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1500 SOUTH COUNTY ROAD
ti 0 1 i i i Ji 1 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /�il Ma Parcel Application Health Division BV�LD'AJG bEPiDate Issued ' • �'"Z��� 4 Conservation Division SEP 14 2016 Application Fee Planning Dept. TOWN OF EARNSTgg�ermit Fee Date Definitive Plan Approved by Planning Board E Historic - OKH _ Preservation / Hyannis pp Project Street Address , 0 l Village Owner V 'GG°' Address Telephone Permit;Re7estIS -- _ 6e liq ins Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain dwateerOverlay Z70V/T-?— 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: ❑ 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 ❑ Appeal # Recorded ❑ Cmmerc' s s�, Gplan review # 'Use c Proposed Use c rK� G I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 7 Z ` Name "i Telephone Numbery Address License # S6 A°/ 2D Home Improvement Contractor# - - �CC�72$ D�Email Worker's Compensation # ALL CO ST�UION DEBRIS R FROM THIS PROJFR; r TAKEN TO SIGNATU DATE l + FOR OFFICIAL USE ONLY 1 APPLICATION # DATE ISSUED 3n I 5 MAP/ PARCEL NO. ADDRESS VILLAGE - OWNER F DATE OF INSPECTION: a: s FOUNDATION - t - r FRAME INSULATION I� FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL z . GAS: ROUGH FINAL FINAL BUILDING 0 Y J, - w DATE CLOSED'OUT - ASSOCIATION PLAN NO: r f FENCING INFORMATION FOR: SWIMMING POOL APPLICATION FOR: THE JACKSON RESIDENCE 1500 SOUTH COUNTY ROAD OSTERVILLE: FENCE WILL BE 5' IN HEIGHT 1 W MINI MESH "SWIMMING POOL COMPLIANT" BLACK VYNAL: ALL GATES TO OPEN "OUTWARD" WITH SELF LATCHING MECHANISUM SET 54"ABOVE GRADE. FENCE WILL BE INSTALLED ON THE NORTH, EAST&SOUTH PROPERTY LINES. ALL DOOR LEADING FRON THE RESIDENCE TO THE POOL AREA WILL BE EQUIPTED WITH "STATE APPROVED, AUDIBLE DOOR ALARMS" FENCE INSTALLER FALLON FENCE POOL INSTALLER SOUTH SHORE GUNITE POOLS RICK BENOIT 508-962-0007 i l i f y h f I I {?ATE 1 � I 1 � !✓C�iC ACign - �iduevgth <�tCiOFG.Fl l _ IN5kft1' I Alllgn ridgy;with groowyl. 3 openirKj botineen 1\ 6d11 pate cmd Bute post V Aa'fate and atlech cellar_ AUTO-LATCH for ORINAMENTAL FENCE SQUARE SQUARE 44' PRODUCT Ft:,,IAME SIZE POST SIZE No.2015 _ No. 2020 . . . . 1" . . . . . _ . 2" No. 2025 1' . . . . . . . 2112` No.221 5 .1 1/a" . . . . . . 1'iz" No.2220 . . . . 1 V4 . . . . . . . 2" No.2225' . . . . T.IAA . . . . . . 21h" No.2515 . . . . 1 5" . . . . . . 11/" No.2520 1 <" . . . . . . . 2" No. 2525 2w, No. 2529 . . Ad»pter K, NLJTO-LATCH ND UST n I i • UL Listed/UL 2017 won.�anr r 9 • Important Safety Feature r r Complies With Building Codes Simple To Operate ' Automatic Reset 8 Battery Powered Easy To Install A 85dB Ham at 10 feet fro tt v Affordable Price Pass Through Feature For Adults Low Battery Indicator �,•� y >:-sz t�Eroarga •tee i The POOLGUARD DOOR&WINDOW ALARM meets the requirements of all building codes and are UL Listed under UL 2017.The POOLGUARD DOOR ALARM was designed specifically to meet the needs of the norew barrier code requirements.POOLGUARD/PBM INDUSTRIES,INC.has been manufacturing pool alarms,do and gate alarms since 1982.All Pootguard products are proudly Made in the USA.The majority of children that drown in pools go out the back door first and Poolguard s Door Alarm can help protect those doors. 33 The DOOR ALARM features are listed below: Poolguard is the only door alarm that is UL listed under UL 2017 for water hazard entrance alarm — D���rA Enlarge equipment. • Poolguard Door Alarm will sound in 7 seconds even if a child goes through the door and doses it behind them. The Door Alarm is always on and will automatically reset under all conditions. • There is no on/off switch. The DOOR ALARM is designed to fit any type door or window and comes with all the necessary hardware for easy installation. The DOOR ALARM can be adapted to alarm the door OR the screen door,if present.Add the additional sensor below,if you need to arm both the screen door and the door. The color of the alarm is white to match any household decor,indoor use only.• The Door Alarm will sound in 7 seconds when a child opens the door,and the alarm will continue to sound until an adult comes to the door and resets the alarm. Poolguard Door Alarm is equipped with an adult pass through feature that will allow adults to go through the door without the alarm sounding. • The hom is 85dB at 10 feet. The hom sound is different than others in house alarms. • The Door Alarm is equipped with a low battery indicator that will audibly alert you when your battery is getting low. Poolguard Door Alarm uses one 9-volt battery,(not included)with a battery life of approximately 1 year• I • The DOOR ALARM has a one year warranty. • Poolguard Swimming Pool Door and Window Alarm Qwners Manual I Client#:38570 2FALL'ONFE DATE(K=DIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 1 09/09/2016 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 endorsement(s). PRODUCER CONTACT NAME: Dowling&0'Neil Insurance Ag HCo"n,E:t:508 775-1620 FAX, (Al5087781218 (A/C No): 973 lyannough Rd,PO Box 1990 EMAIL ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC 0 508 775-1620 INSURER A:National Grange Mutual Insuranc INSURED INSURER B: Fallon Fence,Inc. INSURER C PO Box 276 INSURER D: Centerville,MA 02632 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. �TR ADDL VD TYPE OF INSURANCE INS W POLICY NUMBER MPMMIDDDY EFF MPOMIDDD EXP LIMITS A GENERAL LIABILITY MP09671T 3/28/2016 0312812017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea oa ence $500 000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $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 JET LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Fa a.d.nt $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident UMBRELLA W\B OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC09671T 0313112016 0313112017 X 1TwocgsyTLA1Tmu OTH- ffsAND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y I N E.L.EACH ACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below 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) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Glen&Ruth Jackson SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1500 South County Road ACCORDANCE WITH THE POUCY PROVISIONS. Osterville,MA 02655 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S176425IM176424 LS1 IUl.®RTGAGE INSPECTION PLAN 4pplicant Jaek5&vL, Location: oswylllel E : I p� I TLC - 'L-2. A � ViE 7 13CY TLl 71_\C1ATT_- -mf F Seaptue bpje. OLiCIZ A Ln- RINI q4,' rTCW)L kt-\W AM\ S-LVTW, M ILWT VYMNr_tAzb garrag LM LQ� ric Lol� HITIZ: % 0 Z3 Scaptu-t qc L AUT 'l -KIF Lyeap tv OF T. QU BO-44Z Mood Panel 31ood Zone ce 9kereby certify that this mMtVage inspection nspection was prepared r- 1. I rV')A A 1��A 21A^ Swig- RM41JI-5 tTmd Roge'u, ,,.,,aa .A11a Tke-`dwelling shown kereon_dXjjjDrjah in a'special Ji5kA. flood zone "A"or T,with an effective date of JA-0- and the location of the dwelling &E5_conform to the local zoning by-laws in effect at the time of Scale:1"= Gil' construction with respect to horizontal dimensional setback requirements Date. ld-26:45 or is exempt from violation enforcement action underXig.L eh.40A,sect.7 ,3&,Ajo. 15- 14401 The structures shown on this mortgage inspection are shown a .-Art instrument.surv"is-necessary to pproxbnate Only le or recardin or oses or f Pd=7 10a determine predce location of structures and property fines.this mortqaqe inspection must not be usedft n use in preparing deed descriptions and must not be used for variance or Wilding departrija7tpurposes.Verification of Why locations. proper y line dhinensibris.fences or lotconfiguration can only be accomplished by an accurate instrumentsurvey whidi may refl&tdifferent information than.what is shown hereon. NOTE THIS IS NOT A BOUNDARY SURVEY AND IS FOR MORTGAGE PURPOSES ONLY. COLONIAL LAND SURVEYING COMPANY, INC. POST OFFICE BOX 350 - HUk4AROCK_MA 02047 - R 781-826-7166 - IF 781-8264823 - E:coLONIALSURVEY@GNAAILCOM sessing As-Built Cards http://www.tc)wnofbamstable.uslAssessingtHMdisplayasp9iWpar... TOWN F RN BASTABLE LOCATION S• COU . Qc� SEWAGE VEU AGE OMfVIIU- ASSESSOR'S MAP&LOT 1601 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACflY A LEACHING FACtLny:(Vpe) NO.OF BEDROOMS f BULL DER OR OWNER N /�AIU / WES/C/- PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: - Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leachin8 facility) Fed Edge of Wetland and[.caching Facility(If any wetlands exist widen 300 feet of leachinggffacility) T ) Feet Furnished by '1—/15',OiOA x i sl-U[1�V1�LUl,, � f Q s< 1(0 a 6 - a ag aa• z 3 3 So Yq P"r • r Of 1 8/17/16,12:28 PM i • 1ARNSTABM i Town of Barnstable Regulatory Services Richard V.Scab,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 0, 16't �� Sow ,as Owner of the subject property hereby authorize t mkh C>' ( to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) f Si�e of.Owne ',`Date-U V 1 l L Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\DecolU\AppData\Local\Microso8\Windows\Temporary Intemet Files\Content.Outlook\2PIOlDHR\EXPRES.S.doc Revised 040215 r%�r y`i�eyynraxraru�/��`r"'�rizrs[rc�ri;rlG Qffice of Consumer Affairs&Business Regulation License or registration valid for individual use only R,Y &ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 105485 Type: rrr'� Expiration: 7/17/2018 Supplement Card IO Park Plaza'Suite 5170 Boston,MA 02116 SOUTH SHORE GUNITE POOL'$,SPA INC. RICHARD BENOIT 12 ESQUIRE ROAD NORTH BILLERICA,MA 01862 Undersecretary o�lid without signature 1flassach6setts Department.ot Public Safety Board.of-Building Regulations and Standards 07n%truttiun Supervi.ur . ' Y License: CS-056174 I a RICHARD E BEPIOIT 51 CUSMNG WILL RD�"1 Ni)RWELL N1 A. 02061 c� ' it tt'•f' f Expiration :J.•�..-���� 03/16/2017 CotTirnis�+oner. ACORU® , DATE(MMMD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 8/31/2016 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 endorsement(s). PRODUCER CONTACT Judith George CIC,CPIA,CPIW _MMFIAT/Cross Insurance PH°NEEI. (603)669-3218 FA No:(603)645-4331 1100 Elm Street A�ESS:jgeorge@crossagency.com INSURERS AFFORDING COVERAGE NAIC S Manchester NE 03101 INSURERACNA Ins Co INSURED INSURER B Continental Insurance Company 35289 South Shore Gunite Pools and Spas, Inc. INSURER C:Philadel hia Indemnity Ins Co 12 Esquire Road INSURERD:The North River Insurance Company 21105 INSURER E: North Billerica MA 01862 INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 SSG 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 am POLICY NUMBER M�NUUD EFF MPOMfOD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑R OCCUR DAMAGE TO RENTEDnce $ 100,000 PREMISES Ea ocarrre 4013391907 4/1/2016 4/1/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Subctrct BIM AI FullProd $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 B S ANY AUTO BODILY INJURY(Per person) $ 20,000 ALOWNED SAS ULED 4013391888 4/1/2016 4/1/2017 BODILY INJURY(Per accident) $ 40,000 AOSOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS R AUTOS Per accident $ $ R UMBRELLA LIAR I OCCUR EACH OCCURRENCE $ 5 000 000 C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5 000 000 DED RETENTION$ PRUB535821 4/1/2016 4/1/2017 $ WORKERS COMPENSATION 408728405 8 PER OTH- AND EMPLOYERS'LIABILITY STATUTE E YIN ANY PROPRIETOR/PARTNER/EXECtfTIVE (3a.) MA, NH, CT, RZ, ME, OFFICERIMEMBER EXCLUDED? N❑NIA E.L.EACH ACCIDENT $ 1,000,000 D (Mandatory in NH) NY & VT 4/1/2016 4/1/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Limited Pollution 4013391907 4/1/2016 4/1/2017 Occurrence 1,000,000 Worksites Liability DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Jackson Residence THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1500 South County Road ACCORDANCE WITH THE POLICY PROVISIONS. Osterville, MA 02655 AUTHORIZED REPRESENTATIVE J George CIC,CPIA,CPI 4'&X#' �•' (� fC=L G*•�� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2014011 i 77je Commonwealth of Massac useits Department of Industrial Acciden& Office of Investigations r 600 Washmgton.Street Boston,M4 02111 nww nras&gov/dia Workers' Compensation Insurance Affidavit.Builders/Contractors/Electricians/Plumbers Applicant Information Please Nint LembIv Name(Baumes�rOlgaDimtionlLndividaal): C? — CJCa Address: ' U I 2D- city/state/zip:m Q k&i Pf jfd of GZ Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 1. I am a employer with 1— 4- ❑ �w 6.I am a general contractor and I employees(fall and/or p�-s have hired the sub-contractors construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet_ 7- ❑Remodeling ship and have no employees use sob-contractois have 8. ❑Demolition wig for me in any capacity_ employees and have wows' 9- ❑Building addition [No worms'comp.insurance comp-msuranee i required-] 5. ❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself o workers' _ right of exemption per MGL insurance �&]g c.152,§1(4j,and we have no 12_❑Roof employees [No wodoers' 13_�Other comp_insurance required_] •Any appti�t that checks bar#1 must also#ill out the section below showing their waakeks'eourpensation policy mfntmatioa Homeowa�s who submitd is of davit utdirating they are domS 0 wink and then hue outside contractors umst submit a new affidavit iudicatigg such =Coirauctnrs that check this boot must attached an addidonal sheet showing the nanpe of khe sub-oomnmuors gmd state whether or not those eatides have employees. If the subcoiztzactos have employees,they mast pmvide their workers'comp.policy mnnber- Iam an employer that is providing workers'compensation insurance for sty employees. Below is thepolicy arm job site informadon. tt'' Insurance Company Name: 01 LLT tt �� t 6e-> Policy#or Self-ins.Lic_#: �O// D� Expiration Date- t "t Job Site Address: U. City/state/Zip: Attach a copy of the workers'compensation oflcy declaration page(showing the policy number and expiration date). Failnue 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 S1,500.00 and/or one-year iniprisounienk 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 Ins-estigatiions of the DIA for instacance.c erage verification. I do hereby cent fy under the ' s an of perjury that the information p�ded above i/s and correct Si tune: Date: Phone#-- Qfficcial ass only. Do not write in this area,to be completed by city or tows official City or Town: Per itlLicense It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityffown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Seleeo 13m[ � DENTAIR - +a" r t One cleaning for an entire season? System3 Mod Media filters from Sta-Rite handle 2-3 times An Eco Select® Brand Product more dirt than other filters to deliver maintenance-free performance for up to a full season. Featuring perfectly Water flows very efficiently through the System3 Mod Media balanced flow and an integral manifold design,these fitters filter,often allowing the use of smaller pumps or lower are engineered to deliver the ultimate in labor savings. pump speeds to minimize energy use.And when you rinse System:3 Mod Media filters are ideal for inground pools, cartridges rather than backwash,you can significantly reduce inground hot tubs and water features. water use,too.The Eco Select brand identifies our e Balanced-flow tank hydraulics direct water through "greenest"and most efficient equipment choices. each side of the filter module for uniform dirt loading, As the global leader in pool and spa equipment no clogging,and long,unattended operation. manufacturing,we strive to provide greener e Complete media coverage combined with shallow choices for our customers.We hope you'll ��O® pleats for greater dirt holding capacities, longer join us in embracing more eco-friendly S e I e c t fitter cycles and less cleaning. poolscapes by choosing Eco Select branded _ e Shallow pleat design also permits quick and thorough products for your swimming pool. PENTAIR cleaning—Just rinse the module with a hose' •Modules used in conjunction with certain pool/spa sanitizers may require soaldng in special cleaning sohnions 1 ti — t� .. conveniently , . ;-, Split rank clesign permits rinse-in-place cleaning �. - . . =� and filter ..clams provide secure access to tank - bottomDual drain plugs available—side o remove o -filter 9 Balanced-flow tank hydraulics provide maximum dii-E-loading and . .• Performing to a higher standard �' Ultra-Capacity Filtration Based on extensive research in filtration and media science - Balanced-flow tank design assures debris is by Sta-Rite, System:3 Mod Media filters make Ultra-Capacity evenly collected by the media—no clogging Filtration"a reality. Unlike conventional"cartridges,"these filters or long runs between cleanings. combine a balanced-flow and integral manifold design,plus an easily cleaned media element Modular filter tanks permit quick change of filter media The result is a filter system that not only Filter Performance requires less frequent cleaning,but is also easy to clean. For Pools up to Filter Area Row mate Model 8 Hr.Turnover(Gal.) (Sq.Ft) (GPM) The System:3 Mod Media filter is constructed of Dura-Glas" S7M 120 48,000 300 100 high-density composite resin to weather the elements for long, S7M40o 55,000 400 115 dependable life. And its sleek,contemporary appearance and S8M 150 60,000 450 124 matte black finish look attractive in any pool setting. S8M500 62,400 500 130 Dirt-Loading Comparison Operating limits—Maximum continual operating pressure is 50 psi. Handles 2-3 times more dirt than other media-type filters— For pool/spa(bather)applications,the maximum operating water up to an entire season without cleaning! temperature within the finer is 104°F(40'C) 50 Ibs.or more 35 Ibs or more Available from: S.'. 18111s.or less (filter Area 450 sq.Q) (Filter Area 300 sq.ft.) now STA-RITE' Simply Smarter. www.staritepool.com Phone:800-831-7133 pumps/filters/heaters/ heat pumps/automation / lighting/cleaners/sanitizers/water features/maintenance products All Pentair trademarks and logos are owned by Pentair.Inc Systerre36,Mod Media',Posi-Lok`,Dura-Glas',Sta-Rite`.Ew Select'and Ultra-Capacity Filtration'are tidemarks and/or registered trademarks of Pentair Water Fool and Spa Inc.and/or its affiliated companies in the United States and/or other countries.Because we are continuously improving our products and services.Pentair nerves the right to change specifications without prior notice. Pentair is an equal opportunity employer. 1/14 Part#PI-724 ©2014 Pentair Water Pool and Spa,Inc All rights reserved. f . Town of Barnstable *Permit#Xbi��l��_� � Expires 6 mon r om issued to Regulatory Services Fee i + BAMSTABIE "'A9'� i6� Richard V.Scali,Interim Director p�� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862A038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint ' Map/parcel Number Q , ) ,� / p, Property Address—_4�6 0 S P V �C! Cb LJ N-7) AV. residential Value of Work$- 7 pDCI Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 1J Q' Q $P O M Cz)V 4 7 11) IZ DA D h)0M j A EE —De Y S 7 A11L Rp. sir PWjCt4 MA ©;S36 Contractor's Name Telephone Number 6—P 46 6�'42 Home Improvement Contractor License#(if applicable) Email: BOO)?W e)9,57. NET Construction Supervisor's License#(if applicable) C6FA ftION❑Workman's Compensation Insurance t C�h,e�c one: lad't am a sole proprietor DECO 8 ?o ❑ I am the Homeowner �"o wn I 14 ❑ I have Worker's Compensation Insurance /l! ®� Insurance CompanyName BA R'n 1 u'S TA8L E Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side (yPr7_'4C-f_ [v}�Replacement Windows/doors/sliders.U-Value o . c� 9 (maximum.35)#of windows #of doors: El Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required'q 11111 Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: TAKEVIN MBuilding Changes\EXPRESS PERMMEXPRESS.doc Revised 061313 Regulatory Services M�$ Thomas F. Geller,Director - . rFo►��" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 wWW-to Win.b arnstable.ma.us Office: 508-862-4038 " Fax: 508-790-6230 Property Owner Must Complete and Sign This•Section If Using A Builder. I, I v''-6 SDI Z Cbyh)7►/ �7 , as Owner of the subject property 74 a M Iry Ze -r Cu S7 hereby authorize 4, ,,Bp T W to act on my behalf, y in all matters relative to work authorized bythis building permit application for. 15,NW) CDV ZX lel> v111 E rI A (Address.of Job) ' z Signature of Owner ate Rb, �47 L -3b �1R.� Print Name If PrOl2ettv Owner is applying for permit please complete the- HomeownersLicens,e Exemption Form on the reverse side. Q:FOR ms-O WNERPERMISS ION Town of Barnstable FTHE Jp� do Regulatory Services . Thomas F.Geiler,Director ' � !aNtxarwara, �` -Building Division plE p► `�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,h1A 02601 vow,to wn.b arnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: street village number "HOMEOWNER home phone# work phone# .name . CURFOgT MAILNG ADDRESS: state zip code city/town . 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 hue who does not possess a license,provided that the owner acts as supervisor. DEFIMTION 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) assumes responsibility for compliance with the State Building Code and other The undersigned"homeowner" 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 i 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. ch a building permit is EXEMPTION The Code states that: "Any homeowner performing work fcr,wwnerrengages a pc on(s)for hire ed shall be exempt from e prov to do�such of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeo work,that such Homeowner shall act as supervisor." the onsibilities of'a supervisor(see Appendix Q, Many homeowners"who use this exemption are unaware that they are assuming resp 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, art of the PC it application, To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, P p that the homeowner ccrtify,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. QAW`PFa ESIFORMSIhomccxempLDOC A`"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) 11/14/2014 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 endorsement(s). CONACT PRODUCER ALBERT G BROCK CO INC NAME: PO BOX 1500 PHONENo, FAX NANTUCKET, MA 02554 E-MAIL A/CExtle No: ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: KENNETH HARTKORN INC 360 CROWELL ROAD INSURERC: NORTH CHATHAM MA 02650 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 22366836 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR IN SD D POLICY NUMBER MMIDD/YYYY MM/DDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ MA CLAIMS-MADE OCCUR PREMISES Ea occurrence S MED EXP(Any one person) $ PERSONAL&ADV INJURY $ I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY PRO LOC PRODUCTS-COMP/OPAGG 8 OTHER: $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITYaccident) $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ r_tOED I I RETENTION$ $ A WORKERS COMPENSATION WC5-31S-601942-014 2/21/2014 2/21/2015 SPER TATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS/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 MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BOB BODJIAK THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2 TELEGRAPH HILL ACCORDANCE WITH THE POLICY PROVISIONS. SANDWICH MA 02563 AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 22366836 Anne Chandler 11/14/2014 1:15:47 PM (EST) Page 1 of 1 The Covemongpealth of ASlassachusetts Deparhnent of Industrial Accidents O YU.-e of Investigations 600 Washington Street Boston,AIA 02111 tww .mass.gov/dia Workers' Compensation Insurance Affidavit:BWders/Contractors/Electeicians/Phmbers Applicant Information Please Print L*Zibly 2A S)�G Adcirt .: '2, Tf_ ).rr G,eA 84 12222 Jed QWState/Zip: M Phone lf- 336 6-2 77- Are you an employer?Check the appropriate box: Type of project(required). L❑ I am a employer with 4- X I atrt a general contractor and I employees(full andlor part-time). ve hired the sub-contractors d• [:]New construction 2..X 1 am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no a Wloyees Neese sub-contractors have $- ❑Demolition world, for me in any capacity_ employees and have rwod=s' [No worms'comp.insurance comp.insurance-1 9_ Budding addition .5. ❑ We are.a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3_❑ I arrr>3 honleavrurr doing all wo�xik �11_❑Plumbing repairs or additions myself[No workers'covV_ right of exemption per MGL 12_❑Roof repairs i�ut�ce ] P c..15.2,$1(4)and we have no employers.[No workM' 13..�,Other &g:-S)fIl Al G G� L� ctarrtp_irlslwrarttv required] f_pA C f. W l b S 'Any apph-w that checks box h1 must also fill out ttte section below showing thmk WMhea'caMpensMan policy mfbrMatFM i:Iameou trrs Triter sutuuit this atti&va wdicahag they ale douig all traits and there biota ara[sule coauacmrs noon suUinit a raw abYtdarit iudicatu�r snob. k(,Muwtars that chuck this box roust atuwhed an addttiuuel shrxt shmitg[bee tonne ut the M&-coimwfurs mud strut rrhe*er ar not[Huse etfities bane employees. If the sub-conuaams ham employees,[trey mast p umde then workers'comp.policy number. I am an employer-that is prrr»ieffng tvorke.ao'eotrgmrisatian insurance for my employeetx #claw u thrc proLcy and job site information Insurance Company Name:_ --- -- --- -- Policy 4 of Self-ins.Lie.4: --- --- Expiration Date:----- Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to seLut a coverage as requited under Section 25A of MDL c_ 152 can lead to the itupoasition of criminal penalties of a fine up to S 1,500.00 an&tx-one-year imptisorwent,as•welt as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2.50.00 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 ramify rmdatr the prtins andlre2so Penury that the htformadan ptYrwidad abr,w is Moe and curre3c t Si ttg�e: Dale: )1,4 Phone '90,R t)) .:QP8- 2.3 7 �3 2- M Official use only: Do not writer in this area,to be completed by My or totpn of eat _ r City or Town: -- ---- Permit/License'!l_---- ---- Issuing Authority(circle one):. 1.Board of Health 2.Building Department ment 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6.Other Contact Person: Phone 0: 12/8/2014 Office of Consumer Affairs&Business Regulation-Mass.Gov The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Uo Home Consumer Rights and Resources Home Improvement Contracting Home Improvement Contractor Registration Lookup To search by registration number, enter the registration number in the textbox below and click the 'Search' button. Search by Registration Number Search To search by other fields, enter the search criteria in the fields below and click the 'Search Registrants' button. For the State field, use the two character state abbreviation such as "MA "for Massachusetts and "RI" for Rhode Island. All search fields allow partial text so the search will look for any values that begin with what was entered. For example, if you enter "Fr" in the City/Town field and "MA" in the State field then the search will return records.for Framingham, Franklin, and Freetown which all begin with "Fr" and are located in Massachusetts. To return less information enter in more criteria. For instance, entering in a state of "MA" will return a large number of records but entering in a state of "MA" and a city/town of "Medford" will lower the results. Search by Registrant's company's name --- -*- - Search by Registrant's Fast bodjiak Y j name -- �— � I City/Town State Zip code - - 1,Search Registrants Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Sunday,; December 7, 2014. Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS NAME INDIVIDUAL NUMBER DATE DREAMHOME BODJIAK, ROBERT 180550 P.O. BOX 681 12/01/2016 Current INVESTORS, INC. E. SANDWICH, MA 02537 ©2012 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. http://services.oca.state.ma.us/hicAicenseelist.aspx 1/1 t Massachusetts - Department of Public Safety . Board of Building Regulations and'Standards Construction Supervisor 1 & 2 Fainil� License: CSFA-106090ON ROBERT L BODJEAK 2 TELEGRAPH HILL'IRO AD Sandwich MA.02563 t' R �-�•-- —� • " "' Expiration Commissioner 06/13/2017 i . DECLARATION OF- TRUST 1500 South County Road Nominee Trust Dated: November d 2014 Kenneth Hartkorn of 360 Crowell Road Chatham MA, and Robert Bodjiak of 2 Telegraph Hill Road, Sandwich, MA hereby declare that they and their successors will hold in trust any and all property that may be transferred to them j as Trustees hereunder for the benefit of the beneficiaries listed in the Schedule of Beneficiaries, signed by the Trustees . 1 . This - -trust shall be known as the "1500 South County Road Nominee Trust", of 2 Telegraph Hill, Sandwich, MA 02563 . 2 . Except as hereinafter provided, in case of the termination of this trust, the Trustees shall have no power to deal in or with the trust estate, except as directed by the beneficiary or beneficiaries by majority vote of their respective percentage interests in the trust property. However, the Trustees shall have full power and authority to sell, mortgage, or I - i otherwise dispose of all or any part of the trust property and to "lease all or any part thereof by one or more leases for a term or terms which may extend beyond the date of any possible termination of the trust, and to grant or acquire rights or easements and enter into agreements or arrangements with respect .to K the trust property, all as may be directed by the beneficiary or beneficiaries by majority vote of their respective percentage interests in the trust property, provided that the Trustees shall not be required to take any action so directed which will, in the opinion of the Trustees, involves them in any personal liability unless first indemnified to . their satisfaction. Every instrument executed by any person who, according to the records in the Registry of Deeds in which this instrument is recorded, appears to be the Trustee hereunder, shall constitute conclusive evidence in favor of any person relying thereon or claiming thereunder that, at the time of the delivery thereof, this trust was in full force and effect and that the Trustee was duly directed by the beneficiary or beneficiaries by majority vote of their respective percentage interests in the trust property to execute and deliver the same. 3 . This trust may be terminated at any time by the beneficiary or beneficiaries by majority vote of their. respective percentage interests in the trust property by notice in writing to the Trustee or by the Trustee by notice in writing to the beneficiary or beneficiaries, • which termination shall not take effect until recorded in the Registry of Deeds where this instrument is recorded; and the trust shall terminate in any event twenty-one (21 years after the death of the survivor of the original Trustee) . In the case of any such termination, the Trustee shall transfer and convey the entire . trust estate, subject to any leases, mortgages, contracts, or other encumbrances on the trust estate, to the beneficiary or beneficiaries in their respective interests : 4 . Any Trustee hereunder may resign. by written . instrument signed and acknowledged by such Trustee and recorded in the Registry of Deeds where this instrument is recorded. A successor or additional Trustee may be appointed or any Trustee removed by an - instrument or instruments in writing signed by the beneficiary or beneficiaries by majority vote of their respective percentage interests in the trust property and acknowledged by him or them, provided that,. in each i case of an appointment, the acceptance' in writing by the Trustee appointed shall be recorded in said Registry of Deeds where this instrument is recorded accompanied by a Trustee Certificate indicating that he/she has been properly authorized by the beneficiary/beneficiaries by majority vote of their respective percentage interests in the trust property pursuant to the terms of the Trust to record said acceptance. Upon the appointment of any successor Trustee, the title to the trust estate shall thereupon and without the necessity of any conveyance be vested in said successor Trustee. Any successor Trustee shall have all the rights, powers, authority, and privileges as if named as an original Trustee hereunder. No Trustee shall be required to furnish bond. This declaration of trust may be amended from time to time by an instrument in writing signed and acknowledged, by the then Trustee hereunder at the direction of the . beneficiary or beneficiaries,. provided that the instrument of such amendment shall be recorded in Said Registry of Deeds where this instrument is recorded. 5 . A ._Trustee hereunder for the time being, shall not be liable for any error ' of judgment nor for any loss arising out of. any act or omission in the execution of the trust so long as he/she acts in good faith, but he/she shall be responsible only for his/her own willful breach of trust.,. . No license of court shall be requisite to the validity of any transaction entered into by the Trustee, and the. Trustee shall have full f power and authority to execute all deeds and other instruments necessary or proper to carry such transactions into effect. No purchaser or lender shall be under any liability to see to the application of the purchase money' or any money or property loaned or delivered to the Trustee, or to see that the terms and conditions of this trust have been complied with. Every instrument executed by any person who, according to the records in said Registry of Deeds, appears to be the Trustee hereunder shall constitute conclusive evidence in favor of any person relying thereon or claiming thereunder that, at the time of the delivery thereof, this trust was in full force and effect and I that the non-trust third party may always rely on a certificate signed by any person appearing, from the aforesaid records in Registry of Deeds, to be the Trustee hereunder as to whether or not this declaration of trust has been terminated, as to who are the beneficiary or beneficiaries hereunder, or as to the existence of non-existence of any fact or facts which constitute conditions precedent to acts by the Trustee or are in any other manner germane to the affairs of this trust. 6. The Trustee, by an instrument signed, sealed and acknowledged, may authorize any person or persons (regardless of whether said person or persons may also be a Trustee hereunder) to act as his/her attorney or attorneys, to sign checks drawn on any bank account of the trust, to execute any deeds, mortgages, or. other instruments of any description whatsoever on behalf of the trust and to perform such of the Trustee ' s powers and for such times as are specifically set forth in said instrument of authorization. Witness the execution hereof under seal by the Trustee hereunder the day and year first above written. Kenneth Hartkorn, Trustee Robert Bodjiak, Trustee COMMONWEALTH- OF MASSACHUSETTS Barnstable, ss . November c 2014 Then personally appeared before me, the undersigned Notary Public, Kenneth Hartkorn, who proved to me through satisfactory evidence of identification, which was a drivers license, to be the person whose names is signed on the preceding or attached document and acknowledged to me that he signed it voluntarily for its stated purpose. SHOP HEq S r %M-23,?Q�A��� N l o Q� ym Not blic: s Vs 7 My commission expires : �2 3 I ( _ OF MASgSP MONWEALTH OF MASSACHUSETTS Barnstable, ss . November' 22, 2014 Then personally appeared before me, the undersigned Notary Public, Robert L. Bodjiak who proved to me through satisfactory evidence of identification, which was a drivers license, to be the person whose names is signed. on the preceding or attached document and acknowledged to me that he signed it voluntarily for its stated purpose. .1OPHEq Q�S�M�ssioy`S.o Notary Allic S Vg My commission expires : 1-13 qR 6� J f I �� M a� :v Assessor's map and lot number .. - .:.. - yO* Toy T E r W tuber ��• ` ...:....:............ d Sewage Permit nu. f = 119B39TAME, i House number �." < 0...................................................... 9 SAM �p 1639. \00 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Ilc ..x� ` TYPE,OF CONSTRUCTION .............. ..........................`.......................................................................... .............� .... . .........................19........ y/ TO THE INSPECTOR OF BUILDINGS: . / The undersigned hereby applies for a permit according to the following 4information: Location .. ~ .............................................r ``. ..r��........................... r-.-� r1;.1.`........................................................ ....... ..... Proposed Use r ...................................... .. ` ,n.t.............. .. _ ...... ............................................. I PIN ZoningDistrict ......F. .�......................................................Fire District ...` . ............................................................ Name of Owner ........................a :^� r ;. ke �.� !' Address ``. ............* ........................ .... .... ........ i Name of Builder Address ... .... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........ .........................................................Foundation Exterior ...... ............................................................Roofing h, v�.....................................................Interior s - •� ! f Floors :....................................................................... Heating ....................................Plumbing .....................................:........ .......:.......................................................................... Fireplace ...'� ©�....�r.......................................................................Approximate Cost ....... ........'................................ Definitive Plan Approved by Planning Board ---------------__-____ `= `� 19 ---. Area r ..J......................... Diagram of Lot and Building with Dimensions Fee f � SUBJECT TO APPROVAL OF BOARD OF HEALTH r a r I � I I LAh.t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . :� .�..Z.- . ._.,_............................ SCHILLING, THEODORE A. ZO 2.4S9 .0 Permit for .. ADDITION. . . ...:. ....... No . ....... ....... ..... ...,.. .... .. . Single Family Dwelling = ......................... ........................................ Location 1500 South County Roaa Osterville ......... ..... ....... ... ............... ... ................ ./ Owner Theodore A. Sch-i.11ing •V' - Type of Construction ,,,Frame_ ................................................................................ Plot ............................. ... Lot ................................ , Permit Granted April 7, 83 19 Date of Inspection ....................................19 Date Completed ....................:..................19 PERMIT REFUSED i ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved,,..... .......................................... 19 ......................:........................................................ ..............:................................................................ As.?essor's map and lot number T E TOWN OF BARNSTABLE BUILDING INSPEICTOR APPLICATION .FOR PERMIT TO ....Aj .......................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: � Name of Owner —'�.���AAs��Q��.��.�x—~_�7��JX�0\��Addosu ��u���.�.����s%� ------ . Y " Nome of Builder �0� ��c�.z�� —�~—� —.A66�ms . ��—.. ------ � ^ Nome of Architect ----------------------A66ness ---------------------------- � Numberof Rooms --.�.........................................................Foundation — �........................................................... � -� Eme,io, —.{»°�n�o�^=p............................................................Roofing — ........................................................ Floors — -----------------|nteho, ...................................................... . � Heating ..................................................................................Plumbing --.,��-----__,________________. Fireplace -----------------------'AppnoximoteCos .......?.!Pq2P............................................. ',� ^ . DefinitivePlanninge Plan Approved by Planning Board lQ_---. Area �t����'� ~~~~ yj Diagram of � and Building with� Dimensions Fee ��.x. Lot ----- ' | SUBJECT TO APPROVAL OF BOARD OF HEALTH | � , * � ' � > �l | | | | °.� - � � � | hereby agree to conform to all the Rules and Regulations of the Town of 8omn$o6|e regarding the above construction. l � Name L�,�����. ................................ �& C /G I | SCHILLING, TBEODORE A. ^ � . ' ' ` ... permi+for .A]�D.I�CIO�— ____. — .-- .--. .-� —.. -- —. � Single I7aod'—_ Dve ' ----------.— --v--llino ---_---.. . Location —I50O,-,^ —Co��1�y.-ll���� � le ----- ........................................................... " - ' Owner — ..A.— 11�g� �. ' —.. Type of Construction .����DlQ--------- ` -------------------------lax � ` ��^oi� ' --. Lot ................................ -----� —' . � ' �orjl 7 � 83 ' _ P�rm —'�------lg ' . � Date of ........................... / - - Dote Completed ...........................==, ...lV ` ' ' ^ ' PERMIT REFUSED . ........ lg ` —'L—`-----^---'^—'----------' ' ` ` ----.......—~---------------.— . ' ' ' —,---~..—.-----.—...—.-------- ----.----.~--.......-----.---.—. Approved . . ` ................................................ lR ' ' -----------.—~,..--.—~—.—.—.—.. -----------...----~.~.........—.. . - Assessor's map and lot,,number of7NETod Q Sewage Permit number ...........S;? ..:�.. .....^�... ...� Z BABHSTABLE, i House number ...........I ^. ............. ../................. 9� Mae6 / p 039. 9� Q YPY A,- -TOWN OF BARNSTABLE BUILDING INSPECTOR ...............: �..~� . �., ......... APPLICATION .FOR PERMIT TO ��.......................... ................................................................:. TYPE OF CONSTRUCTION ...................... .l 1 ti-1 I L ........................................................... ........... ........�.�....................19.1� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followirig information: Location ...`S.,m...�•,,�, �,p COJ07 ..PLOP t�:��,+�, �—�.�.�- ProposedUse ........................................ ..............................h..,t,.. .. . . ZoningDistrict .............Q..C................................................Fire District ............G..... ....©........................................ Name of Owner ... 11� .Address ....ISCO...S001............................. 1 : S��Q2 Vll 1 r ..; .. Name of Builder . -sue.. ..-�.........�1� ate..... �1�4 ^".Address ...PL�..•.S=fly `_1\� C'�S,7e__(2 Q)L-L ..... ........................................V................. . i- Nameof Architect ' .................................Address .:..................................................... .............................................................. Number of Rooms .......................Z...........I.........................Foundation ......................................... ................................... Exterior .......Roofing .............�;.: ............................... -'.: i i .... ...... ............................................................................ Floors . ...Interior ....................... ...................................... �--- Heating .................... ......\.................................:....................PluPnbing .................................................................................. Fireplace ................... ^ ........... .Approximate Cost ... .......... ••-0....c, ..q.Definitive Plan Approved by Planning Board -------------__-__------------ Area ...N....................Vt. ... . Diagram of Lot and Building with Dimensions Fee - , ............7..._/J.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH d C�Ar2A&k- ,�- 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. t - — Name �... ...:-?C. ......................................... Construction Supervisor's License .. .�.�a.�.�7 ............. . SCHILLING, THEODORE A. A=120-1-2 28207 Addition No ............... . Pe4rfit for .................................... Single Family Dwelling .................... Location ......1.5.0.0..Sou.t.h.... .C.?.untV .........`........Roa.d............ ..............0 s t..e.�......v i 1..1.e........................................ ...... . 'Owner ...........Theodore. . ..A. ...Sch.i.1liU........ .. .......... . .. .. . ...... . ...... Type of Construction ....Frame .......................... ................................................................................ Plot ............. .............. Lot ................................ July 15, 85 Permit-Granted ........................................19 Datf,,of Inspection ....................................19 Date Completed ............................./........19 745, I 2© — 1 .- Z. �� C gYg?EM MUST BCE Assessor's map and lot number ;:.....1............ ....................... . gEpTt � Bpi TN IN j 6 Sewage Permit number .................�...'.'..�.�...... ...r . .. ��. u�DE ,,. °+► Z BARNSTABLE, i House, number .VS00 E aE(�t��,p►T�ON vo NAM ........................................... ....... i639 9� ' TOWN OFI *BARNSTABLE BUILDING.,.- INSPECTOR APPLICATION FOR PERMIT TO EP �D l � Q TYPE OF CONSTRUCTION ......................rZ S ( fl�►.�-1 t ......................................................... ......................!.2.................19...% TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....5c.... ...��.. .,r"Z© ....Q� �1.1r ..................................................... Proposed Use .........:....................................... .�{?cl--....... �!(1 fN..` '.. \... rT� ..... ZoningDistrict ............. .......................................................Fire District ............G....... ....�........................................ Name of Owner ..-..W.14G..Address � `�.. .Q.S...�..........V.. Name of Builder i ........................Pf .......Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........................Z........ .Foundation CCAIJGKZ�'(.,- Exterior ���D ..Roofing • ��.. �.................................................................................. ��. ...................................... Floors ......... ................ . ........... \mil C � -+�...............Interior ...............�. , ...................................... ...... .... . I Heating. - .. ...��eA. .c- ..............Plumbing ...... .... ..l.la.................................................... Fireplace ....................� .)...................�N��...............Approximate Cost 6..... ®a. _ .... ...... B I S'l .. Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area Zu ...... ......... Diagram of Lot and Building with Dimensions Fee ............. .. ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH `X-�G„ I�DDI'TION ?j 3 �kts"1iNG 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. NameC- *-* -� � ......................................... Construction Supervisor's license .0./lFt.{/ ............ SCHILLING, THEODORE A. 28207 Addition No ... Peeii�it for .............. ..... ............... Single Family Dwelling ................................................... Location ....1500...S.o.uth..Count.y Road. . ............. . ...... ........ . .. .... . .. Osterville ............................................................................... Owner .....Theodore A. Schilling...................... . . ...... . Type of Construction ...............Frame............................ ............ ................................................................... Plot ............................ Lot ................................ Permit-Granted ......Wly...1.5...................19 85 Date.of,Inspection ...19 Date Completed ...... I .................19 e. on My 1 20• I i ' 12"BEA 8" WATERLINE 1 +~ ,•I J I � I 1_-0'DEPTH I 12, - 8'GUNITE , PERIMETER BOND BEAM < I 1 — #4 REBAR,3 RODS,E'O.C. O ' U I THICKNESSWA W w F_ L.0'DEPTH IUl ir BRICK FOR STEEL ALIGNMENT1a RADIUS=B 4'OC.EW(rP-) 3_-7 DEPTH 1 > 1:7(MAX.) I 8'GUNITE FLOOR THICKNESS 4'-O'DEPTH I 03 R. GRADE40 1a TA 5_-D'DEPTH I B'GUNITE FLOOR THICKNESS �volr• L/FLOOR 9'IEEL: I . A3 REBAFi®,2'oc/Ew �/ N 6_0•DEPTH I .. ADDITIONAL 03 BARS,2a LENGTH p�NG p I 1Y.SPACING,S'OFF CENTER RADIUS=5'-0' I LONGITUDINAL®SLOPE TRANSITION POINT. �()► - DEMITE THICKNESS INCREASED ALONG 1:3 MAX. SEP,j DEEP END COVE.Er MIN.THICKNESS. 7=0'DEPTH �•• ° G[A 2)STEEL TO BE POSITIONED TO CENTER I TO'•� ` ?O�C OF STRUCTURE. VV v 8'-('DEPTH op {�e7EA EFT WATER OEPEf: RIB O ADDITIONAL 03 BARS 0 Ir OC pp THROUGH BOTTOM RADIUS. T,qV�L� • TERMINATE BARS WITHIN 12'OF TOP OF BEAM. LAPALL BARS 18"MIN. HYDROSTATIC RELIEF VALVE IF REQUIRED) LOCATED IN 9EPERATE POT I A POOL CROSS SECTION-3FT TO 8FT 1/2, G� 0 f T.O.O. ' I NOTE _ 1I DRAINS TO BE SEPERATED BY A MINIMUM OF 3-0' "OR ON DIFFERENT PLANES. SKIMMER, BERMUDA GUNITE, 08 AWG GROUND .�• °•, PE GAUGE•-- - C.ONNNECTOR BONDED TO y . '- PENTAIR#50ST01 : - REBAR _ ..j 7� -.: °• _ — LIRE GA FILTER D') BEL F-.2"RETURN LINE TO POOL GUNITE NICHE.PVC a, WATERLINE fT' 1' - ."' ','. •. (WATER COOLED AREA) - (MIN') ADDITIONAL STEEL IN SWIMOUT 2••FILTER LINE l' H- _ _ — #3@ITOC,EW N ' SKIMMERS r- II CONDUIT,314,RIGID POOL LIGHT roll ' II (SEALED UNIT) _ 2 1 IT CLR. I (NO BACKWASH) ",ir NOiES: - 1 12"TO PUMP -3.II -------) SVRS - JUNCTION BOXES 70 BE a I( 4' .� - FURNISHED ONLY. DRAIN#1 INSTALLED BY OTHER I —Y SHOTCRETE COVER S .1 :•. _ AROUND NICHE '•.I JUNCTION BOX.3I4',TRIPLE HYDROSTATIC a OUTLET POT r 2"TO PUMP-� I PUMP VNTH HAIR AND LINT STRAINER . LE (PENTAIR)183 ❑ ——_——_—J ' #78310600 ' PRE-BFND'A' :^ INSTALL,18'MIN.FROM PRE-BEND <•': WATERLINE TO TOP OF ' LENS UNLESS LIGHT IS UL LISTED FOR LESSER DRAIN#2 •.: >-�- �� DEPTHS . 8"WALL O =A 12•BEAM , i N LIGHT SECTION DETAIL D SWIMOUT DETAIL E TYPICAL PLUMBING SCHEMATIC B SKIMMER PLAN DETAIL C 1"=1'-0' I =1'-0„ NOTES AND SPECIFICATIONS CONSULTING STRUCTURAL ENGINEER III I O 1)�SECOND DRAIN MAY BE PLACED ON FLAT OR SLOPED FLOOR. 2)ALL DRAINS MUST BE PERDENDICULAR TO FLOOR SURFACE 1.ALL CONSTRUCTION WORK TO CONFORM TO STATE AND LOCAL CODES. NGC STRUCTURAL,LLC LEAF CAN ALIGN TOP OF MV FUSE 2-ALL ELECTRICAL WORK MUST COMPLY WITH ARTICLE 880 OF THE NATIONAL ELECTRIC CODE 241 TOLEND ROAD Qd vd My FUSE LID Wl TOP BOND BEAM(LOCATION VARIES) DOVER,NH 03820 Q V ❑ (NEC).THE PROVISIONS OF THIS ARTICLE APPLY TO THE CONSTRUCTION AND INSTALLATION OF 1a' ELECTRICAL HARING FOR EQUIPMENT IN OR ADJACENT TO ALL PERMANENTLY INSTALLED 603.749.4177 HYDROSTATIC RELIEF POTwtc„u accwnn SWIMMING POOLS AND SPAS,AND TO METALLIC AUXILIARY EQUIPMENT,SUCH AS PUMPS. 7� (NO ACTIVE PUMBING RECUR FILTERS,AND SIMILAR EQUIPMENT.IN COMPLIANCE OF THE NEC,NO DECKING OF LANDSCAPING I I CAN OCCUR AROUND POOL UNTIL AREA HAS BEEN BONDED AND INSPECTED. ENGINEER'S STAMP: 2'TO FILTER 2 1M I " FOR STRUCTURAL USE ONLY HYDROSTATIC RELIEF VALVE I I 3.CONCRETE SHALL BE PLACED BY THE GUNITE METHOD AND HAVE A 28 DAY STRENGTH IN ED) I I EXCESS OF 4,000 PSI. d 8"FLOOR 'W ✓1 ""'"`8""• I I 4.REINFORCING STEEL TO MEET ASTM-615 GRADE 40.SPLICES ARE TO BE LAPPED A MINIMUM �,`P�1H OFF.Igss, . �w Mew OF 40 BAR'DIAMETERS. N 5.PIPING TO}BE NSF APPROVED SCHEDULE 40 PVC PIPING,SOLVENT WELDED AFTER CLEANING o WITH SOLVENT CLEANER. sTRuc,uraL COLLECTOR TUBES .1 SAS PER THE VIRGINIA GRAEME BAKER POOL AND SPA SAFETY ACT,ALL POOLS AND SPAS ENLARGED SUCTION SHALL BE EQUIPPED WITH AN ANTI-ENTRAPMENT.DEVICE.FURTHER,THE SUCTION PIPING SHALL <• !_ y �[��c-]Iv ELEMENT HAVE A SAFETY VACUUM RELEASE SYSTEM AS PER ANSVASME SECTION A11219.17 212'TO LEAF CAN 7•AT DEPTHS OF 5 FEET OF GREATER,ADDITIONAL#3 STEEL BARS @ 12"O.C.VERTICALLY Z THROUGH BOTTOM RADIUS.TERMINATE BARS WITHIN 12"OF TOP OF BEAM,LAP ALL BARS A HYDROSTATIC DETAIL (if re Uq fired) n MDX PE C)DETAIL MINIMUM OF 18-.ADDITIONAL BARS TO BE PLACED IN THE CENTER OF q n `J REGULAR REBAR,RESULTING IN A S"x12"PATTERN. DATE: I' �' 1 SHEET OF € I / i 20' 12"BEA ' • B• r_— WATERLINE I WW��PERIMETER BOND BEAM 04 REBAR,3 RODS,e-O.C. THICKNESS 2_-O'DEPTH I BRICK FOEL AIJONMENT 4'R STE OC.EW(TYP.) 1 r 10' RADIUS•B' i g_0'DEFTH I -! 1:7(MAX.) S'GUNITE FLOOR THICKNESS ® ! 4'-O'DEPTH I GR 9 GRADE 40R 70' 5 0'DEPTH I S'GUNITE FLOOR THICKNESS 1 CA WA i!FLOOR STEEL: 9A3 REBAR®17 OC/EW I vy 8'-0'DEPTH I ADDITIONAL 03 BARS,20'LENGTH WM t r.SPACING,('OFF CENTER RADIUS=5'-0• LONGITUDINAL®SLOPE TRANSmON POINT. O 1N)NffE THICKNESS INCREASED ALONG I 1:3 MAX. DEEP END COVE,S'MIN.THICKNESS. T-0'DEPTH MIN.STRUCTUREPOSTIONED TO CENTER ) , B'-O'DEPTH (jgF DITI 7Key 8FT WATER DmrF aDomoNALx1 BARS®tr oc 4n THROUGH BOTTOM WITHINRADIUS. :.: ® •� O TERMINATE BARS WITHIN 12-OF TOP OF SEAM. LAP ALL BARS 18"MIN. •HYDROSTATIC RELIEF VALVE(IF REQUIRED) LOCATED IN SEPERATE POT ►►►111 A POOL CROSS SECTION-3FT TO 8FT 1/2"=1'-0" IT • G� O ' 8I�"—W—ALL ' I �I T.O.GIJ I A; NOTE �I SKIMMER, 1 r DRAINS TO BE SEPERATED BY A MINIMUM OF 3'-0"OR ON DIFFERENT PLANES. • BERSKIM GUNITE. OBAWGGROUND i''•' CONNNECTOR BONGED TO '`;.:1 `- PE!lTAIR>f308T01 '-. •.°'. RE BAR ....J I, 18, PE _ FILTER- SSURE GAUGE <i BELOW F.2"RETURN LINE TO POOL i lu OUNITE NICHE.PVC WATERLINE rT, - (MIN.) 2"FILTER LINE 1�1' (wgiEa COOLED AREA) ADDITIONAL STEEL IN SWIMOUT _ #3@ 1rOC,EW SKIMMERS I— N II. CONDUIT.314•,RIGID POOL LIGHT ' 811 (SEALED UNIT) 2 12'CLR. i (NO BACKWASH) . II '-.ir NOTES: 1 12"TO PUMP -� SVRS I . —, _ III -• � JUNCTION BOXES TO BE FURNISHED ONLY. DRAIN#1 .I :•• INSTALLED BY OTHERS. sH07C ND NICHE - HYDROSTATIC AROt1FID NICHE I ;' JUNCTION BOX,314•,TRIPLE RELIEF POT 4 I PUMP WITH HAIR AND LINT STRAINER . OUTLET (PENTAIR) 2'TO PUMP 'J LEXAN •7B310800 ——— PREAEND'A .-a MSTALL,18'MIN.FROM PRE-SEND'1W WATERLINE TO TOP OF LENS UNLESS LIGHT IS UL LISTED FOR LESSER DRAIN#2 DEPTHS 6'WALL 12"BEAM B SKIMMER PLAN DETAIL C LIGHT SECTION DETAIL D SWIMOUT DETAIL E TYPICAL PLUMBING SCHEMATIC 1"=1'-0" 1/2"=1'-0" 1/2"=V-0" NOTES AND SPECIFICATIONS 14,1)SECOND DRAIN MAY BE PLACED ON FLAT OR SLOPED FLOOR. ,' CONSULTING STRUCTURAL ENGINEER .I I O 2)ALL DRAINS MUST BE PERDENDICULAR TO FLOOR SURFACE 1.ALL CONSTRUCTION WORK TO CONFORM TO STATE AND LOCAL CODES. �I NGC STRUCTURAL,LLC LEAF CAN ALIGN TOP OF MV FUSE .2/LLL ELECTRICAL WORK MUST COMPLY WITH ARTICLE efiD OF THE NATIONAL ELECTRIC CODE 241 TOLEND ROAD 'Qb .d MA/FUSE L D WI TOP BOND BEAM(LOCATION VARIES) DOVER,NH 03820 r� V O (NEC).THE PROVISIONS OF THIS ARTICLE APPLY TO THE CONSTRUCTION AND INSTALLATION OF ta' ELECTRICAL WIRING FOR EQUIPMENT IN OR ADJACENT TO ALL PERMANENTLY INSTALLED 603.749.4177 HYDROSTATIC RELIEF POT we"usttw SWIMMING POOLS AND SPAS,AND TO METALLIC AUXILIARY EQUIPMENT,SUCH AS PUMPS, N . (NO ACTME PUMBING REQUIRED) "`1CPJiL1vN0E FILTERS,AND SIMILAR EQUIPMENT.IN COMPLIANCE OF THE NEC,NO DECKING OF LANDSCAPING I I CAN OCCUR AROUND POOL UNTIL AREA HAS BEEN BONDED AND INSPECTED. ' z tlz'I I ENGINEER'S STAMP: DO HYDROSTATIC REUEF VALVE T TO FILTER 3.CONCRETE SHALL BE PLACED BY THE GUNITE METHOD AND HAVE A 28 DAY STRENGTH IN FOR STRUCTURAL USE ONLY 8"FLOOR I I EXCESS OF 4,ODO PSI. —1 4.REINFORCING STEEL TO MEET ASTM-615 GRADE 40.SPLICES ARE TO BE LAPPED A MINIMUM V.OFlkv. S F-� "c nn` on I I OF 40 BAR DIAMETERS. �+ P.�. 5.PIPING TO BE NSF APPROVED SCHEDULE 40 PVC PIPING.SOLVENT WELDED AFTER CLEANING COTE.JR. WITH SOLVENT CLEANER. srRucTUPAL m Q p.. COLLECTOR TUBES No.33506 ENLARGED SUCTION t 2 trz' 6AS PER THE VIRGINIA GRAEME BAKER POOL AND SPA SAFETY ACT,ALL POOLS AND SPAS v'rF- TLn�� vJ 'ri q ELEMENT SHALL BE EQUIPPED WITH AN ANTI-ENTRAPMENT.DEVICE.FURTHER,THE SUCTION PIPING SHALL �- I• m HAVE A SAFETY VACUUM RELEASE SYSTEM AS PER ANSUASME SECTION Al12.19.17 I 2 trz'70 LEgF CAN 7.AT DEPTHS OF 5 FEET OF GREATER,ADDITIONAL#3 STEEL BARS @ 12"O.C.VERTICALLY Z Q U U� THROUGH BOTTOM RADIUS.TERMINATE BARS WITHIN 1r OF TOP OF BEAM,LAP ALL BARS A HYDROSTATIC DETAIL -(if re wired PLCC)DETAIL MINIMUM OF 16'.ADDITIONAL BARS TO BE PLACED IN THE CENTER OF q 1 q—� G REGULAR REBAR,RESULTING IN A 6"x12"PATTERN. I 2. 16 1'-0" 1/4 = 1'-0' ` DATE: SHEET OF z