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HomeMy WebLinkAbout0024 BRAMBLEBUSH DRIVE f. _ �� I n �Y n , I '� � �i f 2 .Go 7-1 3 -- z2S/a f • o F�NcE+GPT� N � �• - o M Poo P- ¢4 K t tt 1 13 1 WAI ?OlI � . . • eA%sjge( PLAN S�4 VI.N F I w'. a FOUNDATID ..OGA N C O 'UI T IIAS:SAOW S z W mitm OWNED B Y 7"iy O GoNd'Ti�Z ,Z,o . . .. S4' i/ARMQzJTfh i�h4SS a:e.�:�. SCALE NORJIAN fREB iA:SUR.N Y'OR 194 wr 'Y HEREBY: GER Tit Y THAT. .HIS. .EOUNOATION;4$ LQC�IT ;:ON 7rME. 01 AS . SHOWN .AND .GDNFORMS T0. .T-W TOW :. OF 811RNSTABLE` ZONING REGULA IONS REGADLN4 • �" :i �At o OIL SETBACKS: 'fR;O.lyt :STREET ONES At O SOT AESims '>. Qfi; AN GRO Tr C- TdWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma V Parcel Oq A lication #�- p BUILDINGS DEPT. pp Health Division Date Issued Conservation Division MAR 012017 Application Fee Planning Dept. TOWN OF BARNSTABLF Permit Fee I15 • 0 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address a Q f aN1 b Imo-- 9U S 14 Ar I V-e. ' Village clo�'V u k+ Owner 1�0►T�.L 0.(�-� 1 N S Address So./4-0-- Telephone Permit Request Zl\ (2,LMk/L SW%J,-M u/J9 Paz> L_ /6 'X,3a '*X4J G-- ?b o L Square feet: 1 st floor: existing proposed-qAk�nd floor: existing proposed Total news/ ' Zoning District Flood Plain Groundwater Overlay Project Valuation$3 Construction Type Lot Size as► S a Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family l Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: existing , new size 09Barn: ❑ 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 OJ C\ S 0 &J+QYPPI1-Se_S LNG Telephone Number c568) 9 Ll 9-0 L/302 Address �► d' QOX (0Rd - License* - V Oat ( 7 Home Improvement Contractor# Email N N DRECo� rXw) .N c��u�f Ix-Qr. Worker's Compensation # W WC 31 9 2a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Cam 6..07- fl S fl SIGNATURE �� DATE 0 a' a a 11 -7 y. FOR OFFICIAL USE ONLY ~ APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: O �[ ' FOUNDATION , n 31-- 17 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL , .!FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable - Regulatory Services :AXNErAMM ' Richard V.Scali,Director 39. Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862-403 8 Fax: 509-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize G/`��Sd �/ — �//5 t to act on my behalf, in all matters relative to work authorized by this builch permit application for _&AM�� boa 1)y� C CL WA (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools ate not t be filled or utilized before fence is installed and all final . ins p ormed and accepted. Xignatare of A t (yc•rc k s o Print Name Print Name Date Q:FORMS:oVn UWERWSSIONPOOLS r • Town of Barnstable Regulatory Services dF Richard V.Scali, Director Building Division �•=-"'p'• Paul Roma,Building Commissioner &65 ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable-maus Office: 508-862-4038---.-. ......... _. - F= 508-790-6230 HOMEOWNER LICENSE EXE1V MON Please Print ----- JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILINGADDRESS: city/town state up 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 will be required to comply with the State Building Code Section 127.0 Construction ControL HOMEOWNER'S EIIIV MON The Code states that:'Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to.do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. bi 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 Iast page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. AFVC Guide fa Xbod Conmi-rrctiorf in 1 iAfr k uzdAr-a s_110=pIr f-P'rAdZorx.e • Massaa.chusetts Check f for Ca ' imce usu CKIt5ant�s)' - 4. EL From Tables'i f3 and If and Ima i o of wag slieaftung and aLAdurg AlpertRafin,dIah=T ine Far=&r t Ful(Height Sheathing and Marl Spacing MIT* rnat . b. Wwd Stuch rat Panels shall be murnnum fhicbess of 711 f;and be in�ed as fnriDwz,- L Panek sisaq be insfalled' t sip-�ngHi aus pataIIei fa sts -- ii. M.h=imnt3l jr ris shall ocurr aver and be:nailed to franing UI - Dn-sinjle sfar���SSrucSon,�ne3s stsaD"be a�Ch 'ff D=m plEs and in_inemb�s of fire double - --- -- - --- M—Dnfurasmry onuPPer4=eIMshatIhe in hg4Inewherrsf• 0 Upper doubletap------ ' plate-and-b-band jotsf-at batfnm-of-ganeL-Upper-affar�nr��fi'Iw�er-panel-shall-be-rrrade-fn-lrand j6st---:--- and loweraffachnant made to lowest plate at first f5x arniag. • v. Hori:r d rrA spacing of dodge fop Plates, band joists,and,girders shaf-be a double row of ad - sfaggened.1t 3 inches on cerder per frgures bekiw:Velad and Horfmnfal Narrmg ibr Panel Affachment 5_ Gfaartg pmi or[a)new house orhorimrrfaladdifion-rerluited ifpmjecfls t n0a Drdoseria shore(generaffy,south of Rh--23 ornorfh rf Rf$.5) b)verfical addition-not reguYed tu-le-rs there Is exfax v renoAon in$e frst'ffoor- • c)replacarnenfiVuidovys-needs energy canseivafion compWc�-only(crap f33) ' G.l►laod Frame Canstucfion Manual.(V&-Chil fhr 110 MPH,Fxpa=-a B may be obtained from the AMUical WDDd Cauncsl (AWb)wabsi;: V . • Sf 1 • ca t! 1 • rt 1i , it ..IS [1•� 1 1 ► t II iL [ Q at 11 T [ [ rt trIr -1— 1f fi +rC ii iI1 @ i i a ' r 1 it rl - i I-! m R It 91 a t.PA .c LLL i' ei l l LIrk l at a 1 It at l IL rl 11 [ t [ n IL-•� F` .� �-urra�c,�R Frx`FSPRL�[' . ` Sea l3al 0n h[exf Page VsrUc l and HDT!mr H lrlarTng Dew - Nai v far Pa1yd A�rfurrrs>f ' ��a1 land lfo�r�i ling • - . fbE R3 r Ataclfinerif . . INSTALLER IS RESPONSIBLE Foil PLACING ONE SKIMMER RG fdnrv-- 2'RX3'211 FOR EVERY 800 SQUARE FEET OF SURFACE AREA AND ONE RETURN FOR EVERY 300 SQUARE FEET OF SURFACE AREA. 8' 8' SKIMMER 8 4 RETURN 2'Rx3'2" 2'Rx3'2" 3 �9 i 41 I 3 1 '----------- T' 1 8' 1 21 � � r n�rnl. 2'Rx3'211 16 I Q i i --! SAFETY ROPE V 8 � LIGHT ` ' � I AND FLOAT a Step Option 1 i 8 L ' I 5 4' RETURN)2'Rx'3'2" ' ' " 4' r - �� - i I 2ORx3'2" 2'Rx3'2" I � 8' 4' 8' 8' Wig y RETURN O. -------------------------------- ---------------- r` CO 6"WATERLINES ------ II 3'-4" 3 "4 Z o� o --------- o � � 81 - ----------------------------------- l3 Step Option 2 O 4 -8 2'6" RETURN ICC 4' 6' 14' 8' 32' �o CERT#ESR-2782 ALWAYS DIVING/SLIDING EQUIPMENT SHALL BE H� LATHAMTEEL RECTANGLE-2FT RAD 16-0 X 32-0 EN-rEp Pool- DESIGNED FOR SWIMMING POOLS AND P SHALL BE INSTALLED IN ACCORDANCE I WITH THE DIVING/SLIDING EQUIPMENT ". 42" STEEL PANELS PERIMETER: 93'-8" VOLUME(US Gal): 16700 MANUFACTURER'S SPECIFICATIONS. PLEASE CONTACT THE DIVING/SLIDING 2-6" DWG#: B' SURFACE(ft'): 509 VOLUME(Liters): 63200 ,,{{,, EQUIPMENT MANUFACTURER FOR USRE24S1632-16 LINER(wy 512 DATE: 1/1/2016 DSR: 149 �(�iet First THEIR SPECIFICATIONS. Step Option 3 MEETS DEPTH AND SHAPE MINIMUM KIT#: RE24S1632 COVER(ft2): 612 SCALE: 1/8"= 1'-0" STANDARD ANSI/APSP/ICC-52011 . SHEET:.- 1 OF 2 RECTANGLE-VT RAD 407 ZOO THE CONSTRUCTION METHODS ILLUSTRATED APPLY °a RNER BRACKET ONLY TO NORMAL GROUND CONDITIONS. IF UNUSUAL i SOIL CONDITIONS ARE ENCOUNTERED (I.E. HIGH z�, w _ ORGANIC MATERIAL, HIGH WATER LEVEL) ADDITIONAL z o r MEASURES MUST BE TAKEN TO PROVIDE SUBSURFACE 8 CONDITIONS WITHIN THE STRUCTURAL CAPABILITIES U _ OF THE PANEL. ANY ADDITIONAL PRECAUTIONS OR w Q METHODS OF CONSTRUCTION ARE THE RESPONSIBILITY o OF THE CONTRACTOR. (NOTE: DECK SUPPORTS ARE A F BIG VEE OPTIONAL.) 8 o o 6" RAID. INSERT POOL DECK Q �- .a wElJ O ( j av i RADIUS CORNER F�; OQ U l COPING W z o on W�F CORNER DETAIL H a w o NGULAR POOLS) - Im u a ° a �w O ° oq�q0 dll$u j MIN. 6" THICK CONCRETE COLLAR li _ -3"N °' �wv j REQ'D. AT BASE OF WALL PANELS C1 d w o yqa _ a DRIVE RODS THROUGH = o z z az I HOLES. IN PANELS - ¢ � � � c W WyQa INTO UNDISTURBED EARTH. ° ° o� w z¢ ;I 2" SAND OR VERM. CONC. o. 4 - CURVED CORNER A COPING o UNDISTRUBED — — EARTH i BACKFILL SHALL BE FREE-DRAINING CLEAR GRANDULAR MATERIAL SUCH AS SAND, TRACE CLAY OR TRACE SILT. TYP. LINER INSTALLATION DET. 3/8" x 2" BENT BOLT W/NUT & 2 WASHERS (7 PER JOINT) _ I ZNER DETAIL POOLS) -3-18VISNUVS 30 NMOI - o DL AT RIGHT ANGLES TO SLOPE 10 N OF DECK TO BE 1'00" ABOVE RADE ROUND UP-HILL SIDE OF DRAIN. 1"d3®ON1011nEl AWAY FROM POOL. iHOULD SLOPE MIN. 1/4 PER FOOT 1L. w9 c ` iHED BY OWNER TO SHOW POOLPu :NCLOSURE. P e BING AND FENCING TO CONFORM TO CARDINAL SYSTEMS Q �` 250. RT. 61 S. (570) 385-4733 '7 ` REQ'D. BY SITE CONDITIONS OR SCHUYUOLL HAVEN. PA (570) M-1316 FAX. BY OWNER. DATE, 4 7 11 TITL'CONSTR. DET. SHT. g ANS OF EGRESS SHALL BE PROVIDED. SCALE: NONE UNG LINER STL. POOL > OR LADDER DRAWN: SED FlLE NAME: CONSTDET 3/8" x 1" BOLT WITH NUT & 2 WASHERS (TYP. 14 EA. CORNER) PP 3/8" x 1" BOLT WITH NUT & 2 WASHERS (7 PER JOINT REO'D.) ° ° ° ° WALL - STEEL 14 GA. TYPICA ° W/2oz. (G235)GALVANIZING ° (REC 10 ° ° ° ° ° ° ° ° 3/8" x 2 1/2" BOLT W/: REINF. ROD SUPPORT SUPPORT MAY BE BRACE TIE BOLTED TO THE ANGLE \ POST IN ANY OF THE PRE- \ PUNCHED HOLES. \ TYPICAL WALL BRACE ASSEMBLY CORNER BRACKET CONCRETE DECK REO'D. 7 TYPICAL C RIM-LOK COPING (GRECI # EXTRUDED ALUMINUM PLANNING N.( 12-14 x 1" SELF DRILLING FASTENER (18 O.C.) SET WIDTH OF FINISHED ELEVJ SURROUNDIN( VYNYL LINER PROVIDE SWALE (HUNG) SURFACE WA CONCRETE DEC AWAY FROM PLOT PLAN FU POOL WALL PANEL LOCATION AN RIM-LO K COPING DETAIL ELECTRICAL, PI ALL CODES. OPTIONS' EXTR/ WHEN SPECII :. AT LEAST ONE OPTIONAL ST r zo Jr ?o .'. IV- . 0. .C.o 7T c 3 to6� zzs�a f TX M Poo R- �` VA.(Z K 't i 113 E 4 ZAPA /L.1 L Ir A3 Vf.� /7 PR ��/�DI'V DFpT AR nl?�1 . NoFeq I � ANSTge`� a✓ PLAN SHOWING �. �m a oN a FO�UNDATI:ON LOCATION. �wuo n ua q� o TUI T, 'MASSACHUSE T T`S� Q'!�m GO OWMEp BY: ?W o GCNd'T� So VAAt!td l7N MAS'S SCALE / "=.4G DATE . aEG /98z a�zL NORMAN GROSSMAN RE .6ISTERED� . Np SUR. R - f HEREBY CERTIFY THAT.THIS:-F4UNDAT,ION lS LOCATED `ON :TINE LOT AS . SHOWN AND .GOKFORA(S TO.:' 14E TUWN OF BARNSTABLE ZONING REGU.LA:TIONS REGA_R DING. }, �� ':.I MA °(A.IL. dstwi 4 :SETS LINES AND LOT ,LINES.. R y Ka I21fS p ll0f- AN GROSSMA'N� R L:S DAT : �a t PG DAPT-2 Manual 021115:Layout 1 2t12/15 12:15 PM Page 1 ALARM5. LOW BATTERY FUNCTION SWIMMING POOL SAFETY TIPS 6. INSTALLATION OF OPTIONAL SCREEN DOOR KIT When the 9-Volt battery Is low,the door alarm horn will chirp once every •Supervise Children at all times. CONNECTING DOOR ALARM TO SENSOR SWrTCHES 1D seconds-MIS means It is time to install a new battery,Battery life Is •Never permit swimming alone.Never leave a chlld alone,even READ THE DOOR ALARM MANUAL FOR INSTALLATION ON ONE DOOR FIRST. approximately 1 year.Test your door alarm weekly by opening the door to answer the telephone. THE SENSOR WIRES ARE PERMANENTLY CONNECTED TO THE DOOR Installation Instructions and allowing the alarm to sound. -Always remove the entire solar cover from a pool before ALARM.CONNECT BOTH SENSOR WIRES COMING FROM THE DOOR ALARM MODEL DAPT2 swimming. TO THE SENSOR SWITCH ON THE DOOR FRAME.THEN USE THE SUPPLIED SIGNALING g' JUMPER WIRES TO CONNECT TO THE SCREEN DOOR SENSOR SWITCH MEETS UL 2017 •Remember that alcohol and water safety do not mix. - _ WARRANTY (SEE DIAGRAM BELOW).THE TWO SENSORS SHOULD BE HOOKED UP IN ----__ -Have your pool area fenced and the gate locked to prevent pARELLEI WITH EACH OTHER. _ (5F, L unauthorized entry to the pool,and Install a gate alarm. •THE PLASTIC COVERS ON THE SENSOR SWITCHES s SENSOR •POOLGUARD is sold with a limited warranty to cover defects in pans •Lock and secure all doors In the house which permit easy MAGNET MUST BE REMOVED BEFORE INSTALLATION LISTED and workmanship for one year from date of purchase.(Retain proof of access to the pool,and Install a door alarm. •SWITCHES GO ON THE FRAME BY THE DOOR purohesB). If POOlguertl exhibits a tlOfBct,p10850 Cell Our C.aettlmer •Have aresponsible adult teach swimming and Water Safety to •MAGNETS GOON THE DOOR ITSELF-SEE PICTURE IN MANUAL `Service department at 1-800-242-7163.Unauthorized returns Will not be your children. EQUIPMENT NEEDED accepted.Proper repair Is only ensured when the unit Is returned to the •Maintain Clean,Clear water In the pool. A.ONE DOOR ALARM AND 2 MOUNTING SCREWSmanufacture!. Visit Our website at www.pool,uard.com to fill out your •Do not swim during electrical storms. B.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET AND 4 SCREWSwarranty registration Information. •Do not permit bottles, glass, or sharp objects to be used FOR DOORFRAME a DOORC.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET,JUMPER WIRES, around the pool. AND4SCREWS•Ask your pool dealer how you can Improve your pool safety—they will be glad to assist you. -FOR SCREEN DOOR FRAME AND SCREEN DOOR•Above all: remember that common sense, awareness, andIF YOU HAVE ANY QUESTIONS CALL US AT lA00.242.7IBscauUon will allow you to enjoy your pool. SCREEN DOOR MAINDOORSENSOR SENSOR twntll DOOR ALARM gure 1 = 0 = 0 Poote�µ•ro• The horn is SSdB at 10 feet PBM INDUSTRIES,INC. P.O.Box 858 LED ® IMPORTANT NORTH VERNON,IN 47265 • PASSTHRU 812-46-2648 pOOlguard S O z O • SWITCH e •'• •' The product has been designed to aid In the detection of unwanted ® IUMPER HORN intrusions Into unsupervised areas. POOLGUARD OAPT-2 IS A Pam INDUSTRJES,INC. /' POO 9ua rd www.pooiguard.com WIRES SAFETY ALARM SYSTEM AND NOT A LIFE SAVING DEVICE. It MADE IN THE USA should be used in conjunction with the safety equipment currently In use REV.02-15 Figure 5 SENSING . and should not effect existing safety procedures. WIRES PG DAPT-2 Manual 021115:1-ayout 1 2112/15 12:15 PM Page 2 A.Determine the best location.The door alarm must be Installed at least OPERATING E OOR ALARM e INSTALLING THE 9V BATTERY(FIG.2) 54•above the threshold of the door. �o o I gua rd alkaline P battery.Energizerm Current No. Duracell No. ,, B.With a pencil,mark 2 spots 2 12"apart vertically(up&down)where The POOLGUARD DOOR ALARM uses two tlela modes wAnloh allow A the alarm will be mounted.These 2 marks are where the 2 larger Y A Remove the assembly screw from the back of the door alarm and supplied screws will be Inserted into the wall to hang the door alarm. the user to exit and enter the door without the alarm sounding.These remove the top cover.(See Figure 2) C.Insert the 2larger supplied screws into the Well on the 2 marks.Leave two modes are explained below. B.Pull down the battery spring and install the 9v battery(see figure 2). about 5/32"(rot Including the head of the screw)of the screw from A. FIRST DELAY MODE: When the door is opened the alarm NOTE:It the battery spring Is not In the correct position under the the wall. automatically goes Into the first delay mode which gives you 7 battery,the alarm wilt not go back together. D.Hang the door alarm on the mounted screws and pull downward until seconds after the door is opened to push the pass thru switch. If the r C.When the 9v battery Is installed.the LED will gash once every 10 the screws are positioned in the small end of the hanger holes in the pass thru switch is not pushed within 7 seconds the alarm will sound seconds.When the alarm sounds,the LED will gash once every back of the alarm. With the door open or closed. To silence the alarm close the door second. E.If you purchased the OPTIONAL Screen Door IQ see section 6.Figure 5) then push the pass thru switch. D.Reassemble the door alarm with the assembly screw.NOTE:Once 8.SECOND DELAY MODE:When the door is opened and the pass thru the battery is Installed the alarm may sound accidentally until the 3. INSTALLING DOOR •• switch Is pushed within 7 seconds,this puts the door alarm in the - sensors are connected property. second delay mode which allows you 14 seconds to go through the A.The Door Alarm comes with,one sensor switch and one sensor door and close it. When the door is closed within 14 seconds,the -L 2. INSTALLING r •B B ,.E DOOR ALARM magnet;remove the covers from both of these parts by using your alarm will automatically reset. If the door is not closed within 14 "SAFETY BUOY' Indoor Use nly fingernail or small tool to unclip the cover from the bottom side and seconds,the alarm will sound. ABOVE GROUND POOL ALARM sliding It oil the sensor. SENSOR IN GROUND POOL ALARM Your Pool uard Door Alarm Is designed to be Installed within 12'of the B.Each sensor has 2 holes for mounting Note:Do not mount the Figure 4 SWITCH PLASTIC COVER 9 9 9( WITH REMOTE RECEIVER Sensor switch for the sensor wire connection.To mount the door slam sensors on the side of the door that is Hinged).The sensor magnet 0 on wall next to door: usually goes on the door and the sensor switch Is usually mounted to O v BATTERY 5PRING ��` BATTERY the door frame. = KNOCKOUT l PASSTHRUSWITCH C.Metal framed doors may need a space between the sensors and the .0 door using a small piece of wood or double sided foam tape. E - Figure 2 LED D.Install the Sensors Vertically(as shown In Figure 1)or Horizontally. o TERMINALS -r'ID HORN Maximum space between sensors Is 1+1/4".IMPORTANT:It you Z. '?•R ^ Install the sensors Horizontally at the top of a SLIDING door,spacing 7 - `.J between the sensors needs to be between 1"and 1+1/4". O �` E.Loosen the two terminals on the sensor switch by loosening the GATE ALARM Pootguard'e `NANGER NHOOLE screws then place either wire end coming from the door alarm NOTE:If the alarm sounds for approximately 5 minutes and the door is Family of Products between each of the terminals.It doesn't matter which wire goes to still open.The alarm horn Will start to pulsate,5 seconds ON and 5 Helps Proict Your Famiyl ASSEMBLY SCREW HOLE which terminal,Replace Plastic Covers. seconds OFF.The alarm Will continue to do this until an adult closes Note:If the cover for the sensor switch does not lock into place because the door and pushes the PASS THRU switch on the door alarm to www.pooiguard.com ,N GEER_N of the sensor wires,remove the knockout from the side of the sensor silence the alarm. It the alarm sounds for approximately 5 minutes switch cover.(See Figure 4) and the door Is closed,the alarm wilt reset, I I Search Energy.gov C>L ENERGY SAVER SERVICES Home n Swimming Pool Covers &EA�WIMMING POOL COVERS COOL 4 a'Y FUEL �J♦ y� r -�4 a I� -� Covering a pool when it is not in use is the single most effective means of reducing pool heating costs. Photo courtesy of Aquatherm Industries. You can significantly reduce swimming pool heating costs by using a pool cover. On the following pages, see the tables showing the costs of heating pools with and without pool covers in different U.S. cities: • Estimating Heat Pump Swimming Pool Heater Costs and Savings • Estimating Swimming Pool Gas Heating Costs and Savings Use of a pool cover also can help reduce the size of a solar pool heating system, which can save money. HOW THEY WORK Swimming pools lose energy in a variety of ways, but evaporation is by far the largest source of energy loss. Evaporating water requires tremendous amounts of energy. It only takes 1 Btu (British thermal unit)to raise 1 pound of water 1 degree, but each pound of 80°F water that evaporates takes a whopping 1,048 Btu of heat out of the pool. The evaporation rate from an outdoor pool varies depending on the pool's Outdoor Pool Energy Loss temperature, air temperature and humidity, and the wind speed at the pool Characteristics surface. The higher the pool temperature and wind speed and the lower the Radiation tosses to humidity, the greater the evaporation rate. In windy areas, you can add a to Sky Ground and windbreak—trees, shrubs, or a fence—to reduce evaporation. The windbreak 20% Othert09b needs to be high enough and close enough to the pool that it doesn't create turbulence over the pool, which will increase evaporation. You also don—t want the windbreak to shade the pool from the sun, which helps heat it. Evaporation 70% Indoor pools aren't subjected to the environment, but they still can lose a lot of energy from evaporation. They even require room ventilation to control indoor humidity caused by the large amount of evaporation. The ventilated air also must be conditioned, which adds to the energy costs. Pool covers minimize evaporation from both outdoor and indoor pools. Covering a Indoor Pool Energy Loss pool when it is not in use is the single most effective means of reducing pool Characteristics heating costs. Savings of 50%-70% are possible. Ventilation f�tfier '2'7% 3% Pool covers on indoor pools not only can reduce evaporation but also the need to ventilate indoor air and replace it with.unconditioned outdoor air. You can also shut off exhaust fans when an indoor pool is covered, which saves even more energy. Evaporation TYPES OF POOL COVERS 70% Technically, all you really need for a pool cover is a large sheet of plastic. Plastic meets the requirement of being a vapor barrier. But a large sheet of plastic that you get from the lumber store is probably not your best choice. It will be very difficult,to handle and store, it tears easily, and sunlight will deteriorate it rapidly. You can use a sheet of plastic, but it will be very inconvenient.and it will probably, only last. 1 to 2 seasons maximum. It's best to use a cover designed specifically for swimming pools. They're made of special materials, such as UV- stabilized polyethylene, polypropylene, or vinyl. They can be transparent or opaque. Covers can even be light or dark colored. One of the lowest cost covers made specifically for swimming pools is the bubble (or solar) cover. Bubble covers are similar to bubble packing material except they use a thicker grade of plastic and have UV inhibitors. Vinyl covers consist of a heavier material and have a longer life expectancy than bubble covers. Insulated vinyl covers are also available with a thin layer of flexible insulation sandwiched between two layers of vinyl. bubblelsolar cover Outdoor pools gain heat from the sun, absorbing 75%-85% of the solar energy vinyl cover striking the pool surface. This is an important contribution to the pool's heating ' needs. A pool cover will decrease the solar gain contribution to some extent, tnsulated vinyl cover depending on what type you use. A transparent bubble cover may reduce pool Types of pool covers solar energy absorption by 5%-15%. A completely opaque cover will reduce it by 20%-40%. You need to consider this when selecting a pool cover. You also need to decide whether you want a manual, semi-automatic, or an automatic pool cover. You can manually pull the cover on and off, fold it, and place it somewhere out of the way. You can also purchase a pool cover reel to help manually roll up the pool cover. The reel, usually on wheels, can be rolled out of the way. Semi-automatic covers use a motor-driven reel system. They use electrical power to roll and unroll the cover, but,--, . usually require someone to pull on the cover when unrolling, or'guide the cover onto the reel when rolling up the cover. Semi-automatic:covers'can be built into the pool deck surrounding the pool, or can use reels on carts. Automatic covers have permanently mounted reels that automatically cover and uncover the pool at the push of a button. They're the most expensive option, but they're also the most convenient. Some pool covers fit into.tracks along the sides of the pool. This prevents anything or anybody from getting into the pool. They even support the weight of several people. If liability is a concern, these are a good option to explore. They can be run manually, semi-automatically, or automatically. Safety covers are recommended for public pools, and may be required by inspectors. HOW TO USE A POOL COVER Pool covers should be used during your swimming season. If you use your pool during the daytime, take off the cover just before swimming and replace the cover as soon as you're done using the pool. If you use your pool only at night, the effectiveness of a pool cover will depend on whether the evaporation andiother losses prevented by the cover exceed the solar gain reduction caused by the cover. The type of cover and the climate affects this balance. In dry and/or windy conditions, the evaporation rate of the pool increases. Therefore, it is generally beneficial to have a transparent or bubble cover on during daylight hours. In warm, humid conditions the evaporation rate decreases. In this case, it may be more beneficial to leave the cover off during the daytime. OTHER POOL COVER BENEFITS - Besides offering energy savings, pool covers also do the following: • Conserve water by reducing the amount of make-up water needed by 30%-50% • Reduce the pool's chemical consumption by 35%-60% • Reduce cleaning time by keeping dirt and other debris out of the pool. Learn More Links • Gas swimming pool heaters • Heat pump swimming pool heaters • Solar swimming pool heaters • Installing and operating an efficient swimming pool pump • Managing swimming pool temperature for energy efficiency FOLLOW US WATER HEATING BLOGS ENERGY SAVER 101 : -- - WATER HEATER Follow us on Twitter Tax Tips for Energy Savers: Get Money I N F O G RA P H I C Back for Greening Your Home ENERGY" i Follow us on Facebook Which Water Heater Is Right for You? ��anca�ccdlflof�m #AskEnergySaver: Home Water Heating REBATES & TAX CREDITS DIY PROJECTS: WATER - HEATING Federal tax credits are available for solar water heaters through 2021.Learn more. Savings Project: Lower Water Heating Federal tax credits are also available for Temperature some other types of efficient water heaters through 2016.Learn more. Savings Project: Insulate Hot Water Also find state or local incentives. Pipes for Energy Savings Savings Project: Insulate Your Water Heater Tank CAREERS & INTERNSHIPS CONTACT US Use of a pool cover also can help reduce the size of a solar pool heating system, which can save mon2y. HOW THEY WORK Swimming pools lose energy in a variety of ways, but evaporation is by far the largest source of energy loss. Evaporating water requires tremendous amounts of energy. It only takes 1 Btu (British thermal unit)to raise 1 pound of water 1 degree, but each pound of 80°F water that evaporates takes a whopping 1,048 Btu of heat out of the pool. The evaporation rate from an outdoor pool varies depending on the pool's Outdoor POOL Energy LOSS temperature, air temperature and humidity, and the wind speed at the pool Characteristics surface. The higher the pool temperature and wind speed and the lower the Radiation Losses to humidity, the greater the evaporation rate. In windy areas, you can add a to Sky Ground and 20% Other 10% windbreak—trees, shrubs, or a fence—to reduce evaporation. The windbreak . needs to be high enough and close enough to the pool that it doesn't create turbulence over the pool, which will increase evaporation. You also don—t want the windbreak to shade the pool from the sun, which helps heat it. Evaporation 70% Indoor pools aren't subjected to the environment, but they still can lose a lot of energy from evaporation. They even require room ventilation to control indoor humidity caused by the large amount of evaporation. The ventilated air also must be conditioned, which adds to the energy costs. Pool covers minimize evaporation from both outdoor and indoor pools. Covering a indoor Pool Energy Loss pool when it is not in use is the single most effective means of reducing pool Characteristics heating costs. Savings of 50%-70% are possible. Ventilation Other 27% 3% Pool covers on indoor pools not only can reduce evaporation but also the need to ventilate indoor air and replace it with unconditioned outdoor air. You can also shut off exhaust fans when an indoor pool is covered, which saves even more energy. Evaporation TYPES OF POOL COVERSo Technically, all you'.really need for a pool cover is a large sheet of plastic. Plastic'meets'the requirement of being a vapor barrier. But a large sheet of plastic that you get from the lumber store is probably.not your best choice. It will be very difficult to handle and store, it tears easily, and sunlight will deteriorate it rapidly. You can use a sheet of plastic, but it will be very inconvenient and.-ii will probably only last..1 to 2 seasons maximum. It's best to use a cover designed specifically for swimming pools. They're made of special materials, such as UV- stabilized polyethylene, polypropylene, or vinyl. They can be transparent or opaque. Covers can even be light or dark colored. One of the lowest cost covers made specifically for swimming pools is the bubble (or solar) cover. Bubble covers are similar to bubble packing material except they use a thicker grade of plastic and have UV inhibitors. Vinyl covers consist of a heavier material and have a longer life expectancy than bubble covers. Insulated vinyl Search Energy.gov CQ ENERGY SAVER SERVICES Home»Swimming Pool Covers &EA�WIMMING POOL COVERS COOL f C. rlow, ...... [ L , 1 Covering a pool when it is not in use is the single most effective means of reducing pool heating costs. Photo courtesy of Aquatherm Industries. You can significantly reduce swimming pool heating costs by using a pool cover. On the following pages, see the tables showing the costs of heating pools with and without pool covers in different U.S. cities: • Estimating Heat Pump Swimming Pool Heater Costs and Savings • Estimating Swimming Pool Gas Heating Costs and Savings HAYWARRY a -- ^z •-H ir= b Reliability, efficiency and a quiet backyard lit �:• - i4ARN �� s.�.�.r .✓mil►.: ���0,��, •� {/'``•`6` .. .:o dig\\1�i1�\� �• ' '1 -- - - 111,11t ! IN-GROUNDHE�AT.� PUMP - Total System. Pumps-I' Filters I Heating I Cleaners I Sanitization I Automation Lighting/l Safety I White Goods III IF i ^a k u / O O all 1 r.; 1 HAYWARD'HEATPRO' HP21104TC HP31204T HEAT PUMP HP21004T HP21124T HP21104T Low HP21254T HP21404T Heat/Cool Ambient • 80OF Ambient Air,80°F Water, ••• • ••• • ••• • ••• r. ••• • ••• • ••• 80%Relative Humidity* 80OFAmbient Air,80°F Water, ,• ••• • ••• • ••• • ••• • ••• • ••• ••• 63%Relative Humidity* 50°F Ambient Air,80OF Water, Ste ••• ••• ••• :• ••• ••• : ••• 63%Relative Humidity* • • •• r 80°F Ambient Air, Water, ®� 80%Relative Humidity* 80°F Ambient Air, Water, ®� 63%Relative Humidity* ity* 50°F Ambient Air, Water, • �''®� • • • 63%Relative Humidity* ity* Electronic Temperature Control Thermostat-Dual(Pool and Spa) • ®� . . . . kW Input - ®� Voltage • .• Minimum Circuit Amps Minimum Overload Protection • ��� • • • Maximum Overload Protection •• .• ® .• .• .• .• r Water Flow Rate(GPM) • • ® • • • • Recommended Minimum/Maximum Plumbing Connection Refrigerant - •- Dimensions(inches)W=Width, • • ® • • • i D=Depth, H=Height,DIA=Diameter - � • �• • - • • . . . Net Weight(Ibs.) �®� •• • •• Shipping Weight(Ibs.) • • • •• • �i CERTIFIED_ 1 _ I u¢ 'CN '1 ..................................................................................................................................................... ...................... LIGHTWEIGHT DESIGN. HEAVYWEIGHT PERFORMANCE. ...................................................:.......................................................................................................................... Don't let cool water temperatures limit your swimming enjoyment. High performance, energy-efficient Haywardo HeatPro"heat pumps quietly and economically maintain your ideal water temperature at all times. They let you start your swim season earlier and end later- all while consuming less energy than gas heaters to lower your operating costs by up to 80 percent. QUIET TECHNOLOGY PERFORMANCE RELIABILITY Profiled Fan Blade Industry's Only Ultra Gold Corrosion- quiet Ensuroperation.es efficient air flow and Resistant vaporabil tor Fpecially odereEme dura ity, in coastal environments. Acoustic Compressor Cover Minimizes sound level. Titanium Heat Exchanger Designed for durability and efficiency to ensure maximum heat transfer and resistance to harsh pool chemicals. Enhanced titanium heat exchanger technology delivers dependable, high- efficiency performance. Hayward HeatPro heat pumps incorporate titanium counter-flow heat exchangers for unrivaled and Uncompromising performance-even under the harshest conditions. Other premium features include: >An Ultra Gold corrosion-resistant evaporator fin for extreme durability, especially in coastal environments > Heavy duty, super quiet scroll compressors > Durable, injection molded,UV-resistant body panels that are impervious to rust and deterioration > Stainless steel hardware >A polyethylene screen to protect the evaporator coil and maintain peak efficiency Plus, Hayward HeatPro heat pumps are lightweight, compact and easy to install and service, making them of ideal for new pools or enhancing the one you already have. 0 V TM 0 FQ ProSedes SIDE-MOUNT SAND FILTERS P Ful Minimal maintenance E) for added convenience. QD Hayward Pro Series sand filters deliver crystal clear water through advanced pool filter technology for pools of all types and sizes.And, since this sand filter requires minimal care, users will appreciate its added convenience. The durable housing is molded of corrosion- proof polymeric materials.Additional features include an advanced, self-cleaning lateral system for smooth, efficient flow and totally balanced backwashing. Plus, with a Hayward 6-position Vari-FIoTM control valve,you can quickly dial any of the valve/filter functions for easier operation and maximum efficiency. A _ �..�-��• gam:'" � �` _ Manual Air Relief for easy,manual }, Integral Top Diffuser release of air ensures even distribution from system. of water over the top of the sand media bed.All Durable Flanged internal plumbing is 2" Inspection/Access Cover for superior hydraulic provides convenient performance. access to top of filter. Hayward 6-Position Vari-Flo" Unitized,Corrosion- 0Control Valve Proof Filter Tank with easy-to-use lever- molded of tough,durable, action handle lets you color-fast polymeric dial any of the six valve/ filter functions.Integral material for dependable a sight glass lets you see all-weather performance. when backwash cycle ,- is completed. Efficient,Multilateral • Underdrain Assembly with 360e slotted,self- cleaning laterals,gives totally balanced flow and backwashing. Totally Corrosion-Proof Base Integral Molded Drain Plug , is rugged and attractively for easy draining of tank, styled to provide strong, without the loss of sand. stable support. FILTER TYPE High-Rate Sand:No.Y2 Silica Sand(0.45 mm—0.55 mm) FILTER TANK j Molded Polymeric UNDERDRAIN 360°Slotted Self-Cleaning Slotted Laterals,Precision-Installed in Ball f Joint Assembly / 1 Y2"or 2",6-Position Vari-Flo or 2",2-Position Slide Valve.May also be plumbed CONTROL VALVE ,.. ? singularly or in series with quick disconnect union couplings(less valve). SUPPORT BASE Injection-Molded Polymer PERFORMANCE RANGE 30 to 120 GPM,114 to 454 LPM S210S—20Y2"W x 32%"H(52 cm x 82 cm) DIMENSIONS S244S—24Y2"W x 36"H(62 cm x 91 cm) S310S—30Y2"W x 40"H(78 cm x 104 cm) Vari-Flo 6-Position Control Valve EFFECTIVE TURNOVER MODEL FILTRATION VALVE DESIGN SAND The easy-to-use lever action lets NUMBER AREA FLOW RATE' ': GALLONS KILOLITERS REQUIRED you "dial' any of six valve/filter ft.2 m2 1 GPM i LPM 8 hrs. 10 hrs. 8 hrs. 110 hrs. j lbs. kg functions. S210S 2.20 10.20 1-Y2 Vari-Flo 44 167 121,1.20 26,400 80 100 200 91 S244S 3.14 0.30 1-Y2"Vari-Flo 62 235 29,760 37,200 113 141 300 136 Patented Service-Ease Design S244SV 3.14 0.30 2"Slide Valve 62 235 29,760 37,200 113 141 300 136 with unique folding ball joint design allows S244SLV 3.14 0.30 Not Included. 62 235 i 29,760 37,200 113 141 300 136 lateral assembly to I rAl S310S 4.91 ! 0.46 Not Included 98 371 ; 47,040 58,800 1178 223 500 227 be easily accessed *Based upon 20 GPM/ft,814 LPM/m'(Maximum Allowable NSF Rating) for simple servicing. To take a closer look at Hayward Filters or other Hayward products,go to www.hayward.com or call 1-888-HAYWARD NSF. aa�QaD® 620 Division Street I Elizabeth,NJ 07201 V Hayward is a registered trademarks and Vari-Flo and Pro Series are trademarks of n Hayward Industries,Inc. c 02013 Hayward Industries,Inc. UTPROSM13 D V MaxFbo VSTM CO o VARIABLE-SPEED PUMP SERIES Q 9 C� Energy Savings That Are Just Right MaxFlo VS is right-sized for most medium-head applications,which means it pays for itself faster - than larger,more expensive variable speed models. Upgraded features such as a new built-in time- clock make operation even easier.The intuitive user interface is now rotatable so it always faces the right direction and the new wiring compartment makes installation quick and reliable. MaxFlo VS is an ideal upgrade for those looking to reduce energy use and save money! X= *� f ffJf -y _ - �`. �'---- _ • � is � - a � - Y SHAYWARW Integrated,Programmable Interface Aligns with the entire rv1 Customize speed,start/stop times,and Max-Flo line for seamless �l priming time while monitoring retrofit installations 00063 power consumption. 9 See-Through Strainer Cover Easy to see when the basket The digital interface shows requires cleaning. power consumption for immediate feedback to maximize energy savings. All models include 11h"x 2-way rotatable interface 2"union connections that's always easy to read and operate. ` �' � � Latest hydraulic design New wiring compartment for '; for increased efficiency quick and reliable installations x E, and priming ability ti e Advanced Motor Design �ti(`1liLr��i r n Self-Priming Capability Permanent magnet,totally r e EFC Suction tilt up to 8'above enclosed fan cooled � � �-�;�r, water level. design provides incredible energy efficiency and reliability. Incredibly quiet operation, especially at energy-saving, lower speeds. MaxFlo VS- Pump Variable-speed pumps are the ultimate way to save energy while enjoying MAXFLO VS PERFORMANCE COMPARISON your pool.Most other variable-speedmodels,however,are oversized 60.0 when compared to medium-head pumps such as Hayward®'s MaxFlo - 50.0 _ ____ __— series.The ENERGY STAR®certified MaxFlo VS is right-sized,particularly for applications with 1.5"or 2"plumbing,providing tremendous energy a 40.0 ---- -- — --- savings that result in an even faster return on your investment. o 30.0 --------- — ------------ ------- The new built-in time-clock makes programming even easier compared to basic countdown timers.The 2-way rotatable user interface is always 200 —....._.__— 3000 RPM easy to read&operate and the new wiring compartment for quick and 2400 RPM reliable installations. 10.0 ----- ---------- -------- ------------ 1500flPM MaxFlo VS provides customizable speed,start/stop times,and priming 00 —RPM time to match the needs of both aftermarket and new construction 0 10 20 30 40 50 60 70 80 90 100 110 FLOW(GPM) installations.Advanced permanent magnet and totally enclosed fan cooled(TEFC)motor technologies provide incredible energy efficiency and reliability. Upgrade and save with MaxFlo VS! I'' {►'�� �'� 9.92" 9.48" 12.16" . 9.47" _ Model Number SP2302VSP o 1— Total HP 1.50 _v 1 t.16° ' Motor Design Permanent Magnet,Totally-Enclosed 7.6a — I Speed Range 600 - 3000 RPM t 1.7o I Voltage 230V Single Phase �l- 7.3e"q--1� 6"C— �---—Union Connections Connections 1 Y2" x 2" To take a closer look at MaxFlo VS or other Hayward products,go to MaxFlo VS Series Pumps www.hayward.com or call 1-888-HAYWARD. are listed by: C UL US 15 OT% N&,;�WARIM : 620 Division Street I Elizabeth,NJ 07201 NSF Hayward and Hayward Energy solutions are registered A trademarks and Max-Flo VS is a hademark of Hayward Industries,Inc.®2014 Hayward Industries,Inc. LITMAXFLVSI4 POOLS ° ❑ If located in OKH, fence only requires Certificate of Appropriateness ❑ If located in Hyannis Historic'Waterfront District, pool & fence need Certificate of Appropriateness. ❑ Map/parcel number Sign-offs from: ❑ Health ❑ Conservation ❑ .Tax Collector, ❑ Treasurer ❑ Dimensions ❑ Estimated Cost ❑ Owner's name & address i ❑ Complete dwelling information for the Assessor's dept. i ❑ Applicant's telephone number ❑ Signature ❑ Construction drawings or factory brochures & specifications ❑ Heated Y N If yes, cover information required in application description ❑ Certified Plot Plan ❑ Workman's Comp form. Copy of Insurance Compliance Certificate must be on file. ❑ Application fee ❑ Permit fee ❑ Property Owner must sign Property Owner Letter of Permission In-Ground pools ❑ Home Improvement Specialist's License OR Homeowner's license exemption ❑ Check expiration date&attach photocopy of license(s) ❑ Home Improvement Contractor Affidavit ❑ Show placement of fence, list description of fence and materials used Above-Ground pools No license required. Any pool equal to or greater than 2' deep,or minimum of 250 sq. ft. (I Vdiameter for round), needs a building permit NOTE: INGROUND POOLS MUST BE FENCED WITH A 4' HIGH, NON-CLIMBABLE FENCE WITH A SELF-CLOSING,SELF LATCHING GATE. FISH PONDS; Any pond dr pool equal to or more than 24" deep MUST BE FENCED WITH A MINIMUM 4', NON- CLIMBABLE FENCE WITH SELF LATCHING GATE q-fonns/b Idgperm i is/permitcheck I fists rev.080410 L~ /67 �ZP �%z%z�y2�%z?2�/h/t��i�E!%tn��l�l'G61 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 0211.6 Home Improvement Contractor Registration Registration: 117031 Type: Private Corporation Expiration: 8/17=18 Tr# 419291 NARCISO ENTERPRISES, INC } �- —;; - CARLOS NARCISOt„` P.O. BOX 680 EAST FREETOWN, MA 02717 " ~ M, Update Address and return card.Mark reason for change. scni c zons-av,r - ❑ Address Q Renewal .Employment Lost Card �cnuircwneu/� Office of Consumer Affairs&Basi rss Regulation License or registration valid for individual use only -HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:�A''117031 Type: Office of Consumer Affairs and Business Regulation ZIP Expirat on: 1T/Z018 Private Corporation 10 YarkPlaza-Suite 5170 Boston,MA 02116 NARCISO ENTERPRISES;INC -;'- CARLOS NARCISO C414 9 EDNA CAR. - FREETOViM,MA 02717 Undersecretary of valid out ' (ir i . I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 tv)vw.nuiss.gov/dia Workers'Compensation Insurance Affidavit:General Sadnesses Annikzint Information A I Please Print Le0bly Business/Orgartization Name: I V Oar c 1 so E nfp r�r lSes I nr,. Address:,,,h� \,)01C (O0 0 _— City/State/Zip:E.1:7r-ee4otan MA 0211-1 Phone#: 50'5-'l(o3-1C150 Are you an employer?Check the appropriate box: Busiaess Type(requited): 1.0 1 am a employer with employees(full and/ 5. ❑Retail or prat-time).z 6. ❑RestwrantBar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑Office and/or.Sales(incl.real estate,auto,etc.) employees working for me in any capacity. iNo workers'comp.insurance required) S. ❑Non-profit 3.❑ We are a corporation and its officers have:exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.0 Manufacturing no employees_[No worloccs'comp_insurance required] 1.1.0 Health Care 4.❑ We are a non-profit organization,staffed by volunteers. with no employe.[No worker-,-comp.insurance rrq.i 12-❑Other °Any applicant that cfbxb.box of mutiK ales rin out the aertion hoow shuuang.hcir n»rtcm'eonmx=%alinn policy inrumtatturt. "If the zxporatc ulTieera ha-.v excnqucd thcrtcc 1%-c--lust the cugwmtinn has tuttrrcttrpfuyms.a uvAtm aunpcmwion policy 6 ttquircd and such an organization should dwch boa 01. lam an employer that isprovidta workers'compensation insurance fior my employees Below is thepaolicy brforntat�iom ` Insurance Company Name- W'g es c-o 1(1Su ra n ce- Crirn pa n&4 insure is Addmszs: CitylStatcop: Policy#or Self-iris.Lic.# W W C SVgIN Expiration Date: 201-1 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration dine). F'.dlurt to cure:coverage as r:quin d under Section 25A of MCL c. 152 can lead io the imposition of criminal penalties of a fine up to 81,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby ce>li er du►pair and Pena perjury that 11 a information provided above is tree and correct. Si nature: Date- Ph... Official use ottly. Do not write in t&is area,to be completed by city or tmvn of fat City or Town: Permit/License# Issi ing Authority(circle one): L Board of Health 2.Building Department 3.Cityfrown Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Awn t,eg ?t4 he Contact Person: Phone#• etl""'uscmaiFO11C/0`" o�»t•.mn�_gOv/tint CERTIFICATE OF LIABILITY INSURANCE ° 12 6°""""' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pol(cy(ies)must 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. RODUCER CONTACT Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY,INC. 150 SAWGRASS DRIVE -JAQ NM PHONE . 877-266-6850 FAx No). 585-389-7426 ROCHESTER,NY 14620 EMAIL Certs@paychex.eom INSURER(S)AFFORDING COVERAGE NAIC p 4SURED INSURER A: Wesco Insurance Company 25011 NARCISO ENTERPRISES INC. INSURER B: PO BOX 680 EAST FREETOWN,MA 02717 INSURER C: INSURER D: ( INSURER E: INSURER F: :OVERAGES 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. R TYPE OF INSURANCE DL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS NSR D MIDONYYY) MIDONYYY) GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED 5 �CLAIMS-MAOE�OCCUR HIED EXP(Arty one parson) $ PERSONAL 8 ADV INJURY f GENERAL AGGREGATE $ E7J'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S POLICY Q PROJECT=LAC S AUTOMOBILE LIABILITY COM13INED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED SCILFDutFD BODILY INJURY S AUTOS AUTOS � �) 'MM AUTOS Q OWNED BODILY INJURY S O (Per accident) PROPERTY DAMAGE $ (Peroaddant) S UMRREUA UAB O OCCUR EACH OCCURRENCE S ¢naeee UAa O CL ADAS"ADE AGGREGATE $ DEDI RETENTION 3 $ WORKERS COMPENSATION NO X wC STATtI• OTIt- EMPLOYER.s uAeaJnr W WC3193422 04/04/2016 04/04/2017 PR E.L.EACH ACCIDENT $ 100,000.00 ANY PROPRtETOR/PARTNERlp(ECUTNE oFFX:EPJMEMRER EXCLUDED? EL DISEASE-EA EMPLOYEE S I O0.OD0.00 (Mandatory mund Y N/A If ye:,aesufDo underE.L-DISEASE-POLICY LIMIT S 500,0W.00 ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more$pace Is required) :ERTIFICATE HOLDER CANCELLATION PROOF OF COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ^� 1CORO 25(2010105) 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AsBuilt Page 1 of 2 TOWN OF BARNSTABLE LOCATION VILLAGE<-OfviT ASSESSOR'S MAP&PARCEL 9/ INSTALLER'S NAME&PHONE NO. Ze,0o41'01- 'ems— amp SEPTIC TANK CAPACITY Fs LEACHING FACILITY:(type) C ,y�` `��`` size NO.OF BEDROOMS 3 OWNER PERMIT DATE: �� 3_iy COMPLIANCE DATE: Separation Distance Between the: /✓a /,v"f,1 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility a Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Eck 17 1 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=040091&seq=3 2/7/2017 AsBuilt Page 1 of 2 L0 AT ION EWAE PERMIT N0. Lod 23 ��9„�,��e���s �i bC $a— 79 VILLA/GEE INSTALLER'S N ME� i DDRESS S et-a eo 9}� iS ,9)-movf �e UILDER ORnn OWNER " DATE PERMIT ISSUED C GATE COMPLIANCE ISSUED zf / zz� IL 0 50 3q G a9 4 . Lota3 5-w r http://issgl2/intranet/propOata/prebuilt.aspx?mappar=040091&seq=1 2/7/2017 8'-0" [2438MM] CTR TO CTR POST CAP 7'-7" [2311 MM] FACE TO FACE 1 3" [76MM] 5 1/2" [140MM] 5" [127MM] SQ POST 7/8" [22MM] U—CHANNEL 7/8" [22MM] X H 6" [152MM] T & G PICKET 1 1/2" (38MMI X 5 1/2" [140MM] RAIL 5 1/2" [140MM] — BOTTOM RAIL INCLUDES I I 112" [51 MM] NOM REINFORCING METAL INSERT 30" [762MM] Z� 3 FENCE SECTION ELEVATION POST CAP OPTIONS ' CD 7 I L J vim, oti o 8 ti © NOM HEIGHT (H) fc-Dy 46" [1168MMI NOTES: 1. METRIC DIMENSIONS ARE NOMINAL EOUNALENTS TO U.S. DIMENSIONS. 58" [1473MM] 2: SPECIFICATIONS SHOWN CAN BE CHANGED BY MASTER HALCO ONLY. 70" [1778MM] 3. FOOTING WIDTH TO BE (2)X POST WIDTH. MINIMUM DEPTH 30" (762MM). MASTER LEGEND VINYL SERIES PRIVACY STYLE FENCE BY: ERR DWG: 97_ 1460 by Master Halco DATE: 10-19-99 H A LC 0® Orange, CA REV: C LAYER: 1 Gown @2Mi_2=w, ut mm rro. Phone No.: 800-229-5615 NOM 8' SECTION LENGTH ALL MGMnEBORM. www.FanceOnItno.com REV DATE: 09-20-06 SCALE: 1/2" - 1'-0" a ovals 1 to 2 2 to 3 2'-10" 3 to 5 14'-1 3/4" 4 to 8 34'-2" S1 toS2 16'-0" 1 to 3 1, 0'-3/4" 2 to 4 14'-1 3/4" 3 to H1toH2 16'-0° 1 to 4 3X-1 1/4" 2 to 5 16'-0" 3 to 7 34'-2' 5 to 7 30'-3/4" G� o S1toH1 14'-0" 1 to 5 32'-3" 2 to 6 32'-3" 3 to 8 32'-0. 5 to 8 33'-1 1/4" 111 S2toH2 14'-0" 1 to 6 16'-0" 2 to 7 33'-1 1/4" 4 to 5 2'-10" 5 to 7 2'-10" Part number Descri lion OTY QT _ S1 toH2 21'-3" 1 to 7 1, 3/4" 2 to 8 30-3/4" 4 to 6 30'-3/4" 6 to 8 14'-1 3/4" ST096000 XX 8' 4 3 H1toS2 21'-3" 1 to 8 2'-10" 12'-0" ST0960002' 8'SKIMMER 1 1 ST09.60002' 8'RETURN 2 2 " ST0600001X 5' 2 2 ST0480001X 4' 3 2 ST036000OX 3' 2 d ST030000OX 2'6" ST0240000' 2'LIGHT 1 1 1 .1 '- ST0240000X 2' CN0380241X 2wer)" 4 4 Brace Brace 17 18 IPC-STKPK25 REBAR STAKE 18"25PC 2 2 IPC-HDWSTRT150 BOLT STIR 3/816X1"CIIN NUT 150PC 2 2 ST6018B THKSHT STEP STR 6' 1 1 32 ST8024B THKSHT STEP STIR SIT N STEP 8' SSK-ST192STR2 FE STEEL STEP STR-2'W CN 3 TRD 1 ' A 2�ou � - B � � 2 3 -- i O i OO ----------- O N 4 A B C 1 2-0 30'-0' 34-0 5 2 30'-0" 2'-0" 16'1 112" D • 3 32'-3/4" 2'-0" 14'0" 2 o�� C 4 34%11 1/4" 14'-0° 2 p 5 34'0" 16'-1 1/2" 2'-0" 6 16'.1 1/2" 34'.0" 30'-0" 21-011 7 14'-0" 34'-11 14" 32'-3/4" M. 8 2'-0" 32'.3/4 34'-1114" S2 28'-101 4" 17'-10 3 4" 8'-0" S1 24'.0" 8'-0" 17'-10 3/4' 281.1 2 18'.1 27'-21 22'- 1 .0 1.11.01`AN l►11*91"i Q 1) 10-0 X (�Wp►1i tdQ I�:?4r;1'I(1.);?y• 1'i.�; •I/- — OF 2 ara,w � I/2®•If1 � y Assessor',s map' and lot number .. .....et :.!!�. RAG. 11116A1. Q� ,*IHE racy Sewage Permit number .f .:"....../.��.�.........::...... //�� Z BA"STABLE� i House number ....�? ..Av.4............................................ y� MAB6 p 1639. ♦� 0 MOX a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct TYPE OF CONSTRUCTION .....W00d..FY'ame...Residential. ............................................................................... .......: ...... ................. Nix 18, 1982 ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ram. 23, Brwhlebush Dr. , Cotuit, Ma. Location ......::....:>....................................................... ................................................................................................................... ProposedUse .......Residential............................................................................................................................................ ZoningDistrict ..............;!?!'.....................................................Fire District ... '�+w'k:t............................................................ Name of Owner ................................................Theo Constructim Co. , Inc. ....„Address .24..Great Pend Dr. , S. Yarmouth, M,a. ... ......... ............................................................... Ne of Builder. .............Same a'�m .............................::...............Address .................................................................................... Name of Architect n/a ..............Address Number of Rooms 6 ............................................Foundation ....cured COTtC..'ete......................................... Exierior 9cgar shingle asphalt shine-le ...........................................................................Roofing ........................................... Floors Plywood..................................................................Interior ..........sheetrock...................................................... ..... Heating .............�,� .....Plumbing 1 /2 baths J ....... ................................... ......... ................... ................................... 1 Fireplace .....o..ne... .................................................................... Approximate Cost .....25,000............................................. ..... ..... Definitive Plan Approved by Planning Board _sent.t._21_ ____ 71, . •. 19- — Area ........... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 4, i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �� Name,: <, ...... ct.' :`�.�.............................. THEO CONSTRUCTION CO. , INC. A=4.0-91 24679 One Story No ................. Perinit for":...................................I Single Family Dwelling ................................................................................ Lot #23 24 Bramblebush Dk. Location ................................................................ Cotuit ............................................ .................................. Owner .....Theo Construction...Co.........Inc. ............................................ ..... . Type of Construction ....EKAM9........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .December....2.9.1........19 82 ..... .... ....... .. Date of Inspection ....................................19 Date Completed ......................................19 < 'Y TOWN OF BARNSTABLE Permit No. 24679 .° • --------'------------ Building Inspector, s.nDn.m Cash ''' • �OOAY�" - OCCUPANCY PERMIT4* Bond Issued to Theo Construction Co. Address lot #23 24 Bramblebush Drive, Cotuit Wiring Inspector ~- — Inspection date Plumbing Inspector 9�A.,",1( J ,•Inspection date o ' V �. _. Gas Inspector� (� A Inspection date +r`4.'n. 1[`�'�..-.!_ r`� ,.st .A�1A w /1 Engineering Department - 44`Inspection date.4 � s�7 � . Board of health � Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. • I ....................._., .... ...................:..........�g.. .....,p...�.....' Buil Ins ector . i�o• 13 ° � .Go T .2 3 z2S/a � f 0 n ,t 44 AJ PLAN SHOWING .1w: o FOUNDATION OCATIONol ' OT UI T, MASSACi�:uS� TAT S- . Z zm owN E.o 8Y �"fi� GGNd'Ti� rn°z a o cS4IfZ!? TJT SCALE / 'i-4o OATS Z>41c ITT t ��o.�- NORMAN GROSSMflN-- i=REGISTEREb LAND SURV YOR a l.. NEREBY CEFY THAT ,THIS FOUNDATION i$ LOCATE`0 �g w w a RTI " 'y... `tea * .�"�_ . Y ON ME LOT AS SHOWN -AND CONFORMS TO 1-HE Z t, Ntiitl�A1: �, O In It OF O*RIV I$r --E Z ONl NG REG U.LAT IONS REGARDI NGr ' � CxltS�UIt -• SETBACKS': 'FRD:M-.STREET LINES AND LOT aLf -ES `3 Na t27�Sp NORMAN GR05SMAN R.L:S. � DAT � ` Assessors map,and lot number ... ..7.�.........��.s.�� .�6,/<.. IZ A e-- ///A%l �F THE TOE Sewage Permit number .............D..r2. ....V. . Z SAMSTABLE, i House number ....fn7.. ... .....................................:.........: , 900 39 0 mxf a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........................... .......................:�onstruc.....................................:........................................... TYPE OF CONSTRUCTION .....Wood Frame.Residential ...................................................... ....................................................... ` November 18,,• 1982 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot 23, Bramblebush Dr. , Cotuit, Ma. ....................................................................................................................................................................................... Proposed Use Residential ............................................................................................................................................................................. 9 RC....................................................Fire District ....CC)W t............................................................ Zoning District ............... Name of Owner .Theo Construction Co. , Inc. ,Address .24 Great Pond Dr. , S. Yarmouth, Ma. .................... .... ............................................................... Nameof Builder' .............see..............................................Address .................................................................................... Nameof Architect ...........n./a................................................Address .................................................................................... 6 .................Foundation oared concrete Number of Rooms ................................................. P ................................................................. Exterior ..cedar shingle....................................................Roofing ..........asphalt shingle .. ............................................. Floors ....PZ�wOOCI..................................................................Interior ..........Sheetrock...................................................... Heating �,��� '-..`J ..............................................................Plumbing ....:... 1/......u�,u.5,.: .... .... ............................................... Fireplace .....one......................................................................Approximate Cost .....2 1.900.............................................. . Definitive Plan Approved by Planning Board _Sep _ ................. t. 21 ___________19__73_, Area / / �� S'......................... Diagram of Lot and Building with Dimensions Fee ................ ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH f0v OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nd .................................................................. JHEO CONSTRUCTION INC. v 24679 One CO. ,vtory 0 .................. Permit for .................................... Single Family Dwellin.gr........... . ........................................... Location ...Lot....#.2.3......2.4...Br.amb.le.b.us.h. Dr. . .. ..... ....... .... .. .... .. Cotuit ............................................................................... Owner ..The.o...Construction...Co...,.. Inc .. .. .... .. .... .. .... .. .... .... Type of Construction .......ram Fe ................................... ................................................................................ LPlot ............................ Lot ................................ Permit Granted ..................................December 29,......19 82 Date of Inspection ........ 19 Date Completed ...... ........19 P 2-1 TS ring Dept. (3rd floor) Map O� Parcel O f�Z C�h-Permit# House# Date Issued — Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) + 7,2 1 Fee 4th floor)(8:30-9:30/1:00-2:00) /Nsiq T/c c t floor/School Admin. Bldg.) proved by Planning Board 19 j► O� A TOWN OF BARNSTABLE Building Permit Application Project Street Address Village � .O Owner �,Gtffr//��,�/�•'�q ��L��� Address - O?� ,�'//.f� � ,P_, Telephone �i� Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure /4) Historic House Ll Yes E)No On Old King's Highway ❑Yes a No Basement Type: ❑Full ❑Crawl Jg Walkout ❑Other Basement Finished Area(sq.ft.) — Basement Unfinished Area(sq.ft) /j�d Number of Baths: Full: Existing / New Half: Existing New No.of Bedrooms: Existing of 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) jeZ e,� ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use W Proposed Use Builder Information ame �. 6 QQ� Telephone Number 2& JAddress ap 24f--Ot,6�rae) License# OA6 95 2 )s /W 0a60/ Home Improvement Contractor# Worker's Compensation# 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 TOl ' SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY „ . • �-c -� -PERMIT NO. - DATE ISSUE MAP/PARCEL NO. ADDRESS 1 VILLAGE r OWNER DATE OF INSPECTION: �� FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING• ;tAOUGH FINAL - GAS: RWGH FINAL FINAL BUIL6AC;i�, ! a , moo, 1 ATE CLOSED OUT k.'."> w ASSOCIATION PLAN NO. �'. i The Connmtniveall/r ojAtascuc/rusetts Departrrrent ojlndustrial Accidents _ 011iceb1lnvesligamons •\_<'s':.":.__=r 600 {f ashitt�;ton Street Boston, MUNN. 02111 Workers' Compensation Insurance Affidavit _ . ._ _ ........a._,...._.a...,_. _ . �lnnlicant information: Please PRINT lebl� v name: location �SL�� ,�/I��;nJ�7�,q� �✓Z city l/iS Or' h n � 9 0 I am a hoideowner performing all work myself. ®' I am a sole proprietor and have no one working in anv capacity .. _. . r ..• ..... .. �en.}.. fir.-�..m�' .�-�++....._•:a.�,r..•..-.....-...sq.::a.m.. .�...,..n.,...�, .�.-..,........�..;..,.�,,.__..- - - I am an employer providing workers' compensation for my employees working on this job. cointwev name: /!t7`C CST _ J�✓ �d�n address: Q city: Phone#• insurance co. /���`✓ d/ (�t)/J'11Nu Polio # �,vC�%� i���'/ S�i� 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: S company name: address: cir•: phone#• incur-ince co. nolicv# company name: address: city: 2hone#: insurance co. nolicy# .Attach additional sheet if tieccssary. :r' —+!_ ;L.77 7., _ �''T"�"i�'' '�='�"�'` K�`'� '-' —' •`� F:�ilurc to secure cowcr:tgc:ts required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of alline up to 51.500.00 andiur unc wears' imprisonment:is wcll as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OlTice of Investigations of the DIA for coverage verification. I do herehr certifj turd•ptrins nd p al�ies a per] M t the information provided above is true anndicorrect.C� Si^_nature Datc ✓��- / Print name Phone# rc tTicial use only do not write in this area to be completed by city or town officialty or tow: permit/license# rilluilding Department".:- I []Liccnsing Board ;. O check if immediate response is required c3Seaeetmen•s Office t••: C3I1calth Department contact person: p hone#: r10ther : ' r N A I Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers* compensation for their employees. As quoted from the "law". an cinpinree is defined as every person in the service of ;mother under any contract of hire• express or implied. oral or written. An einplt over is defined as an individual• partnership, association, corporation or other legal entity•, or anv two or more o: the foreuoinu criva�_ed 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 dwcllin�, house or on tiie grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of•a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha\ been presented to the contracting authority. � __.,,.__.__.._............._.. ._.__._._.........�.._ -- . . : _..... ,^ ... _ �-.,,�..--.-.tom..._.._-.•..,,r. ... - -•-••----- T� Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers* compensation policy, please call the Department at the number listed below. City or towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile Office of investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Departinent's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 «'ashington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 . z The Town of Barnstable NAM Department.of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ofr= 508-790-6=7 Ralph Cr0sW4 F= 509-775 3344 Budding Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alWations,=ovation,repair,modernization,convezzion, improvement,temo%-4 demolition. or construction of an addition to any premC dsting owner ooa'Pied building containing at least one but not more than four dwwdling units or to SM==which are ad}a=ut to such residence or building be done by registered contractors,with certain eooegtions, along with other Type of Work: AJC4 S7d i Est.Cost Address of Work: 2 � �5Y1X� 1 Owaer.Name: '44", 1,4r Date of Permit Application I hereby certifv that: Registration is not required for the following rrason(s): Work ccduded by law ob under S1,000 Building not awneroccupied Owner Pulling own Permit Notice is hereby gi<en that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITS UNREGIS-�D CONTRACTORS FOR APPLICABLE HOME 3,4PROVEME14T WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY i I hereby apply for a permit as the agent of the owner. /tea Date Cjo&actorname Registration No. OR t .,t . t t, r r \.it: �t ,Ky� s r�r,r � 1 '� v �� "(r't '� `h� } •' , - .. � ! ��- f .s, r..,' >s � r t rv.l �. , �. r .'.tits<„' d•1' . ' 'i' ) r'.i 'r +;'r d�ryt r ,s, s EYl l � .,�s 1t i�:, .i� �':� 1ti`}•t19.�•'. ,�.~ ��T� ,a .. •� ._: + .\ {• •' i + 14tt'r d - � it ( 1`.! 1 } t y+'1.)av'4'. •i •1. '7 t ' �', !y ts�.�•l1 is ) 1i 'r3 �'{ 1 �• ,♦ 'ti _� ,, .7` +... ,i, l.,_,� :j 4.n�,• e,1 ', 1,.�r "ti ♦a 1 �a�i a ! r. :�: _ s. 'r+ -,5 1�`•�t 1 irs�•Tr•fi.� .t:r 1r ;{{�1'./c'7?t�'s'�•.n'j4st-':����Jr 1��?�.^<,;a; �'•., �s'„�;.•yL7'�.�id'`�tQ J4��'. • '. "i, � - r•, '.i �:"7+' , J 7t 9 e ,r ++j�.,rk=�'a.di .ti, 3't,rtt v,t• � .^j;a, . •�t. � ,. !' •i•. •+� I 4 t r� e •L.�. < •1 �{!.j: �''.it��' .;�-1 , r'io�,v" '1,'.� 1 ', v] a•q+•'�+ r` (, , i••{h 1. t 'l ' .r. ;'. ', .i f� c, .,,s - � + /. �'•il�•f',ot-f,�',,��0•.rHr��„�-�1Ni�i�.',fy',�,��+' 4 k 4, t, ' ' HOME IMPROVEMENT CONTRACTOR Registration 121240 TfPe - INDIVIDUAL Expiration 04/18/98 TIMOTHY ST. PIERRE _ TIMOTHY P. ST. PIERRE '::'' ' ��! "�y*48 ARRONHEAD OR MTRA7OR' ! ' HYANNIS MA 02601 ., ..1. �'�l-eT1:'W*"'.'�eq`y"'ra.•_<a '`�`, • .. � r .. � .. � ' � .'' :f'1'��i}" •:\ •S•t tip:;'+ „ �,r,r,t♦**.-..�.:.r! . 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map NO Parcel O`l I Application # L� Z'Z 3 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 Aaa k !aI_, AA--, Village a/ r/7Sk,6 Owner OCCL71i e e Address Telephone - jS $309 Permit Request AUOyI K2c &G;09� AMA)' 41agP ) i f•�r �L ivC . G � cJ d1-v O Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Tota�new Zoning District Flood Plain Groundwater Overlay o Project Valuation Sim Construction Type �_ `n Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family (# units) -- -� Age of Existing Structure Historic House: ❑ Yes ❑ No On Old King's Highway: 0 Yes..0 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ A Commercial ❑Yes ❑ No If yes, site plan review # -Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _ PJA Telephone Number ! �u✓ r��v � Address ' �"' � �3� License # Home Improvement Contractor# Worker's Compensation # to'. obgl �Bb ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO fZ�60� `7y s✓I i4, i SIGNATURE DATE FOR OFFICIAL USE ONLY <�APPLICATION# DATE ISSUED MAP/PARCELNO. - ADDRESS VILLAGE OWNER. DATE OF INSPECTION: FOUNDATION FRAME INSULATION ` f FIREPLACE ,- ` ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OU.T' ASSOCIATION PLAN NO. r Fot'rti:- , The Commonweakh of.Aitassachuseus _ii}t _ DepariffwW ofIndAccidents " —° Office of Investigations ' I Congress stree4 SuEte 100 Boston,M4 02114-2017 • H,x,yvmasso ov/dia Workers' Compensation Insura>ace Afdaviti BuiIderslContmetors/Electricians%plumbers �— Applkant Information -Please print Legibly Name:(Business 0wnizadon&&vidua!): Utd 1 Address: D 03 City/natelZip: —I M yb Q 6 Phone Are ou an employer. Ch k the appropriafie box: Type of project(regWred): 1. I sin a employer with D •e�4. [j I am a general contrapcfor and I employees Gall and/or part time)* have hired the sub-conbactors 6. []NOW construction 2.❑ 1-a3h a sole proprietor-or partner- 1h`sted on-the attached sheet - 7- [Q Rewdeft ship and have no employees Tie sub-conWd=c N have • 8. 0 Deaiolition working for me in.aay capacity_ employees and have:workers' Mug [No wodmm$comp.insurance cep- ce t 9. ElBui addition r�IIi ;) 5_[� We area corporation and its 10�17ectrzcl t�pais of additions 31 1 am a homeowner doing-all work officers have exercised their_ 11.0 Plumbing iepaas or additions myself.[No Voile ctimp. right ofexemption per MGL �❑ f i�zaits insurance requaed.] t~152,$1(4)and wehaine no employees.[No wow'' 13_ 1?thertc,�lJ` '1 comp_inc�Trance , _- "Anyapplicant that t = s bes f#1 must also All out the sec =bolow showing*4r wodwa compensation polity in = on. fi ffInIY woes who submit this affidavit indleating.aW we doing an wotkw d they hueounMe cmm=fs m=submits ww affl&v&iadicapg9ok 'ConUuWIS dM t this box u u5i attached an aMdonat shca showing the—of the sub-comrados end stue w6cffiaror not dw=mtifies,have employees IFthe sub-cm9=Mrr have employam Ney mustprovide their wortos'comp.policymrmbm lmn an employer thatisproyMing nvy*ers'comip on utsuranceformy employees Bdow is dwpolicy axdjab sip- informadi)L Insurance'CompanyName:_4I_,7 jl _� Policy#or Self-ins.Lin#-- LA)C41002 ,Tr2 M . - Eapitation Dale: noy e I Job Sitc Mdress: p �U'w Rif-, w,W'� Attach a copy of the workers'compensation policy dedaration page ishowhig the policy nnmi er and ea&ation slate). Failure to:secure coverage as requiried under Section 25A of MGL e.152:can lead to the iMp�of ca®ai penalties of a Sae up to$1,500.00 and/or ono-yeas ituprisonmerot,as well as civil penalties in the firim of a STOP WORK ORDER and a fine Of up to$350.00 a day against the violator_ Be advised that a copy of this statement may be forwarded to the Of of Investigations of the DIA for insurance coverage vedficaliaa. . t do hereby certify under the paim and enalffes ofperAny tyrat .the ornumion provMed akwe is&F and correct - — - - Phone Offreial use only. Do not write in dw-areq.to be eompieted by city or town official City or Town: PermWLkense# Issrii Alit oi�ty f+cu`s one L Board of Heart BM_tft Department 3.Cityfram Clerk 4. umpecWr 5.P;unbing.18sgector 5.Other t L''n..t-a..r Pa.•cnw• Db......Jt. - 06/18/2014 22:59 9787778415 PAGE 03 d CERTIFICATE OF LIABILITY INSURANCE 6/19/201'ry' THIS CERTIFICATE K 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 TM COVERAGE AFFORDED BY THE POLICES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SErOM THE ISSUING INSURER(S), AUTHORIZED REMMENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: d the cordecate holder to on ADDITIONAL INSURED,the poky(Ms)num be•ndoA•Q. N SUBROGATION IS WAIVED.Su0)W to the terme and cmdMone of the"" tartain Oolleles may mq*o on endoriemmvL A dd mmd on thle certmeft does net conM HShls to 00 mfflftob holder In Mm of such i. PRODUCER GOWPZT COUNTY ZNSUfAMC6 AGENCY INC (979)774-2463 AIC o (978)777-8d15 123 Sylvan St me Danvers, MA 01923 ADORE W.JMaSu Aanaloiro eovotAOE auace BIBURER A:C0J m ZCo Ins. Co. INSURED Building Performance Contracting, LLC pBURER B,Masa underwriters dba Nauset Insulation wSUMC-AtIahtiC Charter P.O. Box 633 INSURER 0.RB Jones Truro, Na 02666 INSURER E: 1 ' 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.LIMIT$SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI IS. LTA WK OF INSURANCe POLICY NUMBER OMIT• GENERAL LIABILITY EACH OCCURRENCE ! 1. 00.000 ]C COMMERCUL WIERAL La/4M PREMIRS LE2 emways • 50,000 CLAIMSMM DE a OCCUR MEDEXP("ompnion) • 1 000 B MP0020002000041 5/1/14 5/1/15 PERBONA►•ADvIWURY t 1,000 000 GENERAL AGGREGATE ! 2,000,000 GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGO ! 1,000p0001 POLICY 20 Loc ! AUTOMOBILE LIABILITY Wm=INULt_ 1 1,000,000 ANYAM A AAuTos� z SC�HEDULEO BWDGIC 2/2/14 /2/15 BODarlNalltr(a'Mperiprl) ! BOpILYIrWRY{PereQ+drel • VIREO AUTOS NO fpw SWAM • a UMBRELLA LIAB OCCUR EACH OCCURRENCE ! 2,000,000 D ExcEsa Lae HCLASV44ME COBN390d112 5/1/16 5/1/15 hGGKOATE • 2,000,000 DED S ! WORKER•COMPENSATION AND EMPLOYERS!LIABILITY via �' AW PRO y� M III MIA E.L.EACH ACCMfJir ! 500,000 P�Ay+eRee�rlen N we ��-....++ WCV00939900 1/23113 1/23/14 EL DIS�E-EA EMPLOYE ! 300,000 DESCRI OF OPERATIOM belay ILL VIWASE-POLICY LOW I S 300,000 DESCRPTION OF OPERATIONS I LOCATIONS I VEHICLES (ARi h ACORD 101.AWWW Renders 60*M e.It more apece to rMnd) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Barnstable, Ma THE EXPIRATION DATIL THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TH ICY PROVISIONS. � AUrHORaED REPRE•E � 421888-2010 ACORD ORATION. All r1IMa teaerved- ACORD25(20101D5) The ACORD nalnw and Io p am m9bitafed molt of ACORD r Massachusetts-Departmentnf Public Safety Board of Building Regulations•and Standards Construction Supe"nisor :' License:-CS-078815 JOSH EMON_D POBOX-633 Truro MA 0266 cJ—.•�...,l1Jr �,'�4`�X Expiration Commissioner 0312512015 r��pom�t°'1`o o��ac/urae - License or registration valid for individal use only Office of Consumer Affairs&Bnsmess Regulation before the.expiration date. H found return to: ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulatio U'Vejjisbadon: ; 4 35.' Tom..�`" CLC10 Park Plaza-Suite 5170 iration: i 512A] Boston,NU 02U6 r.`u._l�__ it BUILDING PERFORNiiIELiIUCCTING,LLC. JOSH EDMOND 8 KINNIKINNICK RD. TRURO,MA 02666 —' Undersecretary of valid without signature mV-- " ass saw P R PERMIT AUTHORIZATION FORM 1, Graziele Nogueira ,owner of the ro to property rty cased at: (owner's Name,printed) 24 Bramblebush Dr Cotuit (Property Street Address) (Oty) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X Owner's Sig t e Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 6 Participating Contractor Date For Office Use Onty Rev.12132011 — - - Message Page 1 of 1 Anderson, Robin From: Stanton, David Sent: Wednesday, October 01, 2014 8:05 AM To: Miorandi, Donna; HeathDeptMailbox; Lauzon, Jeffrey; Anderson, Robin Subject: RE: 24 Bramblebush Drive, Cotuit They know they cannot have a legal 4 bedroom dwelling. I had several long talks with these guys (the owner and contractor.) They stated it had a new septic installed before they bought it(a couple years ago.) I let them know we had no records in the computer or their street file to confirm this and that they would need to bring in the paperwork for this and the certificate of compliance. They could not produce a COC or evidence of a new septic. They rushed to staples to make copies of their plans and when they came back there was a second story over the garage which they did not show on their original visit(the room over the garage.) I explained to them that this would count as the 4th bedroom which is not allowed as they already knew. They could not get a 5'cased opening or open railing into other habitable space and so they were going to get a deed restriction. They were well aware they could not have 4 bedrooms and said they would not be back for a while. On a side note, this might be the property in which Arch had done a title V inspection and never submitted it to our office, but again if this is the property, it does not matter as they do not have a permit to go to 4 bedrooms and the inspection report does not mean they can have 4 bedrooms. -David -----Original Message----- From: Miorandi, Donna Sent: Tuesday, September 30, 2014 2:00 PM To: Heath DeptMa ilbox; Lauzon, Jeffrey; Anderson, Robin Subject: 24 Bramblebush Drive, Cotuit Just an FYI that the owners think they have a legal 4 bedroom house. It was 1982 built with 2 bedrooms clearly written on building permit. Septic was approved for 3 bedrooms. Never any other permits presented for more bedrooms. Now they want to do an addition because they are running a DAYCARE out of the house. They can only have 3 bedrooms and they are in the Saltwater Estuaries Project. David Stanton ,denied the permit on Sept. 9th stating too many bedrooms. They want to change old garage to a playroom and put a family room over the new garage. Jim LeBoeuf was agitated with me at the counter this morning stating that he wants to do the foundation and that the owners have talked to everybody in town hall regarding this and that it is 4 bedrooms. He couldn't give me any names. After doing research this afternoon I called Jim LeBoeuf to tell him they are stuck at 3 bedrooms and they need a deed restriction. He said ok and we left it at that. Scheduled to do a perc test on Oct. 28th. The owners live in Dennisport, MA 10/1/2014 Message Page 1 of 1 Anderson, Robin From: Miorandi, Donna Sent: Tuesday, September 30, 2014 2:00 PM To: HeathDeptMailbox; Lauzon, Jeffrey; Anderson, Robin Subject: 24 Bramblebush Drive, Cotuit Just an FYI that the owners think they have a legal 4 bedroom house. It was 1982 built with 2 bedrooms clearly written on building permit. Septic was approved for 3 bedrooms. Never any other permits presented for more bedrooms. Now they want to do an addition because they are running a DAYCARE out of the house. They can only have 3 bedrooms and they are in the Saltwater Estuaries Project. David Stanton ,denied the permit on Sept. 9th stating too many bedrooms. They want to change old garage to a playroom and put a family room over the new garage. Jim LeBoeuf was agitated with me at the counter this morning stating that he wants to do the foundation and that the owners have talked to everybody in town hall regarding this and that it is 4 bedrooms. He couldn't give me any names. After doing research this afternoon I called Jim LeBoeuf to tell him they are stuck at 3 bedrooms and they need a deed restriction. He said ok and we left it at that. Scheduled to do a perc test on Oct. 28th. The owners live in Dennisport, MA 9/30/2014