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0141 POINT HILL ROAD
I y I fbih � �� 11� Q �, . o .l i e } ',�,...,.,_,ws,...,,..,�..�...,....,..f,.._:,, ,-.t..�._ +f:.',y-�-""�---..r.n.....w...-._...::.� ..... ,, _ _ _ - - !'=^- ,.z.-+.,_ __tt.t ..►r+-�" - - - '�:�:�..,....s.�.... - ;-v+.t! OJ 2J�aEcvcLFo�o2z UPC 12543 No. 53LOR HASTINGS, MN • S -. �Z' - - - f Barnstable Old Kings Highway Historic [Dist r is t Comm! e : 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 APPLICATION� CERTIHCATE OF APPROPRIATENESS Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts,1473,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply, 1. Building construction: [dNew ❑ Addition ❑.Alteration 2. Tyne of Building: ❑ House f Garagetbarn ❑ Shed ❑ Commercial Other 3. Exterior Painting,roof ❑ new roof, ❑ color/material change,of trim,sitting,window,door 4. Sign: ❑ New Sign ❑ Existing Sign ❑ Repaintin'g Existing Sign 5. Structure: * IdFence El Wall El Flagpole Retaining wall ❑ Tennis court ❑ Other 6. Pool idswimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date 3t MSCR NOTE Alf applications must be signed by the current owner - Owner(print): C He-15 r 1 Ate /4*00't, Telephone Address of Proposed Work: I t'I I IpO I�JT- �i-�- �D Village 4)• 13AAA)9,63145Map Lot# I'�(c, ( 0 Z 2. Mailing Address(if different) 12 3 S U ffV Ll< 'RCS W CULSIC,EV O LL SI AA 0 2.`f e I Owner's Signature 11 (Description of Proposed Work: Give particulars of work to be done: Con L I n YDtm A o01 �.Vt d VoI mbovl Agent or Contractor(print): 01�}tl GV �(YI I Telephone#: G(�]�oZf'p���, -Address: 10 Cowlfflmiwfod u-e r-30 00-11 b Contractor/Agent'signature: eIla For conantti eeatus A only. This Cerfiflcate Is hereby APPROVED/DE.NEED -RBC MD Date2;J Members signatures APR &2 2014 GROWTH MAN.AC F, APPROVE® Town of Barnstable 1 QABoards and CaumissionAoid Kings Highw*OKHApplirarions\OKHDRAFT2011 Ceti Appropriateness DRAFT.dac Old King's Highway Committee r CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please subni$5 copies 1~oundation Type: (Max. 12"exposed)(material-brick/cement,other) 2 Clem!Fn j WIA fi-1 elds6i Veneer- Siding Type: Clapboard_ shingle X other Material: red cedar wbi.te cedar X other Color: Chimney Material: NIA Color: Roof Material: (make&style) _�i`�'P�fT Annm � Color: v 8 d"er Roof Pitch(s): (7/12 minimum) a- 4'(Z (specify o)z plans fo:new buildings, tttajot•atltlitiotts) Window and door trim material: wood X other material,specify Size of corierboards size of casings(1 X 4 min.) color. Wh 1• t Rakes fst member I X(v 2,a member 13�8 Depth of overhang APPROVE® Window: (make/model)_ Serif S material l 1wbal color kt APR 2 3 2014 (Provide Window schedtde on plan for new,buildings, major additions) Town of Barnstable Old King's Highway Window grills(please check all that apply_: Committee true divided lights_ exterior glued grills X grills between class A removable interior_ None �sirnula�d dwdccl liy6t�s� Door style and make: lynVy-M 12 2-8 material WbOk) Color: g•M' E-56eV 6ree" Garage Door,Style NA Size of opening — Material Color Strutter Type/Style/Material: �-dV yefeA -VJb ddl CoeAa-� CoIor: 151m, vsse-�- Gutter Type/Material: Color: -' Deck material: wood — other material,specify Color: Skylight,type/make/model/: tnaterial Color: m' Size: Sign size: Type/Materials: Color: d bcov-d� Fence Type(max 6' )Style thtAiin WeSh material: olor: �- n #- `I Retaining wall: Material: IJ e+�1 r-lW vo 1r dA Y e ehele-r- ILighting,freestanding _ on building ev illuminating si �EJ-VWD OTHER 011F'®)1ZMA'H'ION.: APR 0-2 2I114 THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMfTTEtD GROWTH MANAGEMENT Please provide samples of paint colors,manufacturers brochure of windows,domrs,garcagee door,fences,lamp posts etc Signed: (plan preparer)`�/2�/i p Print Name 1 AICHArw 1 A"eLLA PAS- A Af C I+i T 2 QABo.ards and CODp)tissio?isNOld Kiitgs Kigltway10K11 Applicatiotts10K11 DRAFT 2011 Cert Appropriateness DRAFT.doc L Plans shaU include ithe fioBl owing: _Name of applicant,street location,;nap and parcel. _Name of Builder Designer,or architect; original signature of plan preparer and stamp;plan date,and all revision dates. 'ALL NEW DOUSE OR CON;3 12CIAL BUILDING PLANS TRUST HAVE AN ORIGINAL SIGNATURE AND STAW,IF ANY,BY A REGISTERED ARMTECT,iVI�BER OF A1l3D,OR A LICENSED MASSACI�ETSETTS I-IONMIy'ROVE 1-E t CO1\TTf.ACTOR,UNLESS'I`IUS REQUItZEll�3IN T IS WAIVED BY THE OI H DISTRICT CONBff ME. _ A written and bar drawn scale. Elevations of all(effected)sides of the building with dimensions including height froin the natural grade adjacent to the building to the top of the ridge;location and elevation of jmisIied grade roof pitch(s)dormer setbacks:trim style window and door styles Changes to existing buildings must be clouded on drawings. —Window schedule on plans. Landscaping plan,5 copies drawn on a certified peiineter plan co-atainir!g the following informnation: _Name of applicant,street address,assessor's map and parcel number. —Name, address and telephone number of the plan preparer;plan date and dates of revisions. _The location of existing and proposed buildings and structures,and lot lines. _Natural features of site(e.g.rock outcroppings,streams,wetlands,etc.). Existing buffer areas to remain. _Location and species of trees outside of buffer areas greater than 12"caliper to be retained or removed. The location;number,size and name of proposed new trees and plants. —Driveway,parking areas,walkways,and patios indicating.materials to be used. Existing stone walls,and proposed walls including retaining walls for slope retention or septic systems. (for removal of stone walls,file Demolition Form). _ All proposed exterior lighting and signs. Sketcli or photos of adjacent properties,(1 copy only) A sketch(s)to scale or photographs of nearby adjacent buildings,where present,along both sides of the street .frontage,showing the proposed new house or commercial building in scale and in relationship to the existing buildings. Please discuss with staff if you do not think this is relevant to yo rr application. Photographs of all sides of existing buildings to remain,or being added to(l set only). )bees according to schedule. Please compleie the fo➢l®ems: �R,ECEI � IExIsCing i u lldimg,foot pri-fat: Building I sq.ft. Building 2. 2014 lEydsting l$uailali>ing,gross fflooir area,including area of finisfined basement: Building 1 sq. ft. Building 2 MANAGEMENT New building or addiflon, ©at paint: GROWTH Building 1' 3Zi c�� a'�� sq.ft. Building,2 New Bufldi lmg or addutMon,gross floor area,inchndling area of C�annsPiZedi basement- A r,�,^®�1 Building 1 sq.ft. Building 2 �/ APR 2 3 ZOW 4 OABoards and Cnnanissioru\old Kings Hlglnvay\O1CF1 Applicaiiotrs\OK1(DRAFT'2011 CenAppropriateness DRA!•T.doc Town of Barnstable Old King's Highway Committee 1 y ` Commonwealth of Massachusetts P X. eokwolwooft R Ma ��O Parcel Z.Z.- � Date: Z—I �-,_ Apia 2 ? Z 0',4 Permit bop # Lstunated Job Cost: $ 100 N OFBARNSTABLE e'rmit Fee: $ Plans Submitted: YES X NO Plans Reviewed: YES NO Business Licensee, 7 Applicant License # �1� Business Information: Property Owner/Job Location IIn�formation: Name:CL, �• ��. 3 1 Name:���'\ Street:--ms Street:��'�� PC�\r�c V\.\,\ \Yx . City/Town:�S �C-\�\ City/Town:W—elk Telephone:C<)� �- -�-,--SG Telephoner Photo I.D. required/Copy of Photo I.D. attached: YES -9.- NO Stad Initial :f-1 4-1-unrestricted lice J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family X Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. X over 10,000 s . ft. plumber of Stories: Sheet metal V_orko be completed: New Rork: Renovation: HVACMetal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Pr e detailed description of work to be done: AAA�w INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No ❑ If you have checked YM, indicate the type of coverage by checking the appropriate box below: A liability insurance policy . Other type of indemnity ❑ Bond ❑ I OWNER'S INSURANCE WAIVER: I am aware that the licensee¢,oes not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application wgives this requirement. Check One Only Owner ❑ Agent ❑ i i Signature of Owner or Owner's Agent By checking this boxX],I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress dlnsjjections i Date Comments i Final Insliection Date Comments Type of License: 3y Lip Master ' Fitle ❑ Master-Restricted — e :;ityrrown ❑Journeyperson i Signature of Licensee 'ermii# ❑Journeyperson-Restricted �� License Number: =ee S Check at www.masS.ggyjdj2j nspector Signature of Permit Approval �Aufi. 27Lf.. 2014 7:42AM NNo. 4526 PP. 1 -nosall ro Vk, 47ggLISHEO'�9'j PLUMBIK•HEATING•AIR CONDmOMRS DATE: PHONE: PROPOSED BY: 779 Main Street 0STWIu1=,MA 026SS 7/23/14 508-778-4911 Dllck Mohre (508)126.6365 FAX(508)420.0180 WWW,CAARLRIEO E LL.CO M TO: JOB NAME/LOCATION: ** Atwood Residence** E.J. Jaxtlmer 2 1/2 ton heat pump attic system 48 Rosary Lana 141 Point Hill Road Hyannis, MA 02668 West Barnstable, MA 02668 Rledell will Install an"Amedcan Standard"2 1/2 ton attic installed heat pump system that will provide total cooling and heating comfort In your home. An"American Standard"2 r/z ton air handier along with Insulated duct work will-be Ihstalled In attic area supplying heat and a/c to living area via ceiling diffusers. Riedell will Install a 2 Vi ton 13 seer air handler to.condenser heat pump to complete system. Rledell will conceal exposed-refrigerant Imes with attractive silm duct cover. System will be wired by Rledell. Rledell will charge, start, and test system for proper operation. System Components 'American Standard" c p Condenser 2 V2 ton attic installed a✓ I Air handler Heat pump.system Line set #4A6H3030C1000A-condense - Pad. TAM7A0830H air handler I _ Aux pan 13 Seer/ R-410A Refrigerant w/ Drain io year warranty on compressor and parts - insulated duct work after equipment la registered within 60 days of Installation - slim duct cover I - Wiring I ** Homeowner responsible for any electrical upgrades If needed, We propose hereby to furnish material and labor—Complete In accordance with the above speciftcatlon,for the sum of: M- �` 00 967 i Payment to be made as follows: u f A 50%deposit Is requested with signed proposal. Payments due as work progresses, Balance due upon completion. -� A ri ed RI Il Igna �. All material Is guaranteed to be as specified. All work to be completed } In a professional manner according to standard practices. Any olteratron or devladon from above specifications involving extra costs will be executed only upon written orders and will become an extra s jrpe over and above tho estimate, All agreements contingent upon Acceptance of Proposal -(he above prices, specifications are Akes, accidents or delays beyond our control, Owner to carry satisfactory and are accepted. You are authorized to do adequate home and fire Insurance. Our company and our workers are the work as spe d ment will be made as outlined above. fully covered by Worker's Compensatlon and uabmty Insurance, Signature Note: 71415 proposal may be withdrawn by us If not accepted within 30 days. Slgheture TE ® CERTIFICATE OF LIABILITY INSURANCE DA051062014Y) ACORN 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(les) 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). 'RODUCER. . CONTACT Erica H O'Connor HART INSURANCE AGENCY,INC. NAME' 243 MAIN STREET PHONE 508-759-7326 x205 ac No): 508-759-7633 PO BOX 700 AADDAIL DRESS: BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC k INSURER A: ARBELLA PROTECTION INS CO 41360 NSURED Carl F Riedell B Son Inc INSURERS: ARBELLA INDEMNITY INSURANCE COMPANY 10017 778 Main St Osterville,MA 02655 INSURERC: INSURER D: INSURER E: INSURER F: OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED., NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VSR ADDL SUBR POLICY EFF POLICY EXP LIMITS _TR TYPE OF INSURANCE POLICY NUMBER MM/DO/YYYY MMIDD/YYYY A GENERAL LIABILITY 8500033836 05/01/2014 05/01/2015 EACH OCCURRENCE $ 1,000,00 TO RENTED COMMERCIAL GENERAL LIABILITY PAEMI ES fEe occurrence) $ 300,00 CLAIMS-MADE W OCCUR MED EXP(Any oneperson) S 5,00 PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO LOC $ A AUTOMOBILE LIABILITY 1020018223 05/01/2014 05/01/2015 COMBINED SINGLE LIMIT 1,000,00 Ea ecadenl ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS UTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per. 'd n S A UMBRELLA LIAB OCCUR 4600033837 05/01/2014 05/01/2015 EACH OCCURRENCE b 1,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE s DED I V1 RETENTION$ 10,000 $ B WORKERS COMPENSATION 0054000514 05/01/2014 05/01/2015 WCSTATUDRY LIM - AOTH- AND EMPLOYERS'LIABILITY Y ANY PROPRIETOR/PARTNERIEXECUTIVE � N/A E.L.EACH ACCIDENT S 500,00 OFFICER/MEMBER EXCLUDED9 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ;': <�,%�>.COMMONWEALTH OF MASSACHUSE:TTS::: ':€€ BOARD` SHEET=<::M E TA ISSUE:S..;TNE FOLLOWI N'C=`"L'f C`EN AS A' MASTER:-_U;NR:E:STR I CTED Gl1ftL A :R I E D E L L N CARL F '-R<I''EUELL `ANp>::SO;NS''�`<< IUi 77$*-:MATN ST �. 05TERV'I .E: :::<... ?::;::Mp0.265.. >'09'%z 8:/ 2 89 7 LL � D I I 1 1 1 • 1 /y/ p°oivTy�L Al 4 o� RE'YtrR GUI 2J.OW GrR#JA* 3v sEEfZ G WebbConnect- Online Ordering System for customers of F. W. Webb Company Page 1 of 1 ENY WERE COMP" Welcome Carl A Rledell 0 Items I Cart Checkout LOGOUT ■Rabb iomw Search by Keyword or Part Number ° - HOME MY ACCOUNT TOOLS RESOURCES MY CARTS HELP i Product Manufacturers ^ Heat Loss/Gain Calculator. Product Categories ,.�=• The heat Iosslgain calculation uses the IBR method to determine the healing needs for a home.It estimates: Chemicals&Solder �, � '•� The maximum heat loss in BTU/hr for a coldest day(helpful for furnace sizing) The total yearly heat loss in millions of BTU Controls The total yearly cost for fuel Electrical Fire Protection HEAT LOSSIGAIN HOME PRINT THESE RESULTS Fillings - Gas Products Building Input Calculation Results HVAC Name F-- 01 residence Location Point Rd Wesl Barnstable Building Healing Equipment Gain BTU 31256 Heating Parts Summer design temp. 1 Loss BTU 36272 Winter design temp. -10 GainHoses Room temp. 71 ^ Loss CMF 1042 ' Indoor Air Quality LeeMray as% 10 / � Loss BoaCFM 685 Measurement&Instrumentation Number of people 5@400 , O Base Boats 63 Motors&Circulators Ground temp. 50 • Tonnage 2.6 Pipe&Tube Cooling air 50 Warming air 120 Piping SpecialtiesCaleulation Results Room Plumbing CHANGE INFORMATION Label Zone Gain BTU Gain CFM Loss BTU Loss CFM Base Board , Pumps second floor 29256 975 - 36272 685 63 Refrigeration Roomfnput Safety Label Ext Wall height floor sq.R. Sanitary second floor 116 8 1144 ' � Steam Specialties ADD A NEW ROOM Test Equipment&Gauges Tools Valves Venting Products V Water Systems My Account Tools Resources My Carts Help Edil Account Heal Loss/Gain Calculator Online Catalogs Current Cad Using WebbComrect Saved parts Product Cross Reference Line Cards Saved Carts FAO Pending Orders Product Specification New Cart Product Codes OrderslBtds Products MSDS Information Pending Orders Product Abbreviations AR Information Plumbing&Healing Industry Links Troubleshooting Invoices HVACIRehigeralion Locations Contact Us LP&Nat I Gas News&Events Connecticut Divisions Residential Water Systems News Maine Our Company F.W.Webb Compmry Industrial PVF Events Calendar MassechuseM Corporate Frank Webli s Balh Centers Industrial Plastics New Hampshire Mission Statement Utilities Supply(USCO) Valve Automation&Controls Specialty Markets New Jersey Company History Victor Commercial&Industrial Pumps Government Services New York Green Initiative Webb Bio-Pharm - Biotech&Pharmaceutical Maple Sugar Indus" Pennsylvania Credit Application Webb Fire Protection Fire Protection Ski Industry Rhode Island Employment Webb Kentrol/Sevco Mechanical Sates Sanitary Vermont Webb Pump&Service Webb Water Systems Copyright 0 1999-2013.F.W.Webb Company•All Rights Reserved.I Terms of Access I Warranty I Privacy Policy ®0®fm 1 t http://webbconnect4.fwwebb.com/bin/fwk?wc4.hc.next . 8/26/2014 2 to C'omwvyrnwaUh of Vassachusetts Deparment ofIndusft ial Accidents Oflice of Inveshkations 600 d3'rr;tshington,reet Sostozj MA 02111 wn'w.ma-mgmMia Workers' Compensationlnsurance Affidavit:Budlders/ContractorslFIectricianMumbers' Applicant Infarmation Please Pant ib . Name( ssrorgani-ation/Indivianal): Address_ �� //' // i- -f CitylState/Zip: l Phone Are you an employer?Check app:rapriate box: Type of project(required): L)RI am a employer with� 4_ ❑ I am a general contractor and i 6_ New comstnrctioa employees{full andlorpait-time•}* llavel�iredtbe sub�co�actrns. listed on 2._El I am a sore proprietor or partner- the attached sheet 7- ❑Remodeling ship and have no employees emplThesoyees ees a sub-contractors have g- ❑Demolition w far me in any ct r_ effiP�Y %and have workers' odnng y capa. t5 - $ 4_ ❑Building addition [No workers' comp..kmnmce comp_insuranc S_❑ We are a corporation and its 10_0 Electrical repairs or additions required] . 3_❑ I am a homem mer doing all work officers ham exercised their 1 T_.❑Plumbing repairs or additions myself [No workers'comp- right of exemption per MGL 12-0 Roof repairs insurance required.]T c- 152, §1(4h and wehmmno �loyees_[No workers' 13_❑Other comp_insurance required-]: *Any appUcml that checks boa*1=A also fin out the section below showing ffi&wodctn,7 compensa on policy in{3=adan Hnmeawners vrbn submit this affidavit i>tidscstirtg they ate doing all tto�c and 6aeu hire outside contractors mast submit anew arvdavit md,*�such lCanttacmrs thst check this bout mast attached an additional sheet shutting the name of ffie snRs�and state whether or not these en ities have employees. If the sub-contnctats hale employees,they must provide their workers'comp.policy number. .Taman employer that is prm idirrg ti orke-rs'compensation insurance for my emplayom Below is the petit?and job site information. Insurance Company-Name: Policy ff or Self-ins-Uc_#: Expiration Date: Job Sife Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MIGL c. 152 can lead to the imposition of crimitnal penallies of a fine up to$1,500.00 andlor one-year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a.tray against the violator- Be advised that a copy of this statement may be forwarded to the Office of Iurestigations of the DIA for insurance coverage tiosL I dui hereby mrookaer the nd antes perjury that the information prosi&f a �e' tins and c9frect Date: Phone 9: 0REd-al use only. Do not write in this area,to be cartrpleted by city or town officiaL City or Town: PermltUcense# Issuing Authority(circle one): L Board of Health 2.Budding Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone!#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all'employers to provide workers'compensation for their employees. Pursuantto this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shaII withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the-commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." i Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." 10 Applicants — Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their cernficate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance- If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit T1ne affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Deparbnent of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submif one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations ill (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be;filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of jaeestigatirns 600 WaAingtua Street; Boyton,MA 02111 Tel.A.617-727-4M ext 406 or 1-977-MASWE Revised 42407 Fax# 617-727-7749 www.mass-govldia S FINE)� Town of Barnstable 6ARNSTA6L6. Regulatory Services - 9 t639. Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-8624038 4 Fax: 508-790-6230 Inspection Correction Notice g- .t is Type of Inspection '' 'l Location /�l 1001V 71-6 t AOA Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: t ( 2 rl t 'ee �6 c U7.�� /N•�' �tcJ u /l2C JN�� t Please call: 508-862-4-038=for-re=in e ' . "f Inspected by � G Date � 2 311 V 0 I -installedtion Statement a Q l , . , , . - . , . 9CL Spray Foam Insulation Company Name Cape Cod Insulation, Inc. Phone Number 800-896�61'i Z Applicator Name William Johnson Installation Date 09-22-2014 0 141 Poin7Hill Road,West Barnstable A-Side Lot#'s D348E9170A J Jobsite Address N B-Side Lot#'S 2412001 H Permit Number. Q 8 w a- Total 0Approximate • aThickness Insulation' ' walls 9" R40 360 sf Attic CO CO Thickness / Coverage Rate CO Location Ln : Inturnescent Coating Used saul m CD 817-640-4900 • Info@Demilec.com 0 www.DemilecUSA.com DEMILEC �Z HE r � Town of Barnstable BARNSTABLE. Regulatory Services 9 MASS. 039. Building Division _ prFO MPS a 200 Main Street, Hyannis, MA 02601 e ti M: Office: 508-862-4038 fax: 508-790-6230 Yy � Inspection Correction Notice i I� Tyre of Inspection Location `/0100 —air 17 rt G Permit Number 0 Owner /r► VcjUo Builder �� Y 1 One notice to remain on job site, one notice on file in Building Department. The following items need correcting: o sU orfi _L To !4 cN 6 P4 T boo y-rA ik z, a�J/ �r N g i L O Vr--4 4 w PQC, w 1 n I�" c�� ��s or �iRA-rM�NCB. r _LMQFD44I.V . N Swo a A) oxJ Srr9 rwpG /�� ,oW��iVo /LK�d� NG �Co� .Tut y Alo 7- 0,�,J Please call: 508-862-40H for re-inspect' Inspected by Date /q/ u4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` Parcel �^ #Map Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee - Date Definitive Plan Approved by Planning Board r—f Historic - OKH Preservation / Hyannis �� Project Street Address 141 P6 wa:L I'll I Village W • 6 OL M S fA ILL, Owner Address N 1 poya le"j , W . Telephone _ g - C ` l ' Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type -Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of lPaths: 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: 0 Yes ❑ No N -f Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0e9 isting newDsize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ? crs � Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -' r APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f�JJAX aJ;Y— Telephone Number Address L License #iA:14 alp, �L�L Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WIL BE TAKEN TO CYA btr_s h�v"5 K�_ SIGNATURE DATE Ft FOR OFFICIAL USE'ONLY k AFfL1CATION# DATE ISSUED , MAP/PARCEL NO. - ADDRESS VILLAGE ;+ OWNER / DATE OF,INSPECTION: 1 :C ndv&A, t���FOUNDATION _. � � a FRAME 5 ej j?9 D E•®6 INSULATION f FIREPLACE it _ , ELECTRICAL: ROUGH FINAL G PLUMBING: ROUGH FINALI { s GAS: ROUGH FINAL f FINAL BUILDING r . DATE CLOSED OUT ASSOCIATION PLAN NO.- z I ,. The Commonwealth of Afassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciabs/Plumbers Applicant Information ` Please Print Leeribly Name(Business/Organization/Individual): ;� 1 rY -rI IM ri_ u CEW , /&C Address: Ire City/State/Zip: C(/fZfZ S / Phone.#: g qljy, l/ Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1. 1 am a employer with�_ ❑ 6. $iew construction employees(full and/or part-time).* have hired the sub-contractors 2:❑ I am a'sole proprietor or partner listed on the-attached sheet. 7...❑Remodeling ship and have no employees These sub-contractors have 8. '❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.insurance comp. insurance.t required.] 5. ❑ We are a corporation and its '101] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL myself. [No workers comp. right ❑Roof repairs " insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. QQ�7 �/�-� , / Insurance Company Name: 4v�&4 M&/6 l� m �NS Policy#or Self-ins.Lic. #: Expiration Date: 0/ �-D J Job Site Address: pa l ei+ Jii I I' City/State/Zip: L(� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). • i Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the'imposition of criminal penalties of.a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi un r t ains and penalties of perjury that the information provided above is true and correct. Signafore: — Date: _ Phone k Official use.only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health '2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ® DATE(MMIDDIYYYY) ACDO V CERTIFICATE OF LIABILITY INSURANCE 12/31/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Erica H O'Connor HART INSURANCE AGENCY,INC. NAME` 243 MAIN STREET PHONE 508=759-7326 x205 AxIA EMI, No:508-759 7366 IC NPO BOX 700 ADDRESS, BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC# INSURERA: ARBELLA PROTECTION INS CO 41360 INSURED EJ Jaxtimer Builder,Inc INSURER B: ARBELLA INDEMNITY INSURANCE COMPANY 10017 48 Rosary Lane Hyannis,MA 02601 INSURER c INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY,THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VTR TYPE OF IN ADDLSURANCE INSR SWVn UER POLICY NUMBER MMIDOPLJCfYYYYI Y EFF MWDD LICY EXP LIMITS A GENERAL LIABILITY 8500042039, . 01/01/2014 01/01/2015 EACH OCCURRENCE $ 1;000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISESaoccurrence) S 300�000 CLAIMS-MADE OCCUR MEDEP(Any oneperson) S .5,000 - PERSONAL&ADVINJURY $ 1,000.000 GENERAL AGGREGATE $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY M PRO- LOC $ B AUTOMOBILE LIABILITY 1020011547 01/01/2014 01/01/2015 COMBINED SINGLE LIMIT 1,000,000 Ea accident ' ANY AUTO ' BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ A UMBRELLALIAS OCCUR 4600042040 01/01/2014 01/01/2015 EACH OCCURRENCE s 2,000;000 EXCESS LIAR CLAIMS-MADE AGGREGATE S 2,000,000 DIED RETENTION$10,000 $ B WORKERS COMPENSATION 0053890113 01/01/2014 01/01/2015 V1 We CRYsTATu- OTH- AND EMPLOYERS'LIABILITY LIMITS ER ANY PROPRIETORIPARTNEWEXECUTIVE Y� N/A E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500.000 If yes,describe under ' DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,B more space Is required) CERTIFICATE HOLDER CANCELLATION Fax#:(508)862-4717 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 230 SOUTH STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE ©198 =20 0 O D CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i office of�onsurne Affairs aiad Business Regulation 10 Park Plaza. - Suite 5170 Boston, Massachusetts 021116 Home Improvement Contractor Registration Registration: 110609 Type: Private Corporation Expiration: 11/3/2014 Trg 233027 E J JAXTIMER, BUILDER, INC. ERNEST JAXTIMER 48 ROSARY LN HYANNIS, MA 02601 Update Address and return card.Dark reason for change. Address ❑ Renewal Employment ❑ Lost Card DPS-CAI 0 501VI-04/04-G101216 ✓ie tovr�:zo�zu2a�1� o�''�.ll�i�ac.�W Office of Consumer Affairs&�usiness)2e5ul ahou !License or registration valid for individul use only -_HOME IMPROVEMENT CONTRACTOR. before the expiration date. If found return to: Registration: 110609 Type: Office of consumer Affairs and Business Ibegulation WIN,8 Expiration: 11/3/2014 Private Corporation 10!Park!Plaza-Suite 5170 ]Boston,IYIA 02116 E J J. IMER,BUILDER,INC.. n ERNEST JAXTIMER 48 ROSARY LN HYANNIS,MA 02601 Undersecretary Not valid without signature - L Massachusetts-Department of Public Safety Board of Building Regulations and Standards an _ . Construction Supen'isor License: CS-003251 'I Ts ERNESTJJAXTI1ftR �'�• 48 ROSARY LANE HYANNIS MA 0-2 601 Expiration i Commissioner 01/14/2016 a� • snxivsrnaM • =39- Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, C Wts' AN) ATNCC�� ,as Owner of the subject property i hereby authorize rn yn = T U( a`o act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date C WSWAN AtAVv� Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 r - IPATBIOH A$UAi . - - 6R CtlP0.lRW0I16 A.evue N.\a 5y�ae • , _U o2116 EA�pwap'A m" P:6I T:—TI I P:5OT9PAN2 F:61T36S22T6 F:6R8529AAlTtl www.patrickahearn.com 141 S59°53'2E�"E Point Hill 220.00'-- - --- - - - - ----- Road Itltl' Ah , West Barnstable,MA I i II ••{ II 1 General Notes: V • , I 1 :; 1 GENERAL CONTRACTOR SHAM MARE ALL O or DIE EOEC ENTS SUPPLIERS AWARE II I 1 •-} 1 OF TIE RFgU1RE IETS OF n1ESE NOTES. ALL WORK SEAM HEK"OEMFDIN COW A FLIANCE WMI ALL APPLICAHLE LOCAL ..I.. �..1"'.:..:r� .�:• ,� 1 STATEANONATRINALBUILOING.LVE - It1 _ I' I 'I 1 -��" •.�;•::.j:• ��. 1 SAFM.EI.I:CIRI AN'OFLIJMHI 0.11S. GENFOR.S HANGAR PR.%.BE0.ESPONS •-'} I •' .'l' •�� IRLEFOR SENREDON Of WOW ARY fORC0A1PLLT10NOFW'ORKTIROUGII- - f�' I r�!. •`:L) I I _ I OUT THECONTRACT'DOCUNIENTS. 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Board Fuse Drawing Title: Illustrative Site Plan =v --------------- - Proposed Cabana 1 T Relocate; , - >- Existin /i ;' t Lot: 136 I A-t April 22,2014 Shed 11 °' Parcel: 022 ■slue on E5 Elev:31 ' L arce I BIDDING. amna o / ` Zone: RF PERMIT. o hoard Fente `° y Lot Size: 87,120 SF ❑coNSTRUCTION: - ---� ' REVISIONS: i / I e Yard Setback on y 5'Sid Site plan informati b I oovu: -------- ---' =" CapeSurv(2014) O DRTe: ❑D.. ------- = Mes1f Fence ' p 1T, I---_ - - - - - N59°53'2U �'VY' - - -—- - - - - -—- - ARLNHECURAL STAMP 6JOB NORTH 220.00' I� ' ILLUSTRATIVE SITE PLAN I•=za SITE { ' PAiAIO�A88ARN .. .•..vad.�.e..,. m 'r 141 Point Hill Road west l)—tmble,MA - Pool Elevation Left Side Elevation • Ihewmg Copylight•a 1 Drawing Title: Exterior �IlEffll lEffilHIM ` Elevations .�vrutmv_ May 5,2014 owmvar.. een. mm.a. mwmw.vu - ov. oo.. • $SfiJNa@S__ Cj aw o ow. 9�C: amma� Right Side Elevation gED ARC r W p�41 CK J..ih r i C No•:4450 m H Rear Elevaitoa m,..,..m MA 5 Oyhf4`TN OF W,p5S�4aJ E o � o A-2 IN•�I'Q 1 - Pl � r , � ® Point Hill mT Road wuav<aur+c wirtwx West Hamsmbl0.MA m�m..�Nmmc ovu...n.0 aFPo WrnnOomz 6OAPFAN wort YfiRTE wUME wOR mvso�iG rostow�evavw-rwrteo . 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'•3 aa�Pm'°rNIN NW+aVPD nI aYNo a 9l wpm zzuO•a. 9t%a.B/G L iNl6xv vz" "�_ 7.9m /G GG1l RLO '4WP.`�u9Pw 9'mHd oam aauavea a40�SPP �No. U SaPlPVpwanMKL .�q''' •Tp�'• 12nm1 ayt waWW DaPO nDPM atmld wrWe P P "' ar}ll► ngaa aa9ae0 aagOu aD PPDIaVbnmlat 9aW YI t3VP TYaD.ws/aarm A, W aanf b'll • mn'Cp04 DPmfaw-14 nalP?a Pd t4yeaaaa va"Naaq'dP dL� aIt 1N]F911CX naH H a'Dagya4Ma{mlaas aPne LYmS09 Dann dpa roam P-k-W-,aw5 aa Pa la d"Nuv99lxw.z aDDYJ6� G ,wnMaaPae.SaS.DM�RDaaaS"at.OumSao /wa Yla Iaa=GIWWPMIW-oawe{pp dawWe NanM M99.zpwjnila laGuwepa aP'DuynDp Ppiw ea waggllqH�•••••p�_. a9 iN"L F nta760AlKp1v •neVW awl PaeDeeaaaw aw GN&DV70L e� • .�. ,,e`P Uwww+mMaan'aawaamn+awPmvaDaan � armsam • w.w aawem wDma a amwen a awea as TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION qxl Map 3(n • Parcel V�o� Application �# Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis —I (Project Street Address 'Li Village Owner t/ (`�I� �1t� �(.I�nGC� Address We r � i Telephoney l'Perm_ it Request ^�(L�TQ c � s� c,+eel 7 ` v �l L S. CA Square feet: 1 st flo r: existing proposed 2nd floor: existing proposed Tot Z�r ew Zoning District V:P Flood Plain�0 9 C_ Groundwater Overlay 6l Project Valuation Construction Type zA CPY4. 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 inc uding baths): existing new First Floor Room CQuht Co Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other a Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing Wood/coal steve: Yes ❑ No ,i W 'I'll Detached garage: ❑ existing ❑ new size_Pool: ❑ existing Vn size6)Nam. ❑;existing 0 newer, size_ --a Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: n Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes NZNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) G/ S-_ �OS Name Tele hone Number h , Address 1 U "J,10d License# %1 1 -ev\ta,L_ a_ACA Home Improvement Contractor# 1 OSO S4 1p , cony '. i o�, �o.��g o e Worker's Compensation # ALL(CONSTRUCTION DE RIS RESULTING FROM TH S PROJECT WILL BE TAKEN TO I SIG {NiATURE `i DATE �J FOR OFFICIAL USE ONLY APPLICATION# - DATE ISSUED r - MAP4 PARCEL NO. ` ty ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: ;_E0 NDATiON. zo - FRAME I t r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL. PLUMBING: ROUGH FINAL } GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT ASSOCIATION PLAN.NO. 'r The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit;Builders/Contractors/Electricians/Plumbers Applicant Information ( Please Print Legibly Name(Business/Organization/Individual): t° f 0 l� Address: I() WA(Y10y() j?_oct d a�a � a City/State/Zip: Phone#: - Are you an employer?Check the appropriate box: Type of project(required): 1 am a employer with 4. ❑ I am,a general contractor and I employees (full and/or pair-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp.insurance. � required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself o workers'com right of exemption per MGL 12.0 Roof repairs insurance . p required.]t c. 152, §1(4),and we have no ] employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that cbecks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractor;that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contactors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. G Expiration Date: J Job Site Address: I �T 1 n �( f h ('l City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). .Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50.0.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of erjury that the information provided above is true and correct. Si ature: �.lames • Date: `LI Phone#: �� D 6� � Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/'Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions s s , Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the ' dwelling house of another who employs'persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASWE Fax# 617-727-7749 Revised 4-24-07 www.mass.govfdia ww:l:al'V'11ilC nare raxiu: Uate:;3/b/LV14 10 : 1Z AM Page: 1 of 1 OP ID: CH ACS�RL7" CERTIFICATE 4F LIABILITY INSURANCE 703106114 (MMIDDIYYYY) _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 pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER COIMCT 781-642-9000 NAME: Eastern States Insurance 781-647�670 PHONE F^X Agency, Inc. A/C o E AIC No): 50 Prospect Street EMAIL Waltham,MA 02453 ADDRESS: CUSTOMCER ER ID/:CUSTO-1 INSURERS AFFORDING COVERAGE NAIC INSURED Custom Quality Pools, Inc. INSURERA:Acadia Insurance Company 31325 P.O. Box 1031 INSURERS:Union Insurance Company Billerica, MA 01821 INSURER C:Commerce and Indu"Ins.Co. INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF -POLICY EXP 1TR TYPE OF INSURANCE WVD POLICY NUMBER MMIDD MMIDDrYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPP 0328206-14 02101/14 02/01/15 PREMISES Ea occurrence $ 500,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000.00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: rt PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY B ANY AUTO . MAA 0328208-14 02/01/14 02/01/15 COMBINED SINGLE LIMIT IEe accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY(Per person) $ X SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS Comp/Coll $ AC X Physical Damage Deductible $ 1,00 X UMBRELLA X OCCUR EACH OCCURRENCE $ 2,000,00 EXCESS LIAB CLAIMS-MADE A CUA0328210-14 02/01/14 02/01115 AGGREGATE $ 2,000,00 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN C005871898 02/01/14 02/01/15 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory I under I yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,Irmore space Is required) 'CERTIFICATE HOLDER CANCELLATION EVIDEN- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD 5�ro„ cx c> 1 y .,. ,. t (: i-- -- T-------� 4. �`� � �; �, X 9 x f. 8'� _L a � � � -� � � � � i . s '� _. � � � � � � � � � �__ __ _ _ _ T__ f• � � 5 �_ oaU _. _ • r '�e -C"wwwzaea" cal Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 105084 - - Type: Private Corporation - Expiration: 7/16/2014 Tr# 227813 CUSTOM QUALITY POOLS INC. -_=::. .::;.; . _ Robert Bent PO BOX 1031 Billerica, MA 01821 `Update Address and return card.Mark reason for change. r1 Address FIRenewal F—i Employment.[] Lost Card 34/04-G101216 -- Jt/ �omv�,rtrvea / a'✓t� oa�u�ee License or registration valid for individul use only ffice o oAN'ter airs mess egu a on OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration• ,..105084 Type: Office of Consumer Affairs and Business Regulation xpiration: Z/16/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 JALITY.P.00LS<INC_;. toad 01821 Undersecretary Not valid without signature 1t Massachusetts -DepartmerYt of Public Safety f Board of Building Regulations and Standards Construction SuPcn-ionr License: CS-040192 a ROBERT A BENT,:' - PO BOX 1031 BILLERICA MA701821";'< 'v s•:;' ` =Xpiration 0IM012015 . commissioner `t�1 iti �iy Q ^t;s2!- J • _ L_� Tn nv E r Barnstable Old Kings Highway Historic District Committee : t 200 Main Street,Hyannis,MA 02601,TEL: 508-862-47$7 Fax 508-862-4784 APPLICATION CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts,1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply, 1. Buildinf;construction: EfNew ❑ Addition ❑ Alteration 2. Type of Building: ❑ House �Garage/bam ElShed ❑ Commercial u Other 3. Exterior Painting,roof ❑ new roof. ❑ color/material change,of trim,siding,window,door 4. SIg_: ❑ New Sign ❑Existing Sign ❑ Repainting Existing Sign 5. Structure: UdFence El Wall ❑ Flagpole Retaining wall ❑ Tennis court ❑ Other 6. Pool Idswimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date . 2)t M C H 20(4 NOTE All applications must be signed by the current owner Owner(print): C H e-ISC I M A*00't:h Telephone#: -31 3 S --�_ Address of Proposed Work:, I H 1 e0(1J - Y� t2b- Village lA�• T3 �� 4i3LEMaP Lot# �(O l 0 22 MailingAddress(ifdifferent) 23 S0 f VLt< 'RoPrt> uJ6UfSLEV 11Iu-S MA 02.•f91 Owner's Signature Description of Proposed Work: Give particulars of work to be done: Cot► f: n l n I'Durte� 001 aid Agent or Contractor(print): t�1�'t'I Gk eQ1 l Telephone#: Address: 10 CoyomoAt at 1�0 n Dail (0 Contractor/Agent'signature: G �I a k For committee use-only. This Certificate is hereby APPROVED/DENEFD Date idiem�signatures jo\Mn o`gatnshWay O d Gog,m ee 1 Q,\BoardsaijdCot)imissio)u101dKingsHighway\OKHApplicarions\OKHDRAFI2011 CeitAppropriatenessDRAFT.doc r -CIER'g']fli'>ICATIE OF APPROPRIATENESS SPEC SHEET Please subimnit COPM 11 1~oundation Type: (Max. 12"exposed)(material-brick/cement,other) 2 (J �ng�ayl4 l elASr6e [P eer' Siang Type: Clapboard, shingle X other Material: red cedar white cedar X other Color: Chimney Material: 14/A Color: -fia mo-+c l ftlsl�Roof Material: (make&style) h Color: _O Roof Pitch(s): (7/12 minimum) 7- a (Z (specify on plans for new bttlldings, nhajor additions) Window and door trim material: wood X other material,specify Size of cornerboards size of casings(1 X 4 nun.) X`� color. Wh I • 1 J 8,� -�iasua Rakes 1'st member I Y.(0 2rd nie»iber 13�8 Depth of oyerhathg 14 Window: (make/model) Seci� S material 1VQ lwvv� color kt15b (Provide Window schedhde on plan for new bidldings, major addidons) ii T{i �X'P�:,� i; MENT GROWT Window grills(please check all that apply-: true divided lights— exterior glued grills X grills between Qiass K remoyable interior_ None �stmUk- A46;ACA IIIhls) Door style and make: S I '7 2 ZS material Wboo Color. Garage Door,Style NA Size of opening — Material "" Color "- Shutter Type/Style/Material: �-yy vu-eA -wocA LCM44-) Color: 15'M' VS54 - &.4en Gutter Type/Material: Color: —' Detk material: wood other material,specify _ Color: Skylight,type/make/model/: material Color: Size: Sign size: Type/Materials: Color: bd ]Fence Type(max 6' )Style eh/y a n WSE4 material: n Retaining wall: Material: o� N�1 A S Vcviear' Lighting,freestanding _ on building en PPkr inumina�In sign_ OTHERINFORMATION: APR 3 — stable Town of S Highway THE ATTACHED CHECK LIST MUST BE COMPLETED AND S>BhUTTED old iiommitt8e Please provide samples of paint colors,manufacturers brochure of windows,doors,garage door,fences,lamp posts etc Signed: (plan preparer)`�/� Print Name IMI�HAF�w 1 t�R4M�W� R PAM* AwwA Agc*i* -T 2 Q.\Boards and ComndssionAOld Kings Jlighway10K11 ApplkwimuWK11 DRAFT 2011 Cert Appropriateness DRAFT.doc i Mik plans shall fl claade one GaFdmv�pnge _Name of applicant,street location,map and parcel. _Name of Builder Designer, or architect; original signature of plan preparer and stanaa;plan"date,and all revision dates. ALL NEW DOUSE OR COYOV1-RCIA1r BUILDING PLANS MUST HAVE AN ORIG CX1, SIGNATURE AND STAi1/1P,IF ANY,BY A REGISTERED ARCI-11TECT, i i ER OF AMD,OR A LICENSED MASSACI�LJS`'T T.S 1®1 ' � R®__ 1-.� 1 CONTRACTOR,UNI.L-ss T MS REQUIRENIDENT IS WAIVED BY THE 0K H DISTRICT COka41TTEE- A written and bar drawn scale. Elevations of all(affected)sides of the building with dimensions including height fs)m the natural grade adjacent to the building to the top f the ridge;location and elevation of finished grade roof pitch(s)dormer setbacks trim style window and door styles ChaL->M to existing buildings must be clouded on.drawings. _Window schedule on plans. Landscaptng plan,5 copies drawn on a certified peri-meter plan containing the following information: _Name of applicant,street address,assessor's reap and parcel number. —Name,address and telephone number of the plan preparer;plan date and dates of revisions. _The location of existing and proposed buildings and structures;and lot lines. —Natural features of site(e.g.rock outcroppings,streams,Wetlands,etc.). _Existing buffer areas to remain. Location and species of trees outside of buffer areas greater than 12"caliper to be retained or removed. The location,number,size and name of proposed new trees and plants. _Driveway,parking areas,walkways,and patios indicating materials to be used. —Existing stone wails,and proposed walls including retaining walls for slope retention or septic systems. (for removal of stone walls,file Demolition Form). _All proposed exterior lighting and signs. Sketch or photos of adjacent properties,(1 copy only) A sketch(s)to scale or photographs of nearby adjacent buildings,where present,along both sides of the street frontage,showing the proposed new house or commercial building in scale and in relationship to the existing buildings. Please discuss with staff if you do not think this is relevant to your application. Photographs of aifl sides of existing buildings to remain,or being added to(1 set only). Fees according to schedule. RECEIVED Please complete the 0631owcng: 2 2014 ,..� lEAsting itru lding,foot priatt: Building i sq.ft. Building 2. , Ddstang � r 1$48RpQ1nEIlg9 gross floor area, �includ€n area of finished basea efQ.�®W - , � � Building 1 sq. ft. Building 2 New building or addition,foot print: Building 1 3 2 0 �� �� sq.ft. Building 2 3 Z014 New Building or addition,gross floor area,including area of finished basemento rnstable Building 1 sq.ft. Building 2 }gviway old Coo mittee 4 QABoards and Conw ssious\0ld Kings High%vay\0K11 Applications10K11 DRAFT 2011 Cert Appropriateness DRAFT.doe f rMTh " Exclusive Manufacturer of the HYDRAMATIC Hydraulic Swimming Pool Safety Cover 1 RE: ASTM F-1346-91 CERTIFICATION To Whom It May Concern, The pool cover fabric used by Aquamatic Cover Systems for all the safety cover systems consists of a. 16 oz. sq. yd, solid vinyl, in. cl.u.di.n.g a polyester substrata scrim reinforcing layer to enhance tear strength and prevent tear propagation. The material used substantially exceeds ASTM requirements set forth for safety covers of the type manufactured and distributed by this company, ASTM F-1346-91 require-rnents.art as follows; The cover and fabric installed,on the swimming pool filled to its no-rrnal water level shall be capable of supporting the weight of 485 lbs. This total weight shall be composed of.one 210 lb., one 225 lb., and one 50 lb. weight, each distributed over a one square foot area and.-all three contained within a three foot radius, The test weights shall be placed at the center of the cover system (or at Least 4-ft., but not to exceed 6 fQ from the edge of the swirnnrung pool, The -above test shall nor cause damage to allow any of the test objects or the persons to pass through the cover: The Aquarnatic Cover Systems have, in fact, been independently tested by two testing agencies including Underwriters Laboratories to exceed-the above listed standard. Sincerely, Harry I .Last, BSME, MBA President dm:hjl .Corporate Offices-200 Mayock Road,Gilroy,CA 95020 •.800.262. M Fax 800.600.7087 Aranclh()ffiees:Alhambra.CA • Sterling.VA .Tx 4 V:: 4,08l247.4,937 FAX 4 8/Z4.7=75.40 ' W � i U A.fl'!'U11iA'd'11:..51?I'x.l�-l'1`,,it'N.0 ItOO;L 'C•O''V ail CLliri'. :FICA. '1`l<O.I�J ""..� FCS® File; #059T3030,2 W U . Date; Tested: M-ay 20, 1993 � Date Reported; May 21, 1993 0 . C7 Specification: ASTMV D-esignation: F 13.4.6-91 Z Tested Unit: 13uil:t-1•n, Un-der-Det;k-Track, Autoanatic Swilt3ming 1'00l Cover Sys1•.CIII Source: A�1 Man�if��ct•urer: uatvlut•ic Cover Systems- � w Ad-dress: 4.41 Aldo Avenue, Santa Clara, CA z � I V * 1.A;BIRA'I'0:11'4�1.XS'1 S * ro YtEFrit'-l1WE: S'ttrrr:Jta•rJ Perfc` r,u:a,rree SPecificOtio-71 . an:ci La:i,eli.xxr,g Z tr . It.c�.��i.re►rrenls for . Su•reIy Covers for Swim- ming Pools, ►.a �° i Sims mid 110-t Tubs (ASTAI Desiglr•srtiuh., F 134.6.91). � d W l.. SCOVE .� Reyu'irenic:ills for srifei per ASTNI F 134G-91. W N yl � z o 2. As slfated hi reTerenced saandard, 3. . As stated in referenced standard. � 4. CLASS1Fi•CAII.ON-S & MINI-J1!1 UM CItiTElt)[A 4.1 Power'Sa•fe ty Cower ProNides a high level cyf safety for c•hitd.ren under the age of five by inllibi,ting•tlaeir access to the water, 4.1.1. As stated in referenced sla-nolard, 5. MATERIALS AND MANUFACTURE Test unit complies wills the 5.1, 5.2 and 5.3 requirements. AUTO.II ATI:C SWIMMING Pow, Coum CERUM-CATI.o:N- (page 2 of 4) ' 13CSo file: #.0.59T3,030-1 6, GE NE VA. -L REA QUIRE MNTS FOR.S;AT+'M COVERS 6.1 1- stallationjUse of safety, -covers. Unit complies wAll req:u_iretn:erat, 6.2. Label attached to the cower meets, and/or exceeds the .getA-4.iral requirenieiais as required by the 8.5.1, 8.8, 8.8.1 and 83.2 guid-elin%. 6.3 Markings for safety covers, 6.3,1 Unit lists manufacturers name. Unit 'complies with g:uitl.elane. 6.3.2 Unit lists date Manufactured, Unit complies wit.b.guide-line. 6.3.3 Manufacturer provides instructions to consuiners to inspect-the cover for Premature wear iia coaasumer packaging, Unit o there-fore complies, 6.3.4 Label attaclaed to unit meets the general 'requircm-e-nis described in 8.4.1, 8.7, 8.7,1, 8.7,2,1 8,73, 8;8; 8.8.1 and 8.9.• Unit complies with guideline. 6.4. Faslgalaab Mechanisms or Devices, Fastening devices rem6ned in their intended, secured positions when the test unit was subjected to.the:Joad and perimeter deflection tests performed as called for under the 9,1 and 9,2 guidelines. Unit complies with all requirements.- 6.5. Openings. No openings were allowed, when tested by the test method described in 9.4. Test object slid not gain access to the water, nor was it subject to ell trap in nt. Therefore, unit complies with -his guide-iare, 6.6. Seams, ties or welds in the cover showed no signs of dawage when tested by the Rtethods described in 9.11 9.2, 9'.3 acid 9,4. Unit met all , requirements under this.guideline, 7, P-E%RFOR.MAN•CE REQUIREMENTS FOR WiE'1Y COVERS Refer to Test Methods as .described in the 9.1, 9.2, 9.3 and 9.4 guid.efines, AU QM—--IC_ SIVIA ,DING PO.Q�L C.O.���Z c.l��r��iF A7 IQN (P�, 3 or 4) CCS3 pile; #059T3030-1 81 MINIMUM LABEL IZLQdJIIZEMI NTS Ir lZ ALL COVERS Unit complies-.with requirements. 9. TIDST MI. �"I HOD, FOR SAFETY'COM- 9.1 ' S:tatic-Load Test. Test Unit was-sojected to 490-1b.s (coniposed of one 150-lb, one 1604b and one 180-lb weight). -slightly exceeding load required per Standard. Test objects were applied. at two dif#orent points (the center point of the.-cover; . -and, between a-ttachmen:t points at a dista-tice'of 4.5 feet),and remained in each test position for a period of 5, nihiufies or greater. Although, norinal deflection was observed, no passage j through the cover was possible.. Test Unit complies with requirement. 9.2 Perimeter Deflection Test, Applied 50-lb weight at a.:clistance of four=aatd-o.ae-half feet' from side of pool. Applied 3.6,64b. ellip$oidal shaped test object. Test Vait. did not allow the test object to pass th-rough,. gain access to, or, be ' s.u.bject to eni pmeht betweejh the cover and the side of the pool. Test Utah co-mplies with requirements. 93 Su.rfgce Drainage Test. Applied a 36.6.1b. torso shaped test object in a supine position, faceup, at a distance of two-acid- one-half feet parallel with edge of pool. An even water spray' was applied at a rate of 10 gallons per minute. Alter 3 minutes, mia ntal water collection was observed around test object, . Continued applying water with ito unsafe water pooling. After 30 mintttes drain tim.e., re-applied 36,6-lb test object with a-0 unsafe amount of water pooli.q. Test Unit coil-iplles with requir.enments. 9.4 Opcnings Test, Applied solid faced spherical test object wllt a breadth of 4.5 in. at a eme rate of 40-lbs., steadily, to the top surface of the pool. No allowa.bJepassage.,was observable. Test , Unit complies with req.uironien.ts. 1.0, OPJER-ATYNG CONTROLS, SAk'N COYi:1ZS ' 10.1 Unit coaatplies with requireme-nis. . l`lT.G ,ATI-C S:V.I ,:i1LIN.. 10Q- C y- i It C.Cit'I'1TTfATr.O; (Pb;, 4 of 4) LCS® Idle: #059T'303.0-1 1.02 Unit co11,)pIi•es-wltlh.requirenieltts, 1.0.3 Unit coi17pdaes with r-equiretnelAs. 10.4 PoQa.cover oper.adlig controls. 1:0;9,1 Cotii-ro-is eottip.ly wi,t}rreq,u.irernettts, Unit comphes-wixh.red:uirements, 1.0.4.2 Unit complies with req.uir'etneltts, C1~ N,CLII. tO1u: T6s4ed-mit h-a-s-met all vcgitlmatva3 s-of-tlris .Sjurtsl,ntul. UNtf Co.,Ml?Ll-]C VATH ASTM r 134.6-91 1tLQ:iII ;+hxl XTS. R ,p ed, INC SJJYtV1CLS� n 93,05.20CKK ' NonhbrUuh,llhitr,�s {Bn�) 27Z-b�Or Melville.Now York 1516) '271-6200 Santa Clara,calilomiV{400) 985-N Research Triangle Park, NorthCerolina,(919) 549-1400 - 1lrlrferfri-t:ers i:a ��aD�aEs °L1C.� Camas,lWashinglon•(360) 817-5500 AQUAMATIC COVER SYSTEMS 200 MAYOCK RD , .A canlu.ry of GI"LROY CA 95020 publ{c plely asL 1494 Your most recent listing is shown below, Please review thas inform.4tion"and report any inacmacles to the UL Engineering staff member who handled your UL project, WBAH July 14, 19-98 . Covers For Swi-mming Poots Arad Spas AQUAMA'IIC COOLER SYSTEMS El13958 (S) 2:00 MAYOCK RD, 13I1.9-0Y CA 95.020 Power S.af.ezy. Covers, Models 400, 400•U, 550, 550-U, 800, and 800•1.) Classified in Accordance with ASTM F 134641. LON, FOR CLASSLFICA. 10-N M,A-RXj--% ON PRODUCT I , I 1s95�3ooi Underwriters Ubctratwies Inc.® F11/03489 For information orl placing an order for UL Listing Cards in a 3 x 5 inch card fomat, please refer to the enclosed ordering; information, UND£$§ rrE9B:I AaQXA p9iW INC, A noldof.-profil organization dedlaaled to publle saiol-wand T AVOID. -DROWNING RISK *REMOVE COVER COMPLETELY BEFORE ENTRY OF BATHERS--ENTRAPMENT POSSIBLE. *NON-SECURED OR IMPROPERLY SECURED COVERS AREA HAZARD. *DO NOT WALK ON COVER EXCEPT IN AN EMERGENCY `REMOVE STANDING WATER--CHILD CAN DROWN ON TOP. OF COVER. *FAILURETO FOLLOW.ALL,INSTRUCTIONS MAY RESULT IN INJURY OR DROWNING. INSPECT COVER PERIODICALLY FOR WEAR THJS SAFETY COVER MEETS,ASTM MU"ll STANDARDS WHEN USED IN ACCORDANCE WITH PRINTED INSTRUCTIONS AC?UAMATIC COVER SYSTEMS, 200 MAYOCK ROAD, GILROY,CA M20_(600)262-4044 Town of Barnstable } Regulatory Services g g . Thomas F.Gebx,DhuWr BIIii1ding bicvWon Tom Perry,Bnddiag Commissioner 200 Mara S vct gym MA 02601 s'►vsv tffWAJMrasiabie.maas Office: 508-862-4038 Fay 508-790-6230 Property Owner Must Complete and Sign This Section If Us�A Builder as Owner of the subject ProPaty hereby avxhm ze to act on my beln4 in aR mam=Fela&e to work authorized by this budding permit Address of job) � J ) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are pe7formed and accepted. Signature pf Oavaet Signature of Applicant Print Name Print Name Date QTORM-10 rs&aDL2 i 4 ASSESSORS REF.: 3•r0 3 �•" � •4a�F3 ii � t f IP _oFn Map 136, Parcel 022 OVERLAY DISTRICT: AP — Aquifer Protection District (74 cC.p ' /r Gi6,6 qj D' Alri Sloge µw/ � Forking Areo , Location Ma Ary p oved I e0���° 1"=2,000f' CrLsheo, ` #141 She//Dri'e a, FLOOD ZONE: 2 Sty w/f Zone C o Dwelling Community Panel No. 4 Approx Septic 9y eort AebuOt " ' ./�250001 0011 D 4Pro posed Card 7l i O Enclosure Fence m i ` ;' July 2, 1992 / Q •• °e Vent b �® Lawn ZONE: ' RPOD RF/ of 7 ;' o� oo FB Proposed C A" / Re—location Future Shed W ( ) yo• 35,200±SF ;' �, o Area (min.) 87,120 SF Pool & Spa ;' �o Frontage (min) 150' . Future �' , Q� Setbacks: Cabana i Fron t 30' Side 15' aq NOTE: Rear 15' 1.) The property line information shown was 1012 c compiled from available record information. / J hoe/ s9`S3• ♦` is 2.) The topographic information was obtained e p �y �,y from an on the ground survey performed on VAS ���chorco �� �/ or between 11/MAR114 and 21/MAR/14. ' 3.) The datum used is Approximate mean sea level NARK R , ono % RAC REVX ♦ based on the Town of Barnstable GIS maps. ENO 343A c ,I 0 15 J0 45 60 FEET 1 Sheet # Title: Prepared or: Notes Revisions: Scale: l»=30' Plan Of.Proposed Pool CapeSury Christian Atwood Date: 1 of At 141 Point Hill Road 23 West Bay Rd, Suite G 021MAY114 Osterville MA 02655 BARNSTABLE (West Barnstable) MASS. (508)420-3994 (508)420-3995 fox Wg' copesury t'apecod.net C446_1 g 1 o TOWN OF BARNSTABLE Permit No. ..'382° BUILDING DEPARTMENT I " I TOWN OFFICE BUILDING Cash NAM �_ In �ouY HYANNIS,MASS.02601 Bond .... ...... CERTIFICATE OF USE AND OCCUPANCY Issued to Gerry Street Address Lot #7, 141 Point dill Road West Bdrnstable, llassachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ..........!.!........ .. 19.... ..... ... �� .' ........... Building Inspectors t Assessor's map and lot number ........ .... .... ......... .... .. /^� -7 / QK�� ' CJ �D,G /I 7 �O*TNET�� Sewage Permit number ......czz? ..�.0.3. .............. 33 STABLE, i - House number .: .1........t.1 .......�....................................... s MAea N _ Apo,1639. \00 �E11 wN tr' 'a TOWN OF ` BAR.NSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... .....,,,,••............•,•„......••,••„ TYPE OF CONSTRUCTION .....Wpn ?>;ierV...............Q 01A,................ ............................................................ J' ..............................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location ...1--r) ... .. .........(DO}��.. L- .. ......... ,5 ,. 4� ,x � s �...G ..................................... Proposed Use e :v t- L..1.. :......=.... c........... ................................................................................... Zoning District ....PJ�..........................................................Fire District L Name of Owner ... V.... `...Address S Name of Builder .. .:. ~. ti?>!. 1 ` 1! .:.................Address ..�i-ic�...�....,C�e�.�43 . .ya...p ;�.0 �;lTJ2�3►1 r ,��.� , Name of Architect ...................r.._!n..A � ?Pk. l0Address Number of Rooms ........li®.....................................................Foundation ..... C.,..... .U.,f?,l-:E?........I T ................ ..... Exterior �l-1�.: tl .. :C-:.!..................................Roofing ....P!�Eo..... .QA,(.c r............................................ Floors �(s10C `, e,) 1...... :....................Interior i..... '".. .............. Heating .....u;.�F.9 e.....n.Q.`.`111'............................................Plumbing ....... ,............................... Fireplace MAcSl).J2..N f....................................................Approximate. Cost ......�C�.(�?�.Q�?C� Definitive Plan Approved by Planning Board 7 ---19 �__. Area zvo.7................. Diagram of Lot and Building with Dimensions / Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH V. �u OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS a I hereby agree to conform to ail the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ . ................. Construction Supervisor's License ...('1r') 7 i ' STREET, GERRY A=136-022 28826 0 ......... No ............... Permit for .... . ............. Single Family Dwelling ..........................................................e..................... Location Lot 7, 141 Point Hill Road ................................................................ West Barnstable ............................................................................... Owner ........qerXy..S:t.r.e.e t................................. ,,..Frame.o Type of Construction ....... ............... ....................................................................... Plot ............................. Lot ................................ Permit Granted .... January 9, 19 86 ............................ ....... Date of Inspection .....................................19 Date Completed ......................................19 'aAssessor's map and, lot number ... � < PT / "✓ 0 K O, - B Sewa a Permit �C SEPTIC. ST E g t number ........ 5......�.0.�`�. .....:......: -$Y$T�6� d INSTALLED IN CO NIPLIAN House number /.Y.�..:.... ..... �; BABB9TODLB, l-t'...... ... ................::........:...... WITH TITLE 5 9 0 1639. ENVIRONMENTAL CODE AN®��0 SAY a`e� TOWN ,OF BARN �E� � $ 9 BUILDING INSPECTOR �APPLICATION FOR.PERMIT TO ....... .-�...!I....:........ ......'p.,..q............................................................................ TYPE OF CONSTRUCTION ..... C, �� ... V�:..`�� " .a. . nfJ �.Y�31 -...................................... ........u !..........::::::.............19. : TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies�rfor a permit according to the following information: Location ...�- dr....�..l. ........1�Z tor.az!, ..C� ......... � .1 ...� .t{J.i�' Al. Rl..:�..................................... Proposed Use ..... `-a i t .�..().IJ���r..... ` ` ................................................................................ Zoning District d.... .. .F'..................................................:.......Fire District .... `` `Tl.... .�-.................. Name of Owner ....(.-TeA`-�r- ° ....�.�..�:.`U..—�.�....................Address � ��.�z •' J� � r.1A........................... Name of Builder ....... ... r t fit'{ �j ''(v � :•�`'A�i -'I�?el �; .�._�..�.'jS.`.�..i.1.:a.k... ................Address .�....�..�.1-� L�.L.,.:'�......... ��..................Xi`d Name of Architect PAddress .................................. ................................................. Number of Rooms ........�........................................................Foundation ......4C.. ................. Exterior .......... .�� , �" .�..........---------Roofing .... -.` .....G ..Pd -................................ ............ Floors ..... . �. �� �.�.►���....... .....................-....................Interior ......�...���.......,.. . ° Heating .;.1AN-z1.........................................Plumbing ....... -. . - ............................................................. Fireplace ..........(,. A u r4A— ....................................................Approximate. Cost ......10.0j..Q��.a cs 7.........r................ .. Definitive Plan.Approved by Planning Board A __-Z7-----------9 7-r___ ° Area ...zam...................... • Diagram of Lot and Building with Dimensions Fee ...........ICU ..................... ............. SUBJECT TO APPROVAL OF BOARD OF HEALTHQ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ................ ,. ................................... Construction Supervisor's License .... i........... STREET, GERRY 28826... Permit for ....................................T wo S t ory No .............. Single Family Dwelling ............................................................................... Location Lot...7, 1.4l..P.o.int...Hill. ...Road..... . . .... .. . ...... ...... . ........ We-st Barnstable ............................................................................... Gerry Street Owner ... ........................................... Type'of Construction ........ram.e.......................... . ..................................................;............................. Plot ......... Lot ................................ January .9, 86. Permit Granted ..t......................................:19 Date of Inspection ........ ............ .......19 Date. Completed ............19 A) '77 TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING out i°sY•t�� HYANNIS, MASS. 02601 r� MEMO TO: Town Clerk FROM: Building, Department DATE: _ An Occupancy Permit has been issued for the building authorized by Building Permit #.. .25.. l0._ ......................................................_ ...._._..__............... »»»w issued to �;6 ------_..._. » ..w.................................._...................... ._..._ r; Please release the performance bond. TOWN , TEMPORARY F BAR STABLE Permit No. ____28826_____ is Building Inspectorcash OCCUPANCY PERMIT Bona Issued to Gerry Street Address y Lot #7 141 Point Hill Road West Barnstable Wiring Inspector Inspection date Plumhing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119. OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector • y�F... e TOWN OF BARNSTABLE Permit No. BUILDING DEPARTMENT f neaieT } TOWN OFFICE BUILDING Cash .,r. '��'0■i,Y�' HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Address USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. , 19................. ...... '�?K!�`..... ..... ...... .......... Building Inspector u•:- + A:�.9(.1E.'.,.`:N1f°,c C•;. .1) r;:.E:i♦'�'. .. ..::';•qo.a'•: - t .:•Y, .. PINK DEPT:FILE COPY/WHITE-FIELD COPY"/"YELLOW-APPLICANT.COPY ~ z BUILDING 0 OFr6dRNSTABLE,'MASSACHUSETTS . ::a A>°1.36=oiz. PERMIT VALIDATION 34riu,<iry 9, tsfiT(.) QQQQ�j(Q� tilher DATE 19 PERMIT'NO. APPLICANT,.:._ ADDRESS 140 LuuKview Drive, Centerville ;/G)SL (NO.) (STREET) (CONTR'S LICENSE) PERMIT.TO'.- Build:.Uwel,lin� (' 2: ) STORY SiT.l,;I,-? 'Family DWe':llingg NUMBER OF •��{ r:.:-":'u,.�;1(t', _(TYPE OF IMPROVEMENT).OVEMENT), Np, DWELLING UNITS • (PROPOSED USE) 41'•YOint hill N.O'uQ, s}YUfit b:irl.'ti'%iil)l.f+t. ZONING :+s ENO,) (STREET) DISTRICT k� BETWEEN ..5. .(CROSS STREET) AND (CROSS STREET). . `SUBDIVISION' LOT i LOT BLOCK, SIZE . 'BUILDING IS`T0 BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM-IN CONSTRUCT IC TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION : REMARKSS."` .•••:'SeWti 'e 485-1032 (TYPE) . AREAI'OR L�HS CQ it. [5Oiai ESTIMATED COST $ FEEMIT •161l . J (CUBIC/SQUARE FEET) t Gerry 'Street } OWNER ri—rrl r t ADDRESS ' BUILDING DEPT. BY I . 7r _ - t'-': t ✓,� Li. t�' .tq .� +Y '' �1+3;�'l.. .. :..�b 1...-.; +..�: .....,�.. is - .� 2. PR;CE TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO EFOLATH1. FINAL INSPECTION HAS BEEN MADE. 9, FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 ) 1 ' 1 I i • 2 / 2 2 O G HEATING INSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS OWN �ING B A�RNSBLE `7 + 7 fiQT � A i i WCRK SHALL NCT PROCEED UNT;L THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDiGITED.ON THIS CA �TA ES OF CON CONSTRUCTION. -HE 'aARlcls WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE TVE CAN BE ARRANGED FOR By TELEPHO 7AGE5 OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE, OR WRITTEN NOTIFICATION. 51 TL his>iNG � WEST C3A,?n/ST/-�BL�' wEtc. LOCATION . .. . . . . . ... . .. SCALE . . / •�-. 0� . . DATE ccT 3� �yBS' PLAN REFERENCE . ..43 G. PG•. �,7 . . . . . . . . . . . ... . . . . . . . . . . i v Q No7 = �Z�T/Rr�o.vs B�s�'v oM I y F S�wA�E LoT G 041U" ► F � "�� ��-�� $, 3�► �a o ► ► ems,.,.=zs6o i l I / Resenve, towq Abe Pp-f�v �I - r''`e a • r-- _ti� 0 0 � I�tlI LoT �7/ wez.c. a 7o'f d� z M LoT 08 1� I Of MA r EMA' RP yGs E�RiST/n/G SG—bv�4G t j o. 26100 L LA PE"77 Tjo NEx L. . . ..... .N.DA. .T. .ION.. . TOP OF FOU s CONCRETE COVER •;° CONCRETE COVERS CAST IRON II - MAX. �►+�s*ssrssn,j OR SCHEDULE 40 12"MAX. P.V.C. PIPE PI SCHEDULE 40 P.V.C.(ONLY) • • PITCH 1/4"PER.FT. PIPE- MIN. LEACH PITCH 1/4"PER.FT. PIT PRECAST INVERT J LEACHING `'0 EL..�7•.?0.. INVERT INVERT p . �•i PIT OR o'. SEPTIC TANK bIST. • w ='' EQUIV. INVERT EL.. B/. . BOX EL.zL:.'�7a. ' ; ,>_ :•: /pop GAL. INVERT 6.e►=�-' Q; ;;; „ INVERT v° .;•. 3/4 TO 1 V2� EL.Z6,7,3 •. Ww o• EL.ZG.ec :.• �0 o: WASHED e ffL�-- '"• W STONE -WDIA. -+-� —� o �� • �' /o' DIA---��e e. Ev c• • PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P- 49¢3 SOIL LOG WITNESSED BY : DATES 12/f4 _ TIME. !9.40 14'f D'�!� P. !`!4 BOARD OF HEALTH TEST HOLE I TEST HOLE 2 -DWA? ENGINEER . . . . . . . . . . . . . . . . . . . w000ro „ Sol wo DESIGN DATA : Z� s4�' NUMBER OF BEDROOMS , .3 EZ Z/.¢o TOTAL ESTIMATED FLOW , GALLONS/DAY Nc�. N6D• BOTTOM LEACHING AREA 78•S. . SO.FT. /PIT/G, ,S o SA�v SIDE LEACHING AREA . . . . . SQ.F T./ PIT147/cP.D. GARBAGE DISPOSAL .!1!oN (50% AREA INCREASE). TOTAL LEACHING AREA . . . Z6� . . . SO.FT c�Z ¢o 44,� PERCOLATION RATE .BSet y F,:vf/, MIN/INCH 1 /44 ./B, / eZ. /3,Flo ' AIO. LEACHING AREA PER PERCOLATION RATE .. WATER ENCOUNTERED NUMBER OF LEACHING PITS P(7?. APPROVED . .. . . . . . . . . . BOARD OF HEALTH • ?7kY P aF.5721 v� 40Al, DATE. . . . . . . . . . . . . . . . . y . . . . . . . . . AGENT OR INSPECTOR EA�NN Of kQ.. e�ae i SH OfF n o EDWAR� 7- 7 1 wEAEY A o. 26100 ,mod .WE37- ljR�2�v.S�-.9 [�'. f� `^ss�OfCISTER`�Sa�Sv /STEA�O !/ �AL LpN� SANRAP�p� I PETITIONER �'C7ZA'GD. G•-S7,Z� �7 ; I �. O7- ,t SO o �xI5� �No. o _ Q �a3 0 .4OT 7 v %r 35; ,.2oa °' V ' 02 a2 0. 0 0 , 7• rC CERTIFIED PLOT PLAN LOCATION SCALE . /.'.'.=.Ho DATE PLAN REFERENCE4,�1�!!f j D RD J KELLEY N No. 26100 a �r .f. I CERTIFY THAT THE 4W! ?7lW o&ti- %y�"�a•�` orF�s/ IS vt Lia.� SHOWN ON THIS PLAN IS LOCATED ON THE AS SHOWN HEREON AND THAT IT GROUND T CONFORMS THE SETBACK REQUIREMENTS OF THE TOWN OF I, Ch',' ✓�'$?"-c�: L:""....!'i!i�.WHEN CONSTRUCTED. I. , DATE .✓Aw.L /��G �p" r.;, i REGISTERED LAND SURVEYOR • 1 Town of Barnstable Regulatory Services Thomas F.Geiler,Director BARN STABLE. 9 MASS. Building Division 1639. .� °Tfn Mpg° Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# 2,,!�106�� FEE: $ SHED REGISTRATION 120 square feet or less lL1/ P01-ti � Location of shed(address) Village KellAe,,- /- Soe 74-Iy - 7a1ly Property owner's name Telephone number Size of Shed Map/Parcel# y- Sig ature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commissi n(signature is required) ao PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN`— ��y 1 r, Q-forms-shedreg y REV:121901 ( P/aA.) v,S.e.'- ' irj C�007 /�\\ NOTES SANDY NECK RDAO Z CONTOURS � EXISTING LEACH PIT IS TO BE PUMPED. COLLAPSED AND BORNING EXISTING - - - - - - - 50 \ REMOVED.EXCAVATE ALL ASSOCIATED CONTAMINATED TR LANE o u / \\\ SOILS AND REPLACE WITH CLEAN MEDIUM SANG PER TITLE 5. U a m MINIMAL GRADING PROPOSED ma< LLa n m=Z oD ti / \\ 4ID INSTALLER MAY ELECT TO PLACE VENT /V �w ..'1.E EmE 3' VARIANCE REQUESTED / LOT \� PIPE 1N AN ALTERNATE LOCATION. Qgj4r za w^ O<w / AREA = 35200 sF j0' a7O� I~-JU~I 4 W .ur ee TRanEo wocmamreT Nrxrw amn wNratm�srtcrca/ \\\ 36 Q °HILLIAROS \ 0-0r-c Do>- m 310 CMR 15.221(7)- COMPONENT , �\ LOCUS HAYWAY o mN� m DEPTH TO FINISH GRADE. 36 In36 Jw Z WEST BARN57ABLE. MA m �' �' MAX REQUIRED- VARIANCE TO / / �,�.� <m<._. 60 In OF COVER REQUESTED. / \� 24 FL x 12.5 FL x 2 f L wA if \\\34 L wt HHING GArLLERY ER L 0 C lJ S M A F OJ< LL i NOT TO SCALE w<3 / `v- i SEE DETAIL ON REVERSE Z)uOi� / t�\ ` �L� �\ \\ BENCH MARK N pWtt \ `��` / \ TOP OF DRAIN GRATE a <(!)l0 / 19-P -E,1 ELEVATION - 25.06 w / \ -30 BARNSTABLE GIS DATUM O waITV w / / /\ N \\ J Z <J 1-ti LL w it / /. o ff + ! \ I28 W z C<1 O N U 3 W > O N j / PRICK �Q�1 �m c kr \ /, O zN "x =do < J 0Z <N / ) AryO km3 3 z WN m �L W W W 4ID� MQ �� 10-06/ -0 \\��\1 O� LEGEND < J U ❑ 36-1WELL ~ \�N 36 a/ 150 Ff.FROp-WEL_�, / e-0 / \ EXISTING GALLON E3 WI- aim N WELL& ti / / SEPTIC TANK 34 7 / ` O-BOX o IL F- Z N<< X ` / —� / / / / \ / TEST PIT l� EXISTING a_� p O�Z SIN m N A WELL \\ ' / / O / 24 LEACH PIT O F wwo a \\�` / / 11 / / DRAIN ,O tu WO Z ZZU ID Z 22 A TLNIE-RAOyiNbEilEKgEEZ [OO O ZmW F 30 C Oo < U)0 Q T EREw R(P)R EIEPNNF O4EfEriRiE S'S'E OTTSO-Y O PEEL. IOld6IM P ,\ d �� ��z PLAN 28 / W o <�� \ \ / / /�� �� GARBAGE GRINDER �� �30 I N ,26 \\ JIL Ul Z�� +u m a SCALE:1,T,-30 Ft \. \ / / 20 O c` IS NOT ALLOWED U 3 ^I m 30 - 0 30 60 24"\\\</,� �v/ /� << WITH THIS DESIGN. > 11:N N q W Ou m w 0 i0 26 30 22�'\\ WELL UI NO OTHER WELLS WITHIN 150 Ft \ ' s z Y OF PROPOSED LEACHING GALLERY - SEWAGE DISPOSAL SYSTEM PLAN \20/ ��+0 pSL'�F -TO SERVE EXISTING DWELLING O z \ / / Esr. GERALD & SANDRA STREEI < J / OWNERS OF RECORD a o um ~Q DISTANCES SCALE O J � U A B 141 POINT HILL ROAD 2 a TO LEACHING GALLERY 1 52.6 52.5 �� t995 ALL OISTA EFS ARE IN DECIMAL Q �� m X FEET NOTfNFEETANOINCNES. 2 53.8 5&9 G WEST BARNSTABLE. M in w ED CL 3 71.4 59.4 �St1OFM,1SS9 Try U�AI; �� �� PROPERTY ADDRESS e w 4 77.8 7e.9 � DAVID cyG � ON DAVIDc � ❑ i• 5 59.4 61.9 .g a' N ASSESSORS MAP 136 PARCEL 22 m e o D. D. a 43 TRIANGLE CIRCLE O m s COUGHANOWR SANDWICH MA 02563 PLAN BOOK 249 PAGE 107 COUGHI:NOW'n" O W m 4 No.1093 508 364-0694 DATE: MAY 27. 2007 o ? c aO qF ��° so II Sao.r Pr O NTENU W x w w f Tel /< I UH JOB>ETE-2604 PAGE I OF 2 VERSION: F- w A s SOLELYTHIS AFOR MSTAN IS DLLAT ON OF ON AN THE PROPOSED SEPTIC UMENT SURVEY ANU IS ISYSTEMI DEPICTED HEREON.FOR ANY OTHER CHANGES TO PROPERTY 1NCLUDING VVI'Gy 2.11 LW 7 PLACEMENT OF ADDITIONS.SHEDS.FENCES OR SWIMMING POOLS.041NER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOF r - 1` `' Sue, c 41t ` THE Tqw� Town of Barnstable . °� Old King's Highway Historic District Committee C P� 9�K�`Z� 200 Main Sheet, Hyannis, Massachusetts 02601 (508) 862'-4787 Fax (508) 862-4784 CERTIFICATE OF EXEMPTION Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Exemption under Section 6 and 7 of Chapter 470,Acts and Resolves of Massachusetts, 1973,as amended, for proposed work as described below and on plans,drawings,or photographs accompanying this application: Date U Address of Proposed work, Assessor's Map and lot# f �4`o2 House# Street &A , U 1`�t/"� Village: Bmms+abk This application is for an exemption of the proposed construction on the grounds that work: ❑ Will not be visible from any way or public place ❑ Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ❑ Other Description of Proposed Work: re Agent or contractor(please print): Tel. no. Address —'_ ,,/ p� Owner(please print): ,S(�,SOII(1 !�(�.l�C�1''` Tel no. .617-60-U0 O' Owners mailing address: mm a4(- -we-ol- Signed, Owner/Contractor/Agent For Committee Use Only This Certificate is hereby Approved/Denied �� , Committee Members Signatures: a� I - -- n o13 7t i ID APRA-0. 2008..... ZE gun of_sArnstabje 10 Old King's Highway CommittppAny conditions of approval: • j Q:IGMD-Gro«ps10(d Kin.es HieliwnylOKHNew,4pplOKHExeinplioa Form 07.doc Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies . Foundation Type: (Max. 18"exposed)(material-brick/cement,other) i.y o6A PA, ) c )Q&C ) G yea e 6,_ 6/i��, s Ofr" Siding Type material: -cl C,r S l 1,J,�Jam-Color: . y'Qcu� Ca rt� Chimney Material: Color: Roof Material: (make&style) C Z) !'oo E - {J e_r -h iN� Color: /?OL Trim material ,p0.1 L.3-t Color: wk I e Roof Pitch: (7/12 minimum) �O h W/Ncjv�J LJ�t f e �/ Window: (make/model) t-/ X y/ Up�N,� _material uyvo color u-D<1,ft S/.tyPas I Size(s): SJif� 3' x J a Door style and make:_U 7C )OLti 6ouA� 4-6,-HN material --ee Color: inn to 2o0 Garage Door,Style Size Material Color Shutter Type/Material: Color: Ly /�2 Gutter Type/Material: Color: Decks: material Size Color: Skylight,type/make/model/: material Color: Size: e Sign size: . Type/Materials: Color: Oo 9� Fence Type(max 6' )Style material: Color: ° o3'N�w .� Retaining wall: Material: Lighting, freestanding on building illuminating sign 6 Please provide samples of paint colors and manufacturers brochure of style of windows, doors,garage door, fences,lamp posts etc ADDITIONAL INFORMATION: Signect: (plan preparer) print name r' i 6 tel. no. Location of application: Street no. Street Village 2 C:(Documents and SettingsldecolliklLocal Settingsl Temporary Internet FilesIOLKIIOKH Cert Appropriateness 07.doc I 1 5 a PINE O WOOD PRODUCTS . l6all about the wood" CHATHAM LOFT SHED - 8'x (Elevations - Scale:1/4"=I) LEFT REAR iz' xIP JY Li FLOOR FRAMING SPECIFICATIONS FRONT (2 x 8 Pressure Treated @ 16"ac.) RIGHT -------------- Nrr� 3 0008 _ 2 �_J Q 0 y� O - � V0 TOWN 01 nt iVS TABLE � ova HISTORIC ,RESERVATION r - VE e e �'� • • PMZALUO is VA qtil Y ' .`i P ✓Y� t' -i i€ t'�.rf`'`.!-' �rS.; c �•� "` L� y' '". 5 rr�};� k • • i• • w �1 • • s' ire _ lx a ...��. a • :.F �-rc�` _ ':r�. - EMI.^'.a; —` • . • •• • \• • • •S•. '1^i $ •.+1 i�4:+:.is :4r., �y�.t :.� 4 ::5v' .l-'1l� •'F: _!i�i,;'y';.yy<•1'6'•d'n.. �G... f .a� wf`v' f i - .S" t'i} ^;3'.1:..�cJ :c• .r_i:.. .o. ':Y. - .K:+L{y74 a.: - ` ..-f,; = _ rS+ - .1•: •1 fi •- 011 w TCI r:»-: _. �;j;y i;�:i jai i^:>�j:: '.$.'•`',.. y_es'w. �:�• '.l•' Y.F. - 1, -+•��r fir• Y. • • • •• i ��-:•�-�„,.m" ''�:�.! .f��'^^ ! wr4��r.:T- � w.,3•'�.i-.oc�;:,� :+ � r i .C;:vs f '[. 1 1, � • • • • 1 • ° s a 'i`: F' f t ."9 t:�'�, �.i t n'1 lfYh h.. � �Y wi: r� 1}Q fsiyY 5, x.lJ �' , > 7. ••• • • • 7 • 7 IJ Ri e.<i: a f 3 - a t 1 1 f 1— ;,` �' r' f t A^'• ..i 4}• a;:i 1 r;--•:.e„ar C }r >, ti! [ s. ! ! z s .-� ` { o• . •1 . h ,� ! a y ,-..�.�.,-„--;.o,-�•�f � .�� ]• �a .w `' t-s � � t Zr } eft )[ .'yr e s .� J•.1.q 2 '� 4 G',•. i�`;l:;f-7tl irM vl� �. t4 mar- �3 lat t. �. � P�� � ti i. t �.i�i � t t- 4 ; r cy • � • • �` � t � f .. �' .ri tG��r�� �t'� F c f Y' ..� +•�i � v. �a•�! �t t "�j:;,kct �� ?j., t. ' •tL.E -�r �� yT''E :�. r-.1 c${..�cl� r �. I! aV i i t ':'st i� )):m ..y� :��z• t f a r..i ,y1 ; i cb"• 1 rll 1 >`::'. ..1a'= 5w1 '�' ! ~ _ �1 • Y 1 1 11 • •.:,4, e:4Ms fir` I �,.• ..1_�vt-:i.:+a l�^.��. �°5 .Y.J:.;C;it fi r✓ 1 L � at � h; v s t t.;• •• • �F, f F :It:i f e:. F. • t4�•[�`{���r{tom �Ir'' I / I i ♦ I i •♦ i •• a I• Io i I ) I ♦ I i � • /i I i i � • o NOTES sAl°Y NECK ROAD Y /\ c a� aS�Fn1 CONTOURS EXISTING LEACH PIT IS TO BE PUMPE �A D AND EIIJ �^w ° {nIr Q� LIP, ri i1Q1v EXISTING - - - - - - 5m / . REMOVED. EXCAVATE ALL ASSOCIATE 0�1�AA 1REE n a< TC: '���C pp,ESE,a m MINIMAL GRADING PROPOSED / \ SOILS AND REPLACE WITH CLEAN ME IU 16AN ' L o uIS�QR Lc°n i LOT r1a �`�49 INSTnLLER MAY ELECT 70 PLACE VENT PIPE IN AN ALTERNATE LOCATION `- 2 O oRFar �a W- =m= a VARIANCE REQUESTED / AREA . 35200 EF W4aJa4 °ter w.ecwwl(ow.�u.la"9.K.u.m.rE.,a+rou,wve<c, , 36 A4AY 14. \ °\ ~^N- -- m 310 CMR 15.221(7) - COMPONENT / �� NILLInR05 \\V Jiom mN� m I DEPTH TO FINISH GRADE 36 in / TO LOCUS "^YWAY JUZ� ^ MAX REQUIRED- VARIANCE TO \� �, Wf7Of(j.; «�- 60 1, OF COVER REQUESTED. / �� 36 Old I °"fable WEST BARNSTABLE- MA .. gm , _ ,1\ 24 Ft x 12.5 �� E.rhO,a / 34 LEACHING GRarmM� y LOCUS M A RETAIN OJ< ^C HALL �' -WITH CUT CORNER NOT TO SCALE --'-T WZo2 �� ,. SEE DETAIL ON REVERSE i (noz Era/ I'_ \ V �' ��` BENCH MARK In W )W K / �� 3 ' 70P OF DRAIN GRATE 1- N In Wa w I / ,^ `` / \ ELEVATION I DATUM V ` / ,V �� 3U BARNSTAMLE CIS DATUM N _jo N J Tz 'QI 3 ¢ �1,\I IC O Z 1n+ / vwE J u-, Br\IUW I W Ltl Z �; ' ` ` BRILK �(O J. �0 1•� � ' O wQ ZW < �" Q J J�I. / P'{r70. �3 a x Z 4 x d O I I I / �,�/� i16,o i 11�o < U-- 10 W `� I.LI W 4U ITV/ ® \ QQ\ Z� W W� m �E J W j , �- _ ' � LEGEND W -J." _ __ �w < �W J `n. N 3B WEI.I` /� / I� EXISTING u 0<5 I / .v .t F 1+'>-1C— eo / \ 1000 GALLON E3 OI.- < asm N LELLD /- - -- — -- ,J\\ SEPTIC TANK Zi / W I / O-BOX o ul f \/ LI- IDai N<< X m I 34�` 1 ` � � / / v TEST PIT UW zzz a 1O �I 1�. i W III O ZL° I�N _� 'I i%- / O J U1 2ILp �= N ti �` / ' -24 V EXISTING CH PIT C ln< W V-O- i' �' —�- DRAIN U ww< i� I �� / I 4 B (] X Lj Z U°J W C o U1 \ TREE IEFEwS i0 >Lu z In W ZW _ ty �1 F,� OIArtIER M uOfS 16 W o Z O m< tD U1(0 /\ an J ° �� ` PLAN ��t �e` <-- � Jy T J OF NO°Z N '4I GARBAGE ORINDEF Z + IDI I SCALE.I. 30 rL `�` �' <W U) -I-< M14 `� m 30 0' 30 6H \ '� / O N<< IS NOT ALLOWED ' 2e' \ WITH THIS DESIGN W O m w 0 10 20 30 —\` W !_ / �p WELL N NO OTHER WELLS WITHIN 150 FL OF PROPOSED LEACHING GALLERY \ / SEWAGE DISPOSAL SYSTEM F 1- 1 Y G� TIC -TO SERVE EXISTING DWELLI LL z a � � \� � @. y O z J / EST. GERALD SANDRA STF 0 n. O om �< (� DISTANCES &T / OWNERS OF RECORD LL a a TO LEACHING , sA szs to 141 POINT •HILL RO/ • Z D ALL=-$ —ARE 01 MCI— � � y 1995 a n• m X� 'ErrDTMFEETAOOSIG z 53.8 sa.s L 1 WEST BARN STABLE. PROPERTY ADDRESS tµ OF F= rh IlJ� 3 711 5A4 �.1 '{W6,y� ��H Jr µ�s� �� (J) 5, 534 �g fo=� DAVID cZcs a°ram DAVID 'cyan QNM ASSESSORS MAP l3r PARCEL 2,- . o$ D. 43 TRIANGLE CIRCLE O m s COUGMANOWR SANDWICH MA 02563 PLAN BOOK 249 PAGE 107 T— COUGN NOW2 IL r0i o No.1093 508 364-0694 Z DATE. MAY 27. 2007 S C O TE��O �Q s� r _ IGe•ETE-2604 PAGE 1 OF 2 vERsrDN: Pr 4q w is w w I { U THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS IN SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC S DEPICTED HEREON.FOR ANY CHANGES TO PROPERTY IND PLACEMENT OF ADDITIONS.S ETDS.FENCES OR SWIMMING POCLS. SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SL ftell 6W Detail-NTS �ei1Cr ii �NC�I J size: L! i.� Depth: ' f'` To: L, Main Drain-NTS ParMute r•.Ana: � D GOPiNG Shape: CUs. O-M.� -Q�-UA-L[ ZVL %a L3/#•Conduit to; G C► ' Plnt•r to peck bore Pool Capacity: /-�• ac> ,GALS1 MMtivvorE�x Cawr 1'Above Finer Model: ot�' tiq,IF Wsrcr txvel Z'Min Uotor Model: w� Pump Capacity; Hydrostatic Turnover: i`1Rrii .1 Y ! Ground Lag; A. kMmrier Nlodei: . Ok bOef WaY� e-ne,outdE. Main Drain Model: a 7 1.t �4000 PSI Main Drain:no A 2•ur,e w ver,r„at. a slde suetiorS03l l ov sooty uglrt Add 1San shown Retwns: u Cor•etlon Tub* Pool Ciaaner: i 1n•si«,. •• Backwash To* b Coping: constmoyen Details o v ../ 7 ANt O iA•QPA&Jt,S To Color: Skknfner Section-kTs Ladder: � IBwimout: �- S tG►J: c�/VIM ...AS3U Mt3 �lor-o TU tLt� �A•4� Board size: � • ,% �••,..c S of L.�s tAf c.�, light: (�/o . :. �w'D ZS dtj so IN a la, l�t.n sklmma•cap � _ • Coping aLa,�JN �'� d -S Conduit: snore Long'p . .. `��wwa .r:��ni ( -Q �✓TU2� Rope Rings: �, •w/Rope b Floats. 0 Z fo Heater Model: l y STL water i vw r Vaiiofion O 0 O O G �� ���N OF M,q •,C :.'. ya �tip; Natural Gas� . r L A. s P am❑ Offwr Fuel: PNEIANJR. ... 1. S va25 a` _G�isolihaity. �` _ - . ... aidr►+mas eotnhi.a� � . � `�I�-,; . , . „. wkh la e#e R.a. Vented By: - jcam' �/� p Drettt DNerter: Yes d No' ._riwcer�anP Commaeiela+,r Electric t3y: Electric sy: �i� • .; `,;• ■ PNunb: Yes No•:p .A 1®BE F9NCED PER US b Coping: ASAP L� DT1i ❑ Ty� PW O 0 rY AliCITY alaDalcE. Grading: �" 4"SEL.f CLOSING ETC: {.IR irld&�'CNING BY OWNER, 8b;t — Deck:By: Additional Specifications Deep End Wall Section-.NTS- 4-- Cont. t Bond Bens of t o• #3 Vertical and 14 Ban Horizontal Addondtrm: Date: 4•Max vertical Walt 3'a Depth Profile e�� / 6'•n Sai+esrrtein: �te:1 a/c tadiw Ta• P%yh &y: Scale: 1/8'_V-0" Dude: Water for Gunite Main Dcain(teed ) r o. J NWmber: Set Backs FR. Side Rear' B•Min Thickness In Raclin$ i � i�'if2^ o• , r Min Concrete Cover 61 Min Thicknen Gunite--------------- Swimming .Pool For .�: Name: a c�oa Shallow standard Well section-NTS -- .: as; • •-�—Pool jet space 6Q, • • - �C`�( ' ::• (TVP.of in Pool) f l U TQIWII: .S.tdo: Zip• -'� Drink Cng 3-T m �6 Job Adress: . conttnow lload Dears _ Al ArX w/#3 do.#4 Dots � •� �, ! � Town: State: Zip: « 6•Cadmic Tile �, " . :: '' Res: Phone:_ Bus. Phone: 3M Min r►6ke ' ! r ida�r flit « Mulite PIS*"#1 ub cb 4 of waoee Slop Transition q Slop Tnmsition T 3'Mle Thicknew 2•Mln Covet Mi o-. I � - ■ O QUALITY 'POOLS Cb JL 3 Ban r o/c both ways l . SWImming Paol r Min Gunite Co •• .r •' G in Radiw(I'R.Mtx) 'I 6, Wyman Road,. Billerica, MA 01821 6•Ceramic Tile t pp„ �� � �� .,.� it (97$) 663-8290 Rock Pack: 02 Total bowl of pool Wi t_tom cone 4"min Thickneu __ •-