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0009 CAP'N JAC'S ROAD
i UPC 1 LOR! %yam HASTINGS, YN . ,.� Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on lob and this Card,Must be Kept - M" lbso. Posted Until Final Inspection.Has Been Made.' Permit � - • Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-1639 Applicant Name: SHORELINE POOLS INC Approvals Date Issued: 05/28/2019 Current Use: Structure Perfnit Type: Building-Pool-Inground Expiration Date: 11/28/2019 Foundation: Location: 9 CAP'N JAC'S ROAD,WEST BARNSTABLE Map/Lot: 194-049 Zoning District: RF Sheathing: Owner on Record: PERRY, MICHAEL T SR&DENISE A i Contractor Nam�SSHORELINE POOLS INC Framing: 1 Address: 9 CAPN JACS RD Contractor License: 161240 2 WEST BARNSTABLE, MA 02668 T Est. Project Cost: $90,000.00 Chimney: Description: inground free form vinyl liner swimming pool18x36 pool will be Permit Fee: $ 175.00 fenced in,in accordance with swimming pool enclosure code pool Insulation: will be heated&thermal blanket provided Fee Paid: $ 00 _.� Date: f�, 5/28/28/2019 Final: Project Review Req: [� � Plumbing/Gas i 1 Rough Plumbing: `! %\Building Official ,• Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance. All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. - . /! Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:I Service: 1.Foundation or Footing r f 2.Sheathing Inspection I - _ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Flersons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: .......... .. . O Application Numb.,.I> ...... .. ........ 77 1 MAS& Permit Fee................................... er Fee....... ............... 0,39. Total Fee Paid.............................. ................. ...... ...... TOWN OF BARNSTABLE Permit Approval by...U D................ BUILDING PERMIT �..........�.�.%.4.............Parcel........c��....................... . APPLICATION Section 1 — Owner's Information and Project Location Project Address 5. Village Owners Name i 1Ce. Perv-!7 Owners Legal Address City State A4 Owners Cell# E-mail Z)P C..�C_L Section 2 Use of Structure Use Group ❑ Commercial Structure over 35,0001cubic fe,0. ❑ Commercial Structure under 35,068 cubic fed Single Two Family Dwelling Section 3 — Type of Permit F-1 New Construction ❑ Move/Relocate [:] Accessory Structure ❑ Change of use EJ Demo/(entire structure) 0 Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment ❑ Sprinkler System ❑ Addition [:] Retaining wall Solar E] Renovation Ypool. El Insulation Other—Specify Section 4 - Work Description %V%tra%h-4 f-ruL -&Neon Mat /xk ck2,L WNk !QL k�c" 1-^, 1)% ,&.C.Car-a 9"M co a*-- Last updated. 11/15/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction ' �d� Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method.'❑J MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics El Wiring 0 Oil Tank Storage ` .❑ Smoke Detectors ❑ Plumbing ❑ Gas Y Fire Suppression ❑ HeatingSystem i y ❑ Masonry Chimney' ` -❑ Add/relocate bedroom Water Supply EfPublic ❑ Private Sewage Disposal El 'Municipal ffOn Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway f Debris Disposal Facility: f, I am using a crane ❑ Yes D No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use CSrxbtA'&_L Lot Area Sq. Ft. 430 50 LN. . Percentage of Lot Coverage #of Dw fling Units (on site) Total Frontage A 10 Setbacks Front Yard Required 'IJ�4 Proposed , I . Rear Yard Required .; (� Proposed Side Yard Required,.+ ' l t Proposed _ 2 Has this property had relief from the Zoning Board in the past? ❑ Yes Lid .,No Last updated. 11/15/2018 VAN# tex NEWU.(:Mot&wm&XIMlZES VS INFRARED IjEAT WAVES, Aff H G FATi S �, ,NERATING HOUR , POOL OVER or in-grollild ATAVAVAVA VA ALVAVAVAV above-ground A il iTZ °� �p to awl ' =� ��� dour swim��in� season by up t� six �rr�r�k.,�! � ��� ��atir�g bids by 8�r or more! ����ce E�ap©ration! Sage water ar�d costly r�emical;� t0►.WB 1 t1 AGNA•L ATCH*Safety Cate Latch s nm a sdd p revolutionary breakthrough in latchingscetuity for (( gates around swimming pools,homes and child i safciyurms. Powered by super-strong"Permanent Magnets", l which never lose power,these quality latches incur no mechanical interference to closure and so offer unprecedented reliability,safety and child resistance. vtmeu wu�e.l The popular"Tiip Pull"model is designed I'm utPU WWI I especially far swimming pool gates but can be Fitted to any gate wherechitd safety is important The shorter"Vertical Pull"model is recommended S� for pies at least 5'(1.5m)tall.This model is also known as the"Pet Latch",as it provides security' for pet safety gaits. stu Pau All latches adapt readily to most new or existing aaeeat gates and any gate material.Two models arc key- lockable for added safety. The latest"Series 2"lattices can be adjusted verrienlly eind horhoatedly to ensure safe,reliable latching at any time during or after installatiom Vertical aditrstmeniis quick and easy bemuse the k4GNA@Ml(NhashW ' go latch body slides up and down dovetail-style tracks tested to arse t6mi for easier,sturdier installation. 400,OW CY&matt Horizontal adiusiment is achieved by adjusting a svfmrMagpoolbWW screw within the"Striker.Body'so that the striker 00des MOO gaft10 can be adjusted across gaps ranging from 3IC—I.AC saffAsig WsrllkRfdngihabh6ha j (9-37mm). i}amttltlt ncdmtdthdepeldenryttraedm The"Series 2"models provide extra impact m�tirMsdanatlordtalelyrodes resistance and durability on larger gates and also against heml pedestrian traffic. The`Round Pee Adagor TM kit inchulet#tsi w L�fiGpA•LA tN Kil"Ist VtinmlWfor enckctsaaisK-*toIn mouniina htagoa•tmch eaoanmt cWit tut sad railing Pet Security "Top Pull"ar"\erd at puss diurcters: Pull"W OM to gala Wal t. 11 n 0 uith ,oat pna.. Gate Latch ,� x MAGNA•LATCH is Mitt t 11 j } also suitable for house { t 4 and where �e arcs garden a g B � a r t pet security and pet access control are a important. S Iti Aatetrispeh(ramatr�ingtxdkety 1+ Patal,mnen.i+twr•vas.sttmniG+_M'tapa■„),?'tri77a1m1 rhemwhiIramanWadkrtrM, 0 `l Garrdhmtten:Ri"()Smtnj.Vh`talmmLii?^tagwnm) 1Mt45'uJapbrhnerlad�Ia�'�.la�ge*aa)nfl>h>3: Sately.Privacy A,Security Safctv Gatc Latches F Use the safest... •Magnetically triggered latching —-- •Key lockable safety(two models) •Adjusts horxontall,a►rdvertically •Patented"Lost Motion"Technology coach •Auidc and easy to install apy raag�ed dud _(now with coorertiem sett-dnlGng strews)rmta ryadioceN KEY tOCKA r jj Features Benefits •Potented mognetic sefi4*Wg No modwicol lornrmng during closure i Exceeds intemntiorsol borrier/wfey codes Unprecedented rorinMTily&solely l •Uuotry mow pottram 8 uowess steel No rusting;Noding or coining Adjust i RTI"t •Key Webb(Top Pug&9erfid Pull) Added safety end pemmf-mind In twi •Wty Assurance f10 9001 manufochwer Ufet me Warranty sUartJ s1 •Egneered for ease of iosmlWO Reduced 1"Oflotion time icosh) •fatdins in the locked•position. Exceptiond safety 6 rdk%q C •Won't disengoge from shafting 8 pLffmg Ten'I be forced open •Unprecedented adjusiob4ity Emy to imtag and maintain * •Tested to 4000 cycles Proven to fast the test of rime Maga•lk ORIZON AL trlgg•ring means no resistaiew �F-..�� ;Mr._. s s � -to elosanl r IS0�9mi r¢rttstn "MGM wrecssr euarwsGM 1�NsY yNril Y.idN�il /gNsY L code ` trn _� r�� I �• � �aoad�aAwse��PaP� hlafifa .. r.. 1°"r pad+n 5a'he�to o aide mleip. iL I � _ � at�seheraa�e,la*ahkb�isneedea.R�la. er{te :. 1 ar eita0ve�1®ahNu�ne. . uM g` Whe°owe w0"-agfesft*paolpwgaea�l�q aryl¢shuW mal he used ro prerad loidr amss b�t e L_ r oar t, ' I Qwil6Aadhadies6 two aemaaeemjrw*m a► go^-ltSs'-- ca�rtarWsrtvry sw®ypodo- f°d°'-- AppBmeias s Corm'.., i fdlpPsu FH,paoltQuldSofa(6gks 1bdlVlklie ! _ �`r t•' DetatptlarAdmtmr�oLOU dlhepopdm'fapprA' i m MAI MtdL glani 1he sane hmmes ad a*d h,mtery r v piles"ndwaaLgpooh and dddsafg low,Ahoidad e sd.t- e>/r as o pet pme latch fw.the hodsymd. emne� ta" HigAlpdid resl¢aN,aw�eNrbtrlwq(aa nmd�1 Wr reslsl°omt°tMsoral.t ep ta4 6k for ad�semdN(u91 n t�.c. �o9a6h hmgat deign Awl Pmr tml,acaroie s dtAs. - • .. -9 tosla9otioa ad hap•lath te&perforwaota, ap, fihmost gmesond a4 go Medob WW for gwd(mce I._; i, holoa fin up�rt�wLr-i�/uay..f (aos�t°w f 6v taAmmeshr dgm--�n'�-- - I�dmasweoteot/m�ueotu�0 �.. Alm — mt �pod�emei MA a) I Coda #apputa Color MUD 111virafthidgam*'Gifts w;mRs' Will flamipstoa:lhemmt Popular Mopoataidrmodd.The MW mueu pta lad for safely gales maurdswenmNq pooh and M n° +{I safetra�sahmdoKaecadtrc wa )F rodosaed9dl ktoraddedsaaf'ry.hdlyadlast�taMo- OAK �^ f 11 pan prmldes�stsomaafegodioa� Mir fill moo iftanand d ptel matufA ft Maipaw4ham MRwaft tni�ts6taa dadta9N'111fgmnlgacs/tana asdelotdt'-_ caebekWdWsodwtlherd melmhaomdreAofad KO ue ` dddren � Carrell lad omlwrhbs for h*a /rcmdtmrc+es ) .r awariatYnyp°dpate< W ,o� 4edfec6rtal leer ra. _- t Quick and easy installation MAGN4146ITCH" n *" s 'by wee. HJw6iISJ+tMr INSTAUATION REOUIREIRENTS SAFETY NOTE (Top Pd i VMkd Pd OR") Ahm ImMlohry Wm in frsr4no4 pod ado0w did sdoty y*m-towstirir ems,cost Barrie todos and Standards feSo0 A%b�ed Ved1)'thef UN4repalrernO* o�fibhealvwer •The pool goo host opeo emrl, 1 ar► a �� swap fiat t)ro pool so thefatd mast se dtr k W naives to 6 Fitted to the orfads,of the peel got& j sffedeeFr UN-"ad •The latch noose boob U to be at Mast s Mf lad W II$00m)above ilofshod grooad •Fame 6efght to be rfrr®em 4g• fAs 1 errerFeh 11200t®1 above finished grated Aheays tottfam t)tese rapptirremerds ttith the approprimo lom1 pod orsdet j wd aft in r Your aroe�asioplam rq vap,Inodl cite leer• W In aardoin A local fence UTW lerebB ' reyuloliens for am i Om" owof WOW °/i�I'IN'n-m.a+eatet&dedienaanb WOO L� 'lYd1'/f Ubdadla's7'd'/a lisiru. ' t Suter S"frets to hm to plom WNW amrw*" j It Vortical Poi modal �J r Ago CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 4/4/2019 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Rogers&Gray Ins.-Dennis Branch PHONE FAX 434 Rte 134 •508-398-7980 A/c No):877-816-2156 South Dennis MA 02660 ADDRIESS: mail@rogersgray.com INSURE S AFFORDING COVERAGE NAIC# INSURER A:Arbella Protection Insurance Company,Inc. 41360 INSURED SHORPOO-01 INSURERB:Wesco Insurance Company 25011 Shoreline Pools Inc 32 American Way INSURER C: South Dennis MA 02660 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1614993916 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY) IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 8500052096 7/26/2018 7/26/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE a OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100.000 MED EXP Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECO I T LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 1020013830 2/9/2019 2/9/2020 COMBINEDdiSINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE X HIRED X NON-OWNED $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LIAB OCCUR 4600052138 7/26/2018 7/26/2019 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED I X I RETENTION$ $ 8 WORKERS COMPENSATION VVVVC3395763 2/10/2019 2/10/2020 X PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Additional Insured status is included under the General Liability Coverage when required by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mike Perry ACCORDANCE WITH THE POLICY PROVISIONS. 9 Cap'in Jac's Road AU EDREPRESENTATIVE Centerville MA 02632 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD C�]La�LaG�D° Q TriStaro STANDARD EFFICIENT, MAX- RATED, HIGH-PERFORMANCE - -` PUMP SERIES TriStar is the most hydraulically efficient pool pump that provides superior flow and energy efficiency. Easy to install, service and maintain, fit'=r TriStar outperforms the competition when it comes to flow, efficiency, and value.A super- sized, no-rib basket with extra leaf-holding capacity is a snap to clean.Whether for new construction or aftermarket installations,TriStar is the superior choice. - Ip�W4 o�m �?os oa T lr � fib, t" t s 1 • yilYli.M RUUD 0 @am 0ME" 0 0 , NO-rib basket design Cyrstal clear strainer cover ensures easy debris lets you see when the basket removal.Extra leaf-holding- needs cleaning capacity basket extends Heavy-duty,high time between cleanings. t- performance motor with dynamic airflow delivers cooler operation Tri-Lock cam and ramp strainer cover seals with less than a 1/4 turn Service-ease design: v power-end assembly(motor/ impeller/diffuser)can be removed without disturbing .. plumbing or mounting connections,simply by 2"x 21/2"CPVC removing six bolts union connections makes installation and servicing fast and easy ............................................................................................................................................................................... Additional TriStar Features & Benefits TOTALMAX RATE MAX • Advanced fluid dynamic design delivers superior MODELS HP HP FACTOR. flow, energy efficiency and value SP3205X7 0.94 0.75 1.25 115/230 2 x 21h" 13"3/8" SP3207X10 1.25 1 1.25 115/230 2 x 2'/Y' 13%" • Higher flow rates allow for stepping down in SP321OX15 1.65 1.5 1.10 115/230 2 x 21/2" 13 7/8" pump horsepower for even less cost and SP3215X20 2.20 2 1.10 115/230 2 x 21/2" 15 1/e1, energy consumption. SP3220X25 2.60 2.5 1.04 230 2 x 21/2" 14 7/67/e" • Pressure testable to 50 PSI maximum. sP32i5XW 3.45 3 1.15 1 230 2 x 21W' 15 5//e' • Self-priming (suction lift up to 1 Or aboveDUAL-SPEED MAX TOTAL ' IMENSIO water level) MOI HP FACTOR ZE "A" SP321OX152 I 1.85 1.5 1.73 230 2 x 21/2" 14 3/e" ............................................................................ SP3215X202 2.40 2 1.20 _230 2 x 21/2" 14 7/8" SP3220X252 2.70 2.5 1.08 230 2 x 21/2" 14 7/6" tts3 to.tfi � .A 100 ® so 113.61� It11Y1NARD &16 d 7.63 .a3 O �. 7a , N� v3 TRISTAR 2-SPEED P M, \1 —N� ou TO 70% _ 30 SP3225X30 SAVINGS E r i SP3215X20 P322OX25 ON YOUR ENERGY COSTS . IP322OX252(Low Spd) t— i I SP3210X15 70 f_ '1SP3207X10 TriStar Pumps are listed by: SP3210X152(Low spdj I SP3205X7 0 SP3215X202(Low Spd) 0 10 20 30 40 50 60 70 80 00 100 110 120 130 too 150 160 170 180 100 200 U` NSF C10® Flow(GPM) To take a closer look at TriStar Pumps or other Hayward products,go to hayward.com or call 1-888-HAYWARD 0 HAW WARD, 620 Division Street I Elizabeth,NJ 07201 Hayward and Hayward Energy Solutions are registered trademarks and TriStar is a trademark of Hayward Industries,Inc. 02015 Hayward Industries,Inc. UTTSMR15 I SWimCLear'" ° . ° mom »»» Multi-Element Cartridge Filters , WARNING. �bYE CIS a s i j � MAXIMUM FLOW WITH MINIMAL MAINTENANCE, Featuring an assembly of reusable polyester cartridge elements with precision-engineered cores, SwimClear'"multi-element cartridge filters provide heavy-duty dirt-holding capacity and extra-long fitter cycles. In fact, as the industry's largest filter, the C7030 model offers the longest time possible between cleanings. SwimClear filters' top manifold configuration boasts industry-leading hydraulic performance, facilitating maximum flow through all cartridge elements for superior water clarity and increased energy savings. I _ Heavy-duty,tamper-proof,one- piece clamp provides quick access Reinforced copolymer tank I� to internal components without is durable enough to withstand disturbing plumbing connections tough environmental conditions Low-profile tank base makes { removal of cartridge elements li CPVC 2"or 2-1/2"union connections fast and simple ......................................................................... provide maximum hydraulic performance with 2" plumbing ......................................................... SPECIFICATIONS Filter Type Cartridge elements: z z 225.325,425,and 525 ft (4 cartridge elements),700 ft (8 cartridge elements) Filter Tank High-strength,injection-molded durable glass reinforced copolymer Filter Element Reinforced polyester ................................................................................................................................................................................................................................................................................................................................................................................ Performance Range 84 to 150 GPM,318 to 568 LPM C2030-24"W x 321/2"H(58 cm x 81 cm) C3030-24"W x 341/2"H(58 cm x 87 cm) Dimensions 1 C4030-24"W x 401/2"H(58 cm x 102 cm) C5030-24"W x 461/2"H(58 cm x 117 cm) C7030-24"W x 521/2"H 158 cm x 134 cm) FILTER PERFORMANCE DATA MODEL ; EFFECTIVE TURNOVER NUMBER FILTRATION AREA DESIGN FLOW RATE* 8 HOURS 10 HOURS . ........................................._........................................................ C2030 225 ft2/20.9 m1. i 84 GPM*/318 LPM 40,320 gat/153 kl 50,400 gat/191 kl .. ...........................................................................................:...................................................................................................... C3030 325 ftz/30.2 mz 122 GPM*/462 LPM 58,560 gat/222 kl 73,200 gat/277 kl .. .............................................................................................. ..........._....../_...0...................._...._..............._................................................................................................................................................................................................................_........._...... . . C4030 425 ftz/39.5 m2 150 GPM**/568 LPM 72,000 gal/273 ki 90,000 gal/341 kl ..... .............._...._.............:.....................................................................................................:............................................................................................._....... .................._.........._...._...._............................._...........................,.......................Z.......................2..........................................................................................._.........._ _ C5030 525 ft /48.8 m 150 GPM**/568 LPM 72,000 gat/273 kt 90,000 gal/341 kl .. .............................................................................. C7030 700 ftz/65.0 mz 150 GPM**/568 LPM i 72,000 gal/273 kt, 90,000 gat/341 kl *Based on NSF recommended rate for commercial use at.375 GPM/ftz **Determined by pump size and piping system hydraulics;2"piping is recommended for flow rates equal to or greater than 90 GPM(341 LPM). Hayward doesn't recommend flow rates above 150 GPM. >> 'hayward.com > 1-888-HAYWARD SwimClear Filters are listed by: NSF ................................................................................................................................................................................................................................................................................................................................................................... Pumps >> Filters >> Heating » Cleaners >> Sanitization >> Automation )> Lighting >> Water Features >> White Goods ................................................................................................................................................................................................................................................................................................................................................................... Hayward is a registered trademark and SwimClear is a trademark Hayward Industries,Inc.©snot Hayward Industries, ®� HAYWARD® Inc.All other trademarks not owned by Hayward are the property of theirit respective owners.Hayward is not in any way affiliated with or endorsed by those third parties. I LITSCME17 ram, HAS AR,D m a z 'y �� R4YWGR0 E_ HeatPro I HeatPro, '� -� Reliability efficiency and °`� = a quiet backyard too. • Ir Ak i i j �� Oft, Heat Pro° � ��CERTIFIED. IN-GROUND HEAT PUMP Total System: Pumps I Filters I Heating I Cleaners I Sanitization I Automation I Lighting I Safety I White Goods T u I 0 � G - o � [� o a U LJ D O • a� j p r I j Y J t R ell r �f t- i Io- cK ^ • �c„�C71, o� .7 c Y � Y o oil ........................................................................................................................................................................... LIGHTWEIGHT DESIGN. HEAVYWEIGHT PERFORMANCE. ............................................................................................................................................................................ Don't let cool water temperatures limit your swimming enjoyment. High performance, energy-efficient Haywardo HeatProo 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- �0 Ensures efficient air flow and PoSideaextrEmaduorabt Fquietoperation. ity;especially 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 He'atPro heat pumps incorporate titanium counter-flow heat exchangers for unrivaled and uncompromising performance-even under the .. N. harshest conditions. Other premium features include: >An Ultra Gold corrosion-resistant evaporator fin for extreme durability, especially in coastal environments �w I > Heavy duty,super quiet scroll compressors >Durable, injection molded, UV-resistant body panels HeatPro-I that are impervious to rust and deterioration > Stainless steel hardware >A polyethylene screen to protect the evaporator coil and maintain peak efficiency 6L I"- Plus, Hayward HeatPro heat pumps are lightweight, compact and easy to install and service, making them ideal for new pools or enhancing the one you already hav 'Nos e. c w "Y HAYWARD°HEATPRO° HP21104TC HP31204T HEAT PUMP HP21004T HP21124T HP21104T Low HP21254T 1AP21404T Ambient Heat/Cool • 80°F Ambient Air,80}F,Water, •• • ••• • •••, • ••• ••• • ••• • ••• 80%'Relative Humidity* 80°FAmbientAir,80;FaWater, ,• ••• • ••• • ••• • ••• • ••• • ••• ••• 63%'Relative Humidity* 50°F Ambient Air,,80;F4V5ter, ••• ••• ••• ••• :• ••• ••• : ••• 630 1Re15tive Humidity* COEFFICIENTOF •- 80°F Ambient Air,80}FjWater, ®®® 80%{Relative Humidity* 80°F Ambient Air,umidit *A ®®® 63%Relative Humidity* 50°F Ambient Air,,80°FaWater, • ®®® • • • 63W RRelat:TA Humidity* Electronic Tem erature Control Thermostat-Dual(Pool land jSpa) i kW Input t Voltage •• .• 1 Minimum Circuit Amps ®�� Minimum Overload Protection • ®�® • • • Maximum Overload Protection •• ®®® .• .• .• Water ,I o—w Rate,(GPM) • • • • • • • Recommended Minimum/Maximum ®®® I Plumbing Connection 1 f Refrigerant •• • Dimensions,(inches)W=Width, • • . . • • • I D=Depth, H=Height,DIA=Diameter ®®® } Net Weight(Ibs.) 165 ®®® •• • •• j Shipping Weight(Ibs.) • • • •• •• •• 1' 1' ..:9:CERTIFIED- s`+" _ n Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvemen Contractor Registration Type: 'Corporation S Registration: 161240 SHORELINE POOLS INC 32 AMERICAN WAY Expiration; 10/06/2020 SOUTH DENNIS,MA 02660 d 9 w F Update Address and Return Card. SCA 1 v 20M-05/17 .................. .�e �m�rroirurca�l�a�///Gavv�iuvel/: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individ use only TYECarporation before the expiration date. f nd return to: s Reaistratron• Expiration Office of Consumer AffaIrq00anV Business Regulation 16`1240� t0/06/2020 1000 Washington St et ui 710 hl - Boston,MA 02118 SHORELINE POOL_ =INC,= CHRISTIAN DITTRICH 32 AMERICAN WAYS SOUTH DENNIS,MA 02660 Notly6li ithout signature Undersecretary Apr. 9. 2019 4: 11 PM No. 1265 P. 2 ToWn of Barnstable ' j Regulatory Services Richard V.5calL Maz;t r 16 Building Division, Paul Romn,Bi M mg Com=4ssioaer 200 Main Sbtet,7�yamnis,MA.02,601 wvc'�:to�vn.bartisfiabie.tna.ng . Office: 508-867-4038. Pax. 508-790-6230 Property Owner Mfist Complete and Sio This Section If UsiM A B ilde,� as 0W=of die subject propeay hereby autLAze J'" ?,e lS to act au-mp beba4 Yn all matters rela&e to work anthox zed by this bldlding pemait applica-ti m for: (Ad.dresa of Job) - *Pool fences and alarms ate the zesponsibilitp of the app ' t Pools ' are not to be filled or utilized befott fence is instfled all final iuspecaons as erfotmed and accepted. �,14, suture of cz Sigua f cant z-e-lzrrI,( Print N=e q • Date' QFOT�tvlSU�SR85CO2�OOYS TOWN OF BARNSTABLE r = PERMIT CHECKLIST Sift off hours for Health aad Conservation are 8-9:30 a.m. and 3:304:30 p.m$ A complite permit iWplicadon includes,lltit g all sons 1-13 1. NEW STRUCTURES/REMODELING/RENOVATION/ADDITIONS Site Plan showing setbacks of proposed and existing structures ❑ Commercial—One complete set of full sized plans one reduced 11"x17" (plans may require a stamp by an architect or engineer). ❑ esidential - 5 Sets of floor plans no larger than 11"x 17" smoke/co detectors marked Worker's Comp.Affidavit and policy(if required) ❑ Res Check or COM check from the 2015 International Energy Cod Council(IECC) Letter of financial Interest for new houses only(not required for rebuild after teardown) _ ❑ Performance bond made out for$4.00/foot of road frontage(new construction only) i 2. DEMOLTION OF A BUILDING (NOT PARITIAL) ❑ Everything above plus shut off letters from following utility companies: El Gas ❑ Electrical ❑ Water ❑ Sewer(if required) 3.-DECKS/PORCHES/GAZEEBOS/INSULATION/SOLAR/POOLS/SHEDS 9 ite Plan showing proposed location onstruction plans showing framing detail(if new framing), QPools—Barrier details,pool specs(engineers design) & Workman's Comp Affidavit and policy(if required) FAMILY APARTMENTS ❑ Section 1 Plus: ❑ Family Apartments are subject to approval from the Building Commissioner. Agreement must be signed, notarized and recorded at the Registry of Deeds and returned to the Building Department. Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License a Expiration Date Contractors Email Cell # I understand my responsibilities under rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State BuildCode. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your.license.',. . Signature Date Section 10-Home Improvement Contractor Name CRPj5-t)trirt-A S6PAW 0o STelephoneNumber ` Address 32 14 ftcAtO City SlWhjx�:j State Zip 02 (rv© Registration Number I 612 4 V Expiration Date 0 k 04` 2Z0IZC) I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Mass r State Building Code. I understand the construction inspection procedures,specific inspections and documentation y 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... l Signature I,.,- ate ! d Z ' Section 11 —Home Owners License Exemption Home Owners Name: M%)Cg- L Telephone Number 1,1 4- 8 3(e-190$ Cell or Work Number 11 4- $'3(o- `j 01K I understand my responsibiliti unde the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts Sta uil g Code. I un d th construction inspection procedures,specific inspections and documentation required by, 0 C d the WA le. Signature Date LI ANT SIGNATURE Signature Date Print Name Iris i ;� Telephone Number E-mail permit to: Ch•is IP Ve%orc U.,me- mks Is 1mr- cAw, Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I i L S&L. JtAA _ , as Owner of the subject property hereby authorize t-tj f Qwkhor!�!j to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 11/15/2018 • Imperial POOLS MMANUFACTURING - r January 2013 - Mountain Pond 22'x 36'Left AfoD �: K eroc 47514• ,y _-4 A{ ,9 ,9 A Kr fr B A 9R OR ,9 19 B y tORR IORR F Rt9 R,9 521/4' 11'-0�' 52114' iy 9R DR R9 W 67 21' ST X Y 9R SR I 87 11$' 21'64 63 R9 G R9 i A' _ 1s•T 2,'•Gk' 1T 1014 10,4 + 'I 19 1T4 22 101 194T1T4 16, T -—- E 1E IV,4- F - U BR 9R } 67 ,5••T 87' 19 19 /f1R I I W Z C 9 L R 571�/4• 521�N L- 667JD C JD SR OR FTJ' 9-11• 6'3 R19 1 / ' T-AfRAME SRACE � DIVING PERMITTED ONLY FROM ' DESIGNATED DIVING AREA. i 1.Pau 2500 P.S.I.an W tooft around entire perimeter,rninlie n 9• FROM A TO: FROM B To: Fmw C To: Ni3311T To: FRou T To: FROM U To: H (IOM E 1s•1tr E 04V1 E 17a73T9' trz- E •Y E 'LT�S 4� 2.Back IH with dean eaM•bee of toots end debris. f 30-4 1rl' F 1s•IP F WNW 1? 314' F 2TS,!<' F 9 3 3.be--We deck b ro be poured at,eml 3 dsolmew and a dope o 2V-3 3W 0 29.3 314• O 27.4 3W' 314- O 19.7 3W O 19.7 3/4• oty'ei'6wey trorttae pod. H :5.91rZ' H 34'•91? H 19.9 H 2A'-714' N 24'•714' 4.AO Wide pod ototeralom me to be Malted dYltenslom. J 9-0 i? J W:S 1? J 29$ 1 W J 19-10• J 3S.6 1? 5.Fldshed bon orn ts to be 7 mlriann of SUMM metedd or undisturbed rbed K T•S 1? K 9S 1? K 41'-0 1/4• •C K 35'S 1(t K 19.10- auth, W 24'-0 1? W 31'-0- W 13'•31? 114' W 1SS 1/4' W 24•-0• 6.A solely.D.. d. t U amid,b to DB petmoove.l•esadted 14'to tle X 9-9 X 29-0 1/4' X 19S' 1/4' X 111•9 1/E- X 30-014• I M.D..w Nde Of Ste : Of Ore elope dtage. V 29-0 1W- V 94r V 33-10 114• -0• V WZ 14• V 11-0,?7.CauVn¢Ibn Dtewing:O9fmmtl mdtmdn b, k b.0.coa Ir.W oe Z 311-T Z 24•9 1? Z 23.2 1 11T Z 2BS- Z 15'11 114' rlkdstM M valaw mcr..+mmklore.THs 4 kt to rktkrrraietllry trtd Is 0te tmpons0®y,of the ow&acb who is not en agent of the masradtrer 01 the canponets Pais. &ktadtadon Is to be date In accordance with e5laaerel,slag and lord bu➢attg codes,as well m AN.S.1/A.P.S.P,suggmled sordar a. lee Damncorao mwt_eomvnroemicncenhavNova _aeew.n rrMabpo[d e00iwm ba..lt m.n4tl.e44Mkp. vteS.p.ebnvV 2 2 !' Volume: 20100 gal 76100 L Perimeter: 96'-2' 29.31 m Surface Area: 609.08 ft 56.58 m Liner Sq.Ft.: 655.8750 78 1 w awww w - - v Hug P ? Wf WN w or g B Z@ 6+Q�� (P5cc yN x g66 I9 g I C m Z T4��C ~ �yyyy yyyy rir�p yy ~ W E - O 2 9a a Q aaoa4 � zY42�sg y 7 ON N� W N $ �5� b a �g �Is. � pig *pepipipi'a ','e• V D oz X o cN oN # s 1 s W.. 21n ��- �"PP� o Z T i Wz nl QeT C O p y $ N $m`r'� `N:1 d 3F x A4a D o,i o N 9 S sa m3 a >aee � n1 m v0 n 9 (n 3 C O m m In' D m D�OIT, O r g y S g B m a "'I <m JA vat ono ��1 cZi q$q9 bo88'r� m &g8yr�8_888& A j . / �8N o>a$�r�SNe"iN0 � w Z��. `s __-_-_ '__'�.+-.._,C�'-�--s ._ •.S T-. •(�..•.r..• 6s� ;ep�$ C' D,r - _ _ _ _ _ _ - _ � VJ N� NO STAIRS O 9R x STEEL STAIR S' n� 1I tl D RADIUSIUS PLASTIC STEP t ! I 3$ N d II,\ :j Zr M [� m 03 I E O j T D 0) D D Z 'i (n C o ? - L x M .' �.OCD (D N .. . • �DNxN IrZIN^ N���3I rn m S NOC rn F nm U�2 CD O 7m C oAr? 0x ..MM m 3p>Z 0 IN cO00 zm°OCm O ; I F; I T �y m`a b41aa��9b�j� h4aa"oQ>sv TT k7.N 9c oe ery?jaoSeioA u7 y d 1 � ,� o y y � p ��• �, coV n a y m ��9�a ? � � � � zCzn7 c y y e-3� H 19-1r O "bw>@INN^ °en , U ?10 � zj �n R° �' �' � D m� m lq sad' N 93a a p z C o�Di 1�11 w -' 4 " CVA 7 -l trl 7q �T] F eNC 1e +�—p o�a 4'-0a'�TT s 1�.- 0 H,0 ,0 .� C ? Z a b/ 4•-3�- ; 9'-,1• d ti 0 © > -{ L 4 n� o Z I 4 a6-t3 a�ADS 9� . IdN F. x p� �t p A $ :0 4'-10 S•'d 1 C" f� E171 7tl 4 f -3t- � y rd n I rn Cl) ' I y'ar 00 n Z Y o M 3N' y I � I I Asa arc con CD '� CD O w m n r S o 1 5 CD 22 CD , C d �rIn 1 cn AL n '-: Fl. C) ON 117 CP L.A d C7 d I i SERVICE ROAD Ra2721. 07 A-150.00. LOT 5 4 �� 43, 560 SF. I 0 1 O Q 0 p0 V,.�\ 00 N CL ub89 tiry o � o ? so.00 R o< 5� A 297 53 "W S 72,0044 j "TO THE BEST OF MY KNOWLEDGE. THE PLOT PLAN OF LAND ( FOUNDATION SHOWN ON THIS PLAN IS AS L OCA TED IN IT ACTUALLY EXISTS AND CONFORMS TO WEST BA RNS TA BL E - MASS . THE ZONING REGULATIONS.,.jM.''tIE-:IOWN OF BARNSTABLE. REGARDING.YAAD`.SETB,A;*,5 PREPARED FOR DATE.' JAN.20, 1999 p`�` 'y '•''' •_ CENTRAL CONS TPUC TION CO. � _,�_ ; DA TE.' JAN.2B, 1999 SCALE. 1"a40 FT. 77 ►cjr�`=�'w$�� CAPE 6 ISLANDS ENGINEERING FLOOD ZONE NON—HAZAR 'y D-69 5C ^ L=AN�� MA SHPEE — MASS. i r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map , Parcel `�'' Permit# ll 0 as Health Division )15 /` Date Issued Conservation Division 11 wz, Application Fee 00 Tax Collector Permit Fee 6-0 - Treasurer aoSEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address Village efftL& Owner LLL a.L4 d„aA 1 �P1 Address !?C. Telephone �— Permit Request e_ e I a Square feet: 1st floor: existing proposed 9o9- 2nd floor: existing proposed �Z Total ew Zoning District Flood Plain Groundwater Overlay C, I Project Valuation g�e& Construction Type ^ Lot Size Grandfathered: Cl Yes ❑No If yes;attach supporting documentation. I cD Pi Dwelling Type: Single Family Zr Two Family ❑ Multi-Family(#units) y Age of Existing Structure ems✓` Historic House: ❑Yes ,010 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 L5 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 garageA-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 BUILDER INFORMATION Name / ��r� Telephone Number � o �1''3'�� — O9 Address T"02 V R, License# �4t►W S,g�.4 /P AWr . �a Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY A �• J A Pr 9 Y PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE � OWNER DATE OF INSPECTION: ' FOUNDATION FRAME v ' INSULATION _r e FIREPLACE ELECTRICAL: ROUGH FINAL 1 a PLUMBING: ROUGH FINAL GAS: ROUQT% > FINAL y r mO 03 FINAL BUILDING t?7-1 ? rn n DATE CLOSED OUT C — ASSOCIATION PLAN NO. �— � " 2v m 0 Rr h �� r 5 Aw C Nk `y t � y - l _r► r- .r - = - - rf��r r The Commonwealth of Massachusetts - Department of Industrial Accidents 600 Rrashington Street 'L Cj Boston,Mass. 02111 P Workers' Co m ensation Insurance Affidavit-General Businesses address: &9 � t, e state• work site location fu address: e Retail[]RestaurantBar/EatingEstablishment am a sole proprietor and have no o e Business Typ : �Office El Sales(including Real Estate,Autos etc,) wor]ang in any capacity. ) I am an ea to er with em ] es(fullother /l//P.lr%%///j/o%r� ,//%/ es wor/k�'n oa this job; I am employer pr g Wprkers, oompensation for-my employe � ; ,.,;, r• .f; ; ;• :is- '• ame: ,7- SIIV n ' Cam .. •`�..'C'J� . . .q..•.f;1y,t:.• • :i. .'••• •,,.,jt: •1 a'aai•�ss� ;;; t. •�• 1. : .• •'�; `'•' •• '{:\:,• ':,. ;: •= �" hone#••• r •Gifu: •, •t. . .. .. ., i :,. ',. \ ,,• . ' instiranee.co�e . Workers///� vthe independent contractors listed below who have the followingI am a a. compensation polices:Jd ; ,•E: r' :.i'{'t 4;�, 5:a ,rj i ei 7-777 ice c ; . < / /insirn 91071, Q { . ' J•. .'':: :. •:1'-,\1'1� .r - ;r`{n* .,i�'i„i' f.• .t -�'�t,r't,y' Y.. .I.: :'t,. •.j..• :'••'• _ com•en�,,ine . • ,,::\� 'honed:' ;;';.....•'•- Cliff':' .i.� v„t.�. .y�. {•:� `.1 :u• 'tY�. "�:" ✓.tr•.•� ir•,f.-- .. 'jam ��',• •• .i;'.a" :`}•`•!•':C' f�`•:. 1. olicy. •.".• .,,• .r .1• i•IISl1taDCB'C0:�..•,n : :j=" .. '� / Fallure to secure coverage as required wader Section 15Aof MGL 152 caa'lead to the iniposttioh of criminal peaalt gf a tlae S1;S0 ud sin p one years'ltaprisonment ss well u ctv11 penaltln is the form of a STOP'FyORK'.ORDER and a isne of$100.0U a day n ainst mm Sr copy ottlils statement may be fornatded to the Office of InvaHgntlom of the DTAfor coverage'verification. I do hereby ceri' un the pains and p aiiie f perJary Thai the inform ation provided above,is true and correct � ��- Sigaature Phone# Print name ' oitefal we only do not write in this area to be completed by city.or town official permit/license# ❑Budding Departmnat city or town: QLlcensing Board ❑selectmen's Office ❑checkif immediate response is required QHealthDepartment , phone ❑Other eontaetperson: - -(1•ev5ed9epe1oo3) _ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires an employers to provide workers' compensation for their employees. As quoted from the land", an employee is defined as every person in the service-of another under any contract j of hire,express or implied, oral or written. i An employer is defined as an mdrndual,p�efship, association,corporation or other legal entity, or any two or more of the foregoing engaged is a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnershiP, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or, building appurtenant thereto shall not because of such;.employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance dr 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 com=onwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until liance with the insurance requirements of this chapter have been presented to the contracting acceptable evidence of comp authority. WIN Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Departrhcnt of Industrial Accidents for confirmation of insurance coverage. .Also be sure to sign and date the affidavit The affidavit shouldbe returned to the city or town that the application for the permit or license is being of Industrial Accidents. Should you have any questions regarding the•"law"or if you are requested, not the Department requved to obtain a workers' corupensationpolicy,please call the D.epartrnent at the number listedbelow. . City or Towns Fleasebe sure.that the affidavit is complete and printed legibly. The Departmentbas p-rovided 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 b'e used as a reference number.' The affidavits iMy be returned to. the Department by nail or FAX unless other arrangements have been made. The Office of Investigations would hate to thank you in.advance for you cooperation and should you have any questions, please do not hesitate-to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Offico of Igyest 2dons 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 Town of Barnstable Regulatory Services swutsrna , _ Thomas F.Geller,Director MAM ' Building Division QED MP'��• Tom Perry, Building Commissioner 200 Main Street, IJyamis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize: to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name �FSHE r, Town of Barnstable Regulatory Services snRNSM33 1B, i Thomas F.Geiler,Director Mass. %6s9. p�0� Building Division lED MA'f Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME MROVEN ENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. pp n Type of Work: Q['0►n�4 c aiLA �^ lQco ��'` d�stunated Cost t7 Address of Work: � Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law ❑Job Under$1,000 []Building not owner-occupied UOWRer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ROVEMINT WORK DO NOT HAVE CONTRACTORS FOR ARBITRATION PROGRAM OR GUARANTY FUND UNDERMG 142A. ACCESS TO THE ARJ3 _ SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav � G _ a 2 �, o k. .. � _.,_... r� � .�._ i _ � j.- f t i +.n..- w.-�i. V.y.e .T1i� f 1 i f � - - f ,. � �, Ej � �' ( 4 },� � ��. �' i '' �" � .. _ € _J � � r. f -�_-i ` � ` \ � t _ � � � � � � -�� � � f E - �� � � � � � -� _ �. I SERVICE ROAD R-2721.07 A-150.00 LOT 5 7 - 43. 560 SF O Q O Q W 63 • � O . CL ti0 h0• m 1 � .89 90.00 0 \ -5G Q A_ 29705AAoW S 72. "TO THE BEST OF MY KNOWLEDGE. THE PLOT PLAN OF LAND FOUNDATION SHOWN ON THIS PLAN IS AS LOCATED IN IT ACTUALLY EXISTS AND CONFORMS TO WES T BA RNS TA BL E - MA SS . THE ZONING REGULATIONS '._,M' E--;T_.OWN OF BARNSTABLE. REGARDING :-KAAO' SF�TBA;G'lF,�S" PREPARED FOR DATE.' ✓AN.28, 1999 q�> "�\c -:, CEN TPA L CONSTRUCTION CO. L• DA TE:✓AN.28. 1999 SCALE: 1"-40 FT. CAPE 6 ISLANDS ENGINEERING FLOOD ZONE NON—HAZAR � '•� o-69 5c -- MASHPEE — MASS. r: T ram. APR S• �o ;7 I Fist-Class Rare Central Construction Company, Inc. 261 Blackthorn Drive• Marstons Mills, MA 02648 Owe 1- II �Y--I M M a } i` /I / I t �t MEMO 1 TO: Barnstable Building Dept. FROM: Steve Devlin Central Construction Co. Inc. DATE: March 31, 1999 RE: Insulation Inspection for #9 Capt' Jacs' Road in West Barnstable Dear Richard, Once again, thank you for your cooperation in the wake of my screw-ups. As promised, these are photo's taken by the drywall hanger of the insulation as it was installed by Cape Cod Insulation. I also formed all penetrations between floor and ceiling. If you have any further questions I can be reached days at 776-0516. Otherwise, I will see you soon for a final inspection. Once again, thank you. Sincerely, 5feve nevi in r r { b, { I , �,��: _,- :�.= ,. ,.�,,..q..s . P� Y t it J.�� I 7=CMRAppmmftj Tah1@A=b(eoadnaad) Pnwi fWv9 Packages for&9 and Two 4hmily Rnfilmod l l3utldlap Heated with Foal Fade MAXIMUM MINQHUM plug Glazing Wing wall Floor Basement Slab Hemaag/CooliaB Aegis'(%) ' . U-v h z R-value R vaiw'- P vabd Wall Ae== fiPPmm EM==CY' Paetcaa_e,l I I &valua' &Va ud 5701 to 6500 Readuc Degeea Daw Q 12Y. 0.40 39 13 19 10 6. Normat R 129E OM 30 19 19 10 6 Normal S 129E 030 3E 13 19 10 6 ES AFUE T 15% 0.36 3E 13 2S WA WA Norma! U IS9L 0.46 3E 19 19 10 6 Normal V 13!5 0.44 3E 13 2S WA WA U AFUE LAA 139E Om 30 19 19 10 6 ES AFUE . 18% 02 3E 13 23 WA WA Normal 189E 0.42 3a 19 2s NIA WA Nommt 139E 0.42 3E 13 19 to- 6 90 AFUE 1V/. O30 30 19 19 10 6 "ARM 4 , 1. ADDRESS OF PROPERTY: S -VJ L< 12,u) U i I C; 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 31 S►� { 3. SQUARE FOOTAGE OF ALL GLAZING. I �1S a 4. %GLAZING AREA(#3 DIVIDED BY#2): I � S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a APPCnCUX Footnotes to Table J5Z.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirem ent. For example,3 if of decorative glass may be excluded from a building design with 300 if of glazing area. :After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in acedrdance with die National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness-over the exterior walls without compression, R-30 insulation may be substituted for R-3 8 insulation and R-39 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R values represent the sum of the wall cavity insulation plus insulating sheathing Cif used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R 19'requirement could be met-EITHER by R 19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements.apply to wood-flame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction: The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. ` The R-value requirements•are for unheated slabs.Add an additional R-2 for heated slabs. • If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available,include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1114 Parcel Permit# Ll Health Division ��7��/ /2 /7-�� Date Issued Conservation Division �� 9 Fee °d -Te*QU otor Treasurer ( - __ �� SEPTIC SYS 9 a BE Planning Dept. ''' - , INSTALLED" __IN Cc,..., -:ANCE 1-11 Date Definitive Plan Approved by Planning Board c� ' 3 %�':ITH TITLE 'ENVIRONMENTAL C_ AND' V Historic-OKH Preservation/Hyannis TOWN REGUL�f;i d- Project Street Address 0, JCS Village u t to -PAg-)s-b43 Le- Owner hZk , 1 e All L Address loa vil s-S Telephone Z Permit Request VU c ) Square feet: 1st floor: existing k1 - proposed ( �6 2nd floor:existing N14- proposed �JA Total new l3�6 Estimated Project Cost 000•oo Zoning District Flood Plain Groundwater Overlay Construction Type i✓UUA - a <- Lot Size ( 6-cr-C.. Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ICJ WJ Historic House: ❑Yes U No On Old King's Highway: ❑Yes ¢YNo Basement Type: 'E Full ❑'Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) h Basement Unfinished Area(sq.ft) ,Number of Baths: Full:existing new Z, Half:existing new Number of Bedrooms: existing new 3 +� Total Room Count(not including baths):existing new First Floor Room Count J i Heat Type and Fuel: O Gas Cl Oil ❑Electric ❑Other Central Air: ❑Yes &No Fireplaces: Existing New l Existing wood/coal stove: •❑Yes MINo Detached garage:❑'existing ❑/esize Pool:❑existing ❑new size Barn:❑existing El new size Attached garage:El existing new size `Il Shed:❑existing O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 6<0 If yes,site plan review# Current Use Proposed Use 4) -CA/0 41 l BUILDER INFORMATION Name � -Lvvi w W L.j Iv Telephone Number Address Z b( J wo"r 2.o License# �(r) ct k N M_yrgpS nh6�s • Home Improvement Contractor# D SZ 0 Z(If f— Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO m(c,ai/) 0 I j 0 , r SIGNATURE DATE l I ' FOR OFFICIAL USE ONLY PERMIT,NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: a 4 K 1 FOUNDATION FRAME INSULATION FIREPLACE t r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,r t GAS: ROUGH FINAL FINAL BUILDING r • t DATE CLOSED,OUT ASSOCIATION-PLAN NO. ' r M V + • TOWN Of,' BARNSTABYS. 6D, IT u-1 1 ILDT' ?Eal I'" ",'D 19 4. 04', '3HOBRS" ID 12135 J C, Tim'. F, I H N Ell J.L WIT SIZE, -7,a "i"VELCKINENT D"SM1111" i-1.1' WF-11 PIESCRIPTTON -NEW 3 WPM S)EW i_; T Y P R HTLE NEW RESIDENTIVJ BLDG PMT N TD q t4 T;� rj, GUE,�, gj� k V L ..I Department of Health, Safety and Environmental Services $2'19 .00 $90 ,000.00 r ij..,,!L� DE TACKED 1. PR I VATI? P, S Ti A EgkAlkiN BLK MASS. 1639. BUIL 1 .6, wISI N B EXPIRA"MON DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU_ (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 �//2 9' /� 3 Aq 1 HEATING INSPECTION AR OVALS ENGINEERING DEPARTMENT 2 B ARD OF HEALTH OTHE . UP SITE 6LAN REVIEW APPROVAL WORK 9FALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CO '. INSPECTIONS INDICATED ON THIS '(HE INSMECTOR HAS APPROVED THE STRU,"i*:.4 WORK IS NOT STARTED WITHIN SIA CARD CAN BE ARRANGED FOR )y VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTE" TION. NOTED ABOVE. -ION. 4 TOWN OF BARNSTABLE a ;, CERTIFICATE OF OCCUPANCY PARCEL ID 194 049 GEOBASE ID 12135 ADDRESS 9 .,CAP'N JAC'S ROAD PHONE WEST BARNSTABLE ZIP - i LOT 5 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 38115• DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: pk THE BOND $.00 ( CONSTRUCTION COSTS $.00 �T 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P:' .BA'RNFrABLE, •' - MASS. 163 BUILD �IVIS BY DATE ISSUED 04/29/1999 EXPIRATION DATE TMN PARGAi, D ]94 041.4 G►?nBE.Si ! 0 1 ,13 , AD>> D ('AP'1,, JPC'S P.J)AP, PHONE z 1,P I,Om a OLOCK +A`i' S' .F - Or:4 DEVRU`I NEi+T' LiSTRiGf W8 35,193 DgSCRI PT TON M RW 3 3PRi9 SEWPT0 96-78 A IER74T'1' TYPE: RJLLD TITLE f4EVJ R.�.'SIDENT IAI, BliPt, MT ('ONTPACTOnS- Di-%V r,I N, STEPITEEN Department of Health, Safety and Environmental Services TOTAL $2'19.00 �THE $.00 , ('-N4ST'3()CT1ON COSTS $90,000.00 !O1 S r:rc.LE FAM MvE DE'TACHE.D 1 PRIVATE P *i' STABLE, •' MASS. ED INI�►I BUILDING ISIQN Oi,�Tt? I.CUED 1.2/10/1993 PXPIRNfION 0A` E THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. STREETPOST THIS CARD SO IT IS VISIBLE FROM I I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS V OK 2 2 2 C 3 1 HEATING INSPECTION ROVALS ENGINEERING DEPARTMENT PAX OAS �/Znzu r?o If r/0t-4�' 2 B ARD OF HEALTH J J' OTHE SITE 6LAN REVIEW APPROVAL WORK 4FfALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS JHE INSPECTOR HAS APPROVED THE STRU,;. ;NIWORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR 3Y ARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTF TION. NOTED ABOVE. �_� TION. I I i I . i i j i i i i I i I ^ I - r , i i I I I . I I I I i I� I. . I ;;..t'.r:: ..;..... 'PROJECT TI E ��PR TL i rLoa P 2pr Z�IL I 244 ' .. � � -Ucry+•�.Rn.q rc.rc.�cw_ `.i f� yl ....__. ... 1 N en ^. ♦ \ ^1�� _E'4RnK 1 LLI.2Z � ZZ 717;V V 6 u h S,c LSZY NI _gC 0.2_(IItIS'C� _- z�Ly — 2a2y vrLy I PREPARED FOR Cer.Y;nl Construction Company, jrzvr l)rtdnr•Prriir<rnt ` 12 12 I� — g ;6:.S'Irck:.^.an Orive•Mnrs!ors Alills,MA 01648•SO•.3.i$1 C+`s I c I I SCALE --JL)WC r- L :?RAWNI 1 noh__.��" hO.---- SHEET G.' c• ..,..... ... ..... ,y �'PROJECT TITLE - ... pROpdscr� (z-ca fOtuc<. _ 00 S e2V r(C?A ' IIITI tea„— IFT y--- 4v • - I PREPARED FOR Central Construction Company, ---'-- = Srrur Dnrlrn•Prc1rClnu I b 261 Blockihom Drive•Morslans Milh,MA 0264E•508 42G-I:p SCALE( s,= '1 0 \ DATE DESIGN ti CHECK DRAWN . JOB NO. SHEET OF 64 zn `PROJECT TITLE '•;� usc�...R J�ocs.�t� ---201 — — — -- _ I. CuNrcnvi�Iz Al'1SS -_-S _ 16, i ' 3 I co \/' El_ ' I g Ll 3 IT i 4'r�°n4 I I , IL 1� I �I PREPARED FOR Central Construction Company, Inc. Sw,e Dtn(i,,•Prrsidnu 261 8iocklbcm 0,ive•I,icnlons Mills,MA 02648.508-420.1340 SCALE 0 i j DATE --- — DWG NO. DESIGN __�_t�,ti CHECK 3 { DRAWN JOB NO. - — --1 SHEET OF A% PROJECT TITLE PRo JCC RCS 1O CUCe- ! 2 O Kip -T-. D R�Of.2 Yu•+T i �+ IZ � � Q Q�F �S 2 t KF , S.°_F�'<T.V{N� �J��.SJ_Vn.Tr^r✓ LK7C HC4ort,S R Ir I SuL4r--ir..J ZI(�(SryAy I[,"O.L _ I s SNP PREPARED FOR iSly T+c F.iR <c.•�rN r Du 2clu F6p �alirs li' o.0 ZXT Prim ZY-f-pr1jim —._ .. K.L�li.3ys.gnua• 1 \ 4 PT z,j9_+sJbICA xcv S_.51Q4 Central Construction Company, Inc. (bl Srnrr Drulin•Prr;iArnr 261 8lorklhorn Orire•Morslons MiIIs,MA 01648.$08-420-1340 SCALE _ '1 , I 0 r I DATE Se.cr�Du _fi�nrv. DWG N0. DESIGN SrnGUL ti I CHECK I i DRAWN JOB NO. SHEET OF - PROJECT TITLE co�'� �. ,�;+ (fjl l SCLIVIGC R-U-- ��CK r L7 iY Y 'I s l cl _ Fog � 7) _�, s 4 i s`� I rl _ :i • �rym IL a— ; z'2' i lttr r PREPARED FOR —\'- L'r`f•.i%, _!) Sii r .tF Q•_:ie�:e.:a`.`t L"i'!, Lr�rE . _ I _ I ,r/1�..�--- - -- --- - - - -- --- -� , AWN- - I • s° i - - = The Commonwealth of Massachusetts -- — Department of Industrial Accidents . _- 0/flce of/artsl/aal/oos 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city n4 iy lM 1ts phone# •���—`�Z0— ()���f ❑�a homeowner performing all work myself. M t am a Sole rietor and have no%one worlds gin act.ty /%/O%%/VNE/E%%%% ❑:I am an employer providing workers'compensation for my employees working on this job. comaanv n Add X. Phan #: in suian >.. . WIN I am a sole proprietor, 'eneral contractor,or homeowner(circle one)and have hired the contract=listed below who the following workers'compensation polices. X. ...................................... .::::.:::.::...::.. ............... ........................ companyname ... .3 t..4........ :�1.s ...1.t ....:.:..... . . ::::::.:::::.:::::: :,:: ::.:;:.:<.:<.;:<.;:.;:.:.;:.:.;:.;:.;:.;:.;;:.:.;:.;:.;:.;:.;:.;:.;:::;:.:.;:;< ;: xl, :.: .:..... :: address::::: :::: ............................... i:::ii:: iii n:h'J•:i:ekAO':'a: .............. ::.....::v. :::t�:i:::v:�t*%<?�ii �� h0�{O�:•w4::iv%: w::: . . ....................... campanv.name:.._ t.l ._......1.... 31t.Y.. .:... .........................._............................ :::::::.: ................ :::..::. ::: ::::::::::::::::: :::::::::::....................:.:::::::::.::::::::::::.. >s:>s»»ii aad�ess: X. ...... : .: . ::.;:..:.:.:.;:..;::.:::;:.::. ;:.:;:.;:;::;:.::.>.:.:::;:.::.::.::.::::......................... . .. .. .. .. ...................................................................................................: .:::::::::.:::::i. :.. :.�. •:.;<'r',:; :iii:..�'CY:'::C::::•:':':':yi:•:w:::::::::::::::::�iii::i::i:i::iii::i::i: .............. ........:......:...................................................:..:......................................:.:...:.................:...:......... . ............................................. ............................................... .......... .................................................................:.n:...............................:..:.x:n�.�:::::..................................:::::::::::: vv.�::.:..p ..:. ......................................... .nn....n.w•.J:.J<n<:i �e.� rM1` S ;..• :•.:::;..:::::.;;:.::::.:<:.:::.:.><::.;:.:: piney#�>t�`:is�;:<:<::> ::..:...,..����..<:< ..... ................ Failure to secure coverage ss requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.o0 and/or one years'tmptisotrment as well as civil penalties in the form of a STOP WORK ORDER and a Bne of S100.00 a day against me. I understand Oat a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify Vep unand p of perjury that the information provided above is& :and coned signature Date T Print name S+e (i}rii� wV l Phone# P y Lo"0 6, 1 oificiai use only do not write in this area to he completed by city or town official city or town: permit/license# ❑BUDding Departmmt ❑Licensing Board ❑chedcif Inunediae,response is required ❑Selecbnen's Office ❑Health Department contact person: phone#; _ ❑Other I (tuned 9/95 P]!V 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 employee is defined as every person in the service of another under any corn-a . of hire, express or implied, oral or written. AIt An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver c. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: 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 have been presented to the cons acting authority. , �/��i,��/%/��i �i,��i,.��/���i,���i,���/i �%/�%i,!�� 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 along with a certificate of insurance as all affidavits may be submitted to the Deparnnent 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 ranted legibly. The D a tment has provided a ace at the bottom of the °mP printed eP P, space 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 retuned io the Department by mail or FAX unless other arrangemeuuts have been made. The 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 Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lovestloaffons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 i r ,;°lam ��� �•�✓1� �� i DEPARTMENT OF PUBLIC SAFETY CONST SUPERVISOR LICENSE == Expires:' ' 261 Bi C ROAN-OR ' MARSTONS MILLS, MA..02646 ! I I 4 • 1 asuaaTT sryl �o uorlea AU aol asneo sT ap03 6urpTrng,a3-e3s.sllasnypessep '! ayl 10 uoT31pa luaiino,e ssassod ol.ain.Ife� ' + samon.41TWej d gluo huosem' VT r .''I. (109.'s ZII'J 191) 1 apeds pasoTaua ja 000'st.- Bg • ' .5 O.T.$ BB :ol palat]lsaa S� f . _. ,.-v,,,Y, n,,,�n.'rme.y�e,.....t-••�.,°"�'.�.w'+a¢.�.'.^.s-. r•,'Wkf+r�{F�.`•;,'d. it�f ,' 1 I - ,A SYSTEM PROFILE NOT ;'O SCALE TOP FNDN. FINISH GRADE OVER FINISH GRADE EL . -11 .0 FINISH GRADE r,8N 7 FINISH GRADE OVER GIST. BOX roCo.9 OVER TRENCHES ro5.5 '• A SEPTIC TANK !8. 3 12 MAX. elf.c• a :=n: :oo•.�•;,� ?e'::Q..�a0 o•oP.Yeo4i!'� . .A ti D. .r .i 0 III a o. o.•: o. TOTAL LENGTH OF TRENCH Z5' OUTLET PIPE LEVEL N 3 :4 e _ N FOR 2 FT. MIN. i- 4e:pip ?P u 0 ai• .. ;o;• _u:�' • :a, P ; AL: 1Q i • 'Dt ;v o 6 r0�0.� e:. :Eild 0 31 p CAP END r o .•d C. I. OR PVC TEES �5.s3 L� �S. 14 E;' d•P 6�.70 0� ,�• �.$ o a;:.n: p• a� q. I q� . o • U ABLE MATERIAL MI THIN 5 FT.OF r` 0 0 REMOVE ALL A 6 B UNS IT ;O.e• , �' 1500 GALLON LEIS TRIBU TION BOX LEACHING FACILITY AND REPLACE MITH CLEAN SAND P p•p p•: EL. n 3.5 INSTALL ON LEVEL BASE ��SOO GALLON DR Y!�IEL L S too.:• PPECA S T CONCRETE b 4b H— TO REINFORCED •�b:4b.i,:e�•.be�'!n-4::O;.:Q•p�•Q�•�•.D :C•�'�'Q'°' '°asp': TRENCH SEC TION E INSTALL TANK SEP T NC EVE BASE 0 OR NO TE.• EXCA VA TE TO EL EV V. Nam}/ EMOVE ALL IMPERVIOUS 4� WER TO R MA TERIAL BENEA TH THE LEACHING AREA 4. DIAM i2 MIN. sai t4� iN POLE REPLACE EXCA VA TED MA TERIAL W'I TH •- ti 3" OF ?/B"-?/2" _C-L, 78.7' (�SSUt-tED) •• b• : ':a b' are}• MASHED PEA STONE CLEAN, CLAY FREE SAND .4�:�� �.'o:.; •' .�• �:o• ao . _ 3/4" ?-?/2„ WASHED N �•�• CRUSHED STONE °A -e: o o GENEPA L NOTES TRENCH WIDTH �- CE RO ?. ALL EL EVA TION.,' SHOWN ARE BASED ON ASSUMED NUMBER OF TRENCHES 1 o� 2. ALL PIPES IN HE SYSTEM MUST BE CAST IRON NUMBER OF ORYWEL L S 2 R ' 0.00 J4 SCHEDUL_E�--4C 3. THE BOARD OF MEAL TH MUST BE NOTIFIED P-9293 / 1� WHEN CONSTRUC:7ION IS COMPLETE PRIOR PERCOLATION RATE: i To BA CKFIL L IN(.' ,�� / 4. ANY CHANGES Ili' THIS PLAN MUST BE APPROVED �5 MIN./IN. EXIS7l N WI TNESSED B Y.• GuwEl2 BY THE BOARD OF HEALTH AND CAPE 6 ISLANDS ® SURVEYING CO.. INC. GERRY DUNNING 5. MA TERIALS ANO INSTALLATION SHALL BE IN BARNSTABLl. TH DESIGN DA TA COMPLIANCE WITH THE STATE SANITARY DATE.• oV_2d' �99& CODE - TITLE 4' - AND LOCAL APPLICABLE N •p0 .g '��� RULES AND REGLILA TIONS NUMBER OF BEDROOMS 3 r&ZGEL 48 �� p0 �, 6. NORTH ARROW I.' FROM RECORD PLANS. AND 0" No 6 F IS NOT TO BE USED FOR SOLAR PURPOSES -A- LOAM GARBAGE DISPOSAL R1�.00 g p GAL 49 a o .FL 000 HAZARD ZONE C (NON-HAZARD) 6" w,.• : _ DAILY FLOW GAL . LOT 5 -B- LOAMY SAND SEPTIC TANK REO 'D. ��� GAL . � � B. NA TER SUPPL Y_ �D- �M 43, 560 SF. 60 " io r e '`"T� SEPTIC TANK PROVIDED GAL . 0. �•00` / ,�, LEA CHING REOUIRED � C'PD -C- FINE SAND _ ?52 i - S F. EWAL L AREA o SID A >r S/ ?52S.F.X 0. 74329 .F. _ ?12 GPO. BOTTOM AREA S.F. 329 0. 7T— _ 243 G� S.F.X G/S.F. - GPO LEGEND L EACHING PROVIDED = 355 GPD 29 . -4AMW 0 70 PROPOSED EL EVA TION ?32 N NO GROUNDWA TER s �2 - ' --�o -- ExrsTING CONTOUR SINGLE FA MIL Y RESIDENCE ` 06SERVA TION PIT p�f2GEL `� 0 DISTRIBUTION BOX PROPO.5ED SEWAGE DISPOSAL SYSTEM --- -, i PREPARED FOR ALL A 6 B UNSUITABLE MATERIAL ACHING FACILITY IS TO M IN 5 FT. A� ThE LE .::• . ITH •, BE REMOVED AND REPLACED MITH CLEAN SAND O O SE TIC TANK ,� K k" CEN TPA L CONS TRUC TION - LOT 5 CAP 'N JAC 'S RD. =1 RESERVE AREA �f • ' a WEST BAPNSTABLE — MASS. G ro.00 PI, E INVERT ELEVATION •, ,,., � :.,, - r� , „� DA TE: t�EG. (6, 1 D 9 8 CAPE 6 ISLANDS ENGINEERING `1 A UTH ROAD - SUITE 2E PLOT PLAN � " �` � SCALE AS NOTED ?33 F LMO SCALD•_?."- 40 __ 1 ,�4 : 4g 5 19?7 - --- ..� F PLAN NO.S121553 MASHPEEMASS HIP SEC PCL LOT HSE _- i , T-- NOTES �e Pond 1. DATUM IS NAW88 Q G 2. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE. 3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES d PRIOR TO COMMENCEMENT OF WORK. Ser ice j �o. 125� _ 4. EXISTING SEPTIC; LOCATION PER TIE—CARD ON FILE Locus / WITH TOWN. / 7.81 �), 5. POOL FENCE SHALL HAVE SELF—CLOSING R_2722.51 R�S2 • 9. SELF—LATCHING GATES, SIZE AND MATERIALS TO MEET LOCAL AND STATE BUILDING CODE, ALL DWELLING 119 7S \ DOORS OPENING TO POOL SHALL BE ALARMED TO 122 CODE. Wequaquet Lake LOCUS MAP 121 �2o SCALE 1"=2000't ASSESSORS MAP 194 PARCEL 49 119 1 .• N0151AIG PAVED ZONING SUMMARY DRIVE � Y�c uiut ZONING DISTRICT: RF DISTRICT 118 Y 0� `O MIN. LOT SIZE NN101 ��B?"1'�(T �•�• MIN. LOT FRONTAGE 150' MIN. FRONT SETBACK '.' . 30'.:- _. .. EXISTING MIN. SIDE SETBACK 15' DWELLING 114 r FFLR 121.3 MIN. REAR SETBACK 15' = __ ,—`MAX. BUILDING_HEIGHT�:`30• SITE IS LOCATED WITHIN THE RESOURCE PROTECTION OVERLAY DISTRICT r> > 113 \ SITE IS LOCATED WITHIN THE AQUIFER PROTECTION OVERLAY DISTRICT CO 25,3p V ; PATIO OHO O�0 i 116, FO � 115 � 1 1 10 AJ f -�� SITE PLAN OF RE—LOC / EXISTING Zo°6�,ti #9 CAP'N JAC'S ROAD WEST BARNSTABLE, MA o PREPARED FOR SHORELINE POOLS DATE: MAY 13, 2019 3 ° off 508-362-4541 OrM,gss9 �THoF Mticc9c q� fax 508-362-9880 mac\ pgl�lEi1�7 A c`�� ' off DHN!EL YGmm � I downcape.com a/o OJAL1 � o A ;11 CIVIL � " OJALq down CdA a eI1 IneerhaF iac. No.46502 a No.4J9E0 O mac, Te ``�: 'tr. °F"ss`°�o civil engineers s!Ot�.aL u Er i rz • land S�rVeyOrS Scale: 1 20' S- 13-t�1 �� 3 K'r� 939 Main Street ( R to 6A) DATE DANIEL A. OJALA, P.E., P.L. YARMOUTHPORT MA - 02675 0 10 20 30 40 50 FEET 19-135 DCE ## 19- 135