. LOCO 6" CRUSHED STONE OR MECHANICAL ALL AROUND PRECAST STRUCTURES NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING TOTAL: 746 S.F. 552.1 GPD L OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. COMPACTION. (15.221 (21) cn ( 8 % SLOPE) 4 % SLOPE 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED Cr°n�fe USE (5) 500 GAL. H-10 LEACHING CHAMBERS (ACME OR EQUAL) ( ) (?z SLOPE) WITHOUT INSPECTION BY BOARD OF HEALTH AND WITH 2.5' STONE AT ENDS AND 3' AT SIDES FOUNDATION- 31' SEPTIC TANK 75' LEACHING PERMISSION OBTAINED FROM BOARD OF HEALTH. D BOX 21' 19.0' BOTTOM TH-1 THE INSTALLER SHALL VERIFY THE FACILITY N O. CONTRALTO H NOGROUNDWATER FOU D 1 R S AL L BE RESPONSIBLE FOR CALLING LOCATIONS OF ALL UTILITIES AND ALL LOCUS MAP BUILDING SEWER OUTLETS AND DIGSAFE (1-888-344-7233) AND VERIFYING THE PRIOR TO INSTALLING ANY LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES NOT TO SCALE ELEVATIONS PRIOR TO COMMENCEMENT OF WORK. PO RTION OF SEPTIC SYSTEM 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 317 PARCEL 39 REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. HOLE LOGS TEST O , 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AN P D D ENGINEER: DANIEL E. GONSALVES, SE #13587 REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. ELEV. ELEV. ELEV. ELEV. 13. PROPOSED ADDITION LOCATION PER CAD PLAN FROM WITNESS. DONNA MIORANDI IRS 1 2 3 4 ARCHITECT. DATE: 8/2/13 p" � 37.0 0" � 36.0 p" � 37.0 0" � 38.0 i < 2 MIN/INCH A A A A PERC. RATE = LS LS LS LS CLASS SOILS P# / / » / / I 14089 10YR 4 2 10YR 3 1 10YR 3 2 10YR 3 1 • 12 17 15 12 B B B e ZONING SUMMARY LS LS LS LS 10YR 5/4 10YR 5/6 10YR 5/4 10YR 4/1 , ZONING DISTRICT: RF-2 RESIDENTIAL DISTRICT 4.8 33.8 34.5 3 35.5 27 30 26 30 MIN. LOT SIZE 43 ,560 S.F. G C, G G MIN. LOT FRONTAGE 20' PERC FS PERC FS FS SiL MIN. FRONT SETBACK 30' MIN. SIDE SETBACK10 2.5Y 6/3 MIN. REAR SETBACK 10' j I i 114" 10YR 5/6 27.5' 96" 2.5Y 6/3 28.0' 102" 2.5Y 6/3 28.5' 96" 30.0 C2 C2 SITE IS LOCATED WITHIN AQUIFER PROTECTION OVERLAY DISTRICT S i L C2 C2 FS �I 204" 2.5Y 6/3 20.0' SiL SiL 144" 10YR 6/4 26.0' C3 2.5Y 6/4 2.5Y 6/4 C3 M/CS M/CS 216" 10YR 6/4 19.0' 132" 25.0' 132" 26.0' 196" 2.5Y 6/4 21.7' NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED j . 0 E 43 0 I 2 8 , N 75. 68' V 8'4 43" E EXISTING POOL( HED N 2 � EMOL I I TOBE D cp O �� �� EXISTING GARAGE BE RELO [40.0] EXISTING D TO KS �< 'S p SEPTIC TAN O m I O0 Lot �� �G \ Z of Area= 61 240± Sq. Ft. � li[39.5] yu' �_ 4' HIGH CEDAR (� E ° �` TO COD .FENC E � Or I ` 6 POOL F c,) � N � WITH SELF CLOSING GATE5 � (� �. Ilk �A I 1 . 41 ± Acres ' I� 42 '( o, � I ti t � Q _ J (D 41.0] (b p MM , t v X 0 - {� DOORS TO POL (b N �. _.._ E-AI ARMEb 43 0 � nn o � 2 OPo� M t PROPOSED ADO ON Q F oo I Q _ p wo ED � > _ it X � I _ 0(DL TITLE PLAR N PROPOSED BARN OF v [3s] �, �� � � j 3667 MAINSTREE T w �s -�- - EDGELAWN�RUS �- - . � j BARNSTABLE, MA / 5 8 20 z - S � .6 7 NE ST CY) 0 D I.3 EL CA� '_ Fl ETAINING WALL -� PREPARED FOR R I I (b 1�Q.O`3 4' HIGH BLACK MESH DEs16��y o7Y1 POOL FENCE TO CODE F CLOSING GATES N W SELF WIT H N I ROBERT BAGSHAW 0W 2 � . _ • S 18 3 DATE: SEPTEMBER 10, 2013 0, 16. 00BENCHMARK' 69.3 ,S 37 7J'00" w CONCRETE BOUND Scale: 1"= 20' 1 Flin I EL. = 42.28' 0 10 20 30 40 50 FEET °21 '40" W S 18 (Un de fin ed Way �N OF kfq %�� sq off 508-362-4541 i2 y OFMgss9 i�o fJANIEL G ' I fax 508-362-9880 o A. downcape.com g° DANIRLA. �� OJALA N o OJALA -4 `0 No.40980 down co a en ineefIV inc. v CIVIL o � 0 02 � S S� civil engineers q s land surveyors NIA.• 939 Main Street ( Rte 6A) n DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 DICE # 13- 143 ---